Changes

The ''siroroga'', or the disease(s) of the head, are various clinical representations of headache and vary depending upon ''dosha''-dominance and ''krimi''-infestation. Though headache is a common form of five major types of ''siroroga'', different manifestations of headache can give an idea of the predominant ''dosha'' which may further decide the course of treatment. Similarly ''hridroga'' (heart diseases) and diseases associated with the urinary bladder mentioned in this chapter are also due to ''dosha'' predominance and ''krimi'' infestation.  

The ''siroroga'', or the disease(s) of the head, are various clinical representations of headache and vary depending upon ''dosha''-dominance and ''krimi''-infestation. Though headache is a common form of five major types of ''siroroga'', different manifestations of headache can give an idea of the predominant ''dosha'' which may further decide the course of treatment. Similarly ''hridroga'' (heart diseases) and diseases associated with the urinary bladder mentioned in this chapter are also due to ''dosha'' predominance and ''krimi'' infestation.  

Various permutations and combinations of ''dosha'' have been analysed that help in understanding the pathogenesis of a disease. It is always a matter of debate as to why there are so many diseases and why does a disease have so many different manifestations or forms, depending upon an individual. One answer is that the ''dosha'' involved in pathogenesis varies in the forms of either ''vriddhi'' (increase) or kshaya (decrease), and that a typical permutation or combination of such doshas can manifest the disease in a different way. The verses 45, 46, and 47 deal with aashayaapkarsha (pulling dosha from its location) in which a dominant or increased vata pulls the normal pitta and kapha away from their “seats” and manifests its own features there. Therefore, confusion can occur in the diagnosis and management of the disease. In addition, the concept of vikalpa samprapti (variable pathogenesis) can be a reason for such varied presentations of the disease, since per vikalpa samprapti, the involvement of various properties of dosha may differ depending upon the etiological factors. Eighteen types of kshaya (decreased state) of dosha, dhatu, mala and ojas that may play a significant role in disease pathogenesis are also considered in this chapter. Madhumeha (Diabetes mellitus) which is also termed as ojomeha in other texts is one of the prameha where excessive kshaya of ojas takes place. One of its presentations (or forms) is caused due to avaranajanya samprāpti (obstructive pathogenesis), as explained in this chapter. Madhumeha is one among twenty types of prameha characterised by excessive frequency and quantity of urination. The primary dosha associated with madhumeha is vata and two types of pathogenesis of madhumeha have been discussed in Charaka Samhita. In the first type, dhātukshaya (decreased state of body tissue) causes vata provocation and all the clinical features of a vitiated vata are present in the patient of kshayaja madhumeha (Diabetes mellitus type 1) (Charaka Nidana 4/36-44). In the second type, there is an initial involvement of kapha, pitta, mamsa and medas dhātu, that in turn make avarana (to get covered or overlapped) of vata leading to manifestation of madhumeha (diabetes mellitus type 2) where features of kapha, pitta, medas and mamsa dushti are also observed. Here, therefore, the main line of treatment (i.e., for Type 2) involves pacifying  kapha, pitta, medas and mamsa. Various gati of dosha that are responsible for healthy and diseased states are dealt at the end of the chapter. Charaka has also stressed upon the significance of a regular healthy diet. It can be said that in the 17th chapter, a multi-faceted approach to understanding various presentations of diseases has been mentioned, aided with examples.

Various permutations and combinations of ''dosha'' have been analysed that help in understanding the pathogenesis of a disease. It is always a matter of debate as to why there are so many diseases and why does a disease have so many different manifestations or forms, depending upon an individual. One answer is that the ''dosha'' involved in pathogenesis varies in the forms of either ''vriddhi'' (increase) or ''kshaya'' (decrease), and that a typical permutation or combination of such ''doshas'' can manifest the disease in a different way. The verses 45, 46, and 47 deal with ''ashayapkarsha'' (pulling ''dosha'' from its location) in which a dominant or increased ''vata'' pulls the normal ''pitta'' and ''kapha'' away from their “seats” and manifests its own features there. Therefore, confusion can occur in the diagnosis and management of the disease. In addition, the concept of ''vikalpa samprapti'' (variable pathogenesis) can be a reason for such varied presentations of the disease, since per ''vikalpa samprapti'', the involvement of various properties of ''dosha'' may differ depending upon the etiological factors. Eighteen types of ''kshaya'' (decreased state) of ''dosha, dhatu,'' ''mala'' and ''ojas'' that may play a significant role in disease pathogenesis are also considered in this chapter. ''Madhumeha'' (Diabetes mellitus) which is also termed as ''ojomeha'' in other texts is one of the ''prameha'' where excessive ''kshaya'' of ''ojas'' takes place. One of its presentations (or forms) is caused due to ''avaranajanya samprāpti'' (obstructive pathogenesis), as explained in this chapter. ''Madhumeha'' is one among twenty types of ''prameha'' characterised by excessive frequency and quantity of urination. The primary ''dosha'' associated with ''madhumeha'' is ''vata'' and two types of pathogenesis of ''madhumeha'' have been discussed in [[Charaka Samhita]]. In the first type, ''dhātukshaya'' (decreased state of body tissue) causes ''vata'' provocation and all the clinical features of a vitiated ''vata'' are present in the patient of ''kshayaja madhumeha'' (Diabetes mellitus type 1) (Charaka Nidana 4/36-44). In the second type, there is an initial involvement of kapha, pitta, mamsa and medas dhātu, that in turn make avarana (to get covered or overlapped) of vata leading to manifestation of madhumeha (diabetes mellitus type 2) where features of kapha, pitta, medas and mamsa dushti are also observed. Here, therefore, the main line of treatment (i.e., for Type 2) involves pacifying  kapha, pitta, medas and mamsa. Various gati of dosha that are responsible for healthy and diseased states are dealt at the end of the chapter. Charaka has also stressed upon the significance of a regular healthy diet. It can be said that in the 17th chapter, a multi-faceted approach to understanding various presentations of diseases has been mentioned, aided with examples.

===Sanskrit text, transliteration and english translation===

===Sanskrit text, transliteration and english translation===