Ayurpharm Int J Ayur Alli Sci., Vol. 4, No.

2 (2015) Pages 29 – 34
www.ayurpharm.com
ISSN: 2278-4772

Review Article

A REVIEW ON TRIVIDHA ROGAMARGA & ITS ROLE IN

MANIFESTATION OF DISEASE

Vilas Kad1, Tushar Auti2*

1. Professor & Head, Dept. of Roganidana Avam Vikruti Vigyan, SVNHT’s Ayurved College, Rahuri,
Ahmednagar, Maharashtra, India.
2. PG Scholar, Dept. of Roganidana Avam Vikruti Vigyan, SVNHT’s Ayurved College, Rahuri, Ahmednagar,
Maharashtra, India.

Received: 14-10-2014; Revised: 20-11-2014; Accepted: 22-12-2014

………………………………………………………………………….………….……….……………………..

Abstract

Ayurveda is science of life. It emphasizes on preventive aspect rather than curative treatment. The subject
Rogamarga (disease pathway) indicates relationship between different tissue and organ in a unique way.
Morbid state of Dosha (toxins) which is motivates in a specific way with a specific affinity towards the
selected tissue and organ. The concept is traced in ancient Ayurveda books. This is an objective approach of
ancient scientist helping for the clinical practice. The subject is vast but it is traced in short. Present day
student cannot study and learned the vast subject in a time based period. So through this article we have made
an attempt to highlight its importance in clinical practice. Some of the important Sanskrit shloka (verse) are
presented in picture form. This article highlight the summery based on the concept of Trividha Rogamarga
(three disease pathway).

Keywords: Roga Marma (disease pathway); Koshtha (gastro intestinal tract); Manifestation.

………………………………………………………………………………….….……………………………...

*Address for correspondence:

Vd. Tushar S. Auti,
Dept of Roganidana Avum Vikruti Vigyan,
SVNHT’s Ayurved College,
Rahuri, Ahmednagar, State – 413 706
E-mail: dr.autitusshar@gmail.com

Cite This Article

Vilas Kad, Tushar Auti. A review on trividha rogamarga & its role in manifestation of disease.
Ayurpharm Int J Ayur Alli Sci. 2015;4(2):29-34.

Ayurpharm - International Journal of Ayurveda and Allied Sciences 29

 Ayurpharm Int J Ayur Alli Sci., Vol. 4, No. 2 (2015) Pages 29 – 34
www.ayurpharm.com
ISSN: 2278-4772

INTRODUCTION This plays as the important role in the

treatment of disease in Ayurveda.
Ayurveda is the ancient and well documented Understanding of Rogamarga (disease
science, which priory insists upon the pathway) which involved in manifestation of
prevention of the diseases rather than adopting disease guides us about Roga Vinishchaya
the curative measures. In our classics the very (diagnosis), Sadhya-Asadhyata (curability)
basic definition of Swasta (health) is defined and Chikitsa (treatment) of disease.
as the equilibrium state of Dosha, Dhatu, Agni
(digestive fire) and Mala (Body waste) as well According to Charaka there are three types of
as the pleasant state of Aatma (soul), Indriya Rogamarga (disease pathway).[3] They are
(sense organs) and Manas (mind).[1] At the
same time due to various causes, the Dosha 1. Shaka (branches)
attaining the Vikruta avastha (abnormal state) 2. Marma, asthi, sandhi (vital organs,
leading to the chain of events so called bones, joints)
Samprapti (pathophysiology), ultimately 3. Koshta (gastro intestinal tract)
leading to the manifestation of disease. This
state is termed as Roga (disease), which is 1. Shakhagata rogamarga
nothing but contrary to health. To understand
and to diagnose the Roga (disease) at its full Charaka considered Twak (skin), Raktadi
stretch, we need to rely upon the Samprapti (blood etc.), Dhatus in this Rogamarga
Ghatakas (Pathological factor) starting from (disease pathway) which known to be
Dosha, Dushya, Agni and Rogamarga (disease Bahya (external) Rogamarga (disease
pathway) etc. pathway).[4]

Once the Rogamarga (disease pathway) is 2. Marma, Asthi, Sandhi (vital organs,
understood properly the pathology can be bones, joints)
judged at its initial stage itself can be treated
easily. These all things are the fundamentals Marmas like Basti (bladder), Hridaya
of Ayurveda. (heart), Sira (vein) i.e. three Marmas
(three vital) and also Asthi (bone), Sandhi
The word Rogamarga (disease pathway) is (joints), Snayu (muscle), Kandara
derived into two i.e. roga+marga=Rogamarga (ligament) are Madhyama Rogamarga
(middle disease pathway).[5]
Roga (disease) means which causes pain. Also
Roga (disease) is disequilibrium of the Doshas 3. Koshtagata Rogamarga (middle trunk
while the health is equilibrium of Doshas.[2] disease pathway)
Charaka explains abnormality is
disequilibrium of Dhatu and their equilibrium Charaka has considered Mahanimn
is normal health. Health is known as happiness Madhya (middle trunk) and Pakwashaya
while disorder is unhappiness. (large intestine) etc. are the Paryaya
(synonym).
Marga means pathway. The pathway of
disease considered to be as Rogamarga According to Vagbhata it has been
(disease pathway) is understood properly and considered Antha koshta (intestine) i.e.
pathology can be judged at its initial stage Amashaya (stomach) and Pakwashaya
itself can be traced easily. Trividha (large intestine) and Manasrotas (mind
Rogamarga (disease pathway) is the important channel) in Abhyantara Rogamarga
entities involved in the process of disease. (internal disease pathway).[6]

Ayurpharm - International Journal of Ayurveda and Allied Sciences 30

 Ayurpharm Int J Ayur Alli Sci., Vol. 4, No. 2 (2015) Pages 29 – 34
www.ayurpharm.com
ISSN: 2278-4772

Sushruta mentioned Amashaya (stomach), takes as it spreads or manifests. This means

Pakwashaya (large intestine), Agnashaya that every disease has an affinity for certain
(pancreas), Mootrashaya (urinary bladder), tissues and organs and this understanding can
Raktashaya, Hridaya (heart), Unduka greatly help in diagnosis.
[7]
(appendix), Phupusa (lungs) etc.
The body has three types of disease pathways,
Charaka also mentioned the Rogas (disease) as which are, Bahya (External), Madhyama
per the Rogamarga (disease pathway). So the (Middle), Abhyantara (Internal). The basis for
Trividha Rogamargas (three disease pathway) disease pathways is the movement of the
are the need of an hour in understanding of Doshas.
disease process.
Bahya or Shakagata roga marga (External
AIMS AND OBJECTIVES course)

 To study the concept of Rogamarga The term Shakha means branches of a tree. In
(disease pathway). the body, this relates to the peripheral system
 To study the role of Trividha comprising blood, tissues and skin, which is
Rogamarga (three disease pathway) in spread throughout the body like branches of a
manifestation of disease. tree. The diseases, or conditions, that follow
 To study whether the Shakhagata Roga this route are tumors, skin diseases, leprosy,
(external disease pathway) gets erysipelas, swelling etc. This can also be
converted into Koshtagata Rogamarga termed as the external course for diseases.
(internal disease pathway) or not.
Madhyama roga marga (Middle course)
This conceptual study will be helpful in
management of the various progressive This pathway includes vital organs, such as
chronic diseases. head, sensory organs, bladder, as well as the
bones and joints. The diseases that take this
MATERIAL AND METHODS Marga (pathway) are paralysis, bladder
conditions, diseases of the nerves, emaciation,
Source of data coryza (symptoms of head cold), joint pains,
prolapse of the rectum, diseases related to the
This is a literary research study. In this all the head, and aggravated pain in the scapular
references from samhitas and respective region.
commentaries regarding “a review on Trividha
Rogamarga (three disease pathway) and its Abhyantar roga marga (Internal course)
role in manifestation of disease is compiled.
This pathway is defined as the region
The various Ayurvedic classical texts like extending from the buccal cavity (the mouth)
Charaka samhita, Sushruta samhita, Ashtang to the anus. According to Sushruta, this
hrudaya, Ashtang sangraha, Madhavanidana, includes the large and the small intestines, the
Bhavaprakasha, Research papers, Authentic digestive and the urinary systems, as well as
website and indexed journals were screened. the circulatory and respiratory systems,
including heart, liver and the lungs. The
Conceptual study diseases that use this pathway are fever,
diarrhea, vomiting, cholera, cough, dyspnea,
Roga Marga literally disease pathway, is hiccoughs, among others.
defined as the specific route that a disease

Ayurpharm - International Journal of Ayurveda and Allied Sciences 31

 Ayurpharm Int J Ayur Alli Sci., Vol. 4, No. 2 (2015) Pages 29 – 34
www.ayurpharm.com
ISSN: 2278-4772

Significance of roga marga (disease According to Ashtanga Hridaya

pathway)
1. 7 diseases are mentioned as
1. The knowledge of Roga marga Shakhagata rogamarga because the
(disease pathway) aids the Adhisthana of these diseases are in
understanding of the movement of the Twak and Raktadi Dhatus.
Doshas, thereby the process that a 2. 5 diseases are mentioned as Madhyama
disease follows, and therefore its rogamarga because Adhisthana of
diagnosis. these diseases are in three Marmas and
2. It facilitates the knowledge about the also in Asthi and Sandhi.
prognosis of diseases in the respective 3. 8 diseases are mentioned as Abyantara
Roga Marga (disease pathway). rogamarga because the Adhistana of
Diseases caused by a single Dosha that these diseases are in Anth koshta i.e.
afflict a specific Roga Marga (disease Amashaya, Pakwashaya and
pathway) point to a good prognosis. Mahasrotas.
3. Any disease occurring in the Marma 4. Vagbhata also considered Gulma and
(Vital parts) is the sign of bad Shofa both in Abhyantar and Bahya
prognosis. Rogamarga.[9] (Table 2)

According to Charaka samhita Doshanam koshtat shakhadi gamanam

1. 14 diseases are mentioned as According to Charaka there are mainly 4

Shakhagat roga / Bahyamrgaj roga. reasons for the Dosha enters into Shakha from
Because the Adhistana of this disease Koshta are excessive exercise, excessive heat,
are in Rakta, Mansa, Meda, Asthi, improper way of ahara vihara (food and
Majja, Shukra and Twak which are activities) and excessive Vata gati.[9]
known to be Shakhagata Rogamarga.
2. 13 diseases are mentioned as Marma, Doshanam shakhadibhya
Asthi, Sandhigata / Madhyama koshtabhigamanam
rogamarga. Because the Adhisthana of
this disease are in Mutrashaya, According to Charaka there are five main
Hridaya, Murdha, Kantha, Nabhi and reasons for the dosha enters into koshta from
Guda i.e. (Marma Sthana) and also Shakha. They are Vata prakopa, Vishyandan
Asthi, Sandhi, Snayu, Kandara, are (Secretion), Dosha-paka (maturation of
known to be Madhyam Rogamarga. doshas), Srotomukha Shodhana (channel
3. 10 diseases are mentioned as cleaning), Vayu Nigrahan (Subtraction of
Koshtagata / Abhyantar Rogamarga. vitiated Vata).[10]
Because the Adhishthana of these
diseases are in Mahasrota, Amashaya, DISCUSSION
Pakwashaya, are known to be
Abhyantara Rogamarga. In the manifestation of disease it is necessary
4. Charaka also considered Visarpa, to rely upon the Samprapti Ghataka
Shotha, Gulma, Arsha, Vidradhi, as (pathological factor) mainly the Trividha
both in Bahyamargaja and Abhyantara Rogamarga (three disease pathway). If it is
Margaja roga.[8] (Table 1) able to understand the Trividha Rogamarga
(three disease pathways) properly, the
pathology can be judge at its initial stage and
it will help to treat the diseases easily.

Ayurpharm - International Journal of Ayurveda and Allied Sciences 32

 Ayurpharm Int J Ayur Alli Sci., Vol. 4, No. 2 (2015) Pages 29 – 34
www.ayurpharm.com
ISSN: 2278-4772

Table 1: Rogamarga (disease pathway) according to Vyadhi (disease)

Sr. Bahya Madhyam Abhyantar

Vyadhi
No. Rogamargaja Rogamargaja Rogamargaja
1 Galaganda (goitre) Yes No No
2 Pidaka (pimples) Yes No No
3 Alaji (skin disease) Yes No No
4 Apachi (skin disease) Yes No No
5 Charmakil (skin disease) Yes No No
6 Adhimamsa (Lypoma) Yes No No
7 Mashaka (skin disease) Yes No No
8 Kushtha (skin disease) Yes No No
9 Vyanga (deformity) Yes No No
10 Visarpa (skin disease) Yes No Yes
11 Shotha ( inflammation) Yes No Yes
12 Gulma (tumour) Yes No Yes
13 Arsha (piles) Yes No Yes
14 Vidradhi (abscess) Yes No Yes
15 Pakshavata (paralysis) No Yes No
16 Pakshagraha (paralysis) No Yes No
17 Apatanaka (lock jaw) No Yes No
18 Ardita (facial palsy) No Yes No
19 Shotha (inflammation) No Yes No
20 Rajayakshma (tuberculosis) No Yes No
Asthi-sandhishula (bone joint
21 No Yes No
disorder)
22 Gudabhramsh (rectal prolapse) No Yes No
23 Shiro-roga (female disorder) No Yes No
24 Hrud-roga (heart disease) No Yes No
Basti-roga (urinary bladder
25 No Yes No
disorder)
26 Jwara (fever) No Yes No
27 Atisara (diarrhea) No Yes No
28 Vamana (vomiting) No No Yes
29 Alasaka (abdominal discomfort) No No Yes
30 Visuchika (penetrating pain) No No Yes
31 Kasa (cough) No No Yes
32 Shwasa (dyspnoea) No No Yes
33 Hikka (hiccup) No No Yes
34 Anaha (abdominal discomfort) No No Yes
35 Udara-roga (abdominal disease) No No Yes
36 Pliha-roga (spleen disorder) No No Yes

Thus the proper knowledge of Trividha The Doshas comes into Kostha from the
rogamarga (three disease pathway) helps in Shakha they will remain there for same time
the manifestation of various diseases. Also the waiting for the some powerful cause and after
knowledge of Trividha Rogamarga (three deriving strength from Kala, Artha, Karma etc.
disease pathway) is helpful for finding the it gets aggravated even in other places. So by
Sadhya-Asadhyatwa of disease. this Shakhagan Roga (external) gets converted
into Koshtagat Rogamarga (internal).
By the effect of clearance of channels great
increase in the quantity liquefaction
transformation and mitigation of Doshas.
Ayurpharm - International Journal of Ayurveda and Allied Sciences 33
 Ayurpharm Int J Ayur Alli Sci., Vol. 4, No. 2 (2015) Pages 29 – 34
www.ayurpharm.com
ISSN: 2278-4772

Table 2: Rogamarga (disease pathway) according to Vyadhi (disease)

Sr. Bahya Madhyam Abhyantar Roga

Vyadhi
No. Rogamargaja Rogamargaja margaja
1. Galaganda (goitre ) Yes No No
2. Alaji (skin disease) Yes No No
3. Arbuda (tumour) Yes No No
4. Gulma (Abdominal tumour) Yes No Yes
5. Shofa (swelling) Yes No Yes
6. Masaka (skin disease) Yes No No
7. Vyanga (Melasma) Yes No No
8. Rajayakshma (tuberculosis) No Yes No
9. Pakshavadh (paralysis) No Yes No
10. Ardita (facial paralysis) No Yes No
Sandhi-asthi-trikshul (bone and
11. No Yes No
joint disorder)
12. Murdhadiroga (chest disorder) No Yes No
13. Chardi (vomiting) No No Yes
14. Atisara (diarrhea) No No Yes
15. Kasa (cough) No No Yes
16. Shwasa (dyspnoea) No No Yes
17. Udarda (skin disease) No No Yes
18. Jwara (fevar) No No Yes
19. Visarpa (cellulitis) No No Yes
20. Vidradhi (abscess) No No Yes

CONCLUSION
2. Subhash Ranade. Ayurvediya Vikritivigyan.
The proper knowledge of Trividha Rogamarga 2nd ed. Pune: Anmol Prakashan; 2007.p.58.
(three disease pathway) helps in the 3. Charaka. Caraka Samhita. Gorakshanath
manifestation of various diseases as well as to chaturvedi, editor. 1st ed. Delhi: Chaukhamba
diagnose the diseases. Through the knowledge Sanskrit Prathisthan; 2008.p.177.
4. Charaka. Charaka samhita. Ravidatta Tripathi,
of Trividha Rogamarga (three disease editor. 1st ed. Delhi: Chaukhamba Sanskrit
pathway) is helpful for the Sadhya- Prathisthan; 2004.p.177.
Asadhyatwa of disease and also plays an 5. Charaka. Charaka samhita. Ravidatta Tripathi,
important role in the treatment. The physician editor. 1st ed. Delhi: Chaukhamba Sanskrit
who is diagnosing a disease and treat Prathisthan; 2004.p.177.
6. Vagbhata. Ashtang Hridaya. Yadunandan
accurately according to Rogamarga (three Upadhyaya, editor. 1st ed. Varanasi:
disease pathway) will be successful Chaukhamba Sanskrit Sansthan; 1987.p.180.
practitioner. Because of Samhita Roopa a 7. Sushruta. Sushruta samhita. Anatram Sharma,
Vridhi Doshas inters into Shakha from Koshta editor. 1st ed. Varanasi: Chaukhambha
and because of Vilayana Roopa Vridhi Doshas Surbharati Prakashan; 2008. p.176.
8. Sushruta. Shushruta samhita. Anantram
inters into Koshta from Shakha. Sharma, editor. 1st ed. Varanasi: Chaukhamba
Surbharati Prakashan; 2008. p.177-178.
REFERENCES 9. Subhash Ranade. Ayurvediya Vikritivigyan.
2nd ed. Pune: Anmol Prakashan; 2007.p.50.
1. Sushruta. Shushruta samhita. Anantram 10. Subhash Ranade. Ayurvediya Vikritivigyan.
Sharma, editor. 1st ed. Varanasi: Chaukhamba 2nd ed. Pune: Anmol Prakashan; 2007.p.52.
Surbharati Prakashan; 2008. p.130.

Source of Support: Nil Conflict of Interest: None Declared

Ayurpharm - International Journal of Ayurveda and Allied Sciences 34