Chapter 8 - General classification of Diseases

GENERAL CLASSIFICATION OF DISEASES WITH SPECIAL REFERENCE TO AVARANAS 324 CLASSIFICATION * There are four types of diseases viz. exogenous, vatika, paittika and slaismika. Pain being common to all, diseases are (ultimately) of one type. They are again of two types depending upon their nature, that is exogenous and endogenous. (They are again of two types depending upon their nature, that is exogenous and endogenous.) They are again of two types somatic and psychic- depending on the sites of their manifestation viz. body and mind. Diseases are in fact innumerable inasmuch as the immediate causes, (dhatus afflicted, signs and symptoms), distant causes (like improper diet and regimen), and permutation and combination of various fractions of dosas are innumerable (Su.20:3). GENERAL AETIOLOGICAL FACTORS The exogenous diseases are caused by nails, teeth, fall, spell, curse, psychic afflictions including demoniac seizure, assult, piercing, bandage, rapping, application of pressure, binding by rope, fire, weapon, thunder bolt, natural calamaties etc. Endogenous diseases are caused by the disturbance in the equilibrium of Vata, Pitta and Kapha.

325 FOUR AETIOLOGICAL FACTORS, BASIS OF ALL DISEASES Unwholesome contacts between the sense organs and their objects, intellectual blasphemy and effects of time constitute the common causative factors for both the exogenous and endogenous types of diseases (Su.20:5). All these four types of diseases when aggravated do share the symptoms of each other. Even then, the distinctive features of each one of them too are clearly manifested to allow any confusion (Su.20:6). ROLE OF DOSAS IN THE PATHOGENESIS OF EXOGENOUS AND ENDOGENOUS DISEASES The exogenous diseases begin with pain and then they bring about the disturbance in the equilibrium of Dosas. The endogenous diseases on the other hand with the disturbance in the equilibrium of dosas and them bring about pain (Su.20.7). TYPES OF DISEASES CAUSED BY DIFFERENT DOSAS The entire body is in fact the abode of all the three dosas viz. Vata, Pitta and Kapha and as such these dosas bring about good and results according as they are in normal and abnormal states respectively. When in a normal state, they bring about good results like growth, strength, complexion, happiness, etc. When, in an abnormal state, they, cause various types of diseases (Su. 20:9).

326 Endogenous diseases are of two types viz. diseases caused by Vata, Pitta and Kapha in general and the specific diseases caused by the vitiation of the Vata, Pitta and Kapha. AVARA NAS OF VAYU Charaka says that, the provoction of vata is due to diminution of body elements or due to obstruction to its normal circulation caused by occlusion (i.e. obstructed, stopped or shutoff) in the body channels. The vata, pitta and kapha circulate through all the body channels and spaces. The vata, on account of its quality of subtleness is really the impeller of the other two dosas. When the vata is provoked, it agitates the other two dosas and throwing them out here and there, causes occlusion of the body channels, thereby producing disorders. It also leads to the diminution of the body nutrient fluid and other body elements (ch.28:60). INVOLVING FACTORS Pitta Kapha SYMPTOMS OBSERVED THERE ON burning, thirst, colic, giddiness, darkness of vision, heart burn on eating pungent, acid, salt and hot things, craving for cold (ch.28:61). cold, heaviness, colic, pronounced homologation to pungent and similar article craving for fasting, exertion and dry up hot things (ch.28:62).

327 Blood Flesh Adipose tissueOsseous tissueMarrow Severe burning pain in the area between the skin and the flesh, and there will be oedema with reddish tinge and rashes (Ch.28:63). pimples Appearance of hard, pegmented principles and swellings, horripilation and formication (ch.28:64). Local swelling will be produced, that are movable, Smooth, soft and cold, as well as anorexia. This condition is known as sheumatic condition and is difficult to cure (ch.28:65). Patient likes warmth and pressure, and he becomes exhausted, experiences spletting pain and feels as though his body is being priched with needles (ch.28:66). There will be flexure of the body, pendiculation, girdle pain and colicky pain, on being pressed with the hand the patient gets relief (ch.28:67). Seminal passages- There results either no discharge of semen of hurried discharge of it or a sterile condition of the semen(ch.28:68). Food There will be pain in the stomach on ingestion (ch.28:68). Urine There occurs retention of urine and distension of bladder(ch.28:69).

328 FAECAL MATTER Marrow There occurs absolute retention of faces in its own habitat, that is in the lower part of the colon, and there will be griping pain in the region; and where unctuous matter is ingested is immediately digested and on ingestion of food, The person suffers from increased distension of the abdomen, and Owing to the pressure of the food ingested, the patient passes dry faces with difficulty and after long delay. He is afflicted with pain in the hips, groins and back and the vata moves in a reverse derection (i.e. there is mis-perestalsis); there is also disturbance of the cardiac action (ch.28:70-71). e There will be dislocation, lockjaw, contracture hunch-back, facial paralysis, hemiplegia, atrophy of a part, paraplegia, arthrities, stiffness, rheumatic conditions. These are on account of their deep seated nature, may or may not be cured even after careful treatment. The physician should endeavour to such cure such of these conditions as occur is strong persons and as are of recent origin and un-associated with any complication (ch.28:72-74).

DISORDERS AND DISEASES (VIKARAS) CAUSED BY VATA (CS.Su.20:11). 1. nakhabheda 2. vipadika 3. padasula cracking of nails cracking of feet pain in foot 4. padabhramsa 5. padasuptata 6. vatakhuddata 7. gulphagraha 8. pindikodvestana 9. grahrasi 10. janubheda 11. januvislesa 12. urustambha 13. urusada 14. pangulya 15. gudabhramsa 16. gudarti 17. Mrsanaksepa 18. sephastambha 19. vanksananaha 20. sronibheda 21. vidbheda 22. udavarta 23. khanjatva 24. kubjatva 25. vamanatva 26. trikagra ha 27. prethagraha 28. parsvavamarda 29. udaravesta i 30. hrmmoha 31. hadrava 32. vaksa-uddarsa 33. vaksa-uparod ha 34. vaksastoda foot drop numbness of foot club foot stiff ankle cramps in the calf sciatica genu varum genu valgum stiffness of thigh pain in the thigh paraplegia prolapse rectum tenasmus pain in scrotum stiffness of penis tension of groin pain around the pelvic girdle diarrhoea misperistalsis lameness kyphosis dwarfism arthritis of sacroillac joint stiffness of back pain in chest griping pain in abdomen brady cardia tachycardia rubbing pain in chest impairment of thorasic movement stabbing pain in chest 329

35. bahusosa 36. grivastambha 37. manyastambha 38. kanthodd hvamsa 39. hanubheda 40. osthabheda 41. aksibheda atrophy of arm stiffness of the neck torticollis hoarseness of voice pain in jaw pain in lip pain in eye toothache 42. dantabheda 43. dantasaithilya 44. mukatva 45. vaksanga 46. kasayasyata 47. mukhasosa 48. arasajnata 49. ghrananasa 50. karnasula 51. asabdasravana 52. uccaihsruti 53. badhirya 54. vartmastambha 55. vartma samkoca 56. timira 57. aksisula 58. aksivyudasa 59. bbruvyudasa 60. sankhabheda 61. lalatabheda 62. siroruk looseness of tooth aphasia lalling speech astringent taste in mouth dryness of the mouth ageusia anosmia ear ache tinitus hard of hearing deafness ptosis of eye lid entropion amaurosis pinching pain in eye ptosis of eye ball ptosis of eye brow pain in temporal region pain in frontal region headache 63. kesabhumisphutana dandruff 64. ardita 65. ekangaroga 66. sarvanga roga 67. paksavad ha 68. aksepaka 69. dandaka 70. tama 71. bhrama facial paralysis monoplegia polyplegia hemiplegia clonic convulsion tonic convulsion fainting giddiness 330

72. vep vepathu 73. jambha 74. hikka tremor yawning hiccup 75. visada asthenia 76. atiprala pa delirium 77. rauksya dryness 78. parusya hardness 79. syavarunavad hasata dusky red appearance 80. asvapna sleeplessness 81. anawasthitacittatva unstable meantality DISORDERS AND DISEASES (VIKARAS) CAUSED BY PITTA (CB.Su.20:14) 1. 09a 331 2. plosa 3. daha 4. dawathu 5. dhumaka 6. anlaka 7. vidaha 8. antardaha 9. amsadaha 10. usmadhikya 11. atisveda 12. angagandha 13. angavadarana 14. senitakleda 15. mamsakleda 16. tvagda ha 17. tvagavadarana 18. carmadalana 19. raktakostha 20. raktavisphota 21. raktapitta 22. raktamandala 23. haritatva heating scorching burning boiling fuming acid eructation pyrosis burning sensation inside the body burning sensation in shoulder excessive temperature excessive sweating foetid odour of the body cracking pain in the body sloughing of the blood sloughing of the muscle burning sensation in the skin cracking of the skin itching of the skin urticaria red vesicle bleeding tendency red wheals greenishness

24. haridratva 25. nilika 26. kaksa yellowishness blue moles herpes jaundice bitter taste in mouth 29. lohitagandhasyata smell of blood from the mouth 27. kamala 28. tiktasyata 30. putimukhata 31. trenadhikya 32. atrpti foetid odour of mouth excessive thirst non-satisfaction 33. asyavipaka stomatitis 34. galapaka pharyngitis 332 35. aksipaka 36. guda paka 37. medhra paka i 38. jwadana 39. tamahpravesa conjunctivitis proctitis inflammation of the penis haemorrhage fainting 40. haritaharidra netra mutra varcastva greenish & yellowish colouration of eyes, urine & faeces. DISORDERS AND DISEASES (VIKARAS) CAUSED BY KAPHAJA (Cs.Su.16) 1. tripti 2. tandra 3. nidradhikya anorexia nervosa drowsiness excessive sleep rimisnwaa timidness 4. staimitya 5. gurugatrata heaviness of the body 6. alasya laziness 7. mukhamadhurya sweet taste in mouth 8. mukhasrava salivation 9. slesmodgirana mucus expectoration 10. maladnikya 11. balasaka 12. apakti 13. hrdayopalepa 14. kanthopalepa dha 15. Shamanipraticaya excessive excretion of excreta loss of strength indigestion phlegm adhered in vicinity of heart phlegm adhered to throat hardening of vessals

16. galaganda 17. atisthaulya 18. sitagnita 19. udarda 20. svetavabhasata goiter obesitey suppression of digestive power urticaria pallor 21. svetamutranetravarcastva whiteness of urine, eye and faces. 333 It may be noted above that the disorders and diseases caused by Vata are eighty types, Even though Vata diseases are and disorders. immaumerable, the following eighty diseases (Vikaras) are the most commonly manifested one (actually eighty one diseases are enumerated there appears to be wrong interpolation (Su.20:11). The disorders an diseases due to the vitiation of Pitta are innumerable, the following are the forty varieties which are most commonly manifested. The disorders and diseases due to the vitiation of Kapha are also innumerable but the following are the twenty varieties which are most commonly manifested. The sites mentioned above are those where the vitiation are those where the vitiation of Vata in these places are difficult to cure. So if Vata is controlled in these sites, all types of Vatika diseases can be prevented. It is not able that the numbness is caused by the action of both Kapha and Vata in the former, it is due to in action and in the latter due to loss of sensation. Even though the Vata is devoid of any taste or complexion but it brings about certain taste and complexion due to its specific action.

334 GENERAL PRINCIPLES OF TREATMENT OF VATIKA, PAITTIKA AND KAPHAJA DISORDERS AND DISEASES states The vitiated vata should be treated by drugs having sweet,sour, and saline taste and unctuous and hot qualities and by such devices as oleation, fomentation, asthapana and anuvasana type of enema, inhalation, diet, mass-age, unction, offusion- which should all contain materials having anti vatika properties. This is of course to be done with due regard to the dosage and season. Of all the devices above, the asthapana and anuvasana types of enema or the treatment par excellence for the cure of Vatika diseases because immediately after entering the colon, they strike at the very root of the vitiated vata and when it is over come in the colon, even the entire vitiated vata dwelling in other parts of the body is automatically alleviated. This can be likened to the cutting of the root of a free which results in the automatic destruction of the trunk, branches, sprouts, flowers, fruits, leaves etc. (Ch.Su.20:13). vitiated Pitta This should be treated by drugs having sweet, better, astringent and cooling qualities and such devices as oleation, pergation, unction, affusion, message, etc., which should all contain material having anti-paittika properties. This is of course to be done with due regard to the dosage and season, of all the devices stated above, the purgation is the treatment par excellance for curing paittika diseases because immediately after it is administered, it eliminates the

335 vitiated pitta from its very root. When it is overcome in the amasaya (small intestive), it alleviates the entire vitiated pitta dwelling in other parts of the body. This can be linkened to a not chamber being cooled by removing the fire from inside it. (Cs.Su.20:16). Diseases and disorders due to vitiated Kapha should be treated with drugs having pungent, bitter, astringent, sharp, hot and unctuous qualities and by such therapies like formentation, emesis, elimination of dosas from the head, exercise etc., which should all contain materials having anti-slaismika properties. This is of course to be done with due regard to the dosage and season. Of all the devices stated above, emetic therapy is the treatment per excellence for the cure of diseases due to kapha because immediately after entering the stomach, it strikes at the very root cause of the vitiation of kapha and when it is overcome in the stomach, even the entire vitiated kapha dwelling in other parts of the body is automatically alleviated. This can be likened to the withering away of paddy, barly, etc. for want of barrier of the cornfield (full of water) being broken (CS.Su.20:19). As sites of manifestation of Kapha, both chest and stomach are equally important as stated in the above.