Mala

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The word ‘Mala’ literally means dust, dirt, filth, secretion or impurity.In Ayurveda, the term is applied to the biological products formed after digestion and metabolism (SAT-B.457).

These metabolic waste products are collected at respective sites and excreted from body openings. If accumulated beyond normal physiological limits, they can vitiate the body constituents. This article describes general aspects about mala in Ayurveda.

Etymology and derivation:

The word mala is derived from the Sanskrit root “Mruj” meaning “that which is to be cleaned or eliminated”. The word means excretions of the body, dirt, sin, natural impurity etc.

Synonyms

The synonyms of mala are:

  • Vit, Vishtha: Both terms denote mainly the fecal matter
  • Kittam: It denotes both metallic byproducts as well as waste products of human body which are to be eliminated, byproducts of metals like iron(manduram)
  • Puyam: It denotes the pus from a wound.
  • Papam: it denotes the sinful deeds

Meaning in different contexts

The terms mala is applied in various contexts as below:

  • Fundamental constituent of human body with dosha and dhatu [Su.Sa.Sutra Sthana 15/3]
  • Only the fecal matter [A.Hr. Nidan Sthana 8/4]
  • Any kind of dirty material, impurity at physical and mental level [Cha.Sa.Sutra Sthana 6/93]
  • The constituents formed after digestion and metabolism other than essence (prasad) [Cha.Sa.Sharira Sthana 6/16].

List of metabolic wastes

The different waste products (mala) mentioned in Ayurveda are as below:

Fecal matter(purisha/mala)

  • Urine (mutra)
  • Sweat (sweda)
  • Gases of various kinds(vata)
  • Bile (pitta)
  • Excretions of various openings of the body (kha mala)
  • Waxy excretions of the ear (karna mala/karna sneha)
  • Nasal discharge (nasika mala)
  • Coating over the tongue (Jihwa mala)
  • Secretions in mouth (asya mala)
  • Oily excretions of the skin(Twak-sneha)
  • Excretions discharged trough hair follicles(loma kupa mala)
  • Excretion of genitalia(prajanana mala)
  • Scalp hair (kesha), body hair (loma), facial hair (shmashru)
  • Nails(teeth)

Classification

Waste products are classified into two:

1) Waste products of digestion of food (ahara mala): fecal matter and urine

2) Waste products of tissue metabolism (dhatu mala): all other kinds of waste products formed after tissue metabolism (dhatu agni)

Table 1: Dhatu and their respective mala

Sr. No. Dhatu Mala
1. Rasa Kapha
2. Rakta Pitta
3. Mamsa excreta in ear, nose (kha-mala)
4. Meda sweat (sweda)
5. Asthi scalp hair (kesha) and body hair (loma)
6. Majja unctuousness in eyes, skin and stools (akshi-twacha-vit sneha)
7. Shukra --

Anatomical aspects of waste products

Channels of excretion (malayana)

Two external orifices in the lower part of the body (the anus and urethra), seven orifices in head region (two eyes, two ears, two nostrils and mouth) and numerous openings of sweat glands are the channels for excretion of waste products. [ Cha. Sa. Sutra Sthana 7/42]

Physiological aspect of waste products

A certain amount of waste products is needed for maintaining the proper functioning of the body and equilibrium in body components. The formation and elimination of waste products is a continuous process.

Importance of waste products in diagnosis

The channels of excretion are affected by vitiated dosha and increased waste products. [Cha. Sa. Sutra Sthana 7/42] They show specific clinical features after vitiation. Hence the vitiated state of dosha can be diagnosed by observation of metabolic wastes. For example, the vitiated state of vata can be diagnosed by hard stools, vitiated pitta shows discolored stools.

Clinical features of increase and decrease in waste products

Excessive increase in waste products can be assessed by feeling of heaviness in the excretory channels. Likewise, the decrease is assessed by feeling of emptiness or lightness in excretory channels. [Cha. Sa. Sutra Sthana 7/43] • The decrease of secretions in nose, ears, eyes, mouth and skin lead to feeling of emptiness, lightness and dryness. [Cha. Sa. Sutra Sthana 17/72] • The decrease in waste products is specifically mentioned as the cause of vata predominant type of gulma.[Cha. Sa. Chikitsa Sthana 5/9] • Increase in the waste products (maladhikya) is one among the twenty types of disorders of kapha.[Cha. Sa. Sutra Sthana 20/17] • The increase of waste products is considered as a causative factor of the generalized enlargement of abdomen (udara)[ Cha. Sa. Chikitsa Sthana 13/9]. Role of waste products as vitiated factor (dushya) in pathogenesis diseases: • Bleeding disorders(paktapitta) : The prodromal symptoms of bleeding disorders(raktapitta ) includes appearance of red, green or yellow spots in body parts, feces, urine, sweat, saliva, nose-secretion, excretions from mouth, ear and discharges from boils.[Cha. Sa. Nidana Sthana 2/6] • Obstinate urinary disorders (prameha): Increased amount of bodily excretions, especially those from the sweat pores is considered as a prodromal symptom of obstinate urinary disorders (prameha). [Cha. Sa. Nidana Sthana 4/47]. Discoloration and turbidity of urine is cardinal feature of obstinate urinary disorders including diabetes (prameha and madhumeha). (ref) • Parasites and microorganisms (krimi): The accumulation of waste products over and inside the body provides suitable environment for growth of parasites. These are described as parasites (krimi) originating from excreta (malaja), mucus and other unctuous secretions (shleshmaja), blood (rakaja) and fecal matter (purishaja). [Cha. Sa. Vimana Sthana 7/10] • Fever (jwara): In the first stage of fever, constipation and excessive urination are seen. [ Cha. Sa. Chikitsa Sthana 3/ 134-135] • Skin diseases (kushtha): Sweat (sweda) is important factor in diagnosis of skin diseases. (ref) • Jaundice(kamala) and anemia(pandu): Color of stool is important for differential diagnosis. (ref)

Importance in preservation of health and prevention

The waste products carry impurities that are harmful for the body. Hence, regular formation and elimination of wastes is essential to maintain equilibrium in the body physiology and preserve health. Seasonal purification therapies (ritu shodhana) through panchakarma are recommended to remove micro cellular toxins and wastes. Apart from these preventive panchakarma procedures, the daily regimen like collyrium(anjana), smoking (dhoomapana), mouth wash (gandusha/kavala), oil filling in ear (karna poorana) etc. are beneficial to remove the excessive accumulation of waste products in the orifices of body. This leads to preservation of health of the respective senses .[Cha. Sa. Sutra Sthana 5]

It is advised to take bath twice a day, clean excretory passages and feet frequently to keep external parts of body clean and prevent diseases. [Cha. Sa. Sutra Sthana 8/18] Suppression of natural urges of defecation, urination, flatus, etc. causes diseases. Therefore, it is advised to follow natural urges to preserve health and prevent diseases. [Cha. Sa. Sutra Sthana 7/3]

Management of disorders related to waste products

The disorders related to waste products can be broadly divided into 3 categories: 1. Excessive elimination leading to the decrease of waste products in body 2. Excessive accumulation leading to the increase of waste products in body. 3. Abnormal presentations like altered characteristic features, associated symptoms during elimination etc. indicative of some other underlying pathologies. So, the management strategy for these disorders is based upon this.

Treatment principles in decreased state

• Stop the excessive elimination and promote the consumption of substances with similar properties. [Su. Sa. Sutra Sthana 15/11] For example, in case decrease in stool formation, black gram (masha) is advised in diet which can increase the bulk of stools.

===Treatment principles in increased state===

• Promote the elimination of waste products by correcting the respective pathology [Su. Sa. Sutra Sthana 15/17]. Drugs acting on vata by promoting its natural down ward movement (anulomana) are recommended in case of constipation.

Treatment principles in abnormal state

• Correction of digestive fire (jatharagni) as well as tissue metabolism (dhatwagni) is more important in all these conditions. • Underlying pathology should be diagnosed in terms of dosha and managed accordingly which can automatically correct the abnormal characters of waste products.

Contemporary approach

Human waste or excreta refers to the waste products of digestion and metabolism. In Ayurveda, both urine and feces are considered as waste products formed after digestion of food (ahara mala). A recent experimental study conducted on rats with impaired renal function (induced by intragastric administration of adenine), has proven that intestinal tract had excretory function compensative for renal function. The relation of intestinal tract and kidneys can be explored more to find better management solutions for kidney diseases. Research studies show effect of therapeutic enema (basti) in microalbuminuria and chronic renal failure. Excretion is the process of elimination of the metabolic waste products from the body through the lungs, kidney and the skin. The urinary system consisting of a pair of kidneys and ureters, urinary bladder and urethra helps in the elimination of water soluble waste products of metabolism especially nitrogenous wastes like urea, uric acid, and creatinine in the form of urine. Gaseous wastes diffused from the blood stream such as carbon dioxide is eliminated by lungs as part of normal respiration. Sweat glands in skin are play the role in excretion and electrolyte balance. Various biochemical and laboratory investigations are developed to assess body fluids and metabolic products. Judicious implication of these tests and application of knowledge of concept of ‘mala’ can help in finding better healthcare and disease diagnosis solutions. References: