Bhojani M. K. 1,|
Tanwar Ankur Kumar 1
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
|Publisher||Charak Samhita Research, Training and Development Centre, I.T.R.A., Jamnagar, India|
|Date of publication:||December 16, 2022|
Etymology and derivation
In abnormal states- Papma, mala[Cha. Sa. Sutra Sthana 17/117]
Kapha dosha and triguna
Sites of kapha
- Chest(Ura)[Cha.Sa. Sutra Sthana 20/9] [Su. Sa. Sutra Sthana 21/7][A.S. Sutra Sthana 20/3][A.Hr. Sutra Sthana 12/3] [K.S. Sutra Sthana 27/11]
- Head (shira)[Cha. Sa. Sutra Sthana 20/9] [Su. Sa. Sutra Sthana 21/7][A.S. Sutra Sthana 20/3][A.Hr. Sutra Sthana 12/3]
- Neck region(griva) [Cha.Sa. Sutra Sthana 20/9] [K.S. Sutra Sthana 27/11]
- Joints (parva or sandhi)[Cha.Sa. Sutra Sthana 20/9] [Su. Sa. Sutra Sthana 21/7] [A.S. Sutra Sthana 20/3][A.Hr. Sutra Sthana 12/3][K.S. Sutra Sthana 27/11]
- Stomach(amashaya) [Cha.Sa. Sutra Sthana 20/9] [A.S. Sutra Sthana 20/3] [A.Hr. Sutra Sthana 12/3]
- Fat (meda) [Cha.Sa. Sutra Sthana 20/9] [A.S. Sutra Sthana 20/3] [A.Hr. Sutra Sthana 12/3] [K.S. Sutra Sthana 27/11]
- Throat(kantha) [Su. Sa. Sutra Sthana 21/7] [A.S. Sutra Sthana 20/3][A.Hr. Sutra Sthana 12/3]
- Organ controlling water uptake and loss(kloma) [A.S. Sutra Sthana 20/3] [A.Hr. Sutra Sthana 12/3]
- Nutrient body fluid or plasma (rasa)[A.S. Sutra Sthana 20/3][A.Hr. Sutra Sthana 12/3]
- Nose (ghrana) [A.S. Sutra Sthana 20/3] [A.Hr. Sutra Sthana 12/3]
- Tongue(jihva or rasana)[Su. Sa. Sutra Sthana 21/7][A.S. Sutra Sthana 20/3] [A.Hr. Sutra Sthana 12/3]
- Arms(bahu) [K.S. Sutra Sthana 27/11]
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] [A.Hr. Sutra Sthana 12/3] [Arunadatta on A.Hr. Sutra Sthana 12/3] Kapha dosha is predominately present in stomach(amashaya). [Su. Sa. Sutra Sthana 21/6] Chakrapani precisely explains the location of kapha as upper part of amashaya(stomach). [Chakrapani on Cha.Sa. Sutra Sthana 20/8]
- 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] [A.Hr. Sutra Sthana 1/12] [K.S. Sutra Sthana 27/44] [Sh.Sa.Pratham Khand 5/34]
- 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][Sh.Sa.Pratham Khand 5/34] [A.Hr. Sutra Sthana 1/12][K.S. Sutra Sthana 27/44]
- 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. Sutra Sthana 21/15][A.Hr. Sutra Sthana 1/12][K.S. Sutra Sthana 27/44] [Sha.Sa.Pratham Khand 5/34]
- 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] [Sha.Sa.Pratham Khand 5/34] [K.S. Sutra Sthana 27/44]
- Firmness/stability (sthira) [Cha.Sa. Sutra Sthana 1/61][A.Hr. Sutra Sthana 1/12]
- Sliminess (picchila) [Cha.Sa. Sutra Sthana 1/61][Su. Sa. Sutra Sthana 21/15] [Sha.Sa.Pratham Khand 5/34]
- Whitish (shaukalya or shweta) [Cha.Sa. Sutra Sthana 20/18] [Cha.Sa. Vimana Sthana 8/97][Su. Sa. Sutra Sthana 21/15][Sha.Sa.Pratham Khand 5/34] [K.S. Sutra Sthana 27/44]
- Mouldable (mrutsana) [Cha.Sa. Sutra Sthana 20/18] [A.Hr. Sutra Sthana 1/12]
- Smoothness (shlakshana) [Cha.Sa. Vimana Sthana 8/96] [A.Hr. Sutra Sthana 1/12]
- 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]
- Stable (stimita) [Cha.Sa. Vimana Sthana 8/96]
- Viscous (vijjala) [Cha.Sa. Vimana Sthana 8/96]
- Transparent (accha) [Cha.Sa. Vimana Sthana 8/96]
Functions of kapha
- 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)
Acharya Vagbhata was the first to describe five types of kapha with names. [A.Hr. Sutra Sthana 12/15-18] Five particular functions of kapha are as below: [Su.Sa. Sutra Sthana 15/4] [Dalhana on Su.Sa. Sutra Sthana 15/4]
|S.No.||Type of kapha||Location||Function|
|Root of tongue(jihvamula)
Kapha dominant constitution (prakriti)
- 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
- Thick and dense hair
- Obedient to teachers
Factors responsible for abnormal states of kapha
- 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: Kapha gets increased during the first 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.
- 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 (diwaswapna), lack of exercise(avyayama), drinking water at night(nisha ambupana), mixing wholesome and unwholesome together (samashana) and over eating before digestion of previous meals(adhyashana), etc. [Su.Sa. Sutra Sthana 21/23-24]
- Emotional and behavior factors: pleasure(harsha).
Stages of dosha:
Hyperfunctioning of kapha (vriddhi lakshana)
- Whitish coloration of skin (shaukalaya)
- A feeling of coldness (shaityam)
- Firmness and stiffness (sthairyam)
- Heaviness in body (gauravam)
- Depression (avasada)
- Sleepiness(nidra or atinidrata)
- Lack of firmness in joints (sandhivishlesha)
- Low digestive capacity (agnisadana)
- Salivation (praseka)
- Laziness (alasya)
- Flaccidity (shlathangatvam or angasada)
- Dyspnea (shwasa)
- Blockage of natural passages (srotapidana)
- Syncope (murchha)
- Nausea (hrillasa)
Hypofunctioning of kapha (kshaya lakshana):
- Dryness (rukshata)
- Burning sensation in the body(antardaha)
- Emptiness in all sites of kapha especially stomach(amashyaitara shleshmashaya shunyta)
- 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)
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] (Table 02)
|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:
Subjective and objective methods which may be used to assess the normal functioning of kapha are:
- Test for assessment for muscular strength and endurance like dynamometry and 6 minute walk test, etc.
- Cardio- Pulmonary exercise tests.
- Lipid profile, adiponectin for assessment of meda.
- Dual-energy X-ray absorptiometry
- Bioelectrical impedance devices to measure body fat percent (BF%), fat mass (FM), and fat-free mass (FFM).
- CSF examination
- Lung capacity and volume assessment.
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]
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]
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]
Future area of research
- Vasantika vamana (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 vasant ritu. The general wellness of the volunteers and patients was also seen to have improved.
- 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.
- 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.
- 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.
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