UNIT 7

DOSHA - DH&AmacronTU - MALA

The Susruta Samhita Sootrasth&amacronna 15:3 describes the concept of human physio-pathology under three broad based 'Units' namely Dosha, Dh&amacrontu and Mala. 1 Susruta Sootra 15:3 With reference to context, the term Dosha conveys the idea of Vata, Pitta, Kapha in a vitiated state which would disrupt the structural components. 2 Charaka Sareera 6:18 These doshas may be dormant says Charaka, and become pathogenic when suitable conditions prevail. 3 Charaka Chikitsa 3:68 The term Dh&amacrontu has been specifically used to identify the sevenfold structural components which'support' the body. 4 Susruta Sootra 14:20

Mal&amacrons represent the third 'unit' of the living body. They are factors produced by the organism which are to be excreted as waste products e.g.: faeces, urine, sweat. Their production and excretion are inevitable. Their 'quality' and 'quantity' are valuable indicators of physio-pathological states of the living body. Doshas too could turn out to be mal&amacrons or 'degraded by-products' which needs to be removed or cleansed from the body. Degraded Kapha appears as mucoid excretions or phlegm that is coughed out. Bile, in classical medicine, is labelled as 'Mala Pitta' in &Amacronyurveda, and should not be construed as one of the tribasic functional factors (V&amacronta, Pitta, Kapha) namely Pitta. 'Mala Pitta' is said to be the mala or 'degraded' by-product of Rakta dh&amacrontu (erythrocytes). 5 Ashtanga Hrid: Nid 3:3-4 Flatulence is gas in the stomach / intestines which could be due to food or sluggish peristalsis of the intestines. The gas thus formed should not be equated to the v&amacronta dh&amacrontu.

The concept of V&amacronta, Pitta, Kapha is unique to &Amacronyurveda and their balance and imbalance is a comprehensive theory of resistance and susceptibility to disease manifestation. Though the descriptions and explanations are apparently esoteric, they are meaningful and applicable. A qualified &Amacronyurvedic physician would be able to elicit the clinical features, diagnose and prescribe the appropriate treatment.

Charaka States that 'one should know the normal (physiological) condition first, in order to detect the 'vikruti' or pathological state'. 6 Charaka Chikitsa 15:3; Charaka Indriva 1:8

With due consideration to the importance of the above statement I wish to enumerate at random, some of the salient features that would 'induce the readers' mind to comprehend a better perspective of V&amacronta, Pitta, Kapha, at a later stage, in this presentation.

They:

1. from the &Amacronyurvedic concept of ontology ('Pad&amacronrtha viggn&amacronna') V&amacronta, Pitta, Kapha are considered as Dravyas, and they do behave as dravyas.

(Refer Unit 1)

2. being dravyas they exhibit action (karma) and qualities (gunas). (Refer Unit 1)

3. are formed of the 'pentad cosmic states of matter' or the Pancha bhootas. 1 Charaka Sareera 6:4: 7:16: Susruta Sootra 46:566: Ashtanga Sangaraha Sootra 20

4. are the ultimate rudimentary bio-systems present in every living organism.

5. are identified in a human cell (deha param&amacronnu). 2 Charak Sareera 7:17: 2:14

6. are explained in term of energy and or matter under different situations.

7. are labile or easily disturbed, but always'strive' to maintain their identity establishing a dynamic state of equilibrium or harmony.

8. are not nullified though possessed of antagonistic qualities because of their (V&amacronta, Pitta, Kapha) mutual and natural tendency to preserve homeostasis (sahaja s&amacrontmya). 3 Charaka Chikitsa 26:293

9. are responsible for the development of an individual's psychosomatic profile or the 'Deha prakriti'. Depending on the dominating inborn principle v&amacronta, pitta, or kapha, the individual becomes prone to certain types of disease condition. 4 Charaka Sootra 7:39, 40

Considering V&amacronta, Pitta and Kapha as doshas some of their effects are given below:

• Doshas may remain dormant and become pathogenic when suitable conditions prevail. 1 Charaka Chikitsa 3:68

• The same dosha according to diversity of causes and site of location produce many diseases. 2 Charaka Sootra 18:45 Nidana 6:10

• Doshas could generally exhibit the following abnormal states: a. Decrease (kshaya) b. Increase (vriddhi) c. Obstruction (&amacronvarana). 3 Charaka Chikitsa 28:248

• Dosha vriddhi (dosha when provoked) could be of two types namely 1. Samhati roopa or chaya and 2. Vilayana roopa or prakopa. 4 Dalhana on Susruta Chikitsa 33:3 The above two conditions could be interpreted as quantitative and qualitative increase respectively.

• Provoked doshas move through vessels or channels (srotas) and bring about morbid changes in them (sroto-dushti) resulting in the manifestation of diseases. 5 Susruta Sootra 24:19

• V&amacronta, Pitta, Kapha and Sonita (blood) determine the origin, preservation and death of living organism. 6 Susruta Sootra 21:23

• Pathogenic organism has been regarded as Doshas along with the vitiated V&amacronta Pitta Kapha. The term 'Bhoota' has also been used to connote poisonous microbes. 7 Charaka Sootra 17:14: Chakrapani On Charaka Sareera 1:119,121

• The mind and body are said to be the regions where doshas establish ill health. 8 Charaka Sootra 1:55, 20:3: Charaka Sareera 4:34

• The 'internal fire' or 'Agni' is said to be involved in digestion metabolism and most of the bio-chemical reactions. Agni which is inherent in Pitta if diminished is accepted as the 'root' cause of all ills. 9 Charaka Sootra 12:11; Charaka Chisitsa 15:139: Ashtanga Hridya Nidana 12:1

Once again I wish to stress that the references given above, culled from the &Amacronyurvedic classics clearly points out to the fact that the physiological aspects cannot be explained through a simplistic translation, e.g.: v&amacronta, pitta, kapha as wind, bile and phlegm respectively. A fairly elaborate presentation that follows would further enlighten the reader.

7.1 V&amacronta, Pitta, Kapha - in general

To facilitate a closer and a lucid comparative study, various aspects of v&amacronta, pitta, kapha are considered together instead of dealing with them individually or under different chapters.

Charaka Sootrasth&amacronna 17 and Susruta Soorasth&amacronna 12:21 have given the etymological meanings of the terms v&amacronta, pitta and kapha. The English interpretation would be as follows:

i V&amacronta is that which moves things or that which motivates.

ii Pitta is that which is thermo-genetic; that which digests; that which 'burns'

iii Kapha is that which holds or binds together Sleshma is a synonym for Kapha and it means to 'embrace' or that which exhibits a cohesive effect.

The human body (sareera) is described to be made up of innumerable microscopic 'units" known as Deha param&amacronnu or cells. 1 Charaka Sootral 2:l l; Charaka Chikithsa 15:139; Ashtanga Hridiya Nidana 12:1 V&amacronta Pitta Kapha, as stated by Charaka, permeates the body and should therefore be expected to be present in every deha param&amacronnu to govern its physiological activities. (Fig. 5)

V&amacronta, pitta, kapha are each composed of two dominating bhootas of the pentad cosmic states of matter. 2 Charaka Sareera 2:14;7:17 Accordingly Prithvi and Ap (or Jala) go to form Jala which is the grossest of the three. Kapha represents the colloidal substance of the deha param&amacronnu. That which is responsible for the intra-cellular metabolism (known as dh&amacrontu agni vy&amacronpara) is Pitta. Tej and Ap are the primary and secondary predominant bhootas present in Pitta respectively. It is therefore thermo-genetic and liquid in nature.

The subtlest principle which governs the overall activities of the deha param&amacronnu including its own Pitta and Kapha portions is V&amacronta. It is the subtlest of the tribasic functional factors (v&amacronta, pitta, kapha). The subtler and the subtlest manifestations of the Pentad cosmic states of matter namely, V&amacronyu and &Amacronk&amacrons dominate V&amacronta respectively. (Fig. 6)
The deha param&amacronnus of a multi cellular complex organism, eg: man, have to organise themselves into structures such as the body channels (srotas), tissue elements (sapta dh&amacrontus), organs and systems (tantra-yantra). Just as the Thridh&amacrontus support the functions the Saptadh&amacrontus (Sevenfold structural components) sustain the structure of the human system. Though the seven fold structural components of the body show differentiation, an in-depth study of the deha param&amacronnu and the sapta dh&amacrontus would reveal that they ultimately merge into the functional concept of the Thridh&amacrontus, and that they cannot be isolated from one another. Thus one could now comprehend the rationale that the thridh&amacrontus, as thridoshas, disrupt the body channels (srotas) and the sevenfold structural components (saptadh&amacrontus). 1 Charaka Sareera 6:18
The V&amacronta, Pitta and Kapha, being of Pancha bhootic composition, are to be considered as 'dravyas'. Hence they should conform to the definition of 'dravya' and should react in accordance to the 'Behaviour of entities, things or beings'. (Unit 1)

It is therefore important to know the properties or qualities (guna) and the effects or actions (karma) of v&amacronta, pitta and kapha as stated in the original ayurvedic texts.

7.3 Re-assessment of V&amacronta, Pitta Kapha

A re-assessment of the properties, of V&amacronta, Pitta and Kapha tabled above, would highlight the following points:

1. The rooksha (dehydrating) guna of V&amacronta and the snigdha (oily) guna of Kapha are antagonistic properties. An increase is corrected by measures with the opposite quality.

2. The manda (sluggish) guna of Kapha has a tendency to inhibit or 'buffer' the &amacronsuk&amacronri (acute) effect of V&amacronta and the teekshna guna of Pitta. Suitable medicament could be prescribed to nullify irritation.

3. V&amacronta and Kapha are both seeta (cold) but the usna (hot) guna of Pitta nullifies V&amacronta and Kapha. Pain with swelling, without warmth could be reduced by heat.

4. V&amacronta is said to be the activator of Pitta and Kapha physiologically. 1 Sarangadhara Poorva 5:25 Provoked v&amacronta due to its augmented properties of chala (mobile) and anavasthita (erratic) properties would have a tendency to produce fluctuating effects of the doshas.

5. Unlike Pitta or Kapha, V&amacronta is subtle and formless acute and fluctuating. Careful periodic monitoring of the clinical features is important to detect changes when v&amacronta is a predominating dosha.

6. The khara (rough) guna attributed to V&amacronta, has to be explained as an effect of increased v&amacronta and its rooksha (dehydrating) guna. The roughness produced should be ameliorated with snigdha (oily) medication.

7. An increase in V&amacronta and Pitta leads to the depletion of body fluids (udaka) due to the rooksha (dehydrating) and usna (hot) gunas of v&amacronta and pitta respectively.

8. The rooksha, visada (non slimy) and the khara (rough) effects of increased v&amacronta, reduces the cohesive and lubricating effects of Sleshma (kapha) e.g.: a condition observed in osteoathritis of the knee joint.

9. Kapha, in its physiological state, is responsible for ojas, bala or body resistance to disease. 2 Chakrapani On Charaka Sareera 7:15; Soothra 28:7

10. V&amacronta, Pitta and Kapha, in general, could be envisaged as (a) nerve impulse (b) bio-chemical activator or mediator and (c) cohesive or anabolic factor respectively.

11. Sattva, Rajas and Tamas are stated to pervade every manifestation. (Unit 2). Considering the body-mind complex, the v&amacronta pitta and kapha are the vitiators of the body while Rajas and Tamas are the vitiators of the mind. 1 Charaka Sareera 4:34.

V&amacronta, Pitta and Kapha are associated with Rajas, Sattva and Tamas respectively, when they are in harmony. Such a state leads to psycho-somatic equilibrium. The Sattva guna always remains unaffected and pure. It maintains its characteristic individuality to nullify aberrations of rajas and tamas.

When trigunas are in harmony they are responsible for high standard of moral, intelligence and spiritual awareness.

Daily practice of yoga enhances Sattva guna and corrects psychosomatic disorders. Yoga enriches the quality of life.

7.4 Classification of V&amacronta Pitta Kapha

One cannot expect v&amacronta, pitta and kapha in their three primary forms to accomplish specialised physiological functions in a complex multi-cellular organism and to be involved in the pathological manifestation of a number of disease conditions.

The original &amacronyurvedic classics have classified the primary tribasic functional factors into five different types. Depending on the location or site, each type has been described to perform their own physiological functions (karma) in keeping with their own characteristic properties (guna). The sum total of the functional diversity within the physiological range, supports the structural integrity of the sapta dh&amacrontus and the harmony of the life process.
The holistic and analytical study of the physio-pathological aspects of the classified tribasic functional factors and their effects on the structural components of the body, is yet another unique concept in the field of clinical medicine in &Amacronyurveda. A brief account of the fivefold classification is given below:
The Fivefold Classification
