Posted on

Chapter 1 – Pancha Nidana Lakshanam

Invocation

प्रणम्य जगदुत्पत्तिस्थितिसंहारकारणम् |
स्वर्गापवर्गयोर्द्वारं त्रैलोक्यशरणं शिवम् || १ ||

praNamya jagadutpattisthitisaMhArakAraNam |
svargApavargayordvAraM trailokyasharaNaM shivam || 1 ||

After due worship and propitiation to Shiva, who is instrumental for the creation, conservation as well as destruction of the Universe, who is the bestower of heaven and salvation and the protector of all the three worlds. (I have proceeded) 1

नानामुनीनां वचनैरिदानीं समासतः सद्भिषजां नियोगात् |
सोपद्रवारिष्टनिदानलिङ्गोनिबध्यते रोगविनिश्चयो अयम् || २ ||
नानातन्त्रविहीनानां भिषजामलप मेधसाम् |
सुखं विज्ञातुमातङ्कमयमेव भविष्यति || ३ ||

nAnAmunInAM vachanairidAnIM samAsataH sadbhiShajAM niyogAt |
sopadravAriShTanidAnali~Ngonibadhyate rogavinishchayo ayam || 2 ||
nAnAtantravihInAnAM bhiShajAmalapa medhasAm |
sukhaM vij~nAtumAta~Nkamayameva bhaviShyati || 3 ||

I have authored this treatise Roga Vinischaya on the suggestion of honourable physicians. This work contains in brief, the preaching of various sages on the implications, prognosis, genesis, characteristics and features of diseases. I have done so for those practitioners who are poor in intellect and unable to grasp of different texts, this work could be of great help to understand the diseases easily. 2 – 3

 

निदानं पूर्वरुपाणि रुपान्युपशयस्तथा |
संप्राप्तिस्चेति विज्ञानं रोगाणां पञ्चधा स्मृतं || ४ ||

nidAnaM pUrvarupANi rupAnyupashayastathA |
saMprAptischeti vij~nAnaM rogANAM pa~nchadhA smRRitaM || 4 ||

The five means of understanding diseases are as follows:

  • Nidana (origin etiology)
  • Poorvarupa (premonitory features, prodromal features)
  • Upashaya (diagnostics)
  • Samprapti (process of manifestation, the pathogenesis) 4

Nidana  

निम्मित्तहेत्वायतन प्रत्ययोत्थान कारणैः |
निदानमाहुः पर्यायैः –

nimmittahetvAyatana pratyayotthAna kAraNaiH |
nidAnamAhuH paryAyaiH –

Synonyms such as nimitta, hetu, aayatana, pratyaya, utthana and karana are also used for Nidana (generant, etiology) that is also known by these synonyms. (5)

Purvarupa

—- प्रागृपं येन लक्ष्यते || ५ ||
उत्पित्सुरमयो दोष विशेषेणानधिष्तितः |
लिङ्गमव्यक्तमल्पत्वाद् व्याधीनां तद्यथायथम् || ६ ||

—- prAgRRupaM yena lakShyate || 5 ||
utpitsuramayo doSha visheSheNAnadhiShtitaH |
liNgamavyaktamalpatvAd vyAdhInAM tadyathAyatham || 6 ||

The features that manifest before onset of the disease are called prodromal features or pragrupas. They appear before the involvement of the specific doshas. The clinical features could manifest incompletely due to pathogenic process being minimal. It should be taken as the specific prodromal features of the disease in question. 5-6

Rupa (The symptomology)

तदेव व्यत्क्ततां यातं रूपमित्यभिधीयते |
संस्थानंव्यञ्जनंलिङ्गं लक्षणं चिन्हमाकृतिः || ७ ||

tadeva vyatktatAM yAtaM rUpamityabhidhIyate |
saMsthAnaMvyanjanaMliNgaM lakShaNaM chinhamAkRRitiH || 7 ||

The same characteristics and features manifesting latter and clearly so as known as Rupa. It may be roughly translated as the specific features of the diseases. The term sansthana, vyanjana, linga, Lakshana, cinha and aakrti are the other terms through which rupa are known. 7

Upashaya (The positive trial)

हेतुव्याधिविपर्यस्तार्थ कारिणाम |
औषधान्नविहाराणामुपयोगं सुखावहम् || ८ ||
विध्यादुपशयम् व्याधेः स हि सात्म्यमिति स्मृतः |

hetuvyaadhiviprystaarth kaarinaam |
ausdhaannvihaaraanaamupyogan sukhaavhm || 8 ||
vidhyaadupshym vyaadheah s hi saatmymiti smritah ||

The trial with medicines, diet and daily regimen producing specific beneficial effects by acting directly or indirectly against the causative factors, the process of a disease or the disease itself, is known as Upashaya. It is of two varieties (1) Viparita that is opposite of hetu (cause) and vyadhi (disease) or both of them. (2) Viparitarthakaari that is producing the opposite effect though not actually opposite to either the hetu (cause), vyadhi (disease) or both of them. This is also known as Satmya (Compatibility). 8

 

विपरीतो अनुपशयोयाध्य सात्म्याभि संज्ञितः || ९ ||

viprito anupshyoyaadhy saatmyaabhi snjnyitah || 9 ||

The opposite of Upashaya is anupashaya (that increasing the discomfort) or asatmya (incompatible) to the disease. 9

Samprapti (The pathogenesis)

 यथा दुष्टेन दोषेण यथा चानुविसर्पता |
निवृत्तिरामयस्यासौ संप्राप्तिर्जातिरागतिः || १० ||

yathaa dustena dosena yathaa chaanuvisarpataa |
nivrittiraamysyaasau sampraaptirjaatiraagatiah || 10 ||

The samprapti, jaati, or agati are the terms that denote the process of appearance of the disease by the provoked doshas which are circulating all over the body. 10

संख्याविकल्पप्राधान्यबलकालविशेषतः |
सा भिध्यते यथा आत्रैव वक्ष्यते अष्टौ ज्वरा इति || ११ ||
दोषाणां समवेतानां विकल्पों अशांशकल्पना |
स्वातन्त्र्यपरतन्त्र्याभ्यांव्याधेः प्राधान्यमादिशेत् || १२ ||
हेत्वादि कात्स्नर्यावयवैर्बलाबलविशेषणम् |
नक्तन्दिनर्तुभुक्तांशैर्व्याधिकालो यथामलम् || १३ ||

sankhyaavikalppraadhaanybalakaalvishestah |
saa bhidhyte yathaa aatraiv vaksytastau jvraa iti || 11 ||
dosaanaan smvaanaan viklpon ashaanshklpnaa |
svaatntryprtntryaabhyaanvyaadheah praadhaanymaadishet || 12 ||
hetvaadi kaatsnryaavyvairblaablvishesnm |
nktndinrtubhuktaanshairvyaadhikaalo ythaamlm || 13 ||

Sankhyaa, Vikalpa, Pradhanya, bala and Kaala are five varieties involved in the appearance of a disease. The counting of jvaras as eight in number is samkhyaa samprapti. The Vikalpa Samprapti is the term to point out a symptom as arising from a specific property of a particular dosha. The pradhanya samprapti is the term to signify a disease as primary (or secondary). The term bala samprapti is used to qualify a disease as severe or mild depending upon its cause and other factors. The term Kala samprapti is to signify such factors such as night, day, season, time of digestion of eatables, etc. 11-13

इति प्रोक्तो निदानार्थः स व्यासेनोपदेक्ष्यते |

iti prokto nidaanaarthah s vyaasenopdeksyte |

Thus concludes the discussion on Nidana. The related details concerning different diseases could be discussed later.

सर्वेषामेव रोगाणां निदानं कुपिता मलाः ||१४||
तत्प्रकोपस्य तु प्रोक्तं विविधाहितसेवनम् |

srveshaameva rogaaanaam nidaanam kupitaa malaah ||14||
ttprakopsya tu proktam vividhaahitasevanam |

The reason for all diseases is the vitiated doshas. On the other hand, the doshas mainly get provoked through indulgence in different varieties of unhealthy eating practices or activities. 14

निदनार्थकरो रोगो रोगस्याप्युपजायते || १५ ||

nidnaarthkro rogao rogasyaapyupjaayte || 15 ||

Sometimes some diseases acting as etiological agents, might be instrumental in producing other diseases. 15

तद्यथा ज्वर संतापाद्रक्तपित्तमुदिर्यते |
रक्तपित्ताज्ज्वरस्ताभ्यां शोषश्चाप्युपजायते || १६ ||
प्लीहाभिवृद्ध्या जठरं जठराच्छोथ एव च |
अर्शोभ्योजाठरं दुःखं गुल्मश्चाप्युपजायते || १७ ||
(दिवास्वापादिदोषैश्च प्रतिश्यायश्च जायते)
प्रतिश्यायादथोकासः कासात् संजायते क्षयः |
क्षयो रोगस्य हेतुत्वे शोषस्याप्युपजायते || १८ ||

tadyathaa jvra sntaapaadraktpittmudiryate |
raktpittaajjvrstaabhyaan shosshkaapyupjaayte || 16 ||
plihaabhivriddhyaa jthrn jthraakchoth ev k |
arshobhyojaathrn duahkhn gaulmshkaapyupjaayte || 17 ||
(divaasvaapaadidosaishk prtishyaayshk jaayte)
prtishyaayaadthokaasah kaasaat snjaayte ksyah |
ksyo rogasy hetutve shossyaapyupjaayte || 18 ||

The following factors could be cited for example of the above assumptions (that some diseases acting as etiological agents might be instrumental in producing other diseases).

  1. Hemorrhagic disorders may be a sequel of hyper pyrexia
  2. Consumption may be a sequel of haemorrhagic disorders and / or fever
  3. Ascites may ultimately result in the Splenomegaly
  4. General Anasarca may be a sequel of ascites
  5. Massive ascites as well as abdominal lumps may ultimately result in appearance of piles.
  6. Cough may similarly be a sequel of cold
  7. Consumption may be a sequel of cough
  8. Severe emaciation may ultimately result in the consumption disease. 15 – 18

ते पूर्वं केवला रोगाः पश्चाद्धेत्वर्थकारिणः |

te purvn kevlaa rogaaaah pshkaaddhetvrthkaarinah |

The above diseases begin as a single disease; if not treated properly they could cause several diseases.

कस्चिद्धि रोगो रोगस्य हेतुर्भूत्वा परिशाम्यति || १९ ||
न प्रशाम्यति चाप्यन्यो हेतुत्वं कुरुते अपि च |
एवं कृच्छ्रतमा नृणां दृश्यन्ते व्याधि संकराः || २० ||

kskiddhi rogao rogasy heturbhutvaa prishaamyti || 19 ||
n prshaamyti kaapynyo hetutvn kurutapi k |
evn krikchrtmaa nrinaan drishynte vyaadhi snkraaah || 20 ||

The diseased persons face complex problems indeed. It has been noticed that there are certain pathological symptoms that produce a particular disease and they themselves are pacified. On the other hand, there are certain pathological conditions that produce additional ailments without getting pacified. 19 -20

तस्मध्यात्नेन सद्वैध्यैरिच्छद्भिः सिद्धिमुद्धताम् |
ज्ञातव्यो वक्ष्यते यो अयं ज्वरादीनां विनिश्चयः || २१ ||
इति श्रीमाधवकरविरिचिते माधवनिदाने पञ्चनिदानलक्षणं समाप्तं ||

tsmdhyaatnen sdvaidhyairikchdbhiah siddhimuddhtaam |
jnyaatvyo vksyte yo ayn jvraadinaan vinishkyah || 21 ||
iti shrimaadhavkaravirikite maadhvnidaane pnyknidaanlksnn smaaptn ||

Therefore, the physician desirous of success should strive hard to finalize the diagnosis of diseases like jvara, which have been described below. 21

Thus concludes the first chapter named Panchanidana Lakshanam.