Article by Dr Raghuram Y.S. MD (Ay) & Dr Manasa S, B.A.M.S
From the basic point of understanding, doshas have three kinds of states.
Sama – is a state in which they are in a state of balance. This is also a state of being healthy.
Vriddhi – is a state of doshas where they have increased to abnormal proportions and tend to cause diseases.
Kshaya – is a state of doshas wherein they are decreased. They do not have the strength to cause diseases but would manifest with deficit symptoms.
It is the second state of doshas which we discuss in this article.
Stages of formation of a disease as caused by doshas
The doshas after their initial increase, if they are not addressed, would progress through six different states of pathogenesis – the kriya kalas.
After undergoing an increase in their own seats in the state of sanchaya or chaya, the doshas which are not controlled will get increased. This state of aggravation of doshas is called prakopa or kopa. This too takes place in the seats of the doshas itself.
If the doshas are not controlled in this stage, they tend to spread across the whole body, in a state called prasara. While in prasara, the doshas will search for weak and susceptible tissues wherein they can get lodgment.
Once found, the doshas would invade the tissues, get localized therein and damage the tissues. This state is called sthanasamshraya. The amalgamation of aggravated doshas and dhatus / dushyas in this stage is called dosha-dushya sammurchana. Here, the earlier symptoms of a yet to be manifested disease i.e. purvarupas – premonitory symptoms are formed.
In the next stage i.e. vyakta Avastha – the amalgamation of doshas and dushyas complete and the signs and symptoms of the disease – rupas – clearly manifest. The disease is diagnosed and named in this stage and hence is called as Rupa Avastha or Vyakta Avastha.
Further on, if the doshas are not controlled, they further damage the tissues and the disease progresses to the Bheda Avastha i.e. stage of complications, which makes the prognosis difficult.
From this we learn that the doshas are the prime causes for a disease process to begin, progress and end up with formation of a disease or its complications.
Acharya Vagbhata states that the doshas themselves are the main causes of all the diseases and explains the same with the help of analogies.
Ref – Ashtana Hrdaya Sutra Sthana – Chapter 12, Verses 32-34b ½ (A.Hr.Su.12/32-34 ½)
Analogy to explain the doshas as main causes for all the diseases
दोषा एव हि सर्वेषां रोगाणामेककारणम्।
यथा पक्षी परिपतन् सर्वतः सर्वमप्यहः॥३२॥
छायामत्येति नात्मीया यथा वा कृत्स्नमप्यदः।
विकारजातं विविधं त्रीन् गुणान्नातिवर्तते॥३३॥
तथा स्वधातुवैषम्यनिमित्तमपि सर्वदा।
विकारजात त्रीन्दोषान्
Acharya Vagbhata, in the above said verse says that ‘the doshas alone are always the sole causative factors for all the diseases’.
This implies that no disease forms without the involvement of the doshas. Doshas, thus, are considered as mandatory factors for the causation of all diseases.
Analogies
Analogy 1 – A bird keeps flying everywhere throughout the day. It cannot escape from its own shadow.
Analogy 2 – All the different species which have been created in the form of vikaras (i.e. effects or derivatives, from the causes like Mahat – cosmic intelligence etc. i.e. Earth, wind etc.) cannot be separated from their predecessors or causative elements, three gunas i.e. sattva, rajas and tamas. Nothing in the creation is exclusive of the trigunas. This means to say that everything is created from trigunas.
Similarly, in spite of the diseases getting manifested due to swa dhatu vaishamya i.e. disturbance of their own tissues, they will never manifest without the involvement of the three doshas, as a rule.
To sum up,
A bird and its shadow cannot be separated. The shadow ill follow wherever the bird flies.
Similarly, all vikaras i.e. everything which is created in the world from the primordial elements is created from the trigunas, without exception. So, these species can never be separated from the trigunas.
With the help of the above two analogies, we have to understand that though the diseases manifest due to disturbance in their own tissues, they can never manifest without the involvement of the three doshas. Firstly, the tridoshas would get disturbed and vitiated. Later they spread and get localized in the tissues or organs and damage them. Following these events only any disease is formed. This is also as a rule and without any exceptions.