Article on Comparison of Gangadhar Teeka and ChakrapaniTeeka : "Roga Chatushka"
Published in July 2018
Clinical
features of jalpakalptaru on rogachatushka
Published in July 2018
Clinical
features of Jalpakalpataru on rogachatushka
by Vaidya Yashashree V. Joshi,
Department
of Samhita & Basic Principles College
of Ayurved,
Bharati
Vidyapeeth (Deemed to be University) Pune, India
ABSTRACT
Clinical
features of Jalpakalpataru on rogachatushka
Vaidya Yashashree Joshi, BV(DU),
College of Ayurved, Pune
Key-words:
Gangadhar, Chakrapani
Introduction:
Oftentimes, Gangadhar Rai’s ‘Jalpakalpataru’
is overlooked considering it is reflecting darshanik aspects of Ayurved.
It is also alleged that Gangadhar has less commented on sutras related only to
clinical issues. The author wished to study purely clinical chapters of
Charak-Samhita to assess this supposition and explore Gangadhara’s mastery in
Ayurved as a medical science. For this the author has selected rogachatushka
from sutrasthana.
Methodology:
the study was done by reading Jalpakalpataru on rogachatushka and
comparing it with Ayurved-deepika.
Discussion:
author has come across certain appealing clinical descriptions.
These are discussed in article with following classification-
1 Clinical description
which is not found in Ayurved-deepika
2A
Clinical description which differs from to Ayurved-deepika
2B Clinical descriptions
which give new dimensions to thought-line in principle.
4
Clinical
descriptions which need to be explained with more
details
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Vaidya Yashashree V. Joshi, BV(DU),
College of Ayurved, Pune
Key-words:
Gangadhar, Chakrapani
Introduction:
Gangadhar Rai’s ‘Jalpakalpataru’
is oftentimes overlooked by scholars.
In comparison with Chakrapani’s
Ayurved-deepika, Jalpakalpataru has more emphasis on darshanik aspects
of Ayurved. Therefore it is perceived to be less elaborate about clinical
issues.
On
this background, study of Jalpakalpataru on purely clinical chapters of Charak-Samhita
is undertaken, to assess this supposition and to explore Gangadhara’s mastery
in Ayurved as a medical science. With this view, rogachatushka from sutrasthana
is selected.
Methodology:
the study was done by thorough reading of Jalpakalpataru on rogachatushka
and comparing it with Ayurved-deepika. Details of the Charak-Samhita referred
for this study are as follows- print form of Charak Samhita, edited by Kaviraj
N. Sengupta and Kaviraj B. Sengupta, published by Chaukhamba Orientalia, Varanasi, 2nd
edition,1991, part 2. This book is printed with both commentaries under
discussion. The complete matter discussed further is based on the two commentaries
exclusively on Charak sutrasthan chapter no. 17,18,19,20 i e rogachatushka.
Discussion:
Chronologically Gangadhara Rai (19th century AD) is much later than Chakrapani (11th century
AD).
The name ‘Jalpakalpataru’ signifies this commentary as a ‘Kalpataru’
for Jalpa. Jalpa means debate and Kalpataru is a tree which fulfils wishes of a
person approaching to it. Thus ‘Jalpakalpataru’ is a commentary which is ready-reckoner
for debate.
Furthermore
in accordance with taru (tree) he has mentioned the commentary of each chapter
as a branch (shakha) of that tree. Jalpakaplataru on rogachatushka
is enriched with cross references from Charak Samhita itself (references from maharogadhyaya,
vatakalakaeey, trishothiya, shareersthana in commentary on chapter17) as well as references
from Sushrut Samhita and Nimi in commentary on all chapters of rogachatushka.
At few places, other’s opinion is mentioned as “anyatra drushyate”.
This indicates that Gangadhar Rai has studied other’s Samhitas also.
After
meticulous study of both commentaries with the view of comparison in clinical
features, Gangadhar Rai’s mastery in Ayurved is revealed. The data is collected
with same point of view.
This
comparative study does not aim to declare any one of the commentators is
superior over the other one. The sole intention of this study is exploration of
Gagadhar Rai’s clinical approach.
For
the sake of better understanding, all collected references of clinical descriptions
are categorised as following --
1 Clinical description
which is not found in Ayurved-deepika
2A
Clinical description which differs from to Ayurved-deepika
2B
Clinical descriptions which give new
dimensions to thought-line in principle
4
Clinical
descriptions which need to be explained with more
details
These
are explained further with references. For each example referred here, the part
from commentary is mentioned in English and page number of above mentioned book
is given in bracket.
Let’s
discuss one by one :
1. Clinical descriptions which are not found in Ayurved-deepika --
§ Suryavarta-ardhavbheda-shankhak:
These diseases are described in chapter 17. Gangadhar mentions that all of
these get manifested with tridoshas but the ratio of dominance of tridosha
in each of them is quite different. He quotes that Nimi has stated suryavarta
as vata-kapha dominant and gives further explanation. Additionally
he depicts one more condition with name “suryavarta-viparyaya”.
Table 1. Tridosha dominance
in shiroroga (diseases of head region): (pg 691)
|
Disease
|
Vata
|
Pitta
|
Kapha
|
|
Suryavarta
|
+
+
|
+
|
+
+ +
|
|
Suryavrta-viparyaya
|
+
+ +
|
+
+
|
+
|
|
Ardhavbheda
|
+
+ +
|
+
|
+
+
|
|
Shankhaka
|
+
+
|
+
+ +
|
+
|
Surprisingly, he
mentions - treatment for both, suryavarta and suryavarta -viparyaya
is same.
§ Difference
in Charak Samhita and Sushrut Samhita
: Gangadhar observes difference of opinions in quotations of these two Samhitas
on the types of shiroroga.
Sushrut states raktaja (disease with rakta dominance) and kshayaja
shiroroga (disease due to depletion of dhatus) separately which
are not found in Charak Samhita. Gangadhar quotes both and says Charak includes
raktaja in pittaja shiroroga and kshayaja in vata-pitaja
shiroroga. Thus, Gangadhar reconciles this apparently observed disparity
in scientific manner. (pg 691-2)
§ Sannyasa:
(pg 756) In ashtodareeya chapter, Acharya Charak gives description of sannyasa
as ‘tridoshatmakah, mana-shareera-adhishthanah’. (coma is a
condition developing due to vitiation of all three doshas and has origin
at both sites - mind and body), Here Gangadhar explains this phenomenon as “yugpat
ubhayashray”. This means the word ‘mana-shareera-adhishthanah’
indicates imprisonment of body and mind by tridoshas at the same time
fraction. Thus, in sannyasa functional capacity of both- body and mind
is lost simultaneously.
§ Chaya
(accumulation) and kopa (aggravation)
: These two terms are much familiar. A special feature of these terms is given
by Gangadhar in the description of types of spread of doshas (dosha-gati)
(pg 721). He interprets these as - Chaya and kopa are types of vriddhi
(increase). Chaya is ‘na-anya-dushak’ as it takes place at
its own site whereas kopa is ‘anya-dushak’ as it occurs in
other’s site. That means in the state of chaya there is no involvement
of any other dushya but in the state of kopa, involvement of dushya
gets started. The particular words namely ‘na anya-dushak’ and anya-dushak’
help to understand the meaning of chaya and kopa more
precisely. (dushya is anything which gets vitiated due to dosha).
§ Meanings
of certain Nanatmaja vyadhi
: Gangadhara comments elaborately on nanatmaja vyadhi. Very first
he gives reasoning behind the description of vataja – nanatmaja vyadhi
at first place as – vata has capacity to produce more diseases than pitta
& kapha, additionally many times vata dominant diseases are
severe. Further he gives meanings of so many nanatmaja diseases listed
in Samhita; sometimes they differ than the conventional meaning s. a. bahushosha is avabahuka (vataja),
anga-sweda is continuous sweating in less quantity (pittaja), atrupti
is constant feeling of hunger (pittaja), kamala is a specific
stage of pittapandu and is bahupitta kamala (pittaja).
He gives meaning
of harsha as romaharsha. Further he mentions other’s opinion
about harsha as ‘hrishtachitta’ resembling with ‘euphoric state
of mind’. Then he denies other's opinion
considering chalaguna is responsible for harsha and states that hrishtachitta
is not effect of chalaguna. Instability is main effect of chalaguna.
Hrishtachiita is a long-lasting phase of mind [-mind is stable in one and same
euphoric state for longer period]. Thus he turns down this meaning.
§ Anshanshakalpana in vikrut
karma of dosha: This description can be said as a very much
useful contribution of Gangadhar (pg 775). His study of gurvadi gunas
from vaisheshik darshan is reflected here with applied aspect. In
the description of vata dominant vikrut karma, he mentions
gunas responsible for them. All
these are given further in table-
Table 2 – vata-vikruta-karma and responsible gunas
|
Vata-vikruta-karma
|
Responsible
gunas
|
|
From
sransa to cheshta
|
Chala
|
|
Kahartva
|
Khara
|
|
Parusha
(lack of sneha)
|
Ruksha
|
|
Vishadatva
(apaichchilya)
|
Vishada
|
|
Sushirata
|
Sukshma
|
|
Shosha
|
Ruksha,
laghu
|
|
Supti
|
Laghu,
chala
|
|
Sankocha
|
Sheet
|
|
Khanjata
|
Laghu,
ruksha
|
2A Clinical description
which differs from Ayurved-deepika --
§ Inclusion
of madatyaya in mada
(pittaja nanatmaja vyadhi): In chapter no 19, madatyaya is not
counted separately. Chakrapani justifies this as – madatyaya is not
mentioned separately because mada gets converted into madatyaya.
Gangadhara refers chapter 18 in which it is mentioned that inclusion of all
diseases in every description is nearly
impossible. Therefore, many diseases do not found any mention here in chapter19
and madatyaya is one of them. With this reasoning Gangadhara opposes
Chkrapani’s justification (pg 758) and
moreover clarifies difference between mada and madatyaya
as follows-- madatyaya gets developed due to excess
consumption of alcohol [madya]
and mada is a separately manifested disease due to vitiation of rakta
mainly, along with vatadi doshas.
§ Example of prakruti vishesh
and sthana vishesh
(Chapter 19/14, pg 759-760):
Sarve vikara vata-pitta-kaphan
naativartante |Vata-pitta-shleshmanam tu khalu
sthan-samsthan-prakruti-visheshan sameekshya tadatmakanam api
sarvavikaran.....|| Ch. Su.
19/14
After stating indivisible relation between dosha and
disease, Acharya Charak says- physician should understand a disease by
examining specifications of sthana(site), samsthana(symptom), prakruti(cause)
in relation with dosha. While
commenting on this, Chakrapani mentions ‘shleshma-pleehodar’ as
example of prakruti-vishesh. [Shleshma is cause here.] Gangadhar
reads this example as ‘pleehodar’ and declines it stating that it(pleehodar)
is example of sthana-vishesh and he gives sheetajwara & ushnajwara
as example of prakruti-vishesh.[sheeta & ushna
are causes here.]
Actually
Chakrapani’s prefix-word- ‘Shleshma’ to pleehodara is not
considered by Gangadhar. As per this prefix, shleshma is cause (prakruti)
here. Thus, examples of prakruti-vishesh given by both are correct. [for details please refer - Udar Chikitsa
chapter. Chakrapani has explained- five types of pleehodara in Udar
chikitsa chapter.]
2B Clinical descriptions
which give new dimensions to thought-line in principle--
§ Sannipata
and vikruti-vishama-samavaya:
In chapter no 19, samkhya samprapti (counting of types) of
diseases is given. Regarding the number of disease-types counted here,
Gangadhhara explains that only those numbers of vyadhis are mentioned
here for which treatment differs to certain extent. In case of sansarga (combination
of two doshas) and sannipata (combination of three doshas),
only those are separately written, whose treatment modifies as per type of dosha
dominance. For sansarga, mixed treatment is beneficial, so they are not
counted. Sannipat are counted
separately because they originate with vikruti-vishama-samavaya
and need specific treatment & not only mixed treatment. He further emphasises that separate
mentioning of sannipata at other places also carries this aspect of
treatment.
§ Use
of adjective ashu/kshipra/sheeghra in samprapti:
Acharya Charak has used words like sheeghra/kshipra in the
description of galashotha –galashundika and upajivika (pg
735); but has not include rakta in description. Whereas Achary Sushrut mentions rakta
in this same context. Gangadhar asserts
that use of these adjectives themselves indicates involvement of rakta
in samprapti [because rakta is fast spreading/circulating]. He
draws same conclusion for ‘rohinee’ (pg 741). This guideline is very
much valuable for physicians to understand disease and to chalk out
treatment.
§ One
symptom from two different doshas:
Supti (loss of sensation of touch) is mentioned as vata vikruta
karma and also as kapha vikruta karma. Thus it is
developing from two doshas. Here arises the question – how to know which
dosha is exactly responsible for onset of supti in patient? Gangadhar
helps here by saying – presence of supti at the sites of vata (vatasthana)
indicates its origin from vata and presence of supti at kaphasthan
indicates is origin from kapha (pg 781). That means examination of
particular ‘dehadesha (location on body)’ gives clue for further
treatment. Obviously, it is applicable
for some other symptoms like kandu, kleda.
§ Aasthapan-anuvasan’
one word use: In the description of vata-upakrama
(pg 776) one combined word-form of two words. ‘Aasthapan-anuvasana’
is used by Charakacharya. Gangadhar
clarifies that –use of two basti in singular form is indicative of need
of duel basti course for vata regulation. Such singular forms of two words at other
places are likely to carry the same meaning.
4
Clinical
descriptions which need to be explained with
more details--
§ Prameha-pidaka
asadhyata–
for madhumeha and prameha-pidaka, Gangadhar says –there is
no onset of prameha-pidaka, when madhumeha is asadhya.(pg711).
§ Kalakruta
dosha-gati – Gangadhar elaborates
kalakruta doshagati. (pg 722-723-724). This is status of dosha
as per Ritu (season). He gave so much elaboration on this point. The
gist of the whole explanation is mentioned below as per my understanding---- kalakruta doshagati is of two
types viz –prakruti = normal and vaikruti = abnormal. Prakruti
is related to Swastha phase and vikruti is related to diseased
phase. Gangadhar calculates ritu as per Sushrut Samhita - that means he
includes pravrit in six ritu and excludes shishir. He
mentions chayadi phases of doshas as per these six ritus
with two aspects viz- normal and abnormal. These aspects are figured out in
following tables—
Table
3. Prakruti Doshagati
|
Dosha
|
Greeshma
|
Pravrut
|
Varsha
|
Sharad
|
Hemant
|
Vasant
|
|
Vata
|
Chaya
|
Prakop
|
Prasham
|
|
|
|
|
Pitta
|
|
|
Chaya
|
Prakop
|
Prasham
|
|
|
Kapha
|
Prasham
|
|
|
|
Chaya
|
Prakop
|
Table
4 : vikruti doshagati
|
Dosha
|
Sharad
|
Hemant
|
Vasant
|
Greeshma
|
Pravrut
|
Varsha
|
|
Vata
|
Chaya
|
Prakop
|
Prasham
|
|
|
|
|
Pitta
|
|
|
Chaya
|
Prakop
|
Prasham
|
|
|
Kapha
|
|
|
Prasham
|
|
Chaya
|
Prakop
|
[point
to be noted here is that - in swastha-chatushka, Acharya Charak has
included shishir and excluded pravrit.
§ Babahuvreehi
& karmadharay – one term is used in two consecutive verses by Acharya
Charak namely ‘swadhatu-vaishmya-nimitta’. This is in
relation with ‘diseases- developing from their root cause namely doshas’.
Gangadhar explains it with two different types of ‘samaas’ in two
verses. He applies bahuvreehi for one and karmadharya for other.
The exactly differentiating aspect with these applications is not cleared. ( pg
759-760) . (Chakrapani has given meaning as per karmadharay in second
verse.)
This is an
honest attempt to highlight Gangadhar Rai’s clinical approach. The stalwarts in Ayurved are requested to comment
freely on the points expressed in this article and also to throw light on the
doubts.
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reference text:
Charak Samhita,
edited by Kaviraj N. Sengupta and Kaviraj B. Sengupta, published by Chaukhamba Orientalia, Varanasi, 2nd
edition,1991, part 2.
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