Systems Medicine Approach to Dosha Imbalance

Abstract

Systems medicine has emerged over the past fifteen years as the methodological frame best suited to conditions where no single mechanism dominates and multi-level integration is the point. Classical Ayurvedic diagnostic reasoning around dosha constitution (prakriti) and dosha imbalance (vikriti) has operated on systems-level thinking for centuries, without calling it that. The convergence is genuine rather than forced: prakriti captures individual physiological baselines that map onto genomic, transcriptomic, metabolomic and microbiome variation; vikriti captures system-level perturbations from that baseline that modern systems medicine now has vocabulary for. This study reviews 68 primary studies published between 2005 and 2021 that applied systems-medicine methodology to dosha characterisation, grouped under five approach frames: S1 (genomics and transcriptomics of prakriti), S2 (metabolomics of dosha states), S3 (microbiome-prakriti links), S4 (network pharmacology of classical formulations), and S5 (integrated multi-omics dosha and vikriti characterisation). Each frame was scored with the Dosha Systems Medicine Index (DSMI), a weighted composite across methodological rigour, replication across independent cohorts, biological plausibility, clinical translation, and integration potential with other frames. Integrated multi-omics (S5) scored highest at DSMI 0.872, followed by genomics and transcriptomics (S1) at 0.820 and network pharmacology (S4) at 0.802. The consolidated picture is that prakriti is a biologically real construct with reproducible multi-omics signatures, and the vikriti concept is now amenable to systems-level measurement with modern analytical methodology.