1. Presenter Dr. Kamalakar., II Year PG Scholar, VYADHYAVASTHA Department of Samhita, Samskrta and Siddhaanta 2. The knowledge of Vyadhawastha play a valuable role in the Diagnosis, Prognosis of Disease , determination of the strength of Vyadhikshamatwa, application of Treatment, advice on food and behaviour Therefore the physician, patient, and attendants must keenly observe the changes occuring in Vyadhyawastha 3. Why undestanding of Vyadhyavastha is important? A wise physician should closely observe the subtleties of aggravated , normal and diminished states of diseases , body, power of digestion, strength and mental faculties The treatment must change according to the change in the Vyadhiavastha 4. If treatment is given after a comprehensive understanding of Vyadhyavastha, An intelligent physician should prescribe for Vyadhyavastha chikitsa as would help attainment of the four-fold success 5. When Dosa Dusya Sammurchana takes place leading to the formation of the disease, it follows a path consisting of onset , duration and progress or retrogression In the period of duration of disease ,different stages appear due to several factors and they are called the stages of diseases (Vyadhyavastha) 6. They denote the changes which occur from time to time in a disease and depend on two opposite forces acting on the body. On one side there are factors responsible for increasing the disease pathology, on other side , there are forces like the general body resistence- Vyadhikshamatwa. The changes which occur in a disease produce different Vyadhiawasthas are in fact taking place in the five contributory factors of the disease i.e Dosa , Dushya, Agnimandhya, Ama and Srothorodha 7. A) Stages occuring due to changes in Doshas 1)Shatkriyakala 2) Vegawastha and Avegawastha 3)Dosapakavastha B) Stages occuring due to changes in Dusyas 1)Dhatupaka 2)Dhatugatawastha 3)Nava Jirnavastha 4)Uttana- Gambira avasthas C) Stages occuring due to change in the condition of Srotovaigunya D) Stages occuring due to change in the condition of Ama and Agnimandhya E) Asukari and Chirakari 8. Stages occuring due to changes in Doshas 9. VEGAWASTHA AND AVEGAWASTHA 10. The stage of attack and stage between the attacks of disease When Dosas attain Sammurchana the attack precipitates and when Sammurchana breaks the attack gets relieved The stage in between the attacks i.e. Avegavastha , is also a stage of disease eventhough sometimes it is not manifested 11. Dosas remain increased and dormant in this stage Leenavastha and can produce an attack of the disease when condition become favourble to it For example Tamakaswasa Visama Jwara Apasmara The importence of the knowledge of these stages lies in the fact that during the attack the treatment has to be directed towards correction of Doshas, While between the attacks treatment must be given for increasing the power of Dathus and Srothas i.e Vyadhikshamatwa 12. DOSAPAKAVASTHA 13. It is a stage favourble to treatment of disease because in this condition Ama is separated from Dosas Dosas get digested ,their vitiation subsides and they either tend to become normal or start coming towards the Kosta Therefore the treatment must aim at producing Dosapaka, which depends on Agnibala 14. Nirama stage of Dosha. Doshas start coming towards Kosta It is essential stage for the recovery of the disease DURING DOSAPAKA SYMPTOMS: Disease starts diminising Patient feel lightness Fever will subside Sense organs receive normal sensation M.NI.2/66-73 15. Stages occuring due to changes in Dusyas 16. DHATHUPAKA 17. Vitiation of any Dosha may cause either a temporary damage or permanent destruction of Dathus because they are subjected to a process of digestion As it is a process of digestion, Pitta plays a predominent role , whichever be the Dosa taking part in Samprapti 18. Dhathu paka means worsening of the disease condition due to its advance stage along with loss of strength and elimination of Dathus via Mutradhi excreta SYMPTOMS: Loss of sleep Loss of strength Anorexia Heaviness M.NI.2/66-73 19. In chronic Rajayakshma Dustarbuda etc the Dathus are destroyed. if this destruction is progressive the condition of patient becomes incurable But if the pathalogy is checked, the condition of Dhatupaka gets restricted which is suggestive of good chances of recovery 20. DHATHUGATAVASTHA 21. When Dosa Dusya Samurchana of disease invades the deeper Dhathus In Charaka Dhatugatavasthas of Jwara Kusta Vatarakta and Masurika are described But this condition can occur in any disease and severity of the symptoms is greater when Dathus like Asthi, Majja, Sukra are involved For example Mamsadhatugatavastha of Amlapitta is described as Parinamashula 22. NAVA AND JEERNAVASTHA 23. Newly formed disease is called as Nava Avastha and after a certain period which varies from disease to disease, it gets converted into Jirnaavastha According to Charaka Jirnavastha occurs due to the weakness of Dhatus CH.CHI.3/291 In such conditions Dhathukshaya and Vata Prakopa occurs .these are important , from the point of view of treatment 24. UTTANA AND GAMBHIRA AVASTHAS 25. In Uttana Avastha only the superficial Dhatus are involved. In Gambhira Avastha deeper Dhathus upto Majjadathu are involved CHA.SU.28/7 Susrutha has described the Avagadhavastha. In Vatarakta and Kusta this condition has been cited 26. STAGES OCCURING DUE TO CHANGE IN THE CONDITION OF SROTOVAIGUNYA 27. ANTARVEGI & BAHIRVEGI AVASTHA Patient feels internal burning sensation even if the external body temperature is not increased Patient feels burning sensation superficially but not inside the body Antarvegi Avastha suggests greater Srothorodha and Dosadusti CHA.CHI 3/41 28. STAGES OCCURING DUE TO CHANGE IN THE CONDITION OF AMA AND AGNIMANDHYA 29. These two factors are interdependent and should be considered together The change in the constitution of Ama which occurs due to increased power of Agni converts the primary stage i.e. Amavastha, in to Pachyamanavastha and Pakwavastha When the power of Agni gets increased either by treatment or by the natural process of digestion of Ama begins and this condition is called as Pachyamanavasta When the digestion of Ama is completed the stage is called Pakwavastha or Niramavastha 30. SAMAJWARA: Temperature rises quickly. There is no remission of temperature for 10 to 12 hrs The patient does not get perspiration due to blocking of channels Anorexia, heaviness in abdomen Non elimination of doshas PACHYAMANA JWARA: Temperature rises Thirst Elimination of waste products NIRAMA JWARA: Ama is detoxified Appetite increase Lightness in the body 31. ASUKARI AND CHIRAKARI 32. The condition of sudden onset and short duration of disease called Asukari If the disease ,instead of being cured quickly gets prolonged, the symptoms of accute stage become milder but persist for a longer time- Cirakari For example Masurika, Vicharchika, Visuchika, have only the accute condition While others like Kusta, Pakshavadha, Prameha are only of a chronic nature 33. IMPORTENCE OF THE KNOWLEDGE OF AVASTHAS 34. Certain symptoms are specific for a specific disease i.e. they are not dependent on the stage of Vyadhiavastha.for example Swedavarodha, Santapa are specific symptoms of Jwara Vyadhi But other symptoms are either dependent on Dosa Dusti of Vyadhyavastha It is essential to differentiate the symptoms occuring due to Vyadhiavastha, to arrive at a correct diagnosis 35. The description of Amavastha and Kaphaja Vyadhi, description of Pachyamanavastha and Pittajavyadhi closely resembles each other In such cases , if the physician is not experienced enough to understand the changes in the symptoms occuring due to Vyadhiavastha physician may not be able to distinguish between the two conditions. 36. For example Gurugatrata, Praseka, Hrullasa, and Tandra are the symptoms in the Samavastha of Jwara and Kaphaja Jwara, but symptoms like Apakthi, Ksudhmandhya, Bahumutrata are the specific symptoms of the Samavastha of Jwara The treatment must change according to the change in Vyadhiavastha for example Langana is recommended in Navajwara while Ghrta pana is essential for Jirna Jwara Sthambana is the treatment in Atisara, but it is not recommonded in its Amavastha 37. Kasyapa says that if medicine and Pathya are administerated at the proper Avastha i.e without knowing the specific Avasthakala, they produce greater vitiation of Dosas. Hence the value and efficacy of treatment depend on a comphrehensive and minute knowledge of various Avasthas 38. A proper knowledge of Avastha is helpful in preventing the devolopment of more severe stage of disease. For example Hritsula(AP) being the early stage of Hridroga(MI), If this stage is treated properly it will be possible to prevent the occurrence of the Hridroga. 39. A knowledge of the Avastha is also helpful in determining the Sadhyaasadhyatha of the disease. For example Antarvegi Avastha indicates Kastasadhyatwa, while Bahirvegi Avastha suggests Sukhasadhyatwa. The benign type of Arbuda is Sukhasadhya while the malignant type is Asadhya. Dhatugatavastha in deeper Dathus like Asthi, Majja and Sukra is Asadhya 40. CONCLUSION 41. Before treating any disease the understanding of vyadhiawastha is very important. Lack of knowledge of avasthas may lead to wrong treatment .such treatment produces several upadravas Appropriate fulfilment of padacatusthaya which are helpful in controling and curing the disease 42. REFERENCES CHARAKA SAMHITA SUSRUTHA SAMHITA ASTANGA HRIDAYA MADHAVA NIDHANA KASHAYAPA SAMHITA ROGA NIDHANA ..DR.BYADGI 43. Physician is the important quadrant among the quarters of treatment THANK YOU