Article by Dr Raghuram Y.S. MD (Ay) & Dr Manasa S, B.A.M.S

As a norm of the creation, we all would have seen or experienced from what happens around us that ‘destruction is far easier and quicker’ but to reassemble and reconstruct the destroyed things takes a hell lot of time, more than the original construction. This is because the remnants of the destruction needs to be cleared out before the actual process of reassembling starts.

Same is the case with the human body and mind. Doshas easily get aggravated. They spread quickly. They attack and damage the tissues even faster. The disease is also quickly manifested following the amalgamation of strong doshas and weak and susceptible tissues which cannot defend themselves against ‘dosha assault’. But the reverse engineering – called the treatment process or its effect, ‘the cure’ – is difficult.

The physician needs to do a lot of exercise and invest all his knowledge and practice into effecting this reverse engineering into a successful cure of the disease.

Firstly, he needs to handle ama with ama pachana. He has to balance agni with agni Deepana. He has to loosen the doshas which have stubbornly lodged in the tissues and refuse to come out by means of snehana and swedana. Once the liquified doshas flow from the tissues towards the kostha – stomach / intestine – he shall expel them by administration of ideal shodhana measures – vamana in case of kapha and virechana in case of pitta. He then needs to put the patient on graduated dietetic protocol through administering Samsarjana Krama, so as to bring back the agni weakened due to shodhana, back to normalcy. Then, he needs to administer Rasayana therapy to see that the recovery is good and stable and the chances of recurrence of the disease would lessen and also to enhance the immunity of the person. He should keep having follow ups of the patient until he makes it sure that the person is back to his normal. We can see that this is not achieved easily. It differs from person to person, disease to disease.

But the health seeker will just be looking for relief from his ailments. The expectations will be cosmos high. There may be many questions. ‘Why is it taking so long for my problem to get addressed?’. ‘Why is the treatment not responding quickly?’. ‘Doctor, how many more days will it take for me to become a hundred percent okay?’. And many more. This also builds up the pressure on the physician. This is where he needs to be courageous and confident. Assurance, reassurance and educating the patient is very important.

From the physician’s perspective, he too should know what Acharya Vagbhata beautifully says in this perspective – ‘aggravation of doshas and their spread in the body is fast, their decrease is slow’. Let us see what the master has to say, his reference and analogy – in this direction.

Reference – Ashtanga Hrdaya SutraSthana, Chapter 12, Verses 29 ½ to 30 ½ (A.Hr.Su.12/29b-30a)

Flood Analogy to explain why reversing pathogenesis or dosha aggravation is difficult and slow

व्याप्नोति सहसा देहमापादतलमस्तकम्॥२९॥
निवर्तते तु कुपितो मलाऽल्पाल्पं जलौधवत्।

Acharya Vagbhata gives a ‘flood analogy’ to understand why reversing pathogenesis of a disease or damaged caused by aggravated doshas is difficult and a slow process, in comparison to the quick aggravation and spread of doshas in the body and consequent manifestation of disease.

He says – ‘When floods occur, they spell disaster. The water quickly rushes into the cities breaking all barriers and causing quick and extreme destruction of material and life. This destructive pathway is easy and happens quickly. But to recover the same city from the after-effects cannot be quickly achieved. This is because the reversal process i.e. evacuating the city of the water load is very slow and difficult. It needs immense work and dedicated teams to work for many days to recover the city and put it back to life. Still, everything cannot be claimed and replaced. Whatever is lost, is lost forever. It is almost like rebuilding a ruined city. It may never be the same. It may get a new makeover after a few years. The tragedy and damage may be forgotten. But the city is never the same’.

Putting this analogy in the line of dosha aggravation, the flooding of the city is correlated to flooding of doshas-in-rampage and aggressive mood reaching every corner of the body, which is the city here. The doshas would impact severe destruction of the city of our body. This pathway is easy and quick. But reversing the events and reestablishing peace, normalcy and health in the body is slow and difficult, as explained above.

Acharya says, in his words, ‘the vitiated doshas quickly spread throughout the body from foot to head and cause many diseases, but the decrease of doshas and restoration of normalcy takes place very slowly and takes a lot of time to get reversed, just like the floods’.

So, a physician who knows this and understands this will not hurry up in treating a given patient or condition. He will delicately handle the reverse engineering until the citadel is recovered from its damages.