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Introduction

Viruddha ahara is a unique term described well in Ayurveda, the term “Viruddha” literary means “an opposite thing” and “Ahara” means the Food.(1) According to Charak Samhita,(2) any food which is strongly opposite in Guna (properties), virya (potency), sanyog (combination), procedure, amount of food, if consumed in a regular basis can lead to number of pathologies.(3) The food which is wrong in combination (rasa, guna, virya, vipaka etc.), which has undergone wrong processing, which is consumed in incorrect dose, which is consumed in incorrect time of day or season and in wrong region, is known as viruddha ahara. There is total 18 types of it. Viruddha ahar eventually leads to many diseases mainly – various skin disorders like psoriasis (siddhma kushtha), Shwitra (vitiligo), GIT pathologies, Ascites (Jalodara) etc, this can even lead to the death. Samshodhana upakrama as way of management plays vital role, Acharya charak has mentioned Vaman and Virechan karma to expel out dosha responsible for the diseases out of the body. (4) Vamana is the therapeutic procedure to remove out vitiated dosha through oral route, while Virechana do the same but through the route of anus. This brings all the dosha to its normal state and one’s status of health can be re-established.

Aims and Objectives:

     To review viruddha aharjanya rogas and its management through Samshodhana (Panchakarma) therapy.

Materials and methods:

     Various Ayurveda literatures with its commentaries, Journals, Text books, web search were revised to collect the knowledge about present topic.

     According to the Ayurveda there are total 22 conditions may arise because of Viruddha ahara, they are as follows:

1. Shandhya (Napunsakta).
2. Aandhya (Blindness).
3. Visarpa.
4. Jalodara (Ascitis).
5. Visphot.
6. Unmada.
7. Bhagandara
8. Murcha
9. Mada
10. Aadhman
11. Galgrah
12. Paandu
13. Aamvisha
14. Kilaas
15. Kushtha
16. Grahani
17. Shotha
18. Amlapitta
19. Jwar
20. Peenas
21. Santandosha
22. Mrutyu (death).

All the conditions mentioned above arises due to tridosha dushti, vitiating - Ras, Rakta, Mans, Udaka, Anna, Majja and Shukravaha srotas and are fatal as well.

Management of Shandhya :

     This means impotency. The vitiated dosha ruins the function of shukra dhatu leading to Napunsakta (impotency). This condition can be managed first by using virechana to expel out the dosha (5) then Shukrashodhan and vrushya kshir basti also Vrushya aushadhi siddha kshir or ghrit Sneha are advised to take.

Management of Andhya :

 This refers to blindness or drushti dosha. According to ayurveda, frequent consumption of kshariya aahar, Lavan rasa in more amount can lead to drushti dosha. (6) Virechana helps in management of it. Netra is also the place of Majja dhatu and alochaka pitta so the chikitsa also includes use of Virechana, Tiktak kshir basti, Ghrit Snehapaan, and Netrya/chakshushya basti like Sthiradi niruha. (7)

Management of Visarp:

     Visarpa is rakta (blood) pradoshaja disease and one of Pittaja disease manifesting in twacha (skin). (8) Owing to its spreading nature it is termed visarpa and is classified into 8 subtypes viz., vataja, pittaja, kaphaja, sannipataja, agneya (vaatapittaja), kardama (kaphapittaja) and granthi (kaphavataja). Its management includes – Vaman karma (if the dosha are in aamashaya), Raktamokshana and Virechana if dosha are in Pittasthana i.e. in rakta, lasika, swed, adho-aamashaya, Snehapaan using Tiktak ghrit if there is Vaat pitta dushti. Also, the use of upvas, tikta ras sevan is advised. (9)

Management of Udar (jalodar) :

    Udara roga denotes generalized distension or enlargement of abdomen of any aetiology. Udara roga in Ayurveda is not only limited to ascites, accumulation of fluid in the peritoneal cavity but also includes gaseous distension, hepato-splenomegaly of varied aetiology, intestinal obstruction, and intestinal perforation too. Generalized abdominal distension is the presenting feature in all. Its management mainly includes – Virechana karma. Acharya charak has mentioned to give nitya (frequent) virechana, as udar is developed due to Atidosha sanchiti and obstructions in srotas. (10) Also, the use of asthapana basti, anuvasana basti, dhara sek (parisechan), and use of takra and kshir are advised.

Management of visphota :

     Visphota is type of Kshudra kushtha (skin disease) with white and red coloured thin skinned pappules. Visphota has dominance of Pitta and kapha dosha. Being a type of kushtha vyadhi, its management also includes Vaman, Virechana karma, snehapaan and raktamokshana, ksuhtaghna lepa. (11)

Management of Unmad :

    Unmada is a group of psychological disorders described in Ayurveda under a single heading. The pathological changes involve vitiation of Tridoshas in a person having Alpasatva (can be interpreted as lessened will power), affecting Hridaya which is the seat of Buddhi (Intellect), Sanjna (Consciousness), Jnana (Knowledge component), Smriti (Memory), Bhakti (likes and dislikes), Sheela (Mood), Cheshta (Physical activity) and Achara (Habits).(12) Treatment includes – Snehapaan and mrudu samshodhana (vaman and virechana) in Vaataj unmad, Vaman and virechana karma is advised in kaph Pittadhikya also the use of Niruha basti, Sneha basti, shirovirchana (nasya) is mentioned.(13)

Management of Bhagandar :

     Acharya charak has mentioned that a painful and suppurated pidika in the region of guda, on bursting leads to bhagandar. (14) Acharya charak has told to undergo Virechana karma (15) before any other treatment followed by aishan, paatan karma, daah karma and application of ksharsutra.

Management of Murchha: The literal meaning of the term murcha is fainting. Holding mechanism of this breath stems the feeling of dizziness. Pitta dominant tridosha and Raja-Tama are dependent on external and internal senses. Body and mental defects noun: Those seven sources come suddenly (due to attraction of desire) and create obstacles. Due to this, the feeling of pleasure and enjoyment gets destroyed and the patient falls on the wooden floor (becomes unconscious) and this is called unconsciousness. Snehana-Swedan and Vamnadi purification should be done as per the defect. (16) After providing Snehan and swedana to the patients of, Panchakarma (Vaman, Virechana, nasya, niruhana, anuvasana) should be done after considering the state of their physical and mental strength. Snehapaan with - Mahatiktak Ghrita for lubrication, Kalyanak Ghrita, Kumbha sarpi (ghee). And, Raktamokshana can be done. (17)

Management of Mada:

Mad is considered as a “Shonitoth Vikar.” The heart is the source of all the doshas. A heart attack would result in unconsciousness and a heart rupture would result in death. If there is no serious injury (minor injury) like fainting/renunciation/death in the heart then symptoms like intoxication appear. Consumption of poison and alcohol creates intoxication. Due to the formation of obstructions in the Vatadi dosha and Tam Manas dosha, Manovah, Indriyavah, Rasa-Rakta, these srotas, the intellectual contact of the meanings received by the senses does not occur, hence the attainment of knowledge does not take place/partially takes place. The treatment of Mad is very much similar with as of Murcha due to reason that the Hetu, Dosha- dushya and srotas vikruti are same. (18)

Management of Adhman :

Adhman is the condition of having flatulence in the abdominal region (bloating). Backache, headache, breathing, urine, stool, etc. obstruction of vaat can be present with Adhmana as associated symptoms. Acharya charak has explained its management in the chapter of “Vaman Virechan Vyapat siddhi.” Sarvang abhyanga, Swedan, use of Falvarti, Niruha basti, followed by Anuvasana can be given. (19)

Management of Galgrah:

This disease mainly occurs due to vitiation of kapha dosha which settles in Mukha (Gala) pradesh causing shotha (inflammation) of Gala Pradesh. So, to get rid of such painful disease, Ashtang Hriday has mentioned the Kawal Chikitsa which provides good relief in Mukhagat and Gala rogas. (20) Kawal not only gives soothing effect to the throat (gala Pradesh) but also cures the symptoms like Shoth (Inflammation), Shool (pain), Jwara (Fever), Aruchi (Anorexia) in a very precise manner. So Darvyadi Kwath Kawal has been proposed to treat Galagrah (Pharyngitis) due to its kaphghana karma & extreme usage in mukha-gala rogas. also, according to Charak acharya Vaman can be given in such condition. (21)

Management of Paandu:

Pandu Roga is one of the diseases mentioned in Ayurveda characterized by the changes in the skin colour to white (Shweta), yellowish (Peeta), greenish (Harita) etc. which is one of the “Varnopalakshita Roga" i.e. a disease characterized by the change in the colour. The clinical condition of Pandu in Ayurveda can be co-related with Anaemia described in Modern Medical Science, due to the resemblance in the clinical signs and symptoms. According to Acharya Charak in Sadhya Pandu Rog, Teekshna Vaman and Virechan should be done. (22) According to Acharya Sushruta in Pandu Roga, Dosha which get situated in Dhatus, Srotas and ashayas should be removed by Vaman and Virechan repeatedly if not done so then these Doshas cause Shotha in the different body part. For Abhyantara Snehana Acharya Charak indicated some medicated Ghee i.e. Panchagavya Ghrit, Mahatiktak Ghrit, and Kalyanak Ghrit etc.

Management of Aamvisha:

The unprocessed or undigested food particle is Ama. Having food against (nature, quality, continuous consumption of substances that are against virya), adhyashan (eating again after eating), eating even in the condition of modesty and indigestion, due to which the Aam causes symptoms like poison. It is called common poison and has adverse effects due to its toxicity. (23) Its treatment is done according to the condition. If Aam and dosha are in vitiated state then it must expel out either by Vaman or by Virechan karma. And if Aam and dosha are anutklistha then Pachana upakram should be done followed by Vaman or virechana. (24)

Management of Kilas:

Kilas, Shvitra, Varun are synonyms of each other. Description of the picture Kushtha is a disease completely different from other types of kushtha. Mahakushtha or Kshudrakushtha or both or the inclusion of Shwitra has not been mentioned in the scriptures or should have been mentioned in the context. There is no similarity between skin discoloration or skin disease symptoms like kushtha and Shwitra. Panchakarma management is like the Kushtha chikitsa. Vaman, virechana, Prachchan karma, Jaloukavacharan can be done in such patients. Samsran type of virechana is advised using Malpu rasa. (25)

Management of Kushtha:

A skin condition is kushta roga. The term "kushtha" has been used in Ayurveda to designate all skin conditions. Maha-kushtha and Kshudra Kushtha are the additional divisions that they fall under. According to Acharyas, Tridoshik participation is present in every kushtha. Viruddhahar hetu has been put on first while describing the causes of Kushtha. Being tridoshajanya vyadhi form, Kushtha can be treated with all the panchakarma procedures. Acharya Vagbhata has mentioned that, at period of 15 days vaman should be done, at every 1 month of time Virechana, at every 3 days of time nasya karma should be done, and Raktamokshana (siravedha, Jaloukavacharan) is advised to carry out at period of every 6 months. (26) Basti karma is not that useful but still depending upon Avastha it can be given, Charak acharya has explained Pancha tikta basti works in Meha, Abhishyanda and kushtha vyadhi as well. (27)

Management of Grahani:

Grahani and Agni are having Adhara-Adheya-Sambandha. Grahani is described as an Agni Adhishthana by most of the acharyas. Mandagni is a root cause of Ama Dosha and it is the crucial factor for manifestation of most of the diseases. Among them, Grahani is the prime disease of gastro-intestinal tract. Viruddha ahar affects the work of agni (digestive fire), the long term agni dushti, and formed ama dosha affects the work of Grahani organ. Depending upon the dosha, Grahani disease is of four types viz, Vaataj, Pittaj, Kaphaj and Sannipataj. Its management includes Snehapaan, abhyanga, Swedana, Vaman, virechana karma depending upon prominence of dosha. (28) Apart from this Niruh basti and anuvasan with amla dravya siddha tail is advised to do by Charak acharya. This shodhana procedures helps to remove out aamvisha, establishes the natural characters of agni and helps to recover from the Grahani symptoms.

Management of Shotha:

It is also called Shopha or Shvayathu in the scriptures. In essence, it addresses all types of swellings, from common localised ones to interior ones. Shotha Roga can be correlated with the term oedema of modern medicine. As such swelling anywhere in body due to accumulation of fluid can be called as Shotha or Svayathu. Shotha is an independent disease as well as symptoms. Charak acharya has mentioned viruddhahar as hetu of Shotha disease. Its management can be done considering nidaan (hetu), Dosha, ritu (kaal), and bala of the patient. If the shotha is Aamajanya, then shodhana upakrama (vaman or virechana) can be done after doing langhan and paachan treatment. If shotha is in upper part of the body then Vaman and if shotha resides below part of the body Virechan karma is advised to do. (29) Also, if the shotha is in head region (shirogat,  Shirovirechan type of nasya karma can be done. for ekaanga shotha (regional), Abhyang, Swedan and Vaataghna lep are advised. Raktamokshana upakram is advised to do considering the dosha and Avastha of the patient.

Management of Amlapitta:

Amlapitta is a condition where Pitta is accumulated previously from the self-aggravating causes, gets Vidagdha due to Virudha, Dustha, Amla, Vidahi, Pittakar Ahara and Drava like Phanita, Kulattha, Ikshu Vikara, Bhristha Dhanya, Pulaka etc. In further days due to repeated Nidanas it gets Shuktatva residing in Aamashaya. Amlapitta has symptoms like Avipaka, Klama, Utklesh, Tiktaamlodgara, Gouravata, Hritkantha Daha, Aruchi etc. Yogratnakar has mentioned its management using Panchakarma upakrama. Firstly, its advised to carry out Vaman karma, followed by Virechana. After doing shodhana Asthapana, anuvasana basti can be given considering the doshas involved. (30) Yogratnakar has also mentioned that if no treatment is yielding effect, then Raktamokshana could be also done. (31)

Management of Jwara:

The term ‘Jwara’ implies the ability of a disease to cause anguish to body and mind. This suggests suffering or illness. Based on the similarity in clinical features, Jwara is often considered as fever or pyrexia in medical terminologies. Jwara causes many discomforts including feeling of malaise, fatigue, increases body temperature and affects normal physiological functioning of body. The imbalance state of Pitta leads Jwara which alter physiology of body and produces Amavisha which ultimately triggers disease pathogenesis. Management of jwara wholly depends upon Avastha (nava/Jirna). In the management of Navajwara, Vaman karma is advised to carry out as the dosha are in Amashaya region. Along with this Swedana upakram (niragni sweda) can be done. (32) Jirna jwara can be treated by Abhyanga with Chandanadi/ Agurvadi taila, Parisheka, Avagaah sweda. Virechana karma is advised in the Akshina-bal-mansa patients. (33) If doshas are in Pakvashaya, Niruha basti can be given to remove them out, similarly if doshas are in shiro region (head region) shiro virechana is advised. (34)

Management of Pinas:

Peenasa is one of the most important nasal disorders. It is also called as Apinasa. It either manifests independently or therefore / complication of another nasal disorder - Pratishyaya which is often compared to rhinitis. In Ayurveda treatises both these conditions are often used synonymous to each other. For the treatment of this Snehana, Swedana, Vaman karma, dhoom paana, Gandusha can be done. (35) Ghritpaan can be done in Peenas except in its nava Avastha. Avapidak nasya and vamana are advised considering the doshas.

Management of Santandosha:

 Santandolsha means child defects. This term refers to either death of the foetus in the womb or death immediately after birth or absence of conception. Absence of conception is also known as vandhyatva. This condition can be arisen because of Shukra dhatu dushti. As per Acharya Charak, if such a man conceives, then the child born from the contact of that dushta shukra dhatu is born sick, impotent, short-lived, or deformed. (36) Or through this, conception does not occur at all, if it does happen then the pregnancy is aborted or miscarriage occurs. This condition can be treated using shukravaha srotodushti chikitsa. Madhur tikta Dravya are advised to use, also proper exercises and doing shodhana i.e. vaman, virechana or basti upakrama. (37) Use of Erandmooladi niruha, Mustadi Yapan basti, Vrushya basti can be used. Acharya Kashyap has mentioned that, Virechana also makes beeja (sperm/ovum) working well.

Discussion

Frequent intake of incompatible food act as poison which leads to aggravation of all Doshas. The recommended therapy for diseases caused by incompatible food is Shodhana Chikitsa (Panchakarma therapy), Shamana Chikitsa and avoidance of incompatible of incompatible food. Charaka acharya, who mentioned that incompatible diet, is one of the causes for spreading the morbid humours from the alimentary tract to the peripheral systems and causes diseases. Diseases produced by unwholesome food, can be treated by the help of purification therapy like Panchakarma, especially vamana (emesis) and virechana (purgation), and by shamana or palliative therapy and wholesome diet. Prophylactic measures counteract the disorders born from viruddhahara but nidanparivarjan is the best way to live healthy life. The person who consumes contradictory food regularly in small quantities will lead to okasatmya. viruddhahara generally does not have any effect on those who are young, whose agni (digestive fire) is strong, doing abhyang & person who exercise regularly. One who does exercise regularly and consumes viruddhahara, it gets digested properly without any difficulty or trouble.

Conclusion

Viruddha Ahara (incompatible diet) is a very important concept of Ayurveda, ignoring it results in the manifestation of various diseases and as we know prevention is better than cure, it is very essential to follow guidelines given by Ayurvedic Acharyas to lead a healthy life. As an Ayurvedic physician it is our prime duty to spread alarming health hazards of Viruddha Ahara (incompatible diet). Further research with the help of modern analytical techniques is not only essential but need of today’s 21st century to establish the classical concept of Viruddha Aahara (incompatible diet) in present perspective.