Koshtha in Ayurveda

कोष्ठ:

कोष्ठः क्रूरो मृदुमध्यो मध्यः स्यात्तैः समैरपि ।
कोष्ठ — वायु के कारण मनुष्य का कोष्ठ क्रूर होता है; पित्त के कारण मृदु और कफ के कारण मध्यम होता है। वात- पित्त-कफ की समानता से भी मध्यम कोष्ठ होता है ।
वक्तव्य—सुश्रुत में मृदु, मध्यम और क्रूर तीन कोष्ठ बताये हैं, यथा- ‘तत्र मृदुः क्रूरो, मध्यम इति त्रिविधः कोष्ठो भवति । तत्र बहुपित्तो मृदुः, स दुग्धेनापि विरेच्यते, बहुवातश्लेष्मा क्रूरः स दुविरेच्यः; समदोषो मध्यमः, स साधारण: ।’ इसमें
कफ को योगवाही माना है, यथा- ‘वातोल्वणा स्याद् ग्रहणी, क्रूरकोष्ठस्य देहिनः । पित्तला मृदुकोष्ठस्य योगवाही तयोः कफः ।। वात-कफ से क्रूर; वात-पित्त या कफ-पित्त अथवा वात-पित्त-कफ से मृदु कोष्ठ होता है। सुश्रुत ने वात-कफ की अधिकता से जो क्रूरकोष्ठ कहा है; वह संसर्गपरक है; ऐसा हेमाद्रि का मत है ।

 

 

According to Ayurveda, the human body is composed of four basics – the Dosha, Dhatu, Mala and Agni. There is immense significance of all these basics of the body in Ayurveda. So, is the Koshtha. The term Koshtha refers to the digestive tract or the motility of the intestines and movement of food, faecal matter and its expulsion. Koshtha is included in Abhyantara Rogamarga. It is of three types: Krura, Mridu and Madhya in which dominance of one of the Dosha is seen. Koshtha Pariksha is important for diagnosis and treatment of diseases. Koshtha Pariksha helps in selection of Aushadhi and Aushadhimatra.

Types of Koshtha based on the predominance of Dosha

Koshtha is of three types:

1. Mridu

2. Krura

3. Madhyama

According to Acharya Sushruta

1. Mridu Koshtha – Pitta is dominant.

2. Krura Koshtha – Vata and Kapha is dominant.

3. Madhyama Koshtha – Sama Dosha.

According to Acharya Charaka

1. Mridu Koshtha – Pitta Prabala, Kapha Nyuna and Vata Manda

2. Krura Koshtha – Excessive Vata

3. Madhyama Koshtha – Kapha Pradhana

4. Sadharana (Samavastha)

Krura Koshtha: There is predominant Vata, increase in Vata produces hard faeces with difficulty in emptying of bowel. Koshtha is dominated mainly by Ruksha Guna of Vata leads to hard bowel. Hence, in Krura Koshtha, absorption will be poor.

Mridu Koshtha: Predominance or increase of Pitta causes watery or semisolid feces, moving out more than once or twice, in a day. The fast movement in bowel is due to Sara, Drava and Tikshna Guna of Pitta Dosha. Here, also absorption will be poor.

Madhyama Koshtha: Predominance or increase of Kapha causes soft, solid feces moving out smoothly. In Madhyama Koshtha, there will be predominance of Snigdha, Guru and Sthira Guna. There will be optimum absorption.

Importance of Koshtha:

1. We can observe the Prakriti by the Kostha Pariksha because Vata Prakriti Purusha has Krura Koshtha, Pitta Prakriti Purusha has Mrudu Koshtha and Kapha Prakriti Purusha has Madhyama Koshtha.

2. According to Koshtha, we can decide suitable drug for Chikitsa. If patient can get Virechana with Kshira, Aaragwadha, Ikshu, Takra, Mastu, Guda, Krushara, Nava-Madhya, Ushnodak, Draksha, then we can guess that there is Pitta-Bahulta this Koshta will be Mrudu. If patient can get Virechana with Shama, Kushtha, Triphala, Sudhathan we can guess that there is Vata-Bahulta then this Koshtha will be.

3. Koshtha is important to decide Aushadhi Dravyas and Aushadhi Matra. E.g. Mrudu Koshtha persons require Soumya Aushadhi in minimum dose. Krura Koshtha require Teekshna Aushadhi in large dose.

4. Koshtha Pariksha also helps to understand the Ahara Vihara.

5. Before Shodhana Karma, Snehapana is one of Snehadravya and Sneha Matra can be decided by Koshtha Pariksha.

6. Koshtha and Shodhana Chikitsa: Basti, Virechana and Vamana are main Shodhana Chikitsa in Ayurveda for Dosha Nirharana. So, there is indication of Basti, Virechana and Vamana karma subsequently for Krura, Mridu and Madhyama Koshtha because of Vata, Pitta and Kapha

7. To find out either disease is Koshthagata or Shakhagata or Madhyama.