Issue : 01 DOI : INTERNATIONAL JOURNAL OF DIAGNOSTICS AND RESEARCHVolume : 02
Copyright @ : - Dr.Shikha Makde Inter. J.Digno. and Research IJDRMSID00084 |ISSN :2584-2757 141
Abstract
Background: Ayurveda emphasizes the concept of Pañcamahābhūta (five great elements) as the
foundational principle of the human body, health, and disease. Disease progression and manifestation occur
through defined channels known as Roga-mārga (pathways of disease), as described in Bruhatrayī¹.
Understanding the interplay between Pañcamahābhūta, Doṣa, and Roga-mārga enhances diagnostic
precision and therapeutic decision-making. Objective: This review explores the role of Pañcamahābhūta in
determining disease manifestation and Roga-mārga, through a literary analysis of classical Ayurvedic texts
supplemented with contemporary perspectives. Methods: Classical references from Caraka Saṃhitā,
Suśruta Saṃhitā, and Aṣṭāṅga Hṛdaya were critically reviewed²⁻ ⁷ . Contemporary commentaries and
modern scientific correlations were also analyzed⁸ ⁻ ¹⁰ . Results: Each Mahābhūta exerts dominance over
particular Doṣa, influencing disease site, manifestation, and progression through specific Roga-mārga
(Koṣṭha, Śākhā, Marmāsthi-sandhi)³. This mapping not only reflects Ayurvedic nosology but also supports
holistic management strategies. Conclusion: The Pañcamahābhūta theory provides a unique framework to
understand disease pathways in Ayurveda. Its application in clinical research and practice could refine
personalized approaches to prevention and treatment.
Keywords: Ayurveda, Sthaulya, Atisthūlya, Insulin resistance, Medoroga, Metabolic syndrome, Ashta Doṣa
P
ISSN No. : 2584-2757
Volume : 03
Issue : 01
Publisher
ROGANIDAN VIKRUTIVIGYAN PG ASSOCIATION
FOR PATHOLOGY AND RADIODIGNOSIS
DOI : 1 0 . 5 2 8 1 / z e n o d o . 1 7 3 5 9 9 0 1
Reg. No. : MAHA-703/16(NAG) Year of Establishment – 2016
INTERNATIONAL JOURNAL OF DIAGNOSTICS AND RESEARCH
Corresponding author: Dr. Shikha Makde Article Info: Published on : 15/10/2025
Impact Factor : 1.013
The Role of Pañcamahābhūta in the Pathogenesis and Pathways of Disease: A
Literary Review in Ayurveda Samhita
Dr. Shikha Liladhar Makde1
1Assistant Professor Dept. of Samhita Siddhant ,Sardar Patel Ayurvedic Medical College, Dongariya, Balaghat.
Cite this article as: - Dr. Shikha Makde (2025) ; The Role of Pañcamahābhūta in the Pathogenesis and Pathways of Disease: A
Literary Review in Ayurveda Samhita;Inter .J. Dignostics and Research 3 (1) 141-145, DOI : 1 0 . 5 2 8 1 / z e n o d o . 1 7 3 5 9 9 0 1
G AR V
Copyright @ : - Dr.Shikha Makde Inter. J.Digno. and Research IJDRMSID00084 |ISSN :2584-2757 141
Abstract
Background: Ayurveda emphasizes the concept of Pañcamahābhūta (five great elements) as the
foundational principle of the human body, health, and disease. Disease progression and manifestation occur
through defined channels known as Roga-mārga (pathways of disease), as described in Bruhatrayī¹.
Understanding the interplay between Pañcamahābhūta, Doṣa, and Roga-mārga enhances diagnostic
precision and therapeutic decision-making. Objective: This review explores the role of Pañcamahābhūta in
determining disease manifestation and Roga-mārga, through a literary analysis of classical Ayurvedic texts
supplemented with contemporary perspectives. Methods: Classical references from Caraka Saṃhitā,
Suśruta Saṃhitā, and Aṣṭāṅga Hṛdaya were critically reviewed²⁻ ⁷ . Contemporary commentaries and
modern scientific correlations were also analyzed⁸ ⁻ ¹⁰ . Results: Each Mahābhūta exerts dominance over
particular Doṣa, influencing disease site, manifestation, and progression through specific Roga-mārga
(Koṣṭha, Śākhā, Marmāsthi-sandhi)³. This mapping not only reflects Ayurvedic nosology but also supports
holistic management strategies. Conclusion: The Pañcamahābhūta theory provides a unique framework to
understand disease pathways in Ayurveda. Its application in clinical research and practice could refine
personalized approaches to prevention and treatment.
Keywords: Ayurveda, Sthaulya, Atisthūlya, Insulin resistance, Medoroga, Metabolic syndrome, Ashta Doṣa
P
ISSN No. : 2584-2757
Volume : 03
Issue : 01
Publisher
ROGANIDAN VIKRUTIVIGYAN PG ASSOCIATION
FOR PATHOLOGY AND RADIODIGNOSIS
DOI : 1 0 . 5 2 8 1 / z e n o d o . 1 7 3 5 9 9 0 1
Reg. No. : MAHA-703/16(NAG) Year of Establishment – 2016
INTERNATIONAL JOURNAL OF DIAGNOSTICS AND RESEARCH
Corresponding author: Dr. Shikha Makde Article Info: Published on : 15/10/2025
Impact Factor : 1.013
The Role of Pañcamahābhūta in the Pathogenesis and Pathways of Disease: A
Literary Review in Ayurveda Samhita
Dr. Shikha Liladhar Makde1
1Assistant Professor Dept. of Samhita Siddhant ,Sardar Patel Ayurvedic Medical College, Dongariya, Balaghat.
Cite this article as: - Dr. Shikha Makde (2025) ; The Role of Pañcamahābhūta in the Pathogenesis and Pathways of Disease: A
Literary Review in Ayurveda Samhita;Inter .J. Dignostics and Research 3 (1) 141-145, DOI : 1 0 . 5 2 8 1 / z e n o d o . 1 7 3 5 9 9 0 1
G AR V
Issue : 01 INTERNATIONAL JOURNAL OF DIAGNOSTICS AND RESEARCH [ISSN No.: 2584-2757]Volume : 03
Copyright @ : - Dr.Shikha Makde Inter. J.Digno. and Research IJDRMSID00084 |ISSN :2584-2757 142
Introduction :
Ayurveda, the ancient Indian system of medicine, is
built upon the fundamental doctrine of
Pañcamahābhūta — Ākāśa (ether), Vāyu (air),
Agni/Tejas (fire), Āp (water), and Pṛthvī (earth) [1].
These five elemental principles constitute not only
the universe but also the human body (Śarīra),
physiological processes, and disease mechanisms[2]
. Health is defined as the state of equilibrium
among Doṣa, Dhātu, Mala, and Agni, whereas
disease arises when this equilibrium is disturbed[3].
Importantly, disease does not manifest randomly
but follows specific routes or pathways (Roga-
mārga) as described by Caraka: Koṣṭha (visceral),
Śākhā (peripheral tissues), and Marmāsthi-sandhi
[4] (vital points, bones, joints). This article explores
how Pañcamahābhūta influences disease
manifestation through Roga-mārga, thereby
enriching both understanding and clinical utility of
Ayurvedic pathogenesis (Samprāpti).
Materials and Methods :
A literary review was conducted using primary
Ayurvedic sources — Caraka Saṃhitā, Suśruta
Saṃhitā, and Aṣṭāṅga Hṛdaya. Commentaries like
Ayurveda Dīpikā of Cakrapāṇi were considered.
Contemporary peer-reviewed articles from
PubMed, Scopus, and Google Scholar were
screened to identify modern scientific correlations.
Data were synthesized to conceptualize the role of
Pañcamahābhūta in Roga-mārga.
Literature Review :
1. Pañcamahābhūta and Doṣa
Each Doṣa is derived from specific Mahābhūta[5]:
Vāta: Ākāśa + Vāyu
Pitta: Agni + Āp
Kapha: Āp + Pṛthvī
Thus, disturbances in elemental balance directly
influence Doṣa and subsequently lead to disease.
2. Pañcamahābhūta: The Five Great Elements
Mahābhūta Attributes &
Functions[6]
Pathological
Role[7]
Ākāśa
(Ether)
Subtlety,
lightness,
expansiveness;
provides space for
organs and
channels (srotas).
Imbalance leads
to tissue
depletion or
abnormal
expansion.
Vāyu (Air)
Mobility, dryness,
movement, neural
transmission,
circulation.
Excess causes
neurological
and
degenerative
disorders.
Agni/Tejas
(Fire)
Heat, sharpness,
transformation,
metabolism.
Excess causes
inflammation;
deficiency
causes sluggish
digestion
Āp (Water)
Liquidity,
cohesion,
smoothness, fluid
balance.
Excess causes
edema;
deficiency
causes dryness.
Pṛthvī
(Earth)
Stability,
heaviness,
structure.
Excess causes
obesity and
blockages;
deficiency
causes fragility.
Copyright @ : - Dr.Shikha Makde Inter. J.Digno. and Research IJDRMSID00084 |ISSN :2584-2757 142
Introduction :
Ayurveda, the ancient Indian system of medicine, is
built upon the fundamental doctrine of
Pañcamahābhūta — Ākāśa (ether), Vāyu (air),
Agni/Tejas (fire), Āp (water), and Pṛthvī (earth) [1].
These five elemental principles constitute not only
the universe but also the human body (Śarīra),
physiological processes, and disease mechanisms[2]
. Health is defined as the state of equilibrium
among Doṣa, Dhātu, Mala, and Agni, whereas
disease arises when this equilibrium is disturbed[3].
Importantly, disease does not manifest randomly
but follows specific routes or pathways (Roga-
mārga) as described by Caraka: Koṣṭha (visceral),
Śākhā (peripheral tissues), and Marmāsthi-sandhi
[4] (vital points, bones, joints). This article explores
how Pañcamahābhūta influences disease
manifestation through Roga-mārga, thereby
enriching both understanding and clinical utility of
Ayurvedic pathogenesis (Samprāpti).
Materials and Methods :
A literary review was conducted using primary
Ayurvedic sources — Caraka Saṃhitā, Suśruta
Saṃhitā, and Aṣṭāṅga Hṛdaya. Commentaries like
Ayurveda Dīpikā of Cakrapāṇi were considered.
Contemporary peer-reviewed articles from
PubMed, Scopus, and Google Scholar were
screened to identify modern scientific correlations.
Data were synthesized to conceptualize the role of
Pañcamahābhūta in Roga-mārga.
Literature Review :
1. Pañcamahābhūta and Doṣa
Each Doṣa is derived from specific Mahābhūta[5]:
Vāta: Ākāśa + Vāyu
Pitta: Agni + Āp
Kapha: Āp + Pṛthvī
Thus, disturbances in elemental balance directly
influence Doṣa and subsequently lead to disease.
2. Pañcamahābhūta: The Five Great Elements
Mahābhūta Attributes &
Functions[6]
Pathological
Role[7]
Ākāśa
(Ether)
Subtlety,
lightness,
expansiveness;
provides space for
organs and
channels (srotas).
Imbalance leads
to tissue
depletion or
abnormal
expansion.
Vāyu (Air)
Mobility, dryness,
movement, neural
transmission,
circulation.
Excess causes
neurological
and
degenerative
disorders.
Agni/Tejas
(Fire)
Heat, sharpness,
transformation,
metabolism.
Excess causes
inflammation;
deficiency
causes sluggish
digestion
Āp (Water)
Liquidity,
cohesion,
smoothness, fluid
balance.
Excess causes
edema;
deficiency
causes dryness.
Pṛthvī
(Earth)
Stability,
heaviness,
structure.
Excess causes
obesity and
blockages;
deficiency
causes fragility.
Issue : 01 INTERNATIONAL JOURNAL OF DIAGNOSTICS AND RESEARCH [ISSN No.: 2584-2757]Volume : 03
Copyright @ : - Dr.Shikha Makde Inter. J.Digno. and Research IJDRMSID00084 |ISSN :2584-2757 143
3. Concept of Roga-mārga
Caraka classifies disease pathways as[8]:
Koṣṭha mārga: internal organs, GI tract
Śākhā mārga: peripheral tissues (Dhātu-s
like rasa, rakta, māṃsa)
Marmāsthi-sandhi mārga: bones, joints,
vital points
Roga-
mārga Pathway Dominant
Elements
Clinical
Correlate
s
Koṣṭha
Viscera
(GI tract,
internal
organs)
Agni, Āp,
Pṛthvī
Digestive
disorders,
visceral
inflammati
on
Śākhā
Peripher
al tissues
(muscles,
skin,
vessels)
Vāyu, Ākāśa
Pain,
neuropath
y,
peripheral
disorders
Marmāst
hi-sandhi
Bones,
joints,
vital
points
Pṛthvī, Vāyu
Degenerati
ve
disorders,
injuries
4. Correlation of Pañcamahābhūta, Doṣa, and
Roga-mārga :
Mahāb
hūta
Domin
ant
Doṣa
Examp
le Roga
Roga-
mārga
Clinical
Correlate
s
Ākāśa Vāta
Gridhra
sī,
Vātavyā
dhi
Śākhā
Nerve
compressi
on,
radiating
pain
Vāyu Vāta
Sandhiv
āta,
Pakṣāg
hāta
Śākhā /
Marmā
sthi-
sandhi
Neuromus
cular
disorders
Agni Pitta
Amlapit
ta,
Jvara
Koṣṭha
Gastritis,
febrile
conditions
Mahābh
ūta
Domin
ant
Doṣa
Examp
le Roga
Roga-
mārga
Clinical
Correlat
es
Āp Kapha
Śotha,
Kaphaj
a Roga
Koṣṭha /
Śākhā
Edema,
respirato
ry
congesti
on
Pṛthvī Kapha
Sthauly
a,
Sandhiv
āta
Marmās
thi-
sandhi
Obesity,
bone
degenera
tion
Discussion :
The Pañcamahābhūta model provides a diagnostic
and therapeutic scaffold for Ayurveda. Recognizing
Mahābhūta dominance allows clinicians to localize
disease origin, predict course, and select treatment
modalities.
Clinical Significance:
Diagnostic Utility: Enables precise
localization of disease initiation and
progression.
Therapeutic Planning: Śodhana for
Koṣṭha diseases, Snehana–Svedana for
Śākhā diseases.
Preventive Approach: Understanding
Prakṛti and elemental dominance helps
anticipate vulnerabilities.
Modern Perspectives
Ayurgenomics: Genetic expression patterns
correlate with Prakṛti, reflecting elemental
constitution[9].
Systems Biology: Pañcamahābhūta can be
interpreted as functional archetypes linking
structure, metabolism, and environment. [10]
Copyright @ : - Dr.Shikha Makde Inter. J.Digno. and Research IJDRMSID00084 |ISSN :2584-2757 143
3. Concept of Roga-mārga
Caraka classifies disease pathways as[8]:
Koṣṭha mārga: internal organs, GI tract
Śākhā mārga: peripheral tissues (Dhātu-s
like rasa, rakta, māṃsa)
Marmāsthi-sandhi mārga: bones, joints,
vital points
Roga-
mārga Pathway Dominant
Elements
Clinical
Correlate
s
Koṣṭha
Viscera
(GI tract,
internal
organs)
Agni, Āp,
Pṛthvī
Digestive
disorders,
visceral
inflammati
on
Śākhā
Peripher
al tissues
(muscles,
skin,
vessels)
Vāyu, Ākāśa
Pain,
neuropath
y,
peripheral
disorders
Marmāst
hi-sandhi
Bones,
joints,
vital
points
Pṛthvī, Vāyu
Degenerati
ve
disorders,
injuries
4. Correlation of Pañcamahābhūta, Doṣa, and
Roga-mārga :
Mahāb
hūta
Domin
ant
Doṣa
Examp
le Roga
Roga-
mārga
Clinical
Correlate
s
Ākāśa Vāta
Gridhra
sī,
Vātavyā
dhi
Śākhā
Nerve
compressi
on,
radiating
pain
Vāyu Vāta
Sandhiv
āta,
Pakṣāg
hāta
Śākhā /
Marmā
sthi-
sandhi
Neuromus
cular
disorders
Agni Pitta
Amlapit
ta,
Jvara
Koṣṭha
Gastritis,
febrile
conditions
Mahābh
ūta
Domin
ant
Doṣa
Examp
le Roga
Roga-
mārga
Clinical
Correlat
es
Āp Kapha
Śotha,
Kaphaj
a Roga
Koṣṭha /
Śākhā
Edema,
respirato
ry
congesti
on
Pṛthvī Kapha
Sthauly
a,
Sandhiv
āta
Marmās
thi-
sandhi
Obesity,
bone
degenera
tion
Discussion :
The Pañcamahābhūta model provides a diagnostic
and therapeutic scaffold for Ayurveda. Recognizing
Mahābhūta dominance allows clinicians to localize
disease origin, predict course, and select treatment
modalities.
Clinical Significance:
Diagnostic Utility: Enables precise
localization of disease initiation and
progression.
Therapeutic Planning: Śodhana for
Koṣṭha diseases, Snehana–Svedana for
Śākhā diseases.
Preventive Approach: Understanding
Prakṛti and elemental dominance helps
anticipate vulnerabilities.
Modern Perspectives
Ayurgenomics: Genetic expression patterns
correlate with Prakṛti, reflecting elemental
constitution[9].
Systems Biology: Pañcamahābhūta can be
interpreted as functional archetypes linking
structure, metabolism, and environment. [10]
Issue : 01 INTERNATIONAL JOURNAL OF DIAGNOSTICS AND RESEARCH [ISSN No.: 2584-2757]Volume : 03
Copyright @ : - Dr.Shikha Makde Inter. J.Digno. and Research IJDRMSID00084 |ISSN :2584-2757 144
Conclusion :
The doctrine of Pañcamahābhūta forms the
cornerstone of Ayurvedic understanding of health
and disease. Its interplay with Doṣa and Roga-
mārga not only elucidates the pathogenesis but also
guides therapeutic strategies. Integrating this
ancient wisdom with modern science can
strengthen personalized and holistic healthcare.
References :
1. Charaka Samhita, Sutra Sthana Chapter 26, Verse
10-12. In: Sharma PV, editor. Charaka Samhita (Text
with English Translation). Vol. 1. Varanasi:
Chaukhambha Orientalia; 2014. p. 470.
2. Ashtanga Hridaya, Sutra Sthana Chapter 1, Verse 7–
9. In: Murthy KRS, editor. Ashtanga Hridaya (Text,
English Translation, Notes). Vol. 1. Varanasi:
Chaukhambha Krishnadas Academy; 2017. p. 5.
3. Sushruta Samhita, Sutra Sthana Chapter 15, Verse
41. In: Sharma PV, editor. Sushruta Samhita (Text
with English Translation). Vol. 1. Varanasi:
Chaukhambha Visvabharati; 2012. p. 78.
4. Charaka Samhita, Sutra Sthana Chapter 11,
Verse 48. In: Sharma PV, editor. Charaka
Samhita (Text with English Translation). Vol. 1.
Varanasi: Chaukhambha Orientalia; 2014. P.
229–230.
5. Caraka Saṃhitā, Sūtra Sthāna 26/10. In: Tripathi
B, editor. Caraka Saṃhitā of Agniveśa –
Elaborated by Charaka and Dridhabala (Text
with Hindi Commentary). Vol. 1. Varanasi:
Chaukhambha Surbharati Prakashan; 2020. P.
477.
6. Charaka Samhita, Sutra Sthana Chapter 26,
Verse 10-12. In: Sharma PV, editor. Charaka
Samhita (Text with English Translation). Vol. 1.
Varanasi: Chaukhambha Orientalia; 2014. P.
470.
7. Lad V. Textbook of Ayurveda, Vol. 1:
Fundamental Principles of Ayurveda.
Albuquerque: The Ayurvedic Press; 2002. P.
34–36.
8. Charaka Samhita, Sutra Sthana Chapter 11,
Verse 48-49. In: Sharma PV, editor. Charaka
Samhita (Text with English Translation). Vol. 1.
Varanasi: Chaukhambha Orientalia; 2014. P.
229–230.
9. Mukerji, M., et al. (2023). “Ayurgenomics:
Merging Ayurveda and Genomics.” Journal of
Ayurveda and Integrative Medicine, 14(2), 123-
130. https://doi.org/10.1016/j.jaim.2022.11.005
10. Sharma, P., et al. (2022). “Pañcamahābhūta
and Systems Biology: A Functional Archetype
Approach.” Journal of Ayurveda and Integrative
Medicine, 13(3), 210-217.
https://doi.org/10.1016/j.jaim.2022.05.004
Declaration :
Conflict of Interest : None
Copyright @ : - Dr.Shikha Makde Inter. J.Digno. and Research IJDRMSID00084 |ISSN :2584-2757 144
Conclusion :
The doctrine of Pañcamahābhūta forms the
cornerstone of Ayurvedic understanding of health
and disease. Its interplay with Doṣa and Roga-
mārga not only elucidates the pathogenesis but also
guides therapeutic strategies. Integrating this
ancient wisdom with modern science can
strengthen personalized and holistic healthcare.
References :
1. Charaka Samhita, Sutra Sthana Chapter 26, Verse
10-12. In: Sharma PV, editor. Charaka Samhita (Text
with English Translation). Vol. 1. Varanasi:
Chaukhambha Orientalia; 2014. p. 470.
2. Ashtanga Hridaya, Sutra Sthana Chapter 1, Verse 7–
9. In: Murthy KRS, editor. Ashtanga Hridaya (Text,
English Translation, Notes). Vol. 1. Varanasi:
Chaukhambha Krishnadas Academy; 2017. p. 5.
3. Sushruta Samhita, Sutra Sthana Chapter 15, Verse
41. In: Sharma PV, editor. Sushruta Samhita (Text
with English Translation). Vol. 1. Varanasi:
Chaukhambha Visvabharati; 2012. p. 78.
4. Charaka Samhita, Sutra Sthana Chapter 11,
Verse 48. In: Sharma PV, editor. Charaka
Samhita (Text with English Translation). Vol. 1.
Varanasi: Chaukhambha Orientalia; 2014. P.
229–230.
5. Caraka Saṃhitā, Sūtra Sthāna 26/10. In: Tripathi
B, editor. Caraka Saṃhitā of Agniveśa –
Elaborated by Charaka and Dridhabala (Text
with Hindi Commentary). Vol. 1. Varanasi:
Chaukhambha Surbharati Prakashan; 2020. P.
477.
6. Charaka Samhita, Sutra Sthana Chapter 26,
Verse 10-12. In: Sharma PV, editor. Charaka
Samhita (Text with English Translation). Vol. 1.
Varanasi: Chaukhambha Orientalia; 2014. P.
470.
7. Lad V. Textbook of Ayurveda, Vol. 1:
Fundamental Principles of Ayurveda.
Albuquerque: The Ayurvedic Press; 2002. P.
34–36.
8. Charaka Samhita, Sutra Sthana Chapter 11,
Verse 48-49. In: Sharma PV, editor. Charaka
Samhita (Text with English Translation). Vol. 1.
Varanasi: Chaukhambha Orientalia; 2014. P.
229–230.
9. Mukerji, M., et al. (2023). “Ayurgenomics:
Merging Ayurveda and Genomics.” Journal of
Ayurveda and Integrative Medicine, 14(2), 123-
130. https://doi.org/10.1016/j.jaim.2022.11.005
10. Sharma, P., et al. (2022). “Pañcamahābhūta
and Systems Biology: A Functional Archetype
Approach.” Journal of Ayurveda and Integrative
Medicine, 13(3), 210-217.
https://doi.org/10.1016/j.jaim.2022.05.004
Declaration :
Conflict of Interest : None
Issue : 01 INTERNATIONAL JOURNAL OF DIAGNOSTICS AND RESEARCH [ISSN No.: 2584-2757]Volume : 03
Copyright @ : - Dr.Shikha Makde Inter. J.Digno. and Research IJDRMSID00084 |ISSN :2584-2757 145
ISSN: 2584-2757
DOI : 1 0 . 5 2 8 1 / z e n o d o . 1 7 3 5 9 9 0 1
Dr. Shikha Makde Inter. J.Digno. and Research
This work is licensed under Creative
Commons Attribution 4.0 License
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Copyright @ : - Dr.Shikha Makde Inter. J.Digno. and Research IJDRMSID00084 |ISSN :2584-2757 145
ISSN: 2584-2757
DOI : 1 0 . 5 2 8 1 / z e n o d o . 1 7 3 5 9 9 0 1
Dr. Shikha Makde Inter. J.Digno. and Research
This work is licensed under Creative
Commons Attribution 4.0 License
Submission Link : http://www.ijdrindia.com
Benefits of Publishing with us
Fast peer review process
Global archiving of the articles
Unrestricted open online access
Author retains copyright
Unique DOI for all articles
https://ijdrindia.com