Hygeia J. D.Med.9 (2) January 2018 - July 2018 ......... ......... Call for papers for the forthcoming issue of Hygeia.J.D.Med.10 (1) July 2018.

Editorial

  • A GLIMPSE OF DIAGNOSIS OF DISEASES IN AYURVEDA



    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 back at least 2,000 years in its codified form. However, it has roots that are much deeper. The present day Caraka Samhita,Suśruta Samhita and Aṣṭāṅgahṛdaya refer to ancient and long-lost treatises like Nimi Tantram and Khāranādi. Nevertheless, in the absenceof authentic records it is difficult to prove the antiquity of Ayurveda. In the late twentieth and early twenty-first centuries, Ayurveda is traversing well beyond the boundaries of its homeland. It is fast becoming a transnational and multicultural phenomenon. It is the fastest growing alternative medical system in German - speaking Austria, Germany and Switzerland.


      The theory and practice of Ayurveda revolve around the tridōṣa doctrine,which states that all biological activities in the human body are controlled by three factors- vātapitta and kapha, collectively called tridōṣa. Dietary and behavioral in discretions and seasonal climatic factors cause destabilization of the tridōṣa,which slowly progresses through four stages (cayamprakōpam,prasaramsthānasamśrayam). This progression results in well-defined disease entities(vyakti) like jvaramatisāramgrahaṇipāṇḍuarśas 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 adopt daily and seasonal regimen, so that the tridōṣaremain in steady state. Many diseases are said to appear on account of the evil actions committed in present and previous lives. Therefore, it is essential to indulge in ethical activities and to refrain from committing unethical acts, if one wants to lead a disease-free life.

      Ayurvedic disease entities are in fact groups of diseases. It is very difficult and misleading toequate an ayurvedic disease entity with just one disease described in western medicine. For example, any disease characterized by the voiding of hard and loose stool belongs to the category of grahaṇi.Amoebic dysentery, irritable bowel syndrome, inflammatory bowel disease and giardiasis can be considered as grahaṇi


     Ayurveda calls upon the physician to elicit from the patient as many symptoms as possible through darśana(observation), sparśana (palpation) and praśna (interrogation). As symptoms are the only tools to gauge the extent of the physiological dysfunction, an ayurvedic physician should have sound knowledge of the various symptoms.  Nevertheless, diseases are diagnosed in contemporary ayurvedic practice using principles of western medicine and treatment is carried out with the help of ayurvedic medicines. This approach is self-defeating and lowers the usefulness of Ayurveda.


      Out of curiosity we attempted to list all the symptoms described in the famous Ayurveda textbook Aṣṭāṅgahṛdaya. This exercise revealed many interesting facts.There are 2645 well-defined symptoms mentioned in this treatise which is considered as the best textbook of Ayurveda. The maximally occurring symptom is jvara (130) followed by excessive thirst (tṛṣṇa, 114), aruci (distaste for food, 93) and burning sensation (dāha, 89).  Jvara,mahōdarachardiand kṣaya(consumption) are considered as symptoms as well as diseases. Many symptoms are mentioned using synonyms. For example, hypersomnia is described with such synonyms like nidraatinidra and svapnam. Similarly, excessive thirst (trṣṇa) is denoted by tṛṣṇatīvratṛṣṇa,atitṛṣṇatṛbhśamtṛatitṛtīvratṛtṛtṛṣyataatitṛṣyatapipāsajalātṛptitṛṣṇāgṛhīta and tṛṣānvita. Though these are seemingly synonyms, scholarly physicians say that there can be subtle differences among the synonyms. Thus, nidrābhramśam may refer to disrupted sleep and not just insomnia.

     

     

      The study also revealed an interesting aspect of Ayurveda texts. To facilitate memorizing of the entire text, Ayurveda texts are written in a cryptic manner with brevity as norm. For deciphering the meaning of many of the verses, the help of a physician 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 (vātapitta and kaphaare enraged in relation to yōni(vagina) and garbhāśaya (region of the uterus), a disease called Sannipatikīmakes its appearance, accompanied by distressing symptoms”. Cheppat Achyutha Variar interprets Sannipatikī as adisease characterized by pain, pricking pain, heat, suppuration, cold an ditching in the yōni and region of garbhāśaya. Each pair of the symptoms is related to vātapitta or kapha. From the description of symptoms, the disease seems to be cancerous 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 a good 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.




    [Pdf]

Hygeia J. D. Med.





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