Pathological Movement Of Doshas From Koshta To Shakha

By Dr Raghuram Y.S. MD (Ay) & Dr Manasa, B.A.M.S
Doshas reside in tissues. This relationship is called Ashraya ashrayi bhava. This is their normal mutual association in healthy people. 

Introduction

Biphasic movement of doshas.
Terms to note in this discussion –
Koshta – visceral organs
Shakha – Tissues – blood, muscle, bone, marrow, etc.

In normal conditions, doshas will have free and unobstructed transit from tissue to visceral organs and again from visceral organs to tissues.

Physiology

Why this movement?
Doshas are physiological components of body. They reside in anatomical components i.e. tissues and excreta.  These tissues make up walls of visceral organs. When doshas need to perform their function they move from tissues into the organ lumen. When they finish their functions they move back into tissues, which of course is their residence.
Read Movement Of Doshas From Tissues To Visceral Organs (Shakha To Koshta Gati)

Let us understand this with example
When I need to work I move from my home to my clinic. I see patients, finish my work and after finishing my work I will come back to my home. This is natural.

Now let us see what happens in terms of doshas.
Let us take for example, one of the subtypes of pitta i.e. pachaka pitta. This pitta resides in between colon and stomach. Thus, pachaka pitta which is a representative of core metabolic fire is situated in stomach and intestines.

Let us consider that pitta is located in the walls of intestines and stomach. These walls are made up of muscular tissues. When this pachaka pitta needs to perform its natural function i.e. to digest  food, it moves from walls of stomach and small intestine into lumen of these organs. Here it comes into contact with food and digests it.

We can correlate this with  movement of or release of acids and digestive enzymes into digestive organs from the glands located within their walls.

After they finish their functions, the pachaka pitta goes back into its tissue i.e. walls of intestine. This looks absurd.
Now we will understand this in simple language. Pachaka pitta going back into tissues means that the pitta is no longer produced since it is no longer needed until next consignment of food comes into the organ. This can be correlated with feedback mechanism.
Read Dosha Paka Lakshanas Symptoms Of Digestion Of Doshas

Doshas stagnated in the tissues and refusing to come into visceral organ are the trouble makers.
As long as there is to and fro movement of doshas there would not be any problem.
Abnormal is when I go to clinic and refuse to come back home.

Pathology

Abnormal is when doshas move from visceral organ to the tissues after finishing their functions and refuse to come back into visceral organ when they are needed on the next day. And when they constantly refuse to come out into visceral organ , doshas get stagnated in the tissues. But there is always an urge to come out. When they are not able to come out into  visceral organ, doshas tend to damage tissues in an attempt to escape.

This one-way movement of doshas from visceral organs into the tissues causes tissue damage. This happens due to stagnation of doshas in the tissues. This movement of dosha is thus considered as pathological and is called ‘Shakha Gati’.
Read Upward, Downward, Lateral Dosha Movement (Urdhwa Adho Tiryak Doshagati)

Obstructive causes/ activities

Why don’t the doshas come back from tissue to visceral organ?

To understand this we shall have a look into factors which are responsible for blocking doshas in  tissues not allowing them to come towards visceral organs.
Below mentioned are four factors which enable doshas to move from visceral organ to tissue and get stagnated there in.
– Vyaayama – excessive exercise
– Ushmanah taikshnyaad – intensity of heat
– Hitasya anavacharanaad – not consuming wholesome and compatible foods and daily activities
– Drutatvaat marutasya – speedy movement and push propelled by vata

Among these factors, excessive exercise and speed of vata are factors which indicate involvement of vata in pushing doshas into the tissues. Excessive exercise too causes vata vitiation. Speedy movement of vata may be caused due to excessive consumption of causative factors which aggravate vata. Intensity of heat provided by pitta will help in the process. Consuming unwholesome foods and daily activities will vitiate all doshas and cause this movement of doshas.
Read Vitiation Of Doshas According To Movement Of Doshas In The Body

Pathophysiology

Fate of doshas which have entered shakhas
Doshas which have gone into tissues do not produce diseases immediately. They also will not produce immediate damage or disturbance. If tissues are healthy, strong and immune, doshas will take long time to produce disease.

The doshas which are stagnated in tissues will not undergo aggravation due to non availability of stimulating etiological factors. Therefore they are not capable enough to produce diseases immediately. Doshas while waiting for etiological factors will not get into untimely aggravation in undesired sites of body.

When dosha vitiating etiological factors are available, doshas undergo untimely vitiation in undesired places. These doshas move into the tissues, get stagnated therein and cause diseases.
This explains that only vitiated doshas move from visceral organ to tissues and refuse to come back from tissues. These doshas get stagnated in tissues and cause diseases.
For this to happen, doshas need to be exposed to the etiological factors which eventually vitiate them.
Read Koshta Shakha Marma-Asthi-Sandhi Gati Of Dosha – Doshas In Organs And Joints

If doshas are not disturbed, they move uninterruptedly from visceral organs to the tissues and from tissues to visceral organs. This will keep body functions run smoothly.

Effect of pathological transit of doshas from visceral organs to the tissues
– Stagnation of doshas in tissues
– Damage to the tissues
– Vitiation of doshas in tissues on availability of etiological factors
– Causation of various diseases by morbid doshas
Read: Involvement of Multiple Doshas In The Disease process

Remedy

What should be done in such cases?
As remedy, these doshas which have got stagnated in tissues should be mobilized towards visceral organs. From visceral organs these morbid doshas should be removed by administration of cleansing treatments of Panchakarma, mainly therapeutic emesis and therapeutic purgation.
Etiological factors should be avoided to prevent further vitiation of doshas.

Clinical importance

Need of knowledge of pathological transit of doshas from visceral organs to tissues
Physician should have a thorough knowledge of these movements of doshas. This will enable the physician to give timely treatment and revert back the stagnated doshas towards the stomach and intestines and expel them through emesis or purgation.
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