Disease subtype, cause, manifestation & symptoms and their significance

Ayurveda for a healthy life ! – 39/2024 will be on 1.11.2024

How can we differentiate between stage of a disease and a complication ? When a disease progresses, new clinical manifestations are encountered depending on the stage of the disease example in small pox one gets stages of papules, vesicles, pustules and scab formation. Similarly, in many diseases, we get Saama avastha followed by Niraama avastha. Though the clinical manifestations may vary from stage to stage, the site of the disease remains the same in all the stages. On the other hand, in complications the disease affects a site different from the original site of the disease. Sometimes the complication may occur at the same site as the original disease. However, the character of the lesion and manifestations are quite different from those described under various stages of the same disease example development of secondary infection in the form of boils and abscess in a case of scabies.

संप्राप्तिः

संख्याविकल्पप्राधान्यबलकालविशेषतः । – मा. नि.

Apart from these stages, pathogenesis is also described under Sankhya, Vikalpa, Pradhanya, Bala and Kala.

1.    Sankhya samprapti : Each disease is classified into different sub-types, example Jwara that is fever is classified into 8 varieties, Kasa that is cough is classified into 5 sub-types. It is important to know exact number that is varieties of disease entity so that one can get complete idea of the disease process.

2.    Vikalpa samprapti : It is not enough to know which dosha is affected. It is important that the physician takes into consideration the degree to which each dosha is increased, decreased or vitiated. This concept of the extent to which each dosha is increased, decreased or vitiated, the exact & relative state of each dosha is known as Vikalpa samprapti.

3.    Pradhana samprapti : In a particular disease, many causative factors may be at work and may give rise to the disease in different ways. It is important to know Pradhana that is the most important cause and the most important mechanism of the development of the disease.

4.    Bala samprapti : It is important to know Bala that is how powerful or strong are the causative factors, doshas, premonitory symptoms, clinical manifestations etc.

5.    Kala samprapti : The relation of time of the day, night as well as the season of onset, aggravation and relief of the disease is termed as kala samprapti and gives important clue to the causative dosha.

Rogalakshanani Tesham Mahatvam Cha (Symptoms and their significance)

Every symptom arises because of 1. Imbalance of doshas, that is vata, pitta and kapha 2. Increased, decreased or vitiated state of various tissues or organs 3. Increased, decreased or vitiated quantity or quality of waste products.

Symptoms indicate the type of disturbance in the body and give us guidelines about the treatment. Often the symptom while giving a signal of ill health to the patient, also gives clue to the physician to act appropriately and correct the disturbance of doshas, tissues and waste products and restore health. Some of the symptoms, their interpretation and significance is given below.

1.     Fever

Fever indicates presence of toxins, pyrogens and vitiated doshas in the body fluids and blood circulation. During fever, activity of various tissue enzymes increase, which leads to rapid digestion of pyrogens or toxins by various cells in the body fluids.

High body temperature by itself will denature or detoxify the various toxins, which give rise to fever. In addition, the increased activity of various tissues and cellular enzymes, particularly in the white cells, macrophages and reticuloendothelial cells help to digest the various toxins and pyrogens. The digestive enzymes & appetite are decreased in fever. This helps by cutting down the food intake and further formation of Aama or toxins. Fever will persist till all the toxins or germs are digested, killed or thrown away from the body. We boil milk and water to destroy the germs. Nature raises body temperature to destroy germs, or denature toxins or Aama that give rise to fever. Thus fever, like a true friend will not leave the body till the last germ is killed or the body is free from all the toxins.

A.    Doshas and fever :The character of the fever gives us an idea about the dosha which is affected. Irregular fever, high fever & mild fever indicate increase in vata, pitta and kapha doshas respectively.

B.    Tissues and fever :The following table gives us the important symptoms seen when a particular tissue is affected by toxins.

Sr No.	Tissue affected by toxins of fever	Symptoms
1.	Rasa	Anorexia, vomiting
2.	Rakta	Burning sensation and skin eruptions
3.	Muscular tissue	Excessive perspiration
4.	Bony tissue	Pain in the bones
5.	Nervous Tissue	Loss of consciousness

Cramps in the calf muscles indicate that the toxins of fever have entered the muscular tissue and are being digested by the enzymes in the muscles. Thus one gets lot of information about the affected doshas and tissues by studying the character of fever and its associated symptoms.

Temperature curves and associated symptoms also give guidelines about the stage of the disease and its prognosis. Thus, fever is a friend of the patient, as it itself acts as a therapeutic agent. Fever is also a friend of physician, as it gives the physician important guidelines about the stage of disease, doshas and tissues affected, which help him to treat the patient with appropriate measures.

2.     Atisara

Diarrhoea that is increased frequency of stools having liquid consistency is a symptom of intestinal dysfunction. Diarrhoea occurs because of increased peristalsis of intestines, inflammation of the intestines and indigestion of food because
of weak digestive power. Diarrhoea helps the patient by getting rid of undigested food matter and toxins from the intestines.

Character of the stools gives us indication of the affected doshas example reddish and foamy stool with colicky pain is seen in vataja diarrhoea. Watery, yellowish or reddish stools with thirst and burning sensation indicates pittaja diarrhoea. Whitish, sticky and foul-smelling stools indicate kaphaja diarrhoea.

During early or Aama stage, the stools are sticky, foul smelling and heavy that is they sink in water. Physician should not attempt to stop diarrhoea during this stage, as toxins retained in the intestines can give rise to distension of abdomen, paralytic ileus and if absorbed into circulation may give rise to toxaemia.

Similarly cough and vomiting help the body to get rid of toxins, bacteria etc. from the lungs and stomach.