Are doshas and diseases permanently and inseparably associated?

Article by Dr Raghuram Y.S. MD (Ay) & Dr Manasa S, B.A.M.S

We know the association between the morbid doshas and manifestation of diseases. Ayurveda says that no disease can manifest without the involvement of the doshas – vata, pitta and kapha (and also rakta according to Acharya Sushruta, who considers rakta or blood as fourth dosha).

The aggravated doshas attack the weak tissues, get lodged therein, cause tissue damage and produce many diseases.

But an important question about this dosha-vyadhi relationship arises in the 24^th chapter of Sushruta Samhita Sutra Sthana.

Is the association between the doshas and diseases a permanent one or a temporary one? Is it a separable one or an inseparable one?

Acharya gives a precise answer for this debatable query at the end of the discussion.

In this article we shall touch upon this context and try to find answers for this question.

Are doshas and diseases associated permanently or temporarily?

1. The context or preamble for this question

कुपितानां हि दोषाणां शरीरे परिधावताम् ॥
यत्र सङ्गः खगैगुण्याद्व्चधिस्तत्रोपजायते॥१०॥

The aggravated doshas keep circulating all over the body. While circulating, due to the kha vaigunya – abnormality of the channels (in the tissues), these doshas get obstructed. As a result, they also get stagnated therein, at the point or area of obstruction. The diseases get manifested at that place of dosha aggravation or where aggravated doshas are obstructed and stagnated.

This part of discussion becomes a preamble for the question to arise.

2. Question related to the relationship between doshas and vyadhi (disease)

भृयोऽत्र जुज्ञास्यं, किं वातादीनां ज्वरादीनां च नित्यः संश्लेषः परिच्छेदो वा?इति ; यदि नित्यह् संश्लेषः स्यात्तार्हि नित्यातुराः सर्व एव प्रणिनः स्युः; अथाप्यन्य्हथ वातदीनां ज्वरादीनं  मूलानीति  तन्न। अत्रोच्यते-दोषान् प्रत्याख्याय  ज्वरादयो नभवन्ति;अब च न  नित्यः संबन्धः;यथाहि विद्युद्वाताशनिर्षाण्याकाशं प्रत्याख्याय न, भवन्ति, सत्यप्याकाशे कदाचित्र भवन्ति, अथ च  निमित्ततस्तत एवोत्पत्तिरितिः तरङ्गबुद्वुदायश्चोदकविशेषा एव, वातादीनां ज्वरादीनां च नाप्येवं संश्लेषो न परिच्छेदः शाच्छेद :, अथ च निमित्तत एवोत्पत्तिरिति ॥११॥

In this context, a great debatable point is about the relationship between the doshas (vata, pitta, kapha, rakta) and diseases like jwara etc. Is this relationship a samshlesha – permanent, ongoing and inseparable one or is it a parichcheda – temporary and separable relationship?

Case 1 – Nitya, Samshlesha – The doshas and disease always holds a permanent and inseparable relationship

If we take the hypothesis that the doshas and diseases have a permanent relationship always, then all the living beings in the world should become sick and diseased at the same time and at all times.

But this is impossible. All living beings are not always diseased and all living beings in the world do not fall sick at the same time. So, the relationship is not a permanent one and should be otherwise.

Case 2 – Anitya, Vishlesha, Parichcheda – The doshas and disease always holds a temporary and separable relationship

If the relationship between the doshas and the diseases is considered to be always a temporary one and also a separable one, the symptoms of vata etc doshas and jwara etc diseases cannot be manifested in a single / same place, due to the presence of these doshas and diseases at different places. This is because, logically the features (symptoms) of something present at some place will not appear elsewhere (at some other place). Therefore, in this case, the vata etc doshas will not be the root causes of jwara etc diseases.

The conclusive remarks by Acharya

Contradicting the opinions above, Acharya says that ‘diseases like jwara etc will not occur without the involvement of the doshas’. At the same time, the relationship between the doshas and diseases is also not a permanent, inseparable and constant one.

Analogy – ‘Lightening, wind, thunderbolt and rain cannot occur without the sky i.e. they always occur in the sky. On the other hand, in spite of the sky being present at all the times, the lightning, wind etc do not happen at all times. But the same lightning, wind etc would manifest in the same sky when there is presence of existing causes (for them to manifest) and suitable time for their manifestation (and do not occur at all times). Similarly, the water bubbles and the water waves also do not get manifested elsewhere, they manifest in the water only. We can see that the water bubbles and waves too, like lightning etc explained above, do not occur at all times in the water. They manifest only in the water at suitable times and in presence of suitable causes.’

The same logic needs to be applied to understand the relationship between the doshas and diseases also. The relationship between doshas and the diseases is neither of permanent association nor of permanent dissociation. The diseases get manifested only by those doshas which undergo aggravation due to the causes / etiological factors such as improper foods and activities, in the time of their occurrence i.e. when the pathogenesis has been completed.