Karana Pariksha – Examination Of Treatment Instruments and Medicines

Dr Raghuram Y.S. MD (Ay) & Dr Manasa, B.A.M.S
Karana means equipment or medicines. It is the second factor to be examined in accordance with the ‘tenfold’ factors to be examined i.e. Dashavidha Parikshya Bhavas as explained by Master Charaka.

The first factor to be examined is Kaarana i.e. cause for establishing the equilibrium of tissues and body components of the patients and establishing health in them. The physician who works in this perspective is called a kaarana. Karana is that which is used by the kaarana. This means to tell that the physician uses these equipment in the treatment process. Before he uses them they should be thoroughly examined.
Read – Karana (Pramaana): Amenities For Comprehensive Knowledge

Definition, Meaning of Karana

Those equipment (medicines) which help the doer (physician) who is putting all efforts towards accomplishment of an action (treatment) are considered as karana.

Master Charaka says that the medicines are called karana. It is very clear from the concept that these would be the most valued equipment a physician would like to have in hands to deal with ailing subjects. Without proper medicines the physician cannot do much to bring the balance of body components and establish health in an ailing individual.

Bheshaja as karana

Further describing the medicine master Charaka says ‘anything which helps the physician in achieving his goal of establishing balance of body components and health in the ailing individuals or for balancing the health in already healthy individuals is called medicine. This medicine is itself the instrument of treating the diseases’.

Bheshaja or medicine should be considered as different from the other factors i.e. karyayoni, desha, kala, pravrutti and upaya. All these are also the factors to be examined as per tenfold examination explained by Charaka.

This explanation also indicates that these factors too can help the physician in attaining his goal of establishing equilibrium of body components and establishing health in the patients and they too can be considered as karana – equipment to be examined. But since they are separately explained only the medicines shall be considered as the ‘to be examined’ equipment / instrument i.e. karana.
Read – Definition of Ayurvedic Herbal Pharmaceutics – Bhaishajya Kalpana

Why do other mentioned factors not count as karana in spite of them being helpful for the physician?

Karyayoni means source of action i.e. disease / imbalances in tissues and body components on which the physician operates. So karyayoni is the target for the physician to operate on. But without a disease being diagnosed the physician cannot do anything in terms of implementation of treatment. Therefore the presence of a disease or imbalance in the body components gives a target for operation for the physician and helps him in accomplishment of his task. Since the disease helps him in offering a territory of operation in the treatment process it should be a karana. But it is not! Master Chakrapani clarifies that though the presence of the disease is a must for the physician to operate it cannot be considered as karana. Since the karyayoni expresses in the form of and causes the disease i.e. it represents a state of imbalance and disturbance it is totally different from the most effective karana i.e. medicines.

Since pravritti i.e. initiation of action and upaya i.e. means of action have the nature of both the doer (physician) and the instrument, they cannot be considered as pure instruments. Later we would learn from Master Charaka that the initiation of action includes involvement of not only physicians but also medicines, patients and attendants. The integral association of all these 4 components towards initiation of treatment is called pravritti. On the other hand, upaya is an extension of pravritti. Though it comprises medicine, like pravritti it too is not a pure instrument due to the association of other 4 components. The integrated approach by the physician, medicine, patient and attendants adorned with their best qualities towards establishment of health (collective effort) is called as upaya. Therefore pravritti and upaya are different from karana and they are not synonymous.

Similarly the desha i.e. habitat and kala i.e. time factor are not the most effective instruments in the process of treatment and shall not be considered as instruments of treatment.

Therefore only those which help a doer i.e. physician in accomplishing his task of implementing treatment should be considered as instruments.
Read – Roga, Rogi Pareeksha: Examination Of Disease And Patient

Types of Medicines

Medicine is of two kinds. They are –

A. Ashraya Bheda – classification on the basis of source / practice

1. Daivavyapashraya – Divine therapies / Godly based treatments

This mainly includes non-medicinal therapies. They include –
Mantra – chanting the sacred hymns
Aushadha dharana – wearing / tying the medicinal herbs on body parts
Mani dharana – wearing gems and precious stones having medical effects on body parts
Mangala – auspicious rituals
Bali – sacrifice rituals / any offering offered during worship
Upahara – kind of religious service, offering, oblation
Havana – offering oblation to fire God
Niyama – practices of self restraint
Prayaschita – atonement / expiation
Upavasa – fasting
Swastyayana – reciting mantras for good luck and prosperity
Pranipata – salutation / reverence / prostration / humble submission and falling at the feet of Gods, teachers, elders etc
Gamana – traveling / visiting pilgrimages, temples, religious shrines for offering prayers etc
Read – Daiva Vyapashraya Chikitsa – Divine Therapies of Ayurveda

2. Yuktivyapashraya – Administration of medicines, diet and regimens in skillful way.
This comprises interventions whose effects and results are readily visible / evident. This mainly comprises of –

a. Samshodhana – purification therapies which includes Panchakarma therapies i.e.
Vamana – therapeutic emesis
Virechana – therapeutic purgation
Niruha / Asthapana Vasti – decoction / evacuation enemas
Anuvasana Vasti – unctuous / oil enemas
Nasya – nasal medication / errhines

b. Samshamana – palliative treatments – includes therapies like anointment of medicinal pastes, showering of medicinal liquids on the body parts, ama digesting measures and medicines etc

c. Sattvavajaya – measures taken to control one’s mind and keep it diverted from incompatible and unwholesome things and subjects
Read – Chikitsa: Treatment Types, Ayurvedic classification

B. Ashraya Bheda – classification on the basis of form

This too comprises medicines of two kinds. They are –

a. Dravyabhuta – in this, medicines / herbs will be used in the treatment of diseases
b. Adravyabhuta – In this, no medicines will be used in the treatment of diseases. Different methods are used in treating the diseases. They are –

Bhaya darshana – creating fear in the person
Vismapana – surprising / shocking / astonishing a person / creating an illusion
Vismarana – making the person to forget the things which he often thinks of and gets stressed
Kshobhana – disturb one emotionally
Harshana – cause excitement
Bhartsana – insult / scold
Vadha – beat or act like hitting someone
Bandhana – tie up the person with ropes etc
Svapna – make the person to sleep / sedate
Samvahana – touching or pressing the body of the person in a soothing and pleasant way

The attendants who help in recovery of the patients by serving them with dedication also come into this category. All those who serve the patient and pray for his or her recovery also shall be included in this ‘formless / non-medicinal therapies’.
Read – 10 Factors Of Patient Examination – Dasha Vidha Atura Pareeksha

Examination of Karana – medicines

The medicines used in the treatment of the diseases are the most important tools for establishment of health and equilibrium of body components for a physician. The medicines with form shall be examined for their efficacy. The medicines which are rich with ideal qualities and properties shall be used in the treatment process and only they shall yield good results in the treatment process. The medicines having form shall be used in the cleansing and palliative treatments.

Karana Pareeksha – The examination of medicines shall be done by examining below mentioned aspects –

Prakruti – nature of the herb / drug
Guna – qualities of the herb
Prabhava – effect of the medicine
Desha – geography of the medicine / the habitat in which the medicine is grown
Rutu – season in which the medicine had grown and collected
Gruhita – the way in which the herbs have been collected
Nihita – the way in which the herbs are stored
Upaskrita / samskara – the methods in which the medicines / formulations are prepared using various methods of processing the medicines
Matra – dosage in which the medicines shall be used
Vyadhi prayoga – diseases in which the medicines shall be used
Purusha – persons in which particular herb or medicines / formulations can be used
Doshapakarsha – the quantity of doshas the medicines can expel out of the body and which medicines are capable of flushing out the morbid doshas
Dosha upashamana – which medicines are capable of suppressing (palliative) the doshas and in what proportions they can accomplish it

Any medicines having form and have been subjected to these examinations / tests, should be included for usage in treatments of diseases.
Read – 11 Factors That An Ayurveda Doctor Considers To Decide On Treatment

Sanskrit Verses

Karana in terms of research

Just as the medicines are the instruments for a physician to accomplish the action of treatment successfully, the ‘research methods’ employed by the researcher during the course of doing the research shall be considered as the instruments i.e. karana of research. All methods used by the researcher while studying the research problem are called research methods. The physician too is a researcher. In the above said context, while considering the medicines are karana, he would use the methods of examination explained by master Charaka to make sure that the given herb, medicine or formulation exactly fits into the treatment process to treat a given problem (disease). He needs various methods, skills and knowledge of examining those herbs and they form the research methods. Reasoning alone is not sufficient in research works. Scientific research methods need precise explanations which are based on collected facts, measurements and observations.
The products under investigation and procedures under trial are also considered as karana.
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