AH-Su-Chapter 4: Roganutpadaniya / Preventive Healthcare

Roganutpadaneeya = Roga + Anutpadaneeya
Roga means disease
Utpadana means production. Anutpadana means prevention of production.
So, Roga Anutpadaneeya means – prevention of onset of disease. This chapter deals with preventive healthcare.

Adharaneeya Vega – Natural urges that should not be suppressed:
One should not suppress these natural urges -
1.        Adhovata – flatus (fart)
2.        Vit – faeces
3.        Mutra – urine
4.        Kshavatu – sneeze
5.        Trut – thirst
6.        Kshudha – hunger
7.        Nidra – sleep
8.        Kasa – cough
9.        Shramashvasa – breathing on exertion
10.     Jrumbha – Yawning
11.     Ashru – tears, weeping
12.     Chardi – vomiting
13.     Retas – semen

All these natural urges should not be suppressed by force.

Adhovata abrodha – adverse effects of suppressing flatus –
By suppression of the urge of flatus (farting), on a continuous basis, one becomes prone to abdominal bloating, tumor,
Udavarta – bloating, gaseous distension of abdomen
Ruk – abdominal pain
Klama – tiredness, exhaustion without doing anything
blockage of flatus, constipation and difficulty in urination
loss of vision and
loss of digestive power
diseases related to upper part of stomach and heart

This is because – the Vata gets obstructed in intestine by avoiding farting. At intestines and rectum, natural movement of Vata is downward. But because of suppression of flatus, Vata moves in upward direction and causes all these problems. Most of the problems explained are due to Vata imbalance. 2

Bad effects of suppressing urge to defecate – Shakrut Nirodhaja Roga –
Pindikodveshta – twisting pain of calf muscles
Pratishyaya – running nose
Shiroruja – headache
Urdhvavayu – upward movement of Vata,
Parikarta – anal itching sensation
Hrudayasya Uparodhana – stiffening feeling in chest region
Mukhena Vit pravrutti – foul breath, feces vomiting.

Bad Effects due to Suppression of urination:
Angabhanga – body pain,
Ashmari – Urinary calculi
Pain in penis and bladder region.
Diseases that are mentioned in flatus and faeces may also occur in this condition.

Treatment for suppression of flatus, feces and urine
To treat the diseases arising from suppression of flatus, feces and urine, the following should be given.
Varti – Rectal and urethral suppositories
Abhyanga – Oil massage
Avagaha – tub bath, sitz bath
Svedana – sweating therapy, sudation therapy
Bastikarma – rectal enema
Annapaanam ca vidbhedhi – all food that help to induce purgation should be administered.

Treatment of diseases due to suppression of urination urge –
In diseases caused by suppression of urine, drinking of ghee before lunch is idea. Drinking ghee in the maximum dose at the end of digestion of meal of both the midday and the night is also advised.
Such a process of drinking high doses of ghee is called as Avapidaka Sneha.

Suppression of belching: 
Suppression of belching may cause
Aruchi – Anorexia, lack of interest in taking food
Kampa – tremors
Vibandha – constipation
Hrudayo Raso – stiffening sensation in chest region
Adhmana – bloating, gaseous distension of abdomen
Kasa – cough, cold
Hidhma – hiccup

The treatment for this is similar to treatment for suppression of hiccups.

Suppression of sneezing:
Suppression of sneezing may cause – 
Shiro Arti – headache
Indriya Daurbalya – weakness of sense organs
Manyasthamba – Neck stiffness
Ardita – Facial palsy

Treatment:
Teekshna Dhooma – powerful herbal smoking,
Anjana – Collyrium
Navana – Snuffing
Arkavilokana – seeing Sun directly for a few seconds
Massage, Oleation and sudation therapies are also mentioned as treatment.
All these are done to induce sneezing and to regularize Vata movement.

Suppression of thirst – 
Suppression of thirst causes
Shosha – Emaciation
Angasada – debility, weakness
Badhirya – deafness
Sammoha – loss of consciousness, delusion
Bhrama – delusion
Hrut Gada – cardiac disorder

Treatment: 
All procedures that are cooling in nature – like cold water drinking, cold water bath etc is recommended. 10

Suppression of hunger:
Angabhanga – bodyache, myalgia
Aruchi – Anorexia, lack of interest in taking food
Glani – debility
Karshya – emaciation, weight loss
Shoola – abdominal colic pain
Bhrama – delusion

Treatment:
Light meals, with oily substance (such as ghee), which is hot/warm in nature.

Note: Fasting causes decrease in digestion power and increase in Vata. If you take a large meal after fasting for long, then it will further decrease digestion power. Hence a light meal is advised.

Oily substance such as ghee soothes gastric mucosa.
Hot
/warm food helps to maintain Agni (digestion power).

Suppression of sleep:
Suppression of sleep causes-
Moha – delusion
Murdha Akshi Gourava – heaviness of head and eyes
Alasya – laziness, lassitude
Jrumbhika – yawning
Angabhanga – bodyache, myalgia

Treatment: Sleep and massage. 12

Suppression of cough:
By suppressing cough, it further increases. It further may lead to
Shvasa – Asthma, COPD, wheezing, breathing difficulty
Aruchi – Anorexia, lack of interest in taking food
Hrudamaya – cardiac disorder
Shosha – Emaciation
Hidhma – hiccup

Treatment – All treatment which relieves cough (Regular treatment to cough) should be given. 13

Suppression of breathing on exertion:
Avoiding heavy breathing after heavy work may lead to -
Gulma – Abdominal tumor, bloating
Hrudroga- Cardiac disorder
Sammoha – loss of consciousness, delusion

Treatment:
Vishrama – rest
Vata balancing treatment.

Suppression of yawning:
The suppression of yawning produces similar symptoms to that of suppression of sneezing. Here, Vata balancing activities/treatment should be taken up.

Suppression of tears:
Suppression of tears causes -
Peenasa – running nose, rhinitis
Akshi Roga – eye disorders
Hridrik – heart diseases associated with pain
Manyasthamba – Neck stiffness
Aruchi – Anorexia, lack of interest in taking food
Bhrama – delusion
Gulma – Abdominal tumor, bloating

Treatment: sleep, alcohol and sweet talk with friends and family. 16

Suppression of vomiting: 
Suppression of  vomiting causes -
Visarpa – Herpes, spreading skin disease
Kotha – allergic skin rashes
Kushta – skin diseases
Akshi Roga – eye disorders
Kandu – itching sensation
Pandu – Anemia, intial stages of liver diseases
Jvara – fever
Kasa – cough, cold
Shwasa – Asthma, COPD, wheezing, breathing difficulty
Hrullasa – nausea – vomiting sensation
Vyanga – Pigmented patches on face
Shvayathu – oedema, inflammation. 17

Treatment: 
Gandusha – gargling
Dhumapana – herbal smoke
Rooksha aahara Vamana – eating dry food and inducing vomiting
Vyayama – exercise
Asra Sruti – Blood letting (in case of skin diseases)
Virechana – purgation type of Panchakarma treatment.

Note: Suppression of vomiting causes Pitta imbalance. Hence most of the treatment above is targeted to balance or eliminate Pitta. 18

Suppression of Semen ejaculation:
Suppression of ejaculation causes
Sravana – oozing of semen
Guhya Vedana – pain in groin
Shvayathu – oedema, inflammation
Jvara – fever
Hrid Vyatha – cardiac pain, distress
Mutrasanga – Obstruction to the flow of urine and difficulty
Angabhanga – bodyache, myalgia
Vruddhi – Hernia
Ashma – stone formation
Shandata – Impotency. 19

Treatment:
Tamrachuda – chicken,
Sura – beer, alcohol
Shali – rice
Basti abhyanga – massage to the lower abdomen
Avagaha – immersion bath with oil
Bastishuddhi – cleansing of urinary bladder with enema
Ksheera – treatment with milk processed with herbs
Priya Striyaha – copulation. 20

Whom should not be given treatment?
Who have intense pain and thirst, those who are habituated to suppression of urges – because the Vata and other Doshas will frequently get vitiated due to undesired activity and treatment will not be successful.
Ksheena – who are severely emaciated, Those who vomit faeces – condition has gone out of control.

Root cause for all diseases:
All diseases are caused due to
Vegodeerana – initiation of urges forcefully
Vegadhaarana – Suppression of naturally initiated urges.
For those common diseases arising from these acts, specific treatments have been counted so far. By disturbing the nature, it is Vata that is mainly vitiated. Hence the symptoms arising from suppression of natural urges could be treatment with food and treatment which clear the passages of Vata and help in restoring Vata’s natural movement direction. 22-23

Urges that should be suppressed:
The urges that should be suppressed forcefully are –
Lobha – greed
Irshya – envy
Dvesha – hatredness
Matsarya – jealous
Raga – unlawful, excessive attraction

Shodhana –Panchakarma – purification procedure – timing -
One must exercise precaution to clear out Doshas and waste products at suitable times. Accumulation of such toxins could lead to their aggravation and subsequently even death may occur due to this. 25

Effectiveness of Shodhana – (Panchakarma treatment)  -
The Doshas that are balanced out by Langhana (fasting etc) and Pachana (digestion promoting) therapies may sometime get re-aggravated soon. However, Doshas that have been eliminated out with Shodhna (Panchakarma) therapy will never get re-aggravated.

After proper Panchakarma procedure at suitable times, rejuvenation treatment (Rasayana therapy) should be taken up, with suitable tonics and aphrodisiacs.

Treatment for those who undergo Panchakarma treatment and who feel tired: 
Bruhmana Ahara – nourishing eatables such as
Shashtika Shali – rice that mature in 60 days
Godhuma – wheat
Mudga – green gram
Mamsa – meat
Ghrita – ghee

Medicine with Hrudya (cardiac tonic) and Deepana (digestive, carminative) qualities should be mixed with food and taken.
Abhyanga – oil massage
Udvartana – powder massage
Snana – herbal bath
Niruha Basti –enema treatment
Snehabasti – oil / ghee enema treatment

All these help to restore health of the debilitated.

By these measures, one could gain health, happiness, good intelligence, clarity of vision, strong sense organs, intelligence, sexual vigour and longevity.

Traumatic diseases / caused by external factors -
Those disease produced by
bhuta (evil  spirits,  bacteria, parasites, insects and such microbes),
visha (poisons)
air (hurricane, cyclone), agni (fire, electricity, radiation etc) kshata (injury, wounds etc),
bhanga (fracture of bones) etc., as  also those due to
raga (desire, lust), dvesa (hatred), bhaya (fear) etc. are all know as Agantu diseases  arising from external causes)

Sarvaroga samanya cikitsa- (general treatment for all diseases):
Avoidance of  improper activities of body, mind and speech by willful transgression of rules,
Control of the senses, remembering  previous experiences and acting rightly,
good knowledge of the habitat, season and the self,
adherence to rules of good conduct and rituals
Peaceful procedures as mentioned in Atharva Veda,
Worship of celestial powers – Grahashanti (astronomical palliative procedures)
Staying away from Bhuta (evil spirits, microbes)
Respective treatment followed as per the principles explained above, are the general guidelines to treat all types of diseases. 34

Time for Panchakarma treatment:
The accumulated Doshas arising from winter should be expelled during Vasanta (spring)
That arising from Summer (Greeshma) should be expelled during Abhrakala – Varsha Ritu – rainy season.
That arising from rainy season should be expelled during Ghnatyaya (Sharad – Autumn season)
By this, people will not become victims of diseases born by the effect of the seasons.

Secret of good health:
He, who indulges daily in healthy foods and activities, who discriminates the good and bad of everything and then acts wisely, who is not attached too much to the objects of the senses, who develops the habit of charity, of considering all as equal, of truthfulness, of pardoning and keeping company of good persons only, becomes free from all diseases.

Thus ends the fourth chapter called Roganutpadaniya in Sutrasthana of Astangahrdaya samhita of srimad Vagdhata son of Sri Vaidyapati Simhagupta. 

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