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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 body channels (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 15/36-37] The specific medicines for specific receptors can be developed. [Cha.Sa. 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.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|Sutrasthana]] 11/48]

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

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

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== Significance ==

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As an important phase of pathogenesis (samprapti), the vitiated 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 gati) mentioned as normal (prakriti) and abnormal (vaikrita) are with the same nomenclature viz. koshtha, shakha, marma-asthi-sandhi. This shows the significance of roga marga from physiological view point (prakrita gati of 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 (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) and abnormal (vaikrita) are with the same nomenclature viz. koshtha, shakha, marma-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>

== Etymology ==

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<ol type="A" style='text-align:justify;'><li style="font-weight: bold;">Roga : The word roga is derived from the root ‘ruj’ which means unpleasant, discomfort or pain, to break or disintegrate. It is evident that roga is the outcome of the disintegration of equilibrium of dosha (or dhatusamyata) – Homeostasis, which culminates into pain – physical or psychological. [Arundatta on A.H.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>

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<ol type="A" style='text-align:justify;'><li style="font-weight: bold;">Roga : The word roga is derived from the root ‘ruj’ which means unpleasant, discomfort or pain, to break or disintegrate. It is evident that 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 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>

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<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 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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<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>

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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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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These definitions suggest the appearance of clinical features can be representing a particular roga marga. However, in some cases the pathogenesis can be different with different pathways. For example, carbuncles due to diabetes (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 samprapti can travel to any roga marga during the process.

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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 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.

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

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== 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 are mentioned. [Cha. Sa.Sutra Sthana 17/113] The same are termed as three types of roga marga viz. shakha, 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 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 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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These are the different movements of dosha. As these gati are further classified into prakrita (normal) and vaikrita (abnormal), the healthy channels will render the passage for dosha and when the same channels are weaker/vulnerable, they act as ‘roga marga’.

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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’.

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

| [[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

| [[Vyadhi|Diseases]] like 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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Certain exemplary organs are grouped under different roga margas. The organic implications of each rogamarga can be discussed as follows.

=== Bahya rogamarga: ===

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This includes body components like twak (skin), rakta dhatu (blood), and other similar body consituents. [Cha.Sa.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 (blood), and other similar [[Sharira|body]] consituents. [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, rakta, mamsa, meda, majja pertaining to the internal structures like liver, spleen, brain etc. should not come under bahya roga marga. For example, hrdayagata rasa, yakrita gata rakta should come under abhyantara roga marga. The accessory appendages of skin like hair, nails, tactile cells, sebaceous glands etc. should be considered under bahya rogamarga. 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 rogamarga) 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 (vital organs) like heart, brain, kidneys, bones, joints, ligaments, tendons. [Cha.Sa.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, rakta, mamsa, meda, majja pertaining to the internal structures like liver, spleen, brain etc. should not come under bahya roga marga. For example, hrdayagata rasa, yakrita gata rakta should come under abhyantara roga marga. The accessory appendages of skin like hair, nails, tactile cells, sebaceous glands etc. should be considered under bahya rogamarga. 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 rogamarga) 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 (vital organs) like heart, brain, kidneys, bones, joints, ligaments, tendons. [Cha.Sa.[[Sutra Sthana|Sutra Sthana]] 11/48]

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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 body and any damage to them will give rise to serious consequences.

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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.

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

Kosthanga are mainly responsible for nutrition and excretion of mala. Hridaya is considered a kosthanga for; it is responsible for nutrition and excretion of blood impurities. Same is the case with vikka and basti. But the reason for not considering these organs under kostha 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 rogamarga, there may be indirect influence on the vahana dravya of these organs. eg. rakta mutrata in pittaja jwara, hrdaya asuddhi in ama jwara , bahu mutrata in ajirna etc. Thus, being influenced by kostha and their [[Vyadhi|diseases]], these might have been included in kosthanga. 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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| 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 [Su.Su.21/6] .

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

* The koshthanga are in the abhyantara rogamarga

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== Pathological understanding of roga marga vs. [[Vyadhi|disease]] pathways ==

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

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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/organs are rendered weak by the intake of nidana sevana and this renders the srotas weak, which is termed as [[Kha vaigunya|khavaigunya]]. This results in directing the [[Samprapti|samprapti]] and spread of [[Vyadhi|disease]]. Such weak srotas/ organs becomes rogamarga.

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

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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]

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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== Role of roga-marga in various stages of samprapti ==

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

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<ul style='text-align:justify;'><li style="font-weight: bold;">Sub clinical or formative stages : Of the six stages, accumulaton (chaya), aggravation (prakopa), spread (prasara) are sub-clinical. The symptoms manifested in chaya stage are imprecise, depending on invoved dosha. Prakopa avastha exhibits the symptomatology but not [[Vyadhi|disease]]. In the prasara avastha, when the spread of the morbid doshas starts, the manifestation at roga marga comes into picture. Albeit , as the accumulation (chaya avastha) occurs at the root (mula / utpatti sthana) of the dosha, the involvement of roga marga maybe inferred from accumulation stage (chaya avastha) itself. </li>

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<ul style='text-align:justify;'><li style="font-weight: bold;">Sub clinical or formative stages : Of the six stages, accumulaton (chaya), aggravation (prakopa), spread (prasara) are sub-clinical. The symptoms manifested in chaya stage are imprecise, depending on invoved [[Dosha|dosha]]. Prakopa avastha exhibits the symptomatology but not [[Vyadhi|disease]]. In the prasara avastha, when the spread of the morbid [[Dosha|doshas]] starts, the manifestation at roga marga comes into picture. Albeit , as the accumulation (chaya avastha) occurs at the root (mula / utpatti sthana) of the [[Dosha|dosha]], the involvement of roga marga maybe inferred from accumulation stage (chaya avastha) itself. </li>

<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 which later on cultivates for interaction of dosh and dushya. [Su.Sa.Sutrasthana 24/10] Kha-vaigunya plays directive role for the pathology to spread in different srotas (systems).

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Rogamarga is the site of [[Kha vaigunya|kha-vaigunya]] which later on cultivates for interaction of dosh and dushya. [Su.Sa.[[Sutra Sthana|Sutrasthana]] 24/10] [[Kha vaigunya|Kha-vaigunya]] plays directive role for the pathology to spread in different 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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Though the dosha 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 roga vriddhi takes place. Advancement of [[Vyadhi|disease]] (roga vriddhi) takes place by different modes, which are listed briefly as follows: </li>

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<ol><li style="font-weight: bold;">In the same organ, sthanantara swarupa roga vriddhi : In skin disorders and other contagious [[Vyadhi|diseases]], due to anatomical continuity in skin, the pathogens can travel in the same organ. E.g visarpa. [Cha.Sa.Chikitsa Sthana 21/15] </li>

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<ol><li style="font-weight: bold;">In the same organ, sthanantara swarupa roga vriddhi : In skin disorders and other contagious [[Vyadhi|diseases]], due to anatomical continuity in skin, the pathogens can travel in the same organ. E.g visarpa. [Cha.Sa.[[Chikitsa Sthana|Chikitsa Sthana]] 21/15] </li>

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<li style="font-weight: bold;">Dhatugata swarupa roga vriddhi : The transfer of [[Vyadhi|disease]] or samprapti from one dhatu to another is also the manifestation of roga vriddhi (dhatu gatatva). Dhatugata vyadhi and dhatugata vata are explained to get a clear idea. Apart from the dhatugatatva of dosha, it is explained in certain other contexts also. They are the following : </li>

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<li style="font-weight: bold;">Dhatugata swarupa roga vriddhi : The transfer of [[Vyadhi|disease]] or [[Samprapti|samprapti]] from one dhatu to another is also the manifestation of roga vriddhi (dhatu gatatva). Dhatugata vyadhi and dhatugata vata are explained to get a clear idea. Apart from the dhatugatatva of [[Dosha|dosha]], it is explained in certain other contexts also. They are the following : </li>

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<ol type="i"><li>Dhatugatatva of jwara (the morbid dosha causing fever penetrates into deeper tissues) [Cha. Sa. Chikitsa sthana 3/ 70-83], [Su.Sa.Uttara Tantra 29/83-89]</li>

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<ol type="i"><li>Dhatugatatva of jwara (the morbid [[Dosha|dosha]] causing fever penetrates into deeper tissues) [Cha. Sa. [[Chikitsa Sthana|Chikitsa sthana]] 3/ 70-83], [Su.Sa.Uttara Tantra 29/83-89]</li>

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<li>Dhatugatatva of kushtha (the morbid dosha causing skin [[Vyadhi|diseases]] penetrates into deeper tissues) [Su. Sa. Nidana Sthana 5/20-27] </li>

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<li>Dhatugatatva of kushtha (the morbid [[Dosha|dosha]] causing skin [[Vyadhi|diseases]] penetrates into deeper tissues) [Su. Sa. Nidana Sthana 5/20-27] </li>

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<li>Dhatugatatva of masurika (the morbid dosha causing chicken pox penetrates into deeper tissues) [Ma. Ni. 54 / 14-23] </li>

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<li>Dhatugatatva of masurika (the morbid [[Dosha|dosha]] causing chicken pox penetrates into deeper tissues) [Ma. Ni. 54 / 14-23] </li>

<li>Dhatugatatva of visha vega (the poison penetrates into deeper tissues) [A.Hr.Uttara tantra 19/26] [Su.Sa. Kalpa Sthana 4/39] </li>

The examples of dhatugatatva given in skin diseases (kushtha) can be taken as a model for understanding the symptomatology of dhatugatatva of kapha dominant [[Vyadhi|diseases]]. Likewise, dhatugatatva of jwara for pittaja vyadhis and dhatugatatva described in vatavyadhi for vata dominant disorders.</ol>

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

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<li style="font-weight: bold;">Upadrava swarupa roga vriddhi : [Cha.Sa.Chikitsa ~~Sthana21~~/40] Upadrava also signifies roga vrddhi. In a vigunita sthana, dosha dushya sammurcchana takes place. If it is not treated at early stage and nidana sevana continued then this dosha dushya melaka becomes more virulent and travels to other places and produces upadrava. eg. Upadrava of udara roga (obstinate abdominal [[Vyadhi|diseases]] including ascites) are chhardi (vomiting), atisara (diarrhoea), shwasa (dyspnoea), kasa (cough), trishna (morbid thirst), hikka (hiccup), aruchi (anorexia) etc. [Cha.Sa.Chikitsa Sthana 13/49] </li>

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

<li style="font-weight: bold;">Roga vrddhi in same srotas in a sequential order : Roga initiates from sroto mula or a part of srotas and spreads to whole srotas, if 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;">Roga vrddhi according to dosha sthana : The best example given to study this is in 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;">Roga vrddhi according to [[Dosha|dosha]] sthana : The best example given to study this is in Jwara Prakarana of Sushruta Uttara Sthana. [Nibandha Sangraha commentary by Dalhana on Su.Sa. Uttara tantra 39/ 51-52]

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* Satata jwara in amashaya (In continuous fever, the morbid doshas are in the stomach)

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

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* Anyedhyushka in hridaya (In intermittent fever, the morbid doshas are in the heart / heart region)

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

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* Trutiyaka in kantha (In tertian fever, the morbid doshas are in the throat / throat region)

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* Trutiyaka in kantha (In tertian fever, the morbid [[Dosha|doshas]] are in the throat / throat region)

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* Chaturthaka in sandhi (In quartan type of fever the morbid doshas are in the joints) </li>

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* Chaturthaka in sandhi (In quartan type of fever the morbid [[Dosha|doshas]] are in the joints) </li>

In this way, looking at the different procedures of roga vriddhi, it is evident that roga marga plays a definite role in the roga vriddhi, which may take place in the same roga marga or in other roga marga. </ol></ul>

== The inter-connectedness of the different roga marga ==

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Dosha can move from one marga to another. The movement of the dosha from internal pathway towards other marga will be clear in most of the [[Vyadhi|diseases]]. But in the case of external pathways, the movement of dosha from shakha towards koshtha is not so easy. The reason may be that the [[Vyadhi|diseases]] of the internal pathway produce many symptoms externally. But the [[Vyadhi|diseases]] of the external pathway generally may not have any serious symptoms and signs pertaining to internal or medial pathway. The reason for this can be given in the following paras. <ol type="a"><li>Body due to its defense mechanism generally tries to push out the factors, which are not suitable to it. If the koshtha is filled with such morbid factors, in order to defend the organs of koshtha from any type of damage they are pushed to other margas if not expelled out. This is done preferably through the marga of poshana. The causes of movement of the doshas from koshtha to shakha have been mentioned by acharya Charak. [Cha.Sa.Sutra Sthana 28/31] </li>

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[[Dosha|Dosha]] can move from one marga to another. The movement of the [[Dosha|dosha]] from internal pathway towards other marga will be clear in most of the [[Vyadhi|diseases]]. But in the case of external pathways, the movement of [[Dosha|dosha]] from shakha towards koshtha is not so easy. The reason may be that the [[Vyadhi|diseases]] of the internal pathway produce many symptoms externally. But the [[Vyadhi|diseases]] of the external pathway generally may not have any serious symptoms and signs pertaining to internal or medial pathway. The reason for this can be given in the following paras. <ol type="a"><li>[[Sharira|Body]] due to its defense mechanism generally tries to push out the factors, which are not suitable to it. If the koshtha is filled with such morbid factors, in order to defend the organs of koshtha from any type of damage they are pushed to other margas if not expelled out. This is done preferably through the marga of poshana. The causes of movement of the [[Dosha|doshas]] from koshtha to shakha have been mentioned by acharya Charak. [Cha.Sa.[[Sutra Sthana|Sutra Sthana]] 28/31] </li>

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<li>The same case is not found in the [[Vyadhi|diseases]] of external pathways. Because the morbid dosha will not be able to move back to koshtha easily. This is because the viloma gati of dosha will have to take place here. This sort of movement is possible only with the co-operation of the srotas. The causes of movement of doshas from shakha to koshtha , mentioned by acharya Charak, plays role for this. [Cha.Sa.Sutra Sthana 28/32] Thus, compared to abhyantar rogamarga, the [[Vyadhi|diseases]] of bahya roga marga takes longer duration. </li></ol>

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<li>The same case is not found in the [[Vyadhi|diseases]] of external pathways. Because the morbid [[Dosha|dosha]] will not be able to move back to koshtha easily. This is because the viloma gati of [[Dosha|dosha]] will have to take place here. This sort of movement is possible only with the co-operation of the srotas. The causes of movement of [[Dosha|doshas]] from shakha to koshtha , mentioned by acharya Charak, plays role for this. [Cha.Sa.[[Sutra Sthana|Sutra Sthana]] 28/32] Thus, compared to abhyantar rogamarga, the [[Vyadhi|diseases]] of bahya roga marga takes longer duration. </li></ol>

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The movement of the morbid factors in the [[Vyadhi|diseases]] of medial pathways will be of different type. In these [[Vyadhi|diseases]], the movement of the dosha will be from one organ to the other organ of the same roga marga. In [[Vyadhi|diseases]] like amavata, vatarakta, etc. which are related with the joints coming under medial pathway, signs and symptoms of the malfunction of heart (hridaya) or bladder (basti) or both etc. will be present. In the same way, the involvement of the heart may produce signs and symptoms related with extrenal pathway in their premonitory stage (purvarupavastha). Prameha and rajayakshma, which are the [[Vyadhi|diseases]] of medial pathway, may be quoted as examples. In these disorders, excessive growth of hair, nails etc. are observed in premonitory stage.

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The movement of the morbid factors in the [[Vyadhi|diseases]] of medial pathways will be of different type. In these [[Vyadhi|diseases]], the movement of the [[Dosha|dosha]] will be from one organ to the other organ of the same roga marga. In [[Vyadhi|diseases]] like amavata, vatarakta, etc. which are related with the joints coming under medial pathway, signs and symptoms of the malfunction of heart (hridaya) or bladder (basti) or both etc. will be present. In the same way, the involvement of the heart may produce signs and symptoms related with extrenal pathway in their premonitory stage (purvarupavastha). Prameha and rajayakshma, which are the [[Vyadhi|diseases]] of medial pathway, may be quoted as examples. In these disorders, excessive growth of hair, nails etc. are observed in premonitory stage.

It can be said that most of the [[Vyadhi|diseases]] of external pathway originate from colon (pakwashayottha). In the [[Vyadhi|diseases]] of external pathway apart from the external treatment (bahya chikitsa or bahirparimarjana chikitsa), virechana is preferred. It is only through suitable virechana dravyas, skin [[Vyadhi|diseases]] are treated successfully.

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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.Sutrasthana 11/48] [Chakrapani on Cha.Sa.Sutrasthana 10/12] [Chakrapani on Cha.Sa.Sutrasthana 10/15,16] [Cha.Sa.Sutrasthana 10/18,19] The contribution of roga marga to prognosis depends on the robustness of the site.[Chakrapani on Cha.Sa. 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|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]

== Rogamarga for precise treatment ==

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As koshtha/abhyantar roga-marga is the place of jatharagni, all its [[Vyadhi|diseases]] manifest due to poor agni (agnimandya or agni dushti), resulting into ama. Vamana and virechana maybe the line of treatment for shodhana purpose for the [[Vyadhi|diseases]] occurring here, depending on the classification of origin from stomach (amashaya samuttha) and colon (pakwashaya samuttha vyadhi).

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

For the [[Vyadhi|diseases]] of medial pathway, prana and vyana vayu are found to be involved. Basti and nasya maybe more beneficial. As the [[Vyadhi|diseases]] of madhyama roga-marga are generally originated from colon (pakwashayottha) and due to obstructed vayu, basti maybe the first line of treatment. Basti is capable of preventing and overcoming the afflictions of marma, asthi sandhi etc. [Cha. Sa. 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.

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== Contemporary approach ==

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The contemporary approach to understand the body and the pathogenesis of any [[Vyadhi|disease]] is analytical. Whereas that of ayurveda is holistic and comprehensive. With this basic difference, it maybe said that such a concept of ‘rogamarga’ is also unique in Ayurveda, where different set of [[Vyadhi|diseases]] are said to occur under a single rogamarga. Further, the prognostic approach of contemporary medical science is not based on the systems involved; whereas this concept of rogamarga is also having significance for the prognosis.

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The contemporary approach to understand the [[Sharira|body]] and the [[Samprapti|pathogenesis]] of any [[Vyadhi|disease]] is analytical. Whereas that of ayurveda is holistic and comprehensive. With this basic difference, it maybe said that such a concept of ‘rogamarga’ is also unique in Ayurveda, where different set of [[Vyadhi|diseases]] are said to occur under a single rogamarga. Further, the prognostic approach of contemporary medical science is not based on the systems involved; whereas this concept of rogamarga is also having significance for the prognosis.

== Current researches ==

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<li>Dr. Kulkarni. Pratibha et al., Rogamarga and Dosha Gati ; wjpmr, 2016,2(6), 97-99;<ref name="ref16">Kulkarni Pratibha et .al. Roga Marga and Dosha Gati , World Journal of Pharmaceutical and Medical Research , 2016,2(6), 97-99. </ref></li>

<li>Pushpa Tuppad. Conceptual study of Rogamarga. J Ayurveda Integr Med Sci 2022;3:53-58;<ref name="ref17">Pushpa Tuppad, Conceptual study of Rogamarga. J Ayu Int Med Sci. 2022;7(3):53-58 Available From : https://jaims.in/jaims/article/view/1793 </ref></li>

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These studies have derived the important role played by roga marga in the pathogenesis of the [[Vyadhi|disease]], its prognosis and the line of management. The dosha gati in its vikrita avastha is through the roga marga. </ul>

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These studies have derived the important role played by roga marga in the [[Samprapti|pathogenesis]] of the [[Vyadhi|disease]], its prognosis and the line of management. The dosha gati in its vikrita avastha is through the roga marga. </ul>

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