PART 1

Chapter 4
THE PHYSICAL BODY

OBJECTIVES 4.1 Agni: THE FIRE OF DIGESTION

● To understand the concept of digestion. AND METABOLISM
● To understand the concept of tissue
Agni is the fire within each of us that attends to diges-
development and metabolism.
tion and metabolism, and in its higher form, represents
● To understand the concept of vitality. vitality, perception and discrimination. It is charac-
● To understand the concept of wastes and terised by the qualities of us.n.a (‘hot’), tiks.n.a (‘sharp’)
toxins. and laghu (‘light’), and in many ways resembles pitta.
● To understand the flow of energy, nutrients It is incorrect, however, to assume that they are one and
and tissues elements in the bioenergetic the same. Agni is the pure and cleansing fire of the
channels of the body. body, whereas pitta, as a dos.a, ultimately represents
the qualities of agni in a disturbed state.
Agni is located in the āmāśaya (‘stomach and small
intestine’) as the jat.harāgni. Here the jat.harāgni
attends to separating the food into its subtle essence
(sūks.ma rasa, which feeds the mind), its gross nutrient
portion (rasa, which feeds the body) and waste (kit.t.a,
further separated into purı̄s.a and mūtra, or faeces and
urine, respectively). Beyond its role as the jat.harāgni,
there are several different manifestations of agni in the
body, each having a different name that relates to distinct
metabolic processes. From the activity of post-synaptic
enzymes that break down neurotransmitters, to ATP
generation in the mitochondria, all metabolic processes
are subsets of the jat.harāgni of the āmāśaya. Hence,
when digestion is weak, metabolic activity suffers,
energy levels diminish and waste products begin to accu-
mulate in the body.
The negative effects of each dos. a results in a spe-
cific disturbance of jat.harāgni:
● In vāttika conditions the jat.harāgni is
vis. amāgni, digestion that is erratic and irregular.
● In paittika conditions the jat.harāgni is
tiks. n.āgni, extremely intense, with a burning sen-
sation and thirst.

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36 PART 1: Theory and practice of Ayurveda

● In kaphaja conditions the jat.harāgni is 2. Dhātvāgnis: dhātu-specific agnis which attend

mañdāgni (also called agnimāndya), charac- to the particular function of each dhātu or
terised by sluggishness, with heaviness of the support system (discussed in the next section).
abdomen and lassitude.
In the absence of dos. a increase or vitiation, the
4.2 Sapta dhātus: THE SEVEN
jat.harāgni is samyāgni: correct, proper and normal.
SUPPORTS
Agni interacts with three different kinds of alimen-
tary tract (kos.t.ha), influenced by the predominance of
As the tridos. a theory is used to explain the principle
a particular dos.a during gestation. Vāta is responsible
of function in the human body, the sapta dhātus, or
for a krūra or hard bowel, producing dry, rough faeces
‘seven supports’, is used to describe the principle of
that are difficult to evacuate. Pitta is responsible for a
structure. The sapta dhātus model is another aid for
mr.du or soft bowel, producing semi-solid or liquid fae-
the practitioner to discover the specific actions of tri-
ces. Kapha is responsible for a madhya or medium
dos. a and understand their function within a struc-
bowel, which generally produces bowel movements that
tural model. Just as anatomy cannot be seriously
are neither too hard nor too soft. The nature of the
studied without an understanding of physiology, any
bowel can be tested by introducing certain foods, such
study of the dhātus must take tridos. a into account.
as ghr.ta, jaggery, milk or hot water. If these substances
The seven dhātus and their most commonly trans-
have a laxative effect, the bowel is stated to be mr.du; if
lated definitions follow:
they have a mild laxative effect, the bowel is stated to be
madhya; if they have no laxative effect, the bowel is 1. Rasa: plasma
stated to be krūra. 2. Rakta: blood
It is important to remember that Āyurveda consid- 3. Mām. sa: muscle
ers the partaking of food to be a yāga, or ‘sacrifice’. In 4. Medas: fat
the Hindu tradition, and in most spiritual traditions 5. Asthi: bone
across the world, prayers are usually offered in the 6. Majjā: marrow
form of a sacrificial fire. A candle is lit, incense is 7. Śukra (men), ārtava (women):
burned, or certain herbs or foods are placed on a fire, semen, menstrual blood.
and as these substances burn they release their smoky
The sapta dhātus is a model that describes the
fragrance up to heaven, acting as a kind of vehicle for
basic principles of structure, and does not literally rep-
our prayers, hopes and dreams. Agni represents this
resent the specific activities of their respective trans-
sacrificial fire within us, and when we consume food
lated terms. For example, rakta does not represent the
our digestion becomes a spiritual catalyst. The act of
‘blood’ inasmuch as it represents the ‘blood essence’.
eating therefore is a kind of spiritual ritual, where
All tissues and organs in the body arise from the com-
proper digestion depends upon eating in a conscious
bined effects of vāta, pitta and kapha and are com-
and mindful fashion. Thus meal times for the most part
posed of all seven dhātus in varying proportions. Thus
should be quiet, without distractions such as talking,
the blood will contain all the dhātus, but arises princi-
television and books, with proper attention paid to eat-
pally from rakta. It would be difficult to develop a gen-
ing slowly and chewing the food.
eral principle from an in-depth scientific analysis of
Besides the jat.harāgni there are two additional
blood because it has a multitude of functions and
kinds of agni or, rather, subsets of the jat.harāgni,
aspects. The term rakta is used to describe the essen-
that attend to the body’s various metabolic activities:
tial nature of the ‘blood’, to understand its overall
1. Bhūtāgnis: the types of agni which are function within the human body. The following are
responsible for the assimilation and metabolism of descriptions of each of the dhātus:
the five mahābhūtas. Each of the bhūtāgnis
(i.e. pārthiva, āpya, āgneya, vāyavya and
ākāśı¯ya) works on its respective elemental
Rasa dhātu
component (vis. pr. thvı̄, ap, tejas, vāyu and When food is consumed it undergoes preliminary
ākāśa) that form corporeality. digestion in the āmāśaya under the influence of the
 The physical body 37

jat.harāgni, separated into kit.t.a (‘waste’), āhāra health rakta dhātu provides for a clear complexion
rasa (‘gross nutrient’) and sūks.ma rasa (‘subtle and a deep passion for all living things.
nutrient’). Āhāra rasa is that which enters into and Rakta dhātu is thought to generate the skin, seven
nourishes the entire dhātu system, and is converted separate and distinct layers (i.e. avabhāsini, lohita,
into the first dhātu, i.e. rasa dhātu, under the influ- śveta, tāmra, vedini, rohin.i, māmsadhara), in
ence of a dhātu-specific subset of the jat.harāgni much the same way as cooking milk generates a layer
called the dhātvāgni. of scum. Thus, skin disorders are seen as a manifesta-
Rasa literally means ‘taste’, and in this sense, rasa tion of impurities within the blood. An increase in
dhātu is the essential nutrient quality of the food con- rakta dhātu, either inherited from a vitiated rasa
sumed. As it is created, rasa is directed to the hr. daya dhātu or by direct influence, can manifest as skin dis-
(‘heart’) where it undergoes distribution throughout eases, hepatomegaly, splenomegaly, hepatitis, jaun-
the body by the actions of vyāna vāyu. Rasa is dice, abscess with infection and inflammation,
responsible for the nourishment of all the tissues of arthritis, gout, haemorrhages of the mouth, nose or
the body, circulating as a fluid that bathes the cells anus (i.e. rakta pitta), and a reddish discoloration of
with vitality. One can think of rasa as the internal the eyes, skin and urine. A decrease of rakta dhātu,
manifestation of the primordial ocean from which all transferred by a deficiency of rasa dhātu or other fac-
life arose, as the amniotic and interstitial fluid that tors, manifests as a desire for sour and warming foods,
supports growth and maintains proper development. anaemia, hypotension, dryness of the body, and a
A secondary manifestation of rasa are endometrial weak pulse.
fluids that support gestation and breast milk (stanya).
Rasa dhātu displays a strong resemblance to the
qualities of kapha, and in mental terms relates to
Māmsa dhātu
˙
feelings of purity, compassion and happiness. When Rakta dhātu is then converted into mām.sa dhātu by
functioning optimally rasa is an important compo- the dhātvāgni, which gives rise to all connective tis-
nent of vitality. If food is consumed that ‘increases’ sues excluding blood and bone. Mām.sa means ‘flesh’
(caya, vr. ddhi) kapha, however, or if the jat.harāgni and is responsible for enveloping and covering the
is impaired, rasa dhātu will become vitiated and dis- bones, including tissues such as the muscles, tendons,
play the symptoms of kapha increase such as an ligaments, arteries, veins, lymphatic tissue and certain
increase of phlegm and catarrh. The symptoms of types of endocrine gland. In health mām.sa dhātu
decreased (kaśāya) rasa dhātu are dryness, fatigue, provides for a strong musculature and physical
emaciation, impotency, infertility and an increased endurance, and contributes to feelings of charisma
sensitivity to sonic vibrations, all of which corre- and courageousness. An increase in mām. sa dhātu
spond to an increase of vāta. can manifest as lymphadenitis, lymphadenopathy,
goitre, malignant tumours, fibroids, abscesses and
a general increase in body weight and musculature.
Rakta dhātu A decrease in mām sa dhātu is understood by signs
˙
Rasa dhātu is then converted by the dhātvāgni into and symptoms such as emaciation, fatigue, a lack of
rakta dhātu, which is the ‘blood essence’. Its primary coordination, and muscular atrophy.
function, along with rasa, is the maintenance and
nutrition of all bodily tissues, and is more closely asso-
ciated with pitta. Rakta dhātu gives rise to the
Medas dhātu
haematopoietic system, including the liver and spleen, Mām.sa dhātu is converted into medas dhātu by the
and connective tissue generally through its transfor- dhātvāgni, and can be thought of as the principle
mation into mām. sa dhātu. More than any other of of ‘fat’ tissue. The primary function of medas in
the dhātus, rakta (blood) is an organ unto itself, and the body is the protection of delicate organs (e.g. the
represents a phase of physiological function before it kidneys) and tissues (e.g. the myelin that surrounds
solidifies into specific tissues. As a result rakta is neurons), as well as lubrication and the storage
sometimes seen to function as a fourth dos. a and when of energy. In health medas dhātu provides for a melo-
vitiated produces diseases that are particular to it. In dious voice, a sense of joyfulness and a playful,
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38 PART 1: Theory and practice of Ayurveda

humorous nature. An increase in medas dhātu strual blood is not a dhātu but a kind of eliminatory
may manifest as fatigue, shortness of breath, and sag- product that indicates the health of the numerous
ging of breasts, buttocks and abdomen. A decrease in an.d.ān.u or ‘ova’ contained in the ovaries. In health
medas dhātu may manifest as nervous irritability, śukra and ārtava dhātus provide for self-love, attrac-
weak eyesight, dryness, joint weakness and emacia- tiveness and indicate the vitality of the person. In men,
tion. an increase of śukra can result in insatiable sexual
urges, seminal calculi, odorous perspiration, greasy
skin, greasy hair and acne. A decrease of śukra may
Asthi dhātu result in impotency, premature ejaculation, prostatitis
Asthi dhātu is the conversion of medas by the and urethritis. In women, a metabolic increase of
dhātvāgni, and is the principle of all ‘bone’ tissue in ārtava (i.e. an.d.ān.u) can result in excessive sexual
the body. The primary function of asthi is the physical desire, a consistently short oestrus cycle, odorous per-
structure and shape of the body. In health asthi dhātu spiration, greasy skin, greasy hair and acne.
provides for a flexible nature, self-assurance, confi- A decrease of ārtava (i.e. an.d.ān.u) can result in frigid-
dence, mental stability and a hard-working nature. An ity, amenorrhoea, infertility, leucorrhoea, dysmenor-
increase in asthi dhātu can manifest as the over- rhoea, and menstrual blood that is pellet-like and
growth of bone tissue such as bone spurs, bone cancer malodorous. Śukra and ārtava also generate the ojas,
and metabolic diseases such as gigantism and the final refinement of āhāra rasa by the body, which
acromegaly. A decrease of asthi dhātu can manifest is discussed in the next section.
as osteoporosis, brittle bones, splitting or cracking fin-
ger nails, alopecia and tooth decay.
Dhātu transformation
Besides the process of dhātu transformation alluded to
Majjā dhātu earlier, there are two other ways by which āhāra rasa
Majjā dhātu is the transformation of asthi by the circulates within the dhātus. While the process of
dhātvāgni, and is the principle of ‘marrow,’ or that dhātu transformation previously described is much like
which ‘fills the bones’. Majjā is considered to generate the process by which cow’s milk is transformed into
the nervous system in the sense that it ‘fills’ the spinal dadhi (curd), which is then churned into butter and
column and cranium. Thus majjā can be thought of buttermilk, and then the butter finally made into ghr. ta
as the neural pathways along which electrical (clarified butter), the other two processes are somewhat
impulses flow, but should not be confused with the different. The first analogy of cow’s milk being trans-
impulses themselves, which are governed by vāta. In formed into ghr. ta describes how an imbalance within
health majjā dhātu provides for a sensitive and recep- āhāra rasa can affect each dhātu in succession,
tive mind, a good memory and a compassionate because the nature of what is being transformed is
nature. An increase of majjā usually manifests in passed on through to the next dhātu. The obvious defi-
kapha conditions, such as heaviness, lassitude, hyper- ciency of this analogy, however, is that it does not
trophy, and swelling of joints, and can manifest as describe how metabolic wastes (kit.t.a) are eliminated
obstinate ulcerous conditions. A decrease of majjā from the dhātus. The second analogy is that the
may manifest as a sensation of weakness or lightness dhātus are nourished as if āhāra rasa is scattered on
in the bones, joint pain, rheumatism, giddiness and the ground as differing kinds of seed, with each dhātu
blindness. as a different kind of bird that feeds on these seeds,
selecting the ones most appropriate for its nourish-
ment: what the birds leave behind is kit.t.a. This second
Śukra/Ārtava dhātu analogy describes how an imbalance within āhāra
Majjā is converted by the dhātvāgni into the final rasa can affect one dhātu but not another, because it is
dhātu of śukra in men, and ārtava in women. Śukra a process of selectivity. The third method by which the
is responsible for the generation of semen within dhātus are nourished is like the irrigation of a paddy
a male, while ārtava is the menstrual blood that usu- (rice) field, with each paddy being irrigated by specific
ally indicates ovulation. Technically speaking the men- channels that draw water from the same main channel
 The physical body 39

Figure 4.1 Transformation (black arrows),

selectivity (birds) and irrigation (paddy fields) in
dhātu metabolism.

ojas rasa
agni

sukra/ ojas
artava rasa rakta
ahara
sukra/ rasa
rakta
artava

majja majja mamsa mamsa

asthi medas

asthi
medas

that carries āhāra rasa. This last analogy very much death. Thus, para ojas is jiva, the life force that
resembles the physiology of blood flow, from arteries to separates the animate from the inanimate.
capillaries to the interstitium and then to the veins. ● Apara ojas: also called ardhanjali (‘one hand-
Although these three models of dhātu metabolism ful’), found in a continual state of flux, derived
may seem contradictory, all three processes of trans- directly from the dhātus, circulating throughout
formation (ks.ı̄radadhi), selectivity (khalekapota) the body in the maintenance of health. In this text
and irrigation (kedārikulyā) describe the complexity all subsequent references to the term ‘ojas’ refer to
of dhātu metabolism, and occur simultaneously. In the apara ojas.
case of ks.ı̄radadhi (transformation), it is stated that
Just as prān.a represents the unblemished functions
after the food is digested it is present in the body as rasa
of vāta, and agni represents pitta in an undisturbed
for about 5 days, and then for 5 days for each succes-
state, ojas most closely resembles kapha. Thus, those
sive dhatu until śukra and ārtava are formed. From
with a kapha prakr. ti typically display an abundance
this, ojas is directly nourished.
of ojas, providing for all the beneficial attributes of this
prakr. ti such as longevity, forbearance, generosity and
strength. According to the ancient Vedic agnı̄s.omıiya
4.3 Ojas: THE VITAL ESSENCE
principle, ojas (soma) is the feminine counterpart to
the masculine agni, representing ‘lunar’ characteris-
Ojas is the vital essence of the body, a subtle force that
tics such as the ability to nurture, support, shelter and
incessantly works to keep the body, mind and senses
pacify. In contrast, agni represents solar, masculine
continuously refreshed. Āyurveda describes two types
characteristics such as the ability to consume, destroy,
of ojas: para ojas and apara ojas:
expose and invigorate.
● Para ojas: also called the as. t.ā bindu (‘eight As described earlier, ojas is the refinement of
drops’), located in the heart, representing the tejas śukra and ārtava, the final essence of the dhātus.
of vitality and remaining constant in the body until The process of dhātu transformation is dependent
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40 PART 1: Theory and practice of Ayurveda

upon the health of the individual dhātus, the chan- his nature to awaken. Thus, as men age, measures are
nels (srotām.si) that carry them throughout the body usually taken to supplement the declining male
(see 4.6 Srotām.si: the channels of the body), and essence, to maintain his masculine nature (see 11.13
most importantly, the entire spectrum of agni, from Vajı-karan.a karma: virilisation therapy).
the processes of gastric digestion to the progressively In contrast to men, the dynamic between ojas and
subtle and discriminative efforts of tissue metabolism. reproductive function is somewhat more complex in
Through the activities of agni, ojas accumulates, sup- women. Physiologically a woman is born with several
porting and nourishing the whole body, refreshing the hundred oocytes (an.d.ān.u) that represent her fertility
senses and empowering the heart. Just as ojas is ‘essence’, just as semen (śukra) does for a man. Unlike
dependent upon agni, however, so does ojas sacrifice men, who must constantly generate new sperm cells to
itself to nourish agni. Ojas ‘gives’ itself to agni, pro- produce ojas, a woman draws a limitless supply of
viding the digestive tract and all subsequent tissues of ojas from her ovaries until after menopause. The dif-
the body the energy needed for proper function. Thus, ference between a woman and a man therefore is that
ojas both feeds on and is fed to the dhātus. a man is constantly at risk of depleting his sexual
The principle function of any kind of therapy in essence, whereas a woman contains a large reserve of
Āyurvedic medicine is based upon understanding the potential sexual energy. Thus, while men are coun-
dynamics of the dhātu cycle in individual patients. It selled to restrict excessive sexual activity there is no
explains why after any kind of śodhana (‘purifica- such similar restriction for women. To access this
tory’) therapy in which the dhātus are purified a cor- energy, however, the body maintains regulatory
responding rasāyana (‘rejuvenative’) treatment is processes that promote ovulation, which in turn
begun to rebuild the status of ojas. This nourishment results in menstruation. Thus, in a woman experienc-
of ojas in turn nourishes agni and the dhātus, and as ing a normal healthy menstrual cycle all of her
a result provides for good health and longevity. potential energy is available to her, whereas when
The status of ojas can be assessed by the lustre of menstruation is dysregulated the status of ojas weak-
the eyes, the strength of limbs, and the function of the ens. Thus, time-honoured strategies that seek to
mind and senses. The greatest concentration of ojas is maintain the menstrual cycle (e.g. ārtavajanana,
found in the reproductive tissue, which is to say, the ‘emmenagogues’) help to make ojas available to the
needs of reproductive function are served first in woman, even though they may not specifically nourish
a hierarchical fashion among the various physiological ojas.
systems. In normalcy ojas is for the most part distrib- As a woman ages the number of oocytes becomes
uted equally all over the body, whereas in acute disease diminished and, as hormone levels drop off with
or trauma the flow of ojas is blocked, and in chronic menopause, a fire begins to awaken. This fire burns
disease the flow of ojas gradually becomes deficient. away aspects of her feminine essence, and she begins
In the sexual act ojas concentrates in the reproduc- to take on more of the attributes of a man. Most
tive organs to create life (jiva), but it is in the creation women experience these symptoms as an intense
of this life principle that a ‘little death’ (in French, la flushing, which is sometimes quite uncomfortable.
petite mort) is brought to ojas. In men the continual Although the flushing is probably a compensatory
depletion of semen results in the loss of ojas, and mechanism to liberate hormones such as oestrogen
hence, a weakening of physiological function. In light that are stored in fat, it also an alchemical process by
of this and for several other reasons excessive sexual which the fires of agni are stoked to convert the femi-
activity is discouraged in Āyurvedic medicine, and nine essence into the dynamic aspects of spiritual
guidelines are provided for appropriate sexual activity awakening. As a woman loses the ability to create life,
in accordance with the seasons (see Ch. 5). Among there is a physiological transition that directs a need to
some tantrik practices, however, a sexually active confront death, and thus menopause can be a time of
man suppresses the ejaculation of semen during copu- great learning. On a physiological level treatment is
lation, and by utilising various techniques, attempts to directed to support the declining feminine essence by
use this energy to awaken kundalinı̄. As a man ages using herbal therapies that are similarly used to keep
the dynamic and masculine aspects of his fertility a man sexually potent. These herbs are specifically cho-
slowly decline, allowing the more feminine aspects of sen for their ability to nourish ojas, and lack the us. n.a
 The physical body 41

(‘heating’) properties of similar herbs used in men, stances are released from the kit.t.a and are said to give
e.g. Śatāvarı̄ (Asparagus racemosus) (see 11.13 to rise to flatus, or vāta. Although the regular elimina-
Vajı̄karan.a karma: virilisation therapy). tion of purı̄s. a is considered to be of the utmost impor-
The importance of prān. a cannot be overem- tance in Āyurveda, it is said that in cachexia
phasised when it comes to the issue of ojas. Life is (rājyakśma) the faeces should be protected. In such
dependent upon the air we breathe, and by the use of conditions (e.g. tuberculosis) the tissues of the body
breath control methods like prān. ayama, ojas can are being eliminated to excess, and by preventing the
be increased and its circulation corrected. Without elimination of purı̄s. a, the patient retains some of the
adequate prān. a, or in cases where the air we breathe strength lost by the dhātus. Mūtra is formed in the
is contaminated by pollutants (e.g. exhaust, recycled same way as purı̄s. a, but represents the liquid portion
air, fine particulates, microbes), ojas undergoes of indigestible products and bodily wastes.
decline. According to Caraka, those that wish to pre- The sūks. ma or subtle malas are formed as each
serve ojas should: dhātu metabolizes the sara (‘essence’) of the previous
dhātu. The following list details the waste products
‘. . . avoid unhappiness . . . (and take) diets and
formed by each dhātu by the dhātvāgni:
drugs which are conducive to the heart, ojas
and channels of circulation . . . Tranquility and 1. Rasa: kapha dos. a, as mucoid secretions
wisdom should be followed meticulously for 2. Rakta: pitta dos. a, as bilious secretions
this purpose.’ 3. Mām . sa: impurities and wastes associated with
(Sharma & Dash 1985) the jñāna indriyās (i.e. nose, mouth, eyes, skin,
and ears)
4. Medas: sveda (perspiration)
4.4 Malas: BODILY WASTES
5. Asthi: nakha (nails), keśa (head hair) and loma
(body hair)
The term mala generally refers to any kind of impu-
6. Majjā: akśi (greasy secretions of the eyes), tvak
rity of the mind or body, but in Āyurvedic medicine
vit (sebaceous secretions), and purı̄s. a sneha
usually refers to any ‘waste’ produced by the body.
(greasiness of the faeces)
The malas are an important concept in Āyurveda,
7. Śukra/an.d.ān.u: none.
as health is absolutely dependent upon the proper
formation and excretion of wastes. The improper for- The state of a specific dhātu can be understood by
mation and impaired excretion of waste products is the qualities of its excretion. If a given dhātu is produc-
considered to be an important factor in the develop- ing excessive amounts of the waste product associated
ment of disease. Thus the dos. as, as ‘wind’, ‘bile’ and with it, then one needs to differentiate between the
‘phlegm’, also represent a kind of impaired elimina- causes. If for example cerumen, a waste product of the
tory product. ears and a mala of mām.sa, is being produced in
The malas are said to be of two kinds: those that excess, then one needs to look at the state of mām.sa
are sthūla or ‘gross’, and those that are sūks. ma, or and the tissues it generates to understand the cause.
‘subtle’. The sthūla malas are purı̄s. a (‘faeces’), Mām.sa generates muscle: is the patient thin and weak?
sveda (‘sweat’) and mūtra (‘urine’), collectively If so, then there may be a problem with the mām.sa
referred to as the trimalas (‘three wastes’). The dhātvāgni such that the essence of the previous dhātu
sūks. ma malas (‘subtle wastes’) comprise the remain- is being transformed into waste instead of healthy
ing waste produced by the body. mām.sa. Is the patient well built, with a good muscula-
Purı̄s. a (‘faeces’) is derived from the refinement of ture? Then perhaps the cause is based in an excessive
āhāra rasa during the digestion of food and the intake of dietary articles that specifically strengthen
resultant formation of kit.t.a (‘waste’, lit. ‘that which mām.sa, i.e. meat and animal products. Similarly, in
must be eliminated’). When exposed to the us.n.a (‘hot’) cases of excessive perspiration, is the cause too much fat
and tiks. n. a (‘sharp’) properties of agni, kit.t.a is (medas) or improper dhātu metabolism? Such an
formed into solid lumps that are referred to as purı̄s. a. understanding of the dhātus enables the practitioner
During the intense heat of digestion volatile sub- to refine the treatment strategy.
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42 PART 1: Theory and practice of Ayurveda

When agni is weak āma is formed instead of ojas,

4.5 Āma: TOXINS AND WASTES and as a result, ojas gradually becomes deficient. And,
because ojas feeds agni, a deficiency of ojas results in
The status of agni is the focal point for diagnosis and a further diminution of agni. In the dichotomy
treatment in Āyurveda. Its deficiency or impairment is between ojas and agni, āma represents an entropic
the cause for the creation of āma, which literally tendency in the dhātu cycle. It is the accumulation of
interpreted means ‘undigested food stuff ’. In a āma over many years that eventually robs ojas and
broader context, however, āma is the impairment of agni of much of their power, facilitating the processes
one’s ability to derive nourishment from life, be it of degeneration, decay and death.
physical, emotional, mental or spiritual. A correctly Although the qualities of āma are similar to
functioning agni confers a harmonious benefit to the kapha, āma can associate with any of the dos. as. In
whole organism, with proper discrimination of the such a state a dos. a is said to be sāma, or ‘with āma’.
body, mind and senses. In the absence of āma a dos. a is said to be nirāma, or
As the by-product of poor digestion āma is opposite ‘without āma’. The first treatment of any condition
in nature to agni, displaying qualities such guru in Āyurvedic medicine is the elimination of āma and
(‘heavy’), śita (‘cold’), snigdha (‘greasy’), picchila enhancement of agni. If the condition persists
(‘slimy’), and manda (‘slow’). All qualities of āma are beyond the use of these measures, a specific treat-
essentially identical to kapha. The difference between ment is administered to the vitiated dos. a(s). Table
āma and kapha, however, is that instead of acting as 4.1 describes the differences between sāma and
a counterbalance to the activities of vāta, āma accu- nirāma conditions.
mulates in the srotām.si (‘channels’) and blocks the
flow of vāta. The labile nature of vāta causes it to
move backwards when encountering this obstruction,
Intestinal permeability syndrome
reversing its flow in the body and thereby producing To put a modern slant on the concept of āma, let us
dysregulation and disease. examine the issue of intestinal permeability, or ‘leaky-

TABLE 4.1 Sāma and nirāma conditions.

Sāma conditions Nirāma conditions

Circulatory congestion, feeling of coldness Circulation normal

Loss of strength Normal strength
Lethargy and lassitude after eating Energised and revitalised after eating
Poor appetite Good appetite
Indigestion Good digestion
Constipation At least two bowel movements daily
Sinking stools with mucus congestion Normal stools
Increased urination Normal urination
Joint swelling and inflammation Absence of joint swelling and inflammation
Headache No headache
Thick tongue coating Clear or thin white coating
Orbital oedema, eyes appear dull, poor vision Eyes bright, shining, good vision
The above conditions made worse with cold Health unaffected by changes in weather
and damp weather or climates, and worse or climate
at night
 The physical body 43

gut syndrome’. Succinctly put, intestinal permeability srotām.si include the two nostrils, the two ears, the
describes a process by which some agent or combina- two eyes, the mouth, the urethra and the rectum.
tion of agents initiates an inflammatory response in Females have two additional bāhya srotām.si: the
the digestive tract. Persistent gastrointestinal inflam- two lactiferous glands of the breasts (stanyavaha
mation eventually disrupts the integrity of the srotām.si), and the cervix (ārtavaha srota). There
mucosal lining of the gut, and tiny perforations allow are 13 abhyañtra srotām.si, each of which relates to
for molecules larger than usual to pass across this bar- specific organs, and are increased and vitiated by spe-
rier. These molecules can be derived from the diet, or cific factors. The 13 abhyañtra srotām.si are listed as
may be in the form of microorganisms such as bacte- follows:
ria and fungi that naturally inhabit our digestive tract.
In response to this infiltration, an immune response is
initiated and the body begins to manufacture specific
1. Prān.avaha srotāmsi
˙
antibodies to these antigens. Unfortunately, many Function: provides the medium through which prān.a
human tissues have antigenic sites almost identical to flows, obtained on a corporeal level by the respiratory
those substances that pass across a permeable intes- and gastrointestinal systems, and through the
tinal wall. These antibodies then circulate throughout sūks. ma sarira.
the body and bind with endogenous (self) antigens to Governing dos. a: vāta.
initiate an inflammatory response. Organs: correlates to cardiac function, the respiratory
Āyurveda describes a condition analogous to intes- system and the activities of the digestive tract. In this
tinal permeability, in which a deficiency of agni pro- sense, prān.a is obtained from three sources:
motes the formation of āma. Āma then enters into
(i) from the atmosphere, in which prān.a is obtained
the dhātu cycle and begins to localise in areas such as
by the cyclical nature of breathing, which in turn
the joints, or in already weakened or susceptible areas.
regulates the rhythm of the heart
Once āma is firmly wedged in these locations the
(ii) from food, which contains smaller amounts of
dos. as become vitiated: first kapha, with an increase
prān.a that supply energy to the tissues of the
in congestion; followed by pitta, which sets up a cycle of
body
inflammation; and then vāta, which promotes degen-
(iii) from the subtle realm (sūks. ma sarira), where
erative changes. Thus the basic dynamics of intestinal
extrinsic prān.a is absorbed from the universe,
permeability syndrome were identified several millen-
and especially from the sun.
nia ago in India as being an important causative factor
in the development of disease, even if the pathogenic The term hr.daya (‘heart’) correlates to the general
mechanisms described are somewhat different. functions of the brain, and thus prān.a has an impor-
tant regulatory function in nervous tissue.
Cause of vitiation: consumptive diseases; suppression of
4.6 Srotāmsi: THE CHANNELS natural urges; seasonal, environmental, lifestyle and
˙
OF THE BODY dietary patterns that have a ‘drying’ (rūks. a) nature;
exertion and exercise while hungry.
The body contains several channels through which Symptoms of vitiation: hyperventilation, shortness of
the dos. as, dhātus and malas are transported, called breath, shallow breathing, asthma, hiatus hernia.
srotām.si (sing. srota). The impaired movement or
obstruction of the dos. as, dhātus or malas through
a srota is called srotorodha. Srotorodha interrupts
2. Ambuvaha srotām.si
proper tissue metabolism, causing the regurgitation of Function: water metabolism; responsible for the hydra-
the dos. as, dhātus and malas, and the local forma- tion of bodily tissues and the production of urine.
tion of āma. Āma then moves into the other Governing dos. a: kapha.
srotām.si and circulates through the body, promoting Organs: pancreas, palate.
systemic congestion. Cause of vitiation: exposure to heat, indigestion, alco-
A srota is either bāhya (an ‘external’ channel) or holic drinks, eating excessively drying food, insuffi-
abhyañtra (an ‘internal’ channel). The bāhya cient water intake.
 -
44 PART 1: Theory and practice of Ayurveda

Symptoms of vitiation: dryness of the oral mucosa, Cause of vitiation: sleeping after eating, eating excessive
tongue and throat, lack of appetite, excessive thirst, amounts of food, especially with guru and snigdha
diabetes, pancreatitis. qualities (e.g. dairy, flour products, fatty meat).
Symptoms of vitiation: myoma, uvulitis, tonsilitis,
epiglotitis, goitre, cervical adenitis, boils, non-malignant
3. Annavaha srotām.si growths.
Function: nutrient assimilation, transports assimilated
nutrients to the dhātus.
Governing dos. a: pitta.
7. Medovaha srotām.si
Organs: stomach, duodenum. Function: transports medas throughout the body.
Cause of vitiation: overeating, unwholesome foods, Governing dos. a: kapha.
agnimāndya (‘poor digestion’). Organs: adipose tissue, kidneys, glandular tissue,
Symptoms of vitiation: poor appetite, indigestion, mal- serosal tissue of the viscera.
absorption, anorexia, vomiting, dry tongue, dry lips. Cause of vitiation: lack of exercise, sleeping during the
day, sleeping after eating, eating to excess (especially
sweets), eating excessive amount of foods with a guru
4. Rasavaha srotām.si and snigdha quality; excessive alcohol consumption.
Function: carries rasa throughout the body. Symptoms of vitiation: benign cysts, obesity, atheroscle-
Governing dos. a: kapha. rosis, dysuria, diabetes.
Organs: heart, arteries, lymphatic tissue.
Cause of vitiation: excessive intake of guru, śita or
snigdha dietary articles (e.g. dairy, flour products);
8. Asthivaha srotām.si
agnimāndya (‘poor digestion’). Function: carries asthi throughout the body.
Symptoms of vitiation: poor appetite, decrease in taste Governing dos. a: vāta.
sensation, indigestion, malabsorption, anorexia, vom- Organs: skeletal system, especially the sacrum and
iting, abdominal heaviness, lethargy, fever, malaise, neck.
fainting, oedema, lymphatic congestion, frequent Cause of vitiation: excessive exercise, malnutrition, lack
upper respiratory infections, anaemia, impotence/ of sleep, vāta-provoking foods and activities.
infertility, asthenia, premature ageing. Symptoms of vitiation: osteoarthritis, osteoporosis,
alopecia, dental caries, abnormal nail growth.
5. Raktavaha srotām.si
9. Majjāvaha srotām.si
Function: carries rakta throughout the body.
Governing dos. a: pitta. Function: carries majjā throughout the body.
Organs: liver, spleen, red bone marrow, skin. Governing dos. a: vāta-kapha.
Cause of vitiation: consuming foods that are excessively Organs: nervous system, marrow.
us.n. a, snigdha or tiks. n. a in nature (e.g. alcohol, Cause of vitiation: broken bones, compression (tight
chilies, pork); toxins; excessive exposure to heat and shoes and clothing), eating incompatible foods (e.g.
the sun. fish and dairy).
Symptoms of vitiation: skin disorders (e.g. psoriasis, Symptoms of vitiation: rheumatism, vertigo, fainting,
eczema, herpes, erysipelas), menorrhagia, haemor- memory loss, paralysis, tremors.
rhage, rectal bleeding, hepatomegaly, splenomegaly.
10. Śukravaha srotām.si
6. Mām.savaha srotām.si Function: carries śukra and an.d.ān.u throughout the
Function: carries māmsa throughout the body. body, concentrates ojas in the reproductive organs
˙
Governing dos. a: kapha. during sexual activity.
Organs: tendons, muscles, ligaments, fascia, basement Governing dos. a: kapha.
membrane of the dermis. Organs: reproductive tissue.
 The physical body 45

Cause of vitiation: excessive sexual intercourse, sup- Organs: colon and rectum.
pression of ejaculation, suppression of sexual activi- Cause of vitiation: suppression of the urge to defecate,
ties, excessive sexual stimulation without release, overeating, ignoring satiety, agnimāndya.
sexual activity concurrent with the need to urinate or Symptoms of vitiation: constipation, diarrhoea, irrita-
defecate. ble bowel syndrome, colitis.
Symptoms of vitiation: spermatorrhoea, nocturnal
emission, benign prostatic hyperplasia, amenorrhoea,
leucorrhoea, dysmenorrhoea, uterine fibroids, infer-
13. Svedavaha srotām.si
tility, miscarriage. Function: carries sweat to elimination.
Governing dos. a: pitta.
Organs: sudoriferous glands, hair follicles.
11. Mūtravaha srotām.si Cause of vitiation: excessive exercise, excessive expo-
Function: carries urine to elimination. sure to heat, anger, fear, grief.
Governing dos. a: vāta-kapha. Symptoms of vitiation: absence of or excessive perspira-
Organs: urinary bladder and kidneys. tion, dry skin, calloused skin, hypersensitive skin, hor-
Cause of vitiation: overeating, suppression of the urge ripilations (goose bumps), hives, burning sensations in
to urinate, sexual activity or the consumption of foods skin.
and beverages concurrent with the urge to urinate.
Symptoms of vitiation: frequency, tenesmus, calculi,
pain upon voiding.

12. Purı̄s.avaha srotām.si

Function: carries faeces to elimination.
Governing dos. a: vāta.