E-ISSN:2456-3110

Review Article

Rogmarga

Journal of Ayurveda and Integrated Medical Sciences

2023 Volume 8 Number 3 March
Publisherwww.maharshicharaka.in

Rogamarga - A clinical and therapeutic indicator: A Critical Review

Kumar M.1, Sharma M.2*, Arya P.3, Mehta D.4, Kumar Mandal S.5
DOI: http://dx.doi.org/10.21760/jaims.8.3.15

1 Manish Kumar, Associate Professor, Department of Rog Nidan evam Vikriti Vigyan, Gaur Brahman Ayurvedic College, Rohtak, Haryana, India.

2* Meenakshi Sharma, Assistant Professor, Department of Rog Nidan evam Vikriti Vigyan, Gangaputra Ayurvedic Medical College, Jind, Haryana, India.

3 Pooja Arya, Associate Professor, Department of Shalya Tantra, Gangaputra Ayurvedic Medical College, Jind, Haryana, India.

4 Deepti Mehta, Professor & HOD, Department of Rog Nidan evam Vikriti Vigyan, Shri Krishna Ayush University, Kurukshetra, Haryana, India.

5 Sisir Kumar Mandal, Professor & HOD, Department of Rog Nidan evam Vikriti Vigyan, BHU, Varanasi, Uttar Pradesh, India.

Rogamarga is the unique speciality of Ayurveda which means the pathway of diseases. The Rogmarga act as passage for movement of Doshas and site of amalgamation for morbid Doshas and Dushyas (body tissue). It is essential to understand pathological process involved in manifestation of disease. The normal relationship between Rogmarga, Doshagati and dhatu formation is responsible for health status of individual and any disturbance in the same is responsible for morbidity. Hence, the concept of Rogmarga is vital to understand patho-physiology of body systems. It has diagnostic, prognostic and therapeutic utility both in acute and chronic disease.

Keywords: Pathway, Rogmarga, Pathological process, Khavaigunya, Ayurveda

Corresponding Author How to Cite this Article To Browse
Meenakshi Sharma, Assistant Professor, Department of Rog Nidan evam Vikriti Vigyan, Gangaputra Ayurvedic Medical College, Jind, Haryana, India.
Email: 		Manish Kumar, Meenakshi Sharma, Pooja Arya, Deepti Mehta, Sisir Kumar Mandal, Rogamarga - A clinical and therapeutic indicator: A Critical Review. J Ayu Int Med Sci. 2023;8(3):84-87.
Available From
https://jaims.in/jaims/article/view/2264

Manuscript Received Review Round 1 Review Round 2 Review Round 3 Accepted
2023-01-28 2023-01-31 2023-02-07 2023-02-14 2023-02-21
Conflict of Interest Funding Ethical Approval Plagiarism X-checker Note
Nil Nil Yes 18%

© 2023by Manish Kumar, Meenakshi Sharma, Pooja Arya, Deepti Mehta, Sisir Kumar Mandaland 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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Kumar M et al: Rogamarga A clinical and therapeutic indicator

Introduction

Understanding pathogenesis is still a challenge before medical fraternity, as the process is subtle. Both contemporary as well as classical science has given different postulates to prove it, yet it is still difficult to understand the concept. Rogmarga has important contribution in understanding in the manifestation of disease process. The detailed description of Rogmarga is given in classical texts. Acharya Chakarpani vividly explain the concept for the understanding of diagnosis and prognosis of disease. While Acharya Madhvakara explained it for therapeutic purpose. The basis of Rogamarga is movement of Dosha from one original site to other. During physiological and pathological condition Dosha move from Shakaha to Koshtha and vice versa and hence it has important role in the manifestation of disease. Rogamarga describes the relationship between different tissues and organs of the body. It also helps us to understand the Dosha Gati, Kha-Vaigunya and Samprapti of disease. The study of these parameters and Trividha Rogmarga is helpful in the management (Chikitsa) of various progressive and chronic diseases. As per classical text Rogamarga has an important contribution in disease progression. Rogamarga is explained in Nirdesh Chatuska in “Tisraishaniya Adhyaya” of Sutrasthan of Charaka Samhita.[1] Acharya Chakrapani explained the Rogamarga for the understanding prognosis of Roga.[2] While Acharya Madhavakara explained it for therapeutic purpose.[3] In Ashtang Hridya, Rogamarga is explained in chapter “Doshabedheyamadhyaya” in Sutrasthana.[4]

Aims and Objectives

Present review aims to know about Rogamarga and its importance in the Chikitsa.

Materials and Methods

The searching methodology included two parallel grounds, classical text and search engines like Google scholar, PubMed, Cochrane including Mesh terms Rogmarga, disease pathway etc.

Rogamarga: The word Rogamarga means the disease pathway. The word Roga means Vyadhi, which gives ‘Ruja’ (pain) to the body. The word Marga means Pantha, Ayana i.e., pathway, way, passage and channel from where

Roga spreads into the body.[5] Rogamarga means the way through which the disease progress into the body. According to Acharya Hemadri quotes “Roganam Marga Rogamarga” which means the pathway of disease is considered to be Rogamarga.[6]

Type of Rogamarga[7-9]
Different Rogamarga has been explained in text as mentioned in table1.

Table 1: Classification of Rogamarga.

As per disease manifested Sakha (Bahya) Marmaasthisandhi (Madhyama) Koshtha (Abhyantara)
As per Dosha Gati Kshya Shthana Vriddhi
As per Dosha Gati Urdhava Adhah Tiryaka
According to Ritu Chaya Prakopa Prashamana

1. Rogamarga as per disease manifested
a. Bahya Rogamarga: It means pathway of external disease. it constitutes ‘Tvak’ (Skin) and other 6 Dhatuse., Rakta (Blood), Mamsa (Muscles), Medas (Fat), Asthi (Bone), Majja (Bone marrow), and Sukra (Semen). Any changes in Rasa Dhatu will be reflected through skin. Diseases such as ‘Masak, Vyanga (Skin disease), Ganda (Goitre), Alaji (Skin disease), Arbuda (Tumour), Arsas (piles), Gulma (Tumour) and Sopha (inflammation) occurs in Bahya Rogamarga.

b. Madhya Rogamarga: It constitutes Tri Marmas (Vital organs) i.e., Murdha (head) Basti (bladder), Hridaya (heart) & Sira (vein); Asthi (Bone), Sandhi (joints), Snayu (ligament) and Kandara (Tendon). Diseases such as Yakshma (tuberculosis), Pakshavada (hemiplegia), Ardita (facial palsy), Murdharoga (Diseases of head), Hridya Roga (Diseases of heart), Basti Roga (Diseases of urinary bladder) and Diseases of Sandhi (joints), Asthi (bones), Trika (sacral region), Sula (pain) and Graha (stiffness) occurs in this pathway.

c. Abhyantra Rogamarga: It consist all Kosthangas (visceral organs), Mahasrota (GI tract), Antah Kostha, Sarira Madhya, Mahagatra, Mahanimna, Amasaya, Pakvasaya. Diseases such as Chardhi (vomiting), Atisara (diarrhoea), Kasa (cough), Svasa (breathing disorders), Jalodar (ascites), Jwara (fever) and internally manifested Sopha (swelling), Arsa (piles), Gulma (tumour), Visrpa (erysipelas), and Vidradi (abscess) occurs in this Marga.

2. Rogamarga on the basis of Dosha-Gati[10]
a. Kshaya (Less than normal)
b. Sthana (Normal state of Dosha)


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c. Vriddhi (More than Normal)

3. Rogamarga on the basis of Dosha-Gati.

a. Urdhwa Gati means upward movement of Dosha. eg. Urdhwaga Raktapitta, Chardi

b. Adho Gati means downward movement of Dosha. eg. Atisara (diarrhoea), Pravahika (dysentery), Grahani (irritable bowel syndrome), Adhoga Raktapitta (bleeding disorders), Adhoga Amlapitta (hyper acidity) etc.

c. Teeryak Gati means both side movement of Dosha. eg: Teeryaka Raktapitta, Jwara (fever), Mandagni (slow digestive power) etc.

4. Rogamarga on the basis of Ritu (seasonal variations).
Vata accumulates in Grishama, get aggravated in Varsha and get pacified in Hemanta Ritu and similarly the other two Doshas.

Pathological aspect of Rogamarga: Each Roga Marga is allotted a set of structures or organs. Certain disease are manifested through this pathway. As the pathological process occurs when morbid Doshas moves through these Rogamargas. The role of Rogamarga starts from Prasara Avastha (spreading stage) of Satkriyakala (six stages of disease progression). These spreading Doshas get localized at the site of Khavaigunya (site devoid of normalcy) where amalgamation of Dosha-Dushya take place and pathogenesis happens. The micro and macro channels help in transformation and transportation of Dosha and Dhatu has clinical significance in pathological process. Through these channels the pathogenesis can progress in many directions, but in which particular direction and pattern it will progress is decided by the concept of Rogamarga. Besides Rogamarga also plays an important role in the Nidanarthakaratwa Vyadhis because there is a movement of vitiated Dosha from one passage to other.[11] In equilibrium state of body, no Rogamarga will be reserved for travel of vitiated Doshas. Moreover, the Srotas that get vitiated behaves as Rogamarga.

Diagnostic aspect: Prognosis of disease based on Rogamarga
For the treatment of disease, one should know about the prognosis of the disease. Ayurveda commentator's Acharya Chakrapani and Gangadhara shares their views on the Sadhyasadhyata of Rogamarga. Gangadara

says that the diseases of Bahyarogamarga (external pathway) are Sukhasadhya (easily curable), the disease of Madyama Rogamarga (middle pathway) will be Krichrasadhya (difficult to cure) or Yapya (relives but not cures) and that of Abhyantara Rogamarga (internal pathway) are Sukhasadhya (easily curable), Krichrasadhya (difficult to cure) or Yapya (relives but not cures) or Asadhya (incurable) depending on manifested symptoms.[12]

Diseases of Madhyama Rogamarga will have serious complications, as the particular structure has to exhibit great amount of resistance to combat the complications. The complications may vary from mild to severe within a short period in diseases of Abyantara Rogamarga. While in Bahya Rogamarga, Upadrava will be minor or uncommon. Hence, Rogamargas gives important clue about prognosis of disease.

Therapeutic aspect: Rogamarga is mentioned for Chikitsa Bhedartha purpose in Madhava Nidana Samhita. As vitiated Doshas travel through Rogamarga; therefore, its proper understanding is must for breaking pathological process. The vitiated Dosha travel and spreads through Rogamarga. So Rogamarga concept is very important for the proper management of a disease. Jatharagni Mandya is main responsible factor for the diseases related to Abhyantara Rogamarga. The treatment plan should be to increase digestive fire. Different treatment modalities like Deepana, Pachana and Vamana or Virechana should be administered as per the condition. The diseases occurring in Madhyama Rogamarga are pain dominating, has sudden loss of function and manifested as a result of continuous stress. Here, Shodhana will be the line of treatment. But when there is the involvement of Marma (vital organs), Paripalana of Marma along with Basti Chikitsa is very effective.[13] However, the diseases of Shiras like Ardita, Manyastambha, Pakshaghata etc. can be treated with Nasya.[14] In case of Bahyarogamarga disease, there is formation of Ama resulting in Dhatvagnimandhya (slow metabolism). Therefore, morbid Doshas should be brought back to their original places with the help of Snehana and Swedana. When Doshas enters Koshtha they are eliminated through Vamana or Virechana depending on the condition.

In classics, Virechana and Rakta Mokshana are preferred for Bahya Rogamarga Vyadhi due to involvement of Rakta in pathogenesis.


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Discussion

The knowledge of Rogamarga helps to know the Dosha-Gati, disease progression and its diagnosis. The pathological process is subtle hence the changes manifested through entrance of vitiated Doshas in Rogamargas in of very much clinical significance. It acts as a pathway for mapping the pathological process. Besides, it also facilitates the knowledge about the prognosis of the disease. The understanding of pathophysiology of the disease is very necessary before management in classics. Therefore, it may act as an important instrument for checking pathogenesis, prognosis and deciding the therapeutic route of interventions. (Figure 1)

jaims_2264_01.JPG

The transformation and mitigation of vitiated Doshas may be achieved through proper knowledge of Trividha Rogamargas. It act as an important preventive, prognostic and therapeutic tool.

Conclusion

Rogamarga serve as an important tool for mapping pathological changes. It also has diagnostic and prognostic and therapeutic significance. As it is the site where pathogenesis occurs, so it plays inevitable role in subclinical, clinical and complication stages of morbidity. The prognosis of particular disease is based on its pathway. The disease following a particular Rogamarga has same line of management. Hence, the concept may serve as unique contribution in clinical medice. Though, there is an urgent need to explore it with the help of clinical features and biological markers.

Reference

1. Kasinatha Sastri, The Caraka Samhita of Agnivesa, Vidyotini Hindi Commentary,

Sutra sthana, chapter 11, Chaukhambha Bharati Academy, Varanasi, Reprint: 2014, p.235.

2. Vaidya JT Acharya, Caraka Samhita of Agnivesa with Ayurveda Deepika Commentary, Varanasi, Chowkhamba Krishnadas Academy, 2010, p.77.

3. Upadhyaya, Madhava nidana of Madhavakara with Madhukosha commentary, Varanasi, Chaukhambha Prakashan, 2014, p.3.

4. Vaghbata, Astanga Hridayam of Vagbhata, T Sreekumar, First Ed, Harisree Hospital, Thrissur, Page No; 303.

5. VS Apte, The student’s Sanskrit-English dictionary, New Delhi, Bharatiya granth niketan; 2014, p. 491.

6. Subhash Ranade, Ayurvediya Vikritivigyan, 2nd edition, Pune: Anmol Prakashan; 2007, p.58

7. Kasinatha Sastri, The Caraka Samhita of Agnivesa, Vidyotini Hindi Commentary, Sutrasthana, chapter 11, Chaukhambha Bharati Academy, Varanasi, Reprint: 2014, p.235.

8. K. R. Srikantha Murthy, Astanga Samgraha of Vagbhata, Sutra sthana, chapter 22, verse 9, Chaukhambha Orientalia, Varanasi, 9th edition: 2005, p.402.

9. Bulusu Sitaram, Astanga Hrdayam of Vagbhata, Sutra sthana, chapter 12, Chaukhambha Orientalia, Varanasi, 1st edition: 2008, p.165.

10. Kasinatha Sastri, The Caraka Samhita of Agnivesa, Vidyotini Hindi Commentary, Sutrasthana, chapter 17, Chaukhambha Bharati Academy, Varanasi, Reprint: 2014, p.363.

11. Kaviraja Ambikadutta Shastri, Susruta Samhita of Maharsi Susruta, Part-1, Sutra sthana, chapter 21, Chaukhamba Sanskrit Sansthan, Varanasi, 2012, p.117.

12. PS Byadgi, Ayurvediya Vikrti Vijnana & Roga Vijnana, Vol-1, Chaukhambha Publications, New Delhi, Reprint 2017, p.67.

13. Kasinatha Sastri, The Caraka Samhita of Agnivesa, Vidyotini Hindi Commentary, Sutrasthana, chapter 28, verse 31-32, Chaukhambha Bharati Academy, Varanasi, 2014, p.473.

14. Kasinatha Sastri, The Caraka Samhita of Agnivesa, Vidyotini Hindi Commentary, Siddhisthana, chapter 9, verse 7, Chaukhambha Bharati Academy, Varanasi, 2011, p.1053.


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