Defining ‘Health’ Part II: The Ayurvedic Definition

Today we continue from where we left in Part 1, to see how Ayurveda frames an all-round definition of ‘Health’ comparable to the modern ones we saw in Part 1. (A small disclaimer first, this will be a bit boringly technical article about Ayurveda, as compared to our usual stuff.)

Before we delve into pure Ayurveda:
To sum up what we saw in the first part, a well-rounded definition of Health should include the following features –

  • Absence of disease or infirmity
  • Stable interface with external environmental stimuli
  • Internal stable metabolic state
  • Mental and social wellbeing
  • Normal functioning of all body organs
  • Spiritual wellbeing
  • Ability to lead a productive life

So how does Ayurveda cover all this?

‘Health’ (स्वास्थ्य) is defined in Sushrut Samhita as follows,

समदोष: समाग्निश्च समधातुमलक्रियः।

प्रसन्नात्मेन्द्रियमनस: स्वस्थ इत्यभिधीयते ।।

– S.S.15/41

Word-by-word Translation and Commentary:

‘One whose Doshas are in a natural balanced state’

As regular readers already know, Ayurveda follows a three-bioelements (Doshas) based model in which each bioelement (Dosha) is a broad abstraction of several body constituents/functions. For example, Pitta represents hormones, enzymes, digestive juices etc., Vaata represents peripheral neurons, neuromuscular junctions, bones’ lamellar network that contains bone-marrow etc., and so on.
So balanced Doshas essentially point to homeostasis (a stable state of equilibrium maintained by automatically neutralising any abnormal phenomena) in the body. Conversely, imbalanced Doshas indicate pathology or ‘disease’ as we call it. In fact, Ayurveda defines ‘Disease’ as ‘an imbalance in Doshas caused by pathological stimulus’.

रोगस्तु दोषवैषम्य ।     – A.H.S.1/20
‘Disease is nothing but imbalance of Doshas’.

This imbalance can be of two types depending on its causative source. It may be caused by internal cause (hormonal imbalance, autoimmune response etc.) or external cause (bacterial infection, trauma wound etc.).
द्विविधास्तु व्याधयः, निज आगंतुश्च।    

Disease is thus classified in Ayurveda, on this basis of source stimulus as Nija (internal source) and Aagantu (external source). The Dosha status thus becomes the key indicator for the body’s stable interface with the environment.

‘One whose Agni is in a natural balanced state’

Agni is a key concept in Ayurveda, which means ‘the capacity of the body to transform one form of energy into another’. Energy is consistently transformed amongst various forms during human activity. For example, when food is digested, the chemical energy in the food gets transformed into various forms like glucose, glucagon, ATP etc. in the body. This energy subsequently gets converted into mechanical and heat energy during limb movements. Based on the input and output products of the transformation, Agni is classified into 13 variants. Broadly speaking, the almost corresponding modern scientific term for ‘Agni’ would be ‘Metabolism‘, but in popular perception, Agni is often mistaken with ‘Jatharagni‘ or the so-called ‘digestive fire‘, since Jatharagni is its commonest variant that is also shorthanded as ‘Agni’ sometimes.

To summarize, with a balanced Agni, here we have a balanced metabolism included as an essential ingredient of good ‘health’.

‘One who has normal activity of all Dhatus and Malas’

Dhatu refers to functional types of tissues in Ayurveda, viz. blood, muscles, adipose tissue, bones, bone marrow, sperm/ova etc., and Mala means excretory products, macro- and microscopic, right from stools, urine and sweat to cellular waste products.
Their activity collectively aggregates to become the activity of various physiological organ systems of the body, viz., Mamsa Dhatu (muscle tissue) and Asthi Dhatu (bone tissue) makes up the locomotor system, Ras Dhatu (lymph/serum) and Rakta Dhatu (Cellular Blood components) together make up the circulatory system and so on. Thus, the activity of Dhatus and Malas is a pointer to normalcy in physiological functions and a normal productive life in general.

‘One with a bright and clear soul, sensory organs and mind’

This part largely covers the mental spiritual and social angle of Health. It is very notable that the forefathers of Ayurveda have clearly distinguished and defined mind, body and soul as three separate but largely inter-related entities, and delineated a complete sub-faculty for psychiatry (Bhootvidya) in the earliest treatises. 
In the Bhootvidya physiological model, the Atman (‘soul’) that is impenetrable to any Doshas, controls the physical body through the agency of Manas (the ‘mind’ or ‘super-sensory organ’), which supervises all other senses and cognition, and acts as the steward for the brain. Mental illness (and in turn, social/spiritual ill-being) is described to arise when the Manas becomes tainted by the mental Doshas due to some unbalancing pathological stimulus, causing the Atman’s judgement to go wrong in action. So again, treatment that balances out the Doshas makes the mind stable again, which in turn restores the smooth flow of cognition.
Unfortunately, the word ‘Bhoot Graha’ meaning ‘manifestation of mental illness’ came to be equated with ‘Ghost/demon’ in the later ages, and superstitions took up the place of scientific perspective. Nevertheless, even today Ayurvedic texts describe the clinical picture and management protocols for a variety of mental health conditions, although the specialty as such is not practised much.

स्वस्थ इत्यभिधीयते ।।
‘is termed as having good health.’

And that rounds it all up. 

‘One whose Doshas are in a natural balanced state, 

One who has normal activity of all Dhatus and Malas,

One with a bright and clear soul, sensory organs and mind,

is termed as having good health.’

So this was the definition of ‘Health’ that Acharya Sushrut framed about 2,000 years before any of the various modern definitions we saw in the first part of this article. It is a very sad end however, that the subsequent discredition of the Tri-Dosha theory by modern science (which itself is being re-examined now) led to a blanket apathy towards the comprehensive holistic approach and farsightedness of this legendary surgeon. His surgical knowledge which was millennia ahead of his times, too would merit a complete separate article to do justice to it but not today. Someday later maybe.
For now, we conclude this article leaving the comments box open for discussions as usual. See you again. Till then,
Stay Healthy, stay Happy!

About the Author
Dr. Harshad Rajandekar is a practising physician based out of Nasik, India. He holds an Ayurvedacharya degree from MUHS-N, and is licensed to practise Ayurvedic and modern systems of medicine in the state of Maharashtra. He can be reached here for a consultation.


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