DIAGNOSIS OF SKIN DISEASES
Disease is a state of disturbed equilibrium of the doshas, dhatus, agnis and malas. According to Ayurveda all human diseases can be classified into the seven broad categories, namely :
1. Genetic (Adibalapravritta)
The defects in the sperm (sukra) of father or ovum (sonita) of the mother causes genetic problems . When the problem is caused due to the defect in the sperm of father it is known as pitrija and when caused by the defect in ovum it is known as matrija. The defects further leads to various skin diseases, diabetes, asthma, tuberculosis and hemorrhoids.
Undigested food, abnormal behaviour, addiction of any type and stressful situations affect the reproductive elements of both the male and female, resulting in a defective foetus.
2. Congenital (Janmabalapravritta)
• The unfulfilled desires of the mother during pregnancy (dauhrdya) and nutritional disorder (rasakrita) of mother usually result in janmabalapravritta.
If during pregnancy the vata dosha becomes imbalanced, the fetus might suffer from various deformities like kyphosis (hunchback), blindness and dwarfism. The increased pitta might cause alopecia and yellowish pigmentation of skin and aggravated kapha might cause albinism.
3. Constitutional (Doshabalapravritta)
• Arise out of any dietary or behavioural disturbance brought about by an imbalance in any one of the three vital physical energies (Tridoshas) or the three vital mental energies (Trigunas).
• Thus constitutional disorders are of two types : somatic (Sharirika) & psychic (Manasika).
4. Traumatic (Sanghatabalapravritta)
• Any trauma causing internal or external experience results in traumatic disease. External trauma is induced by injuries inflicted by sharp instruments and bites of animals or venomous insects.
• Stress, overstrain and hard work leads to internal trauma.
5. Seasonal (Klabalapravritta)
• Sometimes the body fails to adjust itself to the sudden and abnormal climatic changes – extreme cold might lead to frostbite and rheumatic disease. While extreme heat may cause sunstroke or fever.
6. Infectious and Spiritual (Daivabalapravritta)
These infectious and spiritual diseases can also be contacted through sexual & physical closeness and sharing of food, plates, bed, clothes, towels, cosmetics and other items of private usage with affected persons. These diseases can also be a result of jealousy and negative thoughts occupying ones mind.
These are caused due to various natural calamities like earthquakes, lightening, floods and the invisible, malevolent forces of the nature.
7. Natural (Swabhavbalapravritta)
This is usually caused by functional, organic and natural changes in the body. According to Ayurveda even the healthiest person suffers from natural weakness and diseases like hunger, thirst, sleep, death and weakness with the age.
In Ayurveda, physicians try to assess the symptoms of these diseases as much as the nature of ailment and its root causes (nidana). This is of utmost importance in ensuring correct choice of remedial & preventive measures for treatment of the disease. For otherwise, even after therapy, one might not get the desired response and there would remain a chance of recurrence.
The early signs and symptoms (purvaroopa) provide useful warnings and the opportunity for taking necessary action before a disease can assume dangerous magnitudes. The main signs and symptoms (roopa) reflect the true nature and intensity of the disease. Another oft used method of diagnosis is exploratory therapy(upasaya) which uses diet, medicines and routines to detect diseases otherwise difficult to diagnose. Acting either against the cause of disease or the disease itself or producing relief. For example a swelling that is alleviated by an oily & hot massage, is obviously caused by an imbalance of vata.
The imbalance of doshas causing various types of diseases and the path followed by the doshas to cause disease is known as pathogenesis or samprapti. Since diseases develop in distinct stages, a good knowledge of those helps in early recognition of disease. Thus, making its treatment more effective. Ayurveda thus elaborates a six stage process for diagnosis. The first 4 stages being unique to Ayurveda in that they permit recognition and elimination of the disease before it ventures into differentiated clinical symptoms.
Ayurveda recognizes the six stages of diagnosis process (pathogenesis) known as kriyakal (action time). These six stages are :
• Stage One – Accumulation (sanchaya)
• Poor digestive power and excess of dosha is responsible for such a condition.
• The toxins (ama) produced by improper digestion collects in the gastro-intestinal (GI) tract.
• These Toxins resulting from a kapha imbalance accumulates in the stomach, those associated with a pitta imbalance collects in the small intestine, and that related to vata malfunction amasses in the colon.
• Due to the presence of one of these toxins, mild and ill-defined symptoms may show.
• We should recognize the toxins and proper eliminate the cause through panchakarma procedures instead of ignoring or suppressing it.
• Stage Two - Aggravation (prokapa)
The diet, lifestyle and seasons excite the accumulated and stagnant doshas. The toxins get accumulated and provoke the site of production in the gastrointestinal tract.
• Stage Three – Spread (prasara)
In the third stage the accumulated toxins in the gastro intestinal tract starts overflowing. Up to this stage the use of proper measures can help in achieving the restoration of doshic balance.
Generally, up to this stage the damage is entirely reversible and restoration of doshic balance can be achieved with proper measures. Or there may be spontaneous prashama (remission) influenced by seasonal changes. Thus there is sanchaya of pitta in rainy season, prakopa in fall and prasara in early winter. Based on degree of excitation, it might even passed the stages of prashama or prasara.
• Stage Four – Agumentation (Sthana Samshraya)
The overflowing toxins from the gastrointestinal tract makes their away to the localizes, weak and defective tissues or dhatus thereby leading to malfunction and structural damage damage. It is from here that specific degenerating disease and susceptibilities to serious infections begin.
• Stage Five - Symptom Manifestation (Vyakti)
The affected location starts showing different symptoms and these symptoms are used for classification and diagnosis of the various diseases.
• Stage Six - Complications/Differentiation (bheda)
The disease becomes chronic and it takes long time to reach at this final stage. This stage provides a complete knowledge of the symptoms making the physicians clear of the nature of the disease.
Besides the stages of disease the physicians should also know the complete history of patient. Ayurveda recognizes the closely knotted relationship between describing the pathological process in a person and assessing the state of disease. Ayurveda has evolved a unique simultaneous approach to diagnosis and pathology. This method is known as rogi-roga pariksha. Ayurveda is the only medical system that describes an elaborate strategy for assessing both the patient (rogi) and the disease (roga). For the complete interrogation and physical examination, Ayurveda uses a two-part approach :
• Rogipareeksha – diagnosis of the patient
• Rogapareeksha – diagnosis of the disease
The rogipareeksha is the real strength of Ayurvedic diagnosis. It includes the physician’s judgment regarding the patient’s temperament, discipline, habits, digestive capacity, support system, genetic traits, intelligence and the constitutional type. The rogipareeksha is carried out in different ways. Rogapareeksha is the diagnosis of the disease and it aims towards assessing the nature of the disease. It involves the examination of pulse, tongue, voice, skin, eye, general appearance, urine & stool. The rogapareeksha provides the complete nature of the disease along with general condition of patient.
CURABILITY OF THE DISEASE ACCORDING TO ASHTANG
Samanyaj This disease is caused due to disequilibrium of any one, two or three Doshas refers to samanyaj vyadhi. Like Anemia that can be caused due to the vitiation of either of Vata, Pitta or Kapha Dosha or all of them.
Nanatmaj This disease is caused due to disequilibrium of one particular Dosha. Like grudhrasi(sciatica), Kamala(jaundice), Medorog(obesity) due to vitiation of Vata, Pitta, Kapha Doshas respectively.
Sadhya refers to curable diseases and Asadhya means incurable diseases.
Sadhya is further divided into following two categories :
• Sukhasadhya refers to diseases, which are easily curable within a short span of time.
• Kruchchhasadhya are those diseases, which are curable with difficulty.
• Asadhya is divided into following two categories :
• Yapya Where in treatments or remedies applied afford relief to the patient but within a short span relapse again. So also the patient is relieved when he is on medication but if the medication is stopped the disease relapses. It is controllable only at the time of medication.
• Anukarma irredeemable i.e. remedies applied in no way give relief to the patient
Characteristics of Sukhasadhya diseases :
Diseases that can be cured in a short span are called su-sadhya.
The body of the patient is capable of withstanding all types of therapies.
The patient has control over his sense organs.
The disease has few causes, mild pro-dormal symptoms, mild characteristic features and no complications.
Doshas, dushyas (tissues), desha (regions), kala (season) and prakruti (constitution of body) are dissimilar.
Disease arising from only one dosha, manifesting in one pathway only and is of recent onset.
Characteristics of Kruchchhasadhya :
It requires more than one difficult method of treatment.
It has many incurable (distressing) symptoms.
Takes long time to develop.
It might need surgical and other methods of treatment.
All such diseases are cured, but with difficulty, hence Krcch - sadhya.
Characteristics of yapya :
It is that disease which though is generally opposite (in qualities) of the curable; still persist for remaining period of life.
Giving slight relief by suitable pathya (diet and medicines).
Getting aggravated again by even trivial causes.
Does not get cured without leaving remnants.
Arising from bad actions of the patient.
Continuing long because the person has a certain definite span (duration) of life.
Characteristics of Anukarma :
It falls under the category of incurable diseases.
Has to be rejected because it possesses qualities entirely opposite to curable.
It produces giddiness, delusion, restlessness, and appearance of fatal signs and loss of function of sense organs.
Even curable (sadhya) diseases, if they are in strong combinations, become incurable (asadhya).
Other than this there are diseases, which falls under the category of Agantuj caused due to external factor like poison, accidents, heat stroke, etc. Nijroga caused due to disharmony of the Doshas and lastly Manas (psychiatric disease).