Dosha Types, Imbalance Symptoms – Ashtanga Hrudaya Sutrasthana 12

12th chapter of Ashtanga Hrudaya Sutrasthana describes about location of Tridosha in the body, classification and functions of each type of Tridosha, causes for its increase or decrease etc. It is called as Doshabhediya Adhyaya.

Place of Tridosha – Doshasthana

Place of Vata Dosha 

Pakavasaya – large intestine,
Kati – waist
Sakthi – hip
Shrotra – ear
Asthi – bones
Sparshanendriya – skin
Special space – large intestine 1

Place of Pitta Dosha

Nabhi – Umbilicus,
Amashaya- stomach and small intestine,
Sweda – sweat,
Lasika- lymph,
Rudhira – blood,
Rasa- plasma,
Druk – eye and
Sparshanam – skin,
Special seat – Nabhi- region around the Umbilicus. 2

Place of Kapha Dosha

Ura – Chest,
Kantha – throat,
Shira – head,
Kloma – Pancreas,
Parvani – bone joints,
Amashaya – Stomach and small intestine,
Rasa –plasma,
Meda – fat
Ghrana – nose and
Jihva – tongue are the seats of Kapha,
Special seat – Ura – chest. 3

5 types of Vata

Vata is of 5 types.

Prana Vata,
Udana Vata,
Vyana Vata,
Samana Vata and
Apana Vata,

Prana Vata –  Prana is located in the head and moves in the chest, throat. It regulates will, heart, sense organs, intellect and vision.
It is the cause for expectoration, sneezing, belching, inspiration and swallowing of food. 4

Udana Vata – The chest is the seat of Udana, it moves in the nose, umbilicus and throat; its functions are initiation of speech (vak), effort (Prayatna), enthusiasm (Urja), strength (bala) , color, complexion (varna) and memory (smruti) 5

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Vyana Vata –
Vyana is located in the heart, moves all over the body in great speed,
It attends to functions such as flexion and extension (locomotor action) opening  and closing of the eyelids etc.
Generally all the body activities are regulated by Vyana Vata. 6-7

Samana Vata –
Samana Vata is located near the digestive fire.
It moves in the Kostha – alimentary tract,
It receives the food into stomach, aids in digestion, helps in dividing the food into useful part and waste part, and moves these parts in their normal paths. 8

Apana Vata
Apana Vata is located in the Apana – large intestine, moves in the waist, bladder, genitals. It attends to the functions such as ejaculation, menstruation, defecation, urination and child birth. 9

Five types of Pitta

Pitta is of 5 types.
Pachaka Pitta
Ranjaka Pitta
Sadhaka Pitta
Alochaka Pitta
Bhrajaka Pitta

Pachaka Pitta –
It is located between large intestine and stomach.  (between Amashaya and Pakvashaya)
It is composed of all the five basic elements (Panchamaha Bhuta), it is predominant with fire element and devoid of water element.
It is called by the term Anala- fire because of its function of Paka – digestion and transformation of food materials.
It cooks the food, divides it into essence and waste,
It bestows grace and influence on other types of Pitta.
Hence, among all the types of Pitta, Pachaka pitta is the dominant one.

Ranjaka Pitta –

The pitta located in the Amasaya- stomach is known as Ranjaka. It converts the useful part of the digestion into blood. Hence it converts Rasa Dhatu into Rakta Dhatu. 12 ½

Sadhaka Pitta –
The pitta located in the Hrudaya –heart is known as Sadhaka.
It attends to mental functions such as knowledge, intelligence, self- consciousness, etc, thereby helping the purpose – aims of life. 13 1/3

Alochaka Pitta – It is located in the eyes. It helps in vision.

Bhrajaka Pitta – It resides in skin and helps exhibition of color and complexions. 14

5 Types of Kapha

Kapha also is of five types;

Avalambaka Kapha –
It is located in the chest and Trika pradesha – the meeting place of shoulder, neck and back;. By its innate strength and by the power of essence of food, it does lubrication, nourishing etc functions that are attributed to water element. It also influences the functioning of other types of Kapha. 15

Kledaka Kapha –
Located in the Amashaya – stomach. It moistens the hard food mass and helps in digestion.

Bodhaka Kapha –
It is located in the tongue. It helps in taste perception.

Tarpaka Kapha –
It is located in the head. It nourishes sense organs.

Shleshaka Kapha –
It is located in the bone joints. It lubricates and strengthens the joint.

Though Tridosha is present all over the body, they are more dominant in specific areas of the body, as explained above.

Qualities that influence increase and decrease of Tridosha

Note: In the description given below,
Chaya means – first level increase of Dosha in their own place.
Kopa / Prakopa means increase and overflow of Doshas from its own place to other places. It has the potential to cause disease.
Shama / Prashama means decrease of increased Dosha and restoration of health.

Qualities that cause Chaya, Kopa and Shama of Vata

Hot  along with dryness, movement, etc causes Vata Chaya.
Coldness along with dryness causes Kopa.
Snigdha (oiliness, unctuousness)  and other qualities- Guru (heavy), Usna (hot) , pichila (stickiness),  sthira (stability)  etc. associated with hotness bring about Shamana of Vata. 19

Qualities that cause Chaya, Kopa and Shama of Pitta

Teekshna (piercing, strong)  and other qualities- dryness, lightness, etc associated with cold cause Chaya- mild increase of Pitta,
The above qualities associated with hot, cause Kopa – profound increase of Pitta.
Manda (viscous, mild) and other qualities like stickiness, stability etc, associated with cold bring about Pitta Shama- reduction back to normal. 20

Qualities that cause Chaya, Kopa and Shama of Kapha

Snigdha –(unctuous, oily) and others –heaviness, stickiness, mild, etc along with cold quality causes Kapha chaya. (mild increase)
Same Snigdha – unctuous, oily etc qualities associated with Usna – hot cause Kapha Kopa
Manda- dull and others- rough, dry, clarity, movement, lightness associated with cold quality bring about Kapha Shama- reduction to normal. 21

Overall,
Vata Dosha –
Ushna (hot) + Ruksha (dryness) and associated qualities  cause Vata Chaya
Sheeta (cold) + Ruksha (dryness) and associated qualities cause Vata Kopa
Ushna (hot) + Snigdha (unctuous, oily) and associated qualities cause Vata shama.

Pitta Dosha
Sheeta (cold) + Teekshna (piercing, strong) etc qualities cause Pitta Chaya
Ushna (hot) +  Teekshna (piercing, strong) etc qualities cause Pitta Kopa
Sheeta (cold) + Manda (mild, dull) cause Pitta Shama.

Kapha Dosha –
Sheeta (Cold) + Snigdha (unctuous, oily) cause Kapha Chaya
Ushna (hot) + Snigdha (unctuous, oily) cause Kapha Kopa
Ushna (hot) + Rooksha (dryness) cause Kapha Shama

Levels of Dosha Increase and Decrease

Chaya means slight increase of Dosha in its own place.  It produces dislike against the things that would cause further increase of particular Dosha.  It is a self defense mechanism of the body to avoid further increase of Dosha, which may lead to disease. 22

Kopa – suggests further increase of Dosha and overflow of increased Dosha into other body channels. It causes appearance of symptoms of increased Dosha, leading to onset of disease process. The premonitory symptoms of the disease can be observed at this stage.

Shama means normalcy. Restoration / decrease of increased Dosha to its normal levels.

Fluctuation of Dosha in different seasons

Dosha Chaya Prakopa Prasama
 VataGrisma (summer)Varsha (rainy)Sharat (Autumn)
PittaVarsha (rainy)Sharat (Autumn)Hemanta (early winter)
KaphaShishira (winter)Vasanta (spring)Grishma (summer)

Vata undergoes chaya (mild increase) during summer by the use of foods possessing qualities such as lightness, dryness etc. It is especially so, in the bodies of  persons possessing such qualities. But during summer, Vata does not undergo profound increase due to the heat of the summer. (Remember, cold is a quality of vata). Hot is opposite to Vata, hence there is no increase to a large extent.

Similarly, Pitta undergoes chaya in rainy season, because of production of Amla vipaka (sour taste at the end of digestion) of water and foods. But it does not undergo further increase in rainy season, because of coldness. (Remember, hot is the quality of Pitta) Coldness checks further increase of Pitta in rainy season.

Kapha undergoes Chaya in winter by the use of foods with cold and oily qualities. But it does not undergo prakopa because Kapha becomes solidified due to severe cold of the winter. 25-27

So, activities and food habits can cause increase or decrease of Dosha. At the same time, seasonal effect also may cause Dosha increase or decrease.  28

Action of increased Dhosha

When there is a flood, the water gushes into the cities very fast, but the reversal process is very slow. Similarly, the increased Doshas spread throughout body from foot to head to produce diseases but the decrease of Dosha and restoration of normalcy takes a very long time. 29

Dosha is the main cause for disease

Like a bird flying high in the sky cannot escape from its shadow, the root cause for disease lies in Tridosha. Even the mental qualities such as Satva, Raja and Tama are influenced by Tridosha. Dosha get vitiated, then cause vitiation of body tissues (Dhatu) and waste products (Mala) to cause disease.  32-34 ¼

Three kinds of causes for Dosha increase

The causes of Dosha increase  can be categorized as
–         Less involvement (Heena yoga),
–         Wrong involvement (Mithya yoga)
–         Over involvement (Atiyoga)
Of
Artha – sense organs
Kala – season
Karma – action .
So, less, wrongful or more involvement of sense organs / seasons / action leads to Dosha imbalance. It is explained further.

Artha – Senses and their correlation

Hinayoga – Poor association of sense organs – insufficient, inadequate, contact or non- contact with the objects of senses – sound, touch, sight, taste and smell with their respective sense organs. For example, not at all listening to sounds, or living in a low lit area etc

 Atiyoga is over indulgence. Seeing objects which are very minute, bright etc, gazing for a very long time, hearing to loud music etc.

Mithya Yoga – wrong indulgence with sense organs – seeing / hearing frightening, very close, very far, disliked and abnormal objects etc. 36-38 ½

Kala – seasons :-
Kala is of three kinds, cold, hot and rainy.
Hinayoga of Kala is – less cold in winter, less temperature in summer and less rain in rainy season.

Atiyoga is – more rain in rainy season, more temperature in summer etc.
Mithyayoga is  manifestation of qualities opposite to those of the natural ones of the season. Example – rain during summer, cold weather during summer etc. 38 ½ 39

Karma: Activities :-
Three types of actions pertaining to mind, body and speech lead to Dosha imbalance.
Heenayoga – speaking very less, very little physical activity, very less thought process.
Atiyoga – excessive speaking, excess physical activity and excessive thinking.
Mithyayoga – wrong speaking, wrong physical activities and wrong, evil thinking, suppression of natural urges, improper postures, abrupt jumping and falling, speaking too much immediately after meals, harboring of desires- attachment, passion, hatred, fear etc. 40-42 ½

These are the causes for increase of Doshas, which lead to production of many kinds of diseases, involving the mind, tissues, viscera, bones and joints. 43-44

Pathways of diseases  – Rogamargas

The body is divided into three sections to explain different diseases.
Antarogamarga – internal path – refers to gastro intestinal tract.
Bahi roga marga – external path – refers to Rakta, Mamsa etc Dhatu (tissues) and skin.
Madhyama rogamarga – it includes vital organs such as brain, heart, blood vessels, joints, nerves etc.
This concept is explained below in detail.

Bahi Koshta / Bahi roga marga – External pathway 

Raktha- blood and others tissues (Blood, muscles, bone, fat, bone marrow and sex related secretions) and skin continue the Bahya Rogamarga – external pathway of disease.

It is related with diseases such as moles, discolored patches on face, Gandalaji – goiter, glandular ulcer on the face, malignant tumors, hemorrhoids, abdominal tumor, swelling and other external diseases. 44 ½ -45

Anta Koshta / Anta Rogamarga – Internal path

Amashaya – stomach and small intestine,
Pakwashaya – large intestine
The above two, along with the entire gastro intestinal tract is called as Mahasrota. (The big channel). This constitutes the Anta Koshta.

Diseases which affect this path are – vomiting, diarrhea, cough, dyspnoea, enlargement of the abdomen, fever, dropsy, hemorrhoids, abdominal tumors, Visarpa (herpes), abscess etc. 46

Madhyama Koshta / Madhyama Rogamarga – The middle path

The head, heart, urinary bladder and such other vital organs, joints of bones, blood vessels, tendons, ligaments, nerves constitute the madhyama rogamarga. From it arise, consumption, hemiplegia, facial paralysis, diseases of the head and other organs, pain, stiffness- loss of movement of the joints, bones, waist etc. 47-48

Different symptoms produced by increased Dosha

Symptoms of Vata increase

Sramsa – Ptosis- drooping down
Vyasa – dilation
Vyadha – cutting pain
Swapa – loss of sensation
Sada – weakness, loss of function
Ruk – pain
Toda – continuous pain
Bhedanam – splitting pain
Sanga – Constriction,
Angabhanga – bodyache,
Sankocha – shrinking of the organ, reduction in size
Varta – twisting,
Harshana – tingling sensation
Tarshana – thirst
Kampa – tremors
Parushya – roughness
Saushirya – feeling of empty
Shosha – dryness
Spandana – pulsating
Veshtana – rigidity, as if tied
Sthambha – stiffness
Kashaya rasata – astringent taste in mouth
Aruna, Shyava Varna  – appearance of blue or crimson discoloration
– these are the abnormal signs and symptoms of increased Vayu –Vata. 49-50

 Symptoms of Pitta increase

Daha – burning sensation
Raga – reddish discoloration
Ushmapakita – heat, increase in temperature, formation of pus, ulcers
Sveda – sweating
Kleda – inflammation with wetness, moistness
Sruti – inflammation with pus / oozing / secretions, exudation
Kotha – putrefaction- decomposition
Sadana – debility
Murchana – fainting
Mada – toxicity
Katuka Amla Rasa –  bitter and sour taste in the mouth
Pandu Aruna Varjitaha –  appearance of color other than yellowish white and crimson. 51- 52 ½

Symptoms of Kapha increase

Sneha – unctuousness, oiliness,
Kathinya – hardness,
Kandu – itching,
Sheetatva – coldness,
Gaurava – heaviness,
Bandha – obstruction,
Upalepa – coating, as if tied with a wet cloth,
Staimitya – stiffness, loss of movement,
Shopha – inflammation,
Apakti – indigestion,
Atinidrata – excessive sleep,
Shveta varna – white discolouration,
Svadu lavana rasa – sweet, salt taste in mouth,
Chirakarita – delay in all activities. 52 ½ -53.

Thus are enumerated, the features, which appear in diseases, are to be recognized by the physician through inspection and others – methods of examination of patient. 54

Importance of patient observation

o gain the knowledge of different stages of disease, the physician should observe the patient every minute.55

Knowledge of successful treatment

Knowledge of successful treatment is obtained from constant practice just as knowledge of determining the quality of gems is obtained only from- knowing the science. 56

Three kinds of diseases and treatment

Three kinds of diseases based on cause – Trividha roga-
Diseases are of three kinds viz,
Karmaja Vyadhi – Includes diseases that originate due to bad deeds of the past lives, or of present life or of both past and present lives. Usually the cause for such disease is not clearly known. 57

Doshaja Vyadhi – Diseases which arise from specific causes, which lead to Dosha increase and then to disease manifestation.

Doshakarmaja – combination of bad deeds and indulgence in causes of disease result in disease.  Usually the symptoms are profound in this case. 58

Treatment for such diseases:
The Doshaja diseases get cured from indulgence in food, activities and medicine that have opposite qualities to the cause.

Karmaja diseases get cured after the termination of the effects of such acts of previous / current lives.

Dosha-Karmaja diseases get cured after the mitigation of Dosha and nullifying of effects of past deeds. 59

Two kinds of diseases and treatment

 Two kinds of diseases – based on cause – Dvividha roga—
1. Svatantra Roga
– independent/ primary –  have their own specific causes, comforting methods and clearly manifested features.

2. Paratantra Roga – secondary diseases, associated diseases. Those which do not have their own specific cause.
It is further of two types.
Purvaja – premonitory symptoms – the symptoms that are seen at the initial stage of a disease
Upadrava – complications of diseases. 6061

The secondary disease (Paratantra Roga) usually subsides when the primary diseases is treated.
If they do not get subsided then, treatment has to be given- for the secondary diseases as well.
If powerful, secondary affections should be treated soon because these complications cause more troubles to the body which is already debilitated by the primary disease. 62-63

The physician should never feel shy for not knowing the nomenclature of the disease, for there is no rule/ custom/ state, that every disease has a name. 64

The very same Doshas, depending upon the nature of the causative factors, travels to many parts of the body and produces many disease, hence treatment of the disease, its abode- site should be judged very quickly with the help of knowledge of the disease. 65-66

Factors to observe in patient

The physician should minutely examine and determine,
Dushya – the Dhatus and Malas involved in a diseases
Desha – the area of the body where disease is manifested, the living place of the patient
Bala – strength of the patient,
Kala- season, how old is the disease, age of the person etc. ,
Anala- digestive power of the patient,
Prakriti- body constitution,
Vayas- age of the patient and disease,
Satva- mind, tolerance capacity of the patient,
Satmya- the food and activities to which the patient is accustomed to.
Ahara- food habits and
Avastha- stages of the diseases

The physician should watch for above factors to decide and only then, should the physician decide on the aggravated Dosha and its appropriate treatment. Such a doctor will never commit mistakes in treatment. 67-68

The symptoms may be affected by the disease and also by the mental status of the patient. The strength of the disease varies based on strength and weakness of the mind and body of the patient. Hence the physician should be very attentive. 69.

The unintelligent physician, who determines a grievous disease as a mild one, goes wrong in treatment because of under estimating the condition and the Dosha. 70

He will administer drugs/ therapies in small doses. Such mild treatment causes worsening of the disease because of ineffective treatment.

On the other hand, if the person over estimates the strength of the disease and over treats with Panchakarma and oral medicines, it will also trouble the health of the patient to a very great extent. 71- 72

Hence the physician should constantly study the science, determine the exact condition of all factors, all the time and then administer appropriate medicines and treatments. 73

Number of Dosha combinations

 Number of combination of Dosha – Dosha Samyoga Samkhya

The number of combinations of Dosha increase and decrease are 62.

The 63rd is the condition, where all the Doshas are in equilibrium, which is called as the state of health. 78

With the association of Rasa, Rakta etc and the level of increase or decrease of Doshas, there can be innumerable permutations and combinations. The physician should understand them by their features – signs and symptoms with an attentive mind.79

Thus ends the chapter known as Dosabhediya Adhyaya. 12th of Sutrasthana of Ashtanga Hridayam.

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