Understanding Health and Disease: The Ayurvedic Perspective

This is the second part of the article by Dr. Paritosh Bhatt. We strongly recommend you to read the first part: click here.

‘Swastha’ is the Ayurvedic word for health. Swastha, which means "a person in his or her natural state", is a far deeper concept than just health. It is important to understand that each person stands out due to their specific dosha dominance, which is mostly set at conception and then altered by surroundings: 

समदोषः समाग्निश्च समधातु मलक्रियाः।

प्रसन्नात्मेन्द्रियमनाः स्वस्थः इत्यभिधीयते।। 

(Sushruta Samhita 15.38.)

When the doshas are in balance, agni (digestive fire) is functioning perfectly, dhatus are in balance and there is prover evacuation of faces, urine and sweat. Beyond that there has to be a happy state of soul, sense organs and mind, then a person is called to be in his/her nature state, Swastha.

When this natural state is altered, disease appears. Indeed, attachment to a single object is not a natural state. The Ashtanga Hridaya very clearly states that attachments and other forms of attachment are diseases. Numerous reasons, including internal and external ones (referred to as nija and agantu respectively), may have contributed to this change. While agantu is caused by external elements like impairment, infection, burns, accidents, poisoning, emotions, etc., nija is internal and occurs when tridoshas become imbalanced for a variety of reasons, leading to a range of diseases depending on the action and weakness of the body. These diseases can be divided as saadhya (sukhasaadhya & krichrasaadhya) and asaadhya (yapya & anupakrama) based on prognosis.

The understanding of disease manifestation is very well explained in classics. There are examples of diseases, their types, causes, pathophysiology, prognosis, treatments, complications, etc are mentioned in detail. It is also said that these are just examples, because with the combinations of dosha equilibrium there is the possibility of innumerable diseases , which are impossible to name. “Na hi Sara vikaaranaam naamato asti”, states the Charaka Samhita. Thus it is important for an ayurveda vaidya to understand the condition of every individual and do the treatment. Again the treatment varies from individual to individual with various factors involved before consideration, like - 

1. Dushya - The affected tissues

2. Desha - Geography

3. Bala - Strength of the person

4. Kala - Season

5. Anala - Digestive fire

6. Prakriti - Constitution

7. Vaya - Age

8. Satva - Mind

9. Saatmya - Habits a person is accustomed with

10. Aahara - Food habits

11. Avastha - Condition

All these factors are minutely considered before a vaidya reaches a conclusion of diagnosis and treatment.

Modalities of Treatment

In Ayurveda, treatment is primarily of two types: shodhana (purification) and shamana (pacification). Shodhana is nothing but panchakarma (the five purificatory therapies), namely (according to Sushruta Samhita):

1. Vamana (Emesis)

2. Virechana (Purgation)

3. Vasti (Medicated enema)

4. Nasya (Method of instilling medicine through nostrils)

5. Rakta Mokshana (Bloodletting)

Shamana is done by control over food, activities and administration of various medicines either by oral route (internal) or through skin (external). A vaidya after assessing the condition (avastha) of the patient (rogi) and the disease (roga) determines a treatment protocol which is suitable for that patient in current condition. The assessment is done through various tools of roga and rogipareeksha (examination). All the processes, external or internal, shamana or shobhana eventually bring two effects: santarpana (nourishment) or apatarpana (reduction or taking away the nourishment). Thus essentially treatment is only of two types. Usually any treatment starts with correction of digestive fire, balancing doshas, treating the existing condition and finally nourishing the system. While treatment is given it is ensured that new conditions should not develop and that is called shuddha (pure) chikitsa (treatment).

Branches of Ayurveda

Vagbhata, the author of the Ashtanga Hridaya divided ayurveda practices into eight branches for easy understanding and treatment. They are:

1. Kaya Chikitsa- Medicine.

2. Shalya Tantra- Surgery.

3. Shalakya Tantra- ENT and Ophthalmology. Essentially all the diseases above the clavicle, which is the head region.

4. Kaumarbhritya- Paediatrics and Obstetrics.

5. Agad Tantra- Toxicology.

6. Bhut Vidya- Psychiatry.

7. Rasayan- Rejuvenation therapy and geriatrics.

8. Vajikaran- Sexology (including aphrodisiac for better progeny).

How to Remain Healthy

Ayurveda not only talks about treatment of diseases, but it gives emphasis to live healthy. Various suggestions in the form of dinacharya (daily regime), ritucharya (seasonal regime), vegan na dharniyam (not controlling the urges), sadvritta (right conduct) and sadachara (right behavior), have been explained. A person who is able to follow these suggestions syncs with nature and lives a long and healthy life.

Conclusion

Ayurveda, as a shastra, gives a comprehensive understanding of life. Not only human life but others also. Over a period of time, ayurveda for humans has developed, it does not mean others are ignored. We can find references where trees are treated with ayurveda (vriksha-ayurveda), elephants are treated with ayurveda (hasti-ayurveda or gaja ayurveda), horses are treated with ayurveda (ashwa ayurveda), domestic animals are treated with ayurveda (mriga ayurveda). This shows that ayurveda was indeed for the benefit of every living being (sarvabhutanukampaya). Ayurveda being shastra with its roots in the Vedas, covers almost all aspects of existence. It is not just treatment modality or some herbal decoctions, or some external treatments like massage, it is complete understanding of existence. The Charaka Samhita mentions, “satvam aatma shariram cha trayam etat tridandavat”, meaning life has three aspects, satva (mind), aatma (soul) and sharira (body) the equilibrium and proper functioning ensures healthy life. While we understand the physical world with panchamahabhuta, we understand functionality with tridoshas, whose balance brings health and disequilibrium brings disease. Ayurveda always advises to prevent the disease, preserve the health of the healthy, but then if a person is having a disease then treat accordingly (swasthasya swasthya rakshanam, aturasya vikara prashamanam). Understanding of disease starts from the mental plane, where raga (attachment) itself is considered as disease. Ayurveda believes that implication on aatma (soul) in the form of karma can also create disease (purva Janma kritam papam vyadhi rupen jaayate), and the body gets affected due to improper food and activities.

The comprehensive understanding and documentation in ayurveda towards life is the result of eternal quest of living long and healthy life. That’s why, it is said: “आयुर्वेदोपदेशेषु विधेयः परमादरः (“Is there any shortcut to live healthy?”). It is suggested that a person who regularly takes the right food and does the right activities, plans before execution, has control on sense organs, does charity, treats everyone equally, speaks truth, forgives and respects elders, such a person will live disease free.

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