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 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

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

रोगहेतवः॥ Causative factors of Rogas

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,

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

प्रज्ञापराधः। Pradjnaparadha (Intellectual error) and

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

कालः। Kala and परिणामः। Parinama,

अर्थः। Artha and असात्म्येन्द्रियार्थसंयोगः। Asatmendriyartha and

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.

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,

॥ 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

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

॥ 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.