International Journal of Applied Ayurved Research ISSN: 2347- 6362 VIKARA VIGHATA BHAVA- (NON OCCURRENCE AND OCCURRENCE OF DISEASE) AND ITS ROLE IN PRAMEHA W.S.R TO MODY 1Verma Meenakshi, 2N.J Trivedi, 3K.K Upadhyay, 4Y.Niranjan 1PG Scholar Department of Kayachikitsa Parul institute of Ayurevda Vadodara Gujarat- 391760, 2Professor & Head, Department of Kriya Shareera, Parul Institute of and Research, Vadodara, Gujarat, India 3Professor, Department of Kayachikitsa, Parul Institute of Ayurveda, Vadodara, Gujarat, India 4Hod &Associate Professor, Department of Kayachikitsa, Parul Institute Of Ayurveda, Vadodara, Gujarat, India ABSTRACT Prameha is a disease known to mankind since Vedic period. It is always caused by severe morbidity of Dosha afflicting the different body elements. In the literature it is said that, collectively 10 Dushya are involved in the pathogenesis of Prameha. Vyadhi is ‘Doshadushya-Samurcchana’that mean there is an involvement of Doshas with Dushyas in a variety of permutations & combination, resulting in the occurrence of various diseases. Many Vyadhis given in -granths, were having similar Doshas combine with similar Dushyas, may be having similar or different Adhishthana i.e. Sthanasanshraya. Basically three components are required for occurrence of any disease i.e. Nidana, Dosha, and Dushya. But, the presence of these three is not an assurance for occurrence of disease. Sometimes when these three are being present in vitiated condition then also disease is not taking place, or occurring late, occurring with few symptoms or symptoms are present in subtle form i.e. Vikara vighat Bhava. This is suggestive of balanced Vyadhikshmatva. and opposite to it is Vikara vighata Abhava that is rapid occurrence of disease, occurrence of disease with all manifested symptoms. This can be correlated to decreased capability to response against any disease i.e. squat Vyadhikshamatva. Keywords: Vyadhi Kshamatva,Vikara vighata Bhava Abhava, Prameha, MODY, Dosha, Dushya. INTRODUCTION dependent upon the food which we take. The focus of Ayurveda is basically on At times it is observed that people taking maintenance of healthiness.But when healthy food are also ailing and people health status is distressed due to any taking unhealthy food are able-bodied. reasons leading to disease, then it helps in The one factor called Vikar Vighat Bhava suppression of disease also. Various is present, which helps the body to fight notions are mentioned in for against the disease causing factors. health preservation like following a daily AIMS AND OBJECTIVES regime (Dinacharya), seasonal regime AIM (Ritucharya),Rasayana therapy, Satmaya  To understand the concept of etc. The factors like Ahara(food intake) “VikaraVighata Bhava Abhava Prativishesha” and Vihara (environment) are supportive  To understand the influence of Vikara of safeguarding wellbeing. The Vighata Bhava Abhava Prativishesha maintenance of wellbeing and disease are in Prameha. [Verma Meenakshi et al : Vikara Vighata Bhava-Abhava (Non Occurrence and Occurrence of Disease) and its Role in Prameha w.s.r to Mody]

OBJECTIVES CharakaPramehachapter. But it is not  To see the inter relation between the only for the Pramehait is applicable for all Visheshas and Prativisheshas. the diseases. Herewe shall describe the  To critically analyses the mechanism suppression or the incidence of the disease influencing the Vishesha and which occur as a result of the variation in Prativishesha. the etiological features.  To illustrate this concept with certain Certain factors which do not help for the hypothetical clinical conditions. Vyadhi Samprapti, In other words which MATERIALS AND METHODS oppose to create the disease is called Vikar VighatkarBhava this is also called All the classical texts of Ayurveda Vikar Anupattikar Bhava.i (Samhitas along with their commentaries) Certain factors which help the Vyadhi were referred for this literary work. The Samprapti or whenVyadhi Utpadakar discussion was made on the basis of Bhavaare present in the body then it will produce the disease calledVikar Vighat conceptual study, and conclusions were Bhava Abhava. In other words the drawn considering the conceptual study Etiologicalfactors having homologous and discussion. properties as Dosha interact with them CONCEPTUAL STUDY quickly leading to manifestation or Basically Vikar Vighat Bhava Abhavais aggravation of disease. described in Nidan Sthana Table no. 1 Nidana Dosha Dushya Disease Divaswapa, Kaph Meda Prameha Asyasukha Excessive intake of Pitaa Rakta Rakta-Pitta kshara, Usna Fasting, swimming Vata Asthi Sandhigata Vata Three components are requiring for present in equilibrium state then disease occurrence of all disease.These are does not occurred, becauseVikara Vighata interconnected to each other i.e. Nidana, Bhavas are present does not lead to Dhatu Dosha, Dushya.Which are responsible for Vaishamya. Analysing the components of occurrence of all the disease, and these disease, the Dosha and Dushya are the Innumerable diseases have different factors without which the disease could not Samprapti.So we also need to analyze the occur; their amalgamation is a responsible various factors affecting the disease. for the same. When treatment is planned Nidana comes from outside of body, while reverse is done, first the external factors Dosha and Dushya are present inside the are removed, then amalgamation is broken body. External vitiating factors is called as and then the vitiated Dosha are brought Bahya Hetuii, where as the vitiated Dosha, under normal level. Dushya are the AbhyantaraHetu, As per Vishesha:The specific factors which Ashraya-Ashrayi Bhava the Dosha reside involve in the Vyadhi Samprapti i.e. in Dhatu(Dushya).iiiWhen the external Nidana, Dosha, Dushya. Basically as explained before these etiological factor etiological factors vitiate the Dosha then are interconnected to each other so after Dushya also get vitiated then leading to the combination of these factor disease Dhatu Vaishamya i.e. disease. will occur ,but is does not happened all the WhenNidana,Dosha and Dushya are time, but when these component are

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[Verma Meenakshi et al : Vikara Vighata Bhava-Abhava (Non Occurrence and Occurrence of Disease) and its Role in Prameha w.s.r to Mody] similar then disease occur instantly and Prativishesha: These are the outcome with all said symptoms. produced by the influence of Vishesha. Table No.2 VIKARA VIGHATAKARA BHAVA VIKARA VIGHATAKARAABHAVA Na Vikara Utpatti Vikara Utpatti ChiratVikara Utpatti Sheegra Vikara Utpatti Alpa Bala Vikara Utpatti Bala Vikara Utpatti The Specialtyof Vikara Vighata Bhavaiv Nidan-Dosha-Dushya

With less intensity With high intensity Highly strong

Presence of Vikarvighata Bhava

Vikar anutpatti Durbal dosha anusaranNidan,Dosha,dushyaKalprakarshat (Not mutually associated) Paraspar anusaran Anusaran (Mutually Associated)(With gap and Season)

Roga-Tanrupa Vijanana AlpalingaRogotpatti Rogasya Chirat Utpatti

Sarva Lakshna Sampurna

This may be acute and chronic Vikara janana- no occurrence of Parasparam Na Anubadhnanti, (not disease.Chirena Vikara janana- late mutually associated) that means occurrence of disease Annu Vikarjanana- Pratiukula condition between occurrence of disease in subtle form or Nidana,Dosha,Dushya in which Samana mild Asarvalinga Vikara janana- guna(Drava, Guna, Karm, occurrence of disease with less symptoms Prabhava)Dhatu Shaithilyata(Intake of or the symptoms are not properly Nidana and action on Dhatu help to vitiate manifested. it), Avirodha(Presence of resistance Another description of Vikarvighat Bhava towards the Vyadhi Samprapti)these are Abhava- responsible for no manifestation of the • Anubadhnanti disease. And second is Parasparam • Kala Anubadhnanti (Mutually Associated) that • Bala means manifestation of the disease A) Anubadhnanti- occur.In other words No AfterNidana,Dosha,Dushya samurchana Samanata(Dissimilarity) between Nidana, Anubadhnanti again divided into Dosha and Dushya as well as Nidana is 1) Parasparam Na Anubadhnanti not capable to creating Shithilata in 2) Parasparam Anubadhnanti Dushya and Presence of VirodhaBhava

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(Absence of resistance towards the Vyadhi C) Bala- After Nidana,Dosha,Dushya Samprapti). samurchanaAgain Bala divided into- B)Kala-After Nidana,Dosha,Dushya 1) Abaliyamso Anubadhnanti or Alpa SamurchanaKala again divided into- bala vikara utpatti, 1) Kalaprakarshat Anubadhnanti 2) Baliyamso or Bala Vikara Utpatti Abaliyamso Anubadhnanti or Alpa bala 2) Sheegram Anubadhnanti vikara utpatti, That means less intake of Kalaprakarshat Anubadhnant(With gap Nidana or that Nidana which posses less and Season) that means Chirat Vikara strength less vitiation of Doshas manifest Utpatti(Disease take long time to disease with mild Or without evolve).When the Nidana is of less all said symptoms, intensity, and if Vyadhikshamatva is Baliyamso or Bala Vikara Utpatti that normal, then the amalgamation of Hetu means more intake of nidana with more with Dosha and Dushya occurs with v strength and Manifestation of disease with passage of time. Here, the disease does all said Lakshanas. not occur. But, again if the same Vyadhikshamatva and Vikara Vighata etiological factors are taken then it vitiates the Doshas, as they are already weak due Bhava Abhava- to previous manifestation. The disease Vyadhikshamatva is not elaborately viii occurs after a period of time. Out of mentioned in Samhitas . The term is different types of Hetus mentioned one is mentioned in the context of wholesome vi Vyabhichari Hetu, which means the cause and unwholesome diet. The diet which is not potent enough to produce a does not disturb the homeostasis of Dhatus diseasesimilarly in the context of Abhesaja as well as bring backs the disequilibrium two types are mentioned Badhana and Sanubadhana.The Sanubadhana is one to equilibrium is termed as Hitkara Ahara, such in which the cause is present inside whereas the diet which disturbs the body and disease occurs after a longer balance of Dhatus as well as vitiates the time. In the condition mentioned imbalance of Dhatus in more amount is Vyabhichari Hetu and Sanubadhana type Ahitkara Ahara. So, intake of wholesome of Abhesaja can be inferred and just diet results in healthy status, while intake opposite to it is the Vikara Vighata of unwholesome diet results in unhealthy Abhava.viiThat means occurrence of disease is rapid, with manifestation of all status i.e. disease. Sometimes, it is symptoms. observed that intake of wholesome food In other words Nidana when consumed at also results in disease, while intake of different gaps then it will lead to delayed unwholesome food results in healthy manifestation of disease, Dosha will wait status. for the favorable Kala, where Kala itself Factors which resist the occurrence of acts as the cause (Nidana) by being similar disease are Vikara Vighata Bhava and the to Dosha and hence leading for the factors which facilitate the happening of manifestation of disease. disease are Vikara Vighata Bhava Abhava. Sheegram Anubadhnanti(Without gap This Vikara Vighata Bhava is the outcome andSeason)that means Sheegra Vikara of Vyadhibala Virodhitatvam. This means Utpatti(Disease do not take long time to the body is immune in such a way that it evolve). In other words If there is resists the abnormal things which are not continuous intake of Nidana without any good for body. Here the abnormal things time gap, or similarity between kala and are the Nidana which vitiate the Dosha. dosha instantaneous vitiation takes place.

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Table no-3 Vikaravighata Bhava-Abhava in relation with Vyadhikshamatva

Nidan Vyadhikshamatva Status of Fate of disease Amalgamation High intensity Low Fast Fast occurrence Low intensity Vital No interaction Fast occurrence Low intensity Vital Interaction with Late occurrence passage of time Aetiological classification of In addition to other factors, the classics Prameha have also accepted the concept of On the basis of aetiology, Sushruta has hereditary factor as a cause of mentioned clearly two types of Prameha. Prameha.Charaka has mentioned that One is Sahaja (hereditary) another is overindulgence of Madhura Rasa by Apathyanimittaja (Acquired). Acharya mother during pregnancy is likely to Bhela has named them as – Prakétaja and induce Prameha Svakétaja Prameha. Apathyanimittaja a.Sahaja:Sahaja Prameha occurs as a Hayanaka, Yavaka, Cinaka, Uddalaka etc. result of Bija Dosa i.e. genetic origin. in newly cultivated form, Consumption of While describing prognosis, Acarya new pulses like Harenu and Masa with Caraka has narrated that Jatapramehi is Ghrita,Guda and Iksu vaikrita preparation, incurable. Milk, fresh Milk, Mandaka dadhi and all b.Apathyanimittaja: It occurs due to other materials which increase Kapha unwholesome Àhara & Vihara.(Faulty diet ,Lack of exercise, Laziness, Excessive & life style errors). sleep during day, alcohol consumption etc. Sahaja Nidana Samprapti of prameha

Bahudravashlesma

Kapha Dosha(Prithvi and Jala Mahabhuta)

Naimittika Dravata- Jala Mahabhuta

Anaimittika Dravata- Mahabhuta

Consumption of Prithvi, Jala, Agni Mahabhuta dominant causative factor

Excess Kleda formation

Prameha disease

Role of Vikar Vighat Bhava Vikar Vighat Bhava-Abhava described in Abhava in Prameha Nidan Sthana Prameha Chapter,basically it is applicable for all the disease because

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[Verma Meenakshi et al : Vikara Vighata Bhava-Abhava (Non Occurrence and Occurrence of Disease) and its Role in Prameha w.s.r to Mody] each and every disease has different diagnosed before 25 years of age and was ix etiological factor and different Samprapti. first recognised by Tattersall in 1974. The word, Prameha is derived from the MODY is the most common form of root ‘mih sechane’ meaning ‘watering’.In monogenic diabetes, accounting for an reference to disease of human beings, it estimated 1–2% of diabetes in Europe, but is often misdiagnosed as type 1 or type many have a meaning of passing urine, x xi qualified by prefix ‘Pra’ meaning excess 2diabetes. - The term MODY is used to in both frequency and quantity.Prameha is describe a group of clinically derived from Pra+Miha. A condition heterogeneous, often non-insulin- characterized by excessive outflow of dependent forms of diabetes that are defined at the molecular genetics level by urine ( kalpadruma). xii So basically Prameha occurs as a result of mutations in different genes. MODY is a Bija Dosai.e.geneticorigin as well as due rare form of diabetes which is different to unwholesome Àhara & Vihara. from both type and type 2 diabetes, and When the parents are healthy and children runs strongly in families. are doing Nidan sevan from their MODY is caused by mutation (or change) childhood then they will suffer from the in a single gene. If a parent has this gene Prameha in very early age of life because mutation, any child they have, has a 50 of absence of Vikarvighat Bhava. It is just percent of inheriting it from them. because of Dosha Vaisamyata, but not If a child does inherit the mutation they because of Bija Dusti. There will be no will generally go on develop MODY Bija dusti occur if parents are healthy, before they are 25, whatever their weight, butPrameha will occur afterDosha Dushya lifestyle, ethnic group etc. Vaisamyata. The key feature of MODY are: When the parents are suffering from 1- Being diagnosed with diabetes under the Pramehathen children already have Bija age of 25. Dusti. But if they will not consume nidan 2- Having a parent with diabetes, with sevan, or follow Dincharya, Ritucharya, diabetes in or more generations. Ratricharya and doing proper exercise will 3- Not necessasarily needing insulin. not suffer from Pramehain early age while CONCLUSION they have Beeja Dusti.It is just because of Vikar Vighat Bhava-Abhava play presence of Vikarvighat Bhava.Butif they important role in Prameha.There are lots will consume Nidan from early age then of etiological factor for occurrence of they will suffer from the prameha in early, disease. Prameha is lifestyle middle or late of age. In Modern Era it is diseases;Prameha includes both Aahara correlated with MODY and Vihara with the combined effect of Vikarvighat Bhava-Bhava Vs MODY these three factors on the Nidan, As explained before When Nidana,Dosha Dosha,and Dushya. In Ayurveda, there are and Dushya are present in equilibrium then certain food items that are described for disease is not occur, the cause is due prevention as well as cure of Vikara Vighata Bhava Bhava. If diseases.Study of these Hetus of Prameha etiological factors having homologous based on dietetics and adopting the right properties then Dosha interact with them kind of diet and implementing it into our quickly leading to manifestation or lifestyles can definitely hamper and aggravation of disease i.e. Vikara Vighata prevent the growth of this disease among Bhava Abhava. the masses.The food habits are not Maturity-onset diabetes of the young is a followed according to the parameters dominantly inherited form of non-insulin mentioned in ancient and modern dietetics dependent diabetes that is typically which has led to the development of many Prameha.

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So if parents are healthy then Pramehawill not occur in offspring, but in the case of 7. Chakrapanidutta, Commnetator irregular life style it will occur very early Agnivesha, Carak Samhita, edited by or late. When parents are suffering from Yadavjee trikramjee Acharya, Prameha and offspring follows healthy life Chaukhamba Sansthan Varanasi, style like, regimens of Dinacharya and 2007,p.212 Ritucharya are followed by the masses 8. Chakrapanidutta, Commnetator, Carak which are mentioned in the Ayurveda Samhita,edited by Yadavjee trikramjee classics for the maintenance of good health Acharya, Chaukhamba Sanskrit Sansthan then they will not occurPrameha although Varanasi, 2007.p.178 they already haveBija dusti so they will 9. Tattersall RB (1974) Mild familial definitely suffer from Prameha but in late diabetes with dominant inheritance. Q J age.Thus the disease Prameha is certainly Med 43:339–357 a lifestyle disease 10. Frayling TM, Evans JC, Bulman MP et Ayurvedic guidelines of Life style for al (2001) Beta-cell genes and diabetes: adopting a healthy dietary pattern along molecular and clinical characterization of with physical activity that are valuable mutations in transcription factors. Diabetes tools in the prevention of Prameha. 50(Suppl 1):S94–S100 Though and Life style intervention 11. Lenderman H (1995) Is maturity-onset may counter theSamprapti ofPrameha. diabetes at young age (MODY) more REFERENCES: common in Europe than previously assumed? Lancet 345:648 1. Agnivesha, Carak Samhita,edited by 12. American Diabetes Association (2007) Yadavjee trikramjee Acharya, Diagnosis and classification of diabetes Chaukhamba Sanskrit Sansthan Varanasi, mellitus. Diabetes Care 30(Suppl 1):S42– 2007, p.105 S47 2. Shreevijayrakshit & shreekanthdutta, Corresponding Author: Madhava Nidana [part-1],revised and Dr. Meenakshi Verma,PG Scholar edited by Yadunandan Upadhyaya, 30th Department of Kayachikitsa Parul institute edition, Chaukhamba Sanskrit Sansthan of Ayurevda Vadodara Gujarat-391760 Varanasi 2000, p.18 Email: [email protected] 3. Vagbhatta,Ashtanghridaya,Kaviraj

Atridev Gupta ,edited by Yadunandan Upadhyaya 13th edition, Chaukhamba Source of support: Nil sanskrita samsthana, Varanasi, 2000, p.88 Conflict of interest: None 4. Chakrapanidutta, Commnetator Declared Agnivesha, Carak Samhita, edited by Cite this Article as :[Verma Meenakshi et Yadavjee trikramjee Acharya, al : Vikara Vighata Bhava-Abhava (Non Chaukhamba Sanskrit Sansthan Varanasi, Occurrence and Occurrence of Disease) and 2007,p.212 5. Shreevijayrakshit & shreekanthdutta, its Role in Prameha w.s.r to Mody] Madhava Nidana[part-1],revised and www.ijaar.in : IJAAR VOLUME II ISSUE IX edited by Yadunandan Upadhyaya, 30th JUL –AUG 2018 Page No:1348-1354 edition, Chaukhamba Sanskrit Sansthan Varanasi. 2000, p.17 6. Shreevijayrakshit & shreekanthdutta, Madhava Nidana[part-1],revised and edited by Yadunandan Upadhyaya, 30th edition, Chaukhamba Sanskrit Sansthan Varanasi. 2000, p.17

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