E-ISSN:2456-3110

Review Article

Siravyadha

Journal of Ayurveda and Integrated Medical Sciences

2022 Volume 7 Number 8 September
Publisherwww.maharshicharaka.in

Anatomical exploration of Sushrutokta sites of Siravyadha in Upper Extremities

Chitragupt A.1*, Bhutali K.2, Patil M.3
DOI:

1* Ankita Chitragupt, Post Graduate Scholar, Department of PG Studies in Rachana Shareera, Shri Shivayogeeshwara Rural Ayurvedic Medical College and Hospital, Inchal, Karnataka , India.

2 Kavita Bhutali, Reader, Department of PG Studies in Rachana Shareera, Shri Shivayogeeshwara Rural Ayurvedic Medical College and Hospital, Inchal, Karnataka , India.

3 M. R. Patil, HOD, Department of PG Studies in Rachana Shareera, Shri Shivayogeeshwara Rural Ayurvedic Medical College and Hospital, Inchal, Karnataka , India.

Ayurveda is a holistic healthcare system of medicine which is more than 5000 year old. Sushruta known as Father of Surgery has described various surgical procedure along with some parasurgical measure. Raktamokshana is the one of the principal Shodhana therapy in Ayuveda. Acharya Sushruta advocate that if all the fivefold purificatory process cannot be performed due to lack of time then ever Raktamoskhana can serve the purpose. Acharya Sushruta has mentioned Siravyadhana most important method where Raktamoskhana is indicate and considered as Ardhachikitsa[1] Siravyadha is found very rarely used in Ayurvedic practise, may be because of lack of experience about the basic concept of Sharia like Vedhya - Avedhya Sira, the exact sites where Shastra Patana can be done and also the other vital structures to be avoid from injury during the procedures. Siravyadha at a specific site according to different diseases is important part of this therapy. As Acharya Sushruta has mentioned specific sites of Siravyadha for various disease in Sharira Sthana,[2] it appear surprising why Sushruta has mentioned particular sites for Siravyadha in different diseases, why can't common sites is selected in all diseases. So, considering its importance a comprehensive study is done to identify and locate Sira of Vyadhana Sthana on basis of available literature. The study is limited to upper extremities.

Keywords: Sushruta Samhita, Siravyadha, Raktamokshana

Corresponding Author How to Cite this Article To Browse
Ankita Chitragupt, Post Graduate Scholar, Department of PG Studies in Rachana Shareera, Shri Shivayogeeshwara Rural Ayurvedic Medical College and Hospital, Inchal, Karnataka , India.
Email: 		Ankita Chitragupt, Kavita Bhutali, M. R. Patil, Anatomical exploration of Sushrutokta sites of Siravyadha in Upper Extremities. J Ayu Int Med Sci. 2022;7(8):93-96.
Available From
https://www.jaims.in/jaims/article/view/2031

Manuscript Received Review Round 1 Review Round 2 Review Round 3 Accepted
2022-07-30 2022-08-01 2022-08-08 2022-08-15 2022-08-22
Conflict of Interest Funding Ethical Approval Plagiarism X-checker Note
Nil Nil Yes 18%

© 2022by Ankita Chitragupt, Kavita Bhutali, M. R. Patiland Published by Maharshi Charaka Ayurveda Organization. This is an Open Access article licensed under a Creative Commons Attribution 4.0 International License https://creativecommons.org/licenses/by/4.0/ unported [CC BY 4.0].

Journal of Ayurveda and Integrated Medical Sciences 2022;7(8)93
Chitragupt A et al: Anatomical exploration of Sushrutokta sites of Siravyadha

Introduction

To show the importance of the study of Sharira Rachana, Acharya Sushruta has rightly quoted that no one can become a good physician without having the proper theoretical & practical knowledge of anatomy of human body (Sharira Rachana).

When, ‘Sira Sharira’,[3] ‘Siravyadha Vidhi Sharira[4] of Sushruta Sharira Sthana are reviewed. Siravyadha is chief line of treatment in management of many diseases. But here the study is limited to only ‘Urdhwa’ Shakhas. Because Acharya Sushruta has quoted different Siravyadhana Sthanas in different diseases.[5]

Bloodletting at a specific locations and veins is an essential part of surgery in Ayurveda and Marma therapy. As being a strong therapy, it should only be performed by therapists who are well trained and who have a good degree of knowledge regarding the sites of superficial veins and also other vital structures to be avoided from injury.[6]

Aims and Objectives

1. To study the Regional Anatomy of sites of Siravyadha in the upper limb by cadaver dissection.

2. To compare various sites of Siravyadha mentioned in Samhitas to the superficial venous pattern to determine the exact superficial vein on which Siravyadha is to be done in various diseases.

3. To correlate upper limb Vedhya Sira with underlined structure according to modern anatomy.

4. To determine the relation between various diseases and their sites of Siravyadha (of upper limb) to the possible extent.

Materials and Methods

1. Various classical Ayurvedic literature have been studies and related references of Sira Sharir and Siravyadha Vidhi Sharir are collected from the following ancient Ayurvedic literature:

a. Brihatrayi (Sushruta Samhita, Charak Samhita, Astanga Hridaya).

b. Laghutrayi (Sharangadhara, Bhavaprakash, Madava Nidana)

c. Upanishad

d. Other Ayurvedic texts

2. Various modern text books were also studies for the anatomy of superficial venous pattern.

3. Comparative study of various structure which can better understanding of Urdha Shakha Siravyadha Sthana and all other structure that can be included in Urdha Shakha Siravyadha Sthana.

4. With reference the various Ayurved Journals and Modern Science applied aspect of surgico-anatomical view have been discussed.

Review of Literature

According to Acharya Sushruta Siras are 700 in number[7] divided in 4 Group out of them 400 are present in extremities Thus these Siras in the extremities should be avoided for surgical operation.

Avedhya Siras

Acharya Sushruta mentioned specific and detailed description of Sriavyadhas well as Vedhya and Avedhya Siras for the first time in the history of Indian medicine and surgery. He mentioned 98 Avedhya Siras[8] which should be taken care by the physician or surgeon at the time of Siravyadha or any other surgical condition. Any trauma of these structures may lead to morbidity or death.

Siravyadha Sthana

In each extremity, the number of Siras are one hundred; out of them, the four viz, one by name ‘Jaladhara’ and three situated deep inside, should not be cut (i.e., Avedhya Siras)

1. Pleehodara[9]

In diseases of Pleeha, puncturing should be done especially in the left arm either at the inner side of elbow joint in the centre of arm or in the area between the little and ring fingers. As per above information in Pleehodara Siravyadha is done in left sided Kurpara Sandhi Sthita Sira i.e., median cubital vein which is situated above “Kurpara Marma.” It is a type of Sandhi Marma controlling Raktavaha Srotas, so that Marma on right controls liver, Marma on left controls spleen.

2. Yakridalyodar[10]

In Yakrudalyudara, puncturing should be done especially done in the right arm at the same space. As per above said quotation


Journal of Ayurveda and Integrated Medical Sciences 2022;7(8)94
Chitragupt A et al: Anatomical exploration of Sushrutokta sites of Siravyadha

in Yakrudotodara and Kaphodara, Kasa Shwasa Siravyadha is done is right sided ‘Kurpara Sandhi Sthita,’ it is right median cubital vein, which is situated above Kurpara Marma. It is a type of Sandhi Marma controlling Raktavaha Srotas, so that it controls functions of liver and spleen.

3. Kaphodara[11]

Kaphodara is a type of Udara, where predisposing factors are Avyayam, Divasvapna, Adhika Madhura, Picchila, Dadhi, Dugdha Sevana. Avrutavata involving Kapha resulting into enlargement of abdomen outside the intestines.

4. Vishwachi

When Prakupitavata involves Bahu, Prushta, Hasta, Tala and Anguli-Kandaras, then there is Karma Kshaya of Bahu. In Vishwachi (pain in the arms) will be similar to that of Grudhrasi, so four Angula above or below the Kurpara Sandhi Siravyadha is done.

5. Apachi[12]

In Apachi Raktamokshana is done 2 Angula below Indrabasti Marma.

Discussion

Science is always subjected for change. On other hand Ayurveda is generally emphasized on its classical texts, Apta Vachana by ancient Acharyas. The concepts are evolved many years ago, because of generation gap and lack of interpretation; concepts are not passed onto future generations properly. So, now we are lacking the opportunity to understand and to clarify the doubts. So, the present study was carried out to ‘anatomically locate Shakhagata Vedhya Sira Sthanas in particular diseases (literary research). So that the concepts of Sira Sharira and Sira Vyadha Vidhi Sharira can be better understood and to pass on knowledge to the future generation for its practical utility.

So, the present study was concerned out to anatomical exploration of Sushrutokta Vedhya Sira Sthana in particular disease.

Conclusion

In Ancient time Acharya Shushrut describe the procedure of Raktamokshana to cure various disease for which Siravyadha is

used. During study of Siravyadha in Urdhashkhagata Vedhya Sira Sthana. This Sira present in left Upper limb in between left Kanisthika and Anamika Angul or Vama Kurpara Sandhi Sthita Sira can be compare with the left median cubital vein in left Upper limb and Dkshina Kurpara Sandhi Sthita Sira. Sira is present in between right Kanishthika and Anamika Angulis. It can also be compared with right Median cubital vein. In present time the theory of Siravyadha given by Acharya Shushrut described in Raktamokshana which is used in medical science as intravenous infusion, i.v. injectable. It can be used in dialysis for fistula, venesection etc. Thus, the Siravyadha procedure given by Acharya Shushruta is seen implemented in modern practice also with a clear perspective that upper limb Siras are hereby the Siras given in ancient studies and vein in modern science.

Reference

1. KaviRaj Dr. Ambika Datta Shastri Sushruta Samhita of maha maharshi sushruta, sharira sthana, Chapter No.8, Shloka No.17, Varanasi, Chaukhambha Sanskrit Santhan, reprint 2013, Page No.87,88.

2. KaviRaj Dr. Ambika Datta Shastri Sushruta Samhita of maha maharshi sushruta, sharira sthana, Chapter No.8, Shloka No.23, Varanasi, Chaukhambha Sanskrit Santhan, reprint 2013, Page No.91

3. KaviRaj Dr. Ambika Datta Shastri Sushruta Samhita of maha maharshi sushruta, sharira sthana, Chapter No.7, Varanasi, Chaukhambha Sanskrit Santhan, reprint 2013.

4. KaviRaj Dr. Ambika Datta Shastri Sushruta Samhita of maha maharshi sushruta, sharira sthana, Chapter No.8, Varanasi, Chaukhambha Sanskrit Santhan, reprint 2013.

5. KaviRaj Dr. Ambika Datta Shastri Sushruta Samhita of maha maharshi sushruta, chikitsa sthana, Chapter No.14, Shloka number 31, Varanasi, Chaukhambha Sanskrit Santhan, reprint 2013. Page No. 70-71.

6. KaviRaj Dr. Ambika Datta Shastri Sushruta Samhita of maha maharshi sushruta, sharira sthana, Chapter No.7, Shloka number 20, Varanasi, Chaukhambha Sanskrit Santhan, reprint 2013. Page No. 82


Journal of Ayurveda and Integrated Medical Sciences 2022;7(8)95
Chitragupt A et al: Anatomical exploration of Sushrutokta sites of Siravyadha

7. KaviRaj Dr. Ambika Datta Shastri Sushruta Samhita of maha maharshi sushruta, sharira sthana, Chapter No.5, Shloka number 6, Varanasi, Chaukhambha Sanskrit Santhan, reprint 2013.

8. KaviRaj Dr. Ambika Datta Shastri Sushruta Samhita of maha maharshi sushruta, sharira sthana, Chapter No.7, Shloka number 6, Varanasi, Chaukhambha Sanskrit Santhan, reprint 2013.

9. KaviRaj Dr. Ambika Datta Shastri Sushruta Samhita of maha maharshi sushruta, nidana sthana, Chapter No.7, Shloka number 13, Varanasi, Chaukhambha Sanskrit Santhan, reprint 2013.

10. KaviRaj Dr. Ambika Datta Shastri Sushruta Samhita of maha maharshi sushruta, sharira sthana, Chapter No.7, Shloka number 16, Varanasi, Chaukhambha Sanskrit Santhan, reprint 2013.

11. KaviRaj Dr. Ambika Datta Shastri Sushruta Samhita of maha maharshi sushruta, nidana sthana, Chapter No.11, Shloka number 10, Varanasi, Chaukhambha Sanskrit Santhan, reprint 2013.

12. KaviRaj Dr. Ambika Datta Shastri Sushruta Samhita of maha maharshi sushruta, nidana sthana, Chapter No.11, Shloka number 10, Varanasi, Chaukhambha Sanskrit Santhan, reprint 2013


Journal of Ayurveda and Integrated Medical Sciences 2022;7(8)96