Article by Dr Raghuram Y.S. MD (Ay) & Dr Manasa, B.A.M.S
Amsha means fraction, portion, bit, piece, section
Amshamsha means every fraction, every bit, every portion
Kalpana translates to treatment, hypothesis, concept (idea), imagination (assumption), arranging, forming ideas.
Here Amshamsha Kalpana means to imagine, form idea or make hypothesis of every fragment and fraction of dosha or doshas in terms of its qualities (gunas) involved in the causation of samprapti or pathogenesis of a disease.
It is known that the vitiated doshas are inevitable participants in the causation of the disease (samprapti, pathogenesis). Vata, Pitta or Kapha either individually or in combinations get vitiated to form diseases. This is not enough. The vitiated doshas have to get lodged, contaminate and damage the cells or tissues of the body (weak and susceptible tissues and organs) at least to some extent if the disease is to be formed.
How do the doshas get vitiated?
The doshas get vitiated when one gets exposed to or consume Nidanas. Nidanas are the causative factors (etiological factors) of a disease). The Nidanas are unwholesome foods, erratic lifestyle practices, stress and tensions, emotional swings, geographic changes, climate changes and anything which causes vitiation of doshas and subsequent formation of diseases.
What happens when doshas get vitiated?
When doshas get vitiated (as explained above), they tend to go through different phases of increase. These phases form different stages of formation of disease, i.e. kriya kalas. Formation of Kriya Kalas following consumption of etiological factors constitutes Samprapti or pathogenesis of a disease.
6 stages of Kriya Kala
The Samprapti of a disease following exposure to Nidanas take place in the below mentioned 6 stages of Kriya Kala –
- Sanchaya – stage of accumulation of doshas in their own sites
- Prakopa – stage of vitiation of doshas in their own places
- Prasara – flow and spread of doshas to other parts of the body (other tissues and organs which do not belong to them)
- Sthana Samshraya – lodgment of doshas in the weak and susceptible tissues of the body is called sthana samshraya and the amalgamation of morbid doshas and tissues is called dosha dushya sammurchana. This amalgamation marks the beginning of the disease process with the manifestation of early symptoms or premonitory symptoms of a disease (purvarupas).
- Vyakta – manifestation of disease with clear-cut signs and symptoms (lakshana or rupa) of that particular disease is called Vyakta Avastha.
- Bheda – stage of complications (upadravas) formed when the disease is not treated even in the vyakta stage.
Among the above stages of Kriya Kala, the earlier stages are easier to treat in comparison to the end stages wherein the disease or complications are formed.
Samprapti is the story of formation of disease which includes the exposure to the nidanas with subsequent formation of Kriya Kalas i.e. formation of disease, its symptoms and complications. It is not mandatory that all stages of kriya kala are formed. If treatment is given in earlier stages, the disease process or pathogenesis (samprapti) gets aborted without the origin of disease or complications.
Samprapti is of 5 types. Among them Vikalpa Samprapti is one. Vikalpa Samprapti helps us to estimate the fractional vitiation of doshas with the help of a tactical hypothetical knowledge called Amshamsha Kalpana.
Thus, Vikalpa Samprapti is the art of doing amshamsha kalpana and learning the subtle pathological changes in a disease by ‘fractional analysis of the qualities of doshas participating in the formation of samprapti or disease pathogenesis.’
What is Amshamsha Kalpana?
When doshas get disturbed due to nidanas they also get vitiated quality wise (gunatah dushti).
Example, when Vata is vitiated its qualities are also vitiated. It is not necessary that all the qualities of Vata get vitiated at a time. The gunas might get vitiated in totality or fractionally few qualities or even a single quality may get vitiated. When sheeta guna or cold quality of vata is increased more than other qualities of vata, it produces coldness in the body. Thus, after diagnosing that a given disease is caused due to Vata, more specific diagnosis is made by telling that the given disease is caused due to predominant vitiation of sheeta guna of vata. Now the treatment will be ushna pradhana i.e. hot comforts and foods are given to pacify vata. Also medicines and medicinal compounds having hot quality is given to relieve the vitiated vata, the coldness caused by the cold quality of vata because heat is antagonistic of cold.
This fractional understanding of dosha in terms of vitiation of one or more of its qualities is called Amshamsha Kalpana.
Vikalpa Samprapti can be understood by understanding Amshamsha Kalpana and the idea of using it in any given disease.
Various areas of administration of the knowledge of Amshamsha Kalpana and its clinical utility
Amshamsha Kalpana is an important tool for diagnosis, fractional analysis and for planning comprehensive treatment and diet protocol for any given disease. A physician should be well equipped with the knowledge of Amshamsha Kalpana to gain exemplary success in the clinical practice.
To find Nidana
Amshamsha Kalpana as a tool for finding out causative factors of disease
Amshamsha Kalpana helps a physician to track down the causative factors or nidanas causing a disease. This can be done during clinical examination and interrogation of the patient by listing out the possible etiological factors to which the patient has been exposed.
Example, excessive consumption of Kalaya (a type of pea) causes vitiation of Vata because of all its qualities i.e. laghu, sheeta, ruksha etc while Kandekshu (type of sugarcane, Lataa saccharum spontaneum, Asteracantha longifolia, Saccharum officinarum) vitiates vata because of its ruksha and sheeta qualities only. The madira (alcoholic medical preparation, wine) prepared from ikshu rasa (sugarcane juice) vitiates only ruksha quality of vata, etc.
The patient may advised to keep away these etiological factors as a point of preventive strategy, not to allow the disease to progress and also as a measure in treatment, to aid quick recovery.
To understand pathogenesis
Amshamsha Kalpana for fractional understanding of the qualitative disturbance of doshas in the pathogenesis of a disease (Vikalpa Samprapti)
Amshamsha Kalpana helps in fractional understanding of doshas and its qualities involved in the pathogenesis of a disease. Amshamsha Kalpana helps in estimating the proportions in which the individual qualities (gunas) of a vitiated dosha is increased so as to contribute to the pathogenesis of the disease.
Amshamsha helps the physician in understanding and analyzing if the disease is caused due to increase in ushna guna (hot quality) of pitta or ruksha guna (dryness) of vata or sheeta guna (coldness) of kapha.
To understand Dosha vitiation
Amshamsha Kalpana in understanding the nature of dual and triple vitiation of doshas
When more than one dosha is combined in a disease, the degree of qualitative and quantitative vitiation of each dosha varies from disease to disease, from patient to patient and from time to time, in the same patient. This minute understanding of fractional variations occurring in the dosha or its qualities occurring in a disease is called Vikalpa.
Amshamsha Kalpana or Vikalpa will help us in understanding the tara-tama bhava (degree of vitiation) of doshas in dual and triple vitiation, i.e. samsarga dushti (vitiation of two doshas at a time) or sannipata dushti (vitiation of all three doshas simultaneously).
Example, in Vata-Kaphaja diseases (diseases caused due to simultaneous vitiation of vata and kapha) the name itself indicates that Vata is more vitiated than the Kapha (by nomenclature and order of names of doshas written). Thus the pradhana (main) and apradhana (secondary) dosha involved in the pathogenesis can be found (Bala Samprapti and Praadhaanya Samprapti).
Alternatively when we closely analyze the dosha components (vitiation or excess gunas or activities caused by increased gunas of particular doshas) we can find that more qualities of Vata are increased than those of Kapha. Like, 4 gunas of Vata and 1 guna of Kapha may be increased for the condition to be called as Vata-Kaphaja. If the condition is reversed (increase of 4 gunas of kapha and 1 guna of vata), the condition or disease will be called as Kapha-Vataja.
To understand Dosha predominance
Amshamsha Kalpana in analyzing the strength of doshas and disease and also the predominance of dosha in a samprapti (to understand bala samprapti and praadhaanya samprapti)
With the help of the above given explanation we can understand that Amshamsha Kalpana and Vikalpa helps us to understand the strength of doshas participating in the pathogenesis of a disease (bala samprapti) and predominance of dosha in a samprapti (praadhaanya samprapti). This can be known through understanding the quantity of vitiation of each dosha.
When more number of qualities of a dosha or a dosha in the combination (dual or triple vitiation) are increased, that particular dosha will be predominantly vitiated (praadhaanya dushti) and that dosha will be strongest in terms of vitiation i.e. having capacity to produce disease (bala samprapti) and the disease produced by such dosha vitiation will be strong (difficult to treat).
Thus Amshamsha Kalpana forms the basis of understanding bala and praadhanya samprapti and also to understand the strength of the disease (vyadhi bala).
Related Reading – Bala Samprapti
To understand Vikriti
Amshamsha Kalpana helps in understanding the vikriti (pathology) of any given disease and the symptoms of the disease
With the help of Amshamsha Kalpana, the nature of disease pathology and the symptoms of the disease can be understood. This is needed for proper diagnosis of disease and for implementing the treatment of that disease.
With the help of Amshamsha Kalpana one can understand that the burning sensation in the body is caused not only by vitiation of pitta but also due to abnormal increase of hot quality of pitta, swelling is not only caused by vitiated kapha but also due to increase in the liquidity quality of kapha and dryness of the body is not only caused by the vitiated Vata but also due to abnormal increase in the ruksha guna i.e. dryness quality of vata.
Related Reading – Praadhaanya Samprapti
Similarly excessive movement (exaggerated movements) of body parts as in kampavata (Parkinson’s disease) is caused due to abnormal increase in chala guna (mobility) of vata, loose and water stools in diarrhea is caused due to abnormal increase in drava guna (liquidity) of pitta, all these can be understood with the help of amshamsha kalpana.
For differential diagnosis
Amshamsha Kalpana in differential diagnosis of diseases
Amshamsha Kalpana helps in differentially understanding a disease.
Example, a disease with excessive coldness (sheetatva caused by sheeta guna) can either be caused by vitiated vata or kapha or both. It is difficult to tell which dosha is causing coldness in the patient in a given disease. In this instance, vikalpa or amshamsha kalpana of doshas and their qualities carefully will help in diagnosing the chief dosha involved in the causation of the disease.
When the sheetatva is caused by kapha, other qualities of kapha will also be disturbed simultaneously, like snigdha guna (unctuous quality, oiliness), manda guna (slowness), mrudu guna (soft quality), guru guna (heaviness) etc. Thus, when sheetatva is associated with gurutva (heaviness caused by increased guru guna of kapha) or snigdhatva (oiliness caused by increased snigdha guna of kapha) one can tell that the given disease is caused by vitiated kapha and its qualities. This condition can be treated by kapha alleviating medicines, treatments and comforts.
On the other hand, when the sheetatva is caused by vata, other qualities of vata are also disturbed simultaneously, like ruksha guna (dryness), laghu guna (lightness), chala guna (mobility), khara guna (roughness) etc. Thus, when coldness is associated with lightness or dryness, it can be inferred that the given disease is caused by vitiated vata and its qualities. This condition can be treated by vata alleviating medicines, treatments and comforts.
For disease treatment
Amshamsha Kalpana as applied in treatment of diseases
Since Amshamsha helps in fractional study and analysis of the disease, it also helps in the treatment of the same, in the most comprehensive way. The disease pathogenesis is split into bits and parcels in Amshamsha Kalpana. This allows the study of the disease in its minutest way. Amshamsha Kalpana helps in prevention of causative factors (nidana parivarjana) since it helps in identifying the etiological factors responsible for vitiation of doshas and their qualities and also responsible for formation of disease. Nidana Parivarjana is the most praised method of treating or preventing a disease in Ayurveda. The modern day proverb too tells ‘Prevention is better than Cure’.
Amshamsha Kalpana helps in providing dosha specific (dosha pratyaneeka), quality specific (guna pratyaneeka) and disease specific (vyadhi pratyaneeka) treatments.
Note: The details about how the amshamsha kalpana works in planning the treatments have been explained in scattered way in the above mentioned passages. I have not touched upon the details with the fear of repetition.
Just Before Finishing –
Since every bit of dosha and its qualities will be considered to understand the Samprapti or pathogenesis of a disease, the method of fractional study of dosha or doshas is called Amshamsha Kalpana. The knowledge of Vikalpa Samprapti helps in minute understanding of a disease pathology and also to comprehensively treat the disease through Amshamsha Kalpana.
Fractional analysis of dosha and its component gunas or qualities is a golden tool for the physician and contributes much to his success in clinical practice. It helps in breaking the samprapti or the pathogenesis of the disease in the best and minutest possible way and thus helps in planning a comprehensive and multi-dimensional treatment protocol.
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