Dosha

The word ‘Dosha’ literally means impurities or morbidities. In Ayurveda, dosha are the governing principles of physiology and psychology. They are the primary and essential constitutional factors of the human organism. They maintain the integrity of the human body. [Su.Sa. Sutra Sthana 21/23] The three dosha at physical level, vata, pitta, and kapha, vitiate different body tissues and can lead to diseases in disequilibrium state. [SAT-B.382] They are the actual intrinsic factors which become excited and imbalanced, either conferring a predisposition to or actually causing morbidities disease (vyadhi). Their state of equilibrium is one of the important pre-requisite for disease free state (arogya) [Cha.Sa. Sutra Sthana 9/4] and health [Su.Sa. Sutra Sthana 15/48]. The dosha have been correlated with systems theory in the field of physics, providing a sound theoretical basis for this Ayurvedic concept, and research utilizing a biostatistical approach to quantify the dosha reveals a sound empirical basis as well. Being the units of microcosm in body, the three dosha, kapha, pitta and vata, maintain integrity of the organism by creating, assimilating and diffusing strength in the same way as the Moon (soma), Sun(surya) and Air (anila), maintain integrity of the macrocosm respectively. [Su.Sa. Sutra Sthana 21/8]

Contributors

Section/Chapter/topic	Sharira / Dosha
Authors	Deole Y.S.1, Shilwant A.A.2
Reviewed by	Basisht G.1
Affiliations	1Charak Samhita Research, Training and Development Centre, I.P.G.T.& R.A., Jamnagar, Gujarat, India 2Department of Kriya Sharir, G.J.Patel Institute of Ayurvedic Studies and Research, New Vallabh Vidyanagar, Anand, Gujarat, India
Correspondence email:	carakasamhita@gmail.com
Date of first publication:	January 24, 2021
DOI	Under process

Etymology and derivation

The word dosha is derived from Sanskrit root ‘dusha’ meaning causing abnormalities (vaikrutye).

Types and sub types of dosha

The dosha are broadly categorized into two:

1. Somatic or physical level (sharira dosha): Three dosha viz. vata, pitta and kapha.
2. Psychic or mental level (manas dosha): Two dosha viz. rajas and tamas. [Cha.Sa. Sutra Sthana 1/ 57]

The present article describes somatic or physical dosha.

Origin of dosha

Dosha at physical level originate from five fundamental elements (pancha mahabhuta). Vata dosha originates from vayu and akasha mahabhuta; Pitta dosha from agni mahabhuta and kapha dosha from combination of aap and prithvi mahabhuta. The dosha represent functions of dominant mahabhuta in the body at gross level. They can be principles of regulators, enhancers or inhibitors of the physiological functions.

Subtypes of dosha

Each physical dosha has five subtypes based on their functions and sites.

1. Vata dosha: Prana, Udana, Samana, Vyana, Apana
2. Pitta dosha: Pachaka, Ranjaka, Sadhaka, Alochaka, Bhrajaka
3. Kapha dosha: Avalambaka, Kledaka, Bodhaka, Tarpaka, Shleshaka [A.Hr. Sutra Sthana 12]

Functions of dosha

The dosha govern all the physiological activities. Growth and development (upachaya), strength (bala), complexion (varna), blissful state (prasannata) depends upon them. [Cha.Sa. Sutra Sthana 20] Vata governs functions in the body related to initiation and movement e. g. food through the digestive tract, transportation of oxygen in the bloodstream, communication between cells via nerve impulses, excretion of metabolic wastes etc. Pitta governs functions that relate to transformation (e.g., digestion of food, processes of metabolism, etc.), hunger, thirst, vision, sensory perception, intelligence, complexion, and heat generation. Kapha governs the structure and cohesion of the body. It relates with function of strength, stability and moisture in body. [A. Hr. Sutra Sthana 11/1-3]

Properties of dosha

The dosha act through their properties (guna). The properties (guna) are responsible for showing specific effect (karma). Dosha govern the functions related to that property and lead to resultant effect. Therefore, these properties are also applied as parameters to assess normal and abnormal states of dosha in body. The resultant effect is observed clinically.

Table 1: Properties of Dosha

Sr.No	Parameter of effect	Vata Dosha	Pitta Dosha	Kapha Dosha
1	Specific gravity/weight/volume	Lightness (laghu)	--	Heaviness (guru)
2	Unctuousness portion	Dryness (ruksha)	Slightly unctuous (sa-sneha)	Unctuous (snigdha)
3	Temperature and potency	Cold (sheeta)	Hot (ushna)	Cold (sheeta)
4	Touch /texture	Roughness (khara)	--	Unctuous/slimy
5	Duration of effect	Quickly acting (ashukari), short lasting effect (alpa), cyclic tendency (muhushchari)	Sharp or pungent (tikshna)/ quick acting, severe effect	Prolong duration of action (chirakari). Long lasting effect, and mild (manda)
6	Movability	Moving (chala)	Slightly movable (sara)	Stable or immovable (sthira)
7	Consistency	Subtle (sukshma)	Liquid (drava)	Slimy, sticky (pichhila)
8	Taste	--	Sour (amla), pungent (katu) in taste [8]	Sweet (madhura) in taste
9	Psychological co-relate	Rajas	Sattva	Tamas
10	Other properties	Cleansing or Non-slimy (vishad), Severely acting (daruna)[5], conducive (yogavahi) [6], Can move oblique or in any direction (tiryag gami), responsible for sound (shabda) and touch(sparsha) perception [6]	Foul smelling (vistra)	--

Charak Samhita[2] Sushrut Samhita[3] Ashtanga Hridaya[4] Kashyap Samhita[5] Sharangdhara Samhita[6]

Primary centers of dosha

These are omnipresent throughout the body. However, their primary centres are located in below umbilicus (vata dosha), between umbilicus and cardiac region (pitta dosha) and above cardiac region (kapha dosha). [A. Hr. Sutra Sthana 1/7] More specifically, vata dosha regulates the functions in the regions of large intestine (pakvashaya), lumbar region (kati), thighs (sakthi), ears (shrotra), bones (asthi) and skin (sparshanendriay). Pitta dosha regulates functions in umbilicus (nabhi), stomach (amashaya), sweat glands (sweda), lymphatics (lasika), blood (rudhira), nutrient fluids (rasa), eyes(drik), and skin (sparshana). Kapha dosha regulates functions in chest, throat, head (shira), all joints (parva), stomach(amashaya), nutrient fluids (rasa), adipose tissue (meda), nose (ghrana) and tongue(jivha). [A.Hr.Sutra Sthana 12/1-3]

Affinity of vitiation

Dosha primarily vitiate their own sites of body constituents (dhatu and mala). The vata dosha resides in and vitiates bones (asthi); pitta dosha vitiates sweat (sweda) and blood (rakta dhatu). Kapha dosha affects all remaining body constituents like nutrient fluids (rasa dhatu), muscle tissue (mamsa dhatu), adipose tissue (meda dhatu), bone marrow(majja), reproductive constituents (shukra dhatu), urine (mutra) and stools (purisha). [A.Hr. Sutra Sthana 11/26]

These sites are important in diagnosis of origin of disease pathology, site of lesion, and target oriented treatments.

Importance of dosha

Dosha are the fundamental principles of body that are responsible for every physiological as well as pathological events in the body. [Su.Sa. Sutra Sthana 15/3, A.sa. Sutra Sthana 16, A.Hr.Sutra Sthana 11] Dosha form the fundamental body constitution (prakriti), play vital role in digestion and metabolism (agni), preserve and maintain health while in state of equilibrium.

Body constitution or phenotype (dosha prakriti)

The body constitution (prakriti) of a person is based upon the relative proportions of the three dosha. The equilibrium or dominance of dosha at the time of formation of embryo determines the body constitution (deha prakriti). [Cha.Sa. Sutra Sthana 7/40] This proportion is further modulated by the diet and lifestyle of mother, age, and the environment in which the person grows to generate the unique dosha-prakriti of the individual. The individual shows characteristic features of respective dominant dosha in prakriti. It is very similar to the phenotype in modern biology. Thus, the current genetic paradigms believe that the phenotype of individual results from interaction between genotype (established at fertilization) and the environment, which includes epigenetic changes resulting from parental age, diet, lifestyle, and other environmental factors. Genomic variations with the classification of prakriti are studied. It is observed that PGM1 correlates with phenotype of pitta prakriti. This suggests that the phenotypic classification has a genetic basis; and its prakriti-based practice resonates with personalized medicine. The relation between clinical phenotype and predisposition of disease is studied. The study was carried out on the association of Methylenetetrahydrofolate reductase (MTHFR) C677T and A1298C with type 2 diabetes and prakriti. An extremely strong association between prakriti (kaphaja/kapha-pittaja) and type 2 diabetes (P < 0.00001) was detected in this study.

Studies have shown that Ayurvedic body type classification may be associated with genes of inflammation and oxidative stress factors, the rate of DNA methylation and development of cardiovascular diseases.

Influence of dosha on digestion (agni) and gut (koshtha)

The dominant dosha influences the biological processes of digestion and metabolism. It also affects the gut functions (koshtha). The digestion and gut patterns are classified into three categories based on the dominance of dosha as shown in table below.

Table 2: Influence of dosha on digestion and gut pattern [9]

Sr.No	Dosha	Agni (digestion pattern)	Koshtha (gut pattern)	Clinical picture
1	Vata Dosha	Irregular digestion (Vishama agni)	Hard bowel (Krura koshta)	Irregular digestion, hard stools, constipation, inhibited intestinal motility, discomfort in defecation and abdominal pressure
2	Pitta Dosha	Fast digestion (Tikshna agni)	Soft bowel (Mrudu koshta)	Fast digestion, increased sensitivity of intestinal mucosa, loose motions, frequent defecation
3	Kapha Dosha	Slow digestion (Manda agni)	Medium (not too soft, not too hard) bowel (Madhyam koshta)	Slow and sluggish digestion, semi solid, soft consistency of stool, defecation with ease

Pathological importance

The dosha are the factors that get vitiated themselves in the initial stage of the disease. Further, they vitiate other body constituents (dhatu and mala). Therefore, disequilibrium of dosha is the primary and fundamental cause of any disease. [Su.Sa.Sutra Sthana 21/3]

Factors influencing dosha in body

Diet and lifestyle

The diet dominant in similar properties of dosha increases the proportion of dosha in body. The diet which is opposite to the properties of dosha decreases the proportion of dosha. Therefore, diet which maintains equilibrium state of dosha in the body is advised for preservation of health. The following table shows specific tastes and potencies that influences the dosha.

Table 3: Influence of taste and potency on dosha

Sr.No	Dosha	Aggravating taste (rasa) and veerya (potency)	Pacifying taste (rasa) and veerya (potency)
1	Vata Dosha	Pungent (katu), bitter (tikta), astringent(kashaya), cold potency	Sweet(madhura), sour(amla), salty(lavana), hot potency
2	Pitta Dosha	Sour(amla), salty(lavana), pungent (katu), hot potency	Sweet(madhura), bitter (tikta), astringent(kashaya), cold potency
3	Kapha Dosha	Sweet(madhura), sour(amla), salty(lavana), cold potency	Pungent (katu), bitter (tikta), astringent(kashaya), hot potency

The lifestyle activities that produce similar effects as of dosha lead to vitiation of dosha and vice versa. For example, excess movement increases vata dosha, and rest pacifies vata dosha. The same principles are applied in treatment of diseases due to vitiation of dosha.

Season, age, time and circadian rhythm

The time factor in terms of season, age, day-night rhythm naturally influences levels of dosha in body. The changes in the microcosm are observed due to changes in macrocosm.

Table 4: Impact of Season, age, time and circadian rhythm on dosha

Sr.No	Dosha	Age	Peak time in day-night cycle	Peak Season	Peak time after meals
1	Vata Dosha	Old age	Time of end of day and night	Rainy season	Post digestion
2	Pitta Dosha	Middle age	Midday and midnight	Autumn	Mid digestion
3	Kapha Dosha	Childhood	Start of day and night	Spring	Immediately after meals, starting of digestion

Natural cycle of dosha as per seasonal variation (ritu kriyakala)

The body is continuously exposed to the external environment and climatic changes as per season. The dosha tend to deviate from normal state and show variations in their levels according to the seasons. These physiological disequilibrium states are maintained by adopting seasonal dietary and lifestyle regimen (ritucharya) to preserve health. As these states are more prone for opportunistic diseases, these are also called as ‘ritu kriyakala’ (seasonal opportunities). The table shows seasonal variations in dosha.

Table 5: Influence of taste and potency on dosha

Sr.No	Dosha	State of accumulation (chaya)	State of aggravation (prakopa)	State of alleviation (prashama)
1	Vata Dosha	Summer (grishma)	Rainy season(varsha)	Autumn (sharada)
2	Pitta Dosha	Rainy season (varsha)	Autumn (sharada)	Pre-winter (hemanta)
3	Kapha Dosha	Winter (shishira)	Spring (vasanta)	Summer (grishma)

Clinical aspect of dosha

Diagnosis of the abnormal state

The increased (vriddhi) or decreased (kshaya) state of dosha in body is diagnosed by assessment of physiological functions of respective dosha. [Cha.Sa. Sutra Sthana 18/52-53]

Diseases due to dosha

The endogenous diseases (nija vyadhi) are caused by the vitiation of dosha (vata, pitta, and kapha). The diseases caused due to combination of two or three dosha are called as general (samanya) diseases. The diseases caused due to vitiation of one dosha only are called as nanatmaja (dosha specific) diseases. [Cha.Sa.Sutra Sthana 20/10]

Treatment

The abnormal states of dosha are treated with rational therapeutic use of pharmacological and non-pharmacological measures. [ Cha.Sa. Sutra Sthana 1/58] The treatment principles of various states of dosha are as follows:

1. Decreased state: Increase dosha by diet and lifestyle
2. Vitiated state: Pacification therapy
3. Aggravated state: Removing the excess to restore equilibrium
4. Normal state: maintain the equilibrium [Su.Sa. Chikitsa Sthana 33/3]

Some primary selective treatments in the increased state of dosha are stated in following table.

Table 6: Selective treatment modality and substance for dosha

Sr.No	Dosha	Type of Treatment	Therapeutic substance
1	Vata Dosha	Therapeutic Enema (Basti)	Oil (Taila)
2	Pitta Dosha	Therapeutic Purgation (Virechan)	Ghee/Clarified butter (Ghrita)
3	Kapha Dosha	Therapeutic Emesis (Vaman)	Honey (Madhu)

Current researches

Relation of dosha to physiological markers and brain functions

Research studies have suggested the patterns of blood chemistry, genetic expression, physiological states, and chronic diseases are associated with each dosha type. Triglycerides, total cholesterol, high LDL, and low HDL concentrations, common risk factors for cardiovascular diseases were reported to be higher in kapha types as compared to pitta and vata types. Whereas Hemoglobin and RBC count tend to be higher in pitta as compared to other types, while serum prolactin was found to be higher in vata types. Genetic expression also distinguishes dosha types. Where genes in the immune response pathways were up-regulated in pitta types, genes related to cell cycles up-regulated in vata types, and genes in the immune signaling pathways were found to be up-regulated in kapha types.

Also, inflammatory genes were up-regulated in vata types, whereas up-regulation of oxidative stress pathway genes were observed in pitta and kapha types. CD25 (activated B cells) and CD56 (natural killer cells) were higher in kapha dosha types. CYP2C19 genotypes, a family of genes that help in detoxification and metabolism of certain drugs were down-regulated in kapha types and up-regulated in pitta types. A research program using physiological and cortical measures is suggested to explore the utility of dosha brain-types. Dosha brain models may give scope to learn in field of relation of dosha to electroencephalography EEG patterns, autonomic activation and autonomic balance, stress reactivity and behavior. This line of research could help clarify variable response to drugs and lifestyle modifications in normal and clinical populations and so help target health promotion at all levels of life. There are possible correlations between autonomous nervous systems and dosha.

The systems approach proposed by Hankey A. shows how tridosha applies to every living organism from the first cells, and how it is inherited and diversified in the history of life. Ayugenomics study confirms dosha's inheritance. Each dosha is responsible for regulating an essential aspect of organism function, connected to a recognised definition of life: Vata, Input/Output (homeostasis); Pitta, Turnover (negative entropy production); Kapha, Storage (inheritable structure).

Relation of vata dosha and vagus nerve

Venil Sumantran and Pratibha Nair proposed strong correlations between vagus nerve and vata dosha activity. They have hypothetically provided four possible reasons to assume vagal activity as a reliable candidate biomarker of important vata dosha functions. First, normal vata dosha and the vagus maintain neural, respiratory, and digestive homeostasis, and dysfunctions in both entities cause very similar diseases. Second, vata dosha regulates higher neural functions such as mental health and behaviour, and the 'polyvagal theory' proposes similar functions for the vagus. Third, the similar roles of vata dosha and vagus in maintaining gut homeostasis, suggest that vagal activity in the 'gut-brain' link is a candidate biomarker of pakwashaya (lower gut), a primary regulatory site for vata dosha. Fourth, the vagus is the only vital nerve whose activity can be reliably measured and manipulated. Vagal nerve stimulation is an approved therapy for certain ailments attributed to impaired vata dosha. This research can provide better understanding in concept and practical approach towards vata dosha.

Nuclear corelation

Sharma H. and Wallace RK proposed that mRNA, tRNA, and protein have features and properties that represent vata, pitta, and kapha at the cellular level. Messenger RNA corresponds with vata (transmission of information), tRNA corresponds with pitta (transformation), and protein corresponds with kapha (structure).

Assessment of dosha

Manohar PR and his team of researchers proposed the heart rate variability analysis to determine functions of dosha in body. Substantial agreement between the HRV analysis and the clinical method of assessing dosha imbalances in pathological conditions is observed in data. S. Shilpa and C.G.Venkatesha Murthy (2011) developed and standardized Mysore Tridosha Scale, wherein only the psychological aspects of the dosha prakriti have been used to build items for the assessment of personality. The psychometric properties of the scale are established with significant reliability and validity of data.

Relation of dosha to sleep

A study was conducted to determine if each dosha can act as a predictor of quality and quantity of sleep. The survey-based cross-sectional study carried out on 995 persons of both sexes (average age 49.1 years) suggests that higher vata scores are associated with a longer time to fall asleep and a lesser feeling of being rested in the morning. Higher kapha scores, in contrast, are associated with longer daytime naps. These results suggest tridosha play important role in sleep physiology. The dosha can influence the quality and quantity of sleep.

References