Pitta dosha (पित्तम् पित्तदोषः वा)

“Pitta” (पित्तम्) literally translates to “bile” or “bilious humor. It is one of three doshas (दोषाः) that are the primary foundations of Ayurveda and more specifically one of the fundamental and unique entities in the understanding of Ayurvedic anatomy, physiology, pathology and etc. Doshas are also known as bio-energies controlling the functioning of the entire body. Some consider Pitta to be equivalent to the bile described in western science, but its properties, its physiology in sharira (शरीरम्) are peculiar and distinct and must be understood from the Ayurvedic point of view. Pitta is known as “heat” in general which is originated from the “agni” mahabhuta (अग्निमहाभूतम्). Thus Pitta represnts the Fire element inside the body which chiefly performs the function of transformation in the body. Along with other doshas, dhatus (धातवः)(tissues) and malas (मलाः), Pitta dosha carries out various other functions as well e.g. vision, skin color generation, generation of hunger, thirst and intelligence etc. Among all these functions, Digestion of food along with maintenance of body temperature is the most important function of the Pitta.

निरुक्तिः॥ Etymology

The word Pitta is derived from the root as below,

‘तप’ सन्तापे | (sush. sutr. 21.5)

Here the root word is “Tapa” (तपस्) which means to generate heat or to burn.

“Santape" (संतापे) literally means to torment, this explains the feature of pitta as that which generates extreme heat.

पित्तदोषस्थानानि॥ Sites of Pitta dosha

Even though the doshas are present all over the body, there are certain sites where there is a predominance of each dosha. Pitta dosha is generally present in the middle region of the sharira, between hriday (हृदयम् | heart) and naabhi (umbilicus).

नाभिरामाशयः स्वेदो लसीका रुधिरं रसः| दृक् स्पर्शनं च पित्तस्य, नाभिरत्र विशेषतः||२|| (Asht. Hrud. 12.2)

Meaning: Pitta is situated in Naabhi(umbilicus), amashaya(stomach precisely), sweda(sweat), lasika(lymph), rasa(correlated loosely as plasma), rudhira(blood), drik(eyes), tvacha(skin). More specifically Nabhi is the chief site of Pitta.

पित्तस्य पाञ्चभौतिकत्वम् ॥ Panchabhuta composition

All the living and non-living entities (matter in the universe) has evolved from or made up of Panchamahabhutas (पञ्चमहाभूतानि). Teja Mahabhuta (तेज महाभूतम्) or Agni mahabhuta (अग्नि महाभूतम्) which literally means the fire element , is predominant in the Pitta dosha. Thus, Pitta dosha originated from the Teja mahabhuta.

अग्निपित्तयोः आश्रयाश्रयीभावः ॥ Relationship between Pitta and Agni

Pitta dosha and Agni Mahabhuta have Ashraya-ashrayi bhava (आश्रय-आश्रयीभावः) which is a unique Ayurvedic concept that precisely states the interdependency of these two separate entities. The word Ashraya means that which “depends on” and Ashrayi means that which is “the dependent”.

Agni is present in our body in the form of pitta dosha, thus Agni works in our sharira through pitta dosha.

Agni and Pitta dosha perform similar functions like Dahana (दहनम् । digestion), Pachana(पाचनम्), and abhipravartana (अभिप्रवर्तनम् । transformation). Both of these when vitiated are managed with sheeta dravya (शीतद्रव्यम् | coolant drugs) or karma ( कर्म । procedures with cooling properties). Although there are certain similarities as well. For instance, Ghrita or ghee is excellent to pacify the aggravated Pitta dosha, but at the same time ghee is used to kindle or increase the digestive fire i.e. agni. Even though they are interdependent in certain ways, while describing “swasthya” (स्वास्थ्यम्) or complete health, they are described as separate entities stating “samadosha” (समदोषः) “Sama Agni” (समाग्निः) which means a balanced state of doshas and a balanced state of Agni is required for maintenance of “swasthya. This understanding of interdependency between the two separate entities is essential for a better understanding of the disease manifestation and prognosis which helps in the planning of management.

पित्त-इन्द्रियसंबंधः ॥ Association with Indriya

Indriyas (इन्द्रियाणि) are the sensory & motor organs through which knowledge is perceived and response in generated. ‘Indra” which means “atman (आत्मन्)” or soul experiences this knowledge. There are five sense organs “Chakshu”(चक्षु । Vision), Shrotra (श्रोत्रम्। Auditory), ghrana (घ्राणम्। olfactory), rasana (रसना । gustatory) and  Sparshana(स्पर्शनम् । tactile). Among these 5 sensory organs, Chakshu (Eye) and Sparshana / Twak (Skin) are the 2 organs where Pitta predominantly resides and controls the functions or these organs.

1. Chakshurendriya (चक्षुरेन्द्रियम्) - The eye is the seat of type of pitta known as Alochaka pitta and is responsible for the visual perception.
2. Sparshanendriya (स्पर्शनेन्द्रियम्) - Twak or skin is the seat of type of pitta known as Bhrajaka Pitta and is responsible for the maintenance of body temperature, provides luster to the skin, and helps in the sensation of touch.

पित्तगुणाः॥ Attributes

Pitta dosha has a set of peculiar properties known as Gunas in Ayurveda, that makes it able to perform certain functions in the body. Following are the properties of pitta described by Charaka, Sushruta and Vagbhata in their treatises,

1. सस्नेहम् । Sasneha - slightly Unctousness or oiliness  
2. तीक्ष्णम् । Tikshna - Teekshna means the Sharpness or the penetrating property of pitta dosha
3. उष्णम् । Ushna -Ushna or Hot or to generate heat. The maintenance of body temperature which is one of the functions of Pitta dosha is because of this quality.
4. लघुः । Laghu -Laghu means Lightness that is present in Pitta dosha due to its origin in Teja Mahabhuta. This property is essential for a physician while prescribing treatment.
5. विस्रम् । Vistra -pitta dosha in its natural form has a bad Odour.
6. सरम्। Sara - Sara means mobility, the property which is unstable in nature and has the capacity to put things in motion.
7. द्रवम् । Drava- Drava means Fluidity or liquidity which explains the form of pitta dosha.
8. पीतम् । Peeta - Peeta means Yellow, here it directly implies to the color it has, which provides other entities which it comes in contact with.
9. विषदम् । Vishada -Vishada means cleansing property that is related to the Agni mahabhuta. This property stated the cleansing nature of pitta dosha.

The Gunas or the properties of doshas are important for the purpose of diagnosis and treatment of rogas (रोगाः। diseases). The dravyas or the drugs that have properties opposite to the pitta dosha are used for pacifying it and the properties similar to that of pitta dosha cause vitiation.

पित्तदोषस्यकार्यम्॥ Functions

Functions of Pitta dosha in body are multidimensional. Various types of pitta located at various parts of the body perform specific functions as below,

1. दर्शनं । - Vision
2. पक्ति । Pakti - Digestion
3. ऊष्मा | Ushma - heat
4. क्षुत्| Kshut - hunger
5. त्तृष्णा| Trushna -thirst
6. देहमार्दव| Dehamardavam - Soft skin
7. प्रभा | Prabha - lusture
8. प्रसाद| Prasada - cheerfulness
9. मेधा॥ Medha - intelligence
10. धीः। Dhee - power of understanding
11. शौर्यम्। Shaurya - Courage
12. क्रोधम्। Krodha - anger
13. प्राकृतवर्णम् । Prakrut Varna - clear/ normal complexion

पित्तभेदाः ॥ Types

Although Pitta dosha is only a single entity in the whole body, on the basis of its distribution and specific function, the pitta in certain sites has been named differently and these are known as the types of Pitta. There are 5 such types of Pitta and those are described briefly in the table below,

Sr.No	Pitta (पित्तभेदाः)	Sthan (स्थानम्)	्Karyam (कार्यम्)
1	Pachaka (पाचकम्)	Pakva-Amashay Madhya (In the gut Between Pakwashaya i.e. large intestine and Amashaya i.e. stomach)	Digestion Differenciation of waste products and nutrients, supports other types of pitta.
2	Ranjaka (रंजकम्)	Amashaya (stomach)	Imparts colour to body tissues
3	Sadhaka (साधकम्)	Hriday (हृदयम्)	Intellectul power, memory, enthusiasm, self esteem,
4	Alochaka (आलोचकम्)	Drishti (दृष्टिः । eyes)	Visual Perception
5	Bhrajak (भ्राजकम्)	Tvak (त्वक् । skin)	Absorption of oils and etc over skin, provides lusture to skin, maintains body temperature, Skin complexion.

Precisely when these types of pitta and their functions are correlated with modern physiological components it can be said that, the Pachaka Pitta is responsible for digestion, the functions of Ranjaka Pitta can be compared with the hematopoiesis, sadhaka pitta controls emotions and behavior, alochaka pitta is responsible for the perception of the vision and Bhrajaka pitta is responsible for temperature regulation.

पित्तजप्रकृतिलक्षणानि॥ Pittaja Prakriti

Individuals who have dominant pitta dosha naturally in their body are said to be having pitta prakrti (प्रकृतिः). they ususally have some specific morphological features and physiological patterns owing to the dominant pitta in their body which is natural for them. The pitta prakriti people are usually as below,

1. उष्णमुखाः| Ushnamukha - the face is warm
2. सुकुमारावदातगात्राः| Sukumara-avadata gatra - delicate body built and fair in complexion
3. प्रभूतविप्लुव्यङ्गतिलपिडकाः | Prabhutapipluvyangatilpidaka - has plenty of freckles, moles and pimples
4. क्षुत्पिपासावन्तः| kshutpipasavanta - have very good thirst and hunger
5. क्षिप्रवलीपलितखालित्यदोषाः| kshipravalikhalityapalityadosha - early development of wrinkles, greying of hair and hairfall/baldness
6. तैक्ष्ण्यात्तीक्ष्णपराक्रमाः| taikshnyat tikshnaparakrama - due to sharpness in guna(property) the individual is mostly courageous
7. तीक्ष्णाग्नयः - strong digestive fire/digestive power
8. प्रभूताशनपानाः - the quantity of intake of food and water is high
9. क्लेशासहिष्णवो - lack of tolerance towards discomfort
10. द्रवत्वाच्छिथिलमृदुसन्धिमांसाः - loose and flacid muscles, joints
11. प्रभूतसृष्टस्वेदमूत्रपुरीषाश्च - excessive sweating, urination and defecation
12. विस्रत्वात्प्रभूतपूतिकक्षास्यशिरःशरीरगन्धाः - foul odour in armpits, and whole body due to visra property of pitta
13. कट्वम्लत्वादल्पशुक्रव्यवायापत्याः - excess pungency and sourness, low semen and further less number of progeny
14. मध्यबला - moderate stamina and strength
15. मध्यायुषो - moderate life span
16. मध्यज्ञानविज्ञान - moderate knowledge and intelligence.

पित्तदुष्टिहेतवः लक्षणानि च॥ Pathological state of Pitta dosha

पित्तदुष्तिहेतवः॥ Factors affecting pitta dosha

There are certain factors that are responsible for the vitiation and aggravation of Pitta dosha. Change in season, age and etc cannot be avoided, although external factors like diet and lifestyle can be controlled to avoid vitiation of pitta dosha in an individual. Any individual with dominant pitta dosha can avoid the below-mentioned external factors for a balanced state of pitta in the body.

प्राकृतहेतवः॥ Natural Factors

1. Season - Pitta dosha gets naturally accumulated in Varsha rutu (वर्षा ऋतु। monsoon), undergoes the Prakopa stage (vitiation)  in Sharada Rutu( शरद ऋतुः। autumn), and gets pacified in Hemanta rutu (हेमन्त ऋतुः। early winter).
2. Age - Pitta dosha is dominant during middle age (appx 40-60 yrs)
3. Circadian rhythm - Pitta gets vitiated during midday and night.
4. Stage of digestion - During “Jiryateanne‘ (जीर्यते॓॓न्ने । mid-digestion) the pitta dosha is dominant

आहारादिहेतवः॥ External factors

1. Diet and lifestyle - Food that is dominant in Katu (pungent), Amla (sour), and lavana (salty) rasas(tastes) causes aggravation of the pitta dosha
2. Emotional - Krodha(anger), Shoka(grief) and Bhaya (fear) vitiate the pitta dosha and vice versa.

पित्तवृद्धिलक्षणानि॥ Pitta vriddhi Lakshana

The Vitiation of Pitta dosha showcases certain signs and symptoms,  

1. Increases hunger and thirst
2. Burning sensation all over body
3. Loss of sleep
4. Generalized debility
5. Weakness in the senses and inability to focus
6. Low energy levels
7. Craving for cold food
8. A feeling of bitterness in the mouth
9. Giddiness
10. Increased anger
11. Loss of strength

पित्तक्षयलक्षणानि॥ Pitta Kshaya Lakshana

There are certain signs and symptoms when there is decrease in the levels of pitta dosha in the body or the hypo functioning of the pitta dosha causes,

1. Decreased digestive strength thus loss of appetite
2. Loss of skin luster
3. Stiffness in the body
4. Pricking like pain
5. Roughness in the skin
6. Tremors
7. Heaviness in the body
8. White discoloration of nails and eyes

पित्तदुष्टिलक्षणानि॥ Clinical diagnosis

The vitiated pitta even if it is not manifested completely must be diagnosed as Pitta dosha disease and managed as same. even though the symptoms of pitta imbalance vary from the organ afflicted there are certain features for the gross diagnosis,

1. Burning sensation all over body
2. feeling of warmth/ heat
3. Excessive perspiration
4. Increases moisture
5. Pain
6. Itching
7. Excess of bodily discharge
8. Redness
9. Bad odor
10. Change of color to greenish-yellowish, blue, and coppery

पित्तस्य नानात्मजविकाराः॥ Pittaja Nanatmaja Vikaras

Pittaja Nanatmaja Vikaras are the forty types of diseases caused due to the imbalance of pitta dosha in the body.

ओष- heat	अन्तर्दाह- internal burning	अक्षिपाक- inflammation in the eyes	रक्तमण्डल- echymosis	पूतिमुखता- halitosis
प्लोष - scorching	अंसदाह- burning sensation in the arm	त्वग्दाह- burning sensation in the skin	कक्षा- furunculosis	लोहितगन्धास्यता- blood like smell from mouth
दाह - burning sesnation	ऊष्माधिक्यं- hyperthermia	त्वगवदरणं - cracking of skin	हरितत्वं- greenish discoloration	तृष्णाधिक्यं- excessive thirst
दवथु extreme heat	अतिस्वेद- excessive sweating	चर्मदल- thickening of skin	हारिद्रत्वं- yellowish discoloration	गुदपाकश्च- anal inflammation
धूमक - fuming sesation	अङ्गगन्ध- bad odor	रक्तकोठ- urticaria	कामला- jaundice	आस्यविपाक- stomatitis
अम्लक- hyperacidity	अङ्गावदरणं- tearing of body parts	रक्तविस्फोट- pustules	तिक्तास्यता- bitterness in mouth	जीवादानं- pure blood discharge
विदाह- burning sensation	शोणितक्लेद- blood putrefication?	रक्तपित्तं - bleeding disorder	गलपाकश्च- throat inflammation	तमःप्रवेश-darkness in front of eyes

दुष्टपित्तचिकित्सा नियमाः॥ Basic aspects of management of vitiated Pitta dosha

Dravyas (द्रव्याणि) which are predominantly in Madhura(मधुर । sweet), tikta(तिक्त। bitter) and kashaya(कषाय। Pungent) rasas (रसाः । taste precisely) which have Sheeta (शीत) guna or cooling property are used for the treatment of Pitta dosha diseases. Also, the Panchakarma therapies like Virechana (विरेचनम्। purgation), Snehana(administration of oil, ghee, etc), parisheka() and Abhyanga (अभ्रङ्गम्।massage) must be carried out with the drugs having the above said properties, with appropriate dosage and time of administration.

Virechana or purgation is considered the best treatment for the treatment of Pitta dosha disorders or imbalance. Acharya Charaka explains this with the help of a metaphor, stating the Pitta dosha when pacified in the amashaya itself which is the seat of the pitta dosha the other organs afflicted with the Pitta get managed as well, similarly, the fire chamber cools down when the fire is extinguished.