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==Fundamental principles==
==Fundamental principles==
The term ''Chikitsa'' means treatment or therapy. <ref> Available from http://spokensanskrit.org/index.php?tran_input=cikitsA&direct=se&script=hk&link=yes&mode=3</ref> This section deals with therapeutics in Ayurveda. This is the most important section focusing on objective of Ayurveda for prevention, preservation of health and treatment of diseases.
The term ''Chikitsa'' means treatment or therapy. <ref> Available from http://spokensanskrit.org/index.php?tran_input=cikitsA&direct=se&script=hk&link=yes&mode=3</ref> . It is important to note that the status of health and etio-pathogenesis of diseases depends upon status of Agni (digestion and metabolism). (Cha.Chi.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 originated due to impaired “Agni”. The medical practice of Kayachikitsa is based upon an intimate understanding of nutrition and the factors responsible for digestion, absorption and metabolism.<ref> Dwarkanath C. Introduction to Kayachikitsa.Chaukhambha Orientalia;third edition. Varanasi. 1996 p.2</ref> [[Chikitsa Sthana]] is the most important section focusing on objective of Ayurveda for prevention, preservation of health and treatment of diseases.
==Structural dimensions of chapter==
[[Chikitsa Sthana]] relates mainly with therapeutics. However each chapter in this section starts with comprehensive information about etio-pathogenesis along with symptomatology, prognosis and classification of the disease before delving into its 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, svedana'' or ''stambhana'' and concerned 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.
==Specialities of Ayurveda therapeutics ==
==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.<ref>Specialties of Medical Practice available from https://en.wikipedia.org/wiki/Specialty_(medicine) retrieved on April 24, 2019</ref>. 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]] and [[Vajikarana]]. 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 - 9th and 10th - deal with [[Unmada Chikitsa]] and [[Apasmara Chikitsa]] focus on this aspect of medicine. Finally, the 30th chapter [[Yonivyapat Chikitsa]] describes miscellaneous matters including the gynecological disorders (''yonivyapat'') and pediatrics (''kaumarabhritya'').
The medical therapeutics today has been classified into many branches focused on a defined group of patients, diseases, skills, or philosophy.<ref>Specialties of Medical Practice available from https://en.wikipedia.org/wiki/Specialty_(medicine) retrieved on April 24, 2019</ref>. 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]] and [[Vajikarana]]. 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, gynaecological 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==
==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.
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]] (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 ageing process.
*The first chapter is on [[Rasayana]] (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 ageing process.
The second chapter, on [[Vajikarana]], 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 second chapter, on [[Vajikarana]], 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 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. Principles of blood tissue and its disorders are referred in this chapter.
*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 like enlargement in abdominal cavity is termed as ''gulma'' and is of five types which includes simple gas phantom to new growth and their treatment. Principles of treatment of swellings in abdomen
*The fifth chapter,[[Gulma Chikitsa]] describes protuberance of abdomen under two headings, local and generalized. Local lump like enlargement 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. Sixth 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).
*Urinary diseases are described according to the presenting symptoms of excessive urine or scanty urine with difficulty/pain. Sixth 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). This chapter also describes principles of treatment for disorders due to impaired fat metabolism.
The management of eighteen types of ''kushtha'' (skin diseases including leprosy) is described in the 7th chapter [[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 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'' (Tuberculosis) has been a problem since time immemorial and according to its etio-pathogenesis it is classified into four types and its detailed treatment is described in the 8th chapter.
*''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'' (psychological diseases); Ninth chapter describes the management of ''unmada'' (insanity/psychotic disorders).
*''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 deals with the management of epilepsy described under the heading of ''apasmara''.
*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 ulcer in chest, bleeding and cachexia is described in 11th chapter.
*''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 occurring in the skin and glands are described under the heading of ''shotha'' in the 12th chapter.
*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 chapter describe management principles of disorders due to impaired fluid and osmosis 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 level 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 entitled [[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 entitled [[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 hairs, ear, nose and throat s 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 systems like digestive system, nervous system, musculo-skeletal system and their managements are described in this chapter.
The conditions leading to generalized enlargement of abdomen such as ascites, splenomegaly are described in 13th chapter under the heading of ''udara roga''.
*The next chapter entitled [[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 gynaecological 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.
==Category==
*Cough (''kasa'') is described in 18th chapter and
* Medicine * Geriatrics * Aphrodisiacs *Dermatology * Urology* Immunology * Psychiatry * Chest medicine * Gatroenterology * Anorectal medicine * Bleeding disorders * Anemia * Hepatic disorders * Fluid Balance * Diarrhoea * Acid Peptic Disorders* Nervous system disorders * Rheaumatology
*Diarrheal disorders (''atisara'') are described in 19th chapter.
*Vomiting (''chhardi'') has been devoted a full 20th chapter.
*Various types of inflammatory skin conditions such as erysipelas are described under the heading of ''visarpa'' in Chapter 21.
*Various conditions manifested in the form of thirst (''trishna'') are described in Chapter 22.
*Chapter 23 is on the management of poisoning (''visha'') relating with ''agada-tantra'' (toxicology).
*Alcoholism was a major problem in ancient India and the management of its various acute and chronic stages and complications are tackled in Chapter 24 under the heading of ''madatyaya''.
*Chapter 25 pertains to ''vrana chikitsa'' (wound management) and surgical disorders (''shalya'')
*Chapter 26 describes other gastrointestinal diseases such as ''udavarta'', ''annaha'' (distension of abdomen), ''aruchi'' (anorexia) etc. The urinary problems with scanty urine occurring with difficulty and accompanied with burning sensation or pain are also described under the heading of ''mutra-krichhra'' and ''ashmari''. Management of other diseases, pertaining to five types of heart diseases and ear, nose, throat and scalp diseases with passing reference to eye diseases.
*Disorders of spinal neuro muscular degeneration or ''Urustambha'' are described in Chapter 27.
*Various nervous system and related disorders including joints (''sandhi-gata-vata'', ''avabahuka'' etc), stroke and their managements are described in Chapter 28, under the caption of ''vata-vyadhi''.
*Chapter 30 ([[Yonivyapat Chikitsa]]) describes miscellaneous matters including the gynecological disorders and children diseases (''kaumarabhritya'').
==References==
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