Understanding Purisha Through the Brihtrayi: A Conceptual Analysis

“Svasthya” denotes a state in which the Doshas, Dhatus, and Malas are in Sama Avastha, and Indriya, Atma, and Manasa function normally.² Mala is a significant concept in Ayurveda, especially in human physiology. The Charaka Samhita identifies Ahara, Nidra, and Brahmacharya as the three sub-pillars that uphold life, and their stability is achieved only when Dosha, Dhatu, and Mala remain in a state of balance. This clearly reflects that Mala has a significant role within the framework of Tryoupasthambha and is accorded special importance in Ayurveda.^3,4 Homeostasis of the living body is maintained through the proper operation of Dosha, Dhatu, Agni and Malakirya.⁵ The Ayurvedic concept of bodily development is encapsulated in the statement “Dosha Dhatu Mala Mulam hi Shariram.” When these three work together, the body remains healthy; when they do not, deformities emerge. Therefore, Ayurveda elaborates on Purisha Mala, prescribing a diet based on an individual’s body heat and emphasizing the proper elimination of mala or waste. Malas are metabolic waste products of the body that must be regularly excreted to maintain physiological balance and internal cleanliness. Proper elimination of the mala is essential for sustaining overall health and well-being.⁶

Svasthavritta mentions Dinacharya and Ritucharya as beneficial practices. Vegadharana, Mandagni, and Malasanchaya are identified as main causes of disease. For a healthy existence, Ayurveda recommends adherence to Dinacharya, Ratricharya, and Ritucharya. In this context, the focus is on mala. It provides strength and support to Pitta, Agni, and Vayu. Malas are metabolic waste products that must eliminated from the body. Dhatu mala (metabolic wastes), and Sharirika mala are the two primary types of malas. Sharirika malas are further divided into three categories: Sweda (sweat), Purisha (stool), and Mutra (urine). In contrast, Dhatu malas are subdivided into seven types. Purisha is a part of Sharirika Mala. Food is the source of both Purisha and Mutra. Following digestion, the “nutritional portion” is absorbed, while the remaining undigested component solidifies and becomes Purisha. If malas are not properly eliminated, the body’s metabolic functions become impaired, leading to the development of disease. Malas are also produced during Ahara Pachana (digestion) in the stages of Avasthapakas.^7,8

Materials and Methods

This article is based on literature from classical Ayurved Samhitas and journals. References for this work have been drawn from the Charaka Samhita, Sushruta Samhita, and Ashtanga Hridaya, along with their corresponding Sanskrit and Hindi commentaries from the Brihtrayi.

Purisha

The significance of mala in the human body is comparable to that of Doshas and Dhatus. The substances classified as mala include Sweda (sweat), Mutra (urine), and Purisha (stool). Additionally, due to the action of digestive bile, food undergoing digestion is classified into two components: Sarabhoot rasa (nutrient essence) and Asarabhoot mala (waste products).^9-11 The primary functions of Purisha (faeces) are to maintain physical strength and to support the Vata and Pitta doshas. Improper eating habits can disturb the Tridoshas, causing their accumulation within the body. When these doshas become vitiated, they disrupt the malas (waste products) and dhatus (tissues), ultimately contributing to the manifestation of various illnesses. Ayurvedic scriptures describe malas as metabolic byproducts belonging to two main categories: Purisha, regarded as an Ahara mala (digestive waste), and Sharirika mala (bodily wastes).^10,11

Etymology of Purisha

The term Purisha is derived from “dhatu malinikarnat,” which means “pru”.¹² As per Amarkosha, Purisha refers to Vishtha, meaning intestinal waste. It is through Purisha that the body expels its waste materials.¹³

Utpatti of Purisha

After digestion is completed and Ahara is separated into Sara and Kittabhaga, Purisha is formed. This Kitta component is further divided into: Vayu, referred to as Purisadhara kala, Drava mala as Mutra, and Ghana mala as Purisha. Following the Madhura and Amla Avasthapakas, the ahara is transported to the Pakvashaya. At this stage, due to Shoshana and the action of Vata in the Pakvashaya, the remaining matter acquires a solid, mass-like form known as Purisha. After ahara is digested by Jatharagni, Pachaka Pitta and Samana Vata play essential roles in Sara Kitta Vibhajana. In terms of excretion physiology, Apanavata is particularly significant. The digested products are separated into Sarabhaga and Kittabhaga after the Pachana of ahara. The solid portion of the Kittabhaga is termed as Shakrut, whereas its liquid portion becomes Mutra.¹⁴

 Synonyms of Purisha

In Ayurvedic literature, several synonyms are used for Purisha, including Guthaka; Varcha / Varchaska - excrement, faeces; Vishtha Avaskara- faeces; Vit; Shamalam; Gutham – faeces; Ucchara- faeces; Kitta - excretion, dirt; Shakrut; Purish, Purishana - faeces, excrement; Gu - going (out from the body); Vishthha - voiding, excrement.^13,15 The term “Purisha” itself denotes faecal matter or stool. The interpretations of these paryayas collectively point to the Malinabhava and Tyajyatva of Purisha.

To explore the Ayurvedic concept of Purisha within the context of clinical practice.

Pramana of Normal Purisha

The quantity of Purisha is described as Sapta Anjali Pramana.¹⁶

Panchbhautik Sanghatam of Purisha

Among the Panchamahabhutas, Prithvi Mahabhuta is predominant in Purisha mala, as it provides solidity and compactness, making it the dominant constituent element. Agni and Vayu Mahabhutas also contribute significantly by imparting colour, odour, and other characteristic properties.¹⁷ Vayu Mahabhuta and Agni give Purisha its yellowish colour, slight Katu rasa (taste), and typical faecal odour. Normal Purisha floats on water due to the predominance of Agni and Vayu Mahabhutas. The variations in the colour and consistency of Purisha

Mulasthana (Site) of Purisha

The Purishvaha Srotasa consist of the Pakvashaya (large intestine), and Sthula Guda (anal canal). These structures form the roots of the colon Purishavaha Srotasa, which originate in the large intestine and terminate at the anus.²¹

Purishadhara Kala

Kalasharira is a concept described in Ayurvedic anatomy (Sharira Rachana). Kala is defined as a structural interface, serving as a unique limiting membrane between Dhatus (tissues) and Ashayas  (organ cavities), and is classified into seven distinct types. Among these, one specific Kala is located in the intestines, at the Koshtha (abdominal cavity) and Yakrita (liver) levels, playing a crucial role in the differentiation of mala (waste products). Acharya Dalhana has further elaborated on this by stating, “Kala Purishadhara saa eva Asthidhara,” emphasizing its significance in bodily functions.²²

Purishvaha Srotas

Pakvasaya and Sthula guda are the abodes of Purishvaha Srotasa.²¹

Purish Karma

1. The strength of an individual is regulated by Shukra, just as the life processes of an individual are regulated by the malas.⁴

2. Avastambha – According to Vagbhata, the main function of Purishamala is Avastambha The term Avastambha means, to erect, stabilize, support, and hold the body. Generally, the word “Dharana” (sustaining) is interpreted as providing structural foundation. Since the composition of Purisha mala composition is primarily dominated by the Prithvi Mahabhuta (earth element), understanding the properties of this element is essential. Prithvi Mahabhuta is responsible for imparting stability, rigidity, and structural integrity to the body. Since Purisha is primarily composed of the earth element, it plays a crucial role in supporting and maintaining the body’s physical framework.²³

3. Eva Kala Purishadhara Saa Eva Asthidhara - Dalhana has referred to Purisha Dhara Kala in the same context as Asthi Dhara Kala. Asthi Dhatu (bone tissue) primarily provides structural support to the body, and likewise, Purisha Mala (faecal matter) plays an important role in Avastambha (support). The supportive function of Purisha must also be understood from a different perspective. The natural, well-formed state of Purisha signifies that an appropriate amount of Ahara Rasa (nutrient essence) has been absorbed from the consumed food. When this absorption is inadequate, the Dhatus (body tissues) do not receive the necessary nutrients.²⁴

4. Deha Dharana - Purisha Mala (faecal matter) must remain in the Pakvashaya (large intestine) for a specific duration. If its elimination occurs too rapidly or too frequently, it may result in the Kshaya (depletion) of Rasa Dhatu and other essential tissues due to inadequate nutrient absorption. Inadequate nourishment of Dhatus ultimately compromises the Sharira Dharana Karma (the body’s structural integrity). Purisha mala must remain in the body for a sufficient period, until it has fulfilled its beneficial role. Failure of this process can lead to the Kshaya (degeneration) of bodily tissues. From this perspective, Purisha plays a crucial role in “Deha Dharana” (maintaining bodily support). Accordingly, Acharya Charaka, in the Rajayakshma Chikitsa Adhyaya, states: “Balam Tasya Hi Vidbalam” - the strength of an individual is closely related to well-formed faeces.²⁵ Once semi-solid waste enters the Pakvashaya (large intestine), absorption of water occurs, along with the uptake of sodium and chloride. Due to the activity of microorganisms in the Pakvashaya, essential body components such as Vitamin K, Vitamin B1 (Thiamine), and Riboflavin are synthesized and absorbed. These processes are crucial for maintaining the body’s structural integrity. For these actions to occur naturally, Purisha mala must remain in the large intestine for a specified duration.²⁶

5. Vayu Dharana (Retention of Vata) – One of the important functions of Purisha mala (faecal matter) is Vayu Dharana, which involves nourishing Vata Dosha and maintaining its natural equilibrium. When food residue reaches the large intestine and undergoes absorption by Agni (digestive fire), it becomes well-formed. Due to its Katu Avastha (pungent nature), Vata increases. The third stage of digestion is Avasthapakas, which occurs in the Pakvashaya (large intestine). At this stage, the remaining food residue develops a Katu (pungent) property, leading to an increase in Vata Dosha.

• Undigested food nourishes Kapha Dosha.

• Over-digested food nourishes Pitta Dosha.

• Nutrient-deficient food (Nissara Ahara), owing to its Ruksha Guna (dry quality), nourishes Vata Dosha.²⁷

• Optimal nourishment of Vata occurs only when Purisha Mala is produced in an appropriate, and well-structured manner. The relationship between natural defecation, Vata Dosha, and the nourishment of the five types of Vayu explains the Vayu prana karma through Purusha.^14,28,29

6. Agni-Dharana (Sustaining the Digestive Fire) - Sushrutacharya, while describing the functions of Purisha mentions, “Vayvagnidharana”, indicating the combined role of retaining both Vata Dosha and Agni. This combined reference underscores the strong interrelationship between Vata and Agni. Since Vata regulates the natural activities of Agni, Vayu Dharan Karma is mentioned first, followed by Agni Dharan Karma. In this context, it is also stated under the Karmas of Vata dosha: “Samiran Anmugneh”.³⁰ Sushrutacharya further explains the relationship between the three Vata forms - Prana, Samana,  Apana, and Agni. When Prana Vayu, Samana Vayu, and Apana Vayu are in their natural state and proper location, they enhance the power of Agni.

• Prana Vayu and Apana Vayu → Assist in igniting Agni Dipti.

• Samana Vayu → Supports and regulates Agnipalan.

During the Katu Avasthapakas stage of digestion, if Purisha is formed in a well-structured and compact manner, the gases generated in this process nourish the Panchavayus (five vital Vata subtypes). These Pranadi Panchavayus aid in igniting, sustaining, and preserving the digestive fire. Hence, Purisha Mala plays a crucial role in maintaining digestive strength and balance. These are the two main constituents of “Prana”.²⁴

This Agni Dharana function of Purisha refers to its role in supporting, sustaining, and enhancing the digestive fire, an activity that is dependent on the balanced state of Vata Dosha and the proper formation of Purisha. This emphasizes the crucial physiological role of faecal matter in Ayurvedic digestion and metabolism.³¹

7. Prinana of Purisha in Ayurveda (Nourishing Function) - Dalhanacarya mentions that some Acharyas consider “Prinana” (nourishment) as one of the functions of Purisha. When considering the physiological significance of Purisha, both Prakruta Purisha Nirmana (proper formation) and Yathochita Nirharana (timely excretion) are essential. Retention of Purisha in the Pakvashaya (large intestine) for an appropriate duration ensures the absorption of vital fluids and nutrients. This process contributes to the Tarpana (nourishment) of the Dhatus (body tissues). This function aligns with the concept of Prinana Karma.³¹

8. Physiological Significance of Malas (Excretory Wastes): Despite being considered Nissara (non-essential), the regulated retention and elimination of Malas (excretory substances) are crucial for maintaining physiological homeostasis. Proper excretion occurring at the appropriate time and in the correct quantity ensures bodily equilibrium, preserves health, and contributes to Sariradharana (supports structural integrity). Thus, in the context of Ayurvedic physiology and health preservation, the role of Purisha extends beyond mere waste elimination, encompassing tissue nourishment and systemic balance.

9. If Purisha remains in the body for longer than the required duration, it leads to “Upaghata”, resulting in pathological disturbances within the system.³²

Purish Vriddhi Lakshna

Purisha Vriddhi (excess accumulation of faecal matter) is characterized by Adhmana (distention of the abdomen), Kukshi (pricking pain in the abdomen and flanks), Atopa (gurgling sounds in the abdomen), Vedana (pain), and Gaurava (a sensation of heaviness).³³

Purish Kshaya Lakshna

Purisha Kshaya (diminished state of Purisha) is characterized by Hridaya Parshwa Pida (pain in the flanks and heart region), Sashabda (gargling sounds), Unnamayan Kukshi (bulging of the abdomen), and Urdhwa Gamana Kukshi Sancharana (upward movement and shifts around in the abdomen).²³

Characteristics of Normal Purisha

The physical characteristics of normal stool, including Gandha, Sparsha, Varna, and Vaishadya, are not individually elaborated in the ancient and medieval Ayurvedic texts.¹⁶

• Colour – Varies from light to dark brown due to the presence of bile pigments.^34-36

• Odour – Has a pungent smell primarily resulting from indole and skatole, which are byproducts of bacterial fermentation and putrefaction. The changes in the odour (Gandha) of Purisha associated with various clinical conditions are summarised below (Table 2).

• Frequency – Typically one to two bowel movements per day, occurring without strain or discomfort (Table 4).

• Consistency – In adults, the stool should be well-formed, neither excessively hard nor too soft, maintaining a consistency comparable to that of a ripe banana (Table 3).^34,37

• Amount – Normal faecal output in an adult ranges from approximately 100 to 200 grams per day.

Despite limited classical descriptions of these features, stool examination holds significant relevance in the diagnosis and understanding of diseases within Ayurveda.

Sama Purisha Lakshna: Purisha that is thick, has a strong, unpleasant smell, and readily sinks in water is referred to as Sama Purisha (seen in a condition of vitiated doshas).

Nirama Purish Lakshna: Purisha that is lighter and floats in water is termed as Nirama Purisha. This form is typically observed in healthy individuals.³⁵

Causes of Purisha Vaha Srotodushti

Purishvaha Srotodushti arises from factors such as the suppression of natural urge to defecate, excessive food consumption, poor digestion, frequent intake of food without adequate intervals, and disturbances in Agni (digestive fire). These factors contribute to the dysfunction of the Purishvaha Srotas, leading to its impairment.

Influence of Doshas on Stool³⁸

• Vata: Smoky, dry, irregular, and frothy

• Pitta: Yellow in colour

• Kapha: Shweta Varna (whitish)

• Vata-Pitta: Hard, fragmented, and tinted yellow or black

• Kapha-Pitta: Moist, mucoid, and sticky, with yellow or white colour

• Tridoshas imbalance: Loose, dry, and variably tinted black, yellow, or white

Purisha may appear frothy in various pathological situations, such as Vataja Grahani, Vataja Arsha, and Vatika Atisara.

Purishavega Dharanjanya: Roga and Chikitsa Lakshana (Symptoms)

Suppression of the natural urge for Purishavegad-harana can lead to several disorders including, Pindikodveshta, Pratishyaya, Shiroruja, Urdhva-vayu, Parikarta, Hridayasya Uparodhana, Mukhena and Vit pravrutti (Table 5).⁴⁰

Chikitsa (Treatment)

To manage these conditions, Ayurvedic interventions focus on restoring normal bowel function and balancing the aggravated Doshas.

The recommended therapies include Swedana Prayoga, Abhayanga, Basti, Avagaha, Varti, Pramathi Annapana (which separates the mala from the srotas), Mala Bhedi Annapanam includes foods and beverages that promote bowel movements, such as Masha (black gram), Yava (barley), and Mastu (a fermented liquid).⁴¹

Discussion

In Ayurvedic physiology, the concept of Mala (excretory wastes) plays a central role in maintaining the overall balance of the body. Among the primary Malas is Purisha (stool), which Ayurveda considers essential for maintaining health. According to Ayurvedic principles, good health (Svasthya) is defined as a state of balance among the Doshas, Dhatus, and Malas, along with harmony of the Atma (soul), Indriyas (senses), and Manas (mind).² Disruptions in the proper functioning of Purisha can lead to a variety of health issues, underscoring its importance.⁶ Purisha is produced in the Pakvashaya (large intestine), and its primary function is the elimination of waste from the body.⁴² The balance of Purisha is crucial for maintaining Svasthya and proper functioning of Pachana Kriyas (digestive processes). Its role extends beyond just waste removal; it is vital for detoxification, nourishment of the body’s tissues (Dhatus), and the prevention of toxin (ama) accumulation, which is often associated with disease. The formation and elimination of Purisha are intricately connected with the state of the Doshas. When Vata is aggravated, the stool tends to be dry and irregular. If Pitta is dominant, the stool may become loose, foul-smelling, and yellowish. When Kapha is imbalanced, Purisha may become pale, sticky, and harder to pass. These variations in the characteristics of Purisha reflect deeper imbalances within the body, serving as vital clues for early diagnosis of Dosha disturbances.⁴³ The elimination process of Purisha is governed by Apanavata, a specific subtype of Vata responsible for downward movement and excretion of waste. Healthy elimination supports the nourishment of bodily tissues and strengthens Agni (digestive fire), which is essential for metabolic processes. When the flow of Purisha is disrupted, it can lead to disorders like Purisha Vriddhi (excess stool) and Purisha Kshaya (deficient stool), both of which can cause digestive disturbances. Purisha Vriddhi may lead to bloating, constipation, or abdominal discomfort, while Purisha Kshaya can cause inadequate waste elimination, contributing to toxin accumulation and digestive issues.¹⁹

Moreover, Ayurveda emphasizes the importance of the timing of Purisha elimination, referred to as Purishadhara Kala.²¹ The longer Purisha remains in the body, the greater the likelihood of developing imbalances. Stagnant waste can overwhelm the digestive system, leading to the buildup of Ama, and weaken Agni.²¹ Conversely, excessive Purisha can overload the system, leading to irregular bowel movements. Importantly, Purisha is not merely a waste product; it is also a reflection of the body’s metabolic health. Proper digestion in the Pakvashaya results in healthy Purisha formation, which helps maintain a balanced metabolism. This balanced process nourishes Dhatus and stabilizes the functioning of the five vital subtypes of Vata, all of which are essential for overall well-being.¹⁷

From a clinical perspective, examining Purisha offers valuable insights into a person’s health. The colour, consistency, and frequency of stool can signal underlying Dosha imbalances, making it an important diagnostic tool. By carefully observing changes in Purisha, Ayurvedic practitioners can identify issues before they become more serious and initiate treatments that restore balance.¹⁸ When the elimination of Purisha is impaired, it can lead to conditions known as Purishavegadharajanya Roga, diseases related to improper excretion.²⁰ This highlights the importance of maintaining proper digestion and excretion to prevent the formation of toxins and the onset of disease. Since Purisha is linked not just to physical health but also to mental well-being, its imbalances often reflect disturbances in the mind as well, reinforcing Ayurveda’s holistic approach to health.

Conclusion

The harmonious functioning of Dosha, Dhatu, and Mala is essential for maintaining overall health and well-being. Among them, Purisha holds particular significance, as its improper elimination can lead to various health issues. It is closely associated with Vikriti (pathological changes) and is often considered a Dushya due to its impact on Dosha imbalances. Recognized as the third essential component of the body alongside Dosha and Dhatu, Purisha requires regular and proper expulsion to maintain digestive health and prevent systemic disorders. In Ayurveda, the Pakwashaya (large intestine) is identified as the primary site for Purishdhara Kala and Purishvaha Srotas, which regulate the formation, retention, and elimination of stool. Any disruption in this process can lead to digestive disturbances and contribute to disease manifestation. An attempt has been made to compile these scattered references from Samhita and journals into a single source, offering a comprehensive understanding of variations in Purisha and their diagnostic significance. This article highlights the significance of Purisha Mala, emphasizing their physiological role and the necessity of their proper elimination.

Conflict of Interest

Nil