Article by Dr Raghuram Y.S. MD (Ay) & Dr Manasa, B.A.M.S
A disease is manifested due to dosha dushya sammurchana – amalgamation of vitiated doshas and weak and susceptible dushyas (tissues and waste products of the body) take place in the body during the stage of lodgment of vitiated circulating doshas in the tissues (sthana samshraya stage of kriya kala).
This is also called as Samprapti. Samprapti means the entire process in which the disease is formed right from exposure to causative factors to the manifestation of disease with its clear-cut signs and symptoms.
Read related: Vyadhi (Disease) Definition, Meaning And Explanation
There are many contributory factors which lead to formation of disease in the body. The below mentioned are the most important and mandatory contributory factors towards the causation of a disease –
Vata, Pitta and Kapha, the three doshas are the prime contributory factors not only for the manifestation of the disease but also for the initiation of disease process (samprapti). Any disease cannot be manifested without the vitiation of doshas. The vitiation of doshas once again depends on the causative factors which lead to their vitiation. Causative factors can be in the form of incompatible foods practices, erratic lifestyle practices, stress, geographical and climatic variations and lot more.
Read related: Shat Kriya Kala – ‘Stage-Wise Disease Management’
The doshas get vitiated in sequential order from feeble to worse in the first three stages of samprapti (pathogenesis) or kriya kala (stages of formation of disease).
In Sanchaya (stage of accumulation), the doshas increase in their respective places and
in Prakopa (vitiation of doshas), the doshas get vitiated in their own places.
In the third stage i.e. Prasara (stage of spread), the doshas spread all through the body in search of weak spot (weak tissue) for lodgment so that they may cause diseases therein.
Thus, the doshas, the vitiated doshas to be precise, are the most important contributory factors participating in the causation of samprapti or pathogenesis of any systemic disease or illness.
Read related: Nidana: Meaning, Word Derivation, Definition
Dushya or Dhatu
Dushyas are the other side of the coin as that of doshas. Just like the disease cannot manifest without the vitiation of doshas, the disease cannot manifest likewise without the dhatus or dushyas (tissues of the body) being contaminated and damaged by the vitiated doshas.
The vitiated doshas invade the dhatus and make a pathological amalgamation with them in the sthanasamshraya (stage of lodgment of doshas in the tissues) stage of Kirya Kala (stages of formation of disease) leading to the earlier and feeble formation of disease process. This combination of vitiated doshas and weak and susceptible dhatus is called dosha dushya sammurchana. This combination strengthens in the absence of treatment strategies and leads to formation of disease with its clear cut signs and symptoms in the Vyakta (stage of manifestation of disease) of the kriya kala or samprapti. The amalgamation of doshas and dushyas is mandatory if the disease needs to be formed.
Thus, dushyas or dhatus form an important contributory factor for a disease process or pathogenesis to set in.
Waste products of the body are also considered as Dushyas, as they are also afflicted by Doshas, in a disease process.
Srotorodha means blockage or obstruction in the srotases. Srotases are the channel or duct system of the body responsible for transportation of tissue forming elements from the site of origin (mula sthana) to the site of utilization or elimination. They carry the preliminary form of tissues and the essential ingredients needed to form, build and maintain the tissues.
Read related: Srotas: Body Channels and Duct systems – Easy Explanation
For each tissue there are separate srotases which are specific for them and are bound and related to them. Each Srotas has mula sthanas (places of origin or control) from where these srotases are spread out. Each category of srotas forms and maintains the being of the tissues which are assigned to them.
According to Ayurveda, the entire body is made up of many millions of srotases. Thus, srotases form the important structural and functional units of the body. The body’s well being is maintained by the healthy srotases. This means that the srotases should be healthy and intact for the body functions to be taking place without any interruption.
Sroto Dushti i.e. contamination of the srotases eventually leading to their obstruction i.e. srotorodha will lead to the disturbance of all the activities causing an imbalance of tissues and nutrients in the body and also by non-elimination of metabolic wastes and toxins from the body.
This forms a suitable backdrop for the development of the disease process. Thus, Srotorodha is an important contributory factor for causation of a disease.
Read related: Samprapti Meaning, Definition, Types, Examples
A famous verse from the Ayurvedic treatises ‘Sarve api rogah mande agnau’ explains that almost all diseases are borne out of low agni – low metabolic activities (imbalanced fire / metabolic activities), unless proved otherwise. Agni is represented in the body in the form of Pitta.
The presence of agni in its active form and balanced proportions (sama agni) is one of the factors for a comprehensive health and well being of an individual (swastha lakshana). The absence of heat in the body is equated to death.
Read related: Understanding Agni: Concept, Definition, Functions, Types
There are 13 types of fire in the body spread out in the entire body, the chief fire being the belly fire or Jatharagni (represented by Pachaka Pitta located in the stomach and intestines). The Jathara Agni is the control station of all the other forms of agnis present throughout the body. The fire should be balanced, in a state of equilibrium if all the activities of the body should take place normally.
The agni digests the food and converts it into nutritional essence or ahara rasa. This ahara rasa is further transported in the entire body from the hridaya (heart) and dasha dhamanis (10 great blood vessels taking their origin from the hridaya). When this ahara rasa reaches the tissues, the tissue fires (dhatu agni) and the elemental fires (bhuta agni) therein convert the nutrients into the body components and tissues. Meanwhile heat, energy and waste products are formed. The wastes are excreted while the energy and heat are utilized for body activities.
If there is agnimandhya or sluggish functioning of agni, these natural processes will be brought to a standstill. All the activities of the body will be compromised. The body will not get essential nutrients and the wastes will not be thrown out. This will create a susceptible backdrop and an ideal situation wherein the disease can develop.
Apart from this, agnimandhya will cause formation of ama (discussed ahead) which will cause blocks in the channel and duct system of the body creating a suitable environment for the causation of the disease. Thus, Agnimandhya is an important contributory factor towards the causation of a vyadhi or disease.
Ama is a sticky and slimy, unprocessed, unformed, foul smelling substance which causes serious discomfort in the body parts apart from clogging and blocking the cells and ducts of the body.
This ama is formed in the stomach as a byproduct of sluggish digestion or agnimandhya (explained above). When the digestive fire in the belly i.e. agni is weak, it cannot digest the food properly. As a result of indigestion of food, unformed and unprocessed and immature digestive juices are formed and are absorbed as such in the intestines. These immature essences of digestion are called ama.
The ama absorbed from the intestines reaches the heart and is put into circulation. This ama circulating all over the body sticks to the walls of all the channels of transportation (srotas) and causes sroto avarodha (blockage of channels or transport system of the body) and also blocks all the cells of the body owing to its sticky nature.
When many orifices and ducts of the body are blocked, the body is deprived of essential nutrients. At the same time the ama gets associated with all the tissues, doshas and excreta forming sama dhatus, sama doshas and sama malas, these components make the body weak. The ama further causes further weakening of agni.
All these pathological events form a backdrop and ideal environment for the manifestation of disease in the body.
Thus, ama forms an important contributory factor for the causation of the disease and samprapti (pathogenesis) of any disease.
Just Before Finishing –
In this article we have discussed about the contributory factors of a vyadhi or disease from an ayurvedic viewpoint, each of which will be discussed as separate articles in future. The knowledge of these factors is very essential to understand the samprapti or pathogenesis of a disease and the quality and quantity of pathology occurring in any disease afflicting the body. This once again forms a foundation for planning and executing the treatment protocol for any disease in a comprehensive way.
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