By Dr Raghuram Y.S. MD (Ay) & Dr Manasa, B.A.M.S
Pradhanika nidanas are the important causative factors of a disease.
Praadhaanika = most important
Praadhaanika Nidanas are those etiological factors which due to their natural intense and aggressive nature cause immediate aggravation of doshas and life threatening conditions consequently. Importance of these etiological factors lay in their aggressive nature. They aggravate doshas very quickly and also quickly cause a disease, a life threatening condition or death in a short period of time.
Read – Main Cause For Diseases As Per Ayurveda
Most popular example for vital etiological factors is poison. Consumption of poison is life threatening. Snake or scorpion sting or exposure to unknown toxins can also cause immediate impact. With an accidental variability, poisons can be seen to cause life threatening complications or death in most people. Thus, behaviour of poison as etiological factor is universal or almost general.
Read – Samprapti Ghatakas – Components Of Manifestation Of Disease
Duration of causation of symptoms or death is also a common pattern. Many times if poison is strong it even need not aggravate doshas. Due to its quick invasive and damage causing nature it spreads quickly in body and causes failure of many systems at a time. Even if doshas get vitiated due to impact of poisoning, it might be behind screen and obviously not observed. Impact of poison and fulminant symptoms caused by it mask the disturbance of doshas.
Read – Charaka Visha Chikitsa 23rd Chapter of Chikitsa Sthana
Anaphylaxis is a severe, life threatening allergic reaction. This can occur within few seconds or minutes of getting exposed to certain etiological factors to which one is allergic. Causes can be as small as consumption of peanuts or follow a bee / wasp sting.
Read – Doshas And Ayurvedic Immunology
This is followed by release of chemicals from one’s immune system leading to shock, with sudden dropping of blood pressure, narrowing of airways and stoppage of breathing.
Certain incompatible foods, unwholesome combinations of food, certain medications and their reaction, venom of insects and latex can cause anaphylaxis. These are often life threatening and do not take time to cause complications or death.
Read – Immunity In Ayurveda: Concept, Diet, Herbs, Medicines, Exercise
It is a condition in which immune system of a person reacts abnormally to a foreign substance. Symptoms are almost immediate and life threatening. They may occur in form of local or systemic manifestation of symptoms. It includes allergy or autoimmunity. Apart from anaphylaxis explained above, hypersensitivity reactions include drug and food allergies, food poisoning, contact dermatitis, allergic asthma, seasonal allergies, etc.
4. External life threatening causes
Massive body trauma including injuries caused due to explosion, air plane crash or major accidents, falls from great heights, machinery accidents in industries, gun shots and stabs, serious injuries including vital organs like heart, kidney and brain, severe bleeding disorders and massive haemorrhage from big arteries, serious infections afflicting brain and meninges, toxins like cyanide etc pose threat to life and are often life taking.
5. Cessation of certain functions in body
Sudden and massive cardiac arrest or stroke cause sudden death without giving any type for interventions.
All above mentioned etiological factors which cause sudden and immediate symptoms leading to life threatening conditions including death are included under praadhaanika nidanas.
Vyabhichari Nidana – Weak Etiological Factors Of A Disease
Vyabhichari – abnormal, weak
Etiological factors are bound to cause diseases. Any etiological factor which deviates from this normal phenomenon and doesn’t cause a disease is called vyabhichari nidana.
These etiological factors are weak and not capable of initiating a disease process in the body and set up a pathogenesis.
Causes for Vyabhichari Nidana not causing a disease
Consumption of weak etiological factors
Consumption of etiological factors and subsequent vitiation of doshas leading to damage of tissues is mandatory in causation of any disease.
For this to happen, etiological factors should be strong enough to disturb doshas once they enter body. If causes are weak, effect too will be weak. These etiological factors sometimes might initiate a disease process by disturbing doshas to a small extent but body’s strength would be great enough to fight back and abort disease process.
Example, eating just a scoop of ice cream may not aggravate Kapha dosha to such a high extent that it causes cold and cough.
Exposure to high sunlight in the afternoon just for a few minutes might not lead to Pitta increase and burning sensation in the body.
Vitiation of doshas in lesser proportions
Manifestation of a disease depends on gradient of dosha disturbance caused by the causative factors. As said earlier, etiological factors may be weak enough not to disturb doshas. On contrary, doshas might be disturbed by such etiological factors to a lesser proportion.
These doshas vitiated in lesser proportions will not cause a disease though they tend to invade tissues, because tissues are strong enough to tackle weak doshas trying to attack them. This would eventually end onset of disease in initial stages of pathogenesis itself.
Weak dosha dushya sammurchana, samprapti
Amalgamation of weak dosha and tissues leading to a weak pathogenesis is also responsible for non-manifestation of a disease. Severe vitiation of doshas is the key for a disease to manifest.
If aggravation of doshas is more in comparison to resistance power of a tissue, doshas attack and damage tissues and cause disease.
If tissue strength is more than strength of vitiated doshas, doshas fail to invade tissues and thus disease is not formed.
But if there is amalgamation of weak doshas i.e. doshas vitiated in lesser proportions and weak tissues, association itself will be so weak so as to not produce a disease.
Good body immunity
Immaterial of strength of etiological factors a disease is not formed if strength and immunity of body is good.
Occasional exposure to etiological factors
When someone is occasionally exposed to etiological factors those factors may not cause disease. In presence of good strength and immunity, etiological factors fail to produce disease when body tissues are exposed to these factors for a short span of time.
We are constantly exposed to wide array of allergens, pathogens and incompatible foods on daily basis. In spite of that we are not diseased daily. This shows nature of those weak causes which couldn’t eventually effect in causation of disease in spite of entering body.
This also reflects strong immunity and tissue strength of an individual. In those who are weak and debilitated, even small quantity of etiological factors which otherwise should not cause a disease, would initiate a disease process.