Āyurvedic classical texts such as Suśrutasaṁhitā, Caraksaṁhitā, Aṣtāñgahṛdaya, etc. were written centuries ago. As time passes, the lifestyles of people along with their eating habits, clothing, daily regimen, etc., all change. The unfavourable changes in the above mentioned factors lead to the cause of diseases, whose clinical picture is entirely different from the diseases mentioned in the ancient texts. Management of such newly originated and undescribed diseases is a great challenge for the physicians of this era. Our ancient ācāryas knew that as time progresses it would lead to new diseases. As such diseases are not mentioned in the ancient classical texts, it is difficult to diagnose and treat them. But the ācāryas gave certain guidelines and principles in the form of trividhabodhyasangraha and the concept of anuktavyādhi to tackle such newly originated clinical conditions. An effort has been made to compile such references along with their commentaries to help to diagnose and treat undescribed diseases.
Diagnosis of newly originated diseases on the basis of trividhabodhyasangraha
The concept of trividhabodhyasangraha is found in Caraksaṁhitā describing that three entities should be taken into consideration for knowing any disease whose description is not available in the classical Āyurvedic texts. The three entities are:
1. Vikārprakṛuti, i.e. the doṣa responsible for the production of the disease;
2. Adhiṣtthān, i.e. the location where the disease is manifested; and
3. Samutthānaviśesa, i.e. the causative factors of the disease.
If a physician is not able to name a particular disease, he should not feel ashamed on that account because it is not always possible to name all types of diseases in definite terms. When aggravated, the same doṣa may cause manifold diseases, depending on the various aetiological factors and the sites of manifestation. So a physician should try to comprehend the nature of the disease, the site of its manifestation and aetiological factors and then initiate treatment. A physician initiating treatment after having full knowledge of the therapeutic properties of these three aspects and paying due regard to scriptural instructions would never fail in his attempt to cure the disease (1).
Cakrapāṇi commentary
Cakrapāṇi, the commentator of Caraksaṁhitā, comments on the above mentioned verse that nomenclature of the disease is not that important in the treatment of the disease (1).
Factors to be examined for newly originated diseases
The physician who minutely examines and determines the condition of dūṣyas, deśa, bala, kāla, anala, prakṛti, vaya, sattva, sātmya, āhāra and avasthā and then decides what are the aggravated doṣas and the appropriate treatment, always attains success and does not go wrong in his treatment (2).
Anuktavyādhi: undescribed diseases in Āyurveda
Cakrapāṇi commentary
There are several other diseases not described in this section of Āyurvedic text with names and forms. Even such diseases are to be treated on the lines suggested in the texts after examining the doṣas and such other factors involved in their manifestation (3).
The other factors refer to bheṣaja (therapeutic measures), deśa (location), kāla (time), bala (strength), śarīra (physical features), āhāra (diet), sātmya (wholesomeness), sattva (mental attitude), prakṛti (constitution) and vaya (age) which are elaborated in sūtrasthāna 15/5.
Treatment protocol for undescribed diseases
Therapies which are opposite to the properties of the doṣas, dūṣyas and aetiological factors involved in the causation of the disease are certainly useful in curing it. If appropriately used, such therapeutic measures will cure all the diseases, whether they are named or not in the text (4).
Diseases are caused both by the aggravation and diminution of doṣas as well as dhātus. If these elements are diminished in quantity, then for their augmentation, therapeutic measures similar in property are to be given. Thus, these are to be treated as of an opposite nature (viruddha). In such conditions, therapeutic measures which are opposed to the doṣas are not to be given, but those which are opposed to the diminution of doṣas are to be administered (5).
Cakrapāṇi commentary: definition of anuktavyādhi
Cakrapāṇi defines anuktavyādhi as diseases whose nomenclature, sign and symptoms are not described in ancient Āyurvedic texts such as Caraksaṁhitā.
Cakrapāṇi commentary
Cakrapāṇi says that the following points should also be taken into consideration before initiating the treatment of such diseases:
1. Deśa (place where the patient is)
2. Kāla (season)
3. Auṣadhakāla (medicine administration time)
4. Auṣadhapramāṇa (quantity of the medicine)
5. Sātmya (suitable for patient, etc.)
If all these points are taken into consideration, the physician will not commit any mistake and will successfully cure the disease.
Treatment suggested as per the location of the doṣas
1. Unfavourable changes in lifestyle along with food habits and daily regimen lead to diseases.
2. As time passes, the changes in climatic conditions are also responsible for the cause of new diseases.
3. It is not possible to find each and every disease in the classical texts along with their names.
4. One should not be ashamed if he/she does not know the name of the disease as the disease is newly originated.
5. Such diseases should be diagnosed on the basis of vikārprakṛti, adhiṣṭhāna and samutthāna, i.e trividhabodhyasangraha.
6. Besides trividhabodhyasangraha, one should also make an effort to understand other factors like duṣya, deśa, bala, kāla, etc. about the patient and the disease.
7. A physician who takes into consideration the above-mentioned factors before initiating treatment never commits any mistake in treatment and achieves success in his field.
