1.
...Sva Prakopak hetus of each urbance or prakop of each of three Doshas......result in a condition called Sannipaata. As it is caused by hetus of each of the doshas.....the condition is almost always grave and asaadhya.
This is pretty clear from tge ref Vimaan sthaan 6/11 guiding as anubandh evam anubandhya dosha.
...a proper history can lead us to find the hetus possibly weather they are of one or two or all three doshas. Althogh its very difficult but not impossible. I have experienced this in many clinical conditions.
2
...Knowing the condition as Sannipaataj gives us a clue that the treatment is going to be difficult and probability of cure is very very less. We can guide our patient as per this.
3.
...Tridoshaj Vyadhi means when all the tridoshas get involved in the said clinical presentation by any means weather statted from single dosha prakop leading to involvement of other doshas in the process OR directly from some other hetu. Here this is not necessary that the patient has consumed the hetus of each of the three doshas. He might have indulged more in the kaphavardhak hetus for examole which at the end disturbed the pitta and vaata dunctions...e.g prameh changing to madhumeh.
4.
..There can be some other indirect reasons to result in a tridoshaj vyaadhi e.g. santarpanjany vyadhis or some kind of maarga avarodh.
5.
...Tridoshaj vyadhis may not be fatel always, there are symptoms of each dosh but they can be managed generally as per the prakope of the dosha in the presenting stage of the condition or as confirmed by tge attending physician e.g. metabolic syndrome.
6.
...A tridoshaj vyadhi when becomes fatel it can be synonymicaly called as Sannipaataj as we can see in Tridoshaj Gulma.
7
...Treatment of tridoshaj vyadhis is possible generally as one or the 2 doshaj hetus are causes and we can apply hetu viprita chikitsa or we can do the treatment of other hetus like santarpan or sometimes maargaavrodh to manage tridoshaj vyadhis.
8.
....But in sannipaataj vyadhi....they are almost asaadhya as....each of the three doshaj hetus have been causing the disease.....and it is almost impossible to apply hetu viprita chikitsa as this becomes antagonistic to each other.
9
...Vyadhi viprita chikitsa also becomes difficult in such a case because the disease might have progressed to a level of Dhaatupaaka. We see this in many autoimmune disorders now a days, let it be multiple myoloma or multiple sclerosis or SLE or many such syndromes.
Vaidya Pawan Madaan
