“Tridosha theory needs revision” (Part-1)
Prof. Kishor Patwardhan
Transcript based on video lecture
“Tridosha Theory Needs Revision”
Disclaimer: This talk of mine overrides all my previous talks on this subject. This is an unusual disclaimer, but it is necessary. This is the first public talk I’m giving after writing my paper, “Confessions of an Ayurvedic Professor,” where I have retracted most of my past views expressed in my previous writings on this subject. The paper was published last year in July in the *Indian Journal of Medical Ethics* (IJME). Patwardhan K. (2023). Confessions of an Ayurveda professor. Indian journal of medical ethics, VIII(1), 61–64. https://doi.org/10.20529/IJME.2022.049
Therefore, any mismatch between this talk and my previous talks should be viewed from this perspective. This is the fundamental disclaimer that I would like to share at the beginning of my talk.
In this lecture, I’ll be covering four major topics or sub-themes. First, I will attempt to reconstruct the Tridosha theory. Second, I will address the question of the value of Tridosha theory in today’s clinical practice. Third, I will discuss which portions of this theory are obsolete and need to be discarded. Finally, I will make some general comments on the current system of education.
Origins of Tridosha Theory:
The Tridosha theory has its roots in the Nyaya-Vaisheshika schools of philosophy. Nyaya is primarily based on common-sense logic, while Vaisheshika can be thought of as primitive physics. The Tridosha theory can be easily traced back to these two schools of philosophy. Before discussing the Tridosha theory, it is essential to have some understanding of the Panchamabhuta, as concepts like Tridosha, Panchamabhuta, and Guna are all interrelated and integrated. That’s how our ancient Indian knowledge systems always linked different concepts with each other.
Panchamabhuta:
Panchamabhuta, the five primary units, is the term used to describe the entire observable universe according to these schools of thought, Nyaya and Vaisheshika. The five primary units are Akasha, Vayu, Agni, Jala, and Prithvi. The translation of these terms can sometimes be confusing or ambiguous. Akasha is often translated as space, but we should not mistake this space for outer space or the sky. No, space here denotes a continuous area or expanse that is free, available, or unoccupied. That is the simplest meaning of Akasha. Vayu is wind, Agni is fire, Apa is water, and Prithvi is earth. There is not much confusion about these, but Akasha is often translated into different terms like ether or sky, which creates confusion. Let us be clear that Akasha simply means space.
Interpreting or translating these five primary units as proto-elements, elements, atoms, or subatomic particles can be problematic and misleading. They are simply to be understood as the five primary units that make up the entire universe. This concept is based on common sense and should not be confused with highly evolved physics or chemistry. According to this theory, the entire observable universe is classified into five classes based on the five different sensory organs we possess. We are equipped with five sensory organs and can perceive only five different sensations, roughly. For example, things that can be heard comprise one class.
So, the observable universe was classified into five classes: things that can be heard as Shabda, things that can be touched as Sparsha, things that can be seen as Rupa, things that can be tasted as Rasa, and things that can be smelled as Gandha. These five classes were integrated into the five Mahabhutas. Akasha was integrated with Shabda because sound can travel even in space. When I speak, you can hear me because sound is traveling through space. Vayu, the wind, is integrated with Sparsha because Vayu, the breeze, can be felt only through touch; there are no other sensory organs with which you can perceive the wind. Similarly, Agni, fire or light, is integrated with Rupa because things can only be seen when there is light. In the absence of light, you cannot see things. Apa, water, is integrated with Rasa because substances dissolved in water can only be tasted; without dissolving in water, you cannot taste something. Prithvi was integrated with Gandha because when it rains, the soil smells good. This is very simple logic, and the soil’s smell has a transcultural connotation. In English, it is called the fragrance of soil; in Hindi, we call it ‘mitti ki khushboo’; in Kannada, we call it ‘mannina vasane’; and even in Tamil, it is ‘mann vasam.’ Fragrance is always associated with soil, not flowers, which is an interesting transcultural phenomenon.
Our voice can be heard by another person because it travels through space, but ancient scholars possibly did not realize that sound needed a medium to travel. For example, when I speak, the person sitting before me can hear my voice because there is air in between; there is space, and this space is filled with air. In the absence of air, sound cannot travel; sound cannot travel in a vacuum. But possibly, our ancient scholars did not think that much because it was commonsensical and based on everyday experiences. So, space can only transmit sound but can’t be felt through other senses. This is why Akasha and Shabda were integrated, and this is commonsensical; it is not super science or advanced physics or chemistry.
Why is everything Panchabhautik?
Now, why is everything Panchabhautik? The reason is that there are things that can be seen as well as touched. For example, a tree—you can see it and also touch it. There are things that can be seen, tasted, and smelled, like eatables—you can see them, taste them, and smell them. Hence, it was logical to propose that everything is composed of these five units but in different proportions. It was quite logical and commonsensical. Hence the saying, “Everything in this universe is Panchabhautik.” However, the Panchamabhuta could not explain health and disease. This is where its limitation lies. Panchamabhuta cannot explain health and disease because even a rock is made up of Panchamabhuta, just as my body is. So, what is the difference between my body and a rock? My body has many things going on inside it, and to explain my health, the theory of Tridosha evolved.
Some observations may help us build a background
Some basic understanding of common-sense observations will help us here. These are some very basic observations: Imagine a plant kept in the dark in a closed airtight jar—it dies soon because it cannot survive without water, sunlight, or nutrients. Similarly, too cold a climate normally does not support life. An animal, when suffocated, dies. One cannot survive without water and food. Again, these are all common-sense observations. Warmth to the touch is a sign of life; a dead body is cold. So these observations led to the formation of a theory called Tridosha.
Name three essentials without which you cannot survive:
If I asked you to name three essentials without which you cannot survive, what would your answer be? Ultimately, most of us would identify these three entities: air or wind, because without breathing we cannot survive; the sun, because all animals depend on plants for energy, and all plants depend on the sun for energy; and water, because we need water to drink and cook food. So possibly, these are the three very essential things without which we cannot survive. This was the fundamental basis for the evolution of the Tridosha theory.
Soma, Surya, Anila:
Soma, Surya, and Anila—‘Visarg adana viksepaihi Soma, Surya, Anila, Yatha. Dharayanti Jagadeham Kapha, Pitta, Anila, tatha.’ Soma has two meanings: Moon and Water. This term is sometimes used interchangeably to mean both. Air or Wind is related to atmosphere, breath, and movement. The sun is associated with light, fire, heat, warmth, and energy. Water is associated with hydration, nourishment, and cooling. These are the features of wind, sun, and water. And hence, based on this, the Tridosha theory was developed—a theory that systematized and integrated the knowledge on health, disease, and therapeutics.
Tridosha and five Mahabhutas integrated :
The Tridosha theory was then integrated with the five Mahabhutas. Wind and Akasha dominate Vata, fire dominates Pitta, and water, to a lesser extent, earth dominates Kapha. This understanding of Tridosha was then associated with physiology, and later on, with pathology, diseases, and even therapeutics. That is why the Tridosha theory was essential.
Physiology and Tridosha:
It was logical to propose that Vata, just as wind controls all activities like movement, Pitta, just as Sun and fire generate heat, impart color, and bring about digestion and metabolism. All these functions were ascribed to Pitta. Kapha was considered responsible for nourishment and also acted as a coolant. Just as water, Kapha acted as a coolant and provided nourishment.
Guna principle:
Next comes the principle of Guna or attributes. This is another important doctrine, also adopted from the Nyaya Vaisheshika system. Each dosha has specific attributes. For instance, ‘Tatra Ruksha, Laghu, Sheeta Khara, Sukshma Chala Anil’. So for Vata, Pitta, and Kapha, there are specific attributes that have been ascribed. Similarly, all medicinal plants also have specific attributes. Some may be Ushna, Tikshna; others may be Laghu or Snigdha. Food grains also have specific attributes, and this understanding has practical applications. It is proposed that the attributes of food that are common to a dosha cause an increase in the activity of the corresponding dosha For example, consumption of oily, sweet, and heavy food leads to an increase in Kapha, which might result in obesity. Similarly, lack of physical activity and excessive daytime sleep also contribute to an increase in Kapha, further leading to obesity. Thus, the theory of Tridosha was integrated with dietary recommendations. Kapha and Vata generally have opposite attributes, except for “Sheeta” (cold). Most attributes of Kapha and Vata are opposite. Hence, anything that shares similar attributes with Vata would decrease Kapha. For instance, physical exercise and the intake of dry, light, and rough food (Ruksha and Laghu) lead to a decrease in Kapha because they increase Vata, and since Vata and Kapha are opposites, this can help treat obesity. Therefore, the treatment involves using dry, light, and rough food substances, engaging in physical exercise, and controlling sleep patterns. This approach makes sense and is based on simple observations. Consequently, therapeutics are classified into Brahmana and Langana based on this theory.
The utility of the Tridosha theory:
However, this theory does have limitations. Before discussing these limitations, let’s address the utility of the Tridosha theory. It is undoubtedly important. Tridosha and their associated attributes are used to identify and classify clinical symptoms. For instance, itching is attributed to Kapha, edema is due to Kapha, pain is associated with Vata, and burning is due to Pitta. This classification facilitates quick clinical decision-making. Additionally, populations can be classified into different groups based on Tridosha theory, which may have some predictive and preventive value. Classification of people into different Prakriti groups has been studied, and there are indications of possible associations with gene distribution and expression—a field evolving into Ayurgenomics. While these studies are not definitive, they suggest some possibilities. Specific medicinal plants are also helpful in treating diseases associated with a particular dosha. For example, Nirgundi is known to balance Vata, and Ushira is known to balance Pitta,Guggulu kaphahara helping physicians choose the appropriate drug. Thus, Tridosha theory is useful in clinical practice to a certain extent.
Deficiency: Gross generalization
Now, regarding the limitations: the problem with Tridosha theory is that it involves a phenomenon known as gross generalization. Tridosha logic is insufficient for diagnosing complex diseases, unlike conditions such as obesity or malnourishment, where it is quite useful. Even obesity itself can have multiple causes. For example, excessive Pitta produces excess heat in the body, but fever can arise from numerous conditions such as infections, hyperthyroidism, cancers, autoimmune disorders, and more. Fever can be a symptom or sign of these diverse conditions, and Tridosha theory falls short in explaining this complexity. The theory’s tendency to generalize can lead to oversimplification, such as attributing all fever to increased Pitta.
Deficiency: Pathophysiology
Additionally, Ayurvedic textbooks lack a description of the role of the pancreas in metabolism. Conditions manifesting with polyuria are categorized under Prameha, Prabhuta, Avila, Mutrata, and this definition of Prameha does not adequately address the pathophysiology of diabetes. Moreover, no endocrine disease has a correct pathological basis as described in Ayurvedic texts. While some scholars argue that Ashta Mahagada or Ashta Nindita Purusha might represent clinical endocrinology, this view is an oversimplification. These manifestations could be due to endocrine disorders, but they might also arise from genetic problems or other issues. Tridosha theory is insufficient for explaining these complexities, and it is important to acknowledge and teach these limitations to students. This is crucial in the current educational context.
