Ashtanga Hrudaya Su.1 – Ayushkamiya Adhyaya

• Purpose of life –
  आयुः कामयमानेन धर्मार्थसुखसाधनम् ।
  आयुर्वेदोपदेशेषु विधेयः परमादरः ॥२॥ (AH.Su.1)
  Purpose/ Objectives of Life is :
  1. Dharma – to determine paths of life
  2. Artha – money
  3. Kama – desires
  4. Moksha – Liberation/ Salvation
• Ayurveda Avatarana (hierarchy of Ayurvedotpatti) –
  ब्रह्मा स्मृत्वाऽऽयुषो वेदं प्रजापतिमजिग्रहत् ।
  सोऽश्विनौ तौ सहस्त्राक्षं सोऽत्रिपुत्रादिकान्मुनीन् ॥३॥
  तेऽग्निवेशादिकांस्ते तु पृथक् तन्त्राणि तेनिरे । (AH.Su.1)

• Eight branches of Ayurveda –
  कायबालग्रह उर्ध्वाङ्ग शल्यदंष्ट्राजरावृषान् ॥५॥
  अष्टावङ्गानितस्याहुः चिकित्सा येषु संश्रिता । (AH.Su.1)
  Eight branches of Ayurveda :

1. 1. Kaya Chikitsa
   2. BalaChikitsa
   3. GrahaChikitsa
   4. UrdhwangaChikitsa
   5. Shalya Chikitsa
   6. DramshtraChikitsa
   7. JaraChikitsa
   8. VrushaChikitsa

• Concept of Tridoshas w.r.t. qualities (Guna), location in body &time period (kaala) –
  वायुः पित्तं कफश्चेति त्रयो दोषाः समासतः ॥६॥
  विकृताविकृता देहं घ्नन्ति ते वर्तयन्ति च । (AH.Su.1)
  There are 3 Dosha :

1. 1. Vata
   2. Pitta
   3. Kapha

विकृत – देहंघ्नन्ति – In vitiated state, they cause diseases & destroys the body.
अविकृत – देहंवर्तयन्ति – In equilibrium state, they maintain the body in healthy condition.

• Dosha Sthana –
  ते व्यापिनोऽपि हृन्नाभ्योः अधोमध्योर्ध्वसंश्रयाः ॥७॥ (AH.Su.1)

Vata	Below Umbilicus
Pitta	Between Umbilicus & Heart
Kapha	Above Heart

वयोहोरात्रिभुक्तानां तेऽन्तमध्यादिगाः क्रमात् । (AH.Su.1)

Dosha	Vaya	Aho	Ratri	Bhukta
Vata	Vruddha	Evening	Late Night	After Digestion
Pitta	Yauvan	Mid Day	Mid Night	Mid Digestion
Kapha	Bala	Morning	Early Night	Before Digestion/ After taking food

• Sapta Dhatu –
  रसासृक् मांसमेदोस्थि मज्जशुक्राणि धातवः । सप्त दूष्याः…….                    (AH.Su.1)

1	Rasa
2	Rakta
3	Mamsa
4	Meda
5	Asthi
6	Majja
7	Shukra

• Mala –
  …… मला मूत्र शकृत् स्वेदादयोऽपि च ॥१३॥ (AH.Su.1)

1	Mutra (Urine)
2	Shakruta (Stool)
3	Sweda (Sweat)

• Concept of Samsara & Sannipata –
  संसर्गः सन्निपातश्च तद् द्वित्रिक्षयकोपतः ॥१२॥ (AH.Su.1)
  Samsarga – Combination of any 2 Doshas which are Vrudhha or Ksheena.
  Sannipata – Combination of any 3 Doshas which are Vruddha or Ksheena.

• Concept of Prakruti (body constitution) –
  शुक्रार्तवस्थैर्जन्मादौ विषेणेव विषक्रिमेः ॥९॥ (AH.Su.1)
  The Prakruti (body constitution) is formed at the time of fertilization of Shukra (Sperm) &Aartav (Ovum) due to dominancy of doshas at that time, just as poisonous worms developed from poisonous material.तैश्च तिस्त्रः प्रकृतयो हीनमध्योत्तमाः पृथक् ।
  समधातुः समस्तासु श्रेष्ठा निन्द्या द्विदोषजाः ॥१०॥ (AH.Su.1)

1	VataPrakruti	HeenaPrakruti (Poor)	EkadoshajPrakruti (Dominance of Single Dosha)
2	Pitta Prakruti	MadhyamPrakruti (Moderate)
3	KaphaPrakruti	UttamPrakruti (Good)
4	Vata-Pitta Prakruti	NindyaPrakruti (Bad)	DwidoshajPrakruti (Combination of 2 Doshas)
5	Vata-KaphaPrakruti
6	Pitta-KaphaPrakruti
7	Sama DoshaPrakruti	ShreshthaPrakruti (Best)	TridoshajPrakruti (Combination of 3 Doshas)

• Three types of digestive fires (Agni) –
  तैर्भवेद् विषमस्तीक्ष्णो मन्दश्चाग्निः समैः समः ॥८॥ (AH.Su.1)

1	Vishamagni	dominance of Vata	Unsteady & erratic digestive activity
2	Tikshnagni	dominance of Pitta	Increased digestive activity
3	Mandagni	dominance of Kapha	Decreased digestive activity
4	Samagni	Tridosha in equilibrium	Normal digestive activity

• Three types of Koshtha –
  कोष्ठः क्रूरो मृदुर्मध्यो मध्यः स्यात्तैः समैरपि । (AH.Su.1)

1	KruraKoshta	dominance of Vata
2	MruduKoshtha	dominance of Pitta
3	Madhya Koshtha	dominance of Kapha
		Tridosha in equilibrium

• Effect of Rasas on Tridosha –
  तत्राद्या मारुतं घ्नन्ति त्रयस्तिक्तादयः कफम् ॥१५॥
  कषायतिक्तमधुराः पित्तं अन्ये तु कुर्वते । (AH.Su.1)

Vata-Kshaya&Kapha-Vruddhi Rasa	Vata-Vruddhi&Kapha-Kshaya Rasa	Pitta-Vruddhi Rasa	Pitta-Kshaya Rasa
Madhura	Tikta	Amla	Madhura
Amla	Katu	Lavana	Tikta
Lavana	Kashaya	Katu	Kashaya

• Two types of potencies (Virya) –
  उष्णशीतगुणोत्कर्षात् तत्र वीर्यं द्विधा स्मृतम् ।  (AH.Su.1)
  Two types of Virya : (Potency)
  1. Ushna
  2. Sheeta

• Three types of Vipaka –
  त्रिधा विपाको द्रव्यस्य स्वाद्वम्लकटुकात्मकः ॥१७॥ (AH.Su.1)
  Three types of Vipaka : (transformation process of food)
  1. Swadu (Madhura)
  2. Amla
  3. Katu

• Three types of Dravya on basis of Prabhav –
  शमनं कोपनं स्वस्थहितं द्रव्यमिति त्रिधा ॥१६॥ (AH.Su.1)
  Three types of Dravya :
  1. Shamana Dravya – which alleviates Doshas.
  2. Kopana Dravya – which vitiates Doshas.
  3. Swasthahita Dravya – which maintain Doshas in Normal state.

• Concept of Vruddhi & Kshaya –
  वृद्धिः समानैः सर्वेषां विपरीतैः विपर्ययः । (AH.Su.1)
  Vruddhi – Similar increases everything.
  Kshaya – Dissimilar decreases everything.

• Causative factors of health & Disease –
  कालार्थकर्मणां योगो हीनमिथ्यातिमात्रकः ।
  सम्यक् योगश्च विज्ञेयो रोगारोग्यैककारणम् ॥१९॥ (AH.Su.1)
  Hina-yoga (Insufficient), Mithya-yoga (wrong), Ati-yoga (Excessive) of Kala, Artha (Indriya), Karma causes Roga, while Samyaka-yoga causes Aarogya.

• Definition of Aarogya & Roga –
  रोगस्तु दोषवैषम्यं दोषसाम्यं अरोगता । (AH.Su.1)
  Roga – is considered as Dosha-vaishamya (vitiation of Doshas)
  Arogata – is Dosha-Samya.

• Types of Roga –
  निजागन्तुविभागेन तत्र रोगा द्विधा स्मृताः ॥२०॥(AH.Su.1)
  1. Nija Roga – Doshas get vitiated at first, and then Signs-symptoms appears.
  2. Agantuj Roga – Due to abhighat (accident) Signs-Symptoms appears first, and then Doshas get vitiated.

• Concept of Roga Adhishthana –
  तेषां कायमनोभेदाद् अधिष्ठानं अपि द्विधा ।(AH.Su.1)
  1. Kaya
  2. Manas

• Manas Dosha –
  रजस्तमश्च मनसो द्वौ च दोषावुदाहृतौ ॥२१॥(AH.Su.1)
  1. Rajas
  2. Tamas

• Methods of assessment of patient –
  दर्शनस्पर्शनप्रश्नैः परीक्षेत च रोगिणम् ।(AH.Su.1)
  1. Darshana Pariksha – Inspection
  2. Sparshana Pariksha – Palpitation
  3. Prashna Pariksha – Interrogation

• Methods of examination of disease –
  रोगं निदानप्राग्रूप लक्षणोपशयाप्तिभिः ॥२२॥(AH.Su.1)

1. 1. Nidana (causative factors)
   2. Pragrupa/ Purvarupa – (Prodormal symptoms)
   3. Lakshana – Signs & Symptoms
   4. Upashaya/ Anupashaya (Therapeutic test)
   5. Apti/ Samprapti – Pathogenesis

• Three types of habitats (Desha) –
  भूमिदेहप्रभेदेन देशमाहुरिह द्विधा ।
  जाङ्गलं वातभूयिष्ठं अनूपं तु कफोल्बणम् ॥२३॥
  साधारणं सममलं त्रिधा भूदेशमादिशेत् । (AH.Su.1)
  Bhumi Desha
  Deha Desha –

1. 1. Jangala – Vata dominant
   2. Anupa – Kapha Dominant
   3. Sadharana – Tridosha in equilibrium

• Two types of Bheshaja Kala –
  क्षणादिर्व्याध्यवस्था च कालो भेषजयोगकृत् ॥२४॥(AH.Su.1)

1. 1. Kshanadi Kala (Moment, second, minutes…)
   2. Vyadhi-avasthik Kala (Shat-kriyakala)

• Classification of treatment modules (Aushadha) –
  शरीरजानां दोषाणां क्रमेण परमौषधम् ॥२५॥
  बस्तिर्विरेको वमनं तथा तैलं घृतं मधु ।(AH.Su.1)

Sharira Dosha Chikitsa
Doshas	Shodhana	Shamana
Vata	Basti	Taila
Pitta	Virechana	Ghrita
Kapha	Vamana	Madhu

• Treatment module for ManasDosha –
  धीधैर्यात्मादिविज्ञानं मनोदोषौषधं परम् ॥२६॥(AH.Su.1)
  • Dhee (Discrimination between right & wrong)
  • Dhairya (Courage)
  • Aatma Vijnana (Spiritual teachings)

• Chikitsa Chatushpada (4 factors of treatment) –
  भिषक् द्रव्याण्युपस्थाता रोगी पादचतुष्टयम् ।
  चिकित्सितस्य निर्दिष्टं प्रत्येकं तद् चतुर्गुणम् ॥२७॥(AH.Su.1)
  Four limbs of treatment :
  1. Bhishak (Physician)
  2. Dravya (Medicinal Dravya)
  3. Upasthata (Attendant)
  4. Rogi (Patient)
  Each one has four qualities.
• Qualities of Bhishak :
  दक्षस्तीर्थात्तशास्त्रार्थो दृष्टकर्मा शुचिर्भिषक् ।(AH.Su.1)

1. 1. Daksha – professionally efficient/ fast acting
   2. Tirthartha shastrartha – must have learned from gurus/ vaidyas.
   3. Drushtakarma – experienced in practical aspects
   4. Shuchi – sanctity or purity in acts of mind, body and speech

• Qualities of Dravya :
  बहुकल्पं बहुगुणं सम्पन्नं योग्यमौषधम् ॥२८॥(AH.Su.1)

1. 1. Bahukalpam – should be in different forms or preparations (Swarasa, Kwatha, Churna, etc.)
   2. Bahugunam – must has many qualities (Gurvadi gunas)
   3. Sampannam – should be potent (Viryatmak)
   4. Yogyam – should be suitable to patient & disease acc to Desha & Kala.

• Qualities of Upasthata :
  अनुरक्तः शुचिर्दक्षो बुद्धिमान् परिचारकः ।(AH.Su.1)

1. 1. Anurakta – Nurse should be affectionate & serviceable to patient
   2. Shuchi – purity & sanctity in all aspects
   3. Daksha – must be efficient/ fast acting
   4. Buddhiman – intelligent

• Qualities of Rogi :
  आढ्यो रोगी भिषक् वश्यो ज्ञापकः सत्त्ववानपि ॥२९॥(AH.Su.1)

1. 1. Adhya – patient should be wealthy
   2. Bhishak-vashya : obedient to physician
   3. Jnapaka – should have memory to recall his problems
   4. Sattvavana – Strong will-power

• Types of prognosis of disease – (Types of diseases according to Sadhya-Asadhyata)
  साध्योऽसाध्य इति व्याधिः द्विधा तौ तु पुनर्द्विधा ।
  सुसाध्यः कृच्छ्रसाध्यश्च याप्योयश्चानुपक्रमः ॥३०॥(AH.Su.1)

• Sadhya Vyadhi –
  1. Sukha-sadhya
  2. Krucchra-sadhya

• Asadhya Vyadhi –
  1. Yapya
  2. Anupakrama

• Sukhasadhya Vyadhi Lakshana :
  • सर्वौषधक्षमे देहे – body should be capable of withstanding all types of treatments
  • यूनः – in adults
  • पुंसो – in males
  • जितात्मनः – control over sense organs
  • अमर्मग – not affecting vital organs
  • अल्पहेत्वग्ररूपरूपो – mild causes, purvarupa, Lakshana
  • अनुपद्रवः – lack of complications
  • अतुल्यदूष्यदेशर्तुप्रकृतिः – dissimilar in respect of Dushya, Desha, Rutu & Prakruti
  • पादसम्पदि – have excellent four limbs of treatment
  • ग्रहेष्वनुगुणेषु – have favourable Graha
  • एक दोषमार्गो – manifested by single dosha & in single Rogamarga
  • नवः – recent onset

• Krucchra Vyadhi Lakshana :
  • शस्त्रादिसाधनः – needs sharp instruments for treatment
  • सङ्करे – which has mix symptoms of Sukhasadhya & Asadhya Vyadhi

• Yapya Vyadhi Lakshana :
  • शेषत्वादायुषो – disease which persists till end of life
  • पथ्याभ्यासाद् – maintain by wholesome food
  • विपर्यये – has qualities opposite to Sukhasadhya Vyadhi

• Anupakram Vyadhi Lakshana :
  • अत्यन्तविपर्यये – symptoms entirely opposite to Sadhya Vyadhi
  • औत्सुक्यमोहारतिकृद् – which produces excitement, restlessness & unconsciousness
  • दृष्टरिष्टो – which shows Arishta Lakshana
  • अक्षनाशनः – loss of functioning of sense organs