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    ?yurvedic Herbology Handbook



    Ideally, prior to any attempt to study disease or imbalance of any sort, one should first define and agree on a concept of health. Since this concept in its fullest appreciation would involve the study of anatomy and physiology in their most basic states, we offer only the most cursory definition and explanation below. We shall assume that the reader has some foundation in this area, at least from the modern perspective, and thus we shall proceed to their abnormal or morbid manifestations. This material on pathology has been introduced at this stage in the course to emphasize the point that treatment must have an objectsomething has to be

    fixed, so to speak. Modern, traditional, and classical concepts of disease are compared in this section. The student should take from this section an appreciation of the notion of ―models of disease‖ and an understanding of the nomenclature of disease / illness. Further, there is a method, not assessment techniques, for coming to an understanding of a given disease and its clinical manifestationsthis section discusses this

    fact, too. The full picture of pathology is achieved by examining certain criteria, also examined in this section. The student will have a fuller picture of health and disease by studying this section.

    It must be remembered, however, that functional disorder (doÃic imbalance) occurs before disease can manifest and this section addresses this fact, also. N.B.: There is a trend in ?yurveda, today, to reserve the word ―disease‖ for the entry of doÃa(s) into d?Ãyas (tissues, organs, and wastes) leading to their structural

    or/and functional distress. This is the doctrine of doÃa d?Ãya samm?rchana / sa?sarga (Ca. Su. XIX.4.9).

    However, for the purposes of this section the term disease shall be used in its broadest sense of disorder or imbalancequalitative or quantitative imbalance of the doÃas, etc.. This assumption should not produce confusion in the mind of the student regarding the mixing of terms of symptomatology / imbalance / disease. On a related matter, ?yurveda holds that some afflictions are caused by toxicity. From the ?yurvedic perspective, disorders of doÃic imbalance are distinct from disorders of toxicity. This section also addresses this cause of ill health.

Appendices Relevant to this section: #1

Introducing the Concept - Health:

    Caraka states that (Su. 9.4) health (prak?ti) is the balance of tissues and tissue imbalance is disease.

    Health is happiness and disease is pain. This means structure and function are appropriate in health and

    otherwise in disease.

    Some terms used to designate health are: arogyam, svastha, sama, etc. It is interesting to note that arogyam translates as absence of disease. It is peculiar that the positive state of health should be viewed as the absence of disease, but this word is frequently used by the ancients. In other words, why would one define something is terms of what it is not, rather than in terms of what it is. On the other hand, savatha can be translated as being established in Self.‖ This term may seem equally peculiar, as it emphasizes the spiritual foundation of life and not a bodily status. For many, however, this is the highest standard of health. The term ―sama‖ can be

    translated as balance and has the value of emphasizing the functional aspects of mind, body, and spirit. (See Appendix 1 for another statement of health from SuÂruta, which includes all of these measnings). This is the operational guideline for health.

B?ja KÃetra Siddh?nta

    Further, it must be stated that ?yurveda subscribes to the ―B?ja KÃetra Siddh?nta.‖ B?ja represents the

    seed or pathogen in all its forms, including microorganisms, and the humorsVPK. KÃetra represents

    the body or field that supports the seed or other organism. If the field or body is sterile then

    development of any living entity will be stifled / prevented. This theory holds that the body will

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    ?yurvedic Herbology Handbook

    naturally heal itself in face of any onslaught, provided there is proper representation of the components

    of the body. This concept is sometimes studied under the terms: vy?dhi kÃamatva and vy?dhibala

    virodhitva. The former refers to the specific strength of doÃas, dh?tus, and malas; the latter term refers

    to a natural resistance or immunity of the body (Murthy, p. 26).

    This thinking, which circulates in the oral tradition of ?yurveda, is countered somewhat by a verse in

    Caraka: The removal of causative factors may not result in the total removal of the disease because the

    effects of the disease may continue to be operative. (Hence cikitsa must also aim at restoration of the

    doshic equilibrium. Ca. Su. 9.5)

Pathology--Synonymy of Signs and Symptoms:

    ?k?ti, lakÃa?a, cihna, sa?sth?na, vyañjana, r?pa (Ca. Ni. I.10)

Signs and Symptoms of Decreased v?ta, pitta, kapha

    Signs of decrease of v?ta: debility of the body, the person speaks very little and does very little activity,

    loss of sensation (awareness), and of consciousness and occurrence of all the symptoms of increased

    kapha.. Decrease of pitta produces weakness of digestive activity, coldness, and loss of complexion.

    Decrease of kapha causes dizziness, emptiness of the organs of kapha, tremors of the heart (palpitation)

    and looseness of the joints. (AH Su. XI.15, 16 AH Su. XI.15)

General Signs And Symptoms For Each Of The DoÃas

    Caraka states (Su XX.12, 15, 18) the general signs and symptoms for each of the doÃas in all its

    disorders these are the natural and specific characters in whole or part:

    V?ta roughness, coldness, lightness, non-sliminess, motion, formlessness, instability are the specific

    characteristics. V?ta produces the following in organs when it enters themseparation, dislocation,

    division, attachment, tearing, malaise, exhilaration, thirst, tremors, circumvention, looseness, piercing

    pain, movement, etc. and also coarseness, roughness, non-sliminess, porosity, reddish luster, astringent

    taste and tastelessness, wasting, numbness, contraction, stiffness, and limping.

    Pitta-heat, sharpness, fluidity, slight unctuousness, colors except white and reddish, fleshy smell,

    pungent and sour taste and spreading tendency. It manifests these actions in respective parts when it

    entersburning, heat, inflammation, perspiration, moisture, sloughing, itching, discharge and redness

    along with the appearance of respective smell, color, and taste.

    Kaphaunctuousness, coldness, whiteness, heaviness, sweetness, stability, sliminess, and softness are

    its specific qualities. It exhibits the following actions when entering an organwhiteness, coldness,

    itching, immobility, heaviness, unctuousness, numbness, moistening, mucus covering, binding,

    sweetness, and chronicity

    Simply stated signs and symptoms of VPK imbalance (A clinician‘s view—Dr. Lad):

    V?ta: worry, fear, anxiety, loneliness, agitation, constipation, dry skin, cracking nails, brittle hair, cold hands and feet, dry eyes, tinitis, and all degenerative disorders.

    Pitta: anger, hate, jealousy, aggressiveness, competitiveness, judgment, burning, sour eructations, skin rash, hives, urticaria, diarrhea, nausea, vomiting, fever, infection and most inflammatory disorders (excepting auto-immune), bleeding, bruising.

    Kapha: greed, attachment, lethargy, excess sleep, pallor, colds, cough, runny nose, edema, swelling, clammy skin, fatty degenerative changes in liver, CHF, hypertension (essential), and all congestive disorders.

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    ?yurvedic Herbology Handbook

Discussion on Significance of Symptoms/Signs

    As we shall see below, there is a tendency in the ?yurvedic tradition to regard tissue imbalance and all concomitant signs and symptoms as the full expression of disease. However, for some theorists, these signs / symptoms have another meaning. The homeopaths, for example, holds signs and symptoms to be the prima facie evidence of the body‘s own healing response—vis medicatrix naturae (Weiner, p. 23). This would seem

    to be a fundamental departure of the traditional thinking. Thus the question arises: Are symptoms / signs properly to be regarded as the healing mechanism in process or the healing response overrun as if attacked from outside (Weiner, p.23)? This seems to be a trivial question at first, but what is the value of intervention strategies that suppress the sign / symptom? Phrased differently, we need to know if symptom elimination is actually driving the disease deeper into physiology/anatomy by blocking elimination of disease entities

    miasms/doÃas, etc. (the predominant theme of allopathic treatment). Obviously, this issue has important implications for treatment. In other words, the manner of symptom elimination will be critical to bringing cure. This discussion can not be completed at this time, because, as we shall learn, there are five distinct models of disease (excluding poisoning) according to ?yurveda. It is likely the case that some symptoms of infectious attack are healing responses of the immune system. But how shall we understand signs and symptoms of the other models. Too be continued........


    The word disease, having its roots in ME (inconvenience, trouble, sickness) and in OE (discomfort), has the following definition in Webster‘s New World Dictionary1). Any departure from health; illness in general 2)

    a particular destructive process in an organ or organism with a specific cause and characteristic symptoms; specifically, an illness, ailment 3) any harmful or destructive condition, as of society. Synonyms: affection, malady, ailment.

Taber‘s Cyclopedic Medical Dictionary offers the French derivation—lack of ease and defines disease thusly:

    a pathological condition of the body that presents a group of clinical signs and symptoms and laboratory findings peculiar to it and that sets the condition apart as an abnormal entity differing from other normal or pathological body states. The concept of disease may include the condition of illness or suffering not necessarily arising from the pathological changes in the body. There is a major distinction between disease and illness in that the former is usually tangible and may even be measured, whereas illness is highly individual and personal, as with pain, suffering, and distress. A person may have a serious disease such as hypertension but no feeling of pain or suffering, and thus no illness. Conversely, a person may be extremely ill, as with hysteria or mental illness, but have no evidence of disease as measured by pathological changes in the body. This word has many modifying forms:

    Acute Constitutional Familial Intercurrent Psychosomatic

    Anticipated Contagious Focal Malignant Secondary

    Auto-immune Deficiency Functional Metabolic Self-limited

    Chronic Degenerative Hereditary Occupational Sporadic

    Communicable Endemic Iatrogenic Organic Storage

    Complicating Epidemic Idiopathic Pandemic Sub-acute

    Congenital Epizootic Infectious Parasitic Systemic

    The ?yurvedic literature is full of the names and synonyms of disease and of a varied classification of its types. Reviewing these names will give a picture of the scope of the concept:

    ; abnormality of the doÃas ; exhibits many kinds of distress--vy?dhi,

    ; unhappiness, sorrow, or miseryduÅkam, ; abnormality--vik?ra,

    ; that which produces painroga, ; born of ?ma--?maya,

    ; born of sin or unhealthy acts--p?pma, ; symptom complexyakÃma,

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; cause of miserable life--?ta?ka, ; continuous or all-around suffering--?b?dh?.

    ; born from more than one causegada, ; feverjvara

    Anything that affects the inner man (Self) is disease and that disease has its primary seat in the inner spring of vitality from which it flows out to the surface, the external body. (The force is felt first at the center of the being/body and moves outward.) Su Su.l.19

    All diseases do not have a name Ca. Su. 18.44-47 The one who can not label a disorder with some name should not feel ashamed because all disorders nave no established footing by name. The reason is that the same vitiated doÃa causes various disorders according to variation in etiology and location. Caraka, an ancient ?yurvedic authority, states that diseases are innumerable (Vi. VI.5) by reason of permissible combinations of constitution, location, symptoms, etiology, and proportion of causative factors (Ca. Su. XX.3)

Resistance to Disease:

    Ca Su. XXVIII.7 states the background for disease vulnerability: Persons too obese or lean, having

    non-compact muscles, blood, bones, weak, indulges in unsuitable food, under-nourished, and weak

    mind are not able to resist diseases, while others of opposite nature are able to resist diseases. Because

    of variations in poor diet, innate pathogenic factors, and condition of the body the diseases are mild or

    severe, acute or chronic. The same v?ta, pitta, and kapha vitiated in different locations produce

    different disorders.

    DoÃic theory of disease is central to ?yurvedastating that nearly all disease (spirit possession, parasites, etc., and mental disorders are notable exceptions) are mediated by the vitiated doÃas. SuÂruta describes this relationship of doÃa to disease as neither constant nor separable (Su. XXIV.25). While the doÃas always exist they need not always be in a morbid state of increase nor in an observable manner but they are always the cause of disease. This is a mechanistic theory of causation. What is unexplained to this point is what causes the mechanism to be tripped.

    N.B. RK Sharma, in his commentary on Caraka Samhita, Su. XIX p. 358 observes that while imbalance of tissues occurs in a disease state, it is not this fact but the outcome of fever, pain, etc. that truly constitutes the disease pathology. Thus the structural changes and pain and suffering constitute the full disease picture.

    Affliction of Srot?nsi (channels) according to Caraka (See also and M?. Ni. 22.15-19)

    Ca Vi V.8-9 For pr?navaha srotas, the origin is h?daya as well as mahasrotas. The symptoms when it

    is affected are these: too long, too short, aggravated, shallow or frequent respiration with sound and


    For udakavaha srotas, the origin is palate and kloma. The symptoms of its affection are these such as

    by observing dryness of tongue, palate, lips, throat and kloma, and excessive thirst.

    Annavaha srotas having it origin in amasaya and the left side. The symptoms of its affection are these:

    loss of desire for food, anorexia, indigestion and vomiting.

    Rasavaha srotas has its root in hridaya and ten dhamanis. ...As regards the symptoms of their morbidity,

    they have already been described in the chapter on various foods and drinks. The symptoms of the

    affected srotas carrying dh?tus are the same as those of the respective dh?tus.

    Mutravahasrotas has its root in basti and va?kÃana. Symptoms of their morbidity are these: excessive

    excretion, excessive obstruction or suppression, vitiated, diminished or frequent thick urine with pain

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    ?yurvedic Herbology Handbook

    Purishavaha srotas has its root in pakvaÂ?ya and sthulaguda. Symptoms of their morbidity are:

    passing of feces with difficulty, small quantity, with sound and pain, too liquid, too scabulous, and in

    large quantity.

    Svedavaha srotas has its root in medas and hair follicles. Symptoms of morbidity are: loss of

    perspiration, excessive perspiration, coarseness, excessive smoothness, extensive burning sensation,

    and horripilation.

    Srotas, sir?, dhaman?, rasav?hin?, n???, pathin, m?rga, Âar?racchidra, sa?v?t?s?v?ta, sth?na, ?Âaya,

    and niketathese are the names of visible and invisible spaces within the Âar?radh?tus. Due to

    morbidity of these the Âar?radh?tus whether in passage (under the process of transformation) or in

    location (fully transformed state) also get affected. Likewise, morbidity of other srotas affects the

    respective contents. The srotas affect the related srotas and so the dh?tus. Because of vitiating nature,

    vitiated v?ta, pitta, kapha vitiate all of them.

    Ca SuXXVIII.8-22

    Rasadh?tu: loss of desire for food, anorexia, distaste in mouth, loss of taste sensation, nausea,

    heaviness, drowsiness, bodyache, fever, feeling of darkness, paleness, obstruction in channels,

    impotency, malaise, leanness, loss of digestive power, untimely wrinkles, and grey hair

    Rakta: leprosy, erysipelas boils, internal hemorrhage, menorrhagia, suppuration of anus, penis, and

    mouth, spleen, gulma, abscess, nilika, jaundice, vyanga, piplu, tilak?laka (black moles), ringworm,

    psoriasis, leucoderma, papules, urticarial patches, red patches

    M??sa: adhim??sa, arbuda, kila, galaÂ?l?ka, galaÂu??ik?, p?tim??sa, alaj?, ga??a, cervical adenitis,


    Medas: these are the despicable ones and the premonitory symptoms of prameha.

    Asthi: adhyasthi, adhidanta, dantabheda, asthiÂula, discoloration, abnormality in hairs of head, body

    hair, nails, beards/moustaches

    Majj?: pain in joints, giddiness, fainting, feeling of darkness, appearance of thick-based wounds

    Àukra: impotency, non-erection; progeny will be sick or impotent or short-lived or deformed, it will be

    miscarried or aborted; the semen, if affected morbidly, afflicts the person along with wife and progeny.

    When doÃas vitiate in sense organs, they afflict them with loss of function and dysfunction.

    DoÃas vitiated in ligaments, vessels, tendons afflict the person with stiffness, contraction, twisting,

    glands, throbbing and numbness.

    DoÃas vitiated while in malas cause breaking, drying up, and other abnormalities of malas and also

    their excessive retention and elimination.

    These are produced by unwholesome food. Avoid them and avoid these diseases.

On the need for a label:

    PV Sharma, p. 125 writes that there is considerable discussion among commentators around what constitutes disease. As stated above the doctrine of doÃa duÃya sammurchana implicates both doÃas and dh?tus directly. But what of syndrome--all of the signs and symptoms? There is a tendency for only the imbalance or disequilibrium of tissues to be called the vik?ra but others argue that it must include both the signs and symptoms; e.g. disequilibrium vs. its manifestation, fever. Cakrap?ni accepts the latter as vik?ra. In light of the manner ?yurveda organizes patterns into diagnoses, there is some comfort in calling imbalance and its manifestations the disease entity. One may find a host of seemingly unrelated symptoms/signs but this poses

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    no reason for concern as the trained ?yurvedic practitioner finds energetic patterns that unite the diversity. Thus it is of little concern to know the disease by experience; the patterns are more important than the details. These patterns are verily often just the names of the doÃasv?ta, pitta, and kapha.

    Disease Nomenclature Conventions

Digression on the significance of classifying

    The data of science are never gathered, recorded, listed, or studied as a single listing of entries. They are always grouped according to some organizing principle. The organizing principle acts as a context for groupings of data so that they may be studied and understood more easily. For example, one organizing principle is botany and another is geology. Data gathered under one heading are seen as pertaining

    primarily to that arena. Further, there is an implicit assumption that these data are closely related in a way that creates meaning and understanding of causal relations. The data of geology are not very much of interest to the diversity of structure and function of plants, thus geological data are scarcely listed among botanical data. ?yurveda is another grouping, and within this grouping are many classes of data: doÃas, dh?tus, treatment, and so on. Each one serves as a further narrowing of perspective for study.

    Thus there is a fundamental need to classify data and scientists find many reasons or perspectives for this act of classifying. The ancient thinkers/writers are no different than modern scientists. There are many different perspectives and each perspective provides a rationale for a new classification. In the course of this handbook, one will see this phenomenon repetitively. Because some sutras use the same terms (two types, or three types, etc.) there may arise some confusion in the student‘s mind. Not to worry, just remember that the classes are rarely given in a broad, summarizing statement. The disease-naming convention sutra, given below, in Caraka is a salient exception. It is all-inclusive.

    A final note on this point is the fact of the need to read/study many sources in ?yurveda for a complete understanding of a given concept. One notable area deals with the common assertion that ?yurveda says that pitta doÃa is comprised of fire and water elements. Reading SuÂruta and V?gbha?a one will not find that these authors have described pitta thusly (fire element only is given). In the context of our present discussion of disease there are many relevant sutras. Thus one must read many sources and sutras to attain a complete understanding of a particular concept.

Disease Naming Conventions in ?yurveda:

    Caraka has described the various ways in which diseases have come to be named. Disease classifications are named according to effect, severity, location, etiology, site of origin (Ca. Vi. VI.3):

    A. Effect fever, swelling, tumor, diarrhea and so on are examples (jvara, Âotha, gulma, atis?ra, etc.).

    The notion here is that one can name a disease by the subjective or objective features produced. High

    temperature (objective) or fever (subjective) are different ways of talking about temperature effects, for


    B. Severity- Another way to talk about disease is to describe it in terms of prognosisis the disease mild

    or strong, treatable or not, etc. The classical perspective follows below:

    ; Diseases are of 3 kinds (M?Ni):

    1. controllabley?pya;

    2. curable (s?dhya ) is of 2 kinds

    1. easilysusahya or

    2. with difficultykaÃ?as?dhya. incurableas?dhya

    3. incurable (as?dhya)--Incurability may arise from several factors including stage and strength of

    disease versus the person‘s strength and treatment that requires treating doÃas and dh?tus

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    which are opposite. With the progression of disease from lack of treatment the curable becomes

    manageable or incurable and the manageable becomes incurable. Severity is mild or severe.

    ; Prognosis is of 4 typescurable, incurable, mild and severe (Ca. Ni. I.11.4).

    Caraka gives the criteria for each category (Su.XI.11-20):

    1. Curable is marked by few causes, signs and symptoms, doÃa different from d?Ãya in

    quality, doÃa not the same as constitution, quality in time is dissimilar, place which is not

    difficult for management, movement is one-sided, disorder has recent origin, no complications,

    only one doÃa in the pathogenesis, strong body able to withstand treatment, and proper

    alignment of the 4 pillars of treatment

    2. Incurable is marked by disease of three doÃas, that which is not amenable to any therapy,

    involves all pathways, produces anxiety, uneasiness, and disturbances of consciousness,

    destroys sensory function, is very advanced, and has signs of impending fatality in the weak


    3. Mild severity is marked by medium cause, prodroma, and symptoms, similarity of any one

    time, constitution, and d?Ãya, pregnant woman, old man or child, not afflicted with too many

    complications, having surgical measures, alkali or fire, not recently developed, location in the

    vital spots (marm?ni), involving one pathway, not having fully the 4 limbs of treatment, 4. Severe is that having two passages involved but of not long duration, and having two

    causative doÃas. It‘s palliable, though incurable, if it does not shorten life and the patient gets

    relief from observing wholesome routine, and the disorder aggravates with little cause. This

    disease is deep-seated, located in more than one tissue, afflicts the vital spots and joints, is of

    long duration, and involves two doÃas.

    ; Inherited diseases are incurable: Ca. Ci. VI.57

    ; Some diseases go into remission without any intervention whatsoever (Ca. Su. X.4) while others with the best of intervention are fatal.

    C. Location This category relates mainly to where the disease is located.

     Location is of two types:

    1. bodily--k?yaka (Ca. Su. XX.3).

    2. mental--m?nasa The mind can be adversely affected by two qualities of functioning called rajas and tamas (Ca. Su. I.57). Rajas is the quality of being over-active/unstable and promotes wrong desires such as addiction and dislikes. Tamas is inert to sensory input. It promotes greed, overeating, and destruction. Other mental factors are: vanity--m?na; attachmentraga; aversion

    dveÃa; and delusionmoha. Ayurveda gives more emphasis to disorders of the body but clearly gives importance to the emotions as having a critical role in health or diseasegreedlobha;

    angerkrodha; fearbahya; griefÂoka.

    3. ?yurveda describes pathogenesis in terms of three pathways: interior GI tract, exterior skin,

    blood, etc., and middle pathway deep tissue, organs, and joints, etc.. Diseases of the interior pathway include diarrhea, vomiting, alasaka, fever, cholera, cough, dyspnea, hiccup, hardness of bowels, abdominal enlargement, spleen enlargement, erysipelas, edema, gaseous tumor / swelling, piles, abscess, etc. Diseases of the exterior pathway include: glandular problems, boils, diabetic boils, scrofula, warts, granuloma, moles, leprosy and other skin disorders, freckles, erysipelas, edema, gaseous tumors / swellings, piles, abscess, etc. Diseases of the middle pathway include: hemiplegia, stiffness of sides, convulsion, facial paralysis, wasting, tuberculosis, pain bone and joints, prolapse of rectum, etc, diseases of head, heart, and bladder, etc. The onset of diseases in the interior pathway are early detected and easily treated for this reason. Those diseases of the exterior pathway are treatable mainly through the digestive tract, which is more difficult, and may show more structural and functional damage. Those of the middle path involve the seats of life (pr??a), their treatment is risky to life itself, and are more likely to be incurable (Murthy, p. 148-49).

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    4. There is another distinctionplace of origin vs. place of manifestation. Some diseases (Murthy, p.

    145) such as hemorrhoids arise and appear in the same location; whereas, some others,e.g. fever,

    arise in one place (stomach) and manifest in another, the skin.

    D. Site of origin From ?yurvedic theory this boils down to the notion that doÃic disorder starts in the GI

    tract and this scheme acknowledges this assertion. This maxim is not necessarily true for infectious,

    spiritual, or mental disorders, however.

    1. Location also pertains to the site of origin from which it spreadsstomach or colon. There is really

    only one sitethe GI Tract but ?yurveda observes that the stomach is the main site of kapha, the

    small intestine and stomach for pitta, and the colon for v?ta. Thus most diseases may be labeled

    disorders of the digestive/eliminative tract.

    2. Bhela (Su. XIII.1-18) has given a short discussion of diseases that are seen to occur according to

    geographical regions (of India). For example, Eastern people suffer from kapha and pitta

    complaints, elephantiasis, goiter, etc. Those in the South get skin disorders. TB is common in the

    West, etc.

    3. Note from above that while a disease may have its origin in the GI-tract not all diseases manifest


    4. SuÂruta has classified diseases according to another perspective (Su. Su. XXIV.2):

    a) medical or b) surgical

    E. Etiology Sometimes it is helpful to know and label a disease by its causative factor. This area is

    broader than the others and, in some ways, more difficult to know. The theory of cause and effect is set

    out below as well as different schema for looking at cause. It may be useful, however, to visit this

    theme from the perspective of modern science first (Dvarakanath, p. 6, 7). In the West it was Francis

    Bacon who gave us the inductive method of reasoningfrom specific event to general or universal

    meaning. He called this the Novum organum meaning new instrument‖—and proposed the

    underlying principle that things which are always present, absent or varying together are causally

    related. Aristotle and others proposed that we could know by analogy and by deducing specific

    conclusions from general propositions. All three methods can be used to demonstrate the presence of

    causal relationships, which is to say that knowledge derived by any of them has the likelihood of being

    valid. Underlying this process of reasoning is repeated experience of an event that can be described in

    its cause and in its effects. We come to know things by classifying and predicting relations and by

    testing these relations--otherwise called trial and error. This is the scientific method. It attempts to

    explain causal relationships.

Summing Up Disease Nomenclature:

    Scanning the literature one finds that nomenclature arises to identify disease according to: v?ta, pitta, kapha (doÃa), tissue (dh?tu), sub-ordinate tissue (upadh?tu), organ (avayava), body part (a?ga ), digestion (agni), vitality (pr?na), immunity (ojas), waste product (mala), the process or effect it producesprimary sign or

    symptom--e.g. swelling (gulma), fever (jvara), the pathway of disease--interior, external, or central, and the channelsrotas. Sometimes the disease is the main symptom (fever of non-specific origin) and sometimes it is a symptom complex or syndrome (fever with infection as in malaria). Additionally, Caraka remarks at length on poisonings, which are not technically to be considered a disease or disease process. Poison sources include vegetables, minerals, and animals (such as snakebites). Toxic effects are often mistaken for diseases. Ci. 23.18 (See below for more on the pathogenesis of poisoning Ca. Ci. XXIII.18-23)

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    Examination of the Disease

    The classical ?yurvedic scheme of examining the patient has at least two meaningssensing and thinking.

    This theme of assessment via the senses has two aspects; the first aspect is studied as the three-fold and eight-fold examinations. Firstly there are data to be gathered by the different sensestrividha parikÃa (three-fold

    examination); secondly there are techniques for conducting the data-gathering (aÃ?avidha parikÃa (eight-fold examination). The three seem to be more about the examiner‘s senses to be used and the eight seem to be special techniques employed for the examination.

    The trividha parikÃa is studied as: darÂa?a (visual exam), sparÂana (tactile exam), and praÂana (questioning). We can see that the senses employed mainly be these are sight, touch, and sound, respectively. Taste and smell are less useful as sensory modalities of assessment.

    The aÃ?avidha parikÃa is studied as: pulse, tongue, eyes, skin, urine, feces, body proportion and compactness, voice/sound. Together these eight techniques comprise an objective study of the patient and his disease. Both anatomy/structure and physiology/function can be assessed by these when used together.

The second aspect of meaning in assessment deals with the cognitive processing of the datathinking. The

    vehicle for this is perceptual data. By this statement we mean that thinking about sensory data involves deduction and induction. Thinking means comparing and contrasting presenting data with what authorities write or say and with one‘s own experiences. The nature of cause thus is revealed directly or indirectly. Some verses describing these two features (sensing and thinking) are:

    Examination of the disease is three-fold: authority, perception, and inference; those having knowledge

    of authority need only apply the remainingperception and inference. Ca. Vi. IV.5

    Ca Vi. IV.6 the learned ones instruct like thisevery disease has such aggravating factors, pathogenic

    material, etiology, specific feature, location, chief complaint, symptom, sound, touch, vision, taste

    and smell, complications, aggravation, stasis and diminution, consequences, name and associations.

    Thus is the procedure for its counteraction or otherwise. All this is known from instructions of


    Ca. Vi. IV. 7 One proceeding to acquire knowledge about the facts relating to the disease should

    examine with perception applying all the sense organs for all the sense objects except in respect of


    The need for correctness of the diagnosis is explained and affirmed by the following verse from Caraka:

    Those who fail to diagnose a case also fail to prescribe a rational remedy for the same. When they take

    the severely diseased as mildly afflicted and considering thus they administer mild evacuating drug

    which further aggravates the doÃas. Those taking the mild for severe administer strong evacuatives

    which harms by over-eliminating the doÃas. Thus those who know partially and fail to recognize this

    do fail in their pursuit. Ca. Vi. VII. 4

    In another chapter of the special features section of his collected writings Caraka lists and describes additional criteria relating to diseases necessary to be known and understood:

    One must know the disease according to etiology, prodroma, symptoms, main symptoms, suitability

    (upaÂaya), sa?pr?pti (pathogenesis) (which has five features: number, predominance, types,

    proportional variation, severity and time. Ca. Vi. I.3 These criteria are commonly referred to as the

    nid?na pañckam ( ―list of five beginning with etiology‖):

    1. etiology(synonyms = nid?nam, nimitta, hetu, ?yatana, pratyaya, utth?na, & k?ra?a),

    2. preliminary or prodromal symptoms and signspurva rupa / pr?grupa,

    ? Copyright 2001 Michael S. Dick All Rights Reserved Rev. 11/02/10 Page 9 of 40

    ?yurvedic Herbology Handbook

    3. main or cardinal signs and symptomsrupa (synonymssam?sth?na, vyañjana, li?ga,

    lakÃa?a, cinha, ?k?ti),

    4. therapeutic index of treatmentupaÂaya

    pathogenesissampr?pti (synonymsj?ti or ?gati) (Ni. I.6). (Also see: V?g. A.H. Ni. I.2-8; M?. Ni.

    Ch. 1) (AH Su. I.22 also)

    There is extensive discussion in the literature of the concept of cause. The discussion of disease must deal with

    the concept of cause if disease is to be cured, etc. Treatment must ultimately aim at the cause of the disease.

    The roots for the notion of cause reach deep into the traditional philosophical systems; especially the darÂana.

    The following is a listing of terms that relate to cause and effect theory embraced by ?yurveda:

    ?yurvedic Terminology of Etiology - Nid?na (Murthy, p. 15 )

    1. samav?yi k?ra?a inherent, inseparable, material cause, inherent in the cause and the destruction of

    which leads to the destruction of the effect

    2. asamav?yi k?ra?a non-inherent, separable cause, may be either in effect or apart from it, the

    destruction of which will not lead to destruction of the effect but may bring about changes in it

    3. nimitta k?ra?a instrumental cause, exists apart from the effect and the destruction of which does not

    lead to the destruction of the effect

    a. Pr?dh?nika k?ra?a -- a powerful, efficient or potent cause

    1. sannik?Ã?a k?ra?a immediate or nearest course

    2. utp?daka k?ra?a an important, chief, potent cause

    3. anubandhya k?ra?a a potent cause followed by many accessory causes

    b. anubandha k?ra?a accessory cause following a chief cause

    1. viprak?Ã?a k?ra?a remote or far off cause

    2. vyabhic?ri k?ra?a the cause which is weak, not capable of producing disease by itself

    3. vyañjaka k?ra?a minor, accessory or weak cause

    c. Miscellany

    1. b?hya k?ra?a external agent acting as cause, e.g. foods, water, air, bacteria

    2. ?bhyantara k?ra?a internal substances acting as cause e.g. doÃas, duÃyas, etc.

    3. doÃa (prakopaka) hetu cause which bring about increase of the doÃas

    4. vy?dhi (utp?daka) hetu cause which produces the disease first e.g. mud eating produces


    5. pr?k?ta k?ra?a cause similar in nature to the season

    6. vaik?ta k?ra?a cause dissimilar in nature to the season

    7. ubhaya hetu cause which produces increase of the doÃ?s and also the disease concurrently

    8. ?Âay?pakarÃa r?pa hetu -- causes which dislodge the doÃ?s from their normal sites, drive

    them to other places and help in the origin of diseases

    9. nid?n?rthakara roga r?pa ketu -- many a time, one disease becomes the cause for another

    One of the 6 systems of Indian philosophy-- Ny?yahas offered an analysis of cause and effect, called the

    ―Doctrine of Triple Cause.‘

    1) Samav?yi k?ra?a = inherent or material causethat which is inseparable from effect, its destruction

    leads to the loss, destruction or absence of the k?rya (effect).

    2) Asamav?yi k?ra?anon-inherent causethat which may be or may not be inherent in the effect

    (k?rya), its destruction will not lead to the loss, destruction of the effect always but might bring about

    alterations in it.

    3) nimitta k?ra?ainstrumental, initiating, aka Pradh?nika (chief) causethat which is always apart

    from or separate from the effect. Its destruction does not lead to the destruction of the effect, the effect

    ? Copyright 2001 Michael S. Dick All Rights Reserved Rev. 11/02/10 Page 10 of 40

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