One who has excess fat and phlegm should first practice the six purificatory acts. Others should not practice them, as their doṣas are in balance.

This verse introduces an important instruction about the ṣaṭkarmas (six purificatory actions). Only those with excess medas (fat) and śleṣma/kapha (phlegm) need to practice them before beginning prāṇāyāma.

The six karmas are: dhauti (cleansing of the digestive tract), basti (colon cleansing), neti (nasal cleansing), trāṭaka (eye cleansing), nauli (abdominal massage), and kapālabhāti (cranial cleansing). These remove physical impurities that obstruct the flow of prāṇa.

However, the verse warns that those whose doṣas (humors) are balanced (samabhāvataḥ) should not practice these karmas, as they could create imbalance where none existed. This is an application of the āyurvedic principle of individualized treatment. An experienced master evaluates the student’s constitution before prescribing specific practices.