Article by Dr Raghuram Y.S. MD (Ay) & Dr Manasa S, B.A.M.S
Acharya Sushruta mentions four important factors, which when working together, will be responsible for establishment and maintenance of good health. The same factors when not operational together or do not complement each other can lead to ill health and diseases.
In this article we shall touch briefly about those four essential factors which determine health or ill-health depending on their chemistry of operation.
Reference – Sushruta Uttara Tantra, Chapter 66, Verse 14 (Su.Ut.66/14)
Four essential factors responsible for good health
भिषक्कर्ताऽथकरणंरसादोषास्तुकारणम्।।
कार्यमारोग्यमेवैकमनारोग्यमतोऽन्यथा।।१४।।
The below mentioned four would lead to establishment and maintenance of good health when they function together –
1. Bhishak – the physician – he is considered as Karta – the performer of treatment, the most important component in the business of health and wellness.
2. Rasas – the tastes or drugs / herbs which have tastes – these are considered as karana – the means or tools for treatment.
3. Doshas – vata, pitta, kapha and rakta – these are considered as kaarana – the causes of the diseases, without which no disease manifests.
4. Arogya – is a state of not having any disease i.e. state of health – it is considered as karya – functions or action or result of treatment which has been administered to treat the diseases or imbalance of doshas.
On the other hand, if these four factors do not operate together, they will lead to ill-health, miseries or diseases.
So, these factors, depending on how they operate relatively, determine health or sickness and are biphasic in nature.
Summary
Acharyas have explained the role of coordinated approach of chikitsa chatushpada – four limbs of treatment towards establishment of comprehensive health, which include – bhishak – the physician, dravya – the medicine, upasthatha – the caretaker / nursing staff and rogi – the patient.
These four factors explained by Master Sushruta are quite different from this. These factors include the bhishak and rasas which represent dravya or aushadha, but the other two factors are doshas and Arogya.
Acharya Sushruta also has connected these factors with kartru etc concepts. Chikitsa – successfully implemented treatment which includes establishment of balance of doshas and dhatus in the body through various measures i.e. Arogya or comprehensive health, which is a Karya. This is the motive of a medical science, Ayurveda here.
| Factor contributing towards comprehensive health | Role in healthcare |
| Bhishak – physician | Karta – doer or performer |
| Rasas – tastes | Karana – tools or means of treatment |
| Doshas | Kaarana – causes of diseases |
| Arogya – health | Karya – result of treatment |
These should operate hand-in-hand for the karya i.e. result of treatment i.e. dhatu samya – establishment of health to be achieved.
There is a connection between each and they form a closed-circuit network in the treatment plan-up.
On the other hand, when these factors do not work in coordination, especially the first three, the karya will not be Arogya, in fact it will end up with roga – disease.
Bhishak – A well learned physician with good experience would become successful in treating diseases and establishing health. If the physician is not well equipped with theoretical and practical experience, he or she will not be able to plan or execute a treatment plan-up to end the disease process or to bring back the equilibrium of doshas and dhatus. An inexperienced physician would cause more harm than help to the patients. The bhishak is karta and is the main gamechanger in the process of treatment of diseases.
Rasas – Each taste has a balancing and aggravating effect on different doshas and hence may favour or antagonize the pathogenesis of diseases. All medicines or herbs used in treatment of diseases are composed of one or more of the rasas. Medicines act on the basis of their rasas. The karta i.e. physician should know to use the right rasas in the right conditions. Wrong rasas administered in the form of medicines or foods, in wrong conditions by an inexperienced bhishak will definitely cause harm and may also cause diseases or complications.
Doshas – No disease is caused without the involvement of imbalanced doshas, mainly the increased or aggravated doshas. An experienced karta administering proper karanas i.e. rasas in the form of foods and medicines would keep the kaaranas in a state of balance, in healthy individuals. The same would cure the diseases in ailing individuals. The action would be exactly opposite when an inexperienced bhishak administers improper rasas. This would eventually lead to causation or worsening of diseases or cause complications. Roga i.e. disease is due to dosha vaishamya i.e. imbalance of doshas and their equilibrium leads to arogata i.e. establishment of comprehensive health, which by itself is the karya.
Arogya – This is the effect or result of how the above said three factors would operate in coordination towards establishment of dhatu samya i.e. equilibrium of body components. A well-equipped physician who is experienced would administer the right rasas to balance the doshas and would lead to establishment of Arogya – health, which is a favourable karya. An inexperienced physician would administer the wrong rasas which would cause imbalance of doshas which would lead to manifestation of diseases or complications, which is an unfavourable karya.
In short, the karya will be favourable in the direction of establishment of health and equilibrium of body components if karta, karana and kaarana will work in utmost coordination in the pathway of achieving that karya.
