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Nidana / Etiology: Cause of All Disease

Nidana / Etiology: Cause of All Disease

All diseases are caused by aggravation of the doshas. This aggravation of different doshas is caused by the intake of improper diet and leading an improper lifestyle (Mithya Ahar Vihar). 
The three causes of illness are excessive, insufficient, or improper use of, 1. The senses 2. Actions 3. Seasonal factors 

1. Unsuitable use of the senses: Unwholesome contact of the senses (taste, touch, sight, sound, and smell) with objects. For example, sound (hearing loud voices, noise pollution cause serious mind and health problems). Touch (contact of the skin with chemicals, hot objects, or overly cold objects). Sight (exposure to too much light, such as staring at the sun). 
2. Actions: Relate to body, speech, and mind. These include, conduct, urge, posture, concern, and emotions. Thoughts and decisions leading to harmful or unhealthy situations are said to be errors of the intellect. Spiritually speaking, the first intellectual error is to believe that anyone or anything is separate from oneself. The Ayurvedic texts say that this is the first cause of all diseases, the loss of faith in the Divine. 
3. Seasonal factors: VAyu accumulates during the dry or dehydrating heat of the summer (Grishma: mid-May to mid-July). It becomes aggravated during the rainy season (Varsha: mid-July to mid-September), which causes weakened digestion, acidic atmospheric conditions, and gas produced from the earth. Pitta accumulates during the rainy season due to the acidic conditions of the atmosphere and a weakened digestion. It is aggravated during autumn (Sharat: mid- September to mid-November) when the heat returns (perhaps equivalent to Indian Summer). This occurs after the cooling spell of the rainy season. Kapha accumulates during the cold season (Shishira: mid-January to mid-March) due to the cold and damp caused by the winds, clouds, and rain. It gets aggravated during the spring (Vasant: mid-March to mid-May) when the warm weather liquefies the accumulating Kapha (from the cold season).

VAyu Increasing Causes: Bitter, salty, and astringent tastes, dry, light, cold foods, fasting, waiting longer than three or four hours between meals suppression or premature initiation of the 13 natural urges, staying awake late at night, prolonged high pitched speaking, excess emesis and purgation, sudden grief, fear, worry, or anxiety; excessive exercise or sexual intercourse; the end of the digestive process. Pitta Increasing Causes: Pungent, sour, and salty tastes, foods causing heat and burning sensations, anger, autumn, the middle of digestion, sun or heat exposure, exhaustion, eating with indigestion. Kapha Increasing Causes: Sweet, sour, and salty tastes, oils, heavy or indigestible foods, overeating, cold foods, lack of exercise, excess sleeping, naps, inadequate emesis and purgation, eating before hungry, in the spring, before noon and early night, the first stage of digestion. 

Factors Increasing All Doshas: Eating excessively, improper diet, uncooked, contaminated or incompatible foods; spoiled food and drinks; dried vegetables, raw root vegetables. Other factors include eating fried sesame seeds and molasses, mud, barley beer, foul and dry meat, eating food out of season; direct breeze, negative thoughts, living in mountain slopes. Malefic positioning of the planets and constellations, improper administration of therapies, illegal actions, and being too inactive also increase all the doshas. Food Intake and Dosha Illness Improper quantity of food results in impairing strength, complexion, weight, distention, longevity, virility, and ojas. It afflicts the body, mind, intellect, and senses, causing harm to the dhAtus (tissues)-especially VAyu. Food taken in excess aggravates all three doshas. Obstructions are produced in the stomach and move through the upper and lower tracts, producing diseases according to ones dosha. 

VAyu: Colic pain, constipation, malaise, dry mouth, fainting, giddiness, irregular digestive power, rigidity, hardening and contracting of vessels. Pitta: Fever, diarrhea, internal burning sensation, thirst, intoxication, giddiness, and delirium. Kapha: Vomiting, anorexia, indigestion, cold fever, laziness, and heaviness. Disease Development: Six Stages Earlier, it was briefly mentioned that six stages of disease development exist. However, modern medical technology can only see the last two stages of any illness. Ayurveda offers insight into the earlier stages and enables those monitoring their health to take care of any small imbalances well before developing any serious illness. The six stages of disease development are: 

1. Accumulation: Illness begins in one of the three main dosha sites: stomach (Kapha), small intestine (Pitta), or the colon (VAyu). Excess Kapha in the stomach creates a blockage in the system that leads to lassitude, heaviness, pallor, bloating, and indigestion. Pitta accumulation creates burning sensations, fever, hyperacidity, bitter taste in the mouth, and anger. The collecting of VAyu creates gas, distention, constipation, dryness, fear, fatigue, insomnia, and the desire for warm things. The value of monitoring these experiences within ones body and mind leads to the earliest detection of an imbalance, while it is still in its hidden or incubatory stages. 

2. Aggravation: As the imbalanced elements (humors) continue to increase, the symptoms mentioned above become more aggravated and will be noticed in other parts of the body as well. Kapha aggravation causes a loss of appetite, indigestion, nausea, excess saliva, heaviness in the heart and head, and oversleeping. The aggravated Pitta experience is one of increased acidity, burning sensations in the abdomen, lowered vitality, or insomnia. VAyu aggravation results in pain and spasm in the abdomen, gas and rumbling in the bowels, and light-headedness. 

3. Overflow: Once the origin site is full with the excess humor (element), it will begin to overflow into the rest of the body using different channels of transportation. The doahas begin to overflow into the GI tract, then join with the circulating plasma and blood. During circulation the humors then begin to seep into the organs, dhAtus (tissues), and malas (waste). Simultaneously, symptoms at the origin site continue to grow worse. 

4. Moving and localization at a distant site: The humors will move to wherever a weak site exists in the body. This is where and when specific diseases begin to develop. For example, a VAyu illness could move to the bones and begin to create arthritis. If the duodenum is weak, humors deposit themselves there and create an ulcer (usually a Pitta condition). Kapha moves to organs like the lungs when weakened. Healing is still simple, even at this fourth stage of illness. 

5. Manifestation: This is the first stage of the development of illness for which Western science can detect signs of disease. Here, diseases become fully developed, showing signs of clinical features. Names are given to imbalances of the humors, such as cancer, bronchitis, arthritis, etc. 

6. Distinction/Chronic Complications: In this last stage, the symptoms become clear enough so that the elemental cause may be determined. For example, VAyu asthma will cause dry skin, constipation, anxiety, attacks at dawn, and the desiring of warmth. Pitta asthma will show yellow phlegm, fever, sweating, and attacks at noon and midnight. Asthma brought on by Kapha will create white phlegm, water in the lungs, and attacks during the morning and evening. Some practitioners describe this stage as the chronic phase of development. 

For example, if one develops an inflammation or abscess in stage five, in stage six, complications set in, and the abscess may burst and become a chronic ulcer. Three Disease Pathways In our consideration of the Ayurvedic view of the body, we also learn of the classification of illness and the healing process through the three paths that disease travels. Inner: This is the digestive tract involving diseases of the GI tract. These diseases are easy to heal because toxins are expelled through the tract. Diseases of the inner path include fever, cough, hiccups, enlarged abdomen or spleen, internal edema, vomiting, and hard stools. Outer: This path refers to the plasma/skin, blood, and superficial tissues. Toxic blood and skin diseases are harder to heal because removing an illness from the tissue is more difficult. Symptoms include abdominal and other malignant tumors, edema, and hemorrhoids. Central: This path refers to muscle, fat, bone, marrow, and deeper nerve tissues. This is the most delicate area of the body, affecting the heart, head, bone joints, and urinary bladder. 

The most difficult diseases develop here, such as cancer or arthritis. These diseases develop between the inner and outer paths. Signs and Symptoms of Disease, by Dosha Excess VAyu: Drooping, dilation, loss of sensation, and weakness; continuous, cutting, pricking, crushing, or splitting pain; obstruction, contraction, or constriction; twisting, tingling, thirst, tremors, roughness, dryness, throbbing, curvatures, gas, winding, stiffness, or rigidity; astringent taste in mouth, blue/crimson discoloration, partial vacuums in bodily liquids. Excess Pitta: Burning sensation, reddish discoloration, heat, high digestive fire, pus, ulcers, perspiration, moistness, debility, fainting, toxicity, bitter and sour tastes in the mouth, oozing, fungus. Excess Kapha: Oiliness, hardness, itching irritations, cold, heaviness, obstructions, toxic or mucus coatings inside the srotas (channels), loss of movement, swelling, edema, indigestion, excessive

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