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“NECESSITY AND IMPORTANCE OF POORVAROOPA IN           ROGA NIDANA AND CHIKITSA”                     BY          DR.BHARATE...
RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES,                  KARNATAKA, BANGALORE                  DECLARATION BY THE CAND...
RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES,                       KARNATAKA, BANGALORE                               DR. B...
RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES,                      KARNATAKA, BANGALORE                              DR. B. ...
COPYRIGHT                   DECLARATION BY THE CANDIDATEI here by declare that the Rajiv Gandhi University of Health Scien...
ACKNOWLEDGEMENT        On  the  eve  of  completion  of  this  dissertation,  I  bow  my  head  to  the  great almighty wh...
I thank librarian Mr. S.D.Hiremath of Shri. BNME Trust’s and Research centre and  I  also  thank  library  staff  Mr.  Bel...
I thank to Mr. Kalyankumar of Preeti computers for the binding work. Certain names  that  have  not  been  mentioned  unin...
ABBREVIATIONSSha.Ka.Dr     :   Shabdakalpadruma.M.M.Wi        :   Monier Monier Williams Dictionary.Ch.Su         :   Char...
ABSTRACTBackground:       The aim of Ayurveda is “Swasthasya swasthya rakshana” and “Aturasya vikaraprashamana”, it is ach...
Interpretation and conclusion:         The explanation regarding Poorvaroopa is given in the context withNidanapanchaka as...
CONTENTSContents                                    Page No.1) Introduction                                 012) Objective...
LIST OF TABLESTable No.                       Contents                  Page No   1. Nidana Panchaka.                     ...
23. Poorvaroopa of Shotha.                                    4224. Poorvaroopa of Prameha.                               ...
Introduction                                     INRODUCTION        Ayurveda the science of life explains Trisutra in the ...
Introduction           Even after a long run on the path of research in Ayurvedic field the necessity andimportance of Poo...
Objectives                                      OBJECTIVES        To Study in detail regarding Nidana panchaka w.s.r. to P...
Review of Literature  HISTORICAL REVIEWSAMHITA KAALABrahtrayees:Charaka samhita       In Charaka Samhita Nidanasthana, 1st...
Review of Literature  Laghutrayees:Sharangadhara samhita       In Sharangadhara samhita Nidana panchaka has been mentioned...
Review of Literature  NIDANA PANCHAKA            The word Nidana panchaka is combination of two words Nidana which refers ...
Review of Literature  Paribhasha:Vyadhiutpatti dhnapti:       “Nidana” helps to know about Hetu, Lakshana, and Samprapti o...
Review of Literature  Hetubhuta:          Factor which manifests diseases is called Nidana.22          Nidana means one wh...
Review of Literature  Three types of aayatana: 32    •   Asatmyendriyartha samyoga (Artha)    •   Prajnaparadha (Karma)   ...
Review of Literature  Two types of hetu: 39      •   Prakrita      •   VaikritaTwo types of Hetu: 40      •   Anubandhya  ...
Review of Literature  Table No-02 Showing Chaya and Prakopa of dosha as per Ritu.      Dosha            Chaya           Pr...
Review of Literature  Table No-03 Showing types Asatmendriyarth samyoga of Indriyartha.        Indriya                 Ati...
Review of Literature  Prajnaparadha: 48, 49           Doing Ashubha karma due to vibramsha of Dhi, Drati and Smruti is cal...
Review of Literature  Table No-05 Showing Ayoga, Atiyoga and Mithyayoga of Kala             Atiyoga                  Ayoga...
Review of Literature  Utpadaka Hetu: 55       Utpadaka Hetu is one which favors accumulation of respective doshas withresp...
Review of Literature  Vaikrita Hetu: 60    Vaikrita Hetus are those which manifest unnaturally due to abnormal Ritu, where...
Review of Literature  Ashyapakarsha Hetu: 65        Ashayapakarsha means Prakruta or Sama dosha moves from its own place b...
Review of Literature       Initially Nidanarthkara Rogas manifest independently as a disease and later serves asa Nidana f...
Review of Literature      •   Linga, it indicates general or specific state of dosha’s or stage of diseases by        exhi...
Review of Literature        •   Linga indicates a specific disease by manifesting specific symptoms of that          disea...
Review of Literature          For example-    •   Fever is a common symptom in many diseases having different patterns and...
Review of Literature      •   The Hetuviparita, Vyadhi viparita, Ubhayaviparita, Hetu viparitharthakari,        Vyadhi Vip...
Review of Literature        •    Vyadhi viparitarthkari Aushadha – Drugs which are working against the           disease t...
Review of Literature                         vataja shotha, which       against        sheetottha brings Rukshata in      ...
Review of Literature  Anupashaya:Paribhasha:    •   Opposite to the description of Upashaya is called Anupashaya, which is...
Review of Literature  Paribhasha:    •   Process of understanding the development of disease by the vitiated dosha’s      ...
Review of Literature  Pradhanya samprapti          Pradhanya means which indicates whether the disease is Swatantra andPar...
Review of Literature  Bala samprapti       Understanding the strength of the disease based on symptoms of Nidana,Poorvaroo...
Review of Literature  POORVAROOPANirukti: 116,117          Poorvaroopa is Napunsaka Linga, with karmadhareya samasa i.e. “...
Review of Literature      •    Poorvaroopas are those lakshana which appear earlier to the actual disease, not         spe...
Review of Literature  Vishista Poorvaroopa: Two aspects have been given-    •   Avyakta Poorvaroopa:    Lakshanas which ar...
Review of Literature        •      Manasika Poorvaroopa: Krimi darshana, Kesh in Ahara, Rikta koopa and             Nirjan...
Review of Literature      Twak, mamsa, shonita    Kshudra roga, Kushta, Visarpa     Medo                    Granti, Apache...
Review of Literature  Table No-10 Showing Poorvaroopa of Hikka        Poorvaroopa147          Charaka148       Sushruta149...
Review of Literature        Nidra                                              +      Ashnatopibalakshaya                 ...
Review of Literature  Table No-12 Showing Poorvaroopa of Urakshata:             Poorvaroopa       Charaka152    Uroruk    ...
Review of Literature      Sadana                                        +              +    Klama                         ...
Review of Literature      Anannabhilaha            +             +    Raji janma               +             +            ...
Review of Literature      Vata apata asahatwa            +              +    Aruchi                         +             ...
Review of Literature              Peetmutratwa                                 +              +            Alpavanhi      ...
Review of Literature      Anannabhilasha                   +    Bhuktashya vidaha                +    Paridaha            ...
Review of Literature  Table No-22 Showing Poorvaroopa of Kustha:              Poorvaroopa              Charaka177   Sushru...
Review of Literature  Table No-24 Showing Poorvaroopa of Prameha             Poorvaroopa           Charaka182    Sushruta1...
Review of Literature      Swavedanavarnam dustam            +    saandra avila mutrata    kricchanmutra                   ...
Review of Literature      Kasa shwasa                                     +    Balahani                                   ...
Review of Literature      Murcha                           +              +              +    Pramudhata                  ...
Review of Literature      Hrudgraha                          +             +    Asamaya dhyana                     +    Ay...
Review of Literature  Table No-32 Showing Poorvaroopa of Urusthambha             Poorvaroopa          Charaka200    Atinid...
Review of Literature  Importance of Poorvaroopa in Sapeksha nidana        One who passes deep yellow colored or bloody uri...
Review of Literature          For example –Anyalinga vyadhi- Arsha is the Poorvaroopa vyadhi for the disease like Grahani,...
Review of Literature  Examples given in Charaka Samhita: 215Jwara:     If patient manifests Jwara with all or more number ...
Review of Literature  Kustha:     Even if with slightest touch there is excessive tearing and wounds do not heal, suchpers...
Review of Literature  Bahirayama:      One who gets his hanu, manya and netra stiffened after awaking from sleep,becomes a...
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NECESSITY AND IMPORTANCE OF POORVAROOPA IN ROGA NIDANA AND CHIKITSA” BY DR.BHARATESH KURUNDAWADE, DR. B.N.M.E.T’S SHRI MALLIKARJUNA SWAMIJI POST
GRADUATE AND RESEARCH CENTRE, BIJAPUR

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  1. 1. “NECESSITY AND IMPORTANCE OF POORVAROOPA IN ROGA NIDANA AND CHIKITSA” BY DR.BHARATESH KURUNDAWADE DISSERTATION SUBMITTED TO THE RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES, KARNATAKA, BANGALORE IN THE PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE DEGREE OF DOCTOR OF MEDICINE (Ayurveda Vachaspati) IN SAMHITA UNDER THE GUIDANCE OF DR. KALYANI BHAT M.D (AYU)DEPARTMENT OF POST GRADUATE STUDIES IN SAMHITA, DR. B.N.M.E.T’S SHRI MALLIKARJUNA SWAMIJI POST GRADUATE AND RESEARCH CENTRE, BIJAPUR NOVEMBER 2010
  2. 2. RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES, KARNATAKA, BANGALORE DECLARATION BY THE CANDIDATE I hereby declare that this dissertation thesis entitled “NECESSITY ANDIMPORTANCE OF POORVAROOPA IN ROGA NIDANA AND CHIKITSA”is a bonafide and genuine research work carried out by me under the guidance of DR.KALYANI BHAT M.D (Ayu) Professor, Dept. of Samhita, Shri Mallikarjuna Swamiji PostGraduate and Research Centre, Bijapur.Date:Place: Bijapur. DR.BHARATESH KURUNDAWADE
  3. 3. RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES, KARNATAKA, BANGALORE DR. B. N. M. E. T’s SHRI MALLIKARJUNA SWAMIJI POST GRADUATE AND RESEARCH CENTRE, BIJAPUR DEPARTMENT OF POST GRADUATE STUDIES IN SAMHITA CERTIFICATE BY THE GUIDE This is to certify that the dissertation entitled “NECESSITY ANDIMPORTANCE OF POORVAROOPA IN ROGA NIDANA AND CHIKITSA”is a bonafide research work carried out by DR.BHARATESH KURUNDAWADE inthe partial fulfillment of the requirement for the degree of M.D. (Ayurveda). Signature DR. KALYANI BHAT M.D. (Ayu)Date: ProfessorPlace: Bijapur. Dept. of Samhita, Shri Mallikarjuna Swamiji Post Graduate and Research Centre, Bijapur
  4. 4. RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES, KARNATAKA, BANGALORE DR. B. N. M. E. T’s SHRI MALLIKARJUNA SWAMIJI POST GRADUATE AND RESEARCH CENTRE, BIJAPUR DEPARTMENT OF POST GRADUATE STUDIES IN SAMHITA ENDORSEMENT BY THE H.O.D., PRINCIPAL/HEAD OF THE INSTITUTION This is to certify that the dissertation entitled “NECESSITY ANDIMPORTANCE OF POORVAROOPA IN ROGA NIDANA AND CHIKITSA”is a bonafide research work done by DR.BHARATESH KURUNDAWADE underthe guidance of DR. Kalyani Bhat M.D (AYU) Professor, Dept.of Samhita, ShriMallikarjuna Swamiji Post Graduate and Research Centre, BijapurSeal and Signature of H.O.D Seal and Signature of PrincipalDR. G.B.Bagali M.D (Ayu) DR. R.N.Gennur M.D (Ayu)Date: Date:Place: Bijapur. Place: Bijapur.
  5. 5. COPYRIGHT DECLARATION BY THE CANDIDATEI here by declare that the Rajiv Gandhi University of Health Sciences, Karnataka shallhave the rights to preserve, use & disseminate this dissertation thesis in print orelectronic format for academic/research purpose.Date:Place: Bijapur DR.BHARATESH KURUNDAWADE © Rajiv Gandhi University of Health Sciences, Karnataka
  6. 6. ACKNOWLEDGEMENT On  the  eve  of  completion  of  this  dissertation,  I  bow  my  head  to  the  great almighty who has always showered the blessings on me, filled in me the strength to face all the situations and without whom I could not have achieved anything.  I  express  my  gratitude  to  Dr.  K.B.Nagur  MD  (Ayu)  Honourable  Chairman  and members  of  management  committee  for  providing  all  facilities  and  always supporting the right cause.   I am thankful to Dr.R N.Gennur  MD  (Ayu) Principal, for his support throughout the  course  and  especially  during  my  dissertation  work  and  lending  his  ears  to  our problems always.  I owe a debit of gratitude to my guide Dr.Kalyani.Bhat  MD  (Ayu) for her noble guidance, inspiration and construct to criticism during dissertation work.   My sincere thanks to Dr.G.B.Bagali  MD(Ayu), HOD of Samhita department, for  being our back bone and always helping in the best possible way by giving  valuable suggestions,  guidelines, motivational inspiration, throughout the work.  I  remain  ever  thankful  to  My  Teachers  Dr.  Srinivas  Vadeyar,  who  is  the treasure houses of knowledge and living libraries for me.  My  heartiest  thanks  to  my  department  staff  Dr.M.G.Deshpande  MD  (Ayu)  for helping me with her erudite suggestions in bringing up this dissertation. I express my gratitude  to  all  the  staff  members  of  my  department  Dr.S.G.Kulkarni  MD  (Ayu),  Dr. M.S.Bhupale  MD  (Ayu),  Dr.S.B.Naragund  MD  (Ayu),  Dr.U.C.  Baragi  MD  (Ayu),  Dr.  A.V. Junjurwad MD (Ayu) for helping in so many ways in preparing this work.  Also  I  express  my  deep  sense  of  gratitude  to  the  screening  committee members Dr. B.S. Tamagond MD (Ayu) and Dr. J.C. Huddar MD (Ayu)   i
  7. 7. I thank librarian Mr. S.D.Hiremath of Shri. BNME Trust’s and Research centre and  I  also  thank  library  staff  Mr.  Bellary  and  librarian  of  the  Bhandarkar  Oriental Research Institute Pune for the all the help they have provided.  I thank Mr.Dolli Sir and other office staff – Smt Jatti, Mr Satish, Smt Suvarna for their support.  I  express  my  immense  thanks  to  my  seniors  Dr.  Kalavati,  Dr.  Krishna,  Dr. Suchitra,  Dr.  Shashirekha  and  juniors  Dr.  Bijapur,  Dr.  Santosh,  Dr.  Vijaya,  Dr. Srinivas and Dr. Pramod for all the help.  I  am  thankful  to  my  friends  Dr.  Firoz  Varun,  Dr.  Sunil.P.V,  Dr.  Haroon,  Dr. Deshmukh, Dr. Bharat, Dr. Pankaj, Dr. Sunil, Dr.Ukumnal, Dr.Bhavesh, Dr.Prashant, Dr.Poornima,  Dr.  Trusha,  Dr.Sumangala,  Dr.  Shreedevi,  Dr.  Kavita,  Dr.  Shivleela, Dr.Rupindar and Dr. Surekha for their help.  My strength is my Grandmother Smt Housabai and Parents, Shri Bapusaheb and  Smt  Sunanda  in  whom  I  experience  the  blessings  of  god  and  My  Brothers Dr.Sanmati, Mr Satish, Dr.Ravi, and Mr. Sandeep and Sisters‐in‐law Smt. Sujata and Smt. Anita. It is because of their pain taking efforts I have reached up to this position of life. Also I want to thank my Nephew Mast Vedant for his unconditional love.  A friend in need is a friend indeed. This holds good to my friends Dr.Ismail, Dr. Mallikarjun,  Dr.  Mahantesh,  Dr.  Dadagouda,  Dr.  Basavaraj,  Dr.  Abhilasha, Dr.Sridevi, Dr. Sona, Dr. Shilpa, Mr.Sanju, Mr Mahesh, Mr. Mahaveer, Mr Deepak   for  all  their  help  and  affection  towards  me.  I  find  no  words  to  express  gratitude  to them. Only thing I can say is Thank you.  ii
  8. 8. I thank to Mr. Kalyankumar of Preeti computers for the binding work. Certain names  that  have  not  been  mentioned  unintentionally  who  helped  directly  or indirectly in this work I thank to all of them.   Dr.Bharatesh Kurundawade. iii
  9. 9. ABBREVIATIONSSha.Ka.Dr : Shabdakalpadruma.M.M.Wi : Monier Monier Williams Dictionary.Ch.Su : Charaka Samhita Sutrasthana.Ch.Ni : Charaka Samhita Nidanasthana.Ch.Vi : Charaka Samhita Vimanasthana.Ch.Sh : Charaka Samhita Sharirasthana.Ch.In : Charaka Samhita Indriyasthana.Ch.Chi : Charaka Samhita Chikitsasthana.Su.Su : Sushruta Samhita Sutrasthana.Su.Ni : Sushruta Samhita Nidanasthana.Su.Chi : Sushruta Samhita Chikitsasthana.Su.Ut : Sushruta Samhita Uttaratantra.As.Hr.Su : Ashtanga Hrudayam Sutrasthana.As.Hr.Sh : Ashtanga Hrudayam Sharirasthana.As.Hr.Ni : Ashtanga Hrudayam Nidanasthana.As.Hr.Chi : Ashtanga Hrudayam Chikitsasthana.As.Hr.Ut : Ashtanga Hrudayam Uttaratantra.As.Sa.Ni : Ashtanga Sangraha Nidanasthana.Ma.Ni : Madhava Nidana.Bh.Pr.Pu.Kh : Bhavavaprakasha Purva Khanda.Sh.Pu.Kh : Sharangadhara Purva Khanda.Va.Ni : Vangasena Samhita Nidanasthana. iv  
  10. 10. ABSTRACTBackground: The aim of Ayurveda is “Swasthasya swasthya rakshana” and “Aturasya vikaraprashamana”, it is achieved on the bases of various concepts of Ayurveda. Nidanapanchaka is one of them. To cope with the fast developing field of medicine many Ayurvedic concepts areto be reviewed, also must be updated and presented so as to fulfill the lacunae indiagnosis and treatment. With this background, the study “Necessity and importance ofPoorvaroopa in Roga nidana and Chikitsa” was carried out.Objectives: To Study in detail regarding Nidana panchaka w.s.r. to Poorvaroopa. To explore the Scope of Poorvaroopa in present scenario. To expand the Necessity and Importance of Poorvaroopa in Roga nidana and Chikitsa.Methods: Collection, compilation, sorting and interpretations of various documents rightfrom Vedic scriptures, manuscripts, Samhitas to latest dissertations were done.Results: After analyzing all the relevant sources it revealed that Poorvaroopa plays animportant role in Roga nidana and Chikitsa too. v  
  11. 11. Interpretation and conclusion: The explanation regarding Poorvaroopa is given in the context withNidanapanchaka as a tool for Roga nidana. Poorvaroopa is the part and parcel ofUtpahyamana Vyadhi. The lakshanas appears in Poorvaroopa are very different ofRoopavastha. Poorvaroopa not only helps in the Roga nidana, it also helps to decide thesadhyasadhyata of vyadhi and to treat the disease at its infancy with Specific treatment. Keywords:Nidana panchakaRoga nidanaChikitsaNidanaHetuPoorvaroopaRoopaUpshayaSampraptiSthanasamshrayaSadyasadhyataVyadhi vi  
  12. 12. CONTENTSContents Page No.1) Introduction 012) Objectives 033) Review of Literature 044) Materials and Methods 555) Discussion 596) Conclusion 1007) Recommendation for Future Study 1018) Summary 1029) Classical references 10310) Bibliography 11411) Manuscripts --- vii  
  13. 13. LIST OF TABLESTable No. Contents Page No 1. Nidana Panchaka. 06 2. Chaya and Prakopa of Doshas as per Ritu. 11 3. Types of Asatmendritartha Samyoga of Indriyartha. 12 4. Prajnaparadha 13 5. Ayoga, Atiyoga and Mithya yoga of Kala. 14 6. Examples of Upashaya. 23 7. The Disease and the place of Sthanasamshraya. 32 8. Poorvaroopa of Kasa. 33 9. Poorvaroopa of Swasa. 33 10. Poorvaroopa of Hikka. 34 11. Poorvaroopa of Rajayakshma. 34 12. Poorvaroopa of Urakshata. 36 13. Poorvaroopa of Pratishyaya. 36 14. Poorvaroopa of Chardi. 36 15. Poorvaroopa of Grahani. 36 16. Poorvaroopa of Udara. 37 17. Poorvaroopa of Trushna. 38 18. Poorvaroopa of Jwara. 38 19. Poorvaroopa of Pandu. 39 20. Poorvaroopa of Raktapitta 40 21. Poorvaroopa of Vatarakta. 41 22. Poorvaroopa of Kushtha. 42 viii
  14. 14. 23. Poorvaroopa of Shotha. 4224. Poorvaroopa of Prameha. 4325. Poorvaroopa of Ashmari. 4326. Poorvaroopa of Atisara. 4427. Poorvaroopa of Arsha. 4428. Poorvaroopa of Bhagandhara. 4529. Poorvaroopa of Apasmara. 4530. Poorvaroopa of Unmada. 4631. Poorvaroopa of Gulma. 4732. Poorvaroopa of Urustambha. 4833. Poorvaroopa of Masoorika. 4834. Poorvaroopa of Sheetapitta. 4835. Difference between Poorvaroopa and Roopa. 7536. List of Vyadhis where both Poorvaroopa and Samanya lakshana are mentioned. 8137. List of Vyadhis where only Poorvaroopa is mentioned and not Samanya lakshanas. 8238. List of Vyadhis where both Poorvaroopa and Samanya lakshana are not mentioned. 82 ix
  15. 15. Introduction    INRODUCTION Ayurveda the science of life explains Trisutra in the form of Hetu, Ling andAushadha. Here Hetu refers to causative factor, Linga refers to Lakshana and Aushadarefers to Chikitsa and prime importance is given to Hetu and Linga which contributesVyadhi pareeksha and then to Chikitsa, i.e. “Rogam adou pareekshayet tatho anantara chikitsa” In an age old Ayurvedic classics five tools have been explained for upalabdhi ofvyadhi, which are known as Nidanapanchaka. These are Hetu, Poorvaroopa, Roopa,Upashaya and Samprapti, which are subjective as well as objective, which are theconcept and principles to be applied to understand vyadhi. Without the knowledge of Nidanapanchaka the planning of Chikitsa is a difficulttask. Each and every Nidanapanchaka has its own importance. Description regardingPoorvaroopa is comparatively brief when compared to other. Sushruta samhita explains the Shatkriyakala as the Karmavasara. If vyadhi istreated in its previous stage then it will not proceed to the next stage. So, the wisephysician should start the Chikitsa from Poorvaroopavastha to prevent the furthermanifestation of the vyadhi. Sadhyasadhyata of the Vyadhi purely depends on Poorvaroopavasta of the vyadhi.So negligence of this stage may lead to worsening of vyadhi and makes it kasthasadhyaand then may asadhya. In present days everybody is focused on Roopa without much highlighting thePoorvaroopa. By this type of attitude Vaidya is losing the opportunity to treat the vyadhiin its infancy. “Necessity and Importance of Poorvaroopa in Roga nidana and Chikitsa.”   Page 1  
  16. 16. Introduction    Even after a long run on the path of research in Ayurvedic field the necessity andimportance of Poorvaroopa remains an ignored subject. So it is necessary to put forth thefundamental aspect of Poorvaroopa. Hence this literary research work is undertaken to explore the necessity andimportance of Poorvaroopa in Roga Nidan and Chikitsa in day to day clinical practice. “Necessity and Importance of Poorvaroopa in Roga nidana and Chikitsa.”   Page 2  
  17. 17. Objectives   OBJECTIVES To Study in detail regarding Nidana panchaka w.s.r. to Poorvaroopa. To explore the Scope of Poorvaroopa in present scenario. To expand the Necessity and importance of Poorvaroopa in Roga nidana and Chikitsa. “Necessity and Importance of Poorvaroopa in Roga nidana and Chikitsa.”       Page 3  
  18. 18. Review of Literature  HISTORICAL REVIEWSAMHITA KAALABrahtrayees:Charaka samhita In Charaka Samhita Nidanasthana, 1st chapter, Nidana, Poorvaroopa, Roopa,Upashaya and Samprapti have been explained as the tools to get the complete knowledgeof the vyadhi. But while commenting on this Chakrapani for the first time used the word“Nidana panchaka”Susruta samhita In Susruta samhita, the word Nidana panchaka is not directly mentioned, but thedescription is found scattered throughout the samhita under different headings.Explanation regarding Poorvaroopa and Roopa is found under the heading of Shatkriyakala in Vranaprashamana Adhyaya.While the definition of Poorvaroopa has been statedin Aturopakramaniya Adhyaya. Nidana, Upashaya and Samprapti have found their placein individual context.Astanga Sangraha In Astanga Sangraha, the detail explanation regarding Nidana Panchaka is foundin the first chapter of Nidana Sthana, which shows the importance of diagnosis of thedisease before treatment.Astanga Hrudaya In Astanga Hrudaya, Nidana panchaka are mentioned in Sutrasthana i.e inAyushkamiya adhyaya under explanation of Rogi pariksha, But detailed explanation isdone in Nidana sthana 1st chapter i.e Sarva roga Nidana adhyaya.    “Necessity and Importance of Poorvaroopa in Roga nidana and Chikitsa.”      Page 4 
  19. 19. Review of Literature  Laghutrayees:Sharangadhara samhita In Sharangadhara samhita Nidana panchaka has been mentioned in 1st chapter ofprathama khanda. But detailed explanation is not found.Madhava Nidana In Madhava Nidana there is detailed description regarding Nidana panchaka invery first chapter which is named as the Pancha Nidana. Madhukoshakara Vijayarakshitaexplains each Nidana in a well elaborated manner.Bhavaprakasha Nighantu In Bhavaprakasha there is detailed description regarding Nidana panchaka inPoorva Khanda 7th chapter viz, Rogi pareeksha Prakarana.Other Samhitas:Vangashena samhita In Vangashena samhita Nidana pachaka have been mentioned in 1st chapter ofNidanadhikara    “Necessity and Importance of Poorvaroopa in Roga nidana and Chikitsa.”      Page 5 
  20. 20. Review of Literature  NIDANA PANCHAKA The word Nidana panchaka is combination of two words Nidana which refers toRoganidana and Panchaka is indicative of number i.e. five, these are as fallowsTable No-01 Showing Nidana panchaka: Charaka 1 Vagbhata2,3 Madhava4 Bhavaprakash5 Sharangadhar6 Vangasena7 Nidana Nidana Nidana Hetu Hetu Nidana Poorvaroopa Poorvaroopa Poorvaroopa Samprapti AdiRoopa Poorvaroopa Linga Roopa Roopa Poorvaroopa Akriti Roopa Upshaya Upashaya Upashaya Lakshana Satmya Upashaya Samprapti Samprapti Samprapti Upashaya Jati SampraptiREVIEW ON EACH NIDANA PANCHAKANidana/HetuNirukti: 8, 9 Nidana is Napunsaka Linga shabdha. It means “Ni nischaya diyate anena iti” I.e. Ni+Da+Karane+Lute = Nidana The dictionary meaning is a first or primary cause.Nidana in different usages The word “Nidana” is used in two different contexts i.e. as a Vyadhiutpatti dhnapti(diagnosis of diseases) and as Hetubhuta (etiological factors of the diseases).    “Necessity and Importance of Poorvaroopa in Roga nidana and Chikitsa.”      Page 6 
  21. 21. Review of Literature  Paribhasha:Vyadhiutpatti dhnapti: “Nidana” helps to know about Hetu, Lakshana, and Samprapti of a disease.10 Which gives complete knowledge about vyadhi is called Nidana.11 It is the method by which disease is diagnosed is known as Nidana.12 It is the process by which disease can be diagnosed is called Nidana.13 Which gives knowledge about Hetu, Lakshana, and Samprapti is called Nidana.14 Roga should be examined by Nidana, Pragroopa, Lakshana, Upashaya and Aapti.15 One which produces pain is called Roga. This can be examined by Nidana, Poorvaroopa, Roopa, Upashaya, and Samprapti.16 Nidana, Poorvaroopa, Roopa, Upashaya, and Samprapti are the five means of diagnosis.17 The word Nidana with respect to diagnosis includes Nidana, Poorvaroopa, Linga, Upashaya and Samprapti.18 Five means of diagnosis help to the diagnosis of diseases which are known as Nidanapanchaka.19 Hetu, Samprapti, Poorvaroopa, Lakshana and Upashya these are the tools for examine the disease.20 Roga upalabdhi is achieved by Nidana, Poorvaroopa, Linga, Upashaya and Apti.21    “Necessity and Importance of Poorvaroopa in Roga nidana and Chikitsa.”      Page 7 
  22. 22. Review of Literature  Hetubhuta: Factor which manifests diseases is called Nidana.22 Nidana means one which aggravates vatadi doshas. It may be due to intake of Ahita Ahara and Vihara.23 Nidana is one which describes causative factors of the diseases.24 A factor which is capable of manifesting the development of disease either quickly or after a certain period is called Hetu.25Paryaya: 26, 27, 28, 29, 30 Hetu Nimitta Ayatana Karaka Karta Kaarana Pratyaya Samutthana Moola Yoni NibhandanaHetu bhedaFour types of hetu: 31 • Sannikrista • Viprakrista • Vyabhichari • Pradhanika    “Necessity and Importance of Poorvaroopa in Roga nidana and Chikitsa.”      Page 8 
  23. 23. Review of Literature  Three types of aayatana: 32 • Asatmyendriyartha samyoga (Artha) • Prajnaparadha (Karma) • Parinam (Kala)Three types of Hetu: 33 • Dosha • Vyadhi • UbhayaThree types of Hetu: 34 • Kshaya • Sthana • VriddhiThree types of Hetu: 35 • Urdhvaga • Adhascha • TiryakaThree types of Hetu: 36 • Koshtha • Shakha • Marmasthi sandhishuTwo types of Hetu: 37 • Utpadaka • VyanjakaTwo types of Hetu: 38 • Bahya • Abhyantara    “Necessity and Importance of Poorvaroopa in Roga nidana and Chikitsa.”      Page 9 
  24. 24. Review of Literature  Two types of hetu: 39 • Prakrita • VaikritaTwo types of Hetu: 40 • Anubandhya • AnubandhaTwo types of Hetu: 41 • Prakriti • VikritiAshaya apakarsha hetu: 42Discription of each HetuSannikrista Hetu: 43 • Cause which is near for the Prakopa of the doshas. For example: • Diurnal variation of doshas take place routinely i.e. during night, day and during digestion. • For this, sanchaya of dosha is not essential. • Aggravation of dosha as per age, day, night, during digestion is common and it is a physiological process.For example: Rukshadi Bhojana and Vihara manifest Jwara.Viprakrista Hetu: 44 • It is the distant cause for the production of disease. • Sanchaya of dosha is very much essential. • It is also accepted that Jwara manifest due to wrath of the God Rudra.    “Necessity and Importance of Poorvaroopa in Roga nidana and Chikitsa.”      Page 10 
  25. 25. Review of Literature  Table No-02 Showing Chaya and Prakopa of dosha as per Ritu. Dosha  Chaya  Prakopa  Kapha  Hemant Ritu  Vasant Ritu  Pitta  Varsha Ritu  Sharad Ritu  Vata  Grishma Ritu  Varsha Ritu  • Sanchita Kapha during Hemant Ritu manifests Kaphaja vikara in Vasant Ritu. • Sanchita Pitta during Varsha Ritu manifests Pittaja vikara in Sharad Ritu. • Sanchita Vata during Grishma Ritu manifests Vataja vikara in Varsha Ritu.Vyabhichari Hetu: 45 The cause which is weak and unable to produce the disease but it acts as a carrierwhen favorable situation arises for the manifestation of diseases. When the Nidana, Doshas, Dushyas are unfavorable moderately or strongly witheach other then it will not result in disease, if manifested disease will be simple, with alpaLakshana, alpabalayukta etc.Pradhanika: 46 • It is the powerful cause which produces diseases instantaneously like poision.Asatmyendriyartha samyoga: 47 Atiyoga, Ayoga and Mityayoga of Indriya with Vishaya are calledAsatmyendriyartha samyoga.Asatmendriyartha sanyoga is of five types and further subdivided each into three types,so totally 15 varieties of asatmya sanyoga of Indriya and Artha are observed and it is theroot cause for the manifestation of diseases.    “Necessity and Importance of Poorvaroopa in Roga nidana and Chikitsa.”      Page 11 
  26. 26. Review of Literature  Table No-03 Showing types Asatmendriyarth samyoga of Indriyartha. Indriya  Atiyoga  Ayoga  Mityayoga  Chakshurendriya Excessive gazing at Not at all seeing Seeing things which highly luminous any objects.  are too close or too far substance.  away. Shravanendriya  Hearing uproarious Not at all hearing.  Hearing of harsh noise from thunder words, news about bolt, kettle drum etc.  death of close relatives. Insulting etc Ghranendriya Excessive exposure Not at all Excessive abnormal to exceedingly sharp, smelling  exposure to smell of intense and exceedingly putrid, intoxicating odors unpleasant, impure, etc.  poisonous gas etc  Rasanendriya Excessive Not at all The person who consumption of consuming foods.  doesn’t follow eating various taste foods rules as described constitutes. under Ashta vidha   aharavisheshayatana except Rashi  Sparshanendriya Excessive exposure Not at all Touching unhygienic to cold, hot things etc touching. things etc Each sense organ is subdivided into three varities based on their Atiyoga, Ayogaand Mityayoga of Indriya with Vishaya is called Asatmyendriyartha samyoga. On thecontrary wholesome conjunction with sense organs is called ‘satmya’ and developsfavorable reaction in sense organs.    “Necessity and Importance of Poorvaroopa in Roga nidana and Chikitsa.”      Page 12 
  27. 27. Review of Literature  Prajnaparadha: 48, 49 Doing Ashubha karma due to vibramsha of Dhi, Drati and Smruti is called asPradnyaparadha Prajnaparadha means Mithyayoga of Shareera, Vaak and Mana.Table No-04 Showing Prajnaparadha Shareera mithyayoga Vaak mithyayoga  Manasa mithyayoga  Improper utilization of Improper utilization of Improper usages of mind body activities like speech like back biting, like fear, grief, anger, Vegadharana, lying, untimely speech, greed, confusion, conceit, Vegaudeerana,vishama quarrel, unfavorable envy and mis-conceptions.  swapna,Patana,Angapr talks, irrelevant, harsh anidana,Prahara, words,unpleasant Angapradooshana, utterance etc  Mardhana, Pranoparodha etc Kala: 50 Kala is known as Parinama ie transforming or consequence. Kala is the unit of time comprises of Hemant Ritu, Grishma Ritu, and Varsha Ritucharacterized by Sheeta, Ushna and Varshadharana respectively. Atiyoga, Ayoga andMithyayoga of Kaala is cause for the disease.    “Necessity and Importance of Poorvaroopa in Roga nidana and Chikitsa.”      Page 13 
  28. 28. Review of Literature  Table No-05 Showing Ayoga, Atiyoga and Mithyayoga of Kala Atiyoga Ayoga Mithyayoga       Excessive Lesser manifestation or Improper manifestation of manifestation of not at all manifestation characters in respective characters in of characters of Ritu. subsequent Ritu is subsequent Ritu is called For example: No rainfall called kaalatiyoga. ayoga. in rainy Ritu but there will For example:extreme For example; No rainfall be extreme cold.  cold in winter.  in rainy Ritu. Dosh hetu: 51 Normal Sanchaya, Prakopa and Prashamana of doshas take place in respective Rituand after madhuradi ahara sevana is called dosh hetu.Vyadhi Hetu: 52 Vyadhi hetus are those which are responsible for the development of specific diseaseby specific etiology. For example: o Regular consumption of Mrittika manifests Mridbhakshnaja Pandu Roga. o Excess intake of kalaya manifests kalaya khanja vyadhi.53Ubhaya Hetu: 54 Specific factors such as ustra ashwayana teekshnoshna ahara etc which aggravateVata and Rakta simultaneously and which manifests vatarakta vyadhi. Here causativefactor aggravates doshas and simultaneously manifest disease.    “Necessity and Importance of Poorvaroopa in Roga nidana and Chikitsa.”      Page 14 
  29. 29. Review of Literature  Utpadaka Hetu: 55 Utpadaka Hetu is one which favors accumulation of respective doshas withrespect to Ritu due to changes in Ritu. For example: In Hemanta Ritu due to madhuradi dravya Sanchaya of Kapha observed.Vyanjaka Hetu: 56 Vyanjaka Hetu is one which stimulates the development of diseases. For example: Sanchita Kapha during Hemant Ritu manifests disorders of Kapha in Vasant Ritu dueto the effect of the Sun. 57Bahya Hetu: Disease manifests due to consumption of Ahita Ahara, vihara and due to effect ofRitu, and such other internal factors which are responsible for the development of diseaseare called Bahya Hetus. Vatadi dosha Prakopaka Hetus are included under bahya Hetu.Abhyantara Hetu: 58 Shareerashrita dosha and dushyas is called Abhyantara Hetu.Prakrita Hetu: 59 Prakrita hetus are those who manifest naturally due to variation in Ritu andaccordingly Prakopa of dosha results. For example: Kapha prakopa in Vasant Ritu Pitta Prakopa in Sharad Ritu Vata prakopa in Varsha Ritu    “Necessity and Importance of Poorvaroopa in Roga nidana and Chikitsa.”      Page 15 
  30. 30. Review of Literature  Vaikrita Hetu: 60 Vaikrita Hetus are those which manifest unnaturally due to abnormal Ritu, whereprakopa of Dosha is irrespective of Ritu. For example: In Vasant Ritu – Pitta and Vayu prakopa In Varsha Ritu – Kapha and Pitta prakopa In Sharad Ritu – Kapha and Vata prakopa Understanding of normal and abnormal aggravation of doshas as per influence of Rituis essential to understand the prognosis of disease.Anubandhya Hetu: 61 It is the prime cause, which is having Swtantra vyakta Lakshana and Shastroktaupakrama.Anubandha Hetu: 62 It is the secondary cause, means which is not having Swatantra Lakshana andUpakrama. For example: In Kapha pradhana Vatakaphaja Jwara Here Kapha is Anubandhya and Vata is Anubhanda.Prakriti Hetu: 63 Kapha and Pitta rogas are easily curable in vata prakriti person if those come undercurable category.Vikriti Hetu: 64 Vata rogas are difficult to cure in Vataja prakruti person and same applies to Kaphadiprakriti person also.    “Necessity and Importance of Poorvaroopa in Roga nidana and Chikitsa.”      Page 16 
  31. 31. Review of Literature  Ashyapakarsha Hetu: 65 Ashayapakarsha means Prakruta or Sama dosha moves from its own place byinfluence of vata and produces diseases. For example: If Prakruta dosha moves to different places other than its normal path there itbecomes the Aprakruta because that place is not conducive to that particular dosha.Hetu sankara: 66 Hetu sankara means minglinga of hetu with respect to manifestation of diseases.One hetu manifests many diseases, one disease has one hetu, and another disease hasmany hetus. For Example: Intake of Ruksha ahara manifests Jwara, Bhrama, Pralapa, sometimes only Jwara.Many hetus like Ruksha, Sheeta, Ushna, Lavana, and Viruddha ahara manifest onlyJwara. But in some people the same Hetu’s may manifest Jwara, Gulma, Rakthapitta, etc.depending on the Vyadhikshamatwa of the individual.Nidanarthakara rogas: 67These are the Rogas, where one Roga serves as Nidana for another Roga.For example- • Santapa of Jwara leads to manifestation of Raktapitta. • Raktapitta and Jwara leads to manifestation of shosha. • Pratishyaya develops Kasa. • Kasa manifests Kshaya. • Kshaya manifests Shosha Roga.    “Necessity and Importance of Poorvaroopa in Roga nidana and Chikitsa.”      Page 17 
  32. 32. Review of Literature   Initially Nidanarthkara Rogas manifest independently as a disease and later serves asa Nidana for another Roga, sometimes they serve both purposes i.e. Roga as well asNidana and sometimes become either Nidana or Roga. Nidanarthkara rogas divided into two types.Ekarthakari: Some diseases subside after manifesting another disease is called Ekarthakari.Ubhayarthkari: Initial disease will persist after manifesting another disease and act as Nidana forthe later disease.Roopa:Nirukti: 68 Roopa is Napumsaka shabdha, It means ‘Ruyate kirtiti shaiti iti va’ I.e Ru+swavyashilpa shashyeti’ The meaning is Swabhava, Soundarya, and Namakam, any outward appearance orphenomenon, colour, form.Paryayas: 69, 70, 71, 72, 73 Linga Aakriti Lakshana Cinha Samsthana Vyanjana Roopa    “Necessity and Importance of Poorvaroopa in Roga nidana and Chikitsa.”      Page 18 
  33. 33. Review of Literature   • Linga, it indicates general or specific state of dosha’s or stage of diseases by exhibiting certain features. • Any manifestation of symptoms consciously experienced by the patient is called Akriti. • It is subjective evidence of disease or of patient condition experienced by the patient in the form of symptoms which designates towards disease is called Lakshana. • Which is an indication of the existence of something and it is perceptible to the examining physician is called Chinham. • It is an objective finding detected by the physician, that indicates disease is called Samsthana. • It is a manifestation of symptoms that is almost universally associated with a particular disease is called Vyanjana. • Appearance of noticeable change in the patient condition indicative of some somatic or mental state is called Roopa.Paribhasha: • Complete manifestation of diseases is called Linga.74 • Roopa is the stage in which complete appearance of specific symptoms of the disease is seen. This stage indicates the vatadi doshas and stage of disease i.e. ‘Ama’ or ‘Pakva’ with irrespective of nidana, upashya and samprapti. Pratiniyata linga of the disease is completely observed. For example: o Pratiniyata ling of Jwara is Shareera and mana santapa. o Pratiniyata ling of Atisara is atimalasarana.75    “Necessity and Importance of Poorvaroopa in Roga nidana and Chikitsa.”      Page 19 
  34. 34. Review of Literature   • Linga indicates a specific disease by manifesting specific symptoms of that disease. Sammurchana of doshas and dushyas itself is called vyadhi as a result jwaradi diseases manifest by manifesting symptoms like Aruchi, Gourava etc.76 • Definite signs and symptoms of the disease is Roopa.77, 78, 79,80 • The Vishista Poorvaroopa Lakshanas manifest clearly with Vatadi dosha lakshana i.e. Jrumbadi then these are known as Lakshana.81 Roopa bheda: 82 • Samanya roopa Samanya lakshana of the diseases is called Samanya roopa. For example: Jwara samanya Lakshana Gulma samanya Lakshana • Vishesha roopa Here visista lakshana of diseases is observed. For example: Vataja jwara, pittaja jwara LakshanaLinga sankirya: 83 It gives an idea about the disease based on observation of various symptoms.For example- • one symptom pertains to many diseases • one symptom pertains to one disease • many symptoms observed in one disease • many symptoms arise in many disorders    “Necessity and Importance of Poorvaroopa in Roga nidana and Chikitsa.”      Page 20 
  35. 35. Review of Literature   For example- • Fever is a common symptom in many diseases having different patterns and complicated origin. • Various fever pattern observed in various diseases like Jwara, Shavsa and Hikka etc.Upashaya:Nirukti: 84, 85 It is Pullinga shabda I.e Upa+Shi+Ach = Upashaya The dictionary meanings are • The allaying of disease by suitable remedies, suitableness, usefulness, advantageous medicine. • Diagnosis by the effect of certain articles of food or medicine. 86, 87, 88, 89Paryayas: Sukanubhanda SatmyaParibhasha • Upashaya means which gives pleasure to the person by using of Aushada, Ahara and Vihara. Their action may directly against the Hetu, or to the Vyadhi itself or to the both i.e. to Hetu and Vyadhi.90 • Upashaya means which brings about feeling of happiness or Factors which create happiness and gives knowledge about Gudalinga vyadhi.91    “Necessity and Importance of Poorvaroopa in Roga nidana and Chikitsa.”      Page 21 
  36. 36. Review of Literature   • The Hetuviparita, Vyadhi viparita, Ubhayaviparita, Hetu viparitharthakari, Vyadhi Viparithartha and Ubhaya Viparitharthakari The Aushada, Ahara Vihara which give solace to the above all is called Upashaya/Satmya.92, 93, 94 • Things which are conducive to the body physiology are called satmya and use of such substances bring pleasure is called upashaya.95Upashaya bheda: 96 Upashaya can be classified in to six types, Hetu viparitadi and further these can beclassified into 18 subtypes with respect to Aushadha, Ahara and Vihara viz • Hetu viparita Aushadha – Drugs antagonistic to the cause of the disease. • Hetu viparita Ahara – Food which is antagonistic to the disease. • Hetu viparita Vihara – Regimen antagonistic to the cause of the disease. • Vyadhi viparita Aushadha – Drug anatagonistic to the disease itself. • Vyadhi viparita Ahara – Food antagonistic to the disease. • Vyadhi viparita Vihara – Regimen antagonistic to the disease. • Hetu vyadhi viparita Aushadha – Drugs antagonistic to the cause and disease. • Hetu vyadhi viparita Ahara – Food antagonistic to the cause and disease. • Hetu vyadhi viparita Vihara – Regimen antagonistic to the cause and disease. • Hetu viparitarthkari Aushadha – Drugs which are working against the causative factor of the disease though not actually against. • Hetu viparitarthkari Ahara – Food which are working against the causative factor of the diseases though not actually against. • Hetu viparitarthkari Vihara – Regimen which are working against causative factors of the Disease though not actually against.    “Necessity and Importance of Poorvaroopa in Roga nidana and Chikitsa.”      Page 22 
  37. 37. Review of Literature   • Vyadhi viparitarthkari Aushadha – Drugs which are working against the disease though not actually against. • Vyadhi viparitarthkari Ahara – Food which is working against the disease though not actually against. • Vyadhi viparitarthkari Vihara – Regimen which is working against the disease though not actually against. • Hetu vyadhi viparitarthkari Aushadha – Drug which is working against the cause and disease though not actually against. • Hetu vyadhi viparitarthkari Ahara – Food which is working against cause and disease though not actually against. • Hetu vyadhi viparitarthkari Vihara – Regimen which is working against the cause and disease though not actually against.Table No-06 Showing examples of Upashaya Upashaya  Aushadha  Ahara  Vihara  Hetu viparita  Usage of shunthi Intake of meat juice Ratrijagarana in case against sheetakaphaj in case of vataja of aggravation of Jwara due to its Jwara and Alashya  kapha due to ushnata  Deevaswapa.  Vyadhi viparita  Use of Sthambaka Intake of food Pravahana is the dravya like Patha etc which are treatment of Udavarta in case of Atisara  supporting rogi.  Sthambana activity i.e. Masura etc in Atisara rogi.  Hetu vyadhi Usage of Dashamula Use of ushna dravya Activities like Ratri viparita  kwath in case of and jwaragna yusha jagarana etc. which    “Necessity and Importance of Poorvaroopa in Roga nidana and Chikitsa.”      Page 23 
  38. 38. Review of Literature   vataja shotha, which against sheetottha brings Rukshata in subsides vata as well jwara, which case of Tandra, which as shotha.  subside Sheeta and manifests due to Jwara.  intake of snigdha dravya followed by deevaswapa.  Hetu Application of Usage of Ahara Inducing Bhaya to viparitarthkari  Ushna dravya in dravya which are the patient who is case of pachyamana Ushna in case of suffering from vataja shotha, which pachyamana shotha unmada.  aggravates pitta and due to pitta dosha  helps for recovary. Vyadhi Usage of Vamana Intake of milk in Inducing vomiting by viparitarthkari  dravya like case of Atisara, external support in madanaphala in which induces case of chardi.  case of chardi.  Virechana  Hetu vyadhi Use of Aguru Usage of Swimming therapy viparitarthkari  dravya lepa in case intoxicating alcohol advised in the form of agniplusta against alcoholism of exercise in case of dagdha, here cause induced by vatavyadhi is Ushna and consumption of manifestated due to applied material is alcohol.  excessive exercise. also Ushna. Here vyayam is the therapy which works against cause and disease.      “Necessity and Importance of Poorvaroopa in Roga nidana and Chikitsa.”      Page 24 
  39. 39. Review of Literature  Anupashaya:Paribhasha: • Opposite to the description of Upashaya is called Anupashaya, which is not conducive to the body.97 • Aushadha, Ahara and Vihara which are not conducive to the body and develop displeasure to the body are called Anupashaya. It is also called Asatmya. Anupashaya is not considered as a separate entity within five means of diagnosis due to its similarity with Nidana because both Anupashaya and Hetu enhance doshas and diseases of the body. That’s why Anupashaya is considered under Nidana.98SampraptiNirukti: 99, 100 The word Samprapti is derived from the root ‘Aap’ preceded by prepositions‘Sam’ and ‘Pra’ and followed by suffix ‘Kan’ I.e Sam + Pra + Aap +Klin = Samprapti. The dictionary meaning is complete formation or complete manifestation.Paryaya of samprapti: 101, 102, 103, 104, Jati Agati Nivrutti Nishpatti    “Necessity and Importance of Poorvaroopa in Roga nidana and Chikitsa.”      Page 25 
  40. 40. Review of Literature  Paribhasha: • Process of understanding the development of disease by the vitiated dosha’s which are constantly circulating inside the body.105, 106, 107 • The Vyadhijanaka dosha vyapara or specific action of vitiated doshas responsible for the manifestation of vyadhi is called Samprapti.108 • Vitiation of doshas takes place in various ways like, prakrita, vikrita, anubandhya, anubandha, ekdoshaja, dwidoshaja and tridoshas. It all depends on various Nidana. Vikrita doshas bring Vishamata in Dhatus, Malas and Kalas etc and manifest diseases and understanding of such events is called samprapti. Samprapti means to know the factors which are reasonable for the genesis of diseases and not only to know the diseases.109 • How the disease manifests due to vikrita doshas is called samprapti.110Samprapti bheda: 111, 112, 113, 114,115 • Sankhya • Pradhanya • Vidhi • Vikalpa • Bala • KaalaSankhya samprapti Sankhya samprapti deals with the sub classification of diseaseFor example: o Jwara is of eight types o Gulma is of five types o Kushta is of seven types    “Necessity and Importance of Poorvaroopa in Roga nidana and Chikitsa.”      Page 26 
  41. 41. Review of Literature  Pradhanya samprapti Pradhanya means which indicates whether the disease is Swatantra andParatantra. It helps for the identification of dominance of doshas in case of two or morethan two doshas are involved. For example: In case of two doshas, the word ‘Tara’ is used to denote its dominancy incomparison to other doshas. In case of thri dosha involvement the word ‘tama’ is used todemonstrate its dominancy with other two doshas.Vidhi samprapti: • Vidhi means variety of diseases. It is explained only by Acharya Charaka. For example: o Two varieties of diseases i.e. Nija and Agantuja o Three varieties of doshas based on their vitiation o Four varieties of diseases based on prognosis of disease i.e. Sadhya, Asadhya, Mrudu and Daruna.Vikalpa samprapti: This indicates the proportional analysis of the qualities of the doshas involved. For example: In case of vata involvement whether Samana, Vyana, Apana, Prana and Udana areinvolved either singly or mixing of two or all, such observation can be understood by theknowledge of vikalpa samprapti. Vikalpa samprapti also helps to detect the qualitative,quantitative, functional aggravation of doshas. Sheeta vitiates Vata quickly than Laghu orRuksha substances.    “Necessity and Importance of Poorvaroopa in Roga nidana and Chikitsa.”      Page 27 
  42. 42. Review of Literature  Bala samprapti Understanding the strength of the disease based on symptoms of Nidana,Poorvaroopa and Roopa etc, area of involvement, organ involved and age etc. help toassess the strength of disease.Kala samprapti This indicates the time of aggravation of doshas in relation to Ritu, varioustimings of the day, night and intake of food. For example: Chakrapani says, Kaphaja jwara in Vasant Ritu aggravates in forenoon and earlynight, just after intake of food. Aggravating and reliving factors of the disease may beunderstood by this. Acharya Charaka explained Balakala Samprapti instead of Bala and KaalaSamprapti.    “Necessity and Importance of Poorvaroopa in Roga nidana and Chikitsa.”      Page 28 
  43. 43. Review of Literature  POORVAROOPANirukti: 116,117 Poorvaroopa is Napunsaka Linga, with karmadhareya samasa i.e. “Poorvashyaharoopam Poorvaroopam.” The word Poorvaroopa is derived from ‘ka Niketane’ dhatu which is Strilinga. The dictionary meaning of Poorvaroopa is indication of something, approaching and thesymptom of occurring disease.The meaning of Poorvaroopa – Poorva lakshanas or bhavi vyadhi bodhaka chinha.Paryayas: 118, 119, 120, 121 • Agraja • Poorvalinga • Poorvalakshana • Poorvachinha • Poorvakriti • Poorvasamsthan • Poorvavyanjana • Pragroopa • AdiroopaParibhasha: • The sign and symptoms which appear before the complete manifestation of disease are called as Poorvaroopa.122 • Prakupita doshas get localized i.e doshadushya sammurchana at particular place and produces the lakshanas of bhavivyadhi is called as Poorvaroopa.123 • Anyalakshanas are the signs and symptoms which point out the forthcoming disease are called as Poorvaroopa.124    “Necessity and Importance of Poorvaroopa in Roga nidana and Chikitsa.”      Page 29 
  44. 44. Review of Literature   • Poorvaroopas are those lakshana which appear earlier to the actual disease, not specifically assignable to the doshas and they are not fully clear or they are party clear due to their Anadistata i.e insufficiency in the beginning.125, 126,127 • Poorvaroopas are the disease features i.e Vyadhi vishesha which will occur in future, excluding the knowledge about the dosha vishesha.128 • The one which manifests prior to manifestation of disease is called Poorvaroopa.129 • Poorvaroopa is one which knowledge about bhavivyadhi.130 • Poorvaroopa indicates the forthcoming disease but it does not specify the dosha vishesha and it is mild in nature and poorly manifested feature.131 • Shtanasamshraya stage of Satkriyakala represents Poorvaroopa by manifesting premonitory signs and symptoms of the disease.132Poorvaroopa bhedha:According Madhava Nidana/Bhavaprakash 133, 134 • Samanya • Vishistha – a) Avyakta Poorvaroopa b) Doshaja PoorvaroopaSamanya Poorvaroopa: It is produced due to dosha dushya sammurchana and they indicate bhavi vyadhiwithout expressing the dosh vishesha. For example: Shrama, Arati, Vivarnatwa, Vairashya and Nayanaplava are samanya Poorvaroopa ofJwara.    “Necessity and Importance of Poorvaroopa in Roga nidana and Chikitsa.”      Page 30 
  45. 45. Review of Literature  Vishista Poorvaroopa: Two aspects have been given- • Avyakta Poorvaroopa: Lakshanas which are not clearly manifested or difficult to recognize. For example Vatavyadhi, Urakshata etc • Doshaja Poorvaroopa: Lakshanas indicates specific dosha vishesha in the particular vyadhi. For example: Jrimbha in vataj jwara, Nayana daha in pittaja jawra and Aruchi in kapkaja jwara.According to Chakrapani135 • Bhavivyadhi avyakta lakshana: One which indicates the forthcoming disease but sometimes symptoms may notbe seen or if seen they are poorly manifested with less symptoms. For example: Vatavyadhi, kshataskheena etc • Dosha dushya sammurchanajanya: Second variety of Poorvaroopa manifests after dosha dushya sammurchana withprominent symptoms. For example: Jwara Poorvaroopa – Arati, Romaharsha etcAccording to Arunadatta136 • Shareerika Poorvaroopa: Aasya-vairasya, Gatragourava, Jrimbha etc in jwara Poorvaroopa.    “Necessity and Importance of Poorvaroopa in Roga nidana and Chikitsa.”      Page 31 
  46. 46. Review of Literature   • Manasika Poorvaroopa: Krimi darshana, Kesh in Ahara, Rikta koopa and Nirjana grama in swapna in Rajayakshma Poorvaroopa. • Shareerika-manasika Poorvaroopa: Amla-katu rasa iccha, madhur rasa dwesha.VYAPTI OF POORVAROOPASthanasamshraya: It is the fourth stage of kriya/chikitsa kala. The literal meaning of the word sthanais place, area. The literal meaning of Samshraya is to get localized or to reside. Doshas thus aggravated and spread to different parts of the body and get localizedand it makes the beginning of specific diseases related to location/structures where thedoshas are localized-“Sthansamshraya”137 The prakupita doshas having extended and spread over to the parts other thantheir own places get localized where sroto vaigunya is present.138 The prakupita doshas move all over body and lead to the disease at the site wheresanga and kha- vigunya is there.139 Sthanasamshraya stage represents the Poorvaroopa avastha of the disease yet tomanifest fully.140Table No-07 Showing the disease and place of Sthanasamshraya Sthanasamshraya  Production of disease  Udara   Gulma, Vidradi, Udara, Agnimandya, Anaha, Visuchika, Atisara.  Basti  Prameha, Ashmari, Mutraghata, Mutra dosha.etc  Medra  Niruddha prakarsha, Upadamsha, Shuka dosha etc  Gudagata  Bhagandara, Arsha etc  Vrushana  Vriddhi  Urdhwajatrugata  Urdhwajatrugata vyadhis     “Necessity and Importance of Poorvaroopa in Roga nidana and Chikitsa.”      Page 32 
  47. 47. Review of Literature   Twak, mamsa, shonita  Kshudra roga, Kushta, Visarpa  Medo   Granti, Apache, Arbuda, Gandamala, Alaji etc  Asthigata  Vidradhi, Anushaayi etc  Padagata  Shleepada, Vatashonita, Vatakantaka  Sarvangagata  Jwara, Sarvanga roga etc IMPORTANCE OF POORVAROOPA IN ROGA NIDANAIN DIAGNOSIS OF DISEASE Table No-08 Showing Poorvaroopa of Kasa Poorvaroopa Charaka141 Sushruta142 Vagbhata143 Shukapurnagalasyata + + Kantha kandu + + + Bhojana avarodha + + Gala-talu lepa + Swashabda vaishamya + Arochaka + + Agninasha +Table No-09 Showing Poorvaroopa of Shwasa Poorvaroopa Charaka144 Sushruta145 Vagbhata146 Anaha + + + Parshvashula + + + Hritapidana + + + Pranasya vilomatwa + + Bhaktadvesha + Arati + Vadana-vairasya + Shankhabheda. +    “Necessity and Importance of Poorvaroopa in Roga nidana and Chikitsa.”      Page 33 
  48. 48. Review of Literature  Table No-10 Showing Poorvaroopa of Hikka Poorvaroopa147 Charaka148 Sushruta149Kantha guruta + +Uroguruta + +Vadana kashayata + +Kukshi atopa + +Arati +Table No-11 Showing Poorvaroopa of Rajayakshma Poorvaroopa Charaka149 Sushruta150 Vaghbhata151 Pratishyaya + + Kshavathu + + + Shwasa + Murdha gunthanam + Shleshma praseka + + Mukha madhuryama + + AnAharabhilasha + Bhuktavataschaya + + Hrillasa Utkleshanama ahara + Chhardi + + Agnisada + + Mamsopara + + Aruchi + Talu mukha shosha + Aharakale ayasa + Mukhapada shopha + + Akshnoatimatra + + + shvetavabhasata Angasada + + Pandu +    “Necessity and Importance of Poorvaroopa in Roga nidana and Chikitsa.”      Page 34 
  49. 49. Review of Literature   Nidra + Ashnatopibalakshaya + Mada + Nakha kasha roma + + ativriddhi Strikamata + + Alpadosheshu adosheshu + + doshadarshanam Panyashya avikshamana + + atyarthama Bahu pramana jignyasa + + Nighruntva + + Kaye bhibhatsa + + darshanam Makshika trinakesha + prayonnapanayoh Madya priyata + Darshanam anudakanama + + + uddakosthanama Gram nagar nigam + + janapada shunyate Pavana dhuma dava ardita + taru Krikalasa, mayura vanara shuka, sarpa, kaka, uluka, + + + shallaki nilamantha, ghridhra sparshanam Varaha ustara khara kasha asthi bhasma tusha angara + + rashi adhirohanam Jyotirgirinam patatam + Jvalatam cha mahiruham +    “Necessity and Importance of Poorvaroopa in Roga nidana and Chikitsa.”      Page 35 
  50. 50. Review of Literature  Table No-12 Showing Poorvaroopa of Urakshata: Poorvaroopa Charaka152 Uroruk + Shonita chardi + Kasa + Rakta mutratwa + Parswaprustha katigraha +Table No-13 Showing Poorvaroopa of Pratishyaya Poorvaroopa Sushruta153 Shirogurutwa + Kshavathu + Angamarda + Paridrista romata +Table No-14 Showing Poorvaroopa of Chardi Poorvaroopa Charaka154 Sushruta155 Vaghbhata156 Hridutkleesha + + + Kaphapraseka + + + Ashana dwesha + + + Lavana ashyata +Table No-15 Showing Poorvaroopa of Grahani Poorvaroopa Charaka157 Sushruta158 Vaghbhata159 Trushna + + + Alasya + + Balakshya + + Vidaha Aharasya + + Chirapaka + + Kaya gourava +    “Necessity and Importance of Poorvaroopa in Roga nidana and Chikitsa.”      Page 36 
  51. 51. Review of Literature   Sadana + + Klama + + Aruchi + + Kasa + Karnakshi bheda + + Antrakoojana + + Amlata + Praseka + Vaktravairashya + Bramaha + Udara anaha + Chardhi +Table No-16 Showing Poorvaroopa of Udara Poorvaroopa Charaka160 Sushruta161 Vaghbhata162 Kshudhanasha + + Mukha swadu + Chirapachana + + Vidahana + + + Jeernajeerna ajnyana + + + Ati bhukta ahara asahana + + Pada shopha + + + Balakshaya + + + Alpeapi vyayama Swasa + + Udara/Purisha sanchaya + + Basti sandhi ruk + + + Adhmana + Alpeahare antravridhi + + Alpeahare jathara vridhi + + Valinasha + + +    “Necessity and Importance of Poorvaroopa in Roga nidana and Chikitsa.”      Page 37 
  52. 52. Review of Literature   Anannabhilaha + + Raji janma + + +Table No-17 Showing Poorvaroopa of Trushna Poorvaroopa Charaka163 Sushruta164 Mukhashosha + + Sarvada ambu kamitva + + Brama + Santapa + Pralapa +Table No-18 Showing Poorvaroopa of Jwara Poorvaroopa Charaka165 Sushruta166 Vaghbhata167 Mukhavairasya + + + Gurugatrata + + Anannabhilasha + + Chakshuvyakulata + + Ashru gamana + + Nidradhikya + Arati + + Jrimbha + + + Vinama + + Vepathu + Shrama + + Bhrama + Pralapa + Jagarana + Romaharsha + + + Danta harsha + Shabda asahatva +    “Necessity and Importance of Poorvaroopa in Roga nidana and Chikitsa.”      Page 38 
  53. 53. Review of Literature   Vata apata asahatwa + + Aruchi + + + Avipaka + + Daurbalya + Angamarda + + Sadana + + Alpapranata + + Dhirghasutrata + Alasya + Karmahani + Karya anaskti + Guru vakya asuya + + Balashya pradwesha + + Swadarmeshu chinta + Malyanulepana klesha + Madhur pradwesha + + Amla lavana katu priyata + + Vivarnatva + Nayanaplava + + Tama + Pindakodwesta + Trushna +Table No-19 Showing Poorvaroopa of Pandu Poorvaroopa Charaka168 Sushruta169 Vaghbhata170 Hridspandana + + Roukshya + + Swedabhava + + Shrama + + Aruchi +    “Necessity and Importance of Poorvaroopa in Roga nidana and Chikitsa.”      Page 39 
  54. 54. Review of Literature   Peetmutratwa + + Alpavanhi + Gatrasaad + + Twaksphotana + Shtivana + Mridbhakshana + Prekshanakutshotha + Avipaka +Table No 20 Showing Poorvaroopa of Raktapitta Poorvaroopa Charaka171 Sushruta172 Vaghbhata173 Sadana + + Sheetkamitva + + Kanthadhumayan + + + Vamihi + + + Lohagandhi nishwasa + Shirogurutva + Aruchi + Amlaka udgara + + Chardita baibhatsya + Kasa + Shwasa + Bhrama + Klama + Lohalohita-matsya + + gandhatva Swarakshaya + Twachadi raktaharidra + + varnata Nilalohitpitanam + + varnanamvivechana in swapna    “Necessity and Importance of Poorvaroopa in Roga nidana and Chikitsa.”      Page 40 
  55. 55. Review of Literature   Anannabhilasha + Bhuktashya vidaha + Paridaha +Table No-21 Showing Poorvaroopa of Vatarakta Poorvaroopa Charaka174 Sushruta175 Vaghbhata176 Swedoatyarthama na wa + + pada Karshnya + Sparshadhnyatva + Kshate atiruk + + Sandhishaithilya + + + Aalasya + Sadana + + Pindakodgama + Janujanghaurukatyasaha- + + hastapadangasandhishu nisthod Sphurana + + Bheda + + Gurutwa + + + Supti + + + Kandu + + Sandhishu rugbhutwa + + bhutwa nashyati chaaskrit Vaivarnya + + Mandala utpatti + Kusthasamam + Ati sheeta ati ushnata of + pada Osha +    “Necessity and Importance of Poorvaroopa in Roga nidana and Chikitsa.”      Page 41 
  56. 56. Review of Literature  Table No-22 Showing Poorvaroopa of Kustha: Poorvaroopa Charaka177 Sushruta178 Vaghbhata179 Sparshadhnyatwa + + + Swedoatyarthama na wa + + + Vaivarnya + + Kotha + + Lomaharsha + + + Kandu + + + Toda + + Shrama + + Klama + + Vrananamdhika shulam + + Shighrotpatti Chirasthiti Daha + + Suptangata + + Twkaparushya + + Kshtavisarpana + + Ashrujah krishnta + + Atishlakshna/kharasparsha + Vranarudhanamapi rukshatwa +Table No-23 Showing Poorvaroopa of Shotha Poorvaroopa Charaka180 Vaghbhata181 Ushma + Davathu + + Siranam ayama + + Angaguarava +    “Necessity and Importance of Poorvaroopa in Roga nidana and Chikitsa.”      Page 42 
  57. 57. Review of Literature  Table No-24 Showing Poorvaroopa of Prameha Poorvaroopa Charaka182 Sushruta183 Vaghbhata184 Swedoangagandhatva + + Shithilangata + + Shayyasana swapnasukha- rati + + cha Hritnetrajihwashravanopdeho + + + ghanata Keshanakhaativridhi + + + Sheetapriyatva + + Galatalushosha + + Madhuryamaasye + + Karpadadaha + + + Mutreabhidhavati pipalika + + Snigdha pichilagurugatra + Madhurashukla mutrata + Tandra + Sada + Pipasa + Swasa durghandata + Talujivhadanta malotpatti +Table No-25 Showing Poorvaroopa of Ashmari Poorvaroopa Sushruta185 Vaghbhata186 Bastipida + + Arochaka + + Mutrakriccha + + Bastishiromushkashophaved + + ana Jwara + + Kricchavasada + Bastagandhiva mutrasya +    “Necessity and Importance of Poorvaroopa in Roga nidana and Chikitsa.”      Page 43 
  58. 58. Review of Literature   Swavedanavarnam dustam + saandra avila mutrata kricchanmutra +Table No- 26 Showing Poorvaroopa of Atisara Poorvaroopa Sushruta187 Vaghbhata188 Hritnabhipayuudarkukshitoda + + Gatravsada + + Anilasannirodha + Vitsanga + + Aadhamana + + Avipaka + +Table No-27 Showing Poorvaroopa of Arsha Poorvaroopa Charaka189 Sushruta190 Vaghbhata191 Vistambho annasya + + + Dourbalya + + + Kuksheratopa + + + Karshya + + + Udgarabahulya + + + Sakthisada + + + Alpavitkata + + Grahanidosha pandu udarsya + + + cha aashanka Anne ashradha + + Krichhata paktiamlika + + Paridaha + Pipasa + Akshno kshayathu + + Aantrakujana + + Gudaparikartana +    “Necessity and Importance of Poorvaroopa in Roga nidana and Chikitsa.”      Page 44 
  59. 59. Review of Literature   Kasa shwasa + Balahani + Bhrama + + Tandra + + Manda vanhita + Pindkodweshtana + Shakritabheda athava graha + Marut prachuro mudha + prayonabheadhascharana Marutasaruka + saparikartashcha krischa nirgati Prabhuta mutra + Dhumako amlaka + Shiropristhourasa shula + Aalasya + Bhinnavarnata + Krodha +Table No-28 Showing Poorvaroopa of Bhagandara Poorvaroopa Sushruta192 Katikapalavedana + Kandu + Daha + Gudashopha +Table No-29 Showing Poorvaroopa of Apasmara Poorvaroopa Charaka193 Sushruta194 Vaghbhata195 Hritkampa + + Hrudaya shunyata + + Swedodhyana + +    “Necessity and Importance of Poorvaroopa in Roga nidana and Chikitsa.”      Page 45 
  60. 60. Review of Literature   Murcha + + + Pramudhata + Nidranasha + + Bruvyudasa + + Satataakshnovaikritamshabd + + a shravana Lalasinghanaprasravana + + Anannabhilasha + Arochaka + + Avipak + + Hridayagraha + Kukshiratopa + + Daurbalya + Asthibheda + Angamarda + + Moha + Tamasadarshana + + Bhrama abhikshna + + Swapne madanartana pidana + vepathu vyadhana patanaTable No-30 Showing Poorvaroopa of Unmada Poorvaroopa Charaka196 Sushruta197 Shirashunyata + Chakshu vyakulata + Swana karnayo + + Adhika uchwasa + Adhika asyasrava + Anannabhilasha + Avipaka + Aruchi +    “Necessity and Importance of Poorvaroopa in Roga nidana and Chikitsa.”      Page 46 
  61. 61. Review of Literature   Hrudgraha + + Asamaya dhyana + Ayasa + Sammoha + Udvega + Sadaiva romancha + Jwara abhikshana + Udarda + Arditakruti karana + Swapne bramapoorna, + asthira, anavasthita nindita roopa darshana Tilapidaka chakradi rohana + + Vatakundalikabhicha + + manthana Nimajjane kalushitambu + Chakshunasha + Gatra apakarshana + Ati uthsaha + Swapne kalushiya bhojana +Table No-31 Showing Poorvaroopa of Gulma Poorvaroopa Sushruta198 Vaghbhata199 Vayu vridha + Sadana + Agnimandya + + Atopa + + Antrakoojana + Vit mutra nisanga + + Souhitya asahata + + Udgara bahulya + Admana +    “Necessity and Importance of Poorvaroopa in Roga nidana and Chikitsa.”      Page 47 
  62. 62. Review of Literature  Table No-32 Showing Poorvaroopa of Urusthambha Poorvaroopa Charaka200 Atinidra + Atidhyana + Sthimitata + Jwara + Romaharsha + Aruchi + Chardhi + Jangha uro sadana +Table No-33 Showing Poorvaroopa of Masurika Poorvaroopa Madhava201 Jwara + Kandu + Gatra bhanga + Arati + Bramha + Twacha shota + Netra raga +Table No-34 Showing Poorvaroopa of Sheetapitta Poorvaroopa Madhava202 Pipasa + Aruchi + Hrulasa + Angasada + Anga gourava + Raktalochana +    “Necessity and Importance of Poorvaroopa in Roga nidana and Chikitsa.”      Page 48 
  63. 63. Review of Literature  Importance of Poorvaroopa in Sapeksha nidana One who passes deep yellow colored or bloody urine without exhibitingPoorvaroopa of Prameha should not be diagnosed as a case of Prameha but ofRakthapitta.203, 204Importance of Poorvaroopa in Vyadhipareeksha Acharya Shushruta explains that Vyadhi pareeksha should be done in threeheadings1) Aupasargika2) Prakkevala3) Anyalakshana.Aupasargika: Aupasargika is one which has developed later (than an earlier disease) and it is tobe known as Upadrava and which remains with moolavyadhi. For example- Aupasargika vyadhi – Vranashotha Vrana- Moolavyadhi Shotha- UpadravaPrakkevala: Prakkevala is that which has developed without the Poorvaroopa lakshana andwithout the Upadrava. For example – Prakkevala vyadhi - Vyanga, Mashaka and Nyaccha etcAnyalakshana: Anyalakshanas are those which tell about the future disease, which are known asPoorvaroopas. Anyalakshanas are to be read in preliminary stage only.    “Necessity and Importance of Poorvaroopa in Roga nidana and Chikitsa.”      Page 49 
  64. 64. Review of Literature   For example –Anyalinga vyadhi- Arsha is the Poorvaroopa vyadhi for the disease like Grahani, Panduand Udararoga etc205IMPORTANCE OF POORVAROOPA IN CHIKITSA:In sadhyasadhyata of the Vyadhi: Before planning the treatment Vaidya should have the complete knowledge ofVyadhi. The first criterion is to select the patient for treatment and see whether the patientis fit or unfit for the treatment. If the vyadhi is Sadhya only then one should start Chikitsaotherwise he is sure to loose Artha, Vidya and Yashas206. To determine the nature of the disease, which is easily curable if Hetu, Poorvaroopaand other lakshnas are Alpa or Mridu. 207, 208 Factors responsible for bad prognosis like Nidana, Poorvaroopa and otherLakshanas are of Madyama bala, it determines the diseases which are difficult to cure. 209 If Kaphajanya and Pittajanya meha are manifest along with Poorvaroopas such asSwedoanggandhadi then it is considered as asadhya for the chikitsa and if Pittaja pramehais free of medodhatu dusthi and alpa Poorvaroopa is considered as sadhya even though itis a Vyapya vyadhi. 210, 211Poorvaroopa gamya Arista:The one which exhibits the lakshana of marana is called as Arista212 Chakrapani says, as the flower is Poorvaroopa of forth coming fruit, in the sameway Arista Lakshanas are the Poorvaroopa of the Marana. 213, 214    “Necessity and Importance of Poorvaroopa in Roga nidana and Chikitsa.”      Page 50 
  65. 65. Review of Literature  Examples given in Charaka Samhita: 215Jwara: If patient manifests Jwara with all or more number of Poorvaroopas mentioned inJwara context then he becomes victim of death. This principle is considered in otherdiseases too.Rajayakshma: If the Shosha person affects with strength gradually decreasing and Pratishyayagradually increasing and even after this he is doing sexual indulgence then his death issure. If a patient is carried to the Dakshina disha by dogs, camels or asses in dream, willsuffer from shosha lead to the death. In dreams, if one drinks urine with ghosts or isdragged by dogs, then he dies because of severe fever.Raktapitta: If one sees the sky from nearby distance as like a cloth dyed with laksha rasa, hegets affected by Raktapitta which causes his death. If one in his dream wearing garlandswhich is of red flower, with his entire body raktavarna yukta and who is laughingfrequently, dragged by a woman, he fall a victim of Raktapitta and dies thereform.Gulma: Atimatravat shula, atopa, antrakoojana, dourbalya, vaivarnya of nakha etc. indicatethe advent of gulma causing death eventually. In dream, if one gets spinny creepergrowing in the hradaya pradesh, he will be affected by gulma which is fatal.    “Necessity and Importance of Poorvaroopa in Roga nidana and Chikitsa.”      Page 51 
  66. 66. Review of Literature  Kustha: Even if with slightest touch there is excessive tearing and wounds do not heal, suchperson would be affected by Kustha which is fatal. In dreams, if lotus flower arises on thechest of the person, who is naked bathing with ghee and pouring oil to flameless fire, hedies due to Kustha.Prameha: If the flies are attracted too much by the body of a person even after bath andsugandha dravya lepana, in dream, a person drinks various snehas in company ofchandalas and he is bound by them gets attacked with fatal type of Prameha.Unmada: Dhyanayasa, udvega, moha, arati, and dourbalya these indicate the advent ofUnmada and consequent death. The expert physician observs a person having Aharadwesh, Lupta chitta andUdarda should declare him as the case of marana roopi Unmada. One who is Krodhayukta, Trasabahula rarely having smile on his face and withexcessive fainting and thirst, get marana roopi Unmada. Who dreams like, sinks in waterwhile dancing with demons gets Unmada which leads to death.Apasmara: While awake, if one sees darkness which does not exist and hears various nonexisting sounds, he dies of Apasmara. In dreams, one who is carried away in reverse position by a ghost which is Unmattaand dancing, he leads to Apasmara and death too.    “Necessity and Importance of Poorvaroopa in Roga nidana and Chikitsa.”      Page 52 
  67. 67. Review of Literature  Bahirayama: One who gets his hanu, manya and netra stiffened after awaking from sleep,becomes affected with fatal type of Bahirayama. If in dream, one eats Shushkali andApupa and vomits as it is, he lives no more after waking up. One who knows these prodroma well can understand their association i.e. diseaseand result in death.In Chikitsa: The prime importance of Poorvaroopa is that by the help of it one can diagnose thedisease before it gets completely manifested, after identification of vyadhi inPoorvaroopa avasta treatment should be given accordingly, by which furtheradvancement of vyadhi can be checked. Sushruta explains the Shat kriyakala as opportunity for treating the disease. If thephysician fails to treat the disease in the first stage then it will reach next stage and getstrength. 216 In Sthanasamshraya avastha Poorvaroopa lakshanas begin to appear which gives 4thopportunity for the treatment such as doshapratyanika, dushyapratyanika orubhayapratyanika. 217 Acharya Charaka explains one should treat the disease in the stage ofPoorvaroopavastha only to avoid the vedana of the disease which should happen in futurejust like a dam is constructed to prevent the crop by flood. 218 In Poorvaroopavastha of disease some specific treatments are mentioned in classics    “Necessity and Importance of Poorvaroopa in Roga nidana and Chikitsa.”      Page 53 

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