Vikriti PRG

8/7/2019 Vikriti PRG

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Vaidya Pawankumar GodatwarNational Institute of yurveda

Jaipur


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What do you see?


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Adults who are aware of love andintimacy see the couple embracingYoung children only see the 9 dolphinsOur previous learning changes the way we view the world


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Re-learning the Ancient Perspective:

filled with Air

filled with Water

yurvedically Speaking- the glassis always full!


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Panchamahabhuta Biologicalapplications of

Panchamahabhuta

VAYU

AKASHA

TEJA

JALA

PRITHVI

VATA(Motional energy)

PITTA(Chemical activities)

KAPHA(Solid substratum)

Unity of Man and Universe


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BASIC CAUSE OF DISEASE

LACK OF HARMONY Between

ENVIRONMENT (Loka) & MAN (Purusha)Due to Ayoga ( Absence ), Atiyoga ( Excess ) or Mithyayoga ( Abuse ) Kaala

(Time factor and its chronological influence ), Buddhi ( Intellect of man is the major source of thought information and its

consequences ) & Indriyartha (Objects of the Senses are the majorhubs of information exchanges )

Art work by Dr.DLynnWaldron.


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Vikriti the reason for yurvedvatarana

(Origin of yurveda ):Vikriti (disease) asopposed to Prakriti(health) led to the firstinternational conferencein history of mankindGreat sages from all overthe extant ancient worldgot together to find curefor the newly evolvingdiseases.If there was noill-health, therewould have been noneed for the pursuitof yurveda .


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Arogya (health) implies till not afflicted by diseaseSwastha (healthy) is etymologically derived from theterm niroga which also means not afflicted by disease.

- Chakrapani on Charaka Su.1/67


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Concept of Vikriti:Indian thoughtcontemplates Vikriti invarious ways-Sanskrit - Change ,alteration, modification,illness, indisposition aswell as changed conditionof mind and body.


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yurveda defines Vikriti as-The Derangement of Dhatus or body elements(whereas the equipoise of dhatus is health)

At metaphysical level, Health is Sukha (pleasure)while Vikara or disease is Duhkha (sorrow) (Ca. Su. 9/4).


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At more practical levels-

Vikriti is defined as a Morbid State of Doshas .Avikriti and Vikriti are the two states of Doshas inour body

(Hemadri on Ashtanga Hridaya Su. 1/7)


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Avikriti is the equipoise of doshasmanifesting as normal functioning of themind body complex


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Vikriti is the

imbalance of these factorswhich causes

disturbance innormalfunctioningresulting indisease


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According to Arunadatta - the normal functioning of Doshas is lost inVikriti

Daspandita states that vikriti is a deviation from the normal toabnormal state.Chakrapani defines Vikara as an imbalance of DHTUS (the Doshas ,Saptadhatus and Upadhatus)

Any deviation from equipoise, be it deficiency or excess or vitiation isdeemed as Vikara .


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Scope and Clinical Applications:Understanding the basic concept of Vikriti asvarious Imbalances of DHATUS leads to furtherclinically significant aspects.


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A wise physician should clearly observe the subtleties of aggravated , normal and diminished states of the doshas and disease along with the conditions of Bala (immune profile),Agni (Digestion and metabolism) and Sattva (mental status)and only after a thorough understanding of thesesubtle states should a good physician set up a treatmentprotocol


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Aahaara ( Diet ),Nidra ( Sleep )Brahmacharya

(RegulatedSexual Activity )Are the 3 pillars of Healthif any of the pillar

crumblesDiseases arecaused..


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Shat Kriykla : ( Six stages of aggravation /vitiation of Doshas and diseases meriting intervention)

1. Sanchaya (Accumulation of Doshas in own abode)2. Prakopa (Aggravation of Doshas but contained in

own abode)3. Prasara (spread of the Aggravated Doshas to other

areas)4. Sthana Sanshraya (Localization of Doshas in

conducive places- Dosha Dushya Sammurchana~amalgamation of Dosha and Dushya )

5. Vyakti (Manifestation of disease)6. Bheda (Complications of disease)


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Vta Pitta Kapha

Shishira Vasanta Grishma Varsha Sharad Hemanta


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Sanchaya (Accumulation of Doshas in own abode)

The doshas tend to collectlocally depending on theaetiological factors-For example:

Dietetic indiscretion,Excessive activity andBreathing moist airresult in accumulation of doshas in gastro-intestinaltract, muscles and lungsrespectively.


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Clinical Manifestations :Fullness of stomach in Vata chaya,Yellowish discoloration of skin in Pitta chaya and

Weak digestive power, heaviness of body andlaziness in Kapha chaya.

In addition, one develops aversion to theaetiological factor


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ACCUMULATION OF DOSHAS IN

EXCESS (PRAKOPA STAGE)Clinical Manifestation : Pain inabdomen and awareness of movements of gases in abdomenoccur in Vata prakopa.Pitta prakopa gives rise to thirst,regurgitation with sour taste andburning sensation.Nausea and disgust for food arethe symptoms of Kapha prakopa.In addition, one develops adesire for factors and substanceshaving properties Opposite tothe causative agents.


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Treatmen t: consists of administering substances

having properties opposite to those of aetiologicalfactors.


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The dissemination of the doshas

(Prasara stage)Prasara is compared to the over flow from a vesselfull of f lour (rising of dough), which is undergoingfermentation.


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Treatment : The treatment consists of neutralising theincreased or vitiated doshas by all possible means.

Till this stage, the body tissues or organs are notinvolved and the treatment is directed towardsnormalisation of affected dosha or doshas.


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LOCALISATION OFDOSHAS(STHANASANSHRAYA

STAGE)This is a stage of localisationof disseminated doshas in aparticular site or stage of prodromal symptoms.

The disseminated doshas getlocalised in a tissue or organwhose defence mechanism isweak.The poor local defencemechanism may be geneticor acquired.The aquired cause may bedietetic, environmental,traumatic or sequelae of previous illness, etc.


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Though in the disseminated stage of prasara, thedoshas are present all over the body, theirconcentration in any tissue or organ is not much.In addition, the doshas in prasara stage, though insuperficial contact, do not enter or affect the

individual cells of any organ.On the other hand, in the stage of Sthanasanshraya, the concentration of doshas in aparticular organ is much more.During this stage, the doshas enter the individualcells of the tissue or organ and cause theirdysfunction.


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Interaction of Dosha & DushyaPrakriti Sama Samavaya (Natural & Predictable)

Vikriti Vishama Samaveta (Unnatural andunpredictable)


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Prakriti Sama Samavaya

(Natural & Predictable)


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Vikriti Vishama Samaveta

(Unnatural and unpredictable)

Hydrogen is highly combustible in air. It

burned rapidly inthe Hindenburg disasteron May 6, 1937.

Oxygen isessential forcombustion.


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Dosha Dushya SammurchanaClinical Manifestation : During the stage of chaya,prakopa and prasara, the manifestations are non-specific and are related to the increased or vitiateddosha.In the stage of sthanasanshraya one gets premonitory or prodromal symptoms of a disease which depend onaffection of the involved organ or tissue as well asthe causative dosha .


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Vyakti (Manifestation)When the causative doshasaccumulate in excess and causesignificant damage to the tissues

or organ, the disease manifestsThe classical symptoms andsigns of the disease now becomeapparentThe clinical manifestationdepends on the organ involvedas well as the causative doshaThey are described underindividual diseases


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Nidana Panchaka ( Five diagnostic criteriaunder which a disease ought to be assessed)

1. Nidana (causative factors)2. Purvarupa (Prodromal Signs and Symptoms)3. Rupa (Signs and Symptoms)4. Upashaya (pacifying/aggravating factors)5. Samprapti (Etio-pathogenesis)


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Nidana (causative factors)

Etiological factors have been classified in differentforms by different yurvedicauthorities or Acaryas.Mainly fourteen types have been described under fivedifferent categories.


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Category I1. Asatmyendriyartha samyoga

(Abuse of Senses)2. Prajnyaparadha (Indiscretions)

3. Parinama (Time)Category II4. Sannikrista (Precipitating cause)5. Viprakrishta (Causes of a longer

duration)6. Vyabhichari (feeble)7. Pradhanika (Very strong)

Category III8. Doshahetu (Dosha Vitiating)9. Vyadhihetu (Disease Causing)10. Ubhayahetu (Both together)

Category IV 11. Utpadakahetu12. Vyanjakahetu

Category V 13. Bahyahetu (External)14. Abhyanatarahetu (Internal)


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Upashaya(pacifying /aggravating

factors):Modalities of Treatment-Anna, Vihara,Aushadha


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Roga Bhavas: Management Criteria by which a diseaseought to be classified, studied and therapeutic protocols setup

1. Prakopanam - the primary reason for ultimate vitiation of Doshas .

2. Yonim - Dosha profile3. Utthanam - Natural Course of the

disease4. Atmanam - Defining Signs and

Symptoms (Definitions)5. Adhishthanam - Main sites for the

affliction6. Vedanam - Signs & Symptoms7. Samsthanam - Manifestations of

Systemic involvement8. Shabda , Sparsha , Rupa , Rasa ,

Gandham - Signs & Symptoms Acc.to senses

9. Upadravam - Complications10. Vriddhi - Exacerbating

factors11. Sthana - Factors

maintaining Status Quo.12. Kshaya - Factors reducing

the etiopathology 13. Udarkam - Prognosis14. Namam - Nomenclature

15. Yogam - Drugs16. Pratikarartha Pravritti

Therapeutic measures17. Pratikarartha Nivritti

Contraindications and

Preventive Measures.


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Conclusions:

The guiding principle behind the understanding andmanagement of any Vikriti be it newly evolved diseasessuch as AIDS not mentioned by name in yurvedicclassicsis the principle of vikriti genesis as Acharyas state:A physician should never feel shy for not knowing the

nomenclature of a particular disease, because it is a certaintythat not each and every disease has a name. The very sameDosha, depending upon the nature of the causative factors,travels to various parts of the body and produces variousdiseases. (Ca. Su. 18/46; A. H. Su 12/64-66 ).


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To understand the intricaciesimplied in the term Vikriti incontext of health and disease, itwill be worthwhile to rememberthe paradoxical perspective of Bhagavan Vyasa when heequates-Prakriti is deathVikriti is life


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We have to take note not onlyof the opinions that won or allegedly won- in the debatesbut also of the other points of view that were presented and recorded or remembered.An argument that refuses to beobliterated can remain very

alive

Nobel laureate Amartya Sen(in The Argumentative Indian, page 6, Penguin books, 2005 )


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Vikriti PRG