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This concludes the (excellent section titled) [[Nidana Sthana]]. [16]
This concludes the (excellent section titled) [[Nidana Sthana]]. [16]
Diagnostic principles of diseases:
==== Diagnostic principles of diseases ====
Nidanarthakara roga (disease specific causes):
===== ''Nidanarthakara roga'' (disease specific causes) =====
निदानार्थकरो रोगो रोगस्याप्युपलभ्यते ||१६||
निदानार्थकरो रोगो रोगस्याप्युपलभ्यते ||१६||
nidānārthakarō rōgō rōgasyāpyupalabhyatē||16||
nidānārthakarō rōgō rōgasyāpyupalabhyatē||16||
nidAnArthakaro rogo rogasyApyupalabhyate||16||
nidAnArthakaro rogo rogasyApyupalabhyate||16||
तद्यथा- ज्वरसन्तापाद्रक्तपित्तमुदीर्यते |
तद्यथा- ज्वरसन्तापाद्रक्तपित्तमुदीर्यते |
रक्तपित्ताज्ज्वरस्ताभ्यां शोषश्चाप्युपजायते ||१७||
रक्तपित्ताज्ज्वरस्ताभ्यां शोषश्चाप्युपजायते ||१७||
tadyathā- jvarasantāpādraktapittamudīryatē|
tadyathā- jvarasantāpādraktapittamudīryatē|
raktapittājjvarastābhyāṁ śōṣaścāpyupajāyatē ||17||
raktapittājjvarastābhyāṁ śōṣaścāpyupajāyatē ||17||
raktapittAjjvarastAbhyAM shoShashcApyupajAyate ||17||
raktapittAjjvarastAbhyAM shoShashcApyupajAyate ||17||
For example, elevated temperature in jwara can cause raktapitta and raktapitta can cause jwara. Both the diseases (i.e jwara and raktapitta) may lead to shosha (depletion of dhatus). [17]
For example, elevated temperature in ''jwara'' can cause ''raktapitta'' and ''raktapitta'' can cause ''jwara''. Both the diseases (i.e ''jwara'' and ''raktapitta'') may lead to ''sosha'' (depletion of ''dhatus''). [17]
प्लीहाभिवृद्ध्या जठरं जठराच्छोथ एव च |
प्लीहाभिवृद्ध्या जठरं जठराच्छोथ एव च |
अर्शोभ्यो जठरं दुःखं गुल्मश्चाप्युपजायते ||१८||
अर्शोभ्यो जठरं दुःखं गुल्मश्चाप्युपजायते ||१८||
plīhābhivr̥ddhyā jaṭharaṁ jaṭharācchōtha ēva ca|
plīhābhivr̥ddhyā jaṭharaṁ jaṭharācchōtha ēva ca|
arśōbhyō jaṭharaṁ duḥkhaṁ gulmaścāpyupajāyatē||18||
arśōbhyō jaṭharaṁ duḥkhaṁ gulmaścāpyupajāyatē||18||
plIhAbhivRuddhyA jaTharaM jaTharAcchotha eva ca|
plIhAbhivRuddhyA jaTharaM jaTharAcchotha eva ca|
arshobhyo jaTharaM duHkhaM gulmashcApyupajAyate||18||
arshobhyo jaTharaM duHkhaM gulmashcApyupajAyate||18||
Pleeha (enlargement of spleen) causes jathara (abdominal diseases including ascitis), which leads to shotha (generalized edema). Arsha (hemorrhoids) causes jathara (abdominal diseases including ascitis) that leads to gulma (abdominal lumps). [18]
''Pleeha'' (enlargement of spleen) causes ''jathara'' (abdominal diseases including ascitis), which leads to ''shotha'' (generalized edema). ''Arsha'' (hemorrhoids) causes ''jathara'' (abdominal diseases including ascitis) that leads to ''gulma'' (abdominal lumps). [18]
प्रतिश्यायाद्भवेत् कासः कासात् सञ्जायते क्षयः |
प्रतिश्यायाद्भवेत् कासः कासात् सञ्जायते क्षयः |
क्षयो रोगस्य हेतुत्वे शोषस्याप्युपलभ्यते ||१९||
क्षयो रोगस्य हेतुत्वे शोषस्याप्युपलभ्यते ||१९||
pratiśyāyādbhavēt kāsaḥ kāsāt sañjāyatē kṣayaḥ|
pratiśyāyādbhavēt kāsaḥ kāsāt sañjāyatē kṣayaḥ|
kṣayō rōgasya hētutvē śōṣasyāpyupalabhyatē||19||
kṣayō rōgasya hētutvē śōṣasyāpyupalabhyatē||19||
kShayo rogasya hetutve shoShasyApyupalabhyate||19||
kShayo rogasya hetutve shoShasyApyupalabhyate||19||
Pratishyaya (rhinitis) leads to kasa (cough) which further leads to kshaya (depletion of dhatu), consequently resulting in shosha (emaciation). [19]
''Pratishyaya'' (rhinitis) leads to ''kasa'' (cough) which further leads to ''kshaya'' (depletion of ''dhatu''), consequently resulting in ''sosha'' (emaciation). [19]
ते पूर्वं केवला रोगाः पश्चाद्धेत्वर्थकारिणः |
ते पूर्वं केवला रोगाः पश्चाद्धेत्वर्थकारिणः |
उभयार्थकरा दृष्टास्तथैवैकार्थकारिणः [१] ||२०||
उभयार्थकरा दृष्टास्तथैवैकार्थकारिणः [१] ||२०||
Conditions in their primary stages or forms manifest themselves as diseases and subsequently act as causative factors for other diseases. They thus play a dual role - as a disease and as a causative factor. Some of these play just one role as well– either as a disease or as a causative factor. [20]
Conditions in their primary stages or forms manifest themselves as diseases and subsequently act as causative factors for other diseases. They thus play a dual role - as a disease and as a causative factor. Some of these play just one role as well– either as a disease or as a causative factor. [20]
कश्चिद्धि रोगो रोगस्य हेतुर्भूत्वा प्रशाम्यति |
कश्चिद्धि रोगो रोगस्य हेतुर्भूत्वा प्रशाम्यति |
न प्रशाम्यति चाप्यन्यो हेत्वर्थं कुरुतेऽपि च ||२१||
न प्रशाम्यति चाप्यन्यो हेत्वर्थं कुरुतेऽपि च ||२१||
kaściddhi rōgō rōgasya hēturbhūtvā praśāmyati|
kaściddhi rōgō rōgasya hēturbhūtvā praśāmyati|
na praśāmyati cāpyanyō hētvarthaṁ kurutē'pi ca||21||
na praśāmyati cāpyanyō hētvarthaṁ kurutē'pi ca||21||
Some diseases subside after causing another disease, while some do not subside even after causing another disease. [21]
Some diseases subside after causing another disease, while some do not subside even after causing another disease. [21]
एवं कृच्छ्रतमा नॄणां दृश्यन्ते व्याधिसङ्कराः |
एवं कृच्छ्रतमा नॄणां दृश्यन्ते व्याधिसङ्कराः |
प्रयोगापरिशुद्धत्वात्तथा चान्योन्यसम्भवात् ||२२||
प्रयोगापरिशुद्धत्वात्तथा चान्योन्यसम्भवात् ||२२||
Combinations of diseases in human beings are usually very difficult to treat, owing to the complexity of the line of treatment, and their serving as causative factors of each other. [22]
Combinations of diseases in human beings are usually very difficult to treat, owing to the complexity of the line of treatment, and their serving as causative factors of each other. [22]
Ideal therapy without adverse effects:
===== Ideal therapy without adverse effects =====
प्रयोगः शमयेद्व्याधिं योऽन्यमन्यमुदीरयेत् |
प्रयोगः शमयेद्व्याधिं योऽन्यमन्यमुदीरयेत् |
नासौ विशुद्धः, शुद्धस्तु शमयेद्यो न कोपयेत् ||२३||
नासौ विशुद्धः, शुद्धस्तु शमयेद्यो न कोपयेत् ||२३||
“Diagnosis of diseases” (Nidanasthana) of Agnivesha , as redacted by Charaka.
“Diagnosis of diseases” (Nidanasthana) of Agnivesha , as redacted by Charaka.
Tattva Vimarsha:
=== Tattva Vimarsha ===
• Apasmara is a disease due to vitiation of three sharira doshas and two manas doshas.
• Apasmara is a disease due to vitiation of three sharira doshas and two manas doshas.
• The causative factors of apasmara mainly include consuming unhygenic, impure, decomposed food and encountering inauspicious things that are not compatible with one’s sensibilities.
• The causative factors of apasmara mainly include consuming unhygenic, impure, decomposed food and encountering inauspicious things that are not compatible with one’s sensibilities.
• The doshas that spread obliquely (in the transverse direction) afflict patient for a longer time. These doshas should be managed first, or they should be carefully drawn to koshtha (bowel) by proper measures. After analyzing them in koshtha, the physician should eliminate them through the nearest route.
• The doshas that spread obliquely (in the transverse direction) afflict patient for a longer time. These doshas should be managed first, or they should be carefully drawn to koshtha (bowel) by proper measures. After analyzing them in koshtha, the physician should eliminate them through the nearest route.
Vidhi Vimarsha:
=== Vidhi Vimarsha ===
The chapter on apasmara is sequenced after the one on unmada. The sequence is due to similarities of clinical origin as well as causative and pathophysiological factors, since both diseases are psychosomatic in nature.
The chapter on apasmara is sequenced after the one on unmada. The sequence is due to similarities of clinical origin as well as causative and pathophysiological factors, since both diseases are psychosomatic in nature.