Consitutions and Diseases

 

Ayurveda, according to Charak Saåhitá, was a scientific and logical interpretation, in which tridoßha theory was enumerated along with man- agement of Váyu, Pitta, and Kapha. Nature was seen as uniform, and rational knowledge was em- phasized over the supernatural. Symposia were held for practitioners to express opinions and to arrive at an accepted view of truth. Lord Átreya presided over the talks.
Rather than analyze and name millions of body parts and diseases, Charak Saåhitá holds that it is happiness and unhappiness that result in health and disease respectively The healthy or holistic per- son is termed Purußha, or eternal Divinity. The causes of illness are deha-manasa, or psychoso- matic reasons: mind affects body and body affects mind. Thus, the ‘partial’ view has no place and Sattwavajaya, or holistic psychotherapy, has its origins in the Áyurvedic science.
Áyurveda then, is seen as a highly accurate and personalized method of analyzing people’s con- stitutions and illnesses; it recommends and pro- vides gentle, natural and effective therapies.
Áyurveda relies totally on nature to heal, while Áyurvedic therapies only help in the healing pro- cess. Swabhavoparama (recession by nature) is the method of using herbs, diet, lifestyle, and other therapies (discussed in the next section) to return the mind and body back to its natural state of bal- ance.

The nature of an illness is learned through five methods.
1. Cause (nidána)
2. Premonitory or incubatory signs (púrvarupa)
3. Signs and symptoms (rupa)
4. Diagnostic tests (upaähaya)
5. Pathology or stages of manifestation (samprapti)

1. Nidána or etiology (cause)—All diseases are caused by the aggravation of the doßhas.
2. Púrvarupa (hidden or incubatory signs)—Signs and symptoms cannot be attributed to any specific doßha due to their mild nature. Two forms exist; a)  Symptoms may occur due to one or more of
the aggravated doßhas and disappear when the disease manifests, or
b)  Symptoms that develop into the specific dis- ease.
3. Rupa (signs and symptoms)—Manifestations of the disease are clearly observed.
4. Upaähaya (diagnostic tests)—When practitio- ners cannot determine the cause of the illness through the other methods they test with herbs, food, or habits. These therapies show whether they heal or aggravate the illness.
5. Samprapti or pathogenesis (disease develop- ment) —Not merely symptoms or signs, this is the actual manifestation of disease. Five kinds of de- velopment exist:
a) The varieties of a disease.
b) The different aspects of the doßhas causing the illness.
c) Whether a disease is of primary or secondary nature.
d) The severity of the illness, strong or weak (e.g., due to age, general health, etc.).
e) Time of digestion, day, or season when the doßha
is predominant.

Etiology: Cause of All Disease
All diseases are caused by aggravation of the doßhas. This aggravation of different doßhas is caused by the intake of improper diet and leading an improper lifestyle  (Mithya Áhar Vihar). The three causes of illness are excessive, insufficient, or improper use of,
1. The senses
2. Actions
3. Seasonal factors
1.   Unsuitable use of the senses: Unwholesome contact of the senses (taste, touch, sight, sound, and smell) with objects. For example, sound (hearing loud voices, noise pollution cause se- rious mind and health problems). Touch (con- tact of the skin with chemicals, hot objects, or overly cold objects). Sight (exposure to too much light, such as staring at the sun).
2.   Actions: Relate to body, speech, and mind.
These include, conduct, urge, posture, concern, and emotions. Thoughts and decisions leading to harmful or unhealthy situations are said to be errors of the intellect. Spiritually speaking, the first intellectual error is to believe that any- one or anything is separate from oneself. The Áyurvedic texts say that this is the first cause of all diseases, the loss of faith in the Divine.
3.   Seasonal factors: Váyu accumulates during the dry or dehydrating heat of the summer (Gríßhma: mid-May to mid-July). It becomes aggravated during the rainy season (Varßha: mid-July to mid-September), which causes weakened digestion, acidic atmospheric con- ditions, and gas produced from the earth.
Pitta accumulates during the rainy season due to the acidic conditions of the atmosphere and a weakened digestion. It is aggravated during autumn (£harat: mid- September to mid-November) when the heat returns (perhaps equivalent to Indian Sum- mer). This occurs after the cooling spell of the rainy season.
Kapha accumulates during the cold season
(£hiçhira: mid-January to mid-March) due to the
cold and damp caused by the winds, clouds, and rain. It gets aggravated during the spring (Vasant: mid-March to mid-May) when the warm weather liquefies the accumulating Kapha (from the cold season).
 

 

SeasonalIncreasesoftheDoßhas
 
 
Doßha
 
Accumulate
 
Aggravate
 
Normalize
 
 
 
 
 
 
 
Váyu
 
Summer/
Gríßhma
 
Rainy/
Vahá
 
Autumn/
£harat
 
midMay- midJuly
 
midJuly- midSept.
 
midSept.- midNov.
 
 
heatisdry, dehydrating
weak digestion, acidicrain, earthgas
 
 
sunand warmth
 
 
 
 
 
 
 
Pitta
 
Rainy/
Vahá
 
Autumn/
£harat
 
Winter/
Hemanta
 
midJuly- midSept.
 
midSept.- midNov.
 
midNov.- midJan.
weak digestion, acidicrain
sunand heat returns
 
 
cold,moist
 
 
 
 
 
 
Kapha
 
Cold/
£hiçhira
 
Spring/
Vasant
 
Summer/
Gríßhma
 
midJan.- midMarch
 
midMarch
midMay
 
midMay- midJuly
 
cold,damp
warmth, liquefies
 
warm,dry

 

Váyu Increasing Causes: Bitter, salty, and astrin- gent tastes, dry, light, cold foods, fasting, waiting longer than three or four hours between meals,
suppression or premature initiation of the 13 natu- ral urges, staying awake late at night, prolonged high pitched speaking, excess emesis and purga- tion, sudden grief, fear, worry, or anxiety; exces- sive exercise or sexual intercourse; the end of the digestive process.

Pitta Increasing Causes: Pungent, sour, and salty tastes, foods causing heat and burning sensations, anger, autumn, the middle of digestion, sun or heat exposure, exhaustion, eating with indigestion.

Kapha Increasing Causes: Sweet, sour, and salty tastes, oils, heavy or indigestible foods, overeat- ing, cold foods, lack of exercise, excess sleeping, naps, inadequate emesis and purgation, eating be- fore hungry, in the spring, before noon and early night, the first stage of digestion.

Factors Increasing All Doßhas: Eating excessively, improper diet, uncooked, contaminated or incom- patible foods; spoiled food and drinks; dried veg- etables, raw root vegetables. Other factors include eating fried sesame seeds and molasses, mud, bar- ley beer, foul and dry meat, eating food out of sea- son; direct breeze, negative thoughts, living in mountain slopes. Malefic positioning of the plan- ets and constellations, improper administration of therapies, illegal actions, and being too inactive also increase all the doßhas.

Food Intake and Doßha Illness
Improper quantity of food results in impairing strength, complexion, weight, distention, longevity, virility, and ojas. It afflicts the body, mind, intellect, and senses, causing harm to the dhátus (tissues)—especially Váyu. Food taken
in excess aggravates all three doßhas. Obstructions are produced in the stomach and move
through the upper and lower tracts, producing diseases according to one’s doßha.
Váyu: Colic pain, constipation, malaise, dry mouth, fainting, giddiness, irregular digestive power, rigidity, hardening and contracting of ves- sels.
Pitta: Fever, diarrhea, internal burning sensa- tion, thirst, intoxication, giddiness, and delirium.
Kapha: Vomiting, anorexia, indigestion, cold fever, laziness, and heaviness.

Disease Development: Six Stages
Earlier, it was briefly mentioned that six stages of disease development exist. However, modern medical technology can only see the last two stages of any illness. Áyurveda offers insight into the ear- lier stages and enables those monitoring their health to take care of any small imbalances well before developing any serious illness. The six stages of disease development are:

1. Accumulation: Illness begins in one of the three main doßha sites: stomach (Kapha), small intes- tine (Pitta), or the colon (Váyu). Excess Kapha in the stomach creates a blockage in the system that leads to lassitude, heaviness, pallor, bloating, and indigestion. Pitta accumulation creates burning sensations, fever, hyperacidity, bitter taste in the mouth, and anger. The collecting of Váyu creates gas, distention, constipation, dryness, fear, fatigue, insomnia, and the desire for warm things.
The value of monitoring these experiences within one’s body and mind leads to the earliest detection of an imbalance, while it is still in its hidden or incubatory stages.

2. Aggravation: As the imbalanced elements (hu- mors) continue to increase, the symptoms men- tioned above become more aggravated and will be noticed in other parts of the body as well. Kapha aggravation causes a loss of appetite, indigestion, nausea, excess saliva, heaviness in the heart and head, and oversleeping. The aggravated Pitta ex- perience is one of increased acidity, burning sen- sations in the abdomen, lowered vitality, or insom- nia. Váyu aggravation results in pain and spasm in the abdomen, gas and rumbling in the bowels, and light-headedness.

3. Overflow: Once the origin site is full with the excess humor (element), it will begin to overflow
into the rest of the body using different channels of transportation. The doähas begin to overflow into the GI tract, then join with the circulating plasma and blood. During circulation the humors then begin to seep into the organs, dhátus (tissues), and malas (waste). Simultaneously, symptoms at the origin site continue to grow worse.

4. Moving and localization at a distant site: The humors will move to wherever a weak site exists in the body. This is where and when specific dis- eases begin to develop. For example, a Váyu ill- ness could move to the bones and begin to create arthritis. If the duodenum is weak, humors deposit themselves there and create an ulcer (usually a Pitta condition). Kapha moves to organs like the lungs when weakened. Healing is still simple,  even at this fourth stage of illness.

5. Manifestation: This is the first stage of the de- velopment of illness for which Western science can detect signs of disease. Here, diseases become fully developed, showing signs of clinical features. Names are given to imbalances of the humors, such as cancer, bronchitis, arthritis, etc.

6. Distinction/Chronic Complications: In this last stage, the symptoms become clear enough so that the elemental cause may be determined. For ex- ample, Váyu asthma will cause dry skin, constipa- tion, anxiety, attacks at dawn, and the desiring of warmth. Pitta asthma will show yellow phlegm, fever, sweating, and attacks at noon and midnight. Asthma brought on by Kapha will create white phlegm, water in the lungs, and attacks during the morning and evening.       Some practitioners de- scribe this stage as the chronic phase of develop- ment. For example, if one develops an inflamma- tion or abscess in stage five, in stage six, compli- cations set in, and the abscess may burst and be- come a chronic ulcer.
Three Disease Pathways
In our consideration of the Áyurvedic view of the body, we also learn of the classification of ill-
ness and the healing process through the three paths that disease travels.

Inner: This is the digestive tract involving diseases of the GI tract. These diseases are easy to heal be- cause toxins are expelled through the tract. Dis- eases of the inner path include fever, cough, hic- cups, enlarged abdomen or spleen, internal edema, vomiting, and hard stools.

Outer: This path refers to the plasma/skin, blood, and superficial tissues. Toxic blood and skin dis- eases are harder to heal because removing an ill- ness from the tissue is more difficult. Symptoms include abdominal and other malignant tumors, edema, and hemorrhoids.

Central: This path refers to muscle, fat, bone, mar- row, and deeper nerve tissues. This is the most delicate area of the body, affecting the heart, head, bone joints, and urinary bladder. The most diffi- cult diseases develop here, such as cancer or ar- thritis. These diseases develop between the inner and outer paths.

Signs and Symptoms of Disease, by Doßha Excess Váyu: Drooping, dilation, loss of sensation, and weakness; continuous, cutting, pricking, crush- ing, or splitting pain; obstruction, contraction, or constriction; twisting, tingling, thirst, tremors, roughness, dryness, throbbing, curvatures, gas, winding, stiffness, or rigidity; astringent taste in mouth, blue/crimson discoloration, partial vacu- ums in bodily liquids.

Excess Pitta: Burning sensation, reddish discolora- tion, heat, high digestive fire, pus, ulcers, perspi- ration, moistness, debility, fainting, toxicity, bitter and sour tastes in the mouth, oozing, fungus.

Excess Kapha: Oiliness, hardness, itching irrita- tions, cold, heaviness, obstructions, toxic or mu- cus coatings inside the srotas (channels), loss of movement, swelling, edema, indigestion, excessive
sleep, whitish complexion, sweet and salty tastes in the mouth.

Three Kinds of Diseases
All diseases arise from bad actions occurring in one’s
1. Present life (finding a specific cause of the ill- ness). These are healed with therapies of the op- posite nature.
The Doßhas –
Deciding the Cause of Disease: General Approach
The practitioner has several methods of learn- ing the prak^iti (constitution) and the vik^iti (ill- ness) of patients:

1. Authoritative Instruction
2. Direct Observation
3. Inference

2. Past lives (no apparent cause for an illness). These are healed after the action has worked itself out.
1. Authoritative Instruction comes from a teacher who has had much experience in determining the cause and nature of constitutions and illness.

3. A combination of both (diseases that suddenly manifest as terrible, profound and severe). These require a combination of therapies and the cessa- tion of harmful activities.
Diseases are either primary (initial symptoms) or secondary (complications arising later). If the secondary complications of the doßhas do not sub- side when the primary causes are healed, additional therapies must be administered.

Analysis of Factors
For healing to occur, the practitioner carefully studies and decides the condition of the vitiated tissues (dhátus) and wastes (malas), patient’s habi- tat, strength, and digestive power. He needs to learn the constitution, age, mind, lifestyle, diet, the stage of the disease, and the season, before recommend- ing the appropriate therapy. (Symptoms may ap- pear mild or severe, depending upon the patient’s total strength (mental and physical). Thus, the prac- titioner needs to make a careful and complete analysis).
After determining individual body type and the elemental cause and development of illness, the next step is to analyze the patient’s constitution and illness (prak^iti and vik^iti respectively).
2. Observation includes visual analysis of the face, finger nails, eyes, tongue, urine, stool, complex- ion, and shape; it also includes auditory observa- tions of the tone of voice, listening for intestinal gurgling, cracking sounds of bones and fingers, coughing or hiccups, as well as by palpation, most notably the evaluation of the pulse.  By noticing certain characteristics, the practitioner begins to learn the doßha or prak^iti (constitution) and the doßha imbalance that may be causing the illness (vik^iti).
Áyurvedic observation is a threefold approach: questioning, observing, and palpating (touch). To gain information that is not readily observable, the practitioner addresses questions directly to the patient and also asks the patient to complete a ques- tionnaire or self-test (see appendix 2).
Discussion with the patient helps reveal the prak^iti and vik^iti. Discussing one’s family and personal health history, and learning of the patient’s symptoms round out the consultation.
Questionnaires are self-tests which ask a se- ries of mental and physical questions that help the practitioner decide a person’s mental and physical doßha and illness.
3. Inference Through reasoning the practitioner gains indirect knowledge about the state of vari- ous health conditions. The situations learned through inference are summarized in the following table:

 

Client Knowledge Through Inference

 

 

Condition

 

Inferred From

 

agni (digestive fire)

 

digestive power

 

strength

 

exercise capacity

 

sensory abilities

 

capacity to correctly perceive

 

mental abilities

 

understands instructions

 

mental guòa

(sattwa,rajas, tamas)

 

expression (e.g. gentle, harsh, angry)

 

anger

 

revengeful

 

grief

 

sorrowful

 

fear

 

apprehension

 

joy

 

happy mood

 

pleasure

 

satisfied face & eyes

 

courage

 

resolute mind

 

mental stability

 

expressing balance, lack of mistakes

 

desire

 

amount of requests the client makes

 

intelligence

 

comprehension of spiritual discussion

 

deception

 

subsequent actions

 

Only after a careful analysis of all three areas— that is, considering the cumulative information, — does a practitioner determine the prak^iti (consti- tution) and vik^iti (illness). The practitioner would not make quick judgments based on only one or two signs. Often people have characteristics of all three doßhas, so the practitioner finds the one or two doßhas that predominate. Sometimes a patient is tridoßhic, or having equal parts of all three doßhas. [It is not important what doßha a person is
(i.e., there is no preferred constitution). What is important is that one’s constitution is balanced.]
By observing, listening, and questioning, the practitioner learns of one’s constitution and illness. Below are general guidelines that show which doßha is in excess. Sometimes the patient may use words like “dry,” “hot,” or “lazy,” which alerts the practitioner to the doßha being deranged.

Observation
Face: The face offers various clues to help the practitioner determine the disorder. A thin facial structure is an indication of a Váyu prak^iti. A wide structure is more of a Kapha constitution. Strong muscular or moderate facial structure suggests Pitta doßha. The picture of a face (below) shows which organs may be imbalanced or diseased.

 

 

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