DIPLOMA in Ayurvedic Lifestyle and Nutrition 16 th

DIPLOMA in Ayurvedic Lifestyle and Nutrition 16 th & 17 th February 2019 Module 6 2

THE EXAMINATION OF DISEASE ROGA PARIKSHA

• The word disease is constituted from two terms: ‘dis’ and ‘ease’ • It conveys the meaning of discomfort or un wholesomeness in the body

“Ruja thi Roga” Whatever causes pain or discomfort whether physical or psychological is called disease

“Dosha dhatu Sammuchary Roga” Any dosha or dhatu imbalance is called disease

The five therapeutics of disease In the treatment of disease the following aspects require examination: • Nidana (Etiology or cause of a disease) • Purva-Rupa (Premonitory and prodromal signs and symptoms) • Rupa (Actual signs and symptoms) • Upasaya (Therapuetic trials) • Samprapti (Pathogenesis)

Nidana or Aetiology The two meanings of Nidana: • diagnosis of the disease • aetiology of the disease

The importance of Nidana in Ayurveda: “As long as the cause of the disease is not identified and prevented, there can be no alleviation of the disease” Mādhava-Nidāna – pp. 9 10 & pp. 30 33 & 39 40

The five causative factors of disease • Prajnaparadha (Intellectual blasphemy or misuse of intelligence) • Asatmyendriyartha Samyoga (Unwholesome contacts of senses with their objects) • Kala Parinama (Seasonal perversions and age) • Karma or Samskara (Causative factors) • Krmi (Germs and parasites)

Prajnaparadha (Crime against wisdom or misuse of intelligence) It means: Carrying out an act contrary to the understanding of an awakened consciousness

This covers the following misuse of action of the body, mind or speech in three categories: • Ayoga (non activity or stimuli) • Atiyoga (excessive activity or stimuli) • Mithya yoga (inappropriate activity or stimuli)

Asatmyendriyartha Samyoga (Unwholesome contact of senses with their objects) Asatmya = harmful conjunction between the five senses and their objects leading to disease The harmful conjunction incorporates: • non conjunction (Ayoga) • excessive conjunction (Atiyoga) and • wrongful conjunction (Mithya yoga).

Examples of excessive use of sense objects i. Hearing – Loud sounds, prolonged hearing of high pitched and rough sounds such as roaring, thunder, beating of drums ii. Touch excessive use or handling of very hot or very cold things; too much bathing or massage iii. Sight excessive exposure to bright or powerful light iv. Taste – excessive taste of any or all of the six rasas v. Smell excessive smelling of very strong or pungent or putrid substances

Examples of wrongful use of sense objects i. Hearing hearing of harsh or disagreeable or fearful sounds or mournful news ii. Touch touching poisonous air, exposure to stormy winds or untimely advent of hot or cold weather or to be struck by anything iii. Sight to see extremely fine and small objects very near to the eye or at very great distance; or to see loathsome, dreadful or hostile objects; or any distorted vision iv. Taste to have recourse to only one kind of taste in excess or to exclude one altogether or take very little of one to include in one’s diet; articles of food whose combination is harmful v. Smell to smell putrid, poisonous, nauseating things

Examples of non use of sense objects This self explanatory and is isolation of the senses from any kind of sound, object to touch whether cold or hot; no sight of any object; no taste of six rasas; and nothing to smell For example: • Travelling on the tube • Solitary confinement including sensory deprivation

Parinama (Seasonal perversions and age) • Atiyoga of kala (time) = when a particular season manifests its own characteristic of cold, heat or rains in an excessive degree • Ayoga of kala (time) = when these characteristics are deficient • Mithya yoga of kala (time) = when a season manifests symptoms which are opposite to its particular characteristics

Parinama also means: • Certain diseases can affect certain constitutions in different ways • Genetic effect on survival • Diseases caused by ageing eg. Menopause and osteoarthritis

Classification of disease according to pathophysiology Pathophysiology Bodily (Sarira) Nija Mental (Manas) Aganthuka Nija Aganthuka

Classification of disease according to treatment methods Treatment Surgical Medical

Classification of disease according to causative factors Causative factors Adhyatmika (pertaining to the soul) Adhibahutika (pertaining to physical environment) Adhidaivika (pertaining to the acts of God or nature or karma)

Classification of disease according to causative factors Causative factors Adi – bala – Pravrtta Janamabala Pravrtta Dosha – bala Pravrtta Samghata – bala Pravrtta Kala – bala – Pravrtta Daiva – bala Pravrtta Svabhava – bala – Pravrtta

Classification of disease according to causative factors (i) Adi – bala – Pravrtta (Orginated from any primary inherent cause) (ii) Janamabala Pravrtta (congenital) (iii) Dosa – bala Pravrtta (due to deranged body doshas) (iv) Samghata – bala Pravrtta (due to extraneous causes) (v) Kala – bala – Pravrtta (due to climatic and seasonal distemper) (vi) Daiva – bala Pravrtta (divine or natural havocs) (vii) Svabhava – bala – Pravrtta (Physiological or natural type)

Adi – bala – Pravrtta (Orginated from any primary inherent cause) Caused by defects in: (a) in the father or (b) in the mother These are hereditary diseases, eg: Leprosy, asthma, piles

Janamabala Pravrtta (congenital) Due to any improper conduct on the part of the mother regarding food or hygiene during the period of gestation: (a) Rasa (improper food) or (b) Lack of mindfulness of the hygienic principles (These diseases can happen in spite of the fact that there is no defect in the germ cells of either parent)

Dosha – bala Pravrtta (due to deranged body doshas) Occurs due to derangement of any of the doshas due to improper diet, unhealthy habits or one disease secondary to previous one These can be sub divided as (a) Bodily (vāta, pitta, kapha) or (b) Mental (Rajas and Tamas)

Samghata – bala Pravrtta (due to extraneous causes) These are diseases caused by external factors in two categories: (a) an implement or (a) any ferocious or poisonous animal or allergy

Kala – bala – Pravrtta (due to climatic and seasonal distemper) Disease can precipitate due to: • excessive variabilities in climates of season • atmospheric temperature or • Humidity

Daiva – bala Pravrtta (divine or natural havocs) Disease can be produced by being in the wrong place at the wrong time: • by lightning • any malignant influence • by association • by accident

Svabhava – bala – Pravrtta (Physiological or natural type) Hunger, thirst, old age, death, sleep etc are considered as natural or physiological diseases

Immunity in Caraka and Susruta “Arogya (health in respect of prevention and recovery) depends on bala or body resistance” Caraka Cikitsa “Always try to maintain the bala or resistance of a person, if restored, it arrests the progress of the disease” Susruta Cikitsa “In one who has extremely lost the bala, it is not possible to make him free of the diseases” Susruta, Sutra

Ojas is called Vyadhi-ksamitva Vyadhi = disease Ksamitva = decline This can mean: 1. To arrest the progress of the disease 2. Prevent the occurrence or 3. Re occurrence of the disease

• Sahaja (natural or innate) Vyadhi-bala-virodhitva = natural immunity, generally of non specific type, which attempts to defend the body in the first occurrence of any disease • Yuktikrta (acquired) Vyadhutpada-pratibandhakatva = when the natural immunity is experienced in any way ie. vaccination it often succeeds to check the re occurrence or occurrence of certain diseases

Evidence of immunity in Caraka Nidana • Natural cure patients recover without going under any treatment • A certain inhibiting factor due to which deviations from hygiene rules do not produce a sudden ill effect among the unwholesome or contaminated diet takers eg food poisoning which doesn’t affect everyone • The significant peculiarities in the form of non occurrences, poor – manifestations and full manifestations of diseases are dependent on characteristics of aetiological factors, reacting humours and body tissues

The twelve seats of ojas • • • sonita (blood) mamsa (muscular tissue) medas (adipose tissues or fat) asthi (bone tissues) majja (bone marrow) sukra (genital secretions) sukla (some watery secretions of the body) sweda (sweat) pitta (gastro intestinal secretions) slesman (mucoid secretions) mutra (urine) purisa (stool)

Factors affecting the Grades of Immunity is also inherited and greatly influenced by several other factors such as: • diet • environment • mode of living • psychic patterns • growth or development • age • pathological conditions of the individual

In Ayurveda factors affecting the immunity have been classified into two groups: • factors that lessen immunity • factors that enhance immunity

Lessening factors which lower the defence mechanism of the body • severe infection bhutopghata • excessive loss of body fluids ativartna of kapha, sonita, sukra and mala • wasting ksaya • physical exertion – srama & vyayama • intoxicating liquors – ruksa pana • prolonged awakening – prajagara • mental stress such as anger, anxiety, fear, and grief – kopa, cinta, bhaya & sokainjury, accidental or surgical – abhigata • nutritional disturbances – ksut, anasana, atilanghana, ruksalpaprami – tatsana • season, environment, and age – kala, vatatapa & jara • severe humoral upset – dosa vega

Enhancing factors which enhance the defence mechanism of the body • • • characteristics of race and generation in which birth has taken place genetic peculiarity of parents favourable climate balanced diet constitutional characteristics want of hyper sensitivity mental peace outcome of something latent adolescence proper exercise proper stimulation