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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] 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 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]. 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]

|image=http://www.carakasamhitaonline.com/resources/assets/ogimgs.jpg

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.Third edition.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

|label4 = Affiliations

|label4 = Affiliations

|data4 = ¹[[Charak Samhita Research, Training and Development Centre]], I.P.G.T.& R.A., Jamnagar, Gujarat, India   

|data4 = ¹[[Charak Samhita Research, Training and Development Centre]], I.T.& R.A., Jamnagar, Gujarat, India   

²Department of Kriya Sharir, G.J.Patel Institute of Ayurvedic Studies and Research, New Vallabh Vidyanagar, Anand, Gujarat, India

²Department of Kriya Sharir, G.J.Patel Institute of Ayurvedic Studies and Research, New Vallabh Vidyanagar, Anand, Gujarat, India

|label6 = Date of first publication:

|label6 = Date of first publication:

|data6 = January 24, 2021

|data6 = January 24, 2021

|label7 = DOI

|label7 = DOI

|data7 =  Under process

|data7 =  [https://doi.org/10.47468/CSNE.2021.e01.s09.043 10.47468/CSNE.2021.e01.s09.043]

}}

}}

==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 and sub types of dosha ==

==Types of dosha ==

The dosha are broadly categorized into two:  

The dosha are broadly categorized into two:  

# Somatic or physical level (sharira dosha): Three dosha viz. vata, pitta and kapha.  

# Somatic or physical level ([[sharira]] dosha): Three dosha viz. vata, pitta and kapha.  

# Psychic or mental level (manas dosha): Two dosha viz. rajas and tamas. [Cha.Sa. Sutra Sthana 1/ 57]

# Psychic or mental level ([[manas]] dosha): Two dosha viz. rajas and tamas. [Cha.Sa. [[Sutra Sthana]] 1/ 57]

The present article describes somatic or physical dosha.  

The present article describes somatic or physical dosha.  

==Origin of dosha==

== Origin of dosha ==

Dosha at physical level originate from five fundamental elements ([[pancha mahabhuta]]). Vata dosha originates from [[vayu]] and [[akasha mahabhuta]]; Pitta dosha from agni mahabhuta and kapha dosha from combination of aap and prithvi mahabhuta. The dosha represent functions of dominant mahabhuta in the body at gross level. They can be principles of regulators, enhancers or inhibitors of the physiological functions.  

Dosha at physical level originate from five fundamental elements ([[pancha mahabhuta]]). Vata dosha originates from [[vayu]] and [[akasha mahabhuta]]; Pitta dosha from [[agni mahabhuta]] and kapha dosha from combination of [[aap]] and [[prithvi mahabhuta]]. The dosha represent functions of dominant [[mahabhuta]] in the body at gross level. They can be principles of regulators, enhancers or inhibitors of the physiological functions.  

==Subtypes of dosha==

==Subtypes==

Each physical dosha has five subtypes based on their functions and sites.

Each physical dosha has five subtypes based on their functions and sites.

# 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 of dosha==

==Properties==

The dosha act through their properties (guna). The properties (guna) are responsible for showing specific effect (karma).  Dosha govern the functions related to that property and lead to resultant effect. Therefore, these properties are also applied as parameters to assess normal and abnormal states of dosha in body. The resultant effect is observed clinically.

The dosha act through their properties ([[guna]]). The properties ([[guna]]) are responsible for showing specific effect ([[karma]]).  Dosha govern the functions related to that property and lead to resultant effect. Therefore, these properties are also applied as parameters to assess normal and abnormal states of dosha in body. The resultant effect is observed clinically.

'''Table 1: Properties of Dosha'''

'''Table 1: Properties of dosha'''

{| class="wikitable"

{| class="wikitable"

! Sr.No''' !! ''Parameter of effect''!! ''Vata Dosha''!! ''Pitta Dosha''!! ''Kapha Dosha''!!

! Sr.No''' !! ''Parameter of effect''!! ''Vata dosha''!! ''Pitta dosha''!! ''Kapha dosha''!!

|-

|-

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

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

! 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 (vishad), 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;" | --

|-

|-

|}

|}

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 centres 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 dhatu]]), 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, 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>   

===Influence of dosha on digestion (agni) and gut (koshtha)===

===Influence of dosha on digestion ([[agni]]) and gut (koshtha)===

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''!!

|-

|-

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

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

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

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

| rowspan="1" style="text-align: left;" | Irregular digestion (Vishama agni)  

| rowspan="1" style="text-align: left;" | Irregular digestion (vishama [[agni]])  

| rowspan="1" style="text-align: left;" | Hard bowel (Krura koshta)

| rowspan="1" style="text-align: left;" | Hard bowel (krura koshtha)

| rowspan="1" style="text-align: left;" | Irregular digestion, hard stools, constipation, inhibited intestinal motility, discomfort in defecation and abdominal pressure

| rowspan="1" style="text-align: left;" | Irregular digestion, hard stools, constipation, inhibited intestinal motility, discomfort in defecation and abdominal pressure

|-

|-

! rowspan="1" style="text-align: left;" | 2

! rowspan="1" style="text-align: left;" | 2

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

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

| rowspan="1" style="text-align: left;" | Fast digestion (Tikshna agni)  

| rowspan="1" style="text-align: left;" | Fast digestion (tikshna [[agni]])  

| rowspan="1" style="text-align: left;" | Soft bowel (Mrudu koshta)  

| rowspan="1" style="text-align: left;" | Soft bowel (mrudu koshtha)  

| rowspan="1" style="text-align: left;" | Fast digestion, increased sensitivity of intestinal mucosa, loose motions, frequent defecation  

| rowspan="1" style="text-align: left;" | Fast digestion, increased sensitivity of intestinal mucosa, loose motions, frequent defecation  

|-

|-

! rowspan="1" style="text-align: left;" | 3

! rowspan="1" style="text-align: left;" | 3

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

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

| rowspan="1" style="text-align: left;" | Slow digestion (Manda agni)

| rowspan="1" style="text-align: left;" | Slow digestion (manda [[agni]])

| rowspan="1" style="text-align: left;" | Medium (not too soft, not too hard) bowel (Madhyam koshta)

| rowspan="1" style="text-align: left;" | Medium (not too soft, not too hard) bowel (madhyama koshtha)

| rowspan="1" style="text-align: left;" | Slow and sluggish digestion, semi solid, soft consistency of stool, defecation with ease

| rowspan="1" style="text-align: left;" | Slow and sluggish digestion, semi solid, soft consistency of stool, defecation with ease

|-

|-

===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==

===Diet and lifestyle===

=== Diet and lifestyle ===

The diet dominant in similar properties of dosha increases the proportion of dosha in body. The diet which is opposite to the properties of dosha decreases the proportion of dosha. Therefore, diet which maintains equilibrium state of dosha in the body is advised for preservation of health. The following table shows specific tastes and potencies that influences the dosha.   

The diet dominant in similar properties of dosha increases the proportion of dosha in body. The diet which is opposite to the properties of dosha decreases the proportion of dosha. Therefore, diet which maintains equilibrium state of dosha in the body is advised for preservation of health. The following table shows specific tastes and potencies that influences the dosha.   

'''Table 3: Influence of taste and potency on dosha '''

'''Table 3: Influence of taste and potency on dosha '''

{| class="wikitable"

{| class="wikitable"

! Sr.No''' !! ''Dosha''!! ''Aggravating taste (rasa) and veerya (potency)''!! ''Pacifying taste (rasa) and veerya (potency)''!!  

! Sr.No''' !! ''Dosha''!! ''Aggravating taste ([[rasa]]) and [[veerya]] (potency)''!! ''Pacifying taste ([[rasa]]) and [[veerya]] (potency)''!!  

|-

|-

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

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

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

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

| rowspan="1" style="text-align: left;" | Pungent (katu), bitter (tikta), astringent(kashaya), cold potency  

| rowspan="1" style="text-align: left;" | Pungent (katu), bitter (tikta), astringent(kashaya), cold potency  

| rowspan="1" style="text-align: left;" | Sweet(madhura), sour(amla), salty(lavana), hot potency  

| rowspan="1" style="text-align: left;" | Sweet(madhura), sour(amla), salty(lavana), hot potency  

|-

|-

! rowspan="1" style="text-align: left;" | 2

! rowspan="1" style="text-align: left;" | 2

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

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

| rowspan="1" style="text-align: left;" | Sour(amla), salty(lavana), pungent (katu), hot potency  

| rowspan="1" style="text-align: left;" | Sour(amla), salty(lavana), pungent (katu), hot potency  

| rowspan="1" style="text-align: left;" | Sweet(madhura), bitter (tikta), astringent(kashaya), cold potency  

| rowspan="1" style="text-align: left;" | Sweet(madhura), bitter (tikta), astringent(kashaya), cold potency  

|-

|-

! rowspan="1" style="text-align: left;" | 3

! rowspan="1" style="text-align: left;" | 3

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

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

| rowspan="1" style="text-align: left;" | Sweet(madhura), sour(amla), salty(lavana), cold potency  

| rowspan="1" style="text-align: left;" | Sweet(madhura), sour(amla), salty(lavana), cold potency  

| rowspan="1" style="text-align: left;" | Pungent (katu), bitter (tikta), astringent(kashaya), hot potency  

| rowspan="1" style="text-align: left;" | Pungent (katu), bitter (tikta), astringent(kashaya), hot potency  

|}

|}

The lifestyle activities that produce similar effects as of dosha lead to vitiation of dosha and vice versa.  For example, excess movement increases vata dosha, and rest pacifies vata dosha.  The same principles are applied in treatment of diseases due to vitiation of dosha.  

The lifestyle activities that produce similar effects as of dosha lead to vitiation of dosha and vice versa.  For example, excess movement increases vata dosha, and rest pacifies vata dosha.  The same principles are applied in treatment of diseases due to vitiation of dosha.

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

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

The time factor in terms of season, 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'''

{| class="wikitable"

{| class="wikitable"

! Sr.No''' !! ''Dosha''!! ''Age''!! ''Peak time in day-night cycle''!! ''Peak Season''!! ''Peak time after meals''!!

! Sr.No''' !! ''Dosha''!! ''Age''!! ''Peak time in day-night cycle''!! ''Peak Season''!! ''Peak time after meals''!!

|-

|-

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

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

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

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

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

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

| rowspan="1" style="text-align: left;" | Time of end of day and night  

| rowspan="1" style="text-align: left;" | Time of end of day and night  

|-

|-

! rowspan="1" style="text-align: left;" | 2

! rowspan="1" style="text-align: left;" | 2

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

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

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

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

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

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

|-

|-

! rowspan="1" style="text-align: left;" | 3

! rowspan="1" style="text-align: left;" | 3

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

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

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

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

| rowspan="1" style="text-align: left;" | Start of day and night  

| rowspan="1" style="text-align: left;" | Start of day and night  

|}

|}

==Natural cycle of dosha as per seasonal variation (ritu kriyakala)==

== Natural cycle of dosha as per seasonal variation (ritu kriyakala)==

The body is continuously exposed to the external environment and climatic changes as per season. The dosha tend to deviate from normal state and show variations in their levels according to the seasons. These physiological disequilibrium states are maintained by adopting seasonal dietary and lifestyle regimen (ritucharya) to preserve health.  As these states are more prone for opportunistic diseases, these are also called as ‘ritu kriyakala’ (seasonal opportunities). The table shows seasonal variations in dosha.   

The body is continuously exposed to the external environment and climatic changes as per season. The dosha tend to deviate from normal state and show variations in their levels according to the seasons. These physiological disequilibrium states are maintained by adopting seasonal dietary and lifestyle regimen ([[ritucharya]]) to preserve health.  As these states are more prone for opportunistic diseases, these are also called as ‘ritu kriyakala’ (seasonal opportunities). The table shows seasonal variations in dosha.   

'''Table 5: Influence of taste and potency on dosha '''

'''Table 5: Influence of taste and potency on dosha '''

|-

|-

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

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

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

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

| rowspan="1" style="text-align: left;" | Summer (grishma)

| rowspan="1" style="text-align: left;" | Summer (grishma)

| rowspan="1" style="text-align: left;" | Rainy season(varsha)

| rowspan="1" style="text-align: left;" | Rainy season(varsha)

|-

|-

! rowspan="1" style="text-align: left;" | 2

! rowspan="1" style="text-align: left;" | 2

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

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

| rowspan="1" style="text-align: left;" | Rainy season (varsha)

| rowspan="1" style="text-align: left;" | Rainy season (varsha)

| rowspan="1" style="text-align: left;" | Autumn (sharada)

| rowspan="1" style="text-align: left;" | Autumn (sharada)

|-

|-

! rowspan="1" style="text-align: left;" | 3

! rowspan="1" style="text-align: left;" | 3

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

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

| rowspan="1" style="text-align: left;" | Winter (shishira)

| rowspan="1" style="text-align: left;" | Winter (shishira)

| rowspan="1" style="text-align: left;" | Spring (vasanta)

| rowspan="1" style="text-align: left;" | Spring (vasanta)

|}

|}

==Clinical aspect of dosha==

==Clinical aspects ==

===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 ===

The endogenous diseases (nija vyadhi) are caused by the vitiation of dosha (vata, pitta, and kapha). The diseases caused due to combination of two or three dosha are called as general (samanya) diseases. The diseases caused due to vitiation of one dosha only are called as nanatmaja (dosha specific) diseases. [Cha.Sa.Sutra Sthana 20/10]

The endogenous diseases (nija vyadhi) are caused by the vitiation of dosha (vata, pitta, and kapha). The diseases caused due to combination of two or three dosha are called as general (samanya) diseases. The diseases caused due to vitiation of one dosha only are called as 'nanatmaja' (dosha specific) diseases. [Cha.Sa.[[Sutra Sthana]] 20/10]

===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  

# Vitiated state: Pacification therapy  

# Vitiated state: Pacification therapy  

# Aggravated state: Removing the excess to restore equilibrium  

# Aggravated state: Removing the excess to restore equilibrium  

# Normal state: maintain the equilibrium  [Su.Sa. Chikitsa Sthana 33/3]

# Normal state: maintain the equilibrium  [Su.Sa. Chikitsa Sthana 33/3]<ref name="Sushruta Samhita" />

Some primary selective treatments in the increased state of dosha are stated in following table.

Some primary selective treatments in the increased state of dosha are stated in following table.

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

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

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

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

| rowspan="1" style="text-align: left;" | Therapeutic Enema (Basti)

| rowspan="1" style="text-align: left;" | Therapeutic Enema ([[Basti]])

| rowspan="1" style="text-align: left;" | Oil (Taila)

| rowspan="1" style="text-align: left;" | Oil (Taila)

|-

|-

! rowspan="1" style="text-align: left;" | 2

! rowspan="1" style="text-align: left;" | 2

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

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

| rowspan="1" style="text-align: left;" | Therapeutic Purgation (Virechan)

| rowspan="1" style="text-align: left;" | Therapeutic Purgation ([[Virechana]])

| rowspan="1" style="text-align: left;" | Ghee/Clarified butter (Ghrita)

| rowspan="1" style="text-align: left;" | Ghee/Clarified butter (Ghrita)

|-

|-

! rowspan="1" style="text-align: left;" | 3

! rowspan="1" style="text-align: left;" | 3

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

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

| rowspan="1" style="text-align: left;" | Therapeutic Emesis (Vaman)

| rowspan="1" style="text-align: left;" | Therapeutic Emesis ([[Vamana]])

| rowspan="1" style="text-align: left;" | Honey (Madhu)

| rowspan="1" style="text-align: left;" | Honey (Madhu)

|-

|-

Also, inflammatory genes were up-regulated in vata types, whereas up-regulation of oxidative stress pathway genes were observed in pitta and kapha types. CD25 (activated B cells) and CD56 (natural killer cells) were higher in kapha dosha types. CYP2C19 genotypes, a family of genes that help in detoxification and metabolism of certain drugs were down-regulated in kapha types and up-regulated in pitta types.  A research program using physiological and cortical measures is suggested to explore the utility of dosha brain-types. Dosha brain models may give scope to learn in field of relation of dosha to electroencephalography EEG patterns, autonomic activation and autonomic balance, stress reactivity and behavior.  This line of research could help clarify variable response to drugs and lifestyle modifications in normal and clinical populations and so help target health promotion at all levels of life. There are possible correlations between autonomous nervous systems and dosha.<ref>Travis FT, Wallace RK. Dosha brain-types: A neural model of individual differences. J Ayurveda integrative Med 2015;6:280-5. DOI: 10.4103/0975-9476.172385</ref>   

Also, inflammatory genes were up-regulated in vata types, whereas up-regulation of oxidative stress pathway genes were observed in pitta and kapha types. CD25 (activated B cells) and CD56 (natural killer cells) were higher in kapha dosha types. CYP2C19 genotypes, a family of genes that help in detoxification and metabolism of certain drugs were down-regulated in kapha types and up-regulated in pitta types.  A research program using physiological and cortical measures is suggested to explore the utility of dosha brain-types. Dosha brain models may give scope to learn in field of relation of dosha to electroencephalography EEG patterns, autonomic activation and autonomic balance, stress reactivity and behavior.  This line of research could help clarify variable response to drugs and lifestyle modifications in normal and clinical populations and so help target health promotion at all levels of life. There are possible correlations between autonomous nervous systems and dosha.<ref>Travis FT, Wallace RK. Dosha brain-types: A neural model of individual differences. J Ayurveda integrative Med 2015;6:280-5. DOI: 10.4103/0975-9476.172385</ref>   

The systems approach proposed by Hankey A. shows how tridosha applies to every living organism from the first cells, and how it is inherited and diversified in the history of life. Ayugenomics study confirms dosha's inheritance. Each dosha is responsible for regulating an essential aspect of organism function, connected to a recognised definition of life: Vata, Input/Output (homeostasis); Pitta, Turnover (negative entropy production); Kapha, Storage (inheritable structure).<ref>Hankey A. (2010). Establishing the Scientific Validity of Tridosha part 1: Doshas, Subdoshas and Dosha Prakritis. Ancient science of life, 29(3), 6–18</ref>  

The systems approach proposed by Hankey A. shows how tridosha applies to every living organism from the first cells, and how it is inherited and diversified in the history of life. Ayugenomics study confirms dosha's inheritance. Each dosha is responsible for regulating an essential aspect of organism function, connected to a recognized definition of life: Vata, Input/Output (homeostasis); Pitta, Turnover (negative entropy production); Kapha, Storage (inheritable structure).<ref>Hankey A. (2010). Establishing the Scientific Validity of Tridosha part 1: Doshas, Subdoshas and Dosha Prakritis. Ancient science of life, 29(3), 6–18</ref>  

===Relation of vata dosha and vagus nerve===

===Relation of vata dosha and vagus nerve===

Venil Sumantran and Pratibha Nair proposed strong correlations between vagus nerve and vata dosha activity. They have hypothetically provided four possible reasons to assume vagal activity as a reliable candidate biomarker of important vata dosha functions. First, normal vata dosha and the vagus maintain neural, respiratory, and digestive homeostasis, and dysfunctions in both entities cause very similar diseases.  Second, vata dosha regulates higher neural functions such as mental health and behaviour, and the 'polyvagal theory' proposes similar functions for the vagus. Third, the similar roles of vata dosha and vagus in maintaining gut homeostasis, suggest that vagal activity in the 'gut-brain' link is a candidate biomarker of pakwashaya (lower gut), a primary regulatory site for vata dosha. Fourth, the vagus is the only vital nerve whose activity can be reliably measured and manipulated. Vagal nerve stimulation is an approved therapy for certain ailments attributed to impaired vata dosha.<ref>Venil N Sumantran, Pratibha P Nair. Can the vagus nerve serve as biomarker for vata dosha activity?  J Ayurveda Integr Med, Apr-Jun 2019;10(2):146-151. DOI: 10.1016/j.jaim.2019.04.003</ref>  This research can provide better understanding in concept and practical approach towards vata dosha.  

Venil Sumantran and Pratibha Nair proposed strong correlations between vagus nerve and vata dosha activity. They have hypothetically provided four possible reasons to assume vagal activity as a reliable candidate biomarker of important vata dosha functions. First, normal vata dosha and the vagus maintain neural, respiratory, and digestive homeostasis, and dysfunctions in both entities cause very similar diseases.  Second, vata dosha regulates higher neural functions such as mental health and behaviour, and the 'polyvagal theory' proposes similar functions for the vagus. Third, the similar roles of vata dosha and vagus in maintaining gut homeostasis, suggest that vagal activity in the 'gut-brain' link is a candidate biomarker of pakwashaya (lower gut), a primary regulatory site for vata dosha. Fourth, the vagus is the only vital nerve whose activity can be reliably measured and manipulated. Vagal nerve stimulation is an approved therapy for certain ailments attributed to impaired vata dosha.<ref>Venil N Sumantran, Pratibha P Nair. Can the vagus nerve serve as biomarker for vata dosha activity?  J Ayurveda Integr Med, Apr-Jun 2019;10(2):146-151. DOI: 10.1016/j.jaim.2019.04.003</ref>  This research can provide better understanding in concept and practical approach towards vata dosha.  

===Nuclear corelation===

=== Nuclear correlation ===

Sharma H. and Wallace RK proposed that mRNA, tRNA, and protein have features and properties that represent vata, pitta, and kapha at the cellular level. Messenger RNA corresponds with vata (transmission of information), tRNA corresponds with pitta (transformation), and protein corresponds with kapha (structure).<ref>Hari Sharma and Robert Keith Wallace. Ayurveda and Epigenetics. Medicina 2020, DOI: 10.3390/medicina56120687</ref>

Sharma H. and Wallace RK proposed that mRNA, tRNA, and protein have features and properties that represent vata, pitta, and kapha at the cellular level. Messenger RNA corresponds with vata (transmission of information), tRNA corresponds with pitta (transformation), and protein corresponds with kapha (structure).<ref>Hari Sharma and Robert Keith Wallace. Ayurveda and Epigenetics. Medicina 2020, DOI: 10.3390/medicina56120687</ref>

===Assessment of dosha===

=== Assessment of dosha ===

 

 

 

 

=== Abbreviations ===

Manohar PR and his team of researchers proposed the heart rate variability analysis to determine functions of dosha in body. Substantial agreement between the HRV analysis and the clinical method of assessing dosha imbalances in pathological conditions is observed in data.<ref>Ram Manohar, P., Sorokin, O., Chacko, J., & Nampoothiri, V. (2018). An exploratory clinical study to determine the utility of heart rate variability analysis in the assessment of dosha imbalance. Journal of Ayurveda and integrative medicine, 9(2), 126–130. https://doi.org/10.1016/j.jaim.2017.06.008</ref>  S. Shilpa and C.G.Venkatesha Murthy (2011) developed and standardized Mysore Tridosha Scale, wherein only the psychological aspects of the dosha prakriti have been used to build items for the assessment of personality. The psychometric properties of the scale are established with significant reliability and validity of data.

*SAT = Standard Ayurveda Terminology

*Cha. = Charak

*Su. = Sushruta

*Sha. =Sharangadhara

*Sa. = Samhita

*A. = Ashtanga

*Hr. = Hrudaya

===Relation of dosha to sleep===

== Related chapters ==

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.

[[Deerghanjiviteeya Adhyaya]], [[Vatakalakaliya Adhyaya]], [[Kiyanta Shiraseeya Adhyaya]], [[Trishothiya Adhyaya]], [[Ashtodariya Adhyaya]], [[Maharoga Adhyaya]], [[Rogabhishagjitiya Vimana Adhyaya]]

==References==

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