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Vividhashitapitiya Adhyaya (view source)

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(Chapter dealing with Different Types of Foods and Drinks)

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Abstract

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=== Abstract ===

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The twenty-eighth chapter of Sutra ~~sthana~~ – Vividhashitapitiyamadhyaya - describes the principles of digestion and metabolism. The formation of tissue elements and byproducts during this process are explained in detail. Food is emphasized as the causative factor for preservation of health and occurrence of diseases. Apart from food, factors like habitat, season, combination, potency and excess consumption affecting the status of immunity and disease in the body have also been discussed here. The chapter explains why some people are healthy even after consuming unwholesome food articles while others suffer from diseases even after following wholesome food habits. This chapter also talks of diseases caused to vitiation of various tissue elements and factors responsible for the movement of dosha from koshtha (gut) to shakha (periphery). These factors are important for disease management.

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The twenty-eighth chapter of [[Sutra Sthana]] – Vividhashitapitiyamadhyaya - describes the principles of digestion and metabolism. The formation of tissue elements and byproducts during this process are explained in detail. Food is emphasized as the causative factor for preservation of health and occurrence of diseases. Apart from food, factors like habitat, season, combination, potency and excess consumption affecting the status of immunity and disease in the body have also been discussed here. The chapter explains why some people are healthy even after consuming unwholesome food articles while others suffer from diseases even after following wholesome food habits. This chapter also talks of diseases caused to vitiation of various tissue elements and factors responsible for the movement of dosha from koshtha (gut) to shakha (periphery). These factors are important for disease management.

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Keywords: Food, digestion, eatable, drinks, disorders of various systems, treatment, movement of dosha, koshtha, shakha.

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Introduction:

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=== Introduction ===

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The preceding chapter dealt with properties of various dietary articles and preparations, while this one explains digestion and metabolism processes in brief. Even though Vividhashitapitiyam means different kinds of eatables and drinks, the chapter gives a detailed explanation of assimilation of food and its transformation into body tissues and diseases caused due to an abnormality of dhatus along with their line of treatment. Some references to this are also available later in the Charaka Samhita Chikitsa sthana 15th chapter (Grahani Chikitsa).

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Wholesome food is vital for the nourishment of human body, the creation of healthy tissues, maintenance of health, and for the prevention of diseases. Not following a wholesome food regimen causes vitiation of doshas. These doshas then reside within dhatus (tissue elements), upadhatus (tissues formed from the essence of dhatu during transformation process), or malas (metabolic wastes). In certain situations, the vitiated doshas get aggravated to cause diseases. The entire process is explained with clinical features of association of vitiated dosha with the respective pathogen. The causative factors for movement of dosha from the periphery to the gut and vice versa are important to understand the diseases and prescribe the appropriate purification processes. Digestion and assimilation are the most important physiological processes in the body. Any abnormality in this process results in the improper formation of the dhatu thus resulting in either deficiency or excessive formation of dhatus resulting in disorders. The causes for the movement of vitiated doshas from alimentary tract (koshtha) to the raktadi dhatu and skin (shakha) results in the occurrence of diseases. Moving the doshas back to alimentary tract (koshtha) and after that removing them eliminates diseases. The line of treatment of various diseases due to an abnormality in the dhatus is mentioned in this chapter. Thus, the chapter presents important aspects of food, digestion, metabolism, immunity, diseases of affected tissues, and guidelines for their treatment.

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The original text, transliteration, and translation:

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Wholesome food is vital for the nourishment of human body, the creation of healthy tissues, maintenance of health, and for the prevention of diseases. Not following a wholesome food regimen causes vitiation of doshas. These doshas then reside within dhatus (tissue elements), upadhatus (tissues formed from the essence of dhatu during transformation process), or malas (metabolic wastes). In certain situations, the vitiated doshas get aggravated to cause diseases. The entire process is explained with clinical features of association of vitiated dosha with the respective pathogen. The causative factors for movement of dosha from the periphery to the gut and vice versa are important to understand the diseases and prescribe the appropriate purification processes. Digestion and assimilation are the most important physiological processes in the body. Any abnormality in this process results in the improper formation of the dhatu thus resulting in either deficiency or excessive formation of dhatus resulting in disorders. The causes for the movement of vitiated doshas from alimentary tract (koshtha) to the raktadi dhatu and skin (shakha) results in the occurrence of diseases. Moving the doshas back to alimentary tract (koshtha) and after that removing them eliminates diseases. The line of treatment of various diseases due to an abnormality in the dhatus is mentioned in this chapter. Thus, the chapter presents important aspects of food, digestion, metabolism, immunity, diseases of affected tissues, and guidelines for their treatment.

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=== The original text, transliteration, and translation ===

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२८. विविधाशितपीतीयोऽध्यायः

विविधाशितपीतीयाध्यायोपक्रमः

अथातो विविधाशितपीतीयमध्यायं व्याख्यास्यामः||१||

इति ह स्माह भगवानात्रेयः||२||

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athātō vividhāśitapītīyamadhyāyaṁ vyākhyāsyāmaḥ||1||

iti ha smāha bhagavānātrēyaḥ||2||

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athAto vividhAshitapItIyamadhyAyaM vyAkhyAsyAmaH||1||

iti ha smAha bhagavAnAtreyaH||2||

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Now we shall expound the chapter dealing with "Different types of food and drinks." Thus, said Lord Atreya. [1]

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Digestion process and its effects:

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==== Digestion process and its effects ====

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विविधमशितं पीतं लीढं खादितं जन्तोर्हितमन्तरग्निसन्धुक्षितबलेन यथास्वेनोष्मणा सम्यग्विपच्यमानंकालवदनवस्थितसर्वधातुपाकमनुपहतसर्वधातूष्ममारुतस्रोतः केवलं शरीरमुपचयबलवर्णसुखायुषा योजयति शरीरधातूनूर्जयतिच|

धातवो हि धात्वाहाराः प्रकृतिमनुवर्तन्ते||३||

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vividhamaśitaṁ pītaṁ līḍhaṁ khāditaṁ jantōrhitamantaragnisandhukṣitabalēna yathāsvēnōṣmaṇāsamyagvipacyamānaṁ kālavadanavasthitasarvadhātupākamanupahatasarvadhātūṣmamārutasrōtaḥkēvalaṁ śarīramupacayabalavarṇasukhāyuṣā yōjayati śarīradhātūnūrjayati ca|

dhātavō hi dhātvāhārāḥ prakr̥timanuvartantē||3||

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vividhamashitaM pItaM lIDhaM khAditaM jantorhitamantaragnisandhukShitabalena yathAsvenoShmaNAsamyagvipacyamAnaM kAlavadanavasthitasarvadhAtupākamanupahatasarvaDhātushmamArutasrotaHkevalaM sharIramupacayabalavarNasukhAyuShA yojayati sharIradhAtUnUrjayati ca|

dhAtavo hi dhAtvAhArAH prakRutimanuvartante||3||

Different types of wholesome foods ingested in the form of eatables, drinkables, lickables and masticables stimulate the antaragni (digestive process) and get properly digested by respective bhutagni (specific digestion as per basic constituent or element). Further in due course of time food gets transformed into different dhatus in presence of dhatvagni (tissue specific digestion and metabolism) and vata (vyana vayu) by the process of dhatvagnipaka or metabolism, nourishes the tissues through the channels of circulation without any interruption, and produces plumpness, strength, complexion, health and longevity. The tissues are sustained by getting fed by various nourishing factors (poshaka dhatus). [3]

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Metabolism, excretion, and homeostasis:

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==== Metabolism, excretion, and homeostasis ====

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तत्राहारप्रसादाख्यो रसः किट्टं च मलाख्यमभिनिर्वर्तते|

किट्टात् स्वेदमूत्रपुरीषवातपित्तश्लेष्माणः कर्णाक्षिनासिकास्यलोमकूपप्रजननमलाः केशश्मश्रुलोमनखादयश्चावयवाःपुष्यन्ति|

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निमित्ततस्तु क्षीणवृद्धानां प्रसादाख्यानां धातूनां वृद्धिक्षयाभ्यामाहारमूलाभ्यां रसः साम्यमुत्पादयत्यारोग्याय, किट्टं चमलानामेवमेव|

स्वमानातिरिक्ताः पुनरुत्सर्गिणः शीतोष्णपर्यायगुणैश्चोपचर्यमाणा मलाः शरीर धातुसाम्यकराः समुपलभ्यन्ते||४||

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tatrāhāraprasādākhyō Rasaḥ kiṭṭaṁ ca malākhyamabhinirvartatē|

kiṭṭāt svēdamūtrapurīṣavātaPittaślēṣmāṇaḥ karṇākṣināsikāsyalōmakūpaprajananamalāḥkēśaśmaśrulōmanakhādayaścāvayavāḥ puṣyanti|

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nimittatastu kṣīṇavr̥ddhānāṁ prasādākhyānāṁ dhātūnāṁ vr̥ddhikṣayābhyāmāhāramūlābhyāṁ Rasaḥsāmyamutpādayatyārōgyāya, kiṭṭaṁ ca malānāmēvamēva|

svamānātiriktāḥ punarutsargiṇaḥ śītōṣṇaparyāyaguṇaiścōpacaryamāṇā malāḥ śarīra Dhātusāmyakarāḥsamupalabhyantē||4||

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tatrAhArapRasadAkhyo RasaH kiTTaM ca malAkhyamabhinirvartate|

kiTTAt svedamUtrapurIShaVātaPittashleShmANaH karNAkShinAsikAsyalomakUpaprajananamalAHkeshashmashrulomanakhAdayashcAvayavAH puShyanti|

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The food gets transformed into two forms i.e. prasada or essence form (ahara rasa) and kitta (the waste form). The kitta part nourishes the mala or excretory products like sweat, urine, stool, vata, pitta, kapha, excreta of the ear, nose, mouth, hair follicle, genital organs, hair, beard, body hair, nails, etc. The essence part or ahara rasa nourishes rasa (body fluids), rakta (blood), mamsa (flesh), medas (fat), asthi (bone), majja (bone marrow), shukra (reproductive elements like semen and ovum), ojas (essence of sapta dhatus), basic components of five sense organs, joints, ligaments, tendons and mucilage part in the body. All the malas (wastes) and dhatu (tissue elements) of the body are nourished by the waste part of food and essence of food or ahara rasa respectively. The rasadi dhatus and malas or waste products are nourished so that the quality is maintained according to size and age of the body. Thus, after digestion, the essence and waste of food in their normal quantity maintain the equilibrium of tissues. The tissue elements may increase or decrease due to some etiology, which can be normalized by the essence part of digested food in decreased or increased quantity. Similarly, malas can be transformed into the waste part of ahara rasa. The waste products, when in excess, can be excreted and the status of the body can be brought to an equilibrium through treatments with the therapies having opposite qualities like hot, cold, etc. [4]

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Channels for the nourishment of tissues:

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==== Channels for the nourishment of tissues ====

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तेषां तु मलप्रसादाख्यानां धातूनां स्रोतांस्ययनमुखानि|

तानि यथाविभागेन यथास्वं धातूनापूरयन्ति|

एवमिदं शरीरमशितपीतलीढखादितप्रभवम्|

अशितपीतलीढखादितप्रभवाश्चास्मिञ् शरीरे व्याधयो भवन्ति|

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हिताहितोपयोगविशेषास्त्वत्र शुभाशुभविशेषकरा भवन्तीति||५||

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हिताहितोपयोगविशेषास्त्वत्र शुभाशुभविशेषकरा भवन्तीति||५||

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tēṣāṁ tu malaprasādākhyānāṁ dhātūnāṁ srōtāṁsyayanamukhāni|

tāni yathāvibhāgēna yathāsvaṁ dhātūnāpūrayanti|

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The nourishing as well as excretory products enter different channels of circulation and nourish the respective dhatus. Thus, this body is maintained by the nourishment drawn from eatables, drinkables, linctuses and chewables. The diseases could also be caused by these sources (i.e., eatables, etc.). Intake of wholesome and unwholesome food results in positive health and diseases respectively. [5]

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Query of Agnivesha:

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==== Query of Agnivesha ====

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एवंवादिनं भगवन्तमात्रेयमग्निवेश उवाच-दृश्यन्ते हि भगवन्! हितसमाख्यातमप्याहारमुपयुञ्जाना व्याधिमन्तश्चागदाश्च,तथैवाहितसमाख्यातम्; एवं दुष्टे कथं हिताहितोपयोगविशेषात्मकं शुभाशुभविशेषमुपलभामह इति||६||

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ēvaṁvādinaṁ bhagavantamātrēyamagnivēśa uvāca- dr̥śyantē hi bhagavan!hitasamākhyātamapyāhāramupayuñjānā vyādhimantaścāgadāśca, tathaivāhitasamākhyātam; ēvaṁ duṣṭēkathaṁ hitāhitōpayōgaviśēṣātmakaṁ śubhāśubhaviśēṣamupalabhāmaha iti||6||

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evaMvAdinaM bhagavantamAtreyamagnivesha uvAca- dRushyante hi bhagavan!hitasamAkhyAtamapyAhAramupayu~jjAnA vyAdhimantashcAgadAshca, tathaivAhitasamAkhyAtam; evaMduShTe kathaM hitAhitopayogavisheShAtmakaM shubhAshubhavisheShamupalabhAmaha iti||6||

After hearing an explanation of Lord Atreya, Agnivesha said “Oh Lord, some individuals consuming wholesome food get afflicted with diseases, while some individuals consuming unwholesome food remain healthy. In this regard, how does one infer that health and disease are influenced by wholesome and unwholesome foods respectively?”. [6]

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Answer by Atreya about causative factors of disease and immunity:

तमुवाच भगवानात्रेयः- न हिताहारोपयोगिनामग्निवेश! तन्निमित्ता व्याधयो जायन्ते, न च केवलं हिताहारोपयोगादेवसर्वव्याधिभयमतिक्रान्तं भवति, सन्ति ह्यृतेऽप्यहिताहारोपयोगादन्या रोगप्रकृतयः, तद्यथा- कालविपर्ययः, प्रज्ञापराधः,शब्दस्पर्शरूपरसगन्धाश्चासात्म्या इति|

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शरीराणि चातिस्थूलान्यतिकृशान्यनिविष्टमांसशोणितास्थीनि दुर्बलान्यसात्म्याहारोपचितान्यल्पाहाराण्यल्पसत्त्वानि चभवन्त्यव्याधिसहानि, विपरीतानि पुनर्व्याधिसहानि|

एभ्यश्चैवापथ्याहारदोषशरीरविशेषेभ्यो व्याधयो मृदवो दारुणाः क्षिप्रसमुत्थाश्चिरकारिणश्च भवन्ति|

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त एव वातपित्तश्लेष्माणः स्थानविशेषे प्रकुपिता व्याधिविशेषानभिनिर्वर्तयन्त्यग्निवेश!||७|| tamuvāca bhagavānātrēyaḥ- na hitāhārōpayōgināmagnivēśa! tannimittā vyādhayō jāyantē, na ca kēvalaṁhitāhārōpayōgādēva sarvavyādhibhayamatikrāntaṁ bhavati, santi hyr̥tē'pyahitāhārōpayōgādanyārōgaprakr̥tayaḥ, tadyathā- kālaviparyayaḥ, prajñāparādhaḥ, śabdasparśarūpaRasagandhāścāsātmyā iti|

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त एव वातपित्तश्लेष्माणः स्थानविशेषे प्रकुपिता व्याधिविशेषानभिनिर्वर्तयन्त्यग्निवेश!||७||

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tamuvāca bhagavānātrēyaḥ- na hitāhārōpayōgināmagnivēśa! tannimittā vyādhayō jāyantē, na ca kēvalaṁhitāhārōpayōgādēva sarvavyādhibhayamatikrāntaṁ bhavati, santi hyr̥tē'pyahitāhārōpayōgādanyārōgaprakr̥tayaḥ, tadyathā- kālaviparyayaḥ, prajñāparādhaḥ, śabdasparśarūpaRasagandhāścāsātmyā iti|

tāśca rōgaprakr̥tayō rasān samyagupayuñjānamapi puruṣamaśubhēnōpapādayanti;tasmāddhitāhārōpayōginō'pi dr̥śyantē vyādhimantaḥ|

ahitāhārōpayōgināṁ punaḥ kāraṇatō na sadyō dōṣavān bhavatyapacāraḥ|

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śarīrāṇi cātisthūlānyatikr̥śānyaniviṣṭamāṁsaśōṇitāsthīnidurbalānyasātmyāhārōpacitānyalpāhārāṇyalpasattvāni ca bhavantyavyādhisahāni, viparītānipunarvyādhisahāni|

ēbhyaścaivāpathyāhāradōṣaśarīraviśēṣēbhyō vyādhayō mr̥davō dāruṇāḥ kṣipRasamutthāścirakāriṇaścabhavanti|

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ta ēva vātaPittaślēṣmāṇaḥ sthānaviśēṣē prakupitā vyādhiviśēṣānabhinirvartayantyagnivēśa!||7||

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ta ēva vātaPittaślēṣmāṇaḥ sthānaviśēṣē prakupitā vyādhiviśēṣānabhinirvartayantyagnivēśa!||7||

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tamuvAca bhagavAnAtreyaH- na hitAhAropayoginAmagnivesha! tannimittA vyAdhayo jAyante, na cakevalaM hitAhAropayogAdeva sarvavyAdhibhayamatikrAntaM bhavati, santihyRute~apyahitAhAropayogAdanyA rogaprakRutayaH, tadyathA- kAlaviparyayaH, praj~jAparAdhaH,shabdasparsharUpaRasagandhAshcAsAtmyA iti|

tAshca rogaprakRutayo Rasan samyagupayu~jjAnamapi puruShamashubhenopapAdayanti;tasmAddhitAhAropayogino~api dRushyante vyAdhimantaH|

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Lord Atreya replied, "An individual consuming wholesome food will not get afflicted with disease due to the food. Intake of wholesome food alone is not the causative factor for a disease or can it prevent diseases. Apart from unwholesome food, there are many other etiological factors that lead to a disease, such as changes in season, intellectual errors, unwholesome contacts, excessive, wrong and overutilization of senses of sound, touch, vision, taste and smell. These etiological factors can cause diseases in an individual despite wholesome intake of rasa and diet. Hence, an individual taking wholesome food has also been observed to have taken ill. Similarly, consuming unwholesome diet does not immediately produce untoward effects. All unwholesome food articles are not equally harmful, all the doshas are not of equal strength, and all the bodies are not capable of preventing disease. Unwholesome food can be more harmful depending upon the habitat, season, combination, potency, and intake in excessive quantity. The doshas become acute and extremely difficult to manage when they get associated with multiple factors, treated with wrong therapies, become deep rooted, chronic, get vitiated in one of the ten seats of prana, and when they afflict vital centers within the body known as marma. Individuals, who are excessively obese, emaciated, whose muscles, blood, bones are depleted, who are very weak physically, who are habituated to consuming unwholesome food, who take in inadequate quantities of food, and who have very weak mind cannot withstand diseases. Contrary to this, individuals having opposite qualities to the ones mentioned above are capable of resisting diseases. Thus, unwholesome diet, doshas, and body constitution factors produce diseases of mild, severe, acute and chronic nature. [7]

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Description of diseases affecting various dhatu [tissue]:

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तत्र रसादिषु स्थानेषु प्रकुपितानां दोषाणां यस्मिन् स्थाने ये ये व्याधयः सम्भवन्ति तांस्तान् यथावदनुव्याख्यास्यामः||८||

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tatra rasādiṣu sthānēṣu prakupitānāṁ dōṣāṇāṁ yasmin sthānē yē yē vyādhayaḥ sambhavanti tāṁstānyathāvadanuvyākhyāsyāmaḥ||8||

tatra RasadiShu sthAneShu prakupitAnAM doShANAM yasmin sthAne ye ye vyAdhayaH sambhavantitAMstAn yathAvadanuvyAkhyAsyAmaH||8||

The specific diseases caused due to vitiated doshas in the seats of rasa, rakta, etc. dhatus will be explained further. [8]

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Diseases due to vitiation of rasa:

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अश्रद्धा चारुचिश्चास्यवैरस्यमरसज्ञता|

हृल्लासो गौरवं तन्द्रा साङ्गमर्दो ज्वरस्तमः ||९||

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The following diseases are caused due to vitiation of rakta: Skin disorders including kushtha, erysipelas (visarpa), furuncles (pidaka), rakta pitta (a kind of bleeding disorder), menorrhagia (asrugdara), inflammation of anus, penis, oral cavity, splenic disorders (pliha), abdominal lump (gulma), abscess (vidradhi), blue mole (nilika), jaundice (kamala), freckles/blemish (vyanga), portwine mark (piplu), black mole of the size of sesame seed (tilakalaka), ringworm (dadru), dermatitis (charmadala), leucoderma (svitra), scabies (pama), urticaria (kotha), and circular erythema (asra mandala). [11-13]

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Diseases due to vitiation of mamsa:

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...शृणु मांसप्रदोषजान्||१३||

अधिमांसार्बुदं कीलं गलशालूकशुण्डिके|

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Following diseases are caused due to vitiation of mamsadhatu: adhimamsa (granuloma), arbuda (myoma), kila (piles), galashaluka (uvulitis), galashundika (tonsillitis), putimamsa (gangrene), alaji (boils), ganda (goiter), gandamala (cervical lymphadenitis) and upajihvika (inflammation of epiglottis). [13-15]

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Diseases due to vitiation of meda:

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.. मेदःसंश्रयांस्तु प्रचक्ष्महे|

निन्दितानि प्रमेहाणां पूर्वरूपाणि यानि च||१५||

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Premonitory symptoms of persistent urinary disorders including diabetes mellitus and eight undesirable types of physical constitutions, which are not appreciable in the society (to be avoided, described earlier in chapter 21of ashta nindita) are produced due to vitiation of medas. [15]

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Diseases due to vitiation of asthi:

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अध्यस्थिदन्तौ दन्तास्थिभेदशूलं विवर्णता|

केशलोमनखश्मश्रुदोषाश्चास्थिप्रदोषजाः||१६||

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Hypertrophy of bones and teeth, splitting and severe pain in teeth and bone, discoloration, abnormality of body hair, nail and beard are the diseases caused due to vitiation of asthi. [16]

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Diseases due to vitiation of majja:

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रुक् पर्वणां भ्रमो मूर्च्छा दर्शनं तमसस्तथा|

अरुषां स्थूलमूलानां पर्वजानां च दर्शनम्||१७||

मज्जप्रदोषात्, ...|१८|

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ruk parvaṇāṁ bhramō mūrcchā darśanaṁ tamasastathā|

aruṣāṁ sthūlamūlānāṁ parvajānāṁ ca darśanam||17||

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aruShAM sthUlamUlAnAM parvajAnAM ca darshanam||17||

MajjāpradoShAt, ...|18|

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Pain in the joints, giddiness, unconsciousness, blackouts and deep rooted abscess in joints are caused due to vitiation of majja. [17-18]

Diseases due to vitiation of shukra:

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...शुक्रस्य दोषात् क्लैब्यमहर्षणम्|

रोगि वा क्लीबमल्पायुर्विरूपं वा प्रजायते||१८||

न चास्य जायते गर्भः पतति प्रस्रवत्यपि|

शुक्रं हि दुष्टं सापत्यं सदारं बाधते नरम्||१९||

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...śukrasya dōṣāt klaibyamaharṣaṇam|

rōgi vā klībamalpāyurvirūpaṁ vā prajāyatē||18||

na cāsya jāyatē garbhaḥ patati prasravatyapi|

śukraṁ hi duṣṭaṁ sāpatyaṁ sadāraṁ bādhatē naram||19||

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...Śukrasya doShAt klaibyamaharShaNam|

rogi vA klIbamalpAyurvirUpaM vA prajAyate||18||

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Due to vitiation of shukra, the person becomes sexually impotent, suffers from aharshana (inability to penetrate despite erection), and may have sick, impotent, and short-lived children with congenital abnormalities. There could be cases of no conception, or there will be spontaneous abortion. Thus, abnormalities of shukra result in misery for the individual as well as his family. [18-19]

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Disease of sense organs:

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इन्द्रियाणि समाश्रित्य प्रकुप्यन्ति यदा मलाः|

उपघातोपतापाभ्यां योजयन्तीन्द्रियाणि ते||२०||

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indriyāṇi samāśritya prakupyanti yadā malāḥ|

upaghātōpatāpābhyāṁ yōjayantīndriyāṇi tē||20||

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When the doshas get vitiated in sense organs, they either cause impairment or deformity of the respective sense organ. [20]

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Diseases of ligaments, vessels, and tendons:

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स्नायौ सिराकण्डराभ्यो दुष्टाः क्लिश्नन्ति मानवम्|

स्तम्भसङ्कोचखल्लीभिर्ग्रन्थिस्फुरणसुप्तिभिः||२१||

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snāyau sirākaṇḍarābhyō duṣṭāḥ kliśnanti mānavam|

stambhasaṅkōcakhallībhirgranthisphuraṇasuptibhiḥ||21||

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Stiffness, contraction, and neuralgia of upper and lower extremities, tumor, throbbing sensation and numbness are produced by the vitiated doshas in ligaments, blood vessels and tendons. [21]

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Vitiation of mala by dosha:

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मलानाश्रित्य कुपिता भेदशोषप्रदूषणम्|

दोषा मलानां कुर्वन्ति सङ्गोत्सर्गावतीव च||२२||

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malānāśritya kupitā bhēdaśōṣapradūṣaṇam|

dōṣā malānāṁ kurvanti saṅgōtsargāvatīva ca||22||

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The aggravation of doshas in the malas of the body causes excess discharge (bheda) of mala (as in diarrhea), decrease or dryness of mala, and abnormalities on normal color, smell, etc. leading to their retention or excessive elimination. [22]

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Management principles:

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विविधादशितात् पीतादहिताल्लीढखादितात्|

भवन्त्येते मनुष्याणां विकारा य उदाहृताः||२३||

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नवेगान्धारणेऽध्याये चिकित्सासङ्ग्रहः कृतः|

मलजानां विकाराणां सिद्धिश्चोक्ता क्वचित्क्वचित्||३०||

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vividhādaśitāt pītādahitāllīḍhakhāditāt|

bhavantyētē manuṣyāṇāṁ vikārā ya udāhr̥tāḥ||23||

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