E-ISSN:2456-3110

Review Article

Nabhi Shareer

Journal of Ayurveda and Integrated Medical Sciences

2023 Volume 8 Number 6 June
Publisherwww.maharshicharaka.in

Nabhi Shareer w.s.r. to Nabhi as Pitta Sthana - A Review

Chitragupt A.1*, Rani Ratna B.2
DOI: http://dx.doi.org/10.21760/jaims.8.6.14

1* Ankita Chitragupt, Assistant Professor, Department of Rachana Shareer, Babu Yugraj Singh Ayurvedic Medical College and Hospital, Lucknow, Uttar Pradesh, India.

2 Bibha Rani Ratna, Associate Professor, Department of Dravya Guna, Babu Yugraj Singh Ayurvedic Medical College and Hospital, Lucknow, Uttar Pradesh, India.

Ayurveda is a holistic science. Science always believes on principle and fact that are methodically proved and undeniably accepted. Ayurveda as a medical science cover all aspect of Rachana Shareer and Kriya Shareer. To understand Rachana Shareer the primary knowledge of anatomical landmarks is important. On the basis of these anatomical landmark the Physician and Anatomist can approach these diagnoses and treatment in better way. In Ayurvedic science till date there are many concepts which need to be explained well in which Nabhi is one of the Concept. The Nabhi plays an utmost imp role in development of body from very beginning of life. The central point of body in between Amashaya (location of undigested food) and Pakwashaya (location of digested food) is termed as Nabhi.[1] In classical text of Ayurveda, scattered references regarding Nabhi Shareer is available. But because of intense importers all most all Acharya has considered Nabhi as anatomical landmark to identify the position of various organ. In which Acharya Vagbhata quotes Nabhi as Pitta Sthana.[2] Even though the Dosha are stated to be present all over the body. Among Tridosha, Pitta play a major role in digestion and metabolism, production of heat and from of energy. Many Acharyas explain it as Agni Sthana or Jyoti Sthana. In this review article we are trying to anatomically locate Nabhi as Pitta (Pachak Pitta) based on classical literature.

Keywords: Nabhi Shareer, Pitta Sthana, Anatomical landmark

Corresponding Author How to Cite this Article To Browse
Ankita Chitragupt, Assistant Professor, Department of Rachana Shareer, Babu Yugraj Singh Ayurvedic Medical College and Hospital, Lucknow, Uttar Pradesh, India.
Email: 		Ankita Chitragupt, Bibha Rani Ratna, Nabhi Shareer w.s.r. to Nabhi as Pitta Sthana - A Review. J Ayu Int Med Sci. 2023;8(6):86-90.
Available From
https://jaims.in/jaims/article/view/2539

Manuscript Received Review Round 1 Review Round 2 Review Round 3 Accepted
2023-04-24 2023-04-26 2023-05-03 2023-05-10 2023-05-17
Conflict of Interest Funding Ethical Approval Plagiarism X-checker Note
Nil Nil Yes 17%

© 2023by Ankita Chitragupt, Bibha Rani Ratnaand 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].

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Introduction

To show the importance of the study of Shareer Rachana, Acharya Sushruta has highly quoted that no one can became good physician without having proper theoretical and practical knowledge of anatomy of human body (Shareer Rachna). So, to become a good physician the knowledge of Shareer Rachana is very important to accomplish the successful Chikitsa. A morphological feature of the anatomy is identified and after identification it is used as а reference point for other body organ and that is termed as anatomical landmarks.[3] These anatomical landmarks mainly identify specific structure or position. In Ayurveda, Nabhi Shareer is one such unexplored and anatomical landmarks which is widely used. In Classical text many references are available regarding Nabhi Shareer which is available in scattered form. Nabhi is Agni Sthana or Jyoti Sthana. This is where Samana Vayu (the Prana or life force energy that support digestion, formation and elimination of urine) and Pachak Pitta (digester fire) reside.

Aim and Objectives

1. To study Anatomical landmark of Nabhi

2. To study the various reference from different Samhitas regarding Nabhi Shareer.

3. To correlate Nabhi Shareer as a Pitta Sthana.

Materials and Methods

Source of data: Literary and conceptual study done by collecting data from Bruhatrayis, Laghutrayis and other classical books including Journals, internet website, previous work done.

Review of Literature

Nabhi: The form Nabhi is derived from the words Nah – Bandhe.[4] It means to bind or to tie to the central point just like the spokes of wheel head at the navel.

Paryayas of Nabhi: Reference regarding synonyms of Nabhi stated in Ayurveda Shabdhakosha include as,

1. Bimbi (Navel) - used as umbilicus - an anatomical land mark on the anterior abdominal wall.


2. Chakratumba (Hub of wheel) - used in references, as site of origin of Sira and Dhamanis, simulating the spokes of wheel radiating from the hub.

3. Mukhya, Pramukha (Leader, chief) - in reference to its meaning as the root or its significance.

4. Kasturimruga (Muskdeer) - Due to the fact that the umbilicus of the muskdeer contains the heavenly fragmented musk i.e.,

5. Kshatriya - To illustrate its significance.

6. Moolapurush - May be because of the belief that, Lord Brahma, the creator himself first appeared from the lotus sprung from the Nabhi of Lord Vishnu.

7. Antarbhaga (internal part) - Probably from the root of ‘Nabhi’ that is burst asunder or into a hole.

8. Tundakupi - Tundi meaning ‘protruberant belly’ and Kupi meaning ‘belly cavity’.

9. Udavarta - A coiled land mark of the Udara.

Nabhi explanation by differ various Acharyаs

Sushrutakto view

  • According to Acharya Sushruta, Nabhi is the site of origin of birth Dhamini and Sira. There are 700 Sira[5] and 24 Dhamani[6] in our body.
  • They originate from Nabhi and spread in 3 direction that is up, down and transverse.
  • Nabhi is mentioned as Maturjabhava as it is [7]
  • 12 type of Prana of an organism are located at Nabhi.[8]
  • Nabhi Shareer is surrounded by all side from spokes coming from the center of the wheel the root of Siras is Nabhi because it extends upward, downward and oblique.[9]
  • Nabhi is situated between Pakwashay and Amashaya[10] mentioned that Pakwashya is located below the Nabhi and above the Shroni and [11]

Anatomical landmark: In Sushrut Samhita, the dimensions of various parts of body are mentioned keeping Nabhi as a landmark. The dimensions from Shishn to Nabhi and from Nabhi to Hrudaya are 12 Angula.[12]



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Acharya Sushruta mentioned that if in Uttarbasti, the medicines administered does not comes out, then the physician should press the abdomen below Nabhi with force by clenched fist.[13] In context of Parisravyaudara, it has been mentioned that the region of abdomen below the Nabhi becomes enlarged and it give rise to severe pricking abdominal pain and burning sensation.

Sushruta mention that left side of navel leaving 4 Angula space for laparotomy one should give incision.

Charakota view

  • Term Kostha and Ashaya have been used in reference of cavity and vital organs so among 15 Kosthanaga Nabhi is one of them and present in Madhya Sharer.[14]
  • Nabhi Marma is one among 107 Marma explained by Acharya Chara Injury to this lead immediate death or death within 7 days.[15] This Marma is one's own palm size in area 4 Angula.[16]

Anatomical landmark: Acharya Charak has demarcated the treatment plan in Vataja Gulma on basis of Nabhi. He mentioned that Snehapana is indicated in Gulma, especially if disease is occurring in region above Nabhi. If Gulma is manifested in region of Pakwashaya, then Basti is the treatment of choice. If Gulma is located in Jathar (Nabhi or on either side of abdomen at the level of Nabhi) then both Snehpaan and Basti have to be administered as its treatment plan.[17] Acharya Charak mentioned Nabhi as one of the site where pressure should be applied after giving medicines to induce Vamana.[18]

Astanga view: Astanga Sangraha and Astanga Hrudaya - In both classical text book explain navel as Matrujabhava this suggest Nabhi is soft and delicate structure of 3 Among Kosthanga - Acharya Vagbhata explain Nabhi is one of them.[19]

  • Nabhi as Pitta Sthana[20]
  • Nabhi is one among Dosha Prayathana and Sadya Pranahara Marma.[21]

Nabhi as Pitta Sthana: Among Tridosha, Pitta Dosha is responsible for digestion, metabolism, heat production and other forms of energy. That is why Pitta Dosha is termed as Agni. Pitta Dosha is of 5 types these 5 Pitta Dosha have different location and function.

Among 5 type of Pitta, Pachaka Pitta as and has important function on digestion and metabolism. Astanga Hrudaya and Astanga Sangraha describe about Pachak Pitta, it is Punchbhauthik but Tejo dominant. Nabhi is one of the sites of Pitta. According to Sushruta the Garbha develops due to Rasa and Marutadhmana (flow of Vata). Nabhi is called Jyothi Sthana and the Agni in the Nabhi of the Garbha fanned by Vayu. The same Vayu in combination with the Agni spreads in Srotas in vertical, horizontal and oblique direction and thus growth of the Garbha takes place. Dalhana explains the term Maruta Dhmana by saying "Vata entering into the Srotas (Sira) in Dhatus of the fetus causes their dilatation, thus providing space for its growth". Here two factors are responsible for the development of the fetus – Mother's Ahara Rasa and Vayu with Agni. Here Nabhi is considered as the Jyothi Sthana for the place of Agni. Vaghbhata has considered the Agni lies between Nabhi and Hrudaya. The Garbha gets nutrition through Nabhi Nadi. For this it seems Sushruta has used the word Rasa Nimitta and Maruta Dhmana. Here the term Srotas is interpreted for veins and arteries of the umbilical cord.

Discussion

The above description explains lot of importance of Nabhi Shareer in clinical embryological, anatomical and physiological aspect. In this review article an effort is made to exhibit Nabhi Shareer with anatomical landmark by referring all the classical text books and literature. Nabhi being a center of Agni dominant place. Nabhi structurally is dominant place for Pitta Sthana with the help of Samana Vayu located at Nabhi perform the process of digestion. Acharya Sharangdhara has narrated beautifully the normal physiology of respiration, but by accepting Nabhi as umbilicus it seems difficult to get the practical applicability of the procedure mentioned in it. Nabhistha Prana means deoxygenated blood available in capillaries; converted into oxygenated blood after connecting through Hrat Kamalantaram means lungs.

Generally, Nabhi is considered as a superficial regional landmark to describe the site of various organ like Grahani is situated on Nabhi, Pakvashaya at lower side of it.[22] Amashaya is situated in between Nabhi and Stana.[23] Nabhi is made of dense fibrous tissue.


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Its position is variable. In healthy adults, it lays in anterior median line at the level of disc between L3 and L4 vertebrae. It is lower in infants and in persons with pendulous abdomen. Nabhi is lying midway between the suprasternal notch and symphysis pubis.[24] A cord which is attached with navel of baby and on other side with placenta of mother is known as Umbilical cord (Nabhinadi). Hence; Nabhi is avowed as the Dharani i.e., foundation, truly umbilicus is the base of your body and during foetal life, it is the support of survival for foetus. Regarding the describing the signs indicating the elongated life of baby; Acharya Charaka mentioned that the baby having right curved Navel would get elongated life.[25]

Conclusion

The place of Nabhi is very important in Ayurveda. Nabhi is the structure from where something arise and generates, which is taken to enter where pokes arise and generate as Pitta Sthana. Amashaya and Pakvashaya are considered as the site of origin of most of the disease, so the site of Nabhi is based on its significance in treatment as Dosha Nirharna is done either through anal or oral route. Understanding Pitta (Pachaka) Sthana and its implications more effort is to be given in planning and treatment.

Reference

1. Sushruta Yadavji Trikamji Acharya editor Sushruta samhita with Nibandha Sangraha of Dalhanacharya reprint 2003. Varanasi, Chaukambha Orientalia. pg-373.

2. Vagbhata Astanga Hrudaya of Srimadbhagavata by Dr Brahmanand Tripati, 12 Chp./2 Shloka reprint 2003, Varanasi chaukamba Surbharati Prakashana pg-367.

3. Anatomic landmark. (n.d.) Medical Dictionary for the Dental Professions. (2012). Retrieved May 142021from https://medicaldictionary.thefreedi ctionary.com/anatomic+landmark

4. Pandit Amarasinha, Amarakosha edited by Hargovind Shastri dvitya khanda 8/56, chaukambha Sanskrit sansthan Varanasi 2012,Pg-371.

5. Susruta Yadavji Trikamji Acharya editor Susruta samhita with Nibanda sangraha of Dalhanacharya reprint ed. Varanasi Chaukamba Orientalia 2010 Pg-383.

6. Susruta Yadavji Trikamji Acharya editor Susruta samhita with Nibandha sangraha of Dalhanacharya reprint edition Varanasi Chaukamba Orientalia 2010 pg-376.

7. Agnivesha. Vaidya Yadavji Trikamji Acharya editor Charaka samhita revised by Charaka and Drudbala with Sri Chakrapani datta Ayurveda divika commentary in Sanskrit reprint ed.Varanasi Chaukamba Sanskrit sansthan 2013 pg-310.

8. Susruta Yadavji Trikamji Acharya editor Susruta samhita with Nibandha sangrahs of Dalhanacharya reprint edition 2003 Varanasi Chaukamba orientalia pg-360.

9. Susruta, Susruta samhita Sharira sthana with the Nibandha sangraha commentary of Shri Dalhanacharya edited by Vaidya Yadavji Trikramji Acharya Chaukambha surbharti prakasha Varanasi reprint 2017 3/31 pg-353.

10. Sushruta Yadavji Trikamji Acharya editor Sushruta samhita with Nibandha Sangraha of Dalhanacharya reprint 2003. Varanasi, Chaukambha Orientalia. pg-373.

11. Vaghbhata Astanga Hrudaya Nidana Sthana English translation by k r Krishnamurthy- Krishnadasa academy reprinted 2014 ref 15/9 pg-149,150

12. Susruta, Susruta samhita sutra sthana with the Nibandha sangraha commentary of Shri Dalhanacharya edited by Vaidya Yadavji Trikramji Acharya Chaukambha surbharti prakasha Varanasi reprint 2017 35/13 pg 151.

13. Susruta, Susruta samhita chikitsa sthana with the Nibandha sangraha commentary of Shri Dalhanacharya edited by Vaidya Yadavji Trikramji Acharya Chaukambha surbharti prakasha Varanasi reprint 2017 ref 37/119 pg-539.

14. Agnivesa, Vaidya Yadavji Trikamji Acharya editor Charaka samhita revised by Charaka and Drudbalacharya with Chakrapanidatta Ayurveda dipika commentary in Sanskrit reprint ed. Varanasi Chaukamba Sanskrit sansthan 2013 pg -338.

15. Susruta, Susruta samhita Sharira sthana with the Nibandha sangraha commentary of Shri Dalhanacharya edited by Vaidya Yadavji Trikramji Acharya Chaukambha surbharti prakasha Varanasi reprint 2017 3/31 pg-353.


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16. Susruta, Susruta samhita Sharira sthana with the Nibandha sangraha commentary of Shri Dalhanacharya edited by Vaidya Yadavji Trikramji Acharya Chaukambha surbharti prakasha Varanasi reprint 2017 6/6,25 pg - 370,373.

17. Susruta, Susruta samhita nidana sthana with the Nibandha sangraha commentary of Shri Dalhanacharya edited by Vaidya Yadavji Trikramji Acharya Chaukambha surbharti prakasha Varanasi reprint 2017 ref 7/20 pg 297

18. Agnivesha,Charaka samhita chikitsa stana Ayurveda dipika commentary of Chakrapani datta edited by Yadav ji trikramji Chaukambha surbharti prakasha Varanasi reprint 2016 ref 5/24 pg-437.

19. Ashtanga sangraha of vaghbata translated by Prof K R Krishna Murthy 3rd ed. 2001 Varanasi Chaukamba Orientalia pg -368.

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22. Sharangadhara, Sharangdhara Samhita translated into English by Prof.KR Srikanta Murthy,, Pratham Khandal Kaladikakhyanadhyay, 5/48, Chaukhambha Orientalia, Varanasi, First edition, 1984:pg:25.

23. Agnivesha, redactor Acharya Charak, Charak Samhita edited by Vaidya Yadavaji Trikamji Acharya, Siddhisthana, 01/40, Chaukhamba Surabharat Prakashan, Varanasi, 2008 p.684.

24. Diny Thomas, Kulkarni BG, Nabhi Marma An Embryological and Anatomical Focus, J-ISM, V2(4), Oct- Dec 2014, pg.201-205.

25. Agnivesha, redactor Acharya Charak, Charak Samhita, edited by Vaidya Yadavaji Trikamji Acharya, Chaukhambha Prakashan, Varanasi, 2008.p.350.


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