Dr. Narendra Pendse
M.D. (Ayurveda)
With the shift from Doshic equilibrium, illness follows. In the understanding of the shift there is emphasis on increase in Dosha-qualities, and the consequent functions of Dosha_sare inflicted on the tissues. The shift by decrease is possible, to initiate certain ill health problems. To catch the attention of the professionals, to this happening, the contribution of Ksheen`a Dosha is useful. Major elaborations in texts and commentaries; deal with situations where provocation results in a variety of signs and symptoms of disease, the all out line of management is by choosing enthusiastically, means against the seen attributes of Dosha_s. But providing Dosha provocation factors, as the main components of treatment, Ksheen`a Dosha is required in management of the decreased levels.
This distinction is likely to be missed, if the professional is not timely prompt and keen to imagine this. The success of a capable physician is more enhanced by paying attention to ascertainment about less Dosha status, and appropriate (usually missed) provocation providing treatment for it. It is relatively less in actual incidence, when properly attended; it adds additional credit to relief from pain, suffering, of the clientele. In the following article the transliterated Ayurvedic terms are accompanied by suitable English words, whereby the purpose of communication is served.
The Ayurvedic classics have emphasized the important role of the three Dosha_sin the causation of both:
- Svaasthya i.e. Health &
- Vyaadhi i.e. Disease (A.H.Su. 1/18)
This dual causative role is dependent on the Saamya i.e. Relative balance of the Three Dosha_s vis-a-viseach other. This status or level of three Dosha–Saamya i.e. Relative balance amongst the three Dosha_sis individual specific from birth and termed Deha–Prakruti. (C.Vi. 8/95) This three Dosha level defined at birth, in a healthy individual, is the basic reference scale for that individual and is essentially unchangeable. Whilst in health, the classics have noted that there can be some transient change, in the levels, due to diet, effect of seasons, day and night as well as age, but by and large a good health is maintained.
The three Dosha_spossess suitable group of Gun`a_s (properties / attributes) and Karma_s (actions). (C.Su.1/50) when in balance. (A.H. Su.1/14-16 & 11/1-2, C.Vi8/96-98)
Since the absolute levels of each of the Dosha_scannot be defined as:
- There is variation in individual physiology and
- There are variations taking place in dynamism for homeostasis, attributable to the factor of time or ageing. (S. Su.15/43) it is not reasonable to fix absolute measurements of body components.
Hence, the levels of Dosha_s are to be deduced based on the presence or absence of normal Karma_s. Excessive expression or inhibition of Karma_s is indicative of relative Vriddhi (increase) or Ksheen`ataa (decrease) of Dosha_s. (A.H.Su.11/32, 5-7, 18-20)
By following, the Ksheen`a Dosha status the following features are to be cognized:
- Ati S`hodhana, excessive elimination
- Ati–Sams`hamana, excessive pacifying treatment
- Vega–Vidhaarana suppressing urges, worth attending to
- Asaatmya–Anna, food that is not suitable
- Manastaapa, upsetting of mind
- Vyaayaama, inappropriate exertion
- Anas`hana, fasting, when not indicated
- Ati–Maithuna (S.Su. 15/11) excessive sex indulgence.
The various classics have noted the Lakshan`a_s (signs and symptoms) of Ksheen`a Dosha as follows:
As per Sus`hruta (S.Su. 15/11)
Ksheen`a Vaata Dosha
- Manda–Chesht`ataa
- Alpa Vaktva
- Apraharsha
- Mood`ha–Sandnyataa
Ksheen`a Pitta Dosha
- Manda–Ushma
- Manda–Agni
- Nishprabhatva
Ksheen`a Kapha Dosha
- Rukshataa
- Antardaaha
- Amaas`haya Shoonyataa
- Itar (S`hleshmas`haya) Shoonyataa
- Sandhi S`haithilya
- Trushn`aa
- Daurbalya
- Prajagaran`a
As per Asht`aanga Samgraha
Ksheen`a Vaata Dosha
- Praseka
- Aruchi
- Hrullaasa
Ksheen`a Pitta Dosha
- Stambha
- S`haitya
- Aniyata Toda
- Aniyata Daaha
- Aniyata Arochaka
Ksheen`a S`leshma Dosha
- Bhrama
- Udvesht`ana
- Anidraa
- Angamarda
- Paris`hosha
As per Asht`aanga Hridaya (A.H.Su. 11/18-20)
Ksheen`a Vaata Dosha
- Angasaada
- Alpa Bhashita
- Alpa Ihita
- Samdnyaamoha
- S`hleshmavriddhi
[S`hleshmavriddhi Lakshan`a_s]-:
- Agnisaada
- Praseka
- Aalasya
- Gaurava
- S`hvaitya
- S`haitya
- S`hlathaangatva
- S`hvaasa
- Kaasa
- Atinidraata
Ksheen`a Pitta Dosha
- Manda Anala
- S`heeta
- Prabhaahaani
Ksheen`a S`leshma Dosha
- Bhrama
- S`hleshmaashaya Shoonyatva
- Hriddrava
- S`hlathasandhitaa
According to Charaka (C .Su. 17/32)
According to Charaka; Ksheen`a Dosha_scease to manifest their natural actions.
Besides the above person having Ksheen`a Dosha exhibits certain desires. These are elaborated in detail by various classical authors. These can also help a Vaidya to diagnose and treat the condition of Ksheen`a Dosha.
D`alhan`a in his commentary on the discussion regarding Ksheen`a Dosha in Sushrut, refers to an unidentified quotation which enlists, the types of food attributes desired in such conditions. Sarvaangasundara on AH.Su.11/44 also opines, that such likings or cravings are exhibited by patients affected with Ksheen`a Dosha.
- In Ksheena Vaata Dosha, the following desire are observed;
S`heeta & Ruksha Guna and Kat`u Rasa predominant foods, - In Ksheena Pitta Dosha desire is for;
Ushn`a Gun`a and Kat`u Rasa predominant foods, - In Ksheena Kapha Dosha desire is for:
Snigdha and S`heeta Gun`a predominant foods
Consideration of Ksheen`a Dosha in the causation of disease
Charaka has described Ksheen`a as one of the 3 Gati_s of the Dosha_s. Here Chakrapaan`i has commented that the word Gati implies the meaning of both Prakaara (type) and Avasthaa (stage/condition). According to the commentator Chakrapaan`i (on C.Su. 17/32) Ksheen`a Dosha cannot cause an independent disease because of the inability of the Ksheen`a to migrate from one place to another and vitiate the Dushya_s.
According to Padaartha Chandrikaa commentary on Asht`aanga Hridaya (on A.H.Su. 11/45) Ksheen`a Dosha cannot cause disease because they are:
- Aprakupita (non-aggravated/ not in excess)
- Ksheen`a S`hakti (low strength/low potential)
- Kinchit Karatva (poor kinetic ability)
Importance of Diagnosis of Ksheen`a Dosha:
The classics have noted that Ksheen`a Dosha should not be ignore but must be given due attention to, while making a diagnosis as well as during treatment as they can be misdiagnosed and lead to immense suffering. (Commentaries of Sarvangasundar, Padaarthachandrikaa on A. H. Su. 11/44 and 46 and Hemaadri, Sarvaangasundara, commentaries on A.H.Su.11/33)
Types of Ksheen`a Doshatva
Though the classics have not classified it accordingly the commentators of the classics have done so
- Alpa, (mild)
- Madhya (moderate)
- Bhooya (severe)
(Padaarthachandriakaa commentary on A.H.Su. 11/45)
Gangaadhara, the commentator on Charaka has opined that there are 25 subtypes of Ksheen`a Dosha Avastha_s. However he has not enlisted the Symptomology of each of these subtypes. (Gangaadhara on Charaka. Su. 17/32)
Treatment of Ksheen`a Dosha:
The guiding principle laid down by Sus`hruta is that Sva-Yoni-Vardhana treatment is advised for Ksheen`a Dosha. Sva–Yoni–Vardhana literally translates as increasing ones own roots or origins. This is also interpreted variously.
The commentator D`alhan`a has noted the following interpretations: (S.Su.15/11):
- Indicates usage of (Dosha specific) Gun`a_s of S`heeta, Ruksha etc., to increase the relevant Dosha
- All measures that increase the Dosha_s, (Charaka has laid down the Saamaanya–Vis`hesha Siddhaanta and the commentator Chakrapaan`i has discussed the usage of Gun`a Saamaanya, Dravya Saamaanya and Karma Saamaanya to increase any Dravya (here Dosha) (Chakrapaan`i on C.Su.1/44-45,
- The roots of Kapha and Pitta are Rasa + Rakta Dhaatu respectively so measures, which increases these, Dhaatu_s,will help increase the relevant Dosha. In terms of Paanchbhautikatva it would mean increase of Apya and Apya–Tejas substances.
Dr. Narendra Pendse
Ayurved Consultant, Pune.
Last updated on February 10th, 2021 at 11:01 am