E-ISSN:2456-3110

Review Article

Medovaha Srotas

Journal of Ayurveda and Integrated Medical Sciences

2024 Volume 9 Number 12 DECEMBER
Publisherwww.maharshicharaka.in

The critical appraisal of Medovaha Srotas: A comprehensive review of conceptual framework, clinical implications and contemporary perspective

Kaur P1*, Dhankar S2, Vishwnath3, Lata S4, Sevatkar B5
DOI:10.21760/jaims.9.12.28

1* Prabhjot Kaur, Post Graduate Scholar, Department of Roga Nidana Evum Vikriti Vigyan, National Institute of Ayurveda De Novo, Jaipur, Rajasthan, India.

2 Sanjay Dhankar, PhD Scholar, Department of Roga Nidana Evum Vikriti Vigyan, National Institute of Ayurveda De Novo, Jaipur, Rajasthan, India.

3 Vishwnath, Medical officer, National Institute of Ayurveda De Novo, Jaipur, Rajasthan, India.

4 Suman Lata, Principal, Harmony Ayurvedic Medical College, Firozpur, Punjab, India.

5 Balkrishan Sevatkar, Post Graduate Scholar, Department of Roga Nidana Evum Vikriti Vigyan, National Institute of Ayurveda De Novo, Jaipur, Rajasthan, India.

Objectives: This review article elaborates Meda Dhatu, Medovaha Srotas and possible Samprapti and its relevance to the contemporary sciences and consequences of disorders produced due to its Dusthi, so that a clear understanding of all these, helps in searching out more diagnostics and treatment protocols.

Data Sources: The classical Ayurvedic texts along with the commentaries, modern science books and internet.

Review Methods: The classical information collected is further analysed and tried to collates according to the modern medicinal knowledge and concluded as per the author’s view.

Results: Proper diagnosis is very important for providing proper treatment and cure of disease. Medo Dhatu Dhusthi is present in almost all the non -communicable diseases in today’s era which is the major cause of death worldwide. Medo Dhatu when collates with the modern science corresponds to the lipids and its Dusthi corresponds to the disorders due to lipid metabolism. Medo Dhatu Dushti leads to a vicious cycle of pathogenesis leading to many lifestyle disorders and this pathogenesis can be understood by the Samprapti of Sthaulya Roga as per Ayurveda.

Conclusion: Medo dhatu and Medo Vaha Srotas along with Samprapti of its Dushti and diseases occurring due to this, needs critical understanding in today’s era of urbanisation. Due to Increased burden of non- communicable diseases, it is the need of an hour to elaborate more about these fundamentals, so that new treatment protocols and diagnostics can be found out. Ayurvedic texts has lot of explanation about all these. We require to analyse and use that knowledge for the benefit of mankind.

Keywords: Medodhatu, Medodhatu Dushti, non- communicable diseases

Corresponding Author How to Cite this Article To Browse
Prabhjot Kaur, Post Graduate Scholar, Department of Roga Nidana Evum Vikriti Vigyan, National Institute of Ayurveda De Novo, Jaipur, Rajasthan, India.
Email: 		Kaur P, Dhankar S, Vishwnath, Lata S, Sevatkar B, The critical appraisal of Medovaha Srotas: A comprehensive review of conceptual framework, clinical implications and contemporary perspective. J Ayu Int Med Sci. 2024;9(12):215-219.
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https://jaims.in/jaims/article/view/3871

Manuscript Received Review Round 1 Review Round 2 Review Round 3 Accepted
2024-11-08 2024-11-18 2024-11-28 2024-12-07 2024-12-17
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© 2024by Kaur P, Dhankar S, Vishwnath, Lata S, Sevatkar Band 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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Download PDFBack To ArticleIntroductionReview of LiteratureDiscussionConclusionReferences
Prabhjot K et al. The critical appraisal of Medovaha Srotas

Introduction

Srotas are the minute channels in the body, that aid in transportation and transformation of various Dosha, Dhatu and Mala. The word Srotas is derived from the root word 'Sru Gatau' which means the movement, flow, secreting etc.

Srotas defined by Acharya Sushruta as small hollow spaces or channels, originating from the root and spreading in the entire body like the roots of the lotus flower.[1]

The importance of Srotas is very significantly explained by Acharya Charaka by giving an entire chapter on it. There are total 13 Srotas given by Acharya Charaka[2] and 11 pairs by Acharya Sushruta.[3] Out of the 13 Srotas explained, the 3 Srotas - Pranavaha, Udakvaha and Annavaha Sortas, are responsible for in taking of the sources of energy from the nature in the form of Vayu, Soma (Jala) and Agni respectively.

The successive seven Srotas - Rasavaha, Raktavaha, Mamsavaha, Medovaha, Asthivaha, Majjavaha, Sukravaha Srotas are responsible for doing nourishment or Poshana of the body, by transforming the energy in suitable forms that can be utilized by the body.

The last three Sortas - Mutravaha, Purishvaha and Svedavaha Srotas, are carrying out the work of excreting the Mala, out of the body in three forms, Mutra, Purisha and Sveda. Hence the Srotas carry out the entire physiological functions of the body and maintain the health of a person by performing or aid in performing the function of in taking, utilization and excretion.

For normal functioning of the body, normal functioning of Srotas is very essential. Any vitiation from normalcy, leads to production of many diseases. In today's era of urbanization, the prevalence of non-communicable disease is increasing day by day and in all these disorders, the involvement of Meda and Medovaha Srotas can be seen directly or indirectly. Acc. to WHO, NCDs kill 41 million people each year and out of this 17 million die before the age of 70 years and 77% are from low- and middle-income countries[4] Such a huge burden needs urgent attention for better understanding of this disease and for making improvements in diagnostics and treatment protocols.

Review of Literature

Meda is one of the Sapta Dhatu, maintaining the Snigdhta in the body. Meda is Matreya Bhava[5] and it is formed when the Mamsagani acts on the Mamsa Dhatu.[6] It has Vata pacifying, Kapha and Pitta increasing properties. It gives Bala, Sneha to body and heavy to digest. It does Bramhana to the body.

Table 1: Root of Medovaha Srotas according to different Acharya

Acharya CharakaVriika and Vapavahna[7]
Acharya SusrutaVrikka and Kati[8]
Acharya VaghbhatVrikka and Mamsa[9]

Vrikka: it is explained as one of the Kosthanaga[10] and is developed from the Prasada Bhaga of Rakta and Meda.[11] Achrya Susruta explained that Vrikka is the ''Mamsapindadvyama Eko Vamprashav, Divitya Dakshin Parshavsthitva''.[12]

Vapavahana: is the Snighda Vartika or Taila Vartika[13] present in the Udara region.

Kati is the waist area.

Mamsa is the Dhatu from where the formation of Meda Dhatu is taking place.

Dushti Nidaan:[14]

  • Avyama: Not doing physical activity that produces tiredness in the body.
  • Day sleeping: Due to increase in Snighda Guna.
  • Medovardhaka Anna Panna: Which is rich in oils, Madhur, Amla, Lavana Ras and Sheeta in
  • Varuni Ati Sevana: Acc. to acharya Susruta Varuni is similar to sura in properties[15]e. it is Laghu, Tikshan, Vibandha Har, Brahmna and Deepna etc. When taken in excess quantities, the increased appetite, will leads to increased consumption of food that leads to increase of Meda Dhatu.

Dushti Lakshana

''Ninditani Prameha Purvaroopani''[16]

Acharya Charka mentioned the Lakshan of Medo Dushti as Prameha Poorvaroopa and Astha Nindita.

Acharya Chakrapani explained in the Teeka the meaning of Nindita as Astha Nindita Dosha of Ati Sthula Purusha.


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Table 2: Dusthi Lakshan by Acharya Charaka.

Prameha Purva Roopa: acc. to Acharya CharakaThe Astha Dosha of Ati Sthulya Purusha: acc. to Acharya Charka
1.  Jatilibhavam Kesheshu1.  Ayuso Hraso
2.  Maduram Asyata2.  Javouprodh.
3.  Karopadyo Suptata and Daha3.  Krichravyavyata
4.  Muka, Talu, Kantha Sosha4.  Daurbalyam
5.  Pipasa5.  Daurgandhyama
6.  Alasyama6.  Svedabadha
7.  Mala Kaya7.  Ksruta Ati Matram
8.  Kaye Chidro Updeha8.  Pipasa Atiyoga.
9.  Paridaha Suptata Angeshu
10. Mutra cha Mutra Dosha
11. Visra Gandha
12. Nindra
13. Tandra cha Sarvakala

Table 3: Vidha Lakhshan by Acharya Susruta

Vidhha Lakshan of Medo Dhatu: acc. to Acharya Susruta[17]
1.  Svedaagmana
2.  Snigdha Angta
3.  Talushosha
4.  Sthoola Shopha
5.  Pipasa

Discussion

Meda is one of the important dhatu, responsible for maintaining the body by imparting Snigdhata to it. It has 2 Updhatus, Sandhi and Snayu.[18] Sveda is the Mala of Meda Dhatu.[19] It has Anjali Pramana of 2 Swamya Anjali.[20] Achrya Sushruta has given Medodhara Kala as third Kala present in the Udar and Anu Asthi of the body.[21] It is also present in large Asthi in mixture with Rakta Dhatu. Achrya Chakrapani has explained two types of Dhatu, Sthayi Dhatu and Asthayi Dhatu. Sthayi Meda Dhatu can be correlated with adipose tissues of the body and Asthyai Medo Dhatu with lipids.

Asthayi Dhatus are always in motion and they being transferred from one place to another in their respective Srotas. Any vitiation, increase or decrease in the quantity and quality of the Dhatus, firstly appears in the Asthayi Dhatus then the Sthayi Dhatus, just like in anemia, the iron stores get depleted in chronic stages. Here also the Asthayi Medo Dhatu which can be taken as lipids is always in movement via blood. The diseases produced by Sthayi Medo Dhatu and Asthayi Medo Dhatu will also be different.

1. Vrikka can be correlated with kidneys and adrenal gland. As kidney have coverings of fatty tissues in the form of Para nephric fat followed by peri renal fat and renal sinus fat in the form of Sthayi Meda Dhatu. Adrenal gland present on the top of kidneys is involved in metabolism of lipids with the help of its various hormones, like epinephrine.

2. Vapavahna which is the Snigdha Vartika that can be taken as omentum which is the large peritoneal fold attached to the stomach and acts as store house of fat.

3. Kati region has lot of adipose tissue and deposition of fat can be seen very first in the Kati

4. Mamsa Dhatu is the muscular tissue and it is taken as Moola Sthana due to the fact that muscles use fat as a source of energy and fat can be burnt inside the body by the muscles.

Samprapti: The pathogenesis of Medo Dusthi and Medo Vaha Srotas Dusthi can be understood with the help of pathogenesis of Sthoulya. The consumption of Nidana, that is excess of Medo Vardhaka Aahra vihara leads to increase in Medo Dhatu. Medo Dhatu has property of accumulation inside the hollow paths and it leads to partial and complete obstruction of lumen of the Srotas. It also changes the morphology and structure of the channel, decreasing the elasticity and functioning of the Srotas. As Srotas are involved in transformations and transportation of various Dhatus, the Dhatus after Meda, will be formed in low quantity and quality, leading to decrease in the functions related with them. Obstruction of Srotas will hamper Medo Agni and less amount of Asthi Dhatu will be formed. Obese patients present early with complaints of joints pain due to this reason along with erosive osteopenia. The successive formed less Majja Dhatu will cause Pandu and symptoms related to it like Daurbalyam and Swasa Roga. Where decreased Sukra Dhatu is directly leading to infertility, hampered Sukra Agni will also degenerate male and female hormones, leading to increase in female and male hormones in males and females respectively. In contemporary science also,it is also hypothesized that the sperm quality may be directly affected by fat redistribution in the liver and increased systemic levels of inflammation.Increased amounts of adipose tissue in the groin and scrotal areas may increase local testicular temperature to a level that further affects sperm quality.[22]


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Till this, Anuloma Kshya is taking place, but when Sukra Dhatu level goes down, the Partiloma Kshya will also be started leading to a vicious cycle of pathogenesis which is difficult to break. The accumulation of Meda inside the Srotas of Mutra, Purisha and Sveda will lead to 5 type of pathological changes inside them viz. Sanga, Atipravruti, Bheda, Sosha and Pradushna. The Dusthi of Mutravaha Srotas will leads to either Prameha Poorarupa, Mutragranthi. The Dusthi of Purishvaha Srotas will leads to Vibandha and it will cause Udavrta and Apana Vayu Dusthi.

Apana Vayu Pratiloma Gati will vitiate Prana Vayu and leading to many Vata disorders like Uccha Raktachaapa, Ekangavata, Pakshagata, Ardita and many more. The Dusthi of Svedavaha Srotas in the form of Sanga is due to insulating properties of fat, that will prevent loss of heat from the body in the form of Sveda. The physiological function of Sveda which is to maintain the Kleda of skin, excreting the Mala, maintain the normal body temperature will also be affected leading to accumulation of Mala inside the skin or body. This leads to many skin diseases in the form of Kustha and Premeha Pidika. Atipravriti type of Dusthi of Svedavaha Srotas occurs when there is excess of Meda inside the body, which has not yet accumulated inside the Sveda Vaha Srotas. As Sveda is the Mala of Medo Dhatu excess sweating will occur. This leads to foul smell from the body.

While looking at the NCDs, Medo Vaha Srotas Dusthi is very significantly observed. All the major NCDs, be it cardiovascular, hypertension, dyslipidemias, diabetes, are due to the Medo Dusthi. In contemporary sciences, there are major three types of lipids present in the blood, cholesterol, fatty acids and triglycerides. Since these are insoluble in water, they are carried with the help of lipoproteins in the blood. Cholesterol is an essential component of the cell membranes, and is necessary for synthesis of steroid hormones, and for the formation of bile acids.[23] Cholesterol is synthesized by liver and many other organs, and is also ingested in the diet in very small amounts. Majority of Cholesterol is formed inside the body. The fecal excretion of bile salts is the only route for the excretion of cholesterol from the body. Triglycerides are lipids in which three long-chain fatty acids are attached to glycerol. Triglycerides serve as a source of energy. They are present in dietary fat and also synthesized by liver and adipose tissue.

While carbohydrates and proteins can be utilized for making fatty acids inside the body, the vice versa cannot occur. Fat serves as concentrated sources of energy and are easy to store. All cells store some triglycerides but adipose tissue is the major site.

Epinephrine and glucagon that increases CAMP concentration increases lipolysis and insulin that lowers CAMP, lowers lipolysis. Triglycerides are degraded into free fatty acids and glycerol. Free fatty acids are utilized by the tissues for energy production and glycerol is reutilized for triglycerides synthesis. Fats can be burnt in the muscles only. That’s the reason that our Acharyas has put the Mamsa Dhatu as Moola of Medo Vaha Srotas and regular muscular activity which is Vyama is required for losing the fat and dieting merely do that and hence Guru Apatarpana is advised. One of the Nidana mentioned by the acharya charka of Sthoulya is the Beej Dosha. In contemporary sciences also, fat regulating center fixes the fat set point. Higher the fat set point, high amount of stored fat in the e body and vice versa. This fat set point is determined by our genes, although our habits can change it. Virechana is mentioned as one of the treatment protocols of Vata Vyadi, Kustha, Prameha and all other major Santarpan Janya Vyadhi. We have seen in the contemporary sciences that bile is the only way to excrete cholesterol from the body.

Conclusion

Meda is one of important dhatus. The Srotomoola of Medovaha Srotas are given scientifically by our acharyas. Understanding of Dushti of Medo Vaha Srotas is very important in today’s era. Majority of lifestyles disorders and non-communicable diseases occurring today, are results of eating Medo Vardhaka Ahaar Vihar and it is leading to vicious cycle of disorders, for which there is a need to find new methods of diagnosis and treatment. Virechana plays an important role in all Santarpan Janya Vyadhi.

References

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2. Charaka Samhita Vimaansthana. 5/6. Available from: http://niimh.nic.in/ebooks/ecaraka


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