TIRYAGGATA DOSHA AND CIKITSA SUTRA

TIRYAGGATA DOSHA AND CIKITSA SUTRA (CHA NIDANA 8/36–39)

• The concept of Tiryaggata Dosha (abnormally displaced or deviated doshas) is an important diagnostic and therapeutic consideration in Ayurvedic pathology.

• It is specifically described in the context of Apasmara Nidana in Charaka Samhita Nidana Sthana Chapter 8, Verses 36–39.

• This section emphasizes how doshas, when perverted from their normal gati (direction or mode of movement), cause psychological and somatic disorders.

• The Cikitsa Sutra (treatment principle) based on the understanding of Tiryaggata Dosha forms the foundation of therapeutic approaches in such disorders.

SANSKRIT SLOKA WITH REFERENCE
चरक संहिता निदानस्थानम् – ८ / ३६–३९

श्लेष्मपित्तविषाणां च दोषाणां चाप्यनुग्रहात्।
अकस्मात् समुपेतानि कृतानि हृदि विक्रियाः॥३६॥

तेनाभिसंस्पृष्टमनाः सत्त्वबुद्धिस्मृतिव्यथा।
धारयन्नप्ययं लोकं न स्मरत्यन्यदात्मनः॥३७॥

विधिः स तु समुत्क्लिष्टान् दोषान् पश्यत्यनुग्रहीन्।
तिर्यग्गतान् यथास्वं च प्रतिपद्य स संशयः॥३८॥

तस्माद्दोषप्रसङ्गेऽस्मिन् प्रज्ञां दार्ढ्यं च वारयेत्।
शोकोऽत्यशक्तिः सत्त्वस्थैर्यं हृदयदौर्बल्यमेव च॥३९॥

MEANING AND EXPLANATION OF THE SLOKAS

• Verse 36: The accumulation and perversion of doshas like kapha, pitta, and vata without apparent cause can lead to mental derangement.

• Verse 37: These doshas disturb the mind, intellect, and memory, causing the person to lose awareness of surroundings and self.

• Verse 38: When doshas move abnormally (Tiryaggata), they obstruct or pervert mental faculties, leading to doubt and confusion.

• Verse 39: In such conditions, factors like delusion, weakness, lack of mental stability, and cardiac debility should be prevented or managed.

DEFINITION OF TIRYAGGATA DOSHA

• Tiryaggata means aberrant or deviated movement of doshas.

• When doshas deviate from their normal path and invade non-dominant srotas, they produce unusual or abnormal symptoms.

• Especially important in psychiatric, neurological, or complex psychosomatic disorders.

DOSHIC DEVIATION IN TERMS OF GATI (MOVEMENT)

• Adhogati: Movement of doshas downward (e.g., diarrhea, dysentery).

• Urdhwagati: Upward movement (e.g., vomiting, nausea).

• Tiryaggati (Tiryaggata): Lateral or diffused, perverted movement (seen in Apasmara, Unmada, epilepsy, schizophrenia).

CAUSES OF TIRYAGGATA DOSHA

• Sudden emotional stress

• Suppression of natural urges (Vega Dharana)

• Consumption of incompatible foods

• Excessive indulgence in tamasic and rajasic activities

• Hereditary (Beeja dosha) and environmental triggers

CLINICAL SIGNIFICANCE

• Leads to disruption of Sattva (mental clarity), Buddhi (intellect), Smriti (memory).

• Manifestations include:

  • Sudden loss of consciousness

  • Seizures or jerky movements

  • Delusional thinking, inappropriate behavior

  • Confusion, hallucinations, or forgetfulness

CATEGORIES OF SYMPTOMS (ACCORDING TO DOSHIC PREDOMINANCE)

• Vataja Tiryaggata: Tremors, convulsions, fear, dryness, incoherent speech.

• Pittaja Tiryaggata: Anger, burning sensation, delirium, agitation.

• Kaphaja Tiryaggata: Dullness, heaviness, confusion, slowness.

AYURVEDIC MANAGEMENT PRINCIPLES (CIKITSA SUTRA)

• Dosha Shamana or Shodhana: Based on predominance, doshas should be pacified or eliminated.

  • Vata: Snehana, Basti

  • Pitta: Virechana, Sheetala dravyas

  • Kapha: Vamana, Langhana

• Manasika Chikitsa (Mental Therapies):

  • Use of Medhya Rasayanas – e.g., Brahmi, Mandukaparni, Ashwagandha

  • Sattvavajaya Chikitsa – Control of mind through:

    • Jnana (Knowledge)

    • Vijnana (Analytical Understanding)

    • Dhairya (Courage)

    • Smriti (Memory)

    • Samadhi (Meditative stability)

• Daivavyapashraya Chikitsa: Includes mantra, japa, havana – to influence psychological wellbeing.

EXAMPLES OF DRUGS FOR TIRYAGGATA DOSHA MANAGEMENT

• Brahmi Ghrita

• Saraswatarishta

• Ashwagandha Churna

• Kalyanaka Ghrita

• Mahakalyanaka Ghrita

PROGNOSIS

• Varies with doshic dominance and chronicity.

• Early stage manageable with shodhana and medhya.

• Chronic conditions may need long-term rasayana and psychotherapy.

MODERN CORRELATION

• Tiryaggata Dosha features overlap with:

  • Epilepsy (Apasmara)

  • Schizophrenia (Unmada)

  • Dissociative Disorders

  • Delirium

• Neurological Basis:

  • Neurotransmitter imbalance

  • Structural brain abnormalities

  • Neuroinflammation and oxidative stress

• Modern Treatment Principles:

  • Anticonvulsants (e.g., Valproate, Carbamazepine)

  • Antipsychotics (e.g., Risperidone, Olanzapine)

  • Psychotherapy and Counseling

  • EEG, MRI for diagnosis

RESEARCH AND CASE REFERENCES

• Clinical trials show Medhya Rasayanas improve cognitive functions and reduce seizure frequency.

• Brahmi and Ashwagandha have neuroprotective and anti-stress effects.

• Ayurvedic approaches show integrative benefit when combined with conventional neurological care.