2. PRESENTER
Dr.ASWATHI.T.P
1st YEAR PG SCHOLAR
DEPARTMENT OF PG STUDIES IN
AYURVEDA SAMHITHA & SIDDHANTA
GOVERNMENT AYURVEDA MEDICAL
COLLEGE,MYSURU
UNDER THE GUIDANCE OF
DR. SHREEVATHSA
PROFESSOR & HEAD DEPARTMENT OF
PG STUDIES IN AYURVEDA SAMHITHA &
SIDDHANTA.GOVERNMENT AYURVEDA
MEDICAL COLLEGE,MYSURU
2
3. CONTENTS
1.INTRODUCTION
NIDANA PANCHAKA
GRAHANI
2.REFERENCES FROM SAMHITAS
3.GRAHANI NIRUKTI
4.UNIQUENESS OF GRAHANI AS PER CHARAKA SAMHITA
5.GRAHANI SWARUPA
6.GRAHANI NIDANA
7.GRAHANI PURVA RUPA
3
5. INTRODUCTION
भिषजा प्राक् परीक्ष्यैवं ववकाराणां स्वलक्षणम्|
पश्चात्कममसमारम्िः कायमः साध्येषु धीमता|| (CH.SU.10/21)
A wise physician should examine the distinctive features of the disease first and then
start the management only of the curable disease to get success in practice.
In order to facilitate better understanding , to ease the process of diagnosis &
management of disease Nidana panchakas are utilized.
5
7. POORVA ROOPA
Helps in-
Diagnosing the disease early and to check the disease process at the earliest.
To intervene disease progress to further stages.
Knowing the prognosis of disease.
RUPA
Gives the precise information about the vitiation of dosha.
Indicates the site of actual pathology in body.
Helps in accurate diagnosis, prognosis and treatment
7
8. UPASHAYA
It provides the diagnostic aid for disease which are otherwise difficult to diagnose.
This creates a clearly outlined path in the selection of aushadha, ahara and vihara that
mitigate the lakshanas of vyadhi.
The concept of upashaya can be practically applied to advice the rogi about Pathya &
Apathya in specific disease.
8
9. SAMPRAPTI
It is the process of evolution of disease.
Samprapti of a disease gives an exact idea pertaining to various factors that cause
dosha prakopa , how the doshas travel through different sites for setting up the
disease process, and the dhatus they affect which in turn leads to disease
manifestation.
Samprapti vighatana being the ultimate method to eradicate the disease, the
compilation and comparison of the same becomes significant.
9
10. INTRODUCTION TO GRAHANI
The avayava pradhana vyadhi in which grahani gets vitiated functionally &
structurally, with the impairment of agni is called as grahani roga. The key site of Agni
and Site of occurrence of the disease Grahani roga is organ grahani. It is a
tridoshatmaka vyadhi,which is included in Ashtamahagada(Acharya Vagbhata).
It is hard to diagnose and difficult to cure (Sudustara).Grahani and Agni are having
Adhara –Adheya sambandha.
10
12. GRAHANI NIRUKTI
ACCORDING TO KALPADRUMA
Grahani is अग्न्यब्िष्ठाननाडी|
ACCORDING VACHASPATYAM
ब्पत्तिराख्ये कलाभेदे|
12
13. ACCORDING TO MONIER -WILLIAMS
GRAHANI- Is an imaginary organ supposed to lie between the
stomach and the intestines (the small intestines or that part of the
alimentary canal where the bile assists digestion and from which
vital warms is said to be diffused.
13
14. UNIQUENESS OF
GRAHANI DOSHA CHIKITSITAADHYAYA
OF CHARAKA SAMHITA
In the 15th chapter of Charaka Samhita chikitsa sthana - Grahani dosha chikitsa the basic
physiology of digestion, metabolism and assimilation along with factors influencing the
same is discussed. The concept of agni and its vaishamya is dealt in detail here. Which
form the key to understand many related concepts in Ayurveda. An overview of the chapter
can be given as follows-
14
20. Charakas view
अग्न्यधधष्ठानम्नस्य ग्रहणाद्ग्ग्रहणी मता|
नािेरुपयमह्यग्ग्ननबलेनोपष्टब्धोपबंहहता
अपक्वं धारत्य्नं पक्वं सजतत पाश्वमतः|
दुबमलाग्ग्ननबला दुष्टा त्वाममेव ववमुञ्चतत||
(Ch.chi.15/53-55)
Grahani is the seat of agni and is called so because of its power to restrain the
downward movement of food .
It is situated above umbilical region and is supported and nourished by the
power of agni.
Grahani holds the food till it digested and releases it from the side after it is
digested. 20
21. When it get deranged due to weak digestive fire it releases the ingested material
even in unripe condition.
Grahani dosha is often caused by Arshas, therefore it is described after Arshas
chikitsa.
अ्नमादानकमाम तु प्राणः कोष्ठं प्रकषमतत|
तद्ग्रवैभिम्नसङ्घातं स्नेहेन मदुतां गतम्||६||
समानेनावधूतोऽग्ग्ननरुदयमः [१] पवनोद्ग्वहः|
काले िुक्तं समं सम्यक् पचत्यायुववमवद्ग्धये||७||
एवं रसमलाया्नमाशयस्थमधः ग्स्थतः|
पचत्यग्ग्ननयमथा स्थाल्यामोदनायाम्बुतण्डुलम्||८||(Ch.chi.15/6-8)
21
22. PRANA VATA brings ingested food to koshta
Dravamsha does the BHEDANA OF ANNA SAMGHATA
This get MRIDUTWA by SNEHAMSHA
SAMANA VATA does AGNI DEEPANA
PACHANA of KALA BHUKTA & SAMA BHUKTA ANNA
22
23. The process of digestion by agni in the gut is
comparable to the process of cooking of the raw
recipe kept in an earthen vessel.
23
24. SUSRUTAS VIEW
Grahani is-Pittadhara kala which was described as 6th kala.
Situated between pakwashaya and amashaya.
षष्ठी वपत्तधरा नाम या कला पररकीततमता |
पक्वामाशयमध्यस्था ग्रहणी सा प्रकीततमता (Su.U.40/169)
24
25. ग्रहण्या बलमब्ग्ननब्हि स चाब्प ग्रहणीं ब्ितः |
तस्मात् स्दूब्िते र्ह्नौ ग्रहणी सम्प्रदुष्यब्त || (Su.U.40/170)
Strength of Grahani is agni and that agni resides in grahani.
When agni is vitiated grahani also become vitiated
Grahani dosha is described along with Atisara prakarana,as it lead
to Grahani dosha if it is not properly managed.
25
26. GRAHANI DOSHA NIDANA
ACCORDING TO CHARAKA SAMHITA
यो हह िुङ्क्ते ववधधं त्याक्त्वा ग्रहणीदोषजान् गदान्|
स लौल्याल्लिते शीघ्रं, वक्ष्य्तेऽतः परं तु ते||(Ch.chi.15/40)
In the causation of grahani ahara vidhi has important role.
अिोजनादजीणामततिोजनाद्ग्ववषमाशनात्|
असात्म्यगुरुशीताततरूक्षस्दुष्टिोजनात्||४२||
ववरेकवमनस्नेहववभ्रमाद्ग््याधधकषमणात्|
देशकालतुमवैषम्याद्ग्वेगानां च ववधारणात्||४३||
दुष्यत्यग्ग्ननः,(Ch.chi.15/42)
26
29. IMPORTANCE OF JATHARAGNI
Jatharagni is responsible for digestion and assimilation of food.
Aggravation and diminution of jatharagni results in the aggravation and
diminution of bhutagni and dhatwagni.
If a person takes food without following appropriate procedure, then he
quickly succumbs to disease caused by the vitiation of grahani.(Duodenum
and the and upper part of the small intestine.)
29
30. ACCORDING TO SUSRUTA
दुष्यब्त ग्रहणी ज्तोरब्ग्ननसादनहेतुब्भः ||
अब्तसारे ब्नर्ृत्तेऽब्प म्दाग्ननेरब्हताब्शनः |
भूयः स्दूब्ितो र्ब्ह्नग्रिहणीमब्भदूियेत्(Su.U.40/166)
Agni dushtikara nidanas leads to grahani dushti.
Indulgence in apathya ahara and vihara immediately after recovery
from atisara by a person having poor digestive fire will lead to
Grahani dosha.
30
31. ASHTANGA HRIDAYA
अतीसारेिु यो नाब्तयत्नर्ान् ग्रहणीगदः||१५||
तस्य स्यादब्ग्ननब्र्ध्र्ंसकरैर्यस्य सेब्र्तैः| (Ah.Ni.8/15)
Grahani is the structure that playas major role in ahara pachana. When it is deranged to
an extent in which the functioning is hampered the condition is referred as Grahani
gada.
The two factors leading to the pathology are-
1. The patient of diarrhoea who does not try much to cured of it becomes affected by
disorders of grahani.
2.Also even others who indulge in things food and activities which destroy the agni.
31
32. CHARAKA SUSRUTA VAGBHATA
Trishna
Alasyam
Bala kshayam
Vidaha
Chira anna paka
Kaya gauravam
Trishna
Alasyam
Balakshayam
Vidaha
Klama
Aruchi
Kasa
Karna kshweda
Antra koojana
Trishna
Sadanam
Chira anna paka,
amlaka
klama
Aruchi
Praseka
Vaktravairasyam
Karna kshweda
Antra koojana
Brama
Anadha -udarata
Chardi
POORVA ROOPA
32
34. Parvaruk-pain in small joints
Chardi-vomiting
Jwara-fever
Udgara- having metallic, ama ganda and with tikata- amla
rasa
34
35. SUSRUTA
अथ जाते िवेज्ज्तुः शूनपादकरः कशः |
पवमरुग्नलौल्यतट्छहदमज्वरारोचकदाहवान् ||१७४||
उद्ग्धगरेच्छ
ु क्तततक्ताम्ललोहधूमामगग््धकम् |
प्रसेकमुखवैरस्यतमकारुधचपीडडतः ||(Su.U.40/174)
Swelling in legs and arms,emaciation, joint pain, greediness towards all the tastes, thirst,
vomiting, fever, loss of taste burning sensation in side,vomitus whicha are like vinegar, bitter
and sour,smelling like iron and smoke, suffers from more salivation, bad taste in the mouth,
asthma &anorexia.
35
36. PRATYATMA LAKSHANA OF GRAHANI
एकशः सवमशश्चैव दोषैरत्यथममुग्च्ितैः |
सा दुष्टा बहुशो िुक्तमाममेव ववमुञ्चतत ||१७१||
पक्वं वा सरुजं पूतत मुहुबमद्ग्धं मुहुरमवम्|(Su.U.40/171)
Doshas together or individually vitiates grahani.
Thus excessively vitiated grahani releases the ingested food
either in ama or in pakwa state, accompanied with – features
SARUJA
PUTI
MUHUR BADHAM
MUHURDRAVAM
36
37. VAGBHATA
सामा्यं लक्षणं काश्यं धूमकस्तमको ज्वरः|
मूच्छाम भशरोरुग्ग्नवष्टम्िः श्वयथुः करपादयोः||(Ah.8/21)
Its general symptoms are emaciation, feeling of hot fumes coming
out from the mouth, tamaka, fever, fainting, head ache, stasis of
undigested food in the stomach and swelling of the hands and feet.
37
42. GRAHANI RUPA(Vishesha)
In general the manifestations of grahani can be classified as follows:
ABDOMINAL
SYMPTOMS
NATURE OF
STOOL
SPECIFIC
CHARACTER
GENERALISED
SYMPTOMS
GRAHANI
42
43. VATAJA GRAHANI PITTAJA
GRAHANI
KAPHAJA
GRAHANI
ABDOMINAL SYMPTOMS Food digest with
difficulty,shukta
paka , visuchika
---------
Food digest
with difficulty
NATURE OF STOOL Passes stool with
difficulty,froathy,
undigested,
repeatedly
Watery,
undigested,
bluish-
yellowish or
yellow in
colour
Stool not well
formed,broken,
heavy ,mixed
with ama and
mucous
43
44. GENERALISED
SYMPTOMS
Ruoghness in body,
dryness in throat, and
mouth,
hunger,thirst,blurred-
vision,tinnitus,pain in
thigh, chest etc
Emaciation
,weakness,cough,dyspnoea
Indigestion,anorexia,
thirst,foetid and sour
eructation,burning
sensation in the
cardiac region and
throat,gudaparshwa-
udara-mastaka daha
Nusea,vomiting,
anorexia,sliminess and
sweetishness of
mouth,cough,rhinitis,
sweetish eructations
with foul smell,general-
debility,
lack of desire towards-
woman,weakness &
lassitude
SPECIFIC
CHARACTERS
Flatulence after
and during digestion
Foetid and sour
eructation
Heaviness and stillness of
abdomen
44
CONT….
45. SALIENT FEATURES OF DOSHAJA GRAHANI
• Acharyas states that Vataja grahani leads to suspicion of diseases like vata hridroga ,
gulma, arsha and pandu.
• Acharya Susruta opined that the colour of nails, faeces,urine, eyes and face will be in
accordance with dosha.
45
46. SAMPRAPTHI OF GRAHANI DOSHA
दुबमलो ववदहत्य्नं तद्ग्यात्यूध्वममधोऽवप वा||५१||
अधस्तु पक्वमामं वा प्रवत्तं ग्रहणीगदः|
उच्यते सवममेवा्नं प्रायो ह्यस्य ववदह्यते||५२||
अततसष्टं ववबद्ग्धं वा रवं तदुपहदश्यते| (Ch.chi.15/51)
46
47. SAMPRAPTHI OF GRAHANI ROGA
NIDANA SEVANA MANDATA OF AGNI
VIDAGDATA OF ANNA RASA(Partial digestion)
VIDAGDAANNA RASA ENTER INTO CIRCULATION
MOVES UPWARDS AND DOWNWARDS IN GI TRACT
WHILE DOWNWARD MOVEMENT GRAHANI DOSHA IS MANIFESTED with
PRATYATMA LAKSHANAS AS-
ATISRUSHTA
VIBADHA
DRAVA
47
48. CONCEPT OF AMAAND AJEERNA
Vitiated agni is unable to digest even the light food.
When this agnidushti progress apaka of anna happens.
And the partially digested anna gets shuktata(amla bhava), which on due course act
as ghora anna visha also termed as ama visha.
Which again progress into the condition called ajeerna.
तस्य ब्लङ्गमजीणिस्य ब्र्ष्टम्प्भः सदनं तथा|
ब्शरसो रुक् च मूर्च्ाि च भ्रमः पृष्ठकब्िग्रहः||४५||
जृम्प्भाऽङ्गमदिस्तृष्णा च ज्र्रश््ब्दिः रर्ाहणम्|
अरोचकोऽब्र्पाकश्च, घोरम्नब्र्िं च तत्||(Ch.chi.15/45)
48
49. • When the Ajeerna avastha associated with doshas it shows corresponding
features-
Vata samsrushta- vata roga
Pitta-Amla pitta, daha, trushna,mughamaya
Kapha-Yakhma, peenasa, prameha
When it affects dhatu respective symptoms will be developed.
49
51. 51
DISCUSSION
DISCUSSION ON GRAHANI SWAROOPA
All the Bruhat-trayis have the opinion that Grahani is the adhishtana for agni.
Grahani and Agni are having Adhara –Adheya sambandha(Mutually
supportive).Any derangement that occurs in Grahani will reflect in agni and
vice versa.
Charaka considers nabhi upari pradesha as Grahani sthana.
Susruta describes Grahani as pittadhara kala-situated between pakwashaya
and amashaya.
52. 52
DISCUSSION ON GRAHANI DOSHA NIDANA
All the bruhat trayis opines that agni dushti is the root cause for Grahani dosha.
Charaka elaborates the factors leading to agni dushti wheras Susruta and Vagbhata used the
term Agnividhamsaka,& agni sadana hetus respectively.
While discussing agrya dravyas Charaka states Ajeerna adhyashana as agrya for grahani
dooshana
Acharya Susruta and Vagbhata described it as nidanarthakara roga of atisara.
53. 53
Abhojanat-vata dushti,sara vidhamana
Ajeerna bhojana-Sarvadosha prakopa, agni dushti, samvrutha sroto mugha, pratilomata of
vata, hamperded vega pravruthi, dhatu dushti
Pureesha vaha sroto dushti
Atibhojana- Cause tridosha dushti,Annavaha srotodushti,Rasa vaha sroto dushti.
Vishamashana-Tridosha dushti
Asatmya bhojana-Will affect the well being of individual.
Guru bhojana-Rasa vaha srotodushti
54. 54
Sheeta bhojana- Agni will not be stimulated, hamper digestion,vata gati will be affected,
cause kapha dushti
Rsa vaha sroto dushti
Atirooksha bhojana-Agni will not be stimulated, hamper digestion,vata gati will be
affected
Samdushta bhojana- Tridosha dushti
56. 56
DISCUSSION ON SAMPRAPTI GHATAKA
DOSHA- Tridosha
Vata mainly involved is Samana vata
समानोऽब्ग्ननसमीपस्थः कोष्ठो चरब्त सर्ितः|
अ्नं गृह्णाब्त पचब्त ब्र्र्ेचयब्त मुञ्चब्त|(Ah.su.12/8)
Agni sameepastha Grahani sthana
Anna grahana-अपक्र्मामाशये िारयतीत्यथिः|
Pachana-अग्ग्ननस्धुक्षणाद्ग्िक्तकार इव| (Ah.su.12/8,Sarvanga Sundara Commentary)
Vivechana-संहतम्नं पाकाय वविजते |(Ah.su.12/8,Sarvanga Sundara Commentary)
Munchana- शक्मूत्राहदरूपमधः| (Ah.su.12/8,Sarvanga Sundara Commentary)
Agni dushti leads to the vitiation of samana vata which takes part role in manifestation of
Grahani dosha.
57. 57
Pitta
--------------------तत्र पक्र्ामाशयमध्यगम्|
पञ्चभूतात्मकत्र्ेऽब्प यत्तैजसगुणोदयात्||१०||
त्यक्तद्रर्त्र्ं पाकाब्दकमिणाऽनलशब्धदतम्|
पचत्य्नं ब्र्भजते सारब्कट्टौ पृथक् तथा||११||
तत्रस्थमेर् ब्पत्तानां शेिाणामप्यनुग्रहम्|
करोब्त बलदानेन पाचकं नाम तत्स्मृतम्||(Ah.su.12/10)
Anna pachana, sara-kitta vibhajana, are the functions attributed to pachaka pitta, the
abnormality of which may lead to Grahani dushti
59. 59
SROTAS
The role of anna vaha srotas in the manifestation of grahani roga is direct and significant.
ANNAVAHA SROTO MOOLA
अ्नर्हानां स्रोतसामामाशयो मूलं र्ामं च पार्श्वं,( Ch.vi.5/8)
ANNA VAHA SROTO DUSHTI KARANA
अब्तमात्रस्य चाकाले चाब्हतस्य च भोजनात्|
अ्नर्ाहीब्न दुष्यब््त र्ैगुण्यात् पार्कस्य च||१२|(Ch.vi.5/)
60. 60
RASAVAHA SROTAS
Agni nasha is one among the rasapradoshaja lakshana, which is the key factor for Grahani
roga.
DUSHTI KARANA
गुरुशीतमब्तब्स्नग्निमब्तमात्रं समश्नताम्|
रसर्ाहीब्न दुष्यब््त ब्च्त्यानां चाब्तब्च्तनात्(Ch.vi.5/13)
62. 62
CONCLUSION
Grahani is an avayava pradhana vyadhi where agni dushti plays a major role.
The adhara-adheya sambandha of agni and grahani is forms the key factor in understanding
the disease.
Acharya Charaka considered it as a Swatantra vyadhi while Susruta and Vagbhata
considered it as nidanarthaka roga of atisara.
Charaka used term “Grahani dosha chikitisitam” to emphasise the scope of expansion of the
prakarana as grahani dosha and grahani- asrita rogas.
Knowledge of the disease Grahani forms the base for understanding various concepts in
Ayurveda viz,agni,ama,ajeerna,ahara pachana, shareera poshana etc
63. 63
REFERENCES
Acharya YT,2019,Ayurvedadipika Commentary of Sri Chakrapanidatta on Charaka
Samhita of Agnivesha,Chikitsa stana, Grahanidosha Chikitisitam,15th
chapter,Varanasi,Chaukhamba Orientalia,2015
Acharya JT,2021,Nibandasamgraha Commentary of Sri Dalhanacharya on Susruta
SamhitaUttara tantra,Atisara pratishedham,40th chapter, Varanasi,Chaukhamba
Orientalia,2021
Acharya Dr.Anna Moreswara Kunte,2019, Sarvanga sundara(Arunadatta)&
Ayurveda rasayana(Hemadri) Commentary on Astanga Hrudaya Nidana
Sthana,Atisara Grahani roga Nidana,8th chapter, Varanasi,Chaukhamba
Orientalia,2019
