Changes

The desires in human life were recognized and the modes to fulfillment were determined. The present chapter describes about three basic pursuits of life; these are to live long, to earn wealth and attainment of happiness in next world. Longevity can be achieved by following healthy lifestyle, desire for earning may be fulfilled by adopting appropriate and rightful means of livelihood, various spiritual acts and good deeds for the society are to be performed to fulfill the third desire to get happiness in after life. The main ''tattva'' of this chapter are the three desires and rest of the ''tattvas'' are mentioned to support for achievement of these desires.  

The desires in human life were recognized and the modes to fulfillment were determined. The present chapter describes about three basic pursuits of life; these are to live long, to earn wealth and attainment of happiness in next world. Longevity can be achieved by following healthy lifestyle, desire for earning may be fulfilled by adopting appropriate and rightful means of livelihood, various spiritual acts and good deeds for the society are to be performed to fulfill the third desire to get happiness in after life. The main ''tattva'' of this chapter are the three desires and rest of the ''tattvas'' are mentioned to support for achievement of these desires.  

To maintain health, triad of "supporting pillars (''upasthambha'') are advised. If the ''upasthambhas'' are properly followed then one is bestowed with good physical strength, the triad of ''balas'' (strength) is mentioned. If someone is exposed to etiolgical factors of disease (''nidana sevana'', disease is likely to occur. these factors are again of three types. Diseases manifest by three routes, to treat a disease competent physician is necessary. Three types of physicians are described. A good physician treats the disease by various therapies, which are of three types. When the body ''doshas'' get vitiated and cause diseases, then, three types of therapies can be done to cure those diseases is explained. In this manner every factor described in this chapter is interrelated with each other.

To maintain health, triad of "supporting pillars (''upasthambha'') are advised. If the ''upasthambhas'' are properly followed then one is bestowed with good physical strength, the triad of ''balas'' (strength) is mentioned. If someone is exposed to etiolgical factors of disease (''nidana sevana'', disease is likely to occur. these factors are again of three types. Diseases manifest by three routes, to treat a disease competent physician is necessary. Three types of physicians are described. A good physician treats the disease by various therapies, which are of three types. When the body ''[[dosha]]s'' get vitiated and cause diseases, then, three types of therapies can be done to cure those diseases is explained. In this manner every factor described in this chapter is interrelated with each other.

=== Importance of Three ===

=== Importance of Three ===

# ''Yoni-doshas'' involved.????

# ''Yoni-doshas'' involved.????

# ''Utthana''- mode of manifestation

# ''Utthana''- mode of manifestation

# ''Atman''-nature of disease (seriousness or acuteness)

# ''[[Atman]]''-nature of disease (seriousness or acuteness)

# ''Adhisthana''-Location in organs of body & mind

# ''Adhisthana''-Location in organs of body & mind

# ''Vedana''-Type of pain  

# ''Vedana''-Type of pain  

=== ''Pratyaksha'' ===

=== ''Pratyaksha'' ===

''Pratyaksha'' or direct perception / observation is the knowledge gained by the union of (coming together) of ''atman'', ''indriya'' (sense organs), ''manas'' (mind) and the ''indriyarthas'' (objects). [Cha.Sa.[[Sutra Sthana]] 11/20]

''Pratyaksha'' or direct perception / observation is the knowledge gained by the union of (coming together) of ''[[atman]]'', ''[[indriya]]'' (sense organs), ''[[manas]]'' (mind) and the ''indriyarthas'' (objects). [Cha.Sa.[[Sutra Sthana]] 11/20]

=== Clinical application ===

=== Clinical application ===

# “Taste” of the mouth of a patient: By interrogation  

# “Taste” of the mouth of a patient: By interrogation  

# Impairment of “taste” of an individual: could be inferred by the behavior of parasites like lice (if instead of getting drawn to a person, they get repelled by it), or if someone attracts flies or ants (implying “sweet taste” emanated by the patient)

# Impairment of “taste” of an individual: could be inferred by the behavior of parasites like lice (if instead of getting drawn to a person, they get repelled by it), or if someone attracts flies or ants (implying “sweet taste” emanated by the patient)

# Bleeding from the body: doubts about the nature of blood can be resolved by giving it to dog and crow. Its intake indicates its purity and rejection indicates that the blood is vitiated by ''pitta dosha'' and the patient is suffering from ''raktapitta''.

# Bleeding from the body: doubts about the nature of blood can be resolved by giving it to dog and crow. Its intake indicates its purity and rejection indicates that the blood is vitiated by ''[[pitta]] [[dosha]]'' and the patient is suffering from ''raktapitta''.

# Similarly other tastes can be inferred.  

# Similarly other tastes can be inferred.  

# Age, liking, adaptation, disease, cause of disease from stage of life, habitat, conduciveness, symptoms, pain respectively.

# Age, liking, adaptation, disease, cause of disease from stage of life, habitat, conduciveness, symptoms, pain respectively.

# Disease in latent phase can be diagnosed by therapies which would alleviate or aggravate the symptoms of disease.

# Disease in latent phase can be diagnosed by therapies which would alleviate or aggravate the symptoms of disease.

# Vitiation of ''doshas'' from the quantity of provocating factors

# Vitiation of ''[[dosha]]s'' from the quantity of provocating factors

# Approaching death from prognostic signs

# Approaching death from prognostic signs

# Prosperity from initiation of useful work

# Prosperity from initiation of useful work

=== ''Yukti'' ===

=== ''Yukti'' ===

''Yukti'', or reasoning [Ch Su 11/25], is the fourth ''pariksha''. The intellect perceives things as an outcome of a combination of various factors by employing ''yukti''. ''Trivarga'' or ''dharma, artha'' and ''kama'' can be achieved by ''yukti''.

''Yukti'', or reasoning [Cha.Sa.[[Sutra Sthana]] 11/25], is the fourth ''pariksha''. The intellect perceives things as an outcome of a combination of various factors by employing ''yukti''. ''Trivarga'' or ''dharma, artha'' and ''kama'' can be achieved by ''yukti''.

Example:  

Example:  

# Harvest–due to combination of water, tilling operation, seeds and season.

# Harvest–due to combination of water, tilling operation, seeds and season.

# By combining of ''panchamahabhuta'' and ''chetana, garbha'' is formed (or conceived).

# By combining of ''[[panchamahabhuta]]'' and ''chetana, [[garbha]]'' is formed (or conceived).

# Treatment is possible by the combination of ''chatushpada''.  

# Treatment is possible by the combination of ''chatushpada''.  

''Yukti'' is especially important in the process of planning the course of treatment of a disease. The knowledge of ''hetu, doshas'' vitiated, ''strotas'' involved, type of ''strotas dushti'', stage of disease manifestation etc. will help the physician to decide the treatment modalities.  

''Yukti'' is especially important in the process of planning the course of treatment of a disease. The knowledge of ''hetu, [[dosha]]s'' vitiated, ''strotas'' involved, type of ''strotas dushti'', stage of disease manifestation etc. will help the physician to decide the treatment modalities.  

The maintenance of healthy life is dependent on the lifestyle followed, hence the factors which are mandatory for sustenance of life are mentioned next.

The maintenance of healthy life is dependent on the lifestyle followed, hence the factors which are mandatory for sustenance of life are mentioned next.

=== Three ''Upasthambhas'' ===

=== Three ''Upasthambhas'' ===

The three ''upasthambhas'' or supporting pillars of body mentioned in this chapter are ''ahara'' (diet), ''swapna'' (sleep) and ''brahmacharya'' (celibacy). As diet is critical for the sustenance of life, it is the first of the three, followed by sleep and ''brahmacharya''.  Importance of a healthy and wholesome diet (in [[Sutra Sthana]] , Chapter 27), various classification of dietary items (in [[Sutra Sthana]], Chapter 25), wholesome and unwholesome diets (in [[Sutra Sthana]], Chapter 25), the quantity of diet to be taken and the significance of a balanced diet (in [[Sutra Sthana]], Chapter 5,) eight factors responsible for digestion of food and ''ahara vidhi vidhana'' (rules for diet described in [[Vimana Sthana]] Chapter 1), ''ahara parinamkara bhavas'' (factors affecting diet digestion mentioned in [[Sharira Sthana]] chapter 6), the dietary regimen according to different seasons (in [[Sutra Sthana]] Chapter 6) and the description of incompatible foods (in [[Sutra Sthana]] chapter 26).

The three ''upasthambhas'' or supporting pillars of body mentioned in this chapter are ''ahara'' (diet), ''swapna'' (sleep) and ''brahmacharya'' (celibacy). As diet is critical for the sustenance of life, it is the first of the three, followed by sleep and ''brahmacharya''.  Importance of a healthy and wholesome diet (in [[Sutra Sthana]] , Chapter 27), various classification of dietary items (in [[Sutra Sthana]], Chapter 25), wholesome and unwholesome diets (in [[Sutra Sthana]], Chapter 25), the quantity of diet to be taken and the significance of a balanced diet (in [[Sutra Sthana]], Chapter 5,) eight factors responsible for digestion of food and ''[[ahara vidhi]] vidhana'' (rules for diet described in [[Vimana Sthana]] Chapter 1), ''ahara parinamkara bhavas'' (factors affecting diet digestion mentioned in [[Sharira Sthana]] chapter 6), the dietary regimen according to different seasons (in [[Sutra Sthana]] Chapter 6) and the description of incompatible foods (in [[Sutra Sthana]] chapter 26).

The physiology of sleep, effects, and indications – contraindications of day sleep, effects of night awakening, methods and measures to induce good sleep, causes of insomnia, classification of sleep etc. are discussed in detail in [[Sutra Sthana]] Chapter 21.   

The physiology of sleep, effects, and indications – contraindications of day sleep, effects of night awakening, methods and measures to induce good sleep, causes of insomnia, classification of sleep etc. are discussed in detail in [[Sutra Sthana]] Chapter 21.   

Semen is considered as one of the factors useful in promoting strength and self- control, increasing pleasure, as well as increasing awareness in celibates of the importance of abstinence (from sex), leading to salvation. [Cha.Sa.[[Sutra Sthana]] 30/15] ''Shukra kshaya'' (depletion of ''shukra'') is considered as a causative factor for ''pratiloma kshaya''(emaciation), which in turn may cause ''rajayakshama'', hence it has to be preserved. [Cha. Sa.[[Nidana Sthana]] 6/8]

Semen is considered as one of the factors useful in promoting strength and self- control, increasing pleasure, as well as increasing awareness in celibates of the importance of abstinence (from sex), leading to salvation. [Cha.Sa.[[Sutra Sthana]] 30/15] ''[[Shukra]] kshaya'' (depletion of ''[[shukra]]'') is considered as a causative factor for ''pratiloma kshaya''(emaciation), which in turn may cause ''rajayakshama'', hence it has to be preserved. [Cha. Sa.[[Nidana Sthana]] 6/8]

When the appropriate use of these ''upasthambhas'' is practiced by an individual, he will be bestowed with excellence of strength. Hence, the next topic discussed is about ''bala'' or strength.

When the appropriate use of these ''upasthambhas'' is practiced by an individual, he will be bestowed with excellence of strength. Hence, the next topic discussed is about ''bala'' or strength.

Strength is of three types i.e. ''sahaja'' (constitutional), ''kalaja'' (temporal) and ''yuktikrita'' (acquired):

Strength is of three types i.e. ''sahaja'' (constitutional), ''kalaja'' (temporal) and ''yuktikrita'' (acquired):

   

   

# '''''Sahaja bala''''': It is an inherent characteristic property of an individual and is present since birth. It can be attributed to an equilibrium state of ''doshas'' and does not require any extraneous factor for its improvement.

# '''''Sahaja bala''''': It is an inherent characteristic property of an individual and is present since birth. It can be attributed to an equilibrium state of ''[[dosha]]s'' and does not require any extraneous factor for its improvement.

# '''''Kalaja bala''''': It is dependent on seasonal variations and age of the person. Weakness prevails in ''adanakala'' (depleting strength-summer season), gaining of strength progressively is observed in ''visarga kala'' (increasing strength-winter season) and in middle of these two seasons, strength is moderate and this form of ''bala'' peaks during one’s middle age.

# '''''Kalaja bala''''': It is dependent on seasonal variations and age of the person. Weakness prevails in ''adanakala'' (depleting strength-summer season), gaining of strength progressively is observed in ''visarga kala'' (increasing strength-winter season) and in middle of these two seasons, strength is moderate and this form of ''bala'' peaks during one’s middle age.

# '''''Yuktikrita''''': Acquired strength or immunity is attained by healthy practices related to diet like ghee, meat, milk etc. and activities such as proper rest, exercise etc. It can also be improved by the use of rejuvenation therapies.   

# '''''Yuktikrita''''': Acquired strength or immunity is attained by healthy practices related to diet like ghee, meat, milk etc. and activities such as proper rest, exercise etc. It can also be improved by the use of rejuvenation therapies.   

In Ayurvedic texts word ''bala'' is used as a synonym of ''ojas'' and also for immunity (''vyadhikshamatava''). Charak has considered normal ''kapha'' as ''bala''. ''Sahaja bala'' can be considered as innate immunity while ''yuktikrita bala'' can be considered as acquired immunity that can be achieved by various methods like good quality diet, exercise, vaccination etc.

In Ayurvedic texts word ''bala'' is used as a synonym of ''[[ojas]]'' and also for immunity (''vyadhikshamatava''). Charak has considered normal ''[[kapha]]'' as ''bala''. ''Sahaja bala'' can be considered as innate immunity while ''yuktikrita bala'' can be considered as acquired immunity that can be achieved by various methods like good quality diet, exercise, vaccination etc.

The assessment of ''sharirik bala'' (physical strength) is done by ''anumana'' (inference) by analyzing the capacity of an individual to do physical exercise (or his endurance). [Cha.Sa.[[Vimana Sthana]] 4/8]

The assessment of ''sharirik bala'' (physical strength) is done by ''anumana'' (inference) by analyzing the capacity of an individual to do physical exercise (or his endurance). [Cha.Sa.[[Vimana Sthana]] 4/8]

=== Three ''ayatanas'' (causes of diseases) ===

=== Three ''ayatanas'' (causes of diseases) ===

Three causes of ''nija'' (bodily) diseases are- ''asatmya indriyartha samyoga'' (''atiyoga, ayoga, mithyayoga'') (unwholesome contact of sense organs with objects), ''pragnyaparadha'' (intellectual blasphemy) and ''parinama'' (consequence). The three causes of all the somatic and psychological diseases are ''mithyayoga, ayoga'' and ''atiyoga'' of ''kala'' (time), ''buddhi'' (intellect) and ''indriyartha'' (objects of senses). [Cha.Sa.[[Sutra Sthana]] 1/54]  

Three causes of ''nija'' (bodily) diseases are- ''asatmya indriyartha samyoga'' (''atiyoga, ayoga, mithyayoga'') (unwholesome contact of sense organs with objects), ''[[prajnaparadha]]'' (intellectual blasphemy) and ''parinama'' (consequence). The three causes of all the somatic and psychological diseases are ''mithyayoga, ayoga'' and ''atiyoga'' of ''kala'' (time), ''[[buddhi]]'' (intellect) and ''indriyartha'' (objects of senses). [Cha.Sa.[[Sutra Sthana]] 1/54]  

Desires are the root cause of all the miseries of life, and therefore, elimination of desires leads to eradication of all miseries. Just as a silkworm spins its thread around itself causing its own death, similarly, an ignorant person, bound to worldly miseries of his own creation, remains unhappy all his life. (Cha.Sa.[[Sharira Sthana]] 1/95] Impairment of intellect (''dhi"), patience ("dhruti''), memory (''smriti'') and variations of natural seasons, advent of actions and unwholesome contact with the objects of senses are the causative factors of miseries (diseases). [Cha.Sa.[[Sharira Sthana]] 1/98] The details may be referred to in [[Sharira Sthana]] chapter 1.

Desires are the root cause of all the miseries of life, and therefore, elimination of desires leads to eradication of all miseries. Just as a silkworm spins its thread around itself causing its own death, similarly, an ignorant person, bound to worldly miseries of his own creation, remains unhappy all his life. (Cha.Sa.[[Sharira Sthana]] 1/95] Impairment of intellect (''dhi"), patience ("dhruti''), memory (''smriti'') and variations of natural seasons, advent of actions and unwholesome contact with the objects of senses are the causative factors of miseries (diseases). [Cha.Sa.[[Sharira Sthana]] 1/98] The details may be referred to in [[Sharira Sthana]] chapter 1.

==== ''Kalaja Vyadhi'' ====

==== ''Kalaja Vyadhi'' ====

Ailment caused by the variations of time or season. For example: diseases caused by the vitiation of ''vata dosha'' manifest during the final stage of digestion of food (afternoon and post midnight), and diseases caused by vitiated ''kapha dosha'' manifest during time of intake of food, forenoon and pre-mid night and those caused by the vitiation of ''pitta dosha'' manifest during initial stage of digestion, noon and midnight. The vitiation of three ''doshas'' during the three different stages of life are responsible for manifestation of diseases- ''kaphaja'' diseases during young age, ''pittaja'' diseases during the middle age and ''vataja'' diseases during old age. [Cha.Sa.[[Sharira Sthana]] 1/111-112]

Ailment caused by the variations of time or season. For example: diseases caused by the vitiation of ''[[vata dosha]]'' manifest during the final stage of digestion of food (afternoon and post midnight), and diseases caused by vitiated ''[[kapha]] [[dosha]]'' manifest during time of intake of food, forenoon and pre-mid night and those caused by the vitiation of ''[[pitta]] [[dosha]]'' manifest during initial stage of digestion, noon and midnight. The vitiation of three ''[[dosha]]s'' during the three different stages of life are responsible for manifestation of diseases- ''kaphaja'' diseases during young age, ''pittaja'' diseases during the middle age and ''vataja'' diseases during old age. [Cha.Sa.[[Sharira Sthana]] 1/111-112]

==== ''Atiyoga'' or ''mithyayoga'' ====

==== ''Atiyoga'' or ''mithyayoga'' ====

=== Three classes of ''roga'' (diseases) ===

=== Three classes of ''roga'' (diseases) ===

Classification of diseases helps in the process of diagnosis and the subsequent courses of treatment selected. In this particular chapter, diseases are classified by its underlying cause: ''nija'' (endogenous cause), ''agantuja'' (exogenous cause), and ''manas'' (psychological). ''Sharira'' (body) and ''manas'' (mind) are the ''ashraya'' (refuge, or home) of the diseases. [Cha.Sa.[[Sutra Sthana]] 1/55]   

Classification of diseases helps in the process of diagnosis and the subsequent courses of treatment selected. In this particular chapter, diseases are classified by its underlying cause: ''nija'' (endogenous cause), ''agantuja'' (exogenous cause), and ''[[manas]]'' (psychological). ''Sharira'' (body) and ''[[manas]]'' (mind) are the ''ashraya'' (refuge, or home) of the diseases. [Cha.Sa.[[Sutra Sthana]] 1/55]   

Apart from this classification, diseases are classified in various other ways. For instance, in the preceding chapter, diseases have been classified broadly as ''sadhya'' (curable) and ''asadhya'' (incurable). The sadhya diseases have been further classified into ''sukha sadhya'' (easily curable) and ''kriccha sadhya'' (curable with difficulty), while the ''asadhya'' have been classified into ''yapya'' (palliable) and ''anupakrama'' (non-treatable). ''Sadhya vyadhis'' have also been classified into ''alpa upaya sadhya'' (curable with mild treatment), ''madhya upaya sadhya'' (curable with moderate treatment) and ''utkristta upaya sadhya'' (curable with aggressive treatment modalities).

Apart from this classification, diseases are classified in various other ways. For instance, in the preceding chapter, diseases have been classified broadly as ''sadhya'' (curable) and ''asadhya'' (incurable). The sadhya diseases have been further classified into ''sukha sadhya'' (easily curable) and ''kriccha sadhya'' (curable with difficulty), while the ''asadhya'' have been classified into ''yapya'' (palliable) and ''anupakrama'' (non-treatable). ''Sadhya vyadhis'' have also been classified into ''alpa upaya sadhya'' (curable with mild treatment), ''madhya upaya sadhya'' (curable with moderate treatment) and ''utkristta upaya sadhya'' (curable with aggressive treatment modalities).

The [[Charak Samhita]] also provides classifications and counts of diseases by the organs afflicted or their causative factors. For example, in [[Sutra Sthana]] Chapter 19 (''Astodariyadhyaya''), a count of all disease systems has been provided (that were known at that time), grouped by organs afflicted. These 48 diseases have been grouped into 8 types of ''udara rogas'', 8 types of ''mutraghata'', 7 ''kushthas'', 7 ''pidikas'', 6 ''atisara'', 5 ''gulma'', 5 ''kasa'', 5 ''swasa'', etc. Similarly, in [[Sutra Sthana]] Chapter 20, 4 types of diseases are mentioned according to the causative factor- ''agantuja'' (exogenous), ''vataja, pittaja'' and ''kaphaja''. ''Nanatmaja vikaras'' of ''vata'' are of 80 types; those of ''pitta'' are of 40 types; and ''kapha'' are of 20 types.   

The [[Charak Samhita]] also provides classifications and counts of diseases by the organs afflicted or their causative factors. For example, in [[Sutra Sthana]] Chapter 19 (''Astodariyadhyaya''), a count of all disease systems has been provided (that were known at that time), grouped by organs afflicted. These 48 diseases have been grouped into 8 types of ''udara rogas'', 8 types of ''mutraghata'', 7 ''kushthas'', 7 ''pidikas'', 6 ''atisara'', 5 ''gulma'', 5 ''kasa'', 5 ''swasa'', etc. Similarly, in [[Sutra Sthana]] Chapter 20, 4 types of diseases are mentioned according to the causative factor- ''agantuja'' (exogenous), ''vataja, pittaja'' and ''kaphaja''. ''Nanatmaja vikaras'' of ''[[vata]]'' are of 80 types; those of ''[[pitta]]'' are of 40 types; and ''[[kapha]]'' are of 20 types.   

In [[Vimana Sthana]] Chapter 6, ''Dasharoganikadhyaya'', diseases are classified by their ''prabhava'' (effect) into 10 types, by curability into two types (''sadhya'' (curable) and ''asadhya'' (incurable)), by their ''bala'' (strength) of ''vyadhi'' (disease) into two types (''mridu'' (mild) and ''daruna'' (severe)), by their ''adhisthana'' (location) into two types (''manasika'' (psychic) and ''sharirik'' (somatic)), according to cause into ''nija'' (endogenous) and  ''agantuja'' ( exogenous), according to ''ashaya bheda'' (organ of origin) into ''amashaya samuttha'' (originating from stomach) and ''pakwasaya samuttha'' (originating from large intestines).  

In [[Vimana Sthana]] Chapter 6, ''Dasharoganikadhyaya'', diseases are classified by their ''prabhava'' (effect) into 10 types, by curability into two types (''sadhya'' (curable) and ''asadhya'' (incurable)), by their ''bala'' (strength) of ''vyadhi'' (disease) into two types (''mridu'' (mild) and ''daruna'' (severe)), by their ''adhisthana'' (location) into two types (''manasika'' (psychic) and ''sharirik'' (somatic)), according to cause into ''nija'' (endogenous) and  ''agantuja'' ( exogenous), according to ''ashaya bheda'' (organ of origin) into ''amashaya samuttha'' (originating from stomach) and ''pakwasaya samuttha'' (originating from large intestines).  

=== Three rogamarga (pathways of disease manifestation) ===

=== Three rogamarga (pathways of disease manifestation) ===

In the process of ''sthana samshraya doshas'' after circulating all over the body, get accumulated in ''dushyas'' in particular ''strotas'', next step is ''dosha- dushya sammurchhana'', ''doshas'' vitiate the ''dushyas'' and first produce premonitory symptoms. The manifestation of symptoms of disease follows a route depending upon the movement of vitiated ''doshas'' inside the body and the involvement of ''strotas''. [[Ayurveda]] considers three ''rogamargas'' or ''rogayatana''/ routes for manifestation of diseases - ''shakha'' (''bahya rogamarga'': ''twachha'' and ''raktadi dhatus'' - periphery), ''marma asthisandhi'' (''madhyam rogamarga'': Vital organs, bones, joints & ligaments-tendons), ''kostha'' (''abhyantara rogamarga'': Gastrointestinal tract and central part of body). The diseases manifesting in particular ''rogamarga'' is also described.  

In the process of ''sthana samshraya [[dosha]]s'' after circulating all over the body, get accumulated in ''[[dushya]]s'' in particular ''strotas'', next step is ''[[dosha]]- [[dushya]] sammurchhana'', ''[[dosha]]s'' vitiate the ''[[dushya]]s'' and first produce premonitory symptoms. The manifestation of symptoms of disease follows a route depending upon the movement of vitiated ''[[dosha]]s'' inside the body and the involvement of ''strotas''. [[Ayurveda]] considers three ''rogamargas'' or ''rogayatana''/ routes for manifestation of diseases - ''shakha'' (''bahya rogamarga'': ''twachha'' and ''raktadi dhatus'' - periphery), ''marma asthisandhi'' (''madhyam rogamarga'': Vital organs, bones, joints & ligaments-tendons), ''kostha'' (''abhyantara rogamarga'': Gastrointestinal tract and central part of body). The diseases manifesting in particular ''rogamarga'' is also described.  

Charkapani has commented that three ''rogamarga'' include ''marma asthi sandhi'' as one route, ''shakha'' nomenculature is given for the practical purpose, as the ''dhatus'' here are like the branches of tree. ''Twachha'' denotes here the ''rasa dhatu'' which is present in ''twachha''(skin), directly it is not stated as ''rasa'', as it is different from the ''rasa dhatu'' present in ''hridaya'' (heart). The vitiation of ''rasa'' residing in ''hridaya'' is considered in ''kostha'', also the vitiated ''rakta dhatu'' which is present in ''yakrita'' (liver) and ''pleeha'' (spleen). ''Ama sthana – amashaya'' (stomach), ''agni sthana'' (site of ''agni''- pancreas), site of digested food –''pakwashaya'' (terminal ileum and large intestine), ''mutrashaya'' (urinary bladder), ''rudhir sthana'' (''yakrita''-liver, ''pleeha''- spleen), ''hridaya'' (heart), ''unduka'' (caecum), ''phuphhupus'' (lungs) are considered as part of ''kostha'' (Su.Chi.2). ''Asthi sandhi'' stands for the joints and the tendons and ligaments. The description of ''rogamarga'' helps in knowing the prognosis of diseases. [Chakrapani on Cha.Sa.[[Sutra Sthana]] 11/48]  

Charkapani has commented that three ''rogamarga'' include ''marma asthi sandhi'' as one route, ''shakha'' nomenculature is given for the practical purpose, as the ''[[dhatu]]s'' here are like the branches of tree. ''Twachha'' denotes here the ''[[rasa dhatu]]'' which is present in ''twachha''(skin), directly it is not stated as ''rasa'', as it is different from the ''[[rasa dhatu]]'' present in ''hridaya'' (heart). The vitiation of ''rasa'' residing in ''hridaya'' is considered in ''kostha'', also the vitiated ''[[rakta dhatu]]'' which is present in ''yakrita'' (liver) and ''pleeha'' (spleen). ''Ama sthana – amashaya'' (stomach), ''agni sthana'' (site of ''agni''- pancreas), site of digested food –''pakwashaya'' (terminal ileum and large intestine), ''mutrashaya'' (urinary bladder), ''rudhir sthana'' (''yakrita''-liver, ''pleeha''- spleen), ''hridaya'' (heart), ''unduka'' (caecum), ''phuphhupus'' (lungs) are considered as part of ''kostha'' (Su.Chi.2). ''Asthi sandhi'' stands for the joints and the tendons and ligaments. The description of ''rogamarga'' helps in knowing the prognosis of diseases. [Chakrapani on Cha.Sa.[[Sutra Sthana]] 11/48]  

[[Sutra Sthana]] Chapter 28 has explained the causes responsible for the movement of ''doshas'' from ''kostha'' to ''shakha''. Due to strenuous exercise, hyperfunctioning of ''agni'' (digestive power), non-observance of wholesome regimen and the pressure of vitiated ''vata'' ''dosha'' causes movement of ''doshas'' from ''kostha'' to ''shakhas'', they remain there till further aggravation. If already in stage of aggravation, then only they produce disease. [Cha.Sa.[[Sutra Sthana]] 28/31-32] The factors responsible for the movement of ''doshas'' from ''shakha'' to ''kostha'' are also mentioned, aggravation of ''doshas'', increase in their fluidity, ''paka'' (suppuration), by the removal of the obstruction at the entrance of the channels and reduced pressure of ''vata dosha''. This knowledge helps in planning the treatment for the vitiated ''doshas'' accumulated in particular ''rogamarga''.

[[Sutra Sthana]] Chapter 28 has explained the causes responsible for the movement of ''[[dosha]]s'' from ''kostha'' to ''shakha''. Due to strenuous exercise, hyperfunctioning of ''agni'' (digestive power), non-observance of wholesome regimen and the pressure of vitiated ''[[vata]]'' ''[[dosha]]'' causes movement of ''[[dosha]]s'' from ''kostha'' to ''shakhas'', they remain there till further aggravation. If already in stage of aggravation, then only they produce disease. [Cha.Sa.[[Sutra Sthana]] 28/31-32] The factors responsible for the movement of ''[[dosha]]s'' from ''shakha'' to ''kostha'' are also mentioned, aggravation of ''[[dosha]]s'', increase in their fluidity, ''paka'' (suppuration), by the removal of the obstruction at the entrance of the channels and reduced pressure of ''[[vata dosha]]''. This knowledge helps in planning the treatment for the vitiated ''[[dosha]]s'' accumulated in particular ''rogamarga''.

In contemporary medical science the symptoms of the diseases are mentioned according to involvement of the systems. For eg: diseases produced in respiratory tract are bronchitis, pneumonia, bronchiectasis, bronchial asthma etc. the presenting features of which are cough, expectoration, chest pain, dyspnoea etc.

In contemporary medical science the symptoms of the diseases are mentioned according to involvement of the systems. For eg: diseases produced in respiratory tract are bronchitis, pneumonia, bronchiectasis, bronchial asthma etc. the presenting features of which are cough, expectoration, chest pain, dyspnoea etc.

The physician with good memory, having adequate knowledge of ''hetu'' (causes of disease), proper reasoning, self control and having presence of mind by combination of various drugs can practice medicine. In [[Sutra Sthana]] Chapter 9, [[Khuddakachatushpada Adhyaya]], four aspects of therapeutics- physician, medicament, attendant and the patient are described. The physician occupies the most important place; the qualities of physician are excellence in medical knowledge, having extensive practical experience, expertise and purity. The physician engaged in acquiring the knowledge of medical science, understanding its practical interpretation, implementation in clinical practice and the appropriate knowledge of therapies is often termed as''Pranabhisara Vaidya'' or a life saviour physician. The physician who possesses six qualities – knowledge, critical approach, insight to other sciences, good memory, promptness and perseverance can never become unsuccessful in treatment. The one with knowledge, intellect, concentration, practical experience, constant practice of treatment modalities, success in treatment and has practiced with experienced teachers deserves to be called as ‘good physician’. The physician should be friendly, sympathetic towards patients, show concern towards patients who can be cured and should have detachment towards those who are heading death.  

The physician with good memory, having adequate knowledge of ''hetu'' (causes of disease), proper reasoning, self control and having presence of mind by combination of various drugs can practice medicine. In [[Sutra Sthana]] Chapter 9, [[Khuddakachatushpada Adhyaya]], four aspects of therapeutics- physician, medicament, attendant and the patient are described. The physician occupies the most important place; the qualities of physician are excellence in medical knowledge, having extensive practical experience, expertise and purity. The physician engaged in acquiring the knowledge of medical science, understanding its practical interpretation, implementation in clinical practice and the appropriate knowledge of therapies is often termed as''Pranabhisara Vaidya'' or a life saviour physician. The physician who possesses six qualities – knowledge, critical approach, insight to other sciences, good memory, promptness and perseverance can never become unsuccessful in treatment. The one with knowledge, intellect, concentration, practical experience, constant practice of treatment modalities, success in treatment and has practiced with experienced teachers deserves to be called as ‘good physician’. The physician should be friendly, sympathetic towards patients, show concern towards patients who can be cured and should have detachment towards those who are heading death.  

''Dasha pranayatana'' or the ten important resorts of life are two temples, three vital organs (head, heart and bladder), throat, blood, semen, ''ojas'' and rectum. The physician who has knowledge of these resorts, senses, knowledge of science similar to  

''Dasha pranayatana'' or the ten important resorts of life are two temples, three vital organs (head, heart and bladder), throat, blood, semen, ''[[ojas]]'' and rectum. The physician who has knowledge of these resorts, senses, knowledge of science similar to  

[[Ayurveda]] (all medical fields), reason of consciousness- soul, causes of diseases and recovery from diseases is known as “Saviour of life”. Those who are born in noble families, who have deep knowledge of science, who are skillful in preparing medicines, who have vast practical experience of treating patients medically and surgically, who are hygienic, self controlled, well equipped, sense organs functioning normally, well acquainted with the symptoms of disease and the ''prakriti'' of patient and having the knowledge of the etiological factors of diseases are the saviors of life of patients. Two types of physicians are described by Charak in [[Sutra Sthana]] Chapter 29 - ''pranabhisara vaidya'' (savior of life) and ''rogabhisara vaidya'' (bad physician/votaries of diseases), the qualities of these may be referred to [[Sutra Sthana]] chapter 30, “pallavaghrahita vidya” the physicians with superficial knowledge and their qualities are described (verse 72- 77).  

[[Ayurveda]] (all medical fields), reason of consciousness- soul, causes of diseases and recovery from diseases is known as “Saviour of life”. Those who are born in noble families, who have deep knowledge of science, who are skillful in preparing medicines, who have vast practical experience of treating patients medically and surgically, who are hygienic, self controlled, well equipped, sense organs functioning normally, well acquainted with the symptoms of disease and the ''[[Prakriti]]'' of patient and having the knowledge of the etiological factors of diseases are the saviors of life of patients. Two types of physicians are described by Charak in [[Sutra Sthana]] Chapter 29 - ''pranabhisara vaidya'' (savior of life) and ''rogabhisara vaidya'' (bad physician/votaries of diseases), the qualities of these may be referred to [[Sutra Sthana]] chapter 30, “pallavaghrahita vidya” the physicians with superficial knowledge and their qualities are described (verse 72- 77).  

In present context the utility of this is for selecting doctor for treatment, the qualification of the physician, validity of his medical degree and medical registration, clinical and surgical skills of the physician and the surgeon to whom approaching for treatment. If these things are not checked and the person who is doing treatment is not well qualified, then there is fear of losing money without getting cured and also of losing life.

In present context the utility of this is for selecting doctor for treatment, the qualification of the physician, validity of his medical degree and medical registration, clinical and surgical skills of the physician and the surgeon to whom approaching for treatment. If these things are not checked and the person who is doing treatment is not well qualified, then there is fear of losing money without getting cured and also of losing life.

==== ''Yuktivyapasharaya'' <ref>JayadevVidya Alankara, Charak. Sutra Sthana, Cha.11 Tistraishaniya Adhyaya ver.54. In: JayadevVidya Alankara, Editor. Charak Samhita.9th ed. Delhi: Motilal Banarasidas;1975.</ref> ====

==== ''Yuktivyapasharaya'' <ref>JayadevVidya Alankara, Charak. Sutra Sthana, Cha.11 Tistraishaniya Adhyaya ver.54. In: JayadevVidya Alankara, Editor. Charak Samhita.9th ed. Delhi: Motilal Banarasidas;1975.</ref> ====

This is the therapy done by the planned use of drugs, foods and regimen for the treatment of diseases caused by vitiation of bodily ''doshas''. This is widely practiced and is further classified into three types: ''Antahaparimarjana'' (internal purification), ''Bahirparimarjana'' (external purification) and ''Shastrapranidhana'' (surgical therapy). ''Antahaparimarjana'' is administered for the diseases of ''kostha'' also for the diseases of ''shakha'' to losen the vitiated ''doshas'' from ''shakha'' and bring them into ''kostha'', internal medications are prescribed oral drugs, ''vamana, virechana, basti, uttara basti, shirovirechana'' etc. ''Bahirparimarjana'' is the treatment for the diseases of ''shakha'', also ''bahaya snehana''- ''swedana'' or ''purvakarma'' is done for loosening the vitiated ''doshas'' from the ''shakhas'' and bring them into ''kostha'' for elimination. It is also done for skin disorders application of ''snehana, swedana, lepa,'' ointment, dusting powders and unctions etc. details of various formulations for skin disorders are well discussed in [[Sutra Sthana]], Chapter 3 ([[Aragvadhiya Adhyaya]]). ''Shastrapranidhana'', even though not mentioned in detail in Charak, is the treatment modality for various diseases not cured by medicinal treatment, for the diseases of exogenous factors like trauma, fractures also for diseases like ''arsha, arbuda, granthi'' etc.

This is the therapy done by the planned use of drugs, foods and regimen for the treatment of diseases caused by vitiation of bodily ''[[dosha]]s''. This is widely practiced and is further classified into three types: ''Antahaparimarjana'' (internal purification), ''Bahirparimarjana'' (external purification) and ''Shastrapranidhana'' (surgical therapy). ''Antahaparimarjana'' is administered for the diseases of ''kostha'' also for the diseases of ''shakha'' to losen the vitiated ''[[dosha]]s'' from ''shakha'' and bring them into ''kostha'', internal medications are prescribed oral drugs, ''[[vamana]], [[virechana]], [[basti]], uttara basti, shirovirechana'' etc. ''Bahirparimarjana'' is the treatment for the diseases of ''shakha'', also ''bahaya snehana''- ''[[swedana]]'' or ''purvakarma'' is done for loosening the vitiated ''[[dosha]]s'' from the ''shakhas'' and bring them into ''kostha'' for elimination. It is also done for skin disorders application of ''[[snehana]], [[swedana]], lepa,'' ointment, dusting powders and unctions etc. details of various formulations for skin disorders are well discussed in [[Sutra Sthana]], Chapter 3 ([[Aragvadhiya Adhyaya]]). ''Shastrapranidhana'', even though not mentioned in detail in Charak, is the treatment modality for various diseases not cured by medicinal treatment, for the diseases of exogenous factors like trauma, fractures also for diseases like ''arsha, arbuda, granthi'' etc.

The various causes of the diseases are reasoned out and suitable means and methods are designed to cure, based on fundamental principles of  [[Ayurveda]] viz. ''Pancha mahabhuta, tridosha, samanya visesha'' etc. <ref name=ref23>A. R. V. Murthy and R. H. Singh, The concept of psychotherapy in ayurveda with special reference to satvavajaya, ancient science of life, vol no. Vi no. 4 april 1987, pages 255 - 261</ref>The path of pathogenesis is broken by the administration of appropriate medicines and by advising suitable diets and regimens. These methods include both internal and external application of medication.  

The various causes of the diseases are reasoned out and suitable means and methods are designed to cure, based on fundamental principles of  [[Ayurveda]] viz. ''[[Pancha mahabhuta]], tri[[dosha]], samanya visesha'' etc. <ref name=ref23>A. R. V. Murthy and R. H. Singh, The concept of psychotherapy in ayurveda with special reference to satvavajaya, ancient science of life, vol no. Vi no. 4 april 1987, pages 255 - 261</ref>The path of pathogenesis is broken by the administration of appropriate medicines and by advising suitable diets and regimens. These methods include both internal and external application of medication.  

In internal treatment category have two types of procedures viz., ''samsodhana'' and ''samsamana'':  

In internal treatment category have two types of procedures viz., ''samsodhana'' and ''samsamana'':  

# ''Samsamana'': These  procedures include internal medication to pacify the diseases.

# ''Samsamana'': These  procedures include internal medication to pacify the diseases.

In [[Sutra Sthana]] Chapter 22, six types of therapies are mentioned viz ''langhana'' (to reduce), ''brimhana'' (to nourish), ''rukshana'' (to dry), ''snehana'' (to oleate), ''swedana'' (to fomentate) and ''sthambhana'' (astringent).

In [[Sutra Sthana]] Chapter 22, six types of therapies are mentioned viz ''[[langhana]]'' (to reduce), ''[[brimhana]]'' (to nourish), ''[[rukshana]]'' (to dry), ''[[snehana]]'' (to oleate), ''[[swedana]]'' (to fomentate) and ''[[sthambhana]]'' (astringent).

==== ''Sattvavajaya'' ====  

==== ''Sattvavajaya'' ====  

==== Dimensions of ''Sattvavajaya'' <ref>J.S. Tripathi, dimensions of sattvavajaya chikitsa (ayurvedic psychotherapy) and their clinical applications, Annals Ayurvedic Med. 2012: 1 (1 & 2) 31-38 </ref>====

==== Dimensions of ''Sattvavajaya'' <ref>J.S. Tripathi, dimensions of sattvavajaya chikitsa (ayurvedic psychotherapy) and their clinical applications, Annals Ayurvedic Med. 2012: 1 (1 & 2) 31-38 </ref>====

# '''''Trivarga anveksana''''': The therapy of mental disorders is done by following the ''trivargas'' i.e. the ''dharma, artha'' and ''kama'' (virtue, wealth and pleasure). The person with mental aliment should be made to remain in touch with the experts of treating mental illnesses and to know about ''atma'' (self), ''desha'' (place), ''kala'' (time), ''shakti'' (strength) and capacity properly.  

# '''''Trivarga anveksana''''': The therapy of mental disorders is done by following the ''trivargas'' i.e. the ''dharma, artha'' and ''kama'' (virtue, wealth and pleasure). The person with mental aliment should be made to remain in touch with the experts of treating mental illnesses and to know about ''[[atma]]'' (self), ''desha'' (place), ''[[kala]]'' (time), ''shakti'' (strength) and capacity properly.  

# Psycho-supportive Techniques: Charak has described several psychological supportive techniques, under the category of ''sattvavajaya chikitsa''. He advocates ''aswasana'' (reassurance and explanation), ''suhritvakya'' (guidance and suggestion), ''dharmartha vakya'' (education of individual and family), ''ishta vinashana'' (verbal shock), ''adbhuta darshana'' (showing extra ordinary things), ''tadana'' (physical shock), ''trasana'' (mental shock), ''santwana'' (rehabilitation,reassurance, or consolation), which are also known as psychological intervention.  

# Psycho-supportive Techniques: Charak has described several psychological supportive techniques, under the category of ''sattvavajaya chikitsa''. He advocates ''aswasana'' (reassurance and explanation), ''suhritvakya'' (guidance and suggestion), ''dharmartha vakya'' (education of individual and family), ''ishta vinashana'' (verbal shock), ''adbhuta darshana'' (showing extra ordinary things), ''tadana'' (physical shock), ''trasana'' (mental shock), ''santwana'' (rehabilitation,reassurance, or consolation), which are also known as psychological intervention.  

# Promotion of ''jnayana'' (cognition): The methods for improving ''jnayana'' (cognition) and its components like ''dhi'' (intellect), ''dhrti'' (controlling power) and ''smrti'' (recollection/ memory) are part of ''sattavavajaya chikitsa''. Some important techniques / steps in promoting ''jnana'' are- recognizing and correcting negative automatic thoughts, teaching reattribution techniques, increasing objectivity in perspectives, keeping spiritual  understanding of life, identifying and testing maladaptive assumption, and decentering and it may also include such behavioural techniques as activity scheduling, homework assignments, graded task assignment, behavioural rehearsal, role playing and diversion techniques and teaching problem solving skills

# Promotion of ''jnayana'' (cognition): The methods for improving ''jnayana'' (cognition) and its components like ''dhi'' (intellect), ''dhrti'' (controlling power) and ''[[smrti]]'' (recollection/ memory) are part of ''sattavavajaya chikitsa''. Some important techniques / steps in promoting ''jnana'' are- recognizing and correcting negative automatic thoughts, teaching reattribution techniques, increasing objectivity in perspectives, keeping spiritual  understanding of life, identifying and testing maladaptive assumption, and decentering and it may also include such behavioural techniques as activity scheduling, homework assignments, graded task assignment, behavioural rehearsal, role playing and diversion techniques and teaching problem solving skills

# Promotion of ''vijnayana''- It is mentioned in the scriptures and texts about the activities of the physical world, social and personal conducts, knowledge of the activities and interrelationship of body and mind, dietary rules, rules to be followed in disease state. The promotion of ''vijnana'' in context to ''sattvavajya'' includes the development and uses of behavioral techniques for treating psychosomatic and psychiatric disease. This relieves the patient's apprehensions and calms his disturbed mind.

# Promotion of ''vijnayana''- It is mentioned in the scriptures and texts about the activities of the physical world, social and personal conducts, knowledge of the activities and interrelationship of body and mind, dietary rules, rules to be followed in disease state. The promotion of ''vijnana'' in context to ''sattvavajya'' includes the development and uses of behavioral techniques for treating psychosomatic and psychiatric disease. This relieves the patient's apprehensions and calms his disturbed mind.

# Promotion of ''samadhi'' like state (yogic psychotherapy): ''Samadhi'' is the ultimate stage in the practice of ''yoga'', which is a state of unwavering concentration. Promoting ''samadhi'' in a diseased state is trying to minimize the mental fluctuations, reduce the waverings ultimately leading to focused and tranquilized mind. It is achieved through the application of various yogic techniques.   

# Promotion of ''samadhi'' like state (yogic psychotherapy): ''Samadhi'' is the ultimate stage in the practice of ''yoga'', which is a state of unwavering concentration. Promoting ''samadhi'' in a diseased state is trying to minimize the mental fluctuations, reduce the waverings ultimately leading to focused and tranquilized mind. It is achieved through the application of various yogic techniques.   

# ''Pratyatma chikitsa'' (individual psychotherapy): Each and every individual is having different body constitution (''deha prakriti''), mental constitution (''manas prakriti''), ''desha'' (habitat), ''kala'' (time), ''vaya'' (age), ''pratyatma jeevana vritta'' (Individual life situations). Therefore, every individual patient should be dealt as a separate individual and treatment decisions should be taken after considering all the above factors. Term ''purusampurusam viksaya'' (Ch. Su. 1/124) is used to emphasize the individualistic therapy in treatment of diseases in general and psychological problems in particular.

# ''Pratyatma chikitsa'' (individual psychotherapy): Each and every individual is having different body constitution (''deha [[prakriti]]''), mental constitution (''[[manas]] [[prakriti]]''), ''desha'' (habitat), ''[[kala]]'' (time), ''vaya'' (age), ''pratyatma jeevana vritta'' (Individual life situations). Therefore, every individual patient should be dealt as a separate individual and treatment decisions should be taken after considering all the above factors. Term ''purusampurusam viksaya'' (Ch. Su. 1/124) is used to emphasize the individualistic therapy in treatment of diseases in general and psychological problems in particular.

# ''Pratidvanda chikitsa'' (Replacement of Emotions): Replacement of emotions by opposite emotions (viz. ''kama'' for ''krodha'') is one of the approaches of ''sattvavajaya'' in [[Ayurveda]]. In the case of mental disorders resulting from an excess of desires, grief, delight, envy or greed, should be calmed down by bringing the influence of opposite emotions to bear on the prevailing one and neutralize it. [Cha.Sa.[[Chikitsa Sthana]] 9/86]

# ''Pratidvanda chikitsa'' (Replacement of Emotions): Replacement of emotions by opposite emotions (viz. ''kama'' for ''krodha'') is one of the approaches of ''sattvavajaya'' in [[Ayurveda]]. In the case of mental disorders resulting from an excess of desires, grief, delight, envy or greed, should be calmed down by bringing the influence of opposite emotions to bear on the prevailing one and neutralize it. [Cha.Sa.[[Chikitsa Sthana]] 9/86]

# ''Aswasana'' (reassurance): Reassurance relieves fears, it boosts self confidence and promotes hope in a patient. The nature of the disease should be explained to the patients freely and frankly, so that the patient develops insight into the disease.  

# ''Aswasana'' (reassurance): Reassurance relieves fears, it boosts self confidence and promotes hope in a patient. The nature of the disease should be explained to the patients freely and frankly, so that the patient develops insight into the disease.