Roga (रोगः)

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Roga (रोगः) refers to any disease, illness or disorder in the body or mind of an individual. Ayurveda acharyas have described variety of diseases in their treatises which were prevalent at the time of those acharyas. One can find detailed description on development as well as treatment of these diseases in various samhitas. It is said that, rogas are the reason for dukkhas (state of unhappiness or sadness) since they cause suffering. Thus, absence of rogas is described as Sukham (state of happiness) and a method to obtain such state of happiness can be found in Ayurveda samhitas.

परिचयः॥ Introduction

Ayurveda offers knowledge to maintain Ayu (आयु:। life) which is considered to be the union of body, mind, senses and life energy. It is further believed that, Doshas (दोषाः), dhatus (धातवः) and malas (मलाः) are the basic functional units of physical body and their imbalance leads to development of diseases. Although all these basic functional units display some or the other signs if balance is disturbed, that is only one of the few basic steps progressing to disease development. The disease develops after vitiated doshas lodge into dushyas (दूष्याः। Body component that gets vitiated from dosha) like disturbed dhatus, malas or other structures in the body. Vyadhis (व्याधिः), Papma (पाप्मा), Jwara (ज्वरः), Vikara (विकारः), Dukkham (दुःखम्), Amaya (आमयः), Yakshma (यक्ष्मा), Gada (गदः), Aatanka (आतङ्‍कः), Aabaadha (आबाधः) are the other terms used synonymously with Roga.

व्युत्पत्तिः॥ Etymology

Rogas or Vyadhis (व्याधिः) develop from unification of vitiated doshas with weakened dhatus or malas. Once developed, they manifest their imbalance in the form of clinical features which can be perceived by the patient. These clinical features are the various types of pains or difficulties experienced by the individual. Thus, acharyas have derived the term Roga from the root term ‘Ruk’ (रुक्) which means 'Pain'.

रुक् वेदनायायाम्।

Vedana (वेदना) means any kind of pain or suffering. Therefore roga is the entity which causes pain or suffering.

रोग शब्दस्य परिभाषा॥ Definition of Rogas

Various Ayurveda acharyas have defined roga in different aspects.

Acharyas Charaka defined Roga as ‘Imbalance of doshas or dhatus and also called it Dukkham’.

विकारो धातुवैषम्यं, साम्यं प्रकृतिरुच्यते| सुखसञ्ज्ञकमारोग्यं, विकारो दुःखमेव च|| (Char. Samh. 9.4)

Definition of Vyadhi by Sushruta,

तद्दुःखसंयोगा व्याधय उच्यन्ते || (Sush. Samh. 1.23)

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 (निदानपंचकम् 5 elements for discernment of diseases). Acharya Vagbhata says that,

निदान पूर्वरूपाणि रुपाण्युपशयस्तथा संप्राप्तिश्चेति विज्ञानं रोगाणां पञ्चधा स्मृतम्।

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

Sushruta Samhita offers detailed description on step-wise development of any disease right from the exposure of etiological factor up-to manifestation of complications. This is one of the critical topics from Ayurveda which is required for thorough knowledge of disease development based on the theories of Ayurveda. Acharya Sushruta has described this process under the title of Shatkriyakala and expounded the clinical significance of offering right treatment at each level.

सञ्चयं च प्रकोपं च प्रसरं स्थानसंश्रयम् | व्यक्तिं भेदं च यो वेत्ति दोषाणां स भवेद्भिषक् || (Sush. Samh. 21.36)

व्याधिबलविशेषोपलब्धिः हेतवः॥ Methods of assessment of a disease

It is mandatory for a 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

तत्र विकारं हेतु-दोष-दूष्य-प्रकृति-देश-काल-बलविशेषैर्लिङ्गतश्च परीक्षेत, न ह्यन्तरेण हेत्वादीनां बलविशेषं व्याधिबलविशेषोपलब्धिः| (Char. Samh. 8.101)

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.

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

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,

असात्म्येन्द्रियार्थसंयोगः, प्रज्ञापराधः, परिणामश्चेति त्रयस्त्रिविधविकल्पा हेतवो विकाराणां, समयोगयुक्तास्तु प्रक्रुतिहेतवो भवन्ति । (Char. Samh. 11.44)

asātmyendriyārthasaṁyogaḥ, prajñāparādhaḥ, pariṇāmaśceti trayastrividhavikalpā hetavo vikārāṇāṁ, samayogayuktāstu prakrutihetavo bhavanti ।

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. Acharya Vagbhata (आचार्य वाग्भटः।) has stated the same point in different words as below,

कालार्थकर्मणां योगो हीनमिथ्यातिमात्रकः। सम्यग्योगोश्च विज्ञेयो रोगारोग्यैककारणम्॥ (Ash. Hrud. Soot. 1/19)

kālārthakarmaṇāṁ yogo hīnamithyātimātrakaḥ। samyagyogośca vijñeyo rogārogyaikakāraṇam॥ (Ash. Hrud. Soot. 1/19)

कालः। Kala and परिणामः। Parinama, अर्थः। Artha and असात्म्येन्द्रियार्थसंयोगः। Asatmendriyartha and कर्मः । Karma and प्रज्ञापराधः। Prajnaparadha are used synonymously. It is believed that, Prajnaparadha may result in deficient, perverted or excessive activity of body, mind and speech which may give rise to diseases.

रोगभेदाः॥ Classification of Rogas

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,

स्थानभेदेन॥ On the basis of affected site

1. शारीराः। Sharira- Those where physical body is primarily affected
2. मानसाः। Manas- Those where mind is primarily affected

हेतुउत्पत्तिभेदेन॥ On the basis of site of origin of disease

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.

ते चतुर्विधाः- आगन्तवः, शारीराः, मानसाः, स्वाभाविकाश्चेति || (Su Su 1.24-25) http://niimh.nic.in/ebooks/esushruta/?mod=read

The 4 types of diseases are,

1. आगन्तवः। Aagantu - Diseases caused by factors like contaminated air, water, insect bite, poisons etc.
2. शारीराः। Shaarira - Diseases primarily affecting physical body
3. मानसाः। Maanasa - Diseases primarily affecting mind
4. स्वाभाविकाः। Swabhavika - Diseases associated with physiological variations

उद्भवभेदेन ॥ Based on origin

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.

अध्यात्मिकाः ॥ Adhyatmika

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).

1. 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).
2. 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.
3. 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.

अधिभौतिकाः॥ Adhibhoutika

These type of diseases are also called Sanghata-Bala-Pravrtta diseases. They are produced by extrinsic factors e.g. injury, bites etc.

अधिदैविकाः॥ Adhidaivika

Diseases produced by natural forces beyond the control of the man have been included under this category. They are of three types viz.

1. 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.
2. दैवबलप्रवृत्तः। Daiva-Bala-Pravrtta : This type of diseases are produced by Samsarga (संसर्गः contamination) or accidental causes e.g. lightning, fall etc.
3. स्वभावबलप्रवृत्तः। Svabhava-Bala-Pravrtta : This type of diseases are produced by natural physiological processes e.g. old age, sleep, hunger, thirst etc.

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.