Article by Dr Raghuram Y.S. MD (Ay) & Dr Manasa S, B.A.M.S

Shodhana, which is the best treatment approach in Ayurveda which includes expulsion of morbid doshas from the body, is the foundation for eradication of diseases from their root and also to prevent their recurrence. Disease modifying medicines, diet, Rasayanas and Vajikarana therapies work on the basis of how much and how best the exaggerated doshas are expelled from the body. Shodhana also expels the unnecessary things from the system including the malas and also breaks the greater and smaller blocks in the channels of the body.

Shodhana is the ultimate weapon for destroying chronic and stubborn diseases, to reestablish health and enhance immunity.

But the same shodhana is contraindicated in expelling Sama Doshas.

But why?

This is exactly what we are discussing in this article.

But before this, we need to know what Sama Dosha is!

Among different states of doshas, Sama Dosha and Nirama Dosha are two important states.

Sama Dosha

Sama dosha is a state wherein a dosha is associated with ama. Ama is an intermediate substance of metabolism which is formed due to improper digestion of food in the stomach due to sluggishness (weakness) of digestive fire. Ama is an improperly processed sticky substance which can stick to the inner walls of any channel of the body and cause blocks therein. When ama gets associated with dosha, the dosha too will lose its freedom of movement and would get stuck or adhered to the inner walls of the channels, including the minutest cells, or small channels like blood vessels or larger channels like gut etc. Such sama doshas are responsible for causation of many diseases.

When ama is detached from its association with dosha, it is called Nirama Dosha. This is still a pathological state and the dosha should be addressed.

Ayurveda says that this sama dosha should not be expelled from the body by administration of shodhana i.e. cleansing therapies, be it vamana or virechana or vasti.

Let us see what Acharya Vagbhata has to say about this.

Ref – A.Hr.Su.13/28, 29

Sama Doshas should not be expelled by administering Shodana

सर्वदेहप्रविसृतान् सामान् दोषान् न निर्हरेत्।
लीनान् धातुष्वनुत्क्लिष्टान् फलादामाद्रसानिव॥२८॥
आश्रयस्य हि नाशाय ते स्युर्दुर्निर्हरत्वतः।

The sama doshas which have spread all over the body will come into contact with one or more of the tissues. These sama doshas would get into the tissues and remain hidden therein by adhering to the tissues. Since the doshas are sticky in nature now, due to their association with ama, they would not move out of their places of accumulation i.e. tissues, being adhered therein.

These doshas which have adhered and are lurking within the tissues, should not be forcibly removed. The physician should not make any attempt to remove these doshas through purificatory measures / Panchakarma therapies like emesis, purgation etc. Actually, it is also very difficult to expel these doshas out.

Acharya Vagbhata explains this with an analogy. When one attempts to extract the juice from an unripe fruit, it does not yield any juice but on the other hand, those attempts will definitely destroy the fruit.

Similarly, if the sama doshas are tried to forcibly expelled out, they will not be expelled (just like the juice cannot be extracted by force from an unripe fruit) but will in turn destroy its place of dwelling i.e. the tissues / human body (just like the method of extraction of juice would destroy the fruit). This happens because we are trying to force the sama doshas sticking to the body (tissues) out by administering shodhana.

In this analogy,

–        Body / tissue = unripe fruit
–        Sama doshas = juice of unripe fruit
–        Shodhana = forcible extraction of juice
–        Destruction of body = destruction of fruit

Seeing it the other way, juice can be extracted from the ripe fruit. So, we need to wait for the ripening.

Similarly, we need to wait for the ripening of immature doshas i.e. sama doshas. The doshas would ripen once the ama is separated from them. This can be achieved by ama pachana and swedana. Once ama is separated and destroyed, the doshas are no longer adhering to the tissues. Now these doshas can be pulled towards the koshta i.e. gut and expelled by administration of shodhana.

So, a wise physician should never expel the sama doshas from the body.