Rogamaarga

Ayurveda the eternal science of Ayusha i.e. life, deals with the different aspects of life. It gives certain rules to the followers for enjoying a healthy life. Some principles must be understood and implemented to prevent any diversion from Svaasthya, and many more aspects, are explained in this mesmerizing science.

Rogamaarga is one such principle, which is an extremely essential principle to be studied, without its knowledge, implementation of Ayurvedawill be like, driving a car without knowing where to fill petrol.

Maarga primarily means a pathway or channel. In relation to the body, it means the pathway through which the different substances i.e. Bhaavapadaartha move in the body. The body is made up of innumerable such Maarga_s. The Siraa Dhamanee Srotas are all included in the Maarga. The movement of Vaata in the Vaatavahasiraa can be termed as one Maarga, the movement of Pitta in Pittavaha another Maarga; of Rakta in Raktavaha Siraa and so forth. The whole body is thus literally a collection of different Maarga_sput together.

Maarga has also been used as a synonym for Srotas

The movement of the Bhaavapadaartha from one part of the body to the other is essential for the digestion, nutrition and other functions to be carried out ceaselessly e.g. the function of Kledavahana is done relentlessly by Mootra. The function of circulation throughout the body is essential for the nutrition of the body. The movement of Vaata is essential for the different activities taking place throughout the body e.g. excretion of faeces, ingestion of food, stimulation of Paachakapitta etc.

This movement is incessantly taking place in the body but on formation of pathological changes the movement is hampered and disease formation starts. These pathological changes can be of different kinds, like reduction of lumen (diameter) of the pathway due to different growths, inflammations, pressure, or lack of stimulation etc.

Vyaanavaayu is a type of Vaayu responsible for the circulation of the Rasa Rakta in the body. This is essential for the nourishment of the body and is responsible for the physiological growth of all the Dhaatu_s. This nourishment is achieved by the proper circulation of the Rasa Rakta. To carry out the different functions of the body the secretion of the Dosha and their movements are essential. During this circulation when Rasadhaatu or the Dosha comes across any Khavaigun`ya i.e. weak organ, it gets stranded there and the disease formation takes place. To understand the pattern of disease formation, to have in depth knowledge of the body, in order to make the elimination of the disease easier, Ayurvedahas put forth the concept of Rogamaarga.

The Rogamaarga_s are the pathways on which the diseases are formed. They are divided according to the common pattern followed by the diseases in their wanted paths in the formation pattern.

These Rogamaarga_sare as follows:

1. The Kosht`ha Maarga
2. The S`haakhaa Maarga
3. The Marmaas`hrita Maarga

Their synonyms are as follows:

1. The Abhyantara Maarga or the Maarga most interiorly placed
2. The Baahya Maarga-or the Maarga most exteriorly placed and
3. The Madhyama Maarga the Maarga lying between both the earlier mentioned Maarga_s. Now let us see what these Maarga_sare all about

The Kosht`ha Maarga
First we will see what the word Kosht`ha literally means. It means any hollow space covered by borders of muscles. The word Abhyantara means the internal. The scientific meaning of the Kosht`ha Maarga is the Mahaanimna or the Gastro intestinal tract including the Aamaas`haya i.e. the stomach and Pakvaas`haya the intestines. The other organs included in the Kosht`ha Maarga are the Agnyaas`haya the pancreas the Mootraas`haya also known as the Basti or the urinary bladder, and the Raktaas`haya i.e. Yakrita (Liver) and the Pleeha, (i.e. the spleen). The Hridaya i.e. the heart, all these organs are included in the Kosht`ha Maarga.

The Kosht`ha Maarga also includes the Rasa/Lymph Dhaatu in the heart and the Rakta Dhaatu present in the liver and spleen. The Rasa and Rakta Dhaatu_s present elsewhere are included in the S`haakhaa Maargaa.

To conclude the Kosht`ha Maarga is comprised of

1. The GI tract along with the stomach and intestines
2. The pancreas
3. The urinary bladder
4. The liver and spleen
5. The heart
6. The caecum
7. The lungs

All these organs are present in the Kosht`hai.e. the trunk of the body. The torso is the largest space surrounded by a covering and hence considered the biggest Kosht`hain the body and anatomically also there are organs with spaces which can be filled with some substance e.g. air-in-lungs, Rasa and Rakta Dhaatu in heart, Mootra or urine in bladder and so on.

Now we will see the different diseases included in this Maarga as described by Ayurveda. By its presence it is to be observed that the Sampraapti or pathogenesis occurs at a particular site, which is included in the Kosht`ha Maarga or the diseases known as Kosht`hashnit i.e. occurring in the Kosht`ha.

These diseases are:

1. Jvara – Fever
2. Atisaara – Dysentery
3. Chhardi – Vomiting
4. Alasaka – Type of indigestion
5. Visoochikaa– Gastroenteritis
6. Kaasa – Cough
7. S`hvaasa – Breathlessness
8. Hikkaa – Hiccough
9. Aanaaha – Flatulence
10. Udara – Abdominal distension
11. Pleehaa – disease of spleen
12. Visarpa – Herpes
13. S`hvayathu– Swelling
14. Gulma – Growths
15. Ars`ha – Hemorrhoids
16. Vidradhi – Abscess

S`haakhaa Maarga
The S`haakhaa Maarga is the Maarga exteriorly placed in the body, hence it is also known as the Baahya Rogamaarga. Due to the exterior placement of the structures, it is compared to the S`haakhaa of the trees. Hence it is termed as the S`haakhaa Maarga. The S`haakhaa Maarga includes all the Dhaatu_s or tissues i.e. the Rakta, Maamsa, Meda, Asthi, Majjaa, S`hukra and the Tvachaa or the skin along with the Rasa Dhaatu. We saw in the Kosht`ha Maarga that all the spaces with covering were termed as Kosht`hai.e. the spaces were Kosht`haand the covering which is external to the core space, is to be termed as S`haakhaa. The S`haakhaa Maarga gets denser more developed more complex at each progressive step. Hence the diseases occurring in the succeeding Dhaatu_s become more difficult to treat than the previous ones. This is known as the Dhaatugataavasthaa. The Uttarottara Dhaatu_s are difficult to treat and are more and more vital.

The disease occurring in the S`haakhaamaarga are:

1. Gand`a
2. Peed`akaa
3. Alaji
4. Apachi
5. Charmakeela
6. Adhimaamsa
7. Mashaka
8. Kusht`ha
9. Vyanga
10. Gulma
11. Baahya Ars`ha
12. Baahya Vidradhi
13. Baahya Arbooda
14. Baahya Visarpa

There are many more diseases occurring in the S`haakhaa Maargaa. The Samhitaakaaras have mentioned the word Aadayah i.e. etc and hence kept open the inclusion of all the diseases whose pathogenesis occur in the S`haakhaa Maarga to be included in the S`haakhaa Maarga disease list.

The Madhyama Maarga
This is considered as the most important Maarga of the three Rogamaarga_s. It is known as the Madhyama Maarga because it lies between the peripheral S`haakhaa Maarga and the internal Kosht`ha Maarga. The Madhyama Maarga is spread all over the body and is not demarcated like the S`haakhaa or Kosht`ha Maarga. The structures to be included in the Madhyama Rogamaarga are:

1. The Marma
2. The Asthisandhi
3. The Snaayukand`ara covering the Asthisandhi

If we study minutely, we will find out that the bone joints, Asthi Sandhi are 210 in number and are spread throughout the body. The Marma or the vital points are 107 in number. And the Snaayu Kandara covering the Asthi Sandhi_s are also innumerable. All these structures are included in the Madhyama Maarga. We cannot segregate the S`haakhaa Maarga or the Koshth Maarga from the Madhyama Maarga. The Madhyama Maarga is an extension of the S`haakhaa Maarga and Kosht`ha Maarga. It has been devised as per the importance of the structures.

The Asthi Sandhi found in the S`haakhaa are = 68
The Asthi Sandhi found in the Madhyama S`hareera = 59
The Asthi Sandhi found in the S`hira and above = 83

Though all Asthisandhi or bone joints are very important structures in the body and any disease occurring in them will be very painful with each movement of the body, special importance should be given to Asthisandhi, which have been included in the vital point category i.e. the Marma as they become a combined force of two sites as informed by the Ayurveda – the science.

1. Jaanu Sandhi – 2
2. Koorpara Sandhi – 2
3. Seemanta – 2
4. Adhipati – 2
5. Gulpha – 2
6. Man`ibandha – 2
7. Kukundara – 2
8. Aavarta – 2
9. Krikaat`ikaa – 1

There are 900 Snaayus explained by Sus`hrutaachaarya. They are differentiated in 4 types.

1. Prataanavati
2. Vritta
3. Prithula
4. Sushira

But those to be included in the Madhyama Maarga are the Prataanavati and the Vritta Snaayui.e. Kand`araa. They are the one, which cover the Asthisandhi and hence as per the definition are to be included in the Madhyama Rogamaarga. Now we will see the importance of Marma with reference to the Madhyama Maarga. There are 107 Marma_s in the body and are categorized according to their anatomical structure and effects caused due to trauma on them. The Praan`areside specifically at the site of Marma hence any injury or disease occurring at the Marma site is exceedingly troublesome and difficult to cure due to the intricateness of the anatomical structure. The Praan`aare soma Marut, Tej, Satva, Raja, Tama and the Jivaatmaa. The main three Marmas that are given the utmost Importance inthe Madhyama Maarga are S`hira, Hridaya, Basti. Now if we recollect both the Hridaya (heart) and the Basti (urinary bladder) have been included in the Kosht`ha Maarga. It is due to the structural formation of those organs but as per the importance of the structures and predominant presence of Praan`ain these organs they are specifically included in the Madhyama Maarga.

These three are the most important triadof the body. The S`haakhaa Marma are dependent on the Skandha Marma and the Skandha Marma in turn are dependent on the Trimarma for their existence. This concept is explained by Ayurvedaby saying if the Aas`hraya i.e. the base is destroyed, the Aas`hrita i.e. the structure dependent on this base, will also be destroyed. Hence the Trividha Marma are to be protected with extreme precaution from outside trauma and internal Vaataadi Dosha. Now that we have seen the structures included in the Madhyama Maarga, let us look at the diseases occurring in the Madhyama Maarga. They are:

1. Pakshavadha
2. Graha
3. Apataanaka
4. Ardita
5. S`hosha
6. Raajayakshmaa
7. Asthisandhis`hoola
8. Gudabhrams`ha
9. S`hiroroga
10. Bastiroga
11. Hridaya Roga

These Three Rogamaarga_shave been described, so as to understand the pathogenesis of the disease. The movement of the Dosha from one Maarga to another and the result of this movement have on the Saadhyaasaadhytva i.e. the curability of the disease needs to be studied. The diseases occurring in one Maarga are usually Sukhasaadhya or easily curable. The spread of the disease from one Maarga to the other Maarga, denotes the increase in the vitiation of the Dosha. The increase in the amount of the Dosha causes the Dosha to spread from one Maarga to the other.

The movement of the Dosha from the S`haakhaa Maarga to the Kosht`ha Maarga is the natural movement of the Dosha or the Praakrita Gati. The reasons for this Gati are:

1. Increase in the Dosha amount
2. Liquefaction of the Dosha
3. Paachana of the Dosha
4. Vaayu Nigraha Control of Vaayu

Due to the increase in the amount of Dosha present in the S`haakhaa, it moves towards the Kosht`haas it cannot be accommodated in the S`haakhaa just like overflow of water during floods. The liquefaction of Dosha causes the transfer of the Dosha to the Kosht`hafrom S`haakhaa. The Paachana or digestion of Doshahere actually means separation of the set Dosha, which will stimulate the flow of the Doshato the Kosht`ha. The control over Vaayu causes the healthy functioning of the body by bringing the Dosha into the Kosht`ha. These principles are used specially during S`hodhana Chikitsaa or the purification methods i.e. emesis, Vamana, Virechana-purgation, Niruhabasti and S`hirovirechana. The Doshapresent in the S`haakhaa and causing different diseases are softened by taking, Snehapaana–Oleation therapy for a prescribed period of time. Then they are liquefied and separated by the Svedana fomentation therapy. After this the medicines are administered which cause the surge of the Dosha from the S`haakhaa to the Kosht`haand successively help to purge it out of the body. This pattern of Dosha is the treatment pattern and the natural pattern of the Dosha_sas the body maintains its homeostasis. But when the action of the Dosha is the other way round it is disease formative or disease aggravating. The movement of the Dosha from Kosht`hato the S`haakhaa causes disease. The factors precipitating this movement are as follows:

1. Excessive exercise
2. Excessive intensity of heat
3. Consumption of unhealthy food
4. Increased speed of Vaayu

The intensity of heat liquefies the Doshaand hence causes them to move from the Kosht`hato the S`haakhaa. Consumption of food, which is described as unhealthy by Ayurvedalike Viruddhaahaara-incompatible diet, excessively spicy, hot stale food, are all stimulant factors for movement of the Dosha to the S`haakhaa from the Kosht`ha. The speed of Vaayu when not in a healthy condition i.e. vitiated Vaayu causes the Doshamovement from Kosht`hato the s`haakhaa. The disease formation of cure mainly depends on the condition of the Dosha. The purpose of putting the different structures together is called Rogamaarga and then segregating them wisely into three main types was to be able to comprehend the pattern of disease formation and avoid the factors responsible for precipitatingthe disease in the body. The diseases occurring in the S`haakhaa Maarga and Kosht`ha Maarga are easier to cure as compared to the diseases occurring in the Madhyama Maarga. In the S`haakhaa Maarga the Dosha_sare brought from the S`haakhaa to the Kosht`haand then purged out of the body through the nearestorifice. Though exercising is healthy, anything done in excess is always unhealthy. One should exercise only of ones capacity in the colder seasons and even less in the other seasons. The symptoms of -capacity exercise depends on sweat formation in the armpits, overhead and chest, increased respiratory rate and a feeling of lightness. Calculation of these symptoms, help us to exercise in the right amount.

Excessive exercising causes Kshobha or stress in the body. In any stress, the digestive function of the body is hampered. This is due to withholding the activities of the body to regain an unstressed condition for homeostasis. This leads to the movement of the Doshafrom Kosht`haback to S`haakhaa. The Doshacome to the Kosht`hafor fulfillment of their functions of digestion metabolism at different levels. But due to stress they return to the S`haakhaa. Repeated return of unutilized Dosha back to the S`haakhaa causes Sanchaya or collection of the Doshain the S`haakhaa itself. This cleansing process helps control the disease permanently. The diseases occurring in the Madhyama Maarga are termed as Krichchhra Saadhya. This is due to the intricacy of the structure of this Maarga_s, all the vital points i.e. the Marma are included in this Maarga. For medicine to reach this Maarga and act on the disease it has to be wisely thought because it should not harm the vital points (Marma). For this the Aachaarya_s have suggested the Basti treatment. This treatment works on the whole body but more precisely on the Vaata Dosha, which is responsible for all movements of Doshain the body. Also it has the Sookshma quality, which helps to penetrate through minute structures and carries the medicinal properties of Basti along with it and acts on the diseases occurring in the Madhyama Maarga and S`haakhaa Maarga and Kosht`ha Maarga also. By studying the different Rogamaarga_s and the movementof the Doshafrom one Maarga to other it becomes easier to realize the disease formation process. This in turn helps the Vaidya devise a specific treatment or plan as per the Maarga. Specificity in treatment helps recovery faster and easier.

Dr.Rajeshree Chitre
Lecturer – Ayurveda College Wagholi, Pune.

Last updated on February 12th, 2021 at 05:48 am