Conceptual study of Rogamarga

Pushpa Tuppad

Conceptual study of Rogamarga

Tuppad P.^1*

DOI:

^1* Pushpa Tuppad, Assistant Professor, Department of Kayachikitsa, Rajiv Gandhi Education Society’s Ayurvedic Medical College and Hospital, Ron, Karnataka, India.

Roga Marga concept is a unique contribution for the field of Ayurveda. It is being explained in Nirdesha Chatuska in Tisraishaneeya Aadhyaya of Charaka Samhita. After explaining Triniayatanani and Trayoroga, Trayorogamarga is explained, this indicates the importance of topic. The pathway of disease is considered to be as Rogamarga. The basis of Roga Marga is the Gati of Doshas. The healthy relationship of Doshas with the Dhatus (tissues) and organs in a specific way is termed as Doshagati. The specific relation in pathological progress is termed as Roga Marga. Therefore in disease stage Doshagati is the cause and Vyadhimarga is the effect. Rogamarga has got its importance not only in the field of prognosis but also in the field of therapeutics. This article emphasizes the summary based on the concept of Trividha Roga Marga.

Keywords: Ayurveda, Roga Marga, Doshagati, Shakha, Bahya, Madhyama, Abhyantara, Koshta

Corresponding Author	How to Cite this Article	To Browse
Pushpa Tuppad, Assistant Professor, Department of Kayachikitsa, Rajiv Gandhi Education Society’s Ayurvedic Medical College and Hospital, Ron, Karnataka, India. Email:	Pushpa Tuppad, Conceptual study of Rogamarga. J Ayu Int Med Sci. 2022;7(3):53-58. Available From https://jaims.in/jaims/article/view/1793

Introduction

Under pathological and healthy conditions Doshas behave in different pattern in regard to their direction of spreading and area of localization and manifestation. Because of that certain categories of diseases connected with the direction of Doshas, Doshagati are produced. The basis of Rogamargas is the Gati of the Doshas. The concept of Doshagati is described as the movement of Doshsas from the principle seat or specific state of Doshas under specific conditions. During normal body physiology Doshas move from Koshta to Shakha and Shakha to Koshta. But the vitiated Doshas move from Koshta to Shakha and Marmasthisandhi, producing diseases in the body.

When vitiated Doshas move from their principal abode Koshta, they follow certain specific routes termed as Rogamargas. Rogamargas are not the casual agents of Rogas but only the substrates.^[1] Therefore in the manifestation of disease, Doshagati is the cause and Vyadhimarga is the effect.

The topic Rogamarga indicates relationship between different Dhatus and Ashyas in a unique way .The Nidanaas or factors that vitiate these Doshas make these factors to follow certain specific pathways. The Vikruita Doshas tend to move through selected tissue and organs i.e. In Koshta, Shakha and Marma Asthi Sandhigati. The affinity of noxious Dosha towards tissue and organs manifesting a disease or pathological progress is Rogamarga.

Materials and Methods

Classical texts were reviewed to get the knowledge about Rogamarga. Materials were explored through available texts, published article and authentic websites. The collected materials were critically analyzed and conclusion was drawn.

Definition

Rogamarga the word comprises of two words Roga and Marga.

Roga - which causes pain is called as Roga,^[2] the disequilibrium status of Doshas is also known as Roga while health is equilibrium of Doshas.^[3]

Marga - Srotas (channel / path way)

The pathway of disease is considered to be as Roga Marga.

Classification of Rogamarga

There are 3 Roga Margas^[4]on the basis of Gati. Namely Shakha, Marma Asthi Sandhi and Koshta.

Shakha Marga (Bahya)	Doshas make Gamana in Raktadidhatus.
Marmasthi Sandhimarga (Madhyama)	Doshas make Gamana in Marma, Asthi and Sandhi.
Koshtha Marga (Abhyantara)	Doshas make Gamana in Koshtaangas.

Trividha Roga Marga

Shakha or Bahya Rogmarga

Acharya Hemadri quotes Bahya Rogamarga, as Bahirmargoroganam^[5] and Arundatta quotes Bahyanaamroganamayanamsthanam.^[6]This gives the meaning of Bahyarogamarga as the pathways of external disease.

The term Shakha illustrates Rakthadidhatu and Tvak.^[7] Chakrapani defines that by the term Tvak, the factor residing in it, Rasadhatu is also implied. Shaka includes Tvak and other six Dhatus, like this all the Sevendhatus are included in one Path Bahyaroga Marga.^[8]

Marmasthi Sandhi Roga Marga (Madhyama Rogamarga)

According to Acharya Hemadri, Marmanimarmanibdhahashiradayaschya, asthisandhyahate cha Madhymoroga Marga.^[9]

The Gati of vitiated Doshas through Marmaasthi Sandhi will produce and Madhyama Roga Marga (middle disease pathway). This includes the Mahamarmas.^[10]Basti (blader), Hradaya (heart), Shira (head) and Asthi (bones), Sandhi (joints), which includes the associated Sira (vein), Snayu (muscle), Kandara (ligaments), Dhamani, Kurcha are Madhyama Rogamargas.

Koshtagata Rogamarga

Acharya Hemadri quotes Anthahaanthamargo Roganam.^[11]By virtue of this definition, it is interpreted as internal pathway of diseases. Vagbhbata considered it as Anthakoshta i.e., Amashaya (stomach), Pakwashaya (intestine), and Mahasrotas.

It is defined as Sareeramadhya or Mahanimna, the hollow portion of the body extending from the buccal cavity to the anus. Its synonyms are Mahasrotas, Sareeramadhyam, Mahanimnam, Amapakvasaya Asrayam, Anthakoshta and Antharadhi.^[12]

^[13]

Acharya Susruta uses the term Koshta in a way in which includes Amashaya, Pakwashaya, Agnyasaya, Mutrasaya, Rudhirasaya, Hridaya, Unduka and Phuphusa.

Significance of Rogamarga^[14]

The knowledge of Rogamarga helps to understand the Doshagati, thereby in understanding the disease process and its diagnosis.
It facilitates the knowledge about prognosis of disease in the respective Rogamargas.
Disease caused by single Dosha afflicting one of the Rogmargas with Chatushpaad is a sign of good prognosis (Sukhasadhya).
Diseases occurring in Marmaasthisandhi are a sign of bad prognosis (Kruchrasadhya).
When Doshas are seated in the deeper Dhatus like Meda involving the Dhatus and Marmaasthisandhi it is an indication and palatability (Yaapya).
If disease is manifested by involving all the Margas it clearly indicates the incurability (Prathyakhyeya). Example: If Vata is accumulated Aamashya the Swedana is done initially with Rookshadravyas, if Kapha is accumulated in Pakwashaya the Singdhasweda is done initially followed by Rookshasweda. This is an example for the use of Vyadhimarga in Chikitsa.
There are some disease like Arsha which occurs on two Margas like Bahya and Abhyantara depends on Doshagati and Vyadhi Marga further Chikitsa is planned. For instance, Arsha in Bahya Marga is Shashtrakrata, Arsha in Abhyantaramarga is Ashashtrakrta Chikitsa.
When treating the Sthanika Doshas care is taken not to disturb the Agantu Dosha. This is possible only with the knowledge of Rogamarga.
It is useful on the diagnosis and treatment of disease conditions like Vishamamargas since it is consider as a Dhatujanya Vikara.
The knowledge of Vyadhimarga and Doshagati helps not only in diagnosing a disease but also guides in planning treatment of diseases. For instance, Koshtagatha Doshas are better removed with Vaman and Virechana. For Shakhagata Doshas Raktamokshana will be the better therapy.

Table 1: Showing diseases of each Rogamarga.^[15]

Rogamarga	Diseases
Shakamarga	Ganda, Pidaka, Alaji, Apachi, Charmakila, Adhimamasa, Mashaka, Kushta, Vyanga, External varieties of Visarpa, Shwayatu, Gulma, Arsha, Vidhradi.
Marmaasthisandhimarga	Pakshavadha, Pakshagraha, Apatanaka, Ardita, Sosha, Rajayakshma, Asthisula, Sandhisula, Gudabramsha, Sirorogas, Hridayarogas, Vastirogas.
Koshtamarga	Jwara, Atisara, Charadi, Alasaka, Visucika, Kasa, Svasa, Hikka, Aanaha, Udara, Pliha. Internal varieties of Visarpa, Svayathu, Gulma, Arsha, Vidhradi.

Discussion

Rogamarga means the specific path where the diseases occur. According to Acharya Charaka, the term Shakha illustrates Raktadi Dhatus and Twak. In this Shakha Marga, the word Rasa is not mentioned because Rasadhatu is Moola^[16] and from Rasadhatu the other Dhatus are formed.^[17]

Twacha gets formed after the Paka of Shukra and Shonita like the cream is formed after boiling the milk.The Paka of Shukra and Shonita is depending up on the Ahara Rasa taken by the mother. Hence the Shukra Shonita Paka Kriyas based on Rasa.

As the Ankura (Beeja) is considered as Moola for the formation of the Shakha (branches) of tree. Similarly, the rasa is considered as Moola which helps in development of succeeding Dhatus.

So, Shakha includes 6 Dhatus and Twak. So, all the seven Dhatus are included in one path way as Bahyarogamarga.

As Rasa resides in Twacha, the Rasa word has not used in the Shakha. The Twak has been designated because any changes in the Rasa expressed in the skin.^[18] Though Rasa is not directly mentioned in Shakhagata Roga site, as the Rasa residing in the Twak it is understood the involvement of Rasa Dhatu in Shakhagatarogamarga.

Acharya Charaka and Vagbhata consider Rakta (Rudhira) under Bahyarogamarga, Shakha Raktadaya Twak.

But according to Sushruta while narrating term Koshta, he includes Rudhira^[19] (Rakta) which is present in Yakrut and Pleehadi Ashayas, hence Rudhira (Rakta) and Rudhiraashaya are considered under Koshta.

Relation of Dosas with Koshta Shakhadi Margas

Aahara gets metamorphosed into Aahara Rasa, Dosha, and Kitta. Normal diet has the potentially of producing Doshas, Dhatus and Malas in the body. So Doshas get originated in gut from the digested food material. Such portion is regarded as Sara. All three Doshas originated from Aahara Rasa.^[20]Doshas produced in this way are essential for all the activities of the body. Kapha Dosha for building up tissues, Pitta for anabolic and catabolic conversations and Vata for impulsive and movements of all kinds.

These three functions take place all over the body even at the cellular and psycho-intellectual level. For the performance of all these functions Doshas must pervade the whole body. For that Doshas are constantly passing from Koshta to Shakhas and from Shakha to Koshta according to the requirement. They enter the Koshtas to intake and digestion and return to the Shakhas when that function is over. This to and fro passage of Doshas takes place smoothly under normal physiological conditions. When Doshas get vitiated this smooth transit is hampered for many reasons. Among them mainly the vitiated Doshas produced pathological changes either structural or functional or both in Dhatus or Shakhas (Srothovaigunya). Instead of freely moving between Shakhas and Koshtasamadoshas stick on to the already vitiated Srotases (Marga/ channel). The entire process is called Sthanasamsraya of Doshas in Dhatus. Thus Rogamargas are very much related to Samprapti of a disease. After Dosha visitation how Doshas travel at different parts of the body through Rogamarga. This diversion of Doshas from physiological to pathological activity is known as Shakhagati.

Causes of transit of Doshas from Koshta to Shakhas

According to Acharya Charaka there are mainly four reasons^[21] they are over exercise, due to effect of digestive fire, improper behavior and food habits, and increased activity of Vata. By these all causes Doshas are taken to the other Rogamarga from Koshta. Vagbhata has added Asthi Marmani, while Charaka only mentioned Shakha.

Here, the Shakha word implies to both the Rogamarga (Madhyama and Bahya), because from Koshta it can go into both of these Margas.

Shaakhaashrita Kamala

The intake of rough, cold, heavy and sweet food, over exercise, suppression of natural urges vitiate vata which becomes powerful when mixed it with aggravated Kapha. This displaces Pitta from its own seat and brings about yellow discoloration to eye, urine and skin. The stools being deprived of colour of Pitta (yellow) become white. The shift of Pitta to blood circulation and Pitta being diminished in Koshta, Manifest Shaakhaashrita Kamala.^[22]

Methods of correcting pathological development

The development of diseases means the transit of Doshas from Koshta to Shakha. Naturally the remedy will be either 1) To bring Doshas back to Koshta and remove them through the nearest available tract whenever possible or 2) Suppress them when removal is not suitable. The ideal remedy is the first one i.e., to bring Doshas into Koshta and Remove them.

Chikitsa Shaakhashrita Kamala

Acharya Charak explained five main measures^[23]to bring Dosha from Shakha to Kostha they are Srotomukha Visodhanat (clearance of obstruction from Srotas), Vridhi (increase of vitiated Doshas), Vhishyandan and Pakaat (liquefaction of Doshas by the process of digesation), Vayunigraha (reduction in intensity of stimulation of Vata Dosha).

So main line of treatment for Shaakhaashrita Kamala needs special emphasis because Malaranjaka Pitta is situated in Shakha, therefore Virechanadi Karma will not be effective till Doshas are not brought to the Koshta. Acharya Charak mentioned^[24]Trikatu because of its Ushna, Teekshna and Laghuguna makes Pitta Vruddhi in Shakha. Maatulunga Swarasa due to its Amla Rasa, Amlavipaka Ushna Veerya does Vatashamana. Trikatu due to its Katurasa and Rookshaguna does Kapha Shamana. So, Pitta returns to its own site. When Doshas comes to Koshta the same treatment is given as that of Koshtashrita Kamala. The clinical significance of knowledge of this Gati of Doshas in Rogamarga is in the formulation of treatment protocol.

Conclusion

Roga Marga is the actual path of the disease as it has got definite structure and diseases are grouped

under a particular Roga Marga. Various movements of Vikrita Doshas towards Dhatus leading to genesis of diseases. If the Doshas attains different pathways and leaves their normal seats causes the manifestation of diseases. So, Roga Marga has got a crucial role in manifestation, pathogenesis and progress of diseases. The knowledge of Trividha Rogamarga is helpful for finding Sadhya Asadhyata of diseases. Hence, to achieve over the disease, the physician need to assess the involvement of pathway and treat disease accordingly.

Reference

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Manuscript Received	Review Round 1	Review Round 2	Review Round 3	Accepted
2022-03-03	2022-03-05	2022-03-12	2022-03-19	2022-03-26
Conflict of Interest	Funding	Ethical Approval	Plagiarism X-checker	Note
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Review Article

Rogamarga

Journal of Ayurveda and Integrated Medical Sciences