CHAPTER-2

PIOUS NECTOR OF AYURVEDA

DETAILS OF TRIDOSH

There are only three types of Doshas in the body – Vata, Pitta and Kapha. But each of them is divided into five types, based on their place and functions.

Types and Palaces of Vata Dosha in body –

VATA

“बस्तिः पुरीषाधानं कटिः सक्थिनी पादावस्थीनि पक्वाशयश्च वातस्थानानि, तत्रापि पक्वाशयो विशेषेण वातस्थानं”

Basti – Urinary bladder, urinary system,

Pureesh aadhaana – rectum,

Sakthi – waist,

Padau – thighs, legs,

Asthi – bones and

Pakvashaya – colon are the sites of Vata.

Among them, Pakvashaya (colon) is the most important site.

Vata Dosha dominates these different parts of the body.

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

Prana Vata is considered as the force that takes care of functioning of heart, lungs and throat (swallowing, belching etc).

Udana Vata – The chest is the seat of Udana, it moves in the nose, umbilicus and throat; its functions are initiation of speech, effort, enthusiasm, strength, colour, complexion and memory.

Udana Vata is correlated with breath and process of respiration.  

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.

Vyana is related with blood circulation and muscle activities – flexion and extension.    

Samana Vata –Samana Vata is located near the digestive fire. It moves in the gastro intestinal 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. 

Samana Vata activities are limited to digestive tract, assisting in normal downward peristalsis.

Apana Vata –Apana Vata is located in the Apana – large intestine, moves in the waist, bladder, and genitals. It attends to the functions such as ejaculation, menstruation, defecation, urination and child birth. Apana maintains all excretion process related with lower half of trunk.

Types and Places of Pitta Dosha –

PITTA

स्वेदो रसो लसीका रुधिरमामाशयश्च पित्तस्थानानि, तत्राप्यामाशयो विशेषेण पित्तस्थानम्:

Svedo – Sweat,

Rasa – Rasa dhatu – end product of food digestion, containing all nutrients,

Lasika – Lymph,

Rudhira – blood,

Amashaya – small intestine (lower part of Amashaya) are the sites of pitta.

Among them, small intestine (lower part of Amashaya) is the most important site of Pitta Dosha.

Pitta influences these different body parts....

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.

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.

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

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

Types and places of Kapha Dosha –

KAPHA

उरः शिरो ग्रीवा पर्वाण्यामाशयो मेदश्च श्लेष्मस्थानानि, तत्राप्युरो विशेषेण श्लेष्मस्थानम्||८||

Ura – chest,

Shira – head,

Greeva – neck,

Parva – joint,

Amashaya – stomach (upper part of Amashaya) and

Meda – fat are the sites of Shleshma (Kapha).

Among them, chest is the most important site of Kapha Dosha.

Kapha dominates these different body parts...

Avalambaka Kapha – It is located in the chest. 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.

Kledaka Kapha – Located in the 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.    

FOR CONVENIENCE OF READING WE HAVE TABULATED THE PLACES OF DOSHAS

5 types of vata dosha       

 5 types of pitta dosha

5 types of kapha dosha

 

Prana Vata - Governs inhalation, perception through the senses and governs the mind. Located in the brain, head, throat, heart and respiratory organs.

Udana Vata - Governs speech, self-expression, effort, enthusiasm, strength and vitality. Located in the navel, lungs and throat.

Samana Vata - Governs peristaltic movement of the digestive system. Located in the stomach and small intestines.

Apana Vata - Governs all downward impulses (urination, elimination, menstruation, sexual discharges etc.) Located between the navel and the anus.

Vyana Vata - Governs circulation, heart rhythm, locomotion. Centred in the heart and permeates through the whole body.

Pachaka Pitta - Governs digestion of food which is broken down into nutrients and waste. Located in the lower stomach and small intestine.

Ranjaka Pitta - Governs formation of red blood cells. Gives colour to blood and stools. Located in the liver, gallbladder and spleen.

Alochaka Pitta - Governs visual perception. Located in the eyes.

Sadhaka Pitta - Governs emotions such as contentment, memory, intelligence and digestion of thoughts. Located in the heart.

Bharajaka Pitta - Governs lustre and complexion, temperature and pigmentation of the skin. Located in the skin.

Kledaka Kapha - Governs moistening and liquefying of the food in the initial stages of digestion. Located in the upper part of the stomach.

Avalambhaka Kapha - Governs lubrication of the heart and lungs. Provides strength to the back, chest and heart. Located in the chest, heart and lungs.

Tarpaka Kapha - Governs calmness, happiness and stability. Nourishment of sense and motor organs. Located in the head, sinuses and cerebrospinal fluid.

Bodhaka Kapha - Governs perception of taste, lubricating and moistening of food. Located in the tongue, mouth and throat

Shleshaka Kapha - Governs lubrication of all joints. Located in the joints.

 

General functions of balanced Doshas:

GENERAL

सर्वशरीरचरास्तु वातपित्तश्लेष्माणः सर्वस्मिञ्छरीरे कुपिताकुपिताः शुभाशुभानि कुर्वन्ति- प्रकृतिभूताः शुभान्युपचयबलवर्णप्रसादादीनि, अशुभानि पुनर्विकृतिमापन्ना विकारसञ्ज्ञकानि||९||

All the three Doshas are present in all parts of the body. These Doshas, in normal balanced condition, cause good health and in imbalanced condition, they cause illness.

When they are balanced, they cause

Upachaya – body nourishment

Bala – improvement of strength and immunity

Varna Prasada – improvement of skin health and complexion

Diseases caused by Tridosha Imbalance:

Endogenous diseases (Nija Roga) again are two types:

Samanyaja Vyadhi – Diseases caused by Vata, Pitta and Kapha in different combinations.

Nanatmaja Vyadhi – specific diseases caused by individual Doshas – Vata, Pitta and Kapha.

Samanyaja Vyadhi – Diseases of the combined Doshas are explained in the preceding chapter and diseases caused by individual imbalanced Doshas are being explained here.

Nanatmaja Vyadhi – Diseases caused by individual Doshas –

Vata when imbalanced alone, causes 80 types of disorders.

Pitta when imbalanced alone, causes 40 types of disorders.                                                          

Kapha when imbalanced alone, causes 20 types of disorders.

Eighty diseases caused by Vata alone – Vataja Nanatmaja Vyadhi:

Though Vata imbalance diseases are innumerable, the following eighty diseases are the most commonly manifested ones:

1. Nakhabheda (cracking of nails)

2. Vipadika (cracking of feet)

3. Pada shoola (pain in foot)

4. Pada Bhramsha (foot Drop)

5. Pada Suptata (numbness of foot)

6. Vata khuddata (club foot)

7. Gulpha Graha (stiff ankle)

8. Pindikodveshtana (cramps in calf muscle)

9. Gridhrasi (sciatica)

10. Janu Bheda (Genu varum) - Bow leggedness, bandiness

11. Januvishlesha (Genu valgum) – Knock Knee

12. Urustambha( stiffness of thigh)

13. Urusada (pain in the thigh)

14. Pangulya (paraplegia)

15. Guda Bhramsa (prolapsed rectum)

16. Gudarti (Tenasmus)

17. Vrushanakshepa (pain in scrotum)

18. Shepha Stambha (stiffness of penis)

19. Vankshana anaha (tension of groin)

20. Shroni Bheda (pain around the pelvic girdle)

21. Vidheda (diarrhea)

22. Udavarta (bloating)

23. Khanjatva (lameness)

24. Kubjatva (kyphosis)

25. Vamanatava(dwarfism)

26. Trikagraha (stiffness of sacro-iliac joint)

27. Prsistagraha (stiffness of back)

28. Parshva Marda (pain in chest)

29. Udaraveshta (Gripping pain in abdomen)

30. Hrit Moha (braby cardia)

31. Hrit Drava (tachycardia)

32. Vaksha- Udgharsha (rubbing pain in chest)

33. Vaksha- Uparodha (impairment of thoracic movement)

34. Vakshastoda (stabbing pain in chest)

35. Bahu Shosha (atrophy of arm)

36. Greeva Stambha (stiffness of the neck)

37. Manyastambha (torticollis)

38. Kanthoddhvamsa(hoarseness of voice)

39. Hanu Bheda (pain in jaw)

40. Ostha Bheda (pain in lips)

41. Akshi Bheda (pain in eye)

42. Danta Bheda (toothache)

43. Danta Shaithilya (looseness of tooth)

44. Mookatva (aphasia / dumbness)

45. Vak Sanga(stalling speech)

46. Kashaya asyata (astringent taste in mouth)

47. Mukha shosha (dryness of mouth)

48. Arasajnata(ageusia) – loss of taste function

49. Ghrana Nasha(anosmia) – loss of smell function

50. Karna Shoola (ear ache)

51. Ashabda Shravana (tinnitus)

52. Ucchaih Shruti (hard hearing)

53. Badhirya (deafness)

54. Vartma Stambha (Ptosis of eye lid)

55. Vartma Samkocha (entropies)

56. Timira(amaurosis) – a type of vision loss

57. Akshi Shoola (pinching pain in eye)

58. Akshi Vyudasa (Ptosis of eye ball)

59. Bhru Vyudasa (ptosis of eye brow)

60. Shankha Bheda (pain in temporal region)

61. Lalata Bheda (pain in frontal region)

62. Shiro Ruk (headache)

63. Kesha bhumi sphutana (dandruff)

64. Ardita(facial paralysis)

65. Ekanga Roga (monoplegia)

66. Sarvanga Roga (polyplegia)

67. Pakshavaha (hemiplegia)

68. Akshepaka (convulsion)

69. Dandaka (tonic convulsion)

70. Tama (fainting)

71. Bhrama (giddiness, dizziness)

72. Vepathu (tremor)

73. Jrumbha (yawning)

74. Hikka (hiccup)

75. Vishaada (asthenia) – weakness, depression

76. Ati Pralapa (delirium) – excessive irrelevant talk

77. Raukshya (dryness)

78. Parushya (hardness)

79. Shyava Arunaava Bhasata (dusky red appearance)

80. Asvapna (sleeplessness)

Qualities of Vata Dosha – how it is exhibited in Vata Nanatmaja diseases –

तद्यथा- रौक्ष्यं शैत्यं लाघवं वैशद्यं गतिरमूर्तत्वमनवस्थितत्वं चेति वायोरात्मरूपाणि; एवंविधत्वाच्च वायोः कर्मणः स्वलक्षणमिदमस्य भवति तं तं शरीरावयवमाविशतः ; तद्यथा- स्रंसभ्रंसव्याससङ्गभेदसादहर्षतर्षकम्पवर्तचालतोदव्यथाचेष्टादीनि, तथा खरपरुषविशदसुषिरारुणवर्णकषायविरसमुखत्वशोषशूलसुप्तिसङ्कोचनस्तम्भनखञ्जतादीनि च वायोः कर्माणि; तैरन्वितं वातविकारमेवाध्यवस्येत्||१२||

In all the pure Vata diseases, enumerated or implied, the inherent natural qualities and actions of Vata are quite obviously manifested wholly or partially and as such it is not difficult for a competent physician to correctly diagnose the Vatika type of diseases.

Raukshya – Rookshata – roughness,

Shaitya – Sheetata – coolness,

Laaghava – Laghu – lightness,

Vaishadya – clarity, non-sliminess,

Gati – movement,

Amoortata – shapelessness,

Anavastitatva – instability- these are the inherent qualities of Vata.

How to understand Tridosha by its qualities?

Vata Dosha while moving from one part of the body, if abnormal, exhibits symptoms like –

Sramsa – looseness,

Bhramsa – dislocation,

Vyasa – expansion,

Sangha – obstruction,

Bheda – separation,

Saada – depression,

Harsha – excitation,

Tarsha – thirst,

Kampa – trembling,

Varta – circular movement,

Chaala – motion,

Toda – piercing pain,

Vyatha – aching pain,

Cheshta action etc.

Khara – coarseness,

Parusha – harshness,

Vishada – non-sliminess,

Sushira – porousness,

Aruna Varna – reddishness, (colour of sunrise)

Kashaya – Astringent taste,

Virasa Mukhatva – tastelessness in the mouth,

Shosha – wasting pain,

Shoola – pain,

Supti – numbness,

Samkocha – contraction,

Sthambhana- rigidity and

Khanjata – lameness, etc. – these are the actions that help a competent physician to diagnose the pure Vatik type diseases.

General principles of treatment of Vata disorders:

Madhura, Amla Lavana Snigdha Ushna Upakrama – The vitiated Vata should be treated by drugs having sweet sour and saline taste and unctuous and hot qualities.

Snehana – oleation,

Sveda – fomentation, sweating treatment,

Asthapana – decoction enema,

Anuvasana – oil enema,

Nasyakarma – nasal instillation of drops,

Bhojana – healthy diet,

Abhyanga – massage,

Utsadana – unction,

Parisheka – sprinkling of oil / liquid containing materials having anti-Vata properties.

This is to be done with due regard to the dosage and the season.

Importance of Basti treatment in Vata disorders –

Of all the treatments stated above, the Asthapana (decoction enema) and Anuvasana (oil enema) are the treatment par excellence for the cure of Vatik diseases, because immediately after entering the colon, they strike at the very root of the vitiated Vata and when Vata is overcome in the colon, even the entire vitiated Vata dwelling in other parts of the body is automatically alleviated.

This can be likened to the cutting of the root of a tree which results in the automatic fall of the trunk, branches, sprouts, flowers, fruits, leaves, etc.

Forty specific diseases of Pitta – Pittaja Nanatmaja Vyadhi –

Forty varieties of diseases due to the vitiation of Pitta. Even though the diseases due to the vitiation of Pitta are innumerable, the following forty varieties are the most commonly manifested.

1. Ushna (heating)

2. Plosha (scorching)

3. Daha (burning)

4. Davathu (boiling)

5. Dhoomaka (fuming)

6. Amlaka (acid eructation)

7. Vidaaha (pyrosis) – heart burn

8. Antar daaha (burning sensation inside the body)

9. Amsa daha ( burning sensation in shoulder)

10. Ushmaadhikya (excessive temperature)

11. Ati Sveda (excessive sweating)

12. Anga gandha (bad odour of thee body)

13. Angaavadarana(cracking pain in the body)

14. Shonita kleda(sloughing of the blood)

15. Mamsa kleda (sloughing of the muscle)

16. Tvak Daaha( burning sensation in the skin)

17. Charma dalana(itching of the skin)

18. Tvagavadarana (cracking of the skin)

19. Rakta kotha (urticaria)

20. Rakta visphota (red vesicle)

21. Rakta Pitta(bleeding tendency)

22. Rakta mandala (red wheals)

23. Haritatva (greenishness)

24. Haaridratva (yellowishness)

25. Neelika (blue moles)

26. Kaksha (herpes)

27. Kaamala (jaundice)

28. Tiktaasyata (bitter taste in month)

29. Lohita Gandhasyata (smell of blood from the mouth)

30. Pooti mukhata(foetid odour of mouth)

31. Trishnaadhikya (excessive thirst)

32. Atrupti (non-satisfaction)

33. Aasya Vipaka (stomatitis)

34. Gala paka(pharyngitis)

35. Akshi paka (conjunctivitis)

36. Guda paka (proctitis)

37. Medhra Paka(inflammation of the penis)

38. Jivadana(hemorrhage)

39. Tamah pravesha (fainting)

40. Harita haridra netra mutra varchas (greenish and yellowish coloration of eyes, urine & faeces)[14]

Patho- physiology of Pitta diseases:

In all the Paittika type of diseases enumerated or implied, the inherent natural qualities and actions of Pitta are quite obviously manifested wholly or partially and as such it is not difficult for a competent physician to correctly diagnose the Paittika type of diseases.

Qualities of Pitta –

औष्ण्यं तैक्ष्ण्यं द्रवत्वमनतिस्नेहो वर्णश्च शुक्लारुणवर्जो गन्धश्च विस्रो रसौ च कटुकाम्लौ सरत्वं च पित्तस्यात्मरूपाणि;

The inherent natural qualities of Pitta are

Aushnya – Ushna – heat,

Taikshnya – Teekshna – sharpness,

Dravatva – liquidity,

Anati Sneha – slight unctuousness, mild oiliness, all colours except white and red,

Visra Gandha – fishy smell,

Katu, Amla – acrid and sour tastes,

Saratva – fluidity,

Pitta imbalance symptoms –

Daaha – burning sensation,

Aushnya – ushna – heat,

Paaka – suppuration,

Sveda – perspiration,

Kleda – sloughing,

Kotha – putrification,

Kandu – itching,

Srava – discharge,

Raaga – redness

and exhibition of its inherent smell, colour and taste.

General principles of treatment for Pitta diseases:

Madhura, Tikta Kashaya – Pitta is treated with herbs having sweet, bitter and astringent tastes,

Sheeta – cooling qualities,

Snehana – oleation,

Virechana – purgation,

Pradeha – unction,

Parisheka – effusion,

Abhyanga – massage, etc. procedures done with herbs havin anti Pitta qualities.

This is of course to be done with due regard to the dosage and season.

Importance of Virechana in Pitta imbalance –

Of all the devices stated above, the purgation is the treatment par excellence for curing the Paittika diseases because, immediately after it is administered, it eliminates the vitiated Pitta from its very root from the level of intestines. When it is overcome in the Amasaya (small intestine), it alleviates the entire vitiated Pitta dwelling in other parts of the body. This can be likened to a hot chamber being cooled by removing the fire from inside it.

Twenty types of kaphaja diseases – Kaphaja Nanatmaja Vikara.

Now we shall explain the twenty verities of diseases due to the vitiation of Kapha. Even though, the diseases due to the vitiation of Kapha are innumerable; the following are the twenty varieties which are most commonly manifested.

1. Trupti (anorexia nervosa)

2. Tandra (drowsiness)

3. Nidraadhikya(excessive sleep)

4. Staimitya (timidness)

5. Guru Gatrata (heaviness of the body)

6. Alasya (laziness)

7. Mukha Maadhurya (sweet taste in mouth)

8. Mukha Srava (salivation)

9. Shleshmodgirana (mucus expectoration)

10. Malaadhikya (excessive excretion of excreta)

11. Balasaka (loss of strength)

12. Apakti (indigestion)

13. Hrudayopalepa (feeling as if heart is wrapped up with moisture)

14. Kantopalepa (phlegm adhered to throat)

15. Dhamani Pratichaya (hardening of vessels)

16. Galaganda (goiter)

17. Ati Sthaulya (obesity)

18. Sheetaagnita(suppression of digestive powder)

19. Udarda (urticaria)

20. Shvetaavabhasata (pallor), Shveta Mutra Netra Varchastva (whiteness of urine, eye and faces)

Pathophysiology of kaphaja diseases:

एवंविधत्वाच्च श्लेष्मणः कर्मणः स्वलक्षणमिदमस्य भवति तं तं शरीरावयवमाविशतः; तद्यथा- श्लेष्मणः कर्माणि; तैरन्वितं श्लेष्मविकारमेवाध्यवस्येत्||१८||

In all the Shlaishmika (Kaphaja) type of diseases enumerated or implied, the inherent natural qualities and actions of Kapha are quite obviously manifested fully or partly and as such it is not difficult for a competent physician to correctly diagnose the shlaishmika type of diseases.

Qualities of Kapha –

तद्यथा- स्नेह शैत्य शौक्ल्य गौरव माधुर्य स्थैर्य पैच्छिल्य मार्त्स्न्यानि श्लेष्मण आत्मरूपाणि;

Sneha – Unctuousness,

Shaitya – coolness,

Shauklya – whiteness,

Gaurava – heaviness,

Maadhurya – sweetness,

Sthairya – steadiness,

Paicchilya – sliminess,

Maartsnya – viscosity- three are the inherent qualities of kapha.

Kapha brings about following attributes to the body.

श्वैत्य शैत्य कण्डू स्थैर्य गौरव स्नेह सुप्ति क्लेदोपदेह बन्ध माधुर्य चिरकारित्वानि;

Shvaitya – Shveta – whiteness,

Shaitya – Sheeta – coolness,

Kandu – itching,

Sthairya – steadiness, stability,

Gaurava – heaviness,

Sneha – unctuousness, oiliness,

Supti – numbness,

Kleda – moistness, stickiness,

Upadeha – sliminess, as if being anointed with oil,

Bandha – binding, obstruction,

Madhurya – sweetness,

Chirakaritva – slowness, delay in manifestation- these are the actions that help a competent physician to diagnose diseases caused by kapha.

General Principle of treatment for Kaphaja diseases:

They (diseases due to vitiated Kapha) should be treated with

Katu Tikta Kashaya – herbs having pungent, bitter, astringent taste,

Teekshna Ushna Rooksha – treatments and medicines having sharp, hot and dryness qualities,

Sveda – fomentation, sweating,

Vamana – emesis, vomiting therapy,

Shiro Virechana – elimination of Doshas from the head by Nasya procedure,

Vyayama – exercise etc, which should all contain materials having Anti- Slaismika properties.

This is of course to be done with due regard to the dosage and season. Of all the devices stated above, emetic therapy is the treatment par excellence for the cure of diseases due to Kapha because immediately after entering the Amashaya – stomach, it strikes at the very root cause of the vitiation of Kapha and when it is overcome in the stomach, even the entire vitiated Kapha dwelling in other parts of the body is automatically alleviated. This can be likened to the withering away of paddy, barley, etc. for want of barrier of the cornfield (full of water) being broken.

IMPORTANCE OF DIAGNOSIS IN TREATMENT:

रोगमादौ परीक्षेत ततोऽनन्तरमौषधम्|ततः कर्म भिषक् पश्चाज्ज्ञानपूर्वं समाचरेत्||२०||

यस्तु रोगमविज्ञाय कर्माण्यारभते भिषक्|अप्यौषधविधानज्ञस्तस्य सिद्धिर्यदृच्छया||२१||

यस्तु रोगविशेषज्ञः सर्वभैषज्यकोविदः|देशकालप्रमाणज्ञस्तस्य सिद्धिरसंशयम्||२२||

A physician should first of all diagnose the disease and then he should select proper medicine. Thereafter, he should administer the therapy applying the knowledge of the science of medicine, he had already gained.

A physician who initiates treatment without proper diagnosis of the diseases can accomplish the desired object only by chance (he cannot be sure of his success).

The fact that he  is well- acquainted with the knowledge of application of medicine does not necessarily guarantee his success. On the other hand, the physician who is well-versed in diagnosing diseases, who is proficient in the administration of medicines and who knows about the dosage of the therapy that varies from place to place and season to season, is sure to accomplish the desired objective.

STAY HEALTHY STAY BLESSED

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