Prevention of diseases, Ashtanga Hridyam, Sutrasthana.

After ‘Ritucharya Adhyaya‘, Acharya Vagbhata expounded the chapter ‘Roganutpadaniya’ (Prevention of Diseases), thus said Atreya and other great sages.

Preamble: In the present chapter Vagbhata stressed that all the diseases will be manifested due to the forceful expulsion and voluntary suppression of the natural urges only. Hence for the prevention of the diseases one should not suppress the natural urges like urine, feces, semen etc. and suppress the urges relating to rashness and evil deeds physically, mentally and orally.

Two types of urges:

• Suppressible urges (Dharaniya vega)
• Non suppressible urges (Adharaniya vega).

Suppressible urges (Dharaniya vega):

• Lobha (greed)
• Soka (grief)
• Bhaya (fear)
• Krodha (anger)
• Mana (vanity)
• Niralajja (shamelessness)
• Irsya (jealousy)
• Atiraga (too much of attachment)
• Parusa vachana (extremely harsh words)
• Anrta vachana (lying)
• Parapida (physical handling) etc.

These activities should be very carefully restrained mentally, orally and physically.

Non suppressible urges (Adharaniya vegas):

1. Vata (flatus)
2. Vit (feces)
3. Mutra (urine)
4. Ksavat(sneezing)
5. Trsna (thirst)
6. Ksudha (hunger)
7. Nidra (sleep)
8. Kasa (cough)
9. Srama-svasa (dyspnoea on exertion)
10. Jrmbha (yawning)
11. Asru (tears)
12. Chardi(vomiting)
13. Retas(semen) &
14. Udgara (belching/eructation).

These should not be suppressed and it is necessary that the needs of these natural urges are satisfied instantaneously i.e. as soon as they are explicit.

Effects of Suppression of Natural Urges and Their Treatment

Suppression of flatus(Adhovata rodha);

Because of suppression of the urge of flatus, will give rise to the abdominal tumor, upward movement inside the alimentary tract, pain in the abdomen, exhaustion (even without exertion), obstruction to the elimination of flatus, urine, and feces, loss of vision, loss of digestive capacity and diseases of the heart.

Suppression of feces(Sakrt rodha);

Due to Suppression of the urge of feces gives rise to pain in the calves, running in the nose, headache, upward movement of air (belching), cutting pain in the rectum, oppression in the region of the heart, vomiting of feces, and diseases mentioned earlier (under suppression of flatus).

Suppression of urine  (Mutra rodha);

By the suppression of the urge of urine arise, cutting pain all over the body, formation of urinary stones, severe pain in the urinary bladder, penis and groin. And also the diseases mentioned earlier (under suppression of flatus and feces).

Treatment:

For these (diseases arising from suppression of flatus, feces and urine), the treatments are rectal wicks (suppositories), oil massage and bath, immersion bath, tub bath, sudation therapy (Sudation therapy) and enema therapy (Vasti). Special food and drinks which eliminates the obstructed feces is to be given in the diseased condition, due to the suppression of feces  In diseases caused by suppression of urine, drinking of ghee (as per procedure of oleation therapy described in chapter 16) before breakfast is ideal. So also, drinking ghee in the maximum dose at the end of digestion of food of both the midday and the night which is known as avapidaka sneha should be resorted to.

Suppression of belching (Udgara rodha);

Due to suppression of the (urge of), belching produces loss of taste (or of appetite), tremors, feeling of obstruction in the (region of) heart and chest, flatulency, cough and hiccup, treatment for this, is similar to that of hiccup.

Suppression of sneezing (Ksavathurodhag);

Headache, debility (lack of keenness), of the sense organs, stiffness of the neck (wry neck) and facial paralysis arise from suppression of sneezing. (Treatment for these is) inducing sneezing by strong (medicinal) inhalations, collyrium (a soothing solution applied locally to the eye.), snuff, gazing at the sun etc., and oleation (Snehana) and sudation(Swedana) (therapies)

Suppression of thirst;

Suppression of (urge of) thirst will give rise to emaciation, debility of the body, deafness, loss of consciousness (delusion), giddiness and heart diseases; for this, all kinds of cold measures (cold food, drinks, bath, use of drugs of cold potency etc.) is ideal.

Suppression of hunger (Ksudrodha);

Gutting pain in the body, loss of taste (or appetite), debility, emaciation, pain in the abdomen and giddiness (result from suppression of the urge of hunger). These should be treated with food which is easy to digest, fatty, warm and little in quantity.

Suppression of sleep ( Nidrarodha);

Suppression of sleep causes delusion, feeling of heaviness of the head and eyes, lassitude, too much yawning and squeezing pain all over the body. Good sleep and mild massaging are the ideal treatments.

Suppression of cough ( Kasarodha);

Suppression of cough causes its increase, difficulty in breathing, loss of taste (or appetite), heart diseases, emaciation and hiccup. For these, all treatments which relieve (or cure) cough should be done.

Suppression of heavy respiration(Sramasvasa rodha);

Tumors of the abdomen, heart diseases and delusion result from suppression of heavy breathing after strenuous work. Taking rest (not doing any physical -activity) and therapies which mitigate vata are the ideal treatments for these.

Suppression of yawning (Jrmbhrodha);

Prevention of yawning leads to the same diseases enumerated under the suppression of sneezing and remedy for them is all the therapies that mitigate Vata.

Suppression of tears (Asrurodha);

Running in the nose, pain in the eyes, head and heart, stiffness of the neck, loss of taste (or appetite), giddiness and abdominal tumors arise from control of tears. Good sleep, drinking wine and hearing of pleasant stories are the treatments.

Suppression of vomiting ( Vamathurodha);

Visarpa (herpes), rashes on the skin, leprosy (and other skin diseases), irritation in the eyes, pallor (anemia), fevers, cough, oppression in the chest (nausea) pigmented patches on the face and swelling (dropsy) arise from suppression of vomiting. Mouth gargles; inhalations, fasting, eating dry foods, and then inducing vomiting exercises, bloodletting and purgation are the treatment. Oil mixed with alkalis and salts is ideal for oil massage and bath

Suppression of semen (Sukrarodha);

Suppression of semen produces its discharge (constantly), pain and swelling of the genitals, ever, discomfort in (region of) the heart, obstruction to micturition, cutting pain in the body, vriddhi (inguinal and scrotal hernia), urinary stones and impotence. These should be treated with food containing poultry, sura (beer) and rice, enema therapy, oil massage, immersion bath (tub-bath), milk processed with drugs which clean the bladder; and loving women (copulation).

Those persons who are habituated to suppression of urges and having thirst and pain in the abdomen, emaciation and fecal vomiting should be rejected.

All diseases arise from (premature) initiation (by force) and suppression (control by force) of the urges of the body. For those common diseases arising from these acts specific treatments were enumerated so far. In others of different kinds, usually pavana (vata) gets aggravated, hence they should be treated with foods, drinks and therapies which clear the passages (of vata) and help its downward movement.

Dharaniya vega-(urges to be controlled);

He who is desirous of happiness here in this life (Ihloka) and life in the other world (Paraloka) should control the urges of greed, envy, hatred, jealousy, love (desire)/etc. and gain control over his sense organs.

Importance of purification therapies(shodhana chikitsa prasamasa-);

All efforts should be made to clear out the malas (doshas and waste products) at appropriate times If malas gets accumulated extremely, leads to their aggravation and do at times causes threat of life.

The doshas which are mitigated by fasting (langhana) and digestive drugs (pachana) therapies might sometimes become aggravated (again) but those which are cleared (expelled out  by samsodhana (purificatory) therapies will not get aggravated again.

The physician who knows the proper time of every therapy (sodhana or purifactory) should administer them in proper procedure and proper degree, later on administer appropriate effective rejuvenators (tonics) and aphrodisiacs.

Regimen to be adopted after purificatory measures:

By purification or reduction therapies and with constant use of medicines body will become

weak naturally. So, the following steps should be taken to regain the strength.

• Foods like sali, sastika, godhuma, mudga, marhsa, ghrta made appetizing and digestible by combining with palatable and digestive drugs are to be given.
• Abhyahga, udvartana, snana, niruha vasti and sneha vasti art also to be administered.

Traumatic diseases (Aganturoga);

Those diseases produced by bhuta (evil spirits, bacteria, parasites, insects and other living beings), visa (poisons), air (hurricane, cyclone), Agni (fire, electricity, radiation, etc.) ksata (injury, wounds, etc.), bhanga (Fracture of bones), etc., as also those due to raga (desire, lust), dvesa (hatred), bhaya (fear), etc. are all known as Aganu diseases (arising from external causes).

General treatment for all diseases (Sarvaroga samanya chikitsa);

Avoidance of improper activities (of the body, mind, and speech by the willful transgression of rules), control of the senses, remembering previous expectancy (and acting rightly), good knowledge of the land (habitat), time (season, age), and the self (and their importance to health), adherence to rules of good (moral) conduct, the conduct of propitiatory rites as prescribed in the Atharva Veda, worshipping of malevolent planets, not touching (not coming in contact directly) the bhutas (evil spirits, bacteria, insects and other creatures)-these are in brief, enumerated here, as the plan (means, methods) to prevent the onset of diseases-both ninja (organic) and agantu (traumatic)-and also for the cure (or relief) of those (diseases) which have already arisen.

The accumulation of doshas arising from cold (season) should be expelled out during vasanta (spring), that arising from grishma (summer) should be expelled during varsha (rainy season); that arising from varsa, (rainy season) be expelled during sharad (autumn) expeditiously and effectively. By this, people will not become victims of diseases born (by the effect) of the seasons.

Regimen for promotion of health:

The following persons will be disease free:

• Who is adopting the rules and regulations of a wholesome diet and good conduct?
• Doing all activities carefully after thinking twice.
• Having control over senses.
• Treating all living beings equally.
• Speaking truth.
• Having patience and forgiving the mistakes of others.
• Keeping the company of well-learned men etc.

Thus ends the fourth chapter entitled Roganutpadaniya Adhyaya of SutraSthana in Astanga Hridayam Samhita, which was composed by Acharya Vagbhata son of Sri Vaidyapati Simhagupta.

In the chapter Roganutpadaniya, Acharya Vagbhata explained methods of preventing diseases; 14 types of suppressible natural urges; the effects of suppression and the treatment also narrated; persons not eligible for treatment; the importance of seasonal regimen and the elimination therapies, etc. and at the end the features of a disease-free person has been presented.