The doubt might arise in case of determining the nature of the disease. In such a condition Upashya is very useful to ascertain the nature of the disease. For example, when the doubt arises regarding the nature of the predominant dosha i.e. whether it is vata dominance or pitta dominance or kapha dominance, then upashya comes into play. To be confirmed, vata diseases occurs due to imbalance in vata and the physician takes anti-vata measures like he will prescribe the patient with anti-vata medicine or snigdh (slimy) diet or advice him a panchkarma treatment like 'snigdh swed' etc. If the disease condition is improved by this treatment, then the tentative diagnosis of the physician is confirmed. This is called Upashya.
The physician then gets assured that he is proceeding in the proper direction and can pursue the treatment in anti-vata measures in vigorous manner. Thus upashya is the medicine, food, panchkarma therapy or the life style modification, which gives relief from the disease. But sometimes it might occur that the patient's problems are aggravated by following the method and then it is called anupshya. In such a condition the treatment should be immediately stopped. Thus when anupshya is known the physician is able to take an entire different course of treatment. This type of experimentation can only be done by the expert ayurvedic physician and not by everyone as this involves complete knowledge of ayurvedic medicine.Ancient Maharishi Chakrapani mentioned this kind of diagnostic method should be the last option for the intelligent ayurvedic physician to diagnose the disease with hidden symptoms.
Upashya can be defined as the continuous sequence of relief from the disease attained by the use of Ausudh(medicine) or Aahar(food) or Vihar(lifestyle). Upashya brings permanent cure not the temporary relief. For example, ahifen (opium) can be taken as it give temporary relief from headache but it is not a permanent cure as it does not solve the cause by which headache is generated.
Upashya is also called Vyadhisatmya, which means conductive to the welfare of the patient by giving relief from the disease.
There are six types of Upashya- Hetuvipareetha, Vyadhivipareetha, Hetu Vyadhipareetha, Hetuvipareetthaarthakari, Vayadhivipareetharthakari, Hetuvyadhivipareetharthkari.
Hetuvipareetha (against the cause)
It is the minute and detailed study of the cause of the disease. Certain methods like aushadh (medicine), aahar(food) and vihar(lifestyle) should be designed to fight with the cause of the disease, which is called Hetuvipareetha and this is further divided into three parts-
* Ausadh (medicine)- Kapha disease is caused by 'sheet' (cold) and cured by administration of Sunthi (dried ginger) that has ushan (hot) quality.
* Aahar(diet)- The use of maasam rasa or meat juice is useful in fever caused by fatigue and it removes the fatigue, the main cause of the fever.
* Vihar (lifestyle)- Divasayan (excessive sleep in day time) is the cause of Kapha type disease. Here the remedy is act of keeping awake in night, which counteracts kapha as it aggravates vata.
Vyadhivipareetha (against the disease)
The careful examination of the nature of the disease through its symptoms, medicines etc. The administration of Ausadh(medicine), aahar (diet), vihar(lifestyle) all are included under Vyadhipareetha. Again it is divided into three types:
* Ausadh (medicine)- Administration of kashaya(astringent) rasa as the dominent supplement in case of diarrhoea is called Ausadh e.g. kutaja in atisaar (diarhhoea), khadir in kushth(skin disease) and sireesh in visha(poisoning). In these cases the medicines given are specific for the certain diseases hence they are administered blindfold irrespective of the nature or abnormality of the dosha.
* Aahar (food)- In case of indigestion soup made out of kali marich (pepper nigram)is very useful. Intake of Sunthi mixed in vegetable also helps to get rid of indigestion.
* Vihar(Lifestyle)- in case of severe constipation and pain in abdominal region due to disturbed peristaltic movements in the lower gastro-intestinal tract the act of 'straining the rectum part while passing the stool' is advised in udaavartham.
Hetu Vyadhivipareetha (against both cause and diseases)
In some cases both cause and the results have to be considered. All the three factors i.e. medicine, diet and lifestyle are to be arranged in such a way that they can deal with both disease and cause.
* Ausadh(medicine)-When Vatashotha or inflammation caused by vata occurs, the usage of dashmoola (combination of ten herbs)is recommended that is both vata hara(suppresses vata)and sodhra( antiphlogistic). Here dashmoola is the remedy for checking the cause(vata) as well as the disease shotha(inflammation).
* Aahar (food)- In case of vata kapha dominent 'grahnee'roga (trouble related to duodenum), ingestion of 'takra'(skimmed buttermilk) is prescribed to control diarrhea. Here skimmed buttermilk fights against both the cause and effect i.e. the cause-vata and kapha and checks the effect diarrhoea also.
* Vihar(lifestyle)- When excessive sleep occurs by greater intake of snigdh(oil) food, the act of remaining awake at night is recommended. This promotes 'rookshan'(dryness) of mind and body that is helpful for counteracting snigdh (oily) food and thus it opposes both cause and the disease.
Hetuvipareethaarthakari- The word 'arthakari' means similar or same.It is the type of upashaya where medication, diet and lifestyle is prescribed is similar to the cause of the disease. This type of upashya ultimately produces the same result as caused by hetuvipareetha upashya. 'Artha' means purpose. As this form of medicine serves the same purpose like cure of the disease as caused by hetuvipareetha medicine etc it is termed as hetuvipareethaarthakari.
* Ausadh (medicine)- Upanaha Swed (hot fomentation) with substance of herbs that promotes pitta dosha is administered in Shotha (inflammation) process caused by pitta. This kind of treatment may seem to be paradoxical as the herbs that produce pitta are employed in shotha (inflammation)of pitta type.
* Aahar (diet)- When inflammation leads to the pachyamana shotha(suppuration), a stimulant diet is recommended that produces Dah(burning sensation) and pitta. Here the disease is caused by pitta dosha and the substance administered to improve the disease also promotes pitta.
* Vihar (lifestyle)- The example can be cited as threatening a patient who is suffering from insanity caused by vata with the fear of police etc. Fear is one of the causes of promoting insanity as it increases vata and it also helps the patient to ameliorate the disease.
Hetuvyadhivipareethakari- In this particular case the medicines that have to be administered would produce the same condition of cause and the disease. These are the arthakari medicines which act beneficially causing the cure like hetu vyadhivipareetha medicine. Though it might appear at first sight that such treatment is same both in cause and effects to the original disease.
* Ausadh(medicine)- administration of Veesha(poison)to cure a case of poisoning.
* Aahar(diet)- To cure a patient of excessive alcoholism, sometimes application of alcohol is recommended.
* Vihar(lifestyle)- in the vata disease called moodh vata that is caused by physical exertion, swimming is recommended as the curative measure.