Chikitsa Chatushpada


Chikitsa chatuspada or four limbs of treatment or hospital management/medical system as explained in ashtang hridayam. Goal of Ayurveda is to maintain the health of healthy persons and to root out the disease of diseased persons. To eradicate the disease, chikitsa of imbalance doshas is very necessary. In Ayurveda accomplishment of chikitsa depends completely upon four factors (Bhishak, Aushadh, Upasthata and Rrogi) which are known as chikitsa chatushpada. These chatushpada includes Bhishag, Upastha, Rogi and Dravya. Whether these chatushpada (4 limbs of treatment) prosperous with their proper qualities, then they are amenable for the cure of any kind of diseases.

Chikitsa=Treatment

Chatushpada=Chatuhu(four)+pada(limbs)

Therefore- Chikitsa chatuspada means 4 limbs of treatment

Members of Chikitsa Chatushpada- 

“Bhishak dravaani upasthaataa rogi padaa chatushtayam

Chikitsitasya nirdishtam pratyekam tat cha chaturgunam”

  1. Bhishak-doctor
  2. Dravya-Medicine
  3. Upasthata- assistant or nurse
  4. Rogi-patient

Attributes of An Ideal Doctor (bhishak)-

The vaidhya or physician is the most important limb of the medical system. The Physician should have good knowledge in all associatory sciences Along with that he should be skilled too. Bhishak is an important part of chatushpada without whom the effective treatment protocol cannot be accomplished. Only an ideal physician having good qualities always rescues patients from ocean of diseases.

The physician is a person who diagnoses the disease and plan up a line of treatment projected towards effective healing of the disease and the diseased.

According to Acharya vagbhatta-

The ideal physician should posses the following four qualities-

  1. Buddhiman –shrewdly enough to perceive the physician’s instructions and act accordingly
  2. Daksha-Alert or active
  3. Anurakta-Affection or attachment towards patient
  4. Shuchi-purity of mind and body

Qualities Of Ideal Medicine( Dravya)-

Once the disease has been identified by the doctor, the implimantation of suitable treatments for healing comes in question. Prosperity is attained by the of samyak prayog of aushadh (Medicine). Hereupon, a good Physician prosperous with the requisite qualities will prescribe medicines in a proper manner and will be showered with success in his karma. Aushadh (medicine) is also known as Bheshaj because it is known to Bhishak.

  1. Bahuta -It should be available in large quantity
  2. Yogyatam -It should be more effective
  3. Aanekvidhakalpana-Various pharmaceutical forms or multiple uses
  4. Sampat-Richness in efficacy or potency

Attributes Of Ideal Nurse (Upasthata)-

The upasthata means assistance along with the Physician is also significant for achieving success in vyadhiharan (cure of disease). The patient needs someone to take care and provide him or her with the prescribed medicine at proper time, to be affectionate, to provide good diet to offer selfless service by keeping themselves at the diposal of patient.

  1. Upachaarajnata-knowledge of caring and nursing
  2. Daakshya/Dakshta –accompished, disciplined
  3. Anuraga-affectionate and compassionate towards the patients
  4. Shaucham- clinliness, hygiene and purity

Qualities Of Ideal Patient (Rogi)-

The treatment line-up is principally drafted targeting the Patient or diseased. Thus the patient forms another significant limb of the treatment protocol. Last but not the least, among the Chatushpadas the 4h quadrant rogi also plays an important role. Because for the sake of patient only the other 3 are working. without the presence of rogi even qualified vaidya, aushadha, paricharak are having no existence. Also, the vydhiharan is to be done for rogi.

The patient undergoing treatment should possess the following four ideal qualities. He should be

  1. Smruti- good memory power to learn about instructions about medicine and its intake.
  2. Nirdeshakartva/ Bhishagvashya -obedience, ability to follow instuctions properly
  3. Abhirutva/ Satvavaan /–fearlessness, courage
  4. Jnapakatvam cha roganaam –good memory about list of health complaints/disease that he is suffering with.

Importance of Chikitsa Chatushpada:

The above said 4 are the important limbs of a 4 fold medical system / pillars of a treatment protocol. The absence of any one of the four limbs (pada) doesn’t fulfill the format of treatment or rather becomes meaningless.

The whole system will be imbalanced and will be a failure if one or more of the above said 4 limbs fails to work to perfection or if they are inadequately equipped or if they are not working to their best

According to Ayurveda, all Chatushpad equipped with their sixteen qualities are responsible for the success in treatment. Still the Vaidya, by the morality of desirous knowledge of medical science, administrative position and by prescribing capacity occupies the most important position among them. Drug plays important role in the success of treatment. The drugs are the tools of a Physician. So it is rightly called as the weapon of the Vaidya.

From above all references, we can say that, to get success in treatment four pillars are very important.