Difference between revisions of "Kapha dosha"

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<div style='text-align:justify;'>Kapha dosha controls body fluids and maintains the structural cohesion of the organism. It is one of the three dosha. It is responsible for cohesiveness, unctuousness, lubricity, stability, and immunity. Kapha dosha has dominance of prithvi and jala mahabhuta.[Code:SAT-B.414]<ref name="ref1">KhandaleN.S.(2014): Conceptual and Applied study of Snigdha Guna of Kapha Dosha w s r ShariraBala.Dept. of Kriya Sharir, Dr. Sarvepalli Radhakrishnan Rajasthan Ayurved University.</ref> The concept of kapha is the foundation for growth, preservation, and anabolism theories.</div>
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<div style='text-align:justify;'>Kapha dosha controls body fluids and maintains the structural cohesion of the organism. It is one of the three dosha. It is responsible for cohesiveness, unctuousness, lubricity, stability, and immunity. Kapha dosha has dominance of prithvi and jala mahabhuta.[Code:SAT-B.414]<ref name="ref1">National AYUSH Morbidity and Standardized Terminologies Electronic Portal by Ministry of AYUSH Available on http://namstp.ayush.gov.in/#/Ayurveda</ref> The concept of kapha is the foundation for growth, preservation, and anabolism theories.</div>
 
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<li>Spirometry<ref name="ref22">Pierce R. Spirometry: an essential clinical measurement. Aust Fam Physician. 2005 Jul;34(7):535-9.</ref></li></ul>
 
<li>Spirometry<ref name="ref22">Pierce R. Spirometry: an essential clinical measurement. Aust Fam Physician. 2005 Jul;34(7):535-9.</ref></li></ul>
 
These tests will provide a potent analytical tool for determining kapha dosha.</div>
 
These tests will provide a potent analytical tool for determining kapha dosha.</div>
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== Treatment ==
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<div style='text-align:justify;'>The principle of similarities and dissimilarity (samanya- visheshasiddhanta) is applied in treatment. Rasa (taste) and diet, that decrease kapha (shamaka) and aggravate kapha (prakopa), to treat and/or prevent disease are included in management. Lifestyle and behavior to manage the levels of kapha dosha are included. Therapeutic emesis (vamana) is the best intervention indicated for vitiated kapha. [Cha.Sa. Sutra Sthana 20/19] [Cha. Sa. Sutra Sthana 25/40] [K.S. Sutra Sthana 27/48]<ref name="ref9"/>  <br/>Honey (madhu) and oil(tail) is helpful for the vitiated kapha dosha. [Cha. Sa. Sutra Sthana 25/40] <br/>The herbs with pungent, bitter, astringent, hot, and penetrating qualities are used in single or combination along with therapies like swedana (sudation therapy),  nasya (nasal therapy), exercise, etc. These are helpful in the treatment of kapha disorders. [Cha.Sa. Sutra Sthana 20/19] [K.S. Sutra Sthana 27/46]<ref name="ref9"/>
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<br/>'''Dietary modification:''' Three tastes (rasa) that help in controlling the vitiated kapha are – pungent (katu), bitter(tikta), and astringent (kashaya). Ingestion of food having dry, hot properties and in less quantity is useful for kapha dosha management. [Cha. Sa. Sutra Sthana 1/66] [A.Hr. Sutra Sthana 13/10-12]<ref name="ref8"/>
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<br/>'''Lifetsytle modification:''' Less sleep, dry massage of body, fasting, mouth gargles, exercise of different types, desire for sex. [A.Hr. Sutra Sthana 13/10-12]<ref name="ref8"/> </div>
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== Future area of research ==
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<div style='text-align:justify;'>The critical area of research isthe preparation of a validated and standardized questionnaire for assessingthe different states of kapha, like depletion(kshaya), increase (vriddhi), and normalcy. Guna-based assessment of kaphais needed. Evaluation of muscle and joints in various musculoskeletal disorders through modern scientific tools like MRI(magnetic resonance imaging), fMRI(functional -MRI), PET(Positron emission tomography) Scan,etc. may help in understanding normal and abnormal functioning ofkapha. Assessment of kapha state in various physiological phases of life like pregnancy, lactation, childhood, old age, high altitude, space, deep sea through subjective and objective methods.Assessment through application of molecular biology, proteomics, genomics, microbiome, and metabolomicsis needed.The application of kaphain  peripheral physiology, ergonomics, and biomechanics may become future research of interest. </div>
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== Current researches ==
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<ul style='text-align:justify;'><li style="font-weight:bold">Vasantikavamana (therapeutic emesis in spring season) - A preventive measure for diseases of kapha origin: <span style="font-weight:normal">The study was conducted on 69 volunteers/patients who followed classical vamana therapy.The therapeutic emesis (vamana)is confirmed to be safe in the study that was specifically conducted at vasantritu. The general wellness of the volunteers and patients was also seen to have improved.<ref name="ref23">Bhatted S, Shukla VD, Thakar A, Bhatt NN. A study on Vasantika Vamana (therapeutic emesis in spring season) - A preventive measure for diseases of Kapha origin. Ayu. 2011 Apr;32(2):181-6.</ref></span></li>
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<li style="font-weight:bold">Development of a reliable Dosha self-assessment questionnaire: <span style="font-weight:normal">The goal of this study was to create a valid Dosha self-assessment questionnaire with features appropriate for use in clinical research. The basis for developing 108 Dosha-specific test items with a 7-point Likert scale was a review of existing questionnaires and translations of classic Ayurvedic texts, along with an analysis of item-total correlations and ANOVAs by Dosha for 735 responses to a 37-item ipsative questionnaire from an Ayurveda company. From this, a 39-item quiz (13 for each Dosha) was eventually created. This study shows that it is possible to reliably quantify the three dosha for most clinical investigations.<ref name="ref24">Edwards MT, Streiner DL. Development of a reliable Dosha self-assessment questionnaire. Explore (NY). 2022 Sep-Oct;18(5):573-578.</ref></span></li>
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<li style="font-weight:bold">Dosha as a predictor of sleep quality: <span style="font-weight:normal">The present study was conducted on 995 people to see if there was any association between dosha and sleep since sleep is a result of increased kapha using standardized questionnaires. The findings imply that the dosha can affect both the duration and quality of sleep. The results of the study showed that kapha scores strongly predicted both the length of daytime naps in minutes [p<0.05] and daytime somnolence [p<0.05], with higher kapha scores being related to longer daytime naps.<ref name="ref25">Telles S, Pathak S, Kumar A, Mishra P, Balkrishna A. Ayurvedic doshas as predictors of sleep quality. Med Sci Monit. 2015 May 17;21:1421-7.</ref></span></li>
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<li style="font-weight:bold">Heart rate variability analysis in the assessment of dosha imbalance: <span style="font-weight:normal">Total 42 individuals' heart rate variability (HRV) spectrum data were gathered for this study in order to compare it to the clinical evaluation of dosha imbalance. A preliminary investigation to evaluate the diagnostic agreement between the clinical approach and HRV analysis in the assessment of gross dosha imbalance found significant concordance, as shown by the Kappa value of 0.78. The current study highlights the need for more research to confirm the HRV's usefulness in evaluating complicated dosha imbalances and other factors like dhatu imbalance.<ref name="ref26">Ram Manohar P, Sorokin O, Chacko J, Nampoothiri V. An exploratory clinical study to determine the utility of heart rate variability analysis in the assessment of dosha imbalance. J Ayurveda Integr Med. 2018 Apr-Jun;9(2):126-130.</ref></span></li></ul>
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== Theses  done ==
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<ol style='text-align:justify;'><li>KhandaleN.S.(2014): Conceptual and Applied study of Snigdha Guna of Kapha Dosha w s r ShariraBala.Dept. of Kriya Sharir, Dr. Sarvepalli Radhakrishnan Rajasthan Ayurved University.</li>
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<li>Sharad C.(2009): A study of “Taste perception of Madhur Rasa in Kaphadhikya Prakriti with special reference to BodhakKapha.Dept. of Kriya Sharir, College of ayurveda, pune, Bharati Vidyapeeth University.</li>
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<li>Chejara N. (1994):Avalambakakapha ka vaigyanikavivechana.  Dept. of Kriya Sharir, NIA, Jaipur. This study concluded that Pericardial fluid, Pleural fluid, Thyroid, Parathyroid & Thymus gland hormones  may be correlated with avalambakakapha.</li></ol>
  
 
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Revision as of 15:57, 27 December 2022

Cite.png
Kapha dosha controls body fluids and maintains the structural cohesion of the organism. It is one of the three dosha. It is responsible for cohesiveness, unctuousness, lubricity, stability, and immunity. Kapha dosha has dominance of prithvi and jala mahabhuta.[Code:SAT-B.414][1] The concept of kapha is the foundation for growth, preservation, and anabolism theories.
Contributors
Section/Chapter/topic Concepts/Dosha/Kapha Dosha
Authors Bhojani M. K. 1,
Tanwar Ankur Kumar 1
Reviewer Basisht G.2,
Editor Deole Y.S.3
Affiliations 1 Department of Sharir Kriya, All India Institute of Ayurveda, New Delhi, India
2 Rheumatologist, Orlando, Florida, U.S.A.
3Department of Kayachikitsa, G.J.Patel Institute of Ayurvedic Studies and Research, New Vallabh Vidyanagar, Gujarat, India
Correspondence emails meera.samhita@aiia.gov.in,
carakasamhita@gmail.com
Publisher Charak Samhita Research, Training and Development Centre, I.T.R.A., Jamnagar, India
Date of publication: December 16, 2022
DOI 10.47468/CSNE.2022.e01.s09.123

Etymology and derivation

The word kapha is derived from root “kena jalena phalati iti kapha”.[2] It implies that water is the foundation of the kapha. The term ‘Shleshma’ used for kapha is derived from the root “ shlish alingane”.[3][Su. Sa.Sutra Sthana 21/5] The meaning is to cohere, to keep together, or to adhere.

Synonyms:[3][4]

In normal states-Shleshma [Cha. Sa. Sutra Sthana 12/12], bala[Cha. Sa. Sutra Sthana 17/117], oja[Cha. Sa. Sutra Sthana 17/117], balasa[Su. Sa. Sharira Sthana 4/74][3] [Vachaspati on M.N. 2/40][4] balasaka[Vijayarakshita on M.N. 2/40][4], Soma[Cha. Sa. Sutra Sthana 12/12]
In abnormal states- Papma, mala[Cha. Sa. Sutra Sthana 17/117]

Various aspects:

Kapha is related to bala(strength) to perform work. It is a potential source of resistance to disease and aging. It is responsible for union and integration. Soma or water in the body, is implicit in the kapha. [Cha. Sa. Sutra Sthana 12/12] The body weight and growth are both regulated by kapha. It bestows stability and toughness. It is a crucial element in the healing process and is regarded as virility, robust sexual health, and reproductive ability. All biological fluids, whether internal or extracellular, are composed of kapha and serve essential purpose of body. It oversees many types of cohesiveness between cells, tissue, and organs.

Bhautika composition

Kapha dosha has dominance of Jala and Prithvi mahabhuta.[5][A.S. Sutra Sthana 20/2] Although all the mahabhuta participate in the composition, jala mahabhuta expresses dominant role and Prithvi mahabhuta as secondary. Acharya sushruta opines that kapha dosha originatesfrom saumya or jalamahabhuta.[3][Su.Sa. Sutra Sthana42/5] [DalhanaSu.Sa. Sutra Sthana 15/8](Figure 01)

Kapha dosha and triguna

All the living & nonliving thingsoriginate from panchamahabhuta. These panchamahabhutaoriginate from trigunatmaka prakriti as described in evolution process (utpatti karma). Dosha evolve from panchamahbhuta, so these dosha bear triguna property. Sushruta stated that kaphaevolved from jala and prithvi. Jala has sattva and tama predominance. Prithvihas tama predominance [3] [Su. Sa.ShariraSthana 1/20] Shharangdhara and Bhavaprakashopine that kaphahas tama predominance. [Sha.Sa.Pratham Khand 5][6] [Bha. Pra. Purva Khand 3/103][7] (Figure 01)
Figure 01: Relation between Triguna, Mahabhuta and Kapha Dosha.
Figure 01: Relation between Triguna, Mahabhuta and Kapha Dosha.

Sites of kapha

Dosha are present all over the body. [Cha.Sa. Sutra Sthana 20/9] They have specific sites in normal physiological conditions. The general location of kapha is the upper parts of the body. It is marked as above the heart(hridaya).[A.S. Sutra Sthana 1/4][5] Thes pecific seats of kapha areas below: [Code:SAT-B.238][1] [Code:SAT-B.420][1](Figure 02)
  • Chest(Ura)[Cha.Sa. Sutra Sthana 20/9] [Su. Sa.SutraSthana 21/7][3][A.S. Sutra Sthana 20/3][5][A.Hr. Sutra Sthana 12/3][8] [K.S. Sutra Sthana 27/11][9]
  • Head (shira)[Cha.Sa. Sutra Sthana 20/9] [Su. Sa.SutraSthana 21/7][3][A.S. Sutra Sthana 20/3][5][A.Hr. Sutra Sthana 12/3][8]
  • Neck region(griva)[Cha.Sa. Sutra Sthana 20/9][K.S. Sutra Sthana 27/11][9]
  • Joints (parva or sandhi)[Cha.Sa. Sutra Sthana 20/9] [Su. Sa.SutraSthana 21/7][3] [A.S. Sutra Sthana 20/3][5][A.Hr. Sutra Sthana 12/3][8][K.S. Sutra Sthana 27/11][9]
  • Stomach(amashaya)[Cha.Sa. Sutra Sthana 20/9] [A.S. Sutra Sthana 20/3][5] [A.Hr. Sutra Sthana 12/3][8]
  • Fat (meda)[Cha.Sa. Sutra Sthana 20/9] [A.S. Sutra Sthana 20/3][5] [A.Hr. Sutra Sthana 12/3][8] [K.S. Sutra Sthana 27/11][9]
  • Throat(kantha) [Su. Sa.SutraSthana 21/7][3] [A.S. Sutra Sthana 20/3][5][A.Hr. Sutra Sthana 12/3][8]
  • Organ controlling water uptake and loss(kloma) [A.S. Sutra Sthana 20/3][5] [A.Hr. Sutra Sthana 12/3][8]
  • Nutrient body fluid or plasma (rasa)[A.S. Sutra Sthana 20/3][5][A.Hr. Sutra Sthana 12/3][8]
  • Nose (ghrana) [A.S. Sutra Sthana 20/3][5] [A.Hr. Sutra Sthana 12/3][8]
  • Tongue(jihva or rasana)[Su. Sa.SutraSthana 21/7][3][A.S. Sutra Sthana 20/3][5] [A.Hr. Sutra Sthana 12/3][8]
  • Arms(bahu) [K.S. Sutra Sthana 27/11][9]

Among all these sites, chest region (ura) is the prime site of kapha dosha.[Cha.Sa. Sutra Sthana 20/9][A.S. Sutra Sthana 20/3][5] [A.Hr. Sutra Sthana 12/3][8] [Arunadatta on A.Hr. Sutra Sthana 12/3][8] Kapha doshais predominately present in stomach(amashaya). [Su. Sa.Sutra Sthana 21/6][3] Chakrapani precisely explains the location of kapha as upper part of amashaya(stomach). [Chakrapani on Cha.Sa. Sutra Sthana 20/8]

Figure 02. General(A) and specific sites(B) of kapha dosha.
Figure 02. General(A) and specific sites(B) of kapha dosha.

Attributes:

The characteristics of kapha are:
  • Heaviness(guru or gaurava)[Cha.Sa. Sutra Sthana 1/61][Cha.Sa. Sutra Sthana 20/18] [Cha.Sa. Vimana Sthana 8/96] [Su. Sa.Sutra Sthana 21/15][3] [A.Hr. Sutra Sthana 1/12][8] [K.S. Sutra Sthana 27/44][9] [Sh.Sa.Pratham Khand 5/34][6]
  • Coldness(shita)[Cha.Sa. Sutra Sthana 1/61] [Cha.Sa. Sutra Sthana 20/18] [Cha.Sa. Vimana Sthana 8/96][Su. Sa.SutraSthana 21/15][3][Sh.Sa.Pratham Khand 5/34][6] [A.Hr. Sutra Sthana 1/12][8][K.S. Sutra Sthana 27/44][9]
  • Softness (mridu)[Cha.Sa. Sutra Sthana 1/61] [Cha.Sa. Vimana Sthana 8/96]
  • Unctuousness (snigdha) [Cha.Sa. Sutra Sthana 1/61] [Cha.Sa. Sutra Sthana 20/18] [Cha.Sa. Vimana Sthana 8/96] [Su. Sa.SutraSthana 21/15][3][A.Hr. Sutra Sthana 1/12][8][K.S. Sutra Sthana 27/44][9] [Sha.Sa.Pratham Khand 5/34][6]
  • Sweet (madhura)[Cha.Sa. Sutra Sthana 1/61] [Cha.Sa. Sutra Sthana 20/18] [Cha.Sa. Vimana Sthana 8/96] [Su. Sa.Sutra Sthana 21/15][3] [Sha.Sa.Pratham Khand 5/34][6] [K.S. Sutra Sthana 27/44][9]
  • Firmness/stability (sthira)[Cha.Sa. Sutra Sthana 1/61][A.Hr. Sutra Sthana 1/12][8]
  • Sliminess (picchila)[Cha.Sa. Sutra Sthana 1/61][Su. Sa.SutraSthana 21/15][3] [Sha.Sa.Pratham Khand 5/34][6]
  • Whitish(shaukalya or shweta) [Cha.Sa. Sutra Sthana 20/18] [Cha.Sa. Vimana Sthana 8/97][Su. Sa.SutraSthana 21/15][3][Sha.Sa.Pratham Khand 5/34][6] [K.S. Sutra Sthana 27/44][9]
  • Mouldable (mrutsana)[Cha.Sa. Sutra Sthana 20/18] [A.Hr. Sutra Sthana 1/12][8]
  • Smoothness (slakshana) [Cha.Sa. Vimana Sthana 8/96] [A.Hr. Sutra Sthana 1/12][8]
  • Mobile(sara) [Cha.Sa. Vimana Sthana 8/96]
  • Compact(sandra) [Cha.Sa. Vimana Sthana 8/96]
  • Slowness(manda) [Cha.Sa. Vimana Sthana 8/96] [A.Hr. Sutra Sthana 1/12][8]
  • Stable (stimita) [Cha.Sa. Vimana Sthana 8/96]
  • Viscous(vijjala) [Cha.Sa. Vimana Sthana 8/96]
  • Transparent(accha) [Cha.Sa. Vimana Sthana 8/96]
Kaphadosha has sweet(madhura)taste in completely transformed or mature stage.It is salty(lavana) in incomplete stage or when it is not fully formed. [Su. Sa.Sutra Sthana 21/15][3] Kashypa stated kapha is white in color.[K.S. Sutra Sthana 27/44][9]

Functions of kapha

Kapha has independent tasks in the body. However, it is dormant without vata dosha. [Sha.Sa.Pratham Khand 5/25][6] The principal function of kapha dosha is to maintain the normal physiology by supporting growth and anabolism. The special functions of kapha are as below: [Code:SAT-B.421][1] [Cha.Sa. Sutra Sthana 18/51] [Cha.Sa. Sutra Sthana 12/12] [Su. Sa.SutraSthana 15/4][3] [A.Hr. Sutra Sthana 11/3][8]
  • Provides and maintains unctuousness to the body (snehana)
  • Maintains the anatomical integrity of various cells, tissue, and organ with each other, as well as provides support/ Maintain the integrity of joints(bandhana)
  • Maintain firmness and steadiness(sthirata or dardhyata)
  • Provides weight to various structures and organs (gauravata)
  • Maintains reproductive health(vrishta)
  • Provides physical and mental strength(bala)
  • Maintains the quality of forgiveness(kshama)
  • Maintains the quality of patience(dhriti)
  • Maintains the quality of greedlessness(alobha)
  • Growth of the body(upachaya)
  • Fortitude
  • Knowledge(jnana)
  • Intelligence (buddhi)
Figure 03: Categorization of the functions of kapha.
Figure 03: Categorization of the functions of kapha.

Acharya Vagbhatawas the first to describe five types of kapha with names. [A.Hr. Sutra Sthana 12/15-18][8] Five particular functions of kapha are as below: [Su.Sa. Sutra Sthana 15/4][3] [Dalhana on Su.Sa. Sutra Sthana 15/4][3]

  1. Maintains the structural integrity of joints(sandhi samshleshana)
  2. Maintains the unctuousness (snehana)
  3. Helps in the healing process(ropana)
  4. Provides nutrition to the whole body(purana)
  5. Provides strength (bala)

Classification

The classification of kaphais based on different functions and locations in the human body. [Su.Sa. Sutra Sthana 15/4][3] [Su. Sa.Sutra Sthana 21/7][3] [Su.Sa. Sutra Sthana21/12-14][3] [A.S. Sutra Sthana 20/8][5] [A.Hr. Sutra Sthana 12/15-18][8]

Five types:

Avalambaka, kledaka, bhodhaka, tarpaka, and shleshaka are the five classifications of kaphadosha.The location and function of five types of kaphadosha based on different ayurvedic texts are as given in table 01.
Table 01: Description of five types of kapha dosha
S.No. Type of kapha Location Function
01. Avalambaka
[Code:SAT-B.415][1] 		Chest(ura)
  • Supports trika(area of conjugation of head with two arms) [Dalhana on Su.Sa. Sutra Sthana 21/12-14][3] by its inherent power(trikasandharana)
  • Support and maintain the structural and functional integrity of heart by power of nutrients present in food(annarasa).(annarasasahitenhridyaavalambana)
  • Supports other kapha sites(sheshanam cha shleshmasthananamavalambanat)
02. Kledaka
[Code:SAT-B.416][1] 		Stomach(amashaya)
  • Liquefication and disintegration of food articles to facilitates easy digestion.(praklinnambhinnasanghata or annasanghatakledanat)
  • Supports the other kapha sites through its inherent qualities.
03. Bodhaka
[Code:SAT-B.417][1] 		Root of tongue(jihvamula)
Throat(kantha)
  • Facilitates the perception of taste(rasajyane)
04. Tarpaka
[Code:SAT-B.418][1] 		Head (shira)
  • Due to presence of natural qualities, it nourishes the sense organs.(tarpanata)
05. Shleshaka
[Code:SAT-B.419][1] 		Joints (sandhi)
  • Maintains the structural and functional integrity of all joints.(sarvasandhisanshleshat, sarva sandhi anugraha)
Figure 04: Location and Physiological aspect of different types of kapha.
Figure 04: Location and Physiological aspect of different types of kapha.

Kapha dominant constitution (prakriti)

Acharya described the characteristics of kaphaja constitution individuals based on attributes of kapha dosha. [Cha.Sa. Vimana Sthana 8/96] The person having kapha dosha in predominance have the following characteristics:
  • Unctuous and smooth organs
  • Pleasing personality and fair in complexion
  • Compact body appearance
  • Slow digestive process
  • Slow in physical and mental movements
  • Less perspiration, thirst and hunger
  • Intelligent
  • Thick and dense hair
  • Obedient to teachers

Lokapurusha samanya

The universe's entire production process is controlled by kapha. The kapha dosha in the human body represents the jala and prithvimahabhuta. The moon, sun, and wind are responsible for nourishing (visarga), exhausting (adana), and dispersing (vikshepa) in the universe. Similarly, the kapha, pitta, and vata do the same things in the human body.[Su.Sa. Sutra Sthana 29/6][3]

Factors responsible for abnormal states of kapha

Certain factors cause excess or decline of kapha in the human body. These factors are natural or unavoidable and artificial or avoidable.

Natural factors:

These factors are the essential components of biological rhythm occurring in the external as well as internal environment of the body. This natural increase is physiological. These factors are as follows:[Su.Sa. Sutra Sthana 21/24][3], [A.Hr. Sutra Sthana1/8][8], [A.Hr. Sutra Sthana12/24-25][8] [A.Hr. NidanaSthana1/17-18][8](Figure 05)
  • Season(ritu): Kapha undergoes accumulation in winter(hemant and shishira), gets vitiated in during spring(vasanta) and subsides to normal during summer(grishma).
  • Various stages of digestion of food: Kaphagetsincreasedduring thefirst stage of digestion or immediately after eating food(bhuktamatra).
  • Biological rhythm of day and night: Kaphais increased in the morning (purvahe) and evening (purvaratre or pradoshe).
  • Habitat(desha): Marshy area (anupa).
  • Age (vaya): In childhood, kapha is dominant as compared to other dosha.
Figure 05: Natural factors responsible for kapha vriddhi.
Figure 05: Natural factors responsible for kapha vriddhi.

Acquired factors:

Acquired factors are those which increase and aggravate kapha dosha other than natural factors. These are avoidable and used in clinical practice by applying the concept of samanyavisheshasiddhanta. These factors are as follows: [Su.Sa. Sutra Sthana 21/23-24][3] [A.Hr. Nidana Sthana 1/17-18][8]
  • Diet(dravya) and properties of diet: Food with sweet(madhura), sour(amla)and salt(lavana) taste, heavy-to-digest food, slimy, unctuous food articles and excessive intake of water cause kapha vitiation.
  • Lifestyle and other activities: Daytime sleep (diwaswapana), lack of exercise(avyayama), drinking water at night(nishaambupana), mixing wholesome and unwholesome together (samashana) and over eating before digestion of previous meals(adhyashana), etc. [Su.Sa. Sutra Sthana 21/23-24][3]
  • Emotional and behavior factors: pleasure(harsha).

Clinical aspects

Preventive aspect:

A person with a normal state of kapha dosha constitution (prakritakapha), should avoid diet and lifestyle vitiating kapha.

Stages of dosha:

Dosha continues to exist in three states: hypofunction (kshaya), hyperfunction (vriddhi), and normal physiological state (sama). [Cha.Sa. Sutra Sthana17/110]Increase and reduction in dosha functioning (karma) can be used to understand dosha increase and decline in the body. Dosha, when increased, produce their respective features in excess; when decreased, cut off their functions, and when in the normal state, perform their normal functions.

13.2.1Hyperfunctioning of kapha(vridhilakshana):

Whenkapha levels increase, the body exhibits various signs and symptoms as below: [Su.Sa. Sutra Sthana 15/13][3], [A.Hr. Sutra Sthana 11/7-8][8], [A.S. Sutra Sthana 19/5][5]:
  • Whitish coloration of skin(shaukalaya)
  • A feeling of coldness (shaityam)
  • Firmness and stiffness(sthairyam)
  • Heaviness in body(gauravam)
  • Depression (avasada)
  • Drowsiness(tandra)
  • Sleepiness(nidra or atinidrata)
  • Lack of firmness in joints(sandhivishlesha)
  • Low digestive capacity (agnisadana)
  • Salivation(praseka)
  • Laziness(alasya)
  • Flaccidity (slathangatvam or angasada)
  • Dyspnea (shwasa)
  • Cough(kasa)
  • Obesity(sthaulya)
  • Blockage of natural passages(srotapidana)
  • Syncope (murchha)
  • Nausea (hrillasa)

Hypo functioning of kapha (kshayalakshana):

When kaphadosha levels in the body are declining, the body exhibits various signs and symptoms as described below:[Su.Sa. Sutra Sthana15/7][3], [A.Hr. Sutra Sthana11/16][8], [A.S. Sutra Sthana19/8][5]
  • Dryness (rukshata)
  • Burning sensation in the body(antardaha)
  • Emptiness in all sites of kaphaespecially stomach(amashyaitrashleshmashyashunyta)
  • Flaccid joints(sandhi shaithilya)
  • Thirst (trishna)
  • Weakness (daurbalya)
  • Loss of sleep (prajagarana or anidra)
  • Giddiness (bhrama)
  • Twisting pain(udveshtana)
  • Body aches (angamarda)
  • A feeling of burning skin(parishosha)
  • Pricking pain(toda)
  • Tremors (vepana)
  • Burning sensation(daha)
  • A feeling of cracking or breaking pain(sphotana)
  • Feeling of smoke(dhumayana)
  • Palpitation (hridayadrava)

Diagnosis:

The state ofkapha dosha can be diagnosed and assessed based on clinical features. The most common clinical features of kapha dosha are unctuousness (sneha), whitishness(shwetya), coldness(shaitya), itching(kandu), heaviness(gaurava), chronicity (chirkaritvam), accumulation (upachaya), numbness(supti). [Cha.Sa. Sutra Sthana20/15] [K.S. Sutra Sthana 27/45][9]
Forty types of diseases due to an imbalance of kaphadosha(kaphananatmajavyadhi) occur, as below [Cha.Sa. SutraSthana 20/17] [K.S. Sutra Sthana 27/42-43][9] (Table 02)
Table 02: 20 types of disease of kapha (kaphananatmajavikara)[10]
Contentment(trupti) Drowsiness (tandra) Excess sleep (nidradhikya) Rigidity/stiffness (staimitya)
Heaviness in body(gurugatrata) Lassitude (alasya) Sweet taste in mouth (mukhamadhurya) Salivation (mukhastrava)
Expectoration of mucous(shleshmodgirana) Excess accumulation of waste products (maladhikya) Loss of strength (balasaka) Indigestion (apakti)
Adherence or coatingaround heart(hridayopalepa) Adherence or coating in throat (kanthopalepa) Adherence of waste in blood vessels/ atherosclerosis (dhamanipratichaya) Goiter (galaganda)
Morbid obesity (atisthaulya) Decreased digestive power (shitagnita) Urticarial rashes (udarda) Pale look (shvetavabhashata)

Diagnostic and assessment tools:

Kaphadosha can be assessed by clinical features and functions through subjective methods like questionnaires and objective methods. Currently, there are no validated and standardized tools for dosha assessment within the body. Kaphavriddhi and kshaya features will be assessed through a subjective questionnaire.Ayurvedic physicians assess the normalcy and abnormality through the ayurvedic principles of examination (pariksha).
Subjective and objective methods which may be used to assess the normalfunctioning of kapha are:
  • Test for assessment for muscular strength and endurance likedynamometry[11] and 6 minute walk test[12], etc.
  • Cardio- Pulmonary exercise tests[13].
  • Lipid profile[14], adiponectin[15] for assessment of meda.
  • Dual-energy X-ray absorptiometry[16]
  • Bioelectrical impedance devices to measure body fat percent (BF%), fat mass (FM), and fat-free mass (FFM).[17]
  • Electro-gustometry[18]
  • CSF examination[19]
  • Lung capacity and volume assessment[20][21].
  • Spirometry[22]
These tests will provide a potent analytical tool for determining kapha dosha.

Treatment

The principle of similarities and dissimilarity (samanya- visheshasiddhanta) is applied in treatment. Rasa (taste) and diet, that decrease kapha (shamaka) and aggravate kapha (prakopa), to treat and/or prevent disease are included in management. Lifestyle and behavior to manage the levels of kapha dosha are included. Therapeutic emesis (vamana) is the best intervention indicated for vitiated kapha. [Cha.Sa. Sutra Sthana 20/19] [Cha. Sa. Sutra Sthana 25/40] [K.S. Sutra Sthana 27/48][9]
Honey (madhu) and oil(tail) is helpful for the vitiated kapha dosha. [Cha. Sa. Sutra Sthana 25/40]
The herbs with pungent, bitter, astringent, hot, and penetrating qualities are used in single or combination along with therapies like swedana (sudation therapy), nasya (nasal therapy), exercise, etc. These are helpful in the treatment of kapha disorders. [Cha.Sa. Sutra Sthana 20/19] [K.S. Sutra Sthana 27/46][9]


Dietary modification: Three tastes (rasa) that help in controlling the vitiated kapha are – pungent (katu), bitter(tikta), and astringent (kashaya). Ingestion of food having dry, hot properties and in less quantity is useful for kapha dosha management. [Cha. Sa. Sutra Sthana 1/66] [A.Hr. Sutra Sthana 13/10-12][8]


Lifetsytle modification: Less sleep, dry massage of body, fasting, mouth gargles, exercise of different types, desire for sex. [A.Hr. Sutra Sthana 13/10-12][8]

Future area of research

The critical area of research isthe preparation of a validated and standardized questionnaire for assessingthe different states of kapha, like depletion(kshaya), increase (vriddhi), and normalcy. Guna-based assessment of kaphais needed. Evaluation of muscle and joints in various musculoskeletal disorders through modern scientific tools like MRI(magnetic resonance imaging), fMRI(functional -MRI), PET(Positron emission tomography) Scan,etc. may help in understanding normal and abnormal functioning ofkapha. Assessment of kapha state in various physiological phases of life like pregnancy, lactation, childhood, old age, high altitude, space, deep sea through subjective and objective methods.Assessment through application of molecular biology, proteomics, genomics, microbiome, and metabolomicsis needed.The application of kaphain peripheral physiology, ergonomics, and biomechanics may become future research of interest.

Current researches

  • Vasantikavamana (therapeutic emesis in spring season) - A preventive measure for diseases of kapha origin: The study was conducted on 69 volunteers/patients who followed classical vamana therapy.The therapeutic emesis (vamana)is confirmed to be safe in the study that was specifically conducted at vasantritu. The general wellness of the volunteers and patients was also seen to have improved.[23]
  • Development of a reliable Dosha self-assessment questionnaire: The goal of this study was to create a valid Dosha self-assessment questionnaire with features appropriate for use in clinical research. The basis for developing 108 Dosha-specific test items with a 7-point Likert scale was a review of existing questionnaires and translations of classic Ayurvedic texts, along with an analysis of item-total correlations and ANOVAs by Dosha for 735 responses to a 37-item ipsative questionnaire from an Ayurveda company. From this, a 39-item quiz (13 for each Dosha) was eventually created. This study shows that it is possible to reliably quantify the three dosha for most clinical investigations.[24]
  • Dosha as a predictor of sleep quality: The present study was conducted on 995 people to see if there was any association between dosha and sleep since sleep is a result of increased kapha using standardized questionnaires. The findings imply that the dosha can affect both the duration and quality of sleep. The results of the study showed that kapha scores strongly predicted both the length of daytime naps in minutes [p<0.05] and daytime somnolence [p<0.05], with higher kapha scores being related to longer daytime naps.[25]
  • Heart rate variability analysis in the assessment of dosha imbalance: Total 42 individuals' heart rate variability (HRV) spectrum data were gathered for this study in order to compare it to the clinical evaluation of dosha imbalance. A preliminary investigation to evaluate the diagnostic agreement between the clinical approach and HRV analysis in the assessment of gross dosha imbalance found significant concordance, as shown by the Kappa value of 0.78. The current study highlights the need for more research to confirm the HRV's usefulness in evaluating complicated dosha imbalances and other factors like dhatu imbalance.[26]

Theses done

  1. KhandaleN.S.(2014): Conceptual and Applied study of Snigdha Guna of Kapha Dosha w s r ShariraBala.Dept. of Kriya Sharir, Dr. Sarvepalli Radhakrishnan Rajasthan Ayurved University.
  2. Sharad C.(2009): A study of “Taste perception of Madhur Rasa in Kaphadhikya Prakriti with special reference to BodhakKapha.Dept. of Kriya Sharir, College of ayurveda, pune, Bharati Vidyapeeth University.
  3. Chejara N. (1994):Avalambakakapha ka vaigyanikavivechana. Dept. of Kriya Sharir, NIA, Jaipur. This study concluded that Pericardial fluid, Pleural fluid, Thyroid, Parathyroid & Thymus gland hormones may be correlated with avalambakakapha.

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References

  1. ↑ 1.0 1.1 1.2 1.3 1.4 1.5 1.6 1.7 1.8 National AYUSH Morbidity and Standardized Terminologies Electronic Portal by Ministry of AYUSH Available on http://namstp.ayush.gov.in/#/Ayurveda
  2. ↑ Amarkosha. Amarsimha, Edited by Pt. Haragovindasastri. Reprint Ed. Varanasi:Chaukhambha Sanskrit Sansthan, 2020.
  3. ↑ 3.00 3.01 3.02 3.03 3.04 3.05 3.06 3.07 3.08 3.09 3.10 3.11 3.12 3.13 3.14 3.15 3.16 3.17 3.18 3.19 3.20 3.21 3.22 3.23 3.24 3.25 3.26 3.27 3.28 3.29 3.30 Sushruta. Sushruta Samhita. Edited by JadavajiTrikamjiAacharya. 8th ed. Varanasi: Chaukhambha Orientalia;2005.
  4. ↑ 4.0 4.1 4.2 Madhavakar. Madhava Nidanam. Edited by SashtriSudarshana, UpadhayaYadunandana. 30th ed. Varanasi: Chaukhambha Sanskrit Sansthana; 2000.
  5. ↑ 5.00 5.01 5.02 5.03 5.04 5.05 5.06 5.07 5.08 5.09 5.10 5.11 5.12 5.13 5.14 5.15 Vagbhata. Ashtanga Samgraha. Edited by Shivprasadsharma. 3rd Ed., Varanasi: Chowkhamba Sanskrit Series Office; 2012.
  6. ↑ 6.0 6.1 6.2 6.3 6.4 6.5 6.6 6.7 Sharngdhara. Sarngadhara Samhita. Edited by Parashuram Shastri Vidyasagar. Varanasi: ChaukhambhaSurabharatiPrakashan ;2013.
  7. ↑ Bhava mishra. Bhavaprakasha, Edited by Brahmasankara Mishra, Rupalalaji Vaisya. 5th ed. Hindi Commentary Vidyotini; Varanasi: Chaukhambha Sanskrit Sansthan, 1969.
  8. ↑ 8.00 8.01 8.02 8.03 8.04 8.05 8.06 8.07 8.08 8.09 8.10 8.11 8.12 8.13 8.14 8.15 8.16 8.17 8.18 8.19 8.20 8.21 8.22 8.23 8.24 8.25 8.26 8.27 8.28 8.29 Vagbhata. Ashtanga Hridayam. Edited by HarishastriParadkar Vaidya. 1st ed. Varanasi: Krishnadas Academy; 2000.
  9. ↑ 9.00 9.01 9.02 9.03 9.04 9.05 9.06 9.07 9.08 9.09 9.10 9.11 9.12 9.13 9.14 Kashyapa. Kashyapa Samhita. Edited by P. V. Tewari. Reprint. Varanasi: Chaukhambha vishvabharati;2008.
  10. ↑ Byadgi P.S., Saini N..MaharogaAdhyaya. In: Kar A.C., Rai S., Deole Y.S., Basisht G., eds. Charak Samhita New Edition. 1st ed. Jamnagar, Ind: CSRTSDC; 2020. https://www.carakasamhitaonline.com/mediawiki-1.32.1/index.php?title=Maharoga_Adhyaya&oldid=41150. Accessed November 14, 2022.
  11. ↑ Baltzopoulos V, Brodie DA. Isokinetic dynamometry. Applications and limitations. Sports Med. 1989 Aug;8(2):101-16.
  12. ↑ Agarwala P, Salzman SH. Six-Minute Walk Test: Clinical Role, Technique, Coding, and Reimbursement. Chest. 2020 Mar;157(3):603-611.
  13. ↑ Aguilaniu B, Wallaert B. Illustrated interpretation of cardio-pulmonary exercise testing. Rev Mal Respir. 2013 Dec;30(10):812-3.
  14. ↑ Millan J, Pinto X, Munoz A, Zuniga M, Rubies-Prat J, Pallardo LF, Masana L, Mangas A, Hernandez-Mijares A, Gonzalez-Santos P, Ascaso JF. Lipoprotein ratios: physiological significance and clinical usefulness in cardiovascular prevention. Vascular health and risk management. 2009;5:757.
  15. ↑ Achari AE, Jain SK. Adiponectin, a Therapeutic Target for Obesity, Diabetes, and Endothelial Dysfunction. Int J Mol Sci. 2017 Jun 21;18(6):1321.
  16. ↑ Laskey MA. Dual-energy X-ray absorptiometry and body composition. Nutrition. 1996 Jan 1;12(1):45-51.
  17. ↑ Ward LC. Bioelectrical impedance analysis for body composition assessment: reflections on accuracy, clinical utility, and standardisation. Eur J Clin Nutr. 2019 Feb;73(2):194-199.
  18. ↑ Stillman JA, Morton RP, Hay KD, Ahmad Z, Goldsmith D. Electrogustometry: strengths, weaknesses, and clinical evidence of stimulus boundaries. Clin Otolaryngol Allied Sci. 2003 Oct;28(5):406-10.
  19. ↑ Bigner SH. Cerebrospinal fluid (CSF) cytology: current status and diagnostic applications. Journal of neuropathology and experimental neurology. 1992 Mar 1;51(3):235-45.
  20. ↑ Winck AD, Heinzmann-Filho JP, Soares RB, da Silva JS, Woszezenki CT, Zanatta LB. Effects of obesity on lung volume and capacity in children and adolescents: a systematic review. Rev Paul Pediatr. 2016 Dec;34(4):510-517.
  21. ↑ Lutfi MF. The physiological basis and clinical significance of lung volume measurements. Multidisciplinary respiratory medicine. 2017 Dec;12(1):1-2.
  22. ↑ Pierce R. Spirometry: an essential clinical measurement. Aust Fam Physician. 2005 Jul;34(7):535-9.
  23. ↑ Bhatted S, Shukla VD, Thakar A, Bhatt NN. A study on Vasantika Vamana (therapeutic emesis in spring season) - A preventive measure for diseases of Kapha origin. Ayu. 2011 Apr;32(2):181-6.
  24. ↑ Edwards MT, Streiner DL. Development of a reliable Dosha self-assessment questionnaire. Explore (NY). 2022 Sep-Oct;18(5):573-578.
  25. ↑ Telles S, Pathak S, Kumar A, Mishra P, Balkrishna A. Ayurvedic doshas as predictors of sleep quality. Med Sci Monit. 2015 May 17;21:1421-7.
  26. ↑ Ram Manohar P, Sorokin O, Chacko J, Nampoothiri V. An exploratory clinical study to determine the utility of heart rate variability analysis in the assessment of dosha imbalance. J Ayurveda Integr Med. 2018 Apr-Jun;9(2):126-130.
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