Koshta Shakha Marma-Asthi-Sandhi Gati Of Dosha – Doshas In Organs And Joints

Article by Dr Raghuram Y.S. MD (Ay) & Dr Manasa, B.A.M.S
Among the various presentations of Dosha movements, the triplet of Koshta Gati, Shakha Gati and Marmasthi Sandhi Gati is an important one.
Doshas move when they are imbalanced, to other places to cause diseases. 

Koshta Gati

Koshta Gati – movement of Doshas to visceral organs
Localization of vitiated doshas in the visceral organs leading to causation of diseases related to visceral organs like stomach, intestines, liver etc,

Shakha Gati

Shakha Gati – Dosha movement into tissues
Vitiated doshas in the tissues of the body leading to the manifestation of diseases pertaining to tissues like diseases of blood, lymph, muscle tissues, fat etc
Read related: Dhatu – 7 Body Tissues As Explained In Ayurveda

Marma Asthi Sandhi Gati

Imbalanced doshas in the vital organs, bones and bony joints of the body causing the diseases related to vital organs including heart, brain, urinary bladder and also diseases of bones and joints depending on the site of localization of vitiated doshas.

The above mentioned types of gatis of doshas are considered as dosha gatis which reflect the point of localization of vitiated doshas in the body, causing diseases therein.

The vitiated doshas get lodged in one or the other places among the koshta, shaka and marma-asthi-sandhi’s and causes diseases therein.


Koshta means the space for visceral organs. It is in fact a large space which gives occupancy to the koshta angas or visceral organs including stomach, pancreas, large intestine, small intestine, heart, lungs etc. Koshta is considered as Abhyantara Roga Marga (internal routes for diseases). Thus, in Koshta Gati, the vitiated doshas also move within the body or internal passages or pathways. The diseases are more oriented and caused in the alimentary tract or visceral organs.
Read related: Koshta – Large anatomical body cavities

Diseases caused by Koshta Gati of Doshas –

  • Chardi – vomiting,
  • Atisara – diarrhoea,
  • Shoola – colic or pain abdomen,
  • Gulma – abdominal tumors,
  • Vibandha – constipation, etc.


Shakha tissues
Shakha means tissues including twak (skin), rakta (blood), mamsa (muscle), meda (fat), asthi (bone), majja (bone marrow) and shukra (semen).

Skin should be considered as abode of rasa dhatu (lymph, plasma, active essence of digestive juice in circulation).
Shakha is considered as Bahya Roga Marga (external route for diseases). Thus, the doshas in Shakha Gati move in the external pathway or in tissues. The diseases are mainly caused in the skin and tissues like blood, muscle, fat etc

Diseases caused by Shakha Gati of Doshas

  • Rakta rogas – blood borne diseases,
  • Galaganda – goitre,
  • Gandamala – lymphadenitis,
  • Apachi – matted (suppurated or burst out) lymph glands,
  • Medoroga – obesity or diseases caused due to disturbance in fat metabolism,
  • Napumsakata – impotence etc.

Marma Asthi Sandhi

Marma-Asthi-Sandhis are vital organs (Marma), bones (asthi) and joints (sandhi) of the body. They are considered as Madhyama Roga Marga (intermediate route for diseases). The diseases are mainly caused in the Marmas, bones, joints, bone marrow and reproductive tissues.
Read related: Marma Shaareera: Definition, Composition: Vital Points of The Body

Diseases caused due to the Marma Asthi Sandhi Gati of Doshas –

  • Hridroga – heart diseases,
  • Unmada – insanity, mania,
  • Apasmara – epilepsy, memory related problems or diseases,
  • Ashmari – urinary calculi or stones,
  • Prameha – urinary diseases or diabetes,
  • Amavata – rheumatoid arthritis,
  • Sandhigata vata – osteoarthritis, etc


Importance of having the knowledge of Koshta, Shakha and marma-Asthi-Sandhi gati
The knowledge of koshta, shakha and marma-asthi-sandhi gati would help the physician to locate the place at which the disease is located.

This knowledge also would help in deciding the prognosis of the disease since the vitiated doshas or disease located in each of these places would have a different prognosis.

The diseases or vitiated doshas located in the Marma-asthi-sandhi are said to be having difficult prognosis (krichra sadhya). Similarly it is said that the dosha located in one of the above mentioned roga margas is said to be difficult to cure when the chikitsa chatushpadas (4 limbs of treatment) are either not available or not equipped.

The dwidoshaja rogas (diseases caused by simultaneous vitiation of 2 doshas) located in two of the above said 3 margas is krichrasadhya (difficult to cure) when these diseases are not too chronic.

It is also said that the diseases located in multiple shakhas or dhatus (many tissues) and vitiated doshas or diseases which have been localized in Marma, asthi and sandhis are Yapya i.e. manageable.

Diseases located in gambhira dhatus (deeper tissues) i.e. asthi, majja and shukra dhatus, diseases and vitiated doshas located in all or many dhatus, diseases and doshas located in all the margas i.e. shakha, koshta and marma-asthi-sandhi are said to be incurable (asadhya).
Read related: Contributory Factors for a Disease – Ayurvedic View Point

The knowledge of the above said gatis will help in planning and implementing proper treatment for the diseases located in these places after thoroughly considering the prognosis of dosha vitiation or diseases on the basis of their location.
Read related: Upward, Downward, Lateral Dosha Movement (Urdhwa Adho Tiryak Doshagati)

Just Before Finishing –
In this article we have discussed about the movement of doshas towards koshta, shakhas and marma, asthi and sandhis producing the diseases therein and the importance of knowing such gatis.
Click to Consult Dr Raghuram Y.S. MD (Ayu) – Email / Skype

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