7. The five therapeutics of disease
In the treatment of disease the following
aspects require examination:
• Nidana (Etiology or cause of a disease)
• Purva-Rupa (Premonitory and prodromal
signs and symptoms)
• Rupa (Actual signs and symptoms)
• Upasaya (Therapuetic trials)
• Samprapti (Pathogenesis)
8. Nidana or Aetiology
The two meanings of Nidana:
• diagnosis of the disease
• aetiology of the disease
9. The importance of Nidana in Ayurveda:
“As long as the cause of the disease is not
identified and prevented, there can be no
alleviation of the disease”
Mādhava-Nidāna – pp. 9-10 & pp. 30-33 & 39-
40
10. The five causative factors of disease
• Prajnaparadha
(Intellectual blasphemy or misuse of intelligence)
• Asatmyendriyartha Samyoga
(Unwholesome contacts of senses with their objects)
• Kala Parinama
(Seasonal perversions and age)
• Karma or Samskara
(Causative factors)
• Krmi
(Germs and parasites)
11. Prajnaparadha (Crime against wisdom
or misuse of intelligence)
It means:
Carrying out an act contrary to the
understanding of an awakened consciousness
12. This covers the following misuse of action of
the body, mind or speech in three categories:
• Ayoga (non-activity or stimuli)
• Atiyoga (excessive activity or stimuli)
• Mithya yoga (inappropriate activity or
stimuli)
13. Asatmyendriyartha Samyoga
(Unwholesome contact of senses with
their objects)
Asatmya = harmful conjunction between the five
senses and their objects leading to disease
The harmful conjunction incorporates:
• non-conjunction (Ayoga)
• excessive conjunction (Atiyoga) and
• wrongful conjunction (Mithya yoga).
14. Examples of excessive use of sense
objects
i. Hearing – Loud sounds, prolonged hearing of high
pitched and rough sounds such as roaring, thunder,
beating of drums
ii. Touch - excessive use or handling of very hot or very
cold things; too much bathing or massage
iii. Sight - excessive exposure to bright or powerful light
iv. Taste – excessive taste of any or all of the six rasas
v. Smell - excessive smelling of very strong or pungent or
putrid substances
15. Examples of wrongful use of sense
objects
i. Hearing - hearing of harsh or disagreeable or fearful sounds
or mournful news
ii. Touch - touching poisonous air, exposure to stormy winds
or untimely advent of hot or cold weather or to be struck
by anything
iii. Sight - to see extremely fine and small objects very near to
the eye or at very great distance; or to see loathsome,
dreadful or hostile objects; or any distorted vision
iv. Taste - to have recourse to only one kind of taste in excess
or to exclude one altogether or take very little of one to
include in one’s diet; articles of food whose combination is
harmful
v. Smell - to smell putrid, poisonous, nauseating things
16. Examples of non-use of sense objects
This self explanatory and is isolation of the
senses from any kind of sound, object to
touch whether cold or hot; no sight of any
object; no taste of six rasas; and nothing to
smell
For example:
• Travelling on the tube
• Solitary confinement including sensory
deprivation
17. Parinama (Seasonal perversions and
age)
• Atiyoga of kala (time) = when a particular
season manifests its own characteristic of
cold, heat or rains in an excessive degree
• Ayoga of kala (time) = when these
characteristics are deficient
• Mithya yoga of kala (time) = when a season
manifests symptoms which are opposite to its
particular characteristics
18. Parinama also means:
• Certain diseases can affect certain
constitutions in different ways
• Genetic effect on survival
• Diseases caused by ageing eg. Menopause and
osteoarthritis
21. Classification of disease
according to causative factors
Causative factors
Adhidaivika (pertaining to the acts of
God or nature or karma)
Adhibahutika (pertaining to physical
environment)
Adhyatmika (pertaining to the soul)
22. Classification of disease
according to causative factors
Causative factors
Adi – bala – Pravrtta
Janamabala Pravrtta
Dosha – bala Pravrtta
Samghata – bala Pravrtta
Kala – bala – Pravrtta
Daiva – bala Pravrtta
Svabhava – bala – Pravrtta
23. Classification of disease
according to causative factors
(i) Adi – bala – Pravrtta (Orginated from any primary inherent cause)
(ii) Janamabala Pravrtta (congenital)
(iii) Dosa – bala Pravrtta (due to deranged body doshas)
(iv) Samghata – bala Pravrtta (due to extraneous causes)
(v) Kala – bala – Pravrtta (due to climatic and seasonal distemper)
(vi) Daiva – bala Pravrtta (divine or natural havocs)
(vii) Svabhava – bala – Pravrtta (Physiological or natural type)
24. Adi – bala – Pravrtta (Orginated from
any primary inherent cause)
Caused by defects in:
(a) in the father or
(b)in the mother
These are hereditary diseases, eg:
Leprosy, asthma, piles
25. Janamabala Pravrtta (congenital)
Due to any improper conduct on the part of the
mother regarding food or hygiene during the
period of gestation:
(a) Rasa (improper food) or
(b) Lack of mindfulness of the hygienic principles
(These diseases can happen in spite of the fact that
there is no defect in the germ cells of either
parent)
26. Dosha – bala Pravrtta (due to
deranged body doshas)
Occurs due to derangement of any of the doshas
due to improper diet, unhealthy habits or one
disease secondary to previous one
These can be sub-divided as
(a) Bodily (vāta, pitta, kapha) or
(b)Mental (Rajas and Tamas)
27. Samghata – bala Pravrtta (due to
extraneous causes)
These are diseases caused by external factors in
two categories:
(a) an implement or
(a) any ferocious or poisonous animal or allergy
28. Kala – bala – Pravrtta (due to climatic
and seasonal distemper)
Disease can precipitate due to:
• excessive variabilities in climates of season
• atmospheric temperature or
• Humidity
29. Daiva – bala Pravrtta (divine or natural
havocs)
Disease can be produced by being in the wrong
place at the wrong time:
• by lightning
• any malignant influence
• by association
• by accident
30. Svabhava – bala – Pravrtta
(Physiological or natural type)
Hunger, thirst, old-age, death, sleep etc are
considered as natural or physiological diseases
31. Immunity in Caraka and Susruta
“Arogya (health in respect of prevention and recovery)
depends on bala or body resistance”
Caraka Cikitsa
“Always try to maintain the bala or resistance of a person, if
restored, it arrests the progress of the disease”
Susruta Cikitsa
“In one who has extremely lost the bala, it is not possible to
make him free of the diseases”
Susruta, Sutra
32. Ojas
Ojas is called Vyadhi-ksamitva
Vyadhi = disease
Ksamitva = decline
This can mean:
1. To arrest the progress of the disease
2. Prevent the occurrence or
3. Re-occurrence of the disease
33. • Sahaja (natural or innate)
Vyadhi-bala-virodhitva = natural immunity,
generally of non-specific type, which attempts to
defend the body in the first occurrence of any
disease
• Yuktikrta (acquired)
Vyadhutpada-pratibandhakatva = when the
natural immunity is experienced in any way ie.
vaccination it often succeeds to check the re-
occurrence or occurrence of certain diseases
34. Evidence of immunity in Caraka
Nidana
• Natural cure - patients recover without going under
any treatment
• A certain inhibiting factor due to which deviations
from hygiene rules do not produce a sudden ill effect
among the unwholesome or contaminated diet-takers
eg food poisoning which doesn’t affect everyone
• The significant peculiarities in the form of non-
occurrences, poor – manifestations and full
manifestations of diseases are dependent on
characteristics of aetiological factors, reacting humours
and body tissues
36. Factors affecting the Grades of
Immunity
Immunity is also inherited and greatly influenced by
several other factors such as:
• diet
• environment
• mode of living
• psychic patterns
• growth or development
• age
• pathological conditions of the individual
37. In Ayurveda factors affecting the
immunity have been classified into
two groups:
• factors that lessen immunity
• factors that enhance immunity
38. Lessening factors which lower the
defence mechanism of the body
• severe infection - bhutopghata
• excessive loss of body fluids - ativartna of kapha, sonita, sukra and
mala
• wasting - ksaya
• physical exertion – srama & vyayama
• intoxicating liquors – ruksa pana
• prolonged awakening – prajagara
• mental stress such as anger, anxiety, fear, and grief – kopa, cinta,
bhaya & sokainjury, accidental or surgical – abhigata
• nutritional disturbances – ksut, anasana, atilanghana,
ruksalpaprami – tatsana
• season, environment, and age – kala, vatatapa & jara
• severe humoral upset – dosa vega
39. Enhancing factors which enhance the
defence mechanism of the body
• characteristics of race and generation in which birth has taken place
• genetic peculiarity of parents
• favourable climate
• balanced diet
• constitutional characteristics
• want of hyper sensitivity
• mental peace
• outcome of something latent
• adolescence
• proper exercise
• proper stimulation
