6 Stages of Disease

VPK are further sub-divided into 5 sub-doshas with each of it having their seat or natural location within the body. According to Ayurveda, a disease process is said to undergo 6 stages and can be identified by the movement of either the main or sub- doshas from their original location within the body. In the first 4 stages of disease the doshas are only moving out of their original location and entrenching itself in another part of the body. It is only at the 5th stage does the disease manifest (Viyadi) as clinical symptoms and at the 6th stage the complication or variation of disease is classified (Bheda). It is for this reason that an Ayurvedic Physician is able to locate the “seed” of a disease long before the clinical symptoms appear. Ayurveda is strongly based on the principle of identifying the “Root Cause” of the problem.

Each disease is also classified as Vata, Pitta or Kapaha types of diseases and treated and managed accordingly. For example Diabetes is referred to as Madhumeha in Ayurveda and there are altogether 20 types of Madhumeha (Diabetes) in Ayurveda each having is Vata dominance, Pitta dominance and Kapha dominance. Each of it has to be treated and managed differently and for this reason a “one-solution-fits-all” approach will not work for Ayurveda.

Therefore, every human (including plants, animals, minerals etc) has a combination of all five States (PMB) classified into three doshas (VPK) and this combination of VPK is determined at birth and is known as a person’s Prakriti (person’s constitution). When a person lives in harmony with his Prakruti and the environment by following a proper diet and lifestyle, that person will remain healthy.

However when one deviates from his original Prakriti (either through nutrition or lifestyle) it leads to a disease state which vitiates the doshas and is called Vikriti. This does not change a person’s Prakruti as Prakruti is unchangeable. The lifestyle choices such as food, sleep, daily activities, thoughts etc play a major role in either balancing or aggravating our doshas in the body.

Furthermore, every aspect of our environment has VPK in terms of attributes. For example, if the weather is cold and dry like winter, Vata is said to be pre-dominant. If the weather is hot, Pitta is dominating the environment and rainy / wet season has kapha pre-dominance. Even in our lifespan VPK has its own pre-dominance. During early childhood till teenage, Kapha is predominant where the cells anabolic rate is greater than the catabolic rate and that is why, a baby grows and heals quickly. During teenage till middle-age Pitta is dominant and for this reason we see alot of teenage suffering from pimples, gastritis etc. In old age, Vata is dominant and catabolic rate is greater than the anabolic rate thereby leading to decaying body. Knowing the interplay of PMB through VPK will help one to maintain the doshas in balance. Even in a daily cycle there is

predominance of VPK at different times and therefore a Daily Routine to balance the doshas is prescribed by Ayurveda as a Preventive Medicine which I will discuss in my final article.

It is for all these reasons that Ayurveda advocates the balance of doshas (VPK) as the primary method of healthcare and preventive medicine. Only when the doshas are balanced can the other aspect (digestion, tissues etc) be balanced. An imbalanced dosha leads to disease. It is also for this reason that a customised approach is advocated in Ayurveda. Appreciating the PMB through VPK will help not only the Ayurvedic physician but allow each individual to understand one’s own body and design one’s own diet and lifestyle plans.

In my next article, I will explain the second aspect of Ayurveda’s definition of health which deals with the digestion (agni) and tissues (dhatu) and excretion (mala) and how they are made up of the all encompassing PMB and why understanding them through the eyes of PMB is equally vital for health.


Vasanthi Pillay is the President and Founder of the Ayurveda Association of Singapore (AAOS) and the Director of Innergy Ayurveda and Yoga Pte Ltd and the Yoga Ayurveda Institute (YAI). She conducts several Trainings and Workshops on Ayurveda in Singapore and Asia to help people understand the fundamental principles of Ayurveda so that they can apply the principles as a preventive medicine for their families and themselves. Vasanthi works with 2 large conventional hospitals in Taiwan in assisting them with training and integrating Ayurveda and Yoga into the healthcare system. She is also working with Montessori Schools in China and Taiwan in educating the parents and teachers in incorporating a holistic diet and lifestyle program for parent-child education. Vasanthi who has worked in a highly stressful corporate world, developed a keen interest in mind-body relationship. This prompted her to take up her Yoga Instructor Course in Bangalore India in 1995 and several Ayurveda Courses. Vasanthi also holds a Bachelor of Arts (NUS) majoring in Philosophy, Post Graduate Diploma in Business Administration (SIM) and Post Graduate Diploma in Banking and Finance (UNSW, Australia). Vasanthi’s collaborates with M S Ramaiah Indic Centre for Ayurveda and Integrative Medicine (Bangalore) to offer certificate programs on Ayurveda and Yoga.