10 Health and Wellness in Antiquity through the Middle Ages In addition to the doshas , there are other components of the body that are regarded as significant in the disease process, especially the dhatus , the ojas , and the malas . The dhatus , the seven basic structural constitu- ents (tissues and fluids) of the body, evolve in sequence from the most gross to the more compact and refined, with each forming and nourish- ing the following one in turn. Rasa (plasma or chyle), the largest mate- rial substance, produces rakta (blood), followed by mamsa (muscle and flesh), meda (fat), asthi (bone), majjan (marrow and nerve tissue), which forms the most refined of the dhatus , shukra (semen). In addition to the dhatus , another product of the process of nutrition and digestion is ojas , which is perhaps best identified as an essence of vitality or energy. Ojas can be depleted by anxiety, anger, depression, hunger, pain, and excessive physical exercise, leading to ill health. In addition to the fundamental elements of the dhatus and ojas , the body also produces three main waste products, malas , as a result of the process of diges- tion: feces, urine, and sweat. The maintenance of health requires that the malas be effectively eliminated from the body, but they also play an essential role in the body. For example, feces is important for help- ing to separate waste from nutritive materials, while sweat is believed to be valuable for regulating the body’s temperature and moistening the skin. Disproportions of the dhatus and malas manifested various signs in the body. For example, the loss of lymph chyle would lead to pain about the region of the heart, heart palpitations, and thirst loss of blood would be marked by a roughness of the skin, a craving for acidic foods or drinks, and “loose and flabby” veins the loss or scanty formation of fecal matter would cause a sensation of pain in the sides and around the heart, accompanied by gas and a rumbling sound in the intestines and in the region of the liver. In Ayurvedic medicine, the process through which the dhatus and malas are produced is regulated by the agni or fire. Agni , imbued with a transformative power, is a digestive force by which one substance absorbs and assimilates nutrients and is changed into another. Tradi- tional Ayurvedic medical texts recognize several forms of agni , each responsible for different transformative actions, including process- ing the five elements in foods so that they can be absorbed by the body, directing the metabolic process for the creation of the dhatus and malas , and even, on the psychological level, assisting transformations in thought and feeling. The other essential components of the diges- tive process are the srotas , an interconnected network of channels or tubes in the body through which doshas , nutrients, and waste materi- als are transported to the dhatus and organs. Each system of srotas is associated with a different organ or part of the body, and hence a dis-
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