Sushruta Samhita Chapter 24 Vyadhi Samuddesheeya Adhyaya

This article explains Sushruta Samhita Sutrasthana Chapter 24 “Vyadhi Samuddesheeya Adhyaya” – Knowledge of diseases.

Vyadhi Samuddesheeya

Knowledge of diseases
Now, we will expound the chapter by name Vyadhi samuddesheeya – knowledge of diseases in brief; as revealed by the venerable Dhanvantari.
Read – Lord Dhanwantari ‘The God of Ayurveda

Vyadhi Bheda

Kinds of diseases

Diseases are two kinds viz.
1. Shastrasadhya – those diseases which need to be treated by the use of sharp instruments (in other words surgical operation) and
2. Snehadikriyasadhya – those diseases which need to be treated by therapies such as oleation etc. (oleation, sudation, emesis, purgation, enema, nasal medication etc).
In diseases requiring surgical operation, therapies such as oleation etc., are not forbidden (they can be skillfully administered as and when needed). On the other hand, in diseases to be treated with oleation etc. surgical therapies are not done.
Read – Vyadhi (Disease) Definition, Meaning And Explanation

Trividha Dukha

Three kinds of miseries
Again, in this science (of surgery) all diseases (affecting the man) have been described in brief, since it is similar (common) to all branches (of Ayurveda).

It was told earlier (in chapter 1) that diseases are “association of miseries”. Such miseries are of three kinds viz –

1. Adhyatmika – related to one’s own (body, mind, sense organs etc).
2. Adhibhautika – related to other living beings (animals, birds, insects, micro-organisms, plants etc.)
3. Adhidaivika – related to super human beings (Gods, demons, planets etc, rain, lightning, thunderbolt etc).

These pains (miseries) manifest (affect human beings) in seven different kinds of diseases. They are –

Saptavidha Vyadhi – Seven kinds of diseases (categories of) are: –

1.  Adibala Pravritta – those produced by the strength of the causes or origin
2. Janmabala Pravritta – those produced by the strength of birth
3. Doshabala pravritta- those produced by the strength of the Doshas (vata, pitta, Kapha)
4. Sanghatabala Pravritta – those produced by the strength of assault.
5. Kalabala pravritta- those produced by the strength of time / season.
6. Daivabala pravritta – those produced by the strength of super human beings (Gods, demons, planets etc).
7. Svabhavabala pravritta – those produced by the strength of nature (natural events).

1. Adhyatmika vyadhi – diseases of one’s own (individual) body-

1. Adibala pravritta vyadhi – Further, the diseases that are produced by the abnormalities of sukra (semen vis-à-vis sperm) and Sonita (menstrual blood a vis-a-vis ovum) such as leprosy, piles etc are known as Adibala pravritta diseases. These diseases are again of two kinds viz – a. Matruja – derived from the mother and b. Pitruja- derived from the father.

2. Janmabala Pravritta vyadhi –The diseases which are caused (produced) by improper conduct of the mother are known as Janmabala pravritta diseases. All these diseases are produced by birth for example – lameness, blindness, deafness, muteness, nasal speech, deafness etc. These diseases are also of two kinds i.e., a.Rasakruta – produced by rasa (essence of food) & b. Dauhrdapachara kruta – produced by non-fulfillment of longings of the mother during pregnancy.

3. Doshabala Pravritta Vyadhhi – Those diseases which are produced from improper food and activities are known as Doshabala pravritta diseases.  
These are also of two kinds – a. Amashaya samutta –produced / born in the stomach and small intestine. b. Pakvashaya samuttha -produced / born in the large intestine. Again, these are of two kinds, viz, a. Sarira -of the body (somatic) and b. Manasa -of the mind (psychic).

All the above are Adhyatmika diseases concerning (produced by) one’s own self (individual).
Read – Classification of Vyadhi (diseases) according to Ayurveda

II. Adhibhautika Vyadhi- diseases due to external objects: –

4. Sanghata Bala Pravritta Vyadhi – The diseases which are caused due to external or accidental causes, like an assault caused by a strong person over the weaker ones. These also are of two kinds – viz. a. Shastrakruta – caused by weapons and b. Vyala krta – caused by wild animals.

These are Adhibhautika – caused by external objects and other living beings.

III. Adhidaivika Vyadhi – diseases caused by superhuman agencies-

5. Kalabala pravritta Vyadhis – The diseases which are produced by kala (season) such as cold, heat, wind, rain, sunlight etc. are known as Kala bala pravritta diseases. These diseases are also of two kinds i.e., a. Vyapanna Rtu Krta- produced from abnormal seasons and b. Avyapanna Rutu Kruta – produced by normal seasons.

6. Daivabala pravritta Vyadhis – The diseases which are caused by curses of humiliated divine beings, by Atharvana rites (sorcery, witchcraft etc) and by upasarga – developing from proximity of contact with another diseased persons (contagious) are known as Daivalaba pravritta diseases. These are also of two kinds. viz. a. Vidyudasani Krta – produced by lighting, thunderbolt etc. and b. Pishachadi Krta-produced by demons like pisaca etc. Again, these are of two kinds, i.e., a. Samsargaja – produced by close contact or proximity of another diseased person (contagious diseases) and b. Akshamika produced by accident (suddenly, without notice – epidemics).

7. Svabhavabala Pravritta Vyadhis – The diseases such as hunger, thirst, old age, death, sleep and such others are known as Svabhavabala pravritta diseases. These are also of two kinds i.e., a. Kalaja – appearing at the proper / usual time and b. Akalaja-appearing at an improper time (premature or delayed). Among these Kalaja are those which appear even after protection (care or prevention) and Akalaja are those which appear without any protection (care or prevention).

These (above) are Adhidavika diseases – caused by superhuman agencies. With this, all the diseases have been described in brief.

Dosha – Sarvavyadhi Karana

Doshas the causes of all diseases
Vata, Pitta and Shleshma (Kapha) only are the root causes for all the diseases because of exhibiting their features (the symptoms of vata, pitta and kapha are found in these diseases), result (of treating these) being actually seen /observed (when treatment is given to these diseases based on the dosha symptoms that they exhibit, results i.e., cure of those diseases will be observed) and because being exhorted in the scriptures (treatises of Ayurveda). Just as the myriads of substances of the universe are not beyond (without the influence of) Satva, Rajas, and Tamas (three Mahagunas), similarly the multitude of diseases cannot be beyond (without the involvement) Vata, Pitta and kapha, which are present all over the body. Due to the combination of doshas, dhatus (tissues) and malas (excreta), different locations and due to involvement of various etiological factors, many kinds of diseases are caused. Due to the severe contamination / vitiation of tissues by doshas the diseases get different names such as (like telling) – this disease is rasaja (born from rasa tissue), this is sonitaja (produced by blood), this is mamsaja (produced by muscles), this is medoja (born from fat), this is asthija (born from bone), this is majjaja (born from bone marrow) and this is sukraja (born from semen). 
Read – Synonyms of the term Vyadhi (Disease) as per Ayurveda

Dhatu Vikara Rogas

Diseases of each Dhatu
Rasadoshaja Vikara (diseases produced by vitiated rasa dhatu) include –

• lack of desire for food
• loss of taste
• improper digestion
• squeezing pain all over the body
• fever
• nausea
• feeling of contentment (abnormal)
• feeling of heaviness of the body
• diseases of the heart
• anemia
• obstruction of channels in the tissues
• emaciation
• bad taste in the mouth
• debility of the body
• premature appearance of wrinkles of the skin
• grey hairs and others
  Read – Rasa Pradoshaja Rogas – Diseases Due To Vitiated Rasa Dhatu

Raktadoshaja Vikara (diseases produced by vitiated blood) include –

• leprosy (and some other diseases of the skin)
• erysipelas
• eruptions
• moles on the skin, pigmented patches
• tilakalaka – black pinheads
• Nilika (back patch of the face)
• Nyaccha (blue or white patch anywhere on the body)
• Vyanga (blue / black patch on the face)
• Indralupa (alopecia)
• enlargement of spleen
• abscess
• abdominal tumors
• gout
• piles
• malignant tumor
• squeezing pain in the body
• menorrhagia
• bleeding diseases and ulceration of the Anus, mouth and penis, etc
  Read – Rakta Pradoshaja Rogas – When Blood Is Vitiated By Doshas

Mamsadoshaja Vikara (diseases produced by vitiated muscles) include –

• excess growth of muscles
• malignant tumor
• hemorrhoids
• adhijihva (adenoids)
• upajihva (salivary cyst)
• upakusha (gingivitis)
• galashundika (enlargement of uvula)
• alaji (episclerities)
• mamsa sanghata (tumor of the palate)
• oshtha prakopa (inflammation of the lips)
• galaganda (goiter)
• gandamala (scrofula) etc.
  Read – Diseases Due To Pathological Muscle Tissue – Mamsa Pradoshaja Rogas

Medo Doshaja Vikara (diseases produced by vitiated fat tissue) include –

Asthi Doshaja Vikara (diseases due to vitiated bone tissue) include –

• extra growth of bones
• eruption of extra teeth
• pricking pain in bones
• bone pain
• bad nails (distorted shape, texture etc)

Majja Doshaja Vikara(diseases caused by vitiation of bone marrow) include –

• darkness before the eyes (transient blindness)
• fainting
• giddiness
• increase of size of bony joints (small joints of fingers)
• formation of ulcers on them (small joints of the fingers)
• ophthalmia (conjunctivitis) etc.

Sukra Doshaja Vikara (diseases produced by vitiation of semen) include –

• impotence
• absence of desire in sex
• seminal calculus
• spermatorrhea and such others

Malayatana Dosha (diseases of seats of waste products) include –

• diseases of the skin
• decrease, increase or improper flow of wastes

Indriyayatana doshas (diseases of sense organs) include – non-perception or improper perception (of sense organs).
This is a (list of diseases) in brief; more details and causes will be described in each disease separately.

Vyadhi Utpatti Sthana

Place of origin of disease
The aggravated doshas keep circulating all over the body. When these doshas get obstructed and hence get stagnated due to the abnormality of the channels (in the tissues), the diseases get manifested at that place of dosha aggravation.
Read – Role of Doshas In the Causation of Disease

Dosha – Vyadhi Sambandha

Relation between Doshas and disease
Here is a point of great debate. Is the relation between Vata etc. (dosha) and fever etc. (diseases) a permanent (constant, inseparable) one or is it a separable (temporary) one? If we say that the relationship between them is a permanent one, then all living beings should be ill / sick all the time. Since all living beings are not ill always it (relationship) should be otherwise. If the relationship between the doshas and the diseases is considered to be a permanent and long-standing one, due to the presence of vata etc. doshas and fever etc diseases in different places, their symptoms cannot be manifested in a single (same) place because the features of something present at some place will not appear elsewhere. Therefore, the vata etc. doshas are not the root (causes) of jwara etc. diseases.

Taking recourse to the dictum (mentioned above), we now say that fevers etc. (diseases) will not occur without the (involvement of the) Doshas. Their relationship (between doshas and diseases) is not permanent (constant). Just as lightening, wind, thunderbolt and rain cannot happen without the sky, and in spite of the sky being present at all times, these (lightening etc.) do not happen at all times. But when there are (exciting) causes and suitable time (for their manifestation) they (lightening) would manifest in the same sky (and do not occur all time). Similarly, the water bubbles and the water waves do not get manifested elsewhere i.e., they are manifested in water only. The water bubbles and waves do not occur at all times in the water, they manifest at suitable times with suitable causes. So, the relation between vata etc. (dosha) and fever etc. (diseases), is neither permanent association (attachment) nor permanent dissociation (non-attachment). Hence their origin (of the diseases) is only due to an exciting cause (such as improper food and activities).
Read – Main Cause For Diseases As Per Ayurveda

Another verse here –
The quantity / nature, number etc. of abnormalities (signs and symptoms) of all diseases will be described in detail separately in Uttara tantra (chap. 66 of last section of this text).
Thus ends the Twenty fourth chapter by name Vyadhi Samuddesheeya in Sutra Sthana of Susrutha samhita.