The Concept of Vyadhisankara in Ayurveda: A Critical Review and Conceptual Analysis

Abstract

Background: The entity responsible for causing dukha to sharira and manas is vyadhi. Dosha satmya is a fundamental concept in Ayurveda, which emphasizes that the equilibrium of tridosha is essential for maintaining arogata. Disturbance of this physiological balance results in the manifestation of vyadhi. Trisutra siddanta elucidates the three fundamental principles of disease, namely hetu (etiology), linga (symptomatology) and aushadha (therapeutics), specifically in atura. A collection of lakshana constitutes vyadhi, whereas the coexistence of multiple vyadhis is referred to as vyadhisankara. Objective: The primary objectives of this article are to elucidate the concept of vyadhisankara, explore its underlying mechanisms and clinical significance and examine its relationship with the concepts of upadrava and nidanartakara roga. Methods: Relevant Ayurvedic literature was reviewed to analyse the concept of vyadhisankara, including its definition, mechanisms and clinical presentation, with particular emphasis on the descriptions provided by Acharya Charaka. The concepts of upadrava and nidanartakara roga were also examined to clarify their relationship with vyadhisankara further. Results: Vyadhisankara represents a unique clinical condition characterised by the simultaneous presence of more than one disease in an individual. This concept provides a framework for understanding the diversification of samprapti occurring at different levels within the same individual at a given point in time. Acharya Charaka describes two distinct mechanisms responsible for vyadhisankara. In one, multiple diseases arise simultaneously from a common nidana, leading to different vyadhi in the same individual. In the other, one vyadhi develops from another, with both diseases coexisting while sharing certain common features. The clinical presentation of vyadhisankara poses considerable challenges in differential diagnosis and treatment planning. Furthermore, the concepts of upadrava and nidanartakara roga often create ambiguity in understanding vyadhisankara. Conclusion: Vyadhisankara is a distinct Ayurvedic concept that describes the coexistence of multiple vyadhis within the same individual through different mechanisms. A conceptual understanding of vyadhisankara, along with its differentiation from upadrava and nidanartakara roga, may provide greater clarity in interpreting disease manifestation and facilitate appropriate clinical assessment and treatment planning.

Keywords: Vyadhi, Vyadhisankara, Upadrava, Nidanartakara roga