Apayo Laghuta Meaning And Importance In Treatment
By Dr Raghuram Y.S. MD (Ay) & Dr Manasa, B.A.M.S
Apaya Laghuta, these terms are used by Master Charaka in the context of defining the ‘symptoms and nature of vata vyadhi’. (Ref – Charaka Chikitsa Chapter 28)
Vata Vyadhi comprises of a group of special, specific and uncommon disorders caused due to severe aggravation of vata.
Apaya means absence or destruction.
Laghuta means lightness or getting feeble.
Read – Vata Dosha – Introduction, 40 Things To Know
Apayo Laghuta
Before explaining the different types of vata vyadhi, their presentation and symptoms, Master Charaka firstly defines the meanings of three stages or forms of presentation of vata vyadhi. This would help in understanding and diagnosing the vata vyadhis. The knowledge of this would also help in knowing the partial (initial) presence, presence, absence or disappearance of vata vyadhis. The physician would know the stage in which the disease is present.
Purvarupa – means premonitory symptoms of the disease. Herein the disease is in the initial mode of presentation, would present in an incomplete and feeble form. The symptoms of vata vyadhi would manifest in feeble form and suggests that the disease would appear in its full blown form in near future. This would explain partial or initial presence of the disease.
Rupa or Atmarupa – means the fully presenting symptoms of vata vyadhi. The premonitory symptoms of the disease themselves would gradually transform into fully manifested symptoms. Now these symptoms will be called as rupas or atmarupas – symptoms of vata vyadhi. When these symptoms get clearly manifested it becomes easy to diagnose different types of vata vyadhi and also name them.
Apaya – means destruction or disappearance of the disease. This is marked by reduction in the severity and magnitude of the symptoms of the vata vyadhi i.e. laghuta in the rupas or lakshanas of the disease.
Sanskrit Verses
Read – Different Causes For Vata Dosha Imbalance, Increase
Different perspectives of understanding Apayo Laghuta
Gone here, present somewhere else – Partial or occasional absence of vata vyadhi symptoms like stiffness, contractures, tremors etc is called as apaya. This is possible due to the chala guna i.e. ‘mobility’ attribute of vata. When vata aggravation is predominantly enriched by the chala attribute, it pushes the symptoms like stiffness, tremors etc mentioned above from one place to the other. The person may temporarily feel that these symptoms which were existing, have suddenly disappeared or moved away from their site of manifestation. But this is temporary. These symptoms can occur elsewhere.
Bouts gone, disease gone? – It is said ‘when the bouts of symptoms go away the person feels healthy, as occurs in diseases like akshepaka (convulsions) etc.’ But these symptoms get disappeared for time being. So one should not conclude that the disease has disappeared when its bouts pass away. There is a temporary pause; a latent phase we can tell. The disease is opportunistic and will strike back when circumstances become favorable for its manifestation. This may be true with many diseases and the principle might not be limited to just vata vyadhi.
Unpredictable nature of vata and vata vyadhi – This explanation helps us notice that vata vyadhi is unpredictable in nature. It would present as vegavasta i.e. active stage when symptoms are manifested to fullest strength or avegavastha i.e. inactive stage when the symptoms would disappear for time being only to recur when favorable conditions prevail. In between two active stages, there is a period of interval wherein the symptoms disappear. This disappearance of symptoms is temporary. The symptoms have actually not disappeared but have become latent and are opportunistic, waiting for favorable conditions to manifest once again. This is called as ‘laghuta’ i.e. lightness of symptoms and this occurs due to ‘apaya’ i.e. temporary and partial disappearance of symptoms during the inactive phase of the disease.
Read – Understand Vata Dosha By Its Functions
To sum up,
When we consider Vata Vyadhi – the diseases mentioned in the context would appear in a feeble form with the signs and symptoms showing less strength and intensity which also form the premonitory symptoms of the disease. The disease may not be clearly evident here and not fully manifested, just like the fire beneath the heap of ash, ready to manifest and waiting for ideal conditions. A wise physician would catch the clues that the disease is giving and the warning ‘I am coming’. If he can start ideal treatment in this condition, the disease doesn’t progress to the manifested form. This is also a stage wherein the vata vyadhi can be prevented from manifesting and treated comprehensively. Vata Vyadhi is a group of disorders which are tough to handle once they get manifested in the full blown form.
Read – Vata Disorders (Vatavyadhi): Definition, Causes, Symptoms
When not diagnosed in the premonitory stage, the disease would progress and cause further damage. This would eventually lead to the manifestation of atma rupas or lakshanas i.e. full blown symptoms of the disease. This is also a stage wherein the physician would get a clarity about the disease, the disease can be diagnosed and named here. Even when the vata vyadhi is treated comprehensively in this stage, the physician may avoid complications and permanent damages that the disease would impart in due sequence. But the disease is harder to treat in comparison to the ‘premonitory stage’.
Read – Charaka Vatavyadhi Chikitsa 28th Chapter
Now how to know that Vata Vyadhi has been dealt with?
The ‘apayo laghuta’ is the clue for the physician to consider that vata vyadhi has eased off, at least for time being. This ‘time being’ period of the disease i.e. ‘the window period between two attacks / manifestations of the disease’ is the key for administering proper interventions and hitting hard on the disease. The aim is to make the disease to manifest less frequently and prevent recurrences. Apaya means destruction of the disease. The laghuta i.e getting weaker the symptoms of vata vyadhi is itself an indication of the destruction /apaya of symptoms and the disease comprising of those symptoms.
How do the symptoms of the vata vyadhi become weaker?
The symptoms of vata vyadhi can become weaker in two ways, either spontaneously when the disease pathogenesis is weaker or when the patient is stronger and when the conditions are favorable for recovery or with suitable interventions if the disease is of moderate or severe nature or when the patient is weaker and when conditions are unfavorable for the recovery of the disease and if the pathogenesis is stronger and demands treatment.
Read – Difference Between VataVyadhi And Other Pathological Vata Manifestations
Is the destruction of the symptoms or disease of a permanent nature?
The clue and answer for this question is given in the word ‘laghuta’. With or without interventions the symptoms of vata vyadhi would get lighter and this indicates their destruction. Here we need to see that Master Charaka has not mentioned that ‘the symptoms would go away’. He writes as ‘symptoms would get weaker or lighter’. That means in spite of proper treatment the atmarupas i.e. symptoms of vata vyadhi which had manifested would just ease down to become less severe, will get weaker but will not totally wane away. Total cure might occur in very few cases but that too might be ‘super easing down of symptoms’ and not a situation of ‘disease gone away’. In either case, vata vyadhi and its symptoms are opportunistic. Therefore apayo laghuta doesn’t essentially means ‘total absence of symptoms of vata vyadhi’.
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