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INTRODUCTION
Identity of Hrd Roga was established from While it seems that according to
the vedic period (2400 B.C), reference predominance of signs and symptoms
regarding the treatment of heart diseases diseases which have chief complains of
were available in Atharva Veda but signs, oedema with the complaints pertaining to
symptoms and pathogenesis were heart are described under Vatik Sotha, and
completely missing. In Atharva Veda word those having dyspnea in association to
HIRA is used for Sira (Veins) and complaints pertaining to heart under Swasa
Hrdayagata Yaksma is described. Roga. Similarly the diseases/syndromes
marked by severe pain appear to have been
In Ayurvedic samhitas and Puranas (1000 described under Hrcchula. More extensive
BC to 500 AD) observations have been description of Hrda Roga is present in
recorded regarding the concept, Caraka Samhita.
manifestations and management of Hrdaya
Roga. While the Medieval period a As the name indicate Hrda Roga is the
simplification of the knowledge already disease of Hrdaya which is considered to be
rendered in the classical age is found. An heart in this context. This Hrdaya is placed
account of general features, signs and in the thoracic cavity. Left to it are Pliha
symptoms of five types of heart diseases and Fuffusa and right to it are Yakrta and
(Vataja, Pittaja, Kaphaja, Sannipataja and Kloma2, it beats3. It is a Matrija organ and
Krmija), definition of heart diseases, Rakta and Kapha contributes to its
aetiology, pathogenesis and management formation4.
have been described in Carak Samhita,
Susruta Samhita and Astanga Hrdaya. Ruja This Hrdaya is the special seat of Sadhaka
samanyatva is present in all these diseases1. Pitta, Avalambaka Kapha and Vyana Vayu.
TABLE NO. 1
Features of Hrcchula.
Clinical manifestations of heart disease have been described in to two parts. Firstly, the common
clinical features have been innumerated which are likely to be present in all types of heart
diseases. Secondly the distinguishing features of different types of Vataja, Pittaja, Kaphaja,
Sannipataja and Krmija have been dealt with. Majority of the features are constitutional
symptoms. A list of these signs and symptoms is given below with their modern equivalence.
From their study it seems that the symptoms encountered today in relation to heart disease are
already included in Ayurvedic classic13,14,15,16.
In Vatika HRDA Roga pain has been described as the main feature. The character of pain also
mentioned herewith full description. Relation of pain with food has been also observed. In
Vatika Hrda Roga dyspnoea, palpitation and tachycardia are usually observed.
TABLE NO.3
Clinical Features of Vatika Hrda Roga
In addition to Samanya Rupa of Hrdroga, in this type heart burn, bitter taste in mouth,
eructations with bitter and sour taste, exhaustion, thirst, unconsciousness, giddiness and
perspiration occurs. We could understand this as a type of Hrda Roga in which pain precipitated
following Gastric Symptoms.
TABLE NO.4
Clinical Features of Paittika Hrda Roga
General Symptoms:
Udgara eructations
In this type symptoms are bradycardia, stiffness and heaviness of the heart, drowsiness, and
anorexia and a feeling of loaded with stones. Although presence of pain is necessary in this type
of disease also as Ruja is the Samanya Laksana or Hrda Roga but in this type pain seems to be
dull in nature with subacute symptoms.
TABLE NO.5
Clinical Features of Slaismika Hrda Roga
Jvara Fever
Tandra Torpor
Stabdha Fixicity
Nidra Sleepiness
Alasya Lassitude
Sannipatika type of heart disease stated as very painful and difficult to cure as it is caused by
combination of all three dosas. It have clinical features of all three types of Hrda Roga.
Caraka mentions, acute pain (Uttama Rujan) as one of the main symptoms of Vatika Hrda Roga
in general way. But acute type of pain of different intensities which may threaten the life of
patients has been described in relation to Krimija Hrda Roga. The nature of pain mentioned in
the above reference of Caraka Samhita seems to be of quite intense degree. The technical terms
TABLE NO.6
Clinical Features of Krmija Hrda Roga
REFERENCES
6. Susruta Samhita Sutra Sthana 15/38. 12. Susruta Samhita Uttara Tantra
42/132.
7. Caraka Samhita Sutra Sthana 23/5.
13. Astanga Samgraha Nidana 5.
20. Caraka Samhita Sutra Sthana 22/30. 26. Susruta Uttar Tantra 43/20.