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 Table of Contents  
REVIEW ARTICLE
Year : 2022  |  Volume : 16  |  Issue : 4  |  Page : 316-320

A study on medovaha srotas W.S.R.To its moolastana


1 Department of Rachana Shareera, SDM College of Ayurveda and Hospital, Hassan, Karnataka, India
2 Department of Prasuthi Tantra and Stree Roga, SDM College of Ayurveda and Hospital, Hassan, Karnataka, India

Date of Submission28-Dec-2020
Date of Decision16-Jun-2021
Date of Acceptance30-Jun-2021
Date of Web Publication17-Dec-2022

Correspondence Address:
S Prasanna
Department of Rachana Shareera, SDM College of Ayurveda and Hospital, Hassan - 573 201, Karnataka
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/joa.joa_327_20

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  Abstract 


Objectives: (1) Critical study of medovaha srotas. (2) To review the anatomy of medovaha srotas and its moolastana, also to fix its anatomical limitation based on modern parameters. Data Sources: Secondary. Review Methods: Literary method is adopted in the present study from the Ayurvedic literature and contemporary science. Results: Anatomical limitation of Medovaha srotas is assessed based on anatomical and functional points and its moolastana is justified with scientific analysis. Conclusion: Medo dhatu exists throughout the body and moola is only the places of significance. Intestine, lymph vessels, blood vessels, liver, and adipose tissue act as Medovaha srotas/channels at different stages in a particular given time. There are different opinions mentioned by different acharyas based on the most important structural and functional observations made by them.

Keywords: Medovaha, moolasthana, srotas


How to cite this article:
Prasanna S, Madhu M. A study on medovaha srotas W.S.R.To its moolastana. J Ayurveda 2022;16:316-20

How to cite this URL:
Prasanna S, Madhu M. A study on medovaha srotas W.S.R.To its moolastana. J Ayurveda [serial online] 2022 [cited 2023 Feb 6];16:316-20. Available from: http://www.journayu.in/text.asp?2022/16/4/316/364050




  Introduction Top


The Ayurvedic concepts are unique and base of our lives. They are like the roots of the tree, one among them being the concept of Srotas. According to our classics, the human body is an agglomeration of the srotas.

Detailed and clear knowledge of srotas becomes very much necessary as it is responsible for carrying and transforming tissue elements, thereby maintaining health.

The ailment related to meda dhatu is at large of late when viewed globally. In the developed society, the death percentage is more from santarpanaja vyadhies except for carcinoma. It may be due to different reasons such as sedentary lifestyle, food adulteration, and pollution; meda is dushya in most of such diseases such as Prameha and Sthoulya. Obesity (Shoulya) is said to reduce the life span by 5.8 years in females and 7.1 years in males.[1]

The study of medovaha sroto moola is essential as the functioning of srotas is completely dependent on the state of moolastana. It is because “Moolamiti prabhavasthanam,[2] i.e., Moolastana is considered as governing site of the srotas.

There is no direct description of the utility of the knowledge of moolastana of the srotas. As a tree is seriously affected by injury to its root, a similar channel of circulation in the human body is seriously affected when their moolastana is affected.[3]


  Concept of Moolasthana Top


Our Acharyas have explained various srotas with their moolasthana. Due importance has been given to these structures which shows a significant relation in performing efficient functions with respect to their srotas. The moolasthanas are very important for the diagnosis, describing the samprapti and fixing the line of treatment. The concept of moolasthanas cannot be completely understood unless and until we study each srotas systematically ascertaining its moolasthana. Acharya Chakrapani commenting on the word srotomoola has used the word “Prabhavasthana” of the srotas.[2]

Medovaha srotas

The srotas that supply nutrition to the medodhatu or the vessels that carry the nutritive material to the site of Medodhatu can be regarded as Medovaha Srotas.

According to Dr. C. Dwarkanath, the channels which transport the nutrition to the adipose tissues are to be termed as the Medovaha Srotas.[4]

Dr. Ghaneker B.G. explains the medovaha srotasas as the capillaries of the omentum and perinephric tissue.[5]

The fat cells are held together mainly by the network of capillary blood vessels which are distributed to them and even these capillaries constitute Medovaha srotas as they are involved in micro circulation.

Moolas of medovaha srotas (roots)

The Acharyas have explained moola of Medovaha srotas in different ways and these can be enumerated as follows:

As per Charaka, it is the Vrika and Vapavahana,[6] While Sushruta explains Vrika and Kati as their moolas.[7] Vagbhata says Vrika and Mamsa.[8]

The three acharya have considered unanimously vrikka as one of the common moola of Medavaha Srotas but Vapavahana, Kati, and Mamsa are mentioned as the second moola separately.

More Anatomical preference is been given than the Physiological point of view by Sushruta and Vagbhata in considering Kati and Mamsa as “Moola” of the Medovaha Srotas while Charaka's consideration was a physiological one.

The definition given by Dr. Ghanekar[5] for Medovaha srotas seems to be acceptable to a certain extent. In his view, every srotas should have its own channel and “Moola.” The definition thus raises the question, whether the prevalence of Medas and Medovaha srotas should be restricted to the perinephric tissue and the omentum only or something different as it also represents the boundaries of the channel.

There are various other places than the above mentioned where the deposition of fat can be observed. For instance, the skin has some fat beneath it. Hence, the existence of medo dhatu should be accepted as spread up throughout the body while, the mentioned parts or organs are only the places of significance.

If we go through embryology, anatomy, and physiology of vrikka at a glance, it makes it quite difficult to consider Vrikka as kidneys. However, Sushruta says meda associated with rakta plays a prime role in the origin of Vrikka.[9] This can be justified with modern concepts to some extent where both the kidney and adipose tissue are derived from mesoderm. Charaka adds them as considering the “Moola.” If so, then these structures must be directly related to fat metabolism. This complex concept is discussed in the discussion part for better understanding.

However, to the extent of modern science as well as Ayurvedic science, no such function is being seen performed by them. If we take into consideration, two structures situated above the two kidneys, i.e., supra-renal glands as Vrikka then to some extent the concepts can be justified.

Vrikka

Dalhana, the commentator of Sushruta mentions the Vrikka as Mamsa-Pindam.[10] Vrikka is round in shape, composed of mamsa, and situated in the abdomen,[11] Vrikka are two in number and they are situated below the flanks.[12] According to Amarakosha, the Vrikka are Agramamsa.[13] According to Acharya sharangadhara, the two kidneys nourish the medas of the abdomen.[14]

Vapavahana

The 2nd moola of the Medovaha srotas according to Charaka has been stated to be Vapavahana. Two vrikka are agramamsa and Vapavahana is carriers of vasa (fat).[12] Chakrapani has interpreted it as Tailvartika;[15] Dr. Ghananath Sen has considered it as omentum.[16] According to amarakosha, Meda vapa and Vasa are Mamsajanya sneha.[17]

Kati

Sushruta has given first preference to Kati as moolasthana of Medovaha srotas then stating the second as Vrikka. Furthermore, he has pointed out the exact site of the Kati where the abundant fat accumulates.

In all the Samhitas, Shroni or Kati has been mentioned as a region rather than an organ. While numbering the sira, Acharya Vagbhata says, 136 sira present in the Antharadhi, 32 of them present in the Kati which shows that Kati is a part of Antharadhi.[18] Although clear limitations are not mentioned for the demarcation of the region Kati, with the help of the surrounding structures, the limitations could be inferred. The upper limitation could be taken as the Nabhi.,[19] and the lower limit could be taken as the Medra and Mushka.[20]

Mamsa

Apart from Vrikka, Vagbhata has considered Mamsa as the moola of Medovaha.[21]


  Discussion Top


Discussion on medovaha srotas and its moolastana

The kidneys are enclosed by a bulk of adipose connective tissue. Behind the renal fascia, there is a considerable quantity of the fat, pararenal (perinephric) body. The same renal fascia apart from the kidney encloses adrenal glands too. These two glands are surrounded by areolar tissue containing a considerable amount of perinephric fat. Even though these two entities (kidneys and suprarenal glands) are enclosed by the same renal fascia, they are separated from each other by a little fibro areolar tissue.[22]

Histologically, this gland has three major distinct zones or layers, namely, Zona Fasciculata Zona Reticularis, and Zona Glomerulosa. Among these three, Zona fasciculate consists of huge polyhedral cells with basophilic cytoplasm which are arranged in straight columns two cells thick, with fenestrated venous sinusoids coursing parallel with and between columns. The cells contain numerous lipid droplets and large amounts of phospholipids, cholesterol, fats, and fatty acids embedded in a complex arrangement of the agranular endoplasmic reticulum.

Physiologically

The Zona glomerulosa is a superficial and thin layer of cells and lies just below the capsule. It constitutes about 15% of the adrenal cortex. They contain a significantly large amount of enzyme aldosterone synthase which is necessary for the synthesis of aldosterone. Thus, these are the only cells in the adrenal gland which is capable of secreting a good amount of aldosterone.

The Zona fasciculate in the middle and the widest layer. It constitutes about 75% of the adrenal cortex. These secrete the glucocorticoids and corticosterone cortisol and small amounts of adrenal estrogens and androgens.

The deep layer of the cortex is the Zona reticularis. It secretes the adrenal androgens dehydroepiandrosterone and androstenedione. These also secrete small amounts of estrogens and some glucocorticoids.

Among these secretions, cortisol shows some relevant shreds of evidence about the metabolism of fat. Cortisol promotes the mobilization of fatty acids from adipose tissue in the same manner how it promotes amino acid mobilization from muscle. Thus, there is an increase in the concentration of free fatty acids in plasma in turn increases their utilization for energy. Cortisol also enhances the oxidation of fatty acids in the cells.[23]

Although cortisol promotes fatty acid metabolism, the mechanism of mobilization is not clearly understood. However, a part of the metabolism may have resulted from reduced transport of glucose into the fat cells. Deposition and maintenance of triglycerides in these fat cells require Glycerophosphate-derived from glucose. Hence, in the absence of this, the fat cells begin to release fatty acids. These two factors, i.e., the increased mobilization of fats by cortisol and the increased oxidation of fatty acids in the cells helps to shift the metabolic systems of the cells at the time of starvation or other stresses from utilizing the fatty acids.[23]

Although the cortisol can cause some degrees of adipose tissue mobilization into fatty acid, excess secretion of cortisol develops a special type of obesity in many people. It may be due to excess deposition of fat in the head and chest regions of the body. It gives a rounded “moon face” and buffalo-like torso. The cause is unknown, but this obesity may have resulted from the excess stimulation of food intake. The fat may be generated more rapidly in some tissues of the body than it is oxidized and mobilized.

Henceforth, Vrikka is not mean merely the kidneys but should be considered as their entire surrounding including perinephric fat and suprarenal glands.

Vapavahanam as another moolasthana

Grossly, Vapavahanam can be considered to a greater extent with greater omentum. Omentum is the largest peritoneal fold of double sheet folded on it so that it is made up of four layers as higher amount of fat accumulated here and it appears like Tailavarthika.[15]

The Greater omentum is rich in fatty tissue and the major function of it being the storehouse of fat and associated function includes limiting the spread of infection in the peritoneal cavity.

These features might have rendered Acharya Charaka to give priority to it as one of the moola sthana of Medovaha srotas.

And further, it will make more sense if we consider even those structures which are sheltered by greater omentum as moola of Medovaha srotas. To some extent, those structures under this omentum have got regulatory effects on the lipid system. One such important structure is the pancreas. Although the pancreas anatomically shows no such significant relation with adipose tissue, functionally it is an important organ that has got a tremendous effect on this system.

So far, we have considered suprarenal glands as showing more reliability as moola of Medovaha srotas. One amazing notifying thing made by recent research shows that hormones of adrenal origin have got some regulatory effect even on the islet of the pancreas.[24]

Apart from this, the pancreas has got some remarkable relation with lipid activity. Pancreatic has three varieties of cells chiefly in its tissue including alpha, beta, and delta cells each having their own respective important metabolic secretions. One among which is insulin secreted from beta cells. This hormone shows some drastic relation with fat metabolism especially in the Conversion of glucose into fatty acid, which promotes synthesis and storage of fat in the adipose tissue.

Kati as moolasthana

Kati can be correlated with the waist as this portion is prone massively to get itself accumulated with the adipose tissue. Besides, the superficial fascia of the abdomen also consists heavily laden with this fat. When the abdomen is cut open in dissection, especially when we try tracing the kidneys, plenty of fat can be seen over there in and around the kidneys. This fat can be considered as the remnants of that which had contributed to the formation of vrikka during embryological origin.[9] Thus, due to this reason perhaps, Sushruta acharya has primarily given importance to the lumbar and sacral area due to importance to the waist and then concentrated toward vrikka.

Mamsa as moolasthana

Vagbhata's consideration of Mamsa as the moola of Medovaha srotas is a complex entity to understand and to explain precisely. However, it might be considered as vasa (Mamsagata Sneha) which lies underneath the skin in the muscles. Charaka explains that one who keeps himself consuming excess abhishyanda, guru ahara, and then ultimately his mamsavaha srotas will also be vitiated.[2] This implies the intimate relation of Medovaha and mamsavaha srotas. Furthermore, Vagbhata says that mamsavaha srotodusti lakshanas can also be considered under Medovaha srotodusti.

To boost up this view, recent researches are showing that rapid transmission of fatty acid molecules takes place from vessel cells to muscles for their final metabolism. The VEGF-B protein from muscle cells signals to blood vessel cells to facilitate the uptake process.[25] Thus, muscles too contain abundant fatty acids. This justifies Vagbhata's view of considering mamsa as one of the moola.

Extensions of medovaha srotas

To explore its extensions and limitations, a systematic physiological view is needed. Right from its synthesis and up to its end products, the channels/media through which they propagate can be considered as the channels of Medovaha srotas.

During digestion, triglycerides are synthesized from oily foods. Most of these triglycerides split into fatty acids and monoglycerides. When these pass through the intestinal epithelial cells, the fatty acids and monoglycerides are resynthesized into new molecules of triglycerides. These triglycerides enter the lymph as minute and dispersed droplets. These droplets having diameters between 0.08 and 0.6 microns are called chylomicrons. A small amount of apoprotein B (a protein) is adsorbed into the outer surfaces of the chylomicrons in the lymph. This prevents chylomicrons from their adherence to the lymphatic vessel walls. Further, these chylomicrons are transported upward through the thoracic duct and are emptied at the juncture of the jugular and subclavian veins to the circulating venous blood.

During this circulation, most of the chylomicrons are removed as they are carried through the capillaries of adipose tissue and the liver. Both the liver and adipose tissue contain plenty of enzymes called lipoprotein lipase.

Lipoprotein lipase enzyme is especially active in the endothelium of capillary. These enzymes in the capillary wall hydrolyze the triglycerides of chylomicrons when they come in contact with the endothelial wall and thus release glycerol and fatty acids. These fatty acids are highly miscible with the cell membranes. Hence, they immediately diffuse into the liver cells and the fat cells of the adipose tissue. Again the fatty acids are resynthesized within these cells into triglycerides and new glycerol is supplied by the metabolic process of the storage cells.

In the early stages of starvation, large quantities of triglycerides appear in the liver. The conditions where the fat is used for energy instead of carbohydrates such as in diabetes mellitus, in such conditions large quantities of triglycerides are mobilized from adipose tissue and are transported as free fatty acids in the blood. These free fatty acids are then redeposited in the liver as triglycerides. Here, in the liver, the initial stages of much of the fat degradation begin. Thus, in normal physiological conditions, the rate at which the lipids are used for energy determines the total amount of triglycerides in the liver.

In addition to triglycerides, the liver cells contain large quantities of cholesterol and phospholipids too. These are continuously synthesized by the liver. The liver cells are also more and more capable of desaturating fatty acids than other tissues. Hence, the triglycerides of the liver are generally more unsaturated than the adipose tissue triglycerides.

Finally, with these, it can be concluded that, to complete the network of Medovaha srotas, it is important to take into consideration of different structures that act as media for this meda to carry at a given particular time interval, these includes

  1. The intestine where absorption of fats takes place
  2. Lymph channels where these triglycerides are drained from the intestine and besides some protein are bound to them
  3. Blood vessels including their capillaries which carry the lipids from lymph channels, up to the liver and adipose tissue
  4. Liver, where storage, synthesis., etc., process that takes place
  5. Adipose tissue, where storage and liberation when needed takes place.



  Conclusion Top


These conclusions were drawn which are based on the literary reviews and discussions.

  • Medo dhatu exists throughout the body and moolas are only the places of significance
  • Intestine, lymph vessels, blood vessels, liver, and adipose tissue act as Medovaha srotas/channels at different stages in a particular given time
  • Charaka's view of explaining vrikka and vapahanam as moolas of Medovaha srotas was from the functional point of view, while Sushruta's view replacing vapahanam with Kati was anatomical
  • Vrikka which is one of the moola of Medovaha srotas, should not be merely correlated with the kidney, however, should be acknowledged with its surrounding area, chiefly the perinephric fat and suprarenal glands
  • Functionally suprarenal glands have got an intimate relationship with fat metabolism
  • Vapavahanam can be correlated with greater omentum anatomically, while with pancreas functionally
  • The waist is laden with abundant fat, thus kati can be correlated with that portion that lies in between the ribcage and hips
  • Vasa i.e., mamsagata sneha (muscle fat) should be taken as moola of this srotas in respect to Vagbhata's consideration of mamsa.


Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.





 
  References Top

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