According to Ayurveda, illness is the end result of a long process that can be detected and addressed at any stage. This process has been thoroughly studied and its phases delineated in great detail.
The disease process begins with disturbances in the balance of the doshas. Temporary imbalances are common and quite normal; problems arise if the aggravated condition is not corrected. In the normal course of events, vata, pitta, and kapha go through cycles of change in three stages: accumulation, provocation or aggravation, and pacification. Pitta, for example, begins to build up and accumulate in the late spring. It is provoked or aggravated in the hot summer months, and it naturally becomes pacified when the weather cools down in the autumn.
If the increased dosha isn’t pacified naturally through a change in seasons, it undergoes further changes and disease may result. If a person with a predominantly vata constitution experiences some degree of increased vata in the fall due to the cool, dry, windy weather, but it returns to normal soon after, disease will not develop. The person can aid the process of restoring balance, for example, by eating moist, warming foods and dressing warmly in the windy weather.
How to Transform Negative Feelings
Negative feelings can cause hurt both to ourselves and to others. If we express anger or criticism, for example, we inflict pain on someone else. On the other hand, repressing such feelings creates problems for ourselves, as the stressful biochemistry affects the internal organs and systems down to the cellular level.
If both expressing and holding back negative feelings can be harmful, what shall we do when these emotions boil up in us? Ayurveda offers a way to learn from such situations and resolve them in a positive manner.
At the moment the feeling comes up, look into it. Let’s suppose it is a feeling of anger. Take a long, deep breath, let yourself feel the anger, and exhale it out. Give the feeling total freedom to express itself within you, so that you look at it honestly and feel it. Breathe into it, surrender to it, and be with it. Breathe into it, and breathe out. Soon it will dissolve by itself.
You have to be aware not only of the external thing—what your spouse or friend is saying—but at the same time you have to bring awareness to your inner self. When awareness goes both ways, outer and inner, understanding is total. This approach doesn’t put a scar on the mind.
Look at the feeling—any feeling or emotion—without labeling it or naming it. Then the observer and the observed become one. Observe with total awareness, with no division between subject and object, no separation between yourself and the feeling. Give freedom to the feeling; let it flower; let it fade away.
If the condition of aggravated vata continues, vata will move into the general circulation and into the deep connective tissue, where it will generate pathological changes. Disease will develop. Imbalance is disorder, and disorder is disease.
Disease is like a child. It has its own creation within the womb of the body, according to a process known as samprapti or pathogenesis, literally “the birth of pain.” In brief, this is how it happens:
Due to various causes, such as diet, weather, seasons, emotions, and others we have discussed, the doshas begin to accumulate in their respective sites: vata in the colon, pitta in the intestines, and kapha in the stomach. This is the easiest stage at which to treat any incipient health problem. A trained Ayurvedic physician can feel the imbalance in your pulse even at this stage, and you may be able to detect it yourself.
Vata accumulation may be experienced as constipation, abdominal distension, or gases in the colon. Pitta buildup may be felt as heat around the belly button area and can be observed as a slightly yellowish discoloration in the whites of the eyes, or dark yellow-colored urine. The person will be very hungry and will crave candy and sugar. Accumulated kapha leads to feelings of heaviness, lethargy, and loss of appetite.
At this stage the individual is still quite healthy, and when a dosha starts to build up, the body’s intelligence creates an aversion to the causal factor and a craving for opposite qualities, which can restore balance. For example, if you’ve eaten ice cream three days in a row and kapha is building up, the thought of more ice cream will not be appealing; rather, your body will crave cayenne pepper or other spicy food to burn up the kapha and counteract it. One should listen to this wisdom and not continue increasing the cause.
The accumulated dosha continues to build up in its own site. The stomach gets brimmed up with kapha, the intestines fill with pitta, or the colon overflows with vata. These accumulated doshas then try to move from their sites. Kapha tries to go up into the lungs, pitta tries to move into the stomach and gallbladder, and vata tries to move into the flanks.
You can feel this stage, too. For example, if you eat too much kapha food on Saturday night, you might feel full when you wake up on Sunday and think to yourself, “Maybe I should fast or eat very lightly today.” But then someone invites you out for Sunday brunch, and you eat heavily again. The next day you might get a cough or a feeling of congestion in the lungs as the kapha starts to move upward. Excess pitta in the second stage may cause heartburn or acid indigestion, even nausea. Vata rising up may cause pain in the flanks or midback, or even breathlessness.
According to Ayurvedic therapeutics, the disease process can be addressed at any stage, but specific treatments are needed for specific stages. In these first two stages, one can reverse the process by oneself, using common sense to apply the principle of opposite qualities, and taking some home remedies. Once the disease process has gone beyond the gastrointestinal tract and entered the third phase, it is no longer under one’s own control, and trained medical help is needed.
The dosha begins to spread from its place of origin, overflowing into the bloodstream and the general circulation of the body, “looking” for a place to enter. Here the disease process has progressed to the point where eliminating the causal factor will not be enough. A panchakarma purification program (or a similar cleansing regimen) is needed in order to return the doshas to their respective sites in the gastrointestinal tract so they can be excreted from the body.
Ama, Agni, and the Disease Process
The body’s biological fire, which governs the transformation of matter into energy, is of thirteen major types. The central fire, called jatharagni, governs the digestion and assimilation of food. The other agnis (the fire component in the cells, tissues, and organs) perform the local process of digestion and nutrition. When agni is robust and healthy, then whatever a person eats, the system digests, assimilates, and absorbs it, then eliminates the impurities. But when the doshas are aggravated because of poor diet, an unhealthy lifestyle, or negative emotions, they first affect agni, which becomes unbalanced. When agni becomes weakened or disturbed, food is not properly digested.
The undigested, unabsorbed food particles accumulate in the gastrointestinal tract and other subtle sites in the body and turn into a toxic, sticky, foul-smelling substance called ama. (Ama may also be formed by bacterial invasion and cellular metabolic waste.) In the third (“spread”) stage of the disease process, ama overflows from its site of origin to other bodily channels such as the blood vessels, capillaries, and lymphatics, and clogs the channels and the cell membranes.
When these molecules of ama clog the channels, the cellular intelligence (prana) which is constantly flowing between the cells gets blocked, and some cells become isolated. An isolated cell is a lonely cell, and a lonely cell is a confused cell. Pathological changes begin to occur. But the root cause of cytopathological changes is the movement of these molecules of ama. So the ama has to be eliminated from the body by panchakarma or other means.
4. DEPOSITION OR INFILTRATION
The aggravated dosha enters an organ, tissue, or system that is weak or defective, due to previous trauma, genetic predisposition, accumulated emotional stress, repressed emotions, or other factors. These weak areas in the body can be described as negative locations, like potholes in the road. Smoking cigarettes, for example, creates weakness in the lungs; eating too much sugar creates weakness in the pancreas and blood tissue, and so on.
The newly arrived, aggravated humor (dosha) creates confusion within the cellular intelligence of the weaker tissue and overwhelms it, changing its normal qualities and functions. The quality of the aggravated dosha suppresses the normal qualities of the tissue and combines with it, creating an altered state, changed in structure and function. In this way, the “seeds” of disease begin to sprout.
Up to this point, the disease has not appeared on the surface, but it can be detected by a skilled physician or recognized by imbalances in the doshas such as those mentioned above. An alert person can feel subtle changes in the body. If the condition is not interrupted at this stage, it will erupt as a full-blown disease.
In this stage, qualitative changes become apparent. The signs and symptoms of an actual disease appear on the surface; the person becomes sick. Whether in the lungs, kidneys, liver, joints, heart, brain, or wherever, the seeds of disease now sprout and begin to manifest in the area of the defective tissue.
6. CELLULAR DEFORMITY LEADING TO STRUCTURAL DISTORTION
Now the pathological process is fully developed and the disease completely manifested. Structural changes appear, and complications of other organs, tissues, or systems become evident. This is also the stage it which the disease, now fully developed, is therefore most difficult to treat.
In the fifth stage, for example, when aggravated pitta dosha is invading the wall of the stomach, it may manifest as an ulcer. But in the sixth stage, the pitta will perforate the ulcer and cause hemorrhaging, or it may provoke a tumor. Function begins to be disturbed in the fifth stage, but here the structure of the tissue is affected, as well as the surrounding tissues and systems.
Obviously, treatment—restoration of balance and normal functioning—is far easier at earlier stages. That is why prevention is emphasized so strongly in Ayurveda. It is much more effective to treat the illness in its seed stage, before it sprouts and grows.
Both health and disease are processes. Disease is a process of abnormal movement of the doshas, while health is a process of their normal functioning. The wise person understands that the normal rhythm and quality of the process can be reestablished by changing diet and lifestyle and avoiding the etiological factors that cause disease.
The key is awareness. The more you are alert to how your mind, body, and emotions are reacting to changing circumstances; the more you are aware of your constitution and the moment-to-moment choices you can make to maintain health, the less opportunity you create for becoming sick.
SAMPRAPTI (PATHOGENESIS): THE SIX STAGES OF THE DISEASE PROCESS
Source Credits: The Complete Book of Ayurvedic – Vasant Lad, M.A.Sc, Published by Harmony Books, 1998