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

Anukta = unsaid

Dosha Linga = symptoms of doshas

Anukta Dosha Linga means – unsaid symptoms of doshas

Context

Acharya Sushruta states that one (physician or surgeon) should try to identify the unsaid symptoms of doshas also in a given disease and treat the disease accordingly.

Ref – Sushruta Sutra Chapter 35, Verse 19

What is anukta dosha linga?

नास्ति  रोगो विना दोषैर्यस्मात्तस्माद्विचक्षणः ।
अनुक्तमपि दोषाणं लिङ्गैर्व्याधिमुपाचरेत् ॥१९॥ (Su.Su.35/19)

All the diseases that we suffer from are caused by aggravated doshas. No disease will ever manifest without the involvement of doshas. Therefore, an intelligent physician / surgeon will have to identify the doshas in spite of them not being mentioned and treat those diseases promptly.

So, here the Acharya states a rule between doshas and diseases and makes it clear that no disease is manifested without the involvement of aggravated dosha or doshas. This also means that the symptoms and signs found in a given disease are caused by the aggravated dosha or doshas involved in the pathogenesis and manifestation of a disease. Such ‘dosha lakshanas’ i.e. dosha specific symptoms are clearly mentioned in the texts in related contexts or chapters of particular diseases. The classification of diseases like vataja, pittaja etc. is also done based on the predominant dosha involved in the causation of that disease. The symptoms given in the context are those of the related dosha. Example – If the disease is Vataja Jwara i.e. fever caused by aggravated vata, the signs and symptoms of the same are caused by vata. So, the treatment should be according to vata i.e. to mitigate or expel vata with suitable measures, as the case may be.

Coming to the other rule,

Any disease is formed only after the amalgamation of predominantly aggravated dosha and a particular dhatu targeted by that dosha (weak and susceptible dhatu). This is called Dosha Dushya Sammurchana. When the amalgamation has started, there is not much tissue damage. But the reaction between dosha and dhatu / dushya causes some early symptoms of the disease. These symptoms are called purvarupas – premonitory symptoms of a disease. On the other hand, the symptoms of an established or manifested disease which appear after the amalgamation of the dosha and dushya has completed are called as rupas – the signs and symptoms of a disease. These appear after significant tissue damage has been caused by the invading dosha. When not treated even in this condition, complications of disease appear which determines the prognosis of the disease, which is usually bad at this stage. All these symptoms are explained contextually in each and every chapter. They give us a clear picture of the dosha or doshas involved in the pathogenesis and help us to plan the line of treatment accordingly.

Before Purvarupa, the doshas are in subtle form of aggravation as in Sanchaya – wherein dosha accumulation is taking place in its own seats, Purvarupa – wherein dosha aggravation is taking place in its own seats and Prasara – the aggravated doshas leave their seats and spread out in the body. Signs and symptoms of dosha aggravation during these stages too have been specified in the texts.

Seeing this, there is a lot of information in the Ayurveda texts which help us to establish this dosha-roga relationship and treat either the disease causing dosha, or the disease itself or both.

Every disease may be Nija – those caused by doshas, Agantu – those caused by external factors like injury etc and Manasika – mental disorders have a dosha link, at some point of the pathogenesis.

Will there still be any ‘unsaid’ dosha symptoms?

Since Acharya has mentioned it in the mentioned verse, there should be.

Acharya has mentioned the word ‘anukta dosha linga’ to tell that ‘the shastra has its limitations’ and all symptoms cannot be enlisted. Some symptoms need to be understood on the basis of inference (anumana or anumiti jnana) and on one’s knowledge of doshas and the pattern, nature and intensity of symptoms caused by them, either individually or in combinations of two or three, in spite of they not being mentioned or detailed.

With evolution may come up newer diseases, with newer symptoms, which do not have textual reference. Their dosha relationship needs to be established by the physicians of that generation, depending on the dosha knowledge that they have tapped from the ancient texts. The nature of such newer symptoms should be understood from the doshic lens and treated accordingly. This indicates the Bhavishya Jnana i.e. futuristic visualization of our ancient seers and acharyas. This is because they are aptas and they will have knowledge of the past, present and future.