Daivavyapashraya Chikitsa (दैवव्यपाश्रया चिकित्सा)
Daiva vyapashrya chikitsa (दैवव्यपाश्रया चिकित्सा) is an exclusive concept in Ayurveda. It refers to the type of treatment modality which encompasses various methods like chanting mantras (hymns), wearing gems, offering prayers in particular way and many such measures to get health and wellbeing. Since the modus operandi through which these measures work to cure the illness are beyond understanding of a normal human being these methods are included in one group separated from regular pharmacological treatment. Moreover, these measures are also said to be working on one's Daiva (the past life deeds/karma effects) and thus is is known as Daivavyapashraya chikitsa.
परिचयः ॥ Introduction
Daivavyapashrya chikitsa is one among three treatment modalities at a fundamental level described by Acharya Charaka. Daivavyapashraya chikitsa being foremost, followed by yuktivyapashrya (युक्तिव्यपाश्रया) and satvavajaya (सत्वावजय) chikitsa. In literal terms, daivavyapashraya chikitsa means divine therapy wherein there is use of mantra (chanting auspicious hymns), mani (wearing gemstones), homa (performing sacred fire ritual), etc as therapy. There are certain diseases wherein Acharyas have suggested this modality of treatment for better results like in Rajayakshma (राजयक्ष्मा), jwara (ज्वरः) etc.
निरुक्तिः परिभाषा च॥ Etymology and Definition
The term Daivavyapashraya can be split into 2 parts 'Daiva' and 'Vyapashraya'.
दैवमदृष्टं तद्व्यपाश्रयं, तच्च यददृष्टजननेन व्याधिप्रत्यनीकं मन्त्रादि; यदि वा दैवशब्देन देवा उच्यन्ते, तानाश्रित्य यदुपकरोति तत्तथा; मन्त्रादयो हि देवप्रभावादेव व्याधिहराः, बल्युपहारादिप्रीताश्च देवा एव प्रभावाद्व्याधीन् घ्नन्ति| (Chakradatta Commentary on Chara. Samh 11.54)
- 'Daiva' (दैवम्) means divine or og god's/heavenly
- 'Vyapashraya' (व्यपाश्रय) means dependent on.
तत्र दैवव्यपाश्रयं- मन्त्रौषधिमणिमङ्गलबल्युपहारहोमनियमप्रायश्चित्तोपवासस्वस्त्ययनप्रणिपातगमनादि, युक्तिव्यपाश्रयं- पुनराहारौषधद्रव्याणां योजना, सत्त्वावजयः- पुनरहितेभ्योऽर्थेभ्यो मनोनिग्रहः||५४|| (Char. Samh. 11.54)
The treatment modality which is administered with the help of Mantra (hymns), Mani (gemstones), Homa (sacrificial fire and oblations), Upavasa (religious fasting), etc as medicine is Daivavyapashraya Chikitsa. It is one of the three treatment modes along with Yuktivyapashraya Chikitsa and Satvaavajaya Chikitsa, which are two distinct concepts in Ayurveda
दैवव्यपाश्रयचिकित्साभागाः॥Components of Daivavyapashraya Chikitsa
Daivavypashraya chikitsa includes use of various different methods. Acharya Charkaa has described the few commonest methods in the sutra below,
तत्रदैवव्यपाश्रयंमन्त्रौषधिमणिमङ्गलबल्युपहारहोमनियमप्रायश्चित्तोपवासस्वस्त्ययनप्रणिपातगमनादि (Char. Samh. 8.87)
Meaning: Daivavyapashraya chikitsa comprises of use of Mantra(hymns chanting), Mani(precious stones), Mangala(performing good deeds), Bali(sacrificial rites), Upahara, Homa(auspicious fire), Niyama, Prayaschitta, Upavasa(fasting), Svastayana, Pranipaata, Gamana(visiting temples or sacred places).
The actual meaning of these various methods included in Daivavyapashraya Chikitsa is is as below,
|Chikitsa prakara (Treatment method)||Artha(meaning)|
|Mantra (मन्त्रम्)||Chanting sacred hymns. Practitioners of Sanatana dharma chant various mantras praising and describing a particular deity. A particular mantra-chanting in a particular disease could be helpful.|
|Mani (मणिधारणम्)||Wearing precious stones/gems. The gemstones possess peculiar property of refracting, absorbing and dispersing the light rays that fall on them due to their crystal structure. This property of selective emission of light rays or energy is used for therapeutic effect. Gemology is one such branch which focuses on identifying gemstones, confirming its authenticity, evaluating the quality, determining the origin, and disclosing the treatment used for the gemstone. Gemologists incorporate gems into rituals to restore energy fields, gain peace, and promote love and safety. Some practitioners actually place gemstones on certain areas of the body to promote healing. Wearing a piece of jewelry made with a specific gem is sufficient for most people.|
|Aushadhi (ओषधी धारणम्)||Tying herbs to hand/wrist/waist/neck/other body parts. Some specific herbs when tied to a particular body part in particular situation are found to bring about certain actions with their Prabhava.|
|Bali (बलिः)||Oblation/ Sacrificial offering. This is particularly related to animal offering or sacrifice performed during yajnas, homas and other traditional rituals. Although mentioned at few places in vedas this practice is quite obsolete in today's era.|
|Upahara (उपहार)||Offering something to a deity, specific person like girl child or a lady etc to get a certain benefit in life comes under this type.|
|Homa (होमः)||Worshipping Agni and performing yajnas to fulfill a specific wish also comes under this type of treatment.|
|Niyama (नियमः)||Observance of a specific mode of life, discipline or avoiding certain things deliberately comes under thi stype.|
|Swastayana (स्वस्त्ययनम्)||Chanting phrases like mantras for good luck.|
|Upavasa (उपवासम्)||Fasting on specific days or for a specific duration as a means of worship of some deity to get blessings and fulfill wishes|
|Pranipata (प्रणिपात)||Surrendering or humble submission to a certain form of God by doing namaskara or bowing down|
|Mangala (मङ्गल)||Performing Good deeds|
|Yatra gamana (गमनम् / यात्रागमनम्)||Going to Pilgrimage and taking extra efforts to reach upto the deity and offer prayers|
Mantra-chanting is a regular practice in sanatana dharma during any auspicious function or beginning of any new work. Thus even while beginning the study of Ayurveda every student does mantra chanting and homa is performed for an auspicious start. Mantra chanting is also recommended while preparation of some medicines in Ayurveda e.g. while preparing a medicinal preparation in visha chikitsa namely, mahagandhahasti agada, there is mention of beeja mantra, which is recited while preparing the recipe for better results. Mantra chikitsa or chanting of certain auspicious hymns has been described in certain diseases.
- In Unmada (a psychosis like psychiatric disease) chikitsa, while administering ghee, auspicious hymns are chanted along with it. Also, wearing certain precious stones, fasting, performing sacrificial fire as well as a part of treatment.
- In Visha (Poisoning) chikitsa mantra chanting is done while tourniquet application near bite site.
- In management of wounds, certain mantras are chanted after cleansing and application of medicines.
मणिधारणम्॥ Mani dharana
Wearing gems has been suggested as a part of disease management in certain diseases in Ayurveda. Few examples are,
To reduce the burning sensation in Jwara Vyadhi (fever), certain precious stones or Mukta (pearl) is worn along with other oral medications.
In Raktapitta (hemorrhagic disorders), water is to be consumed which has been kept in contact with Vaidurya (cat’s eye stome), Mukta (pearl), and Gairik (ochre).
To prevent the effects of poison or Visha, certain precious stones are worn like emerald and diamond. 
In Kurmapurana, Mani’s were created with the help of seven different rays of light originating from seven planets, thus each ray depicts different energy which when worn influences in a certain way.
Bali means a sacrificial offering. This is particularly related to animal offering or sacrifice performed during yajnas, homas and other traditional rituals. Although mentioned at few places in vedas this practice is quite obsolete in today's era. Bali offering used to be done as a means of pleasing a particular deity, precisely grahas or bhutas, to fulfill some desires or to get freedom from them. In ancient times it was performed by many kings with the idea of bestowing good karma on the king and his kingdom. There is a belief that, animal sacrifice does not mean to kill the animal. Animal sacrifice means to prove the strength of Vedic hymns so that one old animal is put into the fire and it is given again a new life, renewed life, just to show the potency of the hymns, Vedic hymns. But in this age, Kali-yuga, those sacrifices are forbidden in Sanatana dharma since there are hardly any learned and skilled brahmanas qualified to carry it out. Moreover the knowledge of mantras required for giving an old animal the body of a new animal might also not be transferred and conserved properly. However since Ayurveda developed in an era when these practices might be rampant, there are certain references of offering bali in a particular way as a means of getting cure from certain disease. This measure of management of disease is thus included under Daivavyapashraya chikitsa. Few examples are given below,
In the treatment of certain psychiatric conditions, Bali or sacrifice is performed on a certain day at a certain time. (Asht.utt.5.33)
There are certain grahas(psychiatric conditions) where in sacrifice or bali is performed of a certain flower, or food in order to restore health. (Asht.utt.5)
A Gandha prepared of kumkuma, Kesar is kept in a pot where four paths or roads meet together in a place where there is no residency and offered Bali to grahas (the concept that can be mildly co-related with psychosomatic disorders). (sush.sutra.60.31)
One has to sacrifice Snana(bath), vastra(clothes), aahara(food) as well in certain psychiatric conditions until the expected results are seen.(Asht.utt.5.22)
Most of these examples of bali as a mode of management of some disease have been mentioned in the illnesses related to Grahas or bhutas which are the subject of Grahachikitsa or Bhootavidya described in Ayurveda. In all such diseases the mind-body complex of a human is taken over by some celestial energies and thus the life is endangered. These situations are beyond the understanding of basic science since it can not be seen, heard or studied using any physical instruments used in any branch of science. However, clinically it can be understood but becomes extremely difficult to manage such cases. In such circumstances various measures of Daivavyapashraya chikitsa have been advocated by Ayurveda.
Homa is the act of offering or pouring an oblatory material (havis) into the fire. This as a means of treatment for certain illnesses has been mentioned at few places in Ayurveda. Also one is advised to perform homa before starting the Panchakarma procedures like Vamana and Virechana.  There is a reference that says, if homa is performed inappropriately it could be a potential cause of developing Unmada (A group of psychiatric disorders described in Ayurveda similar to psychosis, nurosis etc). At the same time, properly performed Homa has also been said to be therapeutic in the treatment of certain types of Unmada. As a part of treatment, Homa is described in Jwara Roga (Disease concerning fever). 
Upavasa in literal terms means fasting. Langhana is the technical term used in Ayurveda to indicate Upavasa. It is counted under the non-medicinal modes of treatment. It can also be called as Therapeutic fasting. Although intermittent fasting is gaining increasing popularity in today's era, it had been suggested in Ayurveda since thousands of years ago and recommended by practicing Vaidyas in variety of diseases regularly. However fasting as langhana in certian medical conditions can not be counted under Daivavyapashraya chikitsa. If the fasting on a specific day of week or a month, for a specific deity and for a specific time period has been suggested as a way of curing a certain disease even if that medical condition is not otherwise listed under fit for langhana list. These fasts could have more religious angle to it than medical one.
In Raktaja Roga (Rakta dhatu vitiation-related disorders), Upavasa is indicated along with purgation and other therapies. (cha.sutr.24.18)
In the management of Amaja disorders, Upavasa is advised after the elimination of doshas through emesis. (cha.vi.2.13)
When Upavasa is done in pregnancy it leads to underdeveloped childbirth. (cha.sha.8.26)
In certain types of Dhatuja Jwara, Upavasa is advised. (cha.chi.3.316)
The term Niyama refers to the practices of self restraint. Observance of Niyamas involves control of one's body, mind, speech, senses and actions. Only such control can be healing for some illnesses. In Yoga shastra Niyama has been included under Ashtanga yoga. Here Niyama is categorized further into 5 types namely, shoucha (hygiene), santosha (satisfaction), tapas (austerity), swadhyaya, ishwara pranidhana (praying to God). These 5 types are actually the methods of practicing Niyama. This can again be considered as non-medicinal method of treatment. It is believed that one can generate karma through actions of physical body, mind (thoughts, emotions) and speech. All this can be controlled through Niyaam observance. In certain diseases where past life karma is believed to be related to the ill health condition not responding to the regular medicinal treatment, such practices could be followed.
Niyama is also an eminent skill or character of Pranabhisara(the one who saves life). (cha.sutr.29.7)
In Satyuga(one among four Yug according to Hindu dharma), people followed the rules of social wellbeing or Niyama along with fasting, moral discipline, etc, and thus the life span or the quality of life, quality of the surrounding environment was excellent. (cha.vim.3.28)
ओषधिधारणम् ॥ Oshadhi
Binding certain medicinal plants or roots in the form of poultice or pottali or as it is, around the certain body part is known as oshadhi chikitsa as a part of Daiva vyapashraya chikitsa. Tying/possessing herbs as a preventive healthcare is also recommended in Sadvrutta in Ayurveda.
ओषधीः प्रशस्ता धारयेत् 
There is mention of wearing Herbs along with mani in Vishamajwara-certain type of Jwara Roga (fever) as treatment.(cha.chi3.309)
मणीनामोषधीनां च मङ्गल्यानां विषस्य च||३०९|| धारणादगदानां च सेवनान्न भवेज्ज्वरः|३१०| (Char. Samh. 3.309-10)
In children Brahmi, vacha etc are worn around neck, hand to boost immunity, and overall health. (asht.utt.1)
जीवत्खङ्गादिशृङ्गोत्थान् सदा बालः शुभान् मणीन्||२६|| धारयेदौषधीः श्रेष्ठा ब्राह्मयैन्द्रीजीवकादिकाः| हस्ताभ्यां ग्रीवया मूर्ध्ना विशेषात्सततं वचाम्||२७|| आयुर्मेधास्मृतिस्वास्थ्यकरीं रक्षोभिरक्षिणीम्| (Asht. Hrud. 1.26-28)
Namaskara or joining hands indicated surrendering oneself to deva(god),guru.
प्रणिपातो देवादीनां शारीरो नमस्कारः (Char. Samh. Sutra. 11.54 Commentary)
Complete surrender and devotion towards something can make one available to the grace.
In Agantuja Unmada (a group of psychiatric disorders similar to psychosis/neurosis) Pranipata is said to be one of the measures of getting freedom from celestial energies causing the illness. 
Surya namaskara also being one aspect of pranipata has wide spread advantages.
दैवव्यपाश्रयाचिकित्सायाः प्रयोजनम्॥ Need of Daivavyapashraya Chikitsa
Daiva means one's deeds of past life, which are weak or strong in humans and are manifested perpetually. The effects of this daiva are manifested in a congenial environment. Thus, these factors determine the life span of an individual. Disease manifestation might occur as a result of karma (past life deeds), thus, this aspects can be managed with Daivavyapashraya Chikitsa to reduce the suffering. Since the cause of such karmic diseases can not be treated with mere medicines one needs to practice such things which are subtle and have potential to impact the
स्वस्थवृत्ते दैवव्यपाश्रयाचिकित्सा॥ Daivavyapashraya chikitsa in Preventive healthcare
Under Sadvrtta, many measures from Daivayapashraya chikitsa have been included. This suggests the holistic approach of Ayurveda acharyas who included the measures to prevent illnesses occurring not just from present life causes but also past life deeds.
तद्ध्यनुतिष्ठन् युगपत् सम्पादयत्यर्थद्वयमारोग्यमिन्द्रियविजयं चेति; तत् सद्वृत्तमखिलेनोपदेक्ष्यामोऽग्निवेश  ! तद्यथा- देवगोब्राह्मणगुरुवृद्धसिद्धाचार्यानर्चयेत्, ओषधीः प्रशस्ता धारयेत्, .... होता, यष्टा, दाता, चतुष्पथानां नमस्कर्ता, बलीनामुपहर्ता, अतिथीनां पूजकः, पितृभ्यः पिण्डदः, ...(Char. Samh 8.18)
On daily basis or in day-to-day routine, everyone may he be healthy or ill, should follow some practices like paying respect to devata, gomata (cow), brahmins (purohits), guru, Elderly people and teachers. One should tie the right herbs that can protect one like Vacha (acorus), Brahmi (centella asiatica) etc. One should perform homas when necessary or indicated, on eshould donate to the needy, one should bow down at Chatushpatha (cross roads), do sacrificial offering, worship the guests (pay due respect), offer pindadana to pitaras etc. These are included under social, moral and ethical code of conduct for a human being.
व्याधिनुसारिणी दैवव्यपाश्रया चिकित्सा॥ Disease wise daivavyapashraya chikitsa
Daivavyapashraya chikitsa is the treatment of choice in certain diseases. Not in every single disease this modality of treatment has been advised in Ayurveda. Names of such diseases and tpes of daivyvyapashraya chikitsa suggested in these diseases has been described in brief below,
- Jwara - Jwara is a type of disease characterized by rise in body temperature along with disturbances in senses and mind functions to certain extent. In one of its type called as Vishamajwara where the symptoms like fever recur at a particular time period over and over again Daivavyapashraya chikitsa is also mentioned as one of the modes of choice. 
- Mantra Chikitsa is adopted in Vishama Jwara(a kind of fever) as a method of Divine therapy. Chanting of Vishnu Sahasranama(100 names of Vishnu in the form of mantra) is chanted for better recovery. विष्णुं सहस्रमूर्धानं चराचरपतिं विभुम्||३११|| स्तुवन्नामसहस्रेण ज्वरान् सर्वानपोहति|
- Prayers are also offered in the form of yajnya(sacred fire ritual) to Lord Brahma, Ashwini kumaras. Acharya Charaka explains devotion as a method of treatment towards parents and gurus as well.
- Homa(sacred fire), Japa(chanting), and Niyama(discipline) are also mentioned as treatment aspects for Vishama Jwara. Also just listening to Vedas and Darshanas can treat Jwara.
भक्त्या मातुः पितुश्चैव गुरूणां पूजनेन च||३१३|| ब्रह्मचर्येण तपसा सत्येन नियमेन च|
जपहोमप्रदानेन वेदानां श्रवणेन च||३१४|| ज्वराद्विमुच्यते शीघ्रं साधूनां दर्शनेन च|]
- Yonivyapat (A gropu of Gynecological diseases)
- In certain types of impotency Daiva vyapashraya chikitsa (divine or spiritual therapy) methods are indicated by Acharya Charaka.
- While describing the causes of Yonivapat or diseases of the female genital tract, Acharya Charaka mentions Daiva as a cause along with an inappropriate lifestyle and other aspects, here daiva meaning Divine is understood as destiny as well. Thus, daiva yapashraya chikitsa methods can prove useful to some extent in these disorders.
- Rajyakshma (Disorder specific to Ayurveda which can be correlated with infectious diseases like tuberculosis, AIDS etc)
- Charaka Samhita (Sutrasthanam Adhyaya 11 Sutra 54)
- Charaka Samhita (Chikitsasthanam Adhyaya 8 Sutra 189)
- Sushruta Samhita (Uttaratantra Adhyaya 39)
- Charaka Samhita (Vimanasthanam Adhyaya 8 Sutra 87)
- Charaka Samhita (Vimanasthana Adhyaya 8 Sutra 11)
- Charaka Samhita (Chikitsasthanam Adhyaya 23 Sutra 89)
- Charaka Samhita (Chiktisasthana Adhyaya 21 Sutra 33)
- Charaka Samhita (Nidanasthana Adhyaya 7 Sutra 16)
- Charaka Samhita (Chikitsasthanam Adhyaya 23 Sutra 61)
- Sushruta Samhita (Sutrasthanam Adhyaya 5 Sutra 17)
- Charaka Samhita (Chikitsasthanam Adhyaya 3 Sutra 265)
- Charaka Samhita (Chikitsasthanam Adhyaya 4 Sutra 82)
- Charaka Samhita (Chikitsasthanam Adhyaya 23 Sutra 253)
- Deepika P, Shrilatha K, Dhaneshwari H A.Critical analysis of Daivavyapashraya Chikitsa. Int J Ayu Pharm Chem. Nov 2020: Volume 13(2); Pg 220-26
- Charaka Samhita (Sutrasthanam Adhyaya 15 Sutra 17)
- Charaka Samhita (Nidanasthana Adhyaya 7 Sutra 14)
- Charaka Samhita (Chikitsasthanam Adhyaya 3 Sutra 314)
- Charaka Samhita (Sutrasthana Adhyaya 8 Sutra 18)
- Charaka Samhita (Chikitsasthanam Adhyaya 3 Sutra 309-10)
- Ashtanga Hrudayam (Uttartantram Adhyaya 1 Sutra 26-28)
- Charaka Samhita (Nidanasthana Adhyaya 7 Sutra 26)
- Charaka Samhita (Vimanasthana Adhyaya 3 Sutra 35)
- Charaka Samhita (Sutrasthanam Adhyaya 25 Sutra 19)
- Charaka Samhita (Chikitsasthanam Adhyaay 3 Sutras 310-314)
- Charaka Samhita (Chikitsasthanam Adhyaya 30.Sutra 195)
- Charaka Samhita (Chikitsasthanam Adhyaya 30.Sutra 8)
- Charaka Samhita (Chikitsasthanam Adhyaya 8 Sutra 189)