The three basic biological pillars of Ayurveda are Vata, Pitta and Kapha. These biological elements originated from the Panchamahabhutas and are commonly called "Triguna" in health and "Tridosha" in diseased states of the body. Arbitrarily they are referred to as Tridosha". Vata element is produced by combination of "Akasha" and "Vayu" and in the human body it represents "Control", its propulsive effects affect all parts of the body and is brought about through the agency of neuro-musculo-hormonal mechanisms. Smooth co-ordinated movements, functioning of central, autonomic and peripheral nervous systems are identified with functions of vata. An abnormal vata can lead to neuro-muscular disorders and hormonal problems. Pitta element is produced from Teja and Jala and constitutes the transfer and flow of energy within the body. Pitta element controlled by vata brings about the breakdown of food during digestion and food elements within the body to provide the bio-energy. Various catabolic enzymes and hormone systems form part of this element.

Abnormal pitta can lead to thermal disorders, breakdowns and catabolic disorders. Kapha element is produced from Prithvi and Jala mahabhutas and constitutes the formation of solid and fluid constituents of various body elements such as cells, tissues, muscles etc., controlled by vata it induces growth, development and healing of wounds. Kapha element also maintains fluid balance of the body, within it's various organs and organ spaces. Abnormal kapha may lead to accumulative disorders leading to clot formation, stone and tumour formation etc. Increased kapha encourages and sustains infective processes. Vata, Pitta and Kapha within the body are nourished by the food ingredients and they react to changes in environment and mental states. The Vata, Pitta, and Kapha bring about the formation of the 7 dhatus and their tissues in the body, namely: Rasa (body fluids), Rakta (blood elements), Mamsa (Muscles, tendons etc.) Meda (adipose tissues), Majja (nerves), Asthi (bones), Shukra (sperm, ova, regenerative tissues). According to Ayurveda each dhatu is formed from its preceding dhatu. Each dhatu has its metabolism and waste products (Malas). The malas are catabolic aspects of tridoshas for example, gaseous wastes such as Carbon dioxide are malas of vayu, Stercoblin and Uroblin are malas of Pitta and Urea and Uric acid are malas of Kapha. Thus we see that the three doshas, the seven dhatus and the three malas constitute the integral part of the living body, when they are in a balanced state, health reigns supreme in the body. When they are vitiated and unbalanced, disease and ageing process predominate.

The ideal geographic location of Kerala and its salubrious climate has made external purification and rejuvenation therapies most effective for treatment of many psychosomatic disorders The high humidity in Kerala helps to open up the body pores and the medicinal oils used in massaging get easily absorbed into the body there by increasing the effectiveness of the treatment Sirodhara, Pizhichil, Navarakizhi, Thalapothichil, Pachakizhi and Podikizhi are some of the Kerala special ayurvedic procedures . The development of Ayurveda in Kerala is particularly noted for its origins in non-brahminical traditions even before the entry of classical Ayurveda in the early centuries of the Christian era. These two streams subsequently blended so well that it gave a unique strength to the health care tradition of Kerala. Selected few brahmin households, named generally as Ashtavaidyas, were bestowed with the responsibility of maintaining the Ayurvedic tradition by practising it as a health care service as well as by teaching its principles in the unique gurukula tradition. The traditional practitioners of Ayurveda considered Ashtangahridaya as a primary text. Several commentaries were written by experts here. More importantly, new texts were written in Kerala both in Malayalam and Sanskrit. Sahasrayogam, Chikilsamanjari, Vaidyamanorama are just a few examples. These and similar other Kerala texts still remain sources of very useful information on formulation, medicinal plants and therapies.
Another very important contribution by Kerala physicians is the continued practice and enrichment of the panchakarma therapy. Even when they became defunct in the rest of the country due to socio-political reasons, Kerala retained this therapeutic wealth in all its pristine essence. Texts were written here on its practical aspects. More importantly, the famous Kerala special therapies were evolved by the practitioners here. They are essentially preparatory in nature. Dhara, mukkippizhichil, navarakkizhi, etc are typical examples. As the practice of Ayurveda expanded in popular acceptance in the recent past, these treatment modalities have also become more prevalent. There are several unique herbal formulations described in Kerala texts. Many of them have now received national level acclaim and they are included in the Ayurvedic Formulary of India. One important aspect of Kerala formulations is that the stress is more on herbal components rather than on metals or minerals. There is also the history of Ayurvedic physicians developing some areas of specialisations like paediatrics, ophthalmology, martial therapy, etc