E-ISSN:2456-3110

Review Article

Pathya Apathya

Journal of Ayurveda and Integrated Medical Sciences

2025 Volume 10 Number 8 August
Publisherwww.maharshicharaka.in

Role of Pathya Apathya in the management of Surgical Disorders - A Review Article

Suryavanshi SK1*, Gannur PG2, Madni AR3, N Parameshwari4, Naikawade S5
DOI:10.21760/jaims.10.8.31

1* Shilpa K Suryavanshi, Second Year Post Graduate Scholar, Dept of Shalya Tantra, BLDEA's AVS Ayurveda Mahavidyalaya, Vijayapura, Karnataka, India.

2 Prasadshakti G Gannur, Professor and HOD, Dept of Shalya Tantra, BLDEA's AVS Ayurveda Mahavidyalaya, Vijayapura, Karnataka, India.

3 Aneesur Rehman Madni, Associate Professor, Dept of Shalya Tantra, BLDEA's AVS Ayurveda Mahavidyalaya, Vijayapura, Karnataka, India.

4 N Parameshwari, Assistant Professor, Dept of Shalya Tantra, BLDEA's AVS Ayurveda Mahavidyalaya, Vijayapura, Karnataka, India.

5 Sunita Naikawade, Assistant Professor, Dept of Shalya Tantra, BLDEA's AVS Ayurveda Mahavidyalaya, Vijayapura, Karnataka, India.

In the science of Ayurveda, the management of Shalya Vikāras (surgical disorders) is not limited to surgical intervention alone, but also emphasizes a comprehensive approach that includes Āhāra (diet), Vihāra (lifestyle), and Manasika Bhāva (mental state). The principles of Pāthya (wholesome regimen) and Apāthya (unwholesome regimen) hold significant importance in the pre-operative (Pūrvakarma), operative (Pradhānakarma), and post-operative (Pascātkarma) phases of Shalyakarma. Classical texts like Suśruta Saṁhitā and Caraka Saṁhitā strongly emphasize that even a well-performed surgery may not yield desired results if Pāthya-Apāthya is neglected. Proper observance of Pāthya aids in Agnidīpana (enhancing digestive fire), Dhātu Pushti (nourishment of tissues), Vraṇa Ropaṇa (wound healing), and in the prevention of Upadravas (complications). Conversely, indulgence in Apāthya can lead to Agnimāndya, Āma Sanchaya, and delayed recovery. Modern evidence also supports that nutrition and lifestyle influence surgical outcomes, wound healing, and immunity. Thus, the inclusion of Pāthya-Apāthya in the management protocol of surgical disorders ensures a holistic, cost-effective, and patient-centric approach. This article explores the Saṁhitā-based references, clinical relevance, and modern correlations of Pāthya-Apāthya in the effective management of Surgical Disorders.

Keywords: Pathya, Apathya, Shalya Tantra, Vrana Ropana, Agni, Ayurveda

Corresponding Author How to Cite this Article To Browse
Shilpa K Suryavanshi, Second Year Post Graduate Scholar, Dept of Shalya Tantra, BLDEA's AVS Ayurveda Mahavidyalaya, Vijayapura, Karnataka, India.
Email: 		Suryavanshi SK, Gannur PG, Madni AR, N Parameshwari, Naikawade S, Role of Pathya Apathya in the management of Surgical Disorders - A Review Article. J Ayu Int Med Sci. 2025;10(8):191-197.
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Manuscript Received Review Round 1 Review Round 2 Review Round 3 Accepted
2025-06-16 2025-06-27 2025-07-07 2025-07-17 2025-07-27
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© 2025 by Suryavanshi SK, Gannur PG, Madni AR, N Parameshwari, Naikawade S and Published by Maharshi Charaka Ayurveda Organization. This is an Open Access article licensed under a Creative Commons Attribution 4.0 International License https://creativecommons.org/licenses/by/4.0/ unported [CC BY 4.0].

J Ayu Int Med Sci 2025;10(8)191
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Shilpa KS et al. Role of Pathya Apathya in the management of Surgical Disorders

Introduction

Ayurveda, the ancient science of life, emphasizes a holistic approach to health and disease management, integrating physical, mental, and spiritual well-being. Among the eight branches of Ayurveda, Shalya Tantra specifically deals with surgical and Para surgical interventions. While surgical procedures are essential for managing certain conditions, the success of surgery in Ayurveda is not limited to technical excellence but also depends heavily on post-operative care, diet, lifestyle, and mental state.[1] One of the most critical yet often overlooked aspects of Ayurvedic surgical care is the concept of Pathya (wholesome regimen) and Apathya (unwholesome regimen), which govern both dietary and behavioural guidelines.

पथ्यं पथोऽनपेतं यद्यच्चोक्तं मनसः प्रियम्|
यच्चाप्रियमपथ्यं च नियतं तन्न लक्षयेत्||Ch.Su.25/45

Pathya, which is the Aahara-Vihara that calms the mind, is beneficial to the body, and provides nutrients and Apathya, which is the opposite of Pathya.[2]

In M. Monier-Williams, Pathya is a Sanskrit word that means:- "Belonging to a particular way" or being healthy, fit, suitable or appropriate. They include

  • Foods indicated for healthy people.
  • Foods contraindicated for healthy people.
  • Pathya-Apathya toward the patient[3]

Synonyms[4]

Pathya - Satmya, Swastha- paripaalaka, Swastha-hitakara, Hita Ahara, Swastha-urjaskara, Sukha-Parinaamkara, Dhatu-Avirodhi, Dhatu-Saamyakara.

Apathya - Asatmya, Ahitakara, Anupashaya, Swastha-Ahitakara, Asukha-Parinaamakara, Dhatu Asamyakara, Ashrmakara.

पञ्चभूतात्मके देहे ह्याहारः पाञ्चभौतिकः | (Su.Su.46/526)

  • Pathya diet is essential for health and body and diet are
  • Body organs are nourished only through diet.
  • Healthy eating causes physical development while unhealthy eating causes disease.
  • Dosha-Dhatu-Mala are the basics of a body.

Pathya helps nourishing them and maintain the equilibrium.[5]

Acharya Kashyapa has called Ahara as Bheshaja. He stated that food is the best medicine. Only the Hitakara-Ahara can keep a person healthy.[6]

Acharya Harita stressed that if a person does not acknowledge the concept of Pathya-Apathya and consumes Apathya (unhealthy), illness will never leave the body.[7]

The foundation of Pathya-Apathya lies in maintaining the balance of doshas, enhancing Agni (digestive fire), and promoting Dhatu (tissue) regeneration. Pathya-Apathya is not a generic set of instructions but a dynamic and individualized set of guidelines that vary based on the patient’s constitution (Prakriti), the nature and stage of the disease, and the surgical procedure performed.

Now a day’s wound and its healing are the most important problem facing in surgical practice because of number of patients suffering due to improper nutrition. Surgeon’s aim is to minimize the complications of wound, remove or repair damaged structures and to promote the process of wound healing to restore the functions.

Acharya Sushruta has given superior position to Vrana, Sutra sthana of Sushrutha Samhita shows description of Vrana in most of the chapters and Chikitsa sthana of Sushrutha Samhita begins with chapter of Vrana chikitsa & Sixty treatment modalities are mentioned only for Vrana ropana. Acharya Sushruta has mentioned Vrana Vinischaya as a major part of Shalyatantra and dedicated one whole chapter for Pathya and Apathya related to Vrana in Vranitopasaneeya Adhyaya.

Classical Ayurvedic texts like Charaka Samhita, Sushruta Samhita, and Ashtanga Hridaya elaborate on the importance of proper Pathya in the context of wound healing (Vrana Ropana), tissue rejuvenation, and immunity enhancement, particularly in the perioperative phase. Pre-operative preparation in Ayurveda includes a light and digestible diet to optimize Agni and detoxify the body.[8] Intra-operatively, surgical asepsis is maintained through herbal formulations and fumigation practices.[9] Post-operatively, the role of Pathya becomes even more pronounced, with dietary regimens like Manda, Peya, Vilepi, Yavagu, and Yusha recomm-ended to support digestion and tissue repair.


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Behavioural Pathya includes adequate rest, abstinence from physical exertion, and maintaining a calm mental state, all of which are conducive to faster recovery.

In contrast, Apathya practices - such as consuming incompatible foods (Viruddha Ahara), Vyayama, Vyavaya, Krodha, Bhaya - can lead to delayed healing, infection, and recurrence of disease.[10] These practices disturb Doshic balance, weaken immunity, and hamper the healing cascade.

Given the increasing interest in integrative medicine, the Ayurvedic understanding of Pathya and Apathya offers valuable insights into enhancing surgical outcomes through diet and lifestyle management.

This article aims to explore the relevance, applications, and scientific rationale behind these ancient yet timeless principles in the modern context of surgical care.



Pathya-Apathya related to Ahara mentioned in different classics:

ClassicsPathyaApathya
Charaka [11]Na Ati Sheeta, Na Ati Guru, Na Ati Snigdha, AvidahiLavana, Amla, Katu, Ushna, Vidahi, Guru, Viruddhanna, Adyasana
Sushruta [12]Jeerna Shalyodana, Jangala Mamsa Rasa, Tanduliyaka, Jivanti, Sunishannaka, Vastuka, Balmulaka, Vartak, Patol, Karvellaka, Dadima, Amlaki, Saindava, Mudga Rasa, Saktu, Vilepi, Kulmasha, Shritjala.Navadanya, Masha, Tila Kalaya, Kulatta, Nishpava, Haritaka, Amla, Lavana, Katurasa Pradana Dravyas, Gudapishti Vikruti, Vallura, Shushka Shaka, Aja, Avi, Aanupa, Oudaka Mamsa, Shitodaka, Krushara, Dadhi Dugdha, Takra[13]
Vagbhata [14]Yava, Godhuma, Sashatika, Masura, Mudga, Tuvari, Jivanti, Sunishannaka, Bal-Mulaka, Vartaka,
Tanduliyaka, Vastuka, Karvellaka,
Karkota, Patola, Katukaphala,
Saindava, Dadima, Dhatri, Ghrita,
Jala, Jangala Mamsa Rasa.		Navadhanya, Tila, Masha, Ksheera, Ikshu Vikruti, Amla, Katu, Visthamabi, Vidahi, Guru, Sheetal, Madya.

Pathya - Apathya related to Vihara mentioned in different classics:

ClassicsPathyaApathya
CharakaAswapnam DivaMaithuna
Sushruta[15]Nicha Nakha And Roma, Shuchi, Shukla Vaasina, Dhoopa with Sarshapa, Nimba Leaves, Lavana, GheeShould Avoid Chankramana, Asana, Streenam Darshan, Sambhasana, Vaata, Atapa, Rajo, Dhooma, Irshya, Bhaya, Shoka, Raatrijagarana, Vishama Aashana, Shayana, Upavasa, Vaag, Vyayama
Vagbhata[16]Aswapnam DivaMaithuna

Pathya – Apathya mentioned in Sushruta Samhita for different disorders.

1. Pathya-Apathya related to Vrana.

PathyaApathya
Vranitagara
[17]		Vastu, ShuchiThere should not be direct entry of Vaata and Atapa
Nidra[18]Sukha Chesta Prachara, Prachya Dishi, Hridbhir Anukula, Priyovadi UpasyamanoDiwaswapna, Ratrijagarana
Ahara[19]Tanduliyaka, Jivanti, Sunishannaka, Vastuka, Balamulaka, Vartuka, Patola, Karvellaka, Ghrita, Saindava, Dadima and Amlaka, Mudga Yusha, Saktu, Vilepi, KulmashaNavadhanya, Masha, Tila Kalaya, Kulatta, Nispava, Haritakashaka, Amla, Katu, Lavana Ahara, Guda pistavikruti, Vallur, Sushkashaka, Ajamamsa, Sheetodaka, Krasara, Payasa, Dadhi, Dugdha, Takra, Madya Vikara[20]
ViharaNicha Nakha and Roma, Shuchi, Shukla Vaasina, Shanti, Mangala, Deva, Bramhana, Gopooja, Bali, Upahara[21]Vaata, Atapa, Rajo, Dhooma, Irshya, Bhaya, Kopa, Vyayama, Chankramana, Viruddha Adhyasana, Ajirna, Asana, Vishama Shayana, Ucchabhashana, Maithuna[22]
Dhupana[23]Sarshapa, Arishta patra, Saindava, Sarpi-
Shirodharana
[24]		Chatra, Atichatra, Languli, Jatila, Bramacharini, Lakshmi, Guha, Atiguha, Satavirya, Sahasravirya, Shweta Sarshapa-

2. Pathya-Apathya related to Bhagna

PathyaApathya
Ahara[25]Shali, Mamsa Rasa, Ksheera, Sarpi, Yusha, Tinaja, Brumhana AnnapanaLavana, Katu, Kshara, Amla, Ruksha Anna
ViharaBandana, Sheeta Ambu Shechana, PradehaMaithuna, Atapa, Vyayama

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3. Pathya - Apathya related to Arsha

PathyaApathya
Ahara[26]Puranashali, Yava, Godhuma, Nimbayusha, Patola Yusha, Vastuka, Tanduliyaka, Jivanti, Upodika, Asvabala, Bal-Mulaka, Palanka, Asana, Cilli, Cuccu, Kalaya, Valli, Kulattha, Patola, Chitraka, Suvarnakanda, Shunti, Gomutra, Souvira, Tushodaka, Kapittha, Ksheera, GhritaAnupamamsa, Mastya, Pinyaka, Dadhi, Pishtika, Masha, Bilwa
Vihara[27]Alepa, Kshara, Agni, ShastraPrushta Yana, Streesevana, Vegadharana, Utkatasana[28]

4. Pathya -Apathya related to Bhagandara

PathyaApathya
Ahara[29]Trikatu, Vaca, Hingu, Pancha Lavana, Dipyaka should be administered with Kanji, Sauviraka, KulattaViruddha Annapana, Guru Ahara
Vihara[30]Lepa, Langana, Rakta Mokshana, KsharaVishamashana, Kopa, Vyayama, Maithuna, Yuddha, Prustayana

5. Pathya -Apathya related to Shopha

Pathya[31]Apathya[32]
AharaGodhuma, Mudga Yusha, Guda and Haritaki, Devadaru and Shunti, Guda and Adraka, Shunti powder dissolved in milk, Milk boiled with Pippali, Pippali Mula, Cavya, Chitrka, Mayura and Varshabhu or Milk with Varsabhu, Sunthi, Surangi roots or with Trikatu, Eranda and Shyma RootsAmla, Dadhi, Guda, Vasa, Paya, Taila, Ghrita, Pishti, Guru Ahara Mritikabhakshana, Lavana, Dadhi products made up of Gramya Animals and Birds
ViharaAlepa, Parisheka, Asthapana, Swedana, Upanahana, SiravyadanaVegavarodha, Vishamasana, Diwaswapna, Vyavaya, Vyayama

6. Pathya -Apathya related to Vidradhi

PathyaApathya
Ahara[33]Varunadi Gana Dravya, Madhu + Shigru mixed with Maireya, Sura, Asava, Kanjika, Rice cooked with Siddartaka Jala in the decoction of Madhu & Shigru and taken with the Yusha of Yava, Kola, and Kulatta, Tilvaka GhritaAtiushna, Kshara, Amla, Lavana, Viruddha, Dusta, Ashuchi Bhojana
Panchakarma[34]Virechana, Langana, RaktamokshanaSnehana, Dhumapana, Vyayama, Diwaswapna, Swedana, Vyavaya

Discussion

The importance of Pathya and Apathya in the management of surgical diseases cannot be overstated when examined through the lens of Ayurvedic science. While modern surgery addresses structural and anatomical correction through operative methods, Ayurveda extends the healing process by advocating a supportive environment that includes correct dietary habits, regulated behaviour, and mental discipline.

The discussion of Pathya-Apathya is not only relevant but essential for ensuring a smooth post-operative recovery, reducing complications, and preventing recurrence. One of the key factors in post-surgical recovery is the restoration of Agni (digestive fire), which is often compromised due to anaesthesia, tissue trauma, and the stress of surgery.

Ayurvedic texts recommend light, nourishing, and easily digestible foods such as Manda (rice water), Yusha (lentil soup), and Peya (thin gruel) during the initial days following surgery. These not only rekindle Agni but also provide essential nutrients to begin the healing process.

The gradual transition to more complex food items as digestive strength returns is a critical aspect of Pathya that is often overlooked in modern recovery protocols. In terms of behavioural Pathya, emphasis is laid on rest, avoidance of exertion, maintaining hygiene, and emotional stability.

This aligns well with current recommendations for convalescence. However, Ayurveda adds the dimension of individualized care based on the Prakriti (constitution) of the patient and the specific Doshic imbalance present.

For example, a Vata-predominant individual may need more warm, unctuous foods and a calm, grounding environment, while a Pitta type may benefit from cooling, soothing diets and reduced mental stress. Conversely, consumption of Apathya - such as incompatible food combinations (Viruddha Ahara), processed or preserved foods, and habits like smoking or alcohol intake - impairs wound healing, causes inflammation, and increases the risk of infections.

These adverse effects can be explained both in Ayurvedic terms of dosha vitiation and in biomedical terms of oxidative stress, impaired immunity, and poor tissue perfusion.


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This Ayurvedic approach not only aligns with modern nutritional and rehabilitative care but also fills in gaps left by the lack of personalized dietary protocols in many allopathic post-operative care systems. The inclusion of Ayurvedic Pathya-Apathya principles can lead to a more integrative and patient-centric model of surgical recovery. This discussion reaffirms that effective surgical treatment extends beyond the operation theatre and must include conscious efforts in diet and lifestyle to ensure complete and sustained healing.

Conclusion

The principles of Pathya and Apathya form a fundamental pillar in the Ayurvedic management of surgical conditions. While surgical interventions address the structural aspects of disease, true and sustained healing requires comprehensive post-operative care rooted in proper dietary and behavioural regimens. Ayurveda emphasizes the restoration of balance in bodily functions, particularly through support of Agni, Dosha, and Dhatu, all of which are deeply influenced by food and lifestyle.

Ignoring Pathya and indulging in Apathya can hinder recovery, delay wound healing, and increase the risk of complications. Modern research increasingly supports the value of nutrition and personalized care in surgical recovery, echoing Ayurvedic wisdom. Integrating these time-tested concepts into contemporary surgical practice offers a promising avenue for improving patient outcomes, ensuring faster rehabilitation, and promoting holistic well-being. Thus, Pathya-Apathya should be regarded as essential therapeutic tools alongside surgical procedures in the comprehensive management of disease.

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