Cancer in Ayurveda-An Approach in Etiopathogenesis: February 2015

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Cancer in Ayurveda- An Approach in Etiopathogenesis

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Review Article International Ayurvedic Medical Journal ISSN:2320 5091

CANCER IN AURVEDA - AN APPROACH IN ETIOPATHOGENESIS


Kalpana B Kachare1, A C Kar2
1
PhD. Scholar, Vikriti Vigyan Department, Faculty of Ayurveda, IMS, BHU, Varanasi, Uttar
Pradesh, India
2
Professor,, Vikriti Vigyan Dept., Faculty Of Ayurveda, IMS, BHU, Varanasi,
Varana Uttar Pradesh,
India

ABSTRACT
The Cancer is such a disease, which is very complicated in nature with complexity at every
level at anatomy, physiology, biochemistry, molecular biology and gene expression. So treating
such disease is a big challenge. Numerous techniques are employed oyed to combat these diseases,
including surgery, radiotherapy, chemotherapy,
chemotherapy, interferon therapy, hormone therapy and blood
transfusion. But the remedies that are currently in use are either only for reducing the immediate
complications associated with these
these diseases or for slowing down the proliferation of the diseas-
disea
es. Thus the mortality and morbidity rates are more in cancer person. Ayurveda which is not only
a system of medicine but a way of life, advocating prevention of disease as its primary aim and
following holistic approach in dealing with different diseases. As per the sequence of pathogene-
pathogen
sis of disease given by Madhavkara, Nidan is the first step and foremost step of the manifesta-
manifest
tion of disease and it gives the particular knowledge about the pathogenesis
pathogenesis of disease. Ayurveda
is supposed to add a step on to the curative aspects of cancers that have resemblance with clini-
clin
cal entities of arbuda and granthi mentioned in Sushruta samhita.
Key words: Cancer, Ayurveda , Etiopathogenesis, Nidan.

INTRODUCTION
AYURVEDIC CONCEPT OF CANCER Granthi and Arbuda come nearest
nea to cancer
Ayurveda is a Science of life. We than any other disease.
know that Cancer is one of the most dreaded According to Ayurveda,
Ayurveda cancer re-
disease of 20th century and spreading further sults from lifestyle errors such as unhealthy
with continuance and increasing incidence foods, poor hygiene, or poor behavior, or
in 21st century. Classical Ayurvedic texts from physical trauma, all leading to imbal-
imba
have several references to cancer. Some ances of Vata, Pitta, and Kapha,
Kapha resulting in
terms used to describe the condition are injury to the inner layer of the dermis (Rohi-
(
general while others are much more specific. ni, the sixth layer of the skin) and the forma-
form
According to Ayurveda, there are various tion of abnormal branches of blood vessels.
disease entities which resemble new In this stage, early Granthi or Arbuda can
growths. They are described under the head-
hea develop in the form of bubble-shaped
bubble glan-
ings of Shotha, Dushtavrana, Gulma,
Gulma Kshu- dular growths. Granthi has been described
draroga. But for purpose of the malignant as a round, hard, and bulging swelling, pro- pr
nature of the disease, the description of duced owing to the aggravation of Vata and
Kalpana B Kachare & A C Kar : Cancer In Aurveda - An Approach In Etiopathogenesis

Kapha vitiating the muscle, blood, and fatty surrounding tissues. It is almost like well
tissues. Arbuda has been described as a differentiated from the surrounding tissues.
round, large, muscular, immovable, deeply Sushruta have mentioned Adhyarbuda, Dwi-
rooted, slowly growing swelling produced rarbuda , this type of Arbudas can be corre-
owing to the aggravation of Doshas vitiating lated with malignant stage of cancer or me-
the muscle, blood, and fatty tissues. Both tastasis of cancer. Malignant cancer has rap-
types of swelling can be inflammatory or id growth it have the property to invade sur-
non-inflammatory, based on the Doshas in- rounding tissues and capacity of rapid me-
volved. Tridoshaja tumors are usually ma- tastasis.
lignant because all of the three major body SAMPRAPTI AND CAUSES OF AR-
humors lose mutual coordination resulting in BUDA (ETIOLOGY)
a morbid condition various signs and symp- Etiopathogenesis of Arbuda is based
toms arising owing to the progression of on Doshic theory. Human body is made up
cancer have been described in detail for ex- of Tridosha (Vata, Pitta, Kapha). It is be-
ample, anemia, cachexia and loss of appe- lieved that equilibrium of Vata, Pitta and
tite. Kapha ensurse good health. If any of the
Cancer has been understood to exist factors of Tridosha gets vitiated due to the
for thousands of years. While cancer may be changed dietary habit and life style, body
more prevalent today because people live to becomes diseased. Though vitiated “Do-
a greater age than in the past, Cancer has shas” are responsible for the development of
always occurred. Healers since the begin- Arbuda almost all Ayurvedic texts have giv-
ning of time have tried to understand the en maximum importance to Kapha. Sushruta
condition and manage those who have been has mentioned that due to excess of Kapha,
suffering. The following terminology de- Arbuda does not suppurate, which is consi-
scribes the most basic concepts dered to be the common and important fac-
SIGN AND SYMPTOMS OF ARBUDA : tor for any growth in the body. Thus, it
Vrittam, Sthiram, Mandrujam, Ma- seems justified to postulate that excess of
hantama, Unalpa-moolam, Chiravruddhi, vitiated Kapha in the body might be respon-
Apakam these are the symptoms which is sible for the precipitation of cancer.
mentioned by Sushruta. In the modern era Irritation and trauma may precipitate
also these symptoms we are getting in the or activate the formation of Arbuda. Where
case of benign and malignant stage of carci- for the enlargement of external genitalia lo-
noma. cal application of certain irritable medicines
Symptoms of benign tumor grow have been advised. More often improper use
slowly don’t invade and metastasize. These or misuse of those drugs i.e. Linga Vridhika-
are the well differentiated. Vrittam (round), ra Yoga has led to the development of Mam-
Sthiram (immoveble) , Manda ruja (slightly sarbuda. According to Sushruta trauma is
painful), Mahant(big size), Unalpa-moolam also considered to be another causative fac-
(deep seated), Chirvruddhi (slowly increas- tor for the development of Mamsarbuda,
ing) and Apakam(non-supurating) are the whereas Vagbhatta has described that when-
classical symptoms of benign growth. Be- ever there is excessive formation of Mamsa
nign tumor have minimal tendency to invade Dhatu it may lead to various pathological
473 www.iamj.in IAMJ: Volume 3; Issue 2; February- 2015
Kalpana B Kachare & A C Kar : Cancer In Aurveda - An Approach In Etiopathogenesis

conditions, such as Galaganda, Gandamala, sponsible for excessive formation of muscle


Arbuda, Granthi and Adhimamsa. It indi- and soft tissue (Mamsa Dhatu) may lead to
cates that Mithya Ahara and Mithya Vihara the development of tumors and other patho-
probably changes local or systematic bio logical conditions. The genetic cause for the
chemical factors including the hemodynamic manifestation of cancer is also well docu-
leading to the origin of Arbuda. mented in Ayurveda. Unwholesome diet
Excessive use of meat is considered (Mithya Ahara) and unwholesome regimen
to precipitate the formation of tumor de- (Mithya Vihara) are main reasons behind the
scribed in Sushruta Samhita. Mushti Praha- rise in incidence of cancer.
ra (trauma) is another important factor for Fig. No. 1 : Development and progression
development of Mamsaarbuda (Sushruta of cancer through different stages
and Vagbhatta) emphasizes that factor re-

Types of Arbuda according to Dosha tailed fundamental advancement in the field


1. Vataja Arbuda of Ayurveda.
2. Pittaja Arbuda Types of Arbuda according to Dhatu (tis-
3. Kaphaja Arbuda sue or cells)
4. Tridoshaja Arbuda This indicates that ancient Indian
This indicates that probably there are clinicians were aware of the involvement of
four main Doshas or humors playing an im- different tissue either primarily as local fac-
portant role after vitiation or derangement tor or generally by derangement of Doshic
which may be low or high in comparison to factors. According to Sushruta’s description
other humors to precipitate the malignant in Nidana Sthana, Dhatus are involved in
growth in the body. Extreme diversion of Arbuda i.e. three types of Dhatus.
Doshas may lead to fatality. Such variations 1. Raktaja Arbuda –Pitta predominance
in different types of Arbuda can be diag-
nosed or labeled as Vataja, Pittaja, and Ka- 2. Mamsaja Arbuda- Vatika predominance,
phaja based on their symptomatology. sarcoma is considered as Mamsaja Ar-
Those Arbudas having mixed symptoms of buda.
all the three humors can be labeled as Trido- 3. Medoja Arbuda (Fatty tissue)
saja. However to establish or label the par-
ticular types or Doshaja Arbuda require de-
474 www.iamj.in IAMJ: Volume 3; Issue 2; February- 2015
Kalpana B Kachare & A C Kar : Cancer In Aurveda - An Approach In Etiopathogenesis

However, a vivid description is also Recurrence and metastasis:


available where Asthi (Bone) has also been At an interval or period of time, Sad-
involved to give rise to swelling like Arbuda hya Arbuda may develop into Asadhya i.e.
described as ‘Adhyasthi’ but not as Asthyar- from one stage to the other or Asadhya Ar-
buda. Further Asthi-kshaya if localized to buda may give rise to its spread to another
some particular portion resembling patho- place which may be called as metastatic
logical fracture or osteoclastic destructive stage. Such pathogenesis of malignancy has
change in the bone may also be included in been described in Ayurvedic text books as
Asthyarbuda. “Adhyarbuda” or ‘Dwirarbuda’. This most
Types of Arbuda according to sites: probably suggests the recurrence and metas-
According to Sushruta, Arbuda can tasis of tumours to distal places.When Arbu-
occur at any site or tissue of the body and da is appearing at pre-existing site or nearby
probably no site is exempted which cannot primary growth it is called as Adhyarbuda
give rise to Arbuda. This include eye, ear, (recurrence) whereas when a couple of simi-
nose, buccal cavity separately such as Vart- lar types of growth occurring at different
ma-Arbuda (eye lid), Karnarbuda (ear), Na- places, following one after another it is
sarbuda (Nose), Taluarbuda (Palate), Os- called “Dwirarbuda” i.e. metastasis.
tharbuda (Lip), Galarbuda (Throat), Muk- Asadhya Vrana (malignant ulcers)
harbuda (Buccal mucosa) and Sirarbuda Asadhya Vrana may be due to a
(Tumors of head or brain). number of causes and malignancy cannot be
Apart from the above mentioned site, ruled out as one of them. Almost all clinical
genital organ has also been included under presentation of different Asadhya Vrana de-
the nomenclature of “Shuka Dosha”. This scribed by Sushruta can be considered under
includes two types of Arbuda i.e. Mamsar- malignant ulcers. According to Sushruta
buda and Shonitarbuda, which is precipi- these ulcers are chronic in nature and depicts
tated due to misuse of various types of ‘Lin- with raised or rolled edges, multiple firm
ga Vriddhikara Yoga’. fleshy masses similar to cauliflower type
Types of Arbuda according to prognosis: with various types of discharges. Sometimes
Based on the prognosis of the differ- these ulcers also present some general symp-
ent types of Arbudas described in Ayurvedic tomatology i.e. painful respiration, anorexia,
text books, they can be placed under two chronic cough, cachexia etc. suggesting the
categories: stage or spread of cancer to other places.
1. Sadhya Diseases which may be considered as Ma-
2. Asadhya lignancy
Most of the Arbudas including Mam- This includes particularly those dis-
sarbuda, Raktarbuda and Tridoshaja arbuda eases which are labeled as Asadhya along
of any site occurring in ear, nose, throat etc. with certain manifestations similar to malig-
are considered as Asadhya (incurable). nancy. Those are Mamsaja Ostha, Alasa,
However some of the Arbudas are also de- Mamsa Kacchapa, Galaudha, Asadhya Ga-
scribed as Sadhya, which are most probably laganda, Tridosaja Gulma, Asadhya Vrana,
cyst benign tumours or chronic inflammato- Lingarsa etc.
ry swelling.
475 www.iamj.in IAMJ: Volume 3; Issue 2; February- 2015
Kalpana B Kachare & A C Kar : Cancer In Aurveda - An Approach In Etiopathogenesis

Mamsaja Ostha: This is an incurable dis- which is painful, increases gradually in size
ease of lips which becomes heavy, thick pro- and is incurable. This resembles a tumour of
truding fleshy mass and developing ulcers hard palate.
occasionally. Such lesions of the lips can be Galaudha : Simillar to other diseases, this
considered as exophytic lesion (Acerman’s disease develops also due to vitiation of
Cancer). Rakta and Kapha. In this disease, an exten-
Alasa: Due to vitiation of Rakta and Kapha, sive swelling occurs in the throat obstructing
there is a deep seated swelling under the sur- both the passages of oesophagus and trachea
face of the tongue. It increases gradually in with the result that patient develops difficul-
size, with fishy odour discharge and de- ty in swallowing and also in respiration
stroys the surroundings structures. Such which becomes fatal to the patient. A malig-
types of disease resembles Adenocystic and nant growth at oropharynx may give all
Mucoid epidermoid tumours of salivary these symptomatic features
glands. Benign tumors
Mamsa Kacchapa: Due to vitiation of Ka- Table No. 1 : Symptoms of a benign tu-
pha, a big swelling develops on the palate mor
BENIGN SYMPTOMS CAUSE
TUMOR
Vata Granthi Variable, pricking and cutting pain, large, Aggravated Vata, due to dry or
black, round, non-fixed, its size may fluc- stale foods, stress, insomnia,
tuate, hard, bulging and if pricked, exudes fatigue etc.
a clear, thin fluid.
Pitta Granthi Burning sensations, red or yellow in co- Aggravated Pitta, due to res-
lour, suppurates quickly and exudes a tlessness, spicy food, over-
warm blood when pricked. controlling, agressive beha-
viour etc.
Kapha Granthi Painless, large, hard tumor, pale colour, Aggravated Kapha caused by
the area around is cold and itches. Suppu- too much fatty foods, fast
rates slowly and if pricked, exudes thick, foods, lack of movement, le-
white, cloudy pus. thargy.

Rakta Granthi Loss of tactile sensations. Symptoms sim- Aggravated Vata, Pitta and
(Blood) ilar to Pitta Granthi. Kapha circulate through the
bloodstream, with Pitta Dosha
as
The main cause for the distur-
bance.
Mamsa Granthi Large, oily, hard tumor tends to be very Excessive consumption of
(Muscle tissue) vascular. They ulcurate and bleed easily wrong kinds of meat.
and often become malignant. Symptoms
are similar to imbalance of the Kapha Do-

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Kalpana B Kachare & A C Kar : Cancer In Aurveda - An Approach In Etiopathogenesis

sha.
Meda Granthi Soft, fatty tumor, but movable. Symptoms Intake of too much fat, where
(Fatty tissue) similar to imbalanced Kapha Dosha, upon Vata transport it to the
usually grow in proportion to body muscle tissue or skin.
growth. If pricked, exudes a coppery,
white or black fatty fluid.
Asthi Granthi Tumor growth outside of the normal area Fractures or injuries to the
(Bone tissue) of the bone. bone, that accumulate Vata.
Sira Granthi Vascular tumors, painless and do not pul- Overexertion, severly accumu-
(Channels) sate. lated Vata weakens the blood
Contracting, dehydrating, deformation. consistency, which enters the
channels of the body.
Benign tumors, when detected in an secretion of disturbed (vitiated) blood. This
early state, are curable because the drying, form is very difficult to cure. Mamsarbuda
compressing and contracting qualities of Va- occurs when muscles get disrupted from
ta have closed the blood vessels. This has fighting for instance. When from the punch-
made it impossible for the tumor to root ing, the muscles show a swelling which is
deeply in the tissues and growth and nou- stony hard, painless, glossy, and immobile
rishment are highly limited. However when without inflammatory signs, of same colour
these tumors are in the blood-stream, they as the surrounding then this is the tumor.
are much more serious and harder to cure. These are more common in non-vegetarians.
Important features for a successful chance of Mamsarbuda is extremely difficult to cure
recovery are pain and mobility of the tumor. for the same reasons as Raktarbuda.
Whenever a tumor is completely attached Adhyarbuda: Development of another tu-
and has started to grow, it is hard to treat. mor over the first tumor or when a tumor
Malignant tumors arises on a pre existing site or near a primary
Raktarbuda occurs when aggravated tumor.
Doshas hamper blood vessels in their func- Dwirarbuda: When two tumors arise at the
tioning, impeding the blood circulation as same time those tumors that cause large se-
well. This leads to disturbances in the blood, cretion of fluid in the surrounding tissue, are
comparable to the accumulation of toxins located in vital locations or channels (lym-
(Ama) in the blood. These toxins (e.g. carci- phatic system and blood vessel system) or
nogens) can be the cause of a tumor. When attached to the surrounding tissue are highly
tumors develop in the blood vessels, their difficult to cure.
spreading through the blood- and lymphatic The Development of Malignant Tumors
system will soon become a reality. This When a benign tumor suddenly starts
large spreading of tumors will make recov- to grow excessively and roots deeply into
ery extremely difficult. Symptoms of blood the tissue, with symptoms compatible with
tumor little fluid or pus accumulation (in- increased Kapha Dosha and fatty tissue, a
flammatory signs) around the tumor grows malignant tumor is occurring. Malignant
quickly, covered with small metastases and tumors do not suppurate and also do not ex-

477 www.iamj.in IAMJ: Volume 3; Issue 2; February- 2015


Kalpana B Kachare & A C Kar : Cancer In Aurveda - An Approach In Etiopathogenesis
ude fluid, blood or pus anymore. They are part of the body. It can involve Mamsa and
no longer removed by the body, grow quick- Rakta.
ly and cover a large area. They are caused Etiopathogenesis of Arbuda is based
by three vitiated Doshas and always affect on Doshic theory. Though vitiated “Doshas”
muscle tissue, adipose tissue and blood. For are responsible for the development of Ar-
more information see the detailed descrip- buda, almost all Ayurvedic texts have given
tions in the Sushruta Samhita. The four pre- maximum importance to Kapha. Sushruta
viously described benign tumors (Granthi) has mentioned that due to excess of Kapha,
have now developed into a malignant tumor Arbuda does not suppurate which is consid-
(Arbuda). Curable are those Granthi that ered to be the common and important factor
occur in the blood vessels, are painful and for any growth in the body. Thus, it seems
mobile. However, Granthi that is painless, justified to postulate that excess of vitiated
large, immobile and situated in the vital Kapha in the body might be responsible for
parts of the body are exceedingly difficult to the precipitation of cancer. Dhatus involved
cure. in Arbuda are Rakta, Mamsa and Meda hav-
ing Pitta, Vata and Kapha predominance
CONCLUSION respectively. The description of “Adhyar-
The identification and description buda” or ‘Dwirarbuda’ suggests the recur-
of malignant diseases (Tumour) are avail- rence and metastasis of tumours to distal
able in the ancient literature. Classical Ay- places. Cancer is an abnormal excessive,
urvedic texts have several references to can- uncoordinated, autonomous and purposeless
cer. Arbuda is the most specific term for ma- proliferation of cells in any tissue or organ
lignant cancer and Dwirarbuda indicates the of the body.
metastasis or spread of cancer from one part
to other part of the body. As far as Sam- REFERENCES
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Kapha for their uncontrolled growth. Benign met Altern Med 2002;86:75–89.
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5. Bhishagratna KL. Sushruta samhita,, Vol 10. Dash B, Kashyap L. Diagnosis and
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CORRESPONDING AUTHOR
2005.
Dr. Kalpana B Kachare
7. Murthy KRS. Astanga-Hridaya of
PhD. Scholar, Vikriti Vigyan Department,
Vagbhata. Varanasi: Choukhamba orien-
Faculty of Ayurveda, IMS, BHU,
talia; 2005.
Varanasi, Uttar Pradesh, India
8. Murthy KRS. Sarangadhara samhita. Va-
Email: kachare.kalpana@gmail.com
ranasi: Chaukambha Orientalia; 2001.
9. Murthy KRS. Bhavaprakasa of Bha-
vamisra. Varanasi:Chaukambha Krish-
nadas Academy; 2001.

Source of support: Nil


Conflict of interest: None Declared

479 www.iamj.in IAMJ: Volume 3; Issue 2; February- 2015

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