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Background: The Vaisheshika school classifies reality into categories called padarthas. Ayurveda adopts a closely related scheme in the first chapter of the Charaka Samhita and uses it to explain the human body, drugs, diseases and treatment. Objective: To review the Vaisheshika categories, to compare them with the padartha scheme of Charaka, and to describe their clinical correlates in the concepts of samanya, vishesha, dravya, guna and karma. Methods: Classical Ayurvedic and Vaisheshika sources were studied in translation, together with standard works on Indian philosophy. PubMed was searched in November 2026 for indexed literature on Ayurveda and Vaisheshika or padartha. Results: Vaisheshika lists six categories (dravya, guna, karma, samanya, vishesha, samavaya) and later adds abhava. Charaka accepts the six, adds the notion of the aggregate of causes in a drug or disease, and applies the theory of samanya and vishesha to the increase and decrease of body constituents. The scheme underlies the pharmacology of dravya, rasa, guna, virya, vipaka and prabhava. Conclusion: Padartha vigyan supplies the ontological basis for Ayurvedic physiology and pharmacology. Correct understanding of the categories prevents common errors in correlating classical terms with modern concepts.