Charaka Roganikam Vimana: 6th chapter

The 6th chapter of Charaka Samhitha Vimana Sthana is Roganikam Vimanam. It deals with management of diseases affecting persons with different body types and determination of the specific characteristics of diseases, etc.

अथातो रोगानीकं विमानं व्याख्यास्यामः||१||
इति ह स्माह भगवानात्रेयः||२||
athāto rogānīkaṃ vimānaṃ vyākhyāsyāmaḥ||1||
iti ha smāha bhagavānātreyaḥ||2||
“Let us explore Roganika Vimana Adhyaya – the chapter on the determination of the specific characteristics of diseases” thus said Lord Atreya [1-2]

Various types of classification of diseases:
द्वे रोगानीके भवतः प्रभावभेदेन- साध्यम्, असाध्यं च; द्वे रोगानीके बलभेदेन- मृदु, दारुणं च; द्वे रोगानीके अधिष्ठान भेदेन- मनोऽधिष्ठानं, शरीराधिष्ठानं च; द्वे रोगानीके निमित्त भेदेन- स्वधातुवैषम्य निमित्तम्, आगन्तुनिमित्तं च; द्वे रोगानीके आशयभेदेन- आमाशय समुत्थं, पक्वाशय समुत्थं चेति|
dve rogānīke bhavataḥ prabhāvabhedena- sādhyam, asādhyaṃ ca; dve rogānīke balabhedena- mṛdu, dāruṇaṃ ca; dve rogānīke adhiṣṭhāna bhedena- mano’dhiṣṭhānaṃ, śarīrādhiṣṭhānaṃ ca; dve rogānīke nimitta bhedena- svadhātuvaiṣamya nimittam, āgantunimittaṃ ca; dve rogānīke āśayabhedena- āmāśaya samutthaṃ, pakvāśaya samutthaṃ ceti|

Diseases are classified into two groups on the basis of the five different criteria, as follows:-

Types of diseases as per Ayurveda: 
Prabhava Bheda – Based on Prognosis – Curable, Incurable (Sadhya, Asadhya)
Bala Bheda – Based on intensity – mild, severe (Mrudu, Daruna)
Adhishtana Bheda – based on location – Mental, Physical (Mano Adhishtana, Sharira Adhishtana)
Nimitta Bheda – based on nature of the causative factors – Endogenous, Exogenous (sva dhatu vaishamya nimitta, agantu nimitta)
Ashaya bheda – based on site of origin – Having origin from Amashaya (stomach), Having origin from Pakvashaya (colon) (Amashaya samutta, Pakvasay samuttha)

एवमेतत् प्रभावबलाधिष्ठान निमित्ताशय भेदाद्द्वैधं सद्भेदप्रकृत्यन्तरेण भिद्यमानमथवाऽपि सन्धीयमानं स्यादेकत्वं बहुत्वं वा|
evametat prabhāvabalādhiṣṭhāna nimittāśaya bhedāddvaidhaṃ sadbhedaprakṛtyantareṇa bhidyamānamathavā’pi sandhīyamānaṃ syādekatvaṃ bahutvaṃ vā|
Even though diseases are of two groups based on prognosis, intensity, location, nature of the causative factors and site of origin, still by different permutations and combinations they can be classified as one or in many ways.

Diseases as single classification:
एकत्वं तावदेकमेव रोगानीकं, दुःख सामान्यात्; बहुत्वं तु दश रोगानीकानि प्रभावभेदादिना भवन्ति; बहुत्वमपि सङ्ख्येयं स्याद सङ्ख्येयं वा|
ekatvaṃ tāvadekameva rogānīkaṃ, duḥkha sāmānyāt; bahutvaṃ tu daśa rogānīkāni prabhāvabhedādinā bhavanti; bahutvamapi saṅkhyeyaṃ syāda saṅkhyeyaṃ vā|

All diseases may be of one group because manifestation of pain is common for all-  Dukha Samanyaat.
They may be of many groups on the basis of their tenfold classification according to prognosis etc., described above.

Multiplicity of the classification of diseases
तत्र सङ्ख्येयं तावद्यथोक्तमष्टोदरीये, अपरिसङ्ख्येयं पुनर्यथा- महारोगाध्याये रुग्वर्णसमुत्थानादीनामसङ्ख्येयत्वात्||३||
tatra saṅkhyeyaṃ tāvadyathoktamaṣṭodarīye, aparisaṅkhyeyaṃ punaryathā- mahārogādhyāye rugvarṇasamutthānādīnāmasaṅkhyeyatvāt||3||
Diseases can be numerable or innumerable. Their innumerability has been described in the 19th chapter of Sutra sthana – Maharoga Adhyaya and their innumerability on the basis variations in pain, color. [3]

Justification for different types of classification:
न च सङ्ख्येयाग्रेषु भेदप्रकृत्यन्तरीयेषु विगीतिरित्यतो दोषवती स्यादत्र काचित् प्रतिज्ञा, न चाविगीतिरित्यतः स्याददोषवती|
भेत्ता हि भेद्यमन्यथाभिनत्ति, अन्यथा पुरस्ताद्भिन्नं भेद प्रकृत्यन्तरेण भिन्दन् भेद सङ्ख्या विशेषमापादयत्यनेकधा, न च पूर्वं भेदाग्रमुपहन्ति|
समानायामपि खलु भेदप्रकृतौ प्रकृतानुप्रयोगान्तरमपेक्ष्यम् |
सन्ति ह्यर्थान्तराणि समानशब्दाभिहितानि, सन्ति चानर्थान्तराणि पर्याय शब्दाभिहितानि|
na ca saṅkhyeyāgreṣu bheda prakṛtyantarīyeṣu vigītirityato doṣavatī syādatra kācit pratijñā, na cāvigītirityataḥ syādadoṣavatī|
bhettā hi bhedyamanyathābhinatti, anyathā purastādbhinnaṃ bhedaprakṛtyantareṇa bhindan bheda saṅkhyā viśeṣamāpādayatyanekadhā, na ca pūrvaṃ bhedāgramupahanti|
samānāyāmapi khalu bhedaprakṛtau prakṛtānuprayogāntaramapekṣyam |
santi hyarthāntarāṇi samānaśabdābhihitāni, santi cānarthāntarāṇi paryāyaśabdābhihitāni|

If the diseases are classified in different bases does not take away the validity of those classifications.
An individual has the liberty to classify things as he likes. If something is already classified into some groups in a particular manner, he may reclassify it on the basis of different criterion which may result in changes in the number of groups in different ways.

समानो हि रोगशब्दो दोषेषु च व्याधिषु च; दोषा ह्यपि रोगशब्दमातङ्कशब्दं यक्ष्मशब्दं दोषप्रकृतिशब्दं विकारशब्दं च लभन्ते, व्याधयश्च रोगशब्दमातङ्कशब्दं यक्ष्मशब्दं दोषप्रकृतिशब्दं विकारशब्दं च लभन्ते|
samāno hi rogaśabdo doṣeṣu ca vyādhiṣu ca; doṣā hyapi rogaśabdamātaṅkaśabdaṃ yakṣmaśabdaṃ doṣaprakṛtiśabdaṃ vikāraśabdaṃ ca labhante, vyādhayaśca rogaśabdamātaṅkaśabdaṃ yakṣmaśabdaṃ doṣaprakṛtiśabdaṃ vikāraśabdaṃ ca labhante|

This does not invalidate the number of groups according to some other mode of classification. In some cases the criterion of classification may appear to be the same as the previous one but the specific features of each of these criterion is observed based on the validity of this classification.

तत्र दोषेषु चैव व्याधिषु च रोगशब्दः समानः, शेषेषु तु विशेषवान्||४||
tatra doṣeṣu caiva vyādhiṣu ca roga śabdaḥ samānaḥ, śeṣeṣu tu viśeṣavān||4||

The same term may carry different meanings, e.g the word “Roga “denotes both the Doshas as well as diseases. similarly various terms which are synonymous may denote only one thing, e.g Roga, Atanka, Yakshman, Doshaprakrti (having polluting nature) and Vikara (morbidity- these terms carry the meaning of or are synonymous with both Dosha and Vyadhi (diseases) for the rest like Hetu (etiology) etc., this term, viz Roga carries a different meaning. [4]

Physical and mental Doshas and their vitiations:
तत्र व्याधयोऽपरिसङ्ख्येया भवन्ति, अतिबहुत्वात्| दोषास्तु खलु परिसङ्ख्येया भवन्ति, अनतिबहुत्वात्|
tatra vyādhayo’parisaṅkhyeyā bhavanti, atibahutvāt| doṣāstu khalu parisaṅkhyeyā bhavanti, anatibahutvāt|

Because of their highly multitudinous nature, diseases are innumerable. On the other hand, Doshas are numerable because of their limitation in number. So only some of the diseases will be explained by way of illustrations where as Doshas will be explained in their entirety.

Mano Doshas:
तस्माद्यथाचित्रं विकारानुदाहरणार्थम्, अनवशेषेण च दोषान् व्याख्यास्यामः|
रजस्तमश्च मानसौ दोषौ| तयोर्विकाराः काम क्रोध लोभ मोहेर्ष्यामानमद शोक चित्तो(न्तो)द्वेगभय हर्षादयः|
tasmādyathācitraṃ vikārānudāharaṇārtham, anavaśeṣeṇa ca doṣān vyākhyāsyāmaḥ|
rajastamaśca mānasau doṣau| tayorvikārāḥ kāma krodha lobha moherṣyāmānamada śoka citto(nto)dvegabhaya harṣādayaḥ|

Rajas and Tamas are the Doshas pertaining to the mind and the type of morbidity caused by them are Kama (lust), Krodha – anger, Lobha – greed, Moha – attachment, Irshya – envy, Mana – ego, Mada – pride, Shoka – depression, Chinta – worry, Udvega – anxiety, Bhaya – fear, Harsha – excitement etc.
Vata, Pitta and Kapha- these three are the Doshas pertaining to the body.

Sharirika Dosha –
वातपित्तश्लेष्माणस्तु खलु शारीरा दोषाः|
तेषामपि च विकारा ज्वरातीसार शोफ शोष श्वास मेहकुष्ठादयः|
इति दोषाः केवला व्याख्याता विकारैकदेशश्च||५||
vāta pitta śleṣmāṇastu khalu śārīrā doṣāḥ|
teṣāmapi ca vikārā jvarātīsāra śopha śoṣa śvāsa mehakuṣṭhādayaḥ|
iti doṣāḥ kevalā vyākhyātā vikāraikadeśaśca||5||
Diseases caused by them are fever, diarrhea, oedema, emaciation, dyspnoea, Meha – diabetes, urinary tract disorders, skin diseases. Thus, Doshas and diseases are explained:

Causes for vitiation of mental and physical Doshas:
तत्र खल्वेषां द्वयानामपि दोषाणां त्रिविधं प्रकोपणं; तद्यथा- असात्म्येन्द्रियार्थसंयोगः, प्रज्ञापराधः, परिणामश्चेति||६||
tatra khalveṣāṃ dvayānāmapi doṣāṇāṃ trividhaṃ prakopaṇaṃ; tadyathā- asātmyendriyārthasaṃyogaḥ, prajñāparādhaḥ, pariṇāmaśceti||6||

Both the types of Doshas have three types of etiological factors, viz .,
Asatmya Indriya Artha Samyoga – unwholesome contact with the object of senses,
Prajnaparadha – intellectual Blasphemy and
Parinama – seasonal changes. [5-6]

Factors responsible for manifestation of innumerable disease:
प्रकुपितास्तु खलु ते प्रकोपण विशेषाद्दूष्य विशेषाच्च विकार विशेषानभिनिर्वर्तयन्त्य परिसङ्ख्येयान्||७||
prakupitāstu khalu te prakopaṇa viśeṣāddūṣya viśeṣācca vikāra viśeṣānabhinirvartayantya parisaṅkhyeyān||7||
Depending upon the specific nature of the causative factors and also the specificity of the nature elements afflicted, Doshas when aggravated manifest innumerable types of diseases. [7]

Psycho-somatic disease:
ते च विकाराः परस्परमनुवर्तमानाः कदाचिदनुबध्नन्ति कामादयो ज्वरादयश्च||८||
te ca vikārāḥ parasparamanuvartamānāḥ kadācidanubadhnanti kāmādayo jvarādayaśca||8||
When allowed to persist for long, these psychic diseases, Viz, Kama (lust) etc, and somatic diseases viz, fever etc., at times get combined with each other. [8]

Psychic Doshas- their eternal union:
नियतस्त्वनुबन्धो रजस्तमसोः परस्परं, न ह्यरजस्कं तमः प्रवर्तते ||९||
niyatastvanubandho rajastamasoḥ parasparaṃ, na hyarajaskaṃ tamaḥ pravartate ||9||
There is an eternal union between the two Mano Doshas – Rajas and tamas.
Tamas cannot manifest its actions without Rajas. [9]

Combination of physical Doshas:
(प्रायः) शारीर दोषाणामेकाधिष्ठानीयानां सन्निपातः संसर्गो वा समान गुणत्वात्; दोषा हि दूषणैः समानाः||१०||
(prāyaḥ) śārīra doṣāṇāmekādhiṣṭhānīyānāṃ sannipātaḥ saṃsargo vā samāna guṇatvāt; doṣā hi dūṣaṇaiḥ samānāḥ||10||
Vata, Pitta and Kapha located in same place and having similar attributes mostly combine with one another (samsarga) or with all together (Sannipata) to form disease. Attributes of Doshas resemble those of the factors which vitiated them. [10]

Primary & secondary diseases: Anubandhya, Anubandha Roga
तत्रानुबन्ध्यानुबन्धकृतो विशेषः- स्वतन्त्रो व्यक्त लिङ्गो यथोक्त समुत्थानप्रशमो भवत्यनुबन्ध्यः, तद्विपरीत लक्षणस्त्वनुबन्धः|
अनुबन्ध्यलक्षणसमन्वितास्तत्र यदि दोषा भवन्ति तत्त्रिकं सन्निपातमाचक्षते, द्वयं वा संसर्गम्|
अनुबन्ध्यानुबन्धविशेषकृतस्तु बहुविधो दोषभेदः|
एवमेष सञ्ज्ञाप्रकृतो भिषजां दोषेषु व्याधिषु च नाना प्रकृति विशेष व्यूहः ||११||
tatrānubandhyānubandhakṛto viśeṣaḥ- svatantro vyakta liṅgo yathokta samutthānapraśamo bhavatyanubandhyaḥ, tadviparīta lakṣaṇastvanubandhaḥ|
anubandhyalakṣaṇasamanvitāstatra yadi doṣā bhavanti tattrikaṃ sannipātamācakṣate, dvayaṃ vā saṃsargam|
anubandhyānubandhaviśeṣakṛtastu bahuvidho doṣabhedaḥ|
evameṣa sañjñāprakṛto bhiṣajāṃ doṣeṣu vyādhiṣu ca nānā prakṛti viśeṣa vyūhaḥ ||11||

Characteristic features of primary and secondary (subordinate) diseases:
Anubandhya – primary disorder and
Anubandha – secondary disorder.
Anubandhya – primary disease will have its own specific characteristic features. It is caused due to specific etiological facctors mentioned in text books. The other type of disease, without specific features or causes is called Anubandha – secondary.

Sannipata – Here, all the three Doshas are primarily vitiated at a time.
Samsarga – Here two Doshas get vitiated at a time to produce disease.

Based on permutation and combination of causative factors and symptoms, both the above two types of diseases can be classified in different ways.  Considering such characteristic features, physician attribute various names (like Jvara – fever or fever) and Atisara – diarrhoea, dysentery or diarrhea) to different conditions caused by Doshas and diseases. [11]

Four types of Agni:
अग्निषु तु शारीरेषु चतुर्विधो विशेषो बलभेदेन भवति|
तद्यथा- तीक्ष्णो, मन्दः, समो, विषमश्चेति|
agniṣu tu śārīreṣu caturvidho viśeṣo balabhedena bhavati|
tadyathā- tīkṣṇo, mandaḥ, samo, viṣamaśceti|
Depending upon strength, Agni (factors responsible for digestion and metabolism) can be classified under four categories, viz
Teekshna – sharp, high intensity
Manda – mild, low intensity
Sama – regular, normal intensity
Vishama – irregular intensity

तत्र तीक्ष्णोऽग्निः सर्वापचारसहः, तद्विपरीतलक्षणस्तु मन्दः, समस्तु खल्वपचारतो विकृतिमापद्यतेऽनपचारतस्तु प्रकृताववतिष्ठते, समलक्षण विपरीत लक्षणस्तु विषम इति|
tatra tīkṣṇo’gniḥ sarvāpacārasahaḥ, tadviparītalakṣaṇastu mandaḥ, samastu khalvapacārato vikṛtimāpadyate’napacāratastu prakṛtāvavatiṣṭhate, samalakṣaṇa viparīta lakṣaṇastu viṣama iti|

Teeksnagni – Capable of tolerating all types of diet irregularities
mandagni – minor food irregularity leads to diseases
Samagni – moderate food irregularity leads to disease, otherwise maintains health
Vishamagni – Sometimes it gets impaired and sometimes it does not get impaired by food  irregularities. (unpredictable variations)

Agni and Dosha body types:
एते चतुर्विधा भवन्त्यग्नयश्चतुर्विधानामेव पुरुषाणाम्|
तत्र समवात पित्त श्लेष्मणां प्रकृति स्थानां समा भवन्त्यग्नयः, वातलानां तु वाताभिभूतेऽग्न्यधिष्ठाने विषमा भवन्त्यग्नयः, पित्तलानां तु पित्ताभिभूते ह्यग्न्यधिष्ठाने तीक्ष्णा भवन्त्यग्नयः, श्लेष्मलानां तु श्लेष्माभिभूतेऽग्न्यधिष्ठाने मन्दा भवन्त्यग्नयः||१२||
ete caturvidhā bhavantyagnayaścaturvidhānāmeva puruṣāṇām|
tatra samavāta pitta śleṣmaṇāṃ prakṛti sthānāṃ samā bhavantyagnayaḥ, vātalānāṃ tu vātābhibhūte’gnyadhiṣṭhāne viṣamā bhavantyagnayaḥ, pittalānāṃ tu pittābhibhūte hyagnyadhiṣṭhāne tīkṣṇā bhavantyagnayaḥ, śleṣmalānāṃ tu śleṣmābhibhūte’gnyadhiṣṭhāne mandā bhavantyagnayaḥ||12||

Four types of Agni occur in 4 types of individuals.
In a person with balanced Tridoshas – Samagni.
Vata body type person will have Vishamagni
Pitta person will have Teekshnagni
Kapha person will have mandagni . [12]

Prakruti – Physical constitution:
तत्र केचिदाहुः- न समवात पित्त श्लेष्माणो जन्तवः सन्ति, विषमाहारोपयोगित्वान्मनुष्याणां; तस्माच्च वातप्रकृतयः केचित्, केचित् पित्तप्रकृतयः, केचित् पुनः श्लेष्मप्रकृतयो भवन्तीति|
तच्चानुपपन्नं, कस्मात् कारणात्? समवातपित्तश्लेष्माणं ह्यरोगमिच्छन्ति भिषजः, यतः प्रकृतिश्चारोग्यम्, आरोग्यार्था च भेषज प्रवृत्तिः, सा चेष्टरूपा, तस्मात् सन्ति समवातपित्तश्लेष्माणः; न खलु सन्ति वातप्रकृतयः पित्तप्रकृतयः श्लेष्मप्रकृतयो वा|
तस्य तस्य किल दोषस्याधिक्यात् सा सा दोष प्रकृतिरुच्यते मनुष्याणां, न च विकृतेषु दोषेषु प्रकृतिस्थत्वमुपपद्यते, तस्मान्नैताः प्रकृतयः सन्ति; सन्ति तु खलु वातलाः पित्तलाः श्लेष्मलाश्च, अप्रकृतिस्थास्तु ते ज्ञेयाः||१३||
tatra kecidāhuḥ- na samavāta pitta śleṣmāṇo jantavaḥ santi, viṣamāhāropayogitvānmanuṣyāṇāṃ; tasmācca vātaprakṛtayaḥ kecit, kecit pittaprakṛtayaḥ, kecit punaḥ śleṣmaprakṛtayo bhavantīti|
taccānupapannaṃ, kasmāt kāraṇāt? samavātapittaśleṣmāṇaṃ hyarogamicchanti bhiṣajaḥ, yataḥ prakṛtiścārogyam, ārogyārthā ca bheṣaja pravṛttiḥ, sā ceṣṭarūpā, tasmāt santi samavātapittaśleṣmāṇaḥ; na khalu santi vātaprakṛtayaḥ pittaprakṛtayaḥ śleṣmaprakṛtayo vā|
tasya tasya kila doṣasyādhikyāt sā sā doṣa prakṛtirucyate manuṣyāṇāṃ, na ca vikṛteṣu doṣeṣu prakṛtisthatvamupapadyate, tasmānnaitāḥ prakṛtayaḥ santi; santi tu khalu vātalāḥ pittalāḥ śleṣmalāśca, aprakṛtisthāstu te jñeyāḥ||13||

Some scholars opine that no person can have all the three doshas in equilibrium, because food always has one or the other dosha dominance in it. They only believe that there are three Prakrutis – Vata, Pitta and Kapha.
But this is not true because, physicians consider an individual as healthy only when Vata, Pitta, and Kapha are in equilibrium and health represents the natural state of the body. It is with a view to maintaining good health that all types of treatments are prescribed.
Hence, there exists people with Tridosha equilibrium.
The Dosha body types are determined by aggressive, but healthily dominant Dosha in the body, not by vitiated Doshas.

तेषां तु खलु चतुर्विधानां पुरुषाणां चत्वार्यनुप्रणिधानानि श्रेयस्कराणि भवन्ति| तत्र समसर्वधातूनां सर्वाकारसमम्, अधिकदोषाणां तु त्रयाणां यथास्वं दोषाधिक्यमभिसमीक्ष्य दोषप्रतिकूलयोगीनि त्रीण्यनु(न्न)प्रणिधानानि श्रेयस्कराणि भवन्ति यावदग्नेः समीभावात्, समे तु सममेव कार्यम्; एवं चेष्टा भेषजप्रयोगाश्चापरे| तान् विस्तरेणानुव्याख्यास्यामः||१४||
teṣāṃ tu khalu caturvidhānāṃ puruṣāṇāṃ catvāryanupraṇidhānāni śreyaskarāṇi bhavanti| tatra samasarvadhātūnāṃ sarvākārasamam, adhikadoṣāṇāṃ tu trayāṇāṃ yathāsvaṃ doṣādhikyamabhisamīkṣya doṣapratikūlayogīni trīṇyanu(nna)praṇidhānāni śreyaskarāṇi bhavanti yāvadagneḥ samībhāvāt, same tu samameva kāryam; evaṃ ceṣṭā bheṣajaprayogāścāpare| tān vistareṇānuvyākhyāsyāmaḥ||14||

The 4 types of body type (Sama, Vata, Pitta and Kapha) should follow 4 types of regimen.
The person with Sama prakruti – all Doshas in equilibrium should adopt a normal and healthy diet and lifestyle.
The Vata, Pitta and Kapha body type people should follow diet and lifestyle with opposite characteristics to their Dosha.

Treatment principles in Vata Prakriti:
त्रयस्तु
पुरुषा भवन्त्यातुराः, ते त्वनातुरास्तन्त्रान्तरीयाणां भिषजाम्|
तद्यथा- वातलः, पित्तलः, श्लेष्मलश्चेति|
तेषामिदं विशेषविज्ञानं- वातलस्य वातनिमित्ताः, पित्तलस्य पित्तनिमित्ताः, श्लेष्मलस्य श्लेष्मनिमित्ता व्याधयः प्रायेण बलवन्तश्च भवन्ति||१५||
तत्र वातलस्य वातप्रकोपणान्यासेवमानस्य  क्षिप्रं वातः प्रकोपमापद्यते, तथेतरौ दोषौ; तस्य प्रकोपमापन्नो यथोक्तैर्विकारैः शरीरमुपतपति बलवर्णसुखायुषामुपघाताय|
तस्यावजयनं- स्नेहस्वेदौ विधियुक्तौ, मृदूनि संशोधनानि स्नेहोष्णमधुराम्ललवणयुक्तानि, तद्वदभ्यवहार्याणि, अभ्यङ्गोपनाहनोद्वेष्टनोन्मर्दनपरिषेकावगाहनसंवाहनावपीडनवित्रासनविस्मापनविस्मारणानि, सुरासवविधानं, स्नेहाश्चानेकयोनयो दीपनीयपाचनीयवातहरविरेचनीयोपहितास्तथा शतपाकाः सहस्रपाकाः सर्वशश्च प्रयोगार्थाः, बस्तयः, बस्तिनियमः सुखशीलता चेति||१६||

trayastu puruṣā bhavantyāturāḥ, te tvanāturāstantrāntarīyāṇāṃ bhiṣajām|
tadyathā- vātalaḥ, pittalaḥ, śleṣmalaśceti|
teṣāmidaṃ viśeṣavijñānaṃ- vātalasya vātanimittāḥ, pittalasya pittanimittāḥ, śleṣmalasya śleṣmanimittā vyādhayaḥ prāyeṇa balavantaśca bhavanti||15||
tatra vātalasya vātaprakopaṇānyāsevamānasya kṣipraṃ vātaḥ prakopamāpadyate, na tathetarau doṣau; sa tasya prakopamāpanno yathoktairvikāraiḥ śarīramupatapati balavarṇasukhāyuṣāmupaghātāya|
tasyāvajayanaṃ- snehasvedau vidhiyuktau, mṛdūni ca saṃśodhanāni snehoṣṇamadhurāmlalavaṇayuktāni, tadvadabhyavahāryāṇi, abhyaṅgopanāhanodveṣṭanonmardanapariṣekāvagāhanasaṃvāhanāvapīḍanavitrāsanavismāpanavismāraṇāni, surāsavavidhānaṃ, snehāścānekayonayo dīpanīyapācanīyavātaharavirecanīyopahitāstathā śatapākāḥ sahasrapākāḥ sarvaśaśca prayogārthāḥ, bastayaḥ, bastiniyamaḥ sukhaśīlatā ceti||16||

The single Dosha prakruti persons are called Sadatura – they get afflicted by their respective Doshic disorders easily.

In Vata Prakruti person, Vata gets aggravated very easily with Vata vitiating causes. Here, Pitta and kapha does not vitiate easily. Vata aggravation leads to depletion of
Bala – strength
Varna – colour
Sukha – health
Ayusha – quality of life.
Such disorders are treated with
Sneha – oleation
Sweda – sweating treatment
Mrudu Samshodhana – mild Shodhana (elimination) therapies with medicines having
Sneha – unctuousness, hot, sweet, sour, salt properties.

Abhyanga – Massage,  Upanaha – poultice, Udveshtana – bandage, Mardana – kneading, Parisheka – effusion, Avagaha- tub bath, Samvahana, (pressing and massaging by hand), Peedana – pressing, Vitrasana – terrorizing,
Vismapana – surprising and
Vismarana – re-memorizing.
Use of Sura and Asavas (fermented drinks)
usage of different fats with Deepana, Pachana, Vatahara, Virechanaeeyopaga properties, boiled hundred and thousand times and be administered in different ways  viz, internal use, massage, enema with all proper rules and regulations of enema therapies etc

Characteristics of Pitta Parkriti and its management:
पित्तलस्यापि पित्तप्रकोपणान्यासेवमानस्य क्षिप्रं पित्तं प्रकोपमापद्यते, न तथेतरौ दोषौ; तदस्य प्रकोपमापन्नं यथोक्तैर्विकारैः शरीरमुपतपति बलवर्णसुखायुषामुपघाताय|
तस्यावजयनं- सर्पिष्पानं, सर्पिषा च स्नेहनम्, अधश्च दोषहरणं, मधुर तिक्त कषाय शीतानां चौषधाभ्यवहार्याणामुपयोगः, मृदु मधुर सुरभि शीत हृद्यानां गन्धानां चोपसेवा, मुक्ता मणिहारा वलीनां च परम शिशिरवारि संस्थितानां धारणमुरसा, क्षणे क्षणेऽग्र्यचन्दनप्रियङ्गु कालीय मृणाल शीत वातवारिभिरुत्पल कुमुद कोकनद सौगन्धिक पद्मानुगतैश्च वारिभिरभिप्रोक्षणं, श्रुति सुख मृदु मधुर मनोऽनुगानां च गीतवादित्राणां श्रवणं, श्रवणं चाभ्युदयानां, सुहृद्भिः संयोगः, संयोगश्चेष्टाभिः स्त्रीभिः शीतोपहितांशुकस्रग्धारिणीभिः, निशाकरांशु शीतल प्रवात हर्म्यवासः, शैलान्तरपुलिन शिशिर सदन वसन व्यजन पवन सेवनं, रम्याणां चोपवनानां सुख शिशिर सुरभि मारुतोपहितानामुपसेवनं, सेवनं च पद्मोत्पल नलिन कुमुद सौगन्धिक पुण्डरीक शतपत्र हस्तानां, सौम्यानां च सर्वभावानामिति||१७||
pittalasyāpi pittaprakopaṇānyāsevamānasya kṣipraṃ pittaṃ prakopamāpadyate, na tathetarau doṣau; tadasya prakopamāpannaṃ yathoktairvikāraiḥ śarīramupatapati balavarṇasukhāyuṣāmupaghātāya|
tasyāvajayanaṃ- sarpiṣpānaṃ, sarpiṣā ca snehanam, adhaśca doṣaharaṇaṃ, madhura tikta kaṣāya śītānāṃ cauṣadhābhyavahāryāṇāmupayogaḥ, mṛdu madhura surabhi śīta hṛdyānāṃ gandhānāṃ copasevā, muktā maṇihārā valīnāṃ ca parama śiśiravāri saṃsthitānāṃ dhāraṇamurasā, kṣaṇe kṣaṇe’gryacandanapriyaṅgu kālīya mṛṇāla śīta vātavāribhirutpala kumuda kokanada saugandhika padmānugataiśca vāribhirabhiprokṣaṇaṃ, śruti sukha mṛdu madhura mano’nugānāṃ ca gītavāditrāṇāṃ śravaṇaṃ, śravaṇaṃ cābhyudayānāṃ, suhṛdbhiḥ saṃyogaḥ, saṃyogaśceṣṭābhiḥ strībhiḥ śītopahitāṃśukasragdhāriṇībhiḥ, niśākarāṃśu śītala pravāta harmyavāsaḥ, śailāntarapulina śiśira sadana vasana vyajana pavana sevanaṃ, ramyāṇāṃ copavanānāṃ sukha śiśira surabhi mārutopahitānāmupasevanaṃ, sevanaṃ ca padmotpala nalina kumuda saugandhika puṇḍarīka śatapatra hastānāṃ, saumyānāṃ ca sarvabhāvānāmiti||17||

Treatment principles in Pitta person:
If a Pittala individual resorts to Pitta aggravating activities, he develops diseases immediately. In him, Vata and Kapha Doshas do not aggravate easily.
The imbalanced Pitta afflicts the individual by the manifestation of diseases resulting in the impairment of strength, complexion, happiness and longevity.

The following therapies alleviates Pitta Dosha –
Intake of ghee
Oleation by ghee
Purgation – Virechana treatment
Use of medicines and diets having sweet, bitter and astringent tastes and cooling property
Use of scents which are mild, sweet, fragrant, cooling and cordial
Use in the chest of pearls, jewels and garlands which are kept in excessively cold water
Frequent sprinkling of cold water and cold air of Agrya Chandana (Santalum Album Linn), Priyangu (Callicarpa Macrophylla), Kaliya (yellow variety of Chandana (Sandalwood – Santalum album) and Mrunala(Lotus stalk) mixed with Utpala (Nymphaea alba), Kumuda (a variety of Utpala (Nymphaea alba)) Kokanada), Sugandhika (a varieties of Utpala (Nymphaea alba) and Padma – Lotus (Nelumbo nucifera)
Hearing of songs and music which are pleasing to ears, mild, sweet and agreeable
Hearing the information regarding prosperity
Keeping company of friends
Company of agreeable ladies wearing cooling garments and garlands
Residence in building which is cooled by the moon rays and exposed to the breezes from all sides
Residence in cold places in mountains and river banks , use of cold apparel and exposure to the cold winds of fans
Visiting beautiful gardens having pleasing, cold and the body is the most cherished one.

Management of Persons having different types of physical constitution:
तेषां तु खलु चतुर्विधानां पुरुषाणां चत्वार्यनुप्रणिधानानि श्रेयस्कराणि भवन्ति|
तत्र सम सर्वधातूनां सर्वाकारसमम्, अधिकदोषाणां तु त्रयाणां यथास्वं दोषाधिक्यमभिसमीक्ष्य दोष प्रतिकूलयोगीनि त्रीण्यनु(न्न)प्रणिधानानि श्रेयस्कराणि भवन्ति यावदग्नेः समीभावात्, समे तु सममेव कार्यम्; एवं चेष्टा भेषजप्रयोगाश्चापरे|
तान् विस्तरेणानुव्याख्यास्यामः||१४||
teṣāṃ tu khalu caturvidhānāṃ puruṣāṇāṃ catvāryanupraṇidhānāni śreyaskarāṇi bhavanti|
tatra sama sarvadhātūnāṃ sarvākārasamam, adhikadoṣāṇāṃ tu trayāṇāṃ yathāsvaṃ doṣādhikyamabhisamīkṣya doṣa pratikūlayogīni trīṇyanu(nna)praṇidhānāni śreyaskarāṇi bhavanti yāvadagneḥ samībhāvāt, same tu samameva kāryam; evaṃ ceṣṭā bheṣajaprayogāścāpare|
tān vistareṇānuvyākhyāsyāmaḥ||14||
Four types of regimens are prescribed for the benefit of these four categories of individuals. For an individual having the balanced state of all Doshas, all the regimens to be adopted by balanced state all Doshas, all the regimens to be adopted by him is of balanced type.

When there is predominance of Doshas, depending upon the nature of the Doshas involved, it is useful to adopt such there regimens as would be in contradiction with these three predominating Doshas till there is normalcy of Agni. It is only after the normalcy of the Agni is attained, balanced regimens are adopted. Similarly, various therapies and other regimens are administered to these four categories of individuals. We shall now explain them in detail. [14]
body type

Characteristic of Vatala constitution and its management:
त्रयस्तु पुरुषा भवन्त्यातुराः, ते त्वनातुरास्तन्त्रान्तरीयाणां भिषजाम्|
तद्यथा- वातलः, पित्तलः, श्लेष्मलश्चेति|
तेषामिदं विशेष विज्ञानं- वातलस्य वात निमित्ताः, पित्तलस्य पित्त निमित्ताः, श्लेष्मलस्य श्लेष्म निमित्ता व्याधयः प्रायेण बलवन्तश्च भवन्ति||१५||
तत्र वातलस्य वातप्रकोपणान्यासेवमानस्य क्षिप्रं वातः प्रकोपमापद्यते, न तथेतरौ दोषौ; स तस्य प्रकोपमापन्नो यथोक्तैर्विकारैः शरीरमुपतपति बल वर्ण सुखायुषामुपघाताय|
तस्यावजयनं- स्नेह स्वेदौ विधियुक्तौ, मृदूनि च संशोधनानि स्नेहोष्ण मधुराम्ल लवण युक्तानि, तद्वदभ्यवहार्याणि, अभ्यङ्गोपनाहनोद्वेष्टनोन्मर्दनपरिषेकावगाहन संवाहनावपीडनवित्रासनविस्मापनविस्मारणानि, सुरासव विधानं, स्नेहाश्चानेकयोनयो दीपनीय पाचनीय वातहर विरेचनीयोपहितास्तथा शतपाकाः सहस्रपाकाः सर्वशश्च प्रयोगार्थाः, बस्तयः, बस्ति नियमः सुखशीलता चेति||१६||
trayastu puruṣā bhavantyāturāḥ, te tvanāturāstantrāntarīyāṇāṃ bhiṣajām|
tadyathā- vātalaḥ, pittalaḥ, śleṣmalaśceti|
teṣāmidaṃ viśeṣa vijñānaṃ- vātalasya vāta nimittāḥ, pittalasya pitta nimittāḥ, śleṣmalasya śleṣma nimittā vyādhayaḥ prāyeṇa balavantaśca bhavanti||15||
tatra vātalasya vātaprakopaṇānyāsevamānasya kṣipraṃ vātaḥ prakopamāpadyate, na tathetarau doṣau; sa tasya prakopamāpanno yathoktairvikāraiḥ śarīramupatapati bala varṇa sukhāyuṣāmupaghātāya|
tasyāvajayanaṃ- sneha svedau vidhiyuktau, mṛdūni ca saṃśodhanāni snehoṣṇa madhurāmla lavaṇa yuktāni, tadvadabhyavahāryāṇi, abhyaṅgopanāhanodveṣṭanonmardanapariṣekāvagāhana saṃvāhanāvapīḍanavitrāsanavismāpanavismāraṇāni, surāsava vidhānaṃ, snehāścānekayonayo dīpanīya pācanīya vātahara virecanīyopahitāstathā śatapākāḥ sahasrapākāḥ sarvaśaśca prayogārthāḥ, bastayaḥ, bastiniyamaḥ sukhaśīlatā ceti||16||

Characteristic of Vatala constitution and its management:
Vatala (dominance of Vata), Pittala (dominance of Pitta) and Sleshmala (dominance of Kapha) these three are the morbid states in individuals, even though, according to another school of thought they represent the natural states of the body. Their characteristic features are as given below:
Vatala, Pitala and Sleshmala types of individuals are more susceptible to Vatika, Paittika and Sleshmika diseases respectively and such diseases in the respective types of individuals become very severe.

If a Vatala type of individual resorts to such thing as are aggravators of Vata, Vata in his body gets aggravated immediately.

This does not happen in the case of the remaining two Doshas. The aggravate Vata afflicts individuals by manifestation of diseases already described], resulting in the impairment of strength, complexion, happiness and longevity.

The following therapies alleviate this Doshas:
Proper administration of oleation and fomentation;
Mild purgative prepared by the addition of fat, hot things and substances having sweet, sour and saline tastes
Food having the ingredients of the above mentioned properties
Massage, poultices, bandage, kneading, effusion, bath, samvahana (pressing and by hand)pressing, terrorizing, surmising and rememorizing use of wine and Asavas (fermented drinks)
Use of wine and Asavas (fermented drinks)
Fats from different source mixed with drugs having digestive, stimulant, carminative, Vata- alleviating and purgative properties- they may be boiled hundred and thousand times and be used for being administered in different times ways, viz, internal use, massage, enemata etc and
Enemata and regimens to be adopted along with it, the number of enemata may be according to the description available in Siddhi section for Karmabasti, Kalabasti, Yogabasti etc., cf Siddhi 1:47 [ 15-16]

Characteristics of Pittala constitution and its management:
पित्तलस्यापि पित्तप्रकोपणान्यासेवमानस्य क्षिप्रं पित्तं प्रकोपमापद्यते, न तथेतरौ दोषौ; तदस्य प्रकोपमापन्नं यथोक्तैर्विकारैः शरीरमुपतपति बलवर्णसुखायुषामुपघाताय|
तस्यावजयनं- सर्पिष्पानं, सर्पिषा च स्नेहनम्, अधश्च दोषहरणं, मधुरतिक्तकषायशीतानां चौषधाभ्यवहार्याणामुपयोगः, मृदु मधुर सुरभि शीत हृद्यानां गन्धानां चोपसेवा, मुक्तामणिहारावलीनां च परम शिशिरवारि संस्थितानां धारणमुरसा, क्षणे क्षणेऽग्र्यचन्दन प्रियङ्गु कालीय मृणाल शीतवातवारिभिरुत्पल कुमुद कोकनद सौगन्धिक पद्मानुगतैश्च वारिभिरभिप्रोक्षणं, श्रुति सुख मृदु मधुरमनोऽनुगानां च गीतवादित्राणां श्रवणं, श्रवणं चाभ्युदयानां, सुहृद्भिः संयोगः, संयोगश्चेष्टाभिः स्त्रीभिः शीतोपहितांशुकस्रग्धारिणीभिः, निशाकरांशु शीतल प्रवातहर्म्यवासः, शैलान्तरपुलिन शिशिर सदन वसन व्यजन पवन सेवनं, रम्याणां चोपवनानां सुख शिशिर सुरभि मारुतोपहितानामुपसेवनं, सेवनं च पद्मोत्पल नलिन कुमुद सौगन्धिक पुण्डरीक शतपत्र हस्तानां, सौम्यानां च सर्वभावानामिति||१७||
pittalasyāpi pittaprakopaṇānyāsevamānasya kṣipraṃ pittaṃ prakopamāpadyate, na tathetarau doṣau; tadasya prakopamāpannaṃ yathoktairvikāraiḥ śarīramupatapati balavarṇasukhāyuṣāmupaghātāya|
tasyāvajayanaṃ- sarpiṣpānaṃ, sarpiṣā ca snehanam, adhaśca doṣaharaṇaṃ, madhuratiktakaṣāyaśītānāṃ cauṣadhābhyavahāryāṇāmupayogaḥ, mṛdu madhura surabhi śīta hṛdyānāṃ gandhānāṃ copasevā, muktāmaṇihārāvalīnāṃ ca parama śiśiravāri saṃsthitānāṃ dhāraṇamurasā, kṣaṇe kṣaṇe’gryacandana priyaṅgu kālīya mṛṇāla śītavātavāribhirutpala kumuda kokanada saugandhika padmānugataiśca vāribhirabhiprokṣaṇaṃ, śruti sukha mṛdu madhuramano’nugānāṃ ca gītavāditrāṇāṃ śravaṇaṃ, śravaṇaṃ cābhyudayānāṃ, suhṛdbhiḥ saṃyogaḥ, saṃyogaśceṣṭābhiḥ strībhiḥ śītopahitāṃśukasragdhāriṇībhiḥ, niśākarāṃśu śītala pravātaharmyavāsaḥ, śailāntarapulina śiśira sadana vasana vyajana pavana sevanaṃ, ramyāṇāṃ copavanānāṃ sukha śiśira surabhi mārutopahitānāmupasevanaṃ, sevanaṃ ca padmotpala nalina kumuda saugandhika puṇḍarīka śatapatra hastānāṃ, saumyānāṃ ca sarvabhāvānāmiti||17||
If a Pittala individual resorts to such things as are aggravators of Pitta, Pitta in his body gets aggravated immediately. This does not happen in the case of the remaining two Doshas. The aggravated Pitta afflicts the individual by the manifestation of diseases already described resulting in the impairment of strength, complexion, happiness and longevity.

The following therapies alleviate Pitta Dosha:
Intake of ghee
Oleation by ghee
Purgation
Use of drugs and diets having sweet, bitter and astringent tastes and cooling property
Use of scents which are mild, sweet, fragrant, cooling and cordial
Use in the chest of pearls, jewels and garlands which are kept in excessively cold water
Frequent sprinkling of cold water and cold air of AgryaChandana (santalum Album Linn), Priyangu (Callicarpa Macrophylla VahL), Kaliya (yellow variety of Chandana) and Mrnala (lotus stalk) mixed with Utpala (Nymphaea Alba Linn), Kumuda (a variety of Uptpala) Kokanada , Sugandhika (a variety of Utpala) and Padma (Nelumbo Nucifera Gaertn)
Hearing of songs and music which are pleasuring ears, mild, sweet and agreeable
Hearing the information regarding prosperity
Keeping company of friends
Company of agreeable ladies wearing cooling garments and garlands;
Residence in buildings which is cooled by the moon rays and exposed to the breezes from all sides;
Residence in cold places in mountains and river banks, use of cold apparel and exposure to the cold winds of fansl.
Visiting beautiful gardens having pleasing, cold and fragrant wind
Use of the flower of Padma (Nelumbo Nucifera Gaertn), Utpala (Nymphaea Alba Linn), Nalina (a type of lotus), Kumuda (a variety of Utpla), Saugandhika (a variety of Utpala) pundarika (Nymphaea lotus Linn) and Satapatra (a variety of lotus) and
Adoption of such other regimens as are of soothing nature. [17]

Characteristics of Kapha Prakruti and management of aggravation: 
श्लेष्मलस्यापि श्लेष्म प्रकोपणान्यासेवमानस्य क्षिप्रं श्लेष्मा प्रकोपमापद्यते, न तथेतरौ दोषौ; स तस्य प्रकोपमापन्नो यथोक्तैर्विकारैः शरीरमुपतपति बल वर्ण सुखायुषामुपघाताय|
तस्यावजयनं- विधियुक्तानि तीक्ष्णोष्णानि संशोधनानि, रूक्षप्रायाणि चाभ्यवहार्याणि कटुक तिक्त कषायोपहितानि, तथैव धावन लङ्घन प्लवन परिसरण जागरण नियुद्ध व्यवाय व्यायामोन्मर्दन स्नानोत्सादनानि, विशेषतस्तीक्ष्णानां दीर्घकाल स्थितानां च मद्यानामुपयोगः, सधूमपानः सर्वशश्चोपवासः, तथोष्णं वासः, सुख प्रतिषेधश्च सुखार्थमेवेति||१८||

śleṣmalasyāpi śleṣma prakopaṇānyāsevamānasya kṣipraṃ śleṣmā prakopamāpadyate, na tathetarau doṣau; sa tasya prakopamāpanno yathoktairvikāraiḥ śarīramupatapati bala varṇa sukhāyuṣāmupaghātāya|
tasyāvajayanaṃ- vidhiyuktāni tīkṣṇoṣṇāni saṃśodhanāni, rūkṣaprāyāṇi cābhyavahāryāṇi kaṭuka tikta kaṣāyopahitāni, tathaiva dhāvana laṅghana plavana parisaraṇa jāgaraṇa niyuddha vyavāya vyāyāmonmardana snānotsādanāni, viśeṣatastīkṣṇānāṃ dīrghakāla sthitānāṃ ca madyānāmupayogaḥ, sadhūmapānaḥ sarvaśaścopavāsaḥ, tathoṣṇaṃ vāsaḥ, sukha pratiṣedhaśca sukhārthameveti||18||

If a Sleshmala type of individual resorts to Kapha increasing activities, Kapha easily gets aggravated. In him, Vata and Pitta do not aggravate easily.
The aggravated kapha afflicts the individual by the manifestation of diseases, leading to impairments of strength, complexion, happiness and longevity.

The following therapies alleviate Kapha Dosha:
Proper administration of strong and hot elimination therapies – Vamana
Intake of diet which is mostly ununctuous and is composed of ingredients having pungent, bitter and astringent tastes
Running, jumping, swimming whirling, keeping awake during night, fighting, sexual intercourse, exercise, unction, bath and oil massage.
Intake of strong wines preserved for a long time
All lightening therapies (Langhana) along with Dhumapana – herbal smoking
Use of warm apparels and
Giving up comforts of life with to enjoying happiness ultimately. [18]

Thus it is said:-
भवति चात्र-
सर्वरोग विशेषज्ञः सर्वकार्य विशेषवित्|
सर्व भेषज तत्त्वज्ञो राज्ञः प्राणपतिर्भवेदिति||१९||
bhavati cātra-
sarvaroga viśeṣajñaḥ sarvakārya viśeṣavit|
sarva bheṣaja tattvajño rājñaḥ prāṇapatirbhavediti||19||
A man well versed with the specific features of all diseases, principles of their treatment and properties of all medicaments, is entitled to be a royal physician. [19]

तत्र श्लोकाः-
प्रकृत्यन्तरभेदेन रोगानीकविकल्पनम्|
परस्परा विरोधश्च सामान्यं रोगदोषयोः||२०||
दोष सङ्ख्या विकाराणामेकदेशः प्रकोपणम्|
जरणं प्रति चिन्ता च कायाग्नेर्धुक्षणानि च||२१||
नराणां वातलादीनां प्रकृति स्थापनानि च|
रोगानीके विमानेऽस्मिन् व्याहृतानि महर्षिणा||२२||
tatra ślokāḥ-
prakṛtyantarabhedena rogānīkavikalpanam|
parasparā virodhaśca sāmānyaṃ rogadoṣayoḥ||20||
doṣa saṅkhyā vikārāṇāmekadeśaḥ prakopaṇam|
jaraṇaṃ prati cintā ca kāyāgnerdhukṣaṇāni ca||21||
narāṇāṃ vātalādīnāṃ prakṛti sthāpanāni ca|
rogānīke vimāne’smin vyāhṛtāni maharṣiṇā||22||
To sum up:-
Various categories of diseases classified on the basis of different criteria , absence of any contradiction in these statements, identical nature of (Roga (disease) and Dosha , number of Doshas, partial description of diseases, factors responsible for the aggravation of Doshas, digestive powers of digestion, therapies for the maintenance of the health of various types of individuals, viz, Vatala etc, all these topics have been described in this Chapter on “Roganeeka Vimanam”. [20-22]

इत्यग्निवेशकृते तन्त्रे चरक प्रतिसंस्कृते विमान स्थाने रोगानीक विमानं नाम षष्ठोऽध्यायः||६||
ityagniveśakṛte tantre charaka pratisaṃskṛte vimāna sthāne rogānīka vimānaṃ nāma ṣaṣṭho’dhyāyaḥ||6||
Thus ends the Sixth Chapter – Roganeeka Vimana Adhyaya – Determination of Specific Characteristics of Diseases of the Vimana Section of Agnivesha’s work, redacted by Charaka. [6]


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