Involvement of Multiple Doshas In The Disease process

Article by Dr Raghuram Y.S. MD (Ay) & Dr Manasa, B.A.M.S

Introduction

Doshas when undergo vitiation, cause diseases. Vitiation can happen with single Doshas, or even with two or three Doshas together. When 2 Doshas are involved, it is called Samsargaja, when all the 3 are involved, it is called Sannipataja. 

Related Reading – Role of Dosha in the causation of diseases

Dosha imbalance can involve either one dosha, two or all three vitiated doshas.
When one vitiated dosha cause diseases it is called eka doshaja. Such a vitiated dosha is called Eka dosha dushti.
Example – Vataja Kasa, Pittaja Atisara, Kaphaja Hridroga etc

When two doshas are simultaneously vitiated, it is called Samsargaja Dosha Dushti and when three doshas are simultaneously vitiated, it is called Sannipataja Dosha Dushti.

Samsargaja and Sannipataja Dosha Dushti – Dual and Triple dosha vitiation
Samsarga – dual combination
Sannipata – triple combination

Samsargaja Dosha Dushti

Samsargaja Dosha Dushti – simultaneous vitiation of two doshas:
Other Names –

• Dwidoshaja Dushti
• Dwandwa Dushti

The diseases caused by dual vitiation of doshas are called Samsargaja or Dwidoshaja vyadhis. Example, Vata-Pittaja visarpa (herpes caused by vitiation of vata and pitta), Kapha-Vataja jwara (fever caused by vitiation of kapha and vata) etc

Nidanas or causative factors responsible for vitiation of both doshas are also involved in the manifestation of disease by dual vitiation of doshas. Symptoms of both involved doshas will be present in diseases caused by daul vitiation of dosha.

Diseases caused by vitiation of two doshas have bad prognosis, i.e. these diseases are either difficult to cure or manageable with difficulty but not curable in nature.

While treating these diseases both doshas should be taken into consideration. Medicines, diet and lifestyle practices and treatment should be oriented towards mitigating both involved doshas.

Daul vitiation of doshas may take place in 3 forms i.e.

• Vata Pitta Dushti
• Pitta Kapha Dushti and
• Kapha Vata Dushti

Sannipata Dosha Dushti

Sannipata Dosha Dushti – When all the three doshas are vitiated together:
Other name is Tridoshaja Dushti.

The diseases caused by triple vitiation of doshas are called Sannipataja or Tridoshaja vyadhis. Example, Sannipataja jwara (fever caused by vitiation of three doshas), Sannipataja atisara (diarrhea caused by vitiation of three doshas), Tridoshaja Arshas (piles caused by vitiation of three doshas) etc

Causative factors responsible for vitiation of all the three doshas are involved in sannipata dosha dushti or in the manifestation of sannipataja vyadhis. The symptoms of sannipataja dosha dushti or sannipataja vyadhis will be caused by all the three involved doshas, i.e. symptoms of all three involved doshas will be present.

Diseases caused by vitiation of three doshas have bad prognosis, i.e. these diseases are incurable in nature.

While treating these sannipataja diseases all the three doshas should be taken into consideration. Medicines, diet and lifestyle practices and treatment should be oriented towards mitigating all three involved doshas.

Vitiation of three doshas is broadly of two types. They are –

Sama Sannipata dosha dushti – here all there doshas are equally vitiated. This is only of one type.
Vishama Sannipata dosha dushti – here the three doshas are vitiated in different proportions. This is of 12 types.

Thus Triple vitiation of doshas is of 13 types. The examples of such 13 types of sannipata dosha dushti are explained in the context of fever but are applicable for all diseases.

Importance

Importance of having the knowledge of Samsarga and Sannipataja Dosha Dushti
From clinical diagnosis and treatment point of view it is very important for a physician to have a comprehensive knowledge of samsarga and sannipata types of dosha dushti. This knowledge will help in understanding the involvement of multiple doshas in the causation of pathology of diseases and the permutations and combinations of these doshas.

This will help in deciding the gravity and prognosis of diseases and also to plan appropriate treatment protocols for diseases caused by double or triple dosha vitiation.
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