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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

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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    • “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
    • 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
    • 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
    • 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.
    • 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
    • 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
    • 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
    • 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
    • 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  
    • 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  
    • 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  
    • 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  
    • 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
    • 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
    • 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  
    • 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  
    • 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  
    • 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 
    • 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 
    • 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 
    • 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 
    • 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 
    • 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 
    • 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 
    • 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 
    • 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 
    • 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 
    • 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 
    • 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 
    • 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 
    • 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 
    • 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 
    • 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 
    • 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 
    • 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 
    • 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 
    • 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 
    • 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 
    • 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 
    • 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 
    • 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 
    • 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 
    • 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 
    • 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 
    • 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 
    • 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 
    • 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 
    • 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 
    • 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 
    • 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 
    • 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 
    • 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 
    • 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 
    • 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 
    • 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 
    • 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 
    • 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 
    • 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 
    • 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 
    • 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 
    • 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 
    • 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 
    • 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 
    • 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 
    • 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 
    • 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 
    • 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 
    • Review of Literature  For exampleJwara: During the stage of Poorvaroopa of Jwara, intake of laghu ahara or upavasa isuseful because Amashaya is the site of origin of this disease. 219 The intelligent physician should administrate Swachha grita in the stage ofPoorvaroopavastha of Vataja Jwara. In case of, fever of pitta origin, administer Mruduvirechana and in case of, fever of kaphaja origin Prachardhana is to be done. In all fevers arising from combination of two doshas, treatment should beappropriate to the doshas with respect to the dominance of the doshas and if the patient isunfit for the snehana and shodhana karma then langhanadi karma is followed. 220Prameha:In the Poorvaroopavastha of Prameha itself the patient is prescribed fasting i.e.apatarpana, decoctions of drugs having kashaya rasa and goats urine for drinking. Ifpatient who does not adhere to these and continues the use of madhura ahara thenprameha becomes well manifests. 221, 222Ashmari: In the stage of Poorvaroopavastha of Ashmari, the therapies like Snehadikarma isdesirable, by these the root of the disease gets mitigated. 223,224Kushta:During Poorvaroopavastha of kustha, the ubhaya shodhana therapies should beadministered. 225    “Necessity and Importance of Poorvaroopa in Roga nidana and Chikitsa.”      Page 54 
    • Materials and Methods  Materials and methods:Materials:Sources of data – The literary source of the present study were the following; • The classical text of Ayurveda with their commentaries. Other Ayurvedic text and Journals were referred from Dr.B.N.M.E Trust’s Shri Mallikarjuna Swamiji post graduate and research center library, Bijapur • Vedic scripture and manuscript for the study were referred at the Bhandarkara oriental research institute, Pune. • Articles from reputed journals, internet, and medical websites were also collected and used for study.Materials:For the literary study the material were- • Vedic literature • Upanishada • Puranas • Samhitas of Ayurveda with commentaries • Other texts of Ayurveda • Darshana granthas • Periodicals, Magazines • WebsitesClassical texts of Ayurveda: • Charaka samhita • Sushruta samhita“Necessity and Importance of Poorvaroopa in Roga nidana and Chikitsa.” Page 55
    • Materials and Methods   • Ashtanga samgraha • Ashtanga hridaya • Bhavaprakasha • Sharangadhara samhita • Madhava Nidana • Vangasena samhitaCommentrators:Charaka samhita- • Ayurveda deepika of Chakrapani • Jalpakalpataru of Kaviraja Gangadhara • Charakopaskara of Yogindranathsena • Nirantarapadavyakhya of JejjataSushruta samhita- • Nibandha samgraha of DalhanaAshtanga samgraha- • Shashilekha of InduAshtanga hridaya- • Sarvanga sundara of Arunadutta and Ayurveda Rasayana of HemadriMadhva Nidana-Madhukosh of MadhavakaraRelevant references on Vedas:‘Vedo me Ayurveda’ of Ramgopal ShashtriRelevant books on Nidana panchaka:“Necessity and Importance of Poorvaroopa in Roga nidana and Chikitsa.” Page 56
    • Materials and Methods   • Nidana vijnyana pancha lakshanani by Kavirja Ratnakara Shashtri • Nidana panchaka by vaidya Shivasharan Dhyani Nighantu kosh: • Shabda kalpadrum by Rajaha Radhakaoth • Amarakosh of Amara Simha • Vaidyaka shabda sindhu by Kaviraja Umeshchandra GuptaManuscript: It was collected from Bhandarkar oriental research institute, Pune, after goingthrough the description catalogue of government collection of manuscripts deposited intreasure house of ideological research. A thorough study was done on manuscript and itwill be discussed in discussion part.Methodology:Present study is a literary research and method was followed as per the objectives of thestudy. Initially all the references of the Nidana panchaka was compiled, then a briefreview on the Nidana panchaka was done with special reference to Poorvaroopa as perthe classical books and authorative commentators. After this the scope of Poorvaroopa inthe present scenario is explained and also the study was done to know the necessity andimportance of Poorvaroopa in RogaNidana and chikitsa. Here relevant literary references were compiled from different classical texts andcommentaries and sorted under the following sections in order to generate the review, soas to fulfill the aims.“Necessity and Importance of Poorvaroopa in Roga nidana and Chikitsa.” Page 57
    • Materials and Methods  1. To study in detail regarding ‘Nidana panchaka’ w.s.r to Poorvaroopa. Here in this section brief study regarding Nidana, Roopa, Upashaya Sampraptiand detail study about Poorvaroopa is done by collecting reference from differentAyurvedic classical text, Granthas and their commentaries sorted in this section.2. To explore the scope of Poorvaroopa in present scenario. The scope of Poorvaroopa in present era is described with examples and this willbe delt in discussion part.3. To expand the necessity and importance of Poorvaroopa in Roga Nidana andChikitsa. Detailed study regarding the necessity and importance of Poorvaroopa is done andwere analysed to prove the usefulness in Roga Nidana and Chikitsa.Manuscipts A thorough study was done on the Manuscript and it will be discussed indiscussion part. Discussion will be documented in discussion part taking the help of compiledmaterial from review of literature and proper conclusion will be drawn on the bases ofthat.“Necessity and Importance of Poorvaroopa in Roga nidana and Chikitsa.” Page 58
    • Discussion   DISCUSSION: The purpose of any research work is to support or to modify or to advance theexisting trends of knowledge and accept or refuse them after testing critically. This canbe only done by proper interpretation and discussion of available data. Any research without discussion about its nature, utility and importance is said tobe incomplete. Ability of discussion on the basis of ‘Shastra’ i.e. ‘Vitarka’ is to bepresente in a good scholar. Any hypothesis or principle, if to be proved must be discussedthoroughly from all angles. Discussion improves the knowledge and discussion withShastra becomes base establishment of the concept. Therefore the conclusion must besupported always through discussion. Acharya Charaka describes it as; even the truth may not be accepted without thelogical interpretation. Thus discussion is the most crucial phase of any research work. The sequence of discussion here follows the same path as followed in literarystudy. It is in three partsPart I – Discussion on titlePart II – Discussion on review in two sections. • In the first section discussion is brief about the Nidana panchaka with special attention to Poorvaroopa. • In the second section discussion to explore the scope of Poorvaroopa in present scenario and to expand the necessity and importance of Poorvaroopa in Rog Nidan and Chikitsa.Part III • Discussion on material and methods. • Discussion on manuscripts.    “Necessity and Importance of Poorvaroopa in Roga nidana and Chikitsa.” Page 59 
    • Discussion   PART- IDiscussion on the title:“Necessity and importance of Poorvaroopa in Rog Nidana and Chikitsa” When we study the meaning of word ‘Necessity’ in the Oxford dictionary wecome to know that it is a noun and the meaning of word is “The state of being important,significant, consequence or needful thing”. And the word ‘Importance’ is a noun whichmeans “An indispensible thing, a necessary and imperative need”. The word Rog Nidan is composition of ‘Roga’ and ‘Nidana’. Rog is defined as“Santapayati kamapatybhujam na Rog” as per Sanskrit dictionary. “Rujati anena itiRog” means, which gives Ruja (pain) to shareera and mana. Nidana is napunmsakaling shabda, in Shabhdha kalpa dhruma it is defined as –“Ni nischaya dytate anena iti.” The word Nidana used in two different contexts i.e.diagnosis of the disease and etiological factors of the disease. Here it is termed withintention of the diagnosis of the disease i.e. which gives complete knowledge about‘Vyadhi’. The word ‘Chikitsa’ is derived from the root word ‘Kit Rogapanayane’ i.e. ‘Kit’ isto adapt, measures calculated for the removal of factors of the disease. Amarakoshadefines as ‘Ruk pratikriya’, while Shabda sindhu defines as ‘Rog nidana pratikara’.Bhavaprakasha termed as ‘Ya kriya vyadhi harane’. The term ‘Rogapanayana’ and ‘Ruk pratikriya’ convey same meaning i.e.measures adapted for the removal of the disease, causes and the treatment of the diseaserespectively. While the term ‘Rog nidana pratikara’ gives stress on the removal of thecausative factors of the disease formation.    “Necessity and Importance of Poorvaroopa in Roga nidana and Chikitsa.” Page 60 
    • Discussion    Poorvaroopa is the second measure among the Panchanidana or Nidana panchakawhich are the tools for the diagnosis of the disease. The term Poorvaroopa is the combination of two words Poorva and Roopa. Thedictionary meaning of Poorvaroopa is the indication of something approaching andsymptoms of occurring disease. In Ayurvedic classics Poorvaroopa is explained for the Upalabhdi of the Vyadhiwhich helps to diagnose and treat the diseases at early stage only. If the Vyadhi is treatedin its previous stage then it will not produce to next stage. So the wise physician shouldtreat the disease from Poorvaroopavasta to prevent the future manifestation of thedisease. So the title “Necessity and importance of Poorvaroopa in Roga Nidana andChikitsa” is nothing but to acquire the knowledge about the Poorvaroopa which is generalnotion explained in Samhita. Here acquiring the information means not mere collectionof any matter, but compiling matter with reference to Nidana and Chikitsa in a systemeticorder, selecting the important points and discussion of those points, lastly comming at theconclusion through the discussion. Here Nidana means a tool to diagnose the disease andChikitsa referred to treat the disease.    “Necessity and Importance of Poorvaroopa in Roga nidana and Chikitsa.” Page 61 
    • Discussion   PART- IIDiscussion on the reviewSection -1To Study in detail regarding Nidana panchaka w.s.r. to Poorvaroopa.Historical review In all Samhitas, there is no difference of opinion about the types of Nidanapanchaka, but these are mentioned by different paryayas. Poorvaroopa is mentionedunder the heading of Nidana panchaka at the very first chapter of Nidana sthana beforeexplaining the Nidana of the Vyadhi which shows the importance of Nidana panchaka asa tool for diagnosis of the diseases. But Acharya Shushruta not directly mentioned aboutNidana panchaka. The explanation regarding Poorvaroopa is found under the heading of‘Shatakriyakala’ i.e. ‘Sthanasamshraya Awastha’ where the Pradurbhava of thePoorvaroopa laxana is found. While the definition of the Poorvaroopa has been stated in‘Aaturopkramaniya adhyaya’ while explaining Vyadhi pariksha. Bhavaprakasha explainsPoorvaroopa under the heading of Rogipariksha Prakarana.Sequence of Nidana panchaka Charaka, Vagbhata, Madhava, Sharangadhara and Vangasen explain Nidanapanchaka with same order i.e. Poorvaroopa is told just after the Nidana but AcharyaBhavaprakasha explains Poorvaroopa after explaining Nidana and Samprapti. The furthersequence is continued with the same. The intension of Bhavaprakash, explaining Samprapti just after Nidana is may bebecause Vyadhijanma starts from the level of Dosha vikriti only i.e. ‘Yatha dushtenadoshena…||’ and it continued till the Vyaktavastha. This shows that Bhavaprakash    “Necessity and Importance of Poorvaroopa in Roga nidana and Chikitsa.” Page 62 
    • Discussion   considered after Nidana sevana, Sanchaya of Doshas takes place which initiates theprocess of manifestation of diseases, then proceeds with Prakopa, Prasara, andSthanasamshraya which is nothing but the stage of Poorvaroopavastha. By seeing this,the sequence of studying diseases according to Bhavaprakasha is considered the best.NidanaParibhasha: The word ‘Nidana’ is used under two different headingsVyadhi utpatti dnyapti Nidana: Hera the word Nidana is used as to diagnose the disease and it is achieved bystudying Nidana panchaka i.e. Nidana, Poorvaroopa, Roopa, Upashaya, Samprapti.Hetubhuta Nidana: Here Nidana means the causative factors which aggravate the Vatadi doshas. Itmay be Aharaja, Viharaja which ultimately results as cause for the manifestation of thedisease, either quickly or after the certain period. There are number of classificationsmade in Nidana, based on the mode of manifestation of the disease. The Hetus are responsible for the vitiation of Doshas; these Doshas in turn affectDushyas, resulting in the manifestation of the diseases. Nidana may be Bahya orAabhyantara, plays a vital role in the manifestation of the disease, hence it is consideredas one of the important parts of Nidana panchaka and it was explained first as it initiatesthe disease process.    “Necessity and Importance of Poorvaroopa in Roga nidana and Chikitsa.” Page 63 
    • Discussion   Importance of NidanaIn Roga nidana: Hetu gives idea about manifesting and also about manifested disease. Eachdisease has its own Hetu. For example; frequently eating mud causes Pandu (i.e.mridbhakshanajanya pandu)In Chikitsa: Hetu is the prime factor for the menifestation of disease. That’s why Acharyashave mentioned to avoid the etiological factor and it is the primary step in themanagement of any disease. In Sadhyasadhyata: Prabhala hetu signifies the kastasadya or Asadyata of disease for treatment whileAlpa hetu indicates, the sukhasadyata of disease. So hetu gives idea about the prognosisof diseases. Importance of Nidana at the stage of Poorvaroopa: Some of the diseases like Vatarakta and Kustha are having a few samePoorvaroopas like Swedasya ati pravritti or abhava, Vaivarnya and Supti etc so here oneshould take the help of Nidana for proper diagnosis.Roopa Roopa acquires the third place among the Nidanapanchka i.e. after Poorvaroopa.All Acharyas opine that the complete manifestation of the disease with prominent clinicalfeature is called ‘Roopa’. This gives the clear information about the involvement of theDoshas and the avastha of the disease i.e. ‘Ama’ and ‘Pakwavastha’ etc    “Necessity and Importance of Poorvaroopa in Roga nidana and Chikitsa.” Page 64 
    • Discussion    Sammurchana of Dosha and Dushya which itself is Vyadhi as a result JwaradiVyadhi manifests by manifesting symptoms like Aruchi, Gourava etc. Bhvaprakasha explained that the Vishishta Poorvaroopa as Laxana, when itmanifests clearly with Vatadi dosha laxanas i.e. vatajwaradi, it also known as Roopa. Achrya Bhavaprakash has specifically classified Roopa into two types i.e.Samanya and Vishesha Roopa. Here Samanya Roopa acts as Vyadhi Bodhaka while theVishesha refers to the Pradhanyata of the Doshas and avastha of the disease.Importance of Roopa:In Roga nidana: Rupa helps for diagnosis of particular disease. For example; Ati dravamala pravritiindicates Atisara. It also helps to know about the involvement of doshas based on their presentations ifShula is associated with Rukshata indictes vataj shula, daha pin points pittaj shula etc.In Chikitsa: Roopa avastha helps for planning vyadhi pratyanika Chikitsa. In Sadhyasadhyata: Alpa roopa signifies sukhasadhyata and complete manifestation of roopa indicatesthe kasthasadhya or asadhyata of disease for treatment.Upashaya It acquires 4th place among Nidana panchaka. Acharyas have given the similaropinion about the meaning of Upashaya i.e. which gives pleasure to the person; it may beAushadha, Ahara and Vihara. In the context of disease, Upashaya may be Hetu/Vyadhi/Ubhaya Viparita orViparitarthkari.    “Necessity and Importance of Poorvaroopa in Roga nidana and Chikitsa.” Page 65 
    • Discussion   Importance of Upashaya:In Roga nidana: It is helpful in diagnosis of disease where difficulty arises due to similarities inlakshana, in such circumstances Upashaya helps to dignose the case accurately. For example- Some diseases are having hidden things or mimicking nature of lakshana in suchcircumstances upashaya and anupashaya therapy helps to diagnose the condition. For example – Gulma which alleviates by Snehana, Ushna dravya and abhyanga indicate that theperson is suffering from vataja gulma.In Chikitsa: 18 types of Upashaya are used as therapy.Samprapti The Samprapti has been explained at the end of the Nidana panchaka by allAcharyas while Bhavaprakasha has given second place to Samprapti. Just afterexplaining the Nidana, may be because of Samprapti starts from the Dosha Kriyakala,before Poorvaroopa which is starting stage of Vyadhi kriyakala. Samprapti starts from Nidana sevana, vitiation of Doshas. These vitiated doshasdoes the dushana of dhatus, this condition is called as Dosha Dushya Sammurchana,which leads Vyadhi Kriyakala i.e. Poorvaroopavastha then Roopavastha. This entiremechanism of manifestation of diseases has been described in general in the context ofNidanapanchaka where as specific Samprapti of each disease has been explained in thecontext of Samprapti of each disease.    “Necessity and Importance of Poorvaroopa in Roga nidana and Chikitsa.” Page 66 
    • Discussion    Because every disease has its own Samprapti, which is due to different verities ofNidana, different type of vitiation of Doshas i.e of tara and tama bhava and Dushti ofdifferent Dhatus, by these Doshas. This leads to manifestation of variety of diseases byoccupying different places in the body. Hence the entire process of manifestation ofdisease is called Samprapti. Samprapti is classified under five categories, in order to facilitate a detailedaccount of pathogenesis of the disease. In dealing with the types also equal considerationis given to Sthana and Doshas. Acharya Charaka explains five types of Samprapti viz Sankhya, Pradhyanya,Vidhi, Vikalpa and Bala Kala, where as other Acharyas like Vagbhata have includedPradanya under Sankhya samprapti itself, as it also explains about the variety of thedisease and explained Bala and Kala Samprapti separately.Importance of Samprapti:In Roga nidana: Samprapti helps to diagnose the contributory factors of the disease, which in turnindicates the name of the disease.In Chikitsa: Knowledge Samprapti helps to priscrib Samprapti vighatana chikitsa. It also helpsto plan Samshodhana, Samshamana and Langhana Chikitsa.In Sadhyasadhyata: Involvement of all three Doshas, Saptadhatus and Trivida Rogamarga indicate thepoor prognosis of the disease.    “Necessity and Importance of Poorvaroopa in Roga nidana and Chikitsa.” Page 67 
    • Discussion   POORVAROOPAAmong Nidana panchaka Poorvaroopa acquires the second place. The collective meaning of Nirukti is ‘The one which appears before the Roopa i.e.the sign of the occuring disease.Paryaya: Paryayas of Poorvaroopa is not mentioned by Charaka, may be because thesynonyms of Roopa have been given and by prefixing the word Poorva the synonyms ofPoorvaroopa can be formed. Vagbhata, Sharangadhara and Hemadri use the wordPoorvaroopa, Aadiroopa, Agraroopa respectively. Poorva means prior or before, one which appears before the Roopa is known asPoorvaroopa. Whereas Aadi/Agra means, initial. So, initial laxanas of Vyadhi are calledas Poorvaroopa.On definition: Different types of definitions regarding Poorvaroopa had been laid down in theSamhitas. According to Charaka the laxana appearing before the production of Vyadhi iscalled as Poorvaroopa, in this definition the word ‘Vyadhihi’ has been used, by this, onecan say that the first produced laxanas of Vyadhi are called as Poorvaroopa. Chakrapani uses the word ‘Bhavivyadhi Prabodhaka’ to define Poorvaroopa, butNidana also indicates the forthcoming disease so to exclude this word laxana is used, aslaxanas are found in Poorvaroopa. Then the doubt arises, before the production of Vyadhihow does the laxanas appear? This can be solved by simile of Megha and Varsha, byseeing the clouds one can infer rain. Sushruta explains the same with Dhoom and Vanhi.Here the clouds are used as the indicative of rain. The process of raining will start from    “Necessity and Importance of Poorvaroopa in Roga nidana and Chikitsa.” Page 68 
    • Discussion   the appearance of clouds and ends in raining because clouds are made of water. In thesimile of Shushruta, though they are different from one another, ‘Sahachari niyama’ isthere and both are parts of same Karya. When the above instances are applied to the Poorvaroopa and Roopa, the inferenceof Roopa can be done by the Poorvaroopa, both the Poorvaroopa and Roopa are parts ofVyadhi. ‘Bhavishyad vyadhi khyapaka’ means laxanas indicating the generating disease orpresent Vyadhi. While explaining Poorvaroopa Vagbhata used the aphorism ‘Doshvisheshena anadhishtita’ and ‘Uttpitsuramaya’, which means Doshas visheshana is absentin a Vyadhi of rising or affecting. But Gangadhara refuses this view by saying, it is not suitable or acceptable,because the phenomenon like Sanchaya, Prakopa, Prasara are purely related to Doshasand whenever the Sthanasamshraya occurs the disease is produced. In presence ofgenerating disease only the laxanas are seen, for this the word ‘Utpadhyamana vyadhi’ isused. The view of Vagbhata is clearly rejected here, giving the reasons that, it is incorrector yukti virudha. But this can’t be accepted, because the intention of Vagbhata behind stating,’Doshavisheshena anadhishita’ is to clarify that the Poorvaroopa is indicative ofVyadhivishesha rather than Doshavishesha. For example – Alasya, Jrimbha, Vinama,Mukhavairasya etc laxanas appear in Jwara Poorvaroopa, Doshas must be present in thisstate, otherwise how they will become Vyakta in Roopavastha. Ashtanga hridayaexplains that when Doshas attain Vyaktavastha, it is called as Roopavastha.    “Necessity and Importance of Poorvaroopa in Roga nidana and Chikitsa.” Page 69 
    • Discussion    So here the reason behind using the word ‘Doshavisheshana anadhisthita’ is toimply that the knowledge of involved doshas cannot be interpreted in that particularVyadhi.Interpretation of Avyakta Poorvaroopa: In some diseases Poorvaroopa laxanas are Avyakta. Arunadutta opines that the ‘Anasadita bala’ of Roga is the cause for the AvyaktaPoorvaroopa. But Hemadri comments as ‘Visheshajnan heenata’ i.e. lack of knowledgeor due to the lack of Sadhana. Vijayarakshita explains Avyakta as ‘Na ati abhivyaktam’means not clearly expressed because of the Alpata and Anuta of the laxanas. For example – In Urakshata and Vatavyadhi, Poorvaroopa is Avyakta because of incompletenessof laxanas said in Roopa. From the word Alpa one can take meaning of incompletelyformed or it may be due to short time gap within which the laxanas reach Roopavasthawithout permitting the Poorvaroopa to appear in the recognizable state. In Vata Vyadhi itmay be because, as Vata is having quality i.e. Mahajava, which leads to increase intensityof the disease manifestation.Fact behind the Avyaktata of Poorvaroopa: The Poorvaroopas are avyakta in some disease; this is may be because of theAashukari laxanas of vyadhi, where the dosha dushya sammurchana complete in a veryshort period. Hence the Poorvaroopa may be of alpakalayukta or alpabalayukta. That iswhy they are not elicited by patient. For example- Shoola, Visarpa, Daha etc.    “Necessity and Importance of Poorvaroopa in Roga nidana and Chikitsa.” Page 70 
    • Discussion    But some diseases even they are of Ashukari swabhava may be due to Agraroopaof dosha vridhhi and dosha dushya sammurchana lead to Poorvaroopa which may be ofalpakala but they are of spashta swaroopa. For example – Jwara, Atisara etc. In some of the disease due to prakriti sam samveta sammurchana, there is nomarkable difference between Poorvaroopa and Roopa. Where Poorvaroopa may bepresent in alpavega and alpasankhya and those only become poornavyakta inRoopavastha. Acharya Gangadhara clarified it by giving simile of ‘Garbha’ as avyaktaPoorvaroopa and ‘Balaka’ as vyakta Roopa because the existence of Balaka is present inGarbhavastha only, but it becomes vyakta after Prasava. Hence mriduroopa of samanyalaxana may be taken as Poorvaroopa. For example- Amlapitta, Urakshata etc.Classification: In Charaka and Astanga we can’t find the direct references for the classification ofPoorvaroopa, but Acharya Bhavaprakasha, Sushruta and the commentators likeChakrapani, Arunadutta etc, have classified Poorvaroopa accordingly. Achayra Sushruta, Madhava and Bhavaprakasha classified Poorvaroopa asSamanya i.e. which hints only about the Vyadhi jati without expressing the Doshainvolvement and Vishista i.e. which hints about the involved Doshas along with Vyadhis. Chakrapani’s classification is a little bit different as Avyakta laxana and other thanAvyakta laxanas    “Necessity and Importance of Poorvaroopa in Roga nidana and Chikitsa.” Page 71 
    • Discussion    But in continuation of Chakrapani’s commentary, Samanya and VishistaPoorvaroopa are also mentioned. Acharya Sushruta, Madhukoshakara, Bhavaprakasha classified Poorvaroopa intwo aspects-1. Samanya2. VishistaSamanya poorvaroopa: Laxanas produced due to Sammurchana of Dosha and Dushya indicating theVyadhi without pointing towards the involved Doshas, means by Samanya Poorvaroopathe generating Vyadhi can be identified. For example- Shrama, Arati, Vivarnata such laxanas indicates that Utpadhyamana Vyadhi isJwara, but here knowledge of Prakupita Dosha can’t be gained.Vishishta poorvaroopa: When the knowledge of generating disease along with the Prakupita doshas isrevealed then it is called Vishishta Poorvaroopa, But in Urakshata and Vatavyadhi etc Avyakta laxana of Roopa is called asVishistha Poorvaroopa. Here in these diseases Vatadijanya Roopa laxanas are Avyakta inPoorvaroopa. Avyakta means ‘Ishatvyakta’ so this type of Poorvaroopa can be consideredunder Vishishta Poorvaroopa. Sushruta has mentioned Vishishta Poorvaroopa of Jwara in Uttartantra i.e. Jrimbhaas Poorvaroopa of Vataja jwara, Nayana daha of Pittaja jwara and Aruchi of Kaphajajwara. But it is Virodha for the definition of Poorvaroopa because; Poorvaroopa is onewhich tells about the ‘Utpadyamana vyadhi’ but not the Dosha vishesha.    “Necessity and Importance of Poorvaroopa in Roga nidana and Chikitsa.” Page 72 
    • Discussion   To clarify this Acharya Madhava explains as follows Vyadhi Bodhaka laxanas are of two types 1. Sarvanga Bodhaka 2. Ekanga BodhakaSarvanga Bodhaka: These are which tell the Vyadhi and Nidana Shreni i.e. ‘Vyadhi dhnapaka janyanidana’ etc. it may be called as Roopa.Ekanga Bodhaka: These tell about the Vyadhi Shreni i.e Jwara etc and Vyadhi janaka Dosha. Hencethe Poorvaroopa which indicates only about the Vyadhi Shreni is considered as SamanyaPoorvaroopa, while those indicate Vyadhi Shreni and Vyadhi Janaka Dosha, but fail toexplain the Vyadhijnapaka anyalaxana and Vyadhi utpadaka nidana are considered asvishistha poorvaroopa. Here Jrimbha etc are indicative of Vataja jwara but not of Vata prakaopaka nidanai.e. Rukshata, Dhatukshya and Avarana etc. because of this, Acharyas may be includedJrimbha aadi in Vishishta poorvaroopa. But Gangadhara refuses this and states that Jrimbha is Vykta laxana only but as itis residing with Prabhuta Avyakta laxanas i.e. Poorvaroopas hence it is also includedunder Poorvaroopa only i.e. as the rule of ‘Vyapadeshastu bhuyasa’ In vyaktavasthajrimbha is associated with other jwarokta vyakta lakshanas i.e. Roopas. For example- ‘Chatrino gacchati’, here single Achatra dhari is also included under the group ofChatradhari or Masharashi indicates Samavesha of few number of Mudgadi Dhanya also.So here Jrimbha is considered as Poorvaroopa only. In roopavastha it is residing withJwarokta anya roopas.    “Necessity and Importance of Poorvaroopa in Roga nidana and Chikitsa.” Page 73 
    • Discussion    Arunadutta explains three types of Poorvaroopa, among these Shareerikapoorvaroopa is given more importance, as it is Sthayee, but Manasika andShareeramanasa are not considered as they are Ashtyee and will disappear after theappearance of Vyadhi. Above classification seem to be the further continuation of Samanya and VishishtaPoorvaroopa.What is the role of Dosha in the production of Poorvaroopa? Vaghbhata and Madhava used the word ‘Yena’ which indicates the Adristhaja andDoshaja Poorvaroopa while Sushruta consider only the Doshaja Poorvaroopa.To check the involvement of Doshas in the production of Poorvaroopa, example ofRajayakshma Poorvaroopa is elaborated. Madhukoshakara comments that the Poorvaroopas mentioned are not related toDoshas and states that the reason for such Poorvaroopa is not known. That may bebecause he may have considered only Shareerika doshas but not Mansika doshas. By the keen analysation it can be stated that each and every symptom ofPoorvaroopa implies the process of the production of Vyadhi. If laxanas like falling of Trina, Ghuna, and Kasha in the Annapana are producedthen, they must be the result of gradual process, because Rajayakshma is not a singledisease, but it is the Vyadhisamuha, in which both Shareerika and Mansika Vikriti arefound equally. Mythologically it has been described that Chandra suffered with Yakshmadue to Oja kshaya and is treated with Oja vridhhikar dravyas, because Oja is thecontributory factor for Shareerika and Mansika bala. In Yakshma, due to the Dhatu and    “Necessity and Importance of Poorvaroopa in Roga nidana and Chikitsa.” Page 74 
    • Discussion   Oja kshaya, both Shareerika and Mansika laxanas are produced as when Mana of theperson get affected, he feels as Trina have fallen in food etc. laxanas. In Dhatuposhana krama, Sarabhaga is produced in less quantity where as Mala isformed in excessive quantity. As a result Kesha and Nakha grow excessively. Heexperiences peculiar dreams like wells are dried, may be because he experiences shushkabhavas due to Shushkata of Dhatu’s. Ativridhi of Nakha kesha and durmana make himfeel as if placed on the heap of the kesha or Bhasma. All above said Poorvroopas are produced according to Sthanasamshraya ofDoshas. Shareerika doshas produce Vikriti in the body and Manasika Doshas produceVikriti in Manas that is why along with Brimhana chikitsa one should try to please themind of the patient. Whatever helps to please the mind, is Pathya in Rajayakshma.How is Poorvaroopa different from Roopa? Chakrapani says Pushpa is the Poorvaroopa of the Phala i.e.Roopa. Here in pushpathe Phalatva is present. The same can be considered in Dhooma and Vanhi and Meghaand Varsha.Table No-35 showing difference between Poorvaroopa and Roopa Poorvaroopa Roopa Lakshanas produced due to disease Lakshanas produced due to actual is to be appearing. vyadhi. Lakshanas which are not Lakshanas which are clearly specifically assignable to doshas. assignable to doshas. It is the stage of fourth kriyakala. It is the stage of fifth kriyakala    “Necessity and Importance of Poorvaroopa in Roga nidana and Chikitsa.” Page 75 
    • Discussion    Pratyatmaniyata lakshanas are Pratyatmaniyata lakshanas are present absent Amavastha or pakvavastha of Amavastha or pakvavastha of doshas doshas cannot be rule out. can be rule out. Vyadhi jati cannot be explained. Vyadhi jati can be explained. Poorvaroopa is like dhooma. Roopa is like vanhi (as concerned to chikitsa) Poorvaroopas are the Laxanas produced before the complete manifestation of Vyadhis, but they are to be produced in the process of Vyadhi, where as Roopa are the Laxanas produced after complete manifestation of Vyadhi. Roga or Vyadhi can be compared to the procession of king’s huge family. Some precede the king, some accompany and some follow. Here king is compared with Vyadhi, those who proceed are compared with Poorvaroopa accompanying are called as Roopa and who follow are called as Upadrava. The Doshika involvement can’t be judged with Samanya Poorvaroopa, but in Roopa even the Amshamsha kalpana of Doshas can be explained. At the end of Sthanasamshraya, the Poorvaroopa appears and this Avastha is considered as the 4th opportunity for the treatment. But in Vyaktavastha the Roopa laxanas are appear giving the 5th opportunity for the physician to treat the disease. In some disease Poorvaroopas are Avykta or Alpavyakta, where it is difficult to diagnose the disease. In Roopavastha the Laxanas are Pravyakta, means along with the other characteristic Laxanas, the Pratyatma laxana of Vyadhi is also seen.    “Necessity and Importance of Poorvaroopa in Roga nidana and Chikitsa.” Page 76 
    • Discussion    On the basis of Porvaroopa, Samprapti cannot be explained and obviously ‘Aama’ and ‘Pakwavastha’ of Doshas can’t be rule out, where as in Roopavastha, Jati of Vyadhi can be told. Jati is the synonym of Samprapti. By this we can say Samprapti can be explained by seeing Roopa. Amata or Pakwata of Dosha also can be told. For example- In Atisara, pain in Hridaya, Nabhi, Guda, Udara and Kukshi, Gatragourava, Anilasannirodha and Vitsanga are the Poorvaroopas. But only by these Laxanas one can’t explain the Amavastha or Pakwavastha. But in Roopavastha, Amatisara and Pakwatisara laxanas are explained, by which Amata and Pakwata of Doshas can be identified. Poorvaroopa and Roopa are compared to Dhooma and Vanhni, by seeing smoke one can infer fire, in the same way occuring diseases can be predicted by seeing Poorvaroopa. Even then these two are separate entities, because both of them need different planning for treatment.Vyapti of Poorvaroopa Acharya Sushruta explains the process of vyadhi utpatti under the heading of shatkriyakala. The doshas undergo abnormalities due to indulgence in ahita ahara, vihara anddue to kala and those in turn, bring about abnormalities in shareera which further lead tovitiation of the dhatus and produce diseases. These abnormalities gradually develop in successive stages like Sanchaya,Prakopa, Prasara, Sthanasamshraya, Vyakta and Bheda.    “Necessity and Importance of Poorvaroopa in Roga nidana and Chikitsa.” Page 77 
    • Discussion    The series of vikrita kriya is developing successively in different kala, whichgives an opportunity for chikitsa is known as Kriyakala in the evolution of disease. Among these Sthanasamshraya take fourth place. The prakupita doshas while moving in shareera, make sangha where kha vaigunyais present is called as sthanasamshraya and begin to manifest the disease. Among six kriyakala sanchaya, prakopa and prasara are considered as doshakriyakala and remaining comes under the umbrella of vyadi kriya kala. Khavaigunya isvery significant for sthana samshraya, which becomes platform for Dosha dushyasammurchana. Without this manifestation of disease is not possible. As this process is incomplete and still in progress so the laxanas are aspastha. Atthis stage instead of Dosha laxana, Dhatu vikruti laxanas are seen.FACTORS RESPONSIBLE FOR STHANASAMSHRAYA: 1. Vikrita dosha 2. Dushya daurbalya 3. Kha vaigunyaDosha vikruti And Dushya daurbalya: The specific nidanamshas, which are mentioned in particular vyadhi, areresponsible for the Dosha vikruti and Dushya daurbalya.Kha vaigunya: Here ‘kha’ means place and ‘vaigunya’ means vitiated, it is a site where doshadushya sammurchana takes place. It may be avayava, dhatu, and srotas etc. which arenothing but the Roga margas and lead to the disease, which are listed under particularRoga marga.    “Necessity and Importance of Poorvaroopa in Roga nidana and Chikitsa.” Page 78 
    • Discussion   Factors responsible for the Kha-vaigunya The contribution of Nidanamsha is more important in the formation of Kha-vaigunya, because specific nidanamsha is only responsible for the formation of Kha-vigunya for particular disease. For example In Swasa - Raja and Dhuma sevana etc In Urakshata - Plavana, Dhavana and Aghata etc In Arsha - Kathinasana and Atikunthana etc In Vatarakta - Ushtra yaana, Abhighata, Atyadwa gaman etc Same kha-vaigunya (samshraya sthana) may lead to different vyadhi; herespecific dosha vikrati, dushaya daurbalya and nidana lead to particular vyadhi.For example; As Basti is the place of kha vaigunya (samshraya sthana) for disease prameha andashmari too. Here prakupita dosha reaches basti, which is the place of kha vaigunya anddoes sammurchana with particular dushya i.e Dosha dushya sammurchana, and then itfurther leads to sroto dusti, and produces the poorvaroopa of utpadhyamana vyadhi. Thissuggests the clear difference between Kha-Vaigunya and Sroto Dusti. Sthanasamsraya avastha is very important stage, which can be designated astransition between the dosha kriyakala to the vayadhi kriyakala stage. It may also bestated that here onwards involvement of dushyas takes place. So Dosha dushyasammurchana is initiated in Sthanasamsraya avastha and its completion is achieved atVyaktavasta.    “Necessity and Importance of Poorvaroopa in Roga nidana and Chikitsa.” Page 79 
    • Discussion    At this stage the vitiated doshas make Sammurchana with the durbal dushyas atparticular place (kha vaignya). This process is known as Dosha-dushya-sammurcchana.Thus it is the interaction of dosha and dushya in relation to a specific samshraya sthana,which produces lakshanas of occuring disease. The fourth stage of the kriyakala is indeedthe first stage in which the symptoms of the occuring disease begin to appear, althoughnot fully developed. We in fact regard the lakshanas which appear at this stage as thePoorvaroopa. Here poorvaroopa of specific disease appears because of dosha, dushya andnidana of the particular disease. But diseases like Urakshata and Vata vyadhipoorvaroopas are in avyaktavastha.SCHEMATIC REPRESENTATION OF SHAT-KRIYAKALANidana Dosha vaishamya Kriyakala Dushya daurbalya Kha-vigunya Sanchaya Prakopa Prasara (vata and rakta are prasarana sadhakas) Kha vaigunyaDosha dushya sammurchana Sthana samshraya Poorvaroopa Srotodushti Vyakti Roopa Bheda Upadrava    “Necessity and Importance of Poorvaroopa in Roga nidana and Chikitsa.” Page 80 
    • Discussion   How to Consider Poorvaroopa in all Vyadhis:Table No-36 showing list of vyadhis where both Poorvaroopa and Samanyalakshana are mentioned Roga Poorvaroopa Samanya laxana Kasa + + Rajayaksma + + Urakshata + + Grahini + + Udara + + Trushna + + Pandu + + Raktapitta + + Vatarakta + + Sheetapitta + + Kusta + + Shotha + + Shosha + + Prameha + + Murcha + + Ashmari + + Arsha + + Apasmara + + Unmada + + Urusthamba + + Jwara + +    “Necessity and Importance of Poorvaroopa in Roga nidana and Chikitsa.” Page 81 
    • Discussion   Table No-37 showing list of vyadhis where only Poorvaroopa are mentioned and notSamanya lakshana. Roga Poorvaroopa Samanya laxana Swasa + - Hikka + - Pratishaya + - Chardhi + - Masurika + - Atisara + - Bhagandara + - Gulma + -Table No-38 showing list of vyadhis where both Poorvaroopa and Samanyalakshana are not mentioned Roga Poorvaroopa Samanya laxana Swarabheda - - Arochaka - - Agnimandya - - Shoola - - Daha - - Kamala - - Sheetada - - Visarpa - - Kilasa - - Snayuka - - Vispota - - Slipada - - Granthi - - Arbuda - - Mutragata - -    “Necessity and Importance of Poorvaroopa in Roga nidana and Chikitsa.” Page 82 
    • Discussion    Madatyaya - - Atatvabhinivesha - - Shukadosha - - The Poorvaroopa is supposed to be present in all the Vyadhis. Because thedefinition of Vyadhi says- ‘Dosha dushya sammurcchano vyadhi’ and Poorvaroopa is theresult of this only. So it is necessary to present Poorvaroopa in all Vyadhis. They may bein the form of vyakta or Ayakta. While explaining Urakshata and Vatavyadhi it is told that- ‘Avyakta laxanamtesham poorvaroopam iti smritam’. This common rule may be applied wherever the clearreference of poorvaroopa is not available. For most of the vyadhis Poorvaroopa is explained by Acharyas, which acts as thedehusked fruit. But in some of the diseases Poorvaroopa is not explained, here as per thedefinition- ‘Tadeva vyaktam tam roopa iti abhidhiyate’ so the mridu roopa of samanyalaxana is to be considered as Poorvaroopa, as it is avyakta i.e. na ati abhivyakta. It maynot be possible to identify by the vaidya or rogi, it may because of visheshajnanahinata. Itmight be the cause behind not explaining the Poorvaroopa for such disease. But for someof disease both Samanya laxana and Poorvaroopa are not explored, here the one mayconsider the mridu roopa of Roga only.Exceptions for Poorvaroopa – Prakkeval Vyadhi does not have Poorvaroopa. Example- Mashaka, Tilakalaka, Nyaccha and Vyanga etc are produced without theappearance of Poorvaroopa due to their Swabhava.    “Necessity and Importance of Poorvaroopa in Roga nidana and Chikitsa.” Page 83 
    • Discussion   Section- 2To explore the Scope of Poorvaroopa in present scenario: The classical texts of Ayurveda contain a discription of the diagnostic methods ieNidanapanchaka are envisaged by our ancient Acharyas.These discriptions are subjectiveas well as objective; they are the concept & principles to be applied to understand thediseases & the diseased. They are the broad generalisation & classifications, but told insukshma swaroopa. Some are discribed in atisukshma swaroopa which are difficult tounderstand as Poorvaroopa. Today these discriptions require to be interpreted &explained in such a way that the students of Ayurveda and physicians may be benefited inthe learning the most scientific wisdom behind these sutras. In present work the humbleeffect is done to expand the scope of Poorvaroopa which is one among the nidanapanchaka. In present days, everybody is focused on roopa and the laboratory findingswithout much highlighiting the Poorvaroopa; by this type attitude, vaidya is loosing theopportunity to treat the vyadi in its infacy. Even after a long run on the path of research inAyurveda field necessity & importance of Poorvaroopa remains an ignored subject. So itis necessary to put forth the fundamental aspects of Poorvaroopa and practical applicationin day to day clinical pratcice.    “Necessity and Importance of Poorvaroopa in Roga nidana and Chikitsa.” Page 84 
    • Discussion   To expand the Necessity and importance of Poorvaroopa in Roga nidana andChikitsa.In Roganidana: Nidana is derived as ‘Through which the complete knowledge of vyadhi isobtained’. Jejjata gives another derivation that, ‘One through which definite knowledgeabout vyadhi is attained is called Nidana’. For this Nidana of Roga, Acharyas have explained five tools, which are known asNidanapanchaka. Among which poorvaroopa acquires 2nd place, just after nidana or hetu,except Bhavaprakasha where he gives 2nd place to the Samprapti. Hetu is the causative factor for the disease. If a person indulges the nidana sevana,he will be affect by the disease. By the Nidana only we can presume the vyadhi. Thenwhy is poorvaroopa explained? Because same Nidana may be causative factor for manydiseases or one disease may be having many nidanas. So to have the more clear idearegarding the disease, Poorvaroopa has been explained. As Charaka says- ‘Rogama adou pariksheta tadanatara chikita’ before going forthe Chikitsa, the rogi should be examined properly. For this reason Nidana panchaka hasbeen explained. From Poorvaroopa one can diagnose vyadhi before it gets completelymanifestated. In broad, considerations of Poorvaroopa under different heading can be observed. The laxanas which are Avyakta or Alpa in Poorvaroopa may turn severe in Roopa. Sometimes the Poorvaroopa laxanas are totally opposite to that of Roopa. The Poorvaroopa laxanas are totally different from Vyadhi.    “Necessity and Importance of Poorvaroopa in Roga nidana and Chikitsa.” Page 85 
    • Discussion    In vata vyadhi the Poorvaroopa is avyakta. Here avyakta means ‘Ishatvyakta’i.e.the same laxana will be alpa or aspasta in Poorvaroopavastha. But continuation of allPoorvaroopa laxanas in Roopavastha will make the disease asadhya. That is why vatavyadhi is asadhya or kashtasadhya. About the Poorvaroopa some are, exactly opposite to the Roopa of vyadhi, forinstance in Atisara Poorvaroopa i.e. Vitsanga is seen, where as in roopa ‘Atisarana’ ofmala is seen. If vaidya is unaware of Atisara Poorvaroopa, then he may confuse it withmalabadhata and treat it accordingly of disease. Hence the knowledge of Poorvaroopa isvery necessary. In some of diseases the Poorvaroopa seems to be different to the disease, althoughthe Poorvaroopa is the result of Dosha dushya sammurchana which gives rise to disease. For instance, in Prameha vyadhi Acharya Sushruta explains the Jathilibhava ofkesha and Ativridhi of Nakha, which is very different from the vyadhi and dosha dushyainvolved, because kesha and Nakha are considered as mala of Asthidhatu, where asAsthidhatu involvement is not present in Prameha. For this Dalhana opines thatKeshajathilata as anyonya milana of keshas and it is due to sweda and mala bahulya,which is due to the vyadhi prabhava. The same can be considered in the disease likeRajayakshama etc. Here the laxanas are totally different than that of Roopa or disease. When thosePoorvaroopa appear the vaidya may get confused and he may not able to diagnose thedisease in Poorvaroopa avastha missing one opportunity for treatment or his diagnosismay put the patient into some other difficulties.    “Necessity and Importance of Poorvaroopa in Roga nidana and Chikitsa.” Page 86 
    • Discussion   In sapeksha nidana If the patient consulted the physician in the roopavastha, then also the vaidya mayface the difficulty, because the same Roopa can be seen in more than one disease for thathe may need other tool from Nidana panchaka. For example- In Rakthapitta and Prameha, Roopa is the Haridra varna and Rakta varna of mutrais seen, here to diagnose the disease we need to ask what were the Poorvaroopa laxanas,on the basis of which we can diagnose the disease, so takiing the detail history of thePresent illness is very necessary. Thus the Poorvaroopa helps in the differential diagnosis also, but sometimes thepatient may fail to explain the Porvaroopa, in that case it will be difficult to diagnose.In Vyadhipariksha Acharya Sushruta explains the Vyadhipariksha under three headings viz Aupasargika Prakkevala AnyalaxanaAupasargika: Aupasargika is one which develops after the manifestation of primary disease, andit resides with the earliar disease, which is called as ‘Upadrava’. It is not havingswajanma because it is produced by the nidana of the earliar disease only. Hence hereseparate Chikitsa is not necessary for the upadrava swaroopa vyadhi, by treating themulavyadhi upadrava also gets treated i.e. ‘Tasya prayah pradhana meva prashamebhavati’ But when upadrava is prabala, than treate it without disturbing the mulavyadhi.    “Necessity and Importance of Poorvaroopa in Roga nidana and Chikitsa.” Page 87 
    • Discussion   Prakkevala: These are the diseases produced without having Poorvaroopa and are free ofUpadrava. Commenting on this Dalhana tells, Apoorvaroopa is nothing but the absenceof Poorvaroopa and Anupadrava is absence of upadrava. For instance – Mashaka,Tilakalaka, Nyachha and Vyanga etc are prakkevala vyadhis, which are produceddevoide of Poorvaroopa. He opines for this, it is due to Vyadhiswabhava only.Anyalakshana: Anyalaxana or Anyalinga vyadhis are which foretell the feature disease and hereit is known as Poorvaroopa of the uttarkalin vyadhi. For instance – Arsha acts as theanyalaxana vyadhi or Poorvaroopa swaroopa vyadhi for the diseases like Grahani, Panduetc .So to prevent this condition, one should go for treatment as possible as easily i.e. inPoorvaroopavastha only. Anyalaxana resembles the concept of Nidanarthakar rogaswhich is explained by Charakacharya.In chikitsa:In sadhyasadhyata of 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 Yashas. That is why Charaka explained Chikitsathana followed by Indriyasthana. To findout the sadhyasadhyata of vyadhi, many tools have been mentioned. Poorvaroopa is onesuch important tool.    “Necessity and Importance of Poorvaroopa in Roga nidana and Chikitsa.” Page 88 
    • Discussion    Acharya Charaka and Vaghbhata have same opinion about the sadhyasadhyata ofthe vyadhi, with reference to ukta Nidana, Poorvaroopa and Roopa of the particulardisease. They consider if vyadhi is having alpa nidana, alpa poorvaroopa and alpa roopathen it is consider as sukhasadhya. Here word ‘alpa’ indicates both number and strengthof Poorvaroopa in the particular disease. This is may be because of alpa nidana leads to the alpa dosha vikriti and alpadushya dourbalya, which results in the alpa samprapti, which further results in alpata ofPoorvaroopa of vyadhi, which inturn indicates the vyadhibala i.e. alpavyadhi bala whichultimately leads to the sukhasadhyata of the vyadhi i.e. which is cured by alpa upaya andin alpa kala. Acharya Charaka also explains if vyadhi, having madhyama Nidana, Poorvaroopaand Roopa, then it is considered as kastasadhya i.e. treated with yatnapurvaka and inchirakala. If Poorvaroopas are more, then vyadhi is kastasadhya. If Poorvaroopa are less,then vyadhi is sukhasadhya. For example- Acharya Charaka, as mentioned in Poorvaroopa indriya adhyaya, if jwaramenifists with Sarva or atimatra of poorvaroopa, which are explained in jwara nidhanprakaran, which indicates the arist laxana of vyadhi. As per Chakrapani the word Sarvaniindicates Samasta i.e all and Atimatra indicates Atiulbanayukta and apart from these ifpoorvaroopa like “Ashwa ustra khari vapi ……”also indicate the arista lakshan. He alsoexplained arista janya Poorvaroopa for the disease like Shosha, Prameha etc which arementioned in Nidhan sthana. The overall observation of the Poorvaroopa lakshanas, one    “Necessity and Importance of Poorvaroopa in Roga nidana and Chikitsa.” Page 89 
    • Discussion   can infer that these are Agraroopa lakshanas of the disease suppose to be manifested. Thesame principle can be considered in other diseases too. In Prameha vyadhi, Kaphaja prameha is considered as sadhya. Pittaja, Vataja areyapya and asadhya respectively. But if Poorvaroopas which are mentioned in pramehaare continued in Roopavastha, then sadhya Prameha is also becomes asadhya fortreatment. Because, the way how Pushapa gets destroyed itself after the uttpatti of Phala ,which is natural (Prakrita), but if it is present at the stage of Phala avasta, which indicatsthe vikritavastha. The same should be considered in case of Poorvaroopa (Pushpa) andRoopa (Phala) also. If Poorvaroopas are continued in roopavastha of the vyadhi, it showsthe Vikritvastha of the vyadhi. If Pittaja prameha is free of Poorvaroopa andmedodhatudushti is considered as sadhya, even though it is a yapya vyadhi. Arista is thePoorvaroopa of Marana, as the Pushpa is the Poorvaroopa of Phala. Aristhas can be seenin Poorvaroopavashta of the vyadhi.In implication of Chikitsa As per the chikitsa siddhanta one should treat the patient as early as possible i.e.“Chaya yev jayed doshan” which means one should crub the doshas in chaya avastaonly. Acharya Sushruta while explaining the Satkriyakala mentioned the line of treatmentaccording to different stages because disease/dosha should be treated as possible as early.If left untreated disease/dosha then it reaches further stage and becomes Balavattara i.e.“Uttaragatishu balavattara”. Among the Shatkriyakala at Sthanasamshraya avastha, Poorvaroopa lakshanas ofthe disease begin to appear, which gives the fourth opportunity for treatment. Here    “Necessity and Importance of Poorvaroopa in Roga nidana and Chikitsa.” Page 90 
    • Discussion   Dalhana explained that the line of treatment should be Doshapratyanika,Dushyapratyanika or Ubhayapratyanika. Acharya Charaka also supports the above statement by saying that one shouldtreat disease in the stage of Poorvaroopa avastha only, to avoid the further manifestationof vyadhi. Just like a dam is constructed to prevent the crop by flood. In the same way iftreatment is given just after the appearance of Poorvaroopa then vyadhi can be preventedfrom attaining the Vyaktaavastha. In Poorvaroopa avastha of disease some specific treatment is mentioned.For example:Jwara: Whatever the treatment is offered in Poorvaroopavastha will be different fromthat of Roopavastha. Applying the same treatment in both conditions can be harmful.In Poorvaroopastha of Vata, Pitta and Kaphaja jwara Ghrita pana, Mrudu Virechana andVamana are advised respectively but here also treatment cannot be given only based onPoorvaroopa laxanas, Hetu is also taken under consideration because ghritapana can beindicated in the Poorvaroopavastha of Vataja jwara, arised due to shrama, bhaya andkrodha etc., but not in amashayashrita or mithya aharajanya jwara where langhana is thechoice of treatment. In Navajwara both snehana and shodhana are contraindicated thenwhy are they advised in Poorvaroopavastha? This is because the Poorvaroopa and Roopaare compared with dhooma and vanhi, which are different from one another, so treatmentalso differs accordingly.    “Necessity and Importance of Poorvaroopa in Roga nidana and Chikitsa.” Page 91 
    • Discussion   Prameha: Acharya Sushruta and Vaghbhata opine that in the Poorvaroopavastha of pramehaitself, the patient should be prescribed with Upavasadi apatarpana Chikitsa. From this wecan infer that as prameha is santarpanotta vyadhi where apatarpana is the choice oftreatment. It is nothing but Vishesha siddhanta. So here kwatha prepared of drugs havingkashaya rasa i.e. Vat adi are prescribed, which is nothing but the Dosha dushyapratyanika chikitsa because kashaya rasa has the properties like kapha hara, asravishodhana, kleda medo vishoshana. Also goat urine is prescribed for paana. Ubhayatashodhana is also adapted because prameha is considered under Bahudoshajs vyadhi,where shodhana is the line of treatment. Here teekshna virechana is advised because“Pramehi na dukkhena virechayeetum shakyata” If patient is not adhered to these linesof treatment in Poorvaroopavastha and continues the madhuradi ahara sevana pramehabecomes well manifests, which may leads to ghora upadravas like Prameha pidika.Ashmari: Acharya Charaka and Vaghbhata mentioned the therapies like snehadi karma inthe Poorvaroopavastha of Ashmari. Here the word snehadi indicates snehana, swedanaand vamanadi karmas and snehana may be considered as Avapeedaka sneha as vagbhatamentioned “Mutrajeshu tu paane shasyate ghritam” Usually in mutraghata vata prakopais present and for vata vriddhi chikitsa taila is considered as “Vara” i.e. shreshta, but herewhy did Acharya mentione ghrita instead of taila? Because taila may conquer vata, but itleads to Vitsanga and alpa mutrata, so taila is considered as ayogya for paana inmutraghata vikaras.    “Necessity and Importance of Poorvaroopa in Roga nidana and Chikitsa.” Page 92 
    • Discussion   Kushtha: Acharya Sushruta mentioned ubhaya shodhana therapy should be administered inPoorvaroopavastha of kushtha, because as per chikitsa siddhanta in bahu doshajacondition of dosha/vyadhi the first line of treatment is shodhan only. Acharya explained Poorvaroopas for some number of diseases andPoorvaroopagata chikista number were further reduced. But the fundamental principlescan be applied to other diseases too. Vyadhi is defined as Dosha dushya sammurchana janita vyadhi, which leads tothe Poorvaroopa of the particular vyadhi. Here the chikista principles likedoshapratyanika, dushya pratyanika, nidana parivarjana and samprapti vighatana can beapplied in general. This prevents the further manifestation of the disease. Otherwisecomplete manifestation of vyadhi occurs and it may become kasthasadhya,Upadravayukta and even Asadhya too.ie “Uttaragatishu balavattara vyadhi” Hence early diagnosis and early treatment is need of the hour.In Kasa: Acharyas, in kasa, Swasa prakarana have mentioned that, when Poorvaroopa andRoopa lakshanas are seen in a patient and if treatment is not prescribed the disease maybecome chronic and it is very difficult to treat and leads to complications.”Kasat swasakshaya chardi swaradaayo gadha bhavatya upekshana…….yasmat taasmat twareyajayet”In Raktapitta:The conditions where the patient complaining of Haridravarna/Rudhiravarna mutraindicates towards different pathological conditions like Raktapitta and Prameha. Here    “Necessity and Importance of Poorvaroopa in Roga nidana and Chikitsa.” Page 93 
    • Discussion   diagnose and treat disease with help of Poorvaroopa. Raktapitta is one which claims to beAshukari and Mahagada, so it is to be treated as early as possible because, it may becomefatal, so one should start the treatment accordingly like Pittahara and RaktadushtiharaChikitsa, which is nothing but Dosha dushya pratyanika chikitsa.In Swasa: The importance of Poorvaroopa in the treatment can be expressed with the help ofswasa as vyadhi, as it is known that it has vegakalina avastha. If the physican becomesaware about the poorvaroopa laxanas such as Anaha, parswashoola, Hrutpeeda are anearly sign of impending episode of swasa and take measure to prevent the onset of anepisode, one should go for the vatanulomanadi karma ie Samprapti vghatana Chikitsa.Thus Poorvaroopa plays an important role in early diagnosis & adaptation of suitablemeasure. In the disease of episodic nature the same can be considered in the diseases likeunmada, Apasmara etc.In Vatarakta:The disease vatarakta is classified according to Avasthabeda ie Uttana and Gambhira andtreatment also becomes hard accordingly. Hence one should aware of Poorvaroopa ofvatarakta and early diagnosis is followed by treatment like vatanulomana, vatashamaka,raktaprasadana, nidana parivarjana and Bahirparimarjana Chikitsa to prevent themanifestation of the disease.In Chardhi:Charaka mentioned chikista sutra for chardi as ‘Sarvaha chardhya mata langanamtasmad’ thus after manisfestation Poorvaroopas one should adapt shamana langana by    “Necessity and Importance of Poorvaroopa in Roga nidana and Chikitsa.” Page 94 
    • Discussion   which can prevent the chardi in early stages without shodanaroopi langana ie vamana andvirechana.In Urusthambha:In case of Urusthamba with the help of Poorvaroopa like Sthimitata Atinidra, Jangha andUrusadana etc one can differentiate this one from vatavyadhi. It is very important step forthe physician, because both are having similarity in laxanas but with respect to treatmentwhich are bit opposite to one another. In Urusthamba snehana and panchakarma arevarja. Here one may prescribe upakarma like parvatarohana, to walk over sand area in theearly morning and to swim against the flow of water etc. which are nothing but the doshadushya pratyanika chikista. The prime importance of Poorvaroopa is that by the help of it one can diagnose thedisease before it get completely manifested, after diagnosis of vyadhi inPoorvaroopavastha treatment should be given accordingly, by which advancement ofvyadhi can be checked and chikitsa siddhanta of Ayurveda can be achieved.    “Necessity and Importance of Poorvaroopa in Roga nidana and Chikitsa.” Page 95 
    • Discussion   PART –IIIMaterial and Methods: The available classical Ayurveda Samhita and also the relevant manuscripts,books on Veda are the materials for the study. The current study was done on “Necessity and Importance of Poorvaroopa inRoga nidana and Chikitsa” For this, the available classical Ayurveda Samhitas likeCharaka Samhita, Sushruta Samhita, Astanga Hrudaya, Astanga Sangraha, VagasenaSamhita, Bhavaprakash, Madhavanidana and their commentaries and also the relevantmanuscripts, books on Veda are the materials for the study. Original manuscripts, which are available at Bhandarkar’s oriental ResearchInstitute, Pune were taken as materials for the study. These important materials are selected for clear knowledge about the currentstudy. It is to be noted that, the study of Samhita is valuable because, the originalSamhitas are helpful in the uplifting of the basic principles of the science.And if original Samhitas are not understood properly, then the guidelines of therespective commentaries are followed so as to understand and solve the controversies.Methods: The entire study was based on compilation of the scattered matter selection of thefavorable points, discussion on the important points and conclusion of the study. Toachieve the satisfactory compilation of the study the study was carried in a systematicmanner. Based on Aims & objectives the compilation of the scattered matter was done.This complied matter was arranged in a Samucchyaya excluding the sandigdha vishayas.    “Necessity and Importance of Poorvaroopa in Roga nidana and Chikitsa.” Page 96 
    • Discussion   A systematic Vidhana of discussion was done to better understand the Prayojana of thestudy. Finally the Nirnaya of the study was presented in the form of conclusions.Manuscriptology: Among world’s oldest languages that were spoken and written, India holds twoDevanagari or Sanskrit, a native language and Tamil which is practiced by Dravidianssince civilization till date by the scholars of India. Out of different manuscripts, the leaf and paper Manuscripts are very popular forthe following reasons Very handy Can be re-produced Easily storable Environmental tolerability CheaperAnd the demerits of such Manuscripts are Worn out due to time factor Humidity Moth can tarnish them Govt. of India has recognized the importance of preservation of the Manuscripts& supports the storage. The important storages are present at West Bengal Chennai Tanjore Pune    “Necessity and Importance of Poorvaroopa in Roga nidana and Chikitsa.” Page 97 
    • Discussion   Salient features of ManuscriptsExternal features Size variable but usually uniform and on an average 12 x 5 inches. Protected with wooden slabs or the cardboard. Rapped in typical red coloured cotton cloth & may have two periphereal or one central string to tie.Internal features Thickness of the paper is variable Left and right borders with ½ inch free space Top and bottom borders are contentious Written on both sides Each paper is called as Folio Usually starts with separate mangalacharana Colophon, the end notes that is the upasamhara comprehended the presented subject along with the details of authors etc. Each Folio has side A or B. the side ‘A’ does not bear any markings but the side ‘B’ usually consists of abbreviation of each sthana and Devanagari sequential numerical. Left upper quadrant of the border & on right extreme lower quadrant bears Rama, specifying the socio-cultural practices of the writer. It is observed that, most of the manuscripts bear Rama because the social dominance of the literary group called Brahmins. However, such word is not seen in the collected Folio.    “Necessity and Importance of Poorvaroopa in Roga nidana and Chikitsa.” Page 98 
    • Discussion   Manuscripts under study: MSS- 1 and MSS-2 were collected from Bhandarkar’s Oriental Research Institute,Pune. After going through the description catalogue of government collection ofmanuscripts deposited at Bhandarkar’s Oriental Research Institute, Pune. Compiled by,Dr. Hardutt Sharma. MA, Ph.D. Professor, in Sanskrit Hindu College. In volume XVI part -1title “Vaidyaka” dated 1936 AD and manuscript is found to be made up of country paper;Devanagari characters; several hand writings. All quite legible, paper is very old, brittle,musty, and worn out. It has been patched up at several places, Folio 109, 136 and 362 aremissing, though there is no break in the texts. Folio 277 b and 316 b are blank Foil 405,which is unnumbered, is impossible to locate. This is a complete manuscript of CharakaSamhita except few pages at the end of Siddhi Sthana. It has got all 8 sthanas.SutrasthanFolio 1 to 94 a , Nidanasthana Folio, 94 b to 110 a. , Vimanasthan Folio 110b-146b,Sharirasthana Folio 146b -180a , Indriyasthana Folio 180a-210a , Chikitsathana Folio210a-364, Kalpasthana Folio 364a – 377a and Siddisthana Folio 377a-404b. Colophonsare tinged with red pigments. Age – appears to be very old, Author – Charaka BeginsFolio 1b with namaskar shloka as “Shriganeshaya namah bhagavanatreyaha |” ends – atFolio 404b with vrushya yoga as “Atha urdhwa vrishyatama ---- | ------- vrsuhatashecha ||    “Necessity and Importance of Poorvaroopa in Roga nidana and Chikitsa.” Page 99 
    • Conclusions   CONCLUSIONS • Each and every Nidanapanchaka is having its own importance in Roga nidana and Chikitsa. • Poorvaroopa helps to diagnose the disease before its complete manifestation. • Poorvaroopa is the part and parcel of Utpaddhyamana vyadhi. • The lakshanas produced at the end of Sthanasamshraya are called as Poorvaroopa, which will continue till vyadhi attains vyaktavastha. • Doshic involvement cannot be judged except in some case of vishishta Poorvaroopa. • Either Shareerika, Manasika or both dosha are responsible for the production of Poorvaroopa. • In Poorvaroopa, Avyakta lakshana means alpa or aspashta which are difficult to recognize. • It is not mandatory to have Poorvaroopa in all the vyadhis. • Sadhyasadhyata of vyadhi can also be found to some extent. • The line of treatment will differ at Poorvaroopavstha and Roopavastha. • Chikitsa given in Poorvaroopavastha helps to prevent further progression of disease. • Doshapratyanika, Dushyapratyanika and Ubhayapratyanika chikitsa has to be given in Poorvaroopa. • Poorvaroopa can become Arishta lakshanas depending on its severity.   “Necessity and Importance of Poorvaroopa in Roga nidana and Chikitsa.” Page 100 
    • Recommendation for future study   RECOMMENDATION FOR FUTURE STUDY Observational and Applied study on Poorvaroopa in Individual Disease.     “Necessity and Importance of Poorvaroopa in Roga nidana and Chikitsa.” Page 101 
    • Summary    SUMMARY The present research work entitled “Necessity and importance Poorvaroopa inRoganidana and Chikitsa” has been done entirely from a new angle. It reviews theclassical concepts with due evaluation. Pooorvaroopa being second amongst Nidanapanchaka forms the fundamentalbase of Roga nidana and Chikitsa too. The present work was a literary study, which comprises of different sections i.e.Introduction, Objective, Review of literature, Material and methods, Discussion andConclusion. The work started with collection of various references from available resourcesand arranging them to form a review of literature. It includes Historical review, Nirukti,Paryaya, Paribhasha, Bheda of Nidana panchaka later on, Poorvaroopa of vyadhis, vyapti,Sadhyasadhyata, Aristas, Chikitsa sutra with respect to Poorvaroopa by differentAcharayas were collected along with the opinion of different commentators. Material taken for the present study were the classical references of Ayurveda andother books with respective commentaries available in library and manuscript fromrenowned Bhandarkar’s oriental Research institute, Pune. In the discussion part of the work, salient points of the literary study werediscussed elaborately and logical interpretations were presented. Conclusions have been drawn on the basis of discussion regarding the wholestudy. At the end of the study, recommendation for the future studies, the list of classicalreferences, bibliography and photocopies of manuscript are given.    “Necessity and Importance of Poorvaroopa in Roga nidana and Chikitsa.” Page102 
    • Classical references   CLASSICAL REFERENCES Nidanapanchaka   1) Ch.Ni 1/6, 194pp. 2) As.Hr.Su 1/22, 14pp. 3) As.Sa.Ni 1/6, 352pp. 4) Ma.Ni. (Part 1) 1/4, 8pp. 5) Bh.Pr.Pu.Kh 7/23, 919pp. 6) Sh.Pu.Kh 1/5, 3pp. 7) Va.Ni 1/8, 2pp.Nidana Nirukti  8) Sha.Ka.Dr (II Vol), 880pp. 9) M.M.Wi, 548pp.Vyadhiutpattidnyapti Nidana Paribhasha  10) Madukosha.com on Ma.Ni(Part 1) 1/4, 8pp. 11) Madukosha.com on Ma.Ni(Part 1) 1/4, 8pp. 12) Madukosha.com on Ma.Ni(Part 1) 1/4, 8pp. 13) Madukosha.com on Ma.Ni(Part 1) 1/4, 8pp. 14) Madukosha.com on Ma.Ni(Part 1) 1/4, 8pp. 15) As.Hr.Su 1/22, 14pp. 16) As.Sa.Ni 1/6, 352pp. 17) As.Hr.Ni 1/2, 440pp. 18) Gangadhara.com on Ch.Ni 1/2, 193pp. 19) Chakrapani.com on Ch.Ni 1/2, 193pp. 20) Bh.Pr.Pu.Kh 7/23, 919pp. 21) Ch.Ni 1/6, 194pp.   “Necessity and Importance of Poorvaroopa in Roga nidana and Chikitsa.” Page 103 
    • Classical references  Hetubhuta Nidana Paribhasha  22) Madukosha.com on Ma.Ni(Part 1) 1/2, 3pp. 23) As.Sa.Ni 1/10, 353pp. 24) Ch.Ni 1/7, 194pp. 25) Madukosha.com on Ma.Ni(Part 1) 1/4, 8pp.Nidana Paryayas  26) As.Sa.Ni 1/10, 353pp. 27) As.Hr.Ni 1/3, 441pp. 28) Va.Ni 1/10, 2pp. 29) Bh.Pr.Pu.Kh 7/24-25, 919pp. 30) Ch.Ni 1/3, 193pp.Hetubheda  31) Madukosha.com on Ma.Ni(Part 1) 1/5, 19pp. 32) Madukosha.com on Ma.Ni(Part 1) 1/4, 19pp. 33) Madukosha.com on Ma.Ni(Part 1) 1/4, 19pp. 34) Madukosha.com on Ma.Ni(Part 1) 1/4, 19pp. 35) Madukosha.com on Ma.Ni(Part 1) 1/4, 19pp. 36) Madukosha.com on Ma.Ni(Part 1) 1/4, 19pp. 37) Madukosha.com on Ma.Ni(Part 1) 1/4, 19pp. 38) Madukosha.com on Ma.Ni(Part 1) 1/4, 20pp. 39) Madukosha.com on Ma.Ni(Part 1) 1/4, 20pp. 40) Madukosha.com on Ma.Ni(Part 1) 1/4, 20pp. 41) Madukosha.com on Ma.Ni(Part 1) 1/4, 20pp. 42) Madukosha.com on Ma.Ni(Part 1) 1/4, 20pp.Hetu Discriptoin  43) Madukosha.com on Ma.Ni(Part 1) 1/5, 19pp. 44) Madukosha.com on Ma.Ni(Part 1) 1/5, 19pp. 45) Madukosha.com on Ma.Ni(Part 1) 1/5, 19pp. 46) Madukosha.com on Ma.Ni(Part 1) 1/5, 19pp. “Necessity and Importance of Poorvaroopa in Roga nidana and Chikitsa.” Page 104 
    • Classical references   47) Ch.Su 11/37, 74pp. 48) Ch,Sh 1/98, 296pp. 49) Ch.Su 11/39, 76pp 50) Ch.Su 11/42, 76pp. 51) Madukosha.com on Ma.Ni(Part 1) 1/5, 19pp. 52) Madukosha.com on Ma.Ni(Part 1) 1/5, 19pp. 53) Su.Ni 1/78, 269pp. 54) Madukosha.com on Ma.Ni(Part 1) 1/5, 19pp. 55) Madukosha.com on Ma.Ni(Part 1) 1/5, 19pp. 56) Madukosha.com on Ma.Ni(Part 1) 1/5, 19pp. 57) Madukosha.com on Ma.Ni(Part 1) 1/5, 19pp. 58) Madukosha.com on Ma.Ni(Part 1) 1/5, 20pp. 59) Madukosha.com on Ma.Ni(Part 1) 1/5, 20pp. 60) Madukosha.com on Ma.Ni(Part 1) 1/5, 20pp. 61) Madukosha.com on Ma.Ni(Part 1) 1/5, 20pp. 62) Madukosha.com on Ma.Ni(Part 1) 1/5, 20pp. 63) Madukosha.com on Ma.Ni(Part 1) 1/5, 20pp. 64) Madukosha.com on Ma.Ni(Part 1) 1/5, 20pp. 65) Madukosha.com on Ma.Ni(Part 1) 1/5, 20pp.Hetu Sankara  66) Ch.Ni 8/24-26, 228pp.Nidanarthakara Roga  67) Ch.Ni 8/16-21, 228pp.Roopa Nirukti  68) Sha.Ka.Dr (IV Vol), 173pp.Roopa paryayas  69) Gangadhara.com on Ch.Ni 1/2, 1217pp. 70) As.Hr.Ni 1/5, 441pp. “Necessity and Importance of Poorvaroopa in Roga nidana and Chikitsa.” Page 105 
    • Classical references   71) As.Sa.Ni 1/13, 353pp. 72) Bh.Pr.Pu.Kh 7/35, 923pp. 73) Va.Ni 1/12, 2pp.Roopa Paribhasha  74) Ch.Ni 1/9, 195pp. 75) Chakrapani.com on Ch.Ni 1/9, 195pp. 76) Madukosha.com on Ma.Ni(Part 1) 1/7, 43pp. 77) Ch.Ni 1/9, 195pp. 78) As.Hr.Ni 1/5, 441pp. 79) As.Sa.Ni 1/9, 352pp. 80) Va.Ni 1/12, 2pp. 81) Bh.Pr.Pu.Kh 7/35, 923pp.Roopabheda  82) Bh.Pr.Pu.Kh 7/35, 923pp.Linga Sankeerya  83) Ch.Ni 8/27-29, 228pp.Upashaya Nirukti  84) Sha.Ka.Dr (I Vol), 261pp. 85) M.M.Wi, 208pp.Upashaya Paryayas  86) Ch.Vi 1/20, 235pp. 87) As.Hr.Ni 1/7, 442pp. 88) Bh.Pr.Pu.Kh 7/36, 923pp. 89) Va.Ni 1/14, 3pp.Upashaya Paribhasha  90) Ch.Ni 1/10, 195pp. 91) Chakrapani.com on Ch.Ni 1/10, 195pp. 92) As.Hr.Ni 1/6-7, 442pp. “Necessity and Importance of Poorvaroopa in Roga nidana and Chikitsa.” Page 106 
    • Classical references    93) Bh.Pr.Pu.Kh 7/36, 923pp. 94) Va.Ni 1/13-14, 3pp. 95) Ch.Vi 1/20, 235pp. Upashayabheda  96) Gangadhara.com on Ch.Ni 1/2, 1221pp. Anupashaya  97) As.Hr.Ni 1/7, 443pp. 98) Madukosha.com on Ma.Ni(Part 1) 1/9, 49pp. Samprapti Nirukti  99) Sha.Ka.Dr (V Vol), 283pp. 100) M.M.Wi, 1177pp.      Samprapti Paryayas  101) Ch.Ni 1/11, 196pp. 102) As.Hr.Ni 1/8, 443pp. 103) Bh.Pr.Pu.Kh 7/26, 920pp. 104) Va.Ni 1/15, 3pp. Samprapti Paribhasha  105) As.Hr.Ni 1/8, 443pp. 106) Va.Ni 1/15, 3pp. 107) Bh.Pr.Pu.Kh 7/26, 920pp. 108) Chakrapani.com on Ch.Ni 1/11, 196pp. 109) Madukosha.com on Ma.Ni(Part 1) 1/10, 3pp. 110) As.Sa.Ni 1/15, 353pp. Sampraptibheda/Discription  111) Ch.Ni 1/11-12, 196pp. 112) As.Sa.Ni 1/17-22, 354pp. 113) As.Hr.Ni 1/10-12, 443pp. 114) Bh.Pr.Pu.Kh 7/27-31, 921pp. “Necessity and Importance of Poorvaroopa in Roga nidana and Chikitsa.” Page 107  
    • Classical references   115) Va.Ni 1/16-19, 3pp.Poorvaroopa Nirukti  116) Sha.Ka.Dr (III Vol), 223pp. 117) M.M.Wi, 644pp.Poorvaroopa Paryayas  118) Arunadatta.com on As.Hr.Ni 1/5, 442pp. 119) As.Hr.Ni 1/3, 441pp. 120) Sh.Sa.Pu.Kh 1/3 3pp. 121) Chakrapani.com on Ch.Ni 1/8, 194pp.Poorvaroopa Paribhasha  122) Ch.Ni 1/8, 194pp. 123) Chakrapani.com on Ch.Ni 1/8, 194pp. 124) Dalhana.com on Su.Su 35/18, 152pp. 125) As.Hr.Ni 1/3-4, 441pp. 126) Va.Ni 1/11, 2pp. 127) Ma.Ni 1/5(Part 1), 36pp. 128) Indu.com on As.Sa.Ni 1/11, 353pp. 129) As.Hr.Su 12/60, 204pp. 130) Bh.Pr.Pu.Kh 7/34, 922pp. 131) As.Sa.Ni 1/11, 353pp. 132) Su.Su 21/33, 105pp.Poorvaroopabheda  133) Madukosha.com on Ma.Ni(Part 1) 1/5-6, 3pp. 134) Bh.Pr.Pu.Kh 7/34, 922pp. 135) Chakrapani.com on Ch.Ni 1/8, 194pp. 136) Arunadatta.com on As.Hr.Ni 1/3-4, 441pp.Vyapti of Poorvaroopa  137) Su.Su 21/33, 105pp. “Necessity and Importance of Poorvaroopa in Roga nidana and Chikitsa.” Page 108 
    • Classical references   138) Dalhana.com on Su.Su 21/33, 105pp. 139) Su.Su 24/10, 116pp. 140) Chakrapani.com on Ch.Ni 1/8, 194pp.Poorvaroopa of Vyadhi’s Kasa  141) Ch.Chi 18/5, 580pp. 142) Su.Ut 52/7, 766pp. 143) As.Hr.Ni 3/18, 469pp.Swasa  144) Ch.Chi 17/20, 533pp. 145) Su.Ut 51/6, 761pp. 146) As.Hr.Ni 4/4, 472pp.Hikka  147) Ch.Chi 17/19, 533pp. 148) Su.Ut 51/6, 761pp.Rajayaksma  149) Ch.Ni 6/13, 221pp. 150) Ch,Chi 8/33-38, 460pp. 151) Su.Ut 41/29-30, 713pp.Urakshata  152) Ch.Chi 11/12-13, 478pp.Pratishyaya  153) Su,Ut 24/5, 651ppChardhi  154) Ch.Chi 20/6, 555pp. 155) Su.Ut 49/8, 755pp. 156) As.Hr.Ni 5/30, 481pp. “Necessity and Importance of Poorvaroopa in Roga nidana and Chikitsa.” Page 109 
    • Classical references  Grahani  157) Ch.Chi 15/55, 517pp. 158) Su.Ut 40/173, 710pp. 159) As.Hr.Ni 8/19-20, 497pp.Udara  160) Ch.Chi 13/16-19, 492pp. 161) Su.Ni 7/7, 296pp. 162) As.Hr.Ni 12 /5-7, 513pp.Trushna  163) Ch.Chi 22/8, 567pp. 164) Su.Ut 48/7, 751pp.Jwara  165) Ch.Ni 1/33, 202pp. 166) Su.Ut 39/25-38, 672pp. 167) As.Hr.Ni 2 /6-9, 448pp.Pandu  168) Ch.Chi 16/12, 527pp. 169) Su.Ut 44/5, 729pp. 170) As.Hr.Ni 13 /8, 518pp.Raktapitta  171) Ch.Ni 2/6, 206pp. 172) Su.Ut 45/8, 734pp. 173) As.Hr.Ni 3 /4-6, 467pp.Vatarakta  174) Ch.Chi 29/16-18, 628pp. 175) Su.Ni 1/47, 264pp. 176) As.Hr.Ni 16 /5-6, 536pp. “Necessity and Importance of Poorvaroopa in Roga nidana and Chikitsa.” Page 110 
    • Classical references  Kushta  177) Ch.Chi 7/11-12, 451pp. 178) Su.Ni 5/4, 283pp. 179) As.Hr.Ni 14 /11-12, 525pp.Shotha  180) Ch.Chi 12/10, 483pp. 181) As.Hr.Ni 13 /30, 520pp.Prameha  182) Ch.Chi 6/13-14, 446pp. 183) Su.Ni 6/5, 290pp. 184) As.Hr.Ni 10 /38-39, 505pp.Ashmari  185) Su.Ni 3/5-6, 277pp. 186) As.Hr.Ni 9 /6-7, 498pp.Atisara  187) Su.Ut 40/8, 697pp. 188) As.Hr.Ni 8 /4, 495pp.Arsha  189) Ch.Chi 14/22, 503pp. 190) Su.Ni 2/8, 272pp. 191) As.Hr.Ni 7 /15-19, 492pp.Bhagandara  192) Su.Ni 4/4, 280pp.Apasmara  193) Ch.Ni 8/6, 226pp. 194) Su.Ut 61/7, 800pp. “Necessity and Importance of Poorvaroopa in Roga nidana and Chikitsa.” Page 111 
    • Classical references    195) As.Hr.Ut 7 /6-8, 802pp. Unmada  196) Ch.Ni 7/6, 223pp. 197) Su.Ut 62/6-7, 803pp. Gulma  198) Su.Ut 42/9, 717pp. 199) As.Hr.Ni 11 /63, 513pp. Urusthambha  200) Ch.Chi 27/15, 613pp. Masurika  201) Ma.Ni (Part 2) 54/3, 182pp.  Sheetapitta  202) Ma.Ni (Part 2) 50/2, 168 pp.  Importance of Poorvaroopa in Roga Nidana   Sapeksha Nidana  203) Ch.Chi 6/54, 449pp. 204) As.Hr.Ni 10/37, 505pp.  Vyadhipareeksha  205) Dalhana.com on Su.Su 35/18, 152pp.  Sadhyasadhyata  206) Ch.Su 10/7-8, 66pp. 207) As.Hr.Su 1 /30, 18pp. 208) Ch.Su 10/11, 66pp. 209) Ch.Su10/14, 66pp. 210) As.Hr.Ni 10 /41, 506pp. 211) Ch.Chi 6/56, 449pp. “Necessity and Importance of Poorvaroopa in Roga nidana and Chikitsa.” Page 112  
    • Classical references     Poorvaroopa as Aristha  212) Madukosha.com on Ma.Ni(Part 1) 213) Ch.In 2/3, 356pp. 214) As.Hr.Sh 5 /1, 417pp. 215) Ch.In 5/4-26, 361pp.  Importance of Poorvaroopa in Chikitsa  216) Su.Su 21/37, 106pp. 217) Su.Su 21/33, 105pp. 218) Ch.Sh 1/91, 296pp.  Jwara  219) Ch.Ni 1/36, 206pp. 220) Su.Ut 39/97-99, 679pp.  Prameha  221) Su.Ch 12/4, 454pp. 222) As.Hr.Chi 12/39, 680 pp.  Ashmari  223) Su.Ch 7/14, 435pp. 224) As.Hr.Chi 11/17, 674 pp.  Kustha  225) Su.Ch 9/6, 442pp. “Necessity and Importance of Poorvaroopa in Roga nidana and Chikitsa.” Page 113  
    • Bibliography    BIBLIOGRAPHY Sir.Williams M. M., Sanskrit English Dictionary, Ed. 1st reprint, Delhi: Motilal Banarasidas Publishers. Dev. R.R., Shabdakalpadruma, 2nd edition, Delhi: Nag Publication, 2002(i, ii, iii, iv)CHARAKA SAMHITA Vd. Y.T. Acharya., Charak samhita of Agnivesh with Ayurveda deepika teeka of Chakrapani, Ed. Reprint, Varanasi: Choukambha Prakashan, 2007.SUSHRUTA SAMHITA Vd. Y.T. Acharya., Sushruta Samhita of Maharshi Sushrut, Nibandh Sangraha teeka of Dalhana, Ed. Reprint, Varanasi: Choukambha Sanskrit Prakashan, 2008.ASHTANGA HRUDAYA Paradkar H. S. S., Astang Hrudaya of Vagbhat, Sarvang sundar teeka of Arundutta and Ayurveda Rasayana of Hemadri, Ed. Reprint, Varanasi: Choukambha Surbharati Prakashana, 2007.ASHTANGA SANGRAHA Dr. Shivaprasad Sharma., Ashtanga Sangraha of Vriddha Vagbhatta with Shashilekha Sanskrit commentary of Indu, Ed.1st, Varanasi: Chowkhamba Sanskrit series office, 2006.MADHAVA NIDANA Prof. Upadhyaya Y., Madhava Nidan of Madhavakara, Madhukosh teeka of Vijayarakshita, Ed.Reprint, Varanasi: Choukambha surbharati Prakashana, 2003(i, ii) “Necessity and Importance of Poorvaroopa in Roga nidana and Chikitsa.” Page 114
    • Bibliography   SHARANGADHARA SAMHITA Pt. Shastri p., Sharangdhar Samhita of Acharya Sharagdhar, with Deepika and Gudharth Deepika teeka, Ed.6th, Varanasi: Choukambha Orientalia, 2005.BHAVAPRAKASHA NIGHANTU B. Mishra and R. Vaishya., Bhavaprakasha Nighantu of Bhava Mishra with Vidyotini hindi commentary, Ed.8th , Varanasi: Choukambha Sanskrit Pratishthan, 1997(i).VANGASENA SAMHITA Dr. Nirmal Saxena., Vangasena samhita of Vangasena, Ed.1st, Chowkhamba Sanskrit series office, 2004(1). “Necessity and Importance of Poorvaroopa in Roga nidana and Chikitsa.” Page 115
    • MANUSCRIPTS OF NIDANA PANCHAKA 925/1881‐95 94 b 925/1881‐95 95 a