Abstract
A Glimpse of Diagnosis of Diseases in Ayurveda
Guest Editorial
Hygeia.J.D.Med. 2018; 9 (2):1-2
DOI:10.15254/H.J.D.Med.9.2018.15
Dr.D.SURESH KUMAR
Cymbio Pharma Pvt Ltd, Yeswanthpur, Bangalore – 560 022, India
Ayurveda dates backat least 2,000 years in its codified form. However, it has roots that are muchdeeper. The present day Caraka Samhita,Suśruta Samhita and Aṣṭāṅgahṛdaya refer to ancient and long-losttreatises like Nimi Tantram and Khāranādi. Nevertheless, in the absenceof authentic records it is difficult to prove the antiquity of Ayurveda. In thelate twentieth and early twenty-first centuries, Ayurveda is traversing wellbeyond the boundaries of its homeland. It is fast becoming a transnational andmulticultural phenomenon. It is the fastest growing alternative medical systemin German - speaking Austria, Germany and Switzerland.
The theory andpractice of Ayurveda revolve around the tridōṣa doctrine,which states that all biological activities in the human body are controlled bythree factors- vāta, pitta and kapha, collectively called tridōṣa. Dietaryand behavioural indiscretions and seasonal climatic factors causedestabilization of the tridōṣa,which slowly progresses through four stages (cayam, prakōpam,prasaram, sthānasamśrayam). This progression results in well-defined diseaseentities (vyakti) like jvaram, atisāram, grahaṇi, pāṇḍu, arśas etc. However, if left untreated, the disease progresses tothe sixth and last stage (bhēdam) at which it may or may not becurable. Ayurveda calls upon individuals to consume wholesome food and adoptdaily and seasonal regimen, so that the tridōṣaremain in steady state. Many diseases are said to appear on account of the evilactions committed in present and previous lives. Therefore, it is essential toindulge in ethical activities and to refrain from committing unethical acts, ifone wants to lead a disease-free life.
Ayurvedic diseaseentities are in fact groups of diseases. It is very difficult and misleading toequate an ayurvedic disease entity with just one disease described in westernmedicine. For example, any disease characterized by the voiding of hard and loosestool belongs to the category of grahaṇi.Amoebic dysentery, irritable bowel syndrome, inflammatory bowel disease andgiardiasis can be considered as grahaṇi.
Ayurveda callsupon the physician to elicit from the patient as many symptoms as possiblethrough darśana (observation), sparśana (palpation) and praśna (interrogation). As symptoms arethe only tools to gauge the extent of the physiological dysfunction, anayurvedic physician should have sound knowledge of the various symptoms. Nevertheless, diseases are diagnosed incontemporary ayurvedic practice using principles of western medicine andtreatment is carried out with the help of ayurvedic medicines. This approach isself-defeating and lowers the usefulness of Ayurveda.
Out of curiositywe attempted to list all the symptoms described in the famous Ayurveda textbookAṣṭāṅgahṛdaya. This exercise revealed many interesting facts.There are 2645 well-defined symptoms mentioned in this treatise which isconsidered as the best textbook of Ayurveda. The maximally occurring symptom isjvara (130) followed by excessivethirst (tṛṣṇa, 114), aruci (distaste for food, 93) and burning sensation (dāha, 89). Jvara,mahōdara, chardi and kṣaya(consumption) are considered as symptoms as well as diseases. Many symptoms arementioned using synonyms. For example, hypersomnia is described with suchsynonyms like nidra, atinidra and svapnam. Similarly, excessive thirst (trṣṇa) is denoted by tṛṣṇa, tīvratṛṣṇa,atitṛṣṇa, tṛṭ, bhṛśamtṛṭ, atitṛṭ, tīvratṛṭ, tṛṇ, tṛṣyata, atitṛṣyata, pipāsa, jalātṛpti, tṛṣṇāgṛhīta and tṛṣānvita. Though these are seeminglysynonyms, scholarly physicians say that there can be subtle differences amongthe synonyms. Thus, nidrābhramśam mayrefer to disrupted sleep and not just insomnia.
The study alsorevealed an interesting aspect of Ayurveda texts. To facilitate memorizing ofthe entire text, Ayurveda texts are written in a cryptic manner with brevity asnorm. For deciphering the meaning of many of the verses, the help of aphysician well-versed in Sanskrit language is inevitable. For example in Aṣṭāṅgahṛdaya(Uttarasthāna, Chapter 33, ślōka 51) a disease entity called Sannipatikī is mentioned. The ślōkasays: “When tridōṣa(vāta, pitta and kapha) areenraged in relation to yōni(vagina) and garbhāśaya (region ofthe uterus), a disease called Sannipatikīmakes its appearance, accompanied by distressing symptoms”. Cheppat AchyuthaVariar interprets Sannipatikī as adisease characterized by pain, pricking pain, heat, suppuration, cold anditching in the yōniand region of garbhāśaya. Each pairof the symptoms is related to vāta, pitta or kapha. From the description of symptoms, the disease seems to be acancerous condition.
In contemporary Ayurveda, western diagnostic parameters are invariably used in the diagnosis of diseases. It is important that the clinical data obtained through techniques like spectrophotometry, electrocardiography,electromyography and the like are rationally correlated with tridōṣa, if they are to be used in Ayurveda. However, as this has not been achieved so far, it will be appropriate to use principles of Ayurveda for diagnosis of diseases and western medicaltechnology for evaluating the success of ayurvedic diagnosis and treatment. Such an approach will enables to take advantage of the positive aspects of Ayurveda, which advises that agood physician who relies on the tridōṣa doctrine will be able to diagnose and treat any kind of disease, including nameless ones. The very fact that Ayurveda has withstood the test of time emphasizes that its theoretical foundation has good internal consistency.