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Madhav


 Madhavacharya

Madhava, popularly known as Madhavacharya, is acknowledged as one of the finest Ayurvedic physicians even today. The author of a text on medical diagnostics (Rogavinischaya), known as ‘Madhavanidan’, Madhava belonged to the era of 7th century AD. He was the son of Indukara and belonged to the Kara family of physicians; hence he is also referred to as Madhavakara 1 . Madhavanidan is considered as a pioneering compendium developed on the foundations of knowledge resourced from Charaka samhita, Sushruta samhita, Ashtanga sangraha, Ashtanga hrudaya and many other classical texts enriched by Madhavacharya. The legacy of Madhavanidan continued in subsequent centuries being referred to in writings related to diagnostics and other literature concerned with Ayurveda. The popularity and utility of this treatise is evident and prevalent today amongst the practitioners of Ayurvedic system of healthcare. It is an essential component of current undergraduate and postgraduate Indian Medicine.

The diagnostic treatise is unique in its content. The very first chapter of Madhavanidan is ascribed to Pancha-Nidana which encompasses five aspects of clinical diagnosis2 viz. Hetu (etiological considerations), Poorva-rupa (prodromal symptoms), Rupa (clinical features), Samprapti (pathophysiological processes), and Upashaya-anupashaya (therapeutic diagnostics). Besides this for most of the diseases, Upadrava (clinical manifestations of complications) and Sadhyasadhyatva (prognostic features) are also described. Madhavakara is also credited with distinct identification of several clinical entities not clearly described in earlier classics. Some of these are Amavata (Polyarticular inflammatory diseases), ParinamshoolaAnnadravakhyashoola (Gastritis, and peptic ulcer), Amlapitta (Acid-peptic diseases), Medoroga (Obesity and adiposity), Shitapitta-Udarda-Kotha (Urticaria and angioedema), Masurika (Infectious eruptive fevers), Visphotaka (Pemphigoid disorders), Yonikanda (Uterine prolapse), Sutikaroga (Puerperal disorders), and Lingarsha (Venereal warts).

 In Madhava-Nidan a total of 1530 verses are classified in 69 chapters which are arranged as per 6 branches of Ayurveda such as Kayachikitsa (Internal medicine), Grahavidya (Astrology and transcendence), Shalyatantra (Diseases for surgical intervention), Shalakyatantra (Diseases of head and neck), Kaumarbhritya (Pediatrics, inclusive of Obstetrics and gynecology), Agadatantra (Toxicology) while excluding Rasayana (Rejuvenative) and Vajikara (Aphrodisiac) of Ashtang Ayurveda. Madhavacharya’s description of ‘Amavata’ is worth noting. Madhava dedicates a separate chapter for this first ever description of Amavata which is essentially a polyarticular inflammatory disease . The clinical manifestations of Amavata mention pain and swelling of the joints particularly of hands, feet, ankles, knees, hips, skull, and sacro-illiac joints, and generalized stiffness of extremities is an important manifestation of the disease. According to him the diffuse connective tissues, and the sacroiliac joints, are the main locations of the disease and are often associated with multisystem involvement. The significant pathogenetic factors responsible for Amavata are, hypofunctioning of digestive and bio-transformable capacity, toxic conglomerate of antigen-antibodies, and central inflammatory response and generalized physiological dysfunction. Madhava categorically pointed out incompatibility between food and physical activities as one of the causes of the Amavata. Many more clinical symptoms are stated by Madhava in this chapter of Amavatanidanam.

 The importance of Madhava- Nidan is evident from the several commentaries which have been written subsequently on it, and at least 20 of them by reputed Ayurvedic experts are traceable. The most referred commentary is the ‘Madhukosha’ in Sanskrit authored by Shrivijayarakshit and Shrikanthadatta. Madhavanidan which is originally written in Sanskrit language was translated in the Arabic in 8th century AD . Later on several translations are made into English, French, Italian, Sinhala, Hindi, Marathi, Gujarati, Kannada, Malayalam, Telugu, Bengali, Oriya etc. The diagnostic treatise is well preserved through the centuries and forms an essential component of current undergraduate and postgraduate teaching of Ayurveda. Madhava also authored another book ‘Madhava-Chikitsa’, a text on principles of therapeutics and this has been referred to by some authors; however the manuscript is not easily accessible.