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|title=Pitta dosha
|title=Pitta dosha
|titlemode=append
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|keywords=Pitta dosha in ayurveda, Pitta dosha meaning, Pitta dosha,
|keywords=Pitta dosha in ayurveda, Pitta dosha meaning, Pitta dosha, dosha, heat in body, ayurveda, caraka samhita, charak samhita, charak, indian system of medicine, ancient medicine, alternative medicine, deole y.s., basisht g., bhojani m.k., tanwar ankur, all india institute of ayurveda
|description=It is one of the three dosha in body, Pitta dosha is responsible for maintaining body temperature, digestion and metabolism.
|description=Pitta dosha is one of the three dosha in body, Pitta dosha is responsible for maintaining body temperature, digestion and metabolism.
|image=http://www.carakasamhitaonline.com/resources/assets/ogimgs.jpg
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<div style='text-align:justify;'>Pitta dosha is responsible for maintaining body temperature, digestion and metabolism. Pitta dosha is agni mahabhuta predominant. [Code:SAT-B.401]<ref>National AYUSH Morbidity and Standardized Terminologies Electronic Portal by Ministry of AYUSH Available on http://namstp.ayush.gov.in/#/Ayurveda</ref> This chapter describes the physiological functions and pathological importance of pitta dosha. </div>
<p style="text-align:justify;">Pitta dosha is responsible for maintaining [[Sharira|body]] temperature, digestion and metabolism. Pitta dosha is [[Agni mahabhuta|agni mahabhuta]] predominant. [Code:SAT-B.401]<ref>National AYUSH Morbidity and Standardized Terminologies Electronic Portal by Ministry of AYUSH Available on http://namstp.ayush.gov.in/#/Ayurveda</ref> This chapter describes the physiological functions and pathological importance of pitta dosha. </p>
{{Infobox
{{Infobox
|title = Contributors
|title = Contributors
|data2 = Bhojani M. K. <sup>1</sup>,<br/>Tanwar Ankur Kumar <sup>1</sup>
|data2 = Bhojani M. K. <sup>1</sup>,<br/>Tanwar Ankur Kumar <sup>1</sup>
|label3 = Reviewer
|label3 = Reviewer
|data3 = Basisht G.<sup>2</sup>,
|data3 = [[Gopal Basisht|Basisht G.]]<sup>2</sup>
|label4 = Editor
|label4 = Editor
|data4 = Deole Y.S.<sup>3</sup>
|data4 = [[Yogesh Deole|Deole Y.S.]]<sup>3</sup>
|label5 = Affiliations
|label5 = Affiliations
|data5 = <sup>1</sup> Department of Sharir Kriya, All India Institute of Ayurveda, New Delhi, India <br/><sup>2</sup> Rheumatologist, Orlando, Florida, U.S.A. <br/><sup>3</sup>Department of Kayachikitsa, G.J.Patel Institute of Ayurvedic Studies and Research, New Vallabh Vidyanagar, Gujarat, India
|data5 = <sup>1</sup> Department of Sharir Kriya, All India Institute of Ayurveda, New Delhi, India <br/><sup>2</sup> Rheumatologist, Orlando, Florida, U.S.A. <br/><sup>3</sup>Department of Kayachikitsa, G.J.Patel Institute of Ayurvedic Studies and Research, New Vallabh Vidyanagar, Gujarat, India
== Etymology and derivation ==
== Etymology and derivation ==
<div style='text-align:justify;'>The word ‘Pitta’ is derived from Sanskrit root “tap”.<ref name="ref2">Sushruta. Sushruta Samhita. Edited by JadavajiTrikamjiAacharya. 8th ed. Varanasi: Chaukhambha Orientalia;2005.</ref> [Su. Sa.Sutra Sthana 21/5]The root word ‘tap’has three meaning:1) tap dahe means to burn, 2) tap santape means heat generator and 3) tap aishwarye means able to procure eight types of attainments of a yogi (animadi aishwarye).<ref name="ref3">Amarkosa. Amarsimha, Edited by Pt. Haragovinda sastri. Reprint Ed. Varanasi:Chaukhambha Sanskrit Sansthan, 2020.</ref> Dahana denotes transformation or conversion (paka) in the living body. This explains the function of pitta is the transformation or modification of one substance to other. </div>
<div style='text-align:justify;'>The word ‘Pitta’ is derived from Sanskrit root “tap”.[Su. Sa. Sutra Sthana 21/5]<ref name="ref2">Sushruta. Sushruta Samhita. Edited by Jadavaji Trikamji Aacharya. 8th ed. Varanasi: Chaukhambha Orientalia;2005.</ref> The root word ‘tap’ has three meaning: 1) tap dahe means to burn, 2) tap santape means heat generator and 3) tap aishwarye means able to procure eight types of attainments of a yogi (animadi aishwarye).<ref name="ref3">Amarkosha. Amarsimha, Edited by Pt. Haragovinda sastri. Reprint Ed. Varanasi:Chaukhambha Sanskrit Sansthan, 2020.</ref> Dahana denotes transformation or conversion (paka) in the living [[Sharira|body]]. This explains the function of pitta is the transformation or modification of one substance to other. </div>
== Synonyms<ref name="ref3"/><ref name="ref4">Monier-Williams. Monier William's Sanskrit-English Dictionary, 2nd Ed., Oxford University Press;1899.</ref> ==
== Synonyms ==
Mayu, teja, ushma, agni, anala, bile, to inflame, to nourish, a type of kala in the body.<ref name="ref3"/><ref name="ref4">Monier-Williams. Monier William's Sanskrit-English Dictionary, 2nd Ed., Oxford University Press;1899.</ref>
== Bhautika composition ==
== Bhautika composition ==
<div style='text-align:justify;'>Pitta dosha has dominance of teja mahabhauta.<ref name="ref5"> </ref>[A.S. Sutra Sthana 20/1]Pitta dosha is originated from agni or teja mahabhauta.<ref name="ref2"/>[Chakrapani on Su.Sa. Sutra Sthana 15/8][Figure 01] </div>
<div style='text-align:justify;'>
Pitta dosha has dominance of [[Agni mahabhuta|teja mahabhuta]]. [A.S. Sutra Sthana 20/1]<ref name="ref5">Vagbhata. Ashtanga Samgraha. Edited by Shivprasadsharma. 3rd Ed., Varanasi: Chowkhamba Sanskrit Series Office; 2012.</ref> Pitta dosha is originated from [[Agni mahabhuta|agni or teja mahabhuta]].[Chakrapani on Su.Sa. Sutra Sthana 15/8]<ref name="ref2"/>[Figure 01] </div>
=== Pitta dosha and triguna ===
=== Pitta dosha and [[triguna]] ===
<div style='text-align:justify;'>All the living & nonliving things originate from panchamahabhuta which originate from trigunatmaka prakriti as described in evolution process (utpatti karma). Dosha are evolved from panchamahbhuta, so these dosha bear triguna property. Pitta is evolved from agni that has sattva and raja predominance.<ref name="ref2"/> [Su. Sa.Sharira Sthana 1/20] Sharangdhara and Bhavaprakasha opines that pitta has sattva predominance. [Sha.Sa.Pratham Khand 5]<ref name="ref6">Vagbhata. Ashtanga Samgraha. Edited by Shivprasadsharma. 3rd Ed., Varanasi: Chowkhamba Sanskrit Series Office; 2012.</ref> [Bh. P. Purva Khand 3/103]<ref name="ref7">Sharngdhara. Sarngadhara Samhita. Edited by Parashuram Shastri Vidyasagar. Varanasi: Chaukhambha Surbharati Prakashan ;2013.</ref><br/>[Figure 01]
<div style='text-align:justify;'>
[[File:Figure1.jpg]]
All the living & nonliving things originate from [[Pancha mahabhuta|panchamahabhuta]] which originate from trigunatmaka [[Prakriti|prakriti]] as described in evolution process (utpatti krama). [[Dosha|Dosha]] are evolved from [[Pancha mahabhuta|panchamahbhuta]], so these [[Dosha|dosha]] bear [[Triguna|triguna]] property. Pitta is evolved from [[Agni|agni]] that has [[Sattva|sattva]] and [[Rajas|raja]] predominance.<ref name="ref2"/>[Su. Sa.Sharira Sthana 1/20] Sharangadhara and Bhavaprakasha opines that pitta has [[sattva]] predominance. [Sha.Sa.Pratham Khanda 5]<ref name="ref6">Sharangdhara. Sharangadhara Samhita. Edited by Parashuram Shastri Vidyasagar. Varanasi: Chaukhambha Surbharati Prakashan ;2013.</ref> [Bh. P. Purva Khand 3/103]<ref name="ref7">Bhava mishra. Bhavaprakasha, Edited by Brahmasankara Mishra, Rupalalaji Vaisya. 5th ed. Hindi Commentary Vidyotini; Varanasi: Chaukhambha Sanskrit Sansthan, 1969.</ref><br/>[Figure 01]
</div>
[[File:Figure1.jpg|center|Figure 01: Relation between triguna, mahabhauta and pitta dosha.]]<center>'''Figure 01: Relation between [[triguna]], [[mahabhuta]] and pitta dosha.'''</center></div>
=== Sites of pitta ===
<div style='text-align:justify;'>
[[Dosha|Dosha]] are present in every part of the [[Sharira|body]]. [Cha.Sa. [[Sutra Sthana]] 20/9] General location of pitta dosha is the middle part of the [[Sharira|body]], marked between the heart([[Hridaya|hridaya]]) and umbilicus([[nabhi]]).[A.S. Sutra Sthana 1/4]<ref name="ref5"/> Pitta is predominately present in [[Sharira|body]] parts between the large intestine(pakvashaya) and stomach([[Amashaya|amashaya]]). [Su. Sa.Sutra Sthana 21/6]<ref name="ref2"/> <br/>The specific seats of pitta are (Figure 02):
<ul><li>[[Sweda|Sweat(sweda)]] </li>
<li>Nutrient body fluid or plasma ([[Rasa|rasa]]) </li>
<li>Lymph (lasika) </li>
<li>[[Blood]] (rudhira) </li>
<li>Duodenum (lower part of [[Amashaya|amashaya]])</li>
<li>Umbilicus ([[nabhi]]) </li>
<li>Eyes (drika) </li>
<li>Skin (twacha) [Cha.Sa. [[Sutra Sthana]] 20/8], [A.Hr. [[Sutra Sthana]] 12/2],<ref name="ref8">Vagbhata. Ashtanga Hridayam. Edited by HarishastriParadkar Vaidya. 1st ed. Varanasi: Krishnadas Academy; 2000.</ref> [K.S. [[Sutra Sthana]] 27/11]<ref name="ref9">Kashyapa. Kashyapa Samhita. Edited by P. V. Tewari. Reprint. Varanasi: Chaukhambha vishvabharati;2008.</ref></li></ul>
Among all these sites, duodenum ([[Amashaya|amashaya]]) and umbilicus (nabhi) are the prime sites of pitta.[Cha.Sa. [[Sutra Sthana]] 20/8][K.S. Sutra Sthana 27/11]<ref name="ref9"/> [[Amashaya]] (stomach) is located in between the breast (stana) and umbilicus([[nabhi]]). In [[Amashaya|amashaya]], the digestion of all types of food takes place. [Cha.Sa. [[Vimana Sthana]] 2/17] Duodenum is the area of the digestive tract where maximum digestive process occurs. Acharya Chakrapani clears that the location of pitta is lower part of [[Amashaya|amashaya]]( i.e. duodenum). [Chakrapani on Cha.Sa. [[Sutra Sthana]] 20/8]
[[File:Fig2.jpg|center|Figure 02. General (A)and specific sites(B) of Pitta dosha.]]<center>'''Figure 02. General (A)and specific sites(B) of Pitta dosha.'''</center></div>
===Attributes===
The characteristics of pitta are:
<ul style='text-align:justify;'><li>Slight unctuousness (sasneha or ishatsneha)[Cha.Sa. [[Sutra Sthana]] 1/60][K.S. [[Sutra Sthana]] 27/38-39]<ref name="ref9"/> [A.Hr. [[Sutra Sthana]] 1/11]<ref name="ref8"/></li>
<li>Hot(ushna) [Cha.Sa. [[Sutra Sthana]] 1/60] [Cha.Sa. [[Vimana Sthana]] 8/97] [Su. Sa. [[Sutra Sthana]] 21/11]<ref name="ref2"/> [A.Hr. [[Sutra Sthana]] 1/11]<ref name="ref8"/></li>
<li>Penetrating or sharp acting property (tikshna) [Cha.Sa. [[Sutra Sthana]] 1/60] [Cha.Sa. [[Vimana Sthana]] 8/97] [Su. Sa. [[Sutra Sthana]] 21/11]<ref name="ref2"/> [K.S. [[Sutra Sthana]] 27/38-39]<ref name="ref9"/> [A.Hr. [[Sutra Sthana]] 1/11]<ref name="ref8"/></li>
<li>Liquidity (drava) [Cha.Sa. [[Sutra Sthana]] 1/60] [Cha.Sa. [[Vimana Sthana]] 8/97] [Su. Sa. [[Sutra Sthana]] 21/11]<ref name="ref2"/> [A.Hr. [[Sutra Sthana]] 1/11]<ref name="ref8"/></li>
<li>[[Amla|Sour (amla)]] [Cha.Sa. [[Sutra Sthana]] 1/60] [Cha.Sa. [[Vimana Sthana]] 8/97] [Su. Sa. [[Sutra Sthana]] 21/11]<ref name="ref2"/> [K.S. [[Sutra Sthana]] 27/38-39]<ref name="ref9"/></li>
<li>Mobile (sara) [Cha.Sa. [[Sutra Sthana]] 1/60] [A.Hr. [[Sutra Sthana]] 1/11]<ref name="ref8"/></li>
<li>[[Katu|Pungent (katu)]] [Cha.Sa. [[Sutra Sthana]] 1/60] [Cha.Sa. [[Vimana Sthana]] 8/97] [Su. Sa. [[Sutra Sthana]] 21/11]<ref name="ref2"/> [K.S. [[Sutra Sthana]] 27/38-39]<ref name="ref9"/></li>
<li>Raw meat odor (vistra or puti gandha) [Cha.Sa. [[Vimana Sthana]] 8/97] [Su. Sa. [[Sutra Sthana]] 21/11]<ref name="ref2"/> [K.S. [[Sutra Sthana]] 27/38-39]<ref name="ref9"/> [A.Hr. [[Sutra Sthana]] 1/11]<ref name="ref8"/></li>
<li>Blue color (nila) [Su. Sa. [[Sutra Sthana]] 21/11]<ref name="ref2"/> [K.S. [[Sutra Sthana]] 27/38-39]<ref name="ref9"/></li>
<li>Yellow (pita) [Su. Sa. [[Sutra Sthana]] 21/11]<ref name="ref2"/> [K.S. [[Sutra Sthana]] 27/38-39]<ref name="ref9"/></li>
<li>Lightness (laghava) [Su. Sa. [[Sutra Sthana]] 42/7]<ref name="ref2"/> [K.S. [[Sutra Sthana]] 27/38-39]<ref name="ref9"/> [A.Hr. [[Sutra Sthana]] 1/11]<ref name="ref8"/></li>
<li>Cleansing property (vishada) [Su. Sa. [[Sutra Sthana]] 42/7]<ref name="ref2"/></li></ul>
<div style='text-align:justify;'>Pitta is [[Katu|pungent (katu)]] in completely formed or mature stage. It is [[Amla|sour (amla)]] when in raw or incompletely formed stage. [Su. Sa. [[Sutra Sthana]] 21/11]<ref name="ref2"/> Pitta is yellow in color in the mature stage and blue in color in raw stage. [ Dalhana on Su. Sa. [[Sutra Sthana]] 21/11]<ref name="ref2"/><br/>Acharya Chakrapani described the two types of pitta: 1) sadrava and 2) nirdrava. Sadrava is the natural pitta with liquidity and unctuousness. Nirdrava causes [[Jwara|fever(jwara)]] and other [[Vyadhi|diseases]] and is dry(rukshta). [Chakrapani on Cha.Sa. [[Chikitsa Sthana]] 3/217] <br/>These attributes should be considered while taking diet and lifestyle management of health. If the food and lifestyle habits having similar characteristics are followed in excess, a person may experience pitta [[Dosha|dosha]] vitiation leading to pitta disorders. Kashypa stated that pitta have all colors (varna) except white (shweta) and crimson red (aruna). [K.S. [[Sutra Sthana]] 27/38-39]<ref name="ref9"/> </div>
== Functions of Pitta ==
<div style='text-align:justify;'>Pitta has the independent function to perform within the [[Sharira|body]]. The principal function of pitta dosha is to maintain the normal physiology by supplying energy to the [[Sharira|body]] for all processes. The special functions of pitta are: [Cha.Sa. [[Sutra Sthana]] 18/50] [Cha.Sa. [[Sutra Sthana]] 12/11] [Su. Sa.Sutra Sthana 15/4]<ref name="ref2"/> [A.Hr. Sutra Sthana 11/2-3]<ref name="ref8"/>
<ul><li>Vision (darshan)</li>
<li>Digestion (pakti)</li>
<li>Feeling of hunger (kshuta)</li>
<li>Thirst ([[Trishna Chikitsa|trishna]])</li>
<li>Softness within the body (dehamardava)</li>
<li>Luster of the body ([[Prabha|prabha]])</li>
<li>Cheerfulness (prasad)</li>
<li>Intelligence ([[Medha|medha]] or [[Buddhi|buddhi]])</li>
<li>Maintenance of normal body temperature (matratvam ushma)</li>
<li>Normal complexion of skin (prakrit varna)</li>
<li>Courage (shauryam)</li>
<li>Anger (krodha)</li>
<li>Desire of food (ruchi)</li>
<li>Discriminative power and understanding (dhi)</li></ul>
[[File:Fig3.jpg|center|Figure 03: Categorization of the functions of pitta.]]<center>'''Figure 03: Categorization of the functions of pitta.'''</center>
Acharya Sushruta first described five types of pitta and defined their particular functions as below:[Su.Sa. [[Sutra Sthana]] 15/4]<ref name="ref2"/> [Dalhana on Su.Sa. [[Sutra Sthana]] 15/4]<ref name="ref2"/>
<ol><li>Imparting normal color (ragakriit): Ranjaka pitta</li>
<li>Process of digestion (paktikrt): Pachaka pitta</li>
<li>Production of [[Ojas|oja]] and maintenance of intelligence (ojakrit and medhakrit): Sadhaka pitta</li>
<li>Process of vision (tejakrit): Alochaka pitta</li>
<li>Production of heat within the body (ushmakrit): Bhrajaka pitta</li></ol></div>
== Classification ==
<div style='text-align:justify;'>The classification of pitta is based on different functions and locations in human [[Sharira|body]]. [Su.Sa. [[Sutra Sthana]] 21/10]<ref name="ref2"/> [A.S. [[Sutra Sthana]] 20/5]<ref name="ref5"/> [A.Hr. [[Sutra Sthana]] 12/12-14]<ref name="ref8"/></div>
=== Five types of pitta dosha, sites and functions: ===
<div style='text-align:justify;'>Pachaka, ranjaka, sadhaka, alochaka, and bhrajaka are the five types of pitta dosha. Five sets of functions by which pitta dosha is divided into five types are described. [Su.Sa. [[Sutra Sthana]] 15/4]<ref name="ref2"/> The location and function of five types of pitta dosha are based on different Ayurvedic texts, as given in table 01. </div>
{| class="wikitable"
|+ Table 01: Description of five types of pitta dosha
! S.No.
! Type of Pitta
! Location
! Function
|-
| 01.
| Pachaka
| In between the stomach and large intestine (pakva [[Amashaya|amashaya]] madhya)
| <ul><li>Digestion of four types of food stuff (chaturvidha annapanam pachti)</li>
<li>Differentiation of nutrient and waste products from food (vivechyati cha [[Dosha|dosha]] [[Rasa|rasa]] [[Mutra|mutra]] purishani)</li>
<li>Provides support and energy to other pitta (sheshanam pitta sthananam anugraham karoti)</li></ul>
|-
| 02.
| Ranjaka
| Liver (yakrit) <br/>Spleen (pliha) <br/>[[Amashaya|Amashaya]] (lower part of stomach and duodenum)
| Impart color to blood (rasasya ragkrit)
|-
| 03.
| Sadhaka
| Heart ([[Hridaya|hridaya]]) <br/>Brain (mastishka)</li>
| <ul><li>Implementation of desires (abhiparthita manoratha)</li>
<li>Decisive power ([[Buddhi|buddhi]])</li>
<li>Intellect ([[Medha|medha]])</li>
<li>Self esteem (abhimana)</li>
<li>Enthusiasm (utsaha)</li>
<li>Perception of word ([[Shabda|shabda]]), touch ([[Sparsha|sparsha]]) and odor ([[Gandha|gandha]])[Bhe.Sa.4/8]<ref name="ref10">Bhela. Bhela Samhita. Edited by Priya Vrat Sharma. Reprint ed. Varanasi: Chaukhambha Visvabharti;2008.</ref></li></ul>
|-
| 04.
| Alochaka
| Eyes (drishti)
| Perception of vision ([[Rupa|rupa]] grahana)
|-
| 05.
| Bhrajaka
| Skin (twacha)
| <ul><li>Absorption of various formulation applied through massage ([[Abhyanga|abhyanga]]), showering ([[Parisheka|parisheka]]), tub bath (avgahana) and local application (avlepana) </li>
<li>Radiates the glow of skin (chayanam cha prakashaka) </li>
<li>Gives lustre to skin (kantikaritvam) [Bha. P. Purva Khand 3/125]<ref name="ref7"/></li>
<li>Maintenance of normal body temperature [Chakrapani on Cha.Sa. [[Sutra Sthana]] 12/11]</li></ul>
|-
|}
[[File:Fig4.jpg|center|Figure 04: Physiology of different types of pitta dosha]]<center>'''Figure 04: Physiology of different types of pitta dosha'''</center>
== Pitta dominant constitution ([[prakriti]]) ==
<div style='text-align:justify;'>The characteristic features of pitta dominant constitution individuals based on properties of pitta dosha are described as below. [Cha.Sa. [[Vimana Sthana]] 8/97]
<ul><li>The predominance of moles, pimples, wrinkles</li>
<li>Premature graying of hair and scanty hair or baldness</li>
<li>Presence of brownish-reddish hair</li>
<li>Strong digestive power</li>
<li>Excessive sweating and body odor</li>
<li>Intolerance to summer and hot things</li>
<li>Intake of food and water in an excessive amount</li>
<li>Short-tempered</li>
<li>Full of courage</li>
<li>Intelligent person</li></ul></div>
=== [[Loka]] [[Purusha]] Samya ===
<div style='text-align:justify;'>Pitta is responsible for all destruction or catabolism in the cosmos. The [[Agni mahabhuta|agni mahabhuta]] is represented by the pitta dosha in human [[Sharira|body]]. Nourishing ([[Visarga kala|visarga]]), depleting ([[Adana kala|adana]]) and distributing (vikshepa) in the universe are carried by the moon, sun and wind. Similarly, the human [[Sharira|body]] has [[Kapha dosha|kapha]], pitta, and [[Vata dosha|vata]] performing the same functions, respectively. [Su.Sa. [[Sutra Sthana]] 29/6]<ref name="ref2"/></div>
=== Factors responsible for abnormal states of pitta ===
<div style='text-align:justify;'>Certain factors cause excess or decline of pitta in the human [[Sharira|body]]. These factors are natural or unavoidable and artificial or avoidable. </div>
==== Natural factors ====
<div style='text-align:justify;'>These factors are the essential component of biological rhythm occurring in the external as well as internal environment of the [[Sharira|body]]. This natural increase is physiological. These factors are as follows:[Su.Sa. [[Sutra Sthana]] 21/20]<ref name="ref2"/>, [A.Hr. [[Sutra Sthana]] 1/8]<ref name="ref8"/>, [A.Hr. [[Sutra Sthana]] 12/20-21]<ref name="ref8"/> [A.Hr. Nidana Sthana1/16]<ref name="ref8"/>(Figure 05)
<ul><li style="font-weight: bold;">[[Ritu|Season (ritu)]]: <span style="font-weight:normal">Pitta undergoes natural accumulation in rainy season([[Varsha|varsha]]), gets vitiated during [[Sharad|autumn(sharada)]] and subsides to normal during [[Hemanta|winter(hemant)]].</span></li>
<li style="font-weight: bold;">Various stages of digestion of food: <span style="font-weight:normal">Pitta gets vitiated during the meal digestion (jiryteanne).</span></li>
<li style="font-weight: bold;">Biological rhythm of day and night: <span style="font-weight:normal">Pitta gets vitiated in the middle of the day(madhyanhe) and night (ardharatre).</span></li>
<li style="font-weight: bold;">Age ([[vaya]]): <span style="font-weight:normal">In middle age, pitta is in excess as compared to other [[Dosha|doshas]].</span></li></ul>
[[File:Fig5.jpg|center|Figure 05: Natural factors responsible for increase in pitta.]]<center>'''Figure 05: Natural factors responsible for increase in pitta.'''</center></div>
==== Acquired factors ====
<div style='text-align:justify;'>Acquired factors cause vitiation of pitta dosha other than natural factors. These are avoidable and used in clinical practice through the concept of [[Samanya Vishesha Theory|samanya vishesha siddhanta]]. These factors are as follows: [Su.Sa. [[Sutra Sthana]] 21/22]<ref name="ref2"/> [A.Hr. Nidana Sthana 1 /16]<ref name="ref8"/>
<ul><li style="font-weight: bold;">Diet([[Dravya|dravya]]) and a particular property of diet: <span style="font-weight:normal">Food with the dominance of [[Katu|pungent (katu)]], [[Amla|sour (amla)]], and [[Lavana|salty (lavana)]] taste, hot potency cause aggravation of pitta dosha. Intake of insufficient quantity at the improper time leads to vitiation of pitta dosha.</span></li>
<li style="font-weight: bold;">Lifestyle and other activities: <span style="font-weight:normal">Fasting ([[Upavasa|upavasa]]), overstrain (ayasa) and excessive sexual indulgence (maithuna upagamana)</span></li>
<li style="font-weight: bold;">Emotional and behavior factors: <span style="font-weight:normal">Anger(krodha), sorrow(shoka), and fear(bhaya). </span></li></ul></div>
== Clinical aspects ==
<div style='text-align:justify;'>'''Preventive aspect:''' A person with pitta dominant [[Sharira|body]] constitution should avoid the diet and lifestyle mentioned above to maintain equilibrium and healthy status. </div>
=== Stages of dosha: ===
<div style='text-align:justify;'>[[Dosha|Dosha]] continues to exist in three states: hypofunction (kshaya), hyperfunction (vriddhi), and normal physiological state (sama). [Cha.Sa. [[Sutra Sthana]]17/110] Increase and reduction in [[Dosha|dosha]] functioning ([[Karma|karma]]) can be used to understand [[Dosha|dosha]] increase and decline in the [[Sharira|body]]. [[Dosha|Dosha]], when increased, produce their respective features in excess; when decreased, cut off their functions and when in normal state, they perform their normal functions.</div>
=== Hyperfunctioning of pitta (vriddhi lakshana): ===
<div style='text-align:justify;'>When pitta levels increase, the [[Sharira|body]] exhibits various signs and symptoms as stated below: [Su.Sa. [[Sutra Sthana]] 15/13]<ref name="ref2"/>, [A.Hr. [[Sutra Sthana]] 11/7]<ref name="ref8"/>, [A.S. [[Sutra Sthana]] 19/5]<ref name="ref5"/>:
<ul><li>Yellowish coloration of stool([[Purisha|purisha]]), urine([[Mutra|mutra]]), eyes(netra) and skin(twacha). </li>
<li>Increased hunger (kshudha) </li>
<li>Increased thirst ([[Trishna Chikitsa|trishna]]) </li>
<li>Burning sensation(daha) </li>
<li>Less sleep(alpanidrata) </li>
<li>Fainting (glani) </li>
<li>Weakness of senses or inability to work properly(indriya daurbalya) </li>
<li>Vitiation of essence(ojovisramsa) </li>
<li>Desire for cold (shita abhilasha) </li>
<li>Bitter feeling in mouth(tiktasyata) </li>
<li>Giddiness(murchha) </li>
<li>Excessive anger(krodhi)</li>
<li>Less strength(bala hani)</li></ul></div>
=== Hypo functioning of pitta (kshaya lakshana): ===
<div style='text-align:justify;'>When pitta levels decline, the [[Sharira|body]] exhibits various signs and symptoms as below: [Su.Sa. [[Sutra Sthana]] 15/7]<ref name="ref3"/>, [A.Hr. [[Sutra Sthana]] 11/16]<ref name="ref8"/>, [A.S. [[Sutra Sthana]] 19/8]<ref name="ref5"/>
<ul><li>Poor digestive capacity and decreased digestive functions (manda anala) </li>
<li>Coldness(shita) </li>
<li>Loss of skin luster ([[Prabha|prabha]] hani) </li>
<li>Stiffness([[Stambhana|stambha]]) </li>
<li>Pricking pain(toda) </li>
<li>Less desire of food(arochaka) </li>
<li>Excessive coarseness on the body(angaparushya) </li>
<li>Tremors(kampa) </li>
<li>Heaviness in body(gaurav) </li>
<li>Whitish coloration of eyes, nails etc.(nakha-nayana shaukalayadi) </li></ul></div>
=== Diagnosis: ===
<div style='text-align:justify;'>The state of pitta dosha can be diagnosed and assessed based on clinical features. The most common clinical features of pitta dosha are burning sensation(daha), feeling of hotness (ushnata), suppuration(paka), strava(discharge), redness(raga) rigidity([[Stambhana|stambhana]]), wasting ([[Shosha Nidana|shosha]])and harshness(parusha). [Cha.Sa. [[Sutra Sthana]] 20/15] [K.S. [[Sutra Sthana]] 27/39]<ref name="ref9"/> <br/>Forty types of [[Vyadhi|diseases]] are caused due to an imbalance of pitta dosha (pitta nanatmaja [[Vyadhi|vyadhi]]).[Cha.Sa. [[Sutra Sthana]] 20/14][Table 02]:</div>
{| class="wikitable"
|+ Table 2: Disorders due to pitta dosha (pitta nanatmaja vikara)<ref name="ref10"/>
|-
| Heating (osha)
| Scorching (plosha)
| Burning (daha)
| Intense heat (davathu)
|-
| Fuming (dhoomaka)
| Hyperacidity (amlika)
| Burning sensation (vidaha)
| Internal burning (antardaha)
|-
| Burning sensation in arm (amsadaha)
| Hyperthermia (ushmadhikya)
| Excessive sweating (atisveda)
| Foul smell from body (angagandha)
|-
| Tearing of body parts (angavadarana)
| Retention of metabolites in blood (shonita [[Kleda|kleda]])
| Retention of metabolites in muscles ([[Mamsa dhatu|mamsa]] [[Kleda|kleda]])
| Burning sensation in skin (tvag daha)
|-
| Cracking of skin (tvagavadarana)
| Thickness of skin (charmadalana)
| Urticarial patches (rakta kotha)
| Pustules (rakta visphota)
|-
| Bleeding disorders ([[Raktapitta|raktapitta]])
| Hemorrhagic rounded patches/ echymosis (raktamandala)
| Greenish discolouration (haritatva)
| Yellowish discoloration (haridratva)
|-
| Blue moles (neelika)
| Furunculosis (kaksha)
| Jaundice ([[Kamala|kamala]])
| Bitter taste in mouth (tiktasyata)
|-
| Blood-like smell from the oral cavity (lohita gandhasyata)
| Fetid smell from oral cavity, or halitosis (pootimookhata)
| Polydypsia (trishnadhikya)
| Loss of contentment (atripti)
|-
| Stomatitis (asyavipaka)
| Inflammation in throat (galapaka)
| Inflammation in eyes (akshipaka)
| Inflammation in anus (Gudapaka)
|-
| Inflammation in penis (medhrapaka)
| Discharge of pure blood (jivadana)
| Darkness in front of the eye (tamapravesha)
| Green-yellow discoloration of eyes, urine, stool (harita haridra netra [[Mutra|mutra]] varchastva)
|-
|}
=== Diagnostic and assessment tools ===
<div style='text-align:justify;'>Pitta dosha can be assessed by its normal or abnormal functionality through subjective methods like questionnaires and objective methods. Currently, there are no validated and standardized tools for [[Dosha|dosha]] assessment within the [[Sharira|body]]. Pitta vriddhi and kshaya features can be assessed through a subjective questionnaire. Ayurvedic physicians assess the normalcy and abnormality through the ayurvedic principles of examination (pariksha). <br/>Subjective and objective methods which may be used to assess the normal functioning of pitta dosha are:
<ul><li>Test for assessment for digestive enzymes and hormones like serum lipase<ref name="ref12">Byadgi P.S., Saini N.. Maharoga Adhyaya. 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 6, 2022.</ref>, serum amylase<ref name="ref12"/>, serum pepsinogen<ref name="ref13">Ismail OZ, Bhayana V. Lipase or amylase for the diagnosis of acute pancreatitis?. Clin Biochem. 2017;50(18):1275-1280. </ref> and serum gastrin<ref name="ref14">Mukoubayashi C, Yanaoka K, Ohata H, et al. Serum pepsinogen and gastric cancer screening. Intern Med. 2007;46(6):261-266.</ref> etc. </li>
<li>Hemoglobin level, Red blood cell count, Mean Corpuscular Hemoglobin, Mean corpuscular hemoglobin concentration.<ref name="ref15">Jaffe BM. The measurement of serum gastrin. J Surg Res. 1970;10(4):193-200.</ref></li>
<li>Subjective assessment of Intelligence quotient like Wechsler Intelligence Scale for Children (WISC)<ref name="ref16">George-Gay B, Parker K. Understanding the complete blood count with differential. J Perianesth Nurs. 2003;18(2):96-117.</ref>.</li>
<li>Subjective assessment of emotional intelligence like Mayer-Salovey-Caruso emotional intelligence test<ref name="ref17">Woolger C. Wechsler intelligence scale for children-(WISC-III). InUnderstanding psychological assessment 2001 (pp. 219-233). Springer, Boston, MA.</ref>.</li>
<li>Cognitive assessment-Montreal Cognitive Assessment (MoCA)<ref name="ref18">Maul A. The validity of the Mayer–Salovey–Caruso Emotional Intelligence Test (MSCEIT) as a measure of emotional intelligence. Emotion Review. 2012 Oct;4(4):394-402.</ref>, Mini-Cog<ref name="ref19">Kang JM, Cho YS, Park S, et al. Montreal cognitive assessment reflects cognitive reserve. BMC Geriatr. 2018;18(1):261.</ref> & ICMR-PNT(Picture naming test)<ref name="ref20">Borson S, Scanlan JM, Chen P, Ganguli M. The Mini-Cog as a screen for dementia: validation in a population-based sample. J Am Geriatr Soc. 2003;51(10):1451-1454.</ref> etc.</li>
<li>Memory test through memory drum<ref name="ref21">Paplikar A, Varghese F, Alladi S, et al. Picture-naming test for a linguistically diverse population with cognitive impairment and dementia. Int J Lang Commun Disord. 2022;57(4):881-894.</ref>.</li>
<li>Visual acuity-Snellen’s chart<ref name="ref22">Loess H, Waugh NC. Short-term memory and intertrial interval. Journal of Memory and Language. 1967 Aug 1;6(4):455.</ref>.</li>
<li>Perception of vision- tachistoscope<ref name="ref23">Chen TA, Li J, Schallhorn JM, Sun CQ. Comparing a Home Vision Self-Assessment Test to Office-Based Snellen Visual Acuity. Clin Ophthalmol. 2021;15:3205-3211.</ref>.</li>
<li>Skin test like sebum content, trans-epidermal water loss and melanin content through various instruments<ref name="ref24">Benschop R. What is a tachistoscope? Historical explorations of an instrument. Sci Context. 1998;11(1):23-50.</ref>.</li>
<li>Assessment of [[Sharira|body]] Temperature.</li>
<li>Subjective assessment of Agni-Self-Assessment Tool to Estimate Agnibala<ref name="ref25">Hua W, Fan LM, Dai R, et al. Comparison of two series of non-invasive instruments used for the skin physiological properties measurements: the DermaLab® from Cortex Technology vs. the series of detectors from Courage & Khazaka. Skin Res Technol. 2017;23(1):70-78.</ref> & CCRAS Agni assessment tool(http://www.ccras.res.in/ccras_sas/).</li></ul>Application of all such tests will serve as a powerful analytical tool for assessing pitta dosha.</div>
== Treatment ==
<div style='text-align:justify;'>To manage and prevent [[Vyadhi|disease]], the clinician shall follow the theory of similarity and dissimilarity ([[Samanya Vishesha Theory|samanya vishesha siddhanta]]). Avoiding diet and lifestyle factors similar to properties of pitta dosha is required to pacify it. Contrarily, the decline of pitta dosha is treated by consuming foods and lifestyles that stimulate it. Therapeutic purgation ([[Virechana|virechana]]) is the best intervention indicated for vitiated pitta.[Cha.Sa. [[Sutra Sthana]] 20/16] [Cha. Sa. [[Sutra Sthana]] 25/40] <br/>Ingestion of milk and [[Ghee|ghee]] (ghrita) is best for the treatment of pitta. [Cha. Sa. [[Sutra Sthana]] 25/40] [A.Hr. [[Sutra Sthana]] 13/4-9]<ref name="ref8"/> <br/>The herbs having [[Madhura|sweet]], [[Tikta|bitter]], [[Kashaya|astringent]], and cold qualities used in single or combination along with therapies like [[Snehana (unction therapy)|oleation]], [[Virechana|purgation]], massage and shower etc. are helpful in the treatment of pitta disorders. [Cha.Sa. [[Sutra Sthana]] 20/16] [K.S. [[Sutra Sthana]] 27/39]<ref name="ref9"/>
<br/>'''Dietary modification:''' Three tastes ([[Rasa|rasa]]) that help in controlling the vitiated pitta are – [[Madhura|sweet (madhura)]], [[Tikta|bitter (tikta)]] and [[Kashaya|astringent (kashaya)]]. [Cha.Sa. [[Sutra Sthana]] 1/66] [A.Hr. [[Sutra Sthana]] 13/4-9]<ref name="ref8"/>
<br/>'''Lifestyle modification:''' Following modifications in lifestyles and measures help to maintain equilibrium of pitta dosha and manage its disorders.
<ul><li>Frequent application of paste of cool substances like kapur (camphor), [[Chandana|Chandana]] (sandalwood), and ushira (Khashkhash grass) over [[Sharira|body]]</li>
<li>Sitting in the moonlight in the evening</li>
<li>Listening to lovely and soothing music</li>
<li>Exposing to soft cool air</li>
<li>Companionship of individuals who talk honestly and innocuously</li>
<li>Living near ponds, parks, and fountains with fresh water</li>
<li>Wearing garlands/necklaces with appealing and cooling nature.[A.Hr. [[Sutra Sthana]] 13/4-9]<ref name="ref8"/></li></ul></div>
== Current researches ==
=== Analysis of physiology of vision: ===
<div style='text-align:justify;'>[[Ayurveda|Ayurveda]] describes the entire visual process in terms of [[Vata dosha|vata]] and pitta dosha. [[Vata dosha|Vata]] is responsible for excellence of vision (aksha patavam) and pitta dosha is responsible for vision (darshana); particularly, alochaka pitta.<ref name="ref26">Singh A, Singh G, Patwardhan K, Gehlot S. Development, Validation, and Verification of a Self-Assessment Tool to Estimate Agnibala (Digestive Strength). Journal of Evidence-Based Complementary & Alternative Medicine. 2017;22(1):134-140.</ref></div>
=== Functions of pitta dosha as per gender and [[prakriti]]: ===
<div style='text-align:justify;'>This study determines the variance in the functional condition of various pitta forms using objective metrics in 201 young, healthy volunteers. For pachaka pitta, serum lipids, cholesterol, total protein, and glucose levels were assessed. For ranjaka pitta, haemoglobin concentration;for alochaka pitta, visual acuity; for sadhaka pitta, [[Memory|memory]], and response time, and for bhrajaka pitta, Red-Green-Blue(RGB) value were evaluated. Except for bhrajaka pitta, each type of pitta had a separate functional status in each [[Prakriti|prakriti]] for both genders. Study suggested that while organizing and assessing research based on [[Prakriti|prakriti]], gender inequalities be taken into account.<ref name="ref27">Balakrishnan P, Ashwini MJ. Conceptual analysis of Physiology of vision in Ayurveda. J Ayurveda Integr Med. 2014;5(3):190-196. </ref></div>
=== Pitta detection using finger photoplethysmography: ===
<div style='text-align:justify;'>According to the study, an increase in pitta level causes changes in the finger pulse profile features. Some of the selected features, such as A2/A1 of the middle finger and TP2/TPT of the ring finger in both the left and right hands of all three participants, demonstrated a monotonic decrease in variance. According to the study, this change is noticeable primarily in the TP2/TPT feature of the right hand's ring finger due to elevated pitta levels.<ref name="ref28">Agrawal S, Gehlot S. Variations in the functions of Pitta Dosha as per gender and Prakriti. TANG [HUMANITAS MEDICINE] [Internet]. 2017 Nov 30;7(4):18.1-18.8.</ref></div>
=== Analysis of pitta imbalance using machine learning algorithm: ===
<div style='text-align:justify;'>This work focused on evaluating pitta imbalance using a machine learning method and gives fresh insights into pitta dosha analysis utilising real-time pitta datasets and machine learning technologies. Pitta dosha was assessed using the Support Vector Machine (SVM). The work used real-time pitta datasets and machine learning approaches to analyse pitta dosha in 152 healthy subjects. The study revealed that lifestyle modifications had an effect on the vata-pitta dosha.<ref name="ref29">Singh M, Chauhan B. High pitta detection using finger photo plethysmograph based features: a feasibility study. International Journal of Computer Science and Communication. 2012;3:73-5. </ref></div>
== Theses done ==
<ol style='text-align:justify;'><li>Thamman R.K.(1996): Ranjaka pitta ka vaigyanika vivechnatmak adhyayana( yakrit ke paripreshya me), Dept. of Kriya Sharir, NIA Jaipur.</li>
<li>Chhimpa R.(2019): Physiological study of drava and ushna guna of pitta and their applied aspect with clinical evaluation of khanda-kushmanda avaleha and patoladi kwatha in amlapitta,Dept. of Kriya Sharir, NIA Jaipur. This study concluded that guna-based research is useful for determining the appropriate medication to administer in a particular state.</li>
<li>Gautam V.J. (2020): A study on effects of transcendental meditation on healthy volunteers with special reference to sadhaka pitta in ayurveda, Department of Rachana Sharir, B.H.U. This study concluded that by increasing the mental fortitude (sattva) among the healthy volunteers, Transcendental Meditation may be used to regulate and maintain mental health (sadhaka pitta functions) as well as minimize the reactivity to stressful situations.</li></ol>
== Future area of research ==
<div style='text-align:justify;'>The critical area of research is the preparation of a validated and standardization of questionnaires for assessment of states like pitta kshaya, vriddhi, and normal functioning of pitta. [[Guna|Guna]] based assessment of pitta is needed. Evaluation of digestive functions in various disorders like hypothyroidism and hyperthyroidism will help understand the pitta's normal and abnormal functioning. Assessment of pitta state in various physiological and emotional states like anger, sorrow, pleasure, pain through subjective and objective methods. Pitta assessment in criminals may be helpful in counseling and understanding their nature. This may be useful in planning diet and behavioral therapy too. Profession wise pitta assessment may be helpful to choose the best and most suitable profession for the individual. </div>
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