Clinical Implications Of Karya Karana Bhava

Article by Dr Raghuram Y.S. MD (Ay) and Dr Manasa, B.A.M.S
Karya Karana Bhava means the relationship between the cause and its effect. (Kaarya=Work done or effect, Kaarana=Causes). 

Ayurveda effectively uses the theory of Kaarya-Kaaran Bhav (and various vaadaas explained in this context) in the aspects of diagnosis, understanding the disease process and planning the treatment.

Related Reading – Karya Kaarana Bhava: Cause and Effect Relationship
Below enlisted are the clinical implications of Kaarya Kaarana Bhava and related Vaadas (theories) –

Pathogenesis based on 3 Karanas

Understanding the pathogenesis of a disease with the help of 3 types of Kaaranas –
The knowledge of Kaarya Kaarana Bhava helps in understanding the pathogenesis of a disease.
The Kaaranas of a disease can be understood in the following way.

Nimitta Kaaranas

Causes of diseases like Abhighata (trauma, injury), Krimi (microorganisms), mithya ahara vihara (incompatible foods and life style practices) etc are the Nimitta Kaaranas of a disease. They are also called as Nidaanas. Nimitta Kaaranas vitiate the doshas and contaminate the dhatus (tissues).

Samavaayi Kaaranas

Vitiation of doshas is mandatory process in the pathogenesis of a disease. This is caused by Nimitta Kaaranas. The dosha vaishamya caused or brought about by the Nimitta Kaaranas is the Samavaayi Kaarana of the disease.

Asamavaayi Kaaranas

Samavaayi Kaarana i.e. the vitiation of the doshas is not enough for the disease to be formed. For the manifestation of a disease the dosha-dushya sammurchana should mandatorily take place i.e. the contamination of the weak dhatus (tissues) by vitiated doshas has to take place. The attack of the morbid doshas on weak tissues (amalgamation of doshas and dushyas or dhatus) is the Asamavaayi Kaarana of a disease.

Karanas or Asaadhaarana Kaaranas are helpful in begetting comprehensive knowledge, making diagnosis and planning treatment –
If knowledge is Karya (work done), the learner is Karta (doer), the tools which help him to get comprehensive knowledge are called karanas (asaadhaarana kaaranas or special causes). They are of 4 types.

Pratyaksha Rupa Karana

Pratyaksha rupa karana (Knowledge through direct understanding, as perceived by our sense organs) –
This helps in gaining the knowledge as it is and happens through perception by our sense organs, understanding by our mind, differentiation of knowledge by the buddhi or intellect and experiencing of knowledge by atma or soul.

Direct contact of our sense organs with their objects is the karana for knowledge through pratyaksha. This relation between the Karya and Karana helps us in getting true and unadulterated knowledge of most of the things we learn throughout our life time. Therefore the knowledge we get is from Karya Kaarana bhava.

In clinical practice, the inspection (look), palpation and percussion (feel) and auscultation (hear) of different body parts gives us a direct knowledge (as we see, feel and hear) of the disease, i.e. pratyaksha gnana. This helps in making a diagnosis and planning a comprehensive treatment protocol.

Anumana Rupa Karana

Anumaana rupa Karana (Inferential knowledge) – This karana helps in getting the knowledge through inference. Many times we just guess about some result or consequence and try to correlate it with its cause.

Example, seeing a cloud and expecting rain, seeing a person smoke and infer that the person may develop tuberculosis of lungs or chronic bronchitis in future, seeing a person drenching in rain and anticipating that he might be affected with cold etc are karanas for Anumana gnana or inferential knowledge. This helps us to make differential or probable diagnosis of a disease. Thus Anumana is a kaarana for inferential knowledge.

Upamana Rupa Karana

Upamaana rupa Karana (comparative knowledge) – This karana helps us in getting the knowledge based on comparison. This also helps us in clinical practice. The knowledge obtained from this karana helps us in making differential diagnosis of a disease (comparative study of one disease with other) and also differentially analyzing the action of various herbs and compounds or treatments on a disease to access the best effects.

Shabda Swaprupa Karana

Shabda Swarupa Karana (Knowledge through theoretical references) – Theoretical knowledge in a comprehensive way is essential for medical practice. Shabda or Aptopadesha or the reference books and statements of sages, seers, teachers, scholars and stalwarts of Ayurveda (or any other science) are the karanas or asaadhaarana kaaranas (cause) for a shabda rupa gnana (karya).

Applied knowledge

Applied knowledge on the basis of Satkaarya vaada
Satkaarya vaada is a theory related to Kaarya-Kaarana Bhava which explains that the Karya or work done (effect) existed in the Kaarana (cause) before its manifestation.

The theories related to the below mentioned (as explained in Ayurveda) concepts are explained on the basis of Satkaarya Vaada.

  • Roga utpatti – formation of the disease (which was in its causes)
  • Garbhavakranti – formation of fetus (which was in its causes i.e. sperm and ovum)
  • Nidaanarthakara Rogas – one disease leading to the manifestation of the other disease (one disease was present in a latent form in the other disease from which it is caused)
  • Dhatu nirmaana – formation of tissues from the food (tissues were present in the food in latent form)
  • Karma phala – impact of the deeds done in the previous birth
  • Roga anutpatti – non-manifestation of the diseases due to following Swastha Vritta (rules and regulations related to compatible living including those of diet, lifestyle etc)
  • Srushti Utpatti – Creation of the world from Avyakta

Knowledge on the basis of Parinaama Vaada –
This theory tells that the Kaarana (cause) itself gets transformed into Kaarya (effect). Sushruta, has mentioned Parinaama as one among the 6 factors which act as Kaarana for every Kaarya in the creation.

The Krama Dhatu Parinaama i.e. the chronological formation or transformation of one dhatu from the other as explained by Ayurveda can be understood by the help of this theory (Parinaama Vaada).

रसाद् रक्तं ततो मांसं मांसाद् मेदः प्रजायते।
मेदसो अस्थि ततो मज्जा मज्ज्ञः शुक्रस्य सम्भवः॥(सु.सू.१४/१०)

Rakta (blood) is formed from the first tissue i.e. Rasa (lymph, plasma), i.e. Rasa transforms into Rakta. Later following the chronology, Rakta is transformed into Mamsa (muscles), Mamsa into Meda (fat tissue), Meda into Asthi (bones), Asthi into Majja (bone marrow) and Majja into Shukra (semen or reproductive tissue).

Vivarta Vaada

Vivarta Vaada or illusion can be used to treat mental disorders –
This theory explains the knowledge through illusion. Here, the cause is not converted into effect, nor is it hidden in a latent form within the kaarana (cause). Example, looking at a rope and assuming a snake is Vivarta. This concept is used in treatment of psychiatric disorders.

Kshana Bhangura Vaada

Kshana Bhangura Vaada teaches us ‘wear and tear’ phenomenon –
This theory tells that ‘no material is stable’. Things which are created are also destroyed within no time. This allows us to learn the process of ‘wear and tear’ phenomenon taking place in all the cells of our body at a steady pace.

Anekanta Vaada

Anekanta Vaada teaches us ‘research related discussions’ –
This theory tell us that no theory is ‘conclusive’ until discussed, critically discussed, different hypothesis studies differentially, symposiums and seminars to share and analyze the different knowledge sources conducted and probable conclusions reached. Ayurveda text books give us the earliest evidences of such symposiums wherein various minds met to study and take decisions and probable conclusions related to certain hypothetical knowledge.

These were called ‘Tadvidya Sambhasha’. This was the root source for modern day seminars and debates and symposiums. These deliberations take us to various research related works. There may not be commonly accepted conclusions but the decisions taken or possible conclusions drawn may pave way for further studies in future.

Swabhaa uparama Vaada

Swabhaa uparama Vaada teaches us about natural destruction –
This theory explains the natural destruction of the body tissues. This teaches that we are born with an inbuilt mechanism of ‘self destruction’ and nothing is permanent and indestructible. This also explains about the cell death, apoptosis, catabolic process of cells and autoimmune theory.

Saamya Vaishamya Siddhanta

Saamya Vaishamya Siddhanta helps us in making diagnosis and implementing proper treatment and diet –
According to Saankhya school of philosophy, Saamya (similarity) and Vaishamya (dissimilarity, unlike) causes 2 types of Karyas or works. Saamya Vaishamya Siddanta forms the mainstay of Ayurvedic treatment.

साम्य वैषम्याभ्यां कार्य द्वयम्।(सां द.६/४२)
विकारो धातु वैषम्यं साम्यं प्रकृतिः उच्यते।(च.सू.९/४)

The Dhatu Vaishamya (imbalances in the tissues in term of their quality and quantity) is said to be Vikaara or disease. Similarly balance of the tissues and doshas in terms of their quality and quantity in the body is said to be Prakriti or status of perfect health. The secret of treatment is to correct the vaishamyas through proper administration of treatments, medicines and lifestyle practices and bring them to saamya state. On the other hand the Saamya dhatus shall be preserved in the same state and all attempts to keep them in a state of equilibrium should be made.

Just before Finishing –
Many things and businesses in the creation work on the basis of Karya and Karana relationship i.e. the cause and effect relationship. Ayurveda was the first medical science to establish this relationship between these two entities and effectively utilize the concepts in diagnostic and treatment aspects. This article focuses on the ancient knowledge about the clinical implications of cause and effect relationship.
Click to Consult Dr Raghuram Y.S. MD (Ayu)

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