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== निदानपंचकम् ॥ Nidanapanchakam: Tools for discernment of disease  ==
 
== निदानपंचकम् ॥ Nidanapanchakam: Tools for discernment of disease  ==
There exists a methodical approach to study and diagnose any disease according to Ayurveda. One can find detailed description on 5 methods to analyse a disease in Ayurveda’s perspective in classical treatises. These 5 assessment points are collectively known as [[Nidanapanchakam (निदानपञ्चकम्)|Nidanapanchak]]<nowiki/>am (निदानपंचकम् 5 elements for discernment of diseases). Acharya Vagbhata says that, <blockquote>निदान पूर्वरूपाणि रुपाण्युपशयस्तथा संप्राप्तिश्चेति विज्ञानं रोगाणां पञ्चधा स्मृतम्</blockquote>The 5 elements for discernment of the disease are Hetu (हेतु: etiological considerations or origin of disease), Purva-rupa (पूर्वरूपम् Prodromal symptoms), Rupa (रूपम् clinical features or signs & symptoms), Upashayaanupashaya (उपशयानुपशयम् therapeutic diagnosis) and Samprapti (संप्राप्तिः Onset of disease or patho-physiological processes).
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There exists a methodical approach to study and diagnose any disease according to Ayurveda. One can find detailed description on 5 methods to analyse a disease in Ayurveda’s perspective in classical treatises. These 5 assessment points are collectively known as [[Nidanapanchakam (निदानपञ्चकम्)|Nidanapanchak]]<nowiki/>am (निदानपंचकम् 5 elements for discernment of diseases). Acharya Vagbhata says that,<blockquote>निदान पूर्वरूपाणि रुपाण्युपशयस्तथा संप्राप्तिश्चेति विज्ञानं रोगाणां पञ्चधा स्मृतम्।</blockquote>The 5 elements for discernment of the disease are Hetu (हेतु:etiological considerations or origin of disease), Purva-rupa (पूर्वरूपम्। Prodromal symptoms), Rupa (रूपम्। clinical features or signs & symptoms), Upashayaanupashaya (उपशयानुपशयम्। therapeutic diagnosis) and Samprapti (संप्राप्तिः। Onset of disease or patho-physiological processes).
    
== षट्क्रियाकालम्॥ Shatkriyakala: Steps of disease development ==
 
== षट्क्रियाकालम्॥ Shatkriyakala: Steps of disease development ==
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== व्याधिबलविशेषोपलब्धिः हेतवः॥ Methods of assessment of a disease ==
 
== व्याधिबलविशेषोपलब्धिः हेतवः॥ Methods of assessment of a disease ==
It is mandatory for a [[Vaidya (वैद्यः)|Vaidya]] to evaluate any presented roga on the basis of 10 points put forward by Ayurveda acharyas before planning the best suitable treatment for the patients. This is the strength of Ayurveda and an exclusive approach towards offering customized treatments for individuals. This 10 fold assessment helps to determine the strength of not only the disease but also the diseased individual. On the basis of this assessment a wise Vaidya suggests treatment for any disease. The 10 points are as follows<blockquote>तत्र विकारं हेतु-दोष-दूष्य-प्रकृति-देश-काल-बलविशेषैर्लिङ्गतश्च परीक्षेत, न ह्यन्तरेण हेत्वादीनां बलविशेषं व्याधिबलविशेषोपलब्धिः| (Char. Samh. 8.101)<ref>Charaka Samhita (Vimanasthanam Adhyaya 8 Sutram 101)</ref></blockquote>
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It is mandatory for a [[Vaidya (वैद्यः)|Vaidya]] to evaluate any presented roga and rugna (रुग्णः। patient) on the basis of 10 points suggested by Ayurveda acharyas before planning the best suitable treatment for the patients. This kind of assessment is one of the examples of wholesome and exclusive approach in Ayurveda treatments designed to offer customized treatments for individuals. This 10 fold assessment helps to determine the strength of not only the disease but also the diseased individual. On the basis of this assessment a wise Vaidya suggests treatment for any disease. The 10 points are as follows<blockquote>तत्र विकारं हेतु-दोष-दूष्य-प्रकृति-देश-काल-बलविशेषैर्लिङ्गतश्च परीक्षेत, न ह्यन्तरेण हेत्वादीनां बलविशेषं व्याधिबलविशेषोपलब्धिः| (Char. Samh. 8.101)<ref>Charaka Samhita (Vimanasthanam Adhyaya 8 Sutram 101)</ref></blockquote>Menaing: Assessment of diseases should be conducted on the basis of parameters like involved doshas, dushyas, prakrti (body type), region of residence of patient or the site of disease development, season and age of the patient, strength of the patient and clinical features of the diseases. The severity of the disease cannot be understood without knowing the strength of above-mentioned factors.
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Thus, Ayurveda treatments are offered after computing the strength or tolerance level of the patient and severity of the disease appraised using this method. Probably this is the reason why Ayurveda treatments are relatively safer. 
    
== रोगहेतवः॥ Causative factors of Rogas ==
 
== रोगहेतवः॥ Causative factors of Rogas ==
Ayurveda considers 3 fundamental causes for any disease.
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Diseases develop due to disturbance in the levels of doshas, dushyas and malas. Multiple dietary, lifestyle related and other factors are responsible for provocation of doshas and weakness of dhatus, malas or other systems. Ayurveda has described correlation of such etiological factors and affected body components. However, Ayurveda acharyas have not limited themselves up-to this level but have further identified the fundamental causes of exposure to such diseases causing agents. The fundamental causes behind development of any disease are classified in 3 basic types as follows,
 
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असात्म्येन्द्रियार्थसंयोगः, प्रज्ञापराधः, परिणामश्चेति त्रयस्त्रिविधविकल्पा हेतवो विकाराणां, समयोगयुक्तास्तु प्रक्रुतिहेतवो भवन्ति । (Char. Samh. 11.44)
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asātmyendriyārthasaṁyogaḥ, prajñāparādhaḥ, pariṇāmaśceti trayastrividhavikalpā hetavo vikārāṇāṁ, samayogayuktāstu prakrutihetavo bhavanti ।
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Meaning: According to Acharya Charaka the causes are as follows,
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असात्म्येन्द्रियार्थसंयोगः । Asatmendriyartha Samyoga (Inappropriate contact of objects with senses)
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प्रज्ञापराधः। Pradjnaparadha (Intellectual error) and
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परिणामः। Parinama (Consequences/ Time)
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हीन। Heena (Under/ deficient), मिथ्या । Mithya (Inappropriate/perverted) or अति । Ati (Excessive) yoga (union, exposure or contact) with any 3 of the above is said to result in development of diseases.
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आचार्य वाग्भटः। Acharya Vagbhata and आचार्य चरकः । Acharya Charaka in their treatises have stated the 3 causes of disease as, हीनम्। Heena (Under/ deficient), मिथ्या। Mithya (Inappropriate/perverted) or अति। Ati (Excessive) exposure or contact with 3 factors namely, काल। Kala, अर्थ । Artha and कर्म । Karma.
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कालार्थकर्मणां योगो हीनमिथ्यातिमात्रकः। सम्यग्योगोश्च विज्ञेयो रोगारोग्यैककारणम्॥ (Ash. Hrud. Soot. 1/19)
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kālārthakarmaṇāṁ yogo hīnamithyātimātrakaḥ। samyagyogośca vijñeyo rogārogyaikakāraṇam॥ (Ash. Hrud. Soot. 1/19)
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Here the synonymous terms are
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<blockquote>असात्म्येन्द्रियार्थसंयोगः, प्रज्ञापराधः, परिणामश्चेति त्रयस्त्रिविधविकल्पा हेतवो विकाराणां, समयोगयुक्तास्तु प्रक्रुतिहेतवो भवन्ति । (Char. Samh. 11.44)</blockquote><blockquote>asātmyendriyārthasaṁyogaḥ, prajñāparādhaḥ, pariṇāmaśceti trayastrividhavikalpā hetavo vikārāṇāṁ, samayogayuktāstu prakrutihetavo bhavanti ।</blockquote>Meaning: According to Acharya Charaka the causes are, inappropriate Asatmendriyartha Samyoga (असात्म्येन्द्रियार्थसंयोगः। Inappropriate contact of objects with senses), Prajnaparadha (प्रज्ञापराधः। Intellectual error) and Parinama (परिणामः। Consequences/ Time). Heena (हीन। Under/ deficient), Mithya (मिथ्या। Inappropriate/perverted) or Ati (अति। Excessive) yoga (union, exposure or contact) with any of the 3 factors (namely, काल। Kala, अर्थ । Artha and कर्म । Karma), is said to result in development of diseases. 
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कालः। Kala and परिणामः। Parinama,
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Acharya Vagbhata (आचार्य वाग्भटः।) has stated the same point in different words as below,  <blockquote>कालार्थकर्मणां योगो हीनमिथ्यातिमात्रकः। सम्यग्योगोश्च विज्ञेयो रोगारोग्यैककारणम्॥ (Ash. Hrud. Soot. 1/19)</blockquote><blockquote>kālārthakarmaṇāṁ yogo hīnamithyātimātrakaḥ। samyagyogośca vijñeyo rogārogyaikakāraṇam॥ (Ash. Hrud. Soot. 1/19)</blockquote>कालः। Kala and परिणामः। Parinama, अर्थः। Artha and असात्म्येन्द्रियार्थसंयोगः। Asatmendriyartha and कर्मः । Karma and प्रज्ञापराधः। Prajnaparadha are used synonymously. It is believed that, [[Prajnaparadha (प्रज्ञापराधः)|Prajnaparadha]] may result in deficient, perverted or excessive activity of body, mind and speech which may give rise to diseases.
 
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अर्थः। Artha and असात्म्येन्द्रियार्थसंयोगः। Asatmendriyartha and
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कर्मः । Karma and प्रज्ञापराधः। Prajnaparadha.
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It is believed that, Prajnaparadha may result in deficient, perverted or excessive activity of body, mind and speech which might lead to development of diseases.
      
== रोगभेदाः॥ Classification of Rogas ==
 
== रोगभेदाः॥ Classification of Rogas ==
Rogas are classified in different ways on the basis of various factors like etiology, location, prognosis, severity etc. some of the classifications are as follows,
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Ayurveda analyses diseases through various aspects. Therefore, rogas are classified in different ways on the basis of various factors like etiology, location, prognosis, severity etc. some of the classifications are as follows,
 
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=== ॥ On the basis of affected site ===
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Sharira- Those where physical body is primarily affected
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Manas- Those where mind is primarily affected
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=== ॥ On the basis of Site of disease causing agent ===
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ते चतुर्विधाः- आगन्तवः, शारीराः, मानसाः, स्वाभाविकाश्चेति || (Su Su 1.24-25) <nowiki>http://niimh.nic.in/ebooks/esushruta/?mod=read</nowiki> 
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=== ॥ On the basis of causative factor ===
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The diseases are also classified in 3 groups viz. Ādhyātmika, Ādhibhautika and Ādhidaivika.
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==== ॥ Adhyatmika ====
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Ādhyātmika diseases are further subdivided into Ādibalapravṛtta (hereditary), Janmabalapravṛtta (congenital) and Doṣa Bala Pravṛtta (due to vitiation of Doṣa).
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Ādi-Bala-Pravṛtta or hereditary diseases are of two types viz. maternal or Mātṛja and paternal or Pitṛja.
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Janma-Bala-Pravṛtta (congenital) diseases are also of two types viz. Rasa-Kṛta which are due to the vitiated Rasa, Rakta etc. of the mother and Dauhṛdapacāraja which are due to the irregularities in diet during pregnancy.
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=== स्थानभेदेन॥ On the basis of affected site ===
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# शारीराः। Sharira- Those where physical body is primarily affected
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# मानसाः। Manas- Those where mind is primarily affected
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Doṣa-Bala-Pravṛtta diseases are produced due to the vitiation of the three Doṣa-Vāta, Pitta and Kapha.
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=== हेतुउत्पत्तिभेदेन॥ On the basis of site of origin of disease ===
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Acharya Sushruta has classified diseases on the basis of the site of the disease and relevant causative factor. Some diseases primarily affect body while some affect mind. Sometimes external factors like air, water cause illness while some diseases affect due to imbalances caused by physiological variations.  <blockquote>ते चतुर्विधाः- आगन्तवः, शारीराः, मानसाः, स्वाभाविकाश्चेति || (Su Su 1.24-25) <nowiki>http://niimh.nic.in/ebooks/esushruta/?mod=read</nowiki></blockquote>The 4 types of diseases are,
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# आगन्तवः। Aagantu - Diseases caused by factors like contaminated air, water, insect bite, poisons etc.  
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# शारीराः। Shaarira - Diseases primarily affecting physical body
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# मानसाः। Maanasa - Diseases primarily affecting mind
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# स्वाभाविकाः। Swabhavika - Diseases associated with physiological variations 
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==== Adhibhoutika ====
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=== उद्भवभेदेन Based on origin  ===
These type of diseases are also called Saṅghāta-Bala-Pravṛtta diseases. They are produced by extrinsic factors e.g. injury, bites etc.
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The diseases are also classified in 3 groups viz. Adhyatmika (अध्यात्मिकाः), Adhibhautika (अधिभौतिकाः) and Adhidaivika (अधिदैविकाः) on the basis of their origin and nature. This type of classification of diseases is the unique concept described in Ayurveda. Ayurveda has long back appraised the role of hereditary factors, developmental defects, environmental factors, physiological limitations of human body and also natural calamities in the process of diseases development. Diseases originating from all such varied reasons have been classified under this type.
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==== ॥ Adhidaivika ====
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==== अध्यात्मिकाः Adhyatmika ====
These diseases are produced by natural forces beyond the control of the man. They are of three types viz. Kāla-Bala-Pravṛtta, Daivabala-Pravṛtta and Svabhāva-Bala-Pravṛtta.
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Adhyatmika diseases are further subdivided into Adi-bala-pravṛtta (आदिबलप्रवृत्तः। hereditary), Janma-bala-pravṛtta (जन्मबलप्रवृत्तः। congenital) and Dosha-bala-pravrtta (दोषबलप्रवृत्तः। due to vitiation of Dosha).
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# Adi-bala-pravṛtta (आदिबलप्रवृत्तः। hereditary): Adi-bala-pravṛtta or hereditary diseases are of two types viz. maternal or Matruja (मातृजाः) and paternal or Pitruja (पितृजाः).
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# Janma-bala-pravṛtta (जन्मबलप्रवृत्तः। congenital): Janma-Bala-Pravṛtta (congenital) diseases are also of two types viz. Rasa-Kṛta (रसकृताः) which are due to the vitiated Rasa, Rakta etc. of the mother and Douhruda-apacharja (दौहृद-अपचारजाः) which are due to the irregularities in diet during pregnancy and failure to fulfill the longings of the pregnant woman.
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# Dosha-bala-pravrtta (दोषबलप्रवृत्तः। due to vitiation of Dosha): Dosha-bala-pravrtta diseases are produced due to the vitiation of the three Doshas- Vata, Pitta and Kapha.
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Kāla-Bala-Pravṛtta diseases are produced by seasonal changes which may be due to the vitiated (Vyāpanna) seasons or normal changes (Avyāpanna) of the seasons.
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==== अधिभौतिकाः॥ Adhibhoutika ====
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These type of diseases are also called Sanghata-Bala-Pravrtta diseases. They are produced by extrinsic factors e.g. injury, bites etc.
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Daiva-Bala-Pravṛtta diseases are produced by contamination (Saṁsarga) or accidental causes e.g. lightning, fall etc.
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==== अधिदैविकाः॥ Adhidaivika ====
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Diseases produced by natural forces beyond the control of the man have been included under this category. They are of three types viz.
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# कालबलप्रवृत्तः। Kala-Bala-Pravrtta : These diseases are produced by seasonal changes which may be due to the disturbed cycle of seasons or normal changes of the seasons.
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# दैवबलप्रवृत्तः। Daiva-Bala-Pravrtta : This type of diseases are produced by Samsarga (संसर्गः contamination) or accidental causes e.g. lightning, fall etc.
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# स्वभावबलप्रवृत्तः। Svabhava-Bala-Pravrtta : This type of diseases are produced by natural physiological processes e.g. old age, sleep, hunger, thirst etc.
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In this way, variety of classification systems have been used by various acharyas to identify and specify different aspects of understanding the nature of diseases. From the foregoing, it is thus clear that, ancient Ayurveda scholars were wise enough who could identify multifaceted nature of diseases even in the lack of advance science and technology. They have identified and explained all possible causes of diseases. Even before few thousand years ago, these acharyas had identified the hereditary, congenital, contagious disorders and also explained treatment and prognosis of them after carefully reviewing nature of these diseases.  
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Svabhāva-Bala-Pravṛtta diseases are produced by natural physiological processes e.g. old age, sleep, hunger, thirst etc.
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== References ==
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<references />
 
[[Category:Ayurveda]]
 
[[Category:Ayurveda]]
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