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Introduction

If the healthy human body is considered as a happy family, then the vata dosha, rasadi dhatus, and purisha would be considered as members of that family. Just as the well-being of a family depends on the harmony among its members, their mutual affection, and care, similarly, physical health depends on the balance between the doshas, dhatus, and malas.

The balance and coordination among these three components – doshas, dhatus, and malas – is essential for maintaining physical health. This harmonious coordination means keeping them in their proper amounts, functioning together in such a way that they support physical well-being and nourish the body.

Charaka, when describing the body, mentions the term "samayogavahitva" (cooperative functioning). This term is explained by Chakrapani as: "Samena ucitapramanena dhatunam melakena samyangnirogyata viti chitam samayogavahitvam" (Charaka Sutra 6/4). [1]

In this quote, the word "melaka" is used to refer to the proper combination or balance of dhatus. Melaka means maintaining the doshas, dhatus, and malas in their adequate and balanced state to create a disease-free condition, which is called samayogavahitva.

Just as the three components of Triphala (Amalaki, Haritaki and Bibhitaki), when in proper proportion, are renowned for their excellent medicinal qualities, in the same way, the body's doshas, dhatus, and malas must remain in their natural proportions and work together harmoniously to maintain nourishment and health. Hence, the body is described as having "samayogavahitva." When the dhatus becomes imbalanced, either due to deficiency or excess, this condition is known as 'asamayogavahitva' (lack of coordination)." (Charaka Sutra 6/4) [1]

Maintaining the dhatus in an imbalanced state, either in deficiency or excess, is called 'asamayogavahitva'. Deficiency causes disorders, suffering, and disease, while excess can lead to incurable diseases, destruction of the body, or even death. Just as the proper proportion of ingredients enhances their qualities, similarly, the body's fundamental elements – doshas, dhatus, and malas – maintain the body's health through their coordinated balance (samayogavahitva). Without this balance, the health of the body is compromised.

Acharya Charaka further elaborates in Ch. Sha. 6/5) [1]

"By the principle of correspondence, the increase or decrease in a particular dhatu (tissue) results in effects on the corresponding dosha or dhatu. When the increase of one dhatu or dosha occurs, it tends to affect others predictably. However, an opposite effect can occur when there is a qualitative imbalance in another dhatu."

This sutra explains the interrelationship between Doshas, Dhatus (tissues), and Malas (waste products). The increase or decrease of one element can influence another, either directly or inversely. For example, the increase in qualities like heaviness and oiliness in dhatus such as fat may promote the growth of kapha, but this same imbalance may weaken vata. While vata is primarily responsible for physical wear and tear, kapha compensates for this by promoting tissue growth and maintaining equilibrium in the body.

Conversely, when there is a harmonious interaction between vata and kapha, vata's activity may increase, leading to more wear and tear in the body. In the case of the rise of pitta (which is associated with heat and intensity), kapha's cooling and soothing qualities help maintain balance. The enveloping effect of kapha moderates any discomfort caused by excess heat, which is controlled through pitta and the balancing action of vayu.

This passage underscores how the increase of one dosha affects the others and emphasises the importance of balance in maintaining health.

Aim and Objectives-

To explore the concept of Dosha-Dhatu-Mala Samayogavahitva in Ayurvedic physiology, analysing its role in maintaining health and preventing disease.

Objectives:

1. To review classical Ayurvedic texts to gain a deeper understanding of the Dosha-Dhatu-Mala relationship in the context of health and disease.
2. To explain the concept of Samayogavahitva and its significance in balancing Doshas, Dhatus, and Malas for the smooth functioning of the body’s physiological systems.
3. To investigate the role of Dosha-Dhatu-Mala imbalance in the manifestation of diseases according to Ayurvedic pathology.

Materials & Methods-

Role of Dosha-Dhatu-Mala Samayogavahitva in origin of Sharir [2]

Acharya Sushruta describes in Sutrasthan 21/3 that “Vata Pitta Shleshma Eva Dehasambhava hetava”, i.e., in conjunction with Vata, Pitta, and Kapha, the body is formed, and the imbalance of Vata, Pitta, and Kapha contributes to the formation of diseases.

During Garbhavastha, if the dhatus are formed abnormally, and if there is a genetic defect, then impure doshas are primarily responsible for the disease.

Role of Dosha-Dhatu-Mala Samayogavahitva in Dhatu Utpatti (tissue generation)

"After proper digestion of food, the Sara (essence) and Kitta (waste) are separated. The Sara, known as 'Rasa,' is circulated throughout the body by the Vyana Vayu, and its function leads to the sustenance of the body.

Role of Dosha-Dhatu-Mala Samayogavahitva in

Dehadharan (Retention of the body) [3]

“Sharirdharanat dhatava? (A.Hr.Su. 1/13)”. The body is sustained by the dhatus.

Although the primary function of retention (dhara?a) is attributed to the dhatus while discussing the specific functioning of the seven dhatus, the retention capability of the paramanu (invisible atomic) form of the asthi dhatu must be considered. The drava or liquid form of the Asthi dhatu is capable of holding the entire body. The retention function of the gross form of the Asthi dhatu is well known. Similarly, in Sutrasthan14/45, Acharya Sushruta states, “Dehasya rudhiram mulam rudhireneva dharyate” [2]

The function of blood as a dhatu in retaining the body is clearly mentioned here. It is essential to expel waste products from the body that undergo metabolism. Despite this, the Acharyas have given considerable importance to the function of malas (waste products) in retention:

“Avashtambha Purishasya(A.Hr.Su. 11/5)”. In a person with Rajayakshma, the strength lies in retaining Purisha (feces). All the dhatus get depleted, and the strength is derived from holding the feces. (A.Hr.Chi. 5/73) [3]

In rajayakshma, as all the doshas and dhatus are gradually depleted, the patient relies on feces for strength. In Atisar (diarrhea), due to the frequent urge to pass feces, the patient becomes weak. Similarly, in diabetes, the frequent urge to urinate causes weakness. If excessive sweating is observed, the patient becomes weak due to the loss of fluids. From this, it becomes clear that the function of retention performed by malas (waste products) is significant.

In conclusion, the retention of the body is carried out collectively through the combination of doshas, dhatus, and malas.

Role of Upadhatu and Dhatumala in samayogavahitva-

Upadhatu and dhatumala are also considered while discussing the samayogavahitva. For instance, if the teeth (upadhatu of asthi) do not function properly, hindering the chewing process, it will negatively affect digestion. Consequently, the functions of dosha, dhatus, and malas will also become imbalanced.

Association in terminology-

The terms "Dosha-Dhatu-Mala" are traditionally explained as follows:

• Dosha refers to Vata, Pitta, and Kapha.
• Dhatu refers to the seven body tissues like Rasa, Rakta, etc.
• Mala refers to waste products such as purisha, mutra and sweda.

However, in the scriptures, these terms hold broader meanings. For example:

1. "Viparitastatoanye tu vidyadeva malanapi" (A.Hr. Su. 12/61) [3]

Mala can also refer to Doshas.

2. "Vikarao dhatuvaishamyam, samyam prakritiruchyate" (Ch.Su. 9/4) [1]

Dhatus here also include tridosha and trimala.

From these references, we understand the interrelation between the concepts of Dosha, Dhatu, and Mala.

Role of Dosha-Dhatu-Mala Asamayogavahitva in disease manifestation

The origin of the disease is due to the disruption in the harmonious interaction between Dosha, Dhatu, and Mala.

This means the conjunction or interaction between Dosha, Dhatu, and Mala leads to disease.

1. When dosha interacts with Rasa Dhatu, it leads to diseases like jwara(fever).

2. When dosha interacts with Rasa Dhatu and Purisha Mala, it leads to conditions like atisara (diarrhea).

3. When dosha interacts with Rasa Dhatu and Mutra Mala, it leads to urinary issues.

4. When Dosha interacts with Rakta Dhatu, it causes diseases like Vatarakta (gout), Raktapitta (bleeding disorders), Vidradhi (abscess), and Rakta Gulm.

The origin of the disease is primarily due to the impairment in the normal functioning of Dosha, Dhatu and Mala. Initially, the Doshas become impaired, which leads to the disturbance of Dhatus like Rasa. The three Doshas cause disturbances in the seven Dhatus and Malas. As a result, the malayana becomes abnormal, leading to a progressive worsening of the disease.

For example, if Kapha Dosha becomes deranged and combines with Rasa Dhatu, it leads to stiffness and white discolouration. If it affects Rakta Dhatu, it causes Pandu. When it impacts Mamsa Dhatu, conditions like apachi, arbuda will arise. Similarly, if the deranged Kapha Dosha affects Meda Dhatu, it leads to Prameha, or it might cause abnormal sweating by affecting Sweda Mala (sweat).

Therefore, while diagnosing a disease, it is essential to understand the interaction between Dosha, Dhatu and Mala to properly assess the root cause of the disorder.

Concept of Avaran and dosha-dhatu-mala asamayogvahitva

The concept of "Avarana" in Vata disorders, characterised by the predominance of Vata, may exist independently in such conditions. However, from a therapeutic perspective, the study of specific manifestations such as Shonitavrita Vata (blood-encased Vata), Mamsavrita Vata (muscle-encased Vata), and Malavrita Vata (waste-encased Vata) becomes crucial. In Anyonya Avarana, even if Vata is enveloped, the symptoms reflect the involvement of tissues like Ojas (vital essence) and Bala (strength), along with waste-related symptoms such as asweda(absence of perspiration), atisweda(excessive sweating), and haridramutravarchastva (disturbances in urine and stool functions). This indicates the relationship between Vata and other doshas, dhatus and malas. Both in health and disease states, dosha-dhatu-mala interactions are functional. Physical health is aligned with proper functioning (Samyogavahitva), whereas disease correlates with improper functioning (Asamyogavahitva). This distinction clarifies the concepts of "Sukhayu-Hitayu" (healthy and beneficial life) and "Dukhayu-Ahitayu" (unhealthy and harmful life).

Theory of Panchamahabhuta and dosha-dhatu-mala samayogvahitva

"The concept of the five elements and the balance between dosha, dhatu and mala aligns with the Vedanta philosophy's saying, 'Yat Pinde Tat Brahmande' (What is in the body is in the universe). The dosha, dhatu and mala, in their atomic forms, are derived from the five great elements (Panchamahabhutas). Just as these elements maintain the balance of creation through mutual coordination, similarly, the dosha, dhatu and mala, formed from these elements, work together to keep the body healthy. The study of the properties and functions of dosha, dhatu and mala, along with the signs of their increase and decrease, and understanding the balance between them, contributes significantly to the success of medical treatment."

This reflects how Ayurveda links the balance of elements in the body with overall health, in harmony with universal principles.

“pittam pangu kapha pangu pangavo maladhatavah” (Sh.Pu. 5/43) [4]

Even if there is a combination of dosha-dhatu-mala, nourishment of the body also depends on the contribution of other factors.

Given verse describes superiority of vata dosha,but the body's nourishment depends on the contribution of other elements. For example:

1. The action of Vata is related to movement; however, it becomes almost impossible for the actions of Kapha, which are stable and heavy, to function effectively.

2. The special residence of Vyana is within the heart; therefore, the heart cannot function optimally if the supporting doshas, such as Kapha and the sustaining factors, are not in place. Moreover, taking into account the origin of the heart, it cannot function without the involvement of blood and muscle dhatus.

3. The digestion of food primarily occurs through the digestive fire (Agni) and digestive dosha; however, a connection between the digestive dosha and Agni is established through the vital air (Vayu).

4. In the process of sweating, it is sufficient to handle both sweat and the related Vayu.

5. Functions related to sweating, blood circulation, and other dhatu-mala interactions are performed through Vyana.

6. Diseases related to the excretory system, which is the seat of waste (Mala) and urine, are primarily influenced by Apana Vayu. Conditions such as urinary issues, urinary retention, and constipation require significant effort from Apana Vayu.

In the lower abdomen, the retention of feces, expansion, excretion, and the management of urine through proper channelling is primarily achieved through the synergistic action of Apana Vayu, muscle dhatus, mala, and urine.

Discussion

Balanced constitution is not directly perceivable but can be known through inference. Changes in the body according to seasons, the accumulation, aggravation, and pacification of doshas, changes in the datus, malas, agni, bala etc., are aspects of the body's balance that must be studied by physicians through inference.

Weakness during the visarga kaala should not be misunderstood as a disease, but should instead guide dietary and lifestyle recommendations from a treatment perspective. During adan kaala, an increase in digestive fire or the presence of tikshnagni should not be misunderstood. Dietary plans should be designed according to the individual’s digestive capacity.

In cases of vataj pratishyay (vata-related nasal congestion), if treatment is directed toward kapha reduction, it may weaken the body’s vata, resulting in an increase in disease severity. In case of aamvata if treatment focuses on removing aam like Rukshan may further aggravate vata, and if treatment involves oleation, it may aggravate aam related issues. At such times, a balanced approach involving ruksha pottali sweda is effective in eliminating toxins.

In children experiencing atisar( diarrhea) due to teething, the relationship between the purishdhara kala, asthi dhatu and teeth should be taken into account.

In Ashtanga Hridaya, Sutrasthana 11/42 Acharya Vagbhata explains excellent view that the body naturally strives to maintain equilibrium of doshas, dhatus and malas. During treatment, foods or substances that a patient dislikes should be avoided, and those that the patient craves should be included in the treatment plan.This emphasizes the importance of using personal preferences and needs in maintaining bodily balance and healing.

The removal of imbalances in the dhatus produced in the body and restoring equilibrium is not the only goal of treatment. To maintain this balance, Charaka emphasizes the importance of eliminating visham(opposite) qualities and using sama (same) qualities. He suggests that one should have firm faith in the scriptures and follow their principles strictly, adopt the guidelines for daily and seasonal regimens, take rejuvenating formulations, practice ethical conduct, perform regular exercises, pranayama, and follow the rules of diet, sleep, and celibacy—these three pillars of life. Additionally, Panchakarma (purification treatments) should be done periodically to maintain health. These habits help strengthen the balance between the doshas, dhatus and malas in the body, thereby promoting physical and mental well-being.

The Relevance of Dosha Dhatu Mala Samayogavahitva in Modern Health

The ancient concept of Dosha Dhatu Mala Samayogavahitva offers a holistic understanding of human health that resonates with modern concepts of homeostasis, metabolic regulation, and waste elimination. In modern medical terms, the balance of Doshas can be seen as the body’s ability to regulate physiological processes, while the formation and elimination of Dhatus and Malas parallel the body’s nutrient metabolism and excretory functions.

Moreover, Ayurvedic practices such as Panchakarma, dietary modifications, and lifestyle adjustments aim to restore the balance of these three elements.

These methods emphasise prevention and long-term health maintenance, which are increasingly recognised as essential components of modern healthcare. Just like an expert potter requires good quality clay and proper alignment to create a fine earthen pot, similarly, to maintain a healthy body, it is essential to have balanced doshas, dhatus, and malas, and to ensure their proper harmony.

Conclusion

The concept of Dosha Dhatu Mala Samayogavahitva represents a comprehensive framework for understanding health and disease in Ayurveda. The balanced interplay between Doshas, Dhatus and Malas is crucial for maintaining physiological harmony, and any disturbance in this balance results in disease.

Ayurveda’s holistic approach to maintaining this balance through diet, lifestyle, detoxification, and treatments remains relevant today. By restoring the equilibrium of Dosha Dhatu Mala, Ayurveda offers an effective strategy for disease prevention and health maintenance, bridging ancient wisdom with modern health principles.