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Nature of Diseases

The Ayurvedic approach to the problems of health and disease is synthetic and comprehensive. Ayurveda as the science of life has a dual aim, firstly the preservation of health in the healthy human being and prolongation of a happy life, secondly the treatment and cure of disease when it arises. The latter was not the sole purpose of medicine. To gain a clearer conception of what this implies, it is necessary to refer to the Ayurvedic view that what we call the individual is a complex entity. Following the Sankhya this complex was thought to consist of Atman, mind and the body – the Tridhatuka purusa. It was compared to a trident of tridanda which is held up be the combined support of three sticks. Ayurveda however differed from Sankhya in believing that the purusa also acquires the three gunas by its contact with prakriti – so that the gunas do not belong to the latter alone.

This is the basis on which Ayurvedic distinetion between different diseases rests. It also shows that there is a lot of overlap between them. Western medicine has come to recognize the importance of psychosomatic or psychophysiological disorders only recently – largely because it derived its philosophical beliefs from the Cartesian dualism. the Ayurvedic approach, on the other hand, has throughout recognized that there can be no such clear cut cleavage between the bodily and the mental disorders since the individual is a whole, an organism in the real sense of the term, all aspects of which are interlinked and interdependent.

Diseases are therefore spoken of as of three main kinks, endogenous, exogenous and psychic. Of these the endogenous disease is that arising from the discordance of the bodily humors, and the exogenous from such external factors as accidents, fire, winds, injuries and the like. The psychic disorders arise from the gain of underlies and the like. The psychic disorders arise from the gain of undesired as well as desired things i.e. from conative impulses taking wrong direction. The same idea is brought out in Chapter XXV of Sutra Sthana where there is mention of a seminar discussion between many sages. Disease does not arise from the spirit alone, nor from the mind (the view of Saraloma). Vrayovida on the other hand emphasizes that the mind by itself cannot be the cause of anything. Without the body there cannot be any disease of the body, nor, for that matter, the mind’s very existence. Atreya finally clinched the argument by saying that the very elements whose wholesome combination gives rise to the well being of man bring about, in their unwholesome combination, various kinds of disease.

Vagbhata classified diseases into two kinds (1) Bodily which had their source in the derangement of three dosas, vata, pitta and kapha: (2) Mansika, which were related to the sattva guna and rajas and tamas dosas. But as already emphasized, the latter were manifested in bodily symptoms, there being no unbridged chasm between mind and body. Hence such disorders were really manodaihle, or psychosomatic. Of these the main ones considered were; unmade (insanity – psychoses proper), Apasmara (Epilepsy), Apatantraka (Hysteria), Bhrama (Giddiness) and Murchha (Unconsclousness).

To understand the various modes of treatment prescribed, it is necessary to refer to the four fold basic factors of therapeusis. In Chapter X of Sutra Sthana, Maitreya makes an interesting observation, reminiseent of a present day controversy about the utility of psycho therapy. Just as some scholars like Eysenck question whether psychotherapy is of any avail, Maitreya raises the point that of persons who get similar treatment in similar circumstances, some are cured, whereas others die. Conversely, we see others, devoid of means, treated by unskilled physicians, regaining health, and yet others, similarly circumstanced, dying all the same. Treatment is thus like a handful of dust seattered on a flowing river. i.e. treatment is useless – no better than no treatment. 

Atreya rebuts the argument by insisting that not all diseases are amenable to treatment  and of those that are, the cure would not be possible without treatment. This distinction between the curable and the incurable is important. By  suitable means, a competent physician can use drugs and other means to restore the sick to health. The curable diseases are also of two kinds: those that are easily cured, and those cured with difficulty. Similarly, incurable diseases are either palliable or absolutely irremediable.

Of the curable diseases there are again three kinds according to whether they require mild, moderate or strong treatment. The incurable ones, being inexorable, admit of no such classification. Symptoms of each of these are also mentioned. The wise physician should first examine the signs and symptoms of the disease and only then commence treatment of curable ones.

We may add a word about the forms of therapy which were recognized. They are divine therapy, scientific therapy and mind control. Amongst these the first consists of incantations, herbs, gems, ceremonial penitence, fasting and such other things. Scientific therapy consists of the prescription of the line of dietetic regimen and medication. Finally, mind-control consists of restraining the mind from the desire for unwholesome objects.

When the humors in the body have become morbid and provoked, three kinds of therapeutic measures are mainly recommended, namely, internal purification, external purification and operative treatment. There was also emphasis on certain modes of treatment according to the humor disordered e.g. Basti for Vayu, Virechana (purging) for Pitta and Vamana (Emetics) for Kapha. Similarly we use Taila (oil), ghee and madhu for the same, respectively. In addition to these, psychological factors were also given due importance. In a famous sentence reference is made to “intelligence (or understanding or insight), consolation, reassurance and soulful talks.”

A further essential of therapeusis indicated is its four fold basic factors. To make treatment a success all these are important, viz. the physician, the drugs, the attendant and the patient. Each in turn has to possess certain qualifications. The physician must have clear grasp of theoretical knowledge, wide practical experience and skill and purity of body and mind – the tetrad of his desiderata. The drugs should be abundant, applicable, usable in various modes and rich of quality. The nurse should be endowed with knowledge of nursing, skill, affection for the master (i.e. the patient) and cleanliness. Finally, the patient must in turn also fulfill these requirements viz. recollection, obedience to instruction, courage and ability to describe his ailments.

In view of such a comprehensive approach that was made to the field of therapeusis, Lord Dhanvantri very rightly said that there was nothing holier than this art of healing.   

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