Vyadhi

The term ‘Vyadhi’ literally means disease or ailment that causes grief or pain to the individual. [SAT-C.1] In Ayurveda, the nomenclature of disease suggests pathogenic factors or the cardinal feature. The classification of diseases is based on their origin, lesion sites, prognosis, factors involved in pathogenesis. Knowledge of vyadhi is essential in healthcare management as well as for the targeted treatment of diseases.

Contributors

Section/Chapter/topic	Nidana / Vyadhi
Authors	Deole Y.S., Anagha S.
Reviewer and Editor	Basisht G.
Affiliations	Charak Samhita Research, Training and Development Centre, I.T.& R.A., Jamnagar, India
Correspondence email	carakasamhita@gmail.com
Publisher	Charak Samhita Research, Training and Development Centre, I.T.R.A., Jamnagar, India
Date of first publication:	August 4, 2021
DOI	10.47468/CSNE.2021.e01.s09.070

Importance

Knowing the origin (karana) of disease is crucial to eradicating it. If the root cause of the disease is treated, it helps to hasten recovery, prevent recurrence and preserve health. The origin of the disease is not limited to endogenous causes. Instead, various extrinsic factors like seasonal variations, an incompatible union of senses with objects, and the metaphysical causes can affect health status. The management of health and disease depends on knowledge of its causes and the factors influencing it. The present article focuses on the classification of disease. It is crucial to prescribing a comprehensive regimen for restoration and preservation of health.

Etymology and derivation

The Sanskrit word vyadhi is formed by the combination of three roots called “vi”, “aa” and “dha--ki” The word means sickness, disorder, disease, ailment, distress.

Synonyms

• Vikara: The condition that causes deviation from the normal physiological state of health of an individual. (SAT-C.8)

• Roga: Literally, it is the opposite of comfort. It suggests abnormal body function. An interruption, cessation, or disorder of functions at the level of psyche, mind, or body. ( SAT-C.9)

• Amaya: The word ‘amaya’ signifies the diseases originating due to disturbances of digestion and accumulation of metabolic toxins (ama). ( SAT-C.3)

• Gada: The term indicates a condition arose from toxins or multiple factors simultaneously.(SAT-C.4)

• Atanka: The term indicated miserable condition causing fear, terror, or distress. (SAT-C.5)

• Yakshma: The term implies diseases characterized by a constellation of symptoms that occur together. (SAT-C.6)

• Jwara: The term implies the ability of a disease to cause anguish to the mind and body. (SAT-C.7)

• Papma: The term signifies disease, originating from physical or mental sins of the individual in a present or past life.(SAT-C.10)

Types or classification

Two-fold classifications

a) As per the abode (adhishtana) [Cha. Sa. Vimana Sthana 6/3]

1) Somatic (sharirika) 2) Psychological (manasika)

b) As per the origin of pathogenesis [Cha. Sa. Vimana Sthana 6/3]

1) Originating from the upper gastrointestinal tract(amashaya samutha)

2) Originating from the lower gastrointestinal tract (pakwashaya samutha)

c) As per the treatment interventions [ Su. Sa. Sutra Sthana 24/3]

1) Curable by medicines and purification procedures (snehadi kriya sadhya)

2) Curable by surgical interventions (shastra sadhya)

d) As per the prognosis [Cha. Sa. Vimana Sthana 6/3]

1) Curable (sadhya) 2) Incurable (sadhya)

e) As per the factors involved in pathogenesis [Cha. Sa. Vimana Sthana 6/11]

1) Independent or primary disease (swatantra vyadhi/anubandhya) having its etiology, symptoms, specific treatment.

2) Dependant or secondary disease (paratantra vyadhi/anubandha) without an independent cause, symptoms, treatment, or manifested due to other diseases.

f) As per the status of nutrition [Cha. Sa. Sutra Sthana 23]

1) Diseases due to overnutrition (santarpanajanya vyadhi)

2) Diseases due to undernutrition (apatarpanajanya vyadhi)

g) As per the severity [Cha. Sa. Vimana Sthana 6/3]

1) Mild (Mrudu vyadhi) 2) Severe (Daruna vyadhi)

Three-fold classifications

a) As per the nature of cause:

1) Endogenous disease (nija vyadhi): Diseases produced by the intrinsic factors like vitiation of dosha

2) Exogenous diseases (agantu vyadhi): Diseases due to external factors like trauma, infections, poisoning etc.

3) Mental disorders (manasa vyadhi)

b) As per the fundamental cause [A. H. Sutra Sthana 12/58]

1) Due to aggravated dosha (Doshaja)

2) Due to evil deeds in the past life (Karmaja)

3) Due to both the above reasons (Doshakarmaja)

c) As per the site of origin or pathways of disease:

1) Shakhagata (bahya roga marga): Those occur in tissues like rakta dhatu, mamsa dhatu , meda dhatu, asthi dhatu,majja dhatu, shukra dhatu and skin (twak)

2) Koshthagata (abhyatara roga marga): Those originate from the gastrointestinal tract and related organs.

3) Marma-asthi-sandhigata (madhyama rogamarga): Those produced in vital organs, bones, and joints.

d) As per the predominant element [Cha. Sa. Nidana Sthana 1 / 4]

1) Agneya: those produced by aggravation of pitta

2) Soumya: those produced by aggravation of kapha

3) Vayavya: those produced by aggravation of vata

Seven-fold classification

a) Diseases due to personified causes (adhyatmika) [Su. Sa. Sutra Sthana 24/5]

1) Genetic/Hereditary disorders (adibalapravrutta vyadhi): These are caused due to defects in the genetic materials of sperm or ovum of the parents. e.g. skin diseases, hemorrhoids, diabetes etc.

These are further divided into two. i.e. maternal (matruja) and paternal (pitruja)

2) Congenital disorders (janmabalapravrutta vyadhi): These are mainly attributed to the errors in the mother's diet and lifestyle during pregnancy. It includes various defects like congenital blindness, deafness etc. These are caused due to either improper nutrition (rasakruta) or psychological factors like ungratified cravings during pregnancy (dauhrudapacharaja).

3) Endogenous disorders (doshabalapravrutta vyadhi): These are caused due to the imbalance of dosha resulting from the errors in diet, activities, and code of conduct.

These are either somatic or psychosomatic.

b) Diseases due to external injuries(adhibhoutika) [Su. Sa. Sutra Sthana 24/6]

4) Traumatic disorders (sanghatabalapravrutta vyadhi): These are caused due to any trauma, either external or internal injuries.

These are broadly divided into two types:

• Injuries caused by weapons or instruments (shastrakruta)

• Injuries caused by the bite of wild animals, poisonous reptiles etc.(vyalakruta)

c) Providential type (adhidaivika) [Su. Sa. Sutra Sthana 24/7] These types of diseases are caused due to factors which are not in human control like seasonal changes, metaphysical causes and natural phenomena.

5) Disorders due to seasonal changes (kalabalapravrutta vyadhi): Those caused by seasonal changes like hot, cold, humidity, dryness, wind, rain etc.

These may be due to the body's adaptive reactions to natural seasonal variations throughout the year (avyapanna ritukruta). Or these are created by sudden or unexpected variations in climatic conditions like cyclones, or other variations. (vyapanna ritukruta)

6) Disorders due to metaphysical causes (daivabalapravrutta vyadhi): Those are engendered by forces beyond human control. The causes are of metaphysical origin i.e. influence of invisible forces of nature.

7) Disorders due to natural phenomena (swabhavabalapravrutta vyadhi): These are caused by natural organic and functional changes in body and mind, such as senility, hunger, and thirst etc.

These are classified into two, as

• Those appearing at the proper/ usual time (kalaja)

• Those appearing at an improper time, i.e. premature or delayed(akalaja)

Diagnostic aspects

In Ayurveda, diagnosis of a disease is mainly based on 5 factors

1) Etiology/causative factors (nidana/hetu)

2) Prodromal symptoms (purvarupa)

3) Signs and symptoms (rupa)

4) Aggravating and relieving factors (upashaya-anupashaya)

5) Pathogenesis (samprapti)

The origin and stepwise progression of diseases in the body are explained with the concept of six stages of diseases (shatkriyakala). [Su. Sa. Sutra Sthana 21]

These are,

1) Stage of accumulation of dosha (sanchaya)

2) Stage of vitiation (prakopa)

3) Stage of spread (prasara)

4) Stage of localization (sthana samshraya)

5) Stage of manifestation (vyakti)

6) Stage of chronicity and complications (bheda)

Contemporary approach

In contemporary views, the disease is a condition marked by subjective complaints, a specific history, clinical signs and symptoms, and laboratory or radiographic findings.

The disease is differentiated from external injury and defined as a particular abnormal condition that negatively affects the structure or function of all or part of an organism. That is not due to any immediate external injury. The most known and used classification of diseases is the World Health Organization's International Classification of Diseases (ICD).

The process of identifying a disease from its signs and symptoms is known as ‘diagnosis.’ A health history, physical examination, and diagnostic tests, such as blood tests, imaging techniques, biopsies etc. may be used to diagnose a medical condition.

In conventional medicine, mainly two principles of treatment of disease are applied. The first is to reduce the effect of the disease and the second is to kill the microbes causing the disease. Symptomatic treatment may help reduce the impact of a disease but may not cure the root cause of the disease. The administration of certain drugs that block the biochemical processes can help kill the microorganism causing the disease. Antibiotics serve the purpose of killing the microorganisms or preventing their multiplication in the body. The additional information on disease provided in this article should be helpful to design a comprehensive management protocol in healthcare and not limited to diseasecare only.

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