E-ISSN:2456-3110

Review Article

Nidana

Journal of Ayurveda and Integrated Medical Sciences

2022 Volume 7 Number 9 October
Publisherwww.maharshicharaka.in

A conceptual study on Charakokta Nidana of Visarpa with special reference to present day Ahara and Vihara

Shrinvas K.1*, A. Deshmukh R.2, M. Tenahalli R.3, Alias Jyotsna P. Baragi J.4, S. Bagali S.5, Haiyalkar M.6
DOI:

1* KS Shrinvas, Post Graduate Scholar, Dept of Samhita Siddhanta, BLDEA’S AVS Ayurveda Mahavidyalaya, Hospital & Research Centre, Vijayapur, Karnataka, India.

2 Raosaheb A. Deshmukh, Guide & Associate Professor, Dept of Samhita Siddhanta, BLDEA’S AVS Ayurveda Mahavidyalaya, Hospital & Research Centre, Vijayapur, Karnataka, India.

3 Renuka M. Tenahalli, Professor & HOD, Dept of Samhita Siddhanta, BLDEA’S AVS Ayurveda Mahavidyalaya, Hospital & Research Centre, Vijayapur, Karnataka, India.

4 Jyothi Alias Jyotsna P. Baragi, Associate Professor, Dept of Samhita Siddhanta, BLDEA’S AVS Ayurveda Mahavidyalaya, Hospital & Research Centre, Vijayapur, Karnataka, India.

5 Sachin S. Bagali, Associate Professor, Dept of Samhita Siddhanta, BLDEA’S AVS Ayurveda Mahavidyalaya, Hospital & Research Centre, Vijayapur, Karnataka, India.

6 Manjula Haiyalkar, Assistant Professor, Dept of Samhita Siddhanta, BLDEA’S AVS Ayurveda Mahavidyalaya, Hospital & Research Centre, Vijayapur, Karnataka, India.

The aim of Ayurveda is “Swasthasya Swasthya Rakshana” and “Aturasya Vikara Prashamana,” it is achieved on the bases of various concepts of Ayurveda. Nidana is one of them. To cope with the fast developing field of medicine many Ayurvedic concepts are to be reviewed, also must be updated and presented so as to fulfill the lacunae in diagnosis and treatment of the disease. With this background, the study “A conceptual study on Charakokta Nidana of Visarpa with special Reference to present day Aharaja and Viharaja” was carried out. All the skin diseases including Visarpa can be prevented if effective care is taken in terms of avoidance of predisposing factors. Since it is not very sure about the exact causative factors of Visarpa, so this Observational study may help to identify the most commonly involved Nidana. Nidana in causation of Visarpa which in turn may help for initiating preventive measures. Nidana of Visarpa explained in Charaka Samhita still holds good in present day life style.

Keywords: Nidana, Visarpa, Ahara, Vihara, Diet and Lifestyle, Dietetics, Ayurveda

Corresponding Author How to Cite this Article To Browse
KS Shrinvas, Post Graduate Scholar, Dept of Samhita Siddhanta, BLDEA’S AVS Ayurveda Mahavidyalaya, Hospital & Research Centre, Vijayapur, Karnataka, India.
Email: 		KS Shrinvas, Raosaheb A. Deshmukh, Renuka M. Tenahalli, Jyothi Alias Jyotsna P. Baragi, Sachin S. Bagali, Manjula Haiyalkar, A conceptual study on Charakokta Nidana of Visarpa with special reference to present day Ahara and Vihara. J Ayu Int Med Sci. 2022;7(9):115-121.
Available From
https://www.jaims.in/jaims/article/view/2085

Manuscript Received Review Round 1 Review Round 2 Review Round 3 Accepted
2022-08-29 2022-08-31 2022-09-07 2022-09-14 2022-09-21
Conflict of Interest Funding Ethical Approval Plagiarism X-checker Note
Nil Nil Yes 17%

© 2022by KS Shrinvas, Raosaheb A. Deshmukh, Renuka M. Tenahalli, Jyothi Alias Jyotsna P. Baragi, Sachin S. Bagali, Manjula Haiyalkarand Published by Maharshi Charaka Ayurveda Organization. This is an Open Access article licensed under a Creative Commons Attribution 4.0 International License https://creativecommons.org/licenses/by/4.0/ unported [CC BY 4.0].

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Introduction

Ayurveda is the ancient and well documented science which prior insist upon the prevention of diseases rather than adopting the curative measures. According to Ayurveda, the first line of treatment is Nidan Parivarjan means to avoid all the causative factors. So, in order to make people disease free and to make people aware, Study of concept of Nidana as a diagnostic tool will be presented in this Work. Ayurveda has explained the five tools for manifestation of disease known as Nidanpanchak. They are Nidana, Poorvaroopa, Roopa, Upshaya and Samprapti which are the objective as well as subjective for understanding of disease.[1] Nidana helps us to know about etiology, symptomatology and pathogenesis. For proper diagnosis of disease Nidana is one of the most important points for diagnosis of disease. The knowledge of Nidana is useful in five different ways,

  • For maintaining the health of a healthy individual
  • Diagnosis of the disease
  • Differential diagnosis
  • Prognosis of the disease
  • For treatment of the disease.

So, Nidana is prerequisite for Chikitsa. Reference of Nidana have been scattered in Ayurvedic texts, so here an attempt has been made to systematically compile the literature of Nidana as mentioned in Charaka Samhita.

Nidana is defined as the eternal cause of the disease. Diagnosis is never complete without the elicitation of all the factors associated with the diseases.

Visarpa is one of the commonest skin disorders which is widely explained in Ayurveda by all the Acharyas and is one of the most common skin ailments suffered by large population worldwide. The clinical features contemplate Herpes viridae, which is a large family of DNA viruses that cause infections and certain diseases in animals, including humans. The members of this family are also known as herpesviruses.[2]

Around 20 - 30% population suffer from skin ailments. More than 90% of adults have been infected with at least one of these, and a latent form of the virus remains in almost

all humans who have been infected and from lower socio-economic strata.[3] These problems vary from age, locality and season.[4] Among all type of dermatological condition herpes gains immediate notice of a doctor due to its severity in localized spread, pain and burning sensation.[5] Herpes viral infection closely resemble to a condition called Visarpa which is described in Ayurveda.

Hence an attempt is made to study and explore the Nidana for Visarpa disease formation according to Charaka.

Objectives of the Study

Conceptual study on Charakokta Nidana of Visarpa with special reference to present day Ahara and Vihara

Nidana: In Ayurveda the word Nidana is used in two different contexts i.e., as Hetubhuta (etiological factors of the diseases) and as a Vyadhiutpatti Dhnapti (diagnosis of diseases).

Etiological Factors (Hetubhuta): Vyadhi Janakam factor which manifests diseases is called Nidana. Word Nidana relates to etiology.

Nidana is the one which leads to the vitiation of Vatadi Doshas. It may be due to intake of Ahitakara Ahara and Vihara.

Diagnosis of diseases (Vyadhiutpatti Dhnapti)

1. Nidana is the one which gives complete knowledge about the Vyadhi.

2. Nidana means arriving at a conclusive diagnosis of a disease after considering and correlating several factors like etiology, symptamatology, pathology and investigations.

3. Hetu, Lakshana, and Samprapti of a disease are known by Nidana.

Nidana Bheda: Sannikrishta, Viprakrushta, Vyabhichari and Pradhanika

Dosha Hetu, Vyadhi Hetu, Ubhaya Hetu

Bahya and Abhyantara

Utapadaka and Vyanjaka

Sannikrista Hetu: Sannikrishta Hetu is the immediate cause of Vyadhi like Vatadi. The immediate causative factor for the vitiation of the Doshas and which in turn lead to the disease manifestation is called as Sannikrishta Hetu.


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Viprakrushta Hetu: Viprakrushta Hetu is not the immediate cause of disease but it is the distant cause of the disease. Here Sanchaya of the disease is very essential. This Hetu does not cause immediate production if the disease but over a period of time disease manifest.

Vyabhichari Hetu: Vyabhichari Hetu means which deviates from normal. It does not manifest the disease as a Hetu it is weak and unable to produce disease but it acts as a carrier and when a favorable condition arises it leads to manifestation of the disease.

Pradhanik: It is a very strong Hetu like a poison, toxins. When such Hetu (etiological factors) come in contact with the body, they produce disease very quickly.

Dosha Hetu: Dosha Hetu is the factors responsible for vitiation of Doshas. Normally Sanchaya, Prakopa and Prashamana of Doshas take place in respective Ritu and after Madhuradi Ahara Sevana is called Dosh Hetu.

Vyadhi Hetu: Vyadhi Hetus are those which are responsible for the development of specific disease by specific Hetu, irrespective of Dosha.

Ubhaya Hetu: Ubhaya means combined factors. The one which causes vitiation of the particular Dosha which leads to manifestation of the Vyadhi.

Bahya: External factors like food, behavior, seasons, poisons etc. are called as Bahya Hetus or external factors.

Abhyantara: Vitiated Doshas are called as Abhyantara Hetus.

Charaka has described about Visarpa in Chikitsa Sthana 21st chapter. The chapter Visarpa Chikitsa follows that of Chardi Chikitsa because suppression of natural urge Chardi (vomiting) as well as Chardi disease are to be considered as causative factors for Rakta Dusti (vitiation of blood) leading to Visarpa. This indicates that Rakta vitiating factors and vitiation of Rakta is an important basic underlying phenomenon prior to the Visarpa.

Two types of Hetu

Bahya: External factors like food, behavior, seasons, poisons etc. are called as Bahya Hetus or external factors.

Abhyantara: Vitiated Doshas are called as Abhyantara Hetus.

Two types of Hetu

1. Utapadaka

2. Vyanjaka Hetu

Utapadaka: For the manifestation of Vyadhi vitiation of the Dosha is the fundamental cause. Utpadaka Hetu means the real causative factors for the accumulation of Doshas, because unless there is a Chaya - excessive accumulation of Doshas, the precipitating cause will not produce any effect.

For example: In Hemanta Ritu due to Madhuradi Dravya Sevana Sanchaya of Kapha occurs.

Vyanjaka: It acts as a triggering factor.

For example: Sanchita Kapha during Hemant Ritu manifests disorders of Kapha in Vasant Ritu due to the effect of the Sun.

Visarpa Nidana: Charaka has mentioned about Visarpa after the Chardi Chikitsa i.e., the Visarpa Chikitsa follows that of Chardi Chikitsa because suppression of the natural urge Chardi - vomiting as well as Chardi disease are to be considered as causative factors for the Rakta Dusti - Vitiation of the blood, leading to the formation of the Visarpa disease. This indicates that Rakta vitiating factors and vitiation of Rakta is an important basic underlying phenomenon prior to Visarpa.

General Nidana: Etiological factors of Visarpa are Aharaja - diet and Viharaja - life style related, injury, poisons, toxins, burns etc. some of these Nidana causes vitiations of the Dosha and Khavaigunya (disease prone condition) in Dhatu and some cause direct vitiation of Dosha and Dhatu leading to Visarpa. It shows that favorable condition for disease phenomenon or infection occurs first.

Nidanas

1. Lavana Amla Katu Ushna Rasa Atisevana - excessive indulgence in Lavana (salt), Amla (sour), Katu (pungent) and Ushna (hot potency ingredients).

2. Dadhi Amla Mastu Shuktanam Sura Sauviraka - also intake of Amla Dadhi (sour curd), Dadhi Mastu (whey), Shukta (Vinegers), Sura (type of liquor) and Sauviraka (type of wine).

3. The use of Vyapanna Madhya (contaminated wine).


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4. Excessive liquor or heat Inducing Raga (condiments) and Sadava (pickles). The use of Vidahi (cause burning), Shaka (vegetables) and Harita Shaka (lashunadi Harita group Dravya), Kilata (cheese), Kurchika (inspissated milk) and Mandaka (immature curd).

5. The use of Snandaki (fermented wine), Paistika and oil processed by Tila (sesame), Masha (wet land), Udaka Mamsa (aquatic animal) and Lashuna (garlic).

6. The use of Praklinna (putrified food), Asatmya (unwholesome), Virudhha (mutually contradictory ingredients) and Atyashana (over eating), Divaswapna (sleeping during day time), Ajirnashana or Ajirna Bhojana (eating during indigestion), Adhyashana (eating food immediately after meal).

7. Kshata (traumatic injury), Kshata (wound), Bandha (ligature), Prapatana (trauma due to falling), Adharma Karma Atisevana (strainful work).

8. Visha (poisons), Vata Dosha and Agni Dosha

Visarpa Bheda: Acharyas Charaka have classified Visarpa into different varieties based on Dosha and Adhistana.

On the basis of Dosha: Charaka has attributed three to each one of the Dosha, three each to combination of two Doshas and one from the combination of all the three Dosha.

1. Vataja Visarpa.

2. Pittaja Visarpa.

3. Kaphaja Visarpa.

4. Vatapittaja Visarpa also known as Agneya Visarpa.

5. Kapha Pittaja also called as Kardama Visarpa.

6. Vata Kaphaja Visarpa also called as Granthi Visarpa.

7. Sannipataja Visarpa.

Acharyas Charaka have classified Visarpa into different varieties based on Dosha and Adhistana.

On the basis of Adhistana

1. Bahishrita Visarpa or Shakha Ashrita - Externally situated in Shaka, Rasa and Rakta Dhatu and it is Sadhya (curable). In this Visarpa Vatadi Dosha cause Bahya Dhatu

2. Antashrita Visarpa or Abhyantara Ashrita - Internal organs and other Dhatus are involved in the disease. The disease Kashta Sadhya (difficult to treat). In this Visarpa Vatadi Dosha cause Abhyantara Dhatu Dusthti.

3. Ubhayashrita Visarpa - Affects in both external and internal part of the body, the disease is more serious and it is Asadhya (incurable). In this Visarpa Vatadi Dosha cause both Bahya and Abhyantara Dhatu Dushti

Sapta Dravya in Visarpa (Dosha Dushya in Visarpa)
Rakta (Blood), Lasika (lymph), Twaka (skin), Mamsa (flesh) and three Dosha, these seven elements are involved in the pathogenesis of all types Visarpa.

Raktadi Sapta Dravya are similar as like Kushta Sapta Dravya, but the Visarpa having Prasarana Shila (spreading in nature). In Visarpa the Rakta Dhatu and Pitta is primely involved along with Tridosha. By nature, the disease is spreading throughout.

Samprapti Ghataka

  • Dosha - Pitta Pradhana Tridosha
  • Dushya - Rasa (Twak), Rakta, Mamsa and Lasika
  • Agni - Jatharagni, Dhatvagni
  • Agnidusti - Mandagni
  • Srotas - Rasavaha, Raktavaha, Mamsavaha Srotas
  • Srota Dushti - Sangha
  • Adhishthana - Abhyantara and Bahya Roga Marga
  • Udbhava Sthana - Amasayottha and Shaka-Twak
  • Sanchara Sthana - Twaka and other Dhatu
  • Svabhava - Ashukari, Chirakari
  • Prabhava - Eka Doshaja - curable, Agni Visarpa, Kardama Visarpa, Granthi Visarpa, Sannipataja Visarpa are incurable
  • Marga - Abhyantara, Bahya and Madhyama

Discussion

Aharaja Nidana: Dietary factors such as excessive intake of Amla, Katu, Ushna and Lavana


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food stuffs aggravates Doshas. Frequent and excessive consumption of Shukta, Mandaka, Sura, Kilata, Kurchika, Asatmya and Viruddha Ahara along with vitiated Doshas affect the element of the body which results Vyadhi like Visarpa.

Lavana Rasa: It is Nati Guru, Ushna and Snigdha. There are different opinions regarding basic element composition of salt taste. It is composed of, Jala and Agni as per Charaka and Vagbhata, Pruthvi and Agni as per Sushruta and Agni and Jala as per Nagarjuna. Jala and Agni composition theory is the widely accepted one. Because of Jala Mahabhuta, it is Guru and Snigdha. Because of Agni Mahabhuta, it increases Pitta Dosha. Because of its Jala Mahabhuta, it balances Vata and Increases Kapha.

Amla Rasa: Alma Rasa decreases Vata. It increases Pitta and Kapha Dosha. Amla Rasa is composed of Pruthvi and Teja Mahabhuta. Hence is has Guru, Snigdha and Ushna qualities. Because of its Pruthvi Mahabhuta, it has qualities like Guru which increases Kapha Dosha. As it has Agni Mahabhuta, it increases Pitta Dosha. Because it does not contain any Vayu Mahabhuta and as it is Agneya and Guru it pacifies Vata Dosha.

Excess of Amla Rasa causes increase of Pitta leading to following symptoms - Dantaharsha, Trushna, Akshinimeelana, Romanchana, Kapha Dravikarana, Pitta Vruddhi, Rakta Dosha, Mamsa Vidaha, Shareera Shaithilya, Shotha, Paka, Kantha Daaha, Vaksha and Hrudaya Daha.

The food articles with these Rasa have predominance of Agni Mahabhuta and possess qualities homologous to Pitta and Rakta, when consumed in excess leads to Pitta and Rakta Dushti.

Katu Rasa: It is composed of Vayu and Agni Mahabhoota. Because of these to Mahabhutas it is Laghu, Ushna and Rooksha in Nature. These three qualities are the qualities of the food having Katu Rasa. Hence it increases Pitta. Because of its Vayu Mahabhuta it increases Vata Dosha. When Vayu is heated by Agni, its volume increases hence Agni also contributes to Vata Dosha increase. Because Ushna and Laghu are against the Kapha qualities i.e., Sheeta and Guru, Katu Rasa pacifies Kapha Dosha.

Ushna Virya: Lavana, Amla and Katu Rasa are Ushna Viryatmaka and the foods which has hot potency, it causes heat,

burning sensation, digestion, unconsciousness, sweating, purgation, melting, giddiness, thirst, tiredness. It increases Pitta and decreases Vata and Kapha.

Dadhi: Dadhi is classified into three types Madhura Dadhi, Amla Dadhi, and Atyamla Dadhi. Madhura Dadhi is Mahabhishyandi and Kaphameda Vivardhanam. Amla Dadhi is Kaphapitta Kara and Atyamla Dadhi is Rakta Pradooshaka. It is good in case of all the four types of Peenasa (by its Prabhava), Atisara, Vishamajwara, Mootrakrichra, Kaarshya, Raktapitta (Madhura Dadhi) etc. Dadhi can be consumed in Sharad, Greeshma and Vasantha Ritu. Atyamla Dadhi is Rakta Dooshaka and Abhishyandi and Atisevana of it leads to Pittakhaphakara and Raktha Pradhushana and leads to Visarpa disease.

Mastu: Amla Mastu is Pittakara, Atisevana results in Rakta Dushti and Pitta Dusti and results in Visarpa Vyadhi.

Tila: Rasa - Madhura, Kashaya, Tikta, Katu. Vipak - Madhura, Virya - Ushna. Guna - Suksma, Guru, Dipan, Lekhana, Balya. Pancamahabhoutik composition - prominently Pruthvi and Apa. Action on Dosha - Alleviates Tridosha

Madhyapana: Madya Guna - Laghu, Ushņa, Tikshņa, Sukshma, Visha, Amla, Vyavayi, Aashu, Vikashi and Ruksha. Madya is having Guna which are just opposite to that of Oja. Therefore, when Madya reaches the Hridaya, it afflicts the ten Gunas of Oja, which is located in Hridaya. Because of these property of Madhya it causes Tridosha Prakopa.

Kulattha: It possesses Ushna, Kashaya Rasa, Amla Vipaka, Kaphavatahara, Grahi, Shukrahara and leads to Ashmari, Peenasa Kasa-Hikka-Shwasa-Arshohara. It belongs to Shamidhanya Varga and mainly classified as Graamya and Vanya. Other varieties of Kulattha are Shukla, Krishna, Chitra and Lohita. Kulattha is Shonita Dushtikara and Raktapittakara. Atisevana of Kulattha causes Kledanasha and Rookshata in the body. Due to Amlavipaka, it is Pittakara. Hence excessive Sevana of Kulattha may cause Pittaja and Vataja diseases.

Mamsa: It is Vatahara and Pitta Khapha Kara as it is Guru, Snigdha Guna and Madura Vipaka

Masha: It balances Vata Dosha, increases Kapha and Pitta Dosha. As per the Nighatus Masha is one among the 4 substances that increases Kapha and Pitta.


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Lahsuna

Rasa - Madhura, Lavana, Katu, Tikta, Kashaya.

Guna - Snigdha, Guru, Tikshna.

Vipaka - Katu, Ushna Virya

It balances Vata and Kapha. Increases Pitta Dosha.

Viruddha Ahara: Viruddhahara causes many diseases. It is not possible to give treatment of each and every disease separately. Charaka has stated, by avoiding things - Viruddhahara that give rise to vitiation and practicing those - Hita Ahara that help in bringing Samavastha of Dhatus, then vitiated elements do not persist and the vitiated element are continuously brought into existence - Ch. Su. 16/36. Charaka has given more weightage for the avoidance of causative factors - Ch. Su. 18/46. But, one cannot get health by only causative factors.

Ajeernebhojana: If one takes food in Ajeerna leads to further Agni Dusti and thereby Pitta Dusti.

Viharaja Nidana: Teekshna Atapa Sevana and Agni Santapa - In excess lead to Pitta Prakopa due to Ushna and Teekshna properties.

Ati Karma - leads to the vitiation of Vata decreases Kapha and Pitta.

Conclusion

Nidana or etiological factors are source to understand a disease and they also play a key role in treating patients. Visarpa is one of the major skin disease which is explained in detail apart from Kusthavyadhi by every Acharya. This imparts the severity and significance of disease.

Visarpa is characterized by Aashu - Anunnatashopha, Daha, Jwara, Vedana and Nature of Pidika is described as Agnidagtravat.

Prevention is better than cure, this should be followed by everyone so that some problems can be reduced, because of their different incompatible food and life style they are suffering from the diseases like Visarpa. If diet and life style is modified then it can be cured by prevention only. One of the dangerous diseases. As far as knowledge of Nidana of specially Visarpa among lay man is very poor, there is an immediate need to increase awareness about important contribution of Ayurveda, such as Dinacharya, Ritucharya, Ahara Vidhi etc. for prevention of diseases.

In the present changed circumstances and different life style as a result of globalization and modernization, the core idea of Nidana explained by our age old classics, still observed very much resolved.

Reference

1. Vd. Harish Chandra Singh Kushwaha, Charaka Samhita of Agnivesha, vol 1, Varanasi: Chaukhamba Orientalia, 2016, Chapter 11, sloka 47, page no – 171.

2. https://en.wikipedia.org/wiki/Herpesviridae, retrieved on 18/3/2022, Timing 11.30am.

3. API Textbook of MEDICINE, 9th Edition, Yash Pal Munjal,2012, Vol 1 page no. 474

4. Davidson`s Principles and Practice of Medicine, 19th Edition, Christopher Haslett, Edwin R. Chilvers, Nicholas A. Boon, Nicki R. Colledge, page no. 32, 2002.

5. Harrison`s Principles of Internal Medicine, 20th Edition, Larry Jameson, Dennis L.Kasper, Stephen L. Hauser, Joseph Loscalzo,2018, Vol1 page no. 1356.

6. Vd. Harish Chandra Singh Kushwaha, Charaka Samhita of Agnivesha vol 2, Varanasi:

7. Chaukhamba Orientalia, 2018, Chikitsasthana Chapter 21, Sloka 13 – 22, page no-435

8. Dr.R.K.Sharma, Vd.Bhagwan Dash, Charaka Samhita of Agnivesha Based on Chakrapani Datta`s Ayurveda Dipika, Vol-4,Varanasi,Chowkhambha Sanskrit Series Office, 2005, Chikitsasthana Chapter 21,sloka, page no. 259-278.

9. Prof.R.H.Singh, Charaka Samhita of Agnivesha, Eloborated by Charaka And Drdhabala With the Ayurvedadipika Commentary by Chakrapanidatta and Nirantarapada-Vyakhya by Jejjata (on Chikitsa sthana to Siddhi-sthana), vol 2, Varanasi, Chaukhamba Surbharati Prakashan, 2011,, 21stChapter, sloka, page no. 1291.


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