Ati Sweda: Hyperhidrosis, Causes, Diagnosis, Ayurvedic View

Article by Dr Raghuram Y.S. MD (Ay) and Dr Manasa, B.A.M.S
Sweda or Sweating is a natural phenomenon. It is one of the detoxification methods of the body to expel excess fluidity in the body and balance the body fluids. Major part of excretion of unnecessary body fluids takes place in the form of urination and also as a part of defecation. 

Sweda in Ayurveda is considered as Mala or excretory product of metabolism. There are many malas produced in the body. They are:

Sthula Malas – Major excretory products i.e. Pureesha (stools or feces), Mutra (urine) and Sweda (sweat).
Thus, Sweda or sweat is a sthula as well as sookshma mala.

Related reading – Dhatu malas

Sweda, like urine and feces should be eliminated regularly for the body to be healthy.
Depending on the natural constitution of an individual (prakriti), the quantity of sweating differs. Excess Pitta in the body or pitta vitiation (pitta vriddhi, prakopa), causes excessive sweating. Basically the people of Pita Prakriti (constitution) sweat more than other individuals. Vata and Kapha predominant people will sweat less unless they are suffering from pitta morbidity.

Similarly those having excessive meda dhatu or medo vikriti (obesity, excess weight gain) also sweat more because sweat is an excretory material of meda.

Excessive sweating (Ati sweda) is an embarrassing situation and may occur as a symptom or complication of many disorders. This article is to analyze different causes of excessive sweating and also to know about the diseases in which sweating is associated.
Read related: Prickly Heat – Ayurvedic Treatment, Medicines, Remedies

Primary Causes of Excessive Sweating
Pitta Prakopa (Vitiation of Pitta) –
Ati Sweda is one of the symptoms of vitiation of Pitta (pitta prakopa). People who have pitta prakriti (pitta constitution) naturally tend to sweat more than others. This is because of raised metabolism in those people. Pitta and Agni (core metabolic fire) are said to be one and the same by Sushruta, in fact Pitta is representation of fire in the body. So naturally when the fire activity in the gut and also in the tissues is higher than in other people, the sweating process induced by excessive heat in the body is also more in pitta prakriti.

Sweda is also said to be the ashraya (residence, place of stay) of Pitta, i.e. Pitta is located in sweda and they have compatible relationship. Sweating is thus a form of mechanism to balance the heat by throwing excess pitta in the body.

Medo Vriddhi, Medaswina (Excess fat, errors of fat metabolism) –
मेदोज रोग

ग्रन्थि वृद्धि गलगण्ड अर्बुद मेदोज ओष्ठ प्रकोप मधुमेह अतिस्थौल्य अतिस्वेद प्रभृतयो मेदो दोषजाः॥(सु.सू.२४/९)

Sweda is the mala (excreta) of Meda or fat. We generally see that those who are obese or over-weight, sweat more than their counterparts. Thus, excessive sweating is normal in those who have disturbed mathematics of fat and fat metabolism (errors of fat metabolism) in them.

Sushruta has counted atisweda or excessive sweating as one of the ‘morbid fat’ borne diseases.

Among Medo Pradoshaja Vikaras (diseases caused due to morbid fat), Charaka (Charaka Sutra Sthana 28/15) has mentioned Nindita Purushas (socially unfit people, 8 types). Among the 8 ninditas, Ati Sthula (very fat or excessively obese) is one. And ati sweda (excessive sweating) is one of the symptoms or doshas (morbidity) of Ati sthula.

तत्र विद्धस्य् स्वेद आगमनं स्निग्ध अङ्गता तालु शोषः स्थूल शोफता पिपासा च।(सु.शा.9/12)
Sweda agamana or excessive sweating is also a symptom of injury of Medovaha Srotas

Shonita dushti, Shonitaja Roga (Contamination of blood tissue, vitiation of blood and diseases resulting from its vitiation) –

ततः शोणितजा रोगाः……
……स्वेदः शरीर दौर्गन्ध्यं मदः कम्पः स्वर क्षय: (च.सू.२४/११-१६)

Among the diseases and conditions caused by contamination and vitiation of blood tissue, Charaka has mentioned Sweda and daurgandhya i.e. excessive sweating associated with foul smell from the body.

Sweda vaha sroto-dushti (contamination of channels carrying sweat or monitoring the sweating process in the body)
स्वेदो वहानां स्रोतसां मेदो मूलं लोम कूपाः च।
अस्वेदनं अति स्वेदनं पारुष्यं अति श्लक्ष्णताम् अङ्गस्य परिदाहं लोमहर्षं विध्यात्॥(च.वि.५/७)

The roots (mula – control stations) of Sweda vaha srotas (sweat carrying channels) are Meda (fat) and Loma kupa (Minute pores of the skin located around the base of hair follicles of the skin). Thus sweda and meda are interrelated. As discussed, Sweda is also a mala of Meda. This mala (excreta) is thrown out through loma kupas.

Ati swedanam (excessive sweating) is mentioned as one of the symptoms of contamination of swedavaha srotas (which also includes contamination of fat tissue).

Vyana Vayu Dushti (Hyperactivity of Vyana Vayu) –
Vyana Vayu is one of the subtypes of Vayu. Among its other functions, distribution of materials is the key function. Vyana Vayu puts Rasa-Rakta into circulation, i.e. blood with nutrients. The blood is abode of pitta (pitta resides in blood). When the vyana vayu takes the rasa and rakta to the periphery (to skin), along with the nutrients going out to nourish the skin and related tissues, the heat of pitta located in the blood helps in putting the sweat out of the loma kupas (openings in the skin). Therefore for the sweating process to take place normally, the vyana vayu and its functions should be good and balanced. Hyperactivity of Vyana Vayu takes more blood (and the pitta in it) to the periphery. This leads to excessive sweating.
Read related: Why You Should Sweat – To Treat Disease, For Better Health

Disturbance of Samana Vayu and Pachaka Pitta axis
Samana Vayu is the subtype of Vayu which is located in the proximity of Agni (the metabolic fire) located in the stomach (belly). The Agni in the belly is in the form of Pachaka Pitta. These two work in coordination. If Samana Vayu is wind, Pachaka Pitta is fire. If the compatibility between these 2 elements i.e. wind and fire is good, the digestion takes place in a likable manner. Another element present in the gut is Kledaka Kapha which acts as a buffer and protects the stomach whenever there is lot of provocation or aggravation (corrosive) of the previously mentioned elements. Thus Kledaka Kapha acts like a water body. Pachaka Pitta after digesting the food with the help of Samana Vayu, bifurcates the digested food into rasa (nutritive juice), mutra (urine) and pureesha (stools or feces). Samana Vayu too helps in bifurcation of the food into nutritive part and excreta. Sweda too is an excreta formed in minute quantities at this level of metabolism. It is manifested and thrown out from the body in the form of sweat only when it reaches the periphery along with rasa-rakta.

As long as this Pachaka Pitta and Samana Vayu axis is balanced, the excreta are formed in proper proportions. But when this axis is disturbed, the sweda or sweating process gets enhanced. More sweat is formed and more sweating occurs.

Secondary causes of excessive sweating
In this category, we could find that excessive sweating occurs secondary to some major disease i.e. excessive sweating or ati sweda occurs either as a symptom or premonitory symptom or complication or sign of bad prognosis of a disease. The Ayurvedic differential diagnosis of ati sweda vis-à-vis excessive sweating is as given below.

Ati Sweda as Purvarupa (premonitory symptom) – Ati sweda as a purva rupa occurs in –

  • Apasmara – Epilepsy
  • Kushta – Skin diseases
  • Vatarakta – Gout, Peripheral vascular diseases

Ati Sweda as Rupa or Lakshana (symptom) occurs in –

  • Pittaja Arshas – Piles or haemorrhoids caused by aggravated Pitta
  • Vidagdha Ajeerna – Indigestion caused by vitiated Pitta
  • Adhogata Amlapitta – Gastritis or acid-reflux disease, having a downward course
  • Raktagata Kushta – Skin disease settled deep into the blood, deep rooted in blood
  • Pittaja Jwara – Fever caused by vitiated pitta
  • Medogata Jwara – Fever deep rooted in fat tissue
  • Jwaramukti Purvarupa – Premonitory symptom of remission from fever
  • Jwara Mukti – Remission from fever
  • Pittaja Gulma – Abdominal tumors caused by vitiated Pitta
  • Pittaja Daha – Burning sensation caused by vitiated Pitta
  • Pitta dushta stanya pana – child drinking breast milk contaminated by vitiated Pitta
  • Pittavrita Samana – Samana Vayu obstructed by Pitta
  • Medoroga – Disease caused by errors of fat metabolism
  • Pittaja Madatyaya – Alcoholic intoxication worsened by vitiated Pitta
  • Skanda graham – Child afflicted by Skanda Graha (kind of idiopathic, supernatural, infectious diseases occurring in infants)
  • Unmada – Insanity
  • Raktapurna Koshta – bleeding in the visceral organs
  • Pittadhika Vatarakta – Gout caused by vitiation of Pitta
  • Visha – Poisoning
  • Kshayaja Shiroroga – headache caused by wasting diseases
  • Pittaja Shula – Abdominal colic caused by vitiated Pitta
  • Parinama Shula – Peptic ulcers
  • Pittaja SHotha – Swelling occurring due to vitiated pitta
  • Chinna Shwasa – A type of breathless disorder
  • Tamaka Shwasa – Bronchial Asthma
  • Pittaja Murcha – Fainting or unconsciousness caused by vitiated Pitta
  • Pittaja Hridroga – Heart diseases caused by vitiated Pitta

Just before conclusion
Sveda or sweat is natural excreta. It should go out to keep us healthy. It carries along with it a lot of wastes and toxins from the body. But excess sweating is not only an embarrassing condition but also is a harmful condition. Excessive sweating imbalances the water proportions of the body and damages the tissues. It depicts imbalance of Vata, Pitta, Meda and Rakta or some diseases pertaining to them (majorly). Excess sweating which persists for a long duration demands medical attention as it may carry a serious disorder at its backdrop. This article is to present the various conditions in which excessive sweating occurs according to Ayurvedic references. This knowledge will help in proper diagnosis of the diseases or pathological changes existing at the backdrop of this problem and also to provide effective remedies!!
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