One of the prime objects of Ayurvada is to mitigate or cure the disease. Obviously, therefore, the concepts of treatment have been very rationally and scientifically evolved. Despite different types of classification of treatment, the more suitable and comprehensive classification comprises of six therapies called ‘Shadwidhopakram’. The arrangement and division of treatment in to these six therapies encompasses every other classification of treatment. The fundamental principle of treatment is to dislodge the Samprapti, which involves dosha, dushya and srotamsi. The Shadupakramas, therefore should aim at the rectification of the morbidity of either the doshas or dushyas or srotamsi as the case may be. As a matter of principles, therefore, it become imperative for a thinker to locate and understand the
Basic concepts of Ayurvedic pharmacology 118 relationship between the pathogenic events and these Shadupakramas.
Elsewhere in this paper only, it was pointed out and concluded the logical necessity and scientific utility of fixing up of different stages of pathogenesis in relation to the treatment thereof. In order to confirm the previous propositions, the Shadupakramas are selected for correlating with different stages and locations of Samprapti as follows –
ii) Prakopa Koshta ii) Rukshana Ruksha Virya iii) Prasara Dhatu iii) Brimhana Guru Virya iv) Sthanasam
Dhatu iv) Langhana Laghu Virya
v) Vyakti Srotas v) Swedana Ushna Virya
vi) Sthambana Sheeta Virya.
From the above schematic presentation it becomes clear that treatment with drugs should inevitably and invariably involve different Viryas and this involvment should be incoroporated in to the Shadupakramas. With this view only the qualities accepted as Virya by the Ashtavidha Virya Vadis find a predominant role in the Shadupakramas viz;
Snehana-Rukshana on account of Snigdha and ruksha virya, Swedana-Shambhana on account of Ushna-Sheeta Virya and Langhana-Brimhana on account of Laghu-Guru Virya respectively. The two Viryas i.e.Mrudu-Tikshna have not been given much prominence in describing systemic actions of the drug as those two Viryas seem to be concerned with local actions. However, they are mentioned in the substances described to be doing
Basic concepts of Ayurvedic pharmacology 119 one of the six actions in the body. Objections could be raised against fixation of the Shadupa-kramas with respect to their actions in a particular location. It may be argued that by restricting the jurisdiction of these Upakramas to the particular sites of the body their local and general application would become irrelevant. This argument will not be altogether wrong as biological variables obviously reflect in the variations of the treatment as well as its application. However, preference to one should not mean the rejection of the other. It is a matter of selection and suitability.
When we talk of dosha, dushya and Srotamsi we imply thereby certain minutest substances involved in the causation of the disease and those substances are in one way or the other interrelated and interdependent. This is why the pathogenesis is described as a chain of events rather than a separate entity in itself. So also eventhough the Karmas have been fully ascribed to the drug, its fractions have been divided into Rasa Panchakas and these Rasa Panchakas have been discretely mentioned to be activated at different levels of Samprapti. The relationship of Vipakas with the actions they produce in the gastrointestinal tract has been explained on the basis of Snigdha-ruksha property, which the Ashtavidha Viryavadis called as Snigdha and Ruksha Viryas and which the clinicians call them as Snehana and ruksnna therapies. In the present context Snehana Upakrama implies with Abhyantara Sneha. The Bahya sneha also in one way or the other relates to the subsidence of doshic symptoms or pushing the doshas from the systemic circulation to Koshta where from they can be thrown out of the body by emesis or purgation. This is why external and internal application of Snehana is Poorva Karma and does not form the body of the main treatment.
Coming to the Srotamsi and their involvement in the pathogenesis, the Acharyas detected and defined the hyper or hypo motility of the Srotamsi
Basic concepts of Ayurvedic pharmacology 120 implying thereby that osmosis, transaction of the nutrient substances and permeability of the cell wall may decrease or increase. The question of Srotamsi in the patogenesis implies the tiniest structures including the cell wall as the disease is thought of at the cellular level. Such being the case the common observation of the effect of cold and heat on different Srotamsi resulting in their hyper or hypo functioning was probably the clue which the Acharyas clinched to explain Sheeta and Ushna Viryas vis-à-vis Srotamsi.
As pointed out earlier the action of drugs on different Srotamsi in the body may be explained on the basis of sheeta and Ushna Virya. This postulation reflects in the clinician’s view of Shadupakrma where in the qualities of Sthambhana upakaram may lead to the constriction of channels while Swedana upakrama may lead to the dilatation of the channels. Out of these qualities ascribed to these upakramas, ushna plays a predominant role in Swedana while Sheeta plays predominent role in sthambhana. This led the Ashtavvidha Virya vadis to pick up these qualities as one of the Viryas.
Let us now come to the dhatus which play which play a prominent role in Dosha-Dushya Samoorchana by biophysical and biochemical interactions and thereby causing the symptoms of disease through one of the Srotodushti Lakshanas. A detailed study of patients suffering from different diseases revealed one fact beyond doubt that there is a local increase but general decrease of the Dhatus in disease conditions (Ayu 1968 –Rogavastha me Dhatu ki Sthiti). Accordingly the therapeutic measures to rectify the discordance at the tissue level is either to elevate or bring down the qualitative amount of the Dhatus as the case may be. Ultimately the mass of the human body is composed of the Dhatus and their decrease or increase can be qualitatively termed as Guru and Laghu, and the substances affecting these qualities are accepted as Guru and Laghu Viryas by the Ashtavidha
Basic concepts of Ayurvedic pharmacology 121 Virya Vadis. Giving it a detailed and multiferous appearance the clinicians chose the name as Laghana and Brimhana Upakramas. Even the concept of Ama, while interfering with the normal transaction of the Poshaka Dhatus to the Poshya Dhatus implies Gourava and reverse implies Laghava. The Langhana-Brimhana therapies include substances and practices which may bring about the desired effect of the increase or decrease of the Dhatus.
In the foregoing lines it is attempted to correlate the states of Dosha, Dushya and Srotamsi with their sites and location in relation to pathogenic stages and the drugs as well as the therapies to mitigate or rectify them at those particular sites.