In Ayurveda we have detailed descriptions of the pathways in which diseases can occur. An understanding of these Rogamargas and the effect of such an exercise on the prognosis as well as it's effect on choice of drugs used for the Chikitsa vary widely.
The first concept to look at is that this body is a Snigdha pinda which is maintained by the actions of the Tridoshas. Right from the time of formation of a Garbha, Vata dosha plays a crucial role in maintaining the guna : Chala ( movement ). Looking specifically at the movement through the Koshta, we know that there is a continuous process of movement which is a major indicator of life. The smoothness of this movement , without any obstructions, variations or affectations by internal and external factors determines the heath of the sum unit of the body-mind complex. This chalatwam stems from the innermost rogamarga or anthah koshta and spreads into the Madhyama and Baahya rogamargas. The very nature of this movement is what maintains this ghata pratyaksha or body.
Let's look at the parts and corresponding diseases that form each rogamarga.
Bahya Rogamarga
शाखारक्तादयस्त्वक्च बाह्यरोगयनम् हि तत् ।
तदाश्रया मषव्यङ्गगण्डाल्ज्यर्बुदादयः ॥
बहिर्भागाश्च दुर्नामगुल्मशोफादयो गदाः ।
This pathway consists of all the dhatus except rasa, and includes twak. Here, twak can be considered as both the internal and external covering of organs and the body too. A limiting membrane for the koshta as well as the bahya twacha that's visible to naked eye.
Abhyantara Rogamarga
अन्तःकोश्ठोमहास्रोतः आमपक्वाशयाश्रयः ।
तत्स्थानश्छर्द्यतीसार श्वासकासोदरज्वराः ॥
अन्तर्भागं च शोफार्शो गुल्मवीसर्प विद्रधि ।
The Amashaya and Pakwashaya form the major contituent of this rogamarga. According to Sushrutha , the list of 15 koshtangas also have to be included as appendages that play a role and determines what gets affected in a disease condition of this path.
Madhyama Rogamarga
शिरोहृदयबस्त्यादि मर्माण्यस्थ्नां च सन्धयः ।
तन्निबद्धाः सिरास्नायुकण्दडराद्यासश्च मध्यमः ॥
रोगमार्गः स्थितास्तत्र यक्ष्मपक्षवधार्दिताः ।
मूर्धादिरोगाः सन्ध्यस्थि त्रिक शूलग्रहादयः ॥
(अ.हृ.सू. १२/ ४४ - ४७)
This consists of the Trimarmas, all the other Marmas of the body, and Asthi sandhis joined and in confluence with other structures like sira, snayu, kandara etc. This rogamarga consists of complete organ structures and can be considered and structures embedded in a pool of Dhatus.
The three margas are all interconnected but form separate lines. Another interesting point to think about is the relation of these paths with each other in a state of normalcy or swasthyam.
Relation of Rogamarga with specific Tridosha Vaishamyam
- Koshta : Vata-Kaphaja dushti is specific to this region. The koshta is known to be the host for the Jataragni in the body. The agni can easily be affected by vishamata of the vayus or kapha acting in the region . Agni is both supported by but also constantly threatened by the other two doshas. A samprapti could take shape either as snigdhoshna ( drava pitta ) or rookshoshna ( bhasmaka )forms of agni vikaras apart from manda, teekshna and vishama types.
- Shakha : The marga constitutes mainly of the various dhatus which are transformed principles of rasa. The snigdha pinda that undergoes continuous transformation by exposing itself to the heat of pitta/ agni in the body. This is therfore most prone to get affected by kapha-pittaja vikaaras.
- Madhyama : It is a confluence of a variety of structures and faces maximum effects due to the gunas of vata that increase and cause trouble in this path.
This now gives us an understanding of how to look at the chikitsa padhdhati to be followed while dealing with the disorders of specific rogamargas. A proper and thorough dissection and understanding of the factors resulting in the end disease is to be done by the vaidya.
Aushadi prayoga for the specific rogamargas can be inferred through the indications of a gana/ yoga and by identification of the "flag drug " or that one drug / group of drugs that dominate the action of a yoga. Such identification is based on the yukti of the vaidya and experience gathered by treating patients. The following example provides an insight into one such module for flag drug action.
Trikatu : All three of the drugs or even a single one when found in a gana can be considered to have an action on the koshta.
Guduchi : Action based in koshta but with a wider effect on the shakha
Rasna : Action on the madhyama rogamarga
By the above example there might arise a myriad of questions such as ,
1. What about pitta-kapha dushti in the koshta ?
A : Here we would look for tikta rasa and perhaps rooksha kalpanas specifically.
2. What about formulations with more than one flag drug ?
A: Example is rasna sapthaka. It has all three flag drugs and hence the action is also diverse. It acts on Agni and Aama ( nagara ), Stretches out to the baahya rogamarga ( amrutha ) and due to rasna acts on the madhyama rogamarga too. Such kind of deductions are required during the study of shastra.
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We have been given the keys to think about the rogamargas and their effects on the various aspects of health , disease and it's treatment. It lies in our hands to find the bigger picture and fit the puzzle pieces into it. |
Credits and heartfelt thanks to Vaidya. M. Prasad and Dr. K.T. Jayakrishnan for patiently guiding and explaining the concepts to the student community.
Good beginning
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