The four limbs for doing the chikitsa (treatment) are termed as Chikitsa Chatushpada in Ayurveda. Ayurveda is very clear about its aim and objectives. Between its two objectives, the first is to preserve the health of healthy person and second is to cure the disorders, if the person falls ill. To eradicate the disease, Chikitsa is the main thing. Through Ayurveda chikitsa we acquire the balance of imbalanced doshas and are very necessary.
In Ayurveda, the success of Chikitsa depends totally upon four factors which are known as Chikitsa Chatushpada
These Chatushpada includes:
· Bhishak- Doctor
· Dravya- Medicines
· Upasthata-Nurse
· Rogi- Patient
Importance of Chatushpada
If these Chatushpada endowed with their proper qualities, then they are responsible for the cure of any kind of curable diseases. It deals with 4 important limbs or protocol for treating patient. It demands the qualitative involvement of each component towards effective healing.
Ayurveda explains in detail about all the four limbs and the imperative qualities each should poses.
BHISHAK – Doctor or physician
Vaidya or physician is the most important limb of the medical system. Physician is the person who diagnoses the clinical condition of a patient and schedules the line of treatment which propel towards effective healing of the disease. Four attributes of bhishak explained by ayurveda are
1. Daksha- Brilliant and Intelligent. A doctor should be intelligent enough to gather all the evitable information’s from the patients and should be able to read and correlate the condition so as to reach an accurate diagnosis.
2. Shastra artha- Perfect theoretical knowledge. He should posses elaborate knowledge about cause, symptoms about diseases.
3. Drushtakarma- Essential practical knowledge and exposure. Only perfect theoretical knowledge is not going to help a physician to heal mankind.
4. Suchi- purity, clean by thoughts and mind. He should be courageous, righteous, and ethical.
So in order to become a successful physician he should have these attributes explained in Ayurveda. In addition to that, other facets for a good practioner can be explained as one who handles the patients sensitively and sensibly. He should be compassionate, commanding and good at administration.
DRAVYA- Medicine or the Drug
Once the disease has been identified and diagnosed by the physician, the implementation of suitable medicines towards healing of disease is the next step. The medicines prescribed or dispensed in pharmacy should posses certain quality in order to get its specific result. Four attributes of dravya explained by ayurveda are
1. Bahu kalpam- the drug or medicine could be used in many forms. Should be compatible with each other drugs. Aanekvidha kalpana is the other attribute which means various pharmaceutical forms or multiple uses.
2. Bahu gunam- abundance in good qualities. Qualities including rasa-taste, guna-quality, veerya- potency, vipaka- post digestion effects.
3. Sampannam- wholesome, the medicine should be grown in ideal conditions and in suitable climate. It should not be contaminated with insects or pesticides. It should be collected and preserved methodically.
4. Yogyam- it should be readily used in targeted diseases or preventing diseases.
The dravya or the herbs should be plucked and collected in an auspicious day and time as per ayurveda. It should constitute the capacity to destroy morbid dosha.
UPASTHATA- Nurses or Attender
The patient needs someone to take care for and provide him or her with prescribed medicines at proper time. Nursing and support staff at hospital/clinic, family and friends at home to fulfill the role of upasthata.
1. Anuraktaha- kind hearted. A nurse or the care taker should be affectionate and tolerant.
2. Suchi–purity/clean. Along with the hygienic protocols they follow physically, they should be clean by mind and thoughts.
3. Daksha- skilled. A therapist/nurse should be wise, judicious and must have situational understanding.
4. Bhudhimaan- intelligent. A upasthata should be intelligent enough to follow the instructions given by the physicians.
The process of healing becomes difficult in the absence of these kind hearted people. They need to be perfectly trained in profession. They should be strong both physically and mentally.
ROGI- the patient
The treatment line-up is mainly drafted targeting the patient or disease. Thus the patient forms another limb of treatment protocol.
1. Jnapaka- The patient should have the understanding capacity and good memory. This is applicable in order to take the medicines and therapies in correct time.
2. Bhishagvashya – Obedient. A patient should follow the instructions of doctors regarding the diet and medicines.
3. Satvavaan- Having good strength to tolerate disease and treatment. Understanding his/her condition makes the treatment easy.
4. Aadya- The patient should have the arrangements in order to buy or get the prescribed medicines.
A patient should be strong by mind and body to treat the illness early. A rogi should be fearless, courage and self control. Rogi should have everlasting fortitude and strong vital energy.
According to Ayurveda, all Chatushpad equipped with their sixteen qualities are responsible for the success in treatment. Still the Vaidya, by the virtue of his keen knowledge of medical science, administrative position and by prescribing capacity occupies the most important position among them. Drug plays a key role in the success of treatment. The drugs are the tools of a Physician. So it is rightly called as the weapon of the Vaidya..
From above all references, we can say that, to get success in treatment four pillars are very important.
This article is written by Vaidya Sumesh Mani. He is a senior Consultant Physician in Chakrapani Ayurveda Clinic & Research Center.