Charak Samhita – Nidana Sthana – Chapter 6 (Shosha Nidana)

Abstract

Charak Samhit was written by Acharya Charka. It is one of the three brihatrayi Samhita. In charak samhita there is an explanation of various Diseases along with their management through the herbal remedies and panchakarma procedures. There are a total of 120 chapters in charaka samhita and 8 Sthana which are named as Sutra sthana, Nidana sthana, Chikitsa sthana, vimana sthana, indriya sthana, kalp sthana, Siddhi Sthana, Sharira Sthana. In this article we will discuss the sixth chapter of Nidana Sthana named Shosha nidana.

Chapter 6, Charaka Samhita, Nidana Sthana, Shosha Nidana, Charak Samhita - Nidana Sthana, Chapter 6 - Shosha Nidana

Introduction

In this chapter we will discuss Shosha Roga (Pythisis or cachexia) which arises due to various causes that are over exertion, Suppression of Natural urges, Wasting of the body, irregular meals and shows various symptoms. In Sosha basically the person has depletion of the tissues and it dries up fluids of the tissue which leads to this condition. According to the cause it possesses various signs and symptoms which are mentioned below. Sosha can be corrected by the ancient ayurvedic medicine and the wholesome diet which is explained in the chikitsa sthana of the charak samhita.

Causes Of Phthisis (Cachexia)

Agnivesha asked – How many diseases are pertaining to the head and heart? How many disorders are due to proportional variations of vata etc.? How many problems are brought on by kshaya (Wasting)? And how many boils? What are the types of movement of doshas? O alleviator of doshas!

1. Overexertion (Sahas janya)

When a person who is weak fights against the Strong one, does the Strenuous physical exercise, The person talks too much, Carries heavy weight, Swims to a very long Distance, Is Habitual to have a forceful anointing and needing with feet, Travels to a long Distance or does the complicated physical exercise, then his lungs gets wounded because of excessive effort.

There is an aggravation of the vata in lung Wound and gets located there, it takes along kapha which resides in lungs and also affects the pitta dosha and spreads Upwards, Obliquely and Downwards.

The portion which enters into the body joints, It produces symptoms like

  • Yawning (Jrumbha)
  • Malaise (Angamarda)
  • Fever (Jwara)

The portion which affects the Stomach including small intestine (Amashaya) leads to

  • Anorexia (Arochaka)
  • Disease of the chest (Like palpitation and the cardiac Pain)

The portion which affects the throat prodeuces

  • Irritation in the throat (Kanthodhvamsa)
  • Hoarseness of the voice (Swarabheda)

The portion which affects the Channels or Srotas which carries the vital breath causes

  • Dyspnoea
  • Coryza

That which is located in the head Causes Head Distress.

Due to the presence of wounds in the lungs, Abnormal movement of the vata and irritation of the Throat and constant Coughing. Due to the continued cough, the lungs get injured and lead to haemoptysis and the patient becomes weak. Hence, these are the complications which arise due to overexertion which affects the person involved in it. Later due to continued practice of these wasting complications, He patient gradually falls prey to Cachexia (Sosha). So the wise person should perform various activities with regard to his own Strength because the body is dependent on the strength.

Note: Person should abstain from over exertion action to protect his life because he will be able to enjoy his life and desired fruits of action.

2. Vega Sandharana

Again, suppression of the natural urges is a cause for this. When the person suppresses the urge of flatus, urine, Faeces because they might be attending to the king, The master or the preceptor, they have joined the society of Gambling in nobles in the midst of women. The one who is traveling on an uneven vehicle, due to the fear, Bashfulness, environment etc. Due to suppression of natural urges these the vata dosha get vitiated. The vitiated vata dosha aggravates the Pitta and Kapha and Spreads Upwards, Obliquely and Downwards.

Thus it is said that with a portion entering into the body parts will give rise to

  • Pain
  • Diarrhea
  • Increased or excessive pain in both the sides of the chest
  • Pain in Shoulder (Dryning pain)
  • Irritation in the throat
  • Irritation of lungs
  • Headache
  • Cough
  • Dyspnoea
  • Fever
  • Hoarseness of the voice
  • Coryza

So, the wise person should leave everything else, one should observe the way which promotes and protects the body. Body is their Substratum and also the course of the person.

Note: The person leaving everything else, The Person should protect their body because in case of diseases or sufferings. There is no use of the Other entities.

3. Wasting (Kshaya)

The wasting is the cause for phthisis.

  • When the person is excessively invaded at heart by grief and Anxiety, envy, ambitions, fear, Anger etc.
  • Intake of Rough food and Drinks while being emaciated.
  • Weak by birth.
  • Subjected to fasting.
  • Malnutrition.

Due to these, his rasa residing in heart gets diminished and he acquires phthisis. Semen gets diminished when a person due to excessive passion and attachment to the women involved in excessive sexual intercourse. Despite this, if his mind is not detract from women and engages in further sexual acts with more determined passion, Due to the already diminished Stage , his semen is not Discharging due to the physical exertion during coitus. Again due to this the vayu gets vitiated and enters into the blood vessels and causes the blood discharge from them which comes out from the seminal passage, because of loss of semen with the symptoms of vata.

Because of Loss of the Semen and Haemorrhage, the patient’s joints become loose, appear to be rough, and the body becomes further weak and vitiate the vayu. This vitiated vayu spreads in the body devoid of the Semen and blood and aggravates the kapha dosha and pitta dosha, Dries up the Blood and the muscles, Expels Pitta and Kapha, Causes pain in sides of the chest and the shoulders, Irritation in the throat, Aggravates the kapha dosha in head, Refills it kapha and causes joint pain, Body ache, Indigestion and Anorexia.

Due to mixing of pitta and kapha dosha, It gives rise to fever, Cough, Dyspnoea, Coryza and Hoarseness of Voice. Due to the consistent cough the lungs get injured and presented with Haemoptysis. Consequently the patient Suffers from the debility and is affected with these complications, He slowly becomes a victim of cachexia. So, Protecting his body and semen should be a priority because it is the final product of the food.

Note: Semen is the best essence of one’s food, Thus it should be protected by any means, Because absence of lessening of it may produce many Diseases.

4. Irregular Meals (Vishmashana)

Irregular dietary habits are a cause of Phythisis. When a person takes food which is edible, drinkable, Chewable and lickable. Irregular in terms of nature, Combination, Preparation, Quantity, Place, Rules of Dietary Use and Suitability. Due to this the Vata, Pitta and Kapha get imbalanced. These Imbalanced Doshas Spread in the body and when get localized in the entrance on channels of Circulation and do the obstruction. Due to which whatever the person takes mostly is transformed into Faeces and Urine only and not to the other Rasadi Dhatus. In this stage, the person is in support of faeces. So, the faeces are protected in this scenario.

Due to Improper nourishment, The Doshas gets aggravated due to their irregular dieting practice, respective complication and it may lead to further Degradation. In this condition the Vata Dosha Causes –

  • Pain
  • Body ache
  • Irritation of the throat
  • Chest pain
  • Pain in the shoulders
  • Hoarseness of the voice
  • Coryza

Pitta Dosha Causes –

  • Fever
  • Diarrhoea
  • Burning sensation

Kapha Dosha Causes –

  • Coryza
  • Heaviness of the Head
  • Anorexia
  • Cough

Due to frequent coughs the lungs get injured and presents haemoptysis and debility arises. Hence, these three doshas that get aggravated by irregular dieting give rise to this disease. Affected with these Wasting Complications, The patient gradually dries up. So, the wise person should take his food properly not in irregular terms of nature, combination, Preparation, quantity, place, time, Suitability and rules of Dietetic use.

Note: Observing many difficult diseases caused by Irregular Dieting. The Wise one should eat measured, Wholesome, Timely food with Self Restraint.

By regular use of these factors of Cachexia, THe vata, pitta, kapha doshas get vitiated. These Vitiated Doshas Dries up the body with other various complications. Some physicians call it Rajyakhama (Tuberculosis) because it is the most difficult among all the other Diseases or because in the early times it was affected by the king of Stars, Lord Moon.

Prodromal Symptoms

  • Coryza
  • Frequent sneezing
  • Mucus Secretion
  • Sweetness in Mouth
  • Aversion towards food
  • Exhaustion during meal time
  • Patient finds fault in Cereals, Pulses, utensils, Water, Flour preparations, caterers and Spicy preparations which are free from faults
  • Nausea after meals
  • During meals, Intermittent vomiting
  • Swelling on the feet and Face
  • Frequent looking at the hands
  • Excessive whitishness in the eyes
  • Curiosity about measuring the arms
  • Longing for women
  • Loss of disgust
  • Frequent dreams of waterless watery places
  • Loathsome view of the body
  • Frequent dreams of Forests which are dry, Burnt and Destroyed or
  • Riding over or using the vehicles drawn by Parrot, peacock, Monkey, Serpent, chameleon, crow, Camel, Dog, Owl, Ass and boar etc.
  • Riding over the heaps of hairs, bones, Ash and charcoal.

Eleven Symptoms

  1. Head Fullness
  2. Cough
  3. Dyspnoea
  4. Hoarseness of voice
  5. Vomiting of sputum
  6. Haemoptysis
  7. Chest pain
  8. Shoulder pain
  9. Fever
  10. Diarrhoea
  11. Anorexia

Curability Of The Disease

The one who is having all the symptoms of Phythisis can be termed as curable, in case his muscles, strength and blood is not wasted or he is strong and the fatal signs had not appeared. The Well Nourished and Strong, having tolerance to the intensity of the disease and drugs, should be taken as having a few symptoms in spite of having plenty of them.
On the other side, the one who is weak and also has a diminished strength, Blood and Muscles should be considered as having the numerous symptoms and is with the fatal signs even if the patient has a very few symptoms. Because that patient will not have the tolerance to the intensity of the Drugs and Diseases, hence such type of the person should be discarded from the treatment because the fatal sign appears very early and without any Specific cause.

Conclusion

In this chapter there is a complete explanation of the causes of cachexia and their Symptoms. It can be correlated with Rajyakshma (Tuberculosis). In this condition, the patient’s muscles, Strength, blood starts getting wasted or the depletion of the body tissues takes place. The symptoms can somewhat differ according to the cause of the sosha which can be managed with ayurvedic medicines, panchkarma and wholesome diet mentioned in the Chikitsa sthana of Charak Samhita.