Ayurvedic science of health care proposes a fascinating and yet to be explored world of knowledge about diseases: their causes, manifestations and subsequent treatment approaches. The living body is composed of multiple formative components like dosha, dhatu and mala which are responsible for health when functioning optimally and for disease with a suboptimal function.
These all components are interdependent in their function and a functional deficit at one place eventually leads to a subsequent deficit at dependent places. Ayurvedic science of pathogenesis distinctly proposes that a disease may occur as a qualitative or quantitative deficit in one individual physiological component of the body or because of a combination among few such components. For example, considering the dosha as the disease causing agent, there can be mono doshik, bi doshik or tridoshika variants of the pathologies. When we look into the manifestations of such diseases which are caused by more than one physiological components, this is interesting to see how the symptoms and signs actually arrive referring to a particular set of disease causing components.
When two or more of the disease causing components are simultaneously involved in the pathogenesis, there can be many ways of the mutual interaction ultimately decisive to the actual manifestation of the disease. This mutual interaction between the disease causing components can be variable as per the strength of the component, site of involvement, duration of interaction and vital strength of the person. In simple terms, the interaction could be prakriti sam samveta where the features are reflective of disease causing components or the vikriti visham samveta where the manifestations do not directly reflect the disease causing components. This can be understood as a physical and chemical assembly of the substances. In former, the features of reactants are retained and hence the clinical features are reflective of individual components. In the later', the compound made up of a combination is altogether different than the reactants and hence the clinical features do not represent the properties of reactants.
There can be multiple mechanisms of mutual interaction between various disease causing factors. Avarana, Gatatva, Samyoga, Samyukti, and Samanvaya are such possible mechanisms which lead to different type of pathogenesis leading a different manifestation and warranting for a different treatment protocol. Although, looking interesting, the concept of such interaction is really cumbersome to understand. Avarana physically stands for a covering. This is obvious to observe that in such pathologies the features of the avaraka or the covering component may be more visible comparing to the component which is covered. Although this covering as a pathology eventually leads to the deficit functioning of the covered component, but despite of this fact, the primary treatment in such conditions is done for the covering component as it is obliterating the functions of covered component. Adoption of a separate treatment strategy is possible to be adopted in case of avarana because here the avaraka and avritta are separate entities and hence require a differential management plan.
Gatatva has a different mechanism of mutual interaction. Gatatva physically stands for imbibition. This means one component of pathogenesis is imbibed in the other. The resulting feature are complex and often do not directly link with either components of pathogenesis. The treatment approach is also different in such cases.
As a treatment is successful only when it is hitting to the pathogenesis, this is crucial to make a judgment about the process of pathogenesis before a prescription is made.
Ayurveda has many such descriptions where a clinical decision is never easy. Sambhasha (group discussions) has been proposed as one method of eliminating the doubts in these conditions. Classical texts of Ayurveda have the vivid description of how the sambhasha took place in ancient times in order to reach at consensus on controversial issues.
Rashtriya Ayurveda Vidyapeeth organizes annual sambhasha on some issues from Ayurveda which require further discussion and clarification before they can really be adopted to the clinical practice. These sambhasaha are organized to the tune of ancient concept of discussion among learned people upon the questions raised by the disciples. The idea is to reach at consensus and to dissipate the knowledge which is uniformly acceptable.
So far 21 such sambhasha in the form of interactive workshops on various topics have been organized by RAV. This year it is being conducted upon 'Avritatava and Gatatva of Vata' which is organized at Udupi on 16-17 December 2015. The questions raised by various scholars referring to the idea of avritatava and gatatva of vata have been distributed among the experts and the replies are collected. This book is containing all the questions and their replies by various experts referring to the subject of this interactions. We believe that this interactive workshop may prove to be a mile stone in demystifying the complexity associated with avarana and gatatva concept of pathogenesis in ayurveda and will eventually help improving the understanding of ayurveda.
**Contents and Sample Pages**
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