Chikitsa (चिकित्सा)

Chikitsa (चिकित्सा) In Ayurveda, the term ‘Chikitsa’ signifies treatment of a Roga or Vyadhi (Illness or disease). Naturally, it is used frequently in Ayurveda literature. Other terms like Bheshajam, Aushadham, Upachara, Karyam, Kriya, Prashamanam Vyadhiharam, Pathyam and Sadhanam are synonymously used with the word ‘Chikitsa’. Introduction Ayurveda offers the precious knowledge on use of various measures to preserve health and life. Therefore, at most of the places in classics one can find that, various herbs, minerals, food items and even lifestyle measures are suggested as a solution for the presenting illness. Cure of diseases is one of the aims of Ayurveda. Thus, various management protocols are recommended to treat the diseases and re-establish the disturbed balance of body elements to confer health. All these measures are known as the Chikitsa of the disease or illness. Since the methods suggested to obtain health are numerous and change on the basis of cause of illness as well as use of a particular medicinal substance, material or activity; Chikitsa is of various types.

Etymology The word ‘Chikitsa’ is derived from root word ‘Kit’ In Samskrit, Kit means eradication or elimination (of diseases) Kit rogapanayane Thus, the word ‘Chikitsa’ means eliminaitno or separation or destruction of a diseases from the body

As per Amarakosha (2/6/50) Chikitsa ruk pratikriya Hence, Chikitsa is called as the action taken against a disease Or eradicating pain or disease

Definition of Chikitsa

याभिः क्रियाभिर्जायन्ते शरीरे धातवः समाः| सा चिकित्सा विकाराणां कर्म तद्भिषजां स्मृतम्||३४|| कथं शरीरे धातूनां वैषम्यं न भवेदिति| समानां चानुबन्धः स्यादित्यर्थं क्रियते क्रिया||३५||- cha su 16/34-35 yābhiḥ kriyābhirjāyantē śarīrē dhātavaḥ samāḥ| sā cikitsā vikārāṇāṁ karma tadbhiṣajāṁ smr̥tam||34|| kathaṁ śarīrē dhātūnāṁ vaiṣamyaṁ na bhavēditi| samānāṁ cānubandhaḥ syādityarthaṁ kriyatē riya||35|| Meaning: Therapeutics therefore consists of measures or operations by way of which concordance of the tissue elements can be sustained and this (achieving concordance of tissue elements) constitutes the duty of the physician. Therapy is administered with the sole objective of ensuring that no discordance prevails in tissue elements and that there is sustenance of continued concordance. (http://www.carakasamhitaonline.com/mediawiki-1.28.2/index.php?title=Chikitsaprabhritiya_Adhyaya#Definition_of_chikitsa_and_the_duty_of_a_physician)

What is Shuddha chikitsa प्रयोगः शमयेद्व्याधिं योऽन्यमन्यमुदीरयेत्| नासौ विशुद्धः, शुद्धस्तु शमयेद्यो न कोपयेत्|| (cha. Nidan 8/23) http://niimh.nic.in/ebooks/ecaraka/?mod=read&h=vishuddha

Chikitsa chatushpad

चतुर्णां भिषगादीनां शस्तानां धातुवैकृते| प्रवृत्तिर्धातुसाम्यार्था चिकित्सेत्यभिधीयते||५|| caturṇāṁ bhiṣagādīnāṁ śastānāṁ dhātuvaikr̥tē| pravr̥ttirdhātusāmyārthā cikitsētyabhidhīyatē||5|| caturNAM bhiShagAdInAM shastAnAM dhAtuvaikRute| pravRuttirdhAtusAmyArthA cikitsetyabhidhIyate||5|| Employment of all the excellent four – physician etc. – in case of disorder of dhatu with the objective of (re-establishing) their equilibrium is called “Therapeutics”

Types of chikitsa Understanding the various types of chikitsa described in Ayurveda , is important in a way that, one can realise the deep thinking of ancient Ayurveda scholars regarding what all modalities can be used to combat the diseases. It is interesting to know that, Ayurveda scholars have also listed a method wherein a medicinal substance is not directly used. Also, use of chanting vedic mantras, fasting and even holding a precious gem is considered as treatment for certain diseases affecting the union of body, mind, senses and consciousness. Ayurveda chikitsa can be classified in numerous ways. In depth description is available in classical Ayurveda treatises. To name the few, some classifications are listed below. • On the basis of use of medicinal substance o Dravya and adravya chikitsa • On the basis of type of modality used o Shodhan and Shaman chikitsa • On the basis of fundamental cause behinf pathogenesis and chief protocol o Santarpan and Apatarpan chikitsa • On the basis of types of 3 basic types of disease o Daivavyapashraya, Yuktivyapashraya & Satvavajaya • On the basis of mode of administration of a drug o Anta parimarjana, Bahiparimarjana and Shastrapranidhana

Whatever is planned for prevention or elimination of the disease may be known as Cikitsā. It is of three types, viz. Daiva-Vyapāśraya, Yukti-Vyapāśraya and Sattvāvajaya.

Daiva Vyapāśraya Cikitsā consists of wearing the Auṣadha and practice of Mantra, Maṅgala etc. It is not in common use now a days. Sattvāvajava Cikitsā is specially useful for the mental diseases and it consists of Manonigraha i.e. control of mind.

Yukti-Vyapāśrya Cikitsā is being widely used for the prevention and elimination of diseases by the Āyurvedic physicians since time immemorial. This type of treatment consists of planning (Yojanā) of dietetic regimen (Pathya) and medication.

The main object of Yukti-Vyapāśraya Cikitsā is Yukti or Yojanā which means planning. In this type of treatment the physician plans the Āhara, Vihāra, Auṣadha, Matrā, Kāla etc. by taking into consideration, Deśa, Kāla, and causes, symptoms, signs, stage, complications, curability etc. of the disease. Taking all these points in view, a physician whatever plans (by Yukti) for prevention or elimination of a disease is known as Yukti-Vyapāśraya Cikitsā.

Taking the different Yukti into consideration, the physician plans two types of treatment depending upon the condition of the patient. These are Śodhana and Śamana.

Śodhana Cikitsā

The treatment planned for the elimination of increased and morbid Doṣa from the body is known as Śodhana therapy. It is also termed as Pañca Karma (five fold therapy). It consists of Vamana, Virecana, Anuvāsana Basti, Āsthāpana Basti and Śirovirecana (Nasya).

Before undertaking the above five purificatory processes some treatment is to be given, which is called Pūrva-Karma meaning ‘pre-treatment steps.’ It consists of Snehana and Svedana. In the after-treatment steps the patient is taken to normal diet gradually and this is called Saṁsarjana Krama.

Śamana Cikitsā

The treatment in which the Kupita Doṣa is pacified without eliminating it from the body is defined as Śamana Cikitsā. It is classified in two groups viz. Apatarpaṇa and Santarpaṇa. Apararpaṇa Cikitsā consists of three measures viz. Laṅghana, Rūkṣaṇa and Svedana; and Santarpaṇa Cikitsā is divided in Bṛṁhaṇa, Snehana and Stambhana.

This type of treatment is indicated in the diseases of Pitta, Agnidagdha, Atisāra, Vamana etc. The drugs having Śīta, Manda, Mṛdu, Ślakṣṇa, Rūkṣa, Sūkṣma, Drava, Sthira and Laghu properties are used for this treatment.

The above mentioned treatment is done through Auṣadha (medicine), Āhāra (diet) and Vihāra (treatment with other means excluding medicines and diet e.g. exercise, rest, etc.).