The 1st chapter of Nidanasthanam of Ashtanga Hridayam is known as as Sarvaroga Nidanam Adhyaya. This chapter offers with the reason of ‘prognosis of illnesses typically’.
The matters coated on this chapter embody –
- Roga paryayah – synonyms of the time period ‘illness’
- Nidana pancaka – 5 diagnostic instruments
- Nidana – causative components of the illness
- Purvarupa – premonitory signs / prodromal signs
- Rupa – medical options / attribute indicators and signs
- Upasaya – diagnostic exams
- Samprapti – Pathogenesis
- Sorts of Samprapti
- Sarvaroga karana – causes of all illnesses / etiology
- Kinds of unsuitable
- Vatavrddhi karana – causes of improve of vata
- Pittavrddhi karana – causes of improve of pitta
- Kapha vrddhi karana – causes of improve of kapha
- Kapha vrddhi karana – causes of improve of kapha
- SarvaDosha vrddhi karana – causes for improve of all of the Doshas
- Vrddha Dosha gati – destiny of elevated Doshas
Pledge by the writer(s)
अथातः सर्वरोगनिदानं व्याख्यास्यामः।
इति ह स्माहुरात्रेयादयो महर्षयः।गद्यसूत्रे॥२॥
After having provided prayers to the God, henceforth we’re going to clarify the chapter pertaining to the reason of ‘diagnosing the illnesses typically’. Thus say (pledge) Grasp Atreya and different sages.
Roga paryayah – synonyms of the time period ‘illness’
रोगः पाप्मा ज्वरो व्याधिर्विकारो दुःखमामयः।
यक्ष्मातङ्कगदाबाधाः शब्दाः पर्यायवाचिनः॥१॥
Roga, papma, jvara, vyadhi, vikara, duhkha, amaya,yaksma, atanka, gada and abadha – these phrases are synonyms of illness.
Notes – Every of those phrases signifies a sure facet of the illness. The illness known as ‘roga’ as a result of it offers rise to ache, it’s ‘papma’ as a result of it’s born from sinful acts, ’jvara’ as a result of it torments, ‘vyadhi’ for it brings in several sorts of abnormalities, ‘duhkha’ because it causes varied sorts of unhappiness, ‘amaya’ – as a result of it’s brought on by ama (undigested, improperly processed metabolites), ‘yaksma’ as it’s a group of illnesses (symptom advanced, syndrome), ‘atanka’ for it makes life depressing, ‘gada’ as a result of it’s produced by a number of causes, ‘abadha’ for, it produces fixed discomfort (to the physique, thoughts and or sense organs). Along with these, even the time period ‘Dosha’ can be used as a synonym to point the illness.
निदानं पूर्वरूपाणि रूपाण्युपशयस्तथा।
सम्प्राप्तिश्चेति विज्ञानं रोगाणां पञ्चधास्मृतम्॥२॥
Nidana (trigger),
Purvarupa (premonitory signs),
Rupa (indicators and signs attribute of the illness),
Upashaya (diagnostic check) and
Samprapti (mode of manifestation of the illness) are the 5 technique of acquiring full data (prognosis) of illness.
Notes – Information of all these 5 isn’t important for the prognosis of each illness. Many might be identified by realizing anybody or two, typically all of the 5 are essential.
Nidana
निमित्तहेत्वायतनप्रत्ययोत्थानकारणैः।
निदानमाहुःपर्यायैः
Nidana (trigger) is indicated by synonyms such asnimitta, hetu, ayatana, pratyaya, utthana and karana.
Notes – A couple of extra synonyms that are used moderately hardly ever are mula, mukha, prakriti, ayatana and yoni. The time period ‘nidana’ has two which means –
- that which furnishes particular data. On this sense it’s utilized to prognosis of illness and likewise to the part of the textual content which furnishes particular details about illnesses. (Nidana Sthana).
- the ‘trigger’ of something. Within the context of illnesses it refers to the reason for the illness. It’s this second utilization which is extra widespread.
Purvarupa: Premonitory signs / prodromal signs
प्राग्रूपं येन लक्ष्यते॥३॥
उत्पित्सुरामयो दोषविशेषेणानधिष्ठितः।
लिङ्गमव्यक्तमल्पत्वाद्व्याधीनां तद्यथा यथम्॥४॥
Pragrupa (or purvarupa) are these (indicators and signs)which seem earlier to the but to be manifested illness, not assignable to any dosha specificallybecause of their poor manifestation and gentle nature. They’re enumerated in the way in which they manifest in every illness.
Notes – Purva rupa is of two sorts. 1- Samanya and 2-Vishishta. The primary one contains of signs produced by a number of of the aggravated Dosha, these normally disappear when the illness truly manifests, and these could also be widespread to many illnesses. The second, contains of the indicators and signs of the forthcoming illnesses itself, showing mildly and persevering with their existence within the additional phases of the illness. The traditional texts describe the primary form solely below the heading ‘Purvarupa’ in some illnesses, as it’s tough for the doctor to acknowledge them and assign them to particular illnesses. The second form could also be both talked about or not, as it’s simple for the doctor to acknowledge the attribute options of the illnesses. In some illnesses ‘Purvarupa’ isn’t talked about in any respect. This shouldn’t be taken to imply that such a illness has no Purvarupa in any respect, however ought to be understood that in such illnesses the precise options of the illness itself seem as ‘Purvarupa’.
Rupa: Scientific options / attribute indicators and signs
तदेव व्यक्ततां यातं रूपमित्यभिधीयते।
संस्थानं व्यञ्जनं लिङ्गं लक्षणं चिह्नमाकृतिः ॥५॥
Premonitory signs, after attaining clear manifestation, come to be often called rupa (attribute indicators and signs of the illness); additionally known as samsthana, vyanjana, linga, lakshana, chinha and akriti.
Upashaya: Diagnostic exams
हेतुव्याधिविपर्यस्तविपर्यस्तार्थकारिणाम्।
औषधान्नविहाराणामुपयोगं सुखावहम्॥६॥
विद्यादुपशयं व्याधेः स हि सात्म्यमितिस्मृतः।
विपरीतोऽनुपशयो व्याध्यसात्म्याभिसञ्ज्ञितः॥७॥
Administration of both drugs, meals or exercise which is the viparita (reverse) of both the trigger, the illness or of each, or although not truly reverse (however of similar nature), but produces the impact of the other (Viparitarthakari) that of giving consolation to the affected person is named Upashaya. For a given illness, it is usually known as Satmya (appropriate to the illness and the affected person). The other of Upashaya is Anupashaya and is taken into account as Asatmya (unsuitable) to the illness.
Notes – Diagnostic exams turns into essential solely when the doctor is unable to clinch the prognosis by different strategies, the next is an instance furnished by historic commentators. A affected person involves the doctor complaining stiffness (rigidity and lack of motion) of his thigh.
This can be a symptom of two illnesses, viz –
(1) Paksaghata (paralysis of the legs (hemiplegia) a illness brought on by improve of Vata and
(2) Urusthambha – a illness brought on by improve of kapha and medas (fats).
Even after different strategies of examination the doctor is unable to find out the illness. So he prescribes anointing the thigh with oil. If, this remedy offers consolation to the affected person (upasaya) then the illness is decided as paksaghata, as a result of vata was mitigated by the oil. If, however, this remedy elevated the discomfort (anupasya) then the prognosis will likely be, urusthambha, as a result of the oil produced higher improve of kapha. Thus the process helps to clear the doubt within the prognosis. Readers will discover particulars of those completely different sorts of upasaya within the commentaries on Madhava Nidana, Caraka Samhita and so forth.
Samprapti: Pathogenesis
यथादुष्टेन दोषेण यथा चानुविसर्पता।
निर्वृत्तिरामयस्यासौ सम्प्राप्तिर्जातिरागतिः॥८॥
The genesis or means of manifestation of the illness by the vitiated Doshas that are continually circulating is named Samprapti; additionally known as Jati and Agati.
Sorts of Samprapti
सङ्ख्याविकल्पप्राधान्यबलकालविशेषतः।
सा भिद्यते यथात्रैव वक्ष्यन्तेऽष्टौ ज्वरा इति॥९॥
दोषाणां समवेतानां विकल्पोऽंशांशकल्पना।
स्वातन्त्र्यपारतन्त्र्याभ्यां व्याधेः प्राधान्यमादिशेत्॥१०॥
हेत्वादिकार्त्स्न्यावयवैर्बलाबलविशेषणम्।
नक्तन्दिनर्तुभुक्तांशैर्व्याधिकालो यथामलम्॥११॥
It’s of 5 sorts comparable to Sankhya, Vikalpa, Pradhanya, Bala (energy and Kala counting the varieties (sorts) of every illness, as for instance, when it’s stated that jvara (fever) is of eight sorts (and so forth in different illnesses) is Sankhya Samprapti;to point the completely different points of the Doshas concerned (their form, amount, qualities and features) is Vikalpa,samprapti signifying a illness as both unbiased (main) or dependent (secondary) is pradhanya Samprapti;signifying a illness as robust ( serve, grave) or weak (gentle) primarily based on the character of the trigger and so forth. (indicators, signs, organs concerned, nature of abnormalities, common well being, age and intercourse and lots of different points) is bala samprapti;to suggest the time of the evening, day, season, and digestion of meals throughout which the illness and the Dosha are robust (predominant) is Kala samprapti
Abstract of nidana panchaka
इति प्रोक्तो निदानार्थस्तं व्यासेनोपदेक्ष्यति।
Thus a short narration of the nidana (and so forth) right here; they be described intimately later
Sarvaroga karana: Causes of all illnesses / etiology
सर्वेषामेवरोगाणां निदानं कुपिता मलाः॥१२॥
तत्प्रकोपस्य तु प्रोक्तं विविधाहितसेवनम्।
For all of the illnesses, the causes are the aggravated (elevated) mala (Dosha);for his or her (of all Doshas) aggravation (the causes are) indulgence in several sorts of unsuitable meals, actions and so forth is claimed to be the trigger
Kinds of unsuitable
अहितं त्रिविधोयोगस्त्रयाणां प्रागुदाहृतः॥१३॥
Unsuitables are the three sorts of Yoga (affiliation, contact) of the three (components) which had been described beforehand (chapter 12 of Sutrasthana)
Notes – the three Doshas (vata, pitta and kapha ) have three state in respect of their pramana (amount), guna (amount) and karma (operate), viz.,
1 – Sthana / Sama or Prakrita – regular
2-Vrddhi or Prakopa – aggravation or improve, greater than the conventional
3-Ksaya or lower lower than the conventional
The final two are vishama or vikrita / dusta (irregular). The Doshas of their regular state keep the physique in good well being. This normalcy may be very unstable. Doshas bear both improve or lower by the impact of meals, exercise, season and so forth; amongst these two abnormalities, vrddhi or improve is highly effective. The Doshas which have grow to be irregular (particularly the elevated) result in irregular adjustments within the dhatus (tissues) and provides rise to the illnesses. Therefore the above assertion that Doshas are the causes of all illnesses. The causes for the abnormalities of the Doshas are the three components viz. Kala (season), Artha (objects of the 5 sense organs-light, sound, scent style and contact) and Karma (actions of the physique, thoughts and speech) of their three sorts of irregular states (vishama yoga) viz, atiyoga (extra contact), ayoga (insufficient/poor contact and even absence of contact) and mithya Yoga (improper contact, perverse situation and so forth.). Three technical phrases are additionally used to indicate these three causes, viz-
- Asatmyendriyartha Samyoga (improper, extra, poor and perverse – contact of the sense organs with their respective objects).
- Prajnaparadha (transgression or violation of regular routine relating to all of the actions of the physique, thoughts and speech; in different phrases, doing them both in extra, poor or perverse method.
- Parinama – impact of season – the conventional climatic situation of the season turning into extra, poor or perverse.
All these are briefly known as both as Ahitahara Vihara, Mithyahara vihara or Asatmayahara vihara (unsuitable, improper or unaccustomed meals and actions).
Vatavriddhi karana: Causes of improve of vata
तिक्तोषणकषायाल्परूक्षप्रमितभोजनैः।
धारणोदीरणनिशाजागरात्युच्छभाषणैः॥१४॥
क्रियातियोगभीशोकचिन्ताव्यायाममैथुनैः।
ग्रीष्माहोरात्रिभुक्तान्ते प्रकुप्यति समीरणः॥१५॥
Vata will get aggravated from consuming meals that are bitter, salt and astringent in style, of much less amount, dry (moisture much less, fatless), taking meals lengthy after the same old time,suppression and untimely initiation of the urges (of urine, feaces, flatus and so forth.), holding awake at nights, talking in excessive pitch for a very long time, impact of therapies (emesis, purgation and so forth.) in extra (greater than the required diploma); (sudden) worry, grief and fear, extra of bodily actions and sexual activity;throughout summer season, terminal a part of the day; evening and meals (digestion).
Pittavriddhi karana: Causes of improve of pitta
पित्तं कट्वम्लतीक्ष्णोष्णपटुक्रोधविदाहिभिः।
शरन्मध्याह्नरात्र्यर्धविदाहसमयेषुच॥१६॥
Pitta (will get aggravated/elevated) from consuming meals that are of pungent, bitter, and salt tastes, penetrating, sizzling (or warmth producing) and inflicting burning sensation throughout digestion; bouts of anger,throughout autumn, mid-day, mid-night and center a part of digestion.
Kapha vriddhi karana: Causes of improve of kapha
स्वाद्वम्ललवणस्निग्धगुर्वभिष्यन्दिशीतलैः।
आस्यास्वप्नसुखाजीर्णदिवास्वप्नातिबृंहणैः॥१७॥
प्रच्छर्दनाद्ययोगेन भुक्तमात्रवसन्तयोः।
पूर्वाह्णेपूर्वरात्रेचश्लेष्मा
Kapha will get elevated from consuming meals which possess candy, bitter and salt tastes, that are unctuous (fatty, moist); heavy (indigestible, extra in amount) producing extra secretions within the tissues and chilly;sitting for lengthy intervals, sleeping an excessive amount of, consuming raw meals, sleeping throughout day, over nourishment,insufficient diploma of therapies like emesis and so forth; quickly after taking meals (through the first a part of digestion), throughout spring, forenoon and early a part of the evening.
Kapha vriddhi karana: Causes of improve of kapha
द्वन्द्वं तु सङ्करात्॥१८॥
Aggravation of dvandva (two) Dosha, concurrently happens by indulgence in combination of things inflicting their improve.
Sarvadosha vriddhi karana: Causes for improve of all of the Doshas
मिश्रीभावात्समस्तानां सन्निपातस्तथा पुनः।
सङ्कीर्णाजीर्णविषमविरुद्धाध्यशनादिभिः॥१९॥
व्यापन्नमद्यपानीयशुष्कशाकाममूलकैः।
पिण्याकमृद्यवसुरापूतिशुष्ककृशामिषैः॥२०॥
दोषत्रयकरैस्तैस्तैस्तथान्नपरिवर्तनात्।
ऋतोर्दुष्टात्पुरोवाताद्ग्रहावेशाद्विषाद्गरात्॥२१॥
दुष्टान्नात्पर्वताश्लेषाद्ग्रहैर्जन्मर्क्षपीडनात्।
मिथ्यायोगाच्च विविधात्पापानां चनिषेवणात्॥२२॥
स्त्रीणां प्रसववैषम्यात्तथा मिथ्योपचारतः।
Indulgence in combination of things inflicting improve of particular person Dosha offers room for improve of all of the three Doshas (sannipitta)and likewise, indulgence in improper dietary routine, meals that are raw (inflicting indigestion), contaminated, incompatible, and extra (in amount and frequency); wines and different drinks that are spoilt; dried greens, raw roots and tubers, pinyaka (fried seeds of sesame and jaggery pounded collectively and made into balls used as candy pudding), mud (consuming of mud), yavasura (beer ready from barley), meat which is foul smelling, dry and skinny; so additionally consuming meals which is inauspicious, by the impact of spoilt season (irregular climatic adjustments); direct breeze, possession of the physique by evil spirits, poisons (pure) and synthetic poison,contaminated meals, residing within the slopes of mountains; sick results of planetary positions and of the start star (constellation throughout which the particular person is born),improper administration and results of therapies, committing completely different sorts of sin,abnormalities of supply and improper administration (of labor and perpeureum) in ladies these result in improve of all of the three Doshas.
Vriddha Dosha gati: Destiny of elevated Doshas
प्रतिरोगमिति क्रुद्धा रोगाधिष्ठानगामिनीः॥२३॥
रसायनीः प्रपद्याशु दोषा देहे विकुर्वते॥२३ऊअब्॥
Doshas getting aggravated in these methods enter into the channels of rasa (to flow into everywhere in the physique) and produce abnormalities rapidly in locations which grow to be the seat of illnesses.
Notes – The elevated Doshas flow into together with the rasadhatu and accumulate in locations the place the rasadhatu will get obstructed because of abnormalities of the channels (sroto dusti) within the tissues. Such a spot turns into the positioning of origin of the illnesses.
इति श्री वैद्यपति सिंहगुप्तसूनु श्रीमद्वाग्भटविरचितायामष्टाङ्गहृदयसंहिताया निदानस्थाने सर्वरोगनिदानं नाम प्रथमोऽध्याय: ।।१॥
Thus ends the chapter known as Sarvaroga Nidana- the primary in Nidanasthana of Astangahrdaya Samhita composed by Srimad Vagbhata, son of Sri Vaidyapati Simhagupta.
