Arsha and Deha Prakriti: A Conceptual Study on Constitutional Susceptibility to Anorectal Disease

Ayurveda regards Deha Prakriti, the psychosomatic constitution fixed at conception by the relative predominance of Vata, Pitta and Kapha, as the foundation of individualised diagnosis, prognosis and treatment. This conceptual study explores the relationship between Deha Prakriti and Arsha (haemorrhoids), one of the Ashta Mahagada described by Acharya Sushruta, by integrating classical Ayurvedic insight with contemporary clinical understanding. Classical texts explain that Arsha arises through Mithya Ahara and Mithya Vihara, leading to Agnimandya, vitiation of Apana Vata and consequent Mamsankura formation in the Guda Pradesh, and hold that constitutional predominance conditions an individual's susceptibility to such Tridoshaja disorders. Contemporary literature corroborates the multifactorial, lifestyle-driven pathogenesis of haemorrhoids and increasingly recognises host-level (constitutional) variation in disease expression. Preliminary clinical observations from a hospital-based cross-sectional assessment of 100 patients of Arsha, undertaken using the validated CCRAS Deha Prakriti Assessment Proforma, are discussed alongside this literature review: Pittaja-Kaphaja and Vataja-Kaphaja constitutions were numerically predominant among patients, though modifiable dietary, digestive (Agni) and bowel (Koshtha) factors appeared more consistently linked to disease expression than Prakriti alone. The study offers an integrative framework for understanding constitutional susceptibility in Arsha and supports combining Prakriti-based assessment with lifestyle correction in preventive Ayurvedic practice.