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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]<ref name="Sushruta Samhita">Sushruta. Sushruta Samhita. Edited by Jadavaji Trikamji Aacharya. 8th ed. Varanasi: Chaukhambha Orientalia;2005.</ref> 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]<ref>National AYUSH Morbidity and Standardized Terminologies Electronic Portal by Ministry of AYUSH Available on http://namstp.ayush.gov.in/#/sat</ref> They are the actual intrinsic factors which become excited and imbalanced, either conferring a predisposition to or actually causing morbidities disease (vyadhi).<ref>Dwarkanath C. Introduction to Kayachikitsa. Chaukhambha Orientalia. Varanasi; 1996.Pg. 20 </ref>  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]<ref name="Sushruta Samhita" /> 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.<ref>Sharma H., Chandola H.M., Singh G., Basisht G. Utilization of Ayurveda in health care: an approach for prevention, health promotion, and treatment of disease. Part 1 – Ayurveda in primary health care. J Altern Complement Med. 2007;13(9):1011–1019.</ref>  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]<ref name="Sushruta Samhita" />

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]<ref name="Sushruta Samhita">Sushruta. Sushruta Samhita. Edited by Jadavaji Trikamji Aacharya. 8th ed. Varanasi: Chaukhambha Orientalia;2005.</ref> 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]<ref>National AYUSH Morbidity and Standardized Terminologies Electronic Portal by Ministry of AYUSH Available on http://namstp.ayush.gov.in/#/sat</ref> They are the actual intrinsic factors which become excited and imbalanced, either conferring a predisposition to or actually causing morbidities disease (vyadhi).<ref>Dwarkanath C. Introduction to Kayachikitsa. Chaukhambha Orientalia. Varanasi; 1996.Pg. 20 </ref>  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]<ref name="Sushruta Samhita" /> [A.Hr. Sutra Sthana 1/20]<ref name="Ashtanga Hridaya"/> 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.<ref>Sharma H., Chandola H.M., Singh G., Basisht G. Utilization of Ayurveda in health care: an approach for prevention, health promotion, and treatment of disease. Part 1 – Ayurveda in primary health care. J Altern Complement Med. 2007;13(9):1011–1019.</ref>  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]<ref name="Sushruta Samhita" />

{{Infobox

{{Infobox

==Etymology and derivation==

==Etymology and derivation==

The word dosha is derived from Sanskrit root ‘dusha’ meaning causing abnormalities (vaikrutye).<ref>Shabdakalpa druma </ref>   

The word dosha is derived from Sanskrit root ‘dusha’ meaning causing abnormalities (vaikrutye).<ref>Srujan Jha. Shabdakalpadruma app</ref>   

==Types of dosha ==

==Types of dosha ==

# Vata dosha: Prana, Udana, Samana, Vyana, Apana   

# Vata dosha: Prana, Udana, Samana, Vyana, Apana   

# Pitta dosha: Pachaka, Ranjaka, Sadhaka, Alochaka, Bhrajaka   

# Pitta dosha: Pachaka, Ranjaka, Sadhaka, Alochaka, Bhrajaka   

# Kapha dosha: Avalambaka, Kledaka, Bodhaka, Tarpaka, Shleshaka [A. Hr. Sutra Sthana 12]   

# Kapha dosha: Avalambaka, Kledaka, Bodhaka, Tarpaka, Shleshaka [A.Hr. Sutra Sthana 12]<ref name="Ashtanga Hridaya">Vagbhata. Ashtanga Hridayam. Edited by Harishastri Paradkar Vaidya. 1st ed. Varanasi: Krishnadas Academy;2000.</ref>  

==Functions ==

==Functions ==

Pitta dosha 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.  

Pitta dosha 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 dosha 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]

Kapha dosha 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]<ref name="Ashtanga Hridaya"/>

==Properties==

==Properties==

! rowspan="1" style="text-align: left;" | 10

! rowspan="1" style="text-align: left;" | 10

| rowspan="1" style="text-align: left;" | Other properties  

| rowspan="1" style="text-align: left;" | Other properties  

| rowspan="1" style="text-align: left;" | Cleansing or Non-slimy (vishada), Severely acting (daruna)<ref>Kaviraj Atridev Gupta. Ashtang Hridayam. Sutra Sthan. Ayushkamiya. Reprint 2007. Pg. No. 27.</ref>, conducive (yogavahi)<ref>Kashinath Shastri. Charak Samhita. Sutra Sthan. Vatakalakaliya Adhyaya. Reprint 2007. Pg. No. 172.</ref>, Can move oblique or in any direction (tiryag gami), responsible for sound (shabda) and touch(sparsha) perception [6]

| rowspan="1" style="text-align: left;" | Cleansing or Non-slimy (vishada), Severely acting (daruna)[Cha.Sa. [[Sutra Sthana]] 12/4], conducive (yogavahi), Can move oblique or in any direction (tiryag gami), responsible for sound (shabda) and touch(sparsha) perception  

| rowspan="1" style="text-align: left;" | Foul smelling (vistra)

| rowspan="1" style="text-align: left;" | Foul smelling (vistra)

| rowspan="1" style="text-align: left;" | --

| rowspan="1" style="text-align: left;" | --

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[[Charak Samhita]]<ref>Kashinath Shastri. Charak Samhita. Sutra Sthan. Deerghanjivitiya. Reprint 2007. Pg. No. 27.</ref> Sushrut Samhita<ref>Yadavji Trikamji Acharya. Sushrut Samhita. Nidan Sthan. Vatavyadhi Nidan. Chaukhamba Sanskrit Sansthan. Reprint 2012. Pg. No. 257.</ref> Ashtanga Hridaya<ref>Kaviraj Atridev Gupta. Ashtang Hridayam. Sutra Sthan. Ayushkamiya. Reprint 2007. Pg. No. 27.</ref> Kashyap Samhita Sharangdhara Samhita

[[Charak Samhita]], [Su.Sa. Nidana Sthana]<ref name="Sushruta Samhita" /> [A.Hr. Sutra Sthana 1/11-12 ]<ref name="Ashtanga Hridaya"/> Kashyap Samhita, Sharangdhara Samhita

==Primary centers of dosha==

==Primary centers of dosha==

These are omnipresent throughout the body. However, their primary centers 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]     

These are omnipresent throughout the body. However, their primary centers 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]<ref name="Ashtanga Hridaya"/>

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]

      

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]<ref name="Ashtanga Hridaya"/>

==Affinity of vitiation==

==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]

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]<ref name="Ashtanga Hridaya"/>

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

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

==Importance of dosha==

==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]<ref name="Sushruta Samhita" />, [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.   

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]<ref name="Sushruta Samhita" />, [A.sa. Sutra Sthana 16], [A.Hr.Sutra Sthana 11/1]<ref name="Ashtanga Hridaya"/> 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)===

===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.<ref>Lakhotia S. C. (2014). Translating Ayurveda's Dosha-Prakriti into objective parameters. Journal of Ayurveda and integrative medicine, 5(3), 176.</ref>  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.<ref>Govindaraj, P. et al. Genome-wide analysis correlates Ayurveda Prakriti. Sci. Rep. 5, 15786; doi: 10.1038/srep15786 (2015)</ref>  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.<ref>Gupta A, Ali A, Tewari P, Agrawal NK, Patel R, Byadgi PS. Association of kaphaja and kapha-pittaja prakriti and methylenetetrahydrofolate reductase C677T allele with type 2 diabetes. AYU [serial online] 2018 [cited 2020 Jan 5];39:146-50. Available from: http://www.ayujournal.org/text.asp?2018/39/3/146/255251</ref>

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.<ref>Lakhotia S. C. (2014). Translating Ayurveda's Dosha-Prakriti into objective parameters. Journal of Ayurveda and integrative medicine, 5(3), 176.</ref>  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.<ref>Govindaraj, P. et al. Genome-wide analysis correlates Ayurveda Prakriti. Sci. Rep. 5, 15786; doi: 10.1038/srep15786 (2015)</ref>  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.<ref>Gupta A, Ali A, Tewari P, Agrawal NK, Patel R, Byadgi PS. Association of kaphaja and kapha-pittaja prakriti and methylenetetrahydrofolate reductase C677T allele with type 2 diabetes. AYU [serial online] 2018 [cited 2020 Jan 5];39:146-50. Available from: http://www.ayujournal.org/text.asp?2018/39/3/146/255251</ref>

   

   

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.<ref>Anna Korossy, Anna Blazovics. Ayurveda for the treatment of Obesity. Orv Hetil 2016 Aug; 157 (34):1349-52. DOI: 10.1556/650.2016.30534.</ref>   

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.<ref>Anna Korossy, Anna Blazovics. Ayurveda for the treatment of Obesity. Orv Hetil 2016 Aug; 157 (34):1349-52. DOI: 10.1556/650.2016.30534.</ref>   

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.  

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]'''

'''Table 2: Influence of dosha on digestion and gut pattern '''

{| class="wikitable"

{| class="wikitable"

! Sr.No''' !! ''Dosha''!! ''[[Agni]] (digestion pattern)''!! ''Koshtha (gut pattern)''!! ''Clinical picture''!!

! Sr.No''' !! ''Dosha''!! ''[[Agni]] (digestion pattern)''!! ''Koshtha (gut pattern)''!! ''Clinical picture''!!

===Pathological importance===

===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]

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]<ref name="Sushruta Samhita" />

==Factors influencing dosha in body==

==Factors influencing dosha in body==

=== Season, age, time and circadian rhythm===

=== Season, age, time and circadian rhythm===

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

The time factor in terms of season/climate change, age, day-night rhythm naturally influences levels of dosha in body.  The changes in the microcosm are observed due to changes in macrocosm.[A.Hr. Sutra Sthana 1/8]<ref name="Ashtanga Hridaya"/>

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

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

===Diagnosis of the abnormal state===

===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]

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 ===

=== Diseases due to dosha ===

=== Treatment ===

=== 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:  

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:  

# Decreased state: Increase dosha by diet and lifestyle  

# Decreased state: Increase dosha by diet and lifestyle  

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.

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 ==

== References ==