Doshas in Ayurveda, its balance ,imbalance and Management

  

The word ‘dosas’ is derived from the sanksrit root “ Dhush Vaikruthye” ,meaning that which is susceptible to vitiation. Description about Dosas are qualitative and functional and hence can not be quantitativelydetermined.  They are three in number ,namely Vata,Pitta ,and Kapha. The state of equilibrium of these dosas results in good health and disequilibrium will lead to diseases.  

 

A person‘s dosas are understood by the fundamental qualities they poses. Qualities of Vata dosa Dryness, Lightness, Cool, Rough, Subtle , and Mobility.  Qualities of Pitta dosas are Unctuous, Sharp, Hot , Foetid, Flowing , and Liquidity . Kapha dosa constitutes the qualities like Heaviness, Slowness, Fineness, Stickiness, and Stability.  When these qualities are seen in our body with respect to the physical as well as physiological levels, we assume the dosas and its disbalances . 

 

There are certain signs that are visible in general when a person has got some disbalance of their dosas. Increase of Vata will cause Emaciation, black discolouration, desire for heat , tremor, abdominal distention, constipation, lack of sleep ,sensory disturbances,  incoherent talks, giddiness , and sadness . Increase of Pitta will lead to discolouration of stool, urine ,eyes and skin . It also causes excessive hunger, thirst ,burning sensation, and insomnia . Increased Kapha causes dyspepsia, hyper salivation, heaviness, laziness , pallor, coldness, laxity of organs, dyspnoea , cough, excessive sleep.  Dosas will also decrease than normal and shows another set of complaints.  Vata in its decreased state causes weakness of motor functions of the body. It makes the speech feeble , decrease the body movements, loss of consciousness,  and also leads to the increase of kapha. Decrease of Pitta causes weakness of digestion ,cold feeling , and loss of body complexion. Decrease of kapha produces Giddiness, empty feeling in the joints and palpitation. Understanding these changes in different bodily systems will give the clue about dosas that worked under the pathogenesis.  The diseases will be always have the disbalance of more than one dosas in more than one systems . So, the treatment should be in a way that one approach should never be self contradictory to each other in terms of dosas.  

 

 

 

General line of Treatment. 

 

For Vata dosha disbalance ,the following treatments are mentioned in Ashtangahrydhaya un general . 

 

1.External Snehana (Abhyanga): Anointing the body with warm, Vata-pacifying oils like sesame oil.

· Internal Snehana (Snehapana): Drinking medicated fats, especially ghee (ghrita), which is considered the best substance for pacifying Vata due to its penetrating and unctuous qualities.

 

 

 

2. Swedana (Fomentation/Sudation /Steam Therapy)

 

This is used after oleation to counter the cold quality of Vata. Heat is applied to the body to loosen toxins and soothe Vata-related pain and stiffness.

 

· It involves various methods of applying steam or heat, such as steam boxes, poultices, or sitting in a warm room.

 

3. Vasti (Medicated Enema)

 

This is stated as the most important therapy for Vatadisorders. The colon is considered the main seat of Vata, and Basti directly targets it.

 

· Anuvasana Basti (Oil Enema): An enema with medicated oils. This is highly nourishing and is the primary pacifying therapy for Vata.

· Niruha/Asthapana Basti (Decoction Enema): An enema with herbal decoctions. This cleanses the colon of excess Vata while also providing nourishment.

 

. Dietary Guidelines.

The diet should embody the opposite qualities of Vata.

· Taste Preference: Sweet ,Sour,and Salty tastes pacify Vata.

· Food Qualities: Warm, moist, well-cooked, and unctuous foods.

· Examples: Warm milk, cream, butter, ghee, nuts, seeds, whole grains like rice and wheat, root vegetables, and sweet ripe fruits.

 

 

Main Treatment Modalities for Pitta Imbalance

 

1..Virechana (Therapeutic Purgation)

This is considered the primary and most important treatment (Shodhana) for Pitta.

As Pitta primarily resides in the small intestine, its main seat, Virechana uses mild purgatives to gently flush out excess Pitta and toxins (ama) directly from the gastrointestinal tract, clearing the channels of its heat and acidity.

· Herbs Used: Avipattikar churna, Triphala, Nishottar, Trivrit leha. Etc.

 

2. Snehana (Oleation) & Swedana (Fomemtation/Steam therapy ) - with Caution

 

· “Snehana”: While oleation is primary for Vata, for Pitta it is done with cooling oils like coconut oil or olive oil, and only in minimal amounts as a preparatory step for Virechana. Internal oleation with ghee is highly valued because ghee is cooling and acts as a vehicle to carry Pitta-pacifying herbs deep into the tissues.

· Swedana: Sweating therapy is generally avoided or used minimally for pure Pitta conditions because heat aggravates Pitta. If used, it is a very mild, short sweat to open the channels before Virechana.

 

3. Tikta Ksheera Basti (Medicated Enema with Bitter Herbs)

While Basti is the main treatment for Vata, certain types are used for Pitta. Enemas prepared with decoctions of bitter herbs (like neem, patola) and milk (ksheera) have a strong cooling and pacifying effect on the system, especially when Pitta is located in the lower GI tract.

 

4. Dietary Recommendations

This is a critical pillar of Pitta management.

Taste Preference: Sweet, Bitter, and Astringent, tastes pacify Pitta.

· Tastes to Avoid: Sour,Salty, and Pungent tastes, as they are heating.

· Food Qualities: Cool or warm (not hot), dry or moderately oily, and heavy.

· Favorable Foods: Sweet fruits (grapes, melons, mangoes, sweet ripe oranges), vegetables (cucumber, zucchini, broccoli, leafy greens), whole grains (barley, rice, oats), dairy (unsalted butter, ghee, milk), and legumes (mung beans).

· Foods to Avoid: Hot spices, fermented foods, vinegar, alcohol, fried foods, excessive salt, and sour foods like yogurt and citrus fruits.

 

 

Main Treatment Modalities for Kapha Imbalance are , 

 

1. Vamana (Therapeutic Emesis)

This is considered the primary and most important purification treatment for Kapha.

 

In principle,  Kapha primarily resides in the stomach and lungs. Vamana uses emetic herbs to directly and forcefully expel excess Kapha and toxins (ama) from the upper gastrointestinal tract and respiratory system. It clears congestion and heaviness from the core.

· Herbs Used: Madanaphala (Randia dumetorum), Yashtimadhu (Licorice), and salt with honey water etc.

 

2. Nasya (Nasal Administration of Medication)

 

· This is a key treatment for Kapha disorders in the head, such as sinus congestion, headaches, and lethargy. For Kapha, stimulating and drying nasal therapies are used, often with powders (pradhamana nasya) or sharp medicated oils.

· Herbs Used: Vacha (Calamus), Pippali (Long Pepper), Maricha (Black Pepper) etc 

 

3. Rookshana (/Udwarthanam Drying Therapy)

 

This is a general principle applied throughout Kaphatreatment. It involves therapies that absorb moisture and reduce oiliness.

 

· Dry Massage (Udvartana): Massaging the body with dry herbal powders (e.g., chickpea flour, triphalapowder) instead of oil. This is excellent for countering Kapha's oiliness and heaviness, and it helps manage weight.

· Physical Activity: Exercise is a form of rookshana as it creates internal heat and dries moisture (sweat).

 

4. Swedana (Fomentation/Sudation Therapy)

 

· Unlike for Pitta, Swedana is highly recommended for Kapha to counter its cold quality. Strong, penetrating heat helps to liquefy and mobilise stagnant Kapha, making it easier to eliminate.

· Types: General steam (bashpa sweda) or intense sweating therapies are used.

 

5. Dietary Recommendations.

 

This is a critical pillar of Kapha management.

 

· Taste Preference: Pungent, Bitter ,and Astringent tastes pacify Kapha.

· Tastes to Avoid: Sweet, Sour ,and Salty tastes, as they are heavy, moist, and increase Kapha.

· Food Qualities: Light, dry, and hot.

· Favourable Foods: Light grains (barley, corn, millet), legumes, most vegetables (especially leafy greens, broccoli, cauliflower), pungent spices (ginger, black pepper, chili, turmeric), honey (the only recommended sweetener), and light fruits like apples and pears.

· Foods to Avoid: Heavy or moist foods like dairy (especially cheese and yogurt), wheat, sweet fruits (like bananas and dates), fatty or fried foods, and excessive meat.

 

 

These are just a general introduction to the treatment protocols of Ayurveda.  Most of the diseases have disbalances of all the three doshas in various systems in the body.  So, its important to consider all the aspects, otherwise the treatment will be counter productive.  Systematic balancing can be achieved only by following a personalised treatment plan from a qualified ayurvedic physician.  

 

Importance of Shirodhara in sleep disorders.

 Ayurveda ennumerates three important aspect of life that’s called as trayopasthambha ( three basic pillars of life ).  It includes Ahara ( food) , Shayana ( sleep ) and brahmacharya ( reduce over indulgence in sex ). Some of the commentators read Brahmacharya with a prefix “aa” that makes the word exactly the opposite of Brahmacharya in sanksrit. Scholars of this opinion says then Trayopasthambas as food, sleep and sex. Taking the sleep in particular,  Ayurveda projects its physiology,  classification and importance in various contexts.  In Charaka samhitha , sleep is classified into six types according to its causative factors. They are , sleep without any external imbalances ( surroundings) , due to depression , due to increased accumulation of Kapha,due to tiredness, due to some chronic debilitating diseases, or due to some external injury or imbalance of doshas.

 

 

Sleep in ayurveda is predominantly an aspect of Kapha. It makes Tamoguna (inertia) of mind. The disturbances in sleep is induced by Vata and Pitta. So.. that which promotes kapha without aggravating the Vata and Pitta will be considered as the stimulant of sleep. With this understanding,  one can examine the Ayurvedic procedure shirodhara and its impact based on modern physiology of sleep.

 

 

Sleep generated and maintained is more of a balance between two systems in the brain. One is the Synergistic effect produced by Hypothalamus to make the body rest, and the other is Circadian rhythm (Biological clock ) coordinated by the Pineal gland with the hormone Melatonin.  The procedure Shirodhara impacts these two system by inducing a cooling effect into the brain.  There are lotsof studies suggest that the temperature in the brain if drops slightly, can stimulate the secretion of Melatonin.  In this way Shirodhara promotes the sleep cycle and thus have a complementary impact to reduce stress.

 

 

During Shirodhara , the oils that are using is of Vatahara property.  These oils are prepared by saturating it with various fats soluble contents from medicinal plants that have combined effect on controlling Vata. As ayurveda considers neurochemical impulses and brain waves as the feature of Vata , controlling such a hyperstimulated impulses will calm the brain and help to get a stable relaxed sleep. Since these oils are also having a muscle relaxant effect , and is poured directly over the head slowly in a slightly warm . It helps to relax the msucles in the scalp and head that will help to reduce the vascular tension and assure proper blood flow to the brain. Once the blood supply is sufficient,  brain will feel more relaxed and the person will be prone to sleep.

 

 

There is another widely  applied phenomenon called ASMR( Autonomous sensory merdian response ).  The exact mechanism behind this phenomenon needs further studies. But the tingling,  pleasurable sensation we feel when there is gentle touch over the head is one of the implication of ASMR. Shirodhara also make use of this mechanism to make the brain more comfortable to fall asleep.

 

 

Shirodhara thus is a combined effect of all these phenomena.  It relaxes the mind-body system and help to get rid off the stress factor there by promises a good stable sleep.

Frozen shoulder, An Ayurvedic perspective .

There are numerous diseases that have its pathology either in neurological or musculoskeletal system, that are grouped in broad term called Vatavyadhi. Since vata dosha is the etiological factor here, the term Vatavyadhi is even extended to psychosomatic and gastrointestinal system. Among this set of diseases mentioned in Ayurvedic texts, the most proximate reference about frozen shoulder (adhesive capsulitis) is the term Apabahuka. Apabahuka can be correlated with other conditions of shoulder joint including periarthritis, Subacromial or subdeltoid bursitis, subcoracoid bursitis, Bicepital tendonitis, Osteoarthritis of shoulder,  Brachial plexes neuropathies etc..

 

When we look at the pathology behind frozen shoulder , it involves degeneration of focal necrosis of supraspinatous tendon. In Ayurveda, this adverse change is viewed in two ways. Firstly the dryness of sleshaka kapha (shoulder tendon and capsule) will happen and lead to the pain. Secondly , Kaphavruthavata ( Entrapment of vata by Kapha ) , will also make the joint inflammed and stiff. It’s the skill of the physician to rule out the kapha component in its pathology otherwise, treatments will be often contradictory even though there is aggravated vata in both the cases.

 

According to Ayurveda, the aetiology of this condition can be many.  It can be directly due to an external trauma, due to heavy exercise that make the shoulder inflamed ,improper posture during sleep, and also due to excessive intake of food that have tastes like katu (acrid), thikta (bitter) , kashaya (astringent) that are laghu (light) ,sukshma(subtle) and Sheetha (cold) . Because of these factors , there will be lack of adequate blood supply in the areas of insertion of tendons (snayu) or can cause degeneration of collagen fibers (upadhatus) . Such a pathology sometimes trigger an autoimmune response and results in abnormalities in tendons and ligaments.  When these supporting structures loss their ability,  It will make the joint less stable and movements of the joints became either painful or restricted.

 

Ayurvedic treatment principles for vatavyadhi can be judiciously applied in the case of frozen shoulder by carefully understanding the kapha component in its pathology.  The protocol involves Snehana (oleation) , swedhana ( sudation) , Vasti ( retention of oil in the affected areas and Nasya ( errhines). Snehana involves oily massages and snehapana (internal unction) to reduce the depleting impact of vata. Various types of deep tissue massages along with sudation can increase the circulation to the affected area and also will make the muscles and associated structures less stiff. It will also help to bring back the range of motions that might have restricted due to stiffness and pain. Various types of Kizhi ( warm medicated bolus ) that are nourishing to the joints can also be applied.

 

 When it comes to the diet, food that pacifies vata and food that assure antiinflammatory actions and nourishment are to be chosen. It is advisable to take easily digestible food that can have faster nourishment.  Intake of Godhuma ( wheat) , masha ( ural dal ) and Kulattha ( horse gram ) are good to curb vata. Intake of Ghrutha (ghee) , cows milk, Goat’s milk, are good. Fruits like Draksha (grapes),  Dadima ( pomegranate ),  Apples, are beneficial.  Since it’s a vata predominant condition,  the food substance has to be always warm and if possible slightly oily and nourishing.  Intake of fish is good if its not along with milk products. Doing mild exercises without causing further damage is always good to regain normal range of motions. Avoid sleeping in abnormal postures, avoid excessive use of sugar, fried /dried food items,  frozen dairy products and the patient should be completely abstain from consumption of alcohol. Yogasanas like shalabhasana ( locust pose),. Suryanamaskara ( salutation to sun ) , Gomukhasana ( cow face pose) are found to be affective in treating frozen shoulder.