E-ISSN:2456-3110

Research Article

Roga Vinishchaya

Journal of Ayurveda and Integrated Medical Sciences

2023 Volume 8 Number 12 December
Publisherwww.maharshicharaka.in

Contribution of Charaka Nidana Sthana in Roga Vinishchaya

Archana S1*, Aradhana K2, Aruna O3
DOI:10.21760/jaims.8.12.20

1* Solanki Archana, Post Graduate Scholar, Dept of Roga Nidana Evum Vikriti Vigyana, Shri Npa Govt Ayurved College, Raipur, Chhattisgarh, India.

2 Kande Aradhana, Lecturer, Dept of Roga Nidana Evum Vikriti Vigyana, Shri NPA Govt Ayurved College, Raipur, Chhattisgarh, India.

3 Ojha Aruna, Prof and HOD, Dept of Kayachikitsa, Shri NPA Govt Ayurved College, Raipur, Chhattisgarh, India.

Ayurveda is the science of life and the soul of Ayurveda resides in the Samhitas. The three main Samhitas of Ayurveda also known as Brihatrayi are Charak Samhita, Sushruta Samhita and Ashtang Hridaya. Charak Samhita is useful for not only those who want to improve and maintain their health and happiness but also to find cure of diseased i.e. treatment. Before understanding the treatment, it is very necessary to understand the Etiopathogenesis of a disease with the help of Nidanapanchaka (Nidana, Purvarupa, Rupa, Upshaya, Samprapti). Each component of Nidanapanchaka helps a physician for better understanding of disease progress and treatment. The area or Sthana where Charaka narrates the Nidanapanchaka of diseases is actually termed as Nidana Sthana. Here in this article, we will try to explore about Nidana Sthana of Charak Samhita.

Keywords: Nidanapanchaka, Samprapti, Dosha Dushya Sammurchhana, Purvarupa, Upadrava

Corresponding Author How to Cite this Article To Browse
Solanki Archana, Post Graduate Scholar, Dept of Roga Nidana Evum Vikriti Vigyana, Shri Npa Govt Ayurved College, Raipur, Chhattisgarh, India.
Email: 		Archana S, Aradhana K, Aruna O, Contribution of Charaka Nidana Sthana in Roga Vinishchaya. J Ayu Int Med Sci. 2023;8(12):130-134.
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https://jaims.in/jaims/article/view/2960

Manuscript Received Review Round 1 Review Round 2 Review Round 3 Accepted
2023-10-13 2023-10-22 2023-11-01 2023-11-15 2023-11-26
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© 2023by Archana S, Aradhana K, Aruna Oand 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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Archana Solanki et al. Contribution of Charaka Nidana Sthana in Roga Vinishchaya

Introduction

Acharya Charaka has described the Prayojana of Ayurveda as to maintain the health of healthy individual and to treat the disease of sick individuals.[1] Many health maintaining principles are described by Charaka in Sutra Sthana and the principles of diagnosis of diseases are explained in Nidana Sthana. Diagnosis is never complete without the elicitation of all the factors associated with the disease and in Ayurveda, for proper elicitation of all factors we need to understand the concept of Nidanapanchaka. We get the knowledge of Nidanapanchaka mainly from Nidana Sthana. All Brihatrayi stated Nidana Sthana however the explanation of Nidanapanchaka, Nidanarthakara Roga, Utpatti of diseases, Mythological history of diseases etc. were first explained in Charaka Nidana Sthana.[2] Charaka Nidana Sthana consists of 8 diseases viz Jwaranidanam, Raktapittanidanam, Gulmanidanam, Pramehanidanam, Kushthanidanam, Shoshanidanam, Unmadanidanam and Apasmaranidanam. A disease is caused by specific causative factors followed by pathogenesis with the manifestation of signs and symptoms and if ignored the complication is the next outcome. The proper comprehension of disease can be made by understanding the Nidana, Purvarupa, Linga, Upshaya Samprapti (Nidanapanchaka).[3]

Nidana is defined as the eternal cause of disease.[4] Chakrapani explain that Nidana is of two types that is Vyadhi Janaka and Vyadhi Bodhaka.[5] Vyadhi Janaka Nidana means cause of disease (ethological factor) and Vyadhi Bodhaka Nidana means which is the mean of diagnosis. It is highly important to know the Nidana of diseases. Complete cure in curable disease and management of palliable disease can only be achieved after Nidana Parivarjana. If a physician is confused in diagnosing a disease, the Nidana Sevana done by him can be helpful in diagnosis of disease. If Nidana are not identified correctly, Nidana Sevana can't be hampered and long duration of Nidana Sevana worsens the prognosis of disease. Hetu (etiological factor), Linga (signs and symptoms) and Aushadha (drugs and therapy) are the three Sutra of Ayurveda. Without the knowledge of Hetu and Linga the implication of Aushadha is not possible.[6] For this Nidanapanchaka are regarded as basic tool for diagnosis.[7]

Purvarupa are the symptoms, which occurs before manifestation of disease’s actual symptoms.[8] For accurate diagnosis and differential diagnosis, the knowledge of Purvarupa is very important. Charaka has mentioned that if the Hetu, Purvarupa and Rupa are Alpa (less), the disease is Sukha Sadhya.[9] Rupa are the symptoms which indicate the actual onset of manifestation of disease.[10] The pathogenesis (Dosha Dushya Sammurchhana) occurring inside the body is expressed externally as the symptoms of that disease.[11] As this stage refers to actual manufacturing of disease, hence important for planning the treatment protocol. Upashaya can be defined as the Sukhanubandha of Aushadha, Aahara and Vihara.[12] Upashaya plays a very important role in differential diagnosis. When it is difficult to diagnose a disease due to obscure or mysterious manifestation, Upashaya helps to make correct diagnosis.[13] Samprapti (Pathogenesis) can be defined as how the normal Dosha, Dushya gets vitiated by the initiation of etiological factors to the manifestation of symptoms collectively.[14] The Chikitsa or treatment is the Vighatana (dissolution) of the Samprapti. In Nidana Sthana, the Chikitsa Sutra mentioned should be interpreted as Upashayantargata (alleviating factors as for diagnosis).[15]

The knowledge of Nidanapanchaka and other important principles explained in Nidana Sthana can be helpful in proper diagnosing the disease. Also, it guides a physician to diagnose and treat disease with minimal use of laboratory, imaging and other diagnostic tools. If the disease is diagnosed in early stage, we can stop the progression of disease worsening the prognosis and preventing further complications.

Aim and Objectives

1. To study the contribution of Charaka Nidana Sthana in Roga Vinishchaya.

2. To study the important principles mentioned in Charaka Nidana Sthana for disease diagnosis and prognosis.

Materials and Methods

The materials for this study were collected from various Ayurvedic Samhitas available in the library of Govt. Ayurvedic College, Raipur (C.G.). Various articles have also been studied for this study.


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References from Charaka Samhita, Madhava Nidana etc. are reviewed for this article.

Literature Review

Nidana Sthana deals with the principles of diagnosis of diseases which provides guidelines for diagnosing a disease on the basis of Nidanpanchaka through which we get detailed history and do clinical examination. It emphasizes on particular disease’s Dosha, Dhaatu and Strotas involvement which are the cornerstone of treatment. Some of the very important diagnosing principles are also explained in Charaka Nidana Sthana which are like a key for complex diseases. The phenomena of a disease causing another disease is described as Nidanarthakara Roga.[16] One important principle of diagnosis is also mentioned in Prameha Nidana that is the process of onset of disease through interaction between aggravating and pacifying factors is described as Utpadaka and Anutpadaka Karana of Roga.[17] If the Nidana, Dosha and Dushya do not establish a correlation or the aggravating factors are not much stronger, than the disease will not occur or occur later.

Updrava (complications), Udarka (marks of disease after it is cured) are applied for knowing the cause-effect relationship in the pathogenesis of disease.[18] Principles of management of disease are mentioned in brief in each chapter to denote pacifying factors of disease. Each chapter of this section follows the same protocol for comprehensive knowledge of disease. Below is the description of each chapter of Nidana Sthana.

Chapter 1 - Jwara Nidana[19]

Jwara is said to be as the king of all diseases and is explained first in the 8 chapters. All individuals have Jwara at the time of their birth and death. Here in this chapter five roots for diagnosing a disease that is Nidanapanchaka are explained with the synonyms, types and its importance. Later primacy of Jwara with its causes, synonyms, types, pathogenesis are explained. Not only from inflammatory changes, excessive Shrama, Krodha, Hrasha also acts as Nidana of Jwara. Main pathogenesis of Jwara occurs in the Rasa Dhatu, Rasavaha and Swedavaha Strotasa. By this, we can interprete the involvement of thermoregulatory mechanism are observed in the etiopathogenesis and clinical features.

Jwara can be present as a disease entity independently or as a symptom of other diseases like T.B., respiratory diseases etc. Brief treatment of Laghvashana, Aptarpana, Ksheer Bhojana in chronic stage of Jwara is expounded. For Jeerna Jwara, Ghritapaana is also explained. These all can be taken under Upshaya.

Chapter 2 - Raktapitta Nidana[20]

In Raktapitta, involvement of Rakta Dhaatu and Pitta Dosha are explained. Marga of Rakta Pitta are also explained along with the Nidanapanchaka. The Nidana explained in this chapter are excessively Ushna, Tikta and Ushna in nature. Kordusha (Kodo) is Pittahara in nature, but if taken with Nishpava, Masha, Kulthi etc., it causes Raktapitta as the effect of Samyoga Vishesha. Excessive use of Dadhi, Amla Kanji, Sura, Shukta with milk causes Pitta Dushti along with rise in the amount of Rakta. Factors responsible for pathogenesis of disease and appropriate Chikitsa Sutra are also mentioned. At last Pariksha of Rakta is also mentioned for correct treatment.

Chapter 3 - Gulma Nidana[21]

Pathogenesis of Gulma is mentioned with specification to one predominant Dosha i.e., Vaata with other Dosha playing as a subordinate role. Shonita Gulma is said to happen only in females and its symptoms be similar to pregnant women.

The main pathology occurs in five places Hridaya, Basti, Nabhi and two Parshwa (Planks). Mithya Garbha Lakshana are also mentioned in this chapter. Nichaya Gulma should not be treated as it is Asadhya. It is mentioned that main treatment of Gulma is treatment of Vaata Dosha.

Chapter 4 - Prameha Nidana[22]

Involvement of Tridosha and Dasha Dushya are mentioned with specific Dosha “Bahudrava Shleshma” (Dushti of Drava Ansha of Kapha Dosha) and specific Dushya “Bahu Aabadha Meda”. Kaphaja, Pittaja and Vataja Prameha with its subtypes is explained.

One important principle of Roga Utpadaka and Anutpadaka Karana is also explained in this chapter. If the Nidana, Dosha and Dushya do not establish a correlation or the aggravating factors are not much stronger, than the disease will not occur or occur later.


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Vataja Prameha and its subtypes are said to be Asadhya as they are Maha Atyaayikatvata and Virudhha Upkramatvata. This can be understood that all types of Prameha ultimately leads to Vataja Prameha. Upadravas are also mentioned in this chapter. Treatment of Sadhya Prameha are mentioned as Sanshodhana and Sanshamana. The complexity and severity of this disease is explained by a very nice example that this disease does not leave the patient, like a bird does not leave its nest and it comes again and again to its nest.

Chapter 5 - Kushtha Nidana[23]

In Kushth, vitiation of Tridosha and Four Dushya (Twak, Mamsa, Shonita, Lasika) mainly occurs. The classification and treatment of Kushth can be concluded on the basis of Anshansha of Dosha, Anubandha, Sthana, Vedana, Varna, Sansthana, Prabhava. Kushatha is one of the menacing disease which not only affects physically but it has deteriorating effect on mental health as well. The causative factor of Kushtha like excessive use of honey, Fanita (Raaba), fish, radish excessive sunlight exposure, taking bath just after contact with sunlight (high temperature), suppressing urges of vomiting etc.

Later different types of Kushtha are very well explained with examples like Kapala Kushtha appears Ruksha, Aruna, Vishama, have course edges just like a piece of Mrita Kapala. Types of Kushth according to Charaka are mentioned as 7,18 and Asankhya. Description of Saptakushtha are elaborated with specific Lakshanas, its prognosis and complications are mentioned. Also, one important principle of treating a disease in its initial stage as early as possible is also described.

Chapter 6 - Shosha Nidana[24]

In this chapter Acharya Charaka has explained in detail the four causes of Shosha that is Sahasa, Sandharana, Kshaya, Vishamashana along with its pathogenesis. In today’s scenario, people follow the trend of heavy Gyming, Junk food (Vishamashana) etc. which are the Nidana of Shosha. In the Purvarupa of Rajyakshma, Acharya Charaka has described not only Sharirika Purvarupa but also described what the patient will see in his dreams.

Chakrapani described that in Shosha, Vata is dominant Dosha and in Rajyakshma, Kapha Dosha is dominant and that is because of Sansarga of Urastha Shleshma.

One of the most salient instructions by Acharya Charaka is prioritise to protect our body over all other considerations. Some important prognostic points like protection of Shukra and Mala are also discussed. Shosha is said to be Sarva Roganam Kashtatam Vyadhi.

Chapter 7 - Unmada Nidana[25]

Acharya Charaka described the Mansika diseases in chapter 7 and 8 i.e., Unmada Nidana and Apasmara Nidana in Nidana Sthana. Charaka defined Unmada as the Vyatikrama (deviation) of Mana (emotional), Buddhi (thoughts and decision), Sangya-Gyana (orientation), Smriti (memory and learning), Bhakti (desire), Sheela-Cheshta (habits, psychomotor functions) and Aachara (conduct and behaviour) occurs. Etiopathogenesis of Unmada along with Chikitsa Sutra are mentioned. Aagantuja Unmada and Graha Aavesha are also mentioned in this chapter.

Chapter 8 - Apasmara Nidana[26]

Apasmara is a condition where complete loss of consciousness is found. Etiopathogenesis of Apasmara with Chikitsa Sutra are described in this chapter. Nidanathakara Roga are also explained as one Roga act as a Hetu for another Roga. Some examples are origin of Raktapitta due to Santapa of Jwara, origin of Shosha due to Jwara and Raktapitta, origin of Udara Roga due to Pleeha Vriddhi, origin of Udara Roga and Gulma due to Arsha. Another important principle is also mentioned as one Hetu is responsible for one Roga or various Rogas and one disease can be comprised of one Hetu or various Hetus.

Conclusion

As the name suggests, the Charaka Nidana Sthana mainly emphasize on the Nidana (Vyadhi Janaka and Vyadhi Bodhaka) and Nidanapanchaka of 8 diseases both on the basis of mythological historical facts and also clinical examinations. These Nidanapanchaka are the overall framework of clinical examination and diagnosis. After diagnosing a disease, correct treatment can be provided. Not only these 8 diseases, any disease can be diagnosed and treated if we find the Nidanapanchaka. Also, the first line of treatment is Nidana Parivarjana. Nidana Parivarjana not only stops the progression of disease but also cure some minor disbalances in Dosha and Dhaatu.


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If the cause is removed, then half the treatment is done. This stops the progression of disease as well as helps the host to return to the normal state.

The focus of current health care system is more on disease management after its complete manifestation, while Ayurveda emphasizes on identification of abnormality at an early stage to prevent its further progression.

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