Chapter 4: Roganutpadaniya

Preventive Healthcare The fourth chapter of Astanga Hridaya is called as Roganutpadaniya Adhyaya – Preventive healthcare tips. it explains the method of adjusting the body to the natural signs so as to avoid toxic material accumulation and onset of disease process.

Meaning of the chapter name: Roganutpadaneeya = Roga + Anutpadaneeya Roga means disease Utpadana means production. Anutpadana means prevention of production. So, Roga Anutpadaneeya means – prevention of onset of disease. This chapter deals with preventive healthcare.

अधारणीय वे ग Adharaneeya Vega – Natural urges that should not be suppressed वेगा न धारये वात व मु

वत ृ

ुधाम ्

न ाकास म वासज ृ भा ु छ रे तसाम ् 1

One should not suppress these natural urges 1. Adhovata – flatus (fart) 2. Vit – faeces 3. Mutra – urine 4. Kshavatu – sneeze 5. Trut – thirst 6. Kshudha – hunger 7. Nidra – sleep 8. Kasa – cough 9. Shramashvasa – breathing on exertion 10. Jrumbha – Yawning 11. Ashru – tears, weeping 12. Chardi – vomiting 13. Retas – semen All these natural urges should not be suppressed by force.

अधोवातरोध Adhovata abrodha – adverse effects of suppressing flatus – अधोवात य रोधेन

ग ु मोदावत

वातमू श ु स ग

लमाः

यि नवध ु गदाः 2

By suppression of the urge of flatus (farting), on a continuous basis, one becomes prone to abdominal bloating, tumor, Udavarta – bloating, gaseous distension of abdomen Ruk – abdominal pain Klama – tiredness, exhaustion without doing anything blockage of flatus, constipation and difficulty in urination loss of vision and loss of digestive power diseases related to upper part of stomach and heart This is because – the Vata gets obstructed in intestine by avoiding farting. At intestines and rectum, natural movement of Vata is downward. But because of suppression of flatus, Vata moves in upward direction and causes all these problems. Most of the problems explained are due to Vata imbalance. परु ष रोध Bad effects of suppressing urge to defecate – Shakrut Nirodhaja Roga – शकृतः

प डीको वे ट

त याय

पर कत

मुखेन व

व ृि त च

दय योपरोधनम ्

ऊ ववायुः

पूव ता च

शरो जः आमयाः

म ृताः 3-4

Pindikodveshta – twisting pain of calf muscles Pratishyaya – running nose Shiroruja – headache Urdhvavayu – upward movement of Vata, Parikarta – anal itching sensation Hrudayasya Uparodhana – stiffening feeling in chest region Mukhena Vit pravrutti – foul breath, feces vomiting.

Bad Effects due to Suppression of urination: अ गभ गा मर बि तमे वं णवे दनाः मू

य रोधा पूव

च

ायो रोगाः

Angabhanga – body pain, Ashmari – Urinary calculi Pain in penis and bladder region. Diseases that are mentioned in flatus and faeces may also occur in this condition.

Treatment for suppression of flatus, feces and urine – तदौषधं व त अ य ग अवगाह च अ नपानं च व

भे द

व

वेदनं बि तकम च

रोधो थेषु य मसु

To treat the diseases arising from suppression of flatus, feces and urine, the following should be given. Varti – Rectal and urethral suppositories Abhyanga – Oil massage Avagaha – tub bath, sitz bath Svedana – sweating therapy, sudation therapy Bastikarma – rectal enema Annapaanam ca vidbhedhi – all food that help to induce purgation should be administered.

Treatment of diseases due to suppression of urination urge – मू जेषु त ु

पाने च

ा भ तं श यते घ ृतम ्

६

तम ् धारणा पुन :

७

जीणाि तकं चो तमया मा या योजना वयम ् अवपीडकमे त च सं

In diseases caused by suppression of urine, drinking of ghee before lunch is idea. Drinking ghee in the maximum dose at the end of digestion of meal of both the midday and the night is also advised. Such a process of drinking high doses of ghee is called as Avapidaka Sneha.

Suppression of belching: उ गार या चः क पो वब धो

दयोरसोः

आ मानकास ह मा च ह माव त

भेषजम ् ८

Suppression of belching may cause Aruchi – Anorexia, lack of interest in taking food Kampa – tremors Vibandha – constipation Hrudayo Raso – stiffening sensation in chest region Adhmana – bloating, gaseous distension of abdomen Kasa – cough, cold Hidhma – hiccup The treatment for this is similar to treatment for suppression of hiccups.

Suppression of sneezing: शरोत ि

यदौब यम या तंभा दतं

ुतेः

Suppression of sneezing may cause – Shiro Arti – headache Indriya Daurbalya – weakness of sense organs Manyasthamba – Neck stiffness Ardita – Facial palsy

Treatment: ती णधूमा जना ाणनावनाक वलोकनैः वतय

ु त ं स तां

नेह वे दौ च शीलयेत ्

Teekshna Dhooma – powerful herbal smoking, Anjana – Collyrium Navana – Snuffing Arkavilokana – seeing Sun directly for a few seconds Massage, Oleation and sudation therapies are also mentioned as treatment. All these are done to induce sneezing and to regularize Vata movement.

Suppression of thirst – शोषा ग साद बा धय स मोह

म

त ृ णाया न हात ् त

व ध हतः १०

शीतः सव

गदाः

Suppression of thirst causes Shosha – Emaciation Angasada – debility, weakness Badhirya – deafness Sammoha – loss of consciousness, delusion Bhrama – delusion Hrut Gada – cardiac disorder

Treatment: त

शीतः सव

व ध हतः १०

All procedures that are cooling in nature – like cold water drinking, cold water bath etc is recommended.

Suppression of hunger: अ गभ ग अ च

ला न का य शूल

माः

ुधः ११

Angabhanga – bodyache, myalgia Aruchi – Anorexia, lack of interest in taking food Glani – debility Karshya – emaciation, weight loss Shoola – abdominal colic pain Bhrama – delusion

Treatment: त यो यं

लघु ि न धं उ णं अ पं च भोजनम ्

Light meals, with oily substance (such as ghee), which is hot/warm in nature. Note: Fasting causes decrease in digestion power and increase in Vata. If you take a large meal after fasting for long, then it will further decrease digestion power. Hence a light meal is advised. Oily substance such as ghee soothes gastric mucosa. Hot/warm food helps to maintain Agni (digestion power).

Suppression of sleep: न ाया मोह मूधा

अ गमद च

त

गौरवाल य इ टः

जिृ भकाः

व नः संवाहना न च १२

Suppression of sleep causes Moha – delusion Murdha Akshi Gourava – heaviness of head and eyes Alasya – laziness, lassitude Jrumbhika – yawning Angabhanga – bodyache, myalgia Treatment: त

इ टः

व नः संवाहना न च Sleep and massage.

Suppression of cough: कास य रोधात ् त व ृ ः वासा च शोषो ह मा च, काय अ

दामयाः १३

कासहासुतरां व धः

By suppressing cough, it further increases. It further may lead to Shvasa – Asthma, COPD, wheezing, breathing difficulty Aruchi – Anorexia, lack of interest in taking food Hrudamaya – cardiac disorder Shosha – Emaciation Hidhma – hiccup Treatment – काय अ कासहासुतरां व धः All treatment which relieves cough (Regular treatment to cough) should be given.

Suppression of breathing on exertion: गु म

ोग स मोहाः

म वासा वधा रतात ् १४

Avoiding heavy breathing after heavy work may lead to Gulma – Abdominal tumor, bloating Hrudroga- Cardiac disorder Sammoha – loss of consciousness, delusion

Treatment: हतं व मणं त

वात न च

या मः

Vishrama – rest Vata balancing treatment.

Suppression of yawning: ज ृ भायाः

वव ोगाः सव चा नलिज व धः १५

The suppression of yawning produces similar symptoms to that of suppression of sneezing. Here, Vata balancing activities/treatment should be taken up.

Suppression of tears पीनसा

शरो द

म या तंभा च माः

सग ु मा बा पतः त

व नो म यं

याः कथाः १६

Suppression of tears causes Peenasa – running nose, rhinitis Akshi Roga – eye disorders Hridrik – heart diseases associated with pain Manyasthamba – Neck stiffness

Aruchi – Anorexia, lack of interest in taking food Bhrama – delusion Gulma – Abdominal tumor, bloating Treatment: sleep, alcohol and sweet talk with friends and family.

Suppression of vomiting: वसपकोठकु ठ अ

सकास वास

क डूपा

वामय वराः

लास य ग वयथवो

वमेः १७

Suppression of vomiting causes Visarpa – Herpes, spreading skin disease Kotha – allergic skin rashes Kushta – skin diseases Akshi Roga – eye disorders Kandu – itching sensation Pandu – Anemia, intial stages of liver diseases Jvara – fever Kasa – cough, cold Shwasa – Asthma, COPD, wheezing, breathing difficulty Hrullasa – nausea – vomiting sensation Vyanga – Pigmented patches on face Shvayathu – oedema, inflammation Treatment: ग डूषधुमानाहारा यायामः

ु तर

ं भु

वा तद ु वमः

य श तं चा

वरे चनम ् १८

स ारलवणं तैलम य गाथ च श यते Gandusha – gargling Dhumapana – herbal smoke Rooksha aahara Vamana – eating dry food and inducing vomiting Vyayama – exercise Asra Sruti – Blood letting (in case of skin diseases) Virechana – purgation type of Panchakarma treatment. Note: Suppression of vomiting causes Pitta imbalance. Hence most of the treatment above is targeted to balance or eliminate Pitta.

Suppression of Semen ejaculation: शु ा त ह

वणं ग ु यवेदना वयथु वराः १९

यथामू स गा गभ गव ृ

य मष ढताः

Suppression of ejaculation causes Sravana – oozing of semen Guhya Vedana – pain in groin Shvayathu – oedema, inflammation Jvara – fever Hrid Vyatha – cardiac pain, distress Mutrasanga – Obstruction to the flow of urine and difficulty Angabhanga – bodyache, myalgia Vruddhi – Hernia Ashma – stone formation Shandata – Impotency

Treatment: ता चूडसुराशा लब

बि तशु

य य ग अवगाहनम ् २०

करैः स ं भजे

ीरं

याः ि

यः

Tamrachuda – chicken, Sura – beer, alcohol Shali – rice Basti abhyanga – massage to the lower abdomen Avagaha – immersion bath with oil Bastishuddhi – cleansing of urinary bladder with enema Ksheera – treatment with milk processed with herbs Priya Striyaha – copulation Whom should not be given treatment? त ृ शूलात यजेत ्

ीणं व वमं वेगरो धनम ्

Who have intense pain and thirst, those who are habituated to suppression of urges – because the Vata and other Doshas will frequently get vitiated due to undesired activity and treatment will not be successful. Ksheena – who are severely emaciated, Those who vomit faeces – condition has gone out of control

Root cause for all diseases रोगाः सव अ प जाय ते वे गोद रणधारणैः न द टं साधनं त तत चाने कधा

भू य ठं ये तु तान ्

ायः पवना य

अ नपानौषधं त य यु जीतातो

त २२

कु य त

अनल ु ोमनम ् २३

All diseases are caused due to Vegodeerana – initiation of urges forcefully Vegadhaarana – Suppression of naturally initiated urges. For those common diseases arising from these acts, specific treatments have been counted so far. By disturbing the nature, it is Vata that is mainly vitiated. Hence the symptoms arising from suppression of natural urges could be treatment with food and treatment which clear the passages of Vata and help in restoring Vata’s natural movement direction. धारणीय वे गा: – Urges that should be suppressed – धारये तु सदा वे गान ् हतैषी

य चेह च

लोभ ई या वेषमा सयरागाद नां िजतेि

यः २४

The urges that should be suppressed forcefully are – Lobha – greed Irshya – envy Dvesha – hatredness Matsarya – jealous Raga – unlawful, excessive attraction

Shodhana –Panchakarma – purification procedure – timing यतेत ् च यथा कालं मलानां शोधनं

त अ यथ सि चता ते ह

ु ाः

युज वति छदः

One must exercise precaution to clear out Doshas and waste products at suitable times. Accumulation of such toxins could lead to their aggravation and subsequently even death may occur due to this.

Effectiveness of Shodhana – (Panchakarma treatment) दोषाः कदा च कु यि त िजता ल घन पाचनैः ये तु संशोधनैः शु ा न तेषां पन ु

वः २६

The Doshas that are balanced out by Langhana (fasting etc) and Pachana (digestion promoting) therapies may sometime get re-aggravated soon. However, Doshas that have been eliminated out with Shodhna (Panchakarma) therapy will never get re-aggravated.

यथा मं यथायोगमत ऊ व

योजये त ्

रसायना न स ा न व ृ ययोगां च काल वत ् After proper Panchakarma procedure at suitable times, rejuvenation treatment (Rasayana therapy) should be taken up, with suitable tonics and aphrodisiacs.

Treatment for those who undergo Panchakarma treatment and who feel tired: भेषज

पते प यमाहारै ब ृहणं

मात ्

शा लषि टकगोधम ू मु गमांसघत ृ ा द भः यद पनभे ष य संयोगा ु चपि तदैः

सा य गो वतन नान न ह ने हनि त भः Bruhmana Ahara – nourishing eatables such as Shashtika Shali – rice that mature in 60 days Godhuma – wheat Mudga – green gram Mamsa – meat Ghrita – ghee Medicine with Hrudya (cardiac tonic) and Deepana (digestive, carminative) qualities should be mixed with food and taken. Abhyanga – oil massage Udvartana – powder massage Snana – herbal bath Niruha Basti –enema treatment Snehabasti – oil / ghee enema treatment All these help to restore health of the debilitated. तथा स लभते शम सवपावक पाटवम ् धीवणि

य वैम यं वष ु ः ृ तां दै यमायष

By these measures, one could gain health, happiness, good intelligence, clarity of vision, strong sense organs, intelligence, sexual vigour and longevity.

आग तुज रोगा: – Traumatic diseases / caused by external factors ये भूत वषवा वि न तभ गा दसंभवाः

राग वेषमया या च ते

युराग तवो गदाः

Those disease produced by bhuta (evil spirits, bacteria, parasites, insects and such microbes),

visha (poisons) air (hurricane, cyclone), agni (fire, electricity, radiation etc) kshata (injury, wounds etc), bhanga (fracture of bones) etc., as also those due to raga (desire, lust), dvesa (hatred), bhaya (fear) etc. are all know as Agantu diseases arising from external causes)

Sarvaroga samanya cikitsa- (general treatment for all diseases):यागः

ापराधाना मि

दे शकाला म व ानं स अथव व हता शाि तः

योपशमः

म ृ तः

ु त यानुवतनम ् ३२

तकूल हाचनम ्

भूता य पश न द ट च प ृथ क् प ृथक् ३३

अनु प तयै समासेन व धरे षः

द शतः

नजाग त ु वकाराणा मु प नानां च शा तये ३४

Avoidance of improper activities of body, mind and speech by willful transgression of rules, Control of the senses, remembering previous experiences and acting rightly, good knowledge of the habitat, season and the self, adherence to rules of good conduct and rituals Peaceful procedures as mentioned in Atharva Veda, Worship of celestial powers – Grahashanti (astronomical palliative procedures) Staying away from Bhuta (evil spirits, microbes) Respective treatment followed as per the principles explained above, are the general guidelines to treat all types of diseases.

शोधन समय – Time for Panchakarma treatment शीतो

वं दोषचयं

वस ते वशोधयन ्

घना यये वा षकमाशु

स यक्

ी मजं अ काले

ा नो त रोगान ् ऋतुजा न जातु ३५

The accumulated Doshas arising from winter should be expelled during Vasanta (spring) That arising from Summer (Greeshma) should be expelled during Abhrakala – Varsha Ritu – rainy season. That arising from rainy season should be expelled during Ghnatyaya (Sharad – Autumn season) By this, people will not become victims of diseases born by the effect of the seasons.

अरो य हे तव: – Secret of good health न यं हताहार वहारसेवी समी यकार दाता समः स यपरः

वषये वस तः

मावाना तोपसेवी च भव यरोगः

He , who indulges daily in healthy foods and activities, who discriminates the good and bad of everything and then acts wisely, who is not attached too much to the objects of the senses, who develops the habit of charity, of considering all as equal, of truthfulness, of pardoning and keeping company of good persons only, becomes free from all diseases.

Thus ends the chapter called Roganutpadaniya, the fourth in Sutrasthana of Astangahrdaya samhita of srimad Vagdhata son of Sri Vaidyapati Simhagupta.