Changes

A simple example that can illustrate System biology approach is of sickle cell anemia. This disease is caused by a single point mutation at position 6 of the β-chain of hemoglobin, which changes hemoglobin’s oxygen affinity and promotes polymerization under hypoxic conditions. However, individuals with sickle cell disease can present with variety of symptoms which include hemolysis, inflammation, cell adhesion and end-organ ischemia-reperfusion injury and infarction. Patients also experience intermittent painful episodes due to acute vascular obstruction. (Mack KA) [2] There are many reasons for these different clinical manifestations, including the presence of other genes modifying the disease modifying genes (e.g., hemoglobin F). Hence, this example indicates that the knowledge of single gene is not sufficient to understand the disease. There is need to consider other genes or in other words other constituents of the body.  (verse 3)  

A simple example that can illustrate System biology approach is of sickle cell anemia. This disease is caused by a single point mutation at position 6 of the β-chain of hemoglobin, which changes hemoglobin’s oxygen affinity and promotes polymerization under hypoxic conditions. However, individuals with sickle cell disease can present with variety of symptoms which include hemolysis, inflammation, cell adhesion and end-organ ischemia-reperfusion injury and infarction. Patients also experience intermittent painful episodes due to acute vascular obstruction. (Mack KA) [2] There are many reasons for these different clinical manifestations, including the presence of other genes modifying the disease modifying genes (e.g., hemoglobin F). Hence, this example indicates that the knowledge of single gene is not sufficient to understand the disease. There is need to consider other genes or in other words other constituents of the body.  (verse 3)  

==== Definition of sharira and disequilibrium in body elements ====

==== Definition of ''sharira'' and disequilibrium in body elements ====

The consciousness manifested in the body is because of the soul. Since the soul does not have any dwelling place, the word bhuta is added to the term chetana sthana in the text.

The consciousness manifested in the body is because of the soul. Since the soul does not have any dwelling place, the word bhuta is added to the term ''chetana sthana'' in the text.

Dhatus are derived from the mahabhuta and the body represents the union of these dhatus in specific proportions. Hence, maintenance of these proportions becomes important for the maintenance of health. Any change in the quantity of individual dhatu, thereby disturbing the relative proportion of the other dhatu results in ill health. A minor change in proportion results in discomfort while the major change destroys the body completely i.e. it can lead to death. It is important to note here that the change in proportion should be manifested and it should produce klesha (discomfort) and/or vinasha (destruction) to consider it significant.

''Dhatus'' are derived from the ''mahabhuta'' and the body represents the union of these ''dhatus'' in specific proportions. Hence, maintenance of these proportions becomes important for the maintenance of health. Any change in the quantity of individual ''dhatu'', thereby disturbing the relative proportion of the other ''dhatu'' results in ill health. A minor change in proportion results in discomfort while the major change destroys the body completely i.e. it can lead to death. It is important to note here that the change in proportion should be manifested and it should produce ''klesha'' (discomfort) and/or ''vinasha'' (destruction) to consider it significant.

A change in proportion of these dhatus can be due to circadian, seasonal variations etc. Sometimes the change can also occur due to dietary or behavioural changes. For example, increase in the quantity of shukra (one among the seven structural elements) by consumption of milk. However, this kind of change is transitory in nature. To differentiate this transitory state of disequilibrium, the term gamana has been suffixed to the term vaishamya (any increase or decrease beyond the normal range). This indicates that the vaishamya has to be long standing.

A change in proportion of these ''dhatus'' can be due to circadian, seasonal variations etc. Sometimes the change can also occur due to dietary or behavioural changes. For example, increase in the quantity of ''shukra'' (one among the seven structural elements) by consumption of milk. However, this kind of change is transitory in nature. To differentiate this transitory state of disequilibrium, the term ''gamana'' has been suffixed to the term ''vaishamya'' (any increase or decrease beyond the normal range). This indicates that the ''vaishamya'' has to be long standing.

Sometimes a change in proportion of these dhatus can also be seen without discomfort and destruction.  

Sometimes a change in proportion of these ''dhatus'' can also be seen without discomfort and destruction.  

For example,  

For example,  

#The effects of aphrodisiacs by which there is an increase in the quantity of shukra and  

#The effects of aphrodisiacs by which there is an increase in the quantity of ''shukra'' and  

#The increase in dhatus of a child along with the increase of its age.  

#The increase in ''dhatus'' of a child along with the increase of its age.  

In both of these examples, there is no discomfort or destruction. This type of interpretation is not valid as an increase in dhatus of a child is owing to its age, which is natural and does not exceed the desired quantity at the given age of the individual. Even the increase of shukra by the administration of aphrodisiacs does not cause any disease and therefore, this increase should be considered as within the normal range.

In both of these examples, there is no discomfort or destruction. This type of interpretation is not valid as an increase in ''dhatus'' of a child is owing to its age, which is natural and does not exceed the desired quantity at the given age of the individual. Even the increase of ''shukra'' by the administration of aphrodisiacs does not cause any disease and therefore, this increase should be considered as within the normal range.

In the seventh chapter of this section, we would see that the average quantity of dhatu is described in terms of anjali pramana (a measurement by joining palms of both hands). In spite of the description of these quantities one has to depend on the signs and symptoms of aggravation and diminution of dhatu as they are not available directly for measurement. Therefore, the maximum increase of shukra which does not produce a disease should be considered as the limit of the normal range of this dhatu and vaishamya should be diagnosed when abnormal symptoms will get manifested.

In the seventh chapter of this section, we would see that the average quantity of ''dhatu'' is described in terms of ''anjali pramana'' (a measurement by joining palms of both hands). In spite of the description of these quantities one has to depend on the signs and symptoms of aggravation and diminution of ''dhatu'' as they are not available directly for measurement. Therefore, the maximum increase of ''shukra'' which does not produce a disease should be considered as the limit of the normal range of this ''dhatu'' and ''vaishamya'' should be diagnosed when abnormal symptoms will get manifested.

Some scholars opine that sometimes the increase or decrease can be physiological (prakrita). They cite the example (Cha. Su 17/45-46) that the diminution of kapha aggravates vata and further draws the pitta which is in its normal state from its site and makes it circulate through the body to produce pain in the sites of its circulation. In this case, even though the pitta dosha is in its normal state, it causes discomfort in the body because of external factors (paratantra prakopa/ashayapakarsha gati).  

Some scholars opine that sometimes the increase or decrease can be physiological (''prakrita''). They cite the example (Cha. Su 17/45-46) that the diminution of ''kapha'' aggravates ''vata'' and further draws the ''pitta'' which is in its normal state from its site and makes it circulate through the body to produce pain in the sites of its circulation. In this case, even though the ''pitta dosha'' is in its normal state, it causes discomfort in the body because of external factors (''paratantra prakopa/ashayapakarsha gati'').  

This statement is not convincing because in another verse of the same chapter (Cha. Su 17/62), the author has described three different states of dhatu viz. increase, decrease and normalcy along with their diagnostic criteria. In its normal state, a dhatu does not produce any kind of discomfort or destruction. Also, a disease is defined as the result of the imbalance of dhatus and the normal state of these dhatus is described to constitute the health. (Cha. Su 9/4)

This statement is not convincing because in another verse of the same chapter (Cha. Su 17/62), the author has described three different states of ''dhatu'' viz. increase, decrease and normalcy along with their diagnostic criteria. In its normal state, a ''dhatu'' does not produce any kind of discomfort or destruction. Also, a disease is defined as the result of the imbalance of ''dhatus'' and the normal state of these ''dhatus'' is described to constitute the health. (Cha. Su 9/4)

The correct understanding of the verse (Cha. Su 17/45-46) therefore should be that if the pitta in its normal state, when carried by the aggravated vata, circulates in the body, and gets mixed up with the pitta of other places, and then actually there is an increase in local pitta of those places, this increased state of pitta is in fact responsible for the cause of symptoms/disease.

The correct understanding of the verse (Cha. Su 17/45-46) therefore should be that if the ''pitta'' in its normal state, when carried by the aggravated ''vata'', circulates in the body, and gets mixed up with the ''pitta'' of other places, and then actually there is an increase in local ''pitta'' of those places, this increased state of ''pitta'' is in fact responsible for the cause of symptoms/disease.

Even when dhatus are in their normal states before they come in contact with the aggravated dosha, their equilibrium gets disturbed after the interaction with dosha. The manifestation of diseases, therefore, is possible only when dhatu are either increased or decreased due to this interaction and the consequent imbalance.

Even when ''dhatus'' are in their normal states before they come in contact with the aggravated ''dosha'', their equilibrium gets disturbed after the interaction with ''dosha''. The manifestation of diseases, therefore, is possible only when ''dhatu'' are either increased or decreased due to this interaction and the consequent imbalance.

==== Factors responsible for increase and decrease of body elements ====

==== Factors responsible for increase and decrease of body elements ====