Clinical Significance of Depleted Doṣa in Doṣavaiśāmya: A Classical Ayurvedic Review

Abstract

Introduction: Doṣavaiśāmya, the deviation of Vāta, Pitta, and Kapha from their physiological equilibrium, is a foundational concept in Ayurvedic pathology. While doṣavṛddhi is widely recognized for its direct pathogenic potential, the clinical implications of doṣakṣaya are less emphasized in classical and contemporary discourse. This review aims to elucidate the physiological, pathological, and therapeutic significance of depleted doṣa states within the framework of Ayurvedic diagnostics and treatment decision-making.

Methods: A classical textual review was conducted using primary Ayurvedic sources including Caraka Saṃhitā, Suśruta Saṃhitā, and Aṣṭāṅga Hṛdaya, along with their authoritative commentaries. The review focuses on doṣavṛddhi, doṣakṣaya, digestive physiology, treatment principles, and disease-specific therapeutic guidelines. The clinical significance of depleted doṣa is analysed to interpret how depleted doṣas influence physiological outcomes and therapeutic response.

Results: Analysis revealed that doṣakṣaya, though not independently pathogenic, significantly modulates doṣa dynamics and therapeutic suitability. Mṛdu koṣṭha is observed as a physiological response arising from relative depletion of Vāta and Kapha with Pitta predominance, influencing the action of mild laxatives. Doṣakṣaya was found to facilitate dominance of the remaining doṣas in the context of Kapha-kṣaya and pathological conditions like atyagni. Understanding depleted doṣa conditions plays a promising role in the administration of therapeutic substances like ghṛta in jvara vyādhi. The clinical understanding of doṣakṣaya is important in treatment selection, sequencing, and prediction of therapeutic outcomes.

Discussion & Conclusion: Doṣakṣaya plays a decisive yet under-recognized role in current Ayurvedic diagnosis and therapeutics. Identifying depleted doṣas is essential for maintaining homeostasis, selecting appropriate interventions, preventing doṣa aggravation, and optimizing treatment efficacy. Incorporating the assessment of doṣa depletion into clinical practice can enhance precision and improve patient outcomes in Ayurveda.