Roga (रोगः)

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

Introduction

Ayurveda offers knowledge to maintain Ayu (life) which is considered to be the union of body, mind, senses and life energy. It is further believed that, Doshas, dhatus and malas 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 when their balance is disturbed, the disease develops only when vitiated doshas lodge into the disturbed dhatus, malas or other structures in the body which are called as dushyas (the one that gets vitiated from dosha). Papma, Jwara, Vikara, Dukkham, Amaya, Yakshma, Gada, Aatanka, Aabaadha are the other terms used synonymously with Roga.

Etymology

Rogas or Vyadhis develop from unification of vitiated doshas with weak or disturbed dhatus or malas. Once developed they manifest the imbalance by presentation of various clinical features. 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’.

Ruk vedananayam

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

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|| (Charak sutra 9/4) http://niimh.nic.in/ebooks/ecaraka/?mod=read&h=sukh

Tools for knowledge and discernment of disease (Nidanapanchakam)

There exists a methodical approach to study and diagnose any diseases according to Ayurveda. one can find 5 methods to analyse a disease in Ayurveda’s perspective. These 5 assessment points are collectively known as Nidanapanchak – 5 elements for discernment of diseases. Acharya Vagbhata says that,

निदान पूर्वरूपाणि रुपाण्युपशयस्तथा संप्राप्तिश्चेति विज्ञानं रोगाणां पञ्चधा स्मृतम्

The 5 elements for discernment or knowledge of the disease are Hetu (etiological considerations or origin of disease), Purva-rupa (Prodromal symptoms), Rupa (clinical features or signs & symptoms), Upashayaanupashaya (therapeutic diagnosis) and Samprapti (Onset of disease or patho-physiological processes).

Steps of disease development: Shatkriyakala

One can find the detailed description on stepwise development of any disease right from the exposure to the etiological factor upto manifestation of complications. This is one of the critical topics required for thorough knowledge of disease development as per Ayurveda. Acharya Sushruta has described this process as Shatkriyakala and expounded the clinical significance of treating a disease at each level.

सञ्चयं च प्रकोपं च प्रसरं स्थानसंश्रयम् | व्यक्तिं भेदं च यो वेत्ति दोषाणां [१] स भवेद्भिषक् || (sushrut Sutra 21/ 34) http://niimh.nic.in/ebooks/esushruta/?mod=read&h=prasaraM

Methods of assessment of a disease

It is mandatory for a Vaidya to evaluate any presented roga on the basis of 10 points put forward by Ayurveda acharyas, so as to plan the best suitable treatment for the patients. This is the strength of Ayurveda and an exclusive approach to provide customised 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| (charaka vimana 8/101)

Roga (Disease) and its Causes

Ayurveda considers 3 fundamental causes for any disease.

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 as follows,

1. असात्म्येन्द्रियार्थसंयोगः । Asatmendriyartha Samyoga (Inappropriate contact of objects with senses)

2. प्रज्ञापराधः। Pradjnaparadha (Intellectual error) and

3. परिणामः। Parinama (Consequences/ Time)

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.

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.

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

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

Here the synonymous terms are

1. कालः। Kala and परिणामः। Parinama,

2. अर्थः। Artha and असात्म्येन्द्रियार्थसंयोगः। Asatmendriyartha and

3. कर्मः । Karma and प्रज्ञापराधः। Prajnaparadha.

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.

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,

On the basis of affected site

Sharira- Those where physical body is primarily affected

Manas- Those where mind is primarily affected

On the basis of Site of disease causing agent

Nija Roga, Āgantuja Roga and Mānasa Roga.

The diseases caused by the vitiation of Vāta, Pitta and Kapha are called Nija Roga; the diseases due to the trauma, bite etc. are Āgantuja Roga; and mental diseases are Mānasa Roga.

On the basis of causative factor

The diseases are also classified in 3 groups viz. Ādhyātmika, Ādhibhautika and Ādhidaivika.

Adhyatmika

Ādhyātmika diseases are further subdivided into Ādibalapravṛtta (hereditary), Janmabalapravṛtta (congenital) and Doṣa Bala Pravṛtta (due to vitiation of Doṣa).

Ādi-Bala-Pravṛtta or hereditary diseases are of two types viz. maternal or Mātṛja and paternal or Pitṛja.

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.

Doṣa-Bala-Pravṛtta diseases are produced due to the vitiation of the three Doṣa-Vāta, Pitta and Kapha.

Adhibhoutika

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

Adhidaivika

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.

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.

Daiva-Bala-Pravṛtta diseases are produced by contamination (Saṁsarga) or accidental causes e.g. lightning, fall etc.

Svabhāva-Bala-Pravṛtta diseases are produced by natural physiological processes e.g. old age, sleep, hunger, thirst etc.