https://www.carakasamhitaonline.com/api.php?action=feedcontributions&feedformat=atom&user=Manishdubey 2026-04-05T22:30:20Z User contributions MediaWiki 1.43.6 https://www.carakasamhitaonline.com/index.php?title=Udakavaha_srotas&diff=44318 2023-11-03T11:53:14Z

<p>Manishdubey: </p> <hr /> <div>{{CiteButton}}<br /> {{#seo:<br /> |title= UDAKAVAHA SROTAS (Channels for transport and transformation of watery components)<br /> |titlemode=append<br /> |keywords=Udakavaha Srotas, Water metabolism, Bhojani M. K., Tanwar Ankur Kumar, Basisht G, Deole Y.S.<br /> |description=Udaka means water. In body, water is present in the form of various fluids. Udakavaha srotasa are the channels for transport and transformation of fluid (water) and its circulation. <br /> |image=http://www.carakasamhitaonline.com/mediawiki-1.32.1/resources/assets/ogimgs.jpg<br /> |image_alt=carak samhita<br /> |type=article<br /> }}<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Udaka means water. In [[Sharira|body]], water is present in the form of various fluids. Udakavaha srotasa are the channels for transport and transformation of fluid (water) and its circulation. They are the pathways that originate from the palate (talu) or kloma (an internal organ controlling thirst) through which fluids circulate throughout the body. [Code:SAT-B.475]&lt;ref name=&quot;ref1&quot;&gt;National AYUSH Morbidity and Standardized Terminologies Electronic Portal by Ministry of AYUSH Available on http://namstp.ayush.gov.in/#/Ayurveda&lt;/ref&gt; A water-based solution of ions and other compounds makes up most of the adult human body's 60% fluid content. Water makes up most of a cell's primary fluid medium except fat cells. It is present in most cells at a concentration of between 70 and 85 percent.&lt;ref name=&quot;ref2&quot;&gt;A. C. Guyton and J. E. Hall, Textbook of Medical Physiology. 11th edition. Pennsylvania: Elsevier Saunders, 2006.&lt;/ref&gt;The human body uses water as a construction material, a lubricant, a shock absorber, a solvent, a reaction medium, and a reactant. It also serves as a transporter for nutrients and waste products. Water balance must be managed for the preservation of health and life.&lt;ref name=&quot;ref3&quot;&gt;Jéquier E, Constant F. Water as an essential nutrient: the physiological basis of hydration. Eur J ClinNutr. 2010;64(2):115-23.&lt;/ref&gt; So udakavaha srotas are the channels for regulating the water homeostasis in the human body, and failure to do the same can lead to death. This article deals with physiological, pathological and therapeutic aspects of udakavaha srotasa. &lt;/p&gt;<br /> <br /> {{Infobox<br /> |title = Contributors<br /> |label1 = Section/Chapter/topic<br /> |data1 = Concepts/[[Srotas]][[Udakavaha Srotas]] <br /> |label2 = Authors<br /> |data2 = Bhojani M. K. &lt;sup&gt;1&lt;/sup&gt;, Tanwar Ankur Kumar &lt;sup&gt;1&lt;/sup&gt; <br /> |label3 = Reviewer <br /> |data3 = Basisht G.&lt;sup&gt;2&lt;/sup&gt;<br /> |label4 = Editor<br /> |data4 = Deole Y.S.&lt;sup&gt;3&lt;/sup&gt;<br /> |label5 = Affiliations<br /> |data5 = &lt;sup&gt;1&lt;/sup&gt; Department of Sharir Kriya, All India Institute of Ayurveda, New Delhi, India<br /> &lt;sup&gt;2&lt;/sup&gt; Rheumatologist, Orlando, Florida, U.S.A.<br /> &lt;sup&gt;3&lt;/sup&gt; Department of Kayachikitsa, G. J. Patel Institute of Ayurvedic Studies and Research, New Vallabh Vidyanagar, Gujarat, India <br /> |label6 = Correspondence emails<br /> |data6 = [mailto:meera.samhita@aiia.gov.in meera.samhita@aiia.gov.in],&lt;br/&gt; [mailto:carakasamhita@gmail.com carakasamhita@gmail.com]<br /> |label7 = Publisher <br /> |data7 = [[Charak Samhita Research, Training and Development Centre]], I.T.R.A., Jamnagar, India<br /> |label8 = Date of publication:<br /> |data8 = October 10, 2023<br /> |label9 = DOI<br /> |data9 = {{DoiWithLink}}<br /> }}<br /> <br /> == Etymology and derivation:==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;The word udaka is derived from root “undi kledane”.&lt;ref name=&quot;ref4&quot;&gt;Amarkosha. Amarsimha, Edited by Pt. Haragovindasastri. Reprint Ed. Varanasi:Chaukhambha Sanskrit Sansthan, 2020.&lt;/ref&gt; It implies that thing which is to wet is udaka. <br /> &lt;br/&gt;The word srotas is derived from Sanskrit root “sru”.&lt;ref name=&quot;ref4&quot;&gt;Amarkosha. Amarsimha, Edited by Pt. Haragovindasastri. Reprint Ed. Varanasi:Chaukhambha Sanskrit Sansthan, 2020.&lt;/ref&gt; Meaing of sru is to secrete, to flow. Acharya sushruta defines srotas as tubular structures through which fluid material circulates in the body.&lt;ref name=&quot;ref5&quot;&gt;Sushruta. SushrutaSamhita. Edited by JadavajiTrikamjiAacharya. 8th ed. Varanasi: ChaukhambhaOrientalia; 2005. &lt;/ref&gt;[Su. Sa. Sharira Sthana 09/13] Dalhana mentioned two important characteristics of srotas: 1. Passage for fluid (abhivahanshila) and 2. Hollow space to flow (avakash).&lt;ref name=&quot;ref5&quot; /&gt; [Dalhan on Su. Sa. ShariraSthana 09/13] Srotas, according to acharya Charak, is a structure through which anything is conveyed or flows. [Cha. Sa. Sutra Sthana 30/12] Udakavaha srotas are the channels for water regulation.<br /> &lt;/p&gt;<br /> <br /> ==Synonyms: ==<br /> '''Udaka:''' apa, vari, salil, kamal, jalam, payas, water.&lt;ref name=&quot;ref4&quot;&gt;Amarkosha. Amarsimha, Edited by Pt. Haragovindasastri. Reprint Ed. Varanasi:Chaukhambha Sanskrit Sansthan, 2020.&lt;/ref&gt; &lt;ref name=&quot;ref6&quot;&gt;Monier-Williams, Monier William's Sanskrit-English Dictionary, 2nd Ed., Oxford University Press;1899.&lt;/ref&gt;<br /> &lt;br/&gt;'''Srotas:''' ambusarana,svatasan,&lt;ref name=&quot;ref4&quot;&gt;Amarkosha. Amarsimha, Edited by Pt. Haragovindasastri. Reprint Ed. Varanasi:Chaukhambha Sanskrit Sansthan, 2020.&lt;/ref&gt;sira, dhamani, rasayani, rasavahini, nadi, pantha, marga, sharirachhidra, samritasavritta, Sthana, Ashaya, Niketa[Cha. Sa. Vimana Sthana 05/09], yogvahi&lt;ref name=&quot;ref5&quot; /&gt; [Su. Sa. Sharira Sthana 05/05], a wave, the flow, a current, the canal of nutrients in the body.&lt;ref name=&quot;ref6&quot;&gt;Monier-Williams, Monier William's Sanskrit-English Dictionary, 2nd Ed., Oxford University Press;1899.&lt;/ref&gt;<br /> &lt;br/&gt;'''Udakavaha srotas:''' ambuvaha[Cha. Sa. Vimana Sthana 05/9] [Cha. Sa. Chikitsa Sthana 28/8], rasavahini [Cha. Sa. Chikitsa Sthana 22/06], water regulating system.<br /> <br /> ==Origin (Srotomula)==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt; Acharya described the two roots of every srotas. In context of udakavaha srotas, the roots are palate (talu) and junction of throat &amp; chest (kloma). [Cha. Sa. Vimana Sthana 05/09] [Su. Sa. Sharira Sthana 09/12]&lt;ref name=&quot;ref5&quot; /&gt; Acharya described these sites as root because in water imbalance, these organs first manifest the sign of thirst. The exact site of kloma is not defined but it’s the main controlling center for water regulation in the body. Acharya chakrapani described kloma as the site of thirst and mentioned that it is situated near the heart (hridyastha pipasa sthana).[Chakrapani on Cha. Sa. Vimana Sthana 05/08] Acharya Gangadhara described the site of kloma as the junction of throat and chest (Kantha urso sandhi). [Gangadhara on Cha. Sa. Vimana Sthana 05/08] <br /> The name &quot;kloma&quot; can be applied to mediastinum that is located at above mentioned sites.&lt;ref name=&quot;ref7&quot;&gt;Nanal VM. The organ kloma: a fresh appraisal. AncSci Life. 1989;9(2):61-5.&lt;/ref&gt;<br /> Contemporary understanding of regulation of water is a feedback process involving the hypothalamus, the neurohypophysis, and the kidneys.&lt;ref name=&quot;ref8&quot;&gt;Knepper MA, Kwon TH, Nielsen S: Molecular Physiology of Water Balance. N Engl J Med 2015, 373(2):196.&lt;/ref&gt;The main hormone that controls how much water the body retains is arginine vasopressin (AVP), commonly known as anti-diuretic hormone.&lt;ref name=&quot;ref9&quot;&gt;Cuzzo B, Padala SA, Lappin SL. Physiology, Vasopressin. [Updated 2022 Aug 22]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan. &lt;/ref&gt;<br /> &lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;'''Etiological factors behind srotas abnormalities (sroto dushti hetu)'''&lt;/p&gt;<br /> [Cha. Sa. Vimana Sthana 05/11]These factors are:<br /> # Intake of hot food (aushnyat)<br /> # Indigestion (aamat)<br /> # Fear (bhayat)<br /> # Excessive intake of alcohol (panat)<br /> # Intake of excessive dry food article (arishuksha anna sevanat)<br /> # Habit of withholding the urge in excessive thirst (trishnaya cha atipidanat)<br /> All these factors contributed in dysregulation of water regulation. <br /> <br /> [[File:Etiological factor of udakavahasrotodusti.jpg|center]]<br /> &lt;center&gt;''''Figure 01: Etiological factor of udakavahasrotodusti''''&lt;/center&gt;<br /> <br /> <br /> '''Clinical features of srotas abnormality (srotodushti lakshana)'''[Cha. Sa. Vimana Sthana 05/11] <br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;1. Feeling of dryness of tongue (jihwa), palate (talu), lips (ostha), throat (kantha) and kloma.<br /> 2. Excessive thirst (pipasa) &lt;/p&gt;<br /> <br /> [[File:Figure 02- Udakavaha srotodushti Lakshana..jpg|center|link=Special:FilePath/Figure_02-_Udakavaha_srotodushti_Lakshana..jpg]]<br /> &lt;center&gt;'''Figure 02: Udakavaha srotodushti lakshana'''&lt;/center&gt;<br /> <br /> ,,,Signs and symptoms of srotas injury(srotoviddha Lakshana)'''<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Acharya Sushruta defined the clinical signs and symptoms related to injury or trauma to the udakavahasrotas &lt;ref name=&quot;ref5&quot;&gt;Sushruta. SushrutaSamhita. Edited by JadavajiTrikamjiAacharya. 8th ed. Varanasi: ChaukhambhaOrientalia; 2005.&lt;/ref&gt;[Su. Sa. Sharira Sthana 09/12] Signs and symptoms of injury (srotoviddha) are:<br /> 1. Excessive thirst (pipasa)<br /> 2. Sudden death (sdayomarana)<br /> <br /> &lt;/p&gt;<br /> <br /> '''Disorders of srotas abnormality'''<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;The diseases due to vitiation of udakavaha srotas are:<br /> 1. Prameha (Urinary diseases including diabetes) [Cha. Sa. Chikitsa Sthana 06/08]<br /> 2. Trishna (Morbid thirst)[Cha. Sa. Chikitsa Sthana 22/06]<br /> 3. Atisara (Diarrhea and associated disorders) [Cha. Sa. Chikitsa Sthana 19/05-10]<br /> 4. Visuchika (Non-infectious gastroenteritis) [Cha. Sa. Vimana Sthana 02/10-11]<br /> 5. Hikka (Hiccups)[Cha. Sa. Chikitsa Sthana 17/21]<br /> 6. Shwasa(Dyspnea) [Cha. Sa. Chikitsa Sthana 17/45]<br /> 7. Udara roga(Generalised enlargement of abdomen)[Cha. Sa. Chikitsa Sthana 13/20] &lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Some other diseases may be included under udakavaha stotas disorders:&lt;ref name=&quot;ref10&quot;&gt;Al-Shura AN. 12 - Channels receiving food, prana, and water. In: Al-Shura AN, editor. Ayurvedic Perspectives in Integrative Healthcare: Academic Press; 2020. p. 109-15.&lt;/ref&gt;<br /> • Edema<br /> • Hydrocephalus<br /> • Increased intracranial pressure<br /> • Diarrhea<br /> • Craving for sour and pungent food Excessive use of salt and sugar<br /> • Diabetes<br /> • Excessive thirst with dry mouth<br /> • Dry skin<br /> • Profuse sweating<br /> • Profuse urination<br /> • Glaucoma &lt;/p&gt;<br /> <br /> '''Diagnostic and assessment tools:'''<br /> &lt;p style=&quot;text-align:justify;&quot;&gt; The condition of udakavaha srotas can be assessed by subjective methods like questionnaires and objective methods like blood investigations etc.. Udakavaha srotodushti can be assessed through a subjective questionnaire by which an ayurvedic physicians assess the normalcy and abnormality based on ayurvedic principles of examination (pariksha). Some of the objective methods which may be used to assess the normal functioning of udakavaha srotas are:<br /> 1. Urine routine examination for specific gravity, volume, ph etc.<br /> 2. Serum electrolyte (Sodium and potassium)<br /> 3. MRI Scan for hypothalamus abnormality<br /> 4. Blood sugar for assessing the abnormality.<br /> 5. Dual-energy X-ray absorptiometry (DEXA)&lt;ref name=&quot;ref11&quot;&gt;Mazess RB, Barden HS, Bisek JP, Hanson J. Dual-energy x-ray absorptiometry for total-body and regional bone-mineral and soft-tissue composition. Am J ClinNutr. 1990;51:1106–1112.&lt;/ref&gt;<br /> 6. Air displacement plethysmography,&lt;ref name=&quot;ref12&quot;&gt;Dempster P, Aitkens S. A new air displacement method for the determination of human body composition. Med Sci Sports Exerc. 1995;27:1692–1697.&lt;/ref&gt; <br /> 7. Nuclear magnetic resonance spectroscopy &lt;ref name=&quot;ref13&quot;&gt;Rebouche CJ, Pearson GA, Serfass RE, Roth CW, Finley JW. Evaluation of nuclear magnetic resonance spectroscopy for determination of deuterium abundance in body fluids: application to measurement of total-body water in human infants. Am J ClinNutr. 1987;45:373–380.&lt;/ref&gt;, and <br /> 8. Bioelectrical impedance analysis &lt;ref name=&quot;ref14&quot;&gt;NIH Consensus Statement. Bioelectrical impedance analysis in body composition measurement. National Institutes of Health Technology Assessment Conference Statement. December 12-14, 1994. Nutrition. 1996;12:749–762.&lt;/ref&gt; &lt;ref name=&quot;ref15&quot;&gt;Beertema W, van Hezewijk M, Kester A, Forget PP, van Kreel B. Measurement of total body water in children using bioelectrical impedance: a comparison of several prediction equations. J PediatrGastroenterolNutr. 2000;31:428–432.&lt;/ref&gt;<br /> &lt;/p&gt;<br /> <br /> '''Treatment of srotas abnormality'''<br /> &lt;p style=&quot;text-align:justify;&quot;&gt; The treatment for the viation of udakavaha srotas should be done on the principles of management of thirst disorder (trishna chikitsa). [Cha. Sa. Vimana Sthana 05/26]&lt;/ref&gt; &lt;ref name=&quot;ref16&quot;&gt;Sharma R..Trishna Chikitsa Adhyaya. In: Ojha S.N., Deole Y.S., Basisht G., eds. CharakSamhita New Edition. 1st ed. Jamnagar, Ind: CSRTSDC; 2020. https://www.carakasamhitaonline.com/mediawiki-1.32.1/index.php?title=Trishna_Chikitsa&amp;oldid=42725. Accessed April 6, 2023.&lt;/ref&gt;The signs and symptoms of udakavaha srotas vitiation are comparable to morbid thirst (trishna), which develops as a result of vata and pitta vitiation. Because both doshas have absorbent (shoshaka) properties that degrade the rasavaha and udakavaha srotas. This leads to persistent desire for water. Rain water is the best way to quench thirst. However, nowadays rainwater is rarely stored and used for drinking. Therefore water with a mild astringent flavour, light to digest, cold characteristics, nice scent and taste, and no channel obstructing qualities should be deemed comparable to rain water in effect.&lt;ref name=&quot;ref16&quot;&gt;Sharma R..Trishna Chikitsa Adhyaya. In: Ojha S.N., Deole Y.S., Basisht G., eds. CharakSamhita New Edition. 1st ed. Jamnagar, Ind: CSRTSDC; 2020. https://www.carakasamhitaonline.com/mediawiki-1.32.1/index.php?title=Trishna_Chikitsa&amp;oldid=42725. Accessed April 6, 2023.&lt;/ref&gt; &lt;/p&gt; <br /> <br /> <br /> '''Dosha governing the water metabolism'''<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Dosha are the physiological entity in human body governing all systems. For maintenance of water balance different dosha work in synergy to each other. Acharya Charak clearly described the relation between samana vayu and ambuvaha srotas. [Cha. Sa. Chikitsa Sthana 28/8] Samana vayu is situated in swedavaha, doshavaha and ambuvaha or udakavaha srotas. It showed the samana vayu is essential for maintainance of water regulation in human body. Along with samana vayu, pitta (pachaka) and kapha (bodhaka and kledaka) also help in water homeostasis. &lt;/p&gt;<br /> <br /> [[File:Dosha helpful in water metabolism.jpg|center|Figure 03: Dosha helpful in water metabolism.]]<br /> <br /> == Future area of research==<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;The future area of research is the preparation of a validated and standardized questionnaire for assessing the normalcy and abnormality of functioning of udakavaha srotas. Assessment of udakavaha srotas condition in various disease may be helpful in prognosis and treatment outcome. In various physiological conditions like pregnancy, lactation, childhood, old age, space, deep sea and high altitude, the udakavaha srotas assessment may be helpful to understand the dynamic changes occurred within the body. Animal studies to understand the anatomy and physiology of kloma may be helpful for future researches related to udakavaha srotas. &lt;/p&gt;<br /> <br /> ''Thesis works:'''<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;1. Dash Maheshwar (1985): Srotas in ayurveda with special reference to udakavaha srotras, Department of Basic Principles, B.H.U.Varanasi, India <br /> 2. Kambale V.(1997): Udakavaha srotas mulastana nischiti evam kloma tulanatmaka adhyayan, Department of sharir Rachana, Govt. Ayurveda Mahavidyalaya, Nanded. &lt;/p&gt;<br /> <br /> ==Current researches==<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt; Contemporary understanding of udakavaha srotas: The cerebrospinal fluid, salivary amylase, and digestive/hepatobiliary system secretions such HCL, bile, pancreatic lipase, and pancreatic amylase are all included in the udaka/ambuvaha srotas. It is also associated with rasa dhatu, which provides the fluid and oiliness needed to transport the necessary nutrients, lubricate various body processes, and support thermodynamic control.&lt;ref name=&quot;ref10&quot;&gt;Al-Shura AN. 12 - Channels receiving food, prana, and water. In: Al-Shura AN, editor. Ayurvedic Perspectives in Integrative Healthcare: Academic Press; 2020. p. 109-15.&lt;/ref&gt; &lt;/p&gt;<br /> <br /> <br /> '''Udakavaha srotas and shwasa roga:''' &lt;p style=&quot;text-align:justify;&quot;&gt;Shwasa roga (dysnoea) occurrs due to vitiation of prana, anna and udakavaha srotas. But understanding the role of udakavaha srotas is difficult. In causative factors of shwasa (nidana), the majority causes of udakavaha srotas dushti are covered. The five varieties of shwasa exhibit its clinical features. In shwasa chikitsa, additional liquid preparations are suggested in order to correct the body's water balance. So, this review helps to understand the role of udakavaha srotas in shwasa roga.&lt;ref name=&quot;ref17&quot;&gt;Teerthashree NS, Chetan M. Understanding of udakavahasrotas in shwasaroga. EPRA International Journal of Multidisciplinary Research (IJMR). 2022 May 12;8(5):63-8.&lt;/ref&gt; &lt;/p&gt;<br /> <br /> '''13.3 Udakavaha srotodushti with special reference to kapha dominant prameha (obstinate urinary disorders including diabetes):''' &lt;p style=&quot;text-align:justify;&quot;&gt; In order to comprehend the notion of looseness of body components (sharira shaithilya) in the pathogenesis (samprapti) of kapha dominant prameha and to assess the application of the essential ayurveda principles of udakavaha stroto dushti, a clinical research on 40 clinically confirmed patients of kapha dominant prameha was done. The study came to the conclusion that srotodushti and pathogenic factors should be taken into account while treating diabetic patients, so that we can focus on treating sroto dushti and its root as well as the illness.&lt;ref name=&quot;ref18&quot;&gt;Rahangdale D, Kumar B, Dave HH, A Conceptual and Clinical Study to Understand The Principle of Sharira-Shaithilyata and UdakavahaSrotodushtiw.s.r. to KaphajaPrameha (Type II Diabetes Mellitus) JOA XIII-3, 2019; 14 - 21&lt;/ref&gt; &lt;/p&gt;<br /> <br /> &lt;big&gt;'''[[Special:ContactMe|Send us your suggestions and feedback on this page.]]'''&lt;/big&gt;<br /> <br /> ==References==<br /> <br /> &lt;div id=&quot;BackToTop&quot; class=&quot;noprint&quot; style=&quot;background-color:#DDEFDD; position:fixed;<br /> bottom:32px; left:2%; z-index:9999; padding:0; margin:0;&quot;&gt;&lt;span style=&quot;color:blue;<br /> font-size:8pt; font-face:verdana,sans-serif; border:0.2em outset #ceebf7;<br /> padding:0.1em; font-weight:bolder; -moz-border-radius:8px; &quot;&gt;<br /> [[#top| Back to the Top ]]&lt;/span&gt;&lt;/div&gt;</div>

Manishdubey https://www.carakasamhitaonline.com/index.php?title=Talk:Udavarta&diff=44317 2023-11-03T11:22:10Z

<p>Manishdubey: </p> <hr /> <div>{{CiteButton}}<br /> {{#seo:<br /> |title= UDAKAVAHA SROTAS (Channels for transport and transformation of watery components)<br /> |titlemode=append<br /> |keywords=Udakavaha Srotas, Water metabolism, Bhojani M. K., Tanwar Ankur Kumar, Basisht G, Deole Y.S.<br /> |description=Udaka means water. In body, water is present in the form of various fluids. Udakavaha srotasa are the channels for transport and transformation of fluid (water) and its circulation. <br /> |image=http://www.carakasamhitaonline.com/mediawiki-1.32.1/resources/assets/ogimgs.jpg<br /> |image_alt=carak samhita<br /> |type=article<br /> }}<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Udavarta literally means the upward and repeated movements of vata. It is one of the important and commonly observed condition in clinical practice. It manifests with a number of clinical features which may lead to manifestation of other secondary diseases further. Udavarta is mentioned as one among the eighty diseases occurred primarily by the vitiated vata dosha (nanatmaja vata vyadhi). [Cha. Sa. Sutra Sthana 20/11] Udavarta (upward movement of vata) is very common now a days due to change in lifestyle of modern society. The change in dietary habits and due to hectic job schedule, suppression of natural urges (vegadharana) is also very common now a days. The two main cause of udavarta explained in classical texts are: suppression of natural urges (vegadharana) and faulty dietary habits (asatmya ahara sevana). Sushrut Samhita describes that suppression of natural urges (adharaniya vega) leads to manifestation of thirteen types of udavarta. Due to aggravating factors, vata dosha is aggravated, especially apana vata (one of the five subtypes of vata i.e., situated in the pelvic region) is affected. Generally, udavarta means upward movement of vata or apana vata, that results in retention of faeces, urine and flatus. However, the scope of udavarta extends to disturbance in normal functions of vata due to obstruction by metabolic wastes. This unique concept is not explained in any other contemporary sciences. So, understanding this concept and to provide better treatment for this disease is need of the society.&lt;/p&gt;<br /> <br /> {{Infobox<br /> |title = Contributors<br /> |label1 = Section/Chapter/topic<br /> |data1 = Concepts &amp; Practices/[[Udavarta]] <br /> |label2 = Authors<br /> |data2 = Dubey M.&lt;sup&gt;1&lt;/sup&gt;,&lt;br/&gt;Deole Y.S.&lt;sup&gt;2&lt;/sup&gt;<br /> |label3 = Reviewer <br /> |data3 = Basisht G.&lt;sup&gt;3&lt;/sup&gt;, <br /> |label4 = Editor<br /> |data4 = Basisht G.&lt;sup&gt;3&lt;/sup&gt;<br /> |label5 = Affiliations<br /> |data5 = &lt;sup&gt;1&lt;/sup&gt;[[Charak Samhita Research, Training and Development Centre]], I.T.R.A., Jamnagar, India &lt;br/&gt;&lt;sup&gt;2&lt;/sup&gt;Department of Kayachikitsa, G. J. Patel Institute of Ayurvedic Studies and Research, New Vallabh Vidyanagar, Gujarat, India&lt;br/&gt;&lt;sup&gt;3&lt;/sup&gt;Rheumatologist, Orlando, Florida, U.S.A.<br /> |label6 = Correspondence emails<br /> |data6 = dr.manish181@gmail.com, dryogeshdeole@gmail.com<br /> carakasamhita@gmail.com<br /> |label7 = Publisher <br /> |data7 = [[Charak Samhita Research, Training and Development Centre]], I.T.R.A., Jamnagar, India<br /> |label8 = Date of publication:<br /> |data8 =November 03, 2023<br /> |label9 = DOI<br /> |data9 = {{DoiWithLink}}<br /> }}<br /> <br /> ===Nirukti (etymology)===<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;The term udavarta is derived from Utt + Aavat i.e., “Ut + Ang + Vrut + Dhaya” to form word Udavarta.&lt;ref&gt;Shabdakalpadruma by Raja Radhakanta Deva, Prathama Khand. Second edition. Delhi: Naaga Publishers; 2003. pg.no. 237.&lt;/ref&gt; Udavarta is a Sanskrit word derived from 'Ut' verb root (dhatu) with 'Ang' and 'Vrut' preposition (upasarga), suffixed by ‘Dhaya’ pratyaya (suffix). “Ut” means upper side, (Urdhva) “Ang” means entirely and “Vrut” means to move (bhramana). Udavarta means upwards movement, to cause to go out, excrete, to secrete and to retain.&lt;ref&gt;M. Monier Williams Sanskrit English dictionary. &lt;/ref&gt; Udavarta is a class of diseases marked by retention of the feces i.e., disease of the bowel so, in general urdhwa (upward direction) or pratiloma (moving in abnormal direction) movement of apana vata (one of the five subtypes of vata, situated in the pelvic region) is termed as udavarta.&lt;/p&gt;<br /> <br /> ===Definition===<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;‘Udavarta’ is that disease in which there is whirlpool movement (avartana) and upward movement (urdhva gamana) of vata is seen due to retention of vata, urine (mutra) and stool (purisha). The condition in which vata begins to move upwards is called as ‘udavarta’ and in this disease vata is the predominant dosha.&lt;ref&gt;Bhavaprakasha of Sri Bhavamishra edited with Vidyotini hindi commentary by Pandit Shri Brahma Sankar Mishra, Part II, Adhyaya- 31/2, Chaukhambha Sanskrit Bhawan, Varanasi, Ed: 2009, 11&lt;sup&gt;th&lt;/sup&gt; edition. pg. no. 332.&lt;/ref&gt; &lt;/p&gt;<br /> <br /> ===Etiopathogenesis===<br /> *Intake of deficient quantity of food causes udavarta. [Cha. Sa. Vimana Sthana 2/7] <br /> *Intake of astringent, bitter, pungent and un-unctuous (dry) food and excessive fasting<br /> *Withholding natural urges (vegadharana) <br /> *Excessive indulgence in sexual activity. [Cha. Sa. Chikitsa Sthana 26/5-6] <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Due to all above reasons the apana vata which resides in large intestine (pakvashaya) gets aggravated and further obstructs the downward movement of vata causing retention of movement of stool, urine and flatus. This leads to a dreadful disease named as udavarta. [Ca. Sa. Chikitsa Sthana 26/5-6]&lt;/p&gt; <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Acharya Sushruta explained suppression of 13 urges leading to udavarta. [Su. Sa. Uttara Sthana 55/ 3-4] Thus, udavarta is caused by 2 main causes, one is suppression of natural urges and other one unwholesome eating. [Su. Sa. Uttara Sthana 55/ 6] Excess consumption of mudga (Phaseolus mungo), kodrava (Paspalum scrobiculatum Linn.), jurnahva (Sorghum vulgare/jowar), karira (Capparis decidua), chanaka (Cicer arietinum L.), etc. i.e., foods with property of dryness and causing constipation vitiate normal status of vata dosha in its own seat (large intestine). This vata becomes powerful and blocks the downward channels and produces severe obstruction in the movement of feces, flatus and urine leading to udavarta. [A. H. Nidana Sthana 7/46-52]&lt;/p&gt;<br /> <br /> ===Clinical features=== <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Frequent pain in the region of urinary bladder (basti), heart (hridaya), abdomen (udara) and excruciating or intense pain in the back of chest. Other symptoms are flatulence (adhmana), nausea (hrillasa), gripping type of pain in anus (vikartika), pricking (toda) type of pain in whole body, indigestion and inflammation of urinary bladder. Obstruction in passing stool less frequently and with difficulty and in less quantity, after long time and effort. Upward movement of flatus occurs because of obstruction in channels (srotasa), increased roughness, dryness and coldness in the body. [Cha. Sa. Chikitsa Sthana 26/6-7]&lt;/p&gt;<br /> <br /> ===Udavarta janya vikara===<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;If not treated early, udavarta leads to other secondary complications as follows:&lt;/p&gt;<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Fever (jwara), dysuria (mutrakricchhra), dysentery (pravahika), heart disease (hridroga), diseases due to malfunctioning of duodenum (grihani dosha), vomiting (chhardi), blindness, deafness, burning sensation in the head, affliction of abdomen by vata (vatodara), tumors (asthila), psychological diseases (mano vikara), disorders of excessive thirst (trishna roga), an ailment characterized by bleeding from different parts of the body (raktapitta), aruchi (anorexia), phantom tumor (gulma), cough (kasa), dyspnoea (shwasa), chronic rhinitis (pratishyaya), facial paralysis (ardita), diseases of the flanks including lower respiratory tract disorders (parshva roga) and such other serious diseases caused by aggravation of vata. [Cha. Sa. Chikitsa Sthana 26/8-9]&lt;/p&gt;<br /> <br /> ===Udavarta as a causative factor (nidana) of other diseases===<br /> *&lt;p style=&quot;text-align:justify;&quot;&gt;Udavarta is the etiological factor of abdominal swelling caused by intestinal obstruction (baddhagudodara) [Cha. Sa. Chikitsa Sthana 13/39]<br /> *Udavarta is the cause for abdominal swelling afflicted by spleen (plihodara). [Cha. Sa. Chikitsa Sthana 13/75]<br /> *Udavarta is the cause for respiratory diseases including bronchial asthma (pratamaka shwasa-type of tamaka shwasa) characterized by fever, syncope and other such symptoms which are relieved by cold measures. [Cha. Sa. Chikitsa Sthana 17/63]<br /> *Udavarta caused by suppression of the urge of urination is causative factor of condition where severe painful distension of abdomen below umbilicus is present along with obstruction of downward movement of urine (mutrajathara- a type of mutraghata i.e., retention of urine). [Su. Sa. Uttara Sthana 58/13]<br /> *Vidvighata (type of mutraghata i.e., retention of urine): In debilitated person due to loss of fat, udavarta brings small amount of feces into the channels of urine (bladder and urethra) resulting in patients voiding of urine having odour of feces is termed as vidvighata. [A. H. Nidana Sthana 9/33-34]<br /> *Hemorrhoids (arsha): Udavarta is the chief complication in hemorrhoids (durnama/arsha). This udavarta may occur in person who has predominance of vata dosha in alimentary tract (koshtha) even without piles. <br /> *Vatodara: Udavarta is one of the causative factors of abdominal swelling afflicted by vata dosha (vatodara). [Cha. Sa. Chikitsa Sthana 13/23]<br /> *Hiccups (hikka) &amp; dyspnoea (shwasa): Udavarta is the one of the etiological factors for causation of conditions such as hiccups (hikka) and dyspnoea (shwasa).&lt;/p&gt;<br /> <br /> ===Udavarta as symptoms (lakshana) in following diseases===<br /> <br /> #Vataja plihodara (vata predominant plihodara i.e., abdominal swelling afflicted by splenomegaly) [Cha. Sa. Chikitsa Sthana 13/38]<br /> #Vatodara (abdominal swelling afflicted by vata dosha) [Cha. Sa. Chikitsa Sthana 13/25]<br /> #Vataja gulma (vata predominant gulma/ phantom tumor) [Cha. Sa. Chikitsa Sthana 5/10]<br /> #Sahaja arsha (congenital hemorrhoids) [Cha. Sa. Chikitsa Sthana 14/8]<br /> #Vataja arsha (vata predominant hemorrhoids) [Cha. Sa. Chikitsa Sthana 14/11]<br /> #Vyana avruta apana (type of avarana (occlusion) where vyana vata obstructs the flow of apana vata) [Cha. Sa. Chikitsa Sthana 28/211]<br /> #Basti marma viddha (injury to bladder) [Cha. Sa. Siddhi Sthana 9/6]<br /> <br /> ===Types of Udavarta===<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Udavarta is of 6 types which occur by suppression of natural urges viz., apana vata nirodhaja (suppression of flatus), mutra vega nirodhaja (suppression of urine), purisha vega nirodhaja (suppression of faeces), shukra vega nirodhaja (suppression of ejaculation of semen), chhardi vega nirodhaja (suppression of vomiting) and kshavathu vega nirodhaja (suppression of sneezing). [Cha. Sa. Sutra Sthana 18/3]&lt;/p&gt;<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;As per Sushruta Samhita, there are 13 types of suppression of natural urges (vegadharana) namely flatus, faeces, urine, yawning, flow of tears, sneezing, eructation, vomiting, ejaculation of semen, hunger, thirst, breath and sleep. [Su. Sa. Uttara Sthana 55/ 3-4] Suppression of these vega (urges) gives rise to their respective type of udavarta and manifest their respective symptoms which are as follows;&lt;/p&gt;&lt;p style=&quot;text-align:justify;&quot;&gt;'''Table no. 1:''' '''Types of udavarta and their symptoms''' [Su. Sa. Uttara Sthana 55/6-17]&lt;/p&gt;<br /> {| class=&quot;wikitable&quot;<br /> |'''Sr.'''<br /> <br /> '''No.'''<br /> |<br /> <br /> '''  Udavarta type'''<br /> |<br /> <br /> '''                             Symptoms'''<br /> |-<br /> |1.      <br /> |'''Apana vata/ Adhovata nirodhaja udavarta'''<br /> <br /> (Suppression of flatus)<br /> |Flatulence, colic abdominal pain, obstruction in cardiac region, headache, severe dyspnea, hiccoup, cough, coryza, obstruction in throat, terrible spread of kapha and pitta dosha, movement of feces through mouth (reverse peristalsis). <br /> |-<br /> |2.      <br /> |'''Purisha vega nirodhaja udavarta'''<br /> <br /> (Suppression of urge of defecation)<br /> |Abnormal bowel sounds (atopa), colicy abdominal pain, cutting type of pain in abdomen, retention of feces, upward movement of vata causing excessive belching (urdhwavata).  <br /> |-<br /> |3.      <br /> |'''Mutra vega nirodhaja udavarta'''<br /> <br /> (Suppression of urge of micturition)<br /> |Passing of scanty urine with difficulty with distension of urinary bladder, intense pain in penis, groin, anus, groin, pelvis, scrotum and umbilical region or head as if the body is being torn with spikes. <br /> |-<br /> |4.      <br /> |'''Jrimbha vega nirodhaja udavarta'''<br /> <br /> (Suppression of yawning)<br /> |Stiffness of neck (manyastambha), stiffness of throat, diseases of head (shiroroga) and vata predominant diseases (other vataja vyadhi). Severe diseases of ear, mouth, nose and eye are also produced.  <br /> |-<br /> |5.      <br /> |'''Ashru vega nirodhaja udavarta'''<br /> <br /> (Suppression of flow of tears/lacrimation either from pleasure or grief)<br /> |Heaviness of head, severe diseases of eye and coryza (peenasa).  <br /> |-<br /> |6.      <br /> |'''Kshavathu vega nirodhaja udavarta'''<br /> <br /> (Suppression of sneezing)<br /> |Severe diseases of head, eye, nose and ears; filling of mouth and throat, excessive pricking pain, obstruction in breath. <br /> |-<br /> |7.      <br /> |'''Udagara vega nirodhaja udavarta''' (Suppression of urge of belching)<br /> |Severe diseases caused by vata dosha.<br /> |-<br /> |8.      <br /> |'''Chhardi vega nirodhaja udavarta'''<br /> <br /> (Suppression of urge of vomiting)<br /> |Various skin diseases (kushtha) arise with predominance of dosa by which food is vitiated. <br /> |-<br /> |9.      <br /> |'''Shukra vega nirodhaja udavarta'''<br /> <br /> (Suppression of semen ejaculation)<br /> |Swelling and pain in urinary bladder, anus and testicles, retention of urine, seminal calculus, discharge of semen and other related disorders of semen. <br /> |-<br /> |10.   <br /> |'''Kshudha vega nirodhaja udavarta'''<br /> <br /> (Suppression of urge of hunger)<br /> |Drowsiness, body-ache, anorexia, giddiness and weakness of vision. <br /> |-<br /> |11.   <br /> |'''Trishna vega nirodhaja udavarta'''<br /> <br /> (Suppression of urge of thirst)<br /> |Dryness in throat and mouth, deafness and cardiac pain. <br /> |-<br /> |12.<br /> |'''Shrama shwasa/ Shranta nishwasa nirodhaja udavarta'''<br /> <br /> (Suppression of holding breath after exertion)<br /> |Cardiac disorder, mental confusion and phantom tumor (gulma).  <br /> |-<br /> |13. <br /> |'''Nidra vega nirodhaja udavarta'''<br /> <br /> (Suppression of urge of sleep)<br /> |Yawning, body ache, dullness in limbs, head and eyes, drowsiness.  <br /> |}<br /> <br /> ===Asadhyata [incurable stage of diseases]===<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Udavarta with symptoms of excessive thirst, excessively depressed, emaciated, suffering from pain and vomiting of fecal matter is difficult to manage or incurable.[Su. Sa. Uttara Sthana 55/ 17-18] &lt;/p&gt;<br /> <br /> ===Treatment===<br /> &lt;p style=&quot;text-align:justify;&quot;&gt; Treatment principles for udavarta i.e., palliative therapy (shamana) or purification (shodhana) etc., can be selected based on stages of the disease and as well as on the condition of the patient. The treatment guidelines explained in Charaka Samhita are as follows: [Cha. Sa. Chikitsa Sthana 26/11]&lt;/p&gt;<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;The patient suffering from udavarta should be given massage with hot oil described for the treatment of fever presented with cold extremities (sheeta jwara). Then fomentation therapy should be administered for the detachment of the adhered dosha in the tissue cells. This should be followed by the administration of suppository (varti), un-unctuous enema (niruha basti) and unctuous type of purgative (snigdha virechana). The patient should be given food which helps in the normal downward movement (anulomana) of apana vata.&lt;/p&gt;<br /> <br /> '''A) Unction therapy (snehana):''' &lt;p style=&quot;text-align:justify;&quot;&gt;Udavarta is produced due to aggravation of vata and sneha (lipids) is the best treatment for pacification of vata vata (shamana). Therefore, unction therapy (snehana) is indicated in udavarta. &lt;/p&gt;<br /> '''B) Fomentation therapy (swedana):''' &lt;p style=&quot;text-align:justify;&quot;&gt;After massage with oil, fomentation therapy should be administered for the detachment of the adhered dosha in the tissue cells.&lt;/p&gt;<br /> '''C) Suppository (varti):''' &lt;p style=&quot;text-align:justify;&quot;&gt;A suppository having the thickness of the thumb is to be prepared with drugs like Shyama Trivrita (Operculina turpethum), Vidanga (Embeila ribes), Kampillaka (Mallotus philippensis) etc., which should be triturated with gomutra (cow’s urine) or arka (Calotropis gigantea) latex (kshira) and made in to form of suppository (phala varti) by adding jaggery. This suppository should be inserted through anus for the downward movement of apana vata to relieve retention of stool, flatus and urine caused by udavarta.&lt;/p&gt;<br /> '''D) Palliative therapy (shamana):''' &lt;p style=&quot;text-align:justify;&quot;&gt;Shamana includes administration of internal medication such as dviruttara- hingvadi churna, hinguvachadi churna given with warm water as an anupana (co-administers with medicine) for correcting the upward movement of vata.&lt;/p&gt;<br /> '''E) Purification therapy (shodhana):'''&lt;p style=&quot;text-align:justify;&quot;&gt;When the disease is chronic and relief is not observed even by adopting above measures, then purification (shodhana) by non-unctuous enema (niruha basti) or purgation (virechana) is advised.&lt;/p&gt;<br /> '''F) Pathya ahara kalpana (wholesome diet):'''&lt;p style=&quot;text-align:justify;&quot;&gt;Intake of wholesome diet (pathya ahara) which helps in normal downward movement (anulomana) of apana vata whereas, intake of unwholesome diet (apathya ahara) should be avoided for better recovery. Generally, in all types of udavarta all measures for controlling vata should be adopted in order to restore it to its normal channels (srotasa). [Su. Sa. Uttara Sthana 55/ 19]&lt;/p&gt;&lt;p style=&quot;text-align:justify;&quot;&gt;'''Table no. 2:''' '''Types of udavarta and their respective treatment''' [Su. Sa. Uttara Sthana 55/20-34]&lt;/p&gt;<br /> {| class=&quot;wikitable&quot;<br /> |'''Sr.'''<br /> <br /> '''No.'''<br /> | <br /> <br /> '''Udavarta type'''<br /> |<br /> <br /> '''                             Treatment'''<br /> |-<br /> |<br /> <br /> <br /> 1.<br /> |'''Apana vata/ Adhovata nirodhaja udavarta'''<br /> <br /> (Suppression of flatus)<br /> |Massage (abhyanga) and sudation (swedana) followed by asthapana basti (non-unctuous enema). <br /> |-<br /> |<br /> <br /> <br /> 2.<br /> |'''Purisha vega nirodhaja udavarta'''<br /> <br /> (Suppression of urge of defecation)<br /> |Treatment of non- passage of flatus and feces (anaha) should be adopted.<br /> |-<br /> |<br /> <br /> <br /> 3.<br /> |'''Mutra vega nirodhaja udavarta'''<br /> <br /> (Suppression of urge of micturition)<br /> |Treatment of renal calculi (ashmari), dysuria (mutrakrichha) and retention of urine (mutraghata) should be adopted.<br /> |-<br /> |<br /> <br /> <br /> 4. <br /> |'''Jrimbha vega nirodhaja udavarta'''<br /> <br /> (Suppression of yawning)<br /> |Unction therapy (snehana) and fomentation therapy (swedana). <br /> |-<br /> |<br /> <br /> <br /> 5. <br /> |'''Ashru vega nirodhaja udavarta'''<br /> <br /> (Suppression of flow of tears/lacrimation either from pleasure or grief)<br /> |After unction therapy (snehana) and fomentation therapy (swedana) the flow of tears should be stimulated by applying irritant collyrium etc. <br /> |-<br /> |  <br /> <br /> 6.<br /> |'''Kshavathu vega nirodhaja udavarta'''<br /> <br /> (Suppression of sneezing)<br /> |Induce sneezing by application of irritant collyrium, pressed snuff (avapidana nasya), inhalation of irritant odor or by using smoking wick (dhuma varti). <br /> |-<br /> |<br /> <br /> <br /> 7.<br /> |'''Udagara vega nirodhaja udavarta''' (Suppression of urge of belching)<br /> |Unctuous smoking (snehaika dhumapana) with prescribed order and also intake of wine (sura) mixed with bijapura (Citrus medica) juice and added with black salt (sauvarchala lavana/ Unaqua sodium chloride). <br /> |-<br /> |<br /> <br /> <br /> 8.<br /> |'''Chardi vega nirodhaja udavarta'''<br /> <br /> (Suppression of urge of vomiting)<br /> |Unction according to the dosa involved. Massage with ghee mixed with a pinch of alkali prepared from barley (yavakshara) and rock salt (saindhava lavana). <br /> |-<br /> |<br /> <br /> <br /> 9.<br /> |'''Shukra vega nirodhaja udavarta'''<br /> <br /> (Suppression of semen ejaculation)<br /> |Patient advised to drink milk boiled with four times water added with diuretic drugs up to full satisfaction and then indulge in sexual activity. <br /> |-<br /> |10.<br /> |'''Kshudha vega nirodhaja udavarta'''<br /> <br /> (Suppression of urge of hunger)<br /> |Intake of unctuous and warm food in little quantity. <br /> |-<br /> |<br /> <br /> <br /> 11. <br /> |'''Trishna vega nirodhaja udavarta'''<br /> <br /> (Suppression of urge of thirst)<br /> |Intake of churned drink (mantha) or liquid gruel (yavagu) of cold nature. Use of cold water for drinking and other purpose. <br /> |-<br /> |<br /> <br /> <br /> 12.<br /> |'''Shrama shwasa/ Shranta nishwasa nirodhaja udavarta'''<br /> <br /> (Suppression of holding breath after exertion)<br /> |Complete rest and intake of meat soup. <br /> |-<br /> |<br /> <br /> <br /> 13. <br /> |'''Nidra vega nirodhaja udavarta'''<br /> <br /> (Suppression of urge of sleep)<br /> |Advised to go to sleep after intake of milk and listening to favorite stories. <br /> |}<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Complications of udavarta, flatulence (adhmana) and other diseases should be managed with respective measures according to condition. [Su. Sa. Uttara Sthana 55/34-35] For example when vayu in abdomen (koshtha) is aggravated by rough, pungent, bitter and astringent food, it immediately produces udavarta owing to which the channels (srotasa) carrying flatus, feces, urine, blood, kapha and adipose tissue (medas), move in upward direction and harden the feces too much. This results in manifestation of symptoms such as pain in cardiac and pelvic region, heaviness, anorexia, passing of urine, flatus and feces with difficulty. The person gets afflicted with many other disorders caused by aggravation of vata such as dyspnoea, (shwasa), cough (kasa), hiccoup (hikka), thirst (trishna), coryza (pratishyaya), burning sensation (daha), mental confusion (moha), vomiting (chhardi), fever (jwara), diseases of head and abnormalities of mind and ears. [Su. Sa. Uttara Sthana 55/2] &lt;/p&gt;<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;One should advise non-unctuous enema (niruha basti) after the patient is massaged with oil mixed with salt and sudation; then after feces are eliminated, he should be advised to take food followed by administration of unctuous enema (anuvasana basti) according to the dosha involvement. If by above procedures, still no relief found then in severe cases of udavarta, patient is advised to undergo repeated unction therapy (snehana) and fomentation therapy (swedana) and then undergo unctuous purgation (snigdha virechana). [Su. Sa. Uttara Sthana 55/40-41]&lt;/p&gt;<br /> <br /> ===Different treatments of udavarta===<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;1) Saturating drink (mantha) prepared with sugarcane product (phanita), roasted grain flour (saktu), ghee, curd water and vinegar (amla kanji) alleviate udavarta. [Cha. Sa. Sutra Sthana 23/37]&lt;/p&gt;<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;2) 96 gm (2 pala) of dehusked tila (Sesamum indicum Linn.), 48 gm (1 pala) of jaggery and 24 gm (half pala) of nagara (Zingiber officinale) should be made into a paste and taken along with hot milk helps in udavarta. [Cha. Sa. Chikitsa Sthana 5/91-92] &lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;3) Milk cooked with Allum sativum (Lashuna kshirapaka): Garlic cooked with milk by adding water and reducing to the quantity of milk, cures udavarta immediately [Cha. Sa. Chikitsa Sthana 5/94] &lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;4) Alkali prepared from pippali (Piper longum) and other ingredients (Pippalyadi kshara) used in udavarta [Cha. Sa. Chikitsa Sthana 13/159-161] &lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;5) Medicine prepared by boiling medicinal herbs in water and then kept for fermentation with drugs such as haritaki (Terminalia chebula), amalaki (Emblica officinalis), etc. (Phalarishta) used in udavarta. [Cha. Sa. Chikitsa Sthana 14/148-152] &lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;6) Trivrut (Operculina turpethum), pilu (Salvadora persica), yavani (Trachyspermum ammi) with sour gruel mixed with digestants (pachana) drugs. [Su. Sa. Uttara Sthana 55/42-43] &lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt; 7) The combination of hingu (Ferula foetida), kushtha (Saussurea lappa), vacha (Acorus calamus Linn.), svarjika (alkali prepared by burning Lona plant), and vidanga (Embelia ribes) – successively in double quantity cures udavarta and colicky pain by vata dosha (vataja shoola) [Su. Sa. Uttara Sthana 55/42-43]&lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;8) Intake of ghee cooked with decoction of dried radish (Raphanus sativus), sunthi (Zingiber officinale), punarnava (Boerhavia diffusa), brihata panchamula (combination of five herbs viz., bilva, patala, agnimantha, shyonaka and gambhari), and fruits of aragvadha (Cassia fistula) subsides severe udavarta completely. [Su. Sa. Uttara Sthana 55/45-46] &lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;9) Vacha (Acorus calamus Linn.), ativisha (Aconitum heterophyllum), kushtha (Saussurea lappa), yavakshara (alkali prepared from barley), haritaki (Terminalia chebula Retz.), pippali (Piper longum) and agnimantha (Clerodendrum phlomidis) with hot water cures udavarta. [Su. Sa. Uttara Sthana 55/47] &lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;10) Devadaru (Cedrus deodara), chitraka (Plumbago zeylanica), triphala (combination of 3 herbs viz., haritaki, bibhitaki and amalaki), brihati (Solanum indicum) should be taken along with cow’s urine. [Su. Sa. Uttara Sthana 55/49]&lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;11) Suppository: Powder of danti (Baliospermum montanum), kampillaka (Mallotus philippensis), shyama trivrita (Operculina turpethum), ikshvaku (Lagenaria vulgaris Ser.), ajamoda (Apium graveolens), kritavedhana (Luffa acutangula Linn Roxb.), pippali (Piper longum) and salts should cook in cow’s urine and made into suppositories to be inserted in the anus. This provides instant relief in the symptoms of udavarta. [Su. Sa. Uttara Sthana 55/51-52] &lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt; 12) Guggulu (Commiphora mukul) should be taken with decoction of triphala (combination of 3 herbs viz., haritaki, bibhitaki and amalaki), daruharidra (Berberis aristata), patola (Trichosanthes dioica) and kusa (Desmostachya bipinnata) or with urine or hot water for 1 month alleviates udavarta. [Su. Sa. Chikitsa Sthana 5/39-44]&lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;13) Kalyanaka kshara consumed with ghee cures udavarta and constipation (vibandha) [A. H. Chikitsa Sthana 8/142] &lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;14) Erandamooladi enema (basti) helps in alleviating obstruction of faeces, urine and flatus [Ch. Sa. Siddhi Sthana 3/38-42] &lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt; 15) Palashadi niruha basti alleviates non- passage of flatus and feces (anaha) and udavarta [Ch. Sa. Siddhi Sthana 3/44-45]&lt;/p&gt;<br /> <br /> === Treatment as per different conditions===<br /> *In hemorrhoids (arsha), if symptoms of udavarta is present then unctuous enema (anuvasana basti) should be administered. [Cha. Sa. Chikitsa Sthana 14/130]<br /> *In complications by enema (basti vyapat) when unctuous enema gets obstructed by feces then treatment alleviating udavarta should be adopted. [Cha. Sa. Siddhi Sthana 4/36-37]<br /> *In emesis (vamana) and purgation (virechana) complications (vyapta), in extremely vitiated condition of doshas (bahudosha avastha) low dose of medicine is administered, then it causes udavarta, tympanitis (adhmana) in such condition treatment of udavarta is massage (abhyanga), sudation, suppository, non-unctuous enema (niruha basti) and other measures of udavarta should be adopted [Cha. Sa. Siddhi Sthana 6/58-60]<br /> *In pain caused by obstruction of feces (vitshula) the measures mentioned for udavarta should be used in the treatment. [Su. Sa. Uttara Sthana 42/140] <br /> *In treatment of rakta gulma (a variety of phantom tumor) the measures which cures udavarta should be adopted. [A. H. Chikitsa Sthana 14/129]<br /> *Measures which cure udavarta (udavarta hara kriya) should be adopted in abdominal swelling caused by intestinal obstruction (baddhodara). [A. H. Chikitsa Sthana 15/100]<br /> *In emesis (vamana) from improper therapy (mithya yoga), therapies of udavarta should be adopted. [A. H. Kalpasiddhi Sthana 3/13]<br /> *In complications from enema (basti vyapat) the treatment of udavarta should be adopted if fat (sneha) of enema (basti) gets obstructed or enveloped by feces. [A. H. Kalpa-siddhi Sthana 5/39]<br /> <br /> ===Measures alleviating udavarta (udavarta hara)===<br /> <br /> *Mrudvika (Vitis vinifera/grapes) alleviates udavarta [Cha. Sa. Sutra Sthana 27/125-126]<br /> *Haritaki (Terminalia chebula Retz.) used in udavarta [Cha. Sa. Chikitsa Sthana 1/1/31]<br /> *Dish prepared with barley (yavapupa), supernatant liquid proportion of barley preparation (yavaka) and bhristha yava odana/ parched cooked barley (vatya) made from yava (barley) helps in alleviation of udavarta. [Cha. Sa. Sutra Sthana 27/265]<br /> *Saturating drink (mantha) prepared by churning parched grain flour (saktu) with sour taste (amla rasa), fat and jaggery alleviates udavarta. [Su. Sa. Sutra Sthana 46/386]<br /> *Vatya (made by roasted wheat or barley) helps in alleviating udavarta. [Su. Sa. Sutra Sthana 46/410]<br /> *Garlic cooked with milk (lashuna kshirapaka) alleviates udavarta. [A. H. Chikitsa Sthana 14/46]<br /> <br /> ===Diet for udavarta===<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Intake of vegetable preparations prepared from the leaves of trivruta (Operculina turpethum) and snuhi (Euphorbia neriifolia Linn.), tila (Sesamum indicum) and its different preparations, soup of meat of animals inhabiting in marshy land, domestic and aquatic animals, clear top portion of alcohol (prasanna) and molasses rum (sidhu), wine prepared of jaggery, preparations which facilitates motion of flatus, urine and stool. [Cha. Sa. Chikitsa Sthana 26/18] One should never withhold the natural urges of the body. [Su. Sa. Uttara Sthana 55/3]&lt;/p&gt;<br /> <br /> ===Researches===<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;1) A review on diseases manifested due to withholding natural urges (vegadharana janya vikara) focused to identify the effects of suppression of natural urges (adharaneeya vegas) on various system of body such as CVS, gastrointestinal tract, respiratory system urinary system and reproductive system. CVS and gastrointestinal systems are the mostly affected systems. Out of thirteen urges (vegas), seven play major role in both systems. Common clinical features produced by suppression of natural urges (vegadharana) were weakness of the body, constipation, anorexia, headache, diseases of eye, difficulty in micturition, bending of the body and stiffness of the neck. Weakness of the body and anorexia are the commonest clinical features produced by suppression of natural urges. These clinical features arise due to vitiation of vata by vegadharana. Withholding (dharana) of natural urges is strictly prohibited to stay healthy.&lt;ref&gt;Zahara M.S.F, Kulathunga R.D.H, Chathurika L.A.W.J. A Review of Vegadharana.  International Ayurvedic Medical Journal. ISSN 2320 5091, March 2021.&lt;/ref&gt;&lt;/P&gt;<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;2) A physiological study of adharaneeya vega (suppression of natural urges) w.s.r. to apana vayu vega (suppression of apana vata or flatus)&lt;/p&gt;<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Understanding the physiology of suppression of natural urges (vegarodhajanya) symptoms and analyzing them as a pathology of various diseases related to apana vayu (one of the five subtypes of vata situated in the pelvic region). As, seen in clinical practice many a times diseases reoccur after giving proper treatment. Also, in such case causative factors (nidana) of vitiation of apana vayu (one of the five subtypes of vata situated in the pelvic region) is to be analyzed properly for better result. Among the fourteen adharaneeya vega (suppression of natural urges), apana vayu (one of the five subtypes of vata situated in the pelvic region) vega (urge) is most commonly suppressed which leads to vitiation of vata dosha in the pelvic region). Adharaneeya vega (suppression of natural urges) is a reflex mechanism and it is a nervous activity. Nerve supply to gastrointestinal tract is in the form of sympathetic, parasympathetic, enteric nervous system (ENS) and gastrointestinal reflexes. The ENS is to be referred as second brain, it uses serotonin to communicate with the central nervous system. This “brain gut axis’ helps us in understanding how psychological and social stress might cause digestive problems. ENS is closely related to central nervous system (CNS). As mentioned, blindness (‘andhya’) is one of the udavarta janya vikara (diseases caused by udavarta) which is difficult to understand how eyes are related to apana vayu (one of the five subtypes of vata situated in the pelvic region). In an article named ‘Gut microbes linked to eye diseases’ observations have been made by the researchers regarding the possible connection between the gut microbes and the eye diseases. Apana vayu (one of the five subtypes of vata situated in the pelvic region) is mostly parasympathetic in action and its action is related to urine (mutra), stool (purisha), flatus (adhovata) and seminal discharge (shukra vega). Obstruction in passing flatus (apana vayu rodha) invariably affects the prana vayu (one type of the five subtypes of vata situated in upward body or head) among and other vital points in body (marma sthana) like herat (hrudya), brain (shiras), and urinary bladder (basti).&lt;ref&gt;Gugulothu Ramesh, Yadav C.R. A physiological study of Adharaneeya vega w.s.r. to Apanavayu vega. International Ayurvedic Medical Journal. ISSN: 2320 5091, September 2017, 5(9).&lt;/ref&gt;&lt;/p&gt;<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;3) Nidra vegadharana (suppression of sleep) leads to vitiation of vata dosha. Vata controls the functions of mind (mana). Stress is mainly due to mental and physical stimuli which cause disturbances in the internal biological equilibrium. Disturbed and interrupted sleep is very common in the IT professionals due to their work culture. Here, nidra vegadharana (suppression of urge of sleep) acts as a stress stimulus which causes impairment in both sharirika (biological elements vata, pitta and kapha) and manasika (psychological constitution like raja and tama) dosha which causes further loss of sleep (nidranasha). Udavarta affects mind and leads to abnormalities in mental functions similar to mental stress. Hence it is important to avoid nidra vegadharana (suppression of urge of sleep) to prevent further kriyakala i.e., stage of progression of disease leading to stress and other mental disorders.&lt;ref&gt;S. Gopakumar, M. A. Shajahan. A Review on Conceptual Relationship between Nidra vegadharana and Manifestation of Stress among IT professionals. International Ayurvedic Medical Journal, ISSN: 2320 5091, April- May 2107, 1(4). &lt;/ref&gt; &lt;/p&gt;<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;4) In this study total 74 patients have been enrolled which were divided in two groups randomly. The selected drug for clinical trial in group A was Yavanikadi vati (tablet) which contains haritaki (Terminalia chebula), yavani (Trachyspermum ammi), hingu (Ferula foetida), sauvarchala (black salt), yavakshara (alkali prepared from barley) and saindhava (rock salt). The powder of these raw drugs was given 3 times trituration (bhavana) of these raw drugs was given 3 times trituration (bhavana) of lemon juice (nimbu swarasa) to prepare tablet. In group B, Shankha vati (tablet) was taken for control group, which contains purified mercury (shuddha parada) and purified sulphur (shuddha gandhaka). In the group A 31 patients were given Yavanikadi vati in tablet form 1 gm B.D. in two divided doses (1 tablet = 500 mg.) daily, after food for 28 days with water whereas, in Group B total 30 patients were given Shankha Vati. The dose, duration, time of administration and anupana (co-administers with medicine) is same as group A. Comparison of the therapies showed that overall better results as observed in group A as compared to group B which stands closely parallel to group A.&lt;ref&gt;A clinical study of Udavarta with special reference to Udavarta by Taruna Modhera, Department of Roga Nidana Evam Vikriti Vigyana. Institute for Post Graduate Teaching and Research in Ayurveda. Gujarat Ayurved University, Jamnagar, 2008.&lt;/ref&gt; &lt;/p&gt;<br /> <br /> &lt;big&gt;'''[[Special:ContactMe|Send us your suggestions and feedback on this page.]]'''&lt;/big&gt;<br /> <br /> ==References==<br /> <br /> &lt;div id=&quot;BackToTop&quot; class=&quot;noprint&quot; style=&quot;background-color:#DDEFDD; position:fixed;<br /> bottom:32px; left:2%; z-index:9999; padding:0; margin:0;&quot;&gt;&lt;span style=&quot;color:blue;<br /> font-size:8pt; font-face:verdana,sans-serif; border:0.2em outset #ceebf7;<br /> padding:0.1em; font-weight:bolder; -moz-border-radius:8px; &quot;&gt;<br /> [[#top| Back to the Top ]]&lt;/span&gt;&lt;/div&gt;</div>

Manishdubey https://www.carakasamhitaonline.com/index.php?title=Udavarta&diff=44316 2023-11-03T11:19:36Z

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Manishdubey https://www.carakasamhitaonline.com/index.php?title=Talk:Udavarta&diff=44315 2023-11-03T11:19:00Z

<p>Manishdubey: </p> <hr /> <div>{{CiteButton}}<br /> {{#seo:<br /> |title= UDAKAVAHA SROTAS (Channels for transport and transformation of watery components)<br /> |titlemode=append<br /> |keywords=Udakavaha Srotas, Water metabolism, Bhojani M. K., Tanwar Ankur Kumar, Basisht G, Deole Y.S.<br /> |description=Udaka means water. In body, water is present in the form of various fluids. Udakavaha srotasa are the channels for transport and transformation of fluid (water) and its circulation. <br /> |image=http://www.carakasamhitaonline.com/mediawiki-1.32.1/resources/assets/ogimgs.jpg<br /> |image_alt=carak samhita<br /> |type=article<br /> }}<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Udavarta literally means the upward and repeated movements of vata. It is one of the important and commonly observed condition in clinical practice. It manifests with a number of clinical features which may lead to manifestation of other secondary diseases further. Udavarta is mentioned as one among the eighty diseases occurred primarily by the vitiated vata dosha (nanatmaja vata vyadhi). [Cha. Sa. Sutra Sthana 20/11] Udavarta (upward movement of vata) is very common now a days due to change in lifestyle of modern society. The change in dietary habits and due to hectic job schedule, suppression of natural urges (vegadharana) is also very common now a days. The two main cause of udavarta explained in classical texts are: suppression of natural urges (vegadharana) and faulty dietary habits (asatmya ahara sevana). Sushrut Samhita describes that suppression of natural urges (adharaniya vega) leads to manifestation of thirteen types of udavarta. Due to aggravating factors, vata dosha is aggravated, especially apana vata (one of the five subtypes of vata i.e., situated in the pelvic region) is affected. Generally, udavarta means upward movement of vata or apana vata, that results in retention of faeces, urine and flatus. However, the scope of udavarta extends to disturbance in normal functions of vata due to obstruction by metabolic wastes. This unique concept is not explained in any other contemporary sciences. So, understanding this concept and to provide better treatment for this disease is need of the society.&lt;/p&gt;<br /> <br /> {{Infobox<br /> |title = Contributors<br /> |label1 = Section/Chapter/topic<br /> |data1 = Concepts &amp; Practices/[[Udavarta]] <br /> |label2 = Authors<br /> |data2 = Dubey M.&lt;sup&gt;1&lt;/sup&gt;,&lt;br/&gt;Deole Y.S.&lt;sup&gt;2&lt;/sup&gt;<br /> |label3 = Reviewer <br /> |data3 = Basisht G.&lt;sup&gt;3&lt;/sup&gt;, <br /> |label4 = Editor<br /> |data4 = Basisht G.&lt;sup&gt;3&lt;/sup&gt;<br /> |label5 = Affiliations<br /> |data5 = &lt;sup&gt;1&lt;/sup&gt;[[Charak Samhita Research, Training and Development Centre]], I.T.R.A., Jamnagar, India &lt;br/&gt;&lt;sup&gt;2&lt;/sup&gt;Department of Kayachikitsa, G. J. Patel Institute of Ayurvedic Studies and Research, New Vallabh Vidyanagar, Gujarat, India&lt;br/&gt;&lt;sup&gt;3&lt;/sup&gt;Rheumatologist, Orlando, Florida, U.S.A.<br /> |label6 = Correspondence emails<br /> |data6 = dr.manish181@gmail.com, dryogeshdeole@gmail.com<br /> carakasamhita@gmail.com<br /> |label7 = Publisher <br /> |data7 = [[Charak Samhita Research, Training and Development Centre]], I.T.R.A., Jamnagar, India<br /> |label8 = Date of publication:<br /> |data8 =November 03, 2023<br /> |label9 = DOI<br /> |data9 = {{DoiWithLink}}<br /> }}<br /> <br /> ===Nirukti (etymology)===<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;The term udavarta is derived from Utt + Aavat i.e., “Ut + Ang + Vrut + Dhaya” to form word Udavarta.&lt;ref&gt;Shabdakalpadruma by Raja Radhakanta Deva, Prathama Khand. Second edition. Delhi: Naaga Publishers; 2003. pg.no. 237.&lt;/ref&gt; Udavarta is a Sanskrit word derived from 'Ut' verb root (dhatu) with 'Ang' and 'Vrut' preposition (upasarga), suffixed by ‘Dhaya’ pratyaya (suffix). “Ut” means upper side, (Urdhva) “Ang” means entirely and “Vrut” means to move (bhramana). Udavarta means upwards movement, to cause to go out, excrete, to secrete and to retain.&lt;ref&gt;M. Monier Williams Sanskrit English dictionary. &lt;/ref&gt; Udavarta is a class of diseases marked by retention of the feces i.e., disease of the bowel so, in general urdhwa (upward direction) or pratiloma (moving in abnormal direction) movement of apana vata (one of the five subtypes of vata, situated in the pelvic region) is termed as udavarta.&lt;/p&gt;<br /> <br /> ===Definition===<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;‘Udavarta’ is that disease in which there is whirlpool movement (avartana) and upward movement (urdhva gamana) of vata is seen due to retention of vata, urine (mutra) and stool (purisha). The condition in which vata begins to move upwards is called as ‘udavarta’ and in this disease vata is the predominant dosha.&lt;ref&gt;Bhavaprakasha of Sri Bhavamishra edited with Vidyotini hindi commentary by Pandit Shri Brahma Sankar Mishra, Part II, Adhyaya- 31/2, Chaukhambha Sanskrit Bhawan, Varanasi, Ed: 2009, 11&lt;sup&gt;th&lt;/sup&gt; edition. pg. no. 332.&lt;/ref&gt; &lt;/p&gt;<br /> <br /> ===Etiopathogenesis===<br /> *Intake of deficient quantity of food causes udavarta. [Cha. Sa. Vimana Sthana 2/7] <br /> *Intake of astringent, bitter, pungent and un-unctuous (dry) food and excessive fasting<br /> *Withholding natural urges (vegadharana) <br /> *Excessive indulgence in sexual activity. [Cha. Sa. Chikitsa Sthana 26/5-6] <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Due to all above reasons the apana vata which resides in large intestine (pakvashaya) gets aggravated and further obstructs the downward movement of vata causing retention of movement of stool, urine and flatus. This leads to a dreadful disease named as udavarta. [Ca. Sa. Chikitsa Sthana 26/5-6]&lt;/p&gt; <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Acharya Sushruta explained suppression of 13 urges leading to udavarta. [Su. Sa. Uttara Sthana 55/ 3-4] Thus, udavarta is caused by 2 main causes, one is suppression of natural urges and other one unwholesome eating. [Su. Sa. Uttara Sthana 55/ 6] Excess consumption of mudga (Phaseolus mungo), kodrava (Paspalum scrobiculatum Linn.), jurnahva (Sorghum vulgare/jowar), karira (Capparis decidua), chanaka (Cicer arietinum L.), etc. i.e., foods with property of dryness and causing constipation vitiate normal status of vata dosha in its own seat (large intestine). This vata becomes powerful and blocks the downward channels and produces severe obstruction in the movement of feces, flatus and urine leading to udavarta. [A. H. Nidana Sthana 7/46-52]&lt;/p&gt;<br /> <br /> ===Clinical features=== <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Frequent pain in the region of urinary bladder (basti), heart (hridaya), abdomen (udara) and excruciating or intense pain in the back of chest. Other symptoms are flatulence (adhmana), nausea (hrillasa), gripping type of pain in anus (vikartika), pricking (toda) type of pain in whole body, indigestion and inflammation of urinary bladder. Obstruction in passing stool less frequently and with difficulty and in less quantity, after long time and effort. Upward movement of flatus occurs because of obstruction in channels (srotasa), increased roughness, dryness and coldness in the body. [Cha. Sa. Chikitsa Sthana 26/6-7]&lt;/p&gt;<br /> <br /> ===Udavarta janya vikara===<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;If not treated early, udavarta leads to other secondary complications as follows:&lt;/p&gt;<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Fever (jwara), dysuria (mutrakricchhra), dysentery (pravahika), heart disease (hridroga), diseases due to malfunctioning of duodenum (grihani dosha), vomiting (chhardi), blindness, deafness, burning sensation in the head, affliction of abdomen by vata (vatodara), tumors (asthila), psychological diseases (mano vikara), disorders of excessive thirst (trishna roga), an ailment characterized by bleeding from different parts of the body (raktapitta), aruchi (anorexia), phantom tumor (gulma), cough (kasa), dyspnoea (shwasa), chronic rhinitis (pratishyaya), facial paralysis (ardita), diseases of the flanks including lower respiratory tract disorders (parshva roga) and such other serious diseases caused by aggravation of vata. [Cha. Sa. Chikitsa Sthana 26/8-9]&lt;/p&gt;<br /> <br /> ===Udavarta as a causative factor (nidana) of other diseases===<br /> *&lt;p style=&quot;text-align:justify;&quot;&gt;Udavarta is the etiological factor of abdominal swelling caused by intestinal obstruction (baddhagudodara) [Cha. Sa. Chikitsa Sthana 13/39]<br /> *Udavarta is the cause for abdominal swelling afflicted by spleen (plihodara). [Cha. Sa. Chikitsa Sthana 13/75]<br /> *Udavarta is the cause for respiratory diseases including bronchial asthma (pratamaka shwasa-type of tamaka shwasa) characterized by fever, syncope and other such symptoms which are relieved by cold measures. [Cha. Sa. Chikitsa Sthana 17/63]<br /> *Udavarta caused by suppression of the urge of urination is causative factor of condition where severe painful distension of abdomen below umbilicus is present along with obstruction of downward movement of urine (mutrajathara- a type of mutraghata i.e., retention of urine). [Su. Sa. Uttara Sthana 58/13]<br /> *Vidvighata (type of mutraghata i.e., retention of urine): In debilitated person due to loss of fat, udavarta brings small amount of feces into the channels of urine (bladder and urethra) resulting in patients voiding of urine having odour of feces is termed as vidvighata. [A. H. Nidana Sthana 9/33-34]<br /> *Hemorrhoids (arsha): Udavarta is the chief complication in hemorrhoids (durnama/arsha). This udavarta may occur in person who has predominance of vata dosha in alimentary tract (koshtha) even without piles. <br /> *Vatodara: Udavarta is one of the causative factors of abdominal swelling afflicted by vata dosha (vatodara). [Cha. Sa. Chikitsa Sthana 13/23]<br /> *Hiccups (hikka) &amp; dyspnoea (shwasa): Udavarta is the one of the etiological factors for causation of conditions such as hiccups (hikka) and dyspnoea (shwasa).&lt;/p&gt;<br /> <br /> ===Udavarta as symptoms (lakshana) in following diseases===<br /> <br /> #Vataja plihodara (vata predominant plihodara i.e., abdominal swelling afflicted by splenomegaly) [Cha. Sa. Chikitsa Sthana 13/38]<br /> #Vatodara (abdominal swelling afflicted by vata dosha) [Cha. Sa. Chikitsa Sthana 13/25]<br /> #Vataja gulma (vata predominant gulma/ phantom tumor) [Cha. Sa. Chikitsa Sthana 5/10]<br /> #Sahaja arsha (congenital hemorrhoids) [Cha. Sa. Chikitsa Sthana 14/8]<br /> #Vataja arsha (vata predominant hemorrhoids) [Cha. Sa. Chikitsa Sthana 14/11]<br /> #Vyana avruta apana (type of avarana (occlusion) where vyana vata obstructs the flow of apana vata) [Cha. Sa. Chikitsa Sthana 28/211]<br /> #Basti marma viddha (injury to bladder) [Cha. Sa. Siddhi Sthana 9/6]<br /> <br /> ===Types of Udavarta===<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Udavarta is of 6 types which occur by suppression of natural urges viz., apana vata nirodhaja (suppression of flatus), mutra vega nirodhaja (suppression of urine), purisha vega nirodhaja (suppression of faeces), shukra vega nirodhaja (suppression of ejaculation of semen), chhardi vega nirodhaja (suppression of vomiting) and kshavathu vega nirodhaja (suppression of sneezing). [Cha. Sa. Sutra Sthana 18/3]&lt;/p&gt;<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;As per Sushruta Samhita, there are 13 types of suppression of natural urges (vegadharana) namely flatus, faeces, urine, yawning, flow of tears, sneezing, eructation, vomiting, ejaculation of semen, hunger, thirst, breath and sleep. [Su. Sa. Uttara Sthana 55/ 3-4] Suppression of these vega (urges) gives rise to their respective type of udavarta and manifest their respective symptoms which are as follows;&lt;/p&gt;&lt;p style=&quot;text-align:justify;&quot;&gt;'''Table no. 1:''' '''Types of udavarta and their symptoms''' [Su. Sa. Uttara Sthana 55/6-17]&lt;/p&gt;<br /> {| class=&quot;wikitable&quot;<br /> |'''Sr.'''<br /> <br /> '''No.'''<br /> |<br /> <br /> '''  Udavarta type'''<br /> |<br /> <br /> '''                             Symptoms'''<br /> |-<br /> |1.      <br /> |'''Apana vata/ Adhovata nirodhaja udavarta'''<br /> <br /> (Suppression of flatus)<br /> |Flatulence, colic abdominal pain, obstruction in cardiac region, headache, severe dyspnea, hiccoup, cough, coryza, obstruction in throat, terrible spread of kapha and pitta dosha, movement of feces through mouth (reverse peristalsis). <br /> |-<br /> |2.      <br /> |'''Purisha vega nirodhaja udavarta'''<br /> <br /> (Suppression of urge of defecation)<br /> |Abnormal bowel sounds (atopa), colicy abdominal pain, cutting type of pain in abdomen, retention of feces, upward movement of vata causing excessive belching (urdhwavata).  <br /> |-<br /> |3.      <br /> |'''Mutra vega nirodhaja udavarta'''<br /> <br /> (Suppression of urge of micturition)<br /> |Passing of scanty urine with difficulty with distension of urinary bladder, intense pain in penis, groin, anus, groin, pelvis, scrotum and umbilical region or head as if the body is being torn with spikes. <br /> |-<br /> |4.      <br /> |'''Jrimbha vega nirodhaja udavarta'''<br /> <br /> (Suppression of yawning)<br /> |Stiffness of neck (manyastambha), stiffness of throat, diseases of head (shiroroga) and vata predominant diseases (other vataja vyadhi). Severe diseases of ear, mouth, nose and eye are also produced.  <br /> |-<br /> |5.      <br /> |'''Ashru vega nirodhaja udavarta'''<br /> <br /> (Suppression of flow of tears/lacrimation either from pleasure or grief)<br /> |Heaviness of head, severe diseases of eye and coryza (peenasa).  <br /> |-<br /> |6.      <br /> |'''Kshavathu vega nirodhaja udavarta'''<br /> <br /> (Suppression of sneezing)<br /> |Severe diseases of head, eye, nose and ears; filling of mouth and throat, excessive pricking pain, obstruction in breath. <br /> |-<br /> |7.      <br /> |'''Udagara vega nirodhaja udavarta''' (Suppression of urge of belching)<br /> |Severe diseases caused by vata dosha.<br /> |-<br /> |8.      <br /> |'''Chhardi vega nirodhaja udavarta'''<br /> <br /> (Suppression of urge of vomiting)<br /> |Various skin diseases (kushtha) arise with predominance of dosa by which food is vitiated. <br /> |-<br /> |9.      <br /> |'''Shukra vega nirodhaja udavarta'''<br /> <br /> (Suppression of semen ejaculation)<br /> |Swelling and pain in urinary bladder, anus and testicles, retention of urine, seminal calculus, discharge of semen and other related disorders of semen. <br /> |-<br /> |10.   <br /> |'''Kshudha vega nirodhaja udavarta'''<br /> <br /> (Suppression of urge of hunger)<br /> |Drowsiness, body-ache, anorexia, giddiness and weakness of vision. <br /> |-<br /> |11.   <br /> |'''Trishna vega nirodhaja udavarta'''<br /> <br /> (Suppression of urge of thirst)<br /> |Dryness in throat and mouth, deafness and cardiac pain. <br /> |-<br /> |12.<br /> |'''Shrama shwasa/ Shranta nishwasa nirodhaja udavarta'''<br /> <br /> (Suppression of holding breath after exertion)<br /> |Cardiac disorder, mental confusion and phantom tumor (gulma).  <br /> |-<br /> |13. <br /> |'''Nidra vega nirodhaja udavarta'''<br /> <br /> (Suppression of urge of sleep)<br /> |Yawning, body ache, dullness in limbs, head and eyes, drowsiness.  <br /> |}<br /> <br /> ===Asadhyata [incurable stage of diseases]===<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Udavarta with symptoms of excessive thirst, excessively depressed, emaciated, suffering from pain and vomiting of fecal matter is difficult to manage or incurable.[Su. Sa. Uttara Sthana 55/ 17-18] &lt;/p&gt;<br /> <br /> ===Treatment===<br /> &lt;p style=&quot;text-align:justify;&quot;&gt; Treatment principles for udavarta i.e., palliative therapy (shamana) or purification (shodhana) etc., can be selected based on stages of the disease and as well as on the condition of the patient. The treatment guidelines explained in Charaka Samhita are as follows: [Cha. Sa. Chikitsa Sthana 26/11]&lt;/p&gt;<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;The patient suffering from udavarta should be given massage with hot oil described for the treatment of fever presented with cold extremities (sheeta jwara). Then fomentation therapy should be administered for the detachment of the adhered dosha in the tissue cells. This should be followed by the administration of suppository (varti), un-unctuous enema (niruha basti) and unctuous type of purgative (snigdha virechana). The patient should be given food which helps in the normal downward movement (anulomana) of apana vata.&lt;/p&gt;<br /> <br /> '''A) Unction therapy (snehana):''' &lt;p style=&quot;text-align:justify;&quot;&gt;Udavarta is produced due to aggravation of vata and sneha (lipids) is the best treatment for pacification of vata vata (shamana). Therefore, unction therapy (snehana) is indicated in udavarta. &lt;/p&gt;<br /> '''B) Fomentation therapy (swedana):''' &lt;p style=&quot;text-align:justify;&quot;&gt;After massage with oil, fomentation therapy should be administered for the detachment of the adhered dosha in the tissue cells.&lt;/p&gt;<br /> '''C) Suppository (varti):''' &lt;p style=&quot;text-align:justify;&quot;&gt;A suppository having the thickness of the thumb is to be prepared with drugs like Shyama Trivrita (Operculina turpethum), Vidanga (Embeila ribes), Kampillaka (Mallotus philippensis) etc., which should be triturated with gomutra (cow’s urine) or arka (Calotropis gigantea) latex (kshira) and made in to form of suppository (phala varti) by adding jaggery. This suppository should be inserted through anus for the downward movement of apana vata to relieve retention of stool, flatus and urine caused by udavarta.&lt;/p&gt;<br /> '''D) Palliative therapy (shamana):''' &lt;p style=&quot;text-align:justify;&quot;&gt;Shamana includes administration of internal medication such as dviruttara- hingvadi churna, hinguvachadi churna given with warm water as an anupana (co-administers with medicine) for correcting the upward movement of vata.&lt;/p&gt;<br /> '''E) Purification therapy (shodhana):'''&lt;p style=&quot;text-align:justify;&quot;&gt;When the disease is chronic and relief is not observed even by adopting above measures, then purification (shodhana) by non-unctuous enema (niruha basti) or purgation (virechana) is advised.&lt;/p&gt;<br /> '''F) Pathya ahara kalpana (wholesome diet):'''&lt;p style=&quot;text-align:justify;&quot;&gt;Intake of wholesome diet (pathya ahara) which helps in normal downward movement (anulomana) of apana vata whereas, intake of unwholesome diet (apathya ahara) should be avoided for better recovery. Generally, in all types of udavarta all measures for controlling vata should be adopted in order to restore it to its normal channels (srotasa). [Su. Sa. Uttara Sthana 55/ 19]&lt;/p&gt;&lt;p style=&quot;text-align:justify;&quot;&gt;'''Table no. 2:''' '''Types of udavarta and their respective treatment''' [Su. Sa. Uttara Sthana 55/20-34]&lt;/p&gt;<br /> {| class=&quot;wikitable&quot;<br /> |'''Sr.'''<br /> <br /> '''No.'''<br /> | <br /> <br /> '''Udavarta type'''<br /> |<br /> <br /> '''                             Treatment'''<br /> |-<br /> |<br /> <br /> <br /> 1.<br /> |'''Apana vata/ Adhovata nirodhaja udavarta'''<br /> <br /> (Suppression of flatus)<br /> |Massage (abhyanga) and sudation (swedana) followed by asthapana basti (non-unctuous enema). <br /> |-<br /> |<br /> <br /> <br /> 2.<br /> |'''Purisha vega nirodhaja udavarta'''<br /> <br /> (Suppression of urge of defecation)<br /> |Treatment of non- passage of flatus and feces (anaha) should be adopted.<br /> |-<br /> |<br /> <br /> <br /> 3.<br /> |'''Mutra vega nirodhaja udavarta'''<br /> <br /> (Suppression of urge of micturition)<br /> |Treatment of renal calculi (ashmari), dysuria (mutrakrichha) and retention of urine (mutraghata) should be adopted.<br /> |-<br /> |<br /> <br /> <br /> 4. <br /> |'''Jrimbha vega nirodhaja udavarta'''<br /> <br /> (Suppression of yawning)<br /> |Unction therapy (snehana) and fomentation therapy (swedana). <br /> |-<br /> |<br /> <br /> <br /> 5. <br /> |'''Ashru vega nirodhaja udavarta'''<br /> <br /> (Suppression of flow of tears/lacrimation either from pleasure or grief)<br /> |After unction therapy (snehana) and fomentation therapy (swedana) the flow of tears should be stimulated by applying irritant collyrium etc. <br /> |-<br /> |  <br /> <br /> 6.<br /> |'''Kshavathu vega nirodhaja udavarta'''<br /> <br /> (Suppression of sneezing)<br /> |Induce sneezing by application of irritant collyrium, pressed snuff (avapidana nasya), inhalation of irritant odor or by using smoking wick (dhuma varti). <br /> |-<br /> |<br /> <br /> <br /> 7.<br /> |'''Udagara vega nirodhaja udavarta''' (Suppression of urge of belching)<br /> |Unctuous smoking (snehaika dhumapana) with prescribed order and also intake of wine (sura) mixed with bijapura (Citrus medica) juice and added with black salt (sauvarchala lavana/ Unaqua sodium chloride). <br /> |-<br /> |<br /> <br /> <br /> 8.<br /> |'''Chardi vega nirodhaja udavarta'''<br /> <br /> (Suppression of urge of vomiting)<br /> |Unction according to the dosa involved. Massage with ghee mixed with a pinch of alkali prepared from barley (yavakshara) and rock salt (saindhava lavana). <br /> |-<br /> |<br /> <br /> <br /> 9.<br /> |'''Shukra vega nirodhaja udavarta'''<br /> <br /> (Suppression of semen ejaculation)<br /> |Patient advised to drink milk boiled with four times water added with diuretic drugs up to full satisfaction and then indulge in sexual activity. <br /> |-<br /> |10.<br /> |'''Kshudha vega nirodhaja udavarta'''<br /> <br /> (Suppression of urge of hunger)<br /> |Intake of unctuous and warm food in little quantity. <br /> |-<br /> |<br /> <br /> <br /> 11. <br /> |'''Trishna vega nirodhaja udavarta'''<br /> <br /> (Suppression of urge of thirst)<br /> |Intake of churned drink (mantha) or liquid gruel (yavagu) of cold nature. Use of cold water for drinking and other purpose. <br /> |-<br /> |<br /> <br /> <br /> 12.<br /> |'''Shrama shwasa/ Shranta nishwasa nirodhaja udavarta'''<br /> <br /> (Suppression of holding breath after exertion)<br /> |Complete rest and intake of meat soup. <br /> |-<br /> |<br /> <br /> <br /> 13. <br /> |'''Nidra vega nirodhaja udavarta'''<br /> <br /> (Suppression of urge of sleep)<br /> |Advised to go to sleep after intake of milk and listening to favorite stories. <br /> |}<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Complications of udavarta, flatulence (adhmana) and other diseases should be managed with respective measures according to condition. [Su. Sa. Uttara Sthana 55/34-35] For example when vayu in abdomen (koshtha) is aggravated by rough, pungent, bitter and astringent food, it immediately produces udavarta owing to which the channels (srotasa) carrying flatus, feces, urine, blood, kapha and adipose tissue (medas), move in upward direction and harden the feces too much. This results in manifestation of symptoms such as pain in cardiac and pelvic region, heaviness, anorexia, passing of urine, flatus and feces with difficulty. The person gets afflicted with many other disorders caused by aggravation of vata such as dyspnoea, (shwasa), cough (kasa), hiccoup (hikka), thirst (trishna), coryza (pratishyaya), burning sensation (daha), mental confusion (moha), vomiting (chhardi), fever (jwara), diseases of head and abnormalities of mind and ears. [Su. Sa. Uttara Sthana 55/2] &lt;/p&gt;<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;One should advise non-unctuous enema (niruha basti) after the patient is massaged with oil mixed with salt and sudation; then after feces are eliminated, he should be advised to take food followed by administration of unctuous enema (anuvasana basti) according to the dosha involvement. If by above procedures, still no relief found then in severe cases of udavarta, patient is advised to undergo repeated unction therapy (snehana) and fomentation therapy (swedana) and then undergo unctuous purgation (snigdha virechana). [Su. Sa. Uttara Sthana 55/40-41]&lt;/p&gt;<br /> <br /> ===Different treatments of udavarta===<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;1) Saturating drink (mantha) prepared with sugarcane product (phanita), roasted grain flour (saktu), ghee, curd water and vinegar (amla kanji) alleviate udavarta. [Cha. Sa. Sutra Sthana 23/37]&lt;/p&gt;<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;2) 96 gm (2 pala) of dehusked tila (Sesamum indicum Linn.), 48 gm (1 pala) of jaggery and 24 gm (half pala) of nagara (Zingiber officinale) should be made into a paste and taken along with hot milk helps in udavarta. [Cha. Sa. Chikitsa Sthana 5/91-92] &lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;3) Milk cooked with Allum sativum (Lashuna kshirapaka): Garlic cooked with milk by adding water and reducing to the quantity of milk, cures udavarta immediately [Cha. Sa. Chikitsa Sthana 5/94] &lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;4) Alkali prepared from pippali (Piper longum) and other ingredients (Pippalyadi kshara) used in udavarta [Cha. Sa. Chikitsa Sthana 13/159-161] &lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;5) Medicine prepared by boiling medicinal herbs in water and then kept for fermentation with drugs such as haritaki (Terminalia chebula), amalaki (Emblica officinalis), etc. (Phalarishta) used in udavarta. [Cha. Sa. Chikitsa Sthana 14/148-152] &lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;6) Trivrut (Operculina turpethum), pilu (Salvadora persica), yavani (Trachyspermum ammi) with sour gruel mixed with digestants (pachana) drugs. [Su. Sa. Uttara Sthana 55/42-43] &lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt; 7) The combination of hingu (Ferula foetida), kushtha (Saussurea lappa), vacha (Acorus calamus Linn.), svarjika (alkali prepared by burning Lona plant), and vidanga (Embelia ribes) – successively in double quantity cures udavarta and colicky pain by vata dosha (vataja shoola) [Su. Sa. Uttara Sthana 55/42-43]&lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;8) Intake of ghee cooked with decoction of dried radish (Raphanus sativus), sunthi (Zingiber officinale), punarnava (Boerhavia diffusa), brihata panchamula (combination of five herbs viz., bilva, patala, agnimantha, shyonaka and gambhari), and fruits of aragvadha (Cassia fistula) subsides severe udavarta completely. [Su. Sa. Uttara Sthana 55/45-46] &lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;9) Vacha (Acorus calamus Linn.), ativisha (Aconitum heterophyllum), kushtha (Saussurea lappa), yavakshara (alkali prepared from barley), haritaki (Terminalia chebula Retz.), pippali (Piper longum) and agnimantha (Clerodendrum phlomidis) with hot water cures udavarta. [Su. Sa. Uttara Sthana 55/47] &lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;10) Devadaru (Cedrus deodara), chitraka (Plumbago zeylanica), triphala (combination of 3 herbs viz., haritaki, bibhitaki and amalaki), brihati (Solanum indicum) should be taken along with cow’s urine. [Su. Sa. Uttara Sthana 55/49]&lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;11) Suppository: Powder of danti (Baliospermum montanum), kampillaka (Mallotus philippensis), shyama trivrita (Operculina turpethum), ikshvaku (Lagenaria vulgaris Ser.), ajamoda (Apium graveolens), kritavedhana (Luffa acutangula Linn Roxb.), pippali (Piper longum) and salts should cook in cow’s urine and made into suppositories to be inserted in the anus. This provides instant relief in the symptoms of udavarta. [Su. Sa. Uttara Sthana 55/51-52] &lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt; 12) Guggulu (Commiphora mukul) should be taken with decoction of triphala (combination of 3 herbs viz., haritaki, bibhitaki and amalaki), daruharidra (Berberis aristata), patola (Trichosanthes dioica) and kusa (Desmostachya bipinnata) or with urine or hot water for 1 month alleviates udavarta. [Su. Sa. Chikitsa Sthana 5/39-44]&lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;13) Kalyanaka kshara consumed with ghee cures udavarta and constipation (vibandha) [A. H. Chikitsa Sthana 8/142] &lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;14) Erandamooladi enema (basti) helps in alleviating obstruction of faeces, urine and flatus [Ch. Sa. Siddhi Sthana 3/38-42] &lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt; 15) Palashadi niruha basti alleviates non- passage of flatus and feces (anaha) and udavarta [Ch. Sa. Siddhi Sthana 3/44-45]&lt;/p&gt;<br /> <br /> === Treatment as per different conditions===<br /> *In hemorrhoids (arsha), if symptoms of udavarta is present then unctuous enema (anuvasana basti) should be administered. [Cha. Sa. Chikitsa Sthana 14/130]<br /> *In complications by enema (basti vyapat) when unctuous enema gets obstructed by feces then treatment alleviating udavarta should be adopted. [Cha. Sa. Siddhi Sthana 4/36-37]<br /> *In emesis (vamana) and purgation (virechana) complications (vyapta), in extremely vitiated condition of doshas (bahudosha avastha) low dose of medicine is administered, then it causes udavarta, tympanitis (adhmana) in such condition treatment of udavarta is massage (abhyanga), sudation, suppository, non-unctuous enema (niruha basti) and other measures of udavarta should be adopted [Cha. Sa. Siddhi Sthana 6/58-60]<br /> *In pain caused by obstruction of feces (vitshula) the measures mentioned for udavarta should be used in the treatment. [Su. Sa. Uttara Sthana 42/140] <br /> *In treatment of rakta gulma (a variety of phantom tumor) the measures which cures udavarta should be adopted. [A. H. Chikitsa Sthana 14/129]<br /> *Measures which cure udavarta (udavarta hara kriya) should be adopted in abdominal swelling caused by intestinal obstruction (baddhodara). [A. H. Chikitsa Sthana 15/100]<br /> *In emesis (vamana) from improper therapy (mithya yoga), therapies of udavarta should be adopted. [A. H. Kalpasiddhi Sthana 3/13]<br /> *In complications from enema (basti vyapat) the treatment of udavarta should be adopted if fat (sneha) of enema (basti) gets obstructed or enveloped by feces. [A. H. Kalpa-siddhi Sthana 5/39]<br /> <br /> ===Measures alleviating udavarta (udavarta hara)===<br /> <br /> *Mrudvika (Vitis vinifera/grapes) alleviates udavarta [Cha. Sa. Sutra Sthana 27/125-126]<br /> *Haritaki (Terminalia chebula Retz.) used in udavarta [Cha. Sa. Chikitsa Sthana 1/1/31]<br /> *Dish prepared with barley (yavapupa), supernatant liquid proportion of barley preparation (yavaka) and bhristha yava odana/ parched cooked barley (vatya) made from yava (barley) helps in alleviation of udavarta. [Cha. Sa. Sutra Sthana 27/265]<br /> *Saturating drink (mantha) prepared by churning parched grain flour (saktu) with sour taste (amla rasa), fat and jaggery alleviates udavarta. [Su. Sa. Sutra Sthana 46/386]<br /> *Vatya (made by roasted wheat or barley) helps in alleviating udavarta. [Su. Sa. Sutra Sthana 46/410]<br /> *Garlic cooked with milk (lashuna kshirapaka) alleviates udavarta. [A. H. Chikitsa Sthana 14/46]<br /> <br /> ===Diet for udavarta===<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Intake of vegetable preparations prepared from the leaves of trivruta (Operculina turpethum) and snuhi (Euphorbia neriifolia Linn.), tila (Sesamum indicum) and its different preparations, soup of meat of animals inhabiting in marshy land, domestic and aquatic animals, clear top portion of alcohol (prasanna) and molasses rum (sidhu), wine prepared of jaggery, preparations which facilitates motion of flatus, urine and stool. [Cha. Sa. Chikitsa Sthana 26/18] One should never withhold the natural urges of the body. [Su. Sa. Uttara Sthana 55/3]&lt;/p&gt;<br /> <br /> ===Researches===<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;1) A review on diseases manifested due to withholding natural urges (vegadharana janya vikara) focused to identify the effects of suppression of natural urges (adharaneeya vegas) on various system of body such as CVS, gastrointestinal tract, respiratory system urinary system and reproductive system. CVS and gastrointestinal systems are the mostly affected systems. Out of thirteen urges (vegas), seven play major role in both systems. Common clinical features produced by suppression of natural urges (vegadharana) were weakness of the body, constipation, anorexia, headache, diseases of eye, difficulty in micturition, bending of the body and stiffness of the neck. Weakness of the body and anorexia are the commonest clinical features produced by suppression of natural urges. These clinical features arise due to vitiation of vata by vegadharana. Withholding (dharana) of natural urges is strictly prohibited to stay healthy.&lt;ref&gt;Zahara M.S.F, Kulathunga R.D.H, Chathurika L.A.W.J. A Review of Vegadharana.  International Ayurvedic Medical Journal. ISSN 2320 5091, March 2021.&lt;/ref&gt;&lt;/P&gt;<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;2) A physiological study of adharaneeya vega (suppression of natural urges) w.s.r. to apana vayu vega (suppression of apana vata or flatus)&lt;/p&gt;<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Understanding the physiology of suppression of natural urges (vegarodhajanya) symptoms and analyzing them as a pathology of various diseases related to apana vayu (one of the five subtypes of vata situated in the pelvic region). As, seen in clinical practice many a times diseases reoccur after giving proper treatment. Also, in such case causative factors (nidana) of vitiation of apana vayu (one of the five subtypes of vata situated in the pelvic region) is to be analyzed properly for better result. Among the fourteen adharaneeya vega (suppression of natural urges), apana vayu (one of the five subtypes of vata situated in the pelvic region) vega (urge) is most commonly suppressed which leads to vitiation of vata dosha in the pelvic region). Adharaneeya vega (suppression of natural urges) is a reflex mechanism and it is a nervous activity. Nerve supply to gastrointestinal tract is in the form of sympathetic, parasympathetic, enteric nervous system (ENS) and gastrointestinal reflexes. The ENS is to be referred as second brain, it uses serotonin to communicate with the central nervous system. This “brain gut axis’ helps us in understanding how psychological and social stress might cause digestive problems. ENS is closely related to central nervous system (CNS). As mentioned, blindness (‘andhya’) is one of the udavarta janya vikara (diseases caused by udavarta) which is difficult to understand how eyes are related to apana vayu (one of the five subtypes of vata situated in the pelvic region). In an article named ‘Gut microbes linked to eye diseases’ observations have been made by the researchers regarding the possible connection between the gut microbes and the eye diseases. Apana vayu (one of the five subtypes of vata situated in the pelvic region) is mostly parasympathetic in action and its action is related to urine (mutra), stool (purisha), flatus (adhovata) and seminal discharge (shukra vega). Obstruction in passing flatus (apana vayu rodha) invariably affects the prana vayu (one type of the five subtypes of vata situated in upward body or head) among and other vital points in body (marma sthana) like herat (hrudya), brain (shiras), and urinary bladder (basti).&lt;ref&gt;Gugulothu Ramesh, Yadav C.R. A physiological study of Adharaneeya vega w.s.r. to Apanavayu vega. International Ayurvedic Medical Journal. ISSN: 2320 5091, September 2017, 5(9).&lt;/ref&gt;&lt;/p&gt;<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;3) Nidra vegadharana (suppression of sleep) leads to vitiation of vata dosha. Vata controls the functions of mind (mana). Stress is mainly due to mental and physical stimuli which cause disturbances in the internal biological equilibrium. Disturbed and interrupted sleep is very common in the IT professionals due to their work culture. Here, nidra vegadharana (suppression of urge of sleep) acts as a stress stimulus which causes impairment in both sharirika (biological elements vata, pitta and kapha) and manasika (psychological constitution like raja and tama) dosha which causes further loss of sleep (nidranasha). Udavarta affects mind and leads to abnormalities in mental functions similar to mental stress. Hence it is important to avoid nidra vegadharana (suppression of urge of sleep) to prevent further kriyakala i.e., stage of progression of disease leading to stress and other mental disorders.&lt;ref&gt;S. Gopakumar, M. A. Shajahan. A Review on Conceptual Relationship between Nidra vegadharana and Manifestation of Stress among IT professionals. International Ayurvedic Medical Journal, ISSN: 2320 5091, April- May 2107, 1(4). &lt;/ref&gt; &lt;/p&gt;<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;4) In this study total 74 patients have been enrolled which were divided in two groups randomly. The selected drug for clinical trial in group A was Yavanikadi vati (tablet) which contains haritaki (Terminalia chebula), yavani (Trachyspermum ammi), hingu (Ferula foetida), sauvarchala (black salt), yavakshara (alkali prepared from barley) and saindhava (rock salt). The powder of these raw drugs was given 3 times trituration (bhavana) of these raw drugs was given 3 times trituration (bhavana) of lemon juice (nimbu swarasa) to prepare tablet. In group B, Shankha vati (tablet) was taken for control group, which contains purified mercury (shuddha parada) and purified sulphur (shuddha gandhaka). In the group A 31 patients were given Yavanikadi vati in tablet form 1 gm B.D. in two divided doses (1 tablet = 500 mg.) daily, after food for 28 days with water whereas, in Group B total 30 patients were given Shankha Vati. The dose, duration, time of administration and anupana (co-administers with medicine) is same as group A. Comparison of the therapies showed that overall better results as observed in group A as compared to group B which stands closely parallel to group A.&lt;ref&gt;A clinical study of Udavarta with special reference to Udavarta by Taruna Modhera, Department of Roga Nidana Evam Vikriti Vigyana. Institute for Post Graduate Teaching and Research in Ayurveda. Gujarat Ayurved University, Jamnagar, 2008.&lt;/ref&gt; &lt;/p&gt;</div>

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<p>Manishdubey: </p> <hr /> <div>{{CiteButton}}<br /> {{#seo:<br /> |title= UDAKAVAHA SROTAS (Channels for transport and transformation of watery components)<br /> |titlemode=append<br /> |keywords=Udakavaha Srotas, Water metabolism, Bhojani M. K., Tanwar Ankur Kumar, Basisht G, Deole Y.S.<br /> |description=Udaka means water. In body, water is present in the form of various fluids. Udakavaha srotasa are the channels for transport and transformation of fluid (water) and its circulation. <br /> |image=http://www.carakasamhitaonline.com/mediawiki-1.32.1/resources/assets/ogimgs.jpg<br /> |image_alt=carak samhita<br /> |type=article<br /> }}<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Udavarta literally means the upward and repeated movements of vata. It is one of the important and commonly observed condition in clinical practice. It manifests with a number of clinical features which may lead to manifestation of other secondary diseases further. Udavarta is mentioned as one among the eighty diseases occurred primarily by the vitiated vata dosha (nanatmaja vata vyadhi). [Cha. Sa. Sutra Sthana 20/11] Udavarta (upward movement of vata) is very common now a days due to change in lifestyle of modern society. The change in dietary habits and due to hectic job schedule, suppression of natural urges (vegadharana) is also very common now a days. The two main cause of udavarta explained in classical texts are: suppression of natural urges (vegadharana) and faulty dietary habits (asatmya ahara sevana). Sushrut Samhita describes that suppression of natural urges (adharaniya vega) leads to manifestation of thirteen types of udavarta. Due to aggravating factors, vata dosha is aggravated, especially apana vata (one of the five subtypes of vata i.e., situated in the pelvic region) is affected. Generally, udavarta means upward movement of vata or apana vata, that results in retention of faeces, urine and flatus. However, the scope of udavarta extends to disturbance in normal functions of vata due to obstruction by metabolic wastes. This unique concept is not explained in any other contemporary sciences. So, understanding this concept and to provide better treatment for this disease is need of the society.&lt;/p&gt;<br /> <br /> {{Infobox<br /> |title = Contributors<br /> |label1 = Section/Chapter/topic<br /> |data1 = Concepts &amp; Practices/[[Udavarta]] <br /> |label2 = Authors<br /> |data2 = Dubey M.&lt;sup&gt;1&lt;/sup&gt;,&lt;br/&gt;Deole Y.S.&lt;sup&gt;2&lt;/sup&gt;<br /> |label3 = Reviewer <br /> |data3 = Basisht G.&lt;sup&gt;3&lt;/sup&gt;, <br /> |label4 = Editor<br /> |data4 = Basisht G.&lt;sup&gt;3&lt;/sup&gt;<br /> |label5 = Affiliations<br /> |data5 = &lt;sup&gt;1&lt;/sup&gt;[[Charak Samhita Research, Training and Development Centre]], I.T.R.A., Jamnagar, India &lt;br/&gt;&lt;sup&gt;2&lt;/sup&gt;Department of Kayachikitsa, G. J. Patel Institute of Ayurvedic Studies and Research, New Vallabh Vidyanagar, Gujarat, India&lt;br/&gt;&lt;sup&gt;3&lt;/sup&gt;Rheumatologist, Orlando, Florida, U.S.A.<br /> |label6 = Correspondence emails<br /> |data6 = dr.manish181@gmail.com, dryogeshdeole@gmail.com<br /> carakasamhita@gmail.com<br /> |label7 = Publisher <br /> |data7 = [[Charak Samhita Research, Training and Development Centre]], I.T.R.A., Jamnagar, India<br /> |label8 = Date of publication:<br /> |data8 =November 03, 2023<br /> |label9 = DOI<br /> |data9 = {{DoiWithLink}}<br /> }}<br /> <br /> ===Nirukti (etymology)===<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;The term udavarta is derived from Utt + Aavat i.e., “Ut + Ang + Vrut + Dhaya” to form word Udavarta.&lt;ref&gt;Shabdakalpadruma by Raja Radhakanta Deva, Prathama Khand. Second edition. Delhi: Naaga Publishers; 2003. pg.no. 237.&lt;/ref&gt; Udavarta is a Sanskrit word derived from 'Ut' verb root (dhatu) with 'Ang' and 'Vrut' preposition (upasarga), suffixed by ‘Dhaya’ pratyaya (suffix). “Ut” means upper side, (Urdhva) “Ang” means entirely and “Vrut” means to move (bhramana). Udavarta means upwards movement, to cause to go out, excrete, to secrete and to retain.&lt;ref&gt;M. Monier Williams Sanskrit English dictionary. &lt;/ref&gt; Udavarta is a class of diseases marked by retention of the feces i.e., disease of the bowel so, in general urdhwa (upward direction) or pratiloma (moving in abnormal direction) movement of apana vata (one of the five subtypes of vata, situated in the pelvic region) is termed as udavarta.&lt;/p&gt;<br /> <br /> ===Definition===<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;‘Udavarta’ is that disease in which there is whirlpool movement (avartana) and upward movement (urdhva gamana) of vata is seen due to retention of vata, urine (mutra) and stool (purisha). The condition in which vata begins to move upwards is called as ‘udavarta’ and in this disease vata is the predominant dosha.&lt;ref&gt;Bhavaprakasha of Sri Bhavamishra edited with Vidyotini hindi commentary by Pandit Shri Brahma Sankar Mishra, Part II, Adhyaya- 31/2, Chaukhambha Sanskrit Bhawan, Varanasi, Ed: 2009, 11&lt;sup&gt;th&lt;/sup&gt; edition. pg. no. 332.&lt;/ref&gt; &lt;/p&gt;<br /> <br /> ===Etiopathogenesis===<br /> *Intake of deficient quantity of food causes udavarta. [Cha. Sa. Vimana Sthana 2/7] <br /> *Intake of astringent, bitter, pungent and un-unctuous (dry) food and excessive fasting<br /> *Withholding natural urges (vegadharana) <br /> *Excessive indulgence in sexual activity. [Cha. Sa. Chikitsa Sthana 26/5-6] <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Due to all above reasons the apana vata which resides in large intestine (pakvashaya) gets aggravated and further obstructs the downward movement of vata causing retention of movement of stool, urine and flatus. This leads to a dreadful disease named as udavarta. [Ca. Sa. Chikitsa Sthana 26/5-6]&lt;/p&gt; <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Acharya Sushruta explained suppression of 13 urges leading to udavarta. [Su. Sa. Uttara Sthana 55/ 3-4] Thus, udavarta is caused by 2 main causes, one is suppression of natural urges and other one unwholesome eating. [Su. Sa. Uttara Sthana 55/ 6] Excess consumption of mudga (Phaseolus mungo), kodrava (Paspalum scrobiculatum Linn.), jurnahva (Sorghum vulgare/jowar), karira (Capparis decidua), chanaka (Cicer arietinum L.), etc. i.e., foods with property of dryness and causing constipation vitiate normal status of vata dosha in its own seat (large intestine). This vata becomes powerful and blocks the downward channels and produces severe obstruction in the movement of feces, flatus and urine leading to udavarta. [A. H. Nidana Sthana 7/46-52]&lt;/p&gt;<br /> <br /> ===Clinical features=== <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Frequent pain in the region of urinary bladder (basti), heart (hridaya), abdomen (udara) and excruciating or intense pain in the back of chest. Other symptoms are flatulence (adhmana), nausea (hrillasa), gripping type of pain in anus (vikartika), pricking (toda) type of pain in whole body, indigestion and inflammation of urinary bladder. Obstruction in passing stool less frequently and with difficulty and in less quantity, after long time and effort. Upward movement of flatus occurs because of obstruction in channels (srotasa), increased roughness, dryness and coldness in the body. [Cha. Sa. Chikitsa Sthana 26/6-7]&lt;/p&gt;<br /> <br /> ===Udavarta janya vikara===<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;If not treated early, udavarta leads to other secondary complications as follows:&lt;/p&gt;<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Fever (jwara), dysuria (mutrakricchhra), dysentery (pravahika), heart disease (hridroga), diseases due to malfunctioning of duodenum (grihani dosha), vomiting (chhardi), blindness, deafness, burning sensation in the head, affliction of abdomen by vata (vatodara), tumors (asthila), psychological diseases (mano vikara), disorders of excessive thirst (trishna roga), an ailment characterized by bleeding from different parts of the body (raktapitta), aruchi (anorexia), phantom tumor (gulma), cough (kasa), dyspnoea (shwasa), chronic rhinitis (pratishyaya), facial paralysis (ardita), diseases of the flanks including lower respiratory tract disorders (parshva roga) and such other serious diseases caused by aggravation of vata. [Cha. Sa. Chikitsa Sthana 26/8-9]&lt;/p&gt;<br /> <br /> ===Udavarta as a causative factor (nidana) of other diseases===<br /> *&lt;p style=&quot;text-align:justify;&quot;&gt;Udavarta is the etiological factor of abdominal swelling caused by intestinal obstruction (baddhagudodara) [Cha. Sa. Chikitsa Sthana 13/39]<br /> *Udavarta is the cause for abdominal swelling afflicted by spleen (plihodara). [Cha. Sa. Chikitsa Sthana 13/75]<br /> *Udavarta is the cause for respiratory diseases including bronchial asthma (pratamaka shwasa-type of tamaka shwasa) characterized by fever, syncope and other such symptoms which are relieved by cold measures. [Cha. Sa. Chikitsa Sthana 17/63]<br /> *Udavarta caused by suppression of the urge of urination is causative factor of condition where severe painful distension of abdomen below umbilicus is present along with obstruction of downward movement of urine (mutrajathara- a type of mutraghata i.e., retention of urine). [Su. Sa. Uttara Sthana 58/13]<br /> *Vidvighata (type of mutraghata i.e., retention of urine): In debilitated person due to loss of fat, udavarta brings small amount of feces into the channels of urine (bladder and urethra) resulting in patients voiding of urine having odour of feces is termed as vidvighata. [A. H. Nidana Sthana 9/33-34]<br /> *Hemorrhoids (arsha): Udavarta is the chief complication in hemorrhoids (durnama/arsha). This udavarta may occur in person who has predominance of vata dosha in alimentary tract (koshtha) even without piles. <br /> *Vatodara: Udavarta is one of the causative factors of abdominal swelling afflicted by vata dosha (vatodara). [Cha. Sa. Chikitsa Sthana 13/23]<br /> *Hiccups (hikka) &amp; dyspnoea (shwasa): Udavarta is the one of the etiological factors for causation of conditions such as hiccups (hikka) and dyspnoea (shwasa).&lt;/p&gt;<br /> <br /> ===Udavarta as symptoms (lakshana) in following diseases===<br /> <br /> #Vataja plihodara (vata predominant plihodara i.e., abdominal swelling afflicted by splenomegaly) [Cha. Sa. Chikitsa Sthana 13/38]<br /> #Vatodara (abdominal swelling afflicted by vata dosha) [Cha. Sa. Chikitsa Sthana 13/25]<br /> #Vataja gulma (vata predominant gulma/ phantom tumor) [Cha. Sa. Chikitsa Sthana 5/10]<br /> #Sahaja arsha (congenital hemorrhoids) [Cha. Sa. Chikitsa Sthana 14/8]<br /> #Vataja arsha (vata predominant hemorrhoids) [Cha. Sa. Chikitsa Sthana 14/11]<br /> #Vyana avruta apana (type of avarana (occlusion) where vyana vata obstructs the flow of apana vata) [Cha. Sa. Chikitsa Sthana 28/211]<br /> #Basti marma viddha (injury to bladder) [Cha. Sa. Siddhi Sthana 9/6]<br /> <br /> ===Types of Udavarta===<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Udavarta is of 6 types which occur by suppression of natural urges viz., apana vata nirodhaja (suppression of flatus), mutra vega nirodhaja (suppression of urine), purisha vega nirodhaja (suppression of faeces), shukra vega nirodhaja (suppression of ejaculation of semen), chhardi vega nirodhaja (suppression of vomiting) and kshavathu vega nirodhaja (suppression of sneezing). [Cha. Sa. Sutra Sthana 18/3]&lt;/p&gt;<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;As per Sushruta Samhita, there are 13 types of suppression of natural urges (vegadharana) namely flatus, faeces, urine, yawning, flow of tears, sneezing, eructation, vomiting, ejaculation of semen, hunger, thirst, breath and sleep. [Su. Sa. Uttara Sthana 55/ 3-4] Suppression of these vega (urges) gives rise to their respective type of udavarta and manifest their respective symptoms which are as follows;&lt;/p&gt;&lt;p style=&quot;text-align:justify;&quot;&gt;'''Table no. 1:''' '''Types of udavarta and their symptoms''' [Su. Sa. Uttara Sthana 55/6-17]&lt;/p&gt;<br /> {| class=&quot;wikitable&quot;<br /> |'''Sr.'''<br /> <br /> '''No.'''<br /> |<br /> <br /> '''  Udavarta type'''<br /> |<br /> <br /> '''                             Symptoms'''<br /> |-<br /> |1.      <br /> |'''Apana vata/ Adhovata nirodhaja udavarta'''<br /> <br /> (Suppression of flatus)<br /> |Flatulence, colic abdominal pain, obstruction in cardiac region, headache, severe dyspnea, hiccoup, cough, coryza, obstruction in throat, terrible spread of kapha and pitta dosha, movement of feces through mouth (reverse peristalsis). <br /> |-<br /> |2.      <br /> |'''Purisha vega nirodhaja udavarta'''<br /> <br /> (Suppression of urge of defecation)<br /> |Abnormal bowel sounds (atopa), colicy abdominal pain, cutting type of pain in abdomen, retention of feces, upward movement of vata causing excessive belching (urdhwavata).  <br /> |-<br /> |3.      <br /> |'''Mutra vega nirodhaja udavarta'''<br /> <br /> (Suppression of urge of micturition)<br /> |Passing of scanty urine with difficulty with distension of urinary bladder, intense pain in penis, groin, anus, groin, pelvis, scrotum and umbilical region or head as if the body is being torn with spikes. <br /> |-<br /> |4.      <br /> |'''Jrimbha vega nirodhaja udavarta'''<br /> <br /> (Suppression of yawning)<br /> |Stiffness of neck (manyastambha), stiffness of throat, diseases of head (shiroroga) and vata predominant diseases (other vataja vyadhi). Severe diseases of ear, mouth, nose and eye are also produced.  <br /> |-<br /> |5.      <br /> |'''Ashru vega nirodhaja udavarta'''<br /> <br /> (Suppression of flow of tears/lacrimation either from pleasure or grief)<br /> |Heaviness of head, severe diseases of eye and coryza (peenasa).  <br /> |-<br /> |6.      <br /> |'''Kshavathu vega nirodhaja udavarta'''<br /> <br /> (Suppression of sneezing)<br /> |Severe diseases of head, eye, nose and ears; filling of mouth and throat, excessive pricking pain, obstruction in breath. <br /> |-<br /> |7.      <br /> |'''Udagara vega nirodhaja udavarta''' (Suppression of urge of belching)<br /> |Severe diseases caused by vata dosha.<br /> |-<br /> |8.      <br /> |'''Chhardi vega nirodhaja udavarta'''<br /> <br /> (Suppression of urge of vomiting)<br /> |Various skin diseases (kushtha) arise with predominance of dosa by which food is vitiated. <br /> |-<br /> |9.      <br /> |'''Shukra vega nirodhaja udavarta'''<br /> <br /> (Suppression of semen ejaculation)<br /> |Swelling and pain in urinary bladder, anus and testicles, retention of urine, seminal calculus, discharge of semen and other related disorders of semen. <br /> |-<br /> |10.   <br /> |'''Kshudha vega nirodhaja udavarta'''<br /> <br /> (Suppression of urge of hunger)<br /> |Drowsiness, body-ache, anorexia, giddiness and weakness of vision. <br /> |-<br /> |11.   <br /> |'''Trishna vega nirodhaja udavarta'''<br /> <br /> (Suppression of urge of thirst)<br /> |Dryness in throat and mouth, deafness and cardiac pain. <br /> |-<br /> |12.<br /> |'''Shrama shwasa/ Shranta nishwasa nirodhaja udavarta'''<br /> <br /> (Suppression of holding breath after exertion)<br /> |Cardiac disorder, mental confusion and phantom tumor (gulma).  <br /> |-<br /> |13. <br /> |'''Nidra vega nirodhaja udavarta'''<br /> <br /> (Suppression of urge of sleep)<br /> |Yawning, body ache, dullness in limbs, head and eyes, drowsiness.  <br /> |}<br /> <br /> ===Asadhyata [incurable stage of diseases]===<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Udavarta with symptoms of excessive thirst, excessively depressed, emaciated, suffering from pain and vomiting of fecal matter is difficult to manage or incurable.[Su. Sa. Uttara Sthana 55/ 17-18] &lt;/p&gt;<br /> <br /> ===Treatment===<br /> &lt;p style=&quot;text-align:justify;&quot;&gt; Treatment principles for udavarta i.e., palliative therapy (shamana) or purification (shodhana) etc., can be selected based on stages of the disease and as well as on the condition of the patient. The treatment guidelines explained in Charaka Samhita are as follows: [Cha. Sa. Chikitsa Sthana 26/11]&lt;/p&gt;<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;The patient suffering from udavarta should be given massage with hot oil described for the treatment of fever presented with cold extremities (sheeta jwara). Then fomentation therapy should be administered for the detachment of the adhered dosha in the tissue cells. This should be followed by the administration of suppository (varti), un-unctuous enema (niruha basti) and unctuous type of purgative (snigdha virechana). The patient should be given food which helps in the normal downward movement (anulomana) of apana vata.&lt;/p&gt;<br /> <br /> '''A) Unction therapy (snehana):''' &lt;p style=&quot;text-align:justify;&quot;&gt;Udavarta is produced due to aggravation of vata and sneha (lipids) is the best treatment for pacification of vata vata (shamana). Therefore, unction therapy (snehana) is indicated in udavarta. &lt;/p&gt;<br /> '''B) Fomentation therapy (swedana):''' &lt;p style=&quot;text-align:justify;&quot;&gt;After massage with oil, fomentation therapy should be administered for the detachment of the adhered dosha in the tissue cells.&lt;/p&gt;<br /> '''C) Suppository (varti):''' &lt;p style=&quot;text-align:justify;&quot;&gt;A suppository having the thickness of the thumb is to be prepared with drugs like Shyama Trivrita (Operculina turpethum), Vidanga (Embeila ribes), Kampillaka (Mallotus philippensis) etc., which should be triturated with gomutra (cow’s urine) or arka (Calotropis gigantea) latex (kshira) and made in to form of suppository (phala varti) by adding jaggery. This suppository should be inserted through anus for the downward movement of apana vata to relieve retention of stool, flatus and urine caused by udavarta.&lt;/p&gt;<br /> '''D) Palliative therapy (shamana):''' &lt;p style=&quot;text-align:justify;&quot;&gt;Shamana includes administration of internal medication such as dviruttara- hingvadi churna, hinguvachadi churna given with warm water as an anupana (co-administers with medicine) for correcting the upward movement of vata.&lt;/p&gt;<br /> '''E) Purification therapy (shodhana):'''&lt;p style=&quot;text-align:justify;&quot;&gt;When the disease is chronic and relief is not observed even by adopting above measures, then purification (shodhana) by non-unctuous enema (niruha basti) or purgation (virechana) is advised.&lt;/p&gt;<br /> '''F) Pathya ahara kalpana (wholesome diet):'''&lt;p style=&quot;text-align:justify;&quot;&gt;Intake of wholesome diet (pathya ahara) which helps in normal downward movement (anulomana) of apana vata whereas, intake of unwholesome diet (apathya ahara) should be avoided for better recovery. Generally, in all types of udavarta all measures for controlling vata should be adopted in order to restore it to its normal channels (srotasa). [Su. Sa. Uttara Sthana 55/ 19]&lt;/p&gt;&lt;p style=&quot;text-align:justify;&quot;&gt;'''Table no. 2:''' '''Types of udavarta and their respective treatment''' [Su. Sa. Uttara Sthana 55/20-34]&lt;/p&gt;<br /> {| class=&quot;wikitable&quot;<br /> |'''Sr.'''<br /> <br /> '''No.'''<br /> | <br /> <br /> '''Udavarta type'''<br /> |<br /> <br /> '''                             Treatment'''<br /> |-<br /> |<br /> <br /> <br /> 1.<br /> |'''Apana vata/ Adhovata nirodhaja udavarta'''<br /> <br /> (Suppression of flatus)<br /> |Massage (abhyanga) and sudation (swedana) followed by asthapana basti (non-unctuous enema). <br /> |-<br /> |<br /> <br /> <br /> 2.<br /> |'''Purisha vega nirodhaja udavarta'''<br /> <br /> (Suppression of urge of defecation)<br /> |Treatment of non- passage of flatus and feces (anaha) should be adopted.<br /> |-<br /> |<br /> <br /> <br /> 3.<br /> |'''Mutra vega nirodhaja udavarta'''<br /> <br /> (Suppression of urge of micturition)<br /> |Treatment of renal calculi (ashmari), dysuria (mutrakrichha) and retention of urine (mutraghata) should be adopted.<br /> |-<br /> |<br /> <br /> <br /> 4. <br /> |'''Jrimbha vega nirodhaja udavarta'''<br /> <br /> (Suppression of yawning)<br /> |Unction therapy (snehana) and fomentation therapy (swedana). <br /> |-<br /> |<br /> <br /> <br /> 5. <br /> |'''Ashru vega nirodhaja udavarta'''<br /> <br /> (Suppression of flow of tears/lacrimation either from pleasure or grief)<br /> |After unction therapy (snehana) and fomentation therapy (swedana) the flow of tears should be stimulated by applying irritant collyrium etc. <br /> |-<br /> |  <br /> <br /> 6.<br /> |'''Kshavathu vega nirodhaja udavarta'''<br /> <br /> (Suppression of sneezing)<br /> |Induce sneezing by application of irritant collyrium, pressed snuff (avapidana nasya), inhalation of irritant odor or by using smoking wick (dhuma varti). <br /> |-<br /> |<br /> <br /> <br /> 7.<br /> |'''Udagara vega nirodhaja udavarta''' (Suppression of urge of belching)<br /> |Unctuous smoking (snehaika dhumapana) with prescribed order and also intake of wine (sura) mixed with bijapura (Citrus medica) juice and added with black salt (sauvarchala lavana/ Unaqua sodium chloride). <br /> |-<br /> |<br /> <br /> <br /> 8.<br /> |'''Chardi vega nirodhaja udavarta'''<br /> <br /> (Suppression of urge of vomiting)<br /> |Unction according to the dosa involved. Massage with ghee mixed with a pinch of alkali prepared from barley (yavakshara) and rock salt (saindhava lavana). <br /> |-<br /> |<br /> <br /> <br /> 9.<br /> |'''Shukra vega nirodhaja udavarta'''<br /> <br /> (Suppression of semen ejaculation)<br /> |Patient advised to drink milk boiled with four times water added with diuretic drugs up to full satisfaction and then indulge in sexual activity. <br /> |-<br /> |10.<br /> |'''Kshudha vega nirodhaja udavarta'''<br /> <br /> (Suppression of urge of hunger)<br /> |Intake of unctuous and warm food in little quantity. <br /> |-<br /> |<br /> <br /> <br /> 11. <br /> |'''Trishna vega nirodhaja udavarta'''<br /> <br /> (Suppression of urge of thirst)<br /> |Intake of churned drink (mantha) or liquid gruel (yavagu) of cold nature. Use of cold water for drinking and other purpose. <br /> |-<br /> |<br /> <br /> <br /> 12.<br /> |'''Shrama shwasa/ Shranta nishwasa nirodhaja udavarta'''<br /> <br /> (Suppression of holding breath after exertion)<br /> |Complete rest and intake of meat soup. <br /> |-<br /> |<br /> <br /> <br /> 13. <br /> |'''Nidra vega nirodhaja udavarta'''<br /> <br /> (Suppression of urge of sleep)<br /> |Advised to go to sleep after intake of milk and listening to favorite stories. <br /> |}<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Complications of udavarta, flatulence (adhmana) and other diseases should be managed with respective measures according to condition. [Su. Sa. Uttara Sthana 55/34-35] For example when vayu in abdomen (koshtha) is aggravated by rough, pungent, bitter and astringent food, it immediately produces udavarta owing to which the channels (srotasa) carrying flatus, feces, urine, blood, kapha and adipose tissue (medas), move in upward direction and harden the feces too much. This results in manifestation of symptoms such as pain in cardiac and pelvic region, heaviness, anorexia, passing of urine, flatus and feces with difficulty. The person gets afflicted with many other disorders caused by aggravation of vata such as dyspnoea, (shwasa), cough (kasa), hiccoup (hikka), thirst (trishna), coryza (pratishyaya), burning sensation (daha), mental confusion (moha), vomiting (chhardi), fever (jwara), diseases of head and abnormalities of mind and ears. [Su. Sa. Uttara Sthana 55/2] &lt;/p&gt;<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;One should advise non-unctuous enema (niruha basti) after the patient is massaged with oil mixed with salt and sudation; then after feces are eliminated, he should be advised to take food followed by administration of unctuous enema (anuvasana basti) according to the dosha involvement. If by above procedures, still no relief found then in severe cases of udavarta, patient is advised to undergo repeated unction therapy (snehana) and fomentation therapy (swedana) and then undergo unctuous purgation (snigdha virechana). [Su. Sa. Uttara Sthana 55/40-41]&lt;/p&gt;<br /> <br /> ===Different treatments of udavarta===<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;1) Saturating drink (mantha) prepared with sugarcane product (phanita), roasted grain flour (saktu), ghee, curd water and vinegar (amla kanji) alleviate udavarta. [Cha. Sa. Sutra Sthana 23/37]&lt;/p&gt;<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;2) 96 gm (2 pala) of dehusked tila (Sesamum indicum Linn.), 48 gm (1 pala) of jaggery and 24 gm (half pala) of nagara (Zingiber officinale) should be made into a paste and taken along with hot milk helps in udavarta. [Cha. Sa. Chikitsa Sthana 5/91-92] &lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;3) Milk cooked with Allum sativum (Lashuna kshirapaka): Garlic cooked with milk by adding water and reducing to the quantity of milk, cures udavarta immediately [Cha. Sa. Chikitsa Sthana 5/94] &lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;4) Alkali prepared from pippali (Piper longum) and other ingredients (Pippalyadi kshara) used in udavarta [Cha. Sa. Chikitsa Sthana 13/159-161] &lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;5) Medicine prepared by boiling medicinal herbs in water and then kept for fermentation with drugs such as haritaki (Terminalia chebula), amalaki (Emblica officinalis), etc. (Phalarishta) used in udavarta. [Cha. Sa. Chikitsa Sthana 14/148-152] &lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;6) Trivrut (Operculina turpethum), pilu (Salvadora persica), yavani (Trachyspermum ammi) with sour gruel mixed with digestants (pachana) drugs. [Su. Sa. Uttara Sthana 55/42-43] &lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt; 7) The combination of hingu (Ferula foetida), kushtha (Saussurea lappa), vacha (Acorus calamus Linn.), svarjika (alkali prepared by burning Lona plant), and vidanga (Embelia ribes) – successively in double quantity cures udavarta and colicky pain by vata dosha (vataja shoola) [Su. Sa. Uttara Sthana 55/42-43]&lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;8) Intake of ghee cooked with decoction of dried radish (Raphanus sativus), sunthi (Zingiber officinale), punarnava (Boerhavia diffusa), brihata panchamula (combination of five herbs viz., bilva, patala, agnimantha, shyonaka and gambhari), and fruits of aragvadha (Cassia fistula) subsides severe udavarta completely. [Su. Sa. Uttara Sthana 55/45-46] &lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;9) Vacha (Acorus calamus Linn.), ativisha (Aconitum heterophyllum), kushtha (Saussurea lappa), yavakshara (alkali prepared from barley), haritaki (Terminalia chebula Retz.), pippali (Piper longum) and agnimantha (Clerodendrum phlomidis) with hot water cures udavarta. [Su. Sa. Uttara Sthana 55/47] &lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;10) Devadaru (Cedrus deodara), chitraka (Plumbago zeylanica), triphala (combination of 3 herbs viz., haritaki, bibhitaki and amalaki), brihati (Solanum indicum) should be taken along with cow’s urine. [Su. Sa. Uttara Sthana 55/49]&lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;11) Suppository: Powder of danti (Baliospermum montanum), kampillaka (Mallotus philippensis), shyama trivrita (Operculina turpethum), ikshvaku (Lagenaria vulgaris Ser.), ajamoda (Apium graveolens), kritavedhana (Luffa acutangula Linn Roxb.), pippali (Piper longum) and salts should cook in cow’s urine and made into suppositories to be inserted in the anus. This provides instant relief in the symptoms of udavarta. [Su. Sa. Uttara Sthana 55/51-52] &lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt; 12) Guggulu (Commiphora mukul) should be taken with decoction of triphala (combination of 3 herbs viz., haritaki, bibhitaki and amalaki), daruharidra (Berberis aristata), patola (Trichosanthes dioica) and kusa (Desmostachya bipinnata) or with urine or hot water for 1 month alleviates udavarta. [Su. Sa. Chikitsa Sthana 5/39-44]&lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;13) Kalyanaka kshara consumed with ghee cures udavarta and constipation (vibandha) [A. H. Chikitsa Sthana 8/142] &lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;14) Erandamooladi enema (basti) helps in alleviating obstruction of faeces, urine and flatus [Ch. Sa. Siddhi Sthana 3/38-42] &lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt; 15) Palashadi niruha basti alleviates non- passage of flatus and feces (anaha) and udavarta [Ch. Sa. Siddhi Sthana 3/44-45]&lt;/p&gt;<br /> <br /> === Treatment as per different conditions===<br /> *In hemorrhoids (arsha), if symptoms of udavarta is present then unctuous enema (anuvasana basti) should be administered. [Cha. Sa. Chikitsa Sthana 14/130]<br /> *In complications by enema (basti vyapat) when unctuous enema gets obstructed by feces then treatment alleviating udavarta should be adopted. [Cha. Sa. Siddhi Sthana 4/36-37]<br /> *In emesis (vamana) and purgation (virechana) complications (vyapta), in extremely vitiated condition of doshas (bahudosha avastha) low dose of medicine is administered, then it causes udavarta, tympanitis (adhmana) in such condition treatment of udavarta is massage (abhyanga), sudation, suppository, non-unctuous enema (niruha basti) and other measures of udavarta should be adopted [Cha. Sa. Siddhi Sthana 6/58-60]<br /> *In pain caused by obstruction of feces (vitshula) the measures mentioned for udavarta should be used in the treatment. [Su. Sa. Uttara Sthana 42/140] <br /> *In treatment of rakta gulma (a variety of phantom tumor) the measures which cures udavarta should be adopted. [A. H. Chikitsa Sthana 14/129]<br /> *Measures which cure udavarta (udavarta hara kriya) should be adopted in abdominal swelling caused by intestinal obstruction (baddhodara). [A. H. Chikitsa Sthana 15/100]<br /> *In emesis (vamana) from improper therapy (mithya yoga), therapies of udavarta should be adopted. [A. H. Kalpasiddhi Sthana 3/13]<br /> *In complications from enema (basti vyapat) the treatment of udavarta should be adopted if fat (sneha) of enema (basti) gets obstructed or enveloped by feces. [A. H. Kalpa-siddhi Sthana 5/39]<br /> <br /> ===Measures alleviating udavarta (udavarta hara)===<br /> <br /> *Mrudvika (Vitis vinifera/grapes) alleviates udavarta [Cha. Sa. Sutra Sthana 27/125-126]<br /> *Haritaki (Terminalia chebula Retz.) used in udavarta [Cha. Sa. Chikitsa Sthana 1/1/31]<br /> *Dish prepared with barley (yavapupa), supernatant liquid proportion of barley preparation (yavaka) and bhristha yava odana/ parched cooked barley (vatya) made from yava (barley) helps in alleviation of udavarta. [Cha. Sa. Sutra Sthana 27/265]<br /> *Saturating drink (mantha) prepared by churning parched grain flour (saktu) with sour taste (amla rasa), fat and jaggery alleviates udavarta. [Su. Sa. Sutra Sthana 46/386]<br /> *Vatya (made by roasted wheat or barley) helps in alleviating udavarta. [Su. Sa. Sutra Sthana 46/410]<br /> *Garlic cooked with milk (lashuna kshirapaka) alleviates udavarta. [A. H. Chikitsa Sthana 14/46]<br /> <br /> ===Diet for udavarta===<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Intake of vegetable preparations prepared from the leaves of trivruta (Operculina turpethum) and snuhi (Euphorbia neriifolia Linn.), tila (Sesamum indicum) and its different preparations, soup of meat of animals inhabiting in marshy land, domestic and aquatic animals, clear top portion of alcohol (prasanna) and molasses rum (sidhu), wine prepared of jaggery, preparations which facilitates motion of flatus, urine and stool. [Cha. Sa. Chikitsa Sthana 26/18] One should never withhold the natural urges of the body. [Su. Sa. Uttara Sthana 55/3]&lt;/p&gt;<br /> <br /> ===Researches===<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;1) A review on diseases manifested due to withholding natural urges (vegadharana janya vikara) focused to identify the effects of suppression of natural urges (adharaneeya vegas) on various system of body such as CVS, gastrointestinal tract, respiratory system urinary system and reproductive system. CVS and gastrointestinal systems are the mostly affected systems. Out of thirteen urges (vegas), seven play major role in both systems. Common clinical features produced by suppression of natural urges (vegadharana) were weakness of the body, constipation, anorexia, headache, diseases of eye, difficulty in micturition, bending of the body and stiffness of the neck. Weakness of the body and anorexia are the commonest clinical features produced by suppression of natural urges. These clinical features arise due to vitiation of vata by vegadharana. Withholding (dharana) of natural urges is strictly prohibited to stay healthy.&lt;ref&gt;Zahara M.S.F, Kulathunga R.D.H, Chathurika L.A.W.J. A Review of Vegadharana.  International Ayurvedic Medical Journal. ISSN 2320 5091, March 2021.&lt;/ref&gt;&lt;/P&gt;<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;2) A physiological study of adharaneeya vega (suppression of natural urges) w.s.r. to apana vayu vega (suppression of apana vata or flatus)&lt;/p&gt;<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Understanding the physiology of suppression of natural urges (vegarodhajanya) symptoms and analyzing them as a pathology of various diseases related to apana vayu (one of the five subtypes of vata situated in the pelvic region). As, seen in clinical practice many a times diseases reoccur after giving proper treatment. Also, in such case causative factors (nidana) of vitiation of apana vayu (one of the five subtypes of vata situated in the pelvic region) is to be analyzed properly for better result. Among the fourteen adharaneeya vega (suppression of natural urges), apana vayu (one of the five subtypes of vata situated in the pelvic region) vega (urge) is most commonly suppressed which leads to vitiation of vata dosha in the pelvic region). Adharaneeya vega (suppression of natural urges) is a reflex mechanism and it is a nervous activity. Nerve supply to gastrointestinal tract is in the form of sympathetic, parasympathetic, enteric nervous system (ENS) and gastrointestinal reflexes. The ENS is to be referred as second brain, it uses serotonin to communicate with the central nervous system. This “brain gut axis’ helps us in understanding how psychological and social stress might cause digestive problems. ENS is closely related to central nervous system (CNS). As mentioned, blindness (‘andhya’) is one of the udavarta janya vikara (diseases caused by udavarta) which is difficult to understand how eyes are related to apana vayu (one of the five subtypes of vata situated in the pelvic region). In an article named ‘Gut microbes linked to eye diseases’ observations have been made by the researchers regarding the possible connection between the gut microbes and the eye diseases. Apana vayu (one of the five subtypes of vata situated in the pelvic region) is mostly parasympathetic in action and its action is related to urine (mutra), stool (purisha), flatus (adhovata) and seminal discharge (shukra vega). Obstruction in passing flatus (apana vayu rodha) invariably affects the prana vayu (one type of the five subtypes of vata situated in upward body or head) among and other vital points in body (marma sthana) like herat (hrudya), brain (shiras), and urinary bladder (basti).&lt;ref&gt;Gugulothu Ramesh, Yadav C.R. A physiological study of Adharaneeya vega w.s.r. to Apanavayu vega. International Ayurvedic Medical Journal. ISSN: 2320 5091, September 2017, 5(9).&lt;/ref&gt;&lt;/p&gt;<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;3) Nidra vegadharana (suppression of sleep) leads to vitiation of vata dosha. Vata controls the functions of mind (mana). Stress is mainly due to mental and physical stimuli which cause disturbances in the internal biological equilibrium. Disturbed and interrupted sleep is very common in the IT professionals due to their work culture. Here, nidra vegadharana (suppression of urge of sleep) acts as a stress stimulus which causes impairment in both sharirika (biological elements vata, pitta and kapha) and manasika (psychological constitution like raja and tama) dosha which causes further loss of sleep (nidranasha). Udavarta affects mind and leads to abnormalities in mental functions similar to mental stress. Hence it is important to avoid nidra vegadharana (suppression of urge of sleep) to prevent further kriyakala i.e., stage of progression of disease leading to stress and other mental disorders.&lt;ref&gt;S. Gopakumar, M. A. Shajahan. A Review on Conceptual Relationship between Nidra vegadharana and Manifestation of Stress among IT professionals. International Ayurvedic Medical Journal, ISSN: 2320 5091, April- May 2107, 1(4). &lt;/ref&gt; &lt;/p&gt;<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;4) In this study total 74 patients have been enrolled which were divided in two groups randomly. The selected drug for clinical trial in group A was Yavanikadi vati (tablet) which contains haritaki (Terminalia chebula), yavani (Trachyspermum ammi), hingu (Ferula foetida), sauvarchala (black salt), yavakshara (alkali prepared from barley) and saindhava (rock salt). The powder of these raw drugs was given 3 times trituration (bhavana) of these raw drugs was given 3 times trituration (bhavana) of lemon juice (nimbu swarasa) to prepare tablet. In group B, Shankha vati (tablet) was taken for control group, which contains purified mercury (shuddha parada) and purified sulphur (shuddha gandhaka). In the group A 31 patients were given Yavanikadi vati in tablet form 1 gm B.D. in two divided doses (1 tablet = 500 mg.) daily, after food for 28 days with water whereas, in Group B total 30 patients were given Shankha Vati. The dose, duration, time of administration and anupana (co-administers with medicine) is same as group A. Comparison of the therapies showed that overall better results as observed in group A as compared to group B which stands closely parallel to group A.&lt;ref&gt;A clinical study of Udavarta with special reference to Udavarta by Taruna Modhera, Department of Roga Nidana Evam Vikriti Vigyana. Institute for Post Graduate Teaching and Research in Ayurveda. Gujarat Ayurved University, Jamnagar, 2008.&lt;/ref&gt; &lt;/p&gt;</div>

Manishdubey https://www.carakasamhitaonline.com/index.php?title=Udavarta&diff=44312 2023-11-03T11:06:20Z

<p>Manishdubey: </p> <hr /> <div>{{CiteButton}}<br /> {{#seo:<br /> |title= UDAKAVAHA SROTAS (Channels for transport and transformation of watery components)<br /> |titlemode=append<br /> |keywords=Udakavaha Srotas, Water metabolism, Bhojani M. K., Tanwar Ankur Kumar, Basisht G, Deole Y.S.<br /> |description=Udaka means water. In body, water is present in the form of various fluids. Udakavaha srotasa are the channels for transport and transformation of fluid (water) and its circulation. <br /> |image=http://www.carakasamhitaonline.com/mediawiki-1.32.1/resources/assets/ogimgs.jpg<br /> |image_alt=carak samhita<br /> |type=article<br /> }}<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Udavarta literally means the upward and repeated movements of vata. It is one of the important and commonly observed condition in clinical practice. It manifests with a number of clinical features which may lead to manifestation of other secondary diseases further. Udavarta is mentioned as one among the eighty diseases occurred primarily by the vitiated vata dosha (nanatmaja vata vyadhi). [Cha. Sa. Sutra Sthana 20/11] Udavarta (upward movement of vata) is very common now a days due to change in lifestyle of modern society. The change in dietary habits and due to hectic job schedule, suppression of natural urges (vegadharana) is also very common now a days. The two main cause of udavarta explained in classical texts are: suppression of natural urges (vegadharana) and faulty dietary habits (asatmya ahara sevana). Sushrut Samhita describes that suppression of natural urges (adharaniya vega) leads to manifestation of thirteen types of udavarta. Due to aggravating factors, vata dosha is aggravated, especially apana vata (one of the five subtypes of vata i.e., situated in the pelvic region) is affected. Generally, udavarta means upward movement of vata or apana vata, that results in retention of faeces, urine and flatus. However, the scope of udavarta extends to disturbance in normal functions of vata due to obstruction by metabolic wastes. This unique concept is not explained in any other contemporary sciences. So, understanding this concept and to provide better treatment for this disease is need of the society.&lt;/p&gt;<br /> <br /> {{Infobox<br /> |title = Contributors<br /> |label1 = Section/Chapter/topic<br /> |data1 = Concepts &amp; Practices/[[Udavarta]] <br /> |label2 = Authors<br /> |data2 = Dubey M.&lt;sup&gt;1&lt;/sup&gt;,&lt;br/&gt;Deole Y.S.&lt;sup&gt;2&lt;/sup&gt;<br /> |label3 = Reviewer <br /> |data3 = Basisht G.&lt;sup&gt;3&lt;/sup&gt;, <br /> |label4 = Editor<br /> |data4 = Basisht G.&lt;sup&gt;3&lt;/sup&gt;<br /> |label5 = Affiliations<br /> |data5 = &lt;sup&gt;1&lt;/sup&gt;[[Charak Samhita Research, Training and Development Centre]], I.T.R.A., Jamnagar, India &lt;br/&gt;&lt;sup&gt;2&lt;/sup&gt;Department of Kayachikitsa, G. J. Patel Institute of Ayurvedic Studies and Research, New Vallabh Vidyanagar, Gujarat, India&lt;br/&gt;&lt;sup&gt;3&lt;/sup&gt;Rheumatologist, Orlando, Florida, U.S.A.<br /> |label6 = Correspondence emails<br /> |data6 = dr.manish181@gmail.com, dryogeshdeole@gmail.com<br /> carakasamhita@gmail.com<br /> |label7 = Publisher <br /> |data7 = [[Charak Samhita Research, Training and Development Centre]], I.T.R.A., Jamnagar, India<br /> |label8 = Date of publication:<br /> |data8 =November 03, 2023<br /> |label9 = DOI<br /> |data9 = {{DoiWithLink}}<br /> }}<br /> <br /> ===Nirukti (etymology)===<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;The term udavarta is derived from Utt + Aavat i.e., “Ut + Ang + Vrut + Dhaya” to form word Udavarta. [ ] Udavarta is a Sanskrit word derived from 'Ut' verb root (dhatu) with 'Ang' and 'Vrut' preposition (upasarga), suffixed by ‘Dhaya’ pratyaya (suffix). “Ut” means upper side, (Urdhva) “Ang” means entirely and “Vrut” means to move (bhramana). Udavarta means upwards movement, to cause to go out, excrete, to secrete and to retain. Udavarta is a class of diseases marked by retention of the feces i.e., disease of the bowel so, in general urdhwa (upward direction) or pratiloma (moving in abnormal direction) movement of apana vata (one of the five subtypes of vata, situated in the pelvic region) is termed as udavarta.&lt;/p&gt;<br /> <br /> ===Definition===<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;‘Udavarta’ is that disease in which there is whirlpool movement (avartana) and upward movement (urdhva gamana) of vata is seen due to retention of vata, urine (mutra) and stool (purisha). The condition in which vata begins to move upwards is called as ‘udavarta’ and in this disease vata is the predominant dosha. &lt;/p&gt;<br /> <br /> ===Etiopathogenesis===<br /> *Intake of deficient quantity of food causes udavarta. [Cha. Sa. Vimana Sthana 2/7] <br /> *Intake of astringent, bitter, pungent and un-unctuous (dry) food and excessive fasting<br /> *Withholding natural urges (vegadharana) <br /> *Excessive indulgence in sexual activity. [Cha. Sa. Chikitsa Sthana 26/5-6] <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Due to all above reasons the apana vata which resides in large intestine (pakvashaya) gets aggravated and further obstructs the downward movement of vata causing retention of movement of stool, urine and flatus. This leads to a dreadful disease named as udavarta. [Ca. Sa. Chikitsa Sthana 26/5-6]&lt;/p&gt; <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Acharya Sushruta explained suppression of 13 urges leading to udavarta. [Su. Sa. Uttara Sthana 55/ 3-4] Thus, udavarta is caused by 2 main causes, one is suppression of natural urges and other one unwholesome eating. [Su. Sa. Uttara Sthana 55/ 6] Excess consumption of mudga (Phaseolus mungo), kodrava (Paspalum scrobiculatum Linn.), jurnahva (Sorghum vulgare/jowar), karira (Capparis decidua), chanaka (Cicer arietinum L.), etc. i.e., foods with property of dryness and causing constipation vitiate normal status of vata dosha in its own seat (large intestine). This vata becomes powerful and blocks the downward channels and produces severe obstruction in the movement of feces, flatus and urine leading to udavarta. [A. H. Nidana Sthana 7/46-52]&lt;/p&gt;<br /> <br /> ===Clinical features=== <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Frequent pain in the region of urinary bladder (basti), heart (hridaya), abdomen (udara) and excruciating or intense pain in the back of chest. Other symptoms are flatulence (adhmana), nausea (hrillasa), gripping type of pain in anus (vikartika), pricking (toda) type of pain in whole body, indigestion and inflammation of urinary bladder. Obstruction in passing stool less frequently and with difficulty and in less quantity, after long time and effort. Upward movement of flatus occurs because of obstruction in channels (srotasa), increased roughness, dryness and coldness in the body. [Cha. Sa. Chikitsa Sthana 26/6-7]&lt;/p&gt;<br /> <br /> ===Udavarta janya vikara===<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;If not treated early, udavarta leads to other secondary complications as follows:&lt;/p&gt;<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Fever (jwara), dysuria (mutrakricchhra), dysentery (pravahika), heart disease (hridroga), diseases due to malfunctioning of duodenum (grihani dosha), vomiting (chhardi), blindness, deafness, burning sensation in the head, affliction of abdomen by vata (vatodara), tumors (asthila), psychological diseases (mano vikara), disorders of excessive thirst (trishna roga), an ailment characterized by bleeding from different parts of the body (raktapitta), aruchi (anorexia), phantom tumor (gulma), cough (kasa), dyspnoea (shwasa), chronic rhinitis (pratishyaya), facial paralysis (ardita), diseases of the flanks including lower respiratory tract disorders (parshva roga) and such other serious diseases caused by aggravation of vata. [Cha. Sa. Chikitsa Sthana 26/8-9]&lt;/p&gt;<br /> <br /> ===Udavarta as a causative factor (nidana) of other diseases===<br /> *&lt;p style=&quot;text-align:justify;&quot;&gt;Udavarta is the etiological factor of abdominal swelling caused by intestinal obstruction (baddhagudodara) [Cha. Sa. Chikitsa Sthana 13/39]<br /> *Udavarta is the cause for abdominal swelling afflicted by spleen (plihodara). [Cha. Sa. Chikitsa Sthana 13/75]<br /> *Udavarta is the cause for respiratory diseases including bronchial asthma (pratamaka shwasa-type of tamaka shwasa) characterized by fever, syncope and other such symptoms which are relieved by cold measures. [Cha. Sa. Chikitsa Sthana 17/63]<br /> *Udavarta caused by suppression of the urge of urination is causative factor of condition where severe painful distension of abdomen below umbilicus is present along with obstruction of downward movement of urine (mutrajathara- a type of mutraghata i.e., retention of urine). [Su. Sa. Uttara Sthana 58/13]<br /> *Vidvighata (type of mutraghata i.e., retention of urine): In debilitated person due to loss of fat, udavarta brings small amount of feces into the channels of urine (bladder and urethra) resulting in patients voiding of urine having odour of feces is termed as vidvighata. [A. H. Nidana Sthana 9/33-34]<br /> *Hemorrhoids (arsha): Udavarta is the chief complication in hemorrhoids (durnama/arsha). This udavarta may occur in person who has predominance of vata dosha in alimentary tract (koshtha) even without piles. <br /> *Vatodara: Udavarta is one of the causative factors of abdominal swelling afflicted by vata dosha (vatodara). [Cha. Sa. Chikitsa Sthana 13/23]<br /> *Hiccups (hikka) &amp; dyspnoea (shwasa): Udavarta is the one of the etiological factors for causation of conditions such as hiccups (hikka) and dyspnoea (shwasa).&lt;/p&gt;<br /> <br /> ===Udavarta as symptoms (lakshana) in following diseases===<br /> <br /> #Vataja plihodara (vata predominant plihodara i.e., abdominal swelling afflicted by splenomegaly) [Cha. Sa. Chikitsa Sthana 13/38]<br /> #Vatodara (abdominal swelling afflicted by vata dosha) [Cha. Sa. Chikitsa Sthana 13/25]<br /> #Vataja gulma (vata predominant gulma/ phantom tumor) [Cha. Sa. Chikitsa Sthana 5/10]<br /> #Sahaja arsha (congenital hemorrhoids) [Cha. Sa. Chikitsa Sthana 14/8]<br /> #Vataja arsha (vata predominant hemorrhoids) [Cha. Sa. Chikitsa Sthana 14/11]<br /> #Vyana avruta apana (type of avarana (occlusion) where vyana vata obstructs the flow of apana vata) [Cha. Sa. Chikitsa Sthana 28/211]<br /> #Basti marma viddha (injury to bladder) [Cha. Sa. Siddhi Sthana 9/6]<br /> <br /> ===Types of Udavarta===<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Udavarta is of 6 types which occur by suppression of natural urges viz., apana vata nirodhaja (suppression of flatus), mutra vega nirodhaja (suppression of urine), purisha vega nirodhaja (suppression of faeces), shukra vega nirodhaja (suppression of ejaculation of semen), chhardi vega nirodhaja (suppression of vomiting) and kshavathu vega nirodhaja (suppression of sneezing). [Cha. Sa. Sutra Sthana 18/3]&lt;/p&gt;<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;As per Sushruta Samhita, there are 13 types of suppression of natural urges (vegadharana) namely flatus, faeces, urine, yawning, flow of tears, sneezing, eructation, vomiting, ejaculation of semen, hunger, thirst, breath and sleep. [Su. Sa. Uttara Sthana 55/ 3-4] Suppression of these vega (urges) gives rise to their respective type of udavarta and manifest their respective symptoms which are as follows;&lt;/p&gt;<br /> <br /> ===Asadhyata [incurable stage of diseases]===<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Udavarta with symptoms of excessive thirst, excessively depressed, emaciated, suffering from pain and vomiting of fecal matter is difficult to manage or incurable.[Su. Sa. Uttara Sthana 55/ 17-18] &lt;/p&gt;<br /> <br /> ===Treatment===<br /> &lt;p style=&quot;text-align:justify;&quot;&gt; Treatment principles for udavarta i.e., palliative therapy (shamana) or purification (shodhana) etc., can be selected based on stages of the disease and as well as on the condition of the patient. The treatment guidelines explained in Charaka Samhita are as follows: [Cha. Sa. Chikitsa Sthana 26/11]&lt;/p&gt;<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;The patient suffering from udavarta should be given massage with hot oil described for the treatment of fever presented with cold extremities (sheeta jwara). Then fomentation therapy should be administered for the detachment of the adhered dosha in the tissue cells. This should be followed by the administration of suppository (varti), un-unctuous enema (niruha basti) and unctuous type of purgative (snigdha virechana). The patient should be given food which helps in the normal downward movement (anulomana) of apana vata.&lt;/p&gt;<br /> <br /> '''A) Unction therapy (snehana):''' &lt;p style=&quot;text-align:justify;&quot;&gt;Udavarta is produced due to aggravation of vata and sneha (lipids) is the best treatment for pacification of vata vata (shamana). Therefore, unction therapy (snehana) is indicated in udavarta. &lt;/p&gt;<br /> '''B) Fomentation therapy (swedana):''' &lt;p style=&quot;text-align:justify;&quot;&gt;After massage with oil, fomentation therapy should be administered for the detachment of the adhered dosha in the tissue cells.&lt;/p&gt;<br /> '''C) Suppository (varti):''' &lt;p style=&quot;text-align:justify;&quot;&gt;A suppository having the thickness of the thumb is to be prepared with drugs like Shyama Trivrita (Operculina turpethum), Vidanga (Embeila ribes), Kampillaka (Mallotus philippensis) etc., which should be triturated with gomutra (cow’s urine) or arka (Calotropis gigantea) latex (kshira) and made in to form of suppository (phala varti) by adding jaggery. This suppository should be inserted through anus for the downward movement of apana vata to relieve retention of stool, flatus and urine caused by udavarta.&lt;/p&gt;<br /> '''D) Palliative therapy (shamana):''' &lt;p style=&quot;text-align:justify;&quot;&gt;Shamana includes administration of internal medication such as dviruttara- hingvadi churna, hinguvachadi churna given with warm water as an anupana (co-administers with medicine) for correcting the upward movement of vata.&lt;/p&gt;<br /> '''E) Purification therapy (shodhana):'''&lt;p style=&quot;text-align:justify;&quot;&gt;When the disease is chronic and relief is not observed even by adopting above measures, then purification (shodhana) by non-unctuous enema (niruha basti) or purgation (virechana) is advised.&lt;/p&gt;<br /> '''F) Pathya ahara kalpana (wholesome diet):'''&lt;p style=&quot;text-align:justify;&quot;&gt;Intake of wholesome diet (pathya ahara) which helps in normal downward movement (anulomana) of apana vata whereas, intake of unwholesome diet (apathya ahara) should be avoided for better recovery. Generally, in all types of udavarta all measures for controlling vata should be adopted in order to restore it to its normal channels (srotasa). [Su. Sa. Uttara Sthana 55/ 19]&lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Complications of udavarta, flatulence (adhmana) and other diseases should be managed with respective measures according to condition. [Su. Sa. Uttara Sthana 55/34-35] For example when vayu in abdomen (koshtha) is aggravated by rough, pungent, bitter and astringent food, it immediately produces udavarta owing to which the channels (srotasa) carrying flatus, feces, urine, blood, kapha and adipose tissue (medas), move in upward direction and harden the feces too much. This results in manifestation of symptoms such as pain in cardiac and pelvic region, heaviness, anorexia, passing of urine, flatus and feces with difficulty. The person gets afflicted with many other disorders caused by aggravation of vata such as dyspnoea, (shwasa), cough (kasa), hiccoup (hikka), thirst (trishna), coryza (pratishyaya), burning sensation (daha), mental confusion (moha), vomiting (chhardi), fever (jwara), diseases of head and abnormalities of mind and ears. [Su. Sa. Uttara Sthana 55/2] &lt;/p&gt;<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;One should advise non-unctuous enema (niruha basti) after the patient is massaged with oil mixed with salt and sudation; then after feces are eliminated, he should be advised to take food followed by administration of unctuous enema (anuvasana basti) according to the dosha involvement. If by above procedures, still no relief found then in severe cases of udavarta, patient is advised to undergo repeated unction therapy (snehana) and fomentation therapy (swedana) and then undergo unctuous purgation (snigdha virechana). [Su. Sa. Uttara Sthana 55/40-41]&lt;/p&gt;<br /> <br /> ===Different treatments of udavarta===<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;1) Saturating drink (mantha) prepared with sugarcane product (phanita), roasted grain flour (saktu), ghee, curd water and vinegar (amla kanji) alleviate udavarta. [Cha. Sa. Sutra Sthana 23/37]&lt;/p&gt;<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;2) 96 gm (2 pala) of dehusked tila (Sesamum indicum Linn.), 48 gm (1 pala) of jaggery and 24 gm (half pala) of nagara (Zingiber officinale) should be made into a paste and taken along with hot milk helps in udavarta. [Cha. Sa. Chikitsa Sthana 5/91-92] &lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;3) Milk cooked with Allum sativum (Lashuna kshirapaka): Garlic cooked with milk by adding water and reducing to the quantity of milk, cures udavarta immediately [Cha. Sa. Chikitsa Sthana 5/94] &lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;4) Alkali prepared from pippali (Piper longum) and other ingredients (Pippalyadi kshara) used in udavarta [Cha. Sa. Chikitsa Sthana 13/159-161] &lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;5) Medicine prepared by boiling medicinal herbs in water and then kept for fermentation with drugs such as haritaki (Terminalia chebula), amalaki (Emblica officinalis), etc. (Phalarishta) used in udavarta. [Cha. Sa. Chikitsa Sthana 14/148-152] &lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;6) Trivrut (Operculina turpethum), pilu (Salvadora persica), yavani (Trachyspermum ammi) with sour gruel mixed with digestants (pachana) drugs. [Su. Sa. Uttara Sthana 55/42-43] &lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt; 7) The combination of hingu (Ferula foetida), kushtha (Saussurea lappa), vacha (Acorus calamus Linn.), svarjika (alkali prepared by burning Lona plant), and vidanga (Embelia ribes) – successively in double quantity cures udavarta and colicky pain by vata dosha (vataja shoola) [Su. Sa. Uttara Sthana 55/42-43]&lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;8) Intake of ghee cooked with decoction of dried radish (Raphanus sativus), sunthi (Zingiber officinale), punarnava (Boerhavia diffusa), brihata panchamula (combination of five herbs viz., bilva, patala, agnimantha, shyonaka and gambhari), and fruits of aragvadha (Cassia fistula) subsides severe udavarta completely. [Su. Sa. Uttara Sthana 55/45-46] &lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;9) Vacha (Acorus calamus Linn.), ativisha (Aconitum heterophyllum), kushtha (Saussurea lappa), yavakshara (alkali prepared from barley), haritaki (Terminalia chebula Retz.), pippali (Piper longum) and agnimantha (Clerodendrum phlomidis) with hot water cures udavarta. [Su. Sa. Uttara Sthana 55/47] &lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;10) Devadaru (Cedrus deodara), chitraka (Plumbago zeylanica), triphala (combination of 3 herbs viz., haritaki, bibhitaki and amalaki), brihati (Solanum indicum) should be taken along with cow’s urine. [Su. Sa. Uttara Sthana 55/49]&lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;11) Suppository: Powder of danti (Baliospermum montanum), kampillaka (Mallotus philippensis), shyama trivrita (Operculina turpethum), ikshvaku (Lagenaria vulgaris Ser.), ajamoda (Apium graveolens), kritavedhana (Luffa acutangula Linn Roxb.), pippali (Piper longum) and salts should cook in cow’s urine and made into suppositories to be inserted in the anus. This provides instant relief in the symptoms of udavarta. [Su. Sa. Uttara Sthana 55/51-52] &lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt; 12) Guggulu (Commiphora mukul) should be taken with decoction of triphala (combination of 3 herbs viz., haritaki, bibhitaki and amalaki), daruharidra (Berberis aristata), patola (Trichosanthes dioica) and kusa (Desmostachya bipinnata) or with urine or hot water for 1 month alleviates udavarta. [Su. Sa. Chikitsa Sthana 5/39-44]&lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;13) Kalyanaka kshara consumed with ghee cures udavarta and constipation (vibandha) [A. H. Chikitsa Sthana 8/142] &lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;14) Erandamooladi enema (basti) helps in alleviating obstruction of faeces, urine and flatus [Ch. Sa. Siddhi Sthana 3/38-42] &lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt; 15) Palashadi niruha basti alleviates non- passage of flatus and feces (anaha) and udavarta [Ch. Sa. Siddhi Sthana 3/44-45]&lt;/p&gt;<br /> <br /> === Treatment as per different conditions===<br /> *In hemorrhoids (arsha), if symptoms of udavarta is present then unctuous enema (anuvasana basti) should be administered. [Cha. Sa. Chikitsa Sthana 14/130]<br /> *In complications by enema (basti vyapat) when unctuous enema gets obstructed by feces then treatment alleviating udavarta should be adopted. [Cha. Sa. Siddhi Sthana 4/36-37]<br /> *In emesis (vamana) and purgation (virechana) complications (vyapta), in extremely vitiated condition of doshas (bahudosha avastha) low dose of medicine is administered, then it causes udavarta, tympanitis (adhmana) in such condition treatment of udavarta is massage (abhyanga), sudation, suppository, non-unctuous enema (niruha basti) and other measures of udavarta should be adopted [Cha. Sa. Siddhi Sthana 6/58-60]<br /> *In pain caused by obstruction of feces (vitshula) the measures mentioned for udavarta should be used in the treatment. [Su. Sa. Uttara Sthana 42/140] <br /> *In treatment of rakta gulma (a variety of phantom tumor) the measures which cures udavarta should be adopted. [A. H. Chikitsa Sthana 14/129]<br /> *Measures which cure udavarta (udavarta hara kriya) should be adopted in abdominal swelling caused by intestinal obstruction (baddhodara). [A. H. Chikitsa Sthana 15/100]<br /> *In emesis (vamana) from improper therapy (mithya yoga), therapies of udavarta should be adopted. [A. H. Kalpasiddhi Sthana 3/13]<br /> *In complications from enema (basti vyapat) the treatment of udavarta should be adopted if fat (sneha) of enema (basti) gets obstructed or enveloped by feces. [A. H. Kalpa-siddhi Sthana 5/39]<br /> <br /> ===Measures alleviating udavarta (udavarta hara)===<br /> <br /> *Mrudvika (Vitis vinifera/grapes) alleviates udavarta [Cha. Sa. Sutra Sthana 27/125-126]<br /> *Haritaki (Terminalia chebula Retz.) used in udavarta [Cha. Sa. Chikitsa Sthana 1/1/31]<br /> *Dish prepared with barley (yavapupa), supernatant liquid proportion of barley preparation (yavaka) and bhristha yava odana/ parched cooked barley (vatya) made from yava (barley) helps in alleviation of udavarta. [Cha. Sa. Sutra Sthana 27/265]<br /> *Saturating drink (mantha) prepared by churning parched grain flour (saktu) with sour taste (amla rasa), fat and jaggery alleviates udavarta. [Su. Sa. Sutra Sthana 46/386]<br /> *Vatya (made by roasted wheat or barley) helps in alleviating udavarta. [Su. Sa. Sutra Sthana 46/410]<br /> *Garlic cooked with milk (lashuna kshirapaka) alleviates udavarta. [A. H. Chikitsa Sthana 14/46]<br /> <br /> ===Diet for udavarta===<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Intake of vegetable preparations prepared from the leaves of trivruta (Operculina turpethum) and snuhi (Euphorbia neriifolia Linn.), tila (Sesamum indicum) and its different preparations, soup of meat of animals inhabiting in marshy land, domestic and aquatic animals, clear top portion of alcohol (prasanna) and molasses rum (sidhu), wine prepared of jaggery, preparations which facilitates motion of flatus, urine and stool. [Cha. Sa. Chikitsa Sthana 26/18] One should never withhold the natural urges of the body. [Su. Sa. Uttara Sthana 55/3]&lt;/p&gt;<br /> <br /> ===Researches===<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;1) A review on diseases manifested due to withholding natural urges (vegadharana janya vikara) focused to identify the effects of suppression of natural urges (adharaneeya vegas) on various system of body such as CVS, gastrointestinal tract, respiratory system urinary system and reproductive system. CVS and gastrointestinal systems are the mostly affected systems. Out of thirteen urges (vegas), seven play major role in both systems. Common clinical features produced by suppression of natural urges (vegadharana) were weakness of the body, constipation, anorexia, headache, diseases of eye, difficulty in micturition, bending of the body and stiffness of the neck. Weakness of the body and anorexia are the commonest clinical features produced by suppression of natural urges. These clinical features arise due to vitiation of vata by vegadharana. Withholding (dharana) of natural urges is strictly prohibited to stay healthy.&lt;/P&gt;<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;2) A physiological study of adharaneeya vega (suppression of natural urges) w.s.r. to apana vayu vega (suppression of apana vata or flatus)&lt;/p&gt;<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Understanding the physiology of suppression of natural urges (vegarodhajanya) symptoms and analyzing them as a pathology of various diseases related to apana vayu (one of the five subtypes of vata situated in the pelvic region). As, seen in clinical practice many a times diseases reoccur after giving proper treatment. Also, in such case causative factors (nidana) of vitiation of apana vayu (one of the five subtypes of vata situated in the pelvic region) is to be analyzed properly for better result. Among the fourteen adharaneeya vega (suppression of natural urges), apana vayu (one of the five subtypes of vata situated in the pelvic region) vega (urge) is most commonly suppressed which leads to vitiation of vata dosha in the pelvic region). Adharaneeya vega (suppression of natural urges) is a reflex mechanism and it is a nervous activity. Nerve supply to gastrointestinal tract is in the form of sympathetic, parasympathetic, enteric nervous system (ENS) and gastrointestinal reflexes. The ENS is to be referred as second brain, it uses serotonin to communicate with the central nervous system. This “brain gut axis’ helps us in understanding how psychological and social stress might cause digestive problems. ENS is closely related to central nervous system (CNS). As mentioned, blindness (‘andhya’) is one of the udavarta janya vikara (diseases caused by udavarta) which is difficult to understand how eyes are related to apana vayu (one of the five subtypes of vata situated in the pelvic region). In an article named ‘Gut microbes linked to eye diseases’ observations have been made by the researchers regarding the possible connection between the gut microbes and the eye diseases. Apana vayu (one of the five subtypes of vata situated in the pelvic region) is mostly parasympathetic in action and its action is related to urine (mutra), stool (purisha), flatus (adhovata) and seminal discharge (shukra vega). Obstruction in passing flatus (apana vayu rodha) invariably affects the prana vayu (one type of the five subtypes of vata situated in upward body or head) among and other vital points in body (marma sthana) like herat (hrudya), brain (shiras), and urinary bladder (basti).&lt;/p&gt;<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;3) Nidra vegadharana (suppression of sleep) leads to vitiation of vata dosha. Vata controls the functions of mind (mana). Stress is mainly due to mental and physical stimuli which cause disturbances in the internal biological equilibrium. Disturbed and interrupted sleep is very common in the IT professionals due to their work culture. Here, nidra vegadharana (suppression of urge of sleep) acts as a stress stimulus which causes impairment in both sharirika (biological elements vata, pitta and kapha) and manasika (psychological constitution like raja and tama) dosha which causes further loss of sleep (nidranasha). Udavarta affects mind and leads to abnormalities in mental functions similar to mental stress. Hence it is important to avoid nidra vegadharana (suppression of urge of sleep) to prevent further kriyakala i.e., stage of progression of disease leading to stress and other mental disorders. &lt;/p&gt;<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;4) In this study total 74 patients have been enrolled which were divided in two groups randomly. The selected drug for clinical trial in group A was Yavanikadi vati (tablet) which contains haritaki (Terminalia chebula), yavani (Trachyspermum ammi), hingu (Ferula foetida), sauvarchala (black salt), yavakshara (alkali prepared from barley) and saindhava (rock salt). The powder of these raw drugs was given 3 times trituration (bhavana) of these raw drugs was given 3 times trituration (bhavana) of lemon juice (nimbu swarasa) to prepare tablet. In group B, Shankha vati (tablet) was taken for control group, which contains purified mercury (shuddha parada) and purified sulphur (shuddha gandhaka). In the group A 31 patients were given Yavanikadi vati in tablet form 1 gm B.D. in two divided doses (1 tablet = 500 mg.) daily, after food for 28 days with water whereas, in Group B total 30 patients were given Shankha Vati. The dose, duration, time of administration and anupana (co-administers with medicine) is same as group A. Comparison of the therapies showed that overall better results as observed in group A as compared to group B which stands closely parallel to group A. &lt;/p&gt;</div>

Manishdubey https://www.carakasamhitaonline.com/index.php?title=Talk:Udavarta&diff=44311 2023-11-03T11:00:49Z

<p>Manishdubey: </p> <hr /> <div>{{CiteButton}}<br /> {{#seo:<br /> |title= UDAKAVAHA SROTAS (Channels for transport and transformation of watery components)<br /> |titlemode=append<br /> |keywords=Udakavaha Srotas, Water metabolism, Bhojani M. K., Tanwar Ankur Kumar, Basisht G, Deole Y.S.<br /> |description=Udaka means water. In body, water is present in the form of various fluids. Udakavaha srotasa are the channels for transport and transformation of fluid (water) and its circulation. <br /> |image=http://www.carakasamhitaonline.com/mediawiki-1.32.1/resources/assets/ogimgs.jpg<br /> |image_alt=carak samhita<br /> |type=article<br /> }}<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Udavarta literally means the upward and repeated movements of vata. It is one of the important and commonly observed condition in clinical practice. It manifests with a number of clinical features which may lead to manifestation of other secondary diseases further. Udavarta is mentioned as one among the eighty diseases occurred primarily by the vitiated vata dosha (nanatmaja vata vyadhi). [Cha. Sa. Sutra Sthana 20/11] Udavarta (upward movement of vata) is very common now a days due to change in lifestyle of modern society. The change in dietary habits and due to hectic job schedule, suppression of natural urges (vegadharana) is also very common now a days. The two main cause of udavarta explained in classical texts are: suppression of natural urges (vegadharana) and faulty dietary habits (asatmya ahara sevana). Sushrut Samhita describes that suppression of natural urges (adharaniya vega) leads to manifestation of thirteen types of udavarta. Due to aggravating factors, vata dosha is aggravated, especially apana vata (one of the five subtypes of vata i.e., situated in the pelvic region) is affected. Generally, udavarta means upward movement of vata or apana vata, that results in retention of faeces, urine and flatus. However, the scope of udavarta extends to disturbance in normal functions of vata due to obstruction by metabolic wastes. This unique concept is not explained in any other contemporary sciences. So, understanding this concept and to provide better treatment for this disease is need of the society.&lt;/p&gt;<br /> <br /> {{Infobox<br /> |title = Contributors<br /> |label1 = Section/Chapter/topic<br /> |data1 = Concepts &amp; Practices/[[Udavarta]] <br /> |label2 = Authors<br /> |data2 = Dubey M.&lt;sup&gt;1&lt;/sup&gt;,&lt;br/&gt;Deole Y.S.&lt;sup&gt;2&lt;/sup&gt;<br /> |label3 = Reviewer <br /> |data3 = Basisht G.&lt;sup&gt;3&lt;/sup&gt;, <br /> |label4 = Editor<br /> |data4 = Basisht G.&lt;sup&gt;3&lt;/sup&gt;<br /> |label5 = Affiliations<br /> |data5 = &lt;sup&gt;1&lt;/sup&gt;[[Charak Samhita Research, Training and Development Centre]], I.T.R.A., Jamnagar, India &lt;br/&gt;&lt;sup&gt;2&lt;/sup&gt;Department of Kayachikitsa, G. J. Patel Institute of Ayurvedic Studies and Research, New Vallabh Vidyanagar, Gujarat, India&lt;br/&gt;&lt;sup&gt;3&lt;/sup&gt;Rheumatologist, Orlando, Florida, U.S.A.<br /> |label6 = Correspondence emails<br /> |data6 = dr.manish181@gmail.com, dryogeshdeole@gmail.com<br /> carakasamhita@gmail.com<br /> |label7 = Publisher <br /> |data7 = [[Charak Samhita Research, Training and Development Centre]], I.T.R.A., Jamnagar, India<br /> |label8 = Date of publication:<br /> |data8 =November 03, 2023<br /> |label9 = DOI<br /> |data9 = {{DoiWithLink}}<br /> }}<br /> <br /> ===Nirukti (etymology)===<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;The term udavarta is derived from Utt + Aavat i.e., “Ut + Ang + Vrut + Dhaya” to form word Udavarta. [ ] Udavarta is a Sanskrit word derived from 'Ut' verb root (dhatu) with 'Ang' and 'Vrut' preposition (upasarga), suffixed by ‘Dhaya’ pratyaya (suffix). “Ut” means upper side, (Urdhva) “Ang” means entirely and “Vrut” means to move (bhramana). Udavarta means upwards movement, to cause to go out, excrete, to secrete and to retain. Udavarta is a class of diseases marked by retention of the feces i.e., disease of the bowel so, in general urdhwa (upward direction) or pratiloma (moving in abnormal direction) movement of apana vata (one of the five subtypes of vata, situated in the pelvic region) is termed as udavarta.&lt;/p&gt;<br /> <br /> ===Definition===<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;‘Udavarta’ is that disease in which there is whirlpool movement (avartana) and upward movement (urdhva gamana) of vata is seen due to retention of vata, urine (mutra) and stool (purisha). The condition in which vata begins to move upwards is called as ‘udavarta’ and in this disease vata is the predominant dosha. &lt;/p&gt;<br /> <br /> ===Etiopathogenesis===<br /> *Intake of deficient quantity of food causes udavarta. [Cha. Sa. Vimana Sthana 2/7] <br /> *Intake of astringent, bitter, pungent and un-unctuous (dry) food and excessive fasting<br /> *Withholding natural urges (vegadharana) <br /> *Excessive indulgence in sexual activity. [Cha. Sa. Chikitsa Sthana 26/5-6] <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Due to all above reasons the apana vata which resides in large intestine (pakvashaya) gets aggravated and further obstructs the downward movement of vata causing retention of movement of stool, urine and flatus. This leads to a dreadful disease named as udavarta. [Ca. Sa. Chikitsa Sthana 26/5-6]&lt;/p&gt; <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Acharya Sushruta explained suppression of 13 urges leading to udavarta. [Su. Sa. Uttara Sthana 55/ 3-4] Thus, udavarta is caused by 2 main causes, one is suppression of natural urges and other one unwholesome eating. [Su. Sa. Uttara Sthana 55/ 6] Excess consumption of mudga (Phaseolus mungo), kodrava (Paspalum scrobiculatum Linn.), jurnahva (Sorghum vulgare/jowar), karira (Capparis decidua), chanaka (Cicer arietinum L.), etc. i.e., foods with property of dryness and causing constipation vitiate normal status of vata dosha in its own seat (large intestine). This vata becomes powerful and blocks the downward channels and produces severe obstruction in the movement of feces, flatus and urine leading to udavarta. [A. H. Nidana Sthana 7/46-52]&lt;/p&gt;<br /> <br /> ===Clinical features=== <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Frequent pain in the region of urinary bladder (basti), heart (hridaya), abdomen (udara) and excruciating or intense pain in the back of chest. Other symptoms are flatulence (adhmana), nausea (hrillasa), gripping type of pain in anus (vikartika), pricking (toda) type of pain in whole body, indigestion and inflammation of urinary bladder. Obstruction in passing stool less frequently and with difficulty and in less quantity, after long time and effort. Upward movement of flatus occurs because of obstruction in channels (srotasa), increased roughness, dryness and coldness in the body. [Cha. Sa. Chikitsa Sthana 26/6-7]&lt;/p&gt;<br /> <br /> ===Udavarta janya vikara===<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;If not treated early, udavarta leads to other secondary complications as follows:&lt;/p&gt;<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Fever (jwara), dysuria (mutrakricchhra), dysentery (pravahika), heart disease (hridroga), diseases due to malfunctioning of duodenum (grihani dosha), vomiting (chhardi), blindness, deafness, burning sensation in the head, affliction of abdomen by vata (vatodara), tumors (asthila), psychological diseases (mano vikara), disorders of excessive thirst (trishna roga), an ailment characterized by bleeding from different parts of the body (raktapitta), aruchi (anorexia), phantom tumor (gulma), cough (kasa), dyspnoea (shwasa), chronic rhinitis (pratishyaya), facial paralysis (ardita), diseases of the flanks including lower respiratory tract disorders (parshva roga) and such other serious diseases caused by aggravation of vata. [Cha. Sa. Chikitsa Sthana 26/8-9]&lt;/p&gt;<br /> <br /> ===Udavarta as a causative factor (nidana) of other diseases===<br /> *&lt;p style=&quot;text-align:justify;&quot;&gt;Udavarta is the etiological factor of abdominal swelling caused by intestinal obstruction (baddhagudodara) [Cha. Sa. Chikitsa Sthana 13/39]<br /> *Udavarta is the cause for abdominal swelling afflicted by spleen (plihodara). [Cha. Sa. Chikitsa Sthana 13/75]<br /> *Udavarta is the cause for respiratory diseases including bronchial asthma (pratamaka shwasa-type of tamaka shwasa) characterized by fever, syncope and other such symptoms which are relieved by cold measures. [Cha. Sa. Chikitsa Sthana 17/63]<br /> *Udavarta caused by suppression of the urge of urination is causative factor of condition where severe painful distension of abdomen below umbilicus is present along with obstruction of downward movement of urine (mutrajathara- a type of mutraghata i.e., retention of urine). [Su. Sa. Uttara Sthana 58/13]<br /> *Vidvighata (type of mutraghata i.e., retention of urine): In debilitated person due to loss of fat, udavarta brings small amount of feces into the channels of urine (bladder and urethra) resulting in patients voiding of urine having odour of feces is termed as vidvighata. [A. H. Nidana Sthana 9/33-34]<br /> *Hemorrhoids (arsha): Udavarta is the chief complication in hemorrhoids (durnama/arsha). This udavarta may occur in person who has predominance of vata dosha in alimentary tract (koshtha) even without piles. <br /> *Vatodara: Udavarta is one of the causative factors of abdominal swelling afflicted by vata dosha (vatodara). [Cha. Sa. Chikitsa Sthana 13/23]<br /> *Hiccups (hikka) &amp; dyspnoea (shwasa): Udavarta is the one of the etiological factors for causation of conditions such as hiccups (hikka) and dyspnoea (shwasa).&lt;/p&gt;<br /> <br /> ===Udavarta as symptoms (lakshana) in following diseases===<br /> <br /> #Vataja plihodara (vata predominant plihodara i.e., abdominal swelling afflicted by splenomegaly) [Cha. Sa. Chikitsa Sthana 13/38]<br /> #Vatodara (abdominal swelling afflicted by vata dosha) [Cha. Sa. Chikitsa Sthana 13/25]<br /> #Vataja gulma (vata predominant gulma/ phantom tumor) [Cha. Sa. Chikitsa Sthana 5/10]<br /> #Sahaja arsha (congenital hemorrhoids) [Cha. Sa. Chikitsa Sthana 14/8]<br /> #Vataja arsha (vata predominant hemorrhoids) [Cha. Sa. Chikitsa Sthana 14/11]<br /> #Vyana avruta apana (type of avarana (occlusion) where vyana vata obstructs the flow of apana vata) [Cha. Sa. Chikitsa Sthana 28/211]<br /> #Basti marma viddha (injury to bladder) [Cha. Sa. Siddhi Sthana 9/6]<br /> <br /> ===Types of Udavarta===<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Udavarta is of 6 types which occur by suppression of natural urges viz., apana vata nirodhaja (suppression of flatus), mutra vega nirodhaja (suppression of urine), purisha vega nirodhaja (suppression of faeces), shukra vega nirodhaja (suppression of ejaculation of semen), chhardi vega nirodhaja (suppression of vomiting) and kshavathu vega nirodhaja (suppression of sneezing). [Cha. Sa. Sutra Sthana 18/3]&lt;/p&gt;<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;As per Sushruta Samhita, there are 13 types of suppression of natural urges (vegadharana) namely flatus, faeces, urine, yawning, flow of tears, sneezing, eructation, vomiting, ejaculation of semen, hunger, thirst, breath and sleep. [Su. Sa. Uttara Sthana 55/ 3-4] Suppression of these vega (urges) gives rise to their respective type of udavarta and manifest their respective symptoms which are as follows;&lt;/p&gt;<br /> <br /> ===Asadhyata [incurable stage of diseases]===<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Udavarta with symptoms of excessive thirst, excessively depressed, emaciated, suffering from pain and vomiting of fecal matter is difficult to manage or incurable.[Su. Sa. Uttara Sthana 55/ 17-18] &lt;/p&gt;<br /> <br /> ===Treatment===<br /> &lt;p style=&quot;text-align:justify;&quot;&gt; Treatment principles for udavarta i.e., palliative therapy (shamana) or purification (shodhana) etc., can be selected based on stages of the disease and as well as on the condition of the patient. The treatment guidelines explained in Charaka Samhita are as follows: [Cha. Sa. Chikitsa Sthana 26/11]&lt;/p&gt;<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;The patient suffering from udavarta should be given massage with hot oil described for the treatment of fever presented with cold extremities (sheeta jwara). Then fomentation therapy should be administered for the detachment of the adhered dosha in the tissue cells. This should be followed by the administration of suppository (varti), un-unctuous enema (niruha basti) and unctuous type of purgative (snigdha virechana). The patient should be given food which helps in the normal downward movement (anulomana) of apana vata.&lt;/p&gt;<br /> <br /> '''A) Unction therapy (snehana):''' &lt;p style=&quot;text-align:justify;&quot;&gt;Udavarta is produced due to aggravation of vata and sneha (lipids) is the best treatment for pacification of vata vata (shamana). Therefore, unction therapy (snehana) is indicated in udavarta. &lt;/p&gt;<br /> '''B) Fomentation therapy (swedana):''' &lt;p style=&quot;text-align:justify;&quot;&gt;After massage with oil, fomentation therapy should be administered for the detachment of the adhered dosha in the tissue cells.&lt;/p&gt;<br /> '''C) Suppository (varti):''' &lt;p style=&quot;text-align:justify;&quot;&gt;A suppository having the thickness of the thumb is to be prepared with drugs like Shyama Trivrita (Operculina turpethum), Vidanga (Embeila ribes), Kampillaka (Mallotus philippensis) etc., which should be triturated with gomutra (cow’s urine) or arka (Calotropis gigantea) latex (kshira) and made in to form of suppository (phala varti) by adding jaggery. This suppository should be inserted through anus for the downward movement of apana vata to relieve retention of stool, flatus and urine caused by udavarta.&lt;/p&gt;<br /> '''D) Palliative therapy (shamana):''' &lt;p style=&quot;text-align:justify;&quot;&gt;Shamana includes administration of internal medication such as dviruttara- hingvadi churna, hinguvachadi churna given with warm water as an anupana (co-administers with medicine) for correcting the upward movement of vata.&lt;/p&gt;<br /> '''E) Purification therapy (shodhana):'''&lt;p style=&quot;text-align:justify;&quot;&gt;When the disease is chronic and relief is not observed even by adopting above measures, then purification (shodhana) by non-unctuous enema (niruha basti) or purgation (virechana) is advised.&lt;/p&gt;<br /> '''F) Pathya ahara kalpana (wholesome diet):'''&lt;p style=&quot;text-align:justify;&quot;&gt;Intake of wholesome diet (pathya ahara) which helps in normal downward movement (anulomana) of apana vata whereas, intake of unwholesome diet (apathya ahara) should be avoided for better recovery. Generally, in all types of udavarta all measures for controlling vata should be adopted in order to restore it to its normal channels (srotasa). [Su. Sa. Uttara Sthana 55/ 19]&lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Complications of udavarta, flatulence (adhmana) and other diseases should be managed with respective measures according to condition. [Su. Sa. Uttara Sthana 55/34-35] For example when vayu in abdomen (koshtha) is aggravated by rough, pungent, bitter and astringent food, it immediately produces udavarta owing to which the channels (srotasa) carrying flatus, feces, urine, blood, kapha and adipose tissue (medas), move in upward direction and harden the feces too much. This results in manifestation of symptoms such as pain in cardiac and pelvic region, heaviness, anorexia, passing of urine, flatus and feces with difficulty. The person gets afflicted with many other disorders caused by aggravation of vata such as dyspnoea, (shwasa), cough (kasa), hiccoup (hikka), thirst (trishna), coryza (pratishyaya), burning sensation (daha), mental confusion (moha), vomiting (chhardi), fever (jwara), diseases of head and abnormalities of mind and ears. [Su. Sa. Uttara Sthana 55/2] &lt;/p&gt;<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;One should advise non-unctuous enema (niruha basti) after the patient is massaged with oil mixed with salt and sudation; then after feces are eliminated, he should be advised to take food followed by administration of unctuous enema (anuvasana basti) according to the dosha involvement. If by above procedures, still no relief found then in severe cases of udavarta, patient is advised to undergo repeated unction therapy (snehana) and fomentation therapy (swedana) and then undergo unctuous purgation (snigdha virechana). [Su. Sa. Uttara Sthana 55/40-41]&lt;/p&gt;<br /> <br /> ===Different treatments of udavarta===<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;1) Saturating drink (mantha) prepared with sugarcane product (phanita), roasted grain flour (saktu), ghee, curd water and vinegar (amla kanji) alleviate udavarta. [Cha. Sa. Sutra Sthana 23/37]&lt;/p&gt;<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;2) 96 gm (2 pala) of dehusked tila (Sesamum indicum Linn.), 48 gm (1 pala) of jaggery and 24 gm (half pala) of nagara (Zingiber officinale) should be made into a paste and taken along with hot milk helps in udavarta. [Cha. Sa. Chikitsa Sthana 5/91-92] &lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;3) Milk cooked with Allum sativum (Lashuna kshirapaka): Garlic cooked with milk by adding water and reducing to the quantity of milk, cures udavarta immediately [Cha. Sa. Chikitsa Sthana 5/94] &lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;4) Alkali prepared from pippali (Piper longum) and other ingredients (Pippalyadi kshara) used in udavarta [Cha. Sa. Chikitsa Sthana 13/159-161] &lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;5) Medicine prepared by boiling medicinal herbs in water and then kept for fermentation with drugs such as haritaki (Terminalia chebula), amalaki (Emblica officinalis), etc. (Phalarishta) used in udavarta. [Cha. Sa. Chikitsa Sthana 14/148-152] &lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;6) Trivrut (Operculina turpethum), pilu (Salvadora persica), yavani (Trachyspermum ammi) with sour gruel mixed with digestants (pachana) drugs. [Su. Sa. Uttara Sthana 55/42-43] &lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt; 7) The combination of hingu (Ferula foetida), kushtha (Saussurea lappa), vacha (Acorus calamus Linn.), svarjika (alkali prepared by burning Lona plant), and vidanga (Embelia ribes) – successively in double quantity cures udavarta and colicky pain by vata dosha (vataja shoola) [Su. Sa. Uttara Sthana 55/42-43]&lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;8) Intake of ghee cooked with decoction of dried radish (Raphanus sativus), sunthi (Zingiber officinale), punarnava (Boerhavia diffusa), brihata panchamula (combination of five herbs viz., bilva, patala, agnimantha, shyonaka and gambhari), and fruits of aragvadha (Cassia fistula) subsides severe udavarta completely. [Su. Sa. Uttara Sthana 55/45-46] &lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;9) Vacha (Acorus calamus Linn.), ativisha (Aconitum heterophyllum), kushtha (Saussurea lappa), yavakshara (alkali prepared from barley), haritaki (Terminalia chebula Retz.), pippali (Piper longum) and agnimantha (Clerodendrum phlomidis) with hot water cures udavarta. [Su. Sa. Uttara Sthana 55/47] &lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;10) Devadaru (Cedrus deodara), chitraka (Plumbago zeylanica), triphala (combination of 3 herbs viz., haritaki, bibhitaki and amalaki), brihati (Solanum indicum) should be taken along with cow’s urine. [Su. Sa. Uttara Sthana 55/49]&lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;11) Suppository: Powder of danti (Baliospermum montanum), kampillaka (Mallotus philippensis), shyama trivrita (Operculina turpethum), ikshvaku (Lagenaria vulgaris Ser.), ajamoda (Apium graveolens), kritavedhana (Luffa acutangula Linn Roxb.), pippali (Piper longum) and salts should cook in cow’s urine and made into suppositories to be inserted in the anus. This provides instant relief in the symptoms of udavarta. [Su. Sa. Uttara Sthana 55/51-52] &lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt; 12) Guggulu (Commiphora mukul) should be taken with decoction of triphala (combination of 3 herbs viz., haritaki, bibhitaki and amalaki), daruharidra (Berberis aristata), patola (Trichosanthes dioica) and kusa (Desmostachya bipinnata) or with urine or hot water for 1 month alleviates udavarta. [Su. Sa. Chikitsa Sthana 5/39-44]&lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;13) Kalyanaka kshara consumed with ghee cures udavarta and constipation (vibandha) [A. H. Chikitsa Sthana 8/142] &lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;14) Erandamooladi enema (basti) helps in alleviating obstruction of faeces, urine and flatus [Ch. Sa. Siddhi Sthana 3/38-42] &lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt; 15) Palashadi niruha basti alleviates non- passage of flatus and feces (anaha) and udavarta [Ch. Sa. Siddhi Sthana 3/44-45]&lt;/p&gt;<br /> <br /> === Treatment as per different conditions===<br /> *In hemorrhoids (arsha), if symptoms of udavarta is present then unctuous enema (anuvasana basti) should be administered. [Cha. Sa. Chikitsa Sthana 14/130]<br /> *In complications by enema (basti vyapat) when unctuous enema gets obstructed by feces then treatment alleviating udavarta should be adopted. [Cha. Sa. Siddhi Sthana 4/36-37]<br /> *In emesis (vamana) and purgation (virechana) complications (vyapta), in extremely vitiated condition of doshas (bahudosha avastha) low dose of medicine is administered, then it causes udavarta, tympanitis (adhmana) in such condition treatment of udavarta is massage (abhyanga), sudation, suppository, non-unctuous enema (niruha basti) and other measures of udavarta should be adopted [Cha. Sa. Siddhi Sthana 6/58-60]<br /> *In pain caused by obstruction of feces (vitshula) the measures mentioned for udavarta should be used in the treatment. [Su. Sa. Uttara Sthana 42/140] <br /> *In treatment of rakta gulma (a variety of phantom tumor) the measures which cures udavarta should be adopted. [A. H. Chikitsa Sthana 14/129]<br /> *Measures which cure udavarta (udavarta hara kriya) should be adopted in abdominal swelling caused by intestinal obstruction (baddhodara). [A. H. Chikitsa Sthana 15/100]<br /> *In emesis (vamana) from improper therapy (mithya yoga), therapies of udavarta should be adopted. [A. H. Kalpasiddhi Sthana 3/13]<br /> *In complications from enema (basti vyapat) the treatment of udavarta should be adopted if fat (sneha) of enema (basti) gets obstructed or enveloped by feces. [A. H. Kalpa-siddhi Sthana 5/39]<br /> <br /> ===Measures alleviating udavarta (udavarta hara)===<br /> <br /> *Mrudvika (Vitis vinifera/grapes) alleviates udavarta [Cha. Sa. Sutra Sthana 27/125-126]<br /> *Haritaki (Terminalia chebula Retz.) used in udavarta [Cha. Sa. Chikitsa Sthana 1/1/31]<br /> *Dish prepared with barley (yavapupa), supernatant liquid proportion of barley preparation (yavaka) and bhristha yava odana/ parched cooked barley (vatya) made from yava (barley) helps in alleviation of udavarta. [Cha. Sa. Sutra Sthana 27/265]<br /> *Saturating drink (mantha) prepared by churning parched grain flour (saktu) with sour taste (amla rasa), fat and jaggery alleviates udavarta. [Su. Sa. Sutra Sthana 46/386]<br /> *Vatya (made by roasted wheat or barley) helps in alleviating udavarta. [Su. Sa. Sutra Sthana 46/410]<br /> *Garlic cooked with milk (lashuna kshirapaka) alleviates udavarta. [A. H. Chikitsa Sthana 14/46]<br /> <br /> ===Diet for udavarta===<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Intake of vegetable preparations prepared from the leaves of trivruta (Operculina turpethum) and snuhi (Euphorbia neriifolia Linn.), tila (Sesamum indicum) and its different preparations, soup of meat of animals inhabiting in marshy land, domestic and aquatic animals, clear top portion of alcohol (prasanna) and molasses rum (sidhu), wine prepared of jaggery, preparations which facilitates motion of flatus, urine and stool. [Cha. Sa. Chikitsa Sthana 26/18] One should never withhold the natural urges of the body. [Su. Sa. Uttara Sthana 55/3]&lt;/p&gt;<br /> <br /> ===Researches===<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;1) A review on diseases manifested due to withholding natural urges (vegadharana janya vikara) focused to identify the effects of suppression of natural urges (adharaneeya vegas) on various system of body such as CVS, gastrointestinal tract, respiratory system urinary system and reproductive system. CVS and gastrointestinal systems are the mostly affected systems. Out of thirteen urges (vegas), seven play major role in both systems. Common clinical features produced by suppression of natural urges (vegadharana) were weakness of the body, constipation, anorexia, headache, diseases of eye, difficulty in micturition, bending of the body and stiffness of the neck. Weakness of the body and anorexia are the commonest clinical features produced by suppression of natural urges. These clinical features arise due to vitiation of vata by vegadharana. Withholding (dharana) of natural urges is strictly prohibited to stay healthy.&lt;/P&gt;<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;2) A physiological study of adharaneeya vega (suppression of natural urges) w.s.r. to apana vayu vega (suppression of apana vata or flatus)&lt;/p&gt;<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Understanding the physiology of suppression of natural urges (vegarodhajanya) symptoms and analyzing them as a pathology of various diseases related to apana vayu (one of the five subtypes of vata situated in the pelvic region). As, seen in clinical practice many a times diseases reoccur after giving proper treatment. Also, in such case causative factors (nidana) of vitiation of apana vayu (one of the five subtypes of vata situated in the pelvic region) is to be analyzed properly for better result. Among the fourteen adharaneeya vega (suppression of natural urges), apana vayu (one of the five subtypes of vata situated in the pelvic region) vega (urge) is most commonly suppressed which leads to vitiation of vata dosha in the pelvic region). Adharaneeya vega (suppression of natural urges) is a reflex mechanism and it is a nervous activity. Nerve supply to gastrointestinal tract is in the form of sympathetic, parasympathetic, enteric nervous system (ENS) and gastrointestinal reflexes. The ENS is to be referred as second brain, it uses serotonin to communicate with the central nervous system. This “brain gut axis’ helps us in understanding how psychological and social stress might cause digestive problems. ENS is closely related to central nervous system (CNS). As mentioned, blindness (‘andhya’) is one of the udavarta janya vikara (diseases caused by udavarta) which is difficult to understand how eyes are related to apana vayu (one of the five subtypes of vata situated in the pelvic region). In an article named ‘Gut microbes linked to eye diseases’ observations have been made by the researchers regarding the possible connection between the gut microbes and the eye diseases. Apana vayu (one of the five subtypes of vata situated in the pelvic region) is mostly parasympathetic in action and its action is related to urine (mutra), stool (purisha), flatus (adhovata) and seminal discharge (shukra vega). Obstruction in passing flatus (apana vayu rodha) invariably affects the prana vayu (one type of the five subtypes of vata situated in upward body or head) among and other vital points in body (marma sthana) like herat (hrudya), brain (shiras), and urinary bladder (basti).&lt;/p&gt;<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;3) Nidra vegadharana (suppression of sleep) leads to vitiation of vata dosha. Vata controls the functions of mind (mana). Stress is mainly due to mental and physical stimuli which cause disturbances in the internal biological equilibrium. Disturbed and interrupted sleep is very common in the IT professionals due to their work culture. Here, nidra vegadharana (suppression of urge of sleep) acts as a stress stimulus which causes impairment in both sharirika (biological elements vata, pitta and kapha) and manasika (psychological constitution like raja and tama) dosha which causes further loss of sleep (nidranasha). Udavarta affects mind and leads to abnormalities in mental functions similar to mental stress. Hence it is important to avoid nidra vegadharana (suppression of urge of sleep) to prevent further kriyakala i.e., stage of progression of disease leading to stress and other mental disorders. &lt;/p&gt;<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;4) In this study total 74 patients have been enrolled which were divided in two groups randomly. The selected drug for clinical trial in group A was Yavanikadi vati (tablet) which contains haritaki (Terminalia chebula), yavani (Trachyspermum ammi), hingu (Ferula foetida), sauvarchala (black salt), yavakshara (alkali prepared from barley) and saindhava (rock salt). The powder of these raw drugs was given 3 times trituration (bhavana) of these raw drugs was given 3 times trituration (bhavana) of lemon juice (nimbu swarasa) to prepare tablet. In group B, Shankha vati (tablet) was taken for control group, which contains purified mercury (shuddha parada) and purified sulphur (shuddha gandhaka). In the group A 31 patients were given Yavanikadi vati in tablet form 1 gm B.D. in two divided doses (1 tablet = 500 mg.) daily, after food for 28 days with water whereas, in Group B total 30 patients were given Shankha Vati. The dose, duration, time of administration and anupana (co-administers with medicine) is same as group A. Comparison of the therapies showed that overall better results as observed in group A as compared to group B which stands closely parallel to group A. &lt;/p&gt;</div>

Manishdubey https://www.carakasamhitaonline.com/index.php?title=Talk:Udavarta&diff=44310 2023-11-03T11:00:06Z

<p>Manishdubey: /* Researches */</p> <hr /> <div>{{CiteButton}}<br /> {{#seo:<br /> |title= UDAKAVAHA SROTAS (Channels for transport and transformation of watery components)<br /> |titlemode=append<br /> |keywords=Udakavaha Srotas, Water metabolism, Bhojani M. K., Tanwar Ankur Kumar, Basisht G, Deole Y.S.<br /> |description=Udaka means water. In body, water is present in the form of various fluids. Udakavaha srotasa are the channels for transport and transformation of fluid (water) and its circulation. <br /> |image=http://www.carakasamhitaonline.com/mediawiki-1.32.1/resources/assets/ogimgs.jpg<br /> |image_alt=carak samhita<br /> |type=article<br /> }}<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Udavarta literally means the upward and repeated movements of vata. It is one of the important and commonly observed condition in clinical practice. It manifests with a number of clinical features which may lead to manifestation of other secondary diseases further. Udavarta is mentioned as one among the eighty diseases occurred primarily by the vitiated vata dosha (nanatmaja vata vyadhi). [Cha. Sa. Sutra Sthana 20/11] Udavarta (upward movement of vata) is very common now a days due to change in lifestyle of modern society. The change in dietary habits and due to hectic job schedule, suppression of natural urges (vegadharana) is also very common now a days. The two main cause of udavarta explained in classical texts are: suppression of natural urges (vegadharana) and faulty dietary habits (asatmya ahara sevana). Sushrut Samhita describes that suppression of natural urges (adharaniya vega) leads to manifestation of thirteen types of udavarta. Due to aggravating factors, vata dosha is aggravated, especially apana vata (one of the five subtypes of vata i.e., situated in the pelvic region) is affected. Generally, udavarta means upward movement of vata or apana vata, that results in retention of faeces, urine and flatus. However, the scope of udavarta extends to disturbance in normal functions of vata due to obstruction by metabolic wastes. This unique concept is not explained in any other contemporary sciences. So, understanding this concept and to provide better treatment for this disease is need of the society.&lt;/p&gt;<br /> <br /> {{Infobox<br /> |title = Contributors<br /> |label1 = Section/Chapter/topic<br /> |data1 = Concepts &amp; Practices/[[Udavarta]] <br /> |label2 = Authors<br /> |data2 = Dubey M.&lt;sup&gt;1&lt;/sup&gt;,&lt;br/&gt;Deole Y.S.&lt;sup&gt;2&lt;/sup&gt;<br /> |label3 = Reviewer <br /> |data3 = Basisht G.&lt;sup&gt;3&lt;/sup&gt;, <br /> |label4 = Editor<br /> |data4 = Basisht G.&lt;sup&gt;3&lt;/sup&gt;<br /> |label5 = Affiliations<br /> |data5 = &lt;sup&gt;1&lt;/sup&gt;[[Charak Samhita Research, Training and Development Centre]], I.T.R.A., Jamnagar, India &lt;br/&gt;&lt;sup&gt;2&lt;/sup&gt;Department of Kayachikitsa, G. J. Patel Institute of Ayurvedic Studies and Research, New Vallabh Vidyanagar, Gujarat, India&lt;br/&gt;&lt;sup&gt;3&lt;/sup&gt;Rheumatologist, Orlando, Florida, U.S.A.<br /> |label6 = Correspondence emails<br /> |data6 = dr.manish181@gmail.com, dryogeshdeole@gmail.com<br /> carakasamhita@gmail.com<br /> |label7 = Publisher <br /> |data7 = [[Charak Samhita Research, Training and Development Centre]], I.T.R.A., Jamnagar, India<br /> |label8 = Date of publication:<br /> |data8 =November 03, 2023<br /> |label9 = DOI<br /> |data9 = {{DoiWithLink}}<br /> }}<br /> <br /> ===Nirukti (etymology)===<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;The term udavarta is derived from Utt + Aavat i.e., “Ut + Ang + Vrut + Dhaya” to form word Udavarta. [ ] Udavarta is a Sanskrit word derived from 'Ut' verb root (dhatu) with 'Ang' and 'Vrut' preposition (upasarga), suffixed by ‘Dhaya’ pratyaya (suffix). “Ut” means upper side, (Urdhva) “Ang” means entirely and “Vrut” means to move (bhramana). Udavarta means upwards movement, to cause to go out, excrete, to secrete and to retain. Udavarta is a class of diseases marked by retention of the feces i.e., disease of the bowel so, in general urdhwa (upward direction) or pratiloma (moving in abnormal direction) movement of apana vata (one of the five subtypes of vata, situated in the pelvic region) is termed as udavarta.&lt;/p&gt;<br /> <br /> ===Definition===<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;‘Udavarta’ is that disease in which there is whirlpool movement (avartana) and upward movement (urdhva gamana) of vata is seen due to retention of vata, urine (mutra) and stool (purisha). The condition in which vata begins to move upwards is called as ‘udavarta’ and in this disease vata is the predominant dosha. &lt;/p&gt;<br /> <br /> ===Etiopathogenesis===<br /> *Intake of deficient quantity of food causes udavarta. [Cha. Sa. Vimana Sthana 2/7] <br /> *Intake of astringent, bitter, pungent and un-unctuous (dry) food and excessive fasting<br /> *Withholding natural urges (vegadharana) <br /> *Excessive indulgence in sexual activity. [Cha. Sa. Chikitsa Sthana 26/5-6] <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Due to all above reasons the apana vata which resides in large intestine (pakvashaya) gets aggravated and further obstructs the downward movement of vata causing retention of movement of stool, urine and flatus. This leads to a dreadful disease named as udavarta. [Ca. Sa. Chikitsa Sthana 26/5-6]&lt;/p&gt; <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Acharya Sushruta explained suppression of 13 urges leading to udavarta. [Su. Sa. Uttara Sthana 55/ 3-4] Thus, udavarta is caused by 2 main causes, one is suppression of natural urges and other one unwholesome eating. [Su. Sa. Uttara Sthana 55/ 6] Excess consumption of mudga (Phaseolus mungo), kodrava (Paspalum scrobiculatum Linn.), jurnahva (Sorghum vulgare/jowar), karira (Capparis decidua), chanaka (Cicer arietinum L.), etc. i.e., foods with property of dryness and causing constipation vitiate normal status of vata dosha in its own seat (large intestine). This vata becomes powerful and blocks the downward channels and produces severe obstruction in the movement of feces, flatus and urine leading to udavarta. [A. H. Nidana Sthana 7/46-52]&lt;/p&gt;<br /> <br /> ===Clinical features=== <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Frequent pain in the region of urinary bladder (basti), heart (hridaya), abdomen (udara) and excruciating or intense pain in the back of chest. Other symptoms are flatulence (adhmana), nausea (hrillasa), gripping type of pain in anus (vikartika), pricking (toda) type of pain in whole body, indigestion and inflammation of urinary bladder. Obstruction in passing stool less frequently and with difficulty and in less quantity, after long time and effort. Upward movement of flatus occurs because of obstruction in channels (srotasa), increased roughness, dryness and coldness in the body. [Cha. Sa. Chikitsa Sthana 26/6-7]&lt;/p&gt;<br /> <br /> ===Udavarta janya vikara===<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;If not treated early, udavarta leads to other secondary complications as follows:&lt;/p&gt;<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Fever (jwara), dysuria (mutrakricchhra), dysentery (pravahika), heart disease (hridroga), diseases due to malfunctioning of duodenum (grihani dosha), vomiting (chhardi), blindness, deafness, burning sensation in the head, affliction of abdomen by vata (vatodara), tumors (asthila), psychological diseases (mano vikara), disorders of excessive thirst (trishna roga), an ailment characterized by bleeding from different parts of the body (raktapitta), aruchi (anorexia), phantom tumor (gulma), cough (kasa), dyspnoea (shwasa), chronic rhinitis (pratishyaya), facial paralysis (ardita), diseases of the flanks including lower respiratory tract disorders (parshva roga) and such other serious diseases caused by aggravation of vata. [Cha. Sa. Chikitsa Sthana 26/8-9]&lt;/p&gt;<br /> <br /> ===Udavarta as a causative factor (nidana) of other diseases===<br /> *&lt;p style=&quot;text-align:justify;&quot;&gt;Udavarta is the etiological factor of abdominal swelling caused by intestinal obstruction (baddhagudodara) [Cha. Sa. Chikitsa Sthana 13/39]<br /> *Udavarta is the cause for abdominal swelling afflicted by spleen (plihodara). [Cha. Sa. Chikitsa Sthana 13/75]<br /> *Udavarta is the cause for respiratory diseases including bronchial asthma (pratamaka shwasa-type of tamaka shwasa) characterized by fever, syncope and other such symptoms which are relieved by cold measures. [Cha. Sa. Chikitsa Sthana 17/63]<br /> *Udavarta caused by suppression of the urge of urination is causative factor of condition where severe painful distension of abdomen below umbilicus is present along with obstruction of downward movement of urine (mutrajathara- a type of mutraghata i.e., retention of urine). [Su. Sa. Uttara Sthana 58/13]<br /> *Vidvighata (type of mutraghata i.e., retention of urine): In debilitated person due to loss of fat, udavarta brings small amount of feces into the channels of urine (bladder and urethra) resulting in patients voiding of urine having odour of feces is termed as vidvighata. [A. H. Nidana Sthana 9/33-34]<br /> *Hemorrhoids (arsha): Udavarta is the chief complication in hemorrhoids (durnama/arsha). This udavarta may occur in person who has predominance of vata dosha in alimentary tract (koshtha) even without piles. <br /> *Vatodara: Udavarta is one of the causative factors of abdominal swelling afflicted by vata dosha (vatodara). [Cha. Sa. Chikitsa Sthana 13/23]<br /> *Hiccups (hikka) &amp; dyspnoea (shwasa): Udavarta is the one of the etiological factors for causation of conditions such as hiccups (hikka) and dyspnoea (shwasa).&lt;/p&gt;<br /> <br /> ===Udavarta as symptoms (lakshana) in following diseases===<br /> <br /> #Vataja plihodara (vata predominant plihodara i.e., abdominal swelling afflicted by splenomegaly) [Cha. Sa. Chikitsa Sthana 13/38]<br /> #Vatodara (abdominal swelling afflicted by vata dosha) [Cha. Sa. Chikitsa Sthana 13/25]<br /> #Vataja gulma (vata predominant gulma/ phantom tumor) [Cha. Sa. Chikitsa Sthana 5/10]<br /> #Sahaja arsha (congenital hemorrhoids) [Cha. Sa. Chikitsa Sthana 14/8]<br /> #Vataja arsha (vata predominant hemorrhoids) [Cha. Sa. Chikitsa Sthana 14/11]<br /> #Vyana avruta apana (type of avarana (occlusion) where vyana vata obstructs the flow of apana vata) [Cha. Sa. Chikitsa Sthana 28/211]<br /> #Basti marma viddha (injury to bladder) [Cha. Sa. Siddhi Sthana 9/6]<br /> <br /> ===Types of Udavarta===<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Udavarta is of 6 types which occur by suppression of natural urges viz., apana vata nirodhaja (suppression of flatus), mutra vega nirodhaja (suppression of urine), purisha vega nirodhaja (suppression of faeces), shukra vega nirodhaja (suppression of ejaculation of semen), chhardi vega nirodhaja (suppression of vomiting) and kshavathu vega nirodhaja (suppression of sneezing). [Cha. Sa. Sutra Sthana 18/3]&lt;/p&gt;<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;As per Sushruta Samhita, there are 13 types of suppression of natural urges (vegadharana) namely flatus, faeces, urine, yawning, flow of tears, sneezing, eructation, vomiting, ejaculation of semen, hunger, thirst, breath and sleep. [Su. Sa. Uttara Sthana 55/ 3-4] Suppression of these vega (urges) gives rise to their respective type of udavarta and manifest their respective symptoms which are as follows;&lt;/p&gt;<br /> <br /> ===Asadhyata [incurable stage of diseases]===<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Udavarta with symptoms of excessive thirst, excessively depressed, emaciated, suffering from pain and vomiting of fecal matter is difficult to manage or incurable.[Su. Sa. Uttara Sthana 55/ 17-18] &lt;/p&gt;<br /> <br /> ===Treatment===<br /> &lt;p style=&quot;text-align:justify;&quot;&gt; Treatment principles for udavarta i.e., palliative therapy (shamana) or purification (shodhana) etc., can be selected based on stages of the disease and as well as on the condition of the patient. The treatment guidelines explained in Charaka Samhita are as follows: [Cha. Sa. Chikitsa Sthana 26/11]&lt;/p&gt;<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;The patient suffering from udavarta should be given massage with hot oil described for the treatment of fever presented with cold extremities (sheeta jwara). Then fomentation therapy should be administered for the detachment of the adhered dosha in the tissue cells. This should be followed by the administration of suppository (varti), un-unctuous enema (niruha basti) and unctuous type of purgative (snigdha virechana). The patient should be given food which helps in the normal downward movement (anulomana) of apana vata.&lt;/p&gt;<br /> <br /> '''A) Unction therapy (snehana):''' &lt;p style=&quot;text-align:justify;&quot;&gt;Udavarta is produced due to aggravation of vata and sneha (lipids) is the best treatment for pacification of vata vata (shamana). Therefore, unction therapy (snehana) is indicated in udavarta. &lt;/p&gt;<br /> '''B) Fomentation therapy (swedana):''' &lt;p style=&quot;text-align:justify;&quot;&gt;After massage with oil, fomentation therapy should be administered for the detachment of the adhered dosha in the tissue cells.&lt;/p&gt;<br /> '''C) Suppository (varti):''' &lt;p style=&quot;text-align:justify;&quot;&gt;A suppository having the thickness of the thumb is to be prepared with drugs like Shyama Trivrita (Operculina turpethum), Vidanga (Embeila ribes), Kampillaka (Mallotus philippensis) etc., which should be triturated with gomutra (cow’s urine) or arka (Calotropis gigantea) latex (kshira) and made in to form of suppository (phala varti) by adding jaggery. This suppository should be inserted through anus for the downward movement of apana vata to relieve retention of stool, flatus and urine caused by udavarta.&lt;/p&gt;<br /> '''D) Palliative therapy (shamana):''' &lt;p style=&quot;text-align:justify;&quot;&gt;Shamana includes administration of internal medication such as dviruttara- hingvadi churna, hinguvachadi churna given with warm water as an anupana (co-administers with medicine) for correcting the upward movement of vata.&lt;/p&gt;<br /> '''E) Purification therapy (shodhana):'''&lt;p style=&quot;text-align:justify;&quot;&gt;When the disease is chronic and relief is not observed even by adopting above measures, then purification (shodhana) by non-unctuous enema (niruha basti) or purgation (virechana) is advised.&lt;/p&gt;<br /> '''F) Pathya ahara kalpana (wholesome diet):'''&lt;p style=&quot;text-align:justify;&quot;&gt;Intake of wholesome diet (pathya ahara) which helps in normal downward movement (anulomana) of apana vata whereas, intake of unwholesome diet (apathya ahara) should be avoided for better recovery. Generally, in all types of udavarta all measures for controlling vata should be adopted in order to restore it to its normal channels (srotasa). [Su. Sa. Uttara Sthana 55/ 19]&lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Complications of udavarta, flatulence (adhmana) and other diseases should be managed with respective measures according to condition. [Su. Sa. Uttara Sthana 55/34-35] For example when vayu in abdomen (koshtha) is aggravated by rough, pungent, bitter and astringent food, it immediately produces udavarta owing to which the channels (srotasa) carrying flatus, feces, urine, blood, kapha and adipose tissue (medas), move in upward direction and harden the feces too much. This results in manifestation of symptoms such as pain in cardiac and pelvic region, heaviness, anorexia, passing of urine, flatus and feces with difficulty. The person gets afflicted with many other disorders caused by aggravation of vata such as dyspnoea, (shwasa), cough (kasa), hiccoup (hikka), thirst (trishna), coryza (pratishyaya), burning sensation (daha), mental confusion (moha), vomiting (chhardi), fever (jwara), diseases of head and abnormalities of mind and ears. [Su. Sa. Uttara Sthana 55/2] &lt;/p&gt;<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;One should advise non-unctuous enema (niruha basti) after the patient is massaged with oil mixed with salt and sudation; then after feces are eliminated, he should be advised to take food followed by administration of unctuous enema (anuvasana basti) according to the dosha involvement. If by above procedures, still no relief found then in severe cases of udavarta, patient is advised to undergo repeated unction therapy (snehana) and fomentation therapy (swedana) and then undergo unctuous purgation (snigdha virechana). [Su. Sa. Uttara Sthana 55/40-41]&lt;/p&gt;<br /> <br /> ===Different treatments of udavarta===<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;1) Saturating drink (mantha) prepared with sugarcane product (phanita), roasted grain flour (saktu), ghee, curd water and vinegar (amla kanji) alleviate udavarta. [Cha. Sa. Sutra Sthana 23/37]&lt;/p&gt;<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;2) 96 gm (2 pala) of dehusked tila (Sesamum indicum Linn.), 48 gm (1 pala) of jaggery and 24 gm (half pala) of nagara (Zingiber officinale) should be made into a paste and taken along with hot milk helps in udavarta. [Cha. Sa. Chikitsa Sthana 5/91-92] &lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;3) Milk cooked with Allum sativum (Lashuna kshirapaka): Garlic cooked with milk by adding water and reducing to the quantity of milk, cures udavarta immediately [Cha. Sa. Chikitsa Sthana 5/94] &lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;4) Alkali prepared from pippali (Piper longum) and other ingredients (Pippalyadi kshara) used in udavarta [Cha. Sa. Chikitsa Sthana 13/159-161] &lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;5) Medicine prepared by boiling medicinal herbs in water and then kept for fermentation with drugs such as haritaki (Terminalia chebula), amalaki (Emblica officinalis), etc. (Phalarishta) used in udavarta. [Cha. Sa. Chikitsa Sthana 14/148-152] &lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;6) Trivrut (Operculina turpethum), pilu (Salvadora persica), yavani (Trachyspermum ammi) with sour gruel mixed with digestants (pachana) drugs. [Su. Sa. Uttara Sthana 55/42-43] &lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt; 7) The combination of hingu (Ferula foetida), kushtha (Saussurea lappa), vacha (Acorus calamus Linn.), svarjika (alkali prepared by burning Lona plant), and vidanga (Embelia ribes) – successively in double quantity cures udavarta and colicky pain by vata dosha (vataja shoola) [Su. Sa. Uttara Sthana 55/42-43]&lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;8) Intake of ghee cooked with decoction of dried radish (Raphanus sativus), sunthi (Zingiber officinale), punarnava (Boerhavia diffusa), brihata panchamula (combination of five herbs viz., bilva, patala, agnimantha, shyonaka and gambhari), and fruits of aragvadha (Cassia fistula) subsides severe udavarta completely. [Su. Sa. Uttara Sthana 55/45-46] &lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;9) Vacha (Acorus calamus Linn.), ativisha (Aconitum heterophyllum), kushtha (Saussurea lappa), yavakshara (alkali prepared from barley), haritaki (Terminalia chebula Retz.), pippali (Piper longum) and agnimantha (Clerodendrum phlomidis) with hot water cures udavarta. [Su. Sa. Uttara Sthana 55/47] &lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;10) Devadaru (Cedrus deodara), chitraka (Plumbago zeylanica), triphala (combination of 3 herbs viz., haritaki, bibhitaki and amalaki), brihati (Solanum indicum) should be taken along with cow’s urine. [Su. Sa. Uttara Sthana 55/49]&lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;11) Suppository: Powder of danti (Baliospermum montanum), kampillaka (Mallotus philippensis), shyama trivrita (Operculina turpethum), ikshvaku (Lagenaria vulgaris Ser.), ajamoda (Apium graveolens), kritavedhana (Luffa acutangula Linn Roxb.), pippali (Piper longum) and salts should cook in cow’s urine and made into suppositories to be inserted in the anus. This provides instant relief in the symptoms of udavarta. [Su. Sa. Uttara Sthana 55/51-52] &lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt; 12) Guggulu (Commiphora mukul) should be taken with decoction of triphala (combination of 3 herbs viz., haritaki, bibhitaki and amalaki), daruharidra (Berberis aristata), patola (Trichosanthes dioica) and kusa (Desmostachya bipinnata) or with urine or hot water for 1 month alleviates udavarta. [Su. Sa. Chikitsa Sthana 5/39-44]&lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;13) Kalyanaka kshara consumed with ghee cures udavarta and constipation (vibandha) [A. H. Chikitsa Sthana 8/142] &lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;14) Erandamooladi enema (basti) helps in alleviating obstruction of faeces, urine and flatus [Ch. Sa. Siddhi Sthana 3/38-42] &lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt; 15) Palashadi niruha basti alleviates non- passage of flatus and feces (anaha) and udavarta [Ch. Sa. Siddhi Sthana 3/44-45]&lt;/p&gt;<br /> <br /> === Treatment as per different conditions===<br /> *In hemorrhoids (arsha), if symptoms of udavarta is present then unctuous enema (anuvasana basti) should be administered. [Cha. Sa. Chikitsa Sthana 14/130]<br /> *In complications by enema (basti vyapat) when unctuous enema gets obstructed by feces then treatment alleviating udavarta should be adopted. [Cha. Sa. Siddhi Sthana 4/36-37]<br /> *In emesis (vamana) and purgation (virechana) complications (vyapta), in extremely vitiated condition of doshas (bahudosha avastha) low dose of medicine is administered, then it causes udavarta, tympanitis (adhmana) in such condition treatment of udavarta is massage (abhyanga), sudation, suppository, non-unctuous enema (niruha basti) and other measures of udavarta should be adopted [Cha. Sa. Siddhi Sthana 6/58-60]<br /> *In pain caused by obstruction of feces (vitshula) the measures mentioned for udavarta should be used in the treatment. [Su. Sa. Uttara Sthana 42/140] <br /> *In treatment of rakta gulma (a variety of phantom tumor) the measures which cures udavarta should be adopted. [A. H. Chikitsa Sthana 14/129]<br /> *Measures which cure udavarta (udavarta hara kriya) should be adopted in abdominal swelling caused by intestinal obstruction (baddhodara). [A. H. Chikitsa Sthana 15/100]<br /> *In emesis (vamana) from improper therapy (mithya yoga), therapies of udavarta should be adopted. [A. H. Kalpasiddhi Sthana 3/13]<br /> *In complications from enema (basti vyapat) the treatment of udavarta should be adopted if fat (sneha) of enema (basti) gets obstructed or enveloped by feces. [A. H. Kalpa-siddhi Sthana 5/39]<br /> <br /> ===Measures alleviating udavarta (udavarta hara)===<br /> <br /> *Mrudvika (Vitis vinifera/grapes) alleviates udavarta [Cha. Sa. Sutra Sthana 27/125-126]<br /> *Haritaki (Terminalia chebula Retz.) used in udavarta [Cha. Sa. Chikitsa Sthana 1/1/31]<br /> *Dish prepared with barley (yavapupa), supernatant liquid proportion of barley preparation (yavaka) and bhristha yava odana/ parched cooked barley (vatya) made from yava (barley) helps in alleviation of udavarta. [Cha. Sa. Sutra Sthana 27/265]<br /> *Saturating drink (mantha) prepared by churning parched grain flour (saktu) with sour taste (amla rasa), fat and jaggery alleviates udavarta. [Su. Sa. Sutra Sthana 46/386]<br /> *Vatya (made by roasted wheat or barley) helps in alleviating udavarta. [Su. Sa. Sutra Sthana 46/410]<br /> *Garlic cooked with milk (lashuna kshirapaka) alleviates udavarta. [A. H. Chikitsa Sthana 14/46]<br /> <br /> ===Diet for udavarta===<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Intake of vegetable preparations prepared from the leaves of trivruta (Operculina turpethum) and snuhi (Euphorbia neriifolia Linn.), tila (Sesamum indicum) and its different preparations, soup of meat of animals inhabiting in marshy land, domestic and aquatic animals, clear top portion of alcohol (prasanna) and molasses rum (sidhu), wine prepared of jaggery, preparations which facilitates motion of flatus, urine and stool. [Cha. Sa. Chikitsa Sthana 26/18] One should never withhold the natural urges of the body. [Su. Sa. Uttara Sthana 55/3]&lt;/p&gt;<br /> <br /> ===Researches===<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;1) A review on diseases manifested due to withholding natural urges (vegadharana janya vikara) focused to identify the effects of suppression of natural urges (adharaneeya vegas) on various system of body such as CVS, gastrointestinal tract, respiratory system urinary system and reproductive system. CVS and gastrointestinal systems are the mostly affected systems. Out of thirteen urges (vegas), seven play major role in both systems. Common clinical features produced by suppression of natural urges (vegadharana) were weakness of the body, constipation, anorexia, headache, diseases of eye, difficulty in micturition, bending of the body and stiffness of the neck. Weakness of the body and anorexia are the commonest clinical features produced by suppression of natural urges. These clinical features arise due to vitiation of vata by vegadharana. Withholding (dharana) of natural urges is strictly prohibited to stay healthy.&lt;/P&gt;<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;2) A physiological study of adharaneeya vega (suppression of natural urges) w.s.r. to apana vayu vega (suppression of apana vata or flatus)&lt;/p&gt;<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Understanding the physiology of suppression of natural urges (vegarodhajanya) symptoms and analyzing them as a pathology of various diseases related to apana vayu (one of the five subtypes of vata situated in the pelvic region). As, seen in clinical practice many a times diseases reoccur after giving proper treatment. Also, in such case causative factors (nidana) of vitiation of apana vayu (one of the five subtypes of vata situated in the pelvic region) is to be analyzed properly for better result. Among the fourteen adharaneeya vega (suppression of natural urges), apana vayu (one of the five subtypes of vata situated in the pelvic region) vega (urge) is most commonly suppressed which leads to vitiation of vata dosha in the pelvic region). Adharaneeya vega (suppression of natural urges) is a reflex mechanism and it is a nervous activity. Nerve supply to gastrointestinal tract is in the form of sympathetic, parasympathetic, enteric nervous system (ENS) and gastrointestinal reflexes. The ENS is to be referred as second brain, it uses serotonin to communicate with the central nervous system. This “brain gut axis’ helps us in understanding how psychological and social stress might cause digestive problems. ENS is closely related to central nervous system (CNS). As mentioned, blindness (‘andhya’) is one of the udavarta janya vikara (diseases caused by udavarta) which is difficult to understand how eyes are related to apana vayu (one of the five subtypes of vata situated in the pelvic region). In an article named ‘Gut microbes linked to eye diseases’ observations have been made by the researchers regarding the possible connection between the gut microbes and the eye diseases. Apana vayu (one of the five subtypes of vata situated in the pelvic region) is mostly parasympathetic in action and its action is related to urine (mutra), stool (purisha), flatus (adhovata) and seminal discharge (shukra vega). Obstruction in passing flatus (apana vayu rodha) invariably affects the prana vayu (one type of the five subtypes of vata situated in upward body or head) among and other vital points in body (marma sthana) like herat (hrudya), brain (shiras), and urinary bladder (basti).&lt;/p&gt;<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;3) Nidra vegadharana (suppression of sleep) leads to vitiation of vata dosha. Vata controls the functions of mind (mana). Stress is mainly due to mental and physical stimuli which cause disturbances in the internal biological equilibrium. Disturbed and interrupted sleep is very common in the IT professionals due to their work culture. Here, nidra vegadharana (suppression of urge of sleep) acts as a stress stimulus which causes impairment in both sharirika (biological elements vata, pitta and kapha) and manasika (psychological constitution like raja and tama) dosha which causes further loss of sleep (nidranasha). Udavarta affects mind and leads to abnormalities in mental functions similar to mental stress. Hence it is important to avoid nidra vegadharana (suppression of urge of sleep) to prevent further kriyakala i.e., stage of progression of disease leading to stress and other mental disorders. &lt;/p&gt;<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;4) In this study total 74 patients have been enrolled which were divided in two groups randomly. The selected drug for clinical trial in group A was Yavanikadi vati (tablet) which contains haritaki (Terminalia chebula), yavani (Trachyspermum ammi), hingu (Ferula foetida), sauvarchala (black salt), yavakshara (alkali prepared from barley) and saindhava (rock salt). The powder of these raw drugs was given 3 times trituration (bhavana) of these raw drugs was given 3 times trituration (bhavana) of lemon juice (nimbu swarasa) to prepare tablet. In group B, Shankha vati (tablet) was taken for control group, which contains purified mercury (shuddha parada) and purified sulphur (shuddha gandhaka). In the group A 31 patients were given Yavanikadi vati in tablet form 1 gm B.D. in two divided doses (1 tablet = 500 mg.) daily, after food for 28 days with water whereas, in Group B total 30 patients were given Shankha Vati. The dose, duration, time of administration and anupana (co-administers with medicine) is same as group A. Comparison of the therapies showed that overall better results as observed in group A as compared to group B which stands closely parallel to group A. &lt;/p&gt;<br /> <br /> ===Thesis on udavarta===<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;In this study total 74 patients have been enrolled which were divided in two groups randomly. The selected drug for clinical trial in group A was Yavanikadi vati (tablet) which contains haritaki (Terminalia chebula), yavani (Trachyspermum ammi), hingu (Ferula foetida), sauvarchala (black salt), yavakshara (alkali prepared from barley) and saindhava (rock salt). The powder of these raw drugs was given 3 times trituration (bhavana) of these raw drugs was given 3 times trituration (bhavana) of lemon juice (nimbu swarasa) to prepare tablet. In group B, Shankha vati (tablet) was taken for control group, which contains purified mercury (shuddha parada) and purified sulphur (shuddha gandhaka). In the group A 31 patients were given Yavanikadi vati in tablet form 1 gm B.D. in two divided doses (1 tablet = 500 mg.) daily, after food for 28 days with water whereas, in Group B total 30 patients were given Shankha Vati. The dose, duration, time of administration and anupana (co-administers with medicine) is same as group A. Comparison of the therapies showed that overall better results as observed in group A as compared to group B which stands closely parallel to group A. &lt;/p&gt;</div>

Manishdubey https://www.carakasamhitaonline.com/index.php?title=Talk:Udavarta&diff=44309 2023-11-03T10:53:55Z

<p>Manishdubey: /* Researches */</p> <hr /> <div>{{CiteButton}}<br /> {{#seo:<br /> |title= UDAKAVAHA SROTAS (Channels for transport and transformation of watery components)<br /> |titlemode=append<br /> |keywords=Udakavaha Srotas, Water metabolism, Bhojani M. K., Tanwar Ankur Kumar, Basisht G, Deole Y.S.<br /> |description=Udaka means water. In body, water is present in the form of various fluids. Udakavaha srotasa are the channels for transport and transformation of fluid (water) and its circulation. <br /> |image=http://www.carakasamhitaonline.com/mediawiki-1.32.1/resources/assets/ogimgs.jpg<br /> |image_alt=carak samhita<br /> |type=article<br /> }}<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Udavarta literally means the upward and repeated movements of vata. It is one of the important and commonly observed condition in clinical practice. It manifests with a number of clinical features which may lead to manifestation of other secondary diseases further. Udavarta is mentioned as one among the eighty diseases occurred primarily by the vitiated vata dosha (nanatmaja vata vyadhi). [Cha. Sa. Sutra Sthana 20/11] Udavarta (upward movement of vata) is very common now a days due to change in lifestyle of modern society. The change in dietary habits and due to hectic job schedule, suppression of natural urges (vegadharana) is also very common now a days. The two main cause of udavarta explained in classical texts are: suppression of natural urges (vegadharana) and faulty dietary habits (asatmya ahara sevana). Sushrut Samhita describes that suppression of natural urges (adharaniya vega) leads to manifestation of thirteen types of udavarta. Due to aggravating factors, vata dosha is aggravated, especially apana vata (one of the five subtypes of vata i.e., situated in the pelvic region) is affected. Generally, udavarta means upward movement of vata or apana vata, that results in retention of faeces, urine and flatus. However, the scope of udavarta extends to disturbance in normal functions of vata due to obstruction by metabolic wastes. This unique concept is not explained in any other contemporary sciences. So, understanding this concept and to provide better treatment for this disease is need of the society.&lt;/p&gt;<br /> <br /> {{Infobox<br /> |title = Contributors<br /> |label1 = Section/Chapter/topic<br /> |data1 = Concepts &amp; Practices/[[Udavarta]] <br /> |label2 = Authors<br /> |data2 = Dubey M.&lt;sup&gt;1&lt;/sup&gt;,&lt;br/&gt;Deole Y.S.&lt;sup&gt;2&lt;/sup&gt;<br /> |label3 = Reviewer <br /> |data3 = Basisht G.&lt;sup&gt;3&lt;/sup&gt;, <br /> |label4 = Editor<br /> |data4 = Basisht G.&lt;sup&gt;3&lt;/sup&gt;<br /> |label5 = Affiliations<br /> |data5 = &lt;sup&gt;1&lt;/sup&gt;[[Charak Samhita Research, Training and Development Centre]], I.T.R.A., Jamnagar, India &lt;br/&gt;&lt;sup&gt;2&lt;/sup&gt;Department of Kayachikitsa, G. J. Patel Institute of Ayurvedic Studies and Research, New Vallabh Vidyanagar, Gujarat, India&lt;br/&gt;&lt;sup&gt;3&lt;/sup&gt;Rheumatologist, Orlando, Florida, U.S.A.<br /> |label6 = Correspondence emails<br /> |data6 = dr.manish181@gmail.com, dryogeshdeole@gmail.com<br /> carakasamhita@gmail.com<br /> |label7 = Publisher <br /> |data7 = [[Charak Samhita Research, Training and Development Centre]], I.T.R.A., Jamnagar, India<br /> |label8 = Date of publication:<br /> |data8 =November 03, 2023<br /> |label9 = DOI<br /> |data9 = {{DoiWithLink}}<br /> }}<br /> <br /> ===Nirukti (etymology)===<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;The term udavarta is derived from Utt + Aavat i.e., “Ut + Ang + Vrut + Dhaya” to form word Udavarta. [ ] Udavarta is a Sanskrit word derived from 'Ut' verb root (dhatu) with 'Ang' and 'Vrut' preposition (upasarga), suffixed by ‘Dhaya’ pratyaya (suffix). “Ut” means upper side, (Urdhva) “Ang” means entirely and “Vrut” means to move (bhramana). Udavarta means upwards movement, to cause to go out, excrete, to secrete and to retain. Udavarta is a class of diseases marked by retention of the feces i.e., disease of the bowel so, in general urdhwa (upward direction) or pratiloma (moving in abnormal direction) movement of apana vata (one of the five subtypes of vata, situated in the pelvic region) is termed as udavarta.&lt;/p&gt;<br /> <br /> ===Definition===<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;‘Udavarta’ is that disease in which there is whirlpool movement (avartana) and upward movement (urdhva gamana) of vata is seen due to retention of vata, urine (mutra) and stool (purisha). The condition in which vata begins to move upwards is called as ‘udavarta’ and in this disease vata is the predominant dosha. &lt;/p&gt;<br /> <br /> ===Etiopathogenesis===<br /> *Intake of deficient quantity of food causes udavarta. [Cha. Sa. Vimana Sthana 2/7] <br /> *Intake of astringent, bitter, pungent and un-unctuous (dry) food and excessive fasting<br /> *Withholding natural urges (vegadharana) <br /> *Excessive indulgence in sexual activity. [Cha. Sa. Chikitsa Sthana 26/5-6] <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Due to all above reasons the apana vata which resides in large intestine (pakvashaya) gets aggravated and further obstructs the downward movement of vata causing retention of movement of stool, urine and flatus. This leads to a dreadful disease named as udavarta. [Ca. Sa. Chikitsa Sthana 26/5-6]&lt;/p&gt; <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Acharya Sushruta explained suppression of 13 urges leading to udavarta. [Su. Sa. Uttara Sthana 55/ 3-4] Thus, udavarta is caused by 2 main causes, one is suppression of natural urges and other one unwholesome eating. [Su. Sa. Uttara Sthana 55/ 6] Excess consumption of mudga (Phaseolus mungo), kodrava (Paspalum scrobiculatum Linn.), jurnahva (Sorghum vulgare/jowar), karira (Capparis decidua), chanaka (Cicer arietinum L.), etc. i.e., foods with property of dryness and causing constipation vitiate normal status of vata dosha in its own seat (large intestine). This vata becomes powerful and blocks the downward channels and produces severe obstruction in the movement of feces, flatus and urine leading to udavarta. [A. H. Nidana Sthana 7/46-52]&lt;/p&gt;<br /> <br /> ===Clinical features=== <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Frequent pain in the region of urinary bladder (basti), heart (hridaya), abdomen (udara) and excruciating or intense pain in the back of chest. Other symptoms are flatulence (adhmana), nausea (hrillasa), gripping type of pain in anus (vikartika), pricking (toda) type of pain in whole body, indigestion and inflammation of urinary bladder. Obstruction in passing stool less frequently and with difficulty and in less quantity, after long time and effort. Upward movement of flatus occurs because of obstruction in channels (srotasa), increased roughness, dryness and coldness in the body. [Cha. Sa. Chikitsa Sthana 26/6-7]&lt;/p&gt;<br /> <br /> ===Udavarta janya vikara===<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;If not treated early, udavarta leads to other secondary complications as follows:&lt;/p&gt;<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Fever (jwara), dysuria (mutrakricchhra), dysentery (pravahika), heart disease (hridroga), diseases due to malfunctioning of duodenum (grihani dosha), vomiting (chhardi), blindness, deafness, burning sensation in the head, affliction of abdomen by vata (vatodara), tumors (asthila), psychological diseases (mano vikara), disorders of excessive thirst (trishna roga), an ailment characterized by bleeding from different parts of the body (raktapitta), aruchi (anorexia), phantom tumor (gulma), cough (kasa), dyspnoea (shwasa), chronic rhinitis (pratishyaya), facial paralysis (ardita), diseases of the flanks including lower respiratory tract disorders (parshva roga) and such other serious diseases caused by aggravation of vata. [Cha. Sa. Chikitsa Sthana 26/8-9]&lt;/p&gt;<br /> <br /> ===Udavarta as a causative factor (nidana) of other diseases===<br /> *&lt;p style=&quot;text-align:justify;&quot;&gt;Udavarta is the etiological factor of abdominal swelling caused by intestinal obstruction (baddhagudodara) [Cha. Sa. Chikitsa Sthana 13/39]<br /> *Udavarta is the cause for abdominal swelling afflicted by spleen (plihodara). [Cha. Sa. Chikitsa Sthana 13/75]<br /> *Udavarta is the cause for respiratory diseases including bronchial asthma (pratamaka shwasa-type of tamaka shwasa) characterized by fever, syncope and other such symptoms which are relieved by cold measures. [Cha. Sa. Chikitsa Sthana 17/63]<br /> *Udavarta caused by suppression of the urge of urination is causative factor of condition where severe painful distension of abdomen below umbilicus is present along with obstruction of downward movement of urine (mutrajathara- a type of mutraghata i.e., retention of urine). [Su. Sa. Uttara Sthana 58/13]<br /> *Vidvighata (type of mutraghata i.e., retention of urine): In debilitated person due to loss of fat, udavarta brings small amount of feces into the channels of urine (bladder and urethra) resulting in patients voiding of urine having odour of feces is termed as vidvighata. [A. H. Nidana Sthana 9/33-34]<br /> *Hemorrhoids (arsha): Udavarta is the chief complication in hemorrhoids (durnama/arsha). This udavarta may occur in person who has predominance of vata dosha in alimentary tract (koshtha) even without piles. <br /> *Vatodara: Udavarta is one of the causative factors of abdominal swelling afflicted by vata dosha (vatodara). [Cha. Sa. Chikitsa Sthana 13/23]<br /> *Hiccups (hikka) &amp; dyspnoea (shwasa): Udavarta is the one of the etiological factors for causation of conditions such as hiccups (hikka) and dyspnoea (shwasa).&lt;/p&gt;<br /> <br /> ===Udavarta as symptoms (lakshana) in following diseases===<br /> <br /> #Vataja plihodara (vata predominant plihodara i.e., abdominal swelling afflicted by splenomegaly) [Cha. Sa. Chikitsa Sthana 13/38]<br /> #Vatodara (abdominal swelling afflicted by vata dosha) [Cha. Sa. Chikitsa Sthana 13/25]<br /> #Vataja gulma (vata predominant gulma/ phantom tumor) [Cha. Sa. Chikitsa Sthana 5/10]<br /> #Sahaja arsha (congenital hemorrhoids) [Cha. Sa. Chikitsa Sthana 14/8]<br /> #Vataja arsha (vata predominant hemorrhoids) [Cha. Sa. Chikitsa Sthana 14/11]<br /> #Vyana avruta apana (type of avarana (occlusion) where vyana vata obstructs the flow of apana vata) [Cha. Sa. Chikitsa Sthana 28/211]<br /> #Basti marma viddha (injury to bladder) [Cha. Sa. Siddhi Sthana 9/6]<br /> <br /> ===Types of Udavarta===<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Udavarta is of 6 types which occur by suppression of natural urges viz., apana vata nirodhaja (suppression of flatus), mutra vega nirodhaja (suppression of urine), purisha vega nirodhaja (suppression of faeces), shukra vega nirodhaja (suppression of ejaculation of semen), chhardi vega nirodhaja (suppression of vomiting) and kshavathu vega nirodhaja (suppression of sneezing). [Cha. Sa. Sutra Sthana 18/3]&lt;/p&gt;<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;As per Sushruta Samhita, there are 13 types of suppression of natural urges (vegadharana) namely flatus, faeces, urine, yawning, flow of tears, sneezing, eructation, vomiting, ejaculation of semen, hunger, thirst, breath and sleep. [Su. Sa. Uttara Sthana 55/ 3-4] Suppression of these vega (urges) gives rise to their respective type of udavarta and manifest their respective symptoms which are as follows;&lt;/p&gt;<br /> <br /> ===Asadhyata [incurable stage of diseases]===<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Udavarta with symptoms of excessive thirst, excessively depressed, emaciated, suffering from pain and vomiting of fecal matter is difficult to manage or incurable.[Su. Sa. Uttara Sthana 55/ 17-18] &lt;/p&gt;<br /> <br /> ===Treatment===<br /> &lt;p style=&quot;text-align:justify;&quot;&gt; Treatment principles for udavarta i.e., palliative therapy (shamana) or purification (shodhana) etc., can be selected based on stages of the disease and as well as on the condition of the patient. The treatment guidelines explained in Charaka Samhita are as follows: [Cha. Sa. Chikitsa Sthana 26/11]&lt;/p&gt;<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;The patient suffering from udavarta should be given massage with hot oil described for the treatment of fever presented with cold extremities (sheeta jwara). Then fomentation therapy should be administered for the detachment of the adhered dosha in the tissue cells. This should be followed by the administration of suppository (varti), un-unctuous enema (niruha basti) and unctuous type of purgative (snigdha virechana). The patient should be given food which helps in the normal downward movement (anulomana) of apana vata.&lt;/p&gt;<br /> <br /> '''A) Unction therapy (snehana):''' &lt;p style=&quot;text-align:justify;&quot;&gt;Udavarta is produced due to aggravation of vata and sneha (lipids) is the best treatment for pacification of vata vata (shamana). Therefore, unction therapy (snehana) is indicated in udavarta. &lt;/p&gt;<br /> '''B) Fomentation therapy (swedana):''' &lt;p style=&quot;text-align:justify;&quot;&gt;After massage with oil, fomentation therapy should be administered for the detachment of the adhered dosha in the tissue cells.&lt;/p&gt;<br /> '''C) Suppository (varti):''' &lt;p style=&quot;text-align:justify;&quot;&gt;A suppository having the thickness of the thumb is to be prepared with drugs like Shyama Trivrita (Operculina turpethum), Vidanga (Embeila ribes), Kampillaka (Mallotus philippensis) etc., which should be triturated with gomutra (cow’s urine) or arka (Calotropis gigantea) latex (kshira) and made in to form of suppository (phala varti) by adding jaggery. This suppository should be inserted through anus for the downward movement of apana vata to relieve retention of stool, flatus and urine caused by udavarta.&lt;/p&gt;<br /> '''D) Palliative therapy (shamana):''' &lt;p style=&quot;text-align:justify;&quot;&gt;Shamana includes administration of internal medication such as dviruttara- hingvadi churna, hinguvachadi churna given with warm water as an anupana (co-administers with medicine) for correcting the upward movement of vata.&lt;/p&gt;<br /> '''E) Purification therapy (shodhana):'''&lt;p style=&quot;text-align:justify;&quot;&gt;When the disease is chronic and relief is not observed even by adopting above measures, then purification (shodhana) by non-unctuous enema (niruha basti) or purgation (virechana) is advised.&lt;/p&gt;<br /> '''F) Pathya ahara kalpana (wholesome diet):'''&lt;p style=&quot;text-align:justify;&quot;&gt;Intake of wholesome diet (pathya ahara) which helps in normal downward movement (anulomana) of apana vata whereas, intake of unwholesome diet (apathya ahara) should be avoided for better recovery. Generally, in all types of udavarta all measures for controlling vata should be adopted in order to restore it to its normal channels (srotasa). [Su. Sa. Uttara Sthana 55/ 19]&lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Complications of udavarta, flatulence (adhmana) and other diseases should be managed with respective measures according to condition. [Su. Sa. Uttara Sthana 55/34-35] For example when vayu in abdomen (koshtha) is aggravated by rough, pungent, bitter and astringent food, it immediately produces udavarta owing to which the channels (srotasa) carrying flatus, feces, urine, blood, kapha and adipose tissue (medas), move in upward direction and harden the feces too much. This results in manifestation of symptoms such as pain in cardiac and pelvic region, heaviness, anorexia, passing of urine, flatus and feces with difficulty. The person gets afflicted with many other disorders caused by aggravation of vata such as dyspnoea, (shwasa), cough (kasa), hiccoup (hikka), thirst (trishna), coryza (pratishyaya), burning sensation (daha), mental confusion (moha), vomiting (chhardi), fever (jwara), diseases of head and abnormalities of mind and ears. [Su. Sa. Uttara Sthana 55/2] &lt;/p&gt;<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;One should advise non-unctuous enema (niruha basti) after the patient is massaged with oil mixed with salt and sudation; then after feces are eliminated, he should be advised to take food followed by administration of unctuous enema (anuvasana basti) according to the dosha involvement. If by above procedures, still no relief found then in severe cases of udavarta, patient is advised to undergo repeated unction therapy (snehana) and fomentation therapy (swedana) and then undergo unctuous purgation (snigdha virechana). [Su. Sa. Uttara Sthana 55/40-41]&lt;/p&gt;<br /> <br /> ===Different treatments of udavarta===<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;1) Saturating drink (mantha) prepared with sugarcane product (phanita), roasted grain flour (saktu), ghee, curd water and vinegar (amla kanji) alleviate udavarta. [Cha. Sa. Sutra Sthana 23/37]&lt;/p&gt;<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;2) 96 gm (2 pala) of dehusked tila (Sesamum indicum Linn.), 48 gm (1 pala) of jaggery and 24 gm (half pala) of nagara (Zingiber officinale) should be made into a paste and taken along with hot milk helps in udavarta. [Cha. Sa. Chikitsa Sthana 5/91-92] &lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;3) Milk cooked with Allum sativum (Lashuna kshirapaka): Garlic cooked with milk by adding water and reducing to the quantity of milk, cures udavarta immediately [Cha. Sa. Chikitsa Sthana 5/94] &lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;4) Alkali prepared from pippali (Piper longum) and other ingredients (Pippalyadi kshara) used in udavarta [Cha. Sa. Chikitsa Sthana 13/159-161] &lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;5) Medicine prepared by boiling medicinal herbs in water and then kept for fermentation with drugs such as haritaki (Terminalia chebula), amalaki (Emblica officinalis), etc. (Phalarishta) used in udavarta. [Cha. Sa. Chikitsa Sthana 14/148-152] &lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;6) Trivrut (Operculina turpethum), pilu (Salvadora persica), yavani (Trachyspermum ammi) with sour gruel mixed with digestants (pachana) drugs. [Su. Sa. Uttara Sthana 55/42-43] &lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt; 7) The combination of hingu (Ferula foetida), kushtha (Saussurea lappa), vacha (Acorus calamus Linn.), svarjika (alkali prepared by burning Lona plant), and vidanga (Embelia ribes) – successively in double quantity cures udavarta and colicky pain by vata dosha (vataja shoola) [Su. Sa. Uttara Sthana 55/42-43]&lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;8) Intake of ghee cooked with decoction of dried radish (Raphanus sativus), sunthi (Zingiber officinale), punarnava (Boerhavia diffusa), brihata panchamula (combination of five herbs viz., bilva, patala, agnimantha, shyonaka and gambhari), and fruits of aragvadha (Cassia fistula) subsides severe udavarta completely. [Su. Sa. Uttara Sthana 55/45-46] &lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;9) Vacha (Acorus calamus Linn.), ativisha (Aconitum heterophyllum), kushtha (Saussurea lappa), yavakshara (alkali prepared from barley), haritaki (Terminalia chebula Retz.), pippali (Piper longum) and agnimantha (Clerodendrum phlomidis) with hot water cures udavarta. [Su. Sa. Uttara Sthana 55/47] &lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;10) Devadaru (Cedrus deodara), chitraka (Plumbago zeylanica), triphala (combination of 3 herbs viz., haritaki, bibhitaki and amalaki), brihati (Solanum indicum) should be taken along with cow’s urine. [Su. Sa. Uttara Sthana 55/49]&lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;11) Suppository: Powder of danti (Baliospermum montanum), kampillaka (Mallotus philippensis), shyama trivrita (Operculina turpethum), ikshvaku (Lagenaria vulgaris Ser.), ajamoda (Apium graveolens), kritavedhana (Luffa acutangula Linn Roxb.), pippali (Piper longum) and salts should cook in cow’s urine and made into suppositories to be inserted in the anus. This provides instant relief in the symptoms of udavarta. [Su. Sa. Uttara Sthana 55/51-52] &lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt; 12) Guggulu (Commiphora mukul) should be taken with decoction of triphala (combination of 3 herbs viz., haritaki, bibhitaki and amalaki), daruharidra (Berberis aristata), patola (Trichosanthes dioica) and kusa (Desmostachya bipinnata) or with urine or hot water for 1 month alleviates udavarta. [Su. Sa. Chikitsa Sthana 5/39-44]&lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;13) Kalyanaka kshara consumed with ghee cures udavarta and constipation (vibandha) [A. H. Chikitsa Sthana 8/142] &lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;14) Erandamooladi enema (basti) helps in alleviating obstruction of faeces, urine and flatus [Ch. Sa. Siddhi Sthana 3/38-42] &lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt; 15) Palashadi niruha basti alleviates non- passage of flatus and feces (anaha) and udavarta [Ch. Sa. Siddhi Sthana 3/44-45]&lt;/p&gt;<br /> <br /> === Treatment as per different conditions===<br /> *In hemorrhoids (arsha), if symptoms of udavarta is present then unctuous enema (anuvasana basti) should be administered. [Cha. Sa. Chikitsa Sthana 14/130]<br /> *In complications by enema (basti vyapat) when unctuous enema gets obstructed by feces then treatment alleviating udavarta should be adopted. [Cha. Sa. Siddhi Sthana 4/36-37]<br /> *In emesis (vamana) and purgation (virechana) complications (vyapta), in extremely vitiated condition of doshas (bahudosha avastha) low dose of medicine is administered, then it causes udavarta, tympanitis (adhmana) in such condition treatment of udavarta is massage (abhyanga), sudation, suppository, non-unctuous enema (niruha basti) and other measures of udavarta should be adopted [Cha. Sa. Siddhi Sthana 6/58-60]<br /> *In pain caused by obstruction of feces (vitshula) the measures mentioned for udavarta should be used in the treatment. [Su. Sa. Uttara Sthana 42/140] <br /> *In treatment of rakta gulma (a variety of phantom tumor) the measures which cures udavarta should be adopted. [A. H. Chikitsa Sthana 14/129]<br /> *Measures which cure udavarta (udavarta hara kriya) should be adopted in abdominal swelling caused by intestinal obstruction (baddhodara). [A. H. Chikitsa Sthana 15/100]<br /> *In emesis (vamana) from improper therapy (mithya yoga), therapies of udavarta should be adopted. [A. H. Kalpasiddhi Sthana 3/13]<br /> *In complications from enema (basti vyapat) the treatment of udavarta should be adopted if fat (sneha) of enema (basti) gets obstructed or enveloped by feces. [A. H. Kalpa-siddhi Sthana 5/39]<br /> <br /> ===Measures alleviating udavarta (udavarta hara)===<br /> <br /> *Mrudvika (Vitis vinifera/grapes) alleviates udavarta [Cha. Sa. Sutra Sthana 27/125-126]<br /> *Haritaki (Terminalia chebula Retz.) used in udavarta [Cha. Sa. Chikitsa Sthana 1/1/31]<br /> *Dish prepared with barley (yavapupa), supernatant liquid proportion of barley preparation (yavaka) and bhristha yava odana/ parched cooked barley (vatya) made from yava (barley) helps in alleviation of udavarta. [Cha. Sa. Sutra Sthana 27/265]<br /> *Saturating drink (mantha) prepared by churning parched grain flour (saktu) with sour taste (amla rasa), fat and jaggery alleviates udavarta. [Su. Sa. Sutra Sthana 46/386]<br /> *Vatya (made by roasted wheat or barley) helps in alleviating udavarta. [Su. Sa. Sutra Sthana 46/410]<br /> *Garlic cooked with milk (lashuna kshirapaka) alleviates udavarta. [A. H. Chikitsa Sthana 14/46]<br /> <br /> ===Diet for udavarta===<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Intake of vegetable preparations prepared from the leaves of trivruta (Operculina turpethum) and snuhi (Euphorbia neriifolia Linn.), tila (Sesamum indicum) and its different preparations, soup of meat of animals inhabiting in marshy land, domestic and aquatic animals, clear top portion of alcohol (prasanna) and molasses rum (sidhu), wine prepared of jaggery, preparations which facilitates motion of flatus, urine and stool. [Cha. Sa. Chikitsa Sthana 26/18] One should never withhold the natural urges of the body. [Su. Sa. Uttara Sthana 55/3]&lt;/p&gt;<br /> <br /> ===Researches===<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;1) A review on diseases manifested due to withholding natural urges (vegadharana janya vikara) focused to identify the effects of suppression of natural urges (adharaneeya vegas) on various system of body such as CVS, gastrointestinal tract, respiratory system urinary system and reproductive system. CVS and gastrointestinal systems are the mostly affected systems. Out of thirteen urges (vegas), seven play major role in both systems. Common clinical features produced by suppression of natural urges (vegadharana) were weakness of the body, constipation, anorexia, headache, diseases of eye, difficulty in micturition, bending of the body and stiffness of the neck. Weakness of the body and anorexia are the commonest clinical features produced by suppression of natural urges. These clinical features arise due to vitiation of vata by vegadharana. Withholding (dharana) of natural urges is strictly prohibited to stay healthy.&lt;/P&gt;<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;2) A physiological study of adharaneeya vega (suppression of natural urges) w.s.r. to apana vayu vega (suppression of apana vata or flatus)&lt;/p&gt;<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Understanding the physiology of suppression of natural urges (vegarodhajanya) symptoms and analyzing them as a pathology of various diseases related to apana vayu (one of the five subtypes of vata situated in the pelvic region). As, seen in clinical practice many a times diseases reoccur after giving proper treatment. Also, in such case causative factors (nidana) of vitiation of apana vayu (one of the five subtypes of vata situated in the pelvic region) is to be analyzed properly for better result. Among the fourteen adharaneeya vega (suppression of natural urges), apana vayu (one of the five subtypes of vata situated in the pelvic region) vega (urge) is most commonly suppressed which leads to vitiation of vata dosha in the pelvic region). Adharaneeya vega (suppression of natural urges) is a reflex mechanism and it is a nervous activity. Nerve supply to gastrointestinal tract is in the form of sympathetic, parasympathetic, enteric nervous system (ENS) and gastrointestinal reflexes. The ENS is to be referred as second brain, it uses serotonin to communicate with the central nervous system. This “brain gut axis’ helps us in understanding how psychological and social stress might cause digestive problems. ENS is closely related to central nervous system (CNS). As mentioned, blindness (‘andhya’) is one of the udavarta janya vikara (diseases caused by udavarta) which is difficult to understand how eyes are related to apana vayu (one of the five subtypes of vata situated in the pelvic region). In an article named ‘Gut microbes linked to eye diseases’ observations have been made by the researchers regarding the possible connection between the gut microbes and the eye diseases. Apana vayu (one of the five subtypes of vata situated in the pelvic region) is mostly parasympathetic in action and its action is related to urine (mutra), stool (purisha), flatus (adhovata) and seminal discharge (shukra vega). Obstruction in passing flatus (apana vayu rodha) invariably affects the prana vayu (one type of the five subtypes of vata situated in upward body or head) among and other vital points in body (marma sthana) like herat (hrudya), brain (shiras), and urinary bladder (basti).&lt;/p&gt;<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;3) Nidra vegadharana (suppression of sleep) leads to vitiation of vata dosha. Vata controls the functions of mind (mana). Stress is mainly due to mental and physical stimuli which cause disturbances in the internal biological equilibrium. Disturbed and interrupted sleep is very common in the IT professionals due to their work culture. Here, nidra vegadharana (suppression of urge of sleep) acts as a stress stimulus which causes impairment in both sharirika (biological elements vata, pitta and kapha) and manasika (psychological constitution like raja and tama) dosha which causes further loss of sleep (nidranasha). Udavarta affects mind and leads to abnormalities in mental functions similar to mental stress. Hence it is important to avoid nidra vegadharana (suppression of urge of sleep) to prevent further kriyakala i.e., stage of progression of disease leading to stress and other mental disorders. &lt;/p&gt;<br /> <br /> ===Thesis on udavarta===<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;In this study total 74 patients have been enrolled which were divided in two groups randomly. The selected drug for clinical trial in group A was Yavanikadi vati (tablet) which contains haritaki (Terminalia chebula), yavani (Trachyspermum ammi), hingu (Ferula foetida), sauvarchala (black salt), yavakshara (alkali prepared from barley) and saindhava (rock salt). The powder of these raw drugs was given 3 times trituration (bhavana) of these raw drugs was given 3 times trituration (bhavana) of lemon juice (nimbu swarasa) to prepare tablet. In group B, Shankha vati (tablet) was taken for control group, which contains purified mercury (shuddha parada) and purified sulphur (shuddha gandhaka). In the group A 31 patients were given Yavanikadi vati in tablet form 1 gm B.D. in two divided doses (1 tablet = 500 mg.) daily, after food for 28 days with water whereas, in Group B total 30 patients were given Shankha Vati. The dose, duration, time of administration and anupana (co-administers with medicine) is same as group A. Comparison of the therapies showed that overall better results as observed in group A as compared to group B which stands closely parallel to group A. &lt;/p&gt;</div>

Manishdubey https://www.carakasamhitaonline.com/index.php?title=Talk:Udavarta&diff=44308 2023-11-03T10:53:25Z

<p>Manishdubey: /* Researches */</p> <hr /> <div>{{CiteButton}}<br /> {{#seo:<br /> |title= UDAKAVAHA SROTAS (Channels for transport and transformation of watery components)<br /> |titlemode=append<br /> |keywords=Udakavaha Srotas, Water metabolism, Bhojani M. K., Tanwar Ankur Kumar, Basisht G, Deole Y.S.<br /> |description=Udaka means water. In body, water is present in the form of various fluids. Udakavaha srotasa are the channels for transport and transformation of fluid (water) and its circulation. <br /> |image=http://www.carakasamhitaonline.com/mediawiki-1.32.1/resources/assets/ogimgs.jpg<br /> |image_alt=carak samhita<br /> |type=article<br /> }}<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Udavarta literally means the upward and repeated movements of vata. It is one of the important and commonly observed condition in clinical practice. It manifests with a number of clinical features which may lead to manifestation of other secondary diseases further. Udavarta is mentioned as one among the eighty diseases occurred primarily by the vitiated vata dosha (nanatmaja vata vyadhi). [Cha. Sa. Sutra Sthana 20/11] Udavarta (upward movement of vata) is very common now a days due to change in lifestyle of modern society. The change in dietary habits and due to hectic job schedule, suppression of natural urges (vegadharana) is also very common now a days. The two main cause of udavarta explained in classical texts are: suppression of natural urges (vegadharana) and faulty dietary habits (asatmya ahara sevana). Sushrut Samhita describes that suppression of natural urges (adharaniya vega) leads to manifestation of thirteen types of udavarta. Due to aggravating factors, vata dosha is aggravated, especially apana vata (one of the five subtypes of vata i.e., situated in the pelvic region) is affected. Generally, udavarta means upward movement of vata or apana vata, that results in retention of faeces, urine and flatus. However, the scope of udavarta extends to disturbance in normal functions of vata due to obstruction by metabolic wastes. This unique concept is not explained in any other contemporary sciences. So, understanding this concept and to provide better treatment for this disease is need of the society.&lt;/p&gt;<br /> <br /> {{Infobox<br /> |title = Contributors<br /> |label1 = Section/Chapter/topic<br /> |data1 = Concepts &amp; Practices/[[Udavarta]] <br /> |label2 = Authors<br /> |data2 = Dubey M.&lt;sup&gt;1&lt;/sup&gt;,&lt;br/&gt;Deole Y.S.&lt;sup&gt;2&lt;/sup&gt;<br /> |label3 = Reviewer <br /> |data3 = Basisht G.&lt;sup&gt;3&lt;/sup&gt;, <br /> |label4 = Editor<br /> |data4 = Basisht G.&lt;sup&gt;3&lt;/sup&gt;<br /> |label5 = Affiliations<br /> |data5 = &lt;sup&gt;1&lt;/sup&gt;[[Charak Samhita Research, Training and Development Centre]], I.T.R.A., Jamnagar, India &lt;br/&gt;&lt;sup&gt;2&lt;/sup&gt;Department of Kayachikitsa, G. J. Patel Institute of Ayurvedic Studies and Research, New Vallabh Vidyanagar, Gujarat, India&lt;br/&gt;&lt;sup&gt;3&lt;/sup&gt;Rheumatologist, Orlando, Florida, U.S.A.<br /> |label6 = Correspondence emails<br /> |data6 = dr.manish181@gmail.com, dryogeshdeole@gmail.com<br /> carakasamhita@gmail.com<br /> |label7 = Publisher <br /> |data7 = [[Charak Samhita Research, Training and Development Centre]], I.T.R.A., Jamnagar, India<br /> |label8 = Date of publication:<br /> |data8 =November 03, 2023<br /> |label9 = DOI<br /> |data9 = {{DoiWithLink}}<br /> }}<br /> <br /> ===Nirukti (etymology)===<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;The term udavarta is derived from Utt + Aavat i.e., “Ut + Ang + Vrut + Dhaya” to form word Udavarta. [ ] Udavarta is a Sanskrit word derived from 'Ut' verb root (dhatu) with 'Ang' and 'Vrut' preposition (upasarga), suffixed by ‘Dhaya’ pratyaya (suffix). “Ut” means upper side, (Urdhva) “Ang” means entirely and “Vrut” means to move (bhramana). Udavarta means upwards movement, to cause to go out, excrete, to secrete and to retain. Udavarta is a class of diseases marked by retention of the feces i.e., disease of the bowel so, in general urdhwa (upward direction) or pratiloma (moving in abnormal direction) movement of apana vata (one of the five subtypes of vata, situated in the pelvic region) is termed as udavarta.&lt;/p&gt;<br /> <br /> ===Definition===<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;‘Udavarta’ is that disease in which there is whirlpool movement (avartana) and upward movement (urdhva gamana) of vata is seen due to retention of vata, urine (mutra) and stool (purisha). The condition in which vata begins to move upwards is called as ‘udavarta’ and in this disease vata is the predominant dosha. &lt;/p&gt;<br /> <br /> ===Etiopathogenesis===<br /> *Intake of deficient quantity of food causes udavarta. [Cha. Sa. Vimana Sthana 2/7] <br /> *Intake of astringent, bitter, pungent and un-unctuous (dry) food and excessive fasting<br /> *Withholding natural urges (vegadharana) <br /> *Excessive indulgence in sexual activity. [Cha. Sa. Chikitsa Sthana 26/5-6] <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Due to all above reasons the apana vata which resides in large intestine (pakvashaya) gets aggravated and further obstructs the downward movement of vata causing retention of movement of stool, urine and flatus. This leads to a dreadful disease named as udavarta. [Ca. Sa. Chikitsa Sthana 26/5-6]&lt;/p&gt; <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Acharya Sushruta explained suppression of 13 urges leading to udavarta. [Su. Sa. Uttara Sthana 55/ 3-4] Thus, udavarta is caused by 2 main causes, one is suppression of natural urges and other one unwholesome eating. [Su. Sa. Uttara Sthana 55/ 6] Excess consumption of mudga (Phaseolus mungo), kodrava (Paspalum scrobiculatum Linn.), jurnahva (Sorghum vulgare/jowar), karira (Capparis decidua), chanaka (Cicer arietinum L.), etc. i.e., foods with property of dryness and causing constipation vitiate normal status of vata dosha in its own seat (large intestine). This vata becomes powerful and blocks the downward channels and produces severe obstruction in the movement of feces, flatus and urine leading to udavarta. [A. H. Nidana Sthana 7/46-52]&lt;/p&gt;<br /> <br /> ===Clinical features=== <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Frequent pain in the region of urinary bladder (basti), heart (hridaya), abdomen (udara) and excruciating or intense pain in the back of chest. Other symptoms are flatulence (adhmana), nausea (hrillasa), gripping type of pain in anus (vikartika), pricking (toda) type of pain in whole body, indigestion and inflammation of urinary bladder. Obstruction in passing stool less frequently and with difficulty and in less quantity, after long time and effort. Upward movement of flatus occurs because of obstruction in channels (srotasa), increased roughness, dryness and coldness in the body. [Cha. Sa. Chikitsa Sthana 26/6-7]&lt;/p&gt;<br /> <br /> ===Udavarta janya vikara===<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;If not treated early, udavarta leads to other secondary complications as follows:&lt;/p&gt;<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Fever (jwara), dysuria (mutrakricchhra), dysentery (pravahika), heart disease (hridroga), diseases due to malfunctioning of duodenum (grihani dosha), vomiting (chhardi), blindness, deafness, burning sensation in the head, affliction of abdomen by vata (vatodara), tumors (asthila), psychological diseases (mano vikara), disorders of excessive thirst (trishna roga), an ailment characterized by bleeding from different parts of the body (raktapitta), aruchi (anorexia), phantom tumor (gulma), cough (kasa), dyspnoea (shwasa), chronic rhinitis (pratishyaya), facial paralysis (ardita), diseases of the flanks including lower respiratory tract disorders (parshva roga) and such other serious diseases caused by aggravation of vata. [Cha. Sa. Chikitsa Sthana 26/8-9]&lt;/p&gt;<br /> <br /> ===Udavarta as a causative factor (nidana) of other diseases===<br /> *&lt;p style=&quot;text-align:justify;&quot;&gt;Udavarta is the etiological factor of abdominal swelling caused by intestinal obstruction (baddhagudodara) [Cha. Sa. Chikitsa Sthana 13/39]<br /> *Udavarta is the cause for abdominal swelling afflicted by spleen (plihodara). [Cha. Sa. Chikitsa Sthana 13/75]<br /> *Udavarta is the cause for respiratory diseases including bronchial asthma (pratamaka shwasa-type of tamaka shwasa) characterized by fever, syncope and other such symptoms which are relieved by cold measures. [Cha. Sa. Chikitsa Sthana 17/63]<br /> *Udavarta caused by suppression of the urge of urination is causative factor of condition where severe painful distension of abdomen below umbilicus is present along with obstruction of downward movement of urine (mutrajathara- a type of mutraghata i.e., retention of urine). [Su. Sa. Uttara Sthana 58/13]<br /> *Vidvighata (type of mutraghata i.e., retention of urine): In debilitated person due to loss of fat, udavarta brings small amount of feces into the channels of urine (bladder and urethra) resulting in patients voiding of urine having odour of feces is termed as vidvighata. [A. H. Nidana Sthana 9/33-34]<br /> *Hemorrhoids (arsha): Udavarta is the chief complication in hemorrhoids (durnama/arsha). This udavarta may occur in person who has predominance of vata dosha in alimentary tract (koshtha) even without piles. <br /> *Vatodara: Udavarta is one of the causative factors of abdominal swelling afflicted by vata dosha (vatodara). [Cha. Sa. Chikitsa Sthana 13/23]<br /> *Hiccups (hikka) &amp; dyspnoea (shwasa): Udavarta is the one of the etiological factors for causation of conditions such as hiccups (hikka) and dyspnoea (shwasa).&lt;/p&gt;<br /> <br /> ===Udavarta as symptoms (lakshana) in following diseases===<br /> <br /> #Vataja plihodara (vata predominant plihodara i.e., abdominal swelling afflicted by splenomegaly) [Cha. Sa. Chikitsa Sthana 13/38]<br /> #Vatodara (abdominal swelling afflicted by vata dosha) [Cha. Sa. Chikitsa Sthana 13/25]<br /> #Vataja gulma (vata predominant gulma/ phantom tumor) [Cha. Sa. Chikitsa Sthana 5/10]<br /> #Sahaja arsha (congenital hemorrhoids) [Cha. Sa. Chikitsa Sthana 14/8]<br /> #Vataja arsha (vata predominant hemorrhoids) [Cha. Sa. Chikitsa Sthana 14/11]<br /> #Vyana avruta apana (type of avarana (occlusion) where vyana vata obstructs the flow of apana vata) [Cha. Sa. Chikitsa Sthana 28/211]<br /> #Basti marma viddha (injury to bladder) [Cha. Sa. Siddhi Sthana 9/6]<br /> <br /> ===Types of Udavarta===<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Udavarta is of 6 types which occur by suppression of natural urges viz., apana vata nirodhaja (suppression of flatus), mutra vega nirodhaja (suppression of urine), purisha vega nirodhaja (suppression of faeces), shukra vega nirodhaja (suppression of ejaculation of semen), chhardi vega nirodhaja (suppression of vomiting) and kshavathu vega nirodhaja (suppression of sneezing). [Cha. Sa. Sutra Sthana 18/3]&lt;/p&gt;<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;As per Sushruta Samhita, there are 13 types of suppression of natural urges (vegadharana) namely flatus, faeces, urine, yawning, flow of tears, sneezing, eructation, vomiting, ejaculation of semen, hunger, thirst, breath and sleep. [Su. Sa. Uttara Sthana 55/ 3-4] Suppression of these vega (urges) gives rise to their respective type of udavarta and manifest their respective symptoms which are as follows;&lt;/p&gt;<br /> <br /> ===Asadhyata [incurable stage of diseases]===<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Udavarta with symptoms of excessive thirst, excessively depressed, emaciated, suffering from pain and vomiting of fecal matter is difficult to manage or incurable.[Su. Sa. Uttara Sthana 55/ 17-18] &lt;/p&gt;<br /> <br /> ===Treatment===<br /> &lt;p style=&quot;text-align:justify;&quot;&gt; Treatment principles for udavarta i.e., palliative therapy (shamana) or purification (shodhana) etc., can be selected based on stages of the disease and as well as on the condition of the patient. The treatment guidelines explained in Charaka Samhita are as follows: [Cha. Sa. Chikitsa Sthana 26/11]&lt;/p&gt;<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;The patient suffering from udavarta should be given massage with hot oil described for the treatment of fever presented with cold extremities (sheeta jwara). Then fomentation therapy should be administered for the detachment of the adhered dosha in the tissue cells. This should be followed by the administration of suppository (varti), un-unctuous enema (niruha basti) and unctuous type of purgative (snigdha virechana). The patient should be given food which helps in the normal downward movement (anulomana) of apana vata.&lt;/p&gt;<br /> <br /> '''A) Unction therapy (snehana):''' &lt;p style=&quot;text-align:justify;&quot;&gt;Udavarta is produced due to aggravation of vata and sneha (lipids) is the best treatment for pacification of vata vata (shamana). Therefore, unction therapy (snehana) is indicated in udavarta. &lt;/p&gt;<br /> '''B) Fomentation therapy (swedana):''' &lt;p style=&quot;text-align:justify;&quot;&gt;After massage with oil, fomentation therapy should be administered for the detachment of the adhered dosha in the tissue cells.&lt;/p&gt;<br /> '''C) Suppository (varti):''' &lt;p style=&quot;text-align:justify;&quot;&gt;A suppository having the thickness of the thumb is to be prepared with drugs like Shyama Trivrita (Operculina turpethum), Vidanga (Embeila ribes), Kampillaka (Mallotus philippensis) etc., which should be triturated with gomutra (cow’s urine) or arka (Calotropis gigantea) latex (kshira) and made in to form of suppository (phala varti) by adding jaggery. This suppository should be inserted through anus for the downward movement of apana vata to relieve retention of stool, flatus and urine caused by udavarta.&lt;/p&gt;<br /> '''D) Palliative therapy (shamana):''' &lt;p style=&quot;text-align:justify;&quot;&gt;Shamana includes administration of internal medication such as dviruttara- hingvadi churna, hinguvachadi churna given with warm water as an anupana (co-administers with medicine) for correcting the upward movement of vata.&lt;/p&gt;<br /> '''E) Purification therapy (shodhana):'''&lt;p style=&quot;text-align:justify;&quot;&gt;When the disease is chronic and relief is not observed even by adopting above measures, then purification (shodhana) by non-unctuous enema (niruha basti) or purgation (virechana) is advised.&lt;/p&gt;<br /> '''F) Pathya ahara kalpana (wholesome diet):'''&lt;p style=&quot;text-align:justify;&quot;&gt;Intake of wholesome diet (pathya ahara) which helps in normal downward movement (anulomana) of apana vata whereas, intake of unwholesome diet (apathya ahara) should be avoided for better recovery. Generally, in all types of udavarta all measures for controlling vata should be adopted in order to restore it to its normal channels (srotasa). [Su. Sa. Uttara Sthana 55/ 19]&lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Complications of udavarta, flatulence (adhmana) and other diseases should be managed with respective measures according to condition. [Su. Sa. Uttara Sthana 55/34-35] For example when vayu in abdomen (koshtha) is aggravated by rough, pungent, bitter and astringent food, it immediately produces udavarta owing to which the channels (srotasa) carrying flatus, feces, urine, blood, kapha and adipose tissue (medas), move in upward direction and harden the feces too much. This results in manifestation of symptoms such as pain in cardiac and pelvic region, heaviness, anorexia, passing of urine, flatus and feces with difficulty. The person gets afflicted with many other disorders caused by aggravation of vata such as dyspnoea, (shwasa), cough (kasa), hiccoup (hikka), thirst (trishna), coryza (pratishyaya), burning sensation (daha), mental confusion (moha), vomiting (chhardi), fever (jwara), diseases of head and abnormalities of mind and ears. [Su. Sa. Uttara Sthana 55/2] &lt;/p&gt;<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;One should advise non-unctuous enema (niruha basti) after the patient is massaged with oil mixed with salt and sudation; then after feces are eliminated, he should be advised to take food followed by administration of unctuous enema (anuvasana basti) according to the dosha involvement. If by above procedures, still no relief found then in severe cases of udavarta, patient is advised to undergo repeated unction therapy (snehana) and fomentation therapy (swedana) and then undergo unctuous purgation (snigdha virechana). [Su. Sa. Uttara Sthana 55/40-41]&lt;/p&gt;<br /> <br /> ===Different treatments of udavarta===<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;1) Saturating drink (mantha) prepared with sugarcane product (phanita), roasted grain flour (saktu), ghee, curd water and vinegar (amla kanji) alleviate udavarta. [Cha. Sa. Sutra Sthana 23/37]&lt;/p&gt;<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;2) 96 gm (2 pala) of dehusked tila (Sesamum indicum Linn.), 48 gm (1 pala) of jaggery and 24 gm (half pala) of nagara (Zingiber officinale) should be made into a paste and taken along with hot milk helps in udavarta. [Cha. Sa. Chikitsa Sthana 5/91-92] &lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;3) Milk cooked with Allum sativum (Lashuna kshirapaka): Garlic cooked with milk by adding water and reducing to the quantity of milk, cures udavarta immediately [Cha. Sa. Chikitsa Sthana 5/94] &lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;4) Alkali prepared from pippali (Piper longum) and other ingredients (Pippalyadi kshara) used in udavarta [Cha. Sa. Chikitsa Sthana 13/159-161] &lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;5) Medicine prepared by boiling medicinal herbs in water and then kept for fermentation with drugs such as haritaki (Terminalia chebula), amalaki (Emblica officinalis), etc. (Phalarishta) used in udavarta. [Cha. Sa. Chikitsa Sthana 14/148-152] &lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;6) Trivrut (Operculina turpethum), pilu (Salvadora persica), yavani (Trachyspermum ammi) with sour gruel mixed with digestants (pachana) drugs. [Su. Sa. Uttara Sthana 55/42-43] &lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt; 7) The combination of hingu (Ferula foetida), kushtha (Saussurea lappa), vacha (Acorus calamus Linn.), svarjika (alkali prepared by burning Lona plant), and vidanga (Embelia ribes) – successively in double quantity cures udavarta and colicky pain by vata dosha (vataja shoola) [Su. Sa. Uttara Sthana 55/42-43]&lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;8) Intake of ghee cooked with decoction of dried radish (Raphanus sativus), sunthi (Zingiber officinale), punarnava (Boerhavia diffusa), brihata panchamula (combination of five herbs viz., bilva, patala, agnimantha, shyonaka and gambhari), and fruits of aragvadha (Cassia fistula) subsides severe udavarta completely. [Su. Sa. Uttara Sthana 55/45-46] &lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;9) Vacha (Acorus calamus Linn.), ativisha (Aconitum heterophyllum), kushtha (Saussurea lappa), yavakshara (alkali prepared from barley), haritaki (Terminalia chebula Retz.), pippali (Piper longum) and agnimantha (Clerodendrum phlomidis) with hot water cures udavarta. [Su. Sa. Uttara Sthana 55/47] &lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;10) Devadaru (Cedrus deodara), chitraka (Plumbago zeylanica), triphala (combination of 3 herbs viz., haritaki, bibhitaki and amalaki), brihati (Solanum indicum) should be taken along with cow’s urine. [Su. Sa. Uttara Sthana 55/49]&lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;11) Suppository: Powder of danti (Baliospermum montanum), kampillaka (Mallotus philippensis), shyama trivrita (Operculina turpethum), ikshvaku (Lagenaria vulgaris Ser.), ajamoda (Apium graveolens), kritavedhana (Luffa acutangula Linn Roxb.), pippali (Piper longum) and salts should cook in cow’s urine and made into suppositories to be inserted in the anus. This provides instant relief in the symptoms of udavarta. [Su. Sa. Uttara Sthana 55/51-52] &lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt; 12) Guggulu (Commiphora mukul) should be taken with decoction of triphala (combination of 3 herbs viz., haritaki, bibhitaki and amalaki), daruharidra (Berberis aristata), patola (Trichosanthes dioica) and kusa (Desmostachya bipinnata) or with urine or hot water for 1 month alleviates udavarta. [Su. Sa. Chikitsa Sthana 5/39-44]&lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;13) Kalyanaka kshara consumed with ghee cures udavarta and constipation (vibandha) [A. H. Chikitsa Sthana 8/142] &lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;14) Erandamooladi enema (basti) helps in alleviating obstruction of faeces, urine and flatus [Ch. Sa. Siddhi Sthana 3/38-42] &lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt; 15) Palashadi niruha basti alleviates non- passage of flatus and feces (anaha) and udavarta [Ch. Sa. Siddhi Sthana 3/44-45]&lt;/p&gt;<br /> <br /> === Treatment as per different conditions===<br /> *In hemorrhoids (arsha), if symptoms of udavarta is present then unctuous enema (anuvasana basti) should be administered. [Cha. Sa. Chikitsa Sthana 14/130]<br /> *In complications by enema (basti vyapat) when unctuous enema gets obstructed by feces then treatment alleviating udavarta should be adopted. [Cha. Sa. Siddhi Sthana 4/36-37]<br /> *In emesis (vamana) and purgation (virechana) complications (vyapta), in extremely vitiated condition of doshas (bahudosha avastha) low dose of medicine is administered, then it causes udavarta, tympanitis (adhmana) in such condition treatment of udavarta is massage (abhyanga), sudation, suppository, non-unctuous enema (niruha basti) and other measures of udavarta should be adopted [Cha. Sa. Siddhi Sthana 6/58-60]<br /> *In pain caused by obstruction of feces (vitshula) the measures mentioned for udavarta should be used in the treatment. [Su. Sa. Uttara Sthana 42/140] <br /> *In treatment of rakta gulma (a variety of phantom tumor) the measures which cures udavarta should be adopted. [A. H. Chikitsa Sthana 14/129]<br /> *Measures which cure udavarta (udavarta hara kriya) should be adopted in abdominal swelling caused by intestinal obstruction (baddhodara). [A. H. Chikitsa Sthana 15/100]<br /> *In emesis (vamana) from improper therapy (mithya yoga), therapies of udavarta should be adopted. [A. H. Kalpasiddhi Sthana 3/13]<br /> *In complications from enema (basti vyapat) the treatment of udavarta should be adopted if fat (sneha) of enema (basti) gets obstructed or enveloped by feces. [A. H. Kalpa-siddhi Sthana 5/39]<br /> <br /> ===Measures alleviating udavarta (udavarta hara)===<br /> <br /> *Mrudvika (Vitis vinifera/grapes) alleviates udavarta [Cha. Sa. Sutra Sthana 27/125-126]<br /> *Haritaki (Terminalia chebula Retz.) used in udavarta [Cha. Sa. Chikitsa Sthana 1/1/31]<br /> *Dish prepared with barley (yavapupa), supernatant liquid proportion of barley preparation (yavaka) and bhristha yava odana/ parched cooked barley (vatya) made from yava (barley) helps in alleviation of udavarta. [Cha. Sa. Sutra Sthana 27/265]<br /> *Saturating drink (mantha) prepared by churning parched grain flour (saktu) with sour taste (amla rasa), fat and jaggery alleviates udavarta. [Su. Sa. Sutra Sthana 46/386]<br /> *Vatya (made by roasted wheat or barley) helps in alleviating udavarta. [Su. Sa. Sutra Sthana 46/410]<br /> *Garlic cooked with milk (lashuna kshirapaka) alleviates udavarta. [A. H. Chikitsa Sthana 14/46]<br /> <br /> ===Diet for udavarta===<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Intake of vegetable preparations prepared from the leaves of trivruta (Operculina turpethum) and snuhi (Euphorbia neriifolia Linn.), tila (Sesamum indicum) and its different preparations, soup of meat of animals inhabiting in marshy land, domestic and aquatic animals, clear top portion of alcohol (prasanna) and molasses rum (sidhu), wine prepared of jaggery, preparations which facilitates motion of flatus, urine and stool. [Cha. Sa. Chikitsa Sthana 26/18] One should never withhold the natural urges of the body. [Su. Sa. Uttara Sthana 55/3]&lt;/p&gt;<br /> <br /> ===Researches===<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;1)A review on diseases manifested due to withholding natural urges (vegadharana janya vikara) focused to identify the effects of suppression of natural urges (adharaneeya vegas) on various system of body such as CVS, gastrointestinal tract, respiratory system urinary system and reproductive system. CVS and gastrointestinal systems are the mostly affected systems. Out of thirteen urges (vegas), seven play major role in both systems. Common clinical features produced by suppression of natural urges (vegadharana) were weakness of the body, constipation, anorexia, headache, diseases of eye, difficulty in micturition, bending of the body and stiffness of the neck. Weakness of the body and anorexia are the commonest clinical features produced by suppression of natural urges. These clinical features arise due to vitiation of vata by vegadharana. Withholding (dharana) of natural urges is strictly prohibited to stay healthy.&lt;/P&gt;<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;2) A physiological study of adharaneeya vega (suppression of natural urges) w.s.r. to apana vayu vega (suppression of apana vata or flatus)&lt;/p&gt;<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Understanding the physiology of suppression of natural urges (vegarodhajanya) symptoms and analyzing them as a pathology of various diseases related to apana vayu (one of the five subtypes of vata situated in the pelvic region). As, seen in clinical practice many a times diseases reoccur after giving proper treatment. Also, in such case causative factors (nidana) of vitiation of apana vayu (one of the five subtypes of vata situated in the pelvic region) is to be analyzed properly for better result. Among the fourteen adharaneeya vega (suppression of natural urges), apana vayu (one of the five subtypes of vata situated in the pelvic region) vega (urge) is most commonly suppressed which leads to vitiation of vata dosha in the pelvic region). Adharaneeya vega (suppression of natural urges) is a reflex mechanism and it is a nervous activity. Nerve supply to gastrointestinal tract is in the form of sympathetic, parasympathetic, enteric nervous system (ENS) and gastrointestinal reflexes. The ENS is to be referred as second brain, it uses serotonin to communicate with the central nervous system. This “brain gut axis’ helps us in understanding how psychological and social stress might cause digestive problems. ENS is closely related to central nervous system (CNS). As mentioned, blindness (‘andhya’) is one of the udavarta janya vikara (diseases caused by udavarta) which is difficult to understand how eyes are related to apana vayu (one of the five subtypes of vata situated in the pelvic region). In an article named ‘Gut microbes linked to eye diseases’ observations have been made by the researchers regarding the possible connection between the gut microbes and the eye diseases. Apana vayu (one of the five subtypes of vata situated in the pelvic region) is mostly parasympathetic in action and its action is related to urine (mutra), stool (purisha), flatus (adhovata) and seminal discharge (shukra vega). Obstruction in passing flatus (apana vayu rodha) invariably affects the prana vayu (one type of the five subtypes of vata situated in upward body or head) among and other vital points in body (marma sthana) like herat (hrudya), brain (shiras), and urinary bladder (basti).&lt;/p&gt;<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;3) Nidra vegadharana (suppression of sleep) leads to vitiation of vata dosha. Vata controls the functions of mind (mana). Stress is mainly due to mental and physical stimuli which cause disturbances in the internal biological equilibrium. Disturbed and interrupted sleep is very common in the IT professionals due to their work culture. Here, nidra vegadharana (suppression of urge of sleep) acts as a stress stimulus which causes impairment in both sharirika (biological elements vata, pitta and kapha) and manasika (psychological constitution like raja and tama) dosha which causes further loss of sleep (nidranasha). Udavarta affects mind and leads to abnormalities in mental functions similar to mental stress. Hence it is important to avoid nidra vegadharana (suppression of urge of sleep) to prevent further kriyakala i.e., stage of progression of disease leading to stress and other mental disorders. &lt;/p&gt;<br /> <br /> ===Thesis on udavarta===<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;In this study total 74 patients have been enrolled which were divided in two groups randomly. The selected drug for clinical trial in group A was Yavanikadi vati (tablet) which contains haritaki (Terminalia chebula), yavani (Trachyspermum ammi), hingu (Ferula foetida), sauvarchala (black salt), yavakshara (alkali prepared from barley) and saindhava (rock salt). The powder of these raw drugs was given 3 times trituration (bhavana) of these raw drugs was given 3 times trituration (bhavana) of lemon juice (nimbu swarasa) to prepare tablet. In group B, Shankha vati (tablet) was taken for control group, which contains purified mercury (shuddha parada) and purified sulphur (shuddha gandhaka). In the group A 31 patients were given Yavanikadi vati in tablet form 1 gm B.D. in two divided doses (1 tablet = 500 mg.) daily, after food for 28 days with water whereas, in Group B total 30 patients were given Shankha Vati. The dose, duration, time of administration and anupana (co-administers with medicine) is same as group A. Comparison of the therapies showed that overall better results as observed in group A as compared to group B which stands closely parallel to group A. &lt;/p&gt;</div>

Manishdubey https://www.carakasamhitaonline.com/index.php?title=Talk:Udavarta&diff=44307 2023-11-03T10:45:41Z

<p>Manishdubey: /* Researches */</p> <hr /> <div>{{CiteButton}}<br /> {{#seo:<br /> |title= UDAKAVAHA SROTAS (Channels for transport and transformation of watery components)<br /> |titlemode=append<br /> |keywords=Udakavaha Srotas, Water metabolism, Bhojani M. K., Tanwar Ankur Kumar, Basisht G, Deole Y.S.<br /> |description=Udaka means water. In body, water is present in the form of various fluids. Udakavaha srotasa are the channels for transport and transformation of fluid (water) and its circulation. <br /> |image=http://www.carakasamhitaonline.com/mediawiki-1.32.1/resources/assets/ogimgs.jpg<br /> |image_alt=carak samhita<br /> |type=article<br /> }}<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Udavarta literally means the upward and repeated movements of vata. It is one of the important and commonly observed condition in clinical practice. It manifests with a number of clinical features which may lead to manifestation of other secondary diseases further. Udavarta is mentioned as one among the eighty diseases occurred primarily by the vitiated vata dosha (nanatmaja vata vyadhi). [Cha. Sa. Sutra Sthana 20/11] Udavarta (upward movement of vata) is very common now a days due to change in lifestyle of modern society. The change in dietary habits and due to hectic job schedule, suppression of natural urges (vegadharana) is also very common now a days. The two main cause of udavarta explained in classical texts are: suppression of natural urges (vegadharana) and faulty dietary habits (asatmya ahara sevana). Sushrut Samhita describes that suppression of natural urges (adharaniya vega) leads to manifestation of thirteen types of udavarta. Due to aggravating factors, vata dosha is aggravated, especially apana vata (one of the five subtypes of vata i.e., situated in the pelvic region) is affected. Generally, udavarta means upward movement of vata or apana vata, that results in retention of faeces, urine and flatus. However, the scope of udavarta extends to disturbance in normal functions of vata due to obstruction by metabolic wastes. This unique concept is not explained in any other contemporary sciences. So, understanding this concept and to provide better treatment for this disease is need of the society.&lt;/p&gt;<br /> <br /> {{Infobox<br /> |title = Contributors<br /> |label1 = Section/Chapter/topic<br /> |data1 = Concepts &amp; Practices/[[Udavarta]] <br /> |label2 = Authors<br /> |data2 = Dubey M.&lt;sup&gt;1&lt;/sup&gt;,&lt;br/&gt;Deole Y.S.&lt;sup&gt;2&lt;/sup&gt;<br /> |label3 = Reviewer <br /> |data3 = Basisht G.&lt;sup&gt;3&lt;/sup&gt;, <br /> |label4 = Editor<br /> |data4 = Basisht G.&lt;sup&gt;3&lt;/sup&gt;<br /> |label5 = Affiliations<br /> |data5 = &lt;sup&gt;1&lt;/sup&gt;[[Charak Samhita Research, Training and Development Centre]], I.T.R.A., Jamnagar, India &lt;br/&gt;&lt;sup&gt;2&lt;/sup&gt;Department of Kayachikitsa, G. J. Patel Institute of Ayurvedic Studies and Research, New Vallabh Vidyanagar, Gujarat, India&lt;br/&gt;&lt;sup&gt;3&lt;/sup&gt;Rheumatologist, Orlando, Florida, U.S.A.<br /> |label6 = Correspondence emails<br /> |data6 = dr.manish181@gmail.com, dryogeshdeole@gmail.com<br /> carakasamhita@gmail.com<br /> |label7 = Publisher <br /> |data7 = [[Charak Samhita Research, Training and Development Centre]], I.T.R.A., Jamnagar, India<br /> |label8 = Date of publication:<br /> |data8 =November 03, 2023<br /> |label9 = DOI<br /> |data9 = {{DoiWithLink}}<br /> }}<br /> <br /> ===Nirukti (etymology)===<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;The term udavarta is derived from Utt + Aavat i.e., “Ut + Ang + Vrut + Dhaya” to form word Udavarta. [ ] Udavarta is a Sanskrit word derived from 'Ut' verb root (dhatu) with 'Ang' and 'Vrut' preposition (upasarga), suffixed by ‘Dhaya’ pratyaya (suffix). “Ut” means upper side, (Urdhva) “Ang” means entirely and “Vrut” means to move (bhramana). Udavarta means upwards movement, to cause to go out, excrete, to secrete and to retain. Udavarta is a class of diseases marked by retention of the feces i.e., disease of the bowel so, in general urdhwa (upward direction) or pratiloma (moving in abnormal direction) movement of apana vata (one of the five subtypes of vata, situated in the pelvic region) is termed as udavarta.&lt;/p&gt;<br /> <br /> ===Definition===<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;‘Udavarta’ is that disease in which there is whirlpool movement (avartana) and upward movement (urdhva gamana) of vata is seen due to retention of vata, urine (mutra) and stool (purisha). The condition in which vata begins to move upwards is called as ‘udavarta’ and in this disease vata is the predominant dosha. &lt;/p&gt;<br /> <br /> ===Etiopathogenesis===<br /> *Intake of deficient quantity of food causes udavarta. [Cha. Sa. Vimana Sthana 2/7] <br /> *Intake of astringent, bitter, pungent and un-unctuous (dry) food and excessive fasting<br /> *Withholding natural urges (vegadharana) <br /> *Excessive indulgence in sexual activity. [Cha. Sa. Chikitsa Sthana 26/5-6] <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Due to all above reasons the apana vata which resides in large intestine (pakvashaya) gets aggravated and further obstructs the downward movement of vata causing retention of movement of stool, urine and flatus. This leads to a dreadful disease named as udavarta. [Ca. Sa. Chikitsa Sthana 26/5-6]&lt;/p&gt; <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Acharya Sushruta explained suppression of 13 urges leading to udavarta. [Su. Sa. Uttara Sthana 55/ 3-4] Thus, udavarta is caused by 2 main causes, one is suppression of natural urges and other one unwholesome eating. [Su. Sa. Uttara Sthana 55/ 6] Excess consumption of mudga (Phaseolus mungo), kodrava (Paspalum scrobiculatum Linn.), jurnahva (Sorghum vulgare/jowar), karira (Capparis decidua), chanaka (Cicer arietinum L.), etc. i.e., foods with property of dryness and causing constipation vitiate normal status of vata dosha in its own seat (large intestine). This vata becomes powerful and blocks the downward channels and produces severe obstruction in the movement of feces, flatus and urine leading to udavarta. [A. H. Nidana Sthana 7/46-52]&lt;/p&gt;<br /> <br /> ===Clinical features=== <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Frequent pain in the region of urinary bladder (basti), heart (hridaya), abdomen (udara) and excruciating or intense pain in the back of chest. Other symptoms are flatulence (adhmana), nausea (hrillasa), gripping type of pain in anus (vikartika), pricking (toda) type of pain in whole body, indigestion and inflammation of urinary bladder. Obstruction in passing stool less frequently and with difficulty and in less quantity, after long time and effort. Upward movement of flatus occurs because of obstruction in channels (srotasa), increased roughness, dryness and coldness in the body. [Cha. Sa. Chikitsa Sthana 26/6-7]&lt;/p&gt;<br /> <br /> ===Udavarta janya vikara===<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;If not treated early, udavarta leads to other secondary complications as follows:&lt;/p&gt;<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Fever (jwara), dysuria (mutrakricchhra), dysentery (pravahika), heart disease (hridroga), diseases due to malfunctioning of duodenum (grihani dosha), vomiting (chhardi), blindness, deafness, burning sensation in the head, affliction of abdomen by vata (vatodara), tumors (asthila), psychological diseases (mano vikara), disorders of excessive thirst (trishna roga), an ailment characterized by bleeding from different parts of the body (raktapitta), aruchi (anorexia), phantom tumor (gulma), cough (kasa), dyspnoea (shwasa), chronic rhinitis (pratishyaya), facial paralysis (ardita), diseases of the flanks including lower respiratory tract disorders (parshva roga) and such other serious diseases caused by aggravation of vata. [Cha. Sa. Chikitsa Sthana 26/8-9]&lt;/p&gt;<br /> <br /> ===Udavarta as a causative factor (nidana) of other diseases===<br /> *&lt;p style=&quot;text-align:justify;&quot;&gt;Udavarta is the etiological factor of abdominal swelling caused by intestinal obstruction (baddhagudodara) [Cha. Sa. Chikitsa Sthana 13/39]<br /> *Udavarta is the cause for abdominal swelling afflicted by spleen (plihodara). [Cha. Sa. Chikitsa Sthana 13/75]<br /> *Udavarta is the cause for respiratory diseases including bronchial asthma (pratamaka shwasa-type of tamaka shwasa) characterized by fever, syncope and other such symptoms which are relieved by cold measures. [Cha. Sa. Chikitsa Sthana 17/63]<br /> *Udavarta caused by suppression of the urge of urination is causative factor of condition where severe painful distension of abdomen below umbilicus is present along with obstruction of downward movement of urine (mutrajathara- a type of mutraghata i.e., retention of urine). [Su. Sa. Uttara Sthana 58/13]<br /> *Vidvighata (type of mutraghata i.e., retention of urine): In debilitated person due to loss of fat, udavarta brings small amount of feces into the channels of urine (bladder and urethra) resulting in patients voiding of urine having odour of feces is termed as vidvighata. [A. H. Nidana Sthana 9/33-34]<br /> *Hemorrhoids (arsha): Udavarta is the chief complication in hemorrhoids (durnama/arsha). This udavarta may occur in person who has predominance of vata dosha in alimentary tract (koshtha) even without piles. <br /> *Vatodara: Udavarta is one of the causative factors of abdominal swelling afflicted by vata dosha (vatodara). [Cha. Sa. Chikitsa Sthana 13/23]<br /> *Hiccups (hikka) &amp; dyspnoea (shwasa): Udavarta is the one of the etiological factors for causation of conditions such as hiccups (hikka) and dyspnoea (shwasa).&lt;/p&gt;<br /> <br /> ===Udavarta as symptoms (lakshana) in following diseases===<br /> <br /> #Vataja plihodara (vata predominant plihodara i.e., abdominal swelling afflicted by splenomegaly) [Cha. Sa. Chikitsa Sthana 13/38]<br /> #Vatodara (abdominal swelling afflicted by vata dosha) [Cha. Sa. Chikitsa Sthana 13/25]<br /> #Vataja gulma (vata predominant gulma/ phantom tumor) [Cha. Sa. Chikitsa Sthana 5/10]<br /> #Sahaja arsha (congenital hemorrhoids) [Cha. Sa. Chikitsa Sthana 14/8]<br /> #Vataja arsha (vata predominant hemorrhoids) [Cha. Sa. Chikitsa Sthana 14/11]<br /> #Vyana avruta apana (type of avarana (occlusion) where vyana vata obstructs the flow of apana vata) [Cha. Sa. Chikitsa Sthana 28/211]<br /> #Basti marma viddha (injury to bladder) [Cha. Sa. Siddhi Sthana 9/6]<br /> <br /> ===Types of Udavarta===<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Udavarta is of 6 types which occur by suppression of natural urges viz., apana vata nirodhaja (suppression of flatus), mutra vega nirodhaja (suppression of urine), purisha vega nirodhaja (suppression of faeces), shukra vega nirodhaja (suppression of ejaculation of semen), chhardi vega nirodhaja (suppression of vomiting) and kshavathu vega nirodhaja (suppression of sneezing). [Cha. Sa. Sutra Sthana 18/3]&lt;/p&gt;<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;As per Sushruta Samhita, there are 13 types of suppression of natural urges (vegadharana) namely flatus, faeces, urine, yawning, flow of tears, sneezing, eructation, vomiting, ejaculation of semen, hunger, thirst, breath and sleep. [Su. Sa. Uttara Sthana 55/ 3-4] Suppression of these vega (urges) gives rise to their respective type of udavarta and manifest their respective symptoms which are as follows;&lt;/p&gt;<br /> <br /> ===Asadhyata [incurable stage of diseases]===<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Udavarta with symptoms of excessive thirst, excessively depressed, emaciated, suffering from pain and vomiting of fecal matter is difficult to manage or incurable.[Su. Sa. Uttara Sthana 55/ 17-18] &lt;/p&gt;<br /> <br /> ===Treatment===<br /> &lt;p style=&quot;text-align:justify;&quot;&gt; Treatment principles for udavarta i.e., palliative therapy (shamana) or purification (shodhana) etc., can be selected based on stages of the disease and as well as on the condition of the patient. The treatment guidelines explained in Charaka Samhita are as follows: [Cha. Sa. Chikitsa Sthana 26/11]&lt;/p&gt;<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;The patient suffering from udavarta should be given massage with hot oil described for the treatment of fever presented with cold extremities (sheeta jwara). Then fomentation therapy should be administered for the detachment of the adhered dosha in the tissue cells. This should be followed by the administration of suppository (varti), un-unctuous enema (niruha basti) and unctuous type of purgative (snigdha virechana). The patient should be given food which helps in the normal downward movement (anulomana) of apana vata.&lt;/p&gt;<br /> <br /> '''A) Unction therapy (snehana):''' &lt;p style=&quot;text-align:justify;&quot;&gt;Udavarta is produced due to aggravation of vata and sneha (lipids) is the best treatment for pacification of vata vata (shamana). Therefore, unction therapy (snehana) is indicated in udavarta. &lt;/p&gt;<br /> '''B) Fomentation therapy (swedana):''' &lt;p style=&quot;text-align:justify;&quot;&gt;After massage with oil, fomentation therapy should be administered for the detachment of the adhered dosha in the tissue cells.&lt;/p&gt;<br /> '''C) Suppository (varti):''' &lt;p style=&quot;text-align:justify;&quot;&gt;A suppository having the thickness of the thumb is to be prepared with drugs like Shyama Trivrita (Operculina turpethum), Vidanga (Embeila ribes), Kampillaka (Mallotus philippensis) etc., which should be triturated with gomutra (cow’s urine) or arka (Calotropis gigantea) latex (kshira) and made in to form of suppository (phala varti) by adding jaggery. This suppository should be inserted through anus for the downward movement of apana vata to relieve retention of stool, flatus and urine caused by udavarta.&lt;/p&gt;<br /> '''D) Palliative therapy (shamana):''' &lt;p style=&quot;text-align:justify;&quot;&gt;Shamana includes administration of internal medication such as dviruttara- hingvadi churna, hinguvachadi churna given with warm water as an anupana (co-administers with medicine) for correcting the upward movement of vata.&lt;/p&gt;<br /> '''E) Purification therapy (shodhana):'''&lt;p style=&quot;text-align:justify;&quot;&gt;When the disease is chronic and relief is not observed even by adopting above measures, then purification (shodhana) by non-unctuous enema (niruha basti) or purgation (virechana) is advised.&lt;/p&gt;<br /> '''F) Pathya ahara kalpana (wholesome diet):'''&lt;p style=&quot;text-align:justify;&quot;&gt;Intake of wholesome diet (pathya ahara) which helps in normal downward movement (anulomana) of apana vata whereas, intake of unwholesome diet (apathya ahara) should be avoided for better recovery. Generally, in all types of udavarta all measures for controlling vata should be adopted in order to restore it to its normal channels (srotasa). [Su. Sa. Uttara Sthana 55/ 19]&lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Complications of udavarta, flatulence (adhmana) and other diseases should be managed with respective measures according to condition. [Su. Sa. Uttara Sthana 55/34-35] For example when vayu in abdomen (koshtha) is aggravated by rough, pungent, bitter and astringent food, it immediately produces udavarta owing to which the channels (srotasa) carrying flatus, feces, urine, blood, kapha and adipose tissue (medas), move in upward direction and harden the feces too much. This results in manifestation of symptoms such as pain in cardiac and pelvic region, heaviness, anorexia, passing of urine, flatus and feces with difficulty. The person gets afflicted with many other disorders caused by aggravation of vata such as dyspnoea, (shwasa), cough (kasa), hiccoup (hikka), thirst (trishna), coryza (pratishyaya), burning sensation (daha), mental confusion (moha), vomiting (chhardi), fever (jwara), diseases of head and abnormalities of mind and ears. [Su. Sa. Uttara Sthana 55/2] &lt;/p&gt;<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;One should advise non-unctuous enema (niruha basti) after the patient is massaged with oil mixed with salt and sudation; then after feces are eliminated, he should be advised to take food followed by administration of unctuous enema (anuvasana basti) according to the dosha involvement. If by above procedures, still no relief found then in severe cases of udavarta, patient is advised to undergo repeated unction therapy (snehana) and fomentation therapy (swedana) and then undergo unctuous purgation (snigdha virechana). [Su. Sa. Uttara Sthana 55/40-41]&lt;/p&gt;<br /> <br /> ===Different treatments of udavarta===<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;1) Saturating drink (mantha) prepared with sugarcane product (phanita), roasted grain flour (saktu), ghee, curd water and vinegar (amla kanji) alleviate udavarta. [Cha. Sa. Sutra Sthana 23/37]&lt;/p&gt;<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;2) 96 gm (2 pala) of dehusked tila (Sesamum indicum Linn.), 48 gm (1 pala) of jaggery and 24 gm (half pala) of nagara (Zingiber officinale) should be made into a paste and taken along with hot milk helps in udavarta. [Cha. Sa. Chikitsa Sthana 5/91-92] &lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;3) Milk cooked with Allum sativum (Lashuna kshirapaka): Garlic cooked with milk by adding water and reducing to the quantity of milk, cures udavarta immediately [Cha. Sa. Chikitsa Sthana 5/94] &lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;4) Alkali prepared from pippali (Piper longum) and other ingredients (Pippalyadi kshara) used in udavarta [Cha. Sa. Chikitsa Sthana 13/159-161] &lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;5) Medicine prepared by boiling medicinal herbs in water and then kept for fermentation with drugs such as haritaki (Terminalia chebula), amalaki (Emblica officinalis), etc. (Phalarishta) used in udavarta. [Cha. Sa. Chikitsa Sthana 14/148-152] &lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;6) Trivrut (Operculina turpethum), pilu (Salvadora persica), yavani (Trachyspermum ammi) with sour gruel mixed with digestants (pachana) drugs. [Su. Sa. Uttara Sthana 55/42-43] &lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt; 7) The combination of hingu (Ferula foetida), kushtha (Saussurea lappa), vacha (Acorus calamus Linn.), svarjika (alkali prepared by burning Lona plant), and vidanga (Embelia ribes) – successively in double quantity cures udavarta and colicky pain by vata dosha (vataja shoola) [Su. Sa. Uttara Sthana 55/42-43]&lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;8) Intake of ghee cooked with decoction of dried radish (Raphanus sativus), sunthi (Zingiber officinale), punarnava (Boerhavia diffusa), brihata panchamula (combination of five herbs viz., bilva, patala, agnimantha, shyonaka and gambhari), and fruits of aragvadha (Cassia fistula) subsides severe udavarta completely. [Su. Sa. Uttara Sthana 55/45-46] &lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;9) Vacha (Acorus calamus Linn.), ativisha (Aconitum heterophyllum), kushtha (Saussurea lappa), yavakshara (alkali prepared from barley), haritaki (Terminalia chebula Retz.), pippali (Piper longum) and agnimantha (Clerodendrum phlomidis) with hot water cures udavarta. [Su. Sa. Uttara Sthana 55/47] &lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;10) Devadaru (Cedrus deodara), chitraka (Plumbago zeylanica), triphala (combination of 3 herbs viz., haritaki, bibhitaki and amalaki), brihati (Solanum indicum) should be taken along with cow’s urine. [Su. Sa. Uttara Sthana 55/49]&lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;11) Suppository: Powder of danti (Baliospermum montanum), kampillaka (Mallotus philippensis), shyama trivrita (Operculina turpethum), ikshvaku (Lagenaria vulgaris Ser.), ajamoda (Apium graveolens), kritavedhana (Luffa acutangula Linn Roxb.), pippali (Piper longum) and salts should cook in cow’s urine and made into suppositories to be inserted in the anus. This provides instant relief in the symptoms of udavarta. [Su. Sa. Uttara Sthana 55/51-52] &lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt; 12) Guggulu (Commiphora mukul) should be taken with decoction of triphala (combination of 3 herbs viz., haritaki, bibhitaki and amalaki), daruharidra (Berberis aristata), patola (Trichosanthes dioica) and kusa (Desmostachya bipinnata) or with urine or hot water for 1 month alleviates udavarta. [Su. Sa. Chikitsa Sthana 5/39-44]&lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;13) Kalyanaka kshara consumed with ghee cures udavarta and constipation (vibandha) [A. H. Chikitsa Sthana 8/142] &lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;14) Erandamooladi enema (basti) helps in alleviating obstruction of faeces, urine and flatus [Ch. Sa. Siddhi Sthana 3/38-42] &lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt; 15) Palashadi niruha basti alleviates non- passage of flatus and feces (anaha) and udavarta [Ch. Sa. Siddhi Sthana 3/44-45]&lt;/p&gt;<br /> <br /> === Treatment as per different conditions===<br /> *In hemorrhoids (arsha), if symptoms of udavarta is present then unctuous enema (anuvasana basti) should be administered. [Cha. Sa. Chikitsa Sthana 14/130]<br /> *In complications by enema (basti vyapat) when unctuous enema gets obstructed by feces then treatment alleviating udavarta should be adopted. [Cha. Sa. Siddhi Sthana 4/36-37]<br /> *In emesis (vamana) and purgation (virechana) complications (vyapta), in extremely vitiated condition of doshas (bahudosha avastha) low dose of medicine is administered, then it causes udavarta, tympanitis (adhmana) in such condition treatment of udavarta is massage (abhyanga), sudation, suppository, non-unctuous enema (niruha basti) and other measures of udavarta should be adopted [Cha. Sa. Siddhi Sthana 6/58-60]<br /> *In pain caused by obstruction of feces (vitshula) the measures mentioned for udavarta should be used in the treatment. [Su. Sa. Uttara Sthana 42/140] <br /> *In treatment of rakta gulma (a variety of phantom tumor) the measures which cures udavarta should be adopted. [A. H. Chikitsa Sthana 14/129]<br /> *Measures which cure udavarta (udavarta hara kriya) should be adopted in abdominal swelling caused by intestinal obstruction (baddhodara). [A. H. Chikitsa Sthana 15/100]<br /> *In emesis (vamana) from improper therapy (mithya yoga), therapies of udavarta should be adopted. [A. H. Kalpasiddhi Sthana 3/13]<br /> *In complications from enema (basti vyapat) the treatment of udavarta should be adopted if fat (sneha) of enema (basti) gets obstructed or enveloped by feces. [A. H. Kalpa-siddhi Sthana 5/39]<br /> <br /> ===Measures alleviating udavarta (udavarta hara)===<br /> <br /> *Mrudvika (Vitis vinifera/grapes) alleviates udavarta [Cha. Sa. Sutra Sthana 27/125-126]<br /> *Haritaki (Terminalia chebula Retz.) used in udavarta [Cha. Sa. Chikitsa Sthana 1/1/31]<br /> *Dish prepared with barley (yavapupa), supernatant liquid proportion of barley preparation (yavaka) and bhristha yava odana/ parched cooked barley (vatya) made from yava (barley) helps in alleviation of udavarta. [Cha. Sa. Sutra Sthana 27/265]<br /> *Saturating drink (mantha) prepared by churning parched grain flour (saktu) with sour taste (amla rasa), fat and jaggery alleviates udavarta. [Su. Sa. Sutra Sthana 46/386]<br /> *Vatya (made by roasted wheat or barley) helps in alleviating udavarta. [Su. Sa. Sutra Sthana 46/410]<br /> *Garlic cooked with milk (lashuna kshirapaka) alleviates udavarta. [A. H. Chikitsa Sthana 14/46]<br /> <br /> ===Diet for udavarta===<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Intake of vegetable preparations prepared from the leaves of trivruta (Operculina turpethum) and snuhi (Euphorbia neriifolia Linn.), tila (Sesamum indicum) and its different preparations, soup of meat of animals inhabiting in marshy land, domestic and aquatic animals, clear top portion of alcohol (prasanna) and molasses rum (sidhu), wine prepared of jaggery, preparations which facilitates motion of flatus, urine and stool. [Cha. Sa. Chikitsa Sthana 26/18] One should never withhold the natural urges of the body. [Su. Sa. Uttara Sthana 55/3]&lt;/p&gt;<br /> <br /> ===Researches===<br /> #1)A review on diseases manifested due to withholding natural urges (vegadharana janya vikara) focused to identify the effects of suppression of natural urges (adharaneeya vegas) on various system of body such as CVS, gastrointestinal tract, respiratory system urinary system and reproductive system. CVS and gastrointestinal systems are the mostly affected systems. Out of thirteen urges (vegas), seven play major role in both systems. Common clinical features produced by suppression of natural urges (vegadharana) were weakness of the body, constipation, anorexia, headache, diseases of eye, difficulty in micturition, bending of the body and stiffness of the neck. Weakness of the body and anorexia are the commonest clinical features produced by suppression of natural urges. These clinical features arise due to vitiation of vata by vegadharana. Withholding (dharana) of natural urges is strictly prohibited to stay healthy.&lt;/P&gt;<br /> #2) A physiological study of adharaneeya vega (suppression of natural urges) w.s.r. to apana vayu vega (suppression of apana vata or flatus)<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Understanding the physiology of suppression of natural urges (vegarodhajanya) symptoms and analyzing them as a pathology of various diseases related to apana vayu (one of the five subtypes of vata situated in the pelvic region). As, seen in clinical practice many a times diseases reoccur after giving proper treatment. Also, in such case causative factors (nidana) of vitiation of apana vayu (one of the five subtypes of vata situated in the pelvic region) is to be analyzed properly for better result. Among the fourteen adharaneeya vega (suppression of natural urges), apana vayu (one of the five subtypes of vata situated in the pelvic region) vega (urge) is most commonly suppressed which leads to vitiation of vata dosha in the pelvic region). Adharaneeya vega (suppression of natural urges) is a reflex mechanism and it is a nervous activity. Nerve supply to gastrointestinal tract is in the form of sympathetic, parasympathetic, enteric nervous system (ENS) and gastrointestinal reflexes. The ENS is to be referred as second brain, it uses serotonin to communicate with the central nervous system. This “brain gut axis’ helps us in understanding how psychological and social stress might cause digestive problems. ENS is closely related to central nervous system (CNS). As mentioned, blindness (‘andhya’) is one of the udavarta janya vikara (diseases caused by udavarta) which is difficult to understand how eyes are related to apana vayu (one of the five subtypes of vata situated in the pelvic region). In an article named ‘Gut microbes linked to eye diseases’ observations have been made by the researchers regarding the possible connection between the gut microbes and the eye diseases. Apana vayu (one of the five subtypes of vata situated in the pelvic region) is mostly parasympathetic in action and its action is related to urine (mutra), stool (purisha), flatus (adhovata) and seminal discharge (shukra vega). Obstruction in passing flatus (apana vayu rodha) invariably affects the prana vayu (one type of the five subtypes of vata situated in upward body or head) among and other vital points in body (marma sthana) like herat (hrudya), brain (shiras), and urinary bladder (basti).&lt;/p&gt;<br /> #3) Nidra vegadharana (suppression of sleep) leads to vitiation of vata dosha. Vata controls the functions of mind (mana). Stress is mainly due to mental and physical stimuli which cause disturbances in the internal biological equilibrium. Disturbed and interrupted sleep is very common in the IT professionals due to their work culture. Here, nidra vegadharana (suppression of urge of sleep) acts as a stress stimulus which causes impairment in both sharirika (biological elements vata, pitta and kapha) and manasika (psychological constitution like raja and tama) dosha which causes further loss of sleep (nidranasha). Udavarta affects mind and leads to abnormalities in mental functions similar to mental stress. Hence it is important to avoid nidra vegadharana (suppression of urge of sleep) to prevent further kriyakala i.e., stage of progression of disease leading to stress and other mental disorders. &lt;/p&gt;<br /> <br /> ===Thesis on udavarta===<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;In this study total 74 patients have been enrolled which were divided in two groups randomly. The selected drug for clinical trial in group A was Yavanikadi vati (tablet) which contains haritaki (Terminalia chebula), yavani (Trachyspermum ammi), hingu (Ferula foetida), sauvarchala (black salt), yavakshara (alkali prepared from barley) and saindhava (rock salt). The powder of these raw drugs was given 3 times trituration (bhavana) of these raw drugs was given 3 times trituration (bhavana) of lemon juice (nimbu swarasa) to prepare tablet. In group B, Shankha vati (tablet) was taken for control group, which contains purified mercury (shuddha parada) and purified sulphur (shuddha gandhaka). In the group A 31 patients were given Yavanikadi vati in tablet form 1 gm B.D. in two divided doses (1 tablet = 500 mg.) daily, after food for 28 days with water whereas, in Group B total 30 patients were given Shankha Vati. The dose, duration, time of administration and anupana (co-administers with medicine) is same as group A. Comparison of the therapies showed that overall better results as observed in group A as compared to group B which stands closely parallel to group A. &lt;/p&gt;</div>

Manishdubey https://www.carakasamhitaonline.com/index.php?title=Talk:Udavarta&diff=44306 2023-11-03T10:43:24Z

<p>Manishdubey: </p> <hr /> <div>{{CiteButton}}<br /> {{#seo:<br /> |title= UDAKAVAHA SROTAS (Channels for transport and transformation of watery components)<br /> |titlemode=append<br /> |keywords=Udakavaha Srotas, Water metabolism, Bhojani M. K., Tanwar Ankur Kumar, Basisht G, Deole Y.S.<br /> |description=Udaka means water. In body, water is present in the form of various fluids. Udakavaha srotasa are the channels for transport and transformation of fluid (water) and its circulation. <br /> |image=http://www.carakasamhitaonline.com/mediawiki-1.32.1/resources/assets/ogimgs.jpg<br /> |image_alt=carak samhita<br /> |type=article<br /> }}<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Udavarta literally means the upward and repeated movements of vata. It is one of the important and commonly observed condition in clinical practice. It manifests with a number of clinical features which may lead to manifestation of other secondary diseases further. Udavarta is mentioned as one among the eighty diseases occurred primarily by the vitiated vata dosha (nanatmaja vata vyadhi). [Cha. Sa. Sutra Sthana 20/11] Udavarta (upward movement of vata) is very common now a days due to change in lifestyle of modern society. The change in dietary habits and due to hectic job schedule, suppression of natural urges (vegadharana) is also very common now a days. The two main cause of udavarta explained in classical texts are: suppression of natural urges (vegadharana) and faulty dietary habits (asatmya ahara sevana). Sushrut Samhita describes that suppression of natural urges (adharaniya vega) leads to manifestation of thirteen types of udavarta. Due to aggravating factors, vata dosha is aggravated, especially apana vata (one of the five subtypes of vata i.e., situated in the pelvic region) is affected. Generally, udavarta means upward movement of vata or apana vata, that results in retention of faeces, urine and flatus. However, the scope of udavarta extends to disturbance in normal functions of vata due to obstruction by metabolic wastes. This unique concept is not explained in any other contemporary sciences. So, understanding this concept and to provide better treatment for this disease is need of the society.&lt;/p&gt;<br /> <br /> {{Infobox<br /> |title = Contributors<br /> |label1 = Section/Chapter/topic<br /> |data1 = Concepts &amp; Practices/[[Udavarta]] <br /> |label2 = Authors<br /> |data2 = Dubey M.&lt;sup&gt;1&lt;/sup&gt;,&lt;br/&gt;Deole Y.S.&lt;sup&gt;2&lt;/sup&gt;<br /> |label3 = Reviewer <br /> |data3 = Basisht G.&lt;sup&gt;3&lt;/sup&gt;, <br /> |label4 = Editor<br /> |data4 = Basisht G.&lt;sup&gt;3&lt;/sup&gt;<br /> |label5 = Affiliations<br /> |data5 = &lt;sup&gt;1&lt;/sup&gt;[[Charak Samhita Research, Training and Development Centre]], I.T.R.A., Jamnagar, India &lt;br/&gt;&lt;sup&gt;2&lt;/sup&gt;Department of Kayachikitsa, G. J. Patel Institute of Ayurvedic Studies and Research, New Vallabh Vidyanagar, Gujarat, India&lt;br/&gt;&lt;sup&gt;3&lt;/sup&gt;Rheumatologist, Orlando, Florida, U.S.A.<br /> |label6 = Correspondence emails<br /> |data6 = dr.manish181@gmail.com, dryogeshdeole@gmail.com<br /> carakasamhita@gmail.com<br /> |label7 = Publisher <br /> |data7 = [[Charak Samhita Research, Training and Development Centre]], I.T.R.A., Jamnagar, India<br /> |label8 = Date of publication:<br /> |data8 =November 03, 2023<br /> |label9 = DOI<br /> |data9 = {{DoiWithLink}}<br /> }}<br /> <br /> ===Nirukti (etymology)===<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;The term udavarta is derived from Utt + Aavat i.e., “Ut + Ang + Vrut + Dhaya” to form word Udavarta. [ ] Udavarta is a Sanskrit word derived from 'Ut' verb root (dhatu) with 'Ang' and 'Vrut' preposition (upasarga), suffixed by ‘Dhaya’ pratyaya (suffix). “Ut” means upper side, (Urdhva) “Ang” means entirely and “Vrut” means to move (bhramana). Udavarta means upwards movement, to cause to go out, excrete, to secrete and to retain. Udavarta is a class of diseases marked by retention of the feces i.e., disease of the bowel so, in general urdhwa (upward direction) or pratiloma (moving in abnormal direction) movement of apana vata (one of the five subtypes of vata, situated in the pelvic region) is termed as udavarta.&lt;/p&gt;<br /> <br /> ===Definition===<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;‘Udavarta’ is that disease in which there is whirlpool movement (avartana) and upward movement (urdhva gamana) of vata is seen due to retention of vata, urine (mutra) and stool (purisha). The condition in which vata begins to move upwards is called as ‘udavarta’ and in this disease vata is the predominant dosha. &lt;/p&gt;<br /> <br /> ===Etiopathogenesis===<br /> *Intake of deficient quantity of food causes udavarta. [Cha. Sa. Vimana Sthana 2/7] <br /> *Intake of astringent, bitter, pungent and un-unctuous (dry) food and excessive fasting<br /> *Withholding natural urges (vegadharana) <br /> *Excessive indulgence in sexual activity. [Cha. Sa. Chikitsa Sthana 26/5-6] <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Due to all above reasons the apana vata which resides in large intestine (pakvashaya) gets aggravated and further obstructs the downward movement of vata causing retention of movement of stool, urine and flatus. This leads to a dreadful disease named as udavarta. [Ca. Sa. Chikitsa Sthana 26/5-6]&lt;/p&gt; <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Acharya Sushruta explained suppression of 13 urges leading to udavarta. [Su. Sa. Uttara Sthana 55/ 3-4] Thus, udavarta is caused by 2 main causes, one is suppression of natural urges and other one unwholesome eating. [Su. Sa. Uttara Sthana 55/ 6] Excess consumption of mudga (Phaseolus mungo), kodrava (Paspalum scrobiculatum Linn.), jurnahva (Sorghum vulgare/jowar), karira (Capparis decidua), chanaka (Cicer arietinum L.), etc. i.e., foods with property of dryness and causing constipation vitiate normal status of vata dosha in its own seat (large intestine). This vata becomes powerful and blocks the downward channels and produces severe obstruction in the movement of feces, flatus and urine leading to udavarta. [A. H. Nidana Sthana 7/46-52]&lt;/p&gt;<br /> <br /> ===Clinical features=== <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Frequent pain in the region of urinary bladder (basti), heart (hridaya), abdomen (udara) and excruciating or intense pain in the back of chest. Other symptoms are flatulence (adhmana), nausea (hrillasa), gripping type of pain in anus (vikartika), pricking (toda) type of pain in whole body, indigestion and inflammation of urinary bladder. Obstruction in passing stool less frequently and with difficulty and in less quantity, after long time and effort. Upward movement of flatus occurs because of obstruction in channels (srotasa), increased roughness, dryness and coldness in the body. [Cha. Sa. Chikitsa Sthana 26/6-7]&lt;/p&gt;<br /> <br /> ===Udavarta janya vikara===<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;If not treated early, udavarta leads to other secondary complications as follows:&lt;/p&gt;<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Fever (jwara), dysuria (mutrakricchhra), dysentery (pravahika), heart disease (hridroga), diseases due to malfunctioning of duodenum (grihani dosha), vomiting (chhardi), blindness, deafness, burning sensation in the head, affliction of abdomen by vata (vatodara), tumors (asthila), psychological diseases (mano vikara), disorders of excessive thirst (trishna roga), an ailment characterized by bleeding from different parts of the body (raktapitta), aruchi (anorexia), phantom tumor (gulma), cough (kasa), dyspnoea (shwasa), chronic rhinitis (pratishyaya), facial paralysis (ardita), diseases of the flanks including lower respiratory tract disorders (parshva roga) and such other serious diseases caused by aggravation of vata. [Cha. Sa. Chikitsa Sthana 26/8-9]&lt;/p&gt;<br /> <br /> ===Udavarta as a causative factor (nidana) of other diseases===<br /> *&lt;p style=&quot;text-align:justify;&quot;&gt;Udavarta is the etiological factor of abdominal swelling caused by intestinal obstruction (baddhagudodara) [Cha. Sa. Chikitsa Sthana 13/39]<br /> *Udavarta is the cause for abdominal swelling afflicted by spleen (plihodara). [Cha. Sa. Chikitsa Sthana 13/75]<br /> *Udavarta is the cause for respiratory diseases including bronchial asthma (pratamaka shwasa-type of tamaka shwasa) characterized by fever, syncope and other such symptoms which are relieved by cold measures. [Cha. Sa. Chikitsa Sthana 17/63]<br /> *Udavarta caused by suppression of the urge of urination is causative factor of condition where severe painful distension of abdomen below umbilicus is present along with obstruction of downward movement of urine (mutrajathara- a type of mutraghata i.e., retention of urine). [Su. Sa. Uttara Sthana 58/13]<br /> *Vidvighata (type of mutraghata i.e., retention of urine): In debilitated person due to loss of fat, udavarta brings small amount of feces into the channels of urine (bladder and urethra) resulting in patients voiding of urine having odour of feces is termed as vidvighata. [A. H. Nidana Sthana 9/33-34]<br /> *Hemorrhoids (arsha): Udavarta is the chief complication in hemorrhoids (durnama/arsha). This udavarta may occur in person who has predominance of vata dosha in alimentary tract (koshtha) even without piles. <br /> *Vatodara: Udavarta is one of the causative factors of abdominal swelling afflicted by vata dosha (vatodara). [Cha. Sa. Chikitsa Sthana 13/23]<br /> *Hiccups (hikka) &amp; dyspnoea (shwasa): Udavarta is the one of the etiological factors for causation of conditions such as hiccups (hikka) and dyspnoea (shwasa).&lt;/p&gt;<br /> <br /> ===Udavarta as symptoms (lakshana) in following diseases===<br /> <br /> #Vataja plihodara (vata predominant plihodara i.e., abdominal swelling afflicted by splenomegaly) [Cha. Sa. Chikitsa Sthana 13/38]<br /> #Vatodara (abdominal swelling afflicted by vata dosha) [Cha. Sa. Chikitsa Sthana 13/25]<br /> #Vataja gulma (vata predominant gulma/ phantom tumor) [Cha. Sa. Chikitsa Sthana 5/10]<br /> #Sahaja arsha (congenital hemorrhoids) [Cha. Sa. Chikitsa Sthana 14/8]<br /> #Vataja arsha (vata predominant hemorrhoids) [Cha. Sa. Chikitsa Sthana 14/11]<br /> #Vyana avruta apana (type of avarana (occlusion) where vyana vata obstructs the flow of apana vata) [Cha. Sa. Chikitsa Sthana 28/211]<br /> #Basti marma viddha (injury to bladder) [Cha. Sa. Siddhi Sthana 9/6]<br /> <br /> ===Types of Udavarta===<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Udavarta is of 6 types which occur by suppression of natural urges viz., apana vata nirodhaja (suppression of flatus), mutra vega nirodhaja (suppression of urine), purisha vega nirodhaja (suppression of faeces), shukra vega nirodhaja (suppression of ejaculation of semen), chhardi vega nirodhaja (suppression of vomiting) and kshavathu vega nirodhaja (suppression of sneezing). [Cha. Sa. Sutra Sthana 18/3]&lt;/p&gt;<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;As per Sushruta Samhita, there are 13 types of suppression of natural urges (vegadharana) namely flatus, faeces, urine, yawning, flow of tears, sneezing, eructation, vomiting, ejaculation of semen, hunger, thirst, breath and sleep. [Su. Sa. Uttara Sthana 55/ 3-4] Suppression of these vega (urges) gives rise to their respective type of udavarta and manifest their respective symptoms which are as follows;&lt;/p&gt;<br /> <br /> ===Asadhyata [incurable stage of diseases]===<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Udavarta with symptoms of excessive thirst, excessively depressed, emaciated, suffering from pain and vomiting of fecal matter is difficult to manage or incurable.[Su. Sa. Uttara Sthana 55/ 17-18] &lt;/p&gt;<br /> <br /> ===Treatment===<br /> &lt;p style=&quot;text-align:justify;&quot;&gt; Treatment principles for udavarta i.e., palliative therapy (shamana) or purification (shodhana) etc., can be selected based on stages of the disease and as well as on the condition of the patient. The treatment guidelines explained in Charaka Samhita are as follows: [Cha. Sa. Chikitsa Sthana 26/11]&lt;/p&gt;<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;The patient suffering from udavarta should be given massage with hot oil described for the treatment of fever presented with cold extremities (sheeta jwara). Then fomentation therapy should be administered for the detachment of the adhered dosha in the tissue cells. This should be followed by the administration of suppository (varti), un-unctuous enema (niruha basti) and unctuous type of purgative (snigdha virechana). The patient should be given food which helps in the normal downward movement (anulomana) of apana vata.&lt;/p&gt;<br /> <br /> '''A) Unction therapy (snehana):''' &lt;p style=&quot;text-align:justify;&quot;&gt;Udavarta is produced due to aggravation of vata and sneha (lipids) is the best treatment for pacification of vata vata (shamana). Therefore, unction therapy (snehana) is indicated in udavarta. &lt;/p&gt;<br /> '''B) Fomentation therapy (swedana):''' &lt;p style=&quot;text-align:justify;&quot;&gt;After massage with oil, fomentation therapy should be administered for the detachment of the adhered dosha in the tissue cells.&lt;/p&gt;<br /> '''C) Suppository (varti):''' &lt;p style=&quot;text-align:justify;&quot;&gt;A suppository having the thickness of the thumb is to be prepared with drugs like Shyama Trivrita (Operculina turpethum), Vidanga (Embeila ribes), Kampillaka (Mallotus philippensis) etc., which should be triturated with gomutra (cow’s urine) or arka (Calotropis gigantea) latex (kshira) and made in to form of suppository (phala varti) by adding jaggery. This suppository should be inserted through anus for the downward movement of apana vata to relieve retention of stool, flatus and urine caused by udavarta.&lt;/p&gt;<br /> '''D) Palliative therapy (shamana):''' &lt;p style=&quot;text-align:justify;&quot;&gt;Shamana includes administration of internal medication such as dviruttara- hingvadi churna, hinguvachadi churna given with warm water as an anupana (co-administers with medicine) for correcting the upward movement of vata.&lt;/p&gt;<br /> '''E) Purification therapy (shodhana):'''&lt;p style=&quot;text-align:justify;&quot;&gt;When the disease is chronic and relief is not observed even by adopting above measures, then purification (shodhana) by non-unctuous enema (niruha basti) or purgation (virechana) is advised.&lt;/p&gt;<br /> '''F) Pathya ahara kalpana (wholesome diet):'''&lt;p style=&quot;text-align:justify;&quot;&gt;Intake of wholesome diet (pathya ahara) which helps in normal downward movement (anulomana) of apana vata whereas, intake of unwholesome diet (apathya ahara) should be avoided for better recovery. Generally, in all types of udavarta all measures for controlling vata should be adopted in order to restore it to its normal channels (srotasa). [Su. Sa. Uttara Sthana 55/ 19]&lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Complications of udavarta, flatulence (adhmana) and other diseases should be managed with respective measures according to condition. [Su. Sa. Uttara Sthana 55/34-35] For example when vayu in abdomen (koshtha) is aggravated by rough, pungent, bitter and astringent food, it immediately produces udavarta owing to which the channels (srotasa) carrying flatus, feces, urine, blood, kapha and adipose tissue (medas), move in upward direction and harden the feces too much. This results in manifestation of symptoms such as pain in cardiac and pelvic region, heaviness, anorexia, passing of urine, flatus and feces with difficulty. The person gets afflicted with many other disorders caused by aggravation of vata such as dyspnoea, (shwasa), cough (kasa), hiccoup (hikka), thirst (trishna), coryza (pratishyaya), burning sensation (daha), mental confusion (moha), vomiting (chhardi), fever (jwara), diseases of head and abnormalities of mind and ears. [Su. Sa. Uttara Sthana 55/2] &lt;/p&gt;<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;One should advise non-unctuous enema (niruha basti) after the patient is massaged with oil mixed with salt and sudation; then after feces are eliminated, he should be advised to take food followed by administration of unctuous enema (anuvasana basti) according to the dosha involvement. If by above procedures, still no relief found then in severe cases of udavarta, patient is advised to undergo repeated unction therapy (snehana) and fomentation therapy (swedana) and then undergo unctuous purgation (snigdha virechana). [Su. Sa. Uttara Sthana 55/40-41]&lt;/p&gt;<br /> <br /> ===Different treatments of udavarta===<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;1) Saturating drink (mantha) prepared with sugarcane product (phanita), roasted grain flour (saktu), ghee, curd water and vinegar (amla kanji) alleviate udavarta. [Cha. Sa. Sutra Sthana 23/37]&lt;/p&gt;<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;2) 96 gm (2 pala) of dehusked tila (Sesamum indicum Linn.), 48 gm (1 pala) of jaggery and 24 gm (half pala) of nagara (Zingiber officinale) should be made into a paste and taken along with hot milk helps in udavarta. [Cha. Sa. Chikitsa Sthana 5/91-92] &lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;3) Milk cooked with Allum sativum (Lashuna kshirapaka): Garlic cooked with milk by adding water and reducing to the quantity of milk, cures udavarta immediately [Cha. Sa. Chikitsa Sthana 5/94] &lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;4) Alkali prepared from pippali (Piper longum) and other ingredients (Pippalyadi kshara) used in udavarta [Cha. Sa. Chikitsa Sthana 13/159-161] &lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;5) Medicine prepared by boiling medicinal herbs in water and then kept for fermentation with drugs such as haritaki (Terminalia chebula), amalaki (Emblica officinalis), etc. (Phalarishta) used in udavarta. [Cha. Sa. Chikitsa Sthana 14/148-152] &lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;6) Trivrut (Operculina turpethum), pilu (Salvadora persica), yavani (Trachyspermum ammi) with sour gruel mixed with digestants (pachana) drugs. [Su. Sa. Uttara Sthana 55/42-43] &lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt; 7) The combination of hingu (Ferula foetida), kushtha (Saussurea lappa), vacha (Acorus calamus Linn.), svarjika (alkali prepared by burning Lona plant), and vidanga (Embelia ribes) – successively in double quantity cures udavarta and colicky pain by vata dosha (vataja shoola) [Su. Sa. Uttara Sthana 55/42-43]&lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;8) Intake of ghee cooked with decoction of dried radish (Raphanus sativus), sunthi (Zingiber officinale), punarnava (Boerhavia diffusa), brihata panchamula (combination of five herbs viz., bilva, patala, agnimantha, shyonaka and gambhari), and fruits of aragvadha (Cassia fistula) subsides severe udavarta completely. [Su. Sa. Uttara Sthana 55/45-46] &lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;9) Vacha (Acorus calamus Linn.), ativisha (Aconitum heterophyllum), kushtha (Saussurea lappa), yavakshara (alkali prepared from barley), haritaki (Terminalia chebula Retz.), pippali (Piper longum) and agnimantha (Clerodendrum phlomidis) with hot water cures udavarta. [Su. Sa. Uttara Sthana 55/47] &lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;10) Devadaru (Cedrus deodara), chitraka (Plumbago zeylanica), triphala (combination of 3 herbs viz., haritaki, bibhitaki and amalaki), brihati (Solanum indicum) should be taken along with cow’s urine. [Su. Sa. Uttara Sthana 55/49]&lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;11) Suppository: Powder of danti (Baliospermum montanum), kampillaka (Mallotus philippensis), shyama trivrita (Operculina turpethum), ikshvaku (Lagenaria vulgaris Ser.), ajamoda (Apium graveolens), kritavedhana (Luffa acutangula Linn Roxb.), pippali (Piper longum) and salts should cook in cow’s urine and made into suppositories to be inserted in the anus. This provides instant relief in the symptoms of udavarta. [Su. Sa. Uttara Sthana 55/51-52] &lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt; 12) Guggulu (Commiphora mukul) should be taken with decoction of triphala (combination of 3 herbs viz., haritaki, bibhitaki and amalaki), daruharidra (Berberis aristata), patola (Trichosanthes dioica) and kusa (Desmostachya bipinnata) or with urine or hot water for 1 month alleviates udavarta. [Su. Sa. Chikitsa Sthana 5/39-44]&lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;13) Kalyanaka kshara consumed with ghee cures udavarta and constipation (vibandha) [A. H. Chikitsa Sthana 8/142] &lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;14) Erandamooladi enema (basti) helps in alleviating obstruction of faeces, urine and flatus [Ch. Sa. Siddhi Sthana 3/38-42] &lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt; 15) Palashadi niruha basti alleviates non- passage of flatus and feces (anaha) and udavarta [Ch. Sa. Siddhi Sthana 3/44-45]&lt;/p&gt;<br /> <br /> === Treatment as per different conditions===<br /> *In hemorrhoids (arsha), if symptoms of udavarta is present then unctuous enema (anuvasana basti) should be administered. [Cha. Sa. Chikitsa Sthana 14/130]<br /> *In complications by enema (basti vyapat) when unctuous enema gets obstructed by feces then treatment alleviating udavarta should be adopted. [Cha. Sa. Siddhi Sthana 4/36-37]<br /> *In emesis (vamana) and purgation (virechana) complications (vyapta), in extremely vitiated condition of doshas (bahudosha avastha) low dose of medicine is administered, then it causes udavarta, tympanitis (adhmana) in such condition treatment of udavarta is massage (abhyanga), sudation, suppository, non-unctuous enema (niruha basti) and other measures of udavarta should be adopted [Cha. Sa. Siddhi Sthana 6/58-60]<br /> *In pain caused by obstruction of feces (vitshula) the measures mentioned for udavarta should be used in the treatment. [Su. Sa. Uttara Sthana 42/140] <br /> *In treatment of rakta gulma (a variety of phantom tumor) the measures which cures udavarta should be adopted. [A. H. Chikitsa Sthana 14/129]<br /> *Measures which cure udavarta (udavarta hara kriya) should be adopted in abdominal swelling caused by intestinal obstruction (baddhodara). [A. H. Chikitsa Sthana 15/100]<br /> *In emesis (vamana) from improper therapy (mithya yoga), therapies of udavarta should be adopted. [A. H. Kalpasiddhi Sthana 3/13]<br /> *In complications from enema (basti vyapat) the treatment of udavarta should be adopted if fat (sneha) of enema (basti) gets obstructed or enveloped by feces. [A. H. Kalpa-siddhi Sthana 5/39]<br /> <br /> ===Measures alleviating udavarta (udavarta hara)===<br /> <br /> *Mrudvika (Vitis vinifera/grapes) alleviates udavarta [Cha. Sa. Sutra Sthana 27/125-126]<br /> *Haritaki (Terminalia chebula Retz.) used in udavarta [Cha. Sa. Chikitsa Sthana 1/1/31]<br /> *Dish prepared with barley (yavapupa), supernatant liquid proportion of barley preparation (yavaka) and bhristha yava odana/ parched cooked barley (vatya) made from yava (barley) helps in alleviation of udavarta. [Cha. Sa. Sutra Sthana 27/265]<br /> *Saturating drink (mantha) prepared by churning parched grain flour (saktu) with sour taste (amla rasa), fat and jaggery alleviates udavarta. [Su. Sa. Sutra Sthana 46/386]<br /> *Vatya (made by roasted wheat or barley) helps in alleviating udavarta. [Su. Sa. Sutra Sthana 46/410]<br /> *Garlic cooked with milk (lashuna kshirapaka) alleviates udavarta. [A. H. Chikitsa Sthana 14/46]<br /> <br /> ===Diet for udavarta===<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Intake of vegetable preparations prepared from the leaves of trivruta (Operculina turpethum) and snuhi (Euphorbia neriifolia Linn.), tila (Sesamum indicum) and its different preparations, soup of meat of animals inhabiting in marshy land, domestic and aquatic animals, clear top portion of alcohol (prasanna) and molasses rum (sidhu), wine prepared of jaggery, preparations which facilitates motion of flatus, urine and stool. [Cha. Sa. Chikitsa Sthana 26/18] One should never withhold the natural urges of the body. [Su. Sa. Uttara Sthana 55/3]&lt;/p&gt;<br /> <br /> ===Researches===<br /> #1)&lt;p style=&quot;text-align:justify;&quot;&gt;A review on diseases manifested due to withholding natural urges (vegadharana janya vikara) focused to identify the effects of suppression of natural urges (adharaneeya vegas) on various system of body such as CVS, gastrointestinal tract, respiratory system urinary system and reproductive system. CVS and gastrointestinal systems are the mostly affected systems. Out of thirteen urges (vegas), seven play major role in both systems. Common clinical features produced by suppression of natural urges (vegadharana) were weakness of the body, constipation, anorexia, headache, diseases of eye, difficulty in micturition, bending of the body and stiffness of the neck. Weakness of the body and anorexia are the commonest clinical features produced by suppression of natural urges. These clinical features arise due to vitiation of vata by vegadharana. Withholding (dharana) of natural urges is strictly prohibited to stay healthy.&lt;/P&gt;<br /> #2)&lt;p style=&quot;text-align:justify;&quot;&gt; A physiological study of adharaneeya vega (suppression of natural urges) w.s.r. to apana vayu vega (suppression of apana vata or flatus)<br /> Understanding the physiology of suppression of natural urges (vegarodhajanya) symptoms and analyzing them as a pathology of various diseases related to apana vayu (one of the five subtypes of vata situated in the pelvic region). As, seen in clinical practice many a times diseases reoccur after giving proper treatment. Also, in such case causative factors (nidana) of vitiation of apana vayu (one of the five subtypes of vata situated in the pelvic region) is to be analyzed properly for better result. Among the fourteen adharaneeya vega (suppression of natural urges), apana vayu (one of the five subtypes of vata situated in the pelvic region) vega (urge) is most commonly suppressed which leads to vitiation of vata dosha in the pelvic region). Adharaneeya vega (suppression of natural urges) is a reflex mechanism and it is a nervous activity. Nerve supply to gastrointestinal tract is in the form of sympathetic, parasympathetic, enteric nervous system (ENS) and gastrointestinal reflexes. The ENS is to be referred as second brain, it uses serotonin to communicate with the central nervous system. This “brain gut axis’ helps us in understanding how psychological and social stress might cause digestive problems. ENS is closely related to central nervous system (CNS). As mentioned, blindness (‘andhya’) is one of the udavarta janya vikara (diseases caused by udavarta) which is difficult to understand how eyes are related to apana vayu (one of the five subtypes of vata situated in the pelvic region). In an article named ‘Gut microbes linked to eye diseases’ observations have been made by the researchers regarding the possible connection between the gut microbes and the eye diseases. Apana vayu (one of the five subtypes of vata situated in the pelvic region) is mostly parasympathetic in action and its action is related to urine (mutra), stool (purisha), flatus (adhovata) and seminal discharge (shukra vega). Obstruction in passing flatus (apana vayu rodha) invariably affects the prana vayu (one type of the five subtypes of vata situated in upward body or head) among and other vital points in body (marma sthana) like herat (hrudya), brain (shiras), and urinary bladder (basti).&lt;/p&gt;<br /> #3)&lt;p style=&quot;text-align:justify;&quot;&gt; Nidra vegadharana (suppression of sleep) leads to vitiation of vata dosha. Vata controls the functions of mind (mana). Stress is mainly due to mental and physical stimuli which cause disturbances in the internal biological equilibrium. Disturbed and interrupted sleep is very common in the IT professionals due to their work culture. Here, nidra vegadharana (suppression of urge of sleep) acts as a stress stimulus which causes impairment in both sharirika (biological elements vata, pitta and kapha) and manasika (psychological constitution like raja and tama) dosha which causes further loss of sleep (nidranasha). Udavarta affects mind and leads to abnormalities in mental functions similar to mental stress. Hence it is important to avoid nidra vegadharana (suppression of urge of sleep) to prevent further kriyakala i.e., stage of progression of disease leading to stress and other mental disorders. &lt;/p&gt;<br /> <br /> ===Thesis on udavarta===<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;In this study total 74 patients have been enrolled which were divided in two groups randomly. The selected drug for clinical trial in group A was Yavanikadi vati (tablet) which contains haritaki (Terminalia chebula), yavani (Trachyspermum ammi), hingu (Ferula foetida), sauvarchala (black salt), yavakshara (alkali prepared from barley) and saindhava (rock salt). The powder of these raw drugs was given 3 times trituration (bhavana) of these raw drugs was given 3 times trituration (bhavana) of lemon juice (nimbu swarasa) to prepare tablet. In group B, Shankha vati (tablet) was taken for control group, which contains purified mercury (shuddha parada) and purified sulphur (shuddha gandhaka). In the group A 31 patients were given Yavanikadi vati in tablet form 1 gm B.D. in two divided doses (1 tablet = 500 mg.) daily, after food for 28 days with water whereas, in Group B total 30 patients were given Shankha Vati. The dose, duration, time of administration and anupana (co-administers with medicine) is same as group A. Comparison of the therapies showed that overall better results as observed in group A as compared to group B which stands closely parallel to group A. &lt;/p&gt;</div>

Manishdubey https://www.carakasamhitaonline.com/index.php?title=Talk:Udavarta&diff=44305 2023-11-03T10:26:43Z

<p>Manishdubey: </p> <hr /> <div>{{CiteButton}}<br /> {{#seo:<br /> |title= UDAKAVAHA SROTAS (Channels for transport and transformation of watery components)<br /> |titlemode=append<br /> |keywords=Udakavaha Srotas, Water metabolism, Bhojani M. K., Tanwar Ankur Kumar, Basisht G, Deole Y.S.<br /> |description=Udaka means water. In body, water is present in the form of various fluids. Udakavaha srotasa are the channels for transport and transformation of fluid (water) and its circulation. <br /> |image=http://www.carakasamhitaonline.com/mediawiki-1.32.1/resources/assets/ogimgs.jpg<br /> |image_alt=carak samhita<br /> |type=article<br /> }}<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Udavarta literally means the upward and repeated movements of vata. It is one of the important and commonly observed condition in clinical practice. It manifests with a number of clinical features which may lead to manifestation of other secondary diseases further. Udavarta is mentioned as one among the eighty diseases occurred primarily by the vitiated vata dosha (nanatmaja vata vyadhi). [Cha. Sa. Sutra Sthana 20/11] Udavarta (upward movement of vata) is very common now a days due to change in lifestyle of modern society. The change in dietary habits and due to hectic job schedule, suppression of natural urges (vegadharana) is also very common now a days. The two main cause of udavarta explained in classical texts are: suppression of natural urges (vegadharana) and faulty dietary habits (asatmya ahara sevana). Sushrut Samhita describes that suppression of natural urges (adharaniya vega) leads to manifestation of thirteen types of udavarta. Due to aggravating factors, vata dosha is aggravated, especially apana vata (one of the five subtypes of vata i.e., situated in the pelvic region) is affected. Generally, udavarta means upward movement of vata or apana vata, that results in retention of faeces, urine and flatus. However, the scope of udavarta extends to disturbance in normal functions of vata due to obstruction by metabolic wastes. This unique concept is not explained in any other contemporary sciences. So, understanding this concept and to provide better treatment for this disease is need of the society.&lt;/p&gt;<br /> <br /> {{Infobox<br /> |title = Contributors<br /> |label1 = Section/Chapter/topic<br /> |data1 = Concepts &amp; Practices/[[Udavarta]] <br /> |label2 = Authors<br /> |data2 = Dubey M.&lt;sup&gt;1&lt;/sup&gt;,&lt;br/&gt;Deole Y.S.&lt;sup&gt;2&lt;/sup&gt;<br /> |label3 = Reviewer <br /> |data3 = Basisht G.&lt;sup&gt;3&lt;/sup&gt;, <br /> |label4 = Editor<br /> |data4 = Basisht G.&lt;sup&gt;3&lt;/sup&gt;<br /> |label5 = Affiliations<br /> |data5 = &lt;sup&gt;1&lt;/sup&gt;[[Charak Samhita Research, Training and Development Centre]], I.T.R.A., Jamnagar, India &lt;br/&gt;&lt;sup&gt;2&lt;/sup&gt;Department of Kayachikitsa, G. J. Patel Institute of Ayurvedic Studies and Research, New Vallabh Vidyanagar, Gujarat, India&lt;br/&gt;&lt;sup&gt;3&lt;/sup&gt;Rheumatologist, Orlando, Florida, U.S.A.<br /> |label6 = Correspondence emails<br /> |data6 = dr.manish181@gmail.com, dryogeshdeole@gmail.com<br /> carakasamhita@gmail.com<br /> |label7 = Publisher <br /> |data7 = [[Charak Samhita Research, Training and Development Centre]], I.T.R.A., Jamnagar, India<br /> |label8 = Date of publication:<br /> |data8 =November 03, 2023<br /> |label9 = DOI<br /> |data9 = {{DoiWithLink}}<br /> }}<br /> <br /> ===Nirukti (etymology)===<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;The term udavarta is derived from Utt + Aavat i.e., “Ut + Ang + Vrut + Dhaya” to form word Udavarta. [ ] Udavarta is a Sanskrit word derived from 'Ut' verb root (dhatu) with 'Ang' and 'Vrut' preposition (upasarga), suffixed by ‘Dhaya’ pratyaya (suffix). “Ut” means upper side, (Urdhva) “Ang” means entirely and “Vrut” means to move (bhramana). Udavarta means upwards movement, to cause to go out, excrete, to secrete and to retain. Udavarta is a class of diseases marked by retention of the feces i.e., disease of the bowel so, in general urdhwa (upward direction) or pratiloma (moving in abnormal direction) movement of apana vata (one of the five subtypes of vata, situated in the pelvic region) is termed as udavarta.&lt;/p&gt;<br /> <br /> ===Definition===<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;‘Udavarta’ is that disease in which there is whirlpool movement (avartana) and upward movement (urdhva gamana) of vata is seen due to retention of vata, urine (mutra) and stool (purisha). The condition in which vata begins to move upwards is called as ‘udavarta’ and in this disease vata is the predominant dosha. &lt;/p&gt;<br /> <br /> ===Etiopathogenesis===<br /> *Intake of deficient quantity of food causes udavarta. [Cha. Sa. Vimana Sthana 2/7] <br /> *Intake of astringent, bitter, pungent and un-unctuous (dry) food and excessive fasting<br /> *Withholding natural urges (vegadharana) <br /> *Excessive indulgence in sexual activity. [Cha. Sa. Chikitsa Sthana 26/5-6] <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Due to all above reasons the apana vata which resides in large intestine (pakvashaya) gets aggravated and further obstructs the downward movement of vata causing retention of movement of stool, urine and flatus. This leads to a dreadful disease named as udavarta. [Ca. Sa. Chikitsa Sthana 26/5-6]&lt;/p&gt; <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Acharya Sushruta explained suppression of 13 urges leading to udavarta. [Su. Sa. Uttara Sthana 55/ 3-4] Thus, udavarta is caused by 2 main causes, one is suppression of natural urges and other one unwholesome eating. [Su. Sa. Uttara Sthana 55/ 6] Excess consumption of mudga (Phaseolus mungo), kodrava (Paspalum scrobiculatum Linn.), jurnahva (Sorghum vulgare/jowar), karira (Capparis decidua), chanaka (Cicer arietinum L.), etc. i.e., foods with property of dryness and causing constipation vitiate normal status of vata dosha in its own seat (large intestine). This vata becomes powerful and blocks the downward channels and produces severe obstruction in the movement of feces, flatus and urine leading to udavarta. [A. H. Nidana Sthana 7/46-52]&lt;/p&gt;<br /> <br /> ===Clinical features=== <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Frequent pain in the region of urinary bladder (basti), heart (hridaya), abdomen (udara) and excruciating or intense pain in the back of chest. Other symptoms are flatulence (adhmana), nausea (hrillasa), gripping type of pain in anus (vikartika), pricking (toda) type of pain in whole body, indigestion and inflammation of urinary bladder. Obstruction in passing stool less frequently and with difficulty and in less quantity, after long time and effort. Upward movement of flatus occurs because of obstruction in channels (srotasa), increased roughness, dryness and coldness in the body. [Cha. Sa. Chikitsa Sthana 26/6-7]&lt;/p&gt;<br /> <br /> ===Udavarta janya vikara===<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;If not treated early, udavarta leads to other secondary complications as follows:&lt;/p&gt;<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Fever (jwara), dysuria (mutrakricchhra), dysentery (pravahika), heart disease (hridroga), diseases due to malfunctioning of duodenum (grihani dosha), vomiting (chhardi), blindness, deafness, burning sensation in the head, affliction of abdomen by vata (vatodara), tumors (asthila), psychological diseases (mano vikara), disorders of excessive thirst (trishna roga), an ailment characterized by bleeding from different parts of the body (raktapitta), aruchi (anorexia), phantom tumor (gulma), cough (kasa), dyspnoea (shwasa), chronic rhinitis (pratishyaya), facial paralysis (ardita), diseases of the flanks including lower respiratory tract disorders (parshva roga) and such other serious diseases caused by aggravation of vata. [Cha. Sa. Chikitsa Sthana 26/8-9]&lt;/p&gt;<br /> <br /> ===Udavarta as a causative factor (nidana) of other diseases===<br /> *&lt;p style=&quot;text-align:justify;&quot;&gt;Udavarta is the etiological factor of abdominal swelling caused by intestinal obstruction (baddhagudodara) [Cha. Sa. Chikitsa Sthana 13/39]<br /> *Udavarta is the cause for abdominal swelling afflicted by spleen (plihodara). [Cha. Sa. Chikitsa Sthana 13/75]<br /> *Udavarta is the cause for respiratory diseases including bronchial asthma (pratamaka shwasa-type of tamaka shwasa) characterized by fever, syncope and other such symptoms which are relieved by cold measures. [Cha. Sa. Chikitsa Sthana 17/63]<br /> *Udavarta caused by suppression of the urge of urination is causative factor of condition where severe painful distension of abdomen below umbilicus is present along with obstruction of downward movement of urine (mutrajathara- a type of mutraghata i.e., retention of urine). [Su. Sa. Uttara Sthana 58/13]<br /> *Vidvighata (type of mutraghata i.e., retention of urine): In debilitated person due to loss of fat, udavarta brings small amount of feces into the channels of urine (bladder and urethra) resulting in patients voiding of urine having odour of feces is termed as vidvighata. [A. H. Nidana Sthana 9/33-34]<br /> *Hemorrhoids (arsha): Udavarta is the chief complication in hemorrhoids (durnama/arsha). This udavarta may occur in person who has predominance of vata dosha in alimentary tract (koshtha) even without piles. <br /> *Vatodara: Udavarta is one of the causative factors of abdominal swelling afflicted by vata dosha (vatodara). [Cha. Sa. Chikitsa Sthana 13/23]<br /> *Hiccups (hikka) &amp; dyspnoea (shwasa): Udavarta is the one of the etiological factors for causation of conditions such as hiccups (hikka) and dyspnoea (shwasa).&lt;/p&gt;<br /> <br /> ===Udavarta as symptoms (lakshana) in following diseases===<br /> <br /> #Vataja plihodara (vata predominant plihodara i.e., abdominal swelling afflicted by splenomegaly) [Cha. Sa. Chikitsa Sthana 13/38]<br /> #Vatodara (abdominal swelling afflicted by vata dosha) [Cha. Sa. Chikitsa Sthana 13/25]<br /> #Vataja gulma (vata predominant gulma/ phantom tumor) [Cha. Sa. Chikitsa Sthana 5/10]<br /> #Sahaja arsha (congenital hemorrhoids) [Cha. Sa. Chikitsa Sthana 14/8]<br /> #Vataja arsha (vata predominant hemorrhoids) [Cha. Sa. Chikitsa Sthana 14/11]<br /> #Vyana avruta apana (type of avarana (occlusion) where vyana vata obstructs the flow of apana vata) [Cha. Sa. Chikitsa Sthana 28/211]<br /> #Basti marma viddha (injury to bladder) [Cha. Sa. Siddhi Sthana 9/6]<br /> <br /> ===Types of Udavarta===<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Udavarta is of 6 types which occur by suppression of natural urges viz., apana vata nirodhaja (suppression of flatus), mutra vega nirodhaja (suppression of urine), purisha vega nirodhaja (suppression of faeces), shukra vega nirodhaja (suppression of ejaculation of semen), chhardi vega nirodhaja (suppression of vomiting) and kshavathu vega nirodhaja (suppression of sneezing). [Cha. Sa. Sutra Sthana 18/3]&lt;/p&gt;<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;As per Sushruta Samhita, there are 13 types of suppression of natural urges (vegadharana) namely flatus, faeces, urine, yawning, flow of tears, sneezing, eructation, vomiting, ejaculation of semen, hunger, thirst, breath and sleep. [Su. Sa. Uttara Sthana 55/ 3-4] Suppression of these vega (urges) gives rise to their respective type of udavarta and manifest their respective symptoms which are as follows;&lt;/p&gt;<br /> <br /> ===Asadhyata [incurable stage of diseases]===<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Udavarta with symptoms of excessive thirst, excessively depressed, emaciated, suffering from pain and vomiting of fecal matter is difficult to manage or incurable.[Su. Sa. Uttara Sthana 55/ 17-18] &lt;/p&gt;<br /> <br /> ===Treatment===<br /> &lt;p style=&quot;text-align:justify;&quot;&gt; Treatment principles for udavarta i.e., palliative therapy (shamana) or purification (shodhana) etc., can be selected based on stages of the disease and as well as on the condition of the patient. The treatment guidelines explained in Charaka Samhita are as follows: [Cha. Sa. Chikitsa Sthana 26/11]&lt;/p&gt;<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;The patient suffering from udavarta should be given massage with hot oil described for the treatment of fever presented with cold extremities (sheeta jwara). Then fomentation therapy should be administered for the detachment of the adhered dosha in the tissue cells. This should be followed by the administration of suppository (varti), un-unctuous enema (niruha basti) and unctuous type of purgative (snigdha virechana). The patient should be given food which helps in the normal downward movement (anulomana) of apana vata.&lt;/p&gt;<br /> <br /> '''A) Unction therapy (snehana):''' &lt;p style=&quot;text-align:justify;&quot;&gt;Udavarta is produced due to aggravation of vata and sneha (lipids) is the best treatment for pacification of vata vata (shamana). Therefore, unction therapy (snehana) is indicated in udavarta. &lt;/p&gt;<br /> '''B) Fomentation therapy (swedana):''' &lt;p style=&quot;text-align:justify;&quot;&gt;After massage with oil, fomentation therapy should be administered for the detachment of the adhered dosha in the tissue cells.&lt;/p&gt;<br /> '''C) Suppository (varti):''' &lt;p style=&quot;text-align:justify;&quot;&gt;A suppository having the thickness of the thumb is to be prepared with drugs like Shyama Trivrita (Operculina turpethum), Vidanga (Embeila ribes), Kampillaka (Mallotus philippensis) etc., which should be triturated with gomutra (cow’s urine) or arka (Calotropis gigantea) latex (kshira) and made in to form of suppository (phala varti) by adding jaggery. This suppository should be inserted through anus for the downward movement of apana vata to relieve retention of stool, flatus and urine caused by udavarta.&lt;/p&gt;<br /> '''D) Palliative therapy (shamana):''' &lt;p style=&quot;text-align:justify;&quot;&gt;Shamana includes administration of internal medication such as dviruttara- hingvadi churna, hinguvachadi churna given with warm water as an anupana (co-administers with medicine) for correcting the upward movement of vata.&lt;/p&gt;<br /> '''E) Purification therapy (shodhana):'''&lt;p style=&quot;text-align:justify;&quot;&gt;When the disease is chronic and relief is not observed even by adopting above measures, then purification (shodhana) by non-unctuous enema (niruha basti) or purgation (virechana) is advised.&lt;/p&gt;<br /> '''F) Pathya ahara kalpana (wholesome diet):'''&lt;p style=&quot;text-align:justify;&quot;&gt;Intake of wholesome diet (pathya ahara) which helps in normal downward movement (anulomana) of apana vata whereas, intake of unwholesome diet (apathya ahara) should be avoided for better recovery. Generally, in all types of udavarta all measures for controlling vata should be adopted in order to restore it to its normal channels (srotasa). [Su. Sa. Uttara Sthana 55/ 19]&lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Complications of udavarta, flatulence (adhmana) and other diseases should be managed with respective measures according to condition. [Su. Sa. Uttara Sthana 55/34-35] For example when vayu in abdomen (koshtha) is aggravated by rough, pungent, bitter and astringent food, it immediately produces udavarta owing to which the channels (srotasa) carrying flatus, feces, urine, blood, kapha and adipose tissue (medas), move in upward direction and harden the feces too much. This results in manifestation of symptoms such as pain in cardiac and pelvic region, heaviness, anorexia, passing of urine, flatus and feces with difficulty. The person gets afflicted with many other disorders caused by aggravation of vata such as dyspnoea, (shwasa), cough (kasa), hiccoup (hikka), thirst (trishna), coryza (pratishyaya), burning sensation (daha), mental confusion (moha), vomiting (chhardi), fever (jwara), diseases of head and abnormalities of mind and ears. [Su. Sa. Uttara Sthana 55/2] &lt;/p&gt;<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;One should advise non-unctuous enema (niruha basti) after the patient is massaged with oil mixed with salt and sudation; then after feces are eliminated, he should be advised to take food followed by administration of unctuous enema (anuvasana basti) according to the dosha involvement. If by above procedures, still no relief found then in severe cases of udavarta, patient is advised to undergo repeated unction therapy (snehana) and fomentation therapy (swedana) and then undergo unctuous purgation (snigdha virechana). [Su. Sa. Uttara Sthana 55/40-41]&lt;/p&gt;<br /> <br /> ===Different treatments of udavarta===<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;1) Saturating drink (mantha) prepared with sugarcane product (phanita), roasted grain flour (saktu), ghee, curd water and vinegar (amla kanji) alleviate udavarta. [Cha. Sa. Sutra Sthana 23/37]&lt;/p&gt;<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;2) 96 gm (2 pala) of dehusked tila (Sesamum indicum Linn.), 48 gm (1 pala) of jaggery and 24 gm (half pala) of nagara (Zingiber officinale) should be made into a paste and taken along with hot milk helps in udavarta. [Cha. Sa. Chikitsa Sthana 5/91-92] &lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;3) Milk cooked with Allum sativum (Lashuna kshirapaka): Garlic cooked with milk by adding water and reducing to the quantity of milk, cures udavarta immediately [Cha. Sa. Chikitsa Sthana 5/94] &lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;4) Alkali prepared from pippali (Piper longum) and other ingredients (Pippalyadi kshara) used in udavarta [Cha. Sa. Chikitsa Sthana 13/159-161] &lt;/p&gt;</div>

Manishdubey https://www.carakasamhitaonline.com/index.php?title=Talk:Udavarta&diff=44304 2023-11-03T10:20:49Z

<p>Manishdubey: /* Asadhyata [incurable stage of diseases] */</p> <hr /> <div>{{CiteButton}}<br /> {{#seo:<br /> |title= UDAKAVAHA SROTAS (Channels for transport and transformation of watery components)<br /> |titlemode=append<br /> |keywords=Udakavaha Srotas, Water metabolism, Bhojani M. K., Tanwar Ankur Kumar, Basisht G, Deole Y.S.<br /> |description=Udaka means water. In body, water is present in the form of various fluids. Udakavaha srotasa are the channels for transport and transformation of fluid (water) and its circulation. <br /> |image=http://www.carakasamhitaonline.com/mediawiki-1.32.1/resources/assets/ogimgs.jpg<br /> |image_alt=carak samhita<br /> |type=article<br /> }}<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Udavarta literally means the upward and repeated movements of vata. It is one of the important and commonly observed condition in clinical practice. It manifests with a number of clinical features which may lead to manifestation of other secondary diseases further. Udavarta is mentioned as one among the eighty diseases occurred primarily by the vitiated vata dosha (nanatmaja vata vyadhi). [Cha. Sa. Sutra Sthana 20/11] Udavarta (upward movement of vata) is very common now a days due to change in lifestyle of modern society. The change in dietary habits and due to hectic job schedule, suppression of natural urges (vegadharana) is also very common now a days. The two main cause of udavarta explained in classical texts are: suppression of natural urges (vegadharana) and faulty dietary habits (asatmya ahara sevana). Sushrut Samhita describes that suppression of natural urges (adharaniya vega) leads to manifestation of thirteen types of udavarta. Due to aggravating factors, vata dosha is aggravated, especially apana vata (one of the five subtypes of vata i.e., situated in the pelvic region) is affected. Generally, udavarta means upward movement of vata or apana vata, that results in retention of faeces, urine and flatus. However, the scope of udavarta extends to disturbance in normal functions of vata due to obstruction by metabolic wastes. This unique concept is not explained in any other contemporary sciences. So, understanding this concept and to provide better treatment for this disease is need of the society.&lt;/p&gt;<br /> <br /> {{Infobox<br /> |title = Contributors<br /> |label1 = Section/Chapter/topic<br /> |data1 = Concepts &amp; Practices/[[Udavarta]] <br /> |label2 = Authors<br /> |data2 = Dubey M.&lt;sup&gt;1&lt;/sup&gt;,&lt;br/&gt;Deole Y.S.&lt;sup&gt;2&lt;/sup&gt;<br /> |label3 = Reviewer <br /> |data3 = Basisht G.&lt;sup&gt;3&lt;/sup&gt;, <br /> |label4 = Editor<br /> |data4 = Basisht G.&lt;sup&gt;3&lt;/sup&gt;<br /> |label5 = Affiliations<br /> |data5 = &lt;sup&gt;1&lt;/sup&gt;[[Charak Samhita Research, Training and Development Centre]], I.T.R.A., Jamnagar, India &lt;br/&gt;&lt;sup&gt;2&lt;/sup&gt;Department of Kayachikitsa, G. J. Patel Institute of Ayurvedic Studies and Research, New Vallabh Vidyanagar, Gujarat, India&lt;br/&gt;&lt;sup&gt;3&lt;/sup&gt;Rheumatologist, Orlando, Florida, U.S.A.<br /> |label6 = Correspondence emails<br /> |data6 = dr.manish181@gmail.com, dryogeshdeole@gmail.com<br /> carakasamhita@gmail.com<br /> |label7 = Publisher <br /> |data7 = [[Charak Samhita Research, Training and Development Centre]], I.T.R.A., Jamnagar, India<br /> |label8 = Date of publication:<br /> |data8 =November 03, 2023<br /> |label9 = DOI<br /> |data9 = {{DoiWithLink}}<br /> }}<br /> <br /> ===Nirukti (etymology)===<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;The term udavarta is derived from Utt + Aavat i.e., “Ut + Ang + Vrut + Dhaya” to form word Udavarta. [ ] Udavarta is a Sanskrit word derived from 'Ut' verb root (dhatu) with 'Ang' and 'Vrut' preposition (upasarga), suffixed by ‘Dhaya’ pratyaya (suffix). “Ut” means upper side, (Urdhva) “Ang” means entirely and “Vrut” means to move (bhramana). Udavarta means upwards movement, to cause to go out, excrete, to secrete and to retain. Udavarta is a class of diseases marked by retention of the feces i.e., disease of the bowel so, in general urdhwa (upward direction) or pratiloma (moving in abnormal direction) movement of apana vata (one of the five subtypes of vata, situated in the pelvic region) is termed as udavarta.&lt;/p&gt;<br /> <br /> ===Definition===<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;‘Udavarta’ is that disease in which there is whirlpool movement (avartana) and upward movement (urdhva gamana) of vata is seen due to retention of vata, urine (mutra) and stool (purisha). The condition in which vata begins to move upwards is called as ‘udavarta’ and in this disease vata is the predominant dosha. &lt;/p&gt;<br /> <br /> ===Etiopathogenesis===<br /> *Intake of deficient quantity of food causes udavarta. [Cha. Sa. Vimana Sthana 2/7] <br /> *Intake of astringent, bitter, pungent and un-unctuous (dry) food and excessive fasting<br /> *Withholding natural urges (vegadharana) <br /> *Excessive indulgence in sexual activity. [Cha. Sa. Chikitsa Sthana 26/5-6] <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Due to all above reasons the apana vata which resides in large intestine (pakvashaya) gets aggravated and further obstructs the downward movement of vata causing retention of movement of stool, urine and flatus. This leads to a dreadful disease named as udavarta. [Ca. Sa. Chikitsa Sthana 26/5-6]&lt;/p&gt; <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Acharya Sushruta explained suppression of 13 urges leading to udavarta. [Su. Sa. Uttara Sthana 55/ 3-4] Thus, udavarta is caused by 2 main causes, one is suppression of natural urges and other one unwholesome eating. [Su. Sa. Uttara Sthana 55/ 6] Excess consumption of mudga (Phaseolus mungo), kodrava (Paspalum scrobiculatum Linn.), jurnahva (Sorghum vulgare/jowar), karira (Capparis decidua), chanaka (Cicer arietinum L.), etc. i.e., foods with property of dryness and causing constipation vitiate normal status of vata dosha in its own seat (large intestine). This vata becomes powerful and blocks the downward channels and produces severe obstruction in the movement of feces, flatus and urine leading to udavarta. [A. H. Nidana Sthana 7/46-52]&lt;/p&gt;<br /> <br /> ===Clinical features=== <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Frequent pain in the region of urinary bladder (basti), heart (hridaya), abdomen (udara) and excruciating or intense pain in the back of chest. Other symptoms are flatulence (adhmana), nausea (hrillasa), gripping type of pain in anus (vikartika), pricking (toda) type of pain in whole body, indigestion and inflammation of urinary bladder. Obstruction in passing stool less frequently and with difficulty and in less quantity, after long time and effort. Upward movement of flatus occurs because of obstruction in channels (srotasa), increased roughness, dryness and coldness in the body. [Cha. Sa. Chikitsa Sthana 26/6-7]&lt;/p&gt;<br /> <br /> ===Udavarta janya vikara===<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;If not treated early, udavarta leads to other secondary complications as follows:&lt;/p&gt;<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Fever (jwara), dysuria (mutrakricchhra), dysentery (pravahika), heart disease (hridroga), diseases due to malfunctioning of duodenum (grihani dosha), vomiting (chhardi), blindness, deafness, burning sensation in the head, affliction of abdomen by vata (vatodara), tumors (asthila), psychological diseases (mano vikara), disorders of excessive thirst (trishna roga), an ailment characterized by bleeding from different parts of the body (raktapitta), aruchi (anorexia), phantom tumor (gulma), cough (kasa), dyspnoea (shwasa), chronic rhinitis (pratishyaya), facial paralysis (ardita), diseases of the flanks including lower respiratory tract disorders (parshva roga) and such other serious diseases caused by aggravation of vata. [Cha. Sa. Chikitsa Sthana 26/8-9]&lt;/p&gt;<br /> <br /> ===Udavarta as a causative factor (nidana) of other diseases===<br /> *&lt;p style=&quot;text-align:justify;&quot;&gt;Udavarta is the etiological factor of abdominal swelling caused by intestinal obstruction (baddhagudodara) [Cha. Sa. Chikitsa Sthana 13/39]<br /> *Udavarta is the cause for abdominal swelling afflicted by spleen (plihodara). [Cha. Sa. Chikitsa Sthana 13/75]<br /> *Udavarta is the cause for respiratory diseases including bronchial asthma (pratamaka shwasa-type of tamaka shwasa) characterized by fever, syncope and other such symptoms which are relieved by cold measures. [Cha. Sa. Chikitsa Sthana 17/63]<br /> *Udavarta caused by suppression of the urge of urination is causative factor of condition where severe painful distension of abdomen below umbilicus is present along with obstruction of downward movement of urine (mutrajathara- a type of mutraghata i.e., retention of urine). [Su. Sa. Uttara Sthana 58/13]<br /> *Vidvighata (type of mutraghata i.e., retention of urine): In debilitated person due to loss of fat, udavarta brings small amount of feces into the channels of urine (bladder and urethra) resulting in patients voiding of urine having odour of feces is termed as vidvighata. [A. H. Nidana Sthana 9/33-34]<br /> *Hemorrhoids (arsha): Udavarta is the chief complication in hemorrhoids (durnama/arsha). This udavarta may occur in person who has predominance of vata dosha in alimentary tract (koshtha) even without piles. <br /> *Vatodara: Udavarta is one of the causative factors of abdominal swelling afflicted by vata dosha (vatodara). [Cha. Sa. Chikitsa Sthana 13/23]<br /> *Hiccups (hikka) &amp; dyspnoea (shwasa): Udavarta is the one of the etiological factors for causation of conditions such as hiccups (hikka) and dyspnoea (shwasa).&lt;/p&gt;<br /> <br /> ===Udavarta as symptoms (lakshana) in following diseases===<br /> <br /> #Vataja plihodara (vata predominant plihodara i.e., abdominal swelling afflicted by splenomegaly) [Cha. Sa. Chikitsa Sthana 13/38]<br /> #Vatodara (abdominal swelling afflicted by vata dosha) [Cha. Sa. Chikitsa Sthana 13/25]<br /> #Vataja gulma (vata predominant gulma/ phantom tumor) [Cha. Sa. Chikitsa Sthana 5/10]<br /> #Sahaja arsha (congenital hemorrhoids) [Cha. Sa. Chikitsa Sthana 14/8]<br /> #Vataja arsha (vata predominant hemorrhoids) [Cha. Sa. Chikitsa Sthana 14/11]<br /> #Vyana avruta apana (type of avarana (occlusion) where vyana vata obstructs the flow of apana vata) [Cha. Sa. Chikitsa Sthana 28/211]<br /> #Basti marma viddha (injury to bladder) [Cha. Sa. Siddhi Sthana 9/6]<br /> <br /> ===Types of Udavarta===<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Udavarta is of 6 types which occur by suppression of natural urges viz., apana vata nirodhaja (suppression of flatus), mutra vega nirodhaja (suppression of urine), purisha vega nirodhaja (suppression of faeces), shukra vega nirodhaja (suppression of ejaculation of semen), chhardi vega nirodhaja (suppression of vomiting) and kshavathu vega nirodhaja (suppression of sneezing). [Cha. Sa. Sutra Sthana 18/3]&lt;/p&gt;<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;As per Sushruta Samhita, there are 13 types of suppression of natural urges (vegadharana) namely flatus, faeces, urine, yawning, flow of tears, sneezing, eructation, vomiting, ejaculation of semen, hunger, thirst, breath and sleep. [Su. Sa. Uttara Sthana 55/ 3-4] Suppression of these vega (urges) gives rise to their respective type of udavarta and manifest their respective symptoms which are as follows;&lt;/p&gt;<br /> <br /> ===Asadhyata [incurable stage of diseases]===<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Udavarta with symptoms of excessive thirst, excessively depressed, emaciated, suffering from pain and vomiting of fecal matter is difficult to manage or incurable.[Su. Sa. Uttara Sthana 55/ 17-18] &lt;/p&gt;<br /> <br /> ===Treatment===<br /> &lt;p style=&quot;text-align:justify;&quot;&gt; Treatment principles for udavarta i.e., palliative therapy (shamana) or purification (shodhana) etc., can be selected based on stages of the disease and as well as on the condition of the patient. The treatment guidelines explained in Charaka Samhita are as follows: [Cha. Sa. Chikitsa Sthana 26/11]&lt;/p&gt;<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;The patient suffering from udavarta should be given massage with hot oil described for the treatment of fever presented with cold extremities (sheeta jwara). Then fomentation therapy should be administered for the detachment of the adhered dosha in the tissue cells. This should be followed by the administration of suppository (varti), un-unctuous enema (niruha basti) and unctuous type of purgative (snigdha virechana). The patient should be given food which helps in the normal downward movement (anulomana) of apana vata.&lt;/p&gt;<br /> <br /> '''A) Unction therapy (snehana):''' &lt;p style=&quot;text-align:justify;&quot;&gt;Udavarta is produced due to aggravation of vata and sneha (lipids) is the best treatment for pacification of vata vata (shamana). Therefore, unction therapy (snehana) is indicated in udavarta. &lt;/p&gt;<br /> '''B) Fomentation therapy (swedana):''' &lt;p style=&quot;text-align:justify;&quot;&gt;After massage with oil, fomentation therapy should be administered for the detachment of the adhered dosha in the tissue cells.&lt;/p&gt;<br /> '''C) Suppository (varti):''' &lt;p style=&quot;text-align:justify;&quot;&gt;A suppository having the thickness of the thumb is to be prepared with drugs like Shyama Trivrita (Operculina turpethum), Vidanga (Embeila ribes), Kampillaka (Mallotus philippensis) etc., which should be triturated with gomutra (cow’s urine) or arka (Calotropis gigantea) latex (kshira) and made in to form of suppository (phala varti) by adding jaggery. This suppository should be inserted through anus for the downward movement of apana vata to relieve retention of stool, flatus and urine caused by udavarta.&lt;/p&gt;<br /> '''D) Palliative therapy (shamana):''' &lt;p style=&quot;text-align:justify;&quot;&gt;Shamana includes administration of internal medication such as dviruttara- hingvadi churna, hinguvachadi churna given with warm water as an anupana (co-administers with medicine) for correcting the upward movement of vata.&lt;/p&gt;<br /> '''E) Purification therapy (shodhana):'''&lt;p style=&quot;text-align:justify;&quot;&gt;When the disease is chronic and relief is not observed even by adopting above measures, then purification (shodhana) by non-unctuous enema (niruha basti) or purgation (virechana) is advised.&lt;/p&gt;<br /> '''F) Pathya ahara kalpana (wholesome diet):'''&lt;p style=&quot;text-align:justify;&quot;&gt;Intake of wholesome diet (pathya ahara) which helps in normal downward movement (anulomana) of apana vata whereas, intake of unwholesome diet (apathya ahara) should be avoided for better recovery. Generally, in all types of udavarta all measures for controlling vata should be adopted in order to restore it to its normal channels (srotasa). [Su. Sa. Uttara Sthana 55/ 19]&lt;/p&gt;</div>

Manishdubey https://www.carakasamhitaonline.com/index.php?title=Talk:Udavarta&diff=44303 2023-11-03T10:19:36Z

<p>Manishdubey: </p> <hr /> <div>{{CiteButton}}<br /> {{#seo:<br /> |title= UDAKAVAHA SROTAS (Channels for transport and transformation of watery components)<br /> |titlemode=append<br /> |keywords=Udakavaha Srotas, Water metabolism, Bhojani M. K., Tanwar Ankur Kumar, Basisht G, Deole Y.S.<br /> |description=Udaka means water. In body, water is present in the form of various fluids. Udakavaha srotasa are the channels for transport and transformation of fluid (water) and its circulation. <br /> |image=http://www.carakasamhitaonline.com/mediawiki-1.32.1/resources/assets/ogimgs.jpg<br /> |image_alt=carak samhita<br /> |type=article<br /> }}<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Udavarta literally means the upward and repeated movements of vata. It is one of the important and commonly observed condition in clinical practice. It manifests with a number of clinical features which may lead to manifestation of other secondary diseases further. Udavarta is mentioned as one among the eighty diseases occurred primarily by the vitiated vata dosha (nanatmaja vata vyadhi). [Cha. Sa. Sutra Sthana 20/11] Udavarta (upward movement of vata) is very common now a days due to change in lifestyle of modern society. The change in dietary habits and due to hectic job schedule, suppression of natural urges (vegadharana) is also very common now a days. The two main cause of udavarta explained in classical texts are: suppression of natural urges (vegadharana) and faulty dietary habits (asatmya ahara sevana). Sushrut Samhita describes that suppression of natural urges (adharaniya vega) leads to manifestation of thirteen types of udavarta. Due to aggravating factors, vata dosha is aggravated, especially apana vata (one of the five subtypes of vata i.e., situated in the pelvic region) is affected. Generally, udavarta means upward movement of vata or apana vata, that results in retention of faeces, urine and flatus. However, the scope of udavarta extends to disturbance in normal functions of vata due to obstruction by metabolic wastes. This unique concept is not explained in any other contemporary sciences. So, understanding this concept and to provide better treatment for this disease is need of the society.&lt;/p&gt;<br /> <br /> {{Infobox<br /> |title = Contributors<br /> |label1 = Section/Chapter/topic<br /> |data1 = Concepts &amp; Practices/[[Udavarta]] <br /> |label2 = Authors<br /> |data2 = Dubey M.&lt;sup&gt;1&lt;/sup&gt;,&lt;br/&gt;Deole Y.S.&lt;sup&gt;2&lt;/sup&gt;<br /> |label3 = Reviewer <br /> |data3 = Basisht G.&lt;sup&gt;3&lt;/sup&gt;, <br /> |label4 = Editor<br /> |data4 = Basisht G.&lt;sup&gt;3&lt;/sup&gt;<br /> |label5 = Affiliations<br /> |data5 = &lt;sup&gt;1&lt;/sup&gt;[[Charak Samhita Research, Training and Development Centre]], I.T.R.A., Jamnagar, India &lt;br/&gt;&lt;sup&gt;2&lt;/sup&gt;Department of Kayachikitsa, G. J. Patel Institute of Ayurvedic Studies and Research, New Vallabh Vidyanagar, Gujarat, India&lt;br/&gt;&lt;sup&gt;3&lt;/sup&gt;Rheumatologist, Orlando, Florida, U.S.A.<br /> |label6 = Correspondence emails<br /> |data6 = dr.manish181@gmail.com, dryogeshdeole@gmail.com<br /> carakasamhita@gmail.com<br /> |label7 = Publisher <br /> |data7 = [[Charak Samhita Research, Training and Development Centre]], I.T.R.A., Jamnagar, India<br /> |label8 = Date of publication:<br /> |data8 =November 03, 2023<br /> |label9 = DOI<br /> |data9 = {{DoiWithLink}}<br /> }}<br /> <br /> ===Nirukti (etymology)===<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;The term udavarta is derived from Utt + Aavat i.e., “Ut + Ang + Vrut + Dhaya” to form word Udavarta. [ ] Udavarta is a Sanskrit word derived from 'Ut' verb root (dhatu) with 'Ang' and 'Vrut' preposition (upasarga), suffixed by ‘Dhaya’ pratyaya (suffix). “Ut” means upper side, (Urdhva) “Ang” means entirely and “Vrut” means to move (bhramana). Udavarta means upwards movement, to cause to go out, excrete, to secrete and to retain. Udavarta is a class of diseases marked by retention of the feces i.e., disease of the bowel so, in general urdhwa (upward direction) or pratiloma (moving in abnormal direction) movement of apana vata (one of the five subtypes of vata, situated in the pelvic region) is termed as udavarta.&lt;/p&gt;<br /> <br /> ===Definition===<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;‘Udavarta’ is that disease in which there is whirlpool movement (avartana) and upward movement (urdhva gamana) of vata is seen due to retention of vata, urine (mutra) and stool (purisha). The condition in which vata begins to move upwards is called as ‘udavarta’ and in this disease vata is the predominant dosha. &lt;/p&gt;<br /> <br /> ===Etiopathogenesis===<br /> *Intake of deficient quantity of food causes udavarta. [Cha. Sa. Vimana Sthana 2/7] <br /> *Intake of astringent, bitter, pungent and un-unctuous (dry) food and excessive fasting<br /> *Withholding natural urges (vegadharana) <br /> *Excessive indulgence in sexual activity. [Cha. Sa. Chikitsa Sthana 26/5-6] <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Due to all above reasons the apana vata which resides in large intestine (pakvashaya) gets aggravated and further obstructs the downward movement of vata causing retention of movement of stool, urine and flatus. This leads to a dreadful disease named as udavarta. [Ca. Sa. Chikitsa Sthana 26/5-6]&lt;/p&gt; <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Acharya Sushruta explained suppression of 13 urges leading to udavarta. [Su. Sa. Uttara Sthana 55/ 3-4] Thus, udavarta is caused by 2 main causes, one is suppression of natural urges and other one unwholesome eating. [Su. Sa. Uttara Sthana 55/ 6] Excess consumption of mudga (Phaseolus mungo), kodrava (Paspalum scrobiculatum Linn.), jurnahva (Sorghum vulgare/jowar), karira (Capparis decidua), chanaka (Cicer arietinum L.), etc. i.e., foods with property of dryness and causing constipation vitiate normal status of vata dosha in its own seat (large intestine). This vata becomes powerful and blocks the downward channels and produces severe obstruction in the movement of feces, flatus and urine leading to udavarta. [A. H. Nidana Sthana 7/46-52]&lt;/p&gt;<br /> <br /> ===Clinical features=== <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Frequent pain in the region of urinary bladder (basti), heart (hridaya), abdomen (udara) and excruciating or intense pain in the back of chest. Other symptoms are flatulence (adhmana), nausea (hrillasa), gripping type of pain in anus (vikartika), pricking (toda) type of pain in whole body, indigestion and inflammation of urinary bladder. Obstruction in passing stool less frequently and with difficulty and in less quantity, after long time and effort. Upward movement of flatus occurs because of obstruction in channels (srotasa), increased roughness, dryness and coldness in the body. [Cha. Sa. Chikitsa Sthana 26/6-7]&lt;/p&gt;<br /> <br /> ===Udavarta janya vikara===<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;If not treated early, udavarta leads to other secondary complications as follows:&lt;/p&gt;<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Fever (jwara), dysuria (mutrakricchhra), dysentery (pravahika), heart disease (hridroga), diseases due to malfunctioning of duodenum (grihani dosha), vomiting (chhardi), blindness, deafness, burning sensation in the head, affliction of abdomen by vata (vatodara), tumors (asthila), psychological diseases (mano vikara), disorders of excessive thirst (trishna roga), an ailment characterized by bleeding from different parts of the body (raktapitta), aruchi (anorexia), phantom tumor (gulma), cough (kasa), dyspnoea (shwasa), chronic rhinitis (pratishyaya), facial paralysis (ardita), diseases of the flanks including lower respiratory tract disorders (parshva roga) and such other serious diseases caused by aggravation of vata. [Cha. Sa. Chikitsa Sthana 26/8-9]&lt;/p&gt;<br /> <br /> ===Udavarta as a causative factor (nidana) of other diseases===<br /> *&lt;p style=&quot;text-align:justify;&quot;&gt;Udavarta is the etiological factor of abdominal swelling caused by intestinal obstruction (baddhagudodara) [Cha. Sa. Chikitsa Sthana 13/39]<br /> *Udavarta is the cause for abdominal swelling afflicted by spleen (plihodara). [Cha. Sa. Chikitsa Sthana 13/75]<br /> *Udavarta is the cause for respiratory diseases including bronchial asthma (pratamaka shwasa-type of tamaka shwasa) characterized by fever, syncope and other such symptoms which are relieved by cold measures. [Cha. Sa. Chikitsa Sthana 17/63]<br /> *Udavarta caused by suppression of the urge of urination is causative factor of condition where severe painful distension of abdomen below umbilicus is present along with obstruction of downward movement of urine (mutrajathara- a type of mutraghata i.e., retention of urine). [Su. Sa. Uttara Sthana 58/13]<br /> *Vidvighata (type of mutraghata i.e., retention of urine): In debilitated person due to loss of fat, udavarta brings small amount of feces into the channels of urine (bladder and urethra) resulting in patients voiding of urine having odour of feces is termed as vidvighata. [A. H. Nidana Sthana 9/33-34]<br /> *Hemorrhoids (arsha): Udavarta is the chief complication in hemorrhoids (durnama/arsha). This udavarta may occur in person who has predominance of vata dosha in alimentary tract (koshtha) even without piles. <br /> *Vatodara: Udavarta is one of the causative factors of abdominal swelling afflicted by vata dosha (vatodara). [Cha. Sa. Chikitsa Sthana 13/23]<br /> *Hiccups (hikka) &amp; dyspnoea (shwasa): Udavarta is the one of the etiological factors for causation of conditions such as hiccups (hikka) and dyspnoea (shwasa).&lt;/p&gt;<br /> <br /> ===Udavarta as symptoms (lakshana) in following diseases===<br /> <br /> #Vataja plihodara (vata predominant plihodara i.e., abdominal swelling afflicted by splenomegaly) [Cha. Sa. Chikitsa Sthana 13/38]<br /> #Vatodara (abdominal swelling afflicted by vata dosha) [Cha. Sa. Chikitsa Sthana 13/25]<br /> #Vataja gulma (vata predominant gulma/ phantom tumor) [Cha. Sa. Chikitsa Sthana 5/10]<br /> #Sahaja arsha (congenital hemorrhoids) [Cha. Sa. Chikitsa Sthana 14/8]<br /> #Vataja arsha (vata predominant hemorrhoids) [Cha. Sa. Chikitsa Sthana 14/11]<br /> #Vyana avruta apana (type of avarana (occlusion) where vyana vata obstructs the flow of apana vata) [Cha. Sa. Chikitsa Sthana 28/211]<br /> #Basti marma viddha (injury to bladder) [Cha. Sa. Siddhi Sthana 9/6]<br /> <br /> ===Types of Udavarta===<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Udavarta is of 6 types which occur by suppression of natural urges viz., apana vata nirodhaja (suppression of flatus), mutra vega nirodhaja (suppression of urine), purisha vega nirodhaja (suppression of faeces), shukra vega nirodhaja (suppression of ejaculation of semen), chhardi vega nirodhaja (suppression of vomiting) and kshavathu vega nirodhaja (suppression of sneezing). [Cha. Sa. Sutra Sthana 18/3]&lt;/p&gt;<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;As per Sushruta Samhita, there are 13 types of suppression of natural urges (vegadharana) namely flatus, faeces, urine, yawning, flow of tears, sneezing, eructation, vomiting, ejaculation of semen, hunger, thirst, breath and sleep. [Su. Sa. Uttara Sthana 55/ 3-4] Suppression of these vega (urges) gives rise to their respective type of udavarta and manifest their respective symptoms which are as follows;&lt;/p&gt;<br /> <br /> ===Asadhyata [incurable stage of diseases]===<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Udavarta with symptoms of excessive thirst, excessively depressed, emaciated, suffering from pain and vomiting of fecal matter is difficult to manage or incurable. &lt;/p&gt;<br /> <br /> ===Treatment===<br /> &lt;p style=&quot;text-align:justify;&quot;&gt; Treatment principles for udavarta i.e., palliative therapy (shamana) or purification (shodhana) etc., can be selected based on stages of the disease and as well as on the condition of the patient. The treatment guidelines explained in Charaka Samhita are as follows: [Cha. Sa. Chikitsa Sthana 26/11]&lt;/p&gt;<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;The patient suffering from udavarta should be given massage with hot oil described for the treatment of fever presented with cold extremities (sheeta jwara). Then fomentation therapy should be administered for the detachment of the adhered dosha in the tissue cells. This should be followed by the administration of suppository (varti), un-unctuous enema (niruha basti) and unctuous type of purgative (snigdha virechana). The patient should be given food which helps in the normal downward movement (anulomana) of apana vata.&lt;/p&gt;<br /> <br /> '''A) Unction therapy (snehana):''' &lt;p style=&quot;text-align:justify;&quot;&gt;Udavarta is produced due to aggravation of vata and sneha (lipids) is the best treatment for pacification of vata vata (shamana). Therefore, unction therapy (snehana) is indicated in udavarta. &lt;/p&gt;<br /> '''B) Fomentation therapy (swedana):''' &lt;p style=&quot;text-align:justify;&quot;&gt;After massage with oil, fomentation therapy should be administered for the detachment of the adhered dosha in the tissue cells.&lt;/p&gt;<br /> '''C) Suppository (varti):''' &lt;p style=&quot;text-align:justify;&quot;&gt;A suppository having the thickness of the thumb is to be prepared with drugs like Shyama Trivrita (Operculina turpethum), Vidanga (Embeila ribes), Kampillaka (Mallotus philippensis) etc., which should be triturated with gomutra (cow’s urine) or arka (Calotropis gigantea) latex (kshira) and made in to form of suppository (phala varti) by adding jaggery. This suppository should be inserted through anus for the downward movement of apana vata to relieve retention of stool, flatus and urine caused by udavarta.&lt;/p&gt;<br /> '''D) Palliative therapy (shamana):''' &lt;p style=&quot;text-align:justify;&quot;&gt;Shamana includes administration of internal medication such as dviruttara- hingvadi churna, hinguvachadi churna given with warm water as an anupana (co-administers with medicine) for correcting the upward movement of vata.&lt;/p&gt;<br /> '''E) Purification therapy (shodhana):'''&lt;p style=&quot;text-align:justify;&quot;&gt;When the disease is chronic and relief is not observed even by adopting above measures, then purification (shodhana) by non-unctuous enema (niruha basti) or purgation (virechana) is advised.&lt;/p&gt;<br /> '''F) Pathya ahara kalpana (wholesome diet):'''&lt;p style=&quot;text-align:justify;&quot;&gt;Intake of wholesome diet (pathya ahara) which helps in normal downward movement (anulomana) of apana vata whereas, intake of unwholesome diet (apathya ahara) should be avoided for better recovery. Generally, in all types of udavarta all measures for controlling vata should be adopted in order to restore it to its normal channels (srotasa). [Su. Sa. Uttara Sthana 55/ 19]&lt;/p&gt;</div>

Manishdubey https://www.carakasamhitaonline.com/index.php?title=Talk:Udavarta&diff=44302 2023-11-03T10:06:19Z

<p>Manishdubey: </p> <hr /> <div>{{CiteButton}}<br /> {{#seo:<br /> |title= UDAKAVAHA SROTAS (Channels for transport and transformation of watery components)<br /> |titlemode=append<br /> |keywords=Udakavaha Srotas, Water metabolism, Bhojani M. K., Tanwar Ankur Kumar, Basisht G, Deole Y.S.<br /> |description=Udaka means water. In body, water is present in the form of various fluids. Udakavaha srotasa are the channels for transport and transformation of fluid (water) and its circulation. <br /> |image=http://www.carakasamhitaonline.com/mediawiki-1.32.1/resources/assets/ogimgs.jpg<br /> |image_alt=carak samhita<br /> |type=article<br /> }}<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Udavarta literally means the upward and repeated movements of vata. It is one of the important and commonly observed condition in clinical practice. It manifests with a number of clinical features which may lead to manifestation of other secondary diseases further. Udavarta is mentioned as one among the eighty diseases occurred primarily by the vitiated vata dosha (nanatmaja vata vyadhi). [Cha. Sa. Sutra Sthana 20/11] Udavarta (upward movement of vata) is very common now a days due to change in lifestyle of modern society. The change in dietary habits and due to hectic job schedule, suppression of natural urges (vegadharana) is also very common now a days. The two main cause of udavarta explained in classical texts are: suppression of natural urges (vegadharana) and faulty dietary habits (asatmya ahara sevana). Sushrut Samhita describes that suppression of natural urges (adharaniya vega) leads to manifestation of thirteen types of udavarta. Due to aggravating factors, vata dosha is aggravated, especially apana vata (one of the five subtypes of vata i.e., situated in the pelvic region) is affected. Generally, udavarta means upward movement of vata or apana vata, that results in retention of faeces, urine and flatus. However, the scope of udavarta extends to disturbance in normal functions of vata due to obstruction by metabolic wastes. This unique concept is not explained in any other contemporary sciences. So, understanding this concept and to provide better treatment for this disease is need of the society.&lt;/p&gt;<br /> <br /> {{Infobox<br /> |title = Contributors<br /> |label1 = Section/Chapter/topic<br /> |data1 = Concepts &amp; Practices/[[Udavarta]] <br /> |label2 = Authors<br /> |data2 = Dubey M.&lt;sup&gt;1&lt;/sup&gt;,&lt;br/&gt;Deole Y.S.&lt;sup&gt;2&lt;/sup&gt;<br /> |label3 = Reviewer <br /> |data3 = Basisht G.&lt;sup&gt;3&lt;/sup&gt;, <br /> |label4 = Editor<br /> |data4 = Basisht G.&lt;sup&gt;3&lt;/sup&gt;<br /> |label5 = Affiliations<br /> |data5 = &lt;sup&gt;1&lt;/sup&gt;[[Charak Samhita Research, Training and Development Centre]], I.T.R.A., Jamnagar, India &lt;br/&gt;&lt;sup&gt;2&lt;/sup&gt;Department of Kayachikitsa, G. J. Patel Institute of Ayurvedic Studies and Research, New Vallabh Vidyanagar, Gujarat, India&lt;br/&gt;&lt;sup&gt;3&lt;/sup&gt;Rheumatologist, Orlando, Florida, U.S.A.<br /> |label6 = Correspondence emails<br /> |data6 = dr.manish181@gmail.com, dryogeshdeole@gmail.com<br /> carakasamhita@gmail.com<br /> |label7 = Publisher <br /> |data7 = [[Charak Samhita Research, Training and Development Centre]], I.T.R.A., Jamnagar, India<br /> |label8 = Date of publication:<br /> |data8 =November 03, 2023<br /> |label9 = DOI<br /> |data9 = {{DoiWithLink}}<br /> }}<br /> <br /> ===Nirukti (etymology)===<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;The term udavarta is derived from Utt + Aavat i.e., “Ut + Ang + Vrut + Dhaya” to form word Udavarta. [ ] Udavarta is a Sanskrit word derived from 'Ut' verb root (dhatu) with 'Ang' and 'Vrut' preposition (upasarga), suffixed by ‘Dhaya’ pratyaya (suffix). “Ut” means upper side, (Urdhva) “Ang” means entirely and “Vrut” means to move (bhramana). Udavarta means upwards movement, to cause to go out, excrete, to secrete and to retain. Udavarta is a class of diseases marked by retention of the feces i.e., disease of the bowel so, in general urdhwa (upward direction) or pratiloma (moving in abnormal direction) movement of apana vata (one of the five subtypes of vata, situated in the pelvic region) is termed as udavarta.&lt;/p&gt;<br /> <br /> ===Definition===<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;‘Udavarta’ is that disease in which there is whirlpool movement (avartana) and upward movement (urdhva gamana) of vata is seen due to retention of vata, urine (mutra) and stool (purisha). The condition in which vata begins to move upwards is called as ‘udavarta’ and in this disease vata is the predominant dosha. &lt;/p&gt;<br /> <br /> ===Etiopathogenesis===<br /> *Intake of deficient quantity of food causes udavarta. [Cha. Sa. Vimana Sthana 2/7] <br /> *Intake of astringent, bitter, pungent and un-unctuous (dry) food and excessive fasting<br /> *Withholding natural urges (vegadharana) <br /> *Excessive indulgence in sexual activity. [Cha. Sa. Chikitsa Sthana 26/5-6] <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Due to all above reasons the apana vata which resides in large intestine (pakvashaya) gets aggravated and further obstructs the downward movement of vata causing retention of movement of stool, urine and flatus. This leads to a dreadful disease named as udavarta. [Ca. Sa. Chikitsa Sthana 26/5-6]&lt;/p&gt; <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Acharya Sushruta explained suppression of 13 urges leading to udavarta. [Su. Sa. Uttara Sthana 55/ 3-4] Thus, udavarta is caused by 2 main causes, one is suppression of natural urges and other one unwholesome eating. [Su. Sa. Uttara Sthana 55/ 6] Excess consumption of mudga (Phaseolus mungo), kodrava (Paspalum scrobiculatum Linn.), jurnahva (Sorghum vulgare/jowar), karira (Capparis decidua), chanaka (Cicer arietinum L.), etc. i.e., foods with property of dryness and causing constipation vitiate normal status of vata dosha in its own seat (large intestine). This vata becomes powerful and blocks the downward channels and produces severe obstruction in the movement of feces, flatus and urine leading to udavarta. [A. H. Nidana Sthana 7/46-52]&lt;/p&gt;<br /> <br /> ===Clinical features=== <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Frequent pain in the region of urinary bladder (basti), heart (hridaya), abdomen (udara) and excruciating or intense pain in the back of chest. Other symptoms are flatulence (adhmana), nausea (hrillasa), gripping type of pain in anus (vikartika), pricking (toda) type of pain in whole body, indigestion and inflammation of urinary bladder. Obstruction in passing stool less frequently and with difficulty and in less quantity, after long time and effort. Upward movement of flatus occurs because of obstruction in channels (srotasa), increased roughness, dryness and coldness in the body. [Cha. Sa. Chikitsa Sthana 26/6-7]&lt;/p&gt;<br /> <br /> ===Udavarta janya vikara===<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;If not treated early, udavarta leads to other secondary complications as follows:&lt;/p&gt;<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Fever (jwara), dysuria (mutrakricchhra), dysentery (pravahika), heart disease (hridroga), diseases due to malfunctioning of duodenum (grihani dosha), vomiting (chhardi), blindness, deafness, burning sensation in the head, affliction of abdomen by vata (vatodara), tumors (asthila), psychological diseases (mano vikara), disorders of excessive thirst (trishna roga), an ailment characterized by bleeding from different parts of the body (raktapitta), aruchi (anorexia), phantom tumor (gulma), cough (kasa), dyspnoea (shwasa), chronic rhinitis (pratishyaya), facial paralysis (ardita), diseases of the flanks including lower respiratory tract disorders (parshva roga) and such other serious diseases caused by aggravation of vata. [Cha. Sa. Chikitsa Sthana 26/8-9]&lt;/p&gt;<br /> <br /> ===Udavarta as a causative factor (nidana) of other diseases===<br /> *&lt;p style=&quot;text-align:justify;&quot;&gt;Udavarta is the etiological factor of abdominal swelling caused by intestinal obstruction (baddhagudodara) [Cha. Sa. Chikitsa Sthana 13/39]<br /> *Udavarta is the cause for abdominal swelling afflicted by spleen (plihodara). [Cha. Sa. Chikitsa Sthana 13/75]<br /> *Udavarta is the cause for respiratory diseases including bronchial asthma (pratamaka shwasa-type of tamaka shwasa) characterized by fever, syncope and other such symptoms which are relieved by cold measures. [Cha. Sa. Chikitsa Sthana 17/63]<br /> *Udavarta caused by suppression of the urge of urination is causative factor of condition where severe painful distension of abdomen below umbilicus is present along with obstruction of downward movement of urine (mutrajathara- a type of mutraghata i.e., retention of urine). [Su. Sa. Uttara Sthana 58/13]<br /> *Vidvighata (type of mutraghata i.e., retention of urine): In debilitated person due to loss of fat, udavarta brings small amount of feces into the channels of urine (bladder and urethra) resulting in patients voiding of urine having odour of feces is termed as vidvighata. [A. H. Nidana Sthana 9/33-34]<br /> *Hemorrhoids (arsha): Udavarta is the chief complication in hemorrhoids (durnama/arsha). This udavarta may occur in person who has predominance of vata dosha in alimentary tract (koshtha) even without piles. <br /> *Vatodara: Udavarta is one of the causative factors of abdominal swelling afflicted by vata dosha (vatodara). [Cha. Sa. Chikitsa Sthana 13/23]<br /> *Hiccups (hikka) &amp; dyspnoea (shwasa): Udavarta is the one of the etiological factors for causation of conditions such as hiccups (hikka) and dyspnoea (shwasa).&lt;/p&gt;<br /> <br /> ===Udavarta as symptoms (lakshana) in following diseases===<br /> <br /> # 1. Vataja plihodara (vata predominant plihodara i.e., abdominal swelling afflicted by splenomegaly) [Cha. Sa. Chikitsa Sthana 13/38]<br /> # 2. Vatodara (abdominal swelling afflicted by vata dosha) [Cha. Sa. Chikitsa Sthana 13/25]<br /> # 3. Vataja gulma (vata predominant gulma/ phantom tumor) [Cha. Sa. Chikitsa Sthana 5/10]<br /> # 4. Sahaja arsha (congenital hemorrhoids) [Cha. Sa. Chikitsa Sthana 14/8]<br /> # 5. Vataja arsha (vata predominant hemorrhoids) [Cha. Sa. Chikitsa Sthana 14/11]<br /> # 6. Vyana avruta apana (type of avarana (occlusion) where vyana vata obstructs the flow of apana vata) [Cha. Sa. Chikitsa Sthana 28/211]<br /> # 7. Basti marma viddha (injury to bladder) [Cha. Sa. Siddhi Sthana 9/6]<br /> <br /> ===Types of Udavarta===<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Udavarta is of 6 types which occur by suppression of natural urges viz., apana vata nirodhaja (suppression of flatus), mutra vega nirodhaja (suppression of urine), purisha vega nirodhaja (suppression of faeces), shukra vega nirodhaja (suppression of ejaculation of semen), chhardi vega nirodhaja (suppression of vomiting) and kshavathu vega nirodhaja (suppression of sneezing). [Cha. Sa. Sutra Sthana 18/3]&lt;/p&gt;<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;As per Sushruta Samhita, there are 13 types of suppression of natural urges (vegadharana) namely flatus, faeces, urine, yawning, flow of tears, sneezing, eructation, vomiting, ejaculation of semen, hunger, thirst, breath and sleep. [Su. Sa. Uttara Sthana 55/ 3-4] Suppression of these vega (urges) gives rise to their respective type of udavarta and manifest their respective symptoms which are as follows;&lt;/p&gt;<br /> <br /> ===Asadhyata [incurable stage of diseases]===<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Udavarta with symptoms of excessive thirst, excessively depressed, emaciated, suffering from pain and vomiting of fecal matter is difficult to manage or incurable. &lt;/p&gt;<br /> <br /> ===Treatment===<br /> &lt;p style=&quot;text-align:justify;&quot;&gt; Treatment principles for udavarta i.e., palliative therapy (shamana) or purification (shodhana) etc., can be selected based on stages of the disease and as well as on the condition of the patient. The treatment guidelines explained in Charaka Samhita are as follows: [Cha. Sa. Chikitsa Sthana 26/11]&lt;/p&gt;<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;The patient suffering from udavarta should be given massage with hot oil described for the treatment of fever presented with cold extremities (sheeta jwara). Then fomentation therapy should be administered for the detachment of the adhered dosha in the tissue cells. This should be followed by the administration of suppository (varti), un-unctuous enema (niruha basti) and unctuous type of purgative (snigdha virechana). The patient should be given food which helps in the normal downward movement (anulomana) of apana vata.&lt;/p&gt;</div>

Manishdubey https://www.carakasamhitaonline.com/index.php?title=Talk:Udavarta&diff=44301 2023-11-03T10:04:32Z

<p>Manishdubey: /* Udavarta as symptoms (lakshana) in following diseases */</p> <hr /> <div>{{CiteButton}}<br /> {{#seo:<br /> |title= UDAKAVAHA SROTAS (Channels for transport and transformation of watery components)<br /> |titlemode=append<br /> |keywords=Udakavaha Srotas, Water metabolism, Bhojani M. K., Tanwar Ankur Kumar, Basisht G, Deole Y.S.<br /> |description=Udaka means water. In body, water is present in the form of various fluids. Udakavaha srotasa are the channels for transport and transformation of fluid (water) and its circulation. <br /> |image=http://www.carakasamhitaonline.com/mediawiki-1.32.1/resources/assets/ogimgs.jpg<br /> |image_alt=carak samhita<br /> |type=article<br /> }}<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Udavarta literally means the upward and repeated movements of vata. It is one of the important and commonly observed condition in clinical practice. It manifests with a number of clinical features which may lead to manifestation of other secondary diseases further. Udavarta is mentioned as one among the eighty diseases occurred primarily by the vitiated vata dosha (nanatmaja vata vyadhi). [Cha. Sa. Sutra Sthana 20/11] Udavarta (upward movement of vata) is very common now a days due to change in lifestyle of modern society. The change in dietary habits and due to hectic job schedule, suppression of natural urges (vegadharana) is also very common now a days. The two main cause of udavarta explained in classical texts are: suppression of natural urges (vegadharana) and faulty dietary habits (asatmya ahara sevana). Sushrut Samhita describes that suppression of natural urges (adharaniya vega) leads to manifestation of thirteen types of udavarta. Due to aggravating factors, vata dosha is aggravated, especially apana vata (one of the five subtypes of vata i.e., situated in the pelvic region) is affected. Generally, udavarta means upward movement of vata or apana vata, that results in retention of faeces, urine and flatus. However, the scope of udavarta extends to disturbance in normal functions of vata due to obstruction by metabolic wastes. This unique concept is not explained in any other contemporary sciences. So, understanding this concept and to provide better treatment for this disease is need of the society.&lt;/p&gt;<br /> <br /> {{Infobox<br /> |title = Contributors<br /> |label1 = Section/Chapter/topic<br /> |data1 = Concepts &amp; Practices/[[Udavarta]] <br /> |label2 = Authors<br /> |data2 = Dubey M.&lt;sup&gt;1&lt;/sup&gt;,&lt;br/&gt;Deole Y.S.&lt;sup&gt;2&lt;/sup&gt;<br /> |label3 = Reviewer <br /> |data3 = Basisht G.&lt;sup&gt;3&lt;/sup&gt;, <br /> |label4 = Editor<br /> |data4 = Basisht G.&lt;sup&gt;3&lt;/sup&gt;<br /> |label5 = Affiliations<br /> |data5 = &lt;sup&gt;1&lt;/sup&gt;[[Charak Samhita Research, Training and Development Centre]], I.T.R.A., Jamnagar, India &lt;br/&gt;&lt;sup&gt;2&lt;/sup&gt;Department of Kayachikitsa, G. J. Patel Institute of Ayurvedic Studies and Research, New Vallabh Vidyanagar, Gujarat, India&lt;br/&gt;&lt;sup&gt;3&lt;/sup&gt;Rheumatologist, Orlando, Florida, U.S.A.<br /> |label6 = Correspondence emails<br /> |data6 = dr.manish181@gmail.com, dryogeshdeole@gmail.com<br /> carakasamhita@gmail.com<br /> |label7 = Publisher <br /> |data7 = [[Charak Samhita Research, Training and Development Centre]], I.T.R.A., Jamnagar, India<br /> |label8 = Date of publication:<br /> |data8 =November 03, 2023<br /> |label9 = DOI<br /> |data9 = {{DoiWithLink}}<br /> }}<br /> <br /> ===Nirukti (etymology)===<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;The term udavarta is derived from Utt + Aavat i.e., “Ut + Ang + Vrut + Dhaya” to form word Udavarta. [ ] Udavarta is a Sanskrit word derived from 'Ut' verb root (dhatu) with 'Ang' and 'Vrut' preposition (upasarga), suffixed by ‘Dhaya’ pratyaya (suffix). “Ut” means upper side, (Urdhva) “Ang” means entirely and “Vrut” means to move (bhramana). Udavarta means upwards movement, to cause to go out, excrete, to secrete and to retain. Udavarta is a class of diseases marked by retention of the feces i.e., disease of the bowel so, in general urdhwa (upward direction) or pratiloma (moving in abnormal direction) movement of apana vata (one of the five subtypes of vata, situated in the pelvic region) is termed as udavarta.&lt;/p&gt;<br /> <br /> ===Definition===<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;‘Udavarta’ is that disease in which there is whirlpool movement (avartana) and upward movement (urdhva gamana) of vata is seen due to retention of vata, urine (mutra) and stool (purisha). The condition in which vata begins to move upwards is called as ‘udavarta’ and in this disease vata is the predominant dosha. &lt;/p&gt;<br /> <br /> ===Etiopathogenesis===<br /> *Intake of deficient quantity of food causes udavarta. [Cha. Sa. Vimana Sthana 2/7] <br /> *Intake of astringent, bitter, pungent and un-unctuous (dry) food and excessive fasting<br /> *Withholding natural urges (vegadharana) <br /> *Excessive indulgence in sexual activity. [Cha. Sa. Chikitsa Sthana 26/5-6] <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Due to all above reasons the apana vata which resides in large intestine (pakvashaya) gets aggravated and further obstructs the downward movement of vata causing retention of movement of stool, urine and flatus. This leads to a dreadful disease named as udavarta. [Ca. Sa. Chikitsa Sthana 26/5-6]&lt;/p&gt; <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Acharya Sushruta explained suppression of 13 urges leading to udavarta. [Su. Sa. Uttara Sthana 55/ 3-4] Thus, udavarta is caused by 2 main causes, one is suppression of natural urges and other one unwholesome eating. [Su. Sa. Uttara Sthana 55/ 6] Excess consumption of mudga (Phaseolus mungo), kodrava (Paspalum scrobiculatum Linn.), jurnahva (Sorghum vulgare/jowar), karira (Capparis decidua), chanaka (Cicer arietinum L.), etc. i.e., foods with property of dryness and causing constipation vitiate normal status of vata dosha in its own seat (large intestine). This vata becomes powerful and blocks the downward channels and produces severe obstruction in the movement of feces, flatus and urine leading to udavarta. [A. H. Nidana Sthana 7/46-52]&lt;/p&gt;<br /> <br /> ===Clinical features=== <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Frequent pain in the region of urinary bladder (basti), heart (hridaya), abdomen (udara) and excruciating or intense pain in the back of chest. Other symptoms are flatulence (adhmana), nausea (hrillasa), gripping type of pain in anus (vikartika), pricking (toda) type of pain in whole body, indigestion and inflammation of urinary bladder. Obstruction in passing stool less frequently and with difficulty and in less quantity, after long time and effort. Upward movement of flatus occurs because of obstruction in channels (srotasa), increased roughness, dryness and coldness in the body. [Cha. Sa. Chikitsa Sthana 26/6-7]&lt;/p&gt;<br /> <br /> ===Udavarta janya vikara===<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;If not treated early, udavarta leads to other secondary complications as follows:&lt;/p&gt;<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Fever (jwara), dysuria (mutrakricchhra), dysentery (pravahika), heart disease (hridroga), diseases due to malfunctioning of duodenum (grihani dosha), vomiting (chhardi), blindness, deafness, burning sensation in the head, affliction of abdomen by vata (vatodara), tumors (asthila), psychological diseases (mano vikara), disorders of excessive thirst (trishna roga), an ailment characterized by bleeding from different parts of the body (raktapitta), aruchi (anorexia), phantom tumor (gulma), cough (kasa), dyspnoea (shwasa), chronic rhinitis (pratishyaya), facial paralysis (ardita), diseases of the flanks including lower respiratory tract disorders (parshva roga) and such other serious diseases caused by aggravation of vata. [Cha. Sa. Chikitsa Sthana 26/8-9]&lt;/p&gt;<br /> <br /> ===Udavarta as a causative factor (nidana) of other diseases===<br /> *&lt;p style=&quot;text-align:justify;&quot;&gt;Udavarta is the etiological factor of abdominal swelling caused by intestinal obstruction (baddhagudodara) [Cha. Sa. Chikitsa Sthana 13/39]<br /> *Udavarta is the cause for abdominal swelling afflicted by spleen (plihodara). [Cha. Sa. Chikitsa Sthana 13/75]<br /> *Udavarta is the cause for respiratory diseases including bronchial asthma (pratamaka shwasa-type of tamaka shwasa) characterized by fever, syncope and other such symptoms which are relieved by cold measures. [Cha. Sa. Chikitsa Sthana 17/63]<br /> *Udavarta caused by suppression of the urge of urination is causative factor of condition where severe painful distension of abdomen below umbilicus is present along with obstruction of downward movement of urine (mutrajathara- a type of mutraghata i.e., retention of urine). [Su. Sa. Uttara Sthana 58/13]<br /> *Vidvighata (type of mutraghata i.e., retention of urine): In debilitated person due to loss of fat, udavarta brings small amount of feces into the channels of urine (bladder and urethra) resulting in patients voiding of urine having odour of feces is termed as vidvighata. [A. H. Nidana Sthana 9/33-34]<br /> *Hemorrhoids (arsha): Udavarta is the chief complication in hemorrhoids (durnama/arsha). This udavarta may occur in person who has predominance of vata dosha in alimentary tract (koshtha) even without piles. <br /> *Vatodara: Udavarta is one of the causative factors of abdominal swelling afflicted by vata dosha (vatodara). [Cha. Sa. Chikitsa Sthana 13/23]<br /> *Hiccups (hikka) &amp; dyspnoea (shwasa): Udavarta is the one of the etiological factors for causation of conditions such as hiccups (hikka) and dyspnoea (shwasa).&lt;/p&gt;<br /> <br /> ===Udavarta as symptoms (lakshana) in following diseases===<br /> <br /> #1. Vataja plihodara (vata predominant plihodara i.e., abdominal swelling afflicted by splenomegaly) [Cha. Sa. Chikitsa Sthana 13/38]<br /> #2. Vatodara (abdominal swelling afflicted by vata dosha) [Cha. Sa. Chikitsa Sthana 13/25]<br /> #3. Vataja gulma (vata predominant gulma/ phantom tumor) [Cha. Sa. Chikitsa Sthana 5/10]<br /> #4. Sahaja arsha (congenital hemorrhoids) [Cha. Sa. Chikitsa Sthana 14/8]<br /> #5. Vataja arsha (vata predominant hemorrhoids) [Cha. Sa. Chikitsa Sthana 14/11]<br /> #6. Vyana avruta apana (type of avarana (occlusion) where vyana vata obstructs the flow of apana vata) [Cha. Sa. Chikitsa Sthana 28/211]<br /> #7. Basti marma viddha (injury to bladder) [Cha. Sa. Siddhi Sthana 9/6]<br /> <br /> ===Types of Udavarta===<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Udavarta is of 6 types which occur by suppression of natural urges viz., apana vata nirodhaja (suppression of flatus), mutra vega nirodhaja (suppression of urine), purisha vega nirodhaja (suppression of faeces), shukra vega nirodhaja (suppression of ejaculation of semen), chhardi vega nirodhaja (suppression of vomiting) and kshavathu vega nirodhaja (suppression of sneezing). [Cha. Sa. Sutra Sthana 18/3]&lt;/p&gt;<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;As per Sushruta Samhita, there are 13 types of suppression of natural urges (vegadharana) namely flatus, faeces, urine, yawning, flow of tears, sneezing, eructation, vomiting, ejaculation of semen, hunger, thirst, breath and sleep. [Su. Sa. Uttara Sthana 55/ 3-4] Suppression of these vega (urges) gives rise to their respective type of udavarta and manifest their respective symptoms which are as follows;&lt;/p&gt;<br /> <br /> ===Asadhyata [incurable stage of diseases]===<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Udavarta with symptoms of excessive thirst, excessively depressed, emaciated, suffering from pain and vomiting of fecal matter is difficult to manage or incurable. &lt;/p&gt;<br /> <br /> ===Treatment===<br /> &lt;p style=&quot;text-align:justify;&quot;&gt; Treatment principles for udavarta i.e., palliative therapy (shamana) or purification (shodhana) etc., can be selected based on stages of the disease and as well as on the condition of the patient. The treatment guidelines explained in Charaka Samhita are as follows: [Cha. Sa. Chikitsa Sthana 26/11]&lt;/p&gt;<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;The patient suffering from udavarta should be given massage with hot oil described for the treatment of fever presented with cold extremities (sheeta jwara). Then fomentation therapy should be administered for the detachment of the adhered dosha in the tissue cells. This should be followed by the administration of suppository (varti), un-unctuous enema (niruha basti) and unctuous type of purgative (snigdha virechana). The patient should be given food which helps in the normal downward movement (anulomana) of apana vata.&lt;/p&gt;</div>

Manishdubey https://www.carakasamhitaonline.com/index.php?title=Talk:Udavarta&diff=44300 2023-11-03T10:03:27Z

<p>Manishdubey: </p> <hr /> <div>{{CiteButton}}<br /> {{#seo:<br /> |title= UDAKAVAHA SROTAS (Channels for transport and transformation of watery components)<br /> |titlemode=append<br /> |keywords=Udakavaha Srotas, Water metabolism, Bhojani M. K., Tanwar Ankur Kumar, Basisht G, Deole Y.S.<br /> |description=Udaka means water. In body, water is present in the form of various fluids. Udakavaha srotasa are the channels for transport and transformation of fluid (water) and its circulation. <br /> |image=http://www.carakasamhitaonline.com/mediawiki-1.32.1/resources/assets/ogimgs.jpg<br /> |image_alt=carak samhita<br /> |type=article<br /> }}<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Udavarta literally means the upward and repeated movements of vata. It is one of the important and commonly observed condition in clinical practice. It manifests with a number of clinical features which may lead to manifestation of other secondary diseases further. Udavarta is mentioned as one among the eighty diseases occurred primarily by the vitiated vata dosha (nanatmaja vata vyadhi). [Cha. Sa. Sutra Sthana 20/11] Udavarta (upward movement of vata) is very common now a days due to change in lifestyle of modern society. The change in dietary habits and due to hectic job schedule, suppression of natural urges (vegadharana) is also very common now a days. The two main cause of udavarta explained in classical texts are: suppression of natural urges (vegadharana) and faulty dietary habits (asatmya ahara sevana). Sushrut Samhita describes that suppression of natural urges (adharaniya vega) leads to manifestation of thirteen types of udavarta. Due to aggravating factors, vata dosha is aggravated, especially apana vata (one of the five subtypes of vata i.e., situated in the pelvic region) is affected. Generally, udavarta means upward movement of vata or apana vata, that results in retention of faeces, urine and flatus. However, the scope of udavarta extends to disturbance in normal functions of vata due to obstruction by metabolic wastes. This unique concept is not explained in any other contemporary sciences. So, understanding this concept and to provide better treatment for this disease is need of the society.&lt;/p&gt;<br /> <br /> {{Infobox<br /> |title = Contributors<br /> |label1 = Section/Chapter/topic<br /> |data1 = Concepts &amp; Practices/[[Udavarta]] <br /> |label2 = Authors<br /> |data2 = Dubey M.&lt;sup&gt;1&lt;/sup&gt;,&lt;br/&gt;Deole Y.S.&lt;sup&gt;2&lt;/sup&gt;<br /> |label3 = Reviewer <br /> |data3 = Basisht G.&lt;sup&gt;3&lt;/sup&gt;, <br /> |label4 = Editor<br /> |data4 = Basisht G.&lt;sup&gt;3&lt;/sup&gt;<br /> |label5 = Affiliations<br /> |data5 = &lt;sup&gt;1&lt;/sup&gt;[[Charak Samhita Research, Training and Development Centre]], I.T.R.A., Jamnagar, India &lt;br/&gt;&lt;sup&gt;2&lt;/sup&gt;Department of Kayachikitsa, G. J. Patel Institute of Ayurvedic Studies and Research, New Vallabh Vidyanagar, Gujarat, India&lt;br/&gt;&lt;sup&gt;3&lt;/sup&gt;Rheumatologist, Orlando, Florida, U.S.A.<br /> |label6 = Correspondence emails<br /> |data6 = dr.manish181@gmail.com, dryogeshdeole@gmail.com<br /> carakasamhita@gmail.com<br /> |label7 = Publisher <br /> |data7 = [[Charak Samhita Research, Training and Development Centre]], I.T.R.A., Jamnagar, India<br /> |label8 = Date of publication:<br /> |data8 =November 03, 2023<br /> |label9 = DOI<br /> |data9 = {{DoiWithLink}}<br /> }}<br /> <br /> ===Nirukti (etymology)===<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;The term udavarta is derived from Utt + Aavat i.e., “Ut + Ang + Vrut + Dhaya” to form word Udavarta. [ ] Udavarta is a Sanskrit word derived from 'Ut' verb root (dhatu) with 'Ang' and 'Vrut' preposition (upasarga), suffixed by ‘Dhaya’ pratyaya (suffix). “Ut” means upper side, (Urdhva) “Ang” means entirely and “Vrut” means to move (bhramana). Udavarta means upwards movement, to cause to go out, excrete, to secrete and to retain. Udavarta is a class of diseases marked by retention of the feces i.e., disease of the bowel so, in general urdhwa (upward direction) or pratiloma (moving in abnormal direction) movement of apana vata (one of the five subtypes of vata, situated in the pelvic region) is termed as udavarta.&lt;/p&gt;<br /> <br /> ===Definition===<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;‘Udavarta’ is that disease in which there is whirlpool movement (avartana) and upward movement (urdhva gamana) of vata is seen due to retention of vata, urine (mutra) and stool (purisha). The condition in which vata begins to move upwards is called as ‘udavarta’ and in this disease vata is the predominant dosha. &lt;/p&gt;<br /> <br /> ===Etiopathogenesis===<br /> *Intake of deficient quantity of food causes udavarta. [Cha. Sa. Vimana Sthana 2/7] <br /> *Intake of astringent, bitter, pungent and un-unctuous (dry) food and excessive fasting<br /> *Withholding natural urges (vegadharana) <br /> *Excessive indulgence in sexual activity. [Cha. Sa. Chikitsa Sthana 26/5-6] <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Due to all above reasons the apana vata which resides in large intestine (pakvashaya) gets aggravated and further obstructs the downward movement of vata causing retention of movement of stool, urine and flatus. This leads to a dreadful disease named as udavarta. [Ca. Sa. Chikitsa Sthana 26/5-6]&lt;/p&gt; <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Acharya Sushruta explained suppression of 13 urges leading to udavarta. [Su. Sa. Uttara Sthana 55/ 3-4] Thus, udavarta is caused by 2 main causes, one is suppression of natural urges and other one unwholesome eating. [Su. Sa. Uttara Sthana 55/ 6] Excess consumption of mudga (Phaseolus mungo), kodrava (Paspalum scrobiculatum Linn.), jurnahva (Sorghum vulgare/jowar), karira (Capparis decidua), chanaka (Cicer arietinum L.), etc. i.e., foods with property of dryness and causing constipation vitiate normal status of vata dosha in its own seat (large intestine). This vata becomes powerful and blocks the downward channels and produces severe obstruction in the movement of feces, flatus and urine leading to udavarta. [A. H. Nidana Sthana 7/46-52]&lt;/p&gt;<br /> <br /> ===Clinical features=== <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Frequent pain in the region of urinary bladder (basti), heart (hridaya), abdomen (udara) and excruciating or intense pain in the back of chest. Other symptoms are flatulence (adhmana), nausea (hrillasa), gripping type of pain in anus (vikartika), pricking (toda) type of pain in whole body, indigestion and inflammation of urinary bladder. Obstruction in passing stool less frequently and with difficulty and in less quantity, after long time and effort. Upward movement of flatus occurs because of obstruction in channels (srotasa), increased roughness, dryness and coldness in the body. [Cha. Sa. Chikitsa Sthana 26/6-7]&lt;/p&gt;<br /> <br /> ===Udavarta janya vikara===<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;If not treated early, udavarta leads to other secondary complications as follows:&lt;/p&gt;<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Fever (jwara), dysuria (mutrakricchhra), dysentery (pravahika), heart disease (hridroga), diseases due to malfunctioning of duodenum (grihani dosha), vomiting (chhardi), blindness, deafness, burning sensation in the head, affliction of abdomen by vata (vatodara), tumors (asthila), psychological diseases (mano vikara), disorders of excessive thirst (trishna roga), an ailment characterized by bleeding from different parts of the body (raktapitta), aruchi (anorexia), phantom tumor (gulma), cough (kasa), dyspnoea (shwasa), chronic rhinitis (pratishyaya), facial paralysis (ardita), diseases of the flanks including lower respiratory tract disorders (parshva roga) and such other serious diseases caused by aggravation of vata. [Cha. Sa. Chikitsa Sthana 26/8-9]&lt;/p&gt;<br /> <br /> ===Udavarta as a causative factor (nidana) of other diseases===<br /> *&lt;p style=&quot;text-align:justify;&quot;&gt;Udavarta is the etiological factor of abdominal swelling caused by intestinal obstruction (baddhagudodara) [Cha. Sa. Chikitsa Sthana 13/39]<br /> *Udavarta is the cause for abdominal swelling afflicted by spleen (plihodara). [Cha. Sa. Chikitsa Sthana 13/75]<br /> *Udavarta is the cause for respiratory diseases including bronchial asthma (pratamaka shwasa-type of tamaka shwasa) characterized by fever, syncope and other such symptoms which are relieved by cold measures. [Cha. Sa. Chikitsa Sthana 17/63]<br /> *Udavarta caused by suppression of the urge of urination is causative factor of condition where severe painful distension of abdomen below umbilicus is present along with obstruction of downward movement of urine (mutrajathara- a type of mutraghata i.e., retention of urine). [Su. Sa. Uttara Sthana 58/13]<br /> *Vidvighata (type of mutraghata i.e., retention of urine): In debilitated person due to loss of fat, udavarta brings small amount of feces into the channels of urine (bladder and urethra) resulting in patients voiding of urine having odour of feces is termed as vidvighata. [A. H. Nidana Sthana 9/33-34]<br /> *Hemorrhoids (arsha): Udavarta is the chief complication in hemorrhoids (durnama/arsha). This udavarta may occur in person who has predominance of vata dosha in alimentary tract (koshtha) even without piles. <br /> *Vatodara: Udavarta is one of the causative factors of abdominal swelling afflicted by vata dosha (vatodara). [Cha. Sa. Chikitsa Sthana 13/23]<br /> *Hiccups (hikka) &amp; dyspnoea (shwasa): Udavarta is the one of the etiological factors for causation of conditions such as hiccups (hikka) and dyspnoea (shwasa).&lt;/p&gt;<br /> <br /> ===Udavarta as symptoms (lakshana) in following diseases===<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;#1. Vataja plihodara (vata predominant plihodara i.e., abdominal swelling afflicted by splenomegaly) [Cha. Sa. Chikitsa Sthana 13/38]<br /> #2. Vatodara (abdominal swelling afflicted by vata dosha) [Cha. Sa. Chikitsa Sthana 13/25]<br /> #3. Vataja gulma (vata predominant gulma/ phantom tumor) [Cha. Sa. Chikitsa Sthana 5/10]<br /> #4. Sahaja arsha (congenital hemorrhoids) [Cha. Sa. Chikitsa Sthana 14/8]<br /> #5. Vataja arsha (vata predominant hemorrhoids) [Cha. Sa. Chikitsa Sthana 14/11]<br /> #6. Vyana avruta apana (type of avarana (occlusion) where vyana vata obstructs the flow of apana vata) [Cha. Sa. Chikitsa Sthana 28/211]<br /> #7. Basti marma viddha (injury to bladder) [Cha. Sa. Siddhi Sthana 9/6]&lt;/p&gt;<br /> <br /> ===Types of Udavarta===<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Udavarta is of 6 types which occur by suppression of natural urges viz., apana vata nirodhaja (suppression of flatus), mutra vega nirodhaja (suppression of urine), purisha vega nirodhaja (suppression of faeces), shukra vega nirodhaja (suppression of ejaculation of semen), chhardi vega nirodhaja (suppression of vomiting) and kshavathu vega nirodhaja (suppression of sneezing). [Cha. Sa. Sutra Sthana 18/3]&lt;/p&gt;<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;As per Sushruta Samhita, there are 13 types of suppression of natural urges (vegadharana) namely flatus, faeces, urine, yawning, flow of tears, sneezing, eructation, vomiting, ejaculation of semen, hunger, thirst, breath and sleep. [Su. Sa. Uttara Sthana 55/ 3-4] Suppression of these vega (urges) gives rise to their respective type of udavarta and manifest their respective symptoms which are as follows;&lt;/p&gt;<br /> <br /> ===Asadhyata [incurable stage of diseases]===<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Udavarta with symptoms of excessive thirst, excessively depressed, emaciated, suffering from pain and vomiting of fecal matter is difficult to manage or incurable. &lt;/p&gt;<br /> <br /> ===Treatment===<br /> &lt;p style=&quot;text-align:justify;&quot;&gt; Treatment principles for udavarta i.e., palliative therapy (shamana) or purification (shodhana) etc., can be selected based on stages of the disease and as well as on the condition of the patient. The treatment guidelines explained in Charaka Samhita are as follows: [Cha. Sa. Chikitsa Sthana 26/11]&lt;/p&gt;<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;The patient suffering from udavarta should be given massage with hot oil described for the treatment of fever presented with cold extremities (sheeta jwara). Then fomentation therapy should be administered for the detachment of the adhered dosha in the tissue cells. This should be followed by the administration of suppository (varti), un-unctuous enema (niruha basti) and unctuous type of purgative (snigdha virechana). The patient should be given food which helps in the normal downward movement (anulomana) of apana vata.&lt;/p&gt;</div>

Manishdubey https://www.carakasamhitaonline.com/index.php?title=Talk:Udavarta&diff=44299 2023-11-03T09:46:23Z

<p>Manishdubey: </p> <hr /> <div>{{CiteButton}}<br /> {{#seo:<br /> |title= UDAKAVAHA SROTAS (Channels for transport and transformation of watery components)<br /> |titlemode=append<br /> |keywords=Udakavaha Srotas, Water metabolism, Bhojani M. K., Tanwar Ankur Kumar, Basisht G, Deole Y.S.<br /> |description=Udaka means water. In body, water is present in the form of various fluids. Udakavaha srotasa are the channels for transport and transformation of fluid (water) and its circulation. <br /> |image=http://www.carakasamhitaonline.com/mediawiki-1.32.1/resources/assets/ogimgs.jpg<br /> |image_alt=carak samhita<br /> |type=article<br /> }}<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Udavarta literally means the upward and repeated movements of vata. It is one of the important and commonly observed condition in clinical practice. It manifests with a number of clinical features which may lead to manifestation of other secondary diseases further. Udavarta is mentioned as one among the eighty diseases occurred primarily by the vitiated vata dosha (nanatmaja vata vyadhi). [Cha. Sa. Sutra Sthana 20/11] Udavarta (upward movement of vata) is very common now a days due to change in lifestyle of modern society. The change in dietary habits and due to hectic job schedule, suppression of natural urges (vegadharana) is also very common now a days. The two main cause of udavarta explained in classical texts are: suppression of natural urges (vegadharana) and faulty dietary habits (asatmya ahara sevana). Sushrut Samhita describes that suppression of natural urges (adharaniya vega) leads to manifestation of thirteen types of udavarta. Due to aggravating factors, vata dosha is aggravated, especially apana vata (one of the five subtypes of vata i.e., situated in the pelvic region) is affected. Generally, udavarta means upward movement of vata or apana vata, that results in retention of faeces, urine and flatus. However, the scope of udavarta extends to disturbance in normal functions of vata due to obstruction by metabolic wastes. This unique concept is not explained in any other contemporary sciences. So, understanding this concept and to provide better treatment for this disease is need of the society.&lt;/p&gt;<br /> <br /> {{Infobox<br /> |title = Contributors<br /> |label1 = Section/Chapter/topic<br /> |data1 = Concepts &amp; Practices/[[Udavarta]] <br /> |label2 = Authors<br /> |data2 = Dubey M.&lt;sup&gt;1&lt;/sup&gt;,&lt;br/&gt;Deole Y.S.&lt;sup&gt;2&lt;/sup&gt;<br /> |label3 = Reviewer <br /> |data3 = Basisht G.&lt;sup&gt;3&lt;/sup&gt;, <br /> |label4 = Editor<br /> |data4 = Basisht G.&lt;sup&gt;3&lt;/sup&gt;<br /> |label5 = Affiliations<br /> |data5 = &lt;sup&gt;1&lt;/sup&gt;[[Charak Samhita Research, Training and Development Centre]], I.T.R.A., Jamnagar, India &lt;br/&gt;&lt;sup&gt;2&lt;/sup&gt;Department of Kayachikitsa, G. J. Patel Institute of Ayurvedic Studies and Research, New Vallabh Vidyanagar, Gujarat, India&lt;br/&gt;&lt;sup&gt;3&lt;/sup&gt;Rheumatologist, Orlando, Florida, U.S.A.<br /> |label6 = Correspondence emails<br /> |data6 = dr.manish181@gmail.com, dryogeshdeole@gmail.com<br /> carakasamhita@gmail.com<br /> |label7 = Publisher <br /> |data7 = [[Charak Samhita Research, Training and Development Centre]], I.T.R.A., Jamnagar, India<br /> |label8 = Date of publication:<br /> |data8 =November 03, 2023<br /> |label9 = DOI<br /> |data9 = {{DoiWithLink}}<br /> }}<br /> <br /> ===Nirukti (etymology)===<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;The term udavarta is derived from Utt + Aavat i.e., “Ut + Ang + Vrut + Dhaya” to form word Udavarta. [ ] Udavarta is a Sanskrit word derived from 'Ut' verb root (dhatu) with 'Ang' and 'Vrut' preposition (upasarga), suffixed by ‘Dhaya’ pratyaya (suffix). “Ut” means upper side, (Urdhva) “Ang” means entirely and “Vrut” means to move (bhramana). Udavarta means upwards movement, to cause to go out, excrete, to secrete and to retain. Udavarta is a class of diseases marked by retention of the feces i.e., disease of the bowel so, in general urdhwa (upward direction) or pratiloma (moving in abnormal direction) movement of apana vata (one of the five subtypes of vata, situated in the pelvic region) is termed as udavarta.&lt;/p&gt;<br /> <br /> ===Definition===<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;‘Udavarta’ is that disease in which there is whirlpool movement (avartana) and upward movement (urdhva gamana) of vata is seen due to retention of vata, urine (mutra) and stool (purisha). The condition in which vata begins to move upwards is called as ‘udavarta’ and in this disease vata is the predominant dosha. &lt;/p&gt;<br /> <br /> ===Etiopathogenesis===<br /> *Intake of deficient quantity of food causes udavarta. [Cha. Sa. Vimana Sthana 2/7] <br /> *Intake of astringent, bitter, pungent and un-unctuous (dry) food and excessive fasting<br /> *Withholding natural urges (vegadharana) <br /> *Excessive indulgence in sexual activity. [Cha. Sa. Chikitsa Sthana 26/5-6] <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Due to all above reasons the apana vata which resides in large intestine (pakvashaya) gets aggravated and further obstructs the downward movement of vata causing retention of movement of stool, urine and flatus. This leads to a dreadful disease named as udavarta. [Ca. Sa. Chikitsa Sthana 26/5-6]&lt;/p&gt; <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Acharya Sushruta explained suppression of 13 urges leading to udavarta. [Su. Sa. Uttara Sthana 55/ 3-4] Thus, udavarta is caused by 2 main causes, one is suppression of natural urges and other one unwholesome eating. [Su. Sa. Uttara Sthana 55/ 6] Excess consumption of mudga (Phaseolus mungo), kodrava (Paspalum scrobiculatum Linn.), jurnahva (Sorghum vulgare/jowar), karira (Capparis decidua), chanaka (Cicer arietinum L.), etc. i.e., foods with property of dryness and causing constipation vitiate normal status of vata dosha in its own seat (large intestine). This vata becomes powerful and blocks the downward channels and produces severe obstruction in the movement of feces, flatus and urine leading to udavarta. [A. H. Nidana Sthana 7/46-52]&lt;/p&gt;</div>

Manishdubey https://www.carakasamhitaonline.com/index.php?title=Talk:Udavarta&diff=44298 2023-11-03T09:34:39Z

<p>Manishdubey: </p> <hr /> <div>{{CiteButton}}<br /> {{#seo:<br /> |title= UDAKAVAHA SROTAS (Channels for transport and transformation of watery components)<br /> |titlemode=append<br /> |keywords=Udakavaha Srotas, Water metabolism, Bhojani M. K., Tanwar Ankur Kumar, Basisht G, Deole Y.S.<br /> |description=Udaka means water. In body, water is present in the form of various fluids. Udakavaha srotasa are the channels for transport and transformation of fluid (water) and its circulation. <br /> |image=http://www.carakasamhitaonline.com/mediawiki-1.32.1/resources/assets/ogimgs.jpg<br /> |image_alt=carak samhita<br /> |type=article<br /> }}<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt; &lt;/p&gt;</div>

Manishdubey https://www.carakasamhitaonline.com/index.php?title=Manovaha_srotas&diff=44204 2023-10-16T11:14:43Z

<p>Manishdubey: Blanked the page</p> <hr /> <div></div>

Manishdubey https://www.carakasamhitaonline.com/index.php?title=Talk:Manovaha_srotas&diff=44203 2023-10-16T11:14:04Z

<p>Manishdubey: </p> <hr /> <div>{{CiteButton}}{{#seo:<br /> |title= Manovaha srotas<br /> (Channels of transport and transformation of mind and mental factors)<br /> |titlemode=append<br /> |keywords= Manovaha srotas,Hrudya, Sattva pariksha, Sattvavajaya chikitsa, Bhojani M. K.,Deole Y.S., Basisht G<br /> |description=Mana means mind, or psyche. Srotas means channels of transport and transformation. The description and understanding of channels for activities of mind (manovaha srotas) is scattered in ayurveda classics and has not been completely elucidated. Manovaha srotas are considered as channels through which mind and body interact with each other. <br /> |image=http://www.carakasamhitaonline.com/mediawiki-1.32.1/resources/assets/ogimgs.jpg<br /> |image_alt=carak samhita<br /> |type=article<br /> }}&lt;p style=&quot;text-align:justify;&quot;&gt;Mana means mind, or psyche. Srotas means channels of transport and transformation. The description and understanding of channels for activities of mind (manovaha srotas) is scattered in ayurveda classics and has not been completely elucidated. Manovaha srotas are considered as channels through which mind and body interact with each other. These channels pervade throughout the body. [Chakrapani on Cha.Sa. Indriya Sthana 5/41-42] They are responsible for flow of thoughts, em&lt;ref name=&quot;:0&quot;&gt; Kumar B.M.N.(2017). Review on Concept of Hrudya in Ayurveda w.s.r. to modern perspective; World Journal of Pharmaceutical Research; vol 6, issue 16.&lt;/ref&gt;otions, and other psychological functions. This article deals with various aspects of manovaha srotasa i.e. the channels of activities of mind and its development.&lt;/p&gt;{{Infobox<br /> |title = Contributors<br /> |label1 = Section/Chapter/topic<br /> |data1 = Concepts/[[Srotas]]/[[Manovaha Srotas]] <br /> |label2 = Authors<br /> |data2 = Bhojani M. K.&lt;sup&gt;1&lt;/sup&gt; Varma Swati &lt;sup&gt;1&lt;/sup&gt; Deole Y.S.&lt;sup&gt;2&lt;/sup&gt;<br /> |label3 = Reviewer &amp; Editor<br /> |data3 = Basisht G.&lt;sup&gt;3&lt;/sup&gt;, <br /> |label4 = Affiliations<br /> |data4 = &lt;sup&gt;1&lt;/sup&gt; Department of Sharir Kriya, All India Institute of Ayurveda, New Delhi, India<br /> &lt;sup&gt;2&lt;/sup&gt; Department of Kayachikitsa, G. J. Patel Institute of Ayurvedic Studies and Research, New Vallabh Vidyanagar, Gujarat, India <br /> &lt;sup&gt;3&lt;/sup&gt; Rheumatologist, Orlando, Florida, U.S.A.<br /> |label5 = Correspondence emails<br /> |data5 = meera.samhita@aiia.gov.in, carakasamhita@gmail.com<br /> |label6 = Publisher <br /> |data6 = [[Charak Samhita Research, Training and Development Centre]], I.T.R.A., Jamnagar, India<br /> |label7 = Date of publication:<br /> |data7 =October 12, 2023<br /> |label8 = DOI<br /> |data8 = In process<br /> }}<br /> ==Etymology and derivation:==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Srotas originates from Sanskrit root ‘Sru’ that translates to oozing, flow or secretion. It has been defined as ‘sravanat strotamsi’ [Cha. Sa. Sutra Sthana 30/12] which indicates structures designated for conveyance of material inside body. &lt;/p&gt;&lt;p style=&quot;text-align:justify;&quot;&gt;Grossly defining, thirteen major types of srotas have been mentioned that transport substances undergoing biotransformation (parinamam aapadyamanam) from the place of origin to their destination. [Cha. Sa. Vimana Sthana 5/3] Similarly in physiological state, manovaha srotas might be responsible for processing and transformation of ‘doshayukta’ (irrational under influence of rajas and tamas) emotions and thoughts into unbiased reasoning before reaching a conclusion by our intellect (buddhi).&lt;/p&gt;<br /> ==Synonyms of manovaha srotas==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Following terms are used for ‘manovaha srotas’ in different Ayurveda classics :&lt;/p&gt;<br /> #Manovaha dhamani [Chakrapani on Cha. Sa. Indriya sthana 12/42] and [Vijayarakshita in Ma.Ni.Purva Khanda 20/1]<br /> #Chetanavaha srotas [Shivadas Sen on Cha.Sa. Chikitsa sthana 9/5]<br /> #Chetovaha marga [Bhel Samhita Nidana Sthana 7/2]<br /> #Manobuddhivaha sira [ Cha.Sa.Chikitsa Sthana 10/58]<br /> #Sanjnavaha srotas [Su.Sa.Uttar Tantra 61/8]<br /> #Sanjnavaha nadi [Su.Sa. Uttar Tantra 46/7]&lt;p style=&quot;text-align:justify;&quot;&gt;Use of terms like sira, nadi and dhamani, refers to different channels and pathways concerned with maintenance of physiological flow of information. [Cha.Sa. Vimana Sthana 5/8]&lt;/p&gt;<br /> ==Origin==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Every srotas is localized within the hollow space in the body originating from a root (mula) and spreading throughout the body to reach a final structure. Srotas are said to be hollow structures in different shapes and sizes The root (mula) is majorly responsible for regulation and control of functions of that srotas. &lt;/p&gt;&lt;p style=&quot;text-align:justify;&quot;&gt;The channels carrying mind (manovaha srotas) are not exclusively listed. It is however stated that the entire conscious body is abode of mind. Hence these channels are spread throughout the body. [Chakrapani on Cha.Sa. Indriya Sthana 5/41]. &lt;/p&gt;&lt;p style=&quot;text-align:justify;&quot;&gt;However, hridaya (heart) has a universal acceptance as the site of origin (mula) of manovaha srotas. Hence a special mention has been made about ten arteries of heart, probably being the manovaha srotas (visheshen tu hrudya ashritvat manah tadashrita dasha dhamanyo manovaha abhidhiyante) [Chakrapani on Cha.Sa. Indriya Sthana 5/41-42]. These get afflicted by vitiated dosha either all at once or individually. [Chakrapani on Cha.Sa. Indriya Sthana 12/42]&lt;/p&gt;<br /> ==Decoding hridaya (heart)==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;The interpretation of the term ‘hridaya’ has been of confusion among scholars since decades. The first interpretation of the term given by texts of Shatpada Brahmana which highlighted functional aspect of hridaya. The word being composed of three letters viz ‘hri’ (hra harane)- to acquire; ‘Da’ (da dane) – to give; ‘Ya’ (Ya gatau)- which transports. The hridaya thus displays three phases of cardiac cycle i.e., receives, gives, and transports body constituents through it. &lt;ref name=&quot;:0&quot; /&gt; &lt;/p&gt;&lt;p style=&quot;text-align:justify;&quot;&gt;Hridaya is the site of rasa (plasma), sattva (psychic factor/mind), buddhi (intellect) and atma (soul) in conjugation with all sensory organs (jnanendriya).[Cha.Sa. Chikitsa Sthana 24/35] Sadhaka pitta situated in heart (hridaya) regulates proper functioning of intellect (buddhi) and ego (ahamkara). Hridaya is located in between breasts (stanayormadhya) of thoracic region [A. H. Sutra Sthana 12/13-14] [Su. Sa. Sharira Sthana 6/25]. &lt;/p&gt;&lt;p style=&quot;text-align:justify;&quot;&gt;Vedic era was well versed with heart (hridaya) and brain (mastishka) being two distinct entities, with interdependent functional relationship [Atharvaveda Book X. Hymn 2.26]. Kashyap Samhita quotes that all sense and motor organs (indriya) together with mind (manas) emerge from heart (hridaya) [Ka.Sa. Chikitsa Sthana 8/6]. Primary site of action of mind (manas) is brain (shira).[3] It can be concluded that mind (manas) being seated in heart (hridaya) connects to brain (shiras) through manovaha srotas and controls all senses (indriya). Also, any damage pertaining to marma (vital points) of shiras (head) causes loss of consciousness (cheshtanasha). [Cha.Sa. Sidhhi Sthana 9/6] Hence heart (hridaya) and brain (shirasor mastishka) are sites of manovaha srotasa. &lt;/p&gt;&lt;p style=&quot;text-align:justify;&quot;&gt;This approach of understanding hridaya goes well along with the contemporary view of understanding the triguna based psycho-functional principles of Ayurveda within the neural framework. Various research has been conducted which demonstrate that heart continuously sends nervous signals to brain to coordinate higher centres responsible for cognition and emotions. &lt;ref&gt;Murthy A.R.V., The Mind in Ayurveda and other Indian Traditions; Chaukhamba Sanskrit Pratishthan; 2013.&lt;/ref&gt; The neuro- psychological as well as circulatory functions of hridaya mentioned in the classics can thus be explained.&lt;/p&gt;<br /> ==Relation between rasavaha and manovaha srotas==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Heart is the abode of mind (mana) and consciousness (chetana) or soul (atma). [Cha. Sa. Sidhhi Sthana 9/4] It is a site for physical, psychological, and spiritual components. Heart is origin for channels of transportation and transformation of rasa dhatu, too. Both heart and brain are considered under the umbrella term hridaya in terms of anatomical structure and higher-centre functions respectively. &lt;/p&gt;&lt;p style=&quot;text-align:justify;&quot;&gt;Heart (residence of manas) and brain (workplace of manas) are functionally co-dependent upon each other. Manas regulates the cognitive and conative functions of brain in conjunction with soul (atma) under the influence of vata dosha. [Cha. Sa. Sharira Sthana 1/22-23]. Brain is a structural entity needing continuous supply of nourishment and oxygen. This is feasible by heart through circulation (rasa-rakta samvahana kriya) via the ten major vessels (rasavahi dhamani). [A. H. Sharira Sthana 3/18] Heart is a highly vascular organ being surrounded by ten major dhamani (blood vessels) like spokes of a wheel which are known as ‘rasavaha strotomula’ (site of origin of channels of nutrition). These channels are comparable to manovaha srotas. [Chakrapani on Cha. Sa. Chikitsa Sthana 9/4] Manas thus acts like a medium between heart and brain wherein brain is responsible for all sensory and motor functions while heart has been assigned emotional aspect of psyche (manas). &lt;/p&gt;&lt;p style=&quot;text-align:justify;&quot;&gt;One of the factors for vitiation of rasavaha srotas is excessive thinking or worry (atichintan). [Cha. Sa. Vimana Sthana 5/13] Contemporary researchers have found evidence to support the interaction between circulatory system and psyche. The monograph of German professor Ludwig Braun is a pioneer in exploring the psychological and emotional aspect of cardiac diseases especially angina. He presented a correlation between cardiac diseases and ‘Angst’ (a constrictive, tightening and crushing sensation which manifests dread in the patient thereby changing his entire emotional outlook on life), analogous to anxiety. He explains that the cardiac tissue has a special apparatus receptive towards anxiety which manifests as an inner tactile sensation. That region is well supplied with nerve endings that gets irritated by anxiety. This phenomenon of emotional influence over cardiac tissues is termed as cardiac psyche. [4]&lt;/p&gt;<br /> ==Factors vitiating manovaha srotas==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Manovaha srotas are the prime site of abnormalities of channels in all psychological disorders. [Cha.Sa. Nidana Sthana 6/4] Alongside any of the eight factors that are either attributed to hridaya or manas viz. mana (mind), buddhi (intellect), sanjna-jnana (self-awareness), smriti (memory), bhakti (devotion), sheela (habits), cheshta (psychomotor activities) and achara (code of conduct). [Cha.Sa. Nidana Sthana 7/5] &lt;/p&gt;&lt;p style=&quot;text-align:justify;&quot;&gt;These factors when deranged cause vitiation of manas dosha (rajas and tamas), deterioration of sattva guna of manas and gradual derangement of tridosha. Foods, activities and excessive expression of emotions like anger, grief, lust, fear etc and mental traumas are the fundamental etiological factors for the same. [Cha.Sa. Nidana Sthana 7/4] Vitiated tridosha further vitiates rasavaha srotas, which apparently has the same site of origin as of manovaha srotas i.e., hridaya and dasha dhamani (ten great vessels). [Cha. Sa. Vimana Sthana 5/10] Hridaya is seat of manas [Cha.Sa. Sutra Sthana 30/4]. Hence, all the factors vitiating rasa dhatu (nutritive fluid), rasavaha srotas (channels carrying nutritive fluid) and manas dosha viz. rajas and tamas will affect manas and eventually vitiating manovaha srotas. Even the structural derangements of heart (abode of mind) affect manovaha srotas due to their ashrayashrayibhava (state of interdependency). [Cha.Sa. Chikitsa Sthana 9/5]&lt;/p&gt;<br /> ==Pathologies of manovaha srotas==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Manovaha srotas is important factor in understanding disorders like unmada (psychosis), apasmara (epilepsy) and extreme emotional reactions.&lt;/p&gt;<br /> *'''Unmada (psychosis)'''&lt;p style=&quot;text-align:justify;&quot;&gt;When an individual experiences extreme emotions – lust (kama), anger (krodha), fear (bhaya), greed (lobha), happiness or pleasure (harsha), affection (moha), grief (shoka), excessive worry (chinta), they initially harm the intellect which aggravates manas dosha (rajas and tamas) and tridosha (vata, pitta and kapha). These vitiated dosha invade heart and obstruct manovaha srotas (channels transporting psychic impulses) thereby causing unmada. [Dalhan on Su. Sa. Uttar Tantra 62/3]<br /> *'''Apasmara (epilepsy)'''<br /> Overindulging in sensory pleasures, incompatible diet, withholding natural urges and giving into immoral activities under emotional influences (kama, krodha, lobha among others), vitiates rajas and tamas. They poorly influence the manas (mind) and sanjnavaha srotas (manovaha srotas) causing apasmara. [Su.Sa. Uttar Tantra 61/6]<br /> *Mada (intoxication), murchha (syncope), sanyasa (coma) are caused by vitiation of channels of consciousness (chetanavaha srotas or manovaha srotas). [Shivadas Sen on Cha. Sa. Chikitsa Sthana 9/5]<br /> *'''Atattvabhinivesha (perverted state of mind)'''<br /> Considered as mahagada (difficult to treat mental disorder), the person’s conscience gets afflicted by rajas and tamas, which cause complete derangement of intellect (buddhi vibhramsha) as the predominant symptom. The vitiated dosha get lodged in heart (hridaya) to afflict channels of mind and intellect (manobuddhivaha sira in manovaha srotas). [Cha.Sa. Chikitsa Sthana 10/57-60]<br /> *Physiology of nightmares (swapna)<br /> Nightmares are dreams occurring in REM phase of sleep which causes mental projections in the form of feelings of fear, despair, and anxiety. Ayurveda defines REM phase as ‘Natiprasupta’ - the state characterised to be midway between states of deep sleep and fully awake. During any ominous situation, tridosha in their highly aggravated state tend to fill-up the manovaha srotas. This results in terrifying dreams. [Cha.Sa. Indriya Sthana 5/41].<br /> ==Assessment and diagnosis of disorders of manovaha srotas==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Srotas are micro-channels transporting various metabolites across cells throughout the body. It can be deduced that manovaha srotas has different characteristics structurally and functionally from the major thirteen srotas, because it transports and transforms thoughts and feelings. This is evident from objects of mind (manas), viz- thought (chintyam), consideration (vicharyam), hypothesis (uhyam), aims (dhyeyam) and determination (sankalpam). [Cha.Sa. Sharira Sthana 1/20]. Assessment of manovaha srotas can be done via assessment of manas and the degree of derangement of its functions. Ayurveda considers manas as material entity (dravya) which is a super sense and not perceivable by ordinary senses (atindriya) [Cha. Sa. Sutra Sthana 8/4]. Manas is under direct control of vata dosha [Cha. Sa. Sutra Sthana 12/8] and is the mediator between atma (soul) and indriyartha (objects of senses). &lt;/p&gt;&lt;p style=&quot;text-align:justify;&quot;&gt;The contemporary physiological aspects of mind, senses, brain, nervous system and consciousness can be considered for assessment of manovaha srotas. &lt;/p&gt;&lt;p style=&quot;text-align:justify;&quot;&gt;A thorough neurological examination by means of interrogation (prashna pariksha), inspection (darshana pariksha) and assessment of mental strength (sattva bala pariksha) [Cha.Sa. Vimana Sthana 8/119] can be used for assessment and diagnosis of disorders of manovaha srotas.&lt;/p&gt;''' a. Interrogation (prashna pariksha)''' A formal interview of the patient can be conducted for overall and precise diagnosis. The questions related to chief complaints with duration, chronological development, nurturing of patient, family history, addiction, hobbies, interests, daily routine, major life events, achievements, mental traumas, emotional quotient and intellectual quotient is recorded from the patient. If the patient is not in state of giving correct answers, then the relatives or attendants who know patients history are interviewed.<br /> <br /> '''b. Darshan pariksha (Direct observation)''' While interviewing the patient, a physician should pay attention to following attributes that can signify features mentioned for certain psychiatric ailments (manovaha srotodushti)..<br /> #'''Appearance '''– Unusual dressing preferences, use of cosmetics, perfumes or accessories or flamboyant appearance. e.g;- ‘Priye tanu rakta vastradhari’ (liking for adorning clothes made of thin red fabric) is seen in yakshagraha unmada (Su.Sa. Uttara tantra 60/11)<br /> #'''Activity and co-ordination''' - Behaviour, Gait, gestures, patient’s facial expression and body language should be observed during probing them with questions. Eg;- 'Satatama akshano’ (rapid and constant eye movements) is one of the prodromal feature of apasmara (epilepsy) [ Cha.Sa. Nidana sthana 8/6]. Udhasta (patient keeps his hands raised) is a feature of pishacha grahavishta unmada [Su.Sa. Uttara Tantra 60/15]<br /> #'''Conversation style''' – Coherence of speech, articulation, emphasise over certain issue, hesitation and duration of response. E.g. ‘Chitram sa jalpati’ (Patient does irrelevant absurd talks) is seen in patients of manas unmada [Su.Sa. Uttara Tantra 62/13].<br /> #'''Emotional expression''' – Patients may express a wide range of emotions during interview with the physician. E.g. Asthana rodana (Sudden crying) is a feature in vataja unmada while amarsha (intolerance) is seen in patients of pittaja unmada. [Cha.Sa. Chikitsa Sthana 9/11-12] Fleeting ideas, incoherent speech is an important sign for lacking proper emotions.<br /> #'''Cognition''' – Orientation to person, place, time and circumstances, level of intellect, level of understanding, common sense and memory can be identified under the domain of cognition by observing patient’s behaviour as well as by asking questions to them using validated scientific questionnaires. Short term memory and long-term memory shall be assessed properly.<br /> All observations gathered from every method of assessment should be simultaneously analysed to reach the diagnosis.<br /> <br /> '''c. Sattva pariksha (assessment of quality of excellence of mind)'''&lt;p style=&quot;text-align:justify;&quot;&gt;Sattva pariksha assesses the quality of excellence of mind imparted by extent of dominance of sattva guna. Mind (manas) is composed of three attributes (triguna) viz. sattva, rajas and tamas. These impart three types of mental constitutions – Shuddha (pure) (sattvika), rajasika and tamasika. [Cha.Sa. Sharira Sthana 4/36]. Sattvika guna is full of auspiciousness and is considered the healthy (amala) state of mind. Rajasika guna imparts momentum in terms of furious temperament. Whereas tamas guna promotes inertia and moral ignorance. Hence, rajas and tamas are considered inauspicious and called manas dosha. Triguna are present in dynamically varying proportions at any given time and influenced by body (i.e. tridosha) and vice versa. [Chakrapani on Cha.Sa. Vimana Sthana 4/8]. Optimum levels of sattva guna are essential for promoting desired physical and mental strength irrespective of morphological features. [Cha.Sa. Vimana Sthana 8/119]&lt;/p&gt;&lt;p style=&quot;text-align:justify;&quot;&gt;Sattva bala (strength of psyche) is of three types as per strength – pravara (superior), madhyama (moderate) and avara (poor). Pravara sattva persons possess great courage. Despite poor morphological features they seem to be unmoved in the face of adversities. Madhyama sattva persons need some additional moral support to sustain themselves in times of distress. While avara sattva displays catastrophic reactions even during little inconveniences and can neither be sustained by themselves nor by others despite having good quality morphological features. Avara sattva is constantly plagued by inferior emotions like grief, fear, greed, conceit and confusion. When confronted with fierce, ugly, disgusting narratives or flesh and blood, they are prone to become depressed, pale, unconscious or semiconscious, giddy, anxious and can even succumb to death in worst case scenarios. [Cha. Sa. Vimana Sthana 8/119]. &lt;/p&gt;&lt;p style=&quot;text-align:justify;&quot;&gt;Manovaha srotas associated with avara sattva bala is most likely to be vitiated by manas dosha leading to various psychiatric and psychosomatic disorders [Cha.Sa. Chikitsa Sthana 9/5]. It has been observed that avara sattva individuals are more likely to commit prajnaparadha (intellectual defects) [10] thereby voluntarily indulging in various etiological factors for respective psychological as well as somatic disorders. &lt;br?&gt;Thus, assessment of sattva bala can help rule out the predisposition towards manovaha srotodushti and subsequent development of symptoms of psychiatric ailments.&lt;/p&gt;&lt;p style=&quot;text-align:justify;&quot;&gt;'''d. Anumana pariksha (knowledge by inference)''' to determine normalcy of faculties of manas (mind) [Cha.Sa. Vimana Sthana 4/8] Since manas is atindriya ( supersence or imperceivable by ordinary senses), so are it’s faculties which can serve as potential markers for assessment of its functions. [10] The proper functioning of manas itself is inferred by altered or inappropriate mental perceptions even in presence of appropriately functioning indriya (senses) and their respective sense objects whereas the mental faculties can be inferred as follows:-&lt;/p&gt;<br /> {| class=&quot;wikitable&quot;<br /> |'''Faculty'''<br /> |'''object for inference'''<br /> |-<br /> |Vijnanam (expertise/skills )<br /> |Vyavsayena (occupation )<br /> |-<br /> |Dhairyam (fortitude)<br /> |avishadena (courage in face of adversity)<br /> |-<br /> |Viryam (bravery)<br /> |Uthhanena (initiating difficult tasks and enduring them)<br /> |-<br /> |Avasthanama (stability)<br /> |Avibhramana (absence of confusion)<br /> |-<br /> |Shradhha (faith)<br /> |Abhiprayena (purposiveness)<br /> |-<br /> |Medha (intellect)<br /> |Grahanena (grasping power)<br /> |-<br /> |Sanjna (recognition or consciousness level)<br /> |Namagrahanena (ability to recognise or name things)<br /> |-<br /> |Smriti (memory)<br /> |Smaranena (ability to recollect things)<br /> |-<br /> |Dhriti (self restraint)<br /> |Alaulyama (not being carried away by own greed)<br /> |-<br /> |Amala sattva (purity of mind)<br /> |Avikara (free of delusions or illusionary attachments)<br /> |}This inferential knowledge can help an individual become self-aware of his own psyche (sattva). A self-aware individual has an upper hand at avoiding mental illness because these often go unnoticed until they develop some organic manifestations. <br /> <br /> Thus, by means of above discussed assessment methodologies, a physician can assess the degree of derangement in mental faculties and hence the manovaha srotas, irrespective of development of specific signs and symptoms of any psychiatric disorder (vyadhi lakshana).<br /> ==Treatment Guidelines==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Manovaha srotas disorders follow the line of treatment same as described for disorders of manas (mind). Following are therapeutic and preventive practices beneficial for both vitiated manovaha srotas (channels of psyche) and manas obscured by rajas - tamas dosha.&lt;/p&gt;<br /> *Manas dosha can be alleviated through a comprehensive five-fold psychotherapeutic regimen - jnana (spiritual knowledge or self-awareness), vijnana (scriptural or scientific knowledge), dhairya (mental fortitude), smriti (recollection of past successes to regain faith in own abilities) and samadhi (spiritual healing practices to focus mind inwards away from negative external stimuli). [Cha.Sa. Sutra Sthana 1/58]<br /> Restoration of dhi (intellect), dhairya (mental fortitude) and atmadi vijnana (knowledge of self-consciousness) has therapeutic effect in alleviating disorders of manovaha srotas obstructed by manas dosha.<br /> *'''Sattvavajaya chikitsa (treatment to regulate mind)'''<br /> Sattvavajaya chikitsa is a non-invasive therapeutic module for psychological derangements and psychosomatic ailments, analogous to contemporary psychotherapy. ‘Sattva’ stands for mind and ‘avajaya’ translates to win over. Hence, it emphasizes withdrawing the mind from unwholesome objects of senses (factors vitiating rajas and tamas) and diverting it to positive sensory and emotional stimuli. Thereby consciously negating disturbed emotions and behavioural patterns. [Cha.Sa. Sutra Sthana 11/54]<br /> *'''Ashtanga yoga (eight steps of yoga)'''&lt;p style=&quot;text-align:justify;&quot;&gt;Ashtanga yoga can be considered as one of the dimensions of satvavajaya chikitsa. It integrates eight steps of yoga to tame mind from traversing paths in life which are spiritually and mentally harmful for that individual. Of the eight steps, first four viz. yama (principles for moral code), niyama (observances for personal discipline), asana (yogic postures) and pranayama (regulating breath) are termed as bahiranga yoga (external path). These practices gradually alleviate aggravated manas dosha, making the mind less reactive towards external stimuli. The last three limbs viz. dharana (concentration), dhyana (meditation) and samadhi (enlightenment or complete realisation) are termed as antaranga yoga (internal paths). These practices transform the mind, eliminating the fluctuations of mind, thereby strengthening positive habits and outlook on life as well as inner self. Ashtanga yoga maintains a harmonious balance between inner environment (mind and spirit) and external environment (objects of sensory perception). Mind thus gets liberated from worldly pursuits and all psychological sufferings in a stepwise manner.&lt;/p&gt;<br /> *'''Achara rasayana (rejuvenating codes of behavioural conduct)'''&lt;p style=&quot;text-align:justify;&quot;&gt;Achara rasayana is an adravyabhuta (non-pharmacological) rasayana (practices rejuvenating physical and mental health). It includes behavioural conducts which aim to enhance health and longevity by teaching practical methods to potentiate sattva guna of mind. [Cha.Sa. Chikitsa Sthana 1, 4th pada, shloka 30-35] An individual can imbibe easy lifestyle modifications to develop a positive and strong character of mind, thereby avoiding potential etiological factors (for dosha aggravation) and negative psychosocial patterns. Achara rasayana can be divided into five domains of good mental, social, personal, moral and religious conduct. [6]&lt;/p&gt;<br /> *'''Sadvritta (good codes of conduct)'''&lt;p style=&quot;text-align:justify;&quot;&gt;Sadvritta refers to good code of conduct. These are a set of practices, which serve as lifestyle guidelines to prevent mind from falling prey to temporary material pleasures and impulsive thoughts and actions that cause impairment of manas dosha and manovaha srotas. It encompasses guidelines over personal hygiene, personality development as well as for social hygiene and peaceful social interactions. [Cha.Sa. Sutra Sthana 8/18]&lt;/p&gt;Both achara rasayana and sadvritta help to maintain control over sense organs. They majorly add to the preventive and promotive aspect of mental health.<br /> *'''Medhya dravya (medicines enhancing intellectual functions)'''&lt;p style=&quot;text-align:justify;&quot;&gt;Medhya dravyas are the plant based pharmacological agents that promote prajna i.e., dhi (intellect), dhriti (perseverance) and smriti (memory). Researches conducted prove their efficacy in minimizing the cognitive decline among individuals with neural abnormalities. For example, ushna (hot potency) and tikshna nature drugs like jyotishmati and vacha are said to remove blockages caused by kapha, ama or tamas dosha in the manovaha srotas. Once purified, manas can regain unvitiated connect with indriya via manovaha srotas. [8] &lt;/p&gt;&lt;p style=&quot;text-align:justify;&quot;&gt;Ayurveda thus provides a bird’s eye view over different aspects of manovaha srotas through interconnected references in the classics highlighting its physiological importance like the other thirteen major srotas systems in the human body.&lt;/p&gt;<br /> ==Contemporary view==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Mind as per contemporary literature is debatable concept because in some contexts it is identified as conscience, while in others it is seen as the function of conscience. The philosophical dimension of mind was conceived by Plato who considered mind as an inner (soul’s) experience. [11] &lt;/p&gt;&lt;p style=&quot;text-align:justify;&quot;&gt;The western system of medicine addresses brain at the core of majority of psychological distresses, whereas western philosophy involves the concept of psyche (which denotes mind). ‘Psyche’ is a Greek word meaning ‘soul in a living man’. &lt;/p&gt;&lt;p style=&quot;text-align:justify;&quot;&gt;William James, referred to as the father of American Psychology, laid the foundations of physiological aspect of mind. To him mind was a function of brain which conducts mental life in the form of a constant stream of consciousness.[9] At some places he too admitted mind to bear consciousness and tried to assign attributes to consciousness as a separate psychological function thus formulating the Theory of Functionalism which established causal relationship between internal states (perception) and external reactions or behaviour (sensation). He concluded that repeated actions cause adaptive changes in nervous system. This is the fundamental ideology behind the concept of Neuroplasticity – i.e. adaptive structural and functional changes in brain by development of new neuronal pathways due to intrinsic or extrinsic stimuli. [12] &lt;/p&gt;&lt;p style=&quot;text-align:justify;&quot;&gt;James’ counterpart Titchener, an English Psychologist, proposed that consciousness is mind’s awareness of its own functions. Consciousness is something superior to mind itself. He formulated the Theory of Structuralism which aimed at analysing the interrelationship between mental experiences, feelings, and sensations. He used introspection as a tool to break down these complex phenomena of consciousness down to their basic elements without breaking their original structure. &lt;/p&gt;&lt;p style=&quot;text-align:justify;&quot;&gt;Mind is hence regarded as the cumulative effect of all mental processes that have occurred in the lifetime while the consciousness can be understood as the cumulative effect of all mental processes occurring in present moment. Eventually brain was somehow regarded to control the neural activity responsible for accumulating all this sensory data. &lt;/p&gt;&lt;p style=&quot;text-align:justify;&quot;&gt;Many theories were formulated and overruled by their successors with time. Today the concept of mind and consciousness remains yet to be clearly defined. It is observed that mind is often identified as consciousness and they both are accepted as individual closely linked entities. Mind bears synonymity towards consciousness, spirit, and psyche. Some theories view both mind and consciousness as spirit. But mind is invariably understood as the interaction between psychological personality and the external environment, i.e., a subject – object relationship. &lt;/p&gt;&lt;p style=&quot;text-align:justify;&quot;&gt;The neurophysiological basis of minds and the channels of transport of its constituents is yet a challenge in field of neuroscience. In order to bridge this gap, contemporary scientists hypothesise that mental representations and their contents are represented by neural network and their supporting cells thus hinting towards Central Nervous System and it’s peripheral nerves as the channels of mind. [13]&lt;/p&gt;<br /> ==Research works on manovaha srotas==<br /> Various review articles have been published and researches been carried out in the domain of Ayurveda to understand the conceptual as well as pathophysiological aspect of manovaha srotas. Few of them are as follows :- <br /> <br /> '''1. Critical Review of Concept of manovaha Srotas with special reference to Brain''' This review article conceptualizes the contemporary understanding of manovaha srotas in context to CNS due to functional similarity between manas and brain obtained after an extensive research and analysis throughout ayurveda treatises. Further brain was considered as synonymous to hridya ie. mulasthana (site of origin) of manovaha srotas and ‘dasha dhamani’ as the cranial nerves exiting from the 10 major foramen at base of skull. Sanskrit literature considers hridaya as regarded as a central organ similar to brain. 14<br /> <br /> '''2. Circumstantial view on clinical knowing of manovaha srotasa &amp; its physiology''' The review article reconstructs a comprehensive picture of manovaha srotas from the scattered references available in Ayurveda texts, supplementing it with additional information from contemporary science as follows-<br /> *A detailed description of neuroanatomy and physiology has been drawn parallel to Ayurveda point of view about manas’ rachna and kriya sharir.<br /> *Effect of Triguna and tridosha (especially vata) in context of physiological functions and disorders of manas and manovaha srotas have been discussed.<br /> *Correlations between functions of five subtypes of vata and both CNS and ANS has been attempted<br /> *Pariksha krama (examination of nervous system) has been exemplified taking into consideration both Ayurveda and modern methodologies that can be employed for manovaha srotas (nervous system) examination.10<br /> '''3. Concept of stress factor assessment concerning ‘perseverance test’ in light of ayurveda” – a review''' This article highlights the importance of understanding the etiological factors of vitiation of manovaha srotas and manas in all kinds of psychiatric as well as psychosomatic disorders. Imbalance of manas dosha can be treated by means of yoga, meditation and pranayama. Often emotional disturbances remain unattended in diagnosed cases of psychiatric illness which can be managed at home by incorporating wholesome diet (pathya ahara) and moral code of conduct (sadvrutta) in daily routine. Lack of peace and chronic stressors have been observed as major causes of vitiation of channels of mind. 15<br /> <br /> &lt;big&gt;'''[[Special:ContactMe|Send us your suggestions and feedback on this page.]]'''&lt;/big&gt;<br /> ==References==<br /> &lt;div id=&quot;BackToTop&quot; class=&quot;noprint&quot; style=&quot;background-color:#DDEFDD; position:fixed;<br /> bottom:32px; left:2%; z-index:9999; padding:0; margin:0;&quot;&gt;&lt;span style=&quot;color:blue;<br /> font-size:8pt; font-face:verdana,sans-serif; border:0.2em outset #ceebf7;<br /> padding:0.1em; font-weight:bolder; -moz-border-radius:8px; &quot;&gt;[[#top| Back to the Top]]&lt;/span&gt;&lt;/div&gt;</div>

Manishdubey https://www.carakasamhitaonline.com/index.php?title=Manovaha_srotas&diff=44202 2023-10-16T11:12:26Z

<p>Manishdubey: </p> <hr /> <div>{{CiteButton}}{{#seo:<br /> |title= Manovaha srotas<br /> (Channels of transport and transformation of mind and mental factors)<br /> |titlemode=append<br /> |keywords= Manovaha srotas,Hrudya, Sattva pariksha, Sattvavajaya chikitsa, Bhojani M. K.,Deole Y.S., Basisht G<br /> |description=Mana means mind, or psyche. Srotas means channels of transport and transformation. The description and understanding of channels for activities of mind (manovaha srotas) is scattered in ayurveda classics and has not been completely elucidated. Manovaha srotas are considered as channels through which mind and body interact with each other. <br /> |image=http://www.carakasamhitaonline.com/mediawiki-1.32.1/resources/assets/ogimgs.jpg<br /> |image_alt=carak samhita<br /> |type=article<br /> }}&lt;p style=&quot;text-align:justify;&quot;&gt;Mana means mind, or psyche. Srotas means channels of transport and transformation. The description and understanding of channels for activities of mind (manovaha srotas) is scattered in ayurveda classics and has not been completely elucidated. Manovaha srotas are considered as channels through which mind and body interact with each other. These channels pervade throughout the body. [Chakrapani on Cha.Sa. Indriya Sthana 5/41-42] They are responsible for flow of thoughts, em&lt;ref name=&quot;:0&quot;&gt; Kumar B.M.N.(2017). Review on Concept of Hrudya in Ayurveda w.s.r. to modern perspective; World Journal of Pharmaceutical Research; vol 6, issue 16.&lt;/ref&gt;otions, and other psychological functions. This article deals with various aspects of manovaha srotasa i.e. the channels of activities of mind and its development.&lt;/p&gt;{{Infobox<br /> |title = Contributors<br /> |label1 = Section/Chapter/topic<br /> |data1 = Concepts/[[Srotas]]/[[Manovaha Srotas]] <br /> |label2 = Authors<br /> |data2 = Bhojani M. K.&lt;sup&gt;1&lt;/sup&gt; Varma Swati &lt;sup&gt;1&lt;/sup&gt; Deole Y.S.&lt;sup&gt;2&lt;/sup&gt;<br /> |label3 = Reviewer &amp; Editor<br /> |data3 = Basisht G.&lt;sup&gt;3&lt;/sup&gt;, <br /> |label4 = Affiliations<br /> |data4 = &lt;sup&gt;1&lt;/sup&gt; Department of Sharir Kriya, All India Institute of Ayurveda, New Delhi, India<br /> &lt;sup&gt;2&lt;/sup&gt; Department of Kayachikitsa, G. J. Patel Institute of Ayurvedic Studies and Research, New Vallabh Vidyanagar, Gujarat, India <br /> &lt;sup&gt;3&lt;/sup&gt; Rheumatologist, Orlando, Florida, U.S.A.<br /> |label5 = Correspondence emails<br /> |data5 = meera.samhita@aiia.gov.in, carakasamhita@gmail.com<br /> |label6 = Publisher <br /> |data6 = [[Charak Samhita Research, Training and Development Centre]], I.T.R.A., Jamnagar, India<br /> |label7 = Date of publication:<br /> |data7 =October 12, 2023<br /> |label8 = DOI<br /> |data8 = In process<br /> }}<br /> ==Etymology and derivation:==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Srotas originates from Sanskrit root ‘Sru’ that translates to oozing, flow or secretion. It has been defined as ‘sravanat strotamsi’ [Cha. Sa. Sutra Sthana 30/12] which indicates structures designated for conveyance of material inside body. &lt;/p&gt;&lt;p style=&quot;text-align:justify;&quot;&gt;Grossly defining, thirteen major types of srotas have been mentioned that transport substances undergoing biotransformation (parinamam aapadyamanam) from the place of origin to their destination. [Cha. Sa. Vimana Sthana 5/3] Similarly in physiological state, manovaha srotas might be responsible for processing and transformation of ‘doshayukta’ (irrational under influence of rajas and tamas) emotions and thoughts into unbiased reasoning before reaching a conclusion by our intellect (buddhi).&lt;/p&gt;<br /> ==Synonyms of manovaha srotas==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Following terms are used for ‘manovaha srotas’ in different Ayurveda classics :&lt;/p&gt;<br /> #Manovaha dhamani [Chakrapani on Cha. Sa. Indriya sthana 12/42] and [Vijayarakshita in Ma.Ni.Purva Khanda 20/1]<br /> #Chetanavaha srotas [Shivadas Sen on Cha.Sa. Chikitsa sthana 9/5]<br /> #Chetovaha marga [Bhel Samhita Nidana Sthana 7/2]<br /> #Manobuddhivaha sira [ Cha.Sa.Chikitsa Sthana 10/58]<br /> #Sanjnavaha srotas [Su.Sa.Uttar Tantra 61/8]<br /> #Sanjnavaha nadi [Su.Sa. Uttar Tantra 46/7]&lt;p style=&quot;text-align:justify;&quot;&gt;Use of terms like sira, nadi and dhamani, refers to different channels and pathways concerned with maintenance of physiological flow of information. [Cha.Sa. Vimana Sthana 5/8]&lt;/p&gt;<br /> ==Origin==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Every srotas is localized within the hollow space in the body originating from a root (mula) and spreading throughout the body to reach a final structure. Srotas are said to be hollow structures in different shapes and sizes The root (mula) is majorly responsible for regulation and control of functions of that srotas. &lt;/p&gt;&lt;p style=&quot;text-align:justify;&quot;&gt;The channels carrying mind (manovaha srotas) are not exclusively listed. It is however stated that the entire conscious body is abode of mind. Hence these channels are spread throughout the body. [Chakrapani on Cha.Sa. Indriya Sthana 5/41]. &lt;/p&gt;&lt;p style=&quot;text-align:justify;&quot;&gt;However, hridaya (heart) has a universal acceptance as the site of origin (mula) of manovaha srotas. Hence a special mention has been made about ten arteries of heart, probably being the manovaha srotas (visheshen tu hrudya ashritvat manah tadashrita dasha dhamanyo manovaha abhidhiyante) [Chakrapani on Cha.Sa. Indriya Sthana 5/41-42]. These get afflicted by vitiated dosha either all at once or individually. [Chakrapani on Cha.Sa. Indriya Sthana 12/42]&lt;/p&gt;<br /> ==Decoding hridaya (heart)==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;The interpretation of the term ‘hridaya’ has been of confusion among scholars since decades. The first interpretation of the term given by texts of Shatpada Brahmana which highlighted functional aspect of hridaya. The word being composed of three letters viz ‘hri’ (hra harane)- to acquire; ‘Da’ (da dane) – to give; ‘Ya’ (Ya gatau)- which transports. The hridaya thus displays three phases of cardiac cycle i.e., receives, gives, and transports body constituents through it. &lt;ref name=&quot;:0&quot; /&gt; &lt;/p&gt;&lt;p style=&quot;text-align:justify;&quot;&gt;Hridaya is the site of rasa (plasma), sattva (psychic factor/mind), buddhi (intellect) and atma (soul) in conjugation with all sensory organs (jnanendriya).[Cha.Sa. Chikitsa Sthana 24/35] Sadhaka pitta situated in heart (hridaya) regulates proper functioning of intellect (buddhi) and ego (ahamkara). Hridaya is located in between breasts (stanayormadhya) of thoracic region [A. H. Sutra Sthana 12/13-14] [Su. Sa. Sharira Sthana 6/25]. &lt;/p&gt;&lt;p style=&quot;text-align:justify;&quot;&gt;Vedic era was well versed with heart (hridaya) and brain (mastishka) being two distinct entities, with interdependent functional relationship [Atharvaveda Book X. Hymn 2.26]. Kashyap Samhita quotes that all sense and motor organs (indriya) together with mind (manas) emerge from heart (hridaya) [Ka.Sa. Chikitsa Sthana 8/6]. Primary site of action of mind (manas) is brain (shira).[3] It can be concluded that mind (manas) being seated in heart (hridaya) connects to brain (shiras) through manovaha srotas and controls all senses (indriya). Also, any damage pertaining to marma (vital points) of shiras (head) causes loss of consciousness (cheshtanasha). [Cha.Sa. Sidhhi Sthana 9/6] Hence heart (hridaya) and brain (shirasor mastishka) are sites of manovaha srotasa. &lt;/p&gt;&lt;p style=&quot;text-align:justify;&quot;&gt;This approach of understanding hridaya goes well along with the contemporary view of understanding the triguna based psycho-functional principles of Ayurveda within the neural framework. Various research has been conducted which demonstrate that heart continuously sends nervous signals to brain to coordinate higher centres responsible for cognition and emotions. &lt;ref&gt;Murthy A.R.V., The Mind in Ayurveda and other Indian Traditions; Chaukhamba Sanskrit Pratishthan; 2013.&lt;/ref&gt; The neuro- psychological as well as circulatory functions of hridaya mentioned in the classics can thus be explained.&lt;/p&gt;<br /> ==Relation between rasavaha and manovaha srotas==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Heart is the abode of mind (mana) and consciousness (chetana) or soul (atma). [Cha. Sa. Sidhhi Sthana 9/4] It is a site for physical, psychological, and spiritual components. Heart is origin for channels of transportation and transformation of rasa dhatu, too. Both heart and brain are considered under the umbrella term hridaya in terms of anatomical structure and higher-centre functions respectively. &lt;/p&gt;&lt;p style=&quot;text-align:justify;&quot;&gt;Heart (residence of manas) and brain (workplace of manas) are functionally co-dependent upon each other. Manas regulates the cognitive and conative functions of brain in conjunction with soul (atma) under the influence of vata dosha. [Cha. Sa. Sharira Sthana 1/22-23]. Brain is a structural entity needing continuous supply of nourishment and oxygen. This is feasible by heart through circulation (rasa-rakta samvahana kriya) via the ten major vessels (rasavahi dhamani). [A. H. Sharira Sthana 3/18] Heart is a highly vascular organ being surrounded by ten major dhamani (blood vessels) like spokes of a wheel which are known as ‘rasavaha strotomula’ (site of origin of channels of nutrition). These channels are comparable to manovaha srotas. [Chakrapani on Cha. Sa. Chikitsa Sthana 9/4] Manas thus acts like a medium between heart and brain wherein brain is responsible for all sensory and motor functions while heart has been assigned emotional aspect of psyche (manas). &lt;/p&gt;&lt;p style=&quot;text-align:justify;&quot;&gt;One of the factors for vitiation of rasavaha srotas is excessive thinking or worry (atichintan). [Cha. Sa. Vimana Sthana 5/13] Contemporary researchers have found evidence to support the interaction between circulatory system and psyche. The monograph of German professor Ludwig Braun is a pioneer in exploring the psychological and emotional aspect of cardiac diseases especially angina. He presented a correlation between cardiac diseases and ‘Angst’ (a constrictive, tightening and crushing sensation which manifests dread in the patient thereby changing his entire emotional outlook on life), analogous to anxiety. He explains that the cardiac tissue has a special apparatus receptive towards anxiety which manifests as an inner tactile sensation. That region is well supplied with nerve endings that gets irritated by anxiety. This phenomenon of emotional influence over cardiac tissues is termed as cardiac psyche. [4]&lt;/p&gt;<br /> ==Factors vitiating manovaha srotas==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Manovaha srotas are the prime site of abnormalities of channels in all psychological disorders. [Cha.Sa. Nidana Sthana 6/4] Alongside any of the eight factors that are either attributed to hridaya or manas viz. mana (mind), buddhi (intellect), sanjna-jnana (self-awareness), smriti (memory), bhakti (devotion), sheela (habits), cheshta (psychomotor activities) and achara (code of conduct). [Cha.Sa. Nidana Sthana 7/5] &lt;/p&gt;&lt;p style=&quot;text-align:justify;&quot;&gt;These factors when deranged cause vitiation of manas dosha (rajas and tamas), deterioration of sattva guna of manas and gradual derangement of tridosha. Foods, activities and excessive expression of emotions like anger, grief, lust, fear etc and mental traumas are the fundamental etiological factors for the same. [Cha.Sa. Nidana Sthana 7/4] Vitiated tridosha further vitiates rasavaha srotas, which apparently has the same site of origin as of manovaha srotas i.e., hridaya and dasha dhamani (ten great vessels). [Cha. Sa. Vimana Sthana 5/10] Hridaya is seat of manas [Cha.Sa. Sutra Sthana 30/4]. Hence, all the factors vitiating rasa dhatu (nutritive fluid), rasavaha srotas (channels carrying nutritive fluid) and manas dosha viz. rajas and tamas will affect manas and eventually vitiating manovaha srotas. Even the structural derangements of heart (abode of mind) affect manovaha srotas due to their ashrayashrayibhava (state of interdependency). [Cha.Sa. Chikitsa Sthana 9/5]&lt;/p&gt;<br /> ==Pathologies of manovaha srotas==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Manovaha srotas is important factor in understanding disorders like unmada (psychosis), apasmara (epilepsy) and extreme emotional reactions.&lt;/p&gt;<br /> *'''Unmada (psychosis)'''&lt;p style=&quot;text-align:justify;&quot;&gt;When an individual experiences extreme emotions – lust (kama), anger (krodha), fear (bhaya), greed (lobha), happiness or pleasure (harsha), affection (moha), grief (shoka), excessive worry (chinta), they initially harm the intellect which aggravates manas dosha (rajas and tamas) and tridosha (vata, pitta and kapha). These vitiated dosha invade heart and obstruct manovaha srotas (channels transporting psychic impulses) thereby causing unmada. [Dalhan on Su. Sa. Uttar Tantra 62/3]<br /> *'''Apasmara (epilepsy)'''<br /> Overindulging in sensory pleasures, incompatible diet, withholding natural urges and giving into immoral activities under emotional influences (kama, krodha, lobha among others), vitiates rajas and tamas. They poorly influence the manas (mind) and sanjnavaha srotas (manovaha srotas) causing apasmara. [Su.Sa. Uttar Tantra 61/6]<br /> *Mada (intoxication), murchha (syncope), sanyasa (coma) are caused by vitiation of channels of consciousness (chetanavaha srotas or manovaha srotas). [Shivadas Sen on Cha. Sa. Chikitsa Sthana 9/5]<br /> *'''Atattvabhinivesha (perverted state of mind)'''<br /> Considered as mahagada (difficult to treat mental disorder), the person’s conscience gets afflicted by rajas and tamas, which cause complete derangement of intellect (buddhi vibhramsha) as the predominant symptom. The vitiated dosha get lodged in heart (hridaya) to afflict channels of mind and intellect (manobuddhivaha sira in manovaha srotas). [Cha.Sa. Chikitsa Sthana 10/57-60]<br /> *Physiology of nightmares (swapna)<br /> Nightmares are dreams occurring in REM phase of sleep which causes mental projections in the form of feelings of fear, despair, and anxiety. Ayurveda defines REM phase as ‘Natiprasupta’ - the state characterised to be midway between states of deep sleep and fully awake. During any ominous situation, tridosha in their highly aggravated state tend to fill-up the manovaha srotas. This results in terrifying dreams. [Cha.Sa. Indriya Sthana 5/41].<br /> ==Assessment and diagnosis of disorders of manovaha srotas==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Srotas are micro-channels transporting various metabolites across cells throughout the body. It can be deduced that manovaha srotas has different characteristics structurally and functionally from the major thirteen srotas, because it transports and transforms thoughts and feelings. This is evident from objects of mind (manas), viz- thought (chintyam), consideration (vicharyam), hypothesis (uhyam), aims (dhyeyam) and determination (sankalpam). [Cha.Sa. Sharira Sthana 1/20]. Assessment of manovaha srotas can be done via assessment of manas and the degree of derangement of its functions. Ayurveda considers manas as material entity (dravya) which is a super sense and not perceivable by ordinary senses (atindriya) [Cha. Sa. Sutra Sthana 8/4]. Manas is under direct control of vata dosha [Cha. Sa. Sutra Sthana 12/8] and is the mediator between atma (soul) and indriyartha (objects of senses). &lt;/p&gt;&lt;p style=&quot;text-align:justify;&quot;&gt;The contemporary physiological aspects of mind, senses, brain, nervous system and consciousness can be considered for assessment of manovaha srotas. &lt;/p&gt;&lt;p style=&quot;text-align:justify;&quot;&gt;A thorough neurological examination by means of interrogation (prashna pariksha), inspection (darshana pariksha) and assessment of mental strength (sattva bala pariksha) [Cha.Sa. Vimana Sthana 8/119] can be used for assessment and diagnosis of disorders of manovaha srotas.&lt;/p&gt;''' a. Interrogation (prashna pariksha)''' A formal interview of the patient can be conducted for overall and precise diagnosis. The questions related to chief complaints with duration, chronological development, nurturing of patient, family history, addiction, hobbies, interests, daily routine, major life events, achievements, mental traumas, emotional quotient and intellectual quotient is recorded from the patient. If the patient is not in state of giving correct answers, then the relatives or attendants who know patients history are interviewed.<br /> <br /> '''b. Darshan pariksha (Direct observation)''' While interviewing the patient, a physician should pay attention to following attributes that can signify features mentioned for certain psychiatric ailments (manovaha srotodushti)..<br /> #'''Appearance '''– Unusual dressing preferences, use of cosmetics, perfumes or accessories or flamboyant appearance. e.g;- ‘Priye tanu rakta vastradhari’ (liking for adorning clothes made of thin red fabric) is seen in yakshagraha unmada (Su.Sa. Uttara tantra 60/11)<br /> #'''Activity and co-ordination''' - Behaviour, Gait, gestures, patient’s facial expression and body language should be observed during probing them with questions. Eg;- 'Satatama akshano’ (rapid and constant eye movements) is one of the prodromal feature of apasmara (epilepsy) [ Cha.Sa. Nidana sthana 8/6]. Udhasta (patient keeps his hands raised) is a feature of pishacha grahavishta unmada [Su.Sa. Uttara Tantra 60/15]<br /> #'''Conversation style''' – Coherence of speech, articulation, emphasise over certain issue, hesitation and duration of response. E.g. ‘Chitram sa jalpati’ (Patient does irrelevant absurd talks) is seen in patients of manas unmada [Su.Sa. Uttara Tantra 62/13].<br /> #'''Emotional expression''' – Patients may express a wide range of emotions during interview with the physician. E.g. Asthana rodana (Sudden crying) is a feature in vataja unmada while amarsha (intolerance) is seen in patients of pittaja unmada. [Cha.Sa. Chikitsa Sthana 9/11-12] Fleeting ideas, incoherent speech is an important sign for lacking proper emotions.<br /> #'''Cognition''' – Orientation to person, place, time and circumstances, level of intellect, level of understanding, common sense and memory can be identified under the domain of cognition by observing patient’s behaviour as well as by asking questions to them using validated scientific questionnaires. Short term memory and long-term memory shall be assessed properly.<br /> All observations gathered from every method of assessment should be simultaneously analysed to reach the diagnosis.<br /> <br /> '''c. Sattva pariksha (assessment of quality of excellence of mind)'''&lt;p style=&quot;text-align:justify;&quot;&gt;Sattva pariksha assesses the quality of excellence of mind imparted by extent of dominance of sattva guna. Mind (manas) is composed of three attributes (triguna) viz. sattva, rajas and tamas. These impart three types of mental constitutions – Shuddha (pure) (sattvika), rajasika and tamasika. [Cha.Sa. Sharira Sthana 4/36]. Sattvika guna is full of auspiciousness and is considered the healthy (amala) state of mind. Rajasika guna imparts momentum in terms of furious temperament. Whereas tamas guna promotes inertia and moral ignorance. Hence, rajas and tamas are considered inauspicious and called manas dosha. Triguna are present in dynamically varying proportions at any given time and influenced by body (i.e. tridosha) and vice versa. [Chakrapani on Cha.Sa. Vimana Sthana 4/8]. Optimum levels of sattva guna are essential for promoting desired physical and mental strength irrespective of morphological features. [Cha.Sa. Vimana Sthana 8/119]&lt;/p&gt;&lt;p style=&quot;text-align:justify;&quot;&gt;Sattva bala (strength of psyche) is of three types as per strength – pravara (superior), madhyama (moderate) and avara (poor). Pravara sattva persons possess great courage. Despite poor morphological features they seem to be unmoved in the face of adversities. Madhyama sattva persons need some additional moral support to sustain themselves in times of distress. While avara sattva displays catastrophic reactions even during little inconveniences and can neither be sustained by themselves nor by others despite having good quality morphological features. Avara sattva is constantly plagued by inferior emotions like grief, fear, greed, conceit and confusion. When confronted with fierce, ugly, disgusting narratives or flesh and blood, they are prone to become depressed, pale, unconscious or semiconscious, giddy, anxious and can even succumb to death in worst case scenarios. [Cha. Sa. Vimana Sthana 8/119]. &lt;/p&gt;&lt;p style=&quot;text-align:justify;&quot;&gt;Manovaha srotas associated with avara sattva bala is most likely to be vitiated by manas dosha leading to various psychiatric and psychosomatic disorders [Cha.Sa. Chikitsa Sthana 9/5]. It has been observed that avara sattva individuals are more likely to commit prajnaparadha (intellectual defects) [10] thereby voluntarily indulging in various etiological factors for respective psychological as well as somatic disorders. &lt;br?&gt;Thus, assessment of sattva bala can help rule out the predisposition towards manovaha srotodushti and subsequent development of symptoms of psychiatric ailments.&lt;/p&gt;&lt;p style=&quot;text-align:justify;&quot;&gt;'''d. Anumana pariksha (knowledge by inference)''' to determine normalcy of faculties of manas (mind) [Cha.Sa. Vimana Sthana 4/8] Since manas is atindriya ( supersence or imperceivable by ordinary senses), so are it’s faculties which can serve as potential markers for assessment of its functions. [10] The proper functioning of manas itself is inferred by altered or inappropriate mental perceptions even in presence of appropriately functioning indriya (senses) and their respective sense objects whereas the mental faculties can be inferred as follows:-&lt;/p&gt;<br /> {| class=&quot;wikitable&quot;<br /> |'''Faculty'''<br /> |'''object for inference'''<br /> |-<br /> |Vijnanam (expertise/skills )<br /> |Vyavsayena (occupation )<br /> |-<br /> |Dhairyam (fortitude)<br /> |avishadena (courage in face of adversity)<br /> |-<br /> |Viryam (bravery)<br /> |Uthhanena (initiating difficult tasks and enduring them)<br /> |-<br /> |Avasthanama (stability)<br /> |Avibhramana (absence of confusion)<br /> |-<br /> |Shradhha (faith)<br /> |Abhiprayena (purposiveness)<br /> |-<br /> |Medha (intellect)<br /> |Grahanena (grasping power)<br /> |-<br /> |Sanjna (recognition or consciousness level)<br /> |Namagrahanena (ability to recognise or name things)<br /> |-<br /> |Smriti (memory)<br /> |Smaranena (ability to recollect things)<br /> |-<br /> |Dhriti (self restraint)<br /> |Alaulyama (not being carried away by own greed)<br /> |-<br /> |Amala sattva (purity of mind)<br /> |Avikara (free of delusions or illusionary attachments)<br /> |}This inferential knowledge can help an individual become self-aware of his own psyche (sattva). A self-aware individual has an upper hand at avoiding mental illness because these often go unnoticed until they develop some organic manifestations. <br /> <br /> Thus, by means of above discussed assessment methodologies, a physician can assess the degree of derangement in mental faculties and hence the manovaha srotas, irrespective of development of specific signs and symptoms of any psychiatric disorder (vyadhi lakshana).<br /> ==Treatment Guidelines==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Manovaha srotas disorders follow the line of treatment same as described for disorders of manas (mind). Following are therapeutic and preventive practices beneficial for both vitiated manovaha srotas (channels of psyche) and manas obscured by rajas - tamas dosha.&lt;/p&gt;<br /> *Manas dosha can be alleviated through a comprehensive five-fold psychotherapeutic regimen - jnana (spiritual knowledge or self-awareness), vijnana (scriptural or scientific knowledge), dhairya (mental fortitude), smriti (recollection of past successes to regain faith in own abilities) and samadhi (spiritual healing practices to focus mind inwards away from negative external stimuli). [Cha.Sa. Sutra Sthana 1/58]<br /> Restoration of dhi (intellect), dhairya (mental fortitude) and atmadi vijnana (knowledge of self-consciousness) has therapeutic effect in alleviating disorders of manovaha srotas obstructed by manas dosha.<br /> *'''Sattvavajaya chikitsa (treatment to regulate mind)'''<br /> Sattvavajaya chikitsa is a non-invasive therapeutic module for psychological derangements and psychosomatic ailments, analogous to contemporary psychotherapy. ‘Sattva’ stands for mind and ‘avajaya’ translates to win over. Hence, it emphasizes withdrawing the mind from unwholesome objects of senses (factors vitiating rajas and tamas) and diverting it to positive sensory and emotional stimuli. Thereby consciously negating disturbed emotions and behavioural patterns. [Cha.Sa. Sutra Sthana 11/54]<br /> *'''Ashtanga yoga (eight steps of yoga)'''&lt;p style=&quot;text-align:justify;&quot;&gt;Ashtanga yoga can be considered as one of the dimensions of satvavajaya chikitsa. It integrates eight steps of yoga to tame mind from traversing paths in life which are spiritually and mentally harmful for that individual. Of the eight steps, first four viz. yama (principles for moral code), niyama (observances for personal discipline), asana (yogic postures) and pranayama (regulating breath) are termed as bahiranga yoga (external path). These practices gradually alleviate aggravated manas dosha, making the mind less reactive towards external stimuli. The last three limbs viz. dharana (concentration), dhyana (meditation) and samadhi (enlightenment or complete realisation) are termed as antaranga yoga (internal paths). These practices transform the mind, eliminating the fluctuations of mind, thereby strengthening positive habits and outlook on life as well as inner self. Ashtanga yoga maintains a harmonious balance between inner environment (mind and spirit) and external environment (objects of sensory perception). Mind thus gets liberated from worldly pursuits and all psychological sufferings in a stepwise manner.&lt;/p&gt;<br /> *'''Achara rasayana (rejuvenating codes of behavioural conduct)'''&lt;p style=&quot;text-align:justify;&quot;&gt;Achara rasayana is an adravyabhuta (non-pharmacological) rasayana (practices rejuvenating physical and mental health). It includes behavioural conducts which aim to enhance health and longevity by teaching practical methods to potentiate sattva guna of mind. [Cha.Sa. Chikitsa Sthana 1, 4th pada, shloka 30-35] An individual can imbibe easy lifestyle modifications to develop a positive and strong character of mind, thereby avoiding potential etiological factors (for dosha aggravation) and negative psychosocial patterns. Achara rasayana can be divided into five domains of good mental, social, personal, moral and religious conduct. [6]&lt;/p&gt;<br /> *'''Sadvritta (good codes of conduct)'''&lt;p style=&quot;text-align:justify;&quot;&gt;Sadvritta refers to good code of conduct. These are a set of practices, which serve as lifestyle guidelines to prevent mind from falling prey to temporary material pleasures and impulsive thoughts and actions that cause impairment of manas dosha and manovaha srotas. It encompasses guidelines over personal hygiene, personality development as well as for social hygiene and peaceful social interactions. [Cha.Sa. Sutra Sthana 8/18]&lt;/p&gt;Both achara rasayana and sadvritta help to maintain control over sense organs. They majorly add to the preventive and promotive aspect of mental health.<br /> *'''Medhya dravya (medicines enhancing intellectual functions)'''&lt;p style=&quot;text-align:justify;&quot;&gt;Medhya dravyas are the plant based pharmacological agents that promote prajna i.e., dhi (intellect), dhriti (perseverance) and smriti (memory). Researches conducted prove their efficacy in minimizing the cognitive decline among individuals with neural abnormalities. For example, ushna (hot potency) and tikshna nature drugs like jyotishmati and vacha are said to remove blockages caused by kapha, ama or tamas dosha in the manovaha srotas. Once purified, manas can regain unvitiated connect with indriya via manovaha srotas. [8] &lt;/p&gt;&lt;p style=&quot;text-align:justify;&quot;&gt;Ayurveda thus provides a bird’s eye view over different aspects of manovaha srotas through interconnected references in the classics highlighting its physiological importance like the other thirteen major srotas systems in the human body.&lt;/p&gt;<br /> ==Contemporary view==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Mind as per contemporary literature is debatable concept because in some contexts it is identified as conscience, while in others it is seen as the function of conscience. The philosophical dimension of mind was conceived by Plato who considered mind as an inner (soul’s) experience. [11] &lt;/p&gt;&lt;p style=&quot;text-align:justify;&quot;&gt;The western system of medicine addresses brain at the core of majority of psychological distresses, whereas western philosophy involves the concept of psyche (which denotes mind). ‘Psyche’ is a Greek word meaning ‘soul in a living man’. &lt;/p&gt;&lt;p style=&quot;text-align:justify;&quot;&gt;William James, referred to as the father of American Psychology, laid the foundations of physiological aspect of mind. To him mind was a function of brain which conducts mental life in the form of a constant stream of consciousness.[9] At some places he too admitted mind to bear consciousness and tried to assign attributes to consciousness as a separate psychological function thus formulating the Theory of Functionalism which established causal relationship between internal states (perception) and external reactions or behaviour (sensation). He concluded that repeated actions cause adaptive changes in nervous system. This is the fundamental ideology behind the concept of Neuroplasticity – i.e. adaptive structural and functional changes in brain by development of new neuronal pathways due to intrinsic or extrinsic stimuli. [12] &lt;/p&gt;&lt;p style=&quot;text-align:justify;&quot;&gt;James’ counterpart Titchener, an English Psychologist, proposed that consciousness is mind’s awareness of its own functions. Consciousness is something superior to mind itself. He formulated the Theory of Structuralism which aimed at analysing the interrelationship between mental experiences, feelings, and sensations. He used introspection as a tool to break down these complex phenomena of consciousness down to their basic elements without breaking their original structure. &lt;/p&gt;&lt;p style=&quot;text-align:justify;&quot;&gt;Mind is hence regarded as the cumulative effect of all mental processes that have occurred in the lifetime while the consciousness can be understood as the cumulative effect of all mental processes occurring in present moment. Eventually brain was somehow regarded to control the neural activity responsible for accumulating all this sensory data. &lt;/p&gt;&lt;p style=&quot;text-align:justify;&quot;&gt;Many theories were formulated and overruled by their successors with time. Today the concept of mind and consciousness remains yet to be clearly defined. It is observed that mind is often identified as consciousness and they both are accepted as individual closely linked entities. Mind bears synonymity towards consciousness, spirit, and psyche. Some theories view both mind and consciousness as spirit. But mind is invariably understood as the interaction between psychological personality and the external environment, i.e., a subject – object relationship. &lt;/p&gt;&lt;p style=&quot;text-align:justify;&quot;&gt;The neurophysiological basis of minds and the channels of transport of its constituents is yet a challenge in field of neuroscience. In order to bridge this gap, contemporary scientists hypothesise that mental representations and their contents are represented by neural network and their supporting cells thus hinting towards Central Nervous System and it’s peripheral nerves as the channels of mind. [13]&lt;/p&gt;<br /> ==Research works on manovaha srotas==<br /> Various review articles have been published and researches been carried out in the domain of Ayurveda to understand the conceptual as well as pathophysiological aspect of manovaha srotas. Few of them are as follows :- <br /> <br /> '''1. Critical Review of Concept of manovaha Srotas with special reference to Brain''' This review article conceptualizes the contemporary understanding of manovaha srotas in context to CNS due to functional similarity between manas and brain obtained after an extensive research and analysis throughout ayurveda treatises. Further brain was considered as synonymous to hridya ie. mulasthana (site of origin) of manovaha srotas and ‘dasha dhamani’ as the cranial nerves exiting from the 10 major foramen at base of skull. Sanskrit literature considers hridaya as regarded as a central organ similar to brain. 14<br /> <br /> '''2. Circumstantial view on clinical knowing of manovaha srotasa &amp; its physiology''' The review article reconstructs a comprehensive picture of manovaha srotas from the scattered references available in Ayurveda texts, supplementing it with additional information from contemporary science as follows-<br /> *A detailed description of neuroanatomy and physiology has been drawn parallel to Ayurveda point of view about manas’ rachna and kriya sharir.<br /> *Effect of Triguna and tridosha (especially vata) in context of physiological functions and disorders of manas and manovaha srotas have been discussed.<br /> *Correlations between functions of five subtypes of vata and both CNS and ANS has been attempted<br /> *Pariksha krama (examination of nervous system) has been exemplified taking into consideration both Ayurveda and modern methodologies that can be employed for manovaha srotas (nervous system) examination.10<br /> '''3. Concept of stress factor assessment concerning ‘perseverance test’ in light of ayurveda” – a review''' This article highlights the importance of understanding the etiological factors of vitiation of manovaha srotas and manas in all kinds of psychiatric as well as psychosomatic disorders. Imbalance of manas dosha can be treated by means of yoga, meditation and pranayama. Often emotional disturbances remain unattended in diagnosed cases of psychiatric illness which can be managed at home by incorporating wholesome diet (pathya ahara) and moral code of conduct (sadvrutta) in daily routine. Lack of peace and chronic stressors have been observed as major causes of vitiation of channels of mind. 15<br /> <br /> &lt;big&gt;'''[[Special:ContactMe|Send us your suggestions and feedback on this page.]]'''&lt;/big&gt;<br /> ==References==<br /> &lt;div id=&quot;BackToTop&quot; class=&quot;noprint&quot; style=&quot;background-color:#DDEFDD; position:fixed;<br /> bottom:32px; left:2%; z-index:9999; padding:0; margin:0;&quot;&gt;&lt;span style=&quot;color:blue;<br /> font-size:8pt; font-face:verdana,sans-serif; border:0.2em outset #ceebf7;<br /> padding:0.1em; font-weight:bolder; -moz-border-radius:8px; &quot;&gt;[[#top| Back to the Top]]&lt;/span&gt;&lt;/div&gt;</div>

Manishdubey https://www.carakasamhitaonline.com/index.php?title=Manovaha_srotas&diff=44201 2023-10-16T10:56:02Z

<p>Manishdubey: </p> <hr /> <div>{{CiteButton}}{{#seo:<br /> |title= Manovaha srotas<br /> (Channels of transport and transformation of mind and mental factors)<br /> |titlemode=append<br /> |keywords= Manovaha srotas,Hrudya, Sattva pariksha, Sattvavajaya chikitsa, Bhojani M. K.,Deole Y.S., Basisht G<br /> |description=Mana means mind, or psyche. Srotas means channels of transport and transformation. The description and understanding of channels for activities of mind (manovaha srotas) is scattered in ayurveda classics and has not been completely elucidated. Manovaha srotas are considered as channels through which mind and body interact with each other. <br /> |image=http://www.carakasamhitaonline.com/mediawiki-1.32.1/resources/assets/ogimgs.jpg<br /> |image_alt=carak samhita<br /> |type=article<br /> }}&lt;p style=&quot;text-align:justify;&quot;&gt;Mana means mind, or psyche. Srotas means channels of transport and transformation. The description and understanding of channels for activities of mind (manovaha srotas) is scattered in ayurveda classics and has not been completely elucidated. Manovaha srotas are considered as channels through which mind and body interact with each other. These channels pervade throughout the body. [Chakrapani on Cha.Sa. Indriya Sthana 5/41-42] They are responsible for flow of thoughts, emotions, and other psychological functions. This article deals with various aspects of manovaha srotasa i.e. the channels of activities of mind and its development.&lt;/p&gt;{{Infobox<br /> |title = Contributors<br /> |label1 = Section/Chapter/topic<br /> |data1 = Concepts/[[Srotas]]/[[Manovaha Srotas]] <br /> |label2 = Authors<br /> |data2 = Bhojani M. K.&lt;sup&gt;1&lt;/sup&gt; Varma Swati &lt;sup&gt;1&lt;/sup&gt; Deole Y.S.&lt;sup&gt;2&lt;/sup&gt;<br /> |label3 = Reviewer &amp; Editor<br /> |data3 = Basisht G.&lt;sup&gt;3&lt;/sup&gt;, <br /> |label4 = Affiliations<br /> |data4 = &lt;sup&gt;1&lt;/sup&gt; Department of Sharir Kriya, All India Institute of Ayurveda, New Delhi, India<br /> &lt;sup&gt;2&lt;/sup&gt; Department of Kayachikitsa, G. J. Patel Institute of Ayurvedic Studies and Research, New Vallabh Vidyanagar, Gujarat, India <br /> &lt;sup&gt;3&lt;/sup&gt; Rheumatologist, Orlando, Florida, U.S.A.<br /> |label5 = Correspondence emails<br /> |data5 = meera.samhita@aiia.gov.in, carakasamhita@gmail.com<br /> |label6 = Publisher <br /> |data6 = [[Charak Samhita Research, Training and Development Centre]], I.T.R.A., Jamnagar, India<br /> |label7 = Date of publication:<br /> |data7 =October 12, 2023<br /> |label8 = DOI<br /> |data8 = In process<br /> }}<br /> ==Etymology and derivation:==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Srotas originates from Sanskrit root ‘Sru’ that translates to oozing, flow or secretion. It has been defined as ‘sravanat strotamsi’ [Cha. Sa. Sutra Sthana 30/12] which indicates structures designated for conveyance of material inside body. &lt;/p&gt;&lt;p style=&quot;text-align:justify;&quot;&gt;Grossly defining, thirteen major types of srotas have been mentioned that transport substances undergoing biotransformation (parinamam aapadyamanam) from the place of origin to their destination. [Cha. Sa. Vimana Sthana 5/3] Similarly in physiological state, manovaha srotas might be responsible for processing and transformation of ‘doshayukta’ (irrational under influence of rajas and tamas) emotions and thoughts into unbiased reasoning before reaching a conclusion by our intellect (buddhi).&lt;/p&gt;<br /> ==Synonyms of manovaha srotas==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Following terms are used for ‘manovaha srotas’ in different Ayurveda classics :&lt;/p&gt;<br /> #Manovaha dhamani [Chakrapani on Cha. Sa. Indriya sthana 12/42] and [Vijayarakshita in Ma.Ni.Purva Khanda 20/1]<br /> #Chetanavaha srotas [Shivadas Sen on Cha.Sa. Chikitsa sthana 9/5]<br /> #Chetovaha marga [Bhel Samhita Nidana Sthana 7/2]<br /> #Manobuddhivaha sira [ Cha.Sa.Chikitsa Sthana 10/58]<br /> #Sanjnavaha srotas [Su.Sa.Uttar Tantra 61/8]<br /> #Sanjnavaha nadi [Su.Sa. Uttar Tantra 46/7]&lt;p style=&quot;text-align:justify;&quot;&gt;Use of terms like sira, nadi and dhamani, refers to different channels and pathways concerned with maintenance of physiological flow of information. [Cha.Sa. Vimana Sthana 5/8]&lt;/p&gt;<br /> ==Origin==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Every srotas is localized within the hollow space in the body originating from a root (mula) and spreading throughout the body to reach a final structure. Srotas are said to be hollow structures in different shapes and sizes The root (mula) is majorly responsible for regulation and control of functions of that srotas. &lt;/p&gt;&lt;p style=&quot;text-align:justify;&quot;&gt;The channels carrying mind (manovaha srotas) are not exclusively listed. It is however stated that the entire conscious body is abode of mind. Hence these channels are spread throughout the body. [Chakrapani on Cha.Sa. Indriya Sthana 5/41]. &lt;/p&gt;&lt;p style=&quot;text-align:justify;&quot;&gt;However, hridaya (heart) has a universal acceptance as the site of origin (mula) of manovaha srotas. Hence a special mention has been made about ten arteries of heart, probably being the manovaha srotas (visheshen tu hrudya ashritvat manah tadashrita dasha dhamanyo manovaha abhidhiyante) [Chakrapani on Cha.Sa. Indriya Sthana 5/41-42]. These get afflicted by vitiated dosha either all at once or individually. [Chakrapani on Cha.Sa. Indriya Sthana 12/42]&lt;/p&gt;<br /> ==Decoding hridaya (heart)==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;The interpretation of the term ‘hridaya’ has been of confusion among scholars since decades. The first interpretation of the term given by texts of Shatpada Brahmana which highlighted functional aspect of hridaya. The word being composed of three letters viz ‘hri’ (hra harane)- to acquire; ‘Da’ (da dane) – to give; ‘Ya’ (Ya gatau)- which transports. The hridaya thus displays three phases of cardiac cycle i.e., receives, gives, and transports body constituents through it. [2] &lt;/p&gt;&lt;p style=&quot;text-align:justify;&quot;&gt;Hridaya is the site of rasa (plasma), sattva (psychic factor/mind), buddhi (intellect) and atma (soul) in conjugation with all sensory organs (jnanendriya).[Cha.Sa. Chikitsa Sthana 24/35] Sadhaka pitta situated in heart (hridaya) regulates proper functioning of intellect (buddhi) and ego (ahamkara). Hridaya is located in between breasts (stanayormadhya) of thoracic region [A. H. Sutra Sthana 12/13-14] [Su. Sa. Sharira Sthana 6/25]. &lt;/p&gt;&lt;p style=&quot;text-align:justify;&quot;&gt;Vedic era was well versed with heart (hridaya) and brain (mastishka) being two distinct entities, with interdependent functional relationship [Atharvaveda Book X. Hymn 2.26]. Kashyap Samhita quotes that all sense and motor organs (indriya) together with mind (manas) emerge from heart (hridaya) [Ka.Sa. Chikitsa Sthana 8/6]. Primary site of action of mind (manas) is brain (shira).[3] It can be concluded that mind (manas) being seated in heart (hridaya) connects to brain (shiras) through manovaha srotas and controls all senses (indriya). Also, any damage pertaining to marma (vital points) of shiras (head) causes loss of consciousness (cheshtanasha). [Cha.Sa. Sidhhi Sthana 9/6] Hence heart (hridaya) and brain (shirasor mastishka) are sites of manovaha srotasa. &lt;/p&gt;&lt;p style=&quot;text-align:justify;&quot;&gt;This approach of understanding hridaya goes well along with the contemporary view of understanding the triguna based psycho-functional principles of Ayurveda within the neural framework. Various research has been conducted which demonstrate that heart continuously sends nervous signals to brain to coordinate higher centres responsible for cognition and emotions. [1] The neuro- psychological as well as circulatory functions of hridaya mentioned in the classics can thus be explained.&lt;/p&gt;<br /> ==Relation between rasavaha and manovaha srotas==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Heart is the abode of mind (mana) and consciousness (chetana) or soul (atma). [Cha. Sa. Sidhhi Sthana 9/4] It is a site for physical, psychological, and spiritual components. Heart is origin for channels of transportation and transformation of rasa dhatu, too. Both heart and brain are considered under the umbrella term hridaya in terms of anatomical structure and higher-centre functions respectively. &lt;/p&gt;&lt;p style=&quot;text-align:justify;&quot;&gt;Heart (residence of manas) and brain (workplace of manas) are functionally co-dependent upon each other. Manas regulates the cognitive and conative functions of brain in conjunction with soul (atma) under the influence of vata dosha. [Cha. Sa. Sharira Sthana 1/22-23]. Brain is a structural entity needing continuous supply of nourishment and oxygen. This is feasible by heart through circulation (rasa-rakta samvahana kriya) via the ten major vessels (rasavahi dhamani). [A. H. Sharira Sthana 3/18] Heart is a highly vascular organ being surrounded by ten major dhamani (blood vessels) like spokes of a wheel which are known as ‘rasavaha strotomula’ (site of origin of channels of nutrition). These channels are comparable to manovaha srotas. [Chakrapani on Cha. Sa. Chikitsa Sthana 9/4] Manas thus acts like a medium between heart and brain wherein brain is responsible for all sensory and motor functions while heart has been assigned emotional aspect of psyche (manas). &lt;/p&gt;&lt;p style=&quot;text-align:justify;&quot;&gt;One of the factors for vitiation of rasavaha srotas is excessive thinking or worry (atichintan). [Cha. Sa. Vimana Sthana 5/13] Contemporary researchers have found evidence to support the interaction between circulatory system and psyche. The monograph of German professor Ludwig Braun is a pioneer in exploring the psychological and emotional aspect of cardiac diseases especially angina. He presented a correlation between cardiac diseases and ‘Angst’ (a constrictive, tightening and crushing sensation which manifests dread in the patient thereby changing his entire emotional outlook on life), analogous to anxiety. He explains that the cardiac tissue has a special apparatus receptive towards anxiety which manifests as an inner tactile sensation. That region is well supplied with nerve endings that gets irritated by anxiety. This phenomenon of emotional influence over cardiac tissues is termed as cardiac psyche. [4]&lt;/p&gt;<br /> ==Factors vitiating manovaha srotas==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Manovaha srotas are the prime site of abnormalities of channels in all psychological disorders. [Cha.Sa. Nidana Sthana 6/4] Alongside any of the eight factors that are either attributed to hridaya or manas viz. mana (mind), buddhi (intellect), sanjna-jnana (self-awareness), smriti (memory), bhakti (devotion), sheela (habits), cheshta (psychomotor activities) and achara (code of conduct). [Cha.Sa. Nidana Sthana 7/5] &lt;/p&gt;&lt;p style=&quot;text-align:justify;&quot;&gt;These factors when deranged cause vitiation of manas dosha (rajas and tamas), deterioration of sattva guna of manas and gradual derangement of tridosha. Foods, activities and excessive expression of emotions like anger, grief, lust, fear etc and mental traumas are the fundamental etiological factors for the same. [Cha.Sa. Nidana Sthana 7/4] Vitiated tridosha further vitiates rasavaha srotas, which apparently has the same site of origin as of manovaha srotas i.e., hridaya and dasha dhamani (ten great vessels). [Cha. Sa. Vimana Sthana 5/10] Hridaya is seat of manas [Cha.Sa. Sutra Sthana 30/4]. Hence, all the factors vitiating rasa dhatu (nutritive fluid), rasavaha srotas (channels carrying nutritive fluid) and manas dosha viz. rajas and tamas will affect manas and eventually vitiating manovaha srotas. Even the structural derangements of heart (abode of mind) affect manovaha srotas due to their ashrayashrayibhava (state of interdependency). [Cha.Sa. Chikitsa Sthana 9/5]&lt;/p&gt;<br /> ==Pathologies of manovaha srotas==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Manovaha srotas is important factor in understanding disorders like unmada (psychosis), apasmara (epilepsy) and extreme emotional reactions.&lt;/p&gt;<br /> *'''Unmada (psychosis)'''&lt;p style=&quot;text-align:justify;&quot;&gt;When an individual experiences extreme emotions – lust (kama), anger (krodha), fear (bhaya), greed (lobha), happiness or pleasure (harsha), affection (moha), grief (shoka), excessive worry (chinta), they initially harm the intellect which aggravates manas dosha (rajas and tamas) and tridosha (vata, pitta and kapha). These vitiated dosha invade heart and obstruct manovaha srotas (channels transporting psychic impulses) thereby causing unmada. [Dalhan on Su. Sa. Uttar Tantra 62/3]<br /> *'''Apasmara (epilepsy)'''<br /> Overindulging in sensory pleasures, incompatible diet, withholding natural urges and giving into immoral activities under emotional influences (kama, krodha, lobha among others), vitiates rajas and tamas. They poorly influence the manas (mind) and sanjnavaha srotas (manovaha srotas) causing apasmara. [Su.Sa. Uttar Tantra 61/6]<br /> *Mada (intoxication), murchha (syncope), sanyasa (coma) are caused by vitiation of channels of consciousness (chetanavaha srotas or manovaha srotas). [Shivadas Sen on Cha. Sa. Chikitsa Sthana 9/5]<br /> *'''Atattvabhinivesha (perverted state of mind)'''<br /> Considered as mahagada (difficult to treat mental disorder), the person’s conscience gets afflicted by rajas and tamas, which cause complete derangement of intellect (buddhi vibhramsha) as the predominant symptom. The vitiated dosha get lodged in heart (hridaya) to afflict channels of mind and intellect (manobuddhivaha sira in manovaha srotas). [Cha.Sa. Chikitsa Sthana 10/57-60]<br /> *Physiology of nightmares (swapna)<br /> Nightmares are dreams occurring in REM phase of sleep which causes mental projections in the form of feelings of fear, despair, and anxiety. Ayurveda defines REM phase as ‘Natiprasupta’ - the state characterised to be midway between states of deep sleep and fully awake. During any ominous situation, tridosha in their highly aggravated state tend to fill-up the manovaha srotas. This results in terrifying dreams. [Cha.Sa. Indriya Sthana 5/41].<br /> ==Assessment and diagnosis of disorders of manovaha srotas==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Srotas are micro-channels transporting various metabolites across cells throughout the body. It can be deduced that manovaha srotas has different characteristics structurally and functionally from the major thirteen srotas, because it transports and transforms thoughts and feelings. This is evident from objects of mind (manas), viz- thought (chintyam), consideration (vicharyam), hypothesis (uhyam), aims (dhyeyam) and determination (sankalpam). [Cha.Sa. Sharira Sthana 1/20]. Assessment of manovaha srotas can be done via assessment of manas and the degree of derangement of its functions. Ayurveda considers manas as material entity (dravya) which is a super sense and not perceivable by ordinary senses (atindriya) [Cha. Sa. Sutra Sthana 8/4]. Manas is under direct control of vata dosha [Cha. Sa. Sutra Sthana 12/8] and is the mediator between atma (soul) and indriyartha (objects of senses). &lt;/p&gt;&lt;p style=&quot;text-align:justify;&quot;&gt;The contemporary physiological aspects of mind, senses, brain, nervous system and consciousness can be considered for assessment of manovaha srotas. &lt;/p&gt;&lt;p style=&quot;text-align:justify;&quot;&gt;A thorough neurological examination by means of interrogation (prashna pariksha), inspection (darshana pariksha) and assessment of mental strength (sattva bala pariksha) [Cha.Sa. Vimana Sthana 8/119] can be used for assessment and diagnosis of disorders of manovaha srotas.&lt;/p&gt;''' a. Interrogation (prashna pariksha)''' A formal interview of the patient can be conducted for overall and precise diagnosis. The questions related to chief complaints with duration, chronological development, nurturing of patient, family history, addiction, hobbies, interests, daily routine, major life events, achievements, mental traumas, emotional quotient and intellectual quotient is recorded from the patient. If the patient is not in state of giving correct answers, then the relatives or attendants who know patients history are interviewed.<br /> <br /> '''b. Darshan pariksha (Direct observation)''' While interviewing the patient, a physician should pay attention to following attributes that can signify features mentioned for certain psychiatric ailments (manovaha srotodushti)..<br /> #'''Appearance '''– Unusual dressing preferences, use of cosmetics, perfumes or accessories or flamboyant appearance. e.g;- ‘Priye tanu rakta vastradhari’ (liking for adorning clothes made of thin red fabric) is seen in yakshagraha unmada (Su.Sa. Uttara tantra 60/11)<br /> #'''Activity and co-ordination''' - Behaviour, Gait, gestures, patient’s facial expression and body language should be observed during probing them with questions. Eg;- 'Satatama akshano’ (rapid and constant eye movements) is one of the prodromal feature of apasmara (epilepsy) [ Cha.Sa. Nidana sthana 8/6]. Udhasta (patient keeps his hands raised) is a feature of pishacha grahavishta unmada [Su.Sa. Uttara Tantra 60/15]<br /> #'''Conversation style''' – Coherence of speech, articulation, emphasise over certain issue, hesitation and duration of response. E.g. ‘Chitram sa jalpati’ (Patient does irrelevant absurd talks) is seen in patients of manas unmada [Su.Sa. Uttara Tantra 62/13].<br /> #'''Emotional expression''' – Patients may express a wide range of emotions during interview with the physician. E.g. Asthana rodana (Sudden crying) is a feature in vataja unmada while amarsha (intolerance) is seen in patients of pittaja unmada. [Cha.Sa. Chikitsa Sthana 9/11-12] Fleeting ideas, incoherent speech is an important sign for lacking proper emotions.<br /> #'''Cognition''' – Orientation to person, place, time and circumstances, level of intellect, level of understanding, common sense and memory can be identified under the domain of cognition by observing patient’s behaviour as well as by asking questions to them using validated scientific questionnaires. Short term memory and long-term memory shall be assessed properly.<br /> All observations gathered from every method of assessment should be simultaneously analysed to reach the diagnosis.<br /> <br /> '''c. Sattva pariksha (assessment of quality of excellence of mind)'''&lt;p style=&quot;text-align:justify;&quot;&gt;Sattva pariksha assesses the quality of excellence of mind imparted by extent of dominance of sattva guna. Mind (manas) is composed of three attributes (triguna) viz. sattva, rajas and tamas. These impart three types of mental constitutions – Shuddha (pure) (sattvika), rajasika and tamasika. [Cha.Sa. Sharira Sthana 4/36]. Sattvika guna is full of auspiciousness and is considered the healthy (amala) state of mind. Rajasika guna imparts momentum in terms of furious temperament. Whereas tamas guna promotes inertia and moral ignorance. Hence, rajas and tamas are considered inauspicious and called manas dosha. Triguna are present in dynamically varying proportions at any given time and influenced by body (i.e. tridosha) and vice versa. [Chakrapani on Cha.Sa. Vimana Sthana 4/8]. Optimum levels of sattva guna are essential for promoting desired physical and mental strength irrespective of morphological features. [Cha.Sa. Vimana Sthana 8/119]&lt;/p&gt;&lt;p style=&quot;text-align:justify;&quot;&gt;Sattva bala (strength of psyche) is of three types as per strength – pravara (superior), madhyama (moderate) and avara (poor). Pravara sattva persons possess great courage. Despite poor morphological features they seem to be unmoved in the face of adversities. Madhyama sattva persons need some additional moral support to sustain themselves in times of distress. While avara sattva displays catastrophic reactions even during little inconveniences and can neither be sustained by themselves nor by others despite having good quality morphological features. Avara sattva is constantly plagued by inferior emotions like grief, fear, greed, conceit and confusion. When confronted with fierce, ugly, disgusting narratives or flesh and blood, they are prone to become depressed, pale, unconscious or semiconscious, giddy, anxious and can even succumb to death in worst case scenarios. [Cha. Sa. Vimana Sthana 8/119]. &lt;/p&gt;&lt;p style=&quot;text-align:justify;&quot;&gt;Manovaha srotas associated with avara sattva bala is most likely to be vitiated by manas dosha leading to various psychiatric and psychosomatic disorders [Cha.Sa. Chikitsa Sthana 9/5]. It has been observed that avara sattva individuals are more likely to commit prajnaparadha (intellectual defects) [10] thereby voluntarily indulging in various etiological factors for respective psychological as well as somatic disorders. &lt;br?&gt;Thus, assessment of sattva bala can help rule out the predisposition towards manovaha srotodushti and subsequent development of symptoms of psychiatric ailments.&lt;/p&gt;&lt;p style=&quot;text-align:justify;&quot;&gt;'''d. Anumana pariksha (knowledge by inference)''' to determine normalcy of faculties of manas (mind) [Cha.Sa. Vimana Sthana 4/8] Since manas is atindriya ( supersence or imperceivable by ordinary senses), so are it’s faculties which can serve as potential markers for assessment of its functions. [10] The proper functioning of manas itself is inferred by altered or inappropriate mental perceptions even in presence of appropriately functioning indriya (senses) and their respective sense objects whereas the mental faculties can be inferred as follows:-&lt;/p&gt;<br /> {| class=&quot;wikitable&quot;<br /> |'''Faculty'''<br /> |'''object for inference'''<br /> |-<br /> |Vijnanam (expertise/skills )<br /> |Vyavsayena (occupation )<br /> |-<br /> |Dhairyam (fortitude)<br /> |avishadena (courage in face of adversity)<br /> |-<br /> |Viryam (bravery)<br /> |Uthhanena (initiating difficult tasks and enduring them)<br /> |-<br /> |Avasthanama (stability)<br /> |Avibhramana (absence of confusion)<br /> |-<br /> |Shradhha (faith)<br /> |Abhiprayena (purposiveness)<br /> |-<br /> |Medha (intellect)<br /> |Grahanena (grasping power)<br /> |-<br /> |Sanjna (recognition or consciousness level)<br /> |Namagrahanena (ability to recognise or name things)<br /> |-<br /> |Smriti (memory)<br /> |Smaranena (ability to recollect things)<br /> |-<br /> |Dhriti (self restraint)<br /> |Alaulyama (not being carried away by own greed)<br /> |-<br /> |Amala sattva (purity of mind)<br /> |Avikara (free of delusions or illusionary attachments)<br /> |}This inferential knowledge can help an individual become self-aware of his own psyche (sattva). A self-aware individual has an upper hand at avoiding mental illness because these often go unnoticed until they develop some organic manifestations. <br /> <br /> Thus, by means of above discussed assessment methodologies, a physician can assess the degree of derangement in mental faculties and hence the manovaha srotas, irrespective of development of specific signs and symptoms of any psychiatric disorder (vyadhi lakshana).<br /> ==Treatment Guidelines==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Manovaha srotas disorders follow the line of treatment same as described for disorders of manas (mind). Following are therapeutic and preventive practices beneficial for both vitiated manovaha srotas (channels of psyche) and manas obscured by rajas - tamas dosha.&lt;/p&gt;<br /> *Manas dosha can be alleviated through a comprehensive five-fold psychotherapeutic regimen - jnana (spiritual knowledge or self-awareness), vijnana (scriptural or scientific knowledge), dhairya (mental fortitude), smriti (recollection of past successes to regain faith in own abilities) and samadhi (spiritual healing practices to focus mind inwards away from negative external stimuli). [Cha.Sa. Sutra Sthana 1/58]<br /> Restoration of dhi (intellect), dhairya (mental fortitude) and atmadi vijnana (knowledge of self-consciousness) has therapeutic effect in alleviating disorders of manovaha srotas obstructed by manas dosha.<br /> *'''Sattvavajaya chikitsa (treatment to regulate mind)'''<br /> Sattvavajaya chikitsa is a non-invasive therapeutic module for psychological derangements and psychosomatic ailments, analogous to contemporary psychotherapy. ‘Sattva’ stands for mind and ‘avajaya’ translates to win over. Hence, it emphasizes withdrawing the mind from unwholesome objects of senses (factors vitiating rajas and tamas) and diverting it to positive sensory and emotional stimuli. Thereby consciously negating disturbed emotions and behavioural patterns. [Cha.Sa. Sutra Sthana 11/54]<br /> *'''Ashtanga yoga (eight steps of yoga)'''&lt;p style=&quot;text-align:justify;&quot;&gt;Ashtanga yoga can be considered as one of the dimensions of satvavajaya chikitsa. It integrates eight steps of yoga to tame mind from traversing paths in life which are spiritually and mentally harmful for that individual. Of the eight steps, first four viz. yama (principles for moral code), niyama (observances for personal discipline), asana (yogic postures) and pranayama (regulating breath) are termed as bahiranga yoga (external path). These practices gradually alleviate aggravated manas dosha, making the mind less reactive towards external stimuli. The last three limbs viz. dharana (concentration), dhyana (meditation) and samadhi (enlightenment or complete realisation) are termed as antaranga yoga (internal paths). These practices transform the mind, eliminating the fluctuations of mind, thereby strengthening positive habits and outlook on life as well as inner self. Ashtanga yoga maintains a harmonious balance between inner environment (mind and spirit) and external environment (objects of sensory perception). Mind thus gets liberated from worldly pursuits and all psychological sufferings in a stepwise manner.&lt;/p&gt;<br /> *'''Achara rasayana (rejuvenating codes of behavioural conduct)'''&lt;p style=&quot;text-align:justify;&quot;&gt;Achara rasayana is an adravyabhuta (non-pharmacological) rasayana (practices rejuvenating physical and mental health). It includes behavioural conducts which aim to enhance health and longevity by teaching practical methods to potentiate sattva guna of mind. [Cha.Sa. Chikitsa Sthana 1, 4th pada, shloka 30-35] An individual can imbibe easy lifestyle modifications to develop a positive and strong character of mind, thereby avoiding potential etiological factors (for dosha aggravation) and negative psychosocial patterns. Achara rasayana can be divided into five domains of good mental, social, personal, moral and religious conduct. [6]&lt;/p&gt;<br /> *'''Sadvritta (good codes of conduct)'''&lt;p style=&quot;text-align:justify;&quot;&gt;Sadvritta refers to good code of conduct. These are a set of practices, which serve as lifestyle guidelines to prevent mind from falling prey to temporary material pleasures and impulsive thoughts and actions that cause impairment of manas dosha and manovaha srotas. It encompasses guidelines over personal hygiene, personality development as well as for social hygiene and peaceful social interactions. [Cha.Sa. Sutra Sthana 8/18]&lt;/p&gt;Both achara rasayana and sadvritta help to maintain control over sense organs. They majorly add to the preventive and promotive aspect of mental health.<br /> *'''Medhya dravya (medicines enhancing intellectual functions)'''&lt;p style=&quot;text-align:justify;&quot;&gt;Medhya dravyas are the plant based pharmacological agents that promote prajna i.e., dhi (intellect), dhriti (perseverance) and smriti (memory). Researches conducted prove their efficacy in minimizing the cognitive decline among individuals with neural abnormalities. For example, ushna (hot potency) and tikshna nature drugs like jyotishmati and vacha are said to remove blockages caused by kapha, ama or tamas dosha in the manovaha srotas. Once purified, manas can regain unvitiated connect with indriya via manovaha srotas. [8] &lt;/p&gt;&lt;p style=&quot;text-align:justify;&quot;&gt;Ayurveda thus provides a bird’s eye view over different aspects of manovaha srotas through interconnected references in the classics highlighting its physiological importance like the other thirteen major srotas systems in the human body.&lt;/p&gt;<br /> ==Contemporary view==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Mind as per contemporary literature is debatable concept because in some contexts it is identified as conscience, while in others it is seen as the function of conscience. The philosophical dimension of mind was conceived by Plato who considered mind as an inner (soul’s) experience. [11] &lt;/p&gt;&lt;p style=&quot;text-align:justify;&quot;&gt;The western system of medicine addresses brain at the core of majority of psychological distresses, whereas western philosophy involves the concept of psyche (which denotes mind). ‘Psyche’ is a Greek word meaning ‘soul in a living man’. &lt;/p&gt;&lt;p style=&quot;text-align:justify;&quot;&gt;William James, referred to as the father of American Psychology, laid the foundations of physiological aspect of mind. To him mind was a function of brain which conducts mental life in the form of a constant stream of consciousness.[9] At some places he too admitted mind to bear consciousness and tried to assign attributes to consciousness as a separate psychological function thus formulating the Theory of Functionalism which established causal relationship between internal states (perception) and external reactions or behaviour (sensation). He concluded that repeated actions cause adaptive changes in nervous system. This is the fundamental ideology behind the concept of Neuroplasticity – i.e. adaptive structural and functional changes in brain by development of new neuronal pathways due to intrinsic or extrinsic stimuli. [12] &lt;/p&gt;&lt;p style=&quot;text-align:justify;&quot;&gt;James’ counterpart Titchener, an English Psychologist, proposed that consciousness is mind’s awareness of its own functions. Consciousness is something superior to mind itself. He formulated the Theory of Structuralism which aimed at analysing the interrelationship between mental experiences, feelings, and sensations. He used introspection as a tool to break down these complex phenomena of consciousness down to their basic elements without breaking their original structure. &lt;/p&gt;&lt;p style=&quot;text-align:justify;&quot;&gt;Mind is hence regarded as the cumulative effect of all mental processes that have occurred in the lifetime while the consciousness can be understood as the cumulative effect of all mental processes occurring in present moment. Eventually brain was somehow regarded to control the neural activity responsible for accumulating all this sensory data. &lt;/p&gt;&lt;p style=&quot;text-align:justify;&quot;&gt;Many theories were formulated and overruled by their successors with time. Today the concept of mind and consciousness remains yet to be clearly defined. It is observed that mind is often identified as consciousness and they both are accepted as individual closely linked entities. Mind bears synonymity towards consciousness, spirit, and psyche. Some theories view both mind and consciousness as spirit. But mind is invariably understood as the interaction between psychological personality and the external environment, i.e., a subject – object relationship. &lt;/p&gt;&lt;p style=&quot;text-align:justify;&quot;&gt;The neurophysiological basis of minds and the channels of transport of its constituents is yet a challenge in field of neuroscience. In order to bridge this gap, contemporary scientists hypothesise that mental representations and their contents are represented by neural network and their supporting cells thus hinting towards Central Nervous System and it’s peripheral nerves as the channels of mind. [13]&lt;/p&gt;<br /> ==Research works on manovaha srotas==<br /> Various review articles have been published and researches been carried out in the domain of Ayurveda to understand the conceptual as well as pathophysiological aspect of manovaha srotas. Few of them are as follows :- <br /> <br /> '''1. Critical Review of Concept of manovaha Srotas with special reference to Brain''' This review article conceptualizes the contemporary understanding of manovaha srotas in context to CNS due to functional similarity between manas and brain obtained after an extensive research and analysis throughout ayurveda treatises. Further brain was considered as synonymous to hridya ie. mulasthana (site of origin) of manovaha srotas and ‘dasha dhamani’ as the cranial nerves exiting from the 10 major foramen at base of skull. Sanskrit literature considers hridaya as regarded as a central organ similar to brain. 14<br /> <br /> '''2. Circumstantial view on clinical knowing of manovaha srotasa &amp; its physiology''' The review article reconstructs a comprehensive picture of manovaha srotas from the scattered references available in Ayurveda texts, supplementing it with additional information from contemporary science as follows-<br /> *A detailed description of neuroanatomy and physiology has been drawn parallel to Ayurveda point of view about manas’ rachna and kriya sharir.<br /> *Effect of Triguna and tridosha (especially vata) in context of physiological functions and disorders of manas and manovaha srotas have been discussed.<br /> *Correlations between functions of five subtypes of vata and both CNS and ANS has been attempted<br /> *Pariksha krama (examination of nervous system) has been exemplified taking into consideration both Ayurveda and modern methodologies that can be employed for manovaha srotas (nervous system) examination.10<br /> '''3. Concept of stress factor assessment concerning ‘perseverance test’ in light of ayurveda” – a review''' This article highlights the importance of understanding the etiological factors of vitiation of manovaha srotas and manas in all kinds of psychiatric as well as psychosomatic disorders. Imbalance of manas dosha can be treated by means of yoga, meditation and pranayama. Often emotional disturbances remain unattended in diagnosed cases of psychiatric illness which can be managed at home by incorporating wholesome diet (pathya ahara) and moral code of conduct (sadvrutta) in daily routine. Lack of peace and chronic stressors have been observed as major causes of vitiation of channels of mind. 15<br /> <br /> &lt;big&gt;'''[[Special:ContactMe|Send us your suggestions and feedback on this page.]]'''&lt;/big&gt;<br /> ==References==<br /> &lt;div id=&quot;BackToTop&quot; class=&quot;noprint&quot; style=&quot;background-color:#DDEFDD; position:fixed;<br /> bottom:32px; left:2%; z-index:9999; padding:0; margin:0;&quot;&gt;&lt;span style=&quot;color:blue;<br /> font-size:8pt; font-face:verdana,sans-serif; border:0.2em outset #ceebf7;<br /> padding:0.1em; font-weight:bolder; -moz-border-radius:8px; &quot;&gt;[[#top| Back to the Top]]&lt;/span&gt;&lt;/div&gt;</div>

Manishdubey https://www.carakasamhitaonline.com/index.php?title=Talk:Manovaha_srotas&diff=44200 2023-10-16T10:53:04Z

<p>Manishdubey: /* Treatment Guidelines */</p> <hr /> <div>{{CiteButton}}<br /> {{#seo:<br /> |title= Manovaha srotas<br /> (Channels of transport and transformation of mind and mental factors)<br /> |titlemode=append<br /> |keywords= Manovaha srotas,Hrudya, Sattva pariksha, Sattvavajaya chikitsa, Bhojani M. K.,Deole Y.S., Basisht G<br /> |description=Mana means mind, or psyche. Srotas means channels of transport and transformation. The description and understanding of channels for activities of mind (manovaha srotas) is scattered in ayurveda classics and has not been completely elucidated. Manovaha srotas are considered as channels through which mind and body interact with each other. <br /> |image=http://www.carakasamhitaonline.com/mediawiki-1.32.1/resources/assets/ogimgs.jpg<br /> |image_alt=carak samhita<br /> |type=article<br /> }}<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Mana means mind, or psyche. Srotas means channels of transport and transformation. The description and understanding of channels for activities of mind (manovaha srotas) is scattered in ayurveda classics and has not been completely elucidated. Manovaha srotas are considered as channels through which mind and body interact with each other. These channels pervade throughout the body. [Chakrapani on Cha.Sa. Indriya Sthana 5/41-42] They are responsible for flow of thoughts, emotions, and other psychological functions. This article deals with various aspects of manovaha srotasa i.e. the channels of activities of mind and its development.&lt;/p&gt;<br /> <br /> {{Infobox<br /> |title = Contributors<br /> |label1 = Section/Chapter/topic<br /> |data1 = Concepts/[[Srotas]]/[[Manovaha Srotas]] <br /> |label2 = Authors<br /> |data2 = Bhojani M. K.&lt;sup&gt;1&lt;/sup&gt; Varma Swati &lt;sup&gt;1&lt;/sup&gt; Deole Y.S.&lt;sup&gt;2&lt;/sup&gt;<br /> |label3 = Reviewer &amp; Editor<br /> |data3 = Basisht G.&lt;sup&gt;3&lt;/sup&gt;, <br /> |label4 = Affiliations<br /> |data4 = &lt;sup&gt;1&lt;/sup&gt; Department of Sharir Kriya, All India Institute of Ayurveda, New Delhi, India<br /> &lt;sup&gt;2&lt;/sup&gt; Department of Kayachikitsa, G. J. Patel Institute of Ayurvedic Studies and Research, New Vallabh Vidyanagar, Gujarat, India <br /> &lt;sup&gt;3&lt;/sup&gt; Rheumatologist, Orlando, Florida, U.S.A.<br /> |label5 = Correspondence emails<br /> |data5 = meera.samhita@aiia.gov.in, carakasamhita@gmail.com<br /> |label6 = Publisher <br /> |data6 = [[Charak Samhita Research, Training and Development Centre]], I.T.R.A., Jamnagar, India<br /> |label7 = Date of publication:<br /> |data7 =October 12, 2023<br /> |label8 = DOI<br /> |data8 = In process<br /> }}<br /> <br /> ==Etymology and derivation:==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Srotas originates from Sanskrit root ‘Sru’ that translates to oozing, flow or secretion. It has been defined as ‘sravanat strotamsi’ [Cha. Sa. Sutra Sthana 30/12] which indicates structures designated for conveyance of material inside body. <br /> &lt;br/&gt;Grossly defining, thirteen major types of srotas have been mentioned that transport substances undergoing biotransformation (parinamam aapadyamanam) from the place of origin to their destination. [Cha. Sa. Vimana Sthana 5/3] Similarly in physiological state, manovaha srotas might be responsible for processing and transformation of ‘doshayukta’ (irrational under influence of rajas and tamas) emotions and thoughts into unbiased reasoning before reaching a conclusion by our intellect (buddhi). &lt;/p&gt;<br /> <br /> ==Synonyms of manovaha srotas==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Following terms are used for ‘manovaha srotas’ in different Ayurveda classics : &lt;/p&gt;<br /> # Manovaha dhamani [Chakrapani on Cha. Sa. Indriya sthana 12/42] and [Vijayarakshita in Ma.Ni.Purva Khanda 20/1]<br /> # Chetanavaha srotas [Shivadas Sen on Cha.Sa. Chikitsa sthana 9/5] <br /> # Chetovaha marga [Bhel Samhita Nidana Sthana 7/2]<br /> # Manobuddhivaha sira [ Cha.Sa.Chikitsa Sthana 10/58]<br /> # Sanjnavaha srotas [Su.Sa.Uttar Tantra 61/8]<br /> # Sanjnavaha nadi [Su.Sa. Uttar Tantra 46/7]<br /> &lt;p style=&quot;text-align:justify;&quot;&gt; &lt;br/&gt;Use of terms like sira, nadi and dhamani, refers to different channels and pathways concerned with maintenance of physiological flow of information. [Cha.Sa. Vimana Sthana 5/8] &lt;/p&gt;<br /> <br /> ==Origin==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt; Every srotas is localized within the hollow space in the body originating from a root (mula) and spreading throughout the body to reach a final structure. Srotas are said to be hollow structures in different shapes and sizes The root (mula) is majorly responsible for regulation and control of functions of that srotas.<br /> &lt;br/&gt;The channels carrying mind (manovaha srotas) are not exclusively listed. It is however stated that the entire conscious body is abode of mind. Hence these channels are spread throughout the body. [Chakrapani on Cha.Sa. Indriya Sthana 5/41]. <br /> &lt;br/&gt;However, hridaya (heart) has a universal acceptance as the site of origin (mula) of manovaha srotas. Hence a special mention has been made about ten arteries of heart, probably being the manovaha srotas (visheshen tu hrudya ashritvat manah tadashrita dasha dhamanyo manovaha abhidhiyante) [Chakrapani on Cha.Sa. Indriya Sthana 5/41-42]. These get afflicted by vitiated dosha either all at once or individually. [Chakrapani on Cha.Sa. Indriya Sthana 12/42]<br /> &lt;/p&gt;<br /> <br /> ==Decoding hridaya (heart)==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt; The interpretation of the term ‘hridaya’ has been of confusion among scholars since decades. The first interpretation of the term given by texts of Shatpada Brahmana which highlighted functional aspect of hridaya. The word being composed of three letters viz ‘hri’ (hra harane)- to acquire; ‘Da’ (da dane) – to give; ‘Ya’ (Ya gatau)- which transports. The hridaya thus displays three phases of cardiac cycle i.e., receives, gives, and transports body constituents through it. [2]<br /> &lt;br/&gt;Hridaya is the site of rasa (plasma), sattva (psychic factor/mind), buddhi (intellect) and atma (soul) in conjugation with all sensory organs (jnanendriya).[Cha.Sa. Chikitsa Sthana 24/35] Sadhaka pitta situated in heart (hridaya) regulates proper functioning of intellect (buddhi) and ego (ahamkara). Hridaya is located in between breasts (stanayormadhya) of thoracic region [A. H. Sutra Sthana 12/13-14] [Su. Sa. Sharira Sthana 6/25]. <br /> &lt;br/&gt;Vedic era was well versed with heart (hridaya) and brain (mastishka) being two distinct entities, with interdependent functional relationship [Atharvaveda Book X. Hymn 2.26]. Kashyap Samhita quotes that all sense and motor organs (indriya) together with mind (manas) emerge from heart (hridaya) [Ka.Sa. Chikitsa Sthana 8/6]. Primary site of action of mind (manas) is brain (shira).[3] It can be concluded that mind (manas) being seated in heart (hridaya) connects to brain (shiras) through manovaha srotas and controls all senses (indriya). Also, any damage pertaining to marma (vital points) of shiras (head) causes loss of consciousness (cheshtanasha). [Cha.Sa. Sidhhi Sthana 9/6] Hence heart (hridaya) and brain (shirasor mastishka) are sites of manovaha srotasa. <br /> &lt;br/&gt; This approach of understanding hridaya goes well along with the contemporary view of understanding the triguna based psycho-functional principles of Ayurveda within the neural framework. Various research has been conducted which demonstrate that heart continuously sends nervous signals to brain to coordinate higher centres responsible for cognition and emotions. [1] The neuro- psychological as well as circulatory functions of hridaya mentioned in the classics can thus be explained. &lt;/p&gt; <br /> <br /> ==Relation between rasavaha and manovaha srotas==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Heart is the abode of mind (mana) and consciousness (chetana) or soul (atma). [Cha. Sa. Sidhhi Sthana 9/4] It is a site for physical, psychological, and spiritual components. Heart is origin for channels of transportation and transformation of rasa dhatu, too. Both heart and brain are considered under the umbrella term hridaya in terms of anatomical structure and higher-centre functions respectively. <br /> &lt;br/&gt;Heart (residence of manas) and brain (workplace of manas) are functionally co-dependent upon each other. Manas regulates the cognitive and conative functions of brain in conjunction with soul (atma) under the influence of vata dosha. [Cha. Sa. Sharira Sthana 1/22-23]. Brain is a structural entity needing continuous supply of nourishment and oxygen. This is feasible by heart through circulation (rasa-rakta samvahana kriya) via the ten major vessels (rasavahi dhamani). [A. H. Sharira Sthana 3/18] Heart is a highly vascular organ being surrounded by ten major dhamani (blood vessels) like spokes of a wheel which are known as ‘rasavaha strotomula’ (site of origin of channels of nutrition). These channels are comparable to manovaha srotas. [Chakrapani on Cha. Sa. Chikitsa Sthana 9/4] Manas thus acts like a medium between heart and brain wherein brain is responsible for all sensory and motor functions while heart has been assigned emotional aspect of psyche (manas).<br /> &lt;br/&gt;One of the factors for vitiation of rasavaha srotas is excessive thinking or worry (atichintan). [Cha. Sa. Vimana Sthana 5/13] Contemporary researchers have found evidence to support the interaction between circulatory system and psyche. The monograph of German professor Ludwig Braun is a pioneer in exploring the psychological and emotional aspect of cardiac diseases especially angina. He presented a correlation between cardiac diseases and ‘Angst’ (a constrictive, tightening and crushing sensation which manifests dread in the patient thereby changing his entire emotional outlook on life), analogous to anxiety. He explains that the cardiac tissue has a special apparatus receptive towards anxiety which manifests as an inner tactile sensation. That region is well supplied with nerve endings that gets irritated by anxiety. This phenomenon of emotional influence over cardiac tissues is termed as cardiac psyche. [4] <br /> &lt;/p&gt; <br /> <br /> ==Factors vitiating manovaha srotas==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt; Manovaha srotas are the prime site of abnormalities of channels in all psychological disorders. [Cha.Sa. Nidana Sthana 6/4] Alongside any of the eight factors that are either attributed to hridaya or manas viz. mana (mind), buddhi (intellect), sanjna-jnana (self-awareness), smriti (memory), bhakti (devotion), sheela (habits), cheshta (psychomotor activities) and achara (code of conduct). [Cha.Sa. Nidana Sthana 7/5] <br /> &lt;br/&gt;These factors when deranged cause vitiation of manas dosha (rajas and tamas), deterioration of sattva guna of manas and gradual derangement of tridosha. Foods, activities and excessive expression of emotions like anger, grief, lust, fear etc and mental traumas are the fundamental etiological factors for the same. [Cha.Sa. Nidana Sthana 7/4] Vitiated tridosha further vitiates rasavaha srotas, which apparently has the same site of origin as of manovaha srotas i.e., hridaya and dasha dhamani (ten great vessels). [Cha. Sa. Vimana Sthana 5/10] Hridaya is seat of manas [Cha.Sa. Sutra Sthana 30/4]. Hence, all the factors vitiating rasa dhatu (nutritive fluid), rasavaha srotas (channels carrying nutritive fluid) and manas dosha viz. rajas and tamas will affect manas and eventually vitiating manovaha srotas. Even the structural derangements of heart (abode of mind) affect manovaha srotas due to their ashrayashrayibhava (state of interdependency). [Cha.Sa. Chikitsa Sthana 9/5]&lt;/p&gt;<br /> <br /> ==Pathologies of manovaha srotas==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Manovaha srotas is important factor in understanding disorders like unmada (psychosis), apasmara (epilepsy) and extreme emotional reactions. &lt;/p&gt;<br /> <br /> *'''Unmada (psychosis)'''<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;When an individual experiences extreme emotions – lust (kama), anger (krodha), fear (bhaya), greed (lobha), happiness or pleasure (harsha), affection (moha), grief (shoka), excessive worry (chinta), they initially harm the intellect which aggravates manas dosha (rajas and tamas) and tridosha (vata, pitta and kapha). These vitiated dosha invade heart and obstruct manovaha srotas (channels transporting psychic impulses) thereby causing unmada. [Dalhan on Su. Sa. Uttar Tantra 62/3]<br /> *'''Apasmara (epilepsy)'''<br /> Overindulging in sensory pleasures, incompatible diet, withholding natural urges and giving into immoral activities under emotional influences (kama, krodha, lobha among others), vitiates rajas and tamas. They poorly influence the manas (mind) and sanjnavaha srotas (manovaha srotas) causing apasmara. [Su.Sa. Uttar Tantra 61/6]<br /> * Mada (intoxication), murchha (syncope), sanyasa (coma) are caused by vitiation of channels of consciousness (chetanavaha srotas or manovaha srotas). [Shivadas Sen on Cha. Sa. Chikitsa Sthana 9/5] <br /> *'''Atattvabhinivesha (perverted state of mind)'''<br /> Considered as mahagada (difficult to treat mental disorder), the person’s conscience gets afflicted by rajas and tamas, which cause complete derangement of intellect (buddhi vibhramsha) as the predominant symptom. The vitiated dosha get lodged in heart (hridaya) to afflict channels of mind and intellect (manobuddhivaha sira in manovaha srotas). [Cha.Sa. Chikitsa Sthana 10/57-60]<br /> * Physiology of nightmares (swapna)<br /> Nightmares are dreams occurring in REM phase of sleep which causes mental projections in the form of feelings of fear, despair, and anxiety. Ayurveda defines REM phase as ‘Natiprasupta’ - the state characterised to be midway between states of deep sleep and fully awake. During any ominous situation, tridosha in their highly aggravated state tend to fill-up the manovaha srotas. This results in terrifying dreams. [Cha.Sa. Indriya Sthana 5/41]. &lt;/p&gt;<br /> <br /> ==Assessment and diagnosis of disorders of manovaha srotas==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Srotas are micro-channels transporting various metabolites across cells throughout the body. It can be deduced that manovaha srotas has different characteristics structurally and functionally from the major thirteen srotas, because it transports and transforms thoughts and feelings. This is evident from objects of mind (manas), viz- thought (chintyam), consideration (vicharyam), hypothesis (uhyam), aims (dhyeyam) and determination (sankalpam). [Cha.Sa. Sharira Sthana 1/20]. Assessment of manovaha srotas can be done via assessment of manas and the degree of derangement of its functions. Ayurveda considers manas as material entity (dravya) which is a super sense and not perceivable by ordinary senses (atindriya) [Cha. Sa. Sutra Sthana 8/4]. Manas is under direct control of vata dosha [Cha. Sa. Sutra Sthana 12/8] and is the mediator between atma (soul) and indriyartha (objects of senses). <br /> &lt;br/&gt;The contemporary physiological aspects of mind, senses, brain, nervous system and consciousness can be considered for assessment of manovaha srotas. <br /> &lt;br/&gt; A thorough neurological examination by means of interrogation (prashna pariksha), inspection (darshana pariksha) and assessment of mental strength (sattva bala pariksha) [Cha.Sa. Vimana Sthana 8/119] can be used for assessment and diagnosis of disorders of manovaha srotas.&lt;/p&gt;<br /> <br /> ''' a. Interrogation (prashna pariksha)'''<br /> A formal interview of the patient can be conducted for overall and precise diagnosis. The questions related to chief complaints with duration, chronological development, nurturing of patient, family history, addiction, hobbies, interests, daily routine, major life events, achievements, mental traumas, emotional quotient and intellectual quotient is recorded from the patient. If the patient is not in state of giving correct answers, then the relatives or attendants who know patients history are interviewed. <br /> <br /> '''b. Darshan pariksha (Direct observation)'''<br /> While interviewing the patient, a physician should pay attention to following attributes that can signify features mentioned for certain psychiatric ailments (manovaha srotodushti)..<br /> <br /> # '''Appearance '''– Unusual dressing preferences, use of cosmetics, perfumes or accessories or flamboyant appearance. e.g;- ‘Priye tanu rakta vastradhari’ (liking for adorning clothes made of thin red fabric) is seen in yakshagraha unmada (Su.Sa. Uttara tantra 60/11)<br /> # '''Activity and co-ordination''' - Behaviour, Gait, gestures, patient’s facial expression and body language should be observed during probing them with questions. Eg;- 'Satatama akshano’ (rapid and constant eye movements) is one of the prodromal feature of apasmara (epilepsy) [ Cha.Sa. Nidana sthana 8/6]. Udhasta (patient keeps his hands raised) is a feature of pishacha grahavishta unmada [Su.Sa. Uttara Tantra 60/15]<br /> # '''Conversation style''' – Coherence of speech, articulation, emphasise over certain issue, hesitation and duration of response. E.g. ‘Chitram sa jalpati’ (Patient does irrelevant absurd talks) is seen in patients of manas unmada [Su.Sa. Uttara Tantra 62/13].<br /> #'''Emotional expression''' – Patients may express a wide range of emotions during interview with the physician. E.g. Asthana rodana (Sudden crying) is a feature in vataja unmada while amarsha (intolerance) is seen in patients of pittaja unmada. [Cha.Sa. Chikitsa Sthana 9/11-12] Fleeting ideas, incoherent speech is an important sign for lacking proper emotions. <br /> #'''Cognition''' – Orientation to person, place, time and circumstances, level of intellect, level of understanding, common sense and memory can be identified under the domain of cognition by observing patient’s behaviour as well as by asking questions to them using validated scientific questionnaires. Short term memory and long-term memory shall be assessed properly. <br /> &lt;br/&gt;All observations gathered from every method of assessment should be simultaneously analysed to reach the diagnosis.<br /> <br /> '''c. Sattva pariksha (assessment of quality of excellence of mind)'''<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Sattva pariksha assesses the quality of excellence of mind imparted by extent of dominance of sattva guna. Mind (manas) is composed of three attributes (triguna) viz. sattva, rajas and tamas. These impart three types of mental constitutions – Shuddha (pure) (sattvika), rajasika and tamasika. [Cha.Sa. Sharira Sthana 4/36]. Sattvika guna is full of auspiciousness and is considered the healthy (amala) state of mind. Rajasika guna imparts momentum in terms of furious temperament. Whereas tamas guna promotes inertia and moral ignorance. Hence, rajas and tamas are considered inauspicious and called manas dosha. Triguna are present in dynamically varying proportions at any given time and influenced by body (i.e. tridosha) and vice versa. [Chakrapani on Cha.Sa. Vimana Sthana 4/8]. Optimum levels of sattva guna are essential for promoting desired physical and mental strength irrespective of morphological features. [Cha.Sa. Vimana Sthana 8/119]&lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Sattva bala (strength of psyche) is of three types as per strength – pravara (superior), madhyama (moderate) and avara (poor). Pravara sattva persons possess great courage. Despite poor morphological features they seem to be unmoved in the face of adversities. Madhyama sattva persons need some additional moral support to sustain themselves in times of distress. While avara sattva displays catastrophic reactions even during little inconveniences and can neither be sustained by themselves nor by others despite having good quality morphological features. Avara sattva is constantly plagued by inferior emotions like grief, fear, greed, conceit and confusion. When confronted with fierce, ugly, disgusting narratives or flesh and blood, they are prone to become depressed, pale, unconscious or semiconscious, giddy, anxious and can even succumb to death in worst case scenarios. [Cha. Sa. Vimana Sthana 8/119].<br /> &lt;br/&gt;Manovaha srotas associated with avara sattva bala is most likely to be vitiated by manas dosha leading to various psychiatric and psychosomatic disorders [Cha.Sa. Chikitsa Sthana 9/5]. It has been observed that avara sattva individuals are more likely to commit prajnaparadha (intellectual defects) [10] thereby voluntarily indulging in various etiological factors for respective psychological as well as somatic disorders.<br /> &lt;br?&gt;Thus, assessment of sattva bala can help rule out the predisposition towards manovaha srotodushti and subsequent development of symptoms of psychiatric ailments.&lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;'''d. Anumana pariksha (knowledge by inference)''' to determine normalcy of faculties of manas (mind) [Cha.Sa. Vimana Sthana 4/8] Since manas is atindriya ( supersence or imperceivable by ordinary senses), so are it’s faculties which can serve as potential markers for assessment of its functions. [10] The proper functioning of manas itself is inferred by altered or inappropriate mental perceptions even in presence of appropriately functioning indriya (senses) and their respective sense objects whereas the mental faculties can be inferred as follows:-&lt;/p&gt;<br /> {| class=&quot;wikitable&quot;<br /> |'''Faculty''' <br /> |'''object for inference''' <br /> |-<br /> |Vijnanam (expertise/skills )<br /> |Vyavsayena (occupation )<br /> |-<br /> |Dhairyam (fortitude)<br /> |avishadena (courage in face of adversity)<br /> |-<br /> |Viryam (bravery)<br /> |Uthhanena (initiating difficult tasks and enduring them)<br /> |-<br /> |Avasthanama (stability)<br /> |Avibhramana (absence of confusion)<br /> |-<br /> |Shradhha (faith)<br /> |Abhiprayena (purposiveness)<br /> |-<br /> |Medha (intellect)<br /> |Grahanena (grasping power)<br /> |-<br /> |Sanjna (recognition or consciousness level)<br /> |Namagrahanena (ability to recognise or name things)<br /> |-<br /> |Smriti (memory)<br /> |Smaranena (ability to recollect things)<br /> |-<br /> |Dhriti (self restraint)<br /> |Alaulyama (not being carried away by own greed)<br /> |-<br /> |Amala sattva (purity of mind)<br /> |Avikara (free of delusions or illusionary attachments)<br /> |}<br /> This inferential knowledge can help an individual become self-aware of his own psyche (sattva). A self-aware individual has an upper hand at avoiding mental illness because these often go unnoticed until they develop some organic manifestations.<br /> &lt;br /&gt;Thus, by means of above discussed assessment methodologies, a physician can assess the degree of derangement in mental faculties and hence the manovaha srotas, irrespective of development of specific signs and symptoms of any psychiatric disorder (vyadhi lakshana).<br /> <br /> ==Treatment Guidelines==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Manovaha srotas disorders follow the line of treatment same as described for disorders of manas (mind). Following are therapeutic and preventive practices beneficial for both vitiated manovaha srotas (channels of psyche) and manas obscured by rajas - tamas dosha.&lt;/p&gt;<br /> *Manas dosha can be alleviated through a comprehensive five-fold psychotherapeutic regimen - jnana (spiritual knowledge or self-awareness), vijnana (scriptural or scientific knowledge), dhairya (mental fortitude), smriti (recollection of past successes to regain faith in own abilities) and samadhi (spiritual healing practices to focus mind inwards away from negative external stimuli). [Cha.Sa. Sutra Sthana 1/58]<br /> Restoration of dhi (intellect), dhairya (mental fortitude) and atmadi vijnana (knowledge of self-consciousness) has therapeutic effect in alleviating disorders of manovaha srotas obstructed by manas dosha.<br /> <br /> *'''Sattvavajaya chikitsa (treatment to regulate mind)'''<br /> Sattvavajaya chikitsa is a non-invasive therapeutic module for psychological derangements and psychosomatic ailments, analogous to contemporary psychotherapy. ‘Sattva’ stands for mind and ‘avajaya’ translates to win over. Hence, it emphasizes withdrawing the mind from unwholesome objects of senses (factors vitiating rajas and tamas) and diverting it to positive sensory and emotional stimuli. Thereby consciously negating disturbed emotions and behavioural patterns. [Cha.Sa. Sutra Sthana 11/54]<br /> <br /> *'''Ashtanga yoga (eight steps of yoga)'''<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Ashtanga yoga can be considered as one of the dimensions of satvavajaya chikitsa. It integrates eight steps of yoga to tame mind from traversing paths in life which are spiritually and mentally harmful for that individual. Of the eight steps, first four viz. yama (principles for moral code), niyama (observances for personal discipline), asana (yogic postures) and pranayama (regulating breath) are termed as bahiranga yoga (external path). These practices gradually alleviate aggravated manas dosha, making the mind less reactive towards external stimuli. The last three limbs viz. dharana (concentration), dhyana (meditation) and samadhi (enlightenment or complete realisation) are termed as antaranga yoga (internal paths). These practices transform the mind, eliminating the fluctuations of mind, thereby strengthening positive habits and outlook on life as well as inner self. Ashtanga yoga maintains a harmonious balance between inner environment (mind and spirit) and external environment (objects of sensory perception). Mind thus gets liberated from worldly pursuits and all psychological sufferings in a stepwise manner.&lt;/p&gt;<br /> *'''Achara rasayana (rejuvenating codes of behavioural conduct)'''<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Achara rasayana is an adravyabhuta (non-pharmacological) rasayana (practices rejuvenating physical and mental health). It includes behavioural conducts which aim to enhance health and longevity by teaching practical methods to potentiate sattva guna of mind. [Cha.Sa. Chikitsa Sthana 1, 4th pada, shloka 30-35] An individual can imbibe easy lifestyle modifications to develop a positive and strong character of mind, thereby avoiding potential etiological factors (for dosha aggravation) and negative psychosocial patterns. Achara rasayana can be divided into five domains of good mental, social, personal, moral and religious conduct. [6]&lt;/p&gt;<br /> *'''Sadvritta (good codes of conduct)'''<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Sadvritta refers to good code of conduct. These are a set of practices, which serve as lifestyle guidelines to prevent mind from falling prey to temporary material pleasures and impulsive thoughts and actions that cause impairment of manas dosha and manovaha srotas. It encompasses guidelines over personal hygiene, personality development as well as for social hygiene and peaceful social interactions. [Cha.Sa. Sutra Sthana 8/18]&lt;/p&gt;<br /> Both achara rasayana and sadvritta help to maintain control over sense organs. They majorly add to the preventive and promotive aspect of mental health. <br /> *'''Medhya dravya (medicines enhancing intellectual functions)'''<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Medhya dravyas are the plant based pharmacological agents that promote prajna i.e., dhi (intellect), dhriti (perseverance) and smriti (memory). Researches conducted prove their efficacy in minimizing the cognitive decline among individuals with neural abnormalities. For example, ushna (hot potency) and tikshna nature drugs like jyotishmati and vacha are said to remove blockages caused by kapha, ama or tamas dosha in the manovaha srotas. Once purified, manas can regain unvitiated connect with indriya via manovaha srotas. [8] <br /> &lt;br/&gt;Ayurveda thus provides a bird’s eye view over different aspects of manovaha srotas through interconnected references in the classics highlighting its physiological importance like the other thirteen major srotas systems in the human body.&lt;/p&gt;<br /> <br /> ==Contemporary view==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Mind as per contemporary literature is debatable concept because in some contexts it is identified as conscience, while in others it is seen as the function of conscience. The philosophical dimension of mind was conceived by Plato who considered mind as an inner (soul’s) experience. [11]<br /> &lt;br/&gt;The western system of medicine addresses brain at the core of majority of psychological distresses, whereas western philosophy involves the concept of psyche (which denotes mind). ‘Psyche’ is a Greek word meaning ‘soul in a living man’. <br /> &lt;br/&gt;William James, referred to as the father of American Psychology, laid the foundations of physiological aspect of mind. To him mind was a function of brain which conducts mental life in the form of a constant stream of consciousness.[9] At some places he too admitted mind to bear consciousness and tried to assign attributes to consciousness as a separate psychological function thus formulating the Theory of Functionalism which established causal relationship between internal states (perception) and external reactions or behaviour (sensation). He concluded that repeated actions cause adaptive changes in nervous system. This is the fundamental ideology behind the concept of Neuroplasticity – i.e. adaptive structural and functional changes in brain by development of new neuronal pathways due to intrinsic or extrinsic stimuli. [12]<br /> &lt;br/&gt;James’ counterpart Titchener, an English Psychologist, proposed that consciousness is mind’s awareness of its own functions. Consciousness is something superior to mind itself. He formulated the Theory of Structuralism which aimed at analysing the interrelationship between mental experiences, feelings, and sensations. He used introspection as a tool to break down these complex phenomena of consciousness down to their basic elements without breaking their original structure. <br /> &lt;br/&gt;Mind is hence regarded as the cumulative effect of all mental processes that have occurred in the lifetime while the consciousness can be understood as the cumulative effect of all mental processes occurring in present moment. Eventually brain was somehow regarded to control the neural activity responsible for accumulating all this sensory data.<br /> &lt;br/&gt;Many theories were formulated and overruled by their successors with time. Today the concept of mind and consciousness remains yet to be clearly defined. It is observed that mind is often identified as consciousness and they both are accepted as individual closely linked entities. Mind bears synonymity towards consciousness, spirit, and psyche. Some theories view both mind and consciousness as spirit. But mind is invariably understood as the interaction between psychological personality and the external environment, i.e., a subject – object relationship.<br /> &lt;br/&gt;The neurophysiological basis of minds and the channels of transport of its constituents is yet a challenge in field of neuroscience. In order to bridge this gap, contemporary scientists hypothesise that mental representations and their contents are represented by neural network and their supporting cells thus hinting towards Central Nervous System and it’s peripheral nerves as the channels of mind. [13]&lt;/p&gt; <br /> <br /> ==Research works on manovaha srotas==<br /> Various review articles have been published and researches been carried out in the domain of Ayurveda to understand the conceptual as well as pathophysiological aspect of manovaha srotas. Few of them are as follows :-<br /> &lt;br/&gt;'''1. Critical Review of Concept of manovaha Srotas with special reference to Brain'''<br /> This review article conceptualizes the contemporary understanding of manovaha srotas in context to CNS due to functional similarity between manas and brain obtained after an extensive research and analysis throughout ayurveda treatises. Further brain was considered as synonymous to hridya ie. mulasthana (site of origin) of manovaha srotas and ‘dasha dhamani’ as the cranial nerves exiting from the 10 major foramen at base of skull. Sanskrit literature considers hridaya as regarded as a central organ similar to brain. 14<br /> <br /> &lt;br/&gt;'''2. Circumstantial view on clinical knowing of manovaha srotasa &amp; its physiology'''<br /> The review article reconstructs a comprehensive picture of manovaha srotas from the scattered references available in Ayurveda texts, supplementing it with additional information from contemporary science as follows-<br /> *A detailed description of neuroanatomy and physiology has been drawn parallel to Ayurveda point of view about manas’ rachna and kriya sharir. <br /> *Effect of Triguna and tridosha (especially vata) in context of physiological functions and disorders of manas and manovaha srotas have been discussed.<br /> *Correlations between functions of five subtypes of vata and both CNS and ANS has been attempted <br /> *Pariksha krama (examination of nervous system) has been exemplified taking into consideration both Ayurveda and modern methodologies that can be employed for manovaha srotas (nervous system) examination.10<br /> <br /> &lt;br/&gt;'''3. Concept of stress factor assessment concerning ‘perseverance test’ in light of ayurveda” – a review'''<br /> This article highlights the importance of understanding the etiological factors of vitiation of manovaha srotas and manas in all kinds of psychiatric as well as psychosomatic disorders. Imbalance of manas dosha can be treated by means of yoga, meditation and pranayama. Often emotional disturbances remain unattended in diagnosed cases of psychiatric illness which can be managed at home by incorporating wholesome diet (pathya ahara) and moral code of conduct (sadvrutta) in daily routine. Lack of peace and chronic stressors have been observed as major causes of vitiation of channels of mind. 15<br /> <br /> <br /> &lt;big&gt;'''[[Special:ContactMe|Send us your suggestions and feedback on this page.]]'''&lt;/big&gt;<br /> <br /> ==References==<br /> <br /> &lt;div id=&quot;BackToTop&quot; class=&quot;noprint&quot; style=&quot;background-color:#DDEFDD; position:fixed;<br /> bottom:32px; left:2%; z-index:9999; padding:0; margin:0;&quot;&gt;&lt;span style=&quot;color:blue;<br /> font-size:8pt; font-face:verdana,sans-serif; border:0.2em outset #ceebf7;<br /> padding:0.1em; font-weight:bolder; -moz-border-radius:8px; &quot;&gt;<br /> [[#top| Back to the Top ]]&lt;/span&gt;&lt;/div&gt;</div>

Manishdubey https://www.carakasamhitaonline.com/index.php?title=Talk:Manovaha_srotas&diff=44199 2023-10-16T10:50:41Z

<p>Manishdubey: /* Concept of stress factor assessment concerning ‘perseverance test’ in light of ayurveda” – a review */</p> <hr /> <div>{{CiteButton}}<br /> {{#seo:<br /> |title= Manovaha srotas<br /> (Channels of transport and transformation of mind and mental factors)<br /> |titlemode=append<br /> |keywords= Manovaha srotas,Hrudya, Sattva pariksha, Sattvavajaya chikitsa, Bhojani M. K.,Deole Y.S., Basisht G<br /> |description=Mana means mind, or psyche. Srotas means channels of transport and transformation. The description and understanding of channels for activities of mind (manovaha srotas) is scattered in ayurveda classics and has not been completely elucidated. Manovaha srotas are considered as channels through which mind and body interact with each other. <br /> |image=http://www.carakasamhitaonline.com/mediawiki-1.32.1/resources/assets/ogimgs.jpg<br /> |image_alt=carak samhita<br /> |type=article<br /> }}<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Mana means mind, or psyche. Srotas means channels of transport and transformation. The description and understanding of channels for activities of mind (manovaha srotas) is scattered in ayurveda classics and has not been completely elucidated. Manovaha srotas are considered as channels through which mind and body interact with each other. These channels pervade throughout the body. [Chakrapani on Cha.Sa. Indriya Sthana 5/41-42] They are responsible for flow of thoughts, emotions, and other psychological functions. This article deals with various aspects of manovaha srotasa i.e. the channels of activities of mind and its development.&lt;/p&gt;<br /> <br /> {{Infobox<br /> |title = Contributors<br /> |label1 = Section/Chapter/topic<br /> |data1 = Concepts/[[Srotas]]/[[Manovaha Srotas]] <br /> |label2 = Authors<br /> |data2 = Bhojani M. K.&lt;sup&gt;1&lt;/sup&gt; Varma Swati &lt;sup&gt;1&lt;/sup&gt; Deole Y.S.&lt;sup&gt;2&lt;/sup&gt;<br /> |label3 = Reviewer &amp; Editor<br /> |data3 = Basisht G.&lt;sup&gt;3&lt;/sup&gt;, <br /> |label4 = Affiliations<br /> |data4 = &lt;sup&gt;1&lt;/sup&gt; Department of Sharir Kriya, All India Institute of Ayurveda, New Delhi, India<br /> &lt;sup&gt;2&lt;/sup&gt; Department of Kayachikitsa, G. J. Patel Institute of Ayurvedic Studies and Research, New Vallabh Vidyanagar, Gujarat, India <br /> &lt;sup&gt;3&lt;/sup&gt; Rheumatologist, Orlando, Florida, U.S.A.<br /> |label5 = Correspondence emails<br /> |data5 = meera.samhita@aiia.gov.in, carakasamhita@gmail.com<br /> |label6 = Publisher <br /> |data6 = [[Charak Samhita Research, Training and Development Centre]], I.T.R.A., Jamnagar, India<br /> |label7 = Date of publication:<br /> |data7 =October 12, 2023<br /> |label8 = DOI<br /> |data8 = In process<br /> }}<br /> <br /> ==Etymology and derivation:==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Srotas originates from Sanskrit root ‘Sru’ that translates to oozing, flow or secretion. It has been defined as ‘sravanat strotamsi’ [Cha. Sa. Sutra Sthana 30/12] which indicates structures designated for conveyance of material inside body. <br /> &lt;br/&gt;Grossly defining, thirteen major types of srotas have been mentioned that transport substances undergoing biotransformation (parinamam aapadyamanam) from the place of origin to their destination. [Cha. Sa. Vimana Sthana 5/3] Similarly in physiological state, manovaha srotas might be responsible for processing and transformation of ‘doshayukta’ (irrational under influence of rajas and tamas) emotions and thoughts into unbiased reasoning before reaching a conclusion by our intellect (buddhi). &lt;/p&gt;<br /> <br /> ==Synonyms of manovaha srotas==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Following terms are used for ‘manovaha srotas’ in different Ayurveda classics : &lt;/p&gt;<br /> # Manovaha dhamani [Chakrapani on Cha. Sa. Indriya sthana 12/42] and [Vijayarakshita in Ma.Ni.Purva Khanda 20/1]<br /> # Chetanavaha srotas [Shivadas Sen on Cha.Sa. Chikitsa sthana 9/5] <br /> # Chetovaha marga [Bhel Samhita Nidana Sthana 7/2]<br /> # Manobuddhivaha sira [ Cha.Sa.Chikitsa Sthana 10/58]<br /> # Sanjnavaha srotas [Su.Sa.Uttar Tantra 61/8]<br /> # Sanjnavaha nadi [Su.Sa. Uttar Tantra 46/7]<br /> &lt;p style=&quot;text-align:justify;&quot;&gt; &lt;br/&gt;Use of terms like sira, nadi and dhamani, refers to different channels and pathways concerned with maintenance of physiological flow of information. [Cha.Sa. Vimana Sthana 5/8] &lt;/p&gt;<br /> <br /> ==Origin==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt; Every srotas is localized within the hollow space in the body originating from a root (mula) and spreading throughout the body to reach a final structure. Srotas are said to be hollow structures in different shapes and sizes The root (mula) is majorly responsible for regulation and control of functions of that srotas.<br /> &lt;br/&gt;The channels carrying mind (manovaha srotas) are not exclusively listed. It is however stated that the entire conscious body is abode of mind. Hence these channels are spread throughout the body. [Chakrapani on Cha.Sa. Indriya Sthana 5/41]. <br /> &lt;br/&gt;However, hridaya (heart) has a universal acceptance as the site of origin (mula) of manovaha srotas. Hence a special mention has been made about ten arteries of heart, probably being the manovaha srotas (visheshen tu hrudya ashritvat manah tadashrita dasha dhamanyo manovaha abhidhiyante) [Chakrapani on Cha.Sa. Indriya Sthana 5/41-42]. These get afflicted by vitiated dosha either all at once or individually. [Chakrapani on Cha.Sa. Indriya Sthana 12/42]<br /> &lt;/p&gt;<br /> <br /> ==Decoding hridaya (heart)==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt; The interpretation of the term ‘hridaya’ has been of confusion among scholars since decades. The first interpretation of the term given by texts of Shatpada Brahmana which highlighted functional aspect of hridaya. The word being composed of three letters viz ‘hri’ (hra harane)- to acquire; ‘Da’ (da dane) – to give; ‘Ya’ (Ya gatau)- which transports. The hridaya thus displays three phases of cardiac cycle i.e., receives, gives, and transports body constituents through it. [2]<br /> &lt;br/&gt;Hridaya is the site of rasa (plasma), sattva (psychic factor/mind), buddhi (intellect) and atma (soul) in conjugation with all sensory organs (jnanendriya).[Cha.Sa. Chikitsa Sthana 24/35] Sadhaka pitta situated in heart (hridaya) regulates proper functioning of intellect (buddhi) and ego (ahamkara). Hridaya is located in between breasts (stanayormadhya) of thoracic region [A. H. Sutra Sthana 12/13-14] [Su. Sa. Sharira Sthana 6/25]. <br /> &lt;br/&gt;Vedic era was well versed with heart (hridaya) and brain (mastishka) being two distinct entities, with interdependent functional relationship [Atharvaveda Book X. Hymn 2.26]. Kashyap Samhita quotes that all sense and motor organs (indriya) together with mind (manas) emerge from heart (hridaya) [Ka.Sa. Chikitsa Sthana 8/6]. Primary site of action of mind (manas) is brain (shira).[3] It can be concluded that mind (manas) being seated in heart (hridaya) connects to brain (shiras) through manovaha srotas and controls all senses (indriya). Also, any damage pertaining to marma (vital points) of shiras (head) causes loss of consciousness (cheshtanasha). [Cha.Sa. Sidhhi Sthana 9/6] Hence heart (hridaya) and brain (shirasor mastishka) are sites of manovaha srotasa. <br /> &lt;br/&gt; This approach of understanding hridaya goes well along with the contemporary view of understanding the triguna based psycho-functional principles of Ayurveda within the neural framework. Various research has been conducted which demonstrate that heart continuously sends nervous signals to brain to coordinate higher centres responsible for cognition and emotions. [1] The neuro- psychological as well as circulatory functions of hridaya mentioned in the classics can thus be explained. &lt;/p&gt; <br /> <br /> ==Relation between rasavaha and manovaha srotas==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Heart is the abode of mind (mana) and consciousness (chetana) or soul (atma). [Cha. Sa. Sidhhi Sthana 9/4] It is a site for physical, psychological, and spiritual components. Heart is origin for channels of transportation and transformation of rasa dhatu, too. Both heart and brain are considered under the umbrella term hridaya in terms of anatomical structure and higher-centre functions respectively. <br /> &lt;br/&gt;Heart (residence of manas) and brain (workplace of manas) are functionally co-dependent upon each other. Manas regulates the cognitive and conative functions of brain in conjunction with soul (atma) under the influence of vata dosha. [Cha. Sa. Sharira Sthana 1/22-23]. Brain is a structural entity needing continuous supply of nourishment and oxygen. This is feasible by heart through circulation (rasa-rakta samvahana kriya) via the ten major vessels (rasavahi dhamani). [A. H. Sharira Sthana 3/18] Heart is a highly vascular organ being surrounded by ten major dhamani (blood vessels) like spokes of a wheel which are known as ‘rasavaha strotomula’ (site of origin of channels of nutrition). These channels are comparable to manovaha srotas. [Chakrapani on Cha. Sa. Chikitsa Sthana 9/4] Manas thus acts like a medium between heart and brain wherein brain is responsible for all sensory and motor functions while heart has been assigned emotional aspect of psyche (manas).<br /> &lt;br/&gt;One of the factors for vitiation of rasavaha srotas is excessive thinking or worry (atichintan). [Cha. Sa. Vimana Sthana 5/13] Contemporary researchers have found evidence to support the interaction between circulatory system and psyche. The monograph of German professor Ludwig Braun is a pioneer in exploring the psychological and emotional aspect of cardiac diseases especially angina. He presented a correlation between cardiac diseases and ‘Angst’ (a constrictive, tightening and crushing sensation which manifests dread in the patient thereby changing his entire emotional outlook on life), analogous to anxiety. He explains that the cardiac tissue has a special apparatus receptive towards anxiety which manifests as an inner tactile sensation. That region is well supplied with nerve endings that gets irritated by anxiety. This phenomenon of emotional influence over cardiac tissues is termed as cardiac psyche. [4] <br /> &lt;/p&gt; <br /> <br /> ==Factors vitiating manovaha srotas==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt; Manovaha srotas are the prime site of abnormalities of channels in all psychological disorders. [Cha.Sa. Nidana Sthana 6/4] Alongside any of the eight factors that are either attributed to hridaya or manas viz. mana (mind), buddhi (intellect), sanjna-jnana (self-awareness), smriti (memory), bhakti (devotion), sheela (habits), cheshta (psychomotor activities) and achara (code of conduct). [Cha.Sa. Nidana Sthana 7/5] <br /> &lt;br/&gt;These factors when deranged cause vitiation of manas dosha (rajas and tamas), deterioration of sattva guna of manas and gradual derangement of tridosha. Foods, activities and excessive expression of emotions like anger, grief, lust, fear etc and mental traumas are the fundamental etiological factors for the same. [Cha.Sa. Nidana Sthana 7/4] Vitiated tridosha further vitiates rasavaha srotas, which apparently has the same site of origin as of manovaha srotas i.e., hridaya and dasha dhamani (ten great vessels). [Cha. Sa. Vimana Sthana 5/10] Hridaya is seat of manas [Cha.Sa. Sutra Sthana 30/4]. Hence, all the factors vitiating rasa dhatu (nutritive fluid), rasavaha srotas (channels carrying nutritive fluid) and manas dosha viz. rajas and tamas will affect manas and eventually vitiating manovaha srotas. Even the structural derangements of heart (abode of mind) affect manovaha srotas due to their ashrayashrayibhava (state of interdependency). [Cha.Sa. Chikitsa Sthana 9/5]&lt;/p&gt;<br /> <br /> ==Pathologies of manovaha srotas==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Manovaha srotas is important factor in understanding disorders like unmada (psychosis), apasmara (epilepsy) and extreme emotional reactions. &lt;/p&gt;<br /> <br /> *'''Unmada (psychosis)'''<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;When an individual experiences extreme emotions – lust (kama), anger (krodha), fear (bhaya), greed (lobha), happiness or pleasure (harsha), affection (moha), grief (shoka), excessive worry (chinta), they initially harm the intellect which aggravates manas dosha (rajas and tamas) and tridosha (vata, pitta and kapha). These vitiated dosha invade heart and obstruct manovaha srotas (channels transporting psychic impulses) thereby causing unmada. [Dalhan on Su. Sa. Uttar Tantra 62/3]<br /> *'''Apasmara (epilepsy)'''<br /> Overindulging in sensory pleasures, incompatible diet, withholding natural urges and giving into immoral activities under emotional influences (kama, krodha, lobha among others), vitiates rajas and tamas. They poorly influence the manas (mind) and sanjnavaha srotas (manovaha srotas) causing apasmara. [Su.Sa. Uttar Tantra 61/6]<br /> * Mada (intoxication), murchha (syncope), sanyasa (coma) are caused by vitiation of channels of consciousness (chetanavaha srotas or manovaha srotas). [Shivadas Sen on Cha. Sa. Chikitsa Sthana 9/5] <br /> *'''Atattvabhinivesha (perverted state of mind)'''<br /> Considered as mahagada (difficult to treat mental disorder), the person’s conscience gets afflicted by rajas and tamas, which cause complete derangement of intellect (buddhi vibhramsha) as the predominant symptom. The vitiated dosha get lodged in heart (hridaya) to afflict channels of mind and intellect (manobuddhivaha sira in manovaha srotas). [Cha.Sa. Chikitsa Sthana 10/57-60]<br /> * Physiology of nightmares (swapna)<br /> Nightmares are dreams occurring in REM phase of sleep which causes mental projections in the form of feelings of fear, despair, and anxiety. Ayurveda defines REM phase as ‘Natiprasupta’ - the state characterised to be midway between states of deep sleep and fully awake. During any ominous situation, tridosha in their highly aggravated state tend to fill-up the manovaha srotas. This results in terrifying dreams. [Cha.Sa. Indriya Sthana 5/41]. &lt;/p&gt;<br /> <br /> ==Assessment and diagnosis of disorders of manovaha srotas==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Srotas are micro-channels transporting various metabolites across cells throughout the body. It can be deduced that manovaha srotas has different characteristics structurally and functionally from the major thirteen srotas, because it transports and transforms thoughts and feelings. This is evident from objects of mind (manas), viz- thought (chintyam), consideration (vicharyam), hypothesis (uhyam), aims (dhyeyam) and determination (sankalpam). [Cha.Sa. Sharira Sthana 1/20]. Assessment of manovaha srotas can be done via assessment of manas and the degree of derangement of its functions. Ayurveda considers manas as material entity (dravya) which is a super sense and not perceivable by ordinary senses (atindriya) [Cha. Sa. Sutra Sthana 8/4]. Manas is under direct control of vata dosha [Cha. Sa. Sutra Sthana 12/8] and is the mediator between atma (soul) and indriyartha (objects of senses). <br /> &lt;br/&gt;The contemporary physiological aspects of mind, senses, brain, nervous system and consciousness can be considered for assessment of manovaha srotas. <br /> &lt;br/&gt; A thorough neurological examination by means of interrogation (prashna pariksha), inspection (darshana pariksha) and assessment of mental strength (sattva bala pariksha) [Cha.Sa. Vimana Sthana 8/119] can be used for assessment and diagnosis of disorders of manovaha srotas.&lt;/p&gt;<br /> <br /> ''' a. Interrogation (prashna pariksha)'''<br /> A formal interview of the patient can be conducted for overall and precise diagnosis. The questions related to chief complaints with duration, chronological development, nurturing of patient, family history, addiction, hobbies, interests, daily routine, major life events, achievements, mental traumas, emotional quotient and intellectual quotient is recorded from the patient. If the patient is not in state of giving correct answers, then the relatives or attendants who know patients history are interviewed. <br /> <br /> '''b. Darshan pariksha (Direct observation)'''<br /> While interviewing the patient, a physician should pay attention to following attributes that can signify features mentioned for certain psychiatric ailments (manovaha srotodushti)..<br /> <br /> # '''Appearance '''– Unusual dressing preferences, use of cosmetics, perfumes or accessories or flamboyant appearance. e.g;- ‘Priye tanu rakta vastradhari’ (liking for adorning clothes made of thin red fabric) is seen in yakshagraha unmada (Su.Sa. Uttara tantra 60/11)<br /> # '''Activity and co-ordination''' - Behaviour, Gait, gestures, patient’s facial expression and body language should be observed during probing them with questions. Eg;- 'Satatama akshano’ (rapid and constant eye movements) is one of the prodromal feature of apasmara (epilepsy) [ Cha.Sa. Nidana sthana 8/6]. Udhasta (patient keeps his hands raised) is a feature of pishacha grahavishta unmada [Su.Sa. Uttara Tantra 60/15]<br /> # '''Conversation style''' – Coherence of speech, articulation, emphasise over certain issue, hesitation and duration of response. E.g. ‘Chitram sa jalpati’ (Patient does irrelevant absurd talks) is seen in patients of manas unmada [Su.Sa. Uttara Tantra 62/13].<br /> #'''Emotional expression''' – Patients may express a wide range of emotions during interview with the physician. E.g. Asthana rodana (Sudden crying) is a feature in vataja unmada while amarsha (intolerance) is seen in patients of pittaja unmada. [Cha.Sa. Chikitsa Sthana 9/11-12] Fleeting ideas, incoherent speech is an important sign for lacking proper emotions. <br /> #'''Cognition''' – Orientation to person, place, time and circumstances, level of intellect, level of understanding, common sense and memory can be identified under the domain of cognition by observing patient’s behaviour as well as by asking questions to them using validated scientific questionnaires. Short term memory and long-term memory shall be assessed properly. <br /> &lt;br/&gt;All observations gathered from every method of assessment should be simultaneously analysed to reach the diagnosis.<br /> <br /> '''c. Sattva pariksha (assessment of quality of excellence of mind)'''<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Sattva pariksha assesses the quality of excellence of mind imparted by extent of dominance of sattva guna. Mind (manas) is composed of three attributes (triguna) viz. sattva, rajas and tamas. These impart three types of mental constitutions – Shuddha (pure) (sattvika), rajasika and tamasika. [Cha.Sa. Sharira Sthana 4/36]. Sattvika guna is full of auspiciousness and is considered the healthy (amala) state of mind. Rajasika guna imparts momentum in terms of furious temperament. Whereas tamas guna promotes inertia and moral ignorance. Hence, rajas and tamas are considered inauspicious and called manas dosha. Triguna are present in dynamically varying proportions at any given time and influenced by body (i.e. tridosha) and vice versa. [Chakrapani on Cha.Sa. Vimana Sthana 4/8]. Optimum levels of sattva guna are essential for promoting desired physical and mental strength irrespective of morphological features. [Cha.Sa. Vimana Sthana 8/119]&lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Sattva bala (strength of psyche) is of three types as per strength – pravara (superior), madhyama (moderate) and avara (poor). Pravara sattva persons possess great courage. Despite poor morphological features they seem to be unmoved in the face of adversities. Madhyama sattva persons need some additional moral support to sustain themselves in times of distress. While avara sattva displays catastrophic reactions even during little inconveniences and can neither be sustained by themselves nor by others despite having good quality morphological features. Avara sattva is constantly plagued by inferior emotions like grief, fear, greed, conceit and confusion. When confronted with fierce, ugly, disgusting narratives or flesh and blood, they are prone to become depressed, pale, unconscious or semiconscious, giddy, anxious and can even succumb to death in worst case scenarios. [Cha. Sa. Vimana Sthana 8/119].<br /> &lt;br/&gt;Manovaha srotas associated with avara sattva bala is most likely to be vitiated by manas dosha leading to various psychiatric and psychosomatic disorders [Cha.Sa. Chikitsa Sthana 9/5]. It has been observed that avara sattva individuals are more likely to commit prajnaparadha (intellectual defects) [10] thereby voluntarily indulging in various etiological factors for respective psychological as well as somatic disorders.<br /> &lt;br?&gt;Thus, assessment of sattva bala can help rule out the predisposition towards manovaha srotodushti and subsequent development of symptoms of psychiatric ailments.&lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;'''d. Anumana pariksha (knowledge by inference)''' to determine normalcy of faculties of manas (mind) [Cha.Sa. Vimana Sthana 4/8] Since manas is atindriya ( supersence or imperceivable by ordinary senses), so are it’s faculties which can serve as potential markers for assessment of its functions. [10] The proper functioning of manas itself is inferred by altered or inappropriate mental perceptions even in presence of appropriately functioning indriya (senses) and their respective sense objects whereas the mental faculties can be inferred as follows:-&lt;/p&gt;<br /> {| class=&quot;wikitable&quot;<br /> |'''Faculty''' <br /> |'''object for inference''' <br /> |-<br /> |Vijnanam (expertise/skills )<br /> |Vyavsayena (occupation )<br /> |-<br /> |Dhairyam (fortitude)<br /> |avishadena (courage in face of adversity)<br /> |-<br /> |Viryam (bravery)<br /> |Uthhanena (initiating difficult tasks and enduring them)<br /> |-<br /> |Avasthanama (stability)<br /> |Avibhramana (absence of confusion)<br /> |-<br /> |Shradhha (faith)<br /> |Abhiprayena (purposiveness)<br /> |-<br /> |Medha (intellect)<br /> |Grahanena (grasping power)<br /> |-<br /> |Sanjna (recognition or consciousness level)<br /> |Namagrahanena (ability to recognise or name things)<br /> |-<br /> |Smriti (memory)<br /> |Smaranena (ability to recollect things)<br /> |-<br /> |Dhriti (self restraint)<br /> |Alaulyama (not being carried away by own greed)<br /> |-<br /> |Amala sattva (purity of mind)<br /> |Avikara (free of delusions or illusionary attachments)<br /> |}<br /> This inferential knowledge can help an individual become self-aware of his own psyche (sattva). A self-aware individual has an upper hand at avoiding mental illness because these often go unnoticed until they develop some organic manifestations.<br /> &lt;br /&gt;Thus, by means of above discussed assessment methodologies, a physician can assess the degree of derangement in mental faculties and hence the manovaha srotas, irrespective of development of specific signs and symptoms of any psychiatric disorder (vyadhi lakshana).<br /> <br /> ==Treatment Guidelines==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Manovaha srotas disorders follow the line of treatment same as described for disorders of manas (mind). Following are therapeutic and preventive practices beneficial for both vitiated manovaha srotas (channels of psyche) and manas obscured by rajas - tamas dosha.&lt;/p&gt;<br /> Manas dosha can be alleviated through a comprehensive five-fold psychotherapeutic regimen - jnana (spiritual knowledge or self-awareness), vijnana (scriptural or scientific knowledge), dhairya (mental fortitude), smriti (recollection of past successes to regain faith in own abilities) and samadhi (spiritual healing practices to focus mind inwards away from negative external stimuli). [Cha.Sa. Sutra Sthana 1/58]<br /> Restoration of dhi (intellect), dhairya (mental fortitude) and atmadi vijnana (knowledge of self-consciousness) has therapeutic effect in alleviating disorders of manovaha srotas obstructed by manas dosha.<br /> <br /> '''*Sattvavajaya chikitsa (treatment to regulate mind)'''<br /> Sattvavajaya chikitsa is a non-invasive therapeutic module for psychological derangements and psychosomatic ailments, analogous to contemporary psychotherapy. ‘Sattva’ stands for mind and ‘avajaya’ translates to win over. Hence, it emphasizes withdrawing the mind from unwholesome objects of senses (factors vitiating rajas and tamas) and diverting it to positive sensory and emotional stimuli. Thereby consciously negating disturbed emotions and behavioural patterns. [Cha.Sa. Sutra Sthana 11/54]<br /> <br /> '''*Ashtanga yoga (eight steps of yoga)'''<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Ashtanga yoga can be considered as one of the dimensions of satvavajaya chikitsa. It integrates eight steps of yoga to tame mind from traversing paths in life which are spiritually and mentally harmful for that individual. Of the eight steps, first four viz. yama (principles for moral code), niyama (observances for personal discipline), asana (yogic postures) and pranayama (regulating breath) are termed as bahiranga yoga (external path). These practices gradually alleviate aggravated manas dosha, making the mind less reactive towards external stimuli. The last three limbs viz. dharana (concentration), dhyana (meditation) and samadhi (enlightenment or complete realisation) are termed as antaranga yoga (internal paths). These practices transform the mind, eliminating the fluctuations of mind, thereby strengthening positive habits and outlook on life as well as inner self. Ashtanga yoga maintains a harmonious balance between inner environment (mind and spirit) and external environment (objects of sensory perception). Mind thus gets liberated from worldly pursuits and all psychological sufferings in a stepwise manner.&lt;/p&gt;<br /> '''*Achara rasayana (rejuvenating codes of behavioural conduct)'''<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Achara rasayana is an adravyabhuta (non-pharmacological) rasayana (practices rejuvenating physical and mental health). It includes behavioural conducts which aim to enhance health and longevity by teaching practical methods to potentiate sattva guna of mind. [Cha.Sa. Chikitsa Sthana 1, 4th pada, shloka 30-35] An individual can imbibe easy lifestyle modifications to develop a positive and strong character of mind, thereby avoiding potential etiological factors (for dosha aggravation) and negative psychosocial patterns. Achara rasayana can be divided into five domains of good mental, social, personal, moral and religious conduct. [6]&lt;/p&gt;<br /> '''*Sadvritta (good codes of conduct)'''<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Sadvritta refers to good code of conduct. These are a set of practices, which serve as lifestyle guidelines to prevent mind from falling prey to temporary material pleasures and impulsive thoughts and actions that cause impairment of manas dosha and manovaha srotas. It encompasses guidelines over personal hygiene, personality development as well as for social hygiene and peaceful social interactions. [Cha.Sa. Sutra Sthana 8/18]&lt;/p&gt;<br /> Both achara rasayana and sadvritta help to maintain control over sense organs. They majorly add to the preventive and promotive aspect of mental health. <br /> '''*Medhya dravya (medicines enhancing intellectual functions)'''<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Medhya dravyas are the plant based pharmacological agents that promote prajna i.e., dhi (intellect), dhriti (perseverance) and smriti (memory). Researches conducted prove their efficacy in minimizing the cognitive decline among individuals with neural abnormalities. For example, ushna (hot potency) and tikshna nature drugs like jyotishmati and vacha are said to remove blockages caused by kapha, ama or tamas dosha in the manovaha srotas. Once purified, manas can regain unvitiated connect with indriya via manovaha srotas. [8] <br /> &lt;br/&gt;Ayurveda thus provides a bird’s eye view over different aspects of manovaha srotas through interconnected references in the classics highlighting its physiological importance like the other thirteen major srotas systems in the human body.&lt;/p&gt;<br /> <br /> ==Contemporary view==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Mind as per contemporary literature is debatable concept because in some contexts it is identified as conscience, while in others it is seen as the function of conscience. The philosophical dimension of mind was conceived by Plato who considered mind as an inner (soul’s) experience. [11]<br /> &lt;br/&gt;The western system of medicine addresses brain at the core of majority of psychological distresses, whereas western philosophy involves the concept of psyche (which denotes mind). ‘Psyche’ is a Greek word meaning ‘soul in a living man’. <br /> &lt;br/&gt;William James, referred to as the father of American Psychology, laid the foundations of physiological aspect of mind. To him mind was a function of brain which conducts mental life in the form of a constant stream of consciousness.[9] At some places he too admitted mind to bear consciousness and tried to assign attributes to consciousness as a separate psychological function thus formulating the Theory of Functionalism which established causal relationship between internal states (perception) and external reactions or behaviour (sensation). He concluded that repeated actions cause adaptive changes in nervous system. This is the fundamental ideology behind the concept of Neuroplasticity – i.e. adaptive structural and functional changes in brain by development of new neuronal pathways due to intrinsic or extrinsic stimuli. [12]<br /> &lt;br/&gt;James’ counterpart Titchener, an English Psychologist, proposed that consciousness is mind’s awareness of its own functions. Consciousness is something superior to mind itself. He formulated the Theory of Structuralism which aimed at analysing the interrelationship between mental experiences, feelings, and sensations. He used introspection as a tool to break down these complex phenomena of consciousness down to their basic elements without breaking their original structure. <br /> &lt;br/&gt;Mind is hence regarded as the cumulative effect of all mental processes that have occurred in the lifetime while the consciousness can be understood as the cumulative effect of all mental processes occurring in present moment. Eventually brain was somehow regarded to control the neural activity responsible for accumulating all this sensory data.<br /> &lt;br/&gt;Many theories were formulated and overruled by their successors with time. Today the concept of mind and consciousness remains yet to be clearly defined. It is observed that mind is often identified as consciousness and they both are accepted as individual closely linked entities. Mind bears synonymity towards consciousness, spirit, and psyche. Some theories view both mind and consciousness as spirit. But mind is invariably understood as the interaction between psychological personality and the external environment, i.e., a subject – object relationship.<br /> &lt;br/&gt;The neurophysiological basis of minds and the channels of transport of its constituents is yet a challenge in field of neuroscience. In order to bridge this gap, contemporary scientists hypothesise that mental representations and their contents are represented by neural network and their supporting cells thus hinting towards Central Nervous System and it’s peripheral nerves as the channels of mind. [13]&lt;/p&gt; <br /> <br /> ==Research works on manovaha srotas==<br /> Various review articles have been published and researches been carried out in the domain of Ayurveda to understand the conceptual as well as pathophysiological aspect of manovaha srotas. Few of them are as follows :-<br /> &lt;br/&gt;'''1. Critical Review of Concept of manovaha Srotas with special reference to Brain'''<br /> This review article conceptualizes the contemporary understanding of manovaha srotas in context to CNS due to functional similarity between manas and brain obtained after an extensive research and analysis throughout ayurveda treatises. Further brain was considered as synonymous to hridya ie. mulasthana (site of origin) of manovaha srotas and ‘dasha dhamani’ as the cranial nerves exiting from the 10 major foramen at base of skull. Sanskrit literature considers hridaya as regarded as a central organ similar to brain. 14<br /> <br /> &lt;br/&gt;'''2. Circumstantial view on clinical knowing of manovaha srotasa &amp; its physiology'''<br /> The review article reconstructs a comprehensive picture of manovaha srotas from the scattered references available in Ayurveda texts, supplementing it with additional information from contemporary science as follows-<br /> *A detailed description of neuroanatomy and physiology has been drawn parallel to Ayurveda point of view about manas’ rachna and kriya sharir. <br /> *Effect of Triguna and tridosha (especially vata) in context of physiological functions and disorders of manas and manovaha srotas have been discussed.<br /> *Correlations between functions of five subtypes of vata and both CNS and ANS has been attempted <br /> *Pariksha krama (examination of nervous system) has been exemplified taking into consideration both Ayurveda and modern methodologies that can be employed for manovaha srotas (nervous system) examination.10<br /> <br /> &lt;br/&gt;'''3. Concept of stress factor assessment concerning ‘perseverance test’ in light of ayurveda” – a review'''<br /> This article highlights the importance of understanding the etiological factors of vitiation of manovaha srotas and manas in all kinds of psychiatric as well as psychosomatic disorders. Imbalance of manas dosha can be treated by means of yoga, meditation and pranayama. Often emotional disturbances remain unattended in diagnosed cases of psychiatric illness which can be managed at home by incorporating wholesome diet (pathya ahara) and moral code of conduct (sadvrutta) in daily routine. Lack of peace and chronic stressors have been observed as major causes of vitiation of channels of mind. 15<br /> <br /> <br /> &lt;big&gt;'''[[Special:ContactMe|Send us your suggestions and feedback on this page.]]'''&lt;/big&gt;<br /> <br /> ==References==<br /> <br /> &lt;div id=&quot;BackToTop&quot; class=&quot;noprint&quot; style=&quot;background-color:#DDEFDD; position:fixed;<br /> bottom:32px; left:2%; z-index:9999; padding:0; margin:0;&quot;&gt;&lt;span style=&quot;color:blue;<br /> font-size:8pt; font-face:verdana,sans-serif; border:0.2em outset #ceebf7;<br /> padding:0.1em; font-weight:bolder; -moz-border-radius:8px; &quot;&gt;<br /> [[#top| Back to the Top ]]&lt;/span&gt;&lt;/div&gt;</div>

Manishdubey https://www.carakasamhitaonline.com/index.php?title=Talk:Manovaha_srotas&diff=44198 2023-10-16T10:49:56Z

<p>Manishdubey: /* 2. Circumstantial view on clinical knowing of manovaha srotasa &amp; its physiology */</p> <hr /> <div>{{CiteButton}}<br /> {{#seo:<br /> |title= Manovaha srotas<br /> (Channels of transport and transformation of mind and mental factors)<br /> |titlemode=append<br /> |keywords= Manovaha srotas,Hrudya, Sattva pariksha, Sattvavajaya chikitsa, Bhojani M. K.,Deole Y.S., Basisht G<br /> |description=Mana means mind, or psyche. Srotas means channels of transport and transformation. The description and understanding of channels for activities of mind (manovaha srotas) is scattered in ayurveda classics and has not been completely elucidated. Manovaha srotas are considered as channels through which mind and body interact with each other. <br /> |image=http://www.carakasamhitaonline.com/mediawiki-1.32.1/resources/assets/ogimgs.jpg<br /> |image_alt=carak samhita<br /> |type=article<br /> }}<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Mana means mind, or psyche. Srotas means channels of transport and transformation. The description and understanding of channels for activities of mind (manovaha srotas) is scattered in ayurveda classics and has not been completely elucidated. Manovaha srotas are considered as channels through which mind and body interact with each other. These channels pervade throughout the body. [Chakrapani on Cha.Sa. Indriya Sthana 5/41-42] They are responsible for flow of thoughts, emotions, and other psychological functions. This article deals with various aspects of manovaha srotasa i.e. the channels of activities of mind and its development.&lt;/p&gt;<br /> <br /> {{Infobox<br /> |title = Contributors<br /> |label1 = Section/Chapter/topic<br /> |data1 = Concepts/[[Srotas]]/[[Manovaha Srotas]] <br /> |label2 = Authors<br /> |data2 = Bhojani M. K.&lt;sup&gt;1&lt;/sup&gt; Varma Swati &lt;sup&gt;1&lt;/sup&gt; Deole Y.S.&lt;sup&gt;2&lt;/sup&gt;<br /> |label3 = Reviewer &amp; Editor<br /> |data3 = Basisht G.&lt;sup&gt;3&lt;/sup&gt;, <br /> |label4 = Affiliations<br /> |data4 = &lt;sup&gt;1&lt;/sup&gt; Department of Sharir Kriya, All India Institute of Ayurveda, New Delhi, India<br /> &lt;sup&gt;2&lt;/sup&gt; Department of Kayachikitsa, G. J. Patel Institute of Ayurvedic Studies and Research, New Vallabh Vidyanagar, Gujarat, India <br /> &lt;sup&gt;3&lt;/sup&gt; Rheumatologist, Orlando, Florida, U.S.A.<br /> |label5 = Correspondence emails<br /> |data5 = meera.samhita@aiia.gov.in, carakasamhita@gmail.com<br /> |label6 = Publisher <br /> |data6 = [[Charak Samhita Research, Training and Development Centre]], I.T.R.A., Jamnagar, India<br /> |label7 = Date of publication:<br /> |data7 =October 12, 2023<br /> |label8 = DOI<br /> |data8 = In process<br /> }}<br /> <br /> ==Etymology and derivation:==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Srotas originates from Sanskrit root ‘Sru’ that translates to oozing, flow or secretion. It has been defined as ‘sravanat strotamsi’ [Cha. Sa. Sutra Sthana 30/12] which indicates structures designated for conveyance of material inside body. <br /> &lt;br/&gt;Grossly defining, thirteen major types of srotas have been mentioned that transport substances undergoing biotransformation (parinamam aapadyamanam) from the place of origin to their destination. [Cha. Sa. Vimana Sthana 5/3] Similarly in physiological state, manovaha srotas might be responsible for processing and transformation of ‘doshayukta’ (irrational under influence of rajas and tamas) emotions and thoughts into unbiased reasoning before reaching a conclusion by our intellect (buddhi). &lt;/p&gt;<br /> <br /> ==Synonyms of manovaha srotas==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Following terms are used for ‘manovaha srotas’ in different Ayurveda classics : &lt;/p&gt;<br /> # Manovaha dhamani [Chakrapani on Cha. Sa. Indriya sthana 12/42] and [Vijayarakshita in Ma.Ni.Purva Khanda 20/1]<br /> # Chetanavaha srotas [Shivadas Sen on Cha.Sa. Chikitsa sthana 9/5] <br /> # Chetovaha marga [Bhel Samhita Nidana Sthana 7/2]<br /> # Manobuddhivaha sira [ Cha.Sa.Chikitsa Sthana 10/58]<br /> # Sanjnavaha srotas [Su.Sa.Uttar Tantra 61/8]<br /> # Sanjnavaha nadi [Su.Sa. Uttar Tantra 46/7]<br /> &lt;p style=&quot;text-align:justify;&quot;&gt; &lt;br/&gt;Use of terms like sira, nadi and dhamani, refers to different channels and pathways concerned with maintenance of physiological flow of information. [Cha.Sa. Vimana Sthana 5/8] &lt;/p&gt;<br /> <br /> ==Origin==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt; Every srotas is localized within the hollow space in the body originating from a root (mula) and spreading throughout the body to reach a final structure. Srotas are said to be hollow structures in different shapes and sizes The root (mula) is majorly responsible for regulation and control of functions of that srotas.<br /> &lt;br/&gt;The channels carrying mind (manovaha srotas) are not exclusively listed. It is however stated that the entire conscious body is abode of mind. Hence these channels are spread throughout the body. [Chakrapani on Cha.Sa. Indriya Sthana 5/41]. <br /> &lt;br/&gt;However, hridaya (heart) has a universal acceptance as the site of origin (mula) of manovaha srotas. Hence a special mention has been made about ten arteries of heart, probably being the manovaha srotas (visheshen tu hrudya ashritvat manah tadashrita dasha dhamanyo manovaha abhidhiyante) [Chakrapani on Cha.Sa. Indriya Sthana 5/41-42]. These get afflicted by vitiated dosha either all at once or individually. [Chakrapani on Cha.Sa. Indriya Sthana 12/42]<br /> &lt;/p&gt;<br /> <br /> ==Decoding hridaya (heart)==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt; The interpretation of the term ‘hridaya’ has been of confusion among scholars since decades. The first interpretation of the term given by texts of Shatpada Brahmana which highlighted functional aspect of hridaya. The word being composed of three letters viz ‘hri’ (hra harane)- to acquire; ‘Da’ (da dane) – to give; ‘Ya’ (Ya gatau)- which transports. The hridaya thus displays three phases of cardiac cycle i.e., receives, gives, and transports body constituents through it. [2]<br /> &lt;br/&gt;Hridaya is the site of rasa (plasma), sattva (psychic factor/mind), buddhi (intellect) and atma (soul) in conjugation with all sensory organs (jnanendriya).[Cha.Sa. Chikitsa Sthana 24/35] Sadhaka pitta situated in heart (hridaya) regulates proper functioning of intellect (buddhi) and ego (ahamkara). Hridaya is located in between breasts (stanayormadhya) of thoracic region [A. H. Sutra Sthana 12/13-14] [Su. Sa. Sharira Sthana 6/25]. <br /> &lt;br/&gt;Vedic era was well versed with heart (hridaya) and brain (mastishka) being two distinct entities, with interdependent functional relationship [Atharvaveda Book X. Hymn 2.26]. Kashyap Samhita quotes that all sense and motor organs (indriya) together with mind (manas) emerge from heart (hridaya) [Ka.Sa. Chikitsa Sthana 8/6]. Primary site of action of mind (manas) is brain (shira).[3] It can be concluded that mind (manas) being seated in heart (hridaya) connects to brain (shiras) through manovaha srotas and controls all senses (indriya). Also, any damage pertaining to marma (vital points) of shiras (head) causes loss of consciousness (cheshtanasha). [Cha.Sa. Sidhhi Sthana 9/6] Hence heart (hridaya) and brain (shirasor mastishka) are sites of manovaha srotasa. <br /> &lt;br/&gt; This approach of understanding hridaya goes well along with the contemporary view of understanding the triguna based psycho-functional principles of Ayurveda within the neural framework. Various research has been conducted which demonstrate that heart continuously sends nervous signals to brain to coordinate higher centres responsible for cognition and emotions. [1] The neuro- psychological as well as circulatory functions of hridaya mentioned in the classics can thus be explained. &lt;/p&gt; <br /> <br /> ==Relation between rasavaha and manovaha srotas==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Heart is the abode of mind (mana) and consciousness (chetana) or soul (atma). [Cha. Sa. Sidhhi Sthana 9/4] It is a site for physical, psychological, and spiritual components. Heart is origin for channels of transportation and transformation of rasa dhatu, too. Both heart and brain are considered under the umbrella term hridaya in terms of anatomical structure and higher-centre functions respectively. <br /> &lt;br/&gt;Heart (residence of manas) and brain (workplace of manas) are functionally co-dependent upon each other. Manas regulates the cognitive and conative functions of brain in conjunction with soul (atma) under the influence of vata dosha. [Cha. Sa. Sharira Sthana 1/22-23]. Brain is a structural entity needing continuous supply of nourishment and oxygen. This is feasible by heart through circulation (rasa-rakta samvahana kriya) via the ten major vessels (rasavahi dhamani). [A. H. Sharira Sthana 3/18] Heart is a highly vascular organ being surrounded by ten major dhamani (blood vessels) like spokes of a wheel which are known as ‘rasavaha strotomula’ (site of origin of channels of nutrition). These channels are comparable to manovaha srotas. [Chakrapani on Cha. Sa. Chikitsa Sthana 9/4] Manas thus acts like a medium between heart and brain wherein brain is responsible for all sensory and motor functions while heart has been assigned emotional aspect of psyche (manas).<br /> &lt;br/&gt;One of the factors for vitiation of rasavaha srotas is excessive thinking or worry (atichintan). [Cha. Sa. Vimana Sthana 5/13] Contemporary researchers have found evidence to support the interaction between circulatory system and psyche. The monograph of German professor Ludwig Braun is a pioneer in exploring the psychological and emotional aspect of cardiac diseases especially angina. He presented a correlation between cardiac diseases and ‘Angst’ (a constrictive, tightening and crushing sensation which manifests dread in the patient thereby changing his entire emotional outlook on life), analogous to anxiety. He explains that the cardiac tissue has a special apparatus receptive towards anxiety which manifests as an inner tactile sensation. That region is well supplied with nerve endings that gets irritated by anxiety. This phenomenon of emotional influence over cardiac tissues is termed as cardiac psyche. [4] <br /> &lt;/p&gt; <br /> <br /> ==Factors vitiating manovaha srotas==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt; Manovaha srotas are the prime site of abnormalities of channels in all psychological disorders. [Cha.Sa. Nidana Sthana 6/4] Alongside any of the eight factors that are either attributed to hridaya or manas viz. mana (mind), buddhi (intellect), sanjna-jnana (self-awareness), smriti (memory), bhakti (devotion), sheela (habits), cheshta (psychomotor activities) and achara (code of conduct). [Cha.Sa. Nidana Sthana 7/5] <br /> &lt;br/&gt;These factors when deranged cause vitiation of manas dosha (rajas and tamas), deterioration of sattva guna of manas and gradual derangement of tridosha. Foods, activities and excessive expression of emotions like anger, grief, lust, fear etc and mental traumas are the fundamental etiological factors for the same. [Cha.Sa. Nidana Sthana 7/4] Vitiated tridosha further vitiates rasavaha srotas, which apparently has the same site of origin as of manovaha srotas i.e., hridaya and dasha dhamani (ten great vessels). [Cha. Sa. Vimana Sthana 5/10] Hridaya is seat of manas [Cha.Sa. Sutra Sthana 30/4]. Hence, all the factors vitiating rasa dhatu (nutritive fluid), rasavaha srotas (channels carrying nutritive fluid) and manas dosha viz. rajas and tamas will affect manas and eventually vitiating manovaha srotas. Even the structural derangements of heart (abode of mind) affect manovaha srotas due to their ashrayashrayibhava (state of interdependency). [Cha.Sa. Chikitsa Sthana 9/5]&lt;/p&gt;<br /> <br /> ==Pathologies of manovaha srotas==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Manovaha srotas is important factor in understanding disorders like unmada (psychosis), apasmara (epilepsy) and extreme emotional reactions. &lt;/p&gt;<br /> <br /> *'''Unmada (psychosis)'''<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;When an individual experiences extreme emotions – lust (kama), anger (krodha), fear (bhaya), greed (lobha), happiness or pleasure (harsha), affection (moha), grief (shoka), excessive worry (chinta), they initially harm the intellect which aggravates manas dosha (rajas and tamas) and tridosha (vata, pitta and kapha). These vitiated dosha invade heart and obstruct manovaha srotas (channels transporting psychic impulses) thereby causing unmada. [Dalhan on Su. Sa. Uttar Tantra 62/3]<br /> *'''Apasmara (epilepsy)'''<br /> Overindulging in sensory pleasures, incompatible diet, withholding natural urges and giving into immoral activities under emotional influences (kama, krodha, lobha among others), vitiates rajas and tamas. They poorly influence the manas (mind) and sanjnavaha srotas (manovaha srotas) causing apasmara. [Su.Sa. Uttar Tantra 61/6]<br /> * Mada (intoxication), murchha (syncope), sanyasa (coma) are caused by vitiation of channels of consciousness (chetanavaha srotas or manovaha srotas). [Shivadas Sen on Cha. Sa. Chikitsa Sthana 9/5] <br /> *'''Atattvabhinivesha (perverted state of mind)'''<br /> Considered as mahagada (difficult to treat mental disorder), the person’s conscience gets afflicted by rajas and tamas, which cause complete derangement of intellect (buddhi vibhramsha) as the predominant symptom. The vitiated dosha get lodged in heart (hridaya) to afflict channels of mind and intellect (manobuddhivaha sira in manovaha srotas). [Cha.Sa. Chikitsa Sthana 10/57-60]<br /> * Physiology of nightmares (swapna)<br /> Nightmares are dreams occurring in REM phase of sleep which causes mental projections in the form of feelings of fear, despair, and anxiety. Ayurveda defines REM phase as ‘Natiprasupta’ - the state characterised to be midway between states of deep sleep and fully awake. During any ominous situation, tridosha in their highly aggravated state tend to fill-up the manovaha srotas. This results in terrifying dreams. [Cha.Sa. Indriya Sthana 5/41]. &lt;/p&gt;<br /> <br /> ==Assessment and diagnosis of disorders of manovaha srotas==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Srotas are micro-channels transporting various metabolites across cells throughout the body. It can be deduced that manovaha srotas has different characteristics structurally and functionally from the major thirteen srotas, because it transports and transforms thoughts and feelings. This is evident from objects of mind (manas), viz- thought (chintyam), consideration (vicharyam), hypothesis (uhyam), aims (dhyeyam) and determination (sankalpam). [Cha.Sa. Sharira Sthana 1/20]. Assessment of manovaha srotas can be done via assessment of manas and the degree of derangement of its functions. Ayurveda considers manas as material entity (dravya) which is a super sense and not perceivable by ordinary senses (atindriya) [Cha. Sa. Sutra Sthana 8/4]. Manas is under direct control of vata dosha [Cha. Sa. Sutra Sthana 12/8] and is the mediator between atma (soul) and indriyartha (objects of senses). <br /> &lt;br/&gt;The contemporary physiological aspects of mind, senses, brain, nervous system and consciousness can be considered for assessment of manovaha srotas. <br /> &lt;br/&gt; A thorough neurological examination by means of interrogation (prashna pariksha), inspection (darshana pariksha) and assessment of mental strength (sattva bala pariksha) [Cha.Sa. Vimana Sthana 8/119] can be used for assessment and diagnosis of disorders of manovaha srotas.&lt;/p&gt;<br /> <br /> ''' a. Interrogation (prashna pariksha)'''<br /> A formal interview of the patient can be conducted for overall and precise diagnosis. The questions related to chief complaints with duration, chronological development, nurturing of patient, family history, addiction, hobbies, interests, daily routine, major life events, achievements, mental traumas, emotional quotient and intellectual quotient is recorded from the patient. If the patient is not in state of giving correct answers, then the relatives or attendants who know patients history are interviewed. <br /> <br /> '''b. Darshan pariksha (Direct observation)'''<br /> While interviewing the patient, a physician should pay attention to following attributes that can signify features mentioned for certain psychiatric ailments (manovaha srotodushti)..<br /> <br /> # '''Appearance '''– Unusual dressing preferences, use of cosmetics, perfumes or accessories or flamboyant appearance. e.g;- ‘Priye tanu rakta vastradhari’ (liking for adorning clothes made of thin red fabric) is seen in yakshagraha unmada (Su.Sa. Uttara tantra 60/11)<br /> # '''Activity and co-ordination''' - Behaviour, Gait, gestures, patient’s facial expression and body language should be observed during probing them with questions. Eg;- 'Satatama akshano’ (rapid and constant eye movements) is one of the prodromal feature of apasmara (epilepsy) [ Cha.Sa. Nidana sthana 8/6]. Udhasta (patient keeps his hands raised) is a feature of pishacha grahavishta unmada [Su.Sa. Uttara Tantra 60/15]<br /> # '''Conversation style''' – Coherence of speech, articulation, emphasise over certain issue, hesitation and duration of response. E.g. ‘Chitram sa jalpati’ (Patient does irrelevant absurd talks) is seen in patients of manas unmada [Su.Sa. Uttara Tantra 62/13].<br /> #'''Emotional expression''' – Patients may express a wide range of emotions during interview with the physician. E.g. Asthana rodana (Sudden crying) is a feature in vataja unmada while amarsha (intolerance) is seen in patients of pittaja unmada. [Cha.Sa. Chikitsa Sthana 9/11-12] Fleeting ideas, incoherent speech is an important sign for lacking proper emotions. <br /> #'''Cognition''' – Orientation to person, place, time and circumstances, level of intellect, level of understanding, common sense and memory can be identified under the domain of cognition by observing patient’s behaviour as well as by asking questions to them using validated scientific questionnaires. Short term memory and long-term memory shall be assessed properly. <br /> &lt;br/&gt;All observations gathered from every method of assessment should be simultaneously analysed to reach the diagnosis.<br /> <br /> '''c. Sattva pariksha (assessment of quality of excellence of mind)'''<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Sattva pariksha assesses the quality of excellence of mind imparted by extent of dominance of sattva guna. Mind (manas) is composed of three attributes (triguna) viz. sattva, rajas and tamas. These impart three types of mental constitutions – Shuddha (pure) (sattvika), rajasika and tamasika. [Cha.Sa. Sharira Sthana 4/36]. Sattvika guna is full of auspiciousness and is considered the healthy (amala) state of mind. Rajasika guna imparts momentum in terms of furious temperament. Whereas tamas guna promotes inertia and moral ignorance. Hence, rajas and tamas are considered inauspicious and called manas dosha. Triguna are present in dynamically varying proportions at any given time and influenced by body (i.e. tridosha) and vice versa. [Chakrapani on Cha.Sa. Vimana Sthana 4/8]. Optimum levels of sattva guna are essential for promoting desired physical and mental strength irrespective of morphological features. [Cha.Sa. Vimana Sthana 8/119]&lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Sattva bala (strength of psyche) is of three types as per strength – pravara (superior), madhyama (moderate) and avara (poor). Pravara sattva persons possess great courage. Despite poor morphological features they seem to be unmoved in the face of adversities. Madhyama sattva persons need some additional moral support to sustain themselves in times of distress. While avara sattva displays catastrophic reactions even during little inconveniences and can neither be sustained by themselves nor by others despite having good quality morphological features. Avara sattva is constantly plagued by inferior emotions like grief, fear, greed, conceit and confusion. When confronted with fierce, ugly, disgusting narratives or flesh and blood, they are prone to become depressed, pale, unconscious or semiconscious, giddy, anxious and can even succumb to death in worst case scenarios. [Cha. Sa. Vimana Sthana 8/119].<br /> &lt;br/&gt;Manovaha srotas associated with avara sattva bala is most likely to be vitiated by manas dosha leading to various psychiatric and psychosomatic disorders [Cha.Sa. Chikitsa Sthana 9/5]. It has been observed that avara sattva individuals are more likely to commit prajnaparadha (intellectual defects) [10] thereby voluntarily indulging in various etiological factors for respective psychological as well as somatic disorders.<br /> &lt;br?&gt;Thus, assessment of sattva bala can help rule out the predisposition towards manovaha srotodushti and subsequent development of symptoms of psychiatric ailments.&lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;'''d. Anumana pariksha (knowledge by inference)''' to determine normalcy of faculties of manas (mind) [Cha.Sa. Vimana Sthana 4/8] Since manas is atindriya ( supersence or imperceivable by ordinary senses), so are it’s faculties which can serve as potential markers for assessment of its functions. [10] The proper functioning of manas itself is inferred by altered or inappropriate mental perceptions even in presence of appropriately functioning indriya (senses) and their respective sense objects whereas the mental faculties can be inferred as follows:-&lt;/p&gt;<br /> {| class=&quot;wikitable&quot;<br /> |'''Faculty''' <br /> |'''object for inference''' <br /> |-<br /> |Vijnanam (expertise/skills )<br /> |Vyavsayena (occupation )<br /> |-<br /> |Dhairyam (fortitude)<br /> |avishadena (courage in face of adversity)<br /> |-<br /> |Viryam (bravery)<br /> |Uthhanena (initiating difficult tasks and enduring them)<br /> |-<br /> |Avasthanama (stability)<br /> |Avibhramana (absence of confusion)<br /> |-<br /> |Shradhha (faith)<br /> |Abhiprayena (purposiveness)<br /> |-<br /> |Medha (intellect)<br /> |Grahanena (grasping power)<br /> |-<br /> |Sanjna (recognition or consciousness level)<br /> |Namagrahanena (ability to recognise or name things)<br /> |-<br /> |Smriti (memory)<br /> |Smaranena (ability to recollect things)<br /> |-<br /> |Dhriti (self restraint)<br /> |Alaulyama (not being carried away by own greed)<br /> |-<br /> |Amala sattva (purity of mind)<br /> |Avikara (free of delusions or illusionary attachments)<br /> |}<br /> This inferential knowledge can help an individual become self-aware of his own psyche (sattva). A self-aware individual has an upper hand at avoiding mental illness because these often go unnoticed until they develop some organic manifestations.<br /> &lt;br /&gt;Thus, by means of above discussed assessment methodologies, a physician can assess the degree of derangement in mental faculties and hence the manovaha srotas, irrespective of development of specific signs and symptoms of any psychiatric disorder (vyadhi lakshana).<br /> <br /> ==Treatment Guidelines==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Manovaha srotas disorders follow the line of treatment same as described for disorders of manas (mind). Following are therapeutic and preventive practices beneficial for both vitiated manovaha srotas (channels of psyche) and manas obscured by rajas - tamas dosha.&lt;/p&gt;<br /> Manas dosha can be alleviated through a comprehensive five-fold psychotherapeutic regimen - jnana (spiritual knowledge or self-awareness), vijnana (scriptural or scientific knowledge), dhairya (mental fortitude), smriti (recollection of past successes to regain faith in own abilities) and samadhi (spiritual healing practices to focus mind inwards away from negative external stimuli). [Cha.Sa. Sutra Sthana 1/58]<br /> Restoration of dhi (intellect), dhairya (mental fortitude) and atmadi vijnana (knowledge of self-consciousness) has therapeutic effect in alleviating disorders of manovaha srotas obstructed by manas dosha.<br /> <br /> '''*Sattvavajaya chikitsa (treatment to regulate mind)'''<br /> Sattvavajaya chikitsa is a non-invasive therapeutic module for psychological derangements and psychosomatic ailments, analogous to contemporary psychotherapy. ‘Sattva’ stands for mind and ‘avajaya’ translates to win over. Hence, it emphasizes withdrawing the mind from unwholesome objects of senses (factors vitiating rajas and tamas) and diverting it to positive sensory and emotional stimuli. Thereby consciously negating disturbed emotions and behavioural patterns. [Cha.Sa. Sutra Sthana 11/54]<br /> <br /> '''*Ashtanga yoga (eight steps of yoga)'''<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Ashtanga yoga can be considered as one of the dimensions of satvavajaya chikitsa. It integrates eight steps of yoga to tame mind from traversing paths in life which are spiritually and mentally harmful for that individual. Of the eight steps, first four viz. yama (principles for moral code), niyama (observances for personal discipline), asana (yogic postures) and pranayama (regulating breath) are termed as bahiranga yoga (external path). These practices gradually alleviate aggravated manas dosha, making the mind less reactive towards external stimuli. The last three limbs viz. dharana (concentration), dhyana (meditation) and samadhi (enlightenment or complete realisation) are termed as antaranga yoga (internal paths). These practices transform the mind, eliminating the fluctuations of mind, thereby strengthening positive habits and outlook on life as well as inner self. Ashtanga yoga maintains a harmonious balance between inner environment (mind and spirit) and external environment (objects of sensory perception). Mind thus gets liberated from worldly pursuits and all psychological sufferings in a stepwise manner.&lt;/p&gt;<br /> '''*Achara rasayana (rejuvenating codes of behavioural conduct)'''<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Achara rasayana is an adravyabhuta (non-pharmacological) rasayana (practices rejuvenating physical and mental health). It includes behavioural conducts which aim to enhance health and longevity by teaching practical methods to potentiate sattva guna of mind. [Cha.Sa. Chikitsa Sthana 1, 4th pada, shloka 30-35] An individual can imbibe easy lifestyle modifications to develop a positive and strong character of mind, thereby avoiding potential etiological factors (for dosha aggravation) and negative psychosocial patterns. Achara rasayana can be divided into five domains of good mental, social, personal, moral and religious conduct. [6]&lt;/p&gt;<br /> '''*Sadvritta (good codes of conduct)'''<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Sadvritta refers to good code of conduct. These are a set of practices, which serve as lifestyle guidelines to prevent mind from falling prey to temporary material pleasures and impulsive thoughts and actions that cause impairment of manas dosha and manovaha srotas. It encompasses guidelines over personal hygiene, personality development as well as for social hygiene and peaceful social interactions. [Cha.Sa. Sutra Sthana 8/18]&lt;/p&gt;<br /> Both achara rasayana and sadvritta help to maintain control over sense organs. They majorly add to the preventive and promotive aspect of mental health. <br /> '''*Medhya dravya (medicines enhancing intellectual functions)'''<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Medhya dravyas are the plant based pharmacological agents that promote prajna i.e., dhi (intellect), dhriti (perseverance) and smriti (memory). Researches conducted prove their efficacy in minimizing the cognitive decline among individuals with neural abnormalities. For example, ushna (hot potency) and tikshna nature drugs like jyotishmati and vacha are said to remove blockages caused by kapha, ama or tamas dosha in the manovaha srotas. Once purified, manas can regain unvitiated connect with indriya via manovaha srotas. [8] <br /> &lt;br/&gt;Ayurveda thus provides a bird’s eye view over different aspects of manovaha srotas through interconnected references in the classics highlighting its physiological importance like the other thirteen major srotas systems in the human body.&lt;/p&gt;<br /> <br /> ==Contemporary view==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Mind as per contemporary literature is debatable concept because in some contexts it is identified as conscience, while in others it is seen as the function of conscience. The philosophical dimension of mind was conceived by Plato who considered mind as an inner (soul’s) experience. [11]<br /> &lt;br/&gt;The western system of medicine addresses brain at the core of majority of psychological distresses, whereas western philosophy involves the concept of psyche (which denotes mind). ‘Psyche’ is a Greek word meaning ‘soul in a living man’. <br /> &lt;br/&gt;William James, referred to as the father of American Psychology, laid the foundations of physiological aspect of mind. To him mind was a function of brain which conducts mental life in the form of a constant stream of consciousness.[9] At some places he too admitted mind to bear consciousness and tried to assign attributes to consciousness as a separate psychological function thus formulating the Theory of Functionalism which established causal relationship between internal states (perception) and external reactions or behaviour (sensation). He concluded that repeated actions cause adaptive changes in nervous system. This is the fundamental ideology behind the concept of Neuroplasticity – i.e. adaptive structural and functional changes in brain by development of new neuronal pathways due to intrinsic or extrinsic stimuli. [12]<br /> &lt;br/&gt;James’ counterpart Titchener, an English Psychologist, proposed that consciousness is mind’s awareness of its own functions. Consciousness is something superior to mind itself. He formulated the Theory of Structuralism which aimed at analysing the interrelationship between mental experiences, feelings, and sensations. He used introspection as a tool to break down these complex phenomena of consciousness down to their basic elements without breaking their original structure. <br /> &lt;br/&gt;Mind is hence regarded as the cumulative effect of all mental processes that have occurred in the lifetime while the consciousness can be understood as the cumulative effect of all mental processes occurring in present moment. Eventually brain was somehow regarded to control the neural activity responsible for accumulating all this sensory data.<br /> &lt;br/&gt;Many theories were formulated and overruled by their successors with time. Today the concept of mind and consciousness remains yet to be clearly defined. It is observed that mind is often identified as consciousness and they both are accepted as individual closely linked entities. Mind bears synonymity towards consciousness, spirit, and psyche. Some theories view both mind and consciousness as spirit. But mind is invariably understood as the interaction between psychological personality and the external environment, i.e., a subject – object relationship.<br /> &lt;br/&gt;The neurophysiological basis of minds and the channels of transport of its constituents is yet a challenge in field of neuroscience. In order to bridge this gap, contemporary scientists hypothesise that mental representations and their contents are represented by neural network and their supporting cells thus hinting towards Central Nervous System and it’s peripheral nerves as the channels of mind. [13]&lt;/p&gt; <br /> <br /> ==Research works on manovaha srotas==<br /> Various review articles have been published and researches been carried out in the domain of Ayurveda to understand the conceptual as well as pathophysiological aspect of manovaha srotas. Few of them are as follows :-<br /> &lt;br/&gt;'''1. Critical Review of Concept of manovaha Srotas with special reference to Brain'''<br /> This review article conceptualizes the contemporary understanding of manovaha srotas in context to CNS due to functional similarity between manas and brain obtained after an extensive research and analysis throughout ayurveda treatises. Further brain was considered as synonymous to hridya ie. mulasthana (site of origin) of manovaha srotas and ‘dasha dhamani’ as the cranial nerves exiting from the 10 major foramen at base of skull. Sanskrit literature considers hridaya as regarded as a central organ similar to brain. 14<br /> <br /> &lt;br/&gt;'''2. Circumstantial view on clinical knowing of manovaha srotasa &amp; its physiology'''<br /> The review article reconstructs a comprehensive picture of manovaha srotas from the scattered references available in Ayurveda texts, supplementing it with additional information from contemporary science as follows-<br /> *A detailed description of neuroanatomy and physiology has been drawn parallel to Ayurveda point of view about manas’ rachna and kriya sharir. <br /> *Effect of Triguna and tridosha (especially vata) in context of physiological functions and disorders of manas and manovaha srotas have been discussed.<br /> *Correlations between functions of five subtypes of vata and both CNS and ANS has been attempted <br /> *Pariksha krama (examination of nervous system) has been exemplified taking into consideration both Ayurveda and modern methodologies that can be employed for manovaha srotas (nervous system) examination.10<br /> <br /> ===Concept of stress factor assessment concerning ‘perseverance test’ in light of ayurveda” – a review=== <br /> This article highlights the importance of understanding the etiological factors of vitiation of manovaha srotas and manas in all kinds of psychiatric as well as psychosomatic disorders. Imbalance of manas dosha can be treated by means of yoga, meditation and pranayama. Often emotional disturbances remain unattended in diagnosed cases of psychiatric illness which can be managed at home by incorporating wholesome diet (pathya ahara) and moral code of conduct (sadvrutta) in daily routine. Lack of peace and chronic stressors have been observed as major causes of vitiation of channels of mind. 15<br /> <br /> <br /> &lt;big&gt;'''[[Special:ContactMe|Send us your suggestions and feedback on this page.]]'''&lt;/big&gt;<br /> <br /> ==References==<br /> <br /> &lt;div id=&quot;BackToTop&quot; class=&quot;noprint&quot; style=&quot;background-color:#DDEFDD; position:fixed;<br /> bottom:32px; left:2%; z-index:9999; padding:0; margin:0;&quot;&gt;&lt;span style=&quot;color:blue;<br /> font-size:8pt; font-face:verdana,sans-serif; border:0.2em outset #ceebf7;<br /> padding:0.1em; font-weight:bolder; -moz-border-radius:8px; &quot;&gt;<br /> [[#top| Back to the Top ]]&lt;/span&gt;&lt;/div&gt;</div>

Manishdubey https://www.carakasamhitaonline.com/index.php?title=Talk:Manovaha_srotas&diff=44197 2023-10-16T10:49:23Z

<p>Manishdubey: /* Research works on manovaha srotas */</p> <hr /> <div>{{CiteButton}}<br /> {{#seo:<br /> |title= Manovaha srotas<br /> (Channels of transport and transformation of mind and mental factors)<br /> |titlemode=append<br /> |keywords= Manovaha srotas,Hrudya, Sattva pariksha, Sattvavajaya chikitsa, Bhojani M. K.,Deole Y.S., Basisht G<br /> |description=Mana means mind, or psyche. Srotas means channels of transport and transformation. The description and understanding of channels for activities of mind (manovaha srotas) is scattered in ayurveda classics and has not been completely elucidated. Manovaha srotas are considered as channels through which mind and body interact with each other. <br /> |image=http://www.carakasamhitaonline.com/mediawiki-1.32.1/resources/assets/ogimgs.jpg<br /> |image_alt=carak samhita<br /> |type=article<br /> }}<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Mana means mind, or psyche. Srotas means channels of transport and transformation. The description and understanding of channels for activities of mind (manovaha srotas) is scattered in ayurveda classics and has not been completely elucidated. Manovaha srotas are considered as channels through which mind and body interact with each other. These channels pervade throughout the body. [Chakrapani on Cha.Sa. Indriya Sthana 5/41-42] They are responsible for flow of thoughts, emotions, and other psychological functions. This article deals with various aspects of manovaha srotasa i.e. the channels of activities of mind and its development.&lt;/p&gt;<br /> <br /> {{Infobox<br /> |title = Contributors<br /> |label1 = Section/Chapter/topic<br /> |data1 = Concepts/[[Srotas]]/[[Manovaha Srotas]] <br /> |label2 = Authors<br /> |data2 = Bhojani M. K.&lt;sup&gt;1&lt;/sup&gt; Varma Swati &lt;sup&gt;1&lt;/sup&gt; Deole Y.S.&lt;sup&gt;2&lt;/sup&gt;<br /> |label3 = Reviewer &amp; Editor<br /> |data3 = Basisht G.&lt;sup&gt;3&lt;/sup&gt;, <br /> |label4 = Affiliations<br /> |data4 = &lt;sup&gt;1&lt;/sup&gt; Department of Sharir Kriya, All India Institute of Ayurveda, New Delhi, India<br /> &lt;sup&gt;2&lt;/sup&gt; Department of Kayachikitsa, G. J. Patel Institute of Ayurvedic Studies and Research, New Vallabh Vidyanagar, Gujarat, India <br /> &lt;sup&gt;3&lt;/sup&gt; Rheumatologist, Orlando, Florida, U.S.A.<br /> |label5 = Correspondence emails<br /> |data5 = meera.samhita@aiia.gov.in, carakasamhita@gmail.com<br /> |label6 = Publisher <br /> |data6 = [[Charak Samhita Research, Training and Development Centre]], I.T.R.A., Jamnagar, India<br /> |label7 = Date of publication:<br /> |data7 =October 12, 2023<br /> |label8 = DOI<br /> |data8 = In process<br /> }}<br /> <br /> ==Etymology and derivation:==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Srotas originates from Sanskrit root ‘Sru’ that translates to oozing, flow or secretion. It has been defined as ‘sravanat strotamsi’ [Cha. Sa. Sutra Sthana 30/12] which indicates structures designated for conveyance of material inside body. <br /> &lt;br/&gt;Grossly defining, thirteen major types of srotas have been mentioned that transport substances undergoing biotransformation (parinamam aapadyamanam) from the place of origin to their destination. [Cha. Sa. Vimana Sthana 5/3] Similarly in physiological state, manovaha srotas might be responsible for processing and transformation of ‘doshayukta’ (irrational under influence of rajas and tamas) emotions and thoughts into unbiased reasoning before reaching a conclusion by our intellect (buddhi). &lt;/p&gt;<br /> <br /> ==Synonyms of manovaha srotas==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Following terms are used for ‘manovaha srotas’ in different Ayurveda classics : &lt;/p&gt;<br /> # Manovaha dhamani [Chakrapani on Cha. Sa. Indriya sthana 12/42] and [Vijayarakshita in Ma.Ni.Purva Khanda 20/1]<br /> # Chetanavaha srotas [Shivadas Sen on Cha.Sa. Chikitsa sthana 9/5] <br /> # Chetovaha marga [Bhel Samhita Nidana Sthana 7/2]<br /> # Manobuddhivaha sira [ Cha.Sa.Chikitsa Sthana 10/58]<br /> # Sanjnavaha srotas [Su.Sa.Uttar Tantra 61/8]<br /> # Sanjnavaha nadi [Su.Sa. Uttar Tantra 46/7]<br /> &lt;p style=&quot;text-align:justify;&quot;&gt; &lt;br/&gt;Use of terms like sira, nadi and dhamani, refers to different channels and pathways concerned with maintenance of physiological flow of information. [Cha.Sa. Vimana Sthana 5/8] &lt;/p&gt;<br /> <br /> ==Origin==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt; Every srotas is localized within the hollow space in the body originating from a root (mula) and spreading throughout the body to reach a final structure. Srotas are said to be hollow structures in different shapes and sizes The root (mula) is majorly responsible for regulation and control of functions of that srotas.<br /> &lt;br/&gt;The channels carrying mind (manovaha srotas) are not exclusively listed. It is however stated that the entire conscious body is abode of mind. Hence these channels are spread throughout the body. [Chakrapani on Cha.Sa. Indriya Sthana 5/41]. <br /> &lt;br/&gt;However, hridaya (heart) has a universal acceptance as the site of origin (mula) of manovaha srotas. Hence a special mention has been made about ten arteries of heart, probably being the manovaha srotas (visheshen tu hrudya ashritvat manah tadashrita dasha dhamanyo manovaha abhidhiyante) [Chakrapani on Cha.Sa. Indriya Sthana 5/41-42]. These get afflicted by vitiated dosha either all at once or individually. [Chakrapani on Cha.Sa. Indriya Sthana 12/42]<br /> &lt;/p&gt;<br /> <br /> ==Decoding hridaya (heart)==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt; The interpretation of the term ‘hridaya’ has been of confusion among scholars since decades. The first interpretation of the term given by texts of Shatpada Brahmana which highlighted functional aspect of hridaya. The word being composed of three letters viz ‘hri’ (hra harane)- to acquire; ‘Da’ (da dane) – to give; ‘Ya’ (Ya gatau)- which transports. The hridaya thus displays three phases of cardiac cycle i.e., receives, gives, and transports body constituents through it. [2]<br /> &lt;br/&gt;Hridaya is the site of rasa (plasma), sattva (psychic factor/mind), buddhi (intellect) and atma (soul) in conjugation with all sensory organs (jnanendriya).[Cha.Sa. Chikitsa Sthana 24/35] Sadhaka pitta situated in heart (hridaya) regulates proper functioning of intellect (buddhi) and ego (ahamkara). Hridaya is located in between breasts (stanayormadhya) of thoracic region [A. H. Sutra Sthana 12/13-14] [Su. Sa. Sharira Sthana 6/25]. <br /> &lt;br/&gt;Vedic era was well versed with heart (hridaya) and brain (mastishka) being two distinct entities, with interdependent functional relationship [Atharvaveda Book X. Hymn 2.26]. Kashyap Samhita quotes that all sense and motor organs (indriya) together with mind (manas) emerge from heart (hridaya) [Ka.Sa. Chikitsa Sthana 8/6]. Primary site of action of mind (manas) is brain (shira).[3] It can be concluded that mind (manas) being seated in heart (hridaya) connects to brain (shiras) through manovaha srotas and controls all senses (indriya). Also, any damage pertaining to marma (vital points) of shiras (head) causes loss of consciousness (cheshtanasha). [Cha.Sa. Sidhhi Sthana 9/6] Hence heart (hridaya) and brain (shirasor mastishka) are sites of manovaha srotasa. <br /> &lt;br/&gt; This approach of understanding hridaya goes well along with the contemporary view of understanding the triguna based psycho-functional principles of Ayurveda within the neural framework. Various research has been conducted which demonstrate that heart continuously sends nervous signals to brain to coordinate higher centres responsible for cognition and emotions. [1] The neuro- psychological as well as circulatory functions of hridaya mentioned in the classics can thus be explained. &lt;/p&gt; <br /> <br /> ==Relation between rasavaha and manovaha srotas==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Heart is the abode of mind (mana) and consciousness (chetana) or soul (atma). [Cha. Sa. Sidhhi Sthana 9/4] It is a site for physical, psychological, and spiritual components. Heart is origin for channels of transportation and transformation of rasa dhatu, too. Both heart and brain are considered under the umbrella term hridaya in terms of anatomical structure and higher-centre functions respectively. <br /> &lt;br/&gt;Heart (residence of manas) and brain (workplace of manas) are functionally co-dependent upon each other. Manas regulates the cognitive and conative functions of brain in conjunction with soul (atma) under the influence of vata dosha. [Cha. Sa. Sharira Sthana 1/22-23]. Brain is a structural entity needing continuous supply of nourishment and oxygen. This is feasible by heart through circulation (rasa-rakta samvahana kriya) via the ten major vessels (rasavahi dhamani). [A. H. Sharira Sthana 3/18] Heart is a highly vascular organ being surrounded by ten major dhamani (blood vessels) like spokes of a wheel which are known as ‘rasavaha strotomula’ (site of origin of channels of nutrition). These channels are comparable to manovaha srotas. [Chakrapani on Cha. Sa. Chikitsa Sthana 9/4] Manas thus acts like a medium between heart and brain wherein brain is responsible for all sensory and motor functions while heart has been assigned emotional aspect of psyche (manas).<br /> &lt;br/&gt;One of the factors for vitiation of rasavaha srotas is excessive thinking or worry (atichintan). [Cha. Sa. Vimana Sthana 5/13] Contemporary researchers have found evidence to support the interaction between circulatory system and psyche. The monograph of German professor Ludwig Braun is a pioneer in exploring the psychological and emotional aspect of cardiac diseases especially angina. He presented a correlation between cardiac diseases and ‘Angst’ (a constrictive, tightening and crushing sensation which manifests dread in the patient thereby changing his entire emotional outlook on life), analogous to anxiety. He explains that the cardiac tissue has a special apparatus receptive towards anxiety which manifests as an inner tactile sensation. That region is well supplied with nerve endings that gets irritated by anxiety. This phenomenon of emotional influence over cardiac tissues is termed as cardiac psyche. [4] <br /> &lt;/p&gt; <br /> <br /> ==Factors vitiating manovaha srotas==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt; Manovaha srotas are the prime site of abnormalities of channels in all psychological disorders. [Cha.Sa. Nidana Sthana 6/4] Alongside any of the eight factors that are either attributed to hridaya or manas viz. mana (mind), buddhi (intellect), sanjna-jnana (self-awareness), smriti (memory), bhakti (devotion), sheela (habits), cheshta (psychomotor activities) and achara (code of conduct). [Cha.Sa. Nidana Sthana 7/5] <br /> &lt;br/&gt;These factors when deranged cause vitiation of manas dosha (rajas and tamas), deterioration of sattva guna of manas and gradual derangement of tridosha. Foods, activities and excessive expression of emotions like anger, grief, lust, fear etc and mental traumas are the fundamental etiological factors for the same. [Cha.Sa. Nidana Sthana 7/4] Vitiated tridosha further vitiates rasavaha srotas, which apparently has the same site of origin as of manovaha srotas i.e., hridaya and dasha dhamani (ten great vessels). [Cha. Sa. Vimana Sthana 5/10] Hridaya is seat of manas [Cha.Sa. Sutra Sthana 30/4]. Hence, all the factors vitiating rasa dhatu (nutritive fluid), rasavaha srotas (channels carrying nutritive fluid) and manas dosha viz. rajas and tamas will affect manas and eventually vitiating manovaha srotas. Even the structural derangements of heart (abode of mind) affect manovaha srotas due to their ashrayashrayibhava (state of interdependency). [Cha.Sa. Chikitsa Sthana 9/5]&lt;/p&gt;<br /> <br /> ==Pathologies of manovaha srotas==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Manovaha srotas is important factor in understanding disorders like unmada (psychosis), apasmara (epilepsy) and extreme emotional reactions. &lt;/p&gt;<br /> <br /> *'''Unmada (psychosis)'''<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;When an individual experiences extreme emotions – lust (kama), anger (krodha), fear (bhaya), greed (lobha), happiness or pleasure (harsha), affection (moha), grief (shoka), excessive worry (chinta), they initially harm the intellect which aggravates manas dosha (rajas and tamas) and tridosha (vata, pitta and kapha). These vitiated dosha invade heart and obstruct manovaha srotas (channels transporting psychic impulses) thereby causing unmada. [Dalhan on Su. Sa. Uttar Tantra 62/3]<br /> *'''Apasmara (epilepsy)'''<br /> Overindulging in sensory pleasures, incompatible diet, withholding natural urges and giving into immoral activities under emotional influences (kama, krodha, lobha among others), vitiates rajas and tamas. They poorly influence the manas (mind) and sanjnavaha srotas (manovaha srotas) causing apasmara. [Su.Sa. Uttar Tantra 61/6]<br /> * Mada (intoxication), murchha (syncope), sanyasa (coma) are caused by vitiation of channels of consciousness (chetanavaha srotas or manovaha srotas). [Shivadas Sen on Cha. Sa. Chikitsa Sthana 9/5] <br /> *'''Atattvabhinivesha (perverted state of mind)'''<br /> Considered as mahagada (difficult to treat mental disorder), the person’s conscience gets afflicted by rajas and tamas, which cause complete derangement of intellect (buddhi vibhramsha) as the predominant symptom. The vitiated dosha get lodged in heart (hridaya) to afflict channels of mind and intellect (manobuddhivaha sira in manovaha srotas). [Cha.Sa. Chikitsa Sthana 10/57-60]<br /> * Physiology of nightmares (swapna)<br /> Nightmares are dreams occurring in REM phase of sleep which causes mental projections in the form of feelings of fear, despair, and anxiety. Ayurveda defines REM phase as ‘Natiprasupta’ - the state characterised to be midway between states of deep sleep and fully awake. During any ominous situation, tridosha in their highly aggravated state tend to fill-up the manovaha srotas. This results in terrifying dreams. [Cha.Sa. Indriya Sthana 5/41]. &lt;/p&gt;<br /> <br /> ==Assessment and diagnosis of disorders of manovaha srotas==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Srotas are micro-channels transporting various metabolites across cells throughout the body. It can be deduced that manovaha srotas has different characteristics structurally and functionally from the major thirteen srotas, because it transports and transforms thoughts and feelings. This is evident from objects of mind (manas), viz- thought (chintyam), consideration (vicharyam), hypothesis (uhyam), aims (dhyeyam) and determination (sankalpam). [Cha.Sa. Sharira Sthana 1/20]. Assessment of manovaha srotas can be done via assessment of manas and the degree of derangement of its functions. Ayurveda considers manas as material entity (dravya) which is a super sense and not perceivable by ordinary senses (atindriya) [Cha. Sa. Sutra Sthana 8/4]. Manas is under direct control of vata dosha [Cha. Sa. Sutra Sthana 12/8] and is the mediator between atma (soul) and indriyartha (objects of senses). <br /> &lt;br/&gt;The contemporary physiological aspects of mind, senses, brain, nervous system and consciousness can be considered for assessment of manovaha srotas. <br /> &lt;br/&gt; A thorough neurological examination by means of interrogation (prashna pariksha), inspection (darshana pariksha) and assessment of mental strength (sattva bala pariksha) [Cha.Sa. Vimana Sthana 8/119] can be used for assessment and diagnosis of disorders of manovaha srotas.&lt;/p&gt;<br /> <br /> ''' a. Interrogation (prashna pariksha)'''<br /> A formal interview of the patient can be conducted for overall and precise diagnosis. The questions related to chief complaints with duration, chronological development, nurturing of patient, family history, addiction, hobbies, interests, daily routine, major life events, achievements, mental traumas, emotional quotient and intellectual quotient is recorded from the patient. If the patient is not in state of giving correct answers, then the relatives or attendants who know patients history are interviewed. <br /> <br /> '''b. Darshan pariksha (Direct observation)'''<br /> While interviewing the patient, a physician should pay attention to following attributes that can signify features mentioned for certain psychiatric ailments (manovaha srotodushti)..<br /> <br /> # '''Appearance '''– Unusual dressing preferences, use of cosmetics, perfumes or accessories or flamboyant appearance. e.g;- ‘Priye tanu rakta vastradhari’ (liking for adorning clothes made of thin red fabric) is seen in yakshagraha unmada (Su.Sa. Uttara tantra 60/11)<br /> # '''Activity and co-ordination''' - Behaviour, Gait, gestures, patient’s facial expression and body language should be observed during probing them with questions. Eg;- 'Satatama akshano’ (rapid and constant eye movements) is one of the prodromal feature of apasmara (epilepsy) [ Cha.Sa. Nidana sthana 8/6]. Udhasta (patient keeps his hands raised) is a feature of pishacha grahavishta unmada [Su.Sa. Uttara Tantra 60/15]<br /> # '''Conversation style''' – Coherence of speech, articulation, emphasise over certain issue, hesitation and duration of response. E.g. ‘Chitram sa jalpati’ (Patient does irrelevant absurd talks) is seen in patients of manas unmada [Su.Sa. Uttara Tantra 62/13].<br /> #'''Emotional expression''' – Patients may express a wide range of emotions during interview with the physician. E.g. Asthana rodana (Sudden crying) is a feature in vataja unmada while amarsha (intolerance) is seen in patients of pittaja unmada. [Cha.Sa. Chikitsa Sthana 9/11-12] Fleeting ideas, incoherent speech is an important sign for lacking proper emotions. <br /> #'''Cognition''' – Orientation to person, place, time and circumstances, level of intellect, level of understanding, common sense and memory can be identified under the domain of cognition by observing patient’s behaviour as well as by asking questions to them using validated scientific questionnaires. Short term memory and long-term memory shall be assessed properly. <br /> &lt;br/&gt;All observations gathered from every method of assessment should be simultaneously analysed to reach the diagnosis.<br /> <br /> '''c. Sattva pariksha (assessment of quality of excellence of mind)'''<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Sattva pariksha assesses the quality of excellence of mind imparted by extent of dominance of sattva guna. Mind (manas) is composed of three attributes (triguna) viz. sattva, rajas and tamas. These impart three types of mental constitutions – Shuddha (pure) (sattvika), rajasika and tamasika. [Cha.Sa. Sharira Sthana 4/36]. Sattvika guna is full of auspiciousness and is considered the healthy (amala) state of mind. Rajasika guna imparts momentum in terms of furious temperament. Whereas tamas guna promotes inertia and moral ignorance. Hence, rajas and tamas are considered inauspicious and called manas dosha. Triguna are present in dynamically varying proportions at any given time and influenced by body (i.e. tridosha) and vice versa. [Chakrapani on Cha.Sa. Vimana Sthana 4/8]. Optimum levels of sattva guna are essential for promoting desired physical and mental strength irrespective of morphological features. [Cha.Sa. Vimana Sthana 8/119]&lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Sattva bala (strength of psyche) is of three types as per strength – pravara (superior), madhyama (moderate) and avara (poor). Pravara sattva persons possess great courage. Despite poor morphological features they seem to be unmoved in the face of adversities. Madhyama sattva persons need some additional moral support to sustain themselves in times of distress. While avara sattva displays catastrophic reactions even during little inconveniences and can neither be sustained by themselves nor by others despite having good quality morphological features. Avara sattva is constantly plagued by inferior emotions like grief, fear, greed, conceit and confusion. When confronted with fierce, ugly, disgusting narratives or flesh and blood, they are prone to become depressed, pale, unconscious or semiconscious, giddy, anxious and can even succumb to death in worst case scenarios. [Cha. Sa. Vimana Sthana 8/119].<br /> &lt;br/&gt;Manovaha srotas associated with avara sattva bala is most likely to be vitiated by manas dosha leading to various psychiatric and psychosomatic disorders [Cha.Sa. Chikitsa Sthana 9/5]. It has been observed that avara sattva individuals are more likely to commit prajnaparadha (intellectual defects) [10] thereby voluntarily indulging in various etiological factors for respective psychological as well as somatic disorders.<br /> &lt;br?&gt;Thus, assessment of sattva bala can help rule out the predisposition towards manovaha srotodushti and subsequent development of symptoms of psychiatric ailments.&lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;'''d. Anumana pariksha (knowledge by inference)''' to determine normalcy of faculties of manas (mind) [Cha.Sa. Vimana Sthana 4/8] Since manas is atindriya ( supersence or imperceivable by ordinary senses), so are it’s faculties which can serve as potential markers for assessment of its functions. [10] The proper functioning of manas itself is inferred by altered or inappropriate mental perceptions even in presence of appropriately functioning indriya (senses) and their respective sense objects whereas the mental faculties can be inferred as follows:-&lt;/p&gt;<br /> {| class=&quot;wikitable&quot;<br /> |'''Faculty''' <br /> |'''object for inference''' <br /> |-<br /> |Vijnanam (expertise/skills )<br /> |Vyavsayena (occupation )<br /> |-<br /> |Dhairyam (fortitude)<br /> |avishadena (courage in face of adversity)<br /> |-<br /> |Viryam (bravery)<br /> |Uthhanena (initiating difficult tasks and enduring them)<br /> |-<br /> |Avasthanama (stability)<br /> |Avibhramana (absence of confusion)<br /> |-<br /> |Shradhha (faith)<br /> |Abhiprayena (purposiveness)<br /> |-<br /> |Medha (intellect)<br /> |Grahanena (grasping power)<br /> |-<br /> |Sanjna (recognition or consciousness level)<br /> |Namagrahanena (ability to recognise or name things)<br /> |-<br /> |Smriti (memory)<br /> |Smaranena (ability to recollect things)<br /> |-<br /> |Dhriti (self restraint)<br /> |Alaulyama (not being carried away by own greed)<br /> |-<br /> |Amala sattva (purity of mind)<br /> |Avikara (free of delusions or illusionary attachments)<br /> |}<br /> This inferential knowledge can help an individual become self-aware of his own psyche (sattva). A self-aware individual has an upper hand at avoiding mental illness because these often go unnoticed until they develop some organic manifestations.<br /> &lt;br /&gt;Thus, by means of above discussed assessment methodologies, a physician can assess the degree of derangement in mental faculties and hence the manovaha srotas, irrespective of development of specific signs and symptoms of any psychiatric disorder (vyadhi lakshana).<br /> <br /> ==Treatment Guidelines==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Manovaha srotas disorders follow the line of treatment same as described for disorders of manas (mind). Following are therapeutic and preventive practices beneficial for both vitiated manovaha srotas (channels of psyche) and manas obscured by rajas - tamas dosha.&lt;/p&gt;<br /> Manas dosha can be alleviated through a comprehensive five-fold psychotherapeutic regimen - jnana (spiritual knowledge or self-awareness), vijnana (scriptural or scientific knowledge), dhairya (mental fortitude), smriti (recollection of past successes to regain faith in own abilities) and samadhi (spiritual healing practices to focus mind inwards away from negative external stimuli). [Cha.Sa. Sutra Sthana 1/58]<br /> Restoration of dhi (intellect), dhairya (mental fortitude) and atmadi vijnana (knowledge of self-consciousness) has therapeutic effect in alleviating disorders of manovaha srotas obstructed by manas dosha.<br /> <br /> '''*Sattvavajaya chikitsa (treatment to regulate mind)'''<br /> Sattvavajaya chikitsa is a non-invasive therapeutic module for psychological derangements and psychosomatic ailments, analogous to contemporary psychotherapy. ‘Sattva’ stands for mind and ‘avajaya’ translates to win over. Hence, it emphasizes withdrawing the mind from unwholesome objects of senses (factors vitiating rajas and tamas) and diverting it to positive sensory and emotional stimuli. Thereby consciously negating disturbed emotions and behavioural patterns. [Cha.Sa. Sutra Sthana 11/54]<br /> <br /> '''*Ashtanga yoga (eight steps of yoga)'''<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Ashtanga yoga can be considered as one of the dimensions of satvavajaya chikitsa. It integrates eight steps of yoga to tame mind from traversing paths in life which are spiritually and mentally harmful for that individual. Of the eight steps, first four viz. yama (principles for moral code), niyama (observances for personal discipline), asana (yogic postures) and pranayama (regulating breath) are termed as bahiranga yoga (external path). These practices gradually alleviate aggravated manas dosha, making the mind less reactive towards external stimuli. The last three limbs viz. dharana (concentration), dhyana (meditation) and samadhi (enlightenment or complete realisation) are termed as antaranga yoga (internal paths). These practices transform the mind, eliminating the fluctuations of mind, thereby strengthening positive habits and outlook on life as well as inner self. Ashtanga yoga maintains a harmonious balance between inner environment (mind and spirit) and external environment (objects of sensory perception). Mind thus gets liberated from worldly pursuits and all psychological sufferings in a stepwise manner.&lt;/p&gt;<br /> '''*Achara rasayana (rejuvenating codes of behavioural conduct)'''<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Achara rasayana is an adravyabhuta (non-pharmacological) rasayana (practices rejuvenating physical and mental health). It includes behavioural conducts which aim to enhance health and longevity by teaching practical methods to potentiate sattva guna of mind. [Cha.Sa. Chikitsa Sthana 1, 4th pada, shloka 30-35] An individual can imbibe easy lifestyle modifications to develop a positive and strong character of mind, thereby avoiding potential etiological factors (for dosha aggravation) and negative psychosocial patterns. Achara rasayana can be divided into five domains of good mental, social, personal, moral and religious conduct. [6]&lt;/p&gt;<br /> '''*Sadvritta (good codes of conduct)'''<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Sadvritta refers to good code of conduct. These are a set of practices, which serve as lifestyle guidelines to prevent mind from falling prey to temporary material pleasures and impulsive thoughts and actions that cause impairment of manas dosha and manovaha srotas. It encompasses guidelines over personal hygiene, personality development as well as for social hygiene and peaceful social interactions. [Cha.Sa. Sutra Sthana 8/18]&lt;/p&gt;<br /> Both achara rasayana and sadvritta help to maintain control over sense organs. They majorly add to the preventive and promotive aspect of mental health. <br /> '''*Medhya dravya (medicines enhancing intellectual functions)'''<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Medhya dravyas are the plant based pharmacological agents that promote prajna i.e., dhi (intellect), dhriti (perseverance) and smriti (memory). Researches conducted prove their efficacy in minimizing the cognitive decline among individuals with neural abnormalities. For example, ushna (hot potency) and tikshna nature drugs like jyotishmati and vacha are said to remove blockages caused by kapha, ama or tamas dosha in the manovaha srotas. Once purified, manas can regain unvitiated connect with indriya via manovaha srotas. [8] <br /> &lt;br/&gt;Ayurveda thus provides a bird’s eye view over different aspects of manovaha srotas through interconnected references in the classics highlighting its physiological importance like the other thirteen major srotas systems in the human body.&lt;/p&gt;<br /> <br /> ==Contemporary view==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Mind as per contemporary literature is debatable concept because in some contexts it is identified as conscience, while in others it is seen as the function of conscience. The philosophical dimension of mind was conceived by Plato who considered mind as an inner (soul’s) experience. [11]<br /> &lt;br/&gt;The western system of medicine addresses brain at the core of majority of psychological distresses, whereas western philosophy involves the concept of psyche (which denotes mind). ‘Psyche’ is a Greek word meaning ‘soul in a living man’. <br /> &lt;br/&gt;William James, referred to as the father of American Psychology, laid the foundations of physiological aspect of mind. To him mind was a function of brain which conducts mental life in the form of a constant stream of consciousness.[9] At some places he too admitted mind to bear consciousness and tried to assign attributes to consciousness as a separate psychological function thus formulating the Theory of Functionalism which established causal relationship between internal states (perception) and external reactions or behaviour (sensation). He concluded that repeated actions cause adaptive changes in nervous system. This is the fundamental ideology behind the concept of Neuroplasticity – i.e. adaptive structural and functional changes in brain by development of new neuronal pathways due to intrinsic or extrinsic stimuli. [12]<br /> &lt;br/&gt;James’ counterpart Titchener, an English Psychologist, proposed that consciousness is mind’s awareness of its own functions. Consciousness is something superior to mind itself. He formulated the Theory of Structuralism which aimed at analysing the interrelationship between mental experiences, feelings, and sensations. He used introspection as a tool to break down these complex phenomena of consciousness down to their basic elements without breaking their original structure. <br /> &lt;br/&gt;Mind is hence regarded as the cumulative effect of all mental processes that have occurred in the lifetime while the consciousness can be understood as the cumulative effect of all mental processes occurring in present moment. Eventually brain was somehow regarded to control the neural activity responsible for accumulating all this sensory data.<br /> &lt;br/&gt;Many theories were formulated and overruled by their successors with time. Today the concept of mind and consciousness remains yet to be clearly defined. It is observed that mind is often identified as consciousness and they both are accepted as individual closely linked entities. Mind bears synonymity towards consciousness, spirit, and psyche. Some theories view both mind and consciousness as spirit. But mind is invariably understood as the interaction between psychological personality and the external environment, i.e., a subject – object relationship.<br /> &lt;br/&gt;The neurophysiological basis of minds and the channels of transport of its constituents is yet a challenge in field of neuroscience. In order to bridge this gap, contemporary scientists hypothesise that mental representations and their contents are represented by neural network and their supporting cells thus hinting towards Central Nervous System and it’s peripheral nerves as the channels of mind. [13]&lt;/p&gt; <br /> <br /> ==Research works on manovaha srotas==<br /> Various review articles have been published and researches been carried out in the domain of Ayurveda to understand the conceptual as well as pathophysiological aspect of manovaha srotas. Few of them are as follows :-<br /> &lt;br/&gt;'''1. Critical Review of Concept of manovaha Srotas with special reference to Brain'''<br /> This review article conceptualizes the contemporary understanding of manovaha srotas in context to CNS due to functional similarity between manas and brain obtained after an extensive research and analysis throughout ayurveda treatises. Further brain was considered as synonymous to hridya ie. mulasthana (site of origin) of manovaha srotas and ‘dasha dhamani’ as the cranial nerves exiting from the 10 major foramen at base of skull. Sanskrit literature considers hridaya as regarded as a central organ similar to brain. 14<br /> <br /> ===2. Circumstantial view on clinical knowing of manovaha srotasa &amp; its physiology===<br /> The review article reconstructs a comprehensive picture of manovaha srotas from the scattered references available in Ayurveda texts, supplementing it with additional information from contemporary science as follows-<br /> *A detailed description of neuroanatomy and physiology has been drawn parallel to Ayurveda point of view about manas’ rachna and kriya sharir. <br /> *Effect of Triguna and tridosha (especially vata) in context of physiological functions and disorders of manas and manovaha srotas have been discussed.<br /> *Correlations between functions of five subtypes of vata and both CNS and ANS has been attempted <br /> *Pariksha krama (examination of nervous system) has been exemplified taking into consideration both Ayurveda and modern methodologies that can be employed for manovaha srotas (nervous system) examination.10 <br /> ===Concept of stress factor assessment concerning ‘perseverance test’ in light of ayurveda” – a review=== <br /> This article highlights the importance of understanding the etiological factors of vitiation of manovaha srotas and manas in all kinds of psychiatric as well as psychosomatic disorders. Imbalance of manas dosha can be treated by means of yoga, meditation and pranayama. Often emotional disturbances remain unattended in diagnosed cases of psychiatric illness which can be managed at home by incorporating wholesome diet (pathya ahara) and moral code of conduct (sadvrutta) in daily routine. Lack of peace and chronic stressors have been observed as major causes of vitiation of channels of mind. 15<br /> <br /> <br /> &lt;big&gt;'''[[Special:ContactMe|Send us your suggestions and feedback on this page.]]'''&lt;/big&gt;<br /> <br /> ==References==<br /> <br /> &lt;div id=&quot;BackToTop&quot; class=&quot;noprint&quot; style=&quot;background-color:#DDEFDD; position:fixed;<br /> bottom:32px; left:2%; z-index:9999; padding:0; margin:0;&quot;&gt;&lt;span style=&quot;color:blue;<br /> font-size:8pt; font-face:verdana,sans-serif; border:0.2em outset #ceebf7;<br /> padding:0.1em; font-weight:bolder; -moz-border-radius:8px; &quot;&gt;<br /> [[#top| Back to the Top ]]&lt;/span&gt;&lt;/div&gt;</div>

Manishdubey https://www.carakasamhitaonline.com/index.php?title=Talk:Manovaha_srotas&diff=44196 2023-10-16T10:48:12Z

<p>Manishdubey: /* 1. Critical Review of Concept of manovaha Srotas with special reference to Brain */</p> <hr /> <div>{{CiteButton}}<br /> {{#seo:<br /> |title= Manovaha srotas<br /> (Channels of transport and transformation of mind and mental factors)<br /> |titlemode=append<br /> |keywords= Manovaha srotas,Hrudya, Sattva pariksha, Sattvavajaya chikitsa, Bhojani M. K.,Deole Y.S., Basisht G<br /> |description=Mana means mind, or psyche. Srotas means channels of transport and transformation. The description and understanding of channels for activities of mind (manovaha srotas) is scattered in ayurveda classics and has not been completely elucidated. Manovaha srotas are considered as channels through which mind and body interact with each other. <br /> |image=http://www.carakasamhitaonline.com/mediawiki-1.32.1/resources/assets/ogimgs.jpg<br /> |image_alt=carak samhita<br /> |type=article<br /> }}<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Mana means mind, or psyche. Srotas means channels of transport and transformation. The description and understanding of channels for activities of mind (manovaha srotas) is scattered in ayurveda classics and has not been completely elucidated. Manovaha srotas are considered as channels through which mind and body interact with each other. These channels pervade throughout the body. [Chakrapani on Cha.Sa. Indriya Sthana 5/41-42] They are responsible for flow of thoughts, emotions, and other psychological functions. This article deals with various aspects of manovaha srotasa i.e. the channels of activities of mind and its development.&lt;/p&gt;<br /> <br /> {{Infobox<br /> |title = Contributors<br /> |label1 = Section/Chapter/topic<br /> |data1 = Concepts/[[Srotas]]/[[Manovaha Srotas]] <br /> |label2 = Authors<br /> |data2 = Bhojani M. K.&lt;sup&gt;1&lt;/sup&gt; Varma Swati &lt;sup&gt;1&lt;/sup&gt; Deole Y.S.&lt;sup&gt;2&lt;/sup&gt;<br /> |label3 = Reviewer &amp; Editor<br /> |data3 = Basisht G.&lt;sup&gt;3&lt;/sup&gt;, <br /> |label4 = Affiliations<br /> |data4 = &lt;sup&gt;1&lt;/sup&gt; Department of Sharir Kriya, All India Institute of Ayurveda, New Delhi, India<br /> &lt;sup&gt;2&lt;/sup&gt; Department of Kayachikitsa, G. J. Patel Institute of Ayurvedic Studies and Research, New Vallabh Vidyanagar, Gujarat, India <br /> &lt;sup&gt;3&lt;/sup&gt; Rheumatologist, Orlando, Florida, U.S.A.<br /> |label5 = Correspondence emails<br /> |data5 = meera.samhita@aiia.gov.in, carakasamhita@gmail.com<br /> |label6 = Publisher <br /> |data6 = [[Charak Samhita Research, Training and Development Centre]], I.T.R.A., Jamnagar, India<br /> |label7 = Date of publication:<br /> |data7 =October 12, 2023<br /> |label8 = DOI<br /> |data8 = In process<br /> }}<br /> <br /> ==Etymology and derivation:==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Srotas originates from Sanskrit root ‘Sru’ that translates to oozing, flow or secretion. It has been defined as ‘sravanat strotamsi’ [Cha. Sa. Sutra Sthana 30/12] which indicates structures designated for conveyance of material inside body. <br /> &lt;br/&gt;Grossly defining, thirteen major types of srotas have been mentioned that transport substances undergoing biotransformation (parinamam aapadyamanam) from the place of origin to their destination. [Cha. Sa. Vimana Sthana 5/3] Similarly in physiological state, manovaha srotas might be responsible for processing and transformation of ‘doshayukta’ (irrational under influence of rajas and tamas) emotions and thoughts into unbiased reasoning before reaching a conclusion by our intellect (buddhi). &lt;/p&gt;<br /> <br /> ==Synonyms of manovaha srotas==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Following terms are used for ‘manovaha srotas’ in different Ayurveda classics : &lt;/p&gt;<br /> # Manovaha dhamani [Chakrapani on Cha. Sa. Indriya sthana 12/42] and [Vijayarakshita in Ma.Ni.Purva Khanda 20/1]<br /> # Chetanavaha srotas [Shivadas Sen on Cha.Sa. Chikitsa sthana 9/5] <br /> # Chetovaha marga [Bhel Samhita Nidana Sthana 7/2]<br /> # Manobuddhivaha sira [ Cha.Sa.Chikitsa Sthana 10/58]<br /> # Sanjnavaha srotas [Su.Sa.Uttar Tantra 61/8]<br /> # Sanjnavaha nadi [Su.Sa. Uttar Tantra 46/7]<br /> &lt;p style=&quot;text-align:justify;&quot;&gt; &lt;br/&gt;Use of terms like sira, nadi and dhamani, refers to different channels and pathways concerned with maintenance of physiological flow of information. [Cha.Sa. Vimana Sthana 5/8] &lt;/p&gt;<br /> <br /> ==Origin==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt; Every srotas is localized within the hollow space in the body originating from a root (mula) and spreading throughout the body to reach a final structure. Srotas are said to be hollow structures in different shapes and sizes The root (mula) is majorly responsible for regulation and control of functions of that srotas.<br /> &lt;br/&gt;The channels carrying mind (manovaha srotas) are not exclusively listed. It is however stated that the entire conscious body is abode of mind. Hence these channels are spread throughout the body. [Chakrapani on Cha.Sa. Indriya Sthana 5/41]. <br /> &lt;br/&gt;However, hridaya (heart) has a universal acceptance as the site of origin (mula) of manovaha srotas. Hence a special mention has been made about ten arteries of heart, probably being the manovaha srotas (visheshen tu hrudya ashritvat manah tadashrita dasha dhamanyo manovaha abhidhiyante) [Chakrapani on Cha.Sa. Indriya Sthana 5/41-42]. These get afflicted by vitiated dosha either all at once or individually. [Chakrapani on Cha.Sa. Indriya Sthana 12/42]<br /> &lt;/p&gt;<br /> <br /> ==Decoding hridaya (heart)==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt; The interpretation of the term ‘hridaya’ has been of confusion among scholars since decades. The first interpretation of the term given by texts of Shatpada Brahmana which highlighted functional aspect of hridaya. The word being composed of three letters viz ‘hri’ (hra harane)- to acquire; ‘Da’ (da dane) – to give; ‘Ya’ (Ya gatau)- which transports. The hridaya thus displays three phases of cardiac cycle i.e., receives, gives, and transports body constituents through it. [2]<br /> &lt;br/&gt;Hridaya is the site of rasa (plasma), sattva (psychic factor/mind), buddhi (intellect) and atma (soul) in conjugation with all sensory organs (jnanendriya).[Cha.Sa. Chikitsa Sthana 24/35] Sadhaka pitta situated in heart (hridaya) regulates proper functioning of intellect (buddhi) and ego (ahamkara). Hridaya is located in between breasts (stanayormadhya) of thoracic region [A. H. Sutra Sthana 12/13-14] [Su. Sa. Sharira Sthana 6/25]. <br /> &lt;br/&gt;Vedic era was well versed with heart (hridaya) and brain (mastishka) being two distinct entities, with interdependent functional relationship [Atharvaveda Book X. Hymn 2.26]. Kashyap Samhita quotes that all sense and motor organs (indriya) together with mind (manas) emerge from heart (hridaya) [Ka.Sa. Chikitsa Sthana 8/6]. Primary site of action of mind (manas) is brain (shira).[3] It can be concluded that mind (manas) being seated in heart (hridaya) connects to brain (shiras) through manovaha srotas and controls all senses (indriya). Also, any damage pertaining to marma (vital points) of shiras (head) causes loss of consciousness (cheshtanasha). [Cha.Sa. Sidhhi Sthana 9/6] Hence heart (hridaya) and brain (shirasor mastishka) are sites of manovaha srotasa. <br /> &lt;br/&gt; This approach of understanding hridaya goes well along with the contemporary view of understanding the triguna based psycho-functional principles of Ayurveda within the neural framework. Various research has been conducted which demonstrate that heart continuously sends nervous signals to brain to coordinate higher centres responsible for cognition and emotions. [1] The neuro- psychological as well as circulatory functions of hridaya mentioned in the classics can thus be explained. &lt;/p&gt; <br /> <br /> ==Relation between rasavaha and manovaha srotas==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Heart is the abode of mind (mana) and consciousness (chetana) or soul (atma). [Cha. Sa. Sidhhi Sthana 9/4] It is a site for physical, psychological, and spiritual components. Heart is origin for channels of transportation and transformation of rasa dhatu, too. Both heart and brain are considered under the umbrella term hridaya in terms of anatomical structure and higher-centre functions respectively. <br /> &lt;br/&gt;Heart (residence of manas) and brain (workplace of manas) are functionally co-dependent upon each other. Manas regulates the cognitive and conative functions of brain in conjunction with soul (atma) under the influence of vata dosha. [Cha. Sa. Sharira Sthana 1/22-23]. Brain is a structural entity needing continuous supply of nourishment and oxygen. This is feasible by heart through circulation (rasa-rakta samvahana kriya) via the ten major vessels (rasavahi dhamani). [A. H. Sharira Sthana 3/18] Heart is a highly vascular organ being surrounded by ten major dhamani (blood vessels) like spokes of a wheel which are known as ‘rasavaha strotomula’ (site of origin of channels of nutrition). These channels are comparable to manovaha srotas. [Chakrapani on Cha. Sa. Chikitsa Sthana 9/4] Manas thus acts like a medium between heart and brain wherein brain is responsible for all sensory and motor functions while heart has been assigned emotional aspect of psyche (manas).<br /> &lt;br/&gt;One of the factors for vitiation of rasavaha srotas is excessive thinking or worry (atichintan). [Cha. Sa. Vimana Sthana 5/13] Contemporary researchers have found evidence to support the interaction between circulatory system and psyche. The monograph of German professor Ludwig Braun is a pioneer in exploring the psychological and emotional aspect of cardiac diseases especially angina. He presented a correlation between cardiac diseases and ‘Angst’ (a constrictive, tightening and crushing sensation which manifests dread in the patient thereby changing his entire emotional outlook on life), analogous to anxiety. He explains that the cardiac tissue has a special apparatus receptive towards anxiety which manifests as an inner tactile sensation. That region is well supplied with nerve endings that gets irritated by anxiety. This phenomenon of emotional influence over cardiac tissues is termed as cardiac psyche. [4] <br /> &lt;/p&gt; <br /> <br /> ==Factors vitiating manovaha srotas==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt; Manovaha srotas are the prime site of abnormalities of channels in all psychological disorders. [Cha.Sa. Nidana Sthana 6/4] Alongside any of the eight factors that are either attributed to hridaya or manas viz. mana (mind), buddhi (intellect), sanjna-jnana (self-awareness), smriti (memory), bhakti (devotion), sheela (habits), cheshta (psychomotor activities) and achara (code of conduct). [Cha.Sa. Nidana Sthana 7/5] <br /> &lt;br/&gt;These factors when deranged cause vitiation of manas dosha (rajas and tamas), deterioration of sattva guna of manas and gradual derangement of tridosha. Foods, activities and excessive expression of emotions like anger, grief, lust, fear etc and mental traumas are the fundamental etiological factors for the same. [Cha.Sa. Nidana Sthana 7/4] Vitiated tridosha further vitiates rasavaha srotas, which apparently has the same site of origin as of manovaha srotas i.e., hridaya and dasha dhamani (ten great vessels). [Cha. Sa. Vimana Sthana 5/10] Hridaya is seat of manas [Cha.Sa. Sutra Sthana 30/4]. Hence, all the factors vitiating rasa dhatu (nutritive fluid), rasavaha srotas (channels carrying nutritive fluid) and manas dosha viz. rajas and tamas will affect manas and eventually vitiating manovaha srotas. Even the structural derangements of heart (abode of mind) affect manovaha srotas due to their ashrayashrayibhava (state of interdependency). [Cha.Sa. Chikitsa Sthana 9/5]&lt;/p&gt;<br /> <br /> ==Pathologies of manovaha srotas==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Manovaha srotas is important factor in understanding disorders like unmada (psychosis), apasmara (epilepsy) and extreme emotional reactions. &lt;/p&gt;<br /> <br /> *'''Unmada (psychosis)'''<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;When an individual experiences extreme emotions – lust (kama), anger (krodha), fear (bhaya), greed (lobha), happiness or pleasure (harsha), affection (moha), grief (shoka), excessive worry (chinta), they initially harm the intellect which aggravates manas dosha (rajas and tamas) and tridosha (vata, pitta and kapha). These vitiated dosha invade heart and obstruct manovaha srotas (channels transporting psychic impulses) thereby causing unmada. [Dalhan on Su. Sa. Uttar Tantra 62/3]<br /> *'''Apasmara (epilepsy)'''<br /> Overindulging in sensory pleasures, incompatible diet, withholding natural urges and giving into immoral activities under emotional influences (kama, krodha, lobha among others), vitiates rajas and tamas. They poorly influence the manas (mind) and sanjnavaha srotas (manovaha srotas) causing apasmara. [Su.Sa. Uttar Tantra 61/6]<br /> * Mada (intoxication), murchha (syncope), sanyasa (coma) are caused by vitiation of channels of consciousness (chetanavaha srotas or manovaha srotas). [Shivadas Sen on Cha. Sa. Chikitsa Sthana 9/5] <br /> *'''Atattvabhinivesha (perverted state of mind)'''<br /> Considered as mahagada (difficult to treat mental disorder), the person’s conscience gets afflicted by rajas and tamas, which cause complete derangement of intellect (buddhi vibhramsha) as the predominant symptom. The vitiated dosha get lodged in heart (hridaya) to afflict channels of mind and intellect (manobuddhivaha sira in manovaha srotas). [Cha.Sa. Chikitsa Sthana 10/57-60]<br /> * Physiology of nightmares (swapna)<br /> Nightmares are dreams occurring in REM phase of sleep which causes mental projections in the form of feelings of fear, despair, and anxiety. Ayurveda defines REM phase as ‘Natiprasupta’ - the state characterised to be midway between states of deep sleep and fully awake. During any ominous situation, tridosha in their highly aggravated state tend to fill-up the manovaha srotas. This results in terrifying dreams. [Cha.Sa. Indriya Sthana 5/41]. &lt;/p&gt;<br /> <br /> ==Assessment and diagnosis of disorders of manovaha srotas==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Srotas are micro-channels transporting various metabolites across cells throughout the body. It can be deduced that manovaha srotas has different characteristics structurally and functionally from the major thirteen srotas, because it transports and transforms thoughts and feelings. This is evident from objects of mind (manas), viz- thought (chintyam), consideration (vicharyam), hypothesis (uhyam), aims (dhyeyam) and determination (sankalpam). [Cha.Sa. Sharira Sthana 1/20]. Assessment of manovaha srotas can be done via assessment of manas and the degree of derangement of its functions. Ayurveda considers manas as material entity (dravya) which is a super sense and not perceivable by ordinary senses (atindriya) [Cha. Sa. Sutra Sthana 8/4]. Manas is under direct control of vata dosha [Cha. Sa. Sutra Sthana 12/8] and is the mediator between atma (soul) and indriyartha (objects of senses). <br /> &lt;br/&gt;The contemporary physiological aspects of mind, senses, brain, nervous system and consciousness can be considered for assessment of manovaha srotas. <br /> &lt;br/&gt; A thorough neurological examination by means of interrogation (prashna pariksha), inspection (darshana pariksha) and assessment of mental strength (sattva bala pariksha) [Cha.Sa. Vimana Sthana 8/119] can be used for assessment and diagnosis of disorders of manovaha srotas.&lt;/p&gt;<br /> <br /> ''' a. Interrogation (prashna pariksha)'''<br /> A formal interview of the patient can be conducted for overall and precise diagnosis. The questions related to chief complaints with duration, chronological development, nurturing of patient, family history, addiction, hobbies, interests, daily routine, major life events, achievements, mental traumas, emotional quotient and intellectual quotient is recorded from the patient. If the patient is not in state of giving correct answers, then the relatives or attendants who know patients history are interviewed. <br /> <br /> '''b. Darshan pariksha (Direct observation)'''<br /> While interviewing the patient, a physician should pay attention to following attributes that can signify features mentioned for certain psychiatric ailments (manovaha srotodushti)..<br /> <br /> # '''Appearance '''– Unusual dressing preferences, use of cosmetics, perfumes or accessories or flamboyant appearance. e.g;- ‘Priye tanu rakta vastradhari’ (liking for adorning clothes made of thin red fabric) is seen in yakshagraha unmada (Su.Sa. Uttara tantra 60/11)<br /> # '''Activity and co-ordination''' - Behaviour, Gait, gestures, patient’s facial expression and body language should be observed during probing them with questions. Eg;- 'Satatama akshano’ (rapid and constant eye movements) is one of the prodromal feature of apasmara (epilepsy) [ Cha.Sa. Nidana sthana 8/6]. Udhasta (patient keeps his hands raised) is a feature of pishacha grahavishta unmada [Su.Sa. Uttara Tantra 60/15]<br /> # '''Conversation style''' – Coherence of speech, articulation, emphasise over certain issue, hesitation and duration of response. E.g. ‘Chitram sa jalpati’ (Patient does irrelevant absurd talks) is seen in patients of manas unmada [Su.Sa. Uttara Tantra 62/13].<br /> #'''Emotional expression''' – Patients may express a wide range of emotions during interview with the physician. E.g. Asthana rodana (Sudden crying) is a feature in vataja unmada while amarsha (intolerance) is seen in patients of pittaja unmada. [Cha.Sa. Chikitsa Sthana 9/11-12] Fleeting ideas, incoherent speech is an important sign for lacking proper emotions. <br /> #'''Cognition''' – Orientation to person, place, time and circumstances, level of intellect, level of understanding, common sense and memory can be identified under the domain of cognition by observing patient’s behaviour as well as by asking questions to them using validated scientific questionnaires. Short term memory and long-term memory shall be assessed properly. <br /> &lt;br/&gt;All observations gathered from every method of assessment should be simultaneously analysed to reach the diagnosis.<br /> <br /> '''c. Sattva pariksha (assessment of quality of excellence of mind)'''<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Sattva pariksha assesses the quality of excellence of mind imparted by extent of dominance of sattva guna. Mind (manas) is composed of three attributes (triguna) viz. sattva, rajas and tamas. These impart three types of mental constitutions – Shuddha (pure) (sattvika), rajasika and tamasika. [Cha.Sa. Sharira Sthana 4/36]. Sattvika guna is full of auspiciousness and is considered the healthy (amala) state of mind. Rajasika guna imparts momentum in terms of furious temperament. Whereas tamas guna promotes inertia and moral ignorance. Hence, rajas and tamas are considered inauspicious and called manas dosha. Triguna are present in dynamically varying proportions at any given time and influenced by body (i.e. tridosha) and vice versa. [Chakrapani on Cha.Sa. Vimana Sthana 4/8]. Optimum levels of sattva guna are essential for promoting desired physical and mental strength irrespective of morphological features. [Cha.Sa. Vimana Sthana 8/119]&lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Sattva bala (strength of psyche) is of three types as per strength – pravara (superior), madhyama (moderate) and avara (poor). Pravara sattva persons possess great courage. Despite poor morphological features they seem to be unmoved in the face of adversities. Madhyama sattva persons need some additional moral support to sustain themselves in times of distress. While avara sattva displays catastrophic reactions even during little inconveniences and can neither be sustained by themselves nor by others despite having good quality morphological features. Avara sattva is constantly plagued by inferior emotions like grief, fear, greed, conceit and confusion. When confronted with fierce, ugly, disgusting narratives or flesh and blood, they are prone to become depressed, pale, unconscious or semiconscious, giddy, anxious and can even succumb to death in worst case scenarios. [Cha. Sa. Vimana Sthana 8/119].<br /> &lt;br/&gt;Manovaha srotas associated with avara sattva bala is most likely to be vitiated by manas dosha leading to various psychiatric and psychosomatic disorders [Cha.Sa. Chikitsa Sthana 9/5]. It has been observed that avara sattva individuals are more likely to commit prajnaparadha (intellectual defects) [10] thereby voluntarily indulging in various etiological factors for respective psychological as well as somatic disorders.<br /> &lt;br?&gt;Thus, assessment of sattva bala can help rule out the predisposition towards manovaha srotodushti and subsequent development of symptoms of psychiatric ailments.&lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;'''d. Anumana pariksha (knowledge by inference)''' to determine normalcy of faculties of manas (mind) [Cha.Sa. Vimana Sthana 4/8] Since manas is atindriya ( supersence or imperceivable by ordinary senses), so are it’s faculties which can serve as potential markers for assessment of its functions. [10] The proper functioning of manas itself is inferred by altered or inappropriate mental perceptions even in presence of appropriately functioning indriya (senses) and their respective sense objects whereas the mental faculties can be inferred as follows:-&lt;/p&gt;<br /> {| class=&quot;wikitable&quot;<br /> |'''Faculty''' <br /> |'''object for inference''' <br /> |-<br /> |Vijnanam (expertise/skills )<br /> |Vyavsayena (occupation )<br /> |-<br /> |Dhairyam (fortitude)<br /> |avishadena (courage in face of adversity)<br /> |-<br /> |Viryam (bravery)<br /> |Uthhanena (initiating difficult tasks and enduring them)<br /> |-<br /> |Avasthanama (stability)<br /> |Avibhramana (absence of confusion)<br /> |-<br /> |Shradhha (faith)<br /> |Abhiprayena (purposiveness)<br /> |-<br /> |Medha (intellect)<br /> |Grahanena (grasping power)<br /> |-<br /> |Sanjna (recognition or consciousness level)<br /> |Namagrahanena (ability to recognise or name things)<br /> |-<br /> |Smriti (memory)<br /> |Smaranena (ability to recollect things)<br /> |-<br /> |Dhriti (self restraint)<br /> |Alaulyama (not being carried away by own greed)<br /> |-<br /> |Amala sattva (purity of mind)<br /> |Avikara (free of delusions or illusionary attachments)<br /> |}<br /> This inferential knowledge can help an individual become self-aware of his own psyche (sattva). A self-aware individual has an upper hand at avoiding mental illness because these often go unnoticed until they develop some organic manifestations.<br /> &lt;br /&gt;Thus, by means of above discussed assessment methodologies, a physician can assess the degree of derangement in mental faculties and hence the manovaha srotas, irrespective of development of specific signs and symptoms of any psychiatric disorder (vyadhi lakshana).<br /> <br /> ==Treatment Guidelines==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Manovaha srotas disorders follow the line of treatment same as described for disorders of manas (mind). Following are therapeutic and preventive practices beneficial for both vitiated manovaha srotas (channels of psyche) and manas obscured by rajas - tamas dosha.&lt;/p&gt;<br /> Manas dosha can be alleviated through a comprehensive five-fold psychotherapeutic regimen - jnana (spiritual knowledge or self-awareness), vijnana (scriptural or scientific knowledge), dhairya (mental fortitude), smriti (recollection of past successes to regain faith in own abilities) and samadhi (spiritual healing practices to focus mind inwards away from negative external stimuli). [Cha.Sa. Sutra Sthana 1/58]<br /> Restoration of dhi (intellect), dhairya (mental fortitude) and atmadi vijnana (knowledge of self-consciousness) has therapeutic effect in alleviating disorders of manovaha srotas obstructed by manas dosha.<br /> <br /> '''*Sattvavajaya chikitsa (treatment to regulate mind)'''<br /> Sattvavajaya chikitsa is a non-invasive therapeutic module for psychological derangements and psychosomatic ailments, analogous to contemporary psychotherapy. ‘Sattva’ stands for mind and ‘avajaya’ translates to win over. Hence, it emphasizes withdrawing the mind from unwholesome objects of senses (factors vitiating rajas and tamas) and diverting it to positive sensory and emotional stimuli. Thereby consciously negating disturbed emotions and behavioural patterns. [Cha.Sa. Sutra Sthana 11/54]<br /> <br /> '''*Ashtanga yoga (eight steps of yoga)'''<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Ashtanga yoga can be considered as one of the dimensions of satvavajaya chikitsa. It integrates eight steps of yoga to tame mind from traversing paths in life which are spiritually and mentally harmful for that individual. Of the eight steps, first four viz. yama (principles for moral code), niyama (observances for personal discipline), asana (yogic postures) and pranayama (regulating breath) are termed as bahiranga yoga (external path). These practices gradually alleviate aggravated manas dosha, making the mind less reactive towards external stimuli. The last three limbs viz. dharana (concentration), dhyana (meditation) and samadhi (enlightenment or complete realisation) are termed as antaranga yoga (internal paths). These practices transform the mind, eliminating the fluctuations of mind, thereby strengthening positive habits and outlook on life as well as inner self. Ashtanga yoga maintains a harmonious balance between inner environment (mind and spirit) and external environment (objects of sensory perception). Mind thus gets liberated from worldly pursuits and all psychological sufferings in a stepwise manner.&lt;/p&gt;<br /> '''*Achara rasayana (rejuvenating codes of behavioural conduct)'''<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Achara rasayana is an adravyabhuta (non-pharmacological) rasayana (practices rejuvenating physical and mental health). It includes behavioural conducts which aim to enhance health and longevity by teaching practical methods to potentiate sattva guna of mind. [Cha.Sa. Chikitsa Sthana 1, 4th pada, shloka 30-35] An individual can imbibe easy lifestyle modifications to develop a positive and strong character of mind, thereby avoiding potential etiological factors (for dosha aggravation) and negative psychosocial patterns. Achara rasayana can be divided into five domains of good mental, social, personal, moral and religious conduct. [6]&lt;/p&gt;<br /> '''*Sadvritta (good codes of conduct)'''<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Sadvritta refers to good code of conduct. These are a set of practices, which serve as lifestyle guidelines to prevent mind from falling prey to temporary material pleasures and impulsive thoughts and actions that cause impairment of manas dosha and manovaha srotas. It encompasses guidelines over personal hygiene, personality development as well as for social hygiene and peaceful social interactions. [Cha.Sa. Sutra Sthana 8/18]&lt;/p&gt;<br /> Both achara rasayana and sadvritta help to maintain control over sense organs. They majorly add to the preventive and promotive aspect of mental health. <br /> '''*Medhya dravya (medicines enhancing intellectual functions)'''<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Medhya dravyas are the plant based pharmacological agents that promote prajna i.e., dhi (intellect), dhriti (perseverance) and smriti (memory). Researches conducted prove their efficacy in minimizing the cognitive decline among individuals with neural abnormalities. For example, ushna (hot potency) and tikshna nature drugs like jyotishmati and vacha are said to remove blockages caused by kapha, ama or tamas dosha in the manovaha srotas. Once purified, manas can regain unvitiated connect with indriya via manovaha srotas. [8] <br /> &lt;br/&gt;Ayurveda thus provides a bird’s eye view over different aspects of manovaha srotas through interconnected references in the classics highlighting its physiological importance like the other thirteen major srotas systems in the human body.&lt;/p&gt;<br /> <br /> ==Contemporary view==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Mind as per contemporary literature is debatable concept because in some contexts it is identified as conscience, while in others it is seen as the function of conscience. The philosophical dimension of mind was conceived by Plato who considered mind as an inner (soul’s) experience. [11]<br /> &lt;br/&gt;The western system of medicine addresses brain at the core of majority of psychological distresses, whereas western philosophy involves the concept of psyche (which denotes mind). ‘Psyche’ is a Greek word meaning ‘soul in a living man’. <br /> &lt;br/&gt;William James, referred to as the father of American Psychology, laid the foundations of physiological aspect of mind. To him mind was a function of brain which conducts mental life in the form of a constant stream of consciousness.[9] At some places he too admitted mind to bear consciousness and tried to assign attributes to consciousness as a separate psychological function thus formulating the Theory of Functionalism which established causal relationship between internal states (perception) and external reactions or behaviour (sensation). He concluded that repeated actions cause adaptive changes in nervous system. This is the fundamental ideology behind the concept of Neuroplasticity – i.e. adaptive structural and functional changes in brain by development of new neuronal pathways due to intrinsic or extrinsic stimuli. [12]<br /> &lt;br/&gt;James’ counterpart Titchener, an English Psychologist, proposed that consciousness is mind’s awareness of its own functions. Consciousness is something superior to mind itself. He formulated the Theory of Structuralism which aimed at analysing the interrelationship between mental experiences, feelings, and sensations. He used introspection as a tool to break down these complex phenomena of consciousness down to their basic elements without breaking their original structure. <br /> &lt;br/&gt;Mind is hence regarded as the cumulative effect of all mental processes that have occurred in the lifetime while the consciousness can be understood as the cumulative effect of all mental processes occurring in present moment. Eventually brain was somehow regarded to control the neural activity responsible for accumulating all this sensory data.<br /> &lt;br/&gt;Many theories were formulated and overruled by their successors with time. Today the concept of mind and consciousness remains yet to be clearly defined. It is observed that mind is often identified as consciousness and they both are accepted as individual closely linked entities. Mind bears synonymity towards consciousness, spirit, and psyche. Some theories view both mind and consciousness as spirit. But mind is invariably understood as the interaction between psychological personality and the external environment, i.e., a subject – object relationship.<br /> &lt;br/&gt;The neurophysiological basis of minds and the channels of transport of its constituents is yet a challenge in field of neuroscience. In order to bridge this gap, contemporary scientists hypothesise that mental representations and their contents are represented by neural network and their supporting cells thus hinting towards Central Nervous System and it’s peripheral nerves as the channels of mind. [13]&lt;/p&gt; <br /> <br /> ==Research works on manovaha srotas==<br /> Various review articles have been published and researches been carried out in the domain of Ayurveda to understand the conceptual as well as pathophysiological aspect of manovaha srotas. Few of them are as follows :-<br /> '''1. Critical Review of Concept of manovaha Srotas with special reference to Brain'''<br /> This review article conceptualizes the contemporary understanding of manovaha srotas in context to CNS due to functional similarity between manas and brain obtained after an extensive research and analysis throughout ayurveda treatises. Further brain was considered as synonymous to hridya ie. mulasthana (site of origin) of manovaha srotas and ‘dasha dhamani’ as the cranial nerves exiting from the 10 major foramen at base of skull. Sanskrit literature considers hridaya as regarded as a central organ similar to brain. 14<br /> <br /> ===2. Circumstantial view on clinical knowing of manovaha srotasa &amp; its physiology===<br /> The review article reconstructs a comprehensive picture of manovaha srotas from the scattered references available in Ayurveda texts, supplementing it with additional information from contemporary science as follows-<br /> *A detailed description of neuroanatomy and physiology has been drawn parallel to Ayurveda point of view about manas’ rachna and kriya sharir. <br /> *Effect of Triguna and tridosha (especially vata) in context of physiological functions and disorders of manas and manovaha srotas have been discussed.<br /> *Correlations between functions of five subtypes of vata and both CNS and ANS has been attempted <br /> *Pariksha krama (examination of nervous system) has been exemplified taking into consideration both Ayurveda and modern methodologies that can be employed for manovaha srotas (nervous system) examination.10 <br /> ===Concept of stress factor assessment concerning ‘perseverance test’ in light of ayurveda” – a review=== <br /> This article highlights the importance of understanding the etiological factors of vitiation of manovaha srotas and manas in all kinds of psychiatric as well as psychosomatic disorders. Imbalance of manas dosha can be treated by means of yoga, meditation and pranayama. Often emotional disturbances remain unattended in diagnosed cases of psychiatric illness which can be managed at home by incorporating wholesome diet (pathya ahara) and moral code of conduct (sadvrutta) in daily routine. Lack of peace and chronic stressors have been observed as major causes of vitiation of channels of mind. 15<br /> <br /> <br /> &lt;big&gt;'''[[Special:ContactMe|Send us your suggestions and feedback on this page.]]'''&lt;/big&gt;<br /> <br /> ==References==<br /> <br /> &lt;div id=&quot;BackToTop&quot; class=&quot;noprint&quot; style=&quot;background-color:#DDEFDD; position:fixed;<br /> bottom:32px; left:2%; z-index:9999; padding:0; margin:0;&quot;&gt;&lt;span style=&quot;color:blue;<br /> font-size:8pt; font-face:verdana,sans-serif; border:0.2em outset #ceebf7;<br /> padding:0.1em; font-weight:bolder; -moz-border-radius:8px; &quot;&gt;<br /> [[#top| Back to the Top ]]&lt;/span&gt;&lt;/div&gt;</div>

Manishdubey https://www.carakasamhitaonline.com/index.php?title=Talk:Manovaha_srotas&diff=44195 2023-10-16T10:45:23Z

<p>Manishdubey: </p> <hr /> <div>{{CiteButton}}<br /> {{#seo:<br /> |title= Manovaha srotas<br /> (Channels of transport and transformation of mind and mental factors)<br /> |titlemode=append<br /> |keywords= Manovaha srotas,Hrudya, Sattva pariksha, Sattvavajaya chikitsa, Bhojani M. K.,Deole Y.S., Basisht G<br /> |description=Mana means mind, or psyche. Srotas means channels of transport and transformation. The description and understanding of channels for activities of mind (manovaha srotas) is scattered in ayurveda classics and has not been completely elucidated. Manovaha srotas are considered as channels through which mind and body interact with each other. <br /> |image=http://www.carakasamhitaonline.com/mediawiki-1.32.1/resources/assets/ogimgs.jpg<br /> |image_alt=carak samhita<br /> |type=article<br /> }}<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Mana means mind, or psyche. Srotas means channels of transport and transformation. The description and understanding of channels for activities of mind (manovaha srotas) is scattered in ayurveda classics and has not been completely elucidated. Manovaha srotas are considered as channels through which mind and body interact with each other. These channels pervade throughout the body. [Chakrapani on Cha.Sa. Indriya Sthana 5/41-42] They are responsible for flow of thoughts, emotions, and other psychological functions. This article deals with various aspects of manovaha srotasa i.e. the channels of activities of mind and its development.&lt;/p&gt;<br /> <br /> {{Infobox<br /> |title = Contributors<br /> |label1 = Section/Chapter/topic<br /> |data1 = Concepts/[[Srotas]]/[[Manovaha Srotas]] <br /> |label2 = Authors<br /> |data2 = Bhojani M. K.&lt;sup&gt;1&lt;/sup&gt; Varma Swati &lt;sup&gt;1&lt;/sup&gt; Deole Y.S.&lt;sup&gt;2&lt;/sup&gt;<br /> |label3 = Reviewer &amp; Editor<br /> |data3 = Basisht G.&lt;sup&gt;3&lt;/sup&gt;, <br /> |label4 = Affiliations<br /> |data4 = &lt;sup&gt;1&lt;/sup&gt; Department of Sharir Kriya, All India Institute of Ayurveda, New Delhi, India<br /> &lt;sup&gt;2&lt;/sup&gt; Department of Kayachikitsa, G. J. Patel Institute of Ayurvedic Studies and Research, New Vallabh Vidyanagar, Gujarat, India <br /> &lt;sup&gt;3&lt;/sup&gt; Rheumatologist, Orlando, Florida, U.S.A.<br /> |label5 = Correspondence emails<br /> |data5 = meera.samhita@aiia.gov.in, carakasamhita@gmail.com<br /> |label6 = Publisher <br /> |data6 = [[Charak Samhita Research, Training and Development Centre]], I.T.R.A., Jamnagar, India<br /> |label7 = Date of publication:<br /> |data7 =October 12, 2023<br /> |label8 = DOI<br /> |data8 = In process<br /> }}<br /> <br /> ==Etymology and derivation:==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Srotas originates from Sanskrit root ‘Sru’ that translates to oozing, flow or secretion. It has been defined as ‘sravanat strotamsi’ [Cha. Sa. Sutra Sthana 30/12] which indicates structures designated for conveyance of material inside body. <br /> &lt;br/&gt;Grossly defining, thirteen major types of srotas have been mentioned that transport substances undergoing biotransformation (parinamam aapadyamanam) from the place of origin to their destination. [Cha. Sa. Vimana Sthana 5/3] Similarly in physiological state, manovaha srotas might be responsible for processing and transformation of ‘doshayukta’ (irrational under influence of rajas and tamas) emotions and thoughts into unbiased reasoning before reaching a conclusion by our intellect (buddhi). &lt;/p&gt;<br /> <br /> ==Synonyms of manovaha srotas==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Following terms are used for ‘manovaha srotas’ in different Ayurveda classics : &lt;/p&gt;<br /> # Manovaha dhamani [Chakrapani on Cha. Sa. Indriya sthana 12/42] and [Vijayarakshita in Ma.Ni.Purva Khanda 20/1]<br /> # Chetanavaha srotas [Shivadas Sen on Cha.Sa. Chikitsa sthana 9/5] <br /> # Chetovaha marga [Bhel Samhita Nidana Sthana 7/2]<br /> # Manobuddhivaha sira [ Cha.Sa.Chikitsa Sthana 10/58]<br /> # Sanjnavaha srotas [Su.Sa.Uttar Tantra 61/8]<br /> # Sanjnavaha nadi [Su.Sa. Uttar Tantra 46/7]<br /> &lt;p style=&quot;text-align:justify;&quot;&gt; &lt;br/&gt;Use of terms like sira, nadi and dhamani, refers to different channels and pathways concerned with maintenance of physiological flow of information. [Cha.Sa. Vimana Sthana 5/8] &lt;/p&gt;<br /> <br /> ==Origin==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt; Every srotas is localized within the hollow space in the body originating from a root (mula) and spreading throughout the body to reach a final structure. Srotas are said to be hollow structures in different shapes and sizes The root (mula) is majorly responsible for regulation and control of functions of that srotas.<br /> &lt;br/&gt;The channels carrying mind (manovaha srotas) are not exclusively listed. It is however stated that the entire conscious body is abode of mind. Hence these channels are spread throughout the body. [Chakrapani on Cha.Sa. Indriya Sthana 5/41]. <br /> &lt;br/&gt;However, hridaya (heart) has a universal acceptance as the site of origin (mula) of manovaha srotas. Hence a special mention has been made about ten arteries of heart, probably being the manovaha srotas (visheshen tu hrudya ashritvat manah tadashrita dasha dhamanyo manovaha abhidhiyante) [Chakrapani on Cha.Sa. Indriya Sthana 5/41-42]. These get afflicted by vitiated dosha either all at once or individually. [Chakrapani on Cha.Sa. Indriya Sthana 12/42]<br /> &lt;/p&gt;<br /> <br /> ==Decoding hridaya (heart)==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt; The interpretation of the term ‘hridaya’ has been of confusion among scholars since decades. The first interpretation of the term given by texts of Shatpada Brahmana which highlighted functional aspect of hridaya. The word being composed of three letters viz ‘hri’ (hra harane)- to acquire; ‘Da’ (da dane) – to give; ‘Ya’ (Ya gatau)- which transports. The hridaya thus displays three phases of cardiac cycle i.e., receives, gives, and transports body constituents through it. [2]<br /> &lt;br/&gt;Hridaya is the site of rasa (plasma), sattva (psychic factor/mind), buddhi (intellect) and atma (soul) in conjugation with all sensory organs (jnanendriya).[Cha.Sa. Chikitsa Sthana 24/35] Sadhaka pitta situated in heart (hridaya) regulates proper functioning of intellect (buddhi) and ego (ahamkara). Hridaya is located in between breasts (stanayormadhya) of thoracic region [A. H. Sutra Sthana 12/13-14] [Su. Sa. Sharira Sthana 6/25]. <br /> &lt;br/&gt;Vedic era was well versed with heart (hridaya) and brain (mastishka) being two distinct entities, with interdependent functional relationship [Atharvaveda Book X. Hymn 2.26]. Kashyap Samhita quotes that all sense and motor organs (indriya) together with mind (manas) emerge from heart (hridaya) [Ka.Sa. Chikitsa Sthana 8/6]. Primary site of action of mind (manas) is brain (shira).[3] It can be concluded that mind (manas) being seated in heart (hridaya) connects to brain (shiras) through manovaha srotas and controls all senses (indriya). Also, any damage pertaining to marma (vital points) of shiras (head) causes loss of consciousness (cheshtanasha). [Cha.Sa. Sidhhi Sthana 9/6] Hence heart (hridaya) and brain (shirasor mastishka) are sites of manovaha srotasa. <br /> &lt;br/&gt; This approach of understanding hridaya goes well along with the contemporary view of understanding the triguna based psycho-functional principles of Ayurveda within the neural framework. Various research has been conducted which demonstrate that heart continuously sends nervous signals to brain to coordinate higher centres responsible for cognition and emotions. [1] The neuro- psychological as well as circulatory functions of hridaya mentioned in the classics can thus be explained. &lt;/p&gt; <br /> <br /> ==Relation between rasavaha and manovaha srotas==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Heart is the abode of mind (mana) and consciousness (chetana) or soul (atma). [Cha. Sa. Sidhhi Sthana 9/4] It is a site for physical, psychological, and spiritual components. Heart is origin for channels of transportation and transformation of rasa dhatu, too. Both heart and brain are considered under the umbrella term hridaya in terms of anatomical structure and higher-centre functions respectively. <br /> &lt;br/&gt;Heart (residence of manas) and brain (workplace of manas) are functionally co-dependent upon each other. Manas regulates the cognitive and conative functions of brain in conjunction with soul (atma) under the influence of vata dosha. [Cha. Sa. Sharira Sthana 1/22-23]. Brain is a structural entity needing continuous supply of nourishment and oxygen. This is feasible by heart through circulation (rasa-rakta samvahana kriya) via the ten major vessels (rasavahi dhamani). [A. H. Sharira Sthana 3/18] Heart is a highly vascular organ being surrounded by ten major dhamani (blood vessels) like spokes of a wheel which are known as ‘rasavaha strotomula’ (site of origin of channels of nutrition). These channels are comparable to manovaha srotas. [Chakrapani on Cha. Sa. Chikitsa Sthana 9/4] Manas thus acts like a medium between heart and brain wherein brain is responsible for all sensory and motor functions while heart has been assigned emotional aspect of psyche (manas).<br /> &lt;br/&gt;One of the factors for vitiation of rasavaha srotas is excessive thinking or worry (atichintan). [Cha. Sa. Vimana Sthana 5/13] Contemporary researchers have found evidence to support the interaction between circulatory system and psyche. The monograph of German professor Ludwig Braun is a pioneer in exploring the psychological and emotional aspect of cardiac diseases especially angina. He presented a correlation between cardiac diseases and ‘Angst’ (a constrictive, tightening and crushing sensation which manifests dread in the patient thereby changing his entire emotional outlook on life), analogous to anxiety. He explains that the cardiac tissue has a special apparatus receptive towards anxiety which manifests as an inner tactile sensation. That region is well supplied with nerve endings that gets irritated by anxiety. This phenomenon of emotional influence over cardiac tissues is termed as cardiac psyche. [4] <br /> &lt;/p&gt; <br /> <br /> ==Factors vitiating manovaha srotas==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt; Manovaha srotas are the prime site of abnormalities of channels in all psychological disorders. [Cha.Sa. Nidana Sthana 6/4] Alongside any of the eight factors that are either attributed to hridaya or manas viz. mana (mind), buddhi (intellect), sanjna-jnana (self-awareness), smriti (memory), bhakti (devotion), sheela (habits), cheshta (psychomotor activities) and achara (code of conduct). [Cha.Sa. Nidana Sthana 7/5] <br /> &lt;br/&gt;These factors when deranged cause vitiation of manas dosha (rajas and tamas), deterioration of sattva guna of manas and gradual derangement of tridosha. Foods, activities and excessive expression of emotions like anger, grief, lust, fear etc and mental traumas are the fundamental etiological factors for the same. [Cha.Sa. Nidana Sthana 7/4] Vitiated tridosha further vitiates rasavaha srotas, which apparently has the same site of origin as of manovaha srotas i.e., hridaya and dasha dhamani (ten great vessels). [Cha. Sa. Vimana Sthana 5/10] Hridaya is seat of manas [Cha.Sa. Sutra Sthana 30/4]. Hence, all the factors vitiating rasa dhatu (nutritive fluid), rasavaha srotas (channels carrying nutritive fluid) and manas dosha viz. rajas and tamas will affect manas and eventually vitiating manovaha srotas. Even the structural derangements of heart (abode of mind) affect manovaha srotas due to their ashrayashrayibhava (state of interdependency). [Cha.Sa. Chikitsa Sthana 9/5]&lt;/p&gt;<br /> <br /> ==Pathologies of manovaha srotas==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Manovaha srotas is important factor in understanding disorders like unmada (psychosis), apasmara (epilepsy) and extreme emotional reactions. &lt;/p&gt;<br /> <br /> *'''Unmada (psychosis)'''<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;When an individual experiences extreme emotions – lust (kama), anger (krodha), fear (bhaya), greed (lobha), happiness or pleasure (harsha), affection (moha), grief (shoka), excessive worry (chinta), they initially harm the intellect which aggravates manas dosha (rajas and tamas) and tridosha (vata, pitta and kapha). These vitiated dosha invade heart and obstruct manovaha srotas (channels transporting psychic impulses) thereby causing unmada. [Dalhan on Su. Sa. Uttar Tantra 62/3]<br /> *'''Apasmara (epilepsy)'''<br /> Overindulging in sensory pleasures, incompatible diet, withholding natural urges and giving into immoral activities under emotional influences (kama, krodha, lobha among others), vitiates rajas and tamas. They poorly influence the manas (mind) and sanjnavaha srotas (manovaha srotas) causing apasmara. [Su.Sa. Uttar Tantra 61/6]<br /> * Mada (intoxication), murchha (syncope), sanyasa (coma) are caused by vitiation of channels of consciousness (chetanavaha srotas or manovaha srotas). [Shivadas Sen on Cha. Sa. Chikitsa Sthana 9/5] <br /> *'''Atattvabhinivesha (perverted state of mind)'''<br /> Considered as mahagada (difficult to treat mental disorder), the person’s conscience gets afflicted by rajas and tamas, which cause complete derangement of intellect (buddhi vibhramsha) as the predominant symptom. The vitiated dosha get lodged in heart (hridaya) to afflict channels of mind and intellect (manobuddhivaha sira in manovaha srotas). [Cha.Sa. Chikitsa Sthana 10/57-60]<br /> * Physiology of nightmares (swapna)<br /> Nightmares are dreams occurring in REM phase of sleep which causes mental projections in the form of feelings of fear, despair, and anxiety. Ayurveda defines REM phase as ‘Natiprasupta’ - the state characterised to be midway between states of deep sleep and fully awake. During any ominous situation, tridosha in their highly aggravated state tend to fill-up the manovaha srotas. This results in terrifying dreams. [Cha.Sa. Indriya Sthana 5/41]. &lt;/p&gt;<br /> <br /> ==Assessment and diagnosis of disorders of manovaha srotas==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Srotas are micro-channels transporting various metabolites across cells throughout the body. It can be deduced that manovaha srotas has different characteristics structurally and functionally from the major thirteen srotas, because it transports and transforms thoughts and feelings. This is evident from objects of mind (manas), viz- thought (chintyam), consideration (vicharyam), hypothesis (uhyam), aims (dhyeyam) and determination (sankalpam). [Cha.Sa. Sharira Sthana 1/20]. Assessment of manovaha srotas can be done via assessment of manas and the degree of derangement of its functions. Ayurveda considers manas as material entity (dravya) which is a super sense and not perceivable by ordinary senses (atindriya) [Cha. Sa. Sutra Sthana 8/4]. Manas is under direct control of vata dosha [Cha. Sa. Sutra Sthana 12/8] and is the mediator between atma (soul) and indriyartha (objects of senses). <br /> &lt;br/&gt;The contemporary physiological aspects of mind, senses, brain, nervous system and consciousness can be considered for assessment of manovaha srotas. <br /> &lt;br/&gt; A thorough neurological examination by means of interrogation (prashna pariksha), inspection (darshana pariksha) and assessment of mental strength (sattva bala pariksha) [Cha.Sa. Vimana Sthana 8/119] can be used for assessment and diagnosis of disorders of manovaha srotas.&lt;/p&gt;<br /> <br /> ''' a. Interrogation (prashna pariksha)'''<br /> A formal interview of the patient can be conducted for overall and precise diagnosis. The questions related to chief complaints with duration, chronological development, nurturing of patient, family history, addiction, hobbies, interests, daily routine, major life events, achievements, mental traumas, emotional quotient and intellectual quotient is recorded from the patient. If the patient is not in state of giving correct answers, then the relatives or attendants who know patients history are interviewed. <br /> <br /> '''b. Darshan pariksha (Direct observation)'''<br /> While interviewing the patient, a physician should pay attention to following attributes that can signify features mentioned for certain psychiatric ailments (manovaha srotodushti)..<br /> <br /> # '''Appearance '''– Unusual dressing preferences, use of cosmetics, perfumes or accessories or flamboyant appearance. e.g;- ‘Priye tanu rakta vastradhari’ (liking for adorning clothes made of thin red fabric) is seen in yakshagraha unmada (Su.Sa. Uttara tantra 60/11)<br /> # '''Activity and co-ordination''' - Behaviour, Gait, gestures, patient’s facial expression and body language should be observed during probing them with questions. Eg;- 'Satatama akshano’ (rapid and constant eye movements) is one of the prodromal feature of apasmara (epilepsy) [ Cha.Sa. Nidana sthana 8/6]. Udhasta (patient keeps his hands raised) is a feature of pishacha grahavishta unmada [Su.Sa. Uttara Tantra 60/15]<br /> # '''Conversation style''' – Coherence of speech, articulation, emphasise over certain issue, hesitation and duration of response. E.g. ‘Chitram sa jalpati’ (Patient does irrelevant absurd talks) is seen in patients of manas unmada [Su.Sa. Uttara Tantra 62/13].<br /> #'''Emotional expression''' – Patients may express a wide range of emotions during interview with the physician. E.g. Asthana rodana (Sudden crying) is a feature in vataja unmada while amarsha (intolerance) is seen in patients of pittaja unmada. [Cha.Sa. Chikitsa Sthana 9/11-12] Fleeting ideas, incoherent speech is an important sign for lacking proper emotions. <br /> #'''Cognition''' – Orientation to person, place, time and circumstances, level of intellect, level of understanding, common sense and memory can be identified under the domain of cognition by observing patient’s behaviour as well as by asking questions to them using validated scientific questionnaires. Short term memory and long-term memory shall be assessed properly. <br /> &lt;br/&gt;All observations gathered from every method of assessment should be simultaneously analysed to reach the diagnosis.<br /> <br /> '''c. Sattva pariksha (assessment of quality of excellence of mind)'''<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Sattva pariksha assesses the quality of excellence of mind imparted by extent of dominance of sattva guna. Mind (manas) is composed of three attributes (triguna) viz. sattva, rajas and tamas. These impart three types of mental constitutions – Shuddha (pure) (sattvika), rajasika and tamasika. [Cha.Sa. Sharira Sthana 4/36]. Sattvika guna is full of auspiciousness and is considered the healthy (amala) state of mind. Rajasika guna imparts momentum in terms of furious temperament. Whereas tamas guna promotes inertia and moral ignorance. Hence, rajas and tamas are considered inauspicious and called manas dosha. Triguna are present in dynamically varying proportions at any given time and influenced by body (i.e. tridosha) and vice versa. [Chakrapani on Cha.Sa. Vimana Sthana 4/8]. Optimum levels of sattva guna are essential for promoting desired physical and mental strength irrespective of morphological features. [Cha.Sa. Vimana Sthana 8/119]&lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Sattva bala (strength of psyche) is of three types as per strength – pravara (superior), madhyama (moderate) and avara (poor). Pravara sattva persons possess great courage. Despite poor morphological features they seem to be unmoved in the face of adversities. Madhyama sattva persons need some additional moral support to sustain themselves in times of distress. While avara sattva displays catastrophic reactions even during little inconveniences and can neither be sustained by themselves nor by others despite having good quality morphological features. Avara sattva is constantly plagued by inferior emotions like grief, fear, greed, conceit and confusion. When confronted with fierce, ugly, disgusting narratives or flesh and blood, they are prone to become depressed, pale, unconscious or semiconscious, giddy, anxious and can even succumb to death in worst case scenarios. [Cha. Sa. Vimana Sthana 8/119].<br /> &lt;br/&gt;Manovaha srotas associated with avara sattva bala is most likely to be vitiated by manas dosha leading to various psychiatric and psychosomatic disorders [Cha.Sa. Chikitsa Sthana 9/5]. It has been observed that avara sattva individuals are more likely to commit prajnaparadha (intellectual defects) [10] thereby voluntarily indulging in various etiological factors for respective psychological as well as somatic disorders.<br /> &lt;br?&gt;Thus, assessment of sattva bala can help rule out the predisposition towards manovaha srotodushti and subsequent development of symptoms of psychiatric ailments.&lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;'''d. Anumana pariksha (knowledge by inference)''' to determine normalcy of faculties of manas (mind) [Cha.Sa. Vimana Sthana 4/8] Since manas is atindriya ( supersence or imperceivable by ordinary senses), so are it’s faculties which can serve as potential markers for assessment of its functions. [10] The proper functioning of manas itself is inferred by altered or inappropriate mental perceptions even in presence of appropriately functioning indriya (senses) and their respective sense objects whereas the mental faculties can be inferred as follows:-&lt;/p&gt;<br /> {| class=&quot;wikitable&quot;<br /> |'''Faculty''' <br /> |'''object for inference''' <br /> |-<br /> |Vijnanam (expertise/skills )<br /> |Vyavsayena (occupation )<br /> |-<br /> |Dhairyam (fortitude)<br /> |avishadena (courage in face of adversity)<br /> |-<br /> |Viryam (bravery)<br /> |Uthhanena (initiating difficult tasks and enduring them)<br /> |-<br /> |Avasthanama (stability)<br /> |Avibhramana (absence of confusion)<br /> |-<br /> |Shradhha (faith)<br /> |Abhiprayena (purposiveness)<br /> |-<br /> |Medha (intellect)<br /> |Grahanena (grasping power)<br /> |-<br /> |Sanjna (recognition or consciousness level)<br /> |Namagrahanena (ability to recognise or name things)<br /> |-<br /> |Smriti (memory)<br /> |Smaranena (ability to recollect things)<br /> |-<br /> |Dhriti (self restraint)<br /> |Alaulyama (not being carried away by own greed)<br /> |-<br /> |Amala sattva (purity of mind)<br /> |Avikara (free of delusions or illusionary attachments)<br /> |}<br /> This inferential knowledge can help an individual become self-aware of his own psyche (sattva). A self-aware individual has an upper hand at avoiding mental illness because these often go unnoticed until they develop some organic manifestations.<br /> &lt;br /&gt;Thus, by means of above discussed assessment methodologies, a physician can assess the degree of derangement in mental faculties and hence the manovaha srotas, irrespective of development of specific signs and symptoms of any psychiatric disorder (vyadhi lakshana).<br /> <br /> ==Treatment Guidelines==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Manovaha srotas disorders follow the line of treatment same as described for disorders of manas (mind). Following are therapeutic and preventive practices beneficial for both vitiated manovaha srotas (channels of psyche) and manas obscured by rajas - tamas dosha.&lt;/p&gt;<br /> Manas dosha can be alleviated through a comprehensive five-fold psychotherapeutic regimen - jnana (spiritual knowledge or self-awareness), vijnana (scriptural or scientific knowledge), dhairya (mental fortitude), smriti (recollection of past successes to regain faith in own abilities) and samadhi (spiritual healing practices to focus mind inwards away from negative external stimuli). [Cha.Sa. Sutra Sthana 1/58]<br /> Restoration of dhi (intellect), dhairya (mental fortitude) and atmadi vijnana (knowledge of self-consciousness) has therapeutic effect in alleviating disorders of manovaha srotas obstructed by manas dosha.<br /> <br /> '''*Sattvavajaya chikitsa (treatment to regulate mind)'''<br /> Sattvavajaya chikitsa is a non-invasive therapeutic module for psychological derangements and psychosomatic ailments, analogous to contemporary psychotherapy. ‘Sattva’ stands for mind and ‘avajaya’ translates to win over. Hence, it emphasizes withdrawing the mind from unwholesome objects of senses (factors vitiating rajas and tamas) and diverting it to positive sensory and emotional stimuli. Thereby consciously negating disturbed emotions and behavioural patterns. [Cha.Sa. Sutra Sthana 11/54]<br /> <br /> '''*Ashtanga yoga (eight steps of yoga)'''<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Ashtanga yoga can be considered as one of the dimensions of satvavajaya chikitsa. It integrates eight steps of yoga to tame mind from traversing paths in life which are spiritually and mentally harmful for that individual. Of the eight steps, first four viz. yama (principles for moral code), niyama (observances for personal discipline), asana (yogic postures) and pranayama (regulating breath) are termed as bahiranga yoga (external path). These practices gradually alleviate aggravated manas dosha, making the mind less reactive towards external stimuli. The last three limbs viz. dharana (concentration), dhyana (meditation) and samadhi (enlightenment or complete realisation) are termed as antaranga yoga (internal paths). These practices transform the mind, eliminating the fluctuations of mind, thereby strengthening positive habits and outlook on life as well as inner self. Ashtanga yoga maintains a harmonious balance between inner environment (mind and spirit) and external environment (objects of sensory perception). Mind thus gets liberated from worldly pursuits and all psychological sufferings in a stepwise manner.&lt;/p&gt;<br /> '''*Achara rasayana (rejuvenating codes of behavioural conduct)'''<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Achara rasayana is an adravyabhuta (non-pharmacological) rasayana (practices rejuvenating physical and mental health). It includes behavioural conducts which aim to enhance health and longevity by teaching practical methods to potentiate sattva guna of mind. [Cha.Sa. Chikitsa Sthana 1, 4th pada, shloka 30-35] An individual can imbibe easy lifestyle modifications to develop a positive and strong character of mind, thereby avoiding potential etiological factors (for dosha aggravation) and negative psychosocial patterns. Achara rasayana can be divided into five domains of good mental, social, personal, moral and religious conduct. [6]&lt;/p&gt;<br /> '''*Sadvritta (good codes of conduct)'''<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Sadvritta refers to good code of conduct. These are a set of practices, which serve as lifestyle guidelines to prevent mind from falling prey to temporary material pleasures and impulsive thoughts and actions that cause impairment of manas dosha and manovaha srotas. It encompasses guidelines over personal hygiene, personality development as well as for social hygiene and peaceful social interactions. [Cha.Sa. Sutra Sthana 8/18]&lt;/p&gt;<br /> Both achara rasayana and sadvritta help to maintain control over sense organs. They majorly add to the preventive and promotive aspect of mental health. <br /> '''*Medhya dravya (medicines enhancing intellectual functions)'''<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Medhya dravyas are the plant based pharmacological agents that promote prajna i.e., dhi (intellect), dhriti (perseverance) and smriti (memory). Researches conducted prove their efficacy in minimizing the cognitive decline among individuals with neural abnormalities. For example, ushna (hot potency) and tikshna nature drugs like jyotishmati and vacha are said to remove blockages caused by kapha, ama or tamas dosha in the manovaha srotas. Once purified, manas can regain unvitiated connect with indriya via manovaha srotas. [8] <br /> &lt;br/&gt;Ayurveda thus provides a bird’s eye view over different aspects of manovaha srotas through interconnected references in the classics highlighting its physiological importance like the other thirteen major srotas systems in the human body.&lt;/p&gt;<br /> <br /> ==Contemporary view==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Mind as per contemporary literature is debatable concept because in some contexts it is identified as conscience, while in others it is seen as the function of conscience. The philosophical dimension of mind was conceived by Plato who considered mind as an inner (soul’s) experience. [11]<br /> &lt;br/&gt;The western system of medicine addresses brain at the core of majority of psychological distresses, whereas western philosophy involves the concept of psyche (which denotes mind). ‘Psyche’ is a Greek word meaning ‘soul in a living man’. <br /> &lt;br/&gt;William James, referred to as the father of American Psychology, laid the foundations of physiological aspect of mind. To him mind was a function of brain which conducts mental life in the form of a constant stream of consciousness.[9] At some places he too admitted mind to bear consciousness and tried to assign attributes to consciousness as a separate psychological function thus formulating the Theory of Functionalism which established causal relationship between internal states (perception) and external reactions or behaviour (sensation). He concluded that repeated actions cause adaptive changes in nervous system. This is the fundamental ideology behind the concept of Neuroplasticity – i.e. adaptive structural and functional changes in brain by development of new neuronal pathways due to intrinsic or extrinsic stimuli. [12]<br /> &lt;br/&gt;James’ counterpart Titchener, an English Psychologist, proposed that consciousness is mind’s awareness of its own functions. Consciousness is something superior to mind itself. He formulated the Theory of Structuralism which aimed at analysing the interrelationship between mental experiences, feelings, and sensations. He used introspection as a tool to break down these complex phenomena of consciousness down to their basic elements without breaking their original structure. <br /> &lt;br/&gt;Mind is hence regarded as the cumulative effect of all mental processes that have occurred in the lifetime while the consciousness can be understood as the cumulative effect of all mental processes occurring in present moment. Eventually brain was somehow regarded to control the neural activity responsible for accumulating all this sensory data.<br /> &lt;br/&gt;Many theories were formulated and overruled by their successors with time. Today the concept of mind and consciousness remains yet to be clearly defined. It is observed that mind is often identified as consciousness and they both are accepted as individual closely linked entities. Mind bears synonymity towards consciousness, spirit, and psyche. Some theories view both mind and consciousness as spirit. But mind is invariably understood as the interaction between psychological personality and the external environment, i.e., a subject – object relationship.<br /> &lt;br/&gt;The neurophysiological basis of minds and the channels of transport of its constituents is yet a challenge in field of neuroscience. In order to bridge this gap, contemporary scientists hypothesise that mental representations and their contents are represented by neural network and their supporting cells thus hinting towards Central Nervous System and it’s peripheral nerves as the channels of mind. [13]&lt;/p&gt; <br /> <br /> ==Research works on manovaha srotas==<br /> Various review articles have been published and researches been carried out in the domain of Ayurveda to understand the conceptual as well as pathophysiological aspect of manovaha srotas. Few of them are as follows :-<br /> ===1. Critical Review of Concept of manovaha Srotas with special reference to Brain=== <br /> This review article conceptualizes the contemporary understanding of manovaha srotas in context to CNS due to functional similarity between manas and brain obtained after an extensive research and analysis throughout ayurveda treatises. Further brain was considered as synonymous to hridya ie. mulasthana (site of origin) of manovaha srotas and ‘dasha dhamani’ as the cranial nerves exiting from the 10 major foramen at base of skull. Sanskrit literature considers hridaya as regarded as a central organ similar to brain. 14<br /> ===2. Circumstantial view on clinical knowing of manovaha srotasa &amp; its physiology===<br /> The review article reconstructs a comprehensive picture of manovaha srotas from the scattered references available in Ayurveda texts, supplementing it with additional information from contemporary science as follows-<br /> *A detailed description of neuroanatomy and physiology has been drawn parallel to Ayurveda point of view about manas’ rachna and kriya sharir. <br /> *Effect of Triguna and tridosha (especially vata) in context of physiological functions and disorders of manas and manovaha srotas have been discussed.<br /> *Correlations between functions of five subtypes of vata and both CNS and ANS has been attempted <br /> *Pariksha krama (examination of nervous system) has been exemplified taking into consideration both Ayurveda and modern methodologies that can be employed for manovaha srotas (nervous system) examination.10 <br /> ===Concept of stress factor assessment concerning ‘perseverance test’ in light of ayurveda” – a review=== <br /> This article highlights the importance of understanding the etiological factors of vitiation of manovaha srotas and manas in all kinds of psychiatric as well as psychosomatic disorders. Imbalance of manas dosha can be treated by means of yoga, meditation and pranayama. Often emotional disturbances remain unattended in diagnosed cases of psychiatric illness which can be managed at home by incorporating wholesome diet (pathya ahara) and moral code of conduct (sadvrutta) in daily routine. Lack of peace and chronic stressors have been observed as major causes of vitiation of channels of mind. 15<br /> <br /> <br /> &lt;big&gt;'''[[Special:ContactMe|Send us your suggestions and feedback on this page.]]'''&lt;/big&gt;<br /> <br /> ==References==<br /> <br /> &lt;div id=&quot;BackToTop&quot; class=&quot;noprint&quot; style=&quot;background-color:#DDEFDD; position:fixed;<br /> bottom:32px; left:2%; z-index:9999; padding:0; margin:0;&quot;&gt;&lt;span style=&quot;color:blue;<br /> font-size:8pt; font-face:verdana,sans-serif; border:0.2em outset #ceebf7;<br /> padding:0.1em; font-weight:bolder; -moz-border-radius:8px; &quot;&gt;<br /> [[#top| Back to the Top ]]&lt;/span&gt;&lt;/div&gt;</div>

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<p>Manishdubey: </p> <hr /> <div>{{CiteButton}}<br /> {{#seo:<br /> |title= Manovaha srotas<br /> (Channels of transport and transformation of mind and mental factors)<br /> |titlemode=append<br /> |keywords= Manovaha srotas,Hrudya, Sattva pariksha, Sattvavajaya chikitsa, Bhojani M. K.,Deole Y.S., Basisht G<br /> |description=Mana means mind, or psyche. Srotas means channels of transport and transformation. The description and understanding of channels for activities of mind (manovaha srotas) is scattered in ayurveda classics and has not been completely elucidated. Manovaha srotas are considered as channels through which mind and body interact with each other. <br /> |image=http://www.carakasamhitaonline.com/mediawiki-1.32.1/resources/assets/ogimgs.jpg<br /> |image_alt=carak samhita<br /> |type=article<br /> }}<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Mana means mind, or psyche. Srotas means channels of transport and transformation. The description and understanding of channels for activities of mind (manovaha srotas) is scattered in ayurveda classics and has not been completely elucidated. Manovaha srotas are considered as channels through which mind and body interact with each other. These channels pervade throughout the body. [Chakrapani on Cha.Sa. Indriya Sthana 5/41-42] They are responsible for flow of thoughts, emotions, and other psychological functions. This article deals with various aspects of manovaha srotasa i.e. the channels of activities of mind and its development.&lt;/p&gt;<br /> <br /> {{Infobox<br /> |title = Contributors<br /> |label1 = Section/Chapter/topic<br /> |data1 = Concepts/[[Srotas]]/[[Manovaha Srotas]] <br /> |label2 = Authors<br /> |data2 = Bhojani M. K.&lt;sup&gt;1&lt;/sup&gt; Varma Swati &lt;sup&gt;1&lt;/sup&gt; Deole Y.S.&lt;sup&gt;2&lt;/sup&gt;<br /> |label3 = Reviewer &amp; Editor<br /> |data3 = Basisht G.&lt;sup&gt;3&lt;/sup&gt;, <br /> |label4 = Affiliations<br /> |data4 = &lt;sup&gt;1&lt;/sup&gt; Department of Sharir Kriya, All India Institute of Ayurveda, New Delhi, India<br /> &lt;sup&gt;2&lt;/sup&gt; Department of Kayachikitsa, G. J. Patel Institute of Ayurvedic Studies and Research, New Vallabh Vidyanagar, Gujarat, India <br /> &lt;sup&gt;3&lt;/sup&gt; Rheumatologist, Orlando, Florida, U.S.A.<br /> |label5 = Correspondence emails<br /> |data5 = meera.samhita@aiia.gov.in, carakasamhita@gmail.com<br /> |label6 = Publisher <br /> |data6 = [[Charak Samhita Research, Training and Development Centre]], I.T.R.A., Jamnagar, India<br /> |label7 = Date of publication:<br /> |data7 =October 12, 2023<br /> |label8 = DOI<br /> |data8 = In process<br /> }}<br /> <br /> ==Etymology and derivation:==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Srotas originates from Sanskrit root ‘Sru’ that translates to oozing, flow or secretion. It has been defined as ‘sravanat strotamsi’ [Cha. Sa. Sutra Sthana 30/12] which indicates structures designated for conveyance of material inside body. <br /> &lt;br/&gt;Grossly defining, thirteen major types of srotas have been mentioned that transport substances undergoing biotransformation (parinamam aapadyamanam) from the place of origin to their destination. [Cha. Sa. Vimana Sthana 5/3] Similarly in physiological state, manovaha srotas might be responsible for processing and transformation of ‘doshayukta’ (irrational under influence of rajas and tamas) emotions and thoughts into unbiased reasoning before reaching a conclusion by our intellect (buddhi). &lt;/p&gt;<br /> <br /> ==Synonyms of manovaha srotas==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Following terms are used for ‘manovaha srotas’ in different Ayurveda classics : &lt;/p&gt;<br /> # Manovaha dhamani [Chakrapani on Cha. Sa. Indriya sthana 12/42] and [Vijayarakshita in Ma.Ni.Purva Khanda 20/1]<br /> # Chetanavaha srotas [Shivadas Sen on Cha.Sa. Chikitsa sthana 9/5] <br /> # Chetovaha marga [Bhel Samhita Nidana Sthana 7/2]<br /> # Manobuddhivaha sira [ Cha.Sa.Chikitsa Sthana 10/58]<br /> # Sanjnavaha srotas [Su.Sa.Uttar Tantra 61/8]<br /> # Sanjnavaha nadi [Su.Sa. Uttar Tantra 46/7]<br /> &lt;p style=&quot;text-align:justify;&quot;&gt; &lt;br/&gt;Use of terms like sira, nadi and dhamani, refers to different channels and pathways concerned with maintenance of physiological flow of information. [Cha.Sa. Vimana Sthana 5/8] &lt;/p&gt;<br /> <br /> ==Origin==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt; Every srotas is localized within the hollow space in the body originating from a root (mula) and spreading throughout the body to reach a final structure. Srotas are said to be hollow structures in different shapes and sizes The root (mula) is majorly responsible for regulation and control of functions of that srotas.<br /> &lt;br/&gt;The channels carrying mind (manovaha srotas) are not exclusively listed. It is however stated that the entire conscious body is abode of mind. Hence these channels are spread throughout the body. [Chakrapani on Cha.Sa. Indriya Sthana 5/41]. <br /> &lt;br/&gt;However, hridaya (heart) has a universal acceptance as the site of origin (mula) of manovaha srotas. Hence a special mention has been made about ten arteries of heart, probably being the manovaha srotas (visheshen tu hrudya ashritvat manah tadashrita dasha dhamanyo manovaha abhidhiyante) [Chakrapani on Cha.Sa. Indriya Sthana 5/41-42]. These get afflicted by vitiated dosha either all at once or individually. [Chakrapani on Cha.Sa. Indriya Sthana 12/42]<br /> &lt;/p&gt;<br /> <br /> ==Decoding hridaya (heart)==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt; The interpretation of the term ‘hridaya’ has been of confusion among scholars since decades. The first interpretation of the term given by texts of Shatpada Brahmana which highlighted functional aspect of hridaya. The word being composed of three letters viz ‘hri’ (hra harane)- to acquire; ‘Da’ (da dane) – to give; ‘Ya’ (Ya gatau)- which transports. The hridaya thus displays three phases of cardiac cycle i.e., receives, gives, and transports body constituents through it. [2]<br /> &lt;br/&gt;Hridaya is the site of rasa (plasma), sattva (psychic factor/mind), buddhi (intellect) and atma (soul) in conjugation with all sensory organs (jnanendriya).[Cha.Sa. Chikitsa Sthana 24/35] Sadhaka pitta situated in heart (hridaya) regulates proper functioning of intellect (buddhi) and ego (ahamkara). Hridaya is located in between breasts (stanayormadhya) of thoracic region [A. H. Sutra Sthana 12/13-14] [Su. Sa. Sharira Sthana 6/25]. <br /> &lt;br/&gt;Vedic era was well versed with heart (hridaya) and brain (mastishka) being two distinct entities, with interdependent functional relationship [Atharvaveda Book X. Hymn 2.26]. Kashyap Samhita quotes that all sense and motor organs (indriya) together with mind (manas) emerge from heart (hridaya) [Ka.Sa. Chikitsa Sthana 8/6]. Primary site of action of mind (manas) is brain (shira).[3] It can be concluded that mind (manas) being seated in heart (hridaya) connects to brain (shiras) through manovaha srotas and controls all senses (indriya). Also, any damage pertaining to marma (vital points) of shiras (head) causes loss of consciousness (cheshtanasha). [Cha.Sa. Sidhhi Sthana 9/6] Hence heart (hridaya) and brain (shirasor mastishka) are sites of manovaha srotasa. <br /> &lt;br/&gt; This approach of understanding hridaya goes well along with the contemporary view of understanding the triguna based psycho-functional principles of Ayurveda within the neural framework. Various research has been conducted which demonstrate that heart continuously sends nervous signals to brain to coordinate higher centres responsible for cognition and emotions. [1] The neuro- psychological as well as circulatory functions of hridaya mentioned in the classics can thus be explained. &lt;/p&gt; <br /> <br /> ==Relation between rasavaha and manovaha srotas==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Heart is the abode of mind (mana) and consciousness (chetana) or soul (atma). [Cha. Sa. Sidhhi Sthana 9/4] It is a site for physical, psychological, and spiritual components. Heart is origin for channels of transportation and transformation of rasa dhatu, too. Both heart and brain are considered under the umbrella term hridaya in terms of anatomical structure and higher-centre functions respectively. <br /> &lt;br/&gt;Heart (residence of manas) and brain (workplace of manas) are functionally co-dependent upon each other. Manas regulates the cognitive and conative functions of brain in conjunction with soul (atma) under the influence of vata dosha. [Cha. Sa. Sharira Sthana 1/22-23]. Brain is a structural entity needing continuous supply of nourishment and oxygen. This is feasible by heart through circulation (rasa-rakta samvahana kriya) via the ten major vessels (rasavahi dhamani). [A. H. Sharira Sthana 3/18] Heart is a highly vascular organ being surrounded by ten major dhamani (blood vessels) like spokes of a wheel which are known as ‘rasavaha strotomula’ (site of origin of channels of nutrition). These channels are comparable to manovaha srotas. [Chakrapani on Cha. Sa. Chikitsa Sthana 9/4] Manas thus acts like a medium between heart and brain wherein brain is responsible for all sensory and motor functions while heart has been assigned emotional aspect of psyche (manas).<br /> &lt;br/&gt;One of the factors for vitiation of rasavaha srotas is excessive thinking or worry (atichintan). [Cha. Sa. Vimana Sthana 5/13] Contemporary researchers have found evidence to support the interaction between circulatory system and psyche. The monograph of German professor Ludwig Braun is a pioneer in exploring the psychological and emotional aspect of cardiac diseases especially angina. He presented a correlation between cardiac diseases and ‘Angst’ (a constrictive, tightening and crushing sensation which manifests dread in the patient thereby changing his entire emotional outlook on life), analogous to anxiety. He explains that the cardiac tissue has a special apparatus receptive towards anxiety which manifests as an inner tactile sensation. That region is well supplied with nerve endings that gets irritated by anxiety. This phenomenon of emotional influence over cardiac tissues is termed as cardiac psyche. [4] <br /> &lt;/p&gt; <br /> <br /> ==Factors vitiating manovaha srotas==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt; Manovaha srotas are the prime site of abnormalities of channels in all psychological disorders. [Cha.Sa. Nidana Sthana 6/4] Alongside any of the eight factors that are either attributed to hridaya or manas viz. mana (mind), buddhi (intellect), sanjna-jnana (self-awareness), smriti (memory), bhakti (devotion), sheela (habits), cheshta (psychomotor activities) and achara (code of conduct). [Cha.Sa. Nidana Sthana 7/5] <br /> &lt;br/&gt;These factors when deranged cause vitiation of manas dosha (rajas and tamas), deterioration of sattva guna of manas and gradual derangement of tridosha. Foods, activities and excessive expression of emotions like anger, grief, lust, fear etc and mental traumas are the fundamental etiological factors for the same. [Cha.Sa. Nidana Sthana 7/4] Vitiated tridosha further vitiates rasavaha srotas, which apparently has the same site of origin as of manovaha srotas i.e., hridaya and dasha dhamani (ten great vessels). [Cha. Sa. Vimana Sthana 5/10] Hridaya is seat of manas [Cha.Sa. Sutra Sthana 30/4]. Hence, all the factors vitiating rasa dhatu (nutritive fluid), rasavaha srotas (channels carrying nutritive fluid) and manas dosha viz. rajas and tamas will affect manas and eventually vitiating manovaha srotas. Even the structural derangements of heart (abode of mind) affect manovaha srotas due to their ashrayashrayibhava (state of interdependency). [Cha.Sa. Chikitsa Sthana 9/5]&lt;/p&gt;<br /> <br /> ==Pathologies of manovaha srotas==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Manovaha srotas is important factor in understanding disorders like unmada (psychosis), apasmara (epilepsy) and extreme emotional reactions. &lt;/p&gt;<br /> <br /> *'''Unmada (psychosis)'''<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;When an individual experiences extreme emotions – lust (kama), anger (krodha), fear (bhaya), greed (lobha), happiness or pleasure (harsha), affection (moha), grief (shoka), excessive worry (chinta), they initially harm the intellect which aggravates manas dosha (rajas and tamas) and tridosha (vata, pitta and kapha). These vitiated dosha invade heart and obstruct manovaha srotas (channels transporting psychic impulses) thereby causing unmada. [Dalhan on Su. Sa. Uttar Tantra 62/3]<br /> *'''Apasmara (epilepsy)'''<br /> Overindulging in sensory pleasures, incompatible diet, withholding natural urges and giving into immoral activities under emotional influences (kama, krodha, lobha among others), vitiates rajas and tamas. They poorly influence the manas (mind) and sanjnavaha srotas (manovaha srotas) causing apasmara. [Su.Sa. Uttar Tantra 61/6]<br /> * Mada (intoxication), murchha (syncope), sanyasa (coma) are caused by vitiation of channels of consciousness (chetanavaha srotas or manovaha srotas). [Shivadas Sen on Cha. Sa. Chikitsa Sthana 9/5] <br /> *'''Atattvabhinivesha (perverted state of mind)'''<br /> Considered as mahagada (difficult to treat mental disorder), the person’s conscience gets afflicted by rajas and tamas, which cause complete derangement of intellect (buddhi vibhramsha) as the predominant symptom. The vitiated dosha get lodged in heart (hridaya) to afflict channels of mind and intellect (manobuddhivaha sira in manovaha srotas). [Cha.Sa. Chikitsa Sthana 10/57-60]<br /> * Physiology of nightmares (swapna)<br /> Nightmares are dreams occurring in REM phase of sleep which causes mental projections in the form of feelings of fear, despair, and anxiety. Ayurveda defines REM phase as ‘Natiprasupta’ - the state characterised to be midway between states of deep sleep and fully awake. During any ominous situation, tridosha in their highly aggravated state tend to fill-up the manovaha srotas. This results in terrifying dreams. [Cha.Sa. Indriya Sthana 5/41]. &lt;/p&gt;<br /> <br /> ==Assessment and diagnosis of disorders of manovaha srotas==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Srotas are micro-channels transporting various metabolites across cells throughout the body. It can be deduced that manovaha srotas has different characteristics structurally and functionally from the major thirteen srotas, because it transports and transforms thoughts and feelings. This is evident from objects of mind (manas), viz- thought (chintyam), consideration (vicharyam), hypothesis (uhyam), aims (dhyeyam) and determination (sankalpam). [Cha.Sa. Sharira Sthana 1/20]. Assessment of manovaha srotas can be done via assessment of manas and the degree of derangement of its functions. Ayurveda considers manas as material entity (dravya) which is a super sense and not perceivable by ordinary senses (atindriya) [Cha. Sa. Sutra Sthana 8/4]. Manas is under direct control of vata dosha [Cha. Sa. Sutra Sthana 12/8] and is the mediator between atma (soul) and indriyartha (objects of senses). <br /> &lt;br/&gt;The contemporary physiological aspects of mind, senses, brain, nervous system and consciousness can be considered for assessment of manovaha srotas. <br /> &lt;br/&gt; A thorough neurological examination by means of interrogation (prashna pariksha), inspection (darshana pariksha) and assessment of mental strength (sattva bala pariksha) [Cha.Sa. Vimana Sthana 8/119] can be used for assessment and diagnosis of disorders of manovaha srotas.&lt;/p&gt;<br /> <br /> ''' a. Interrogation (prashna pariksha)'''<br /> A formal interview of the patient can be conducted for overall and precise diagnosis. The questions related to chief complaints with duration, chronological development, nurturing of patient, family history, addiction, hobbies, interests, daily routine, major life events, achievements, mental traumas, emotional quotient and intellectual quotient is recorded from the patient. If the patient is not in state of giving correct answers, then the relatives or attendants who know patients history are interviewed. <br /> <br /> '''b. Darshan pariksha (Direct observation)'''<br /> While interviewing the patient, a physician should pay attention to following attributes that can signify features mentioned for certain psychiatric ailments (manovaha srotodushti)..<br /> <br /> # '''Appearance '''– Unusual dressing preferences, use of cosmetics, perfumes or accessories or flamboyant appearance. e.g;- ‘Priye tanu rakta vastradhari’ (liking for adorning clothes made of thin red fabric) is seen in yakshagraha unmada (Su.Sa. Uttara tantra 60/11)<br /> # '''Activity and co-ordination''' - Behaviour, Gait, gestures, patient’s facial expression and body language should be observed during probing them with questions. Eg;- 'Satatama akshano’ (rapid and constant eye movements) is one of the prodromal feature of apasmara (epilepsy) [ Cha.Sa. Nidana sthana 8/6]. Udhasta (patient keeps his hands raised) is a feature of pishacha grahavishta unmada [Su.Sa. Uttara Tantra 60/15]<br /> # '''Conversation style''' – Coherence of speech, articulation, emphasise over certain issue, hesitation and duration of response. E.g. ‘Chitram sa jalpati’ (Patient does irrelevant absurd talks) is seen in patients of manas unmada [Su.Sa. Uttara Tantra 62/13].<br /> #'''Emotional expression''' – Patients may express a wide range of emotions during interview with the physician. E.g. Asthana rodana (Sudden crying) is a feature in vataja unmada while amarsha (intolerance) is seen in patients of pittaja unmada. [Cha.Sa. Chikitsa Sthana 9/11-12] Fleeting ideas, incoherent speech is an important sign for lacking proper emotions. <br /> #'''Cognition''' – Orientation to person, place, time and circumstances, level of intellect, level of understanding, common sense and memory can be identified under the domain of cognition by observing patient’s behaviour as well as by asking questions to them using validated scientific questionnaires. Short term memory and long-term memory shall be assessed properly. <br /> &lt;br/&gt;All observations gathered from every method of assessment should be simultaneously analysed to reach the diagnosis.<br /> <br /> '''c. Sattva pariksha (assessment of quality of excellence of mind)'''<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Sattva pariksha assesses the quality of excellence of mind imparted by extent of dominance of sattva guna. Mind (manas) is composed of three attributes (triguna) viz. sattva, rajas and tamas. These impart three types of mental constitutions – Shuddha (pure) (sattvika), rajasika and tamasika. [Cha.Sa. Sharira Sthana 4/36]. Sattvika guna is full of auspiciousness and is considered the healthy (amala) state of mind. Rajasika guna imparts momentum in terms of furious temperament. Whereas tamas guna promotes inertia and moral ignorance. Hence, rajas and tamas are considered inauspicious and called manas dosha. Triguna are present in dynamically varying proportions at any given time and influenced by body (i.e. tridosha) and vice versa. [Chakrapani on Cha.Sa. Vimana Sthana 4/8]. Optimum levels of sattva guna are essential for promoting desired physical and mental strength irrespective of morphological features. [Cha.Sa. Vimana Sthana 8/119]&lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Sattva bala (strength of psyche) is of three types as per strength – pravara (superior), madhyama (moderate) and avara (poor). Pravara sattva persons possess great courage. Despite poor morphological features they seem to be unmoved in the face of adversities. Madhyama sattva persons need some additional moral support to sustain themselves in times of distress. While avara sattva displays catastrophic reactions even during little inconveniences and can neither be sustained by themselves nor by others despite having good quality morphological features. Avara sattva is constantly plagued by inferior emotions like grief, fear, greed, conceit and confusion. When confronted with fierce, ugly, disgusting narratives or flesh and blood, they are prone to become depressed, pale, unconscious or semiconscious, giddy, anxious and can even succumb to death in worst case scenarios. [Cha. Sa. Vimana Sthana 8/119].<br /> &lt;br/&gt;Manovaha srotas associated with avara sattva bala is most likely to be vitiated by manas dosha leading to various psychiatric and psychosomatic disorders [Cha.Sa. Chikitsa Sthana 9/5]. It has been observed that avara sattva individuals are more likely to commit prajnaparadha (intellectual defects) [10] thereby voluntarily indulging in various etiological factors for respective psychological as well as somatic disorders.<br /> &lt;br?&gt;Thus, assessment of sattva bala can help rule out the predisposition towards manovaha srotodushti and subsequent development of symptoms of psychiatric ailments.&lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;'''d. Anumana pariksha (knowledge by inference)''' to determine normalcy of faculties of manas (mind) [Cha.Sa. Vimana Sthana 4/8] Since manas is atindriya ( supersence or imperceivable by ordinary senses), so are it’s faculties which can serve as potential markers for assessment of its functions. [10] The proper functioning of manas itself is inferred by altered or inappropriate mental perceptions even in presence of appropriately functioning indriya (senses) and their respective sense objects whereas the mental faculties can be inferred as follows:-&lt;/p&gt;<br /> {| class=&quot;wikitable&quot;<br /> |'''Faculty''' <br /> |'''object for inference''' <br /> |-<br /> |Vijnanam (expertise/skills )<br /> |Vyavsayena (occupation )<br /> |-<br /> |Dhairyam (fortitude)<br /> |avishadena (courage in face of adversity)<br /> |-<br /> |Viryam (bravery)<br /> |Uthhanena (initiating difficult tasks and enduring them)<br /> |-<br /> |Avasthanama (stability)<br /> |Avibhramana (absence of confusion)<br /> |-<br /> |Shradhha (faith)<br /> |Abhiprayena (purposiveness)<br /> |-<br /> |Medha (intellect)<br /> |Grahanena (grasping power)<br /> |-<br /> |Sanjna (recognition or consciousness level)<br /> |Namagrahanena (ability to recognise or name things)<br /> |-<br /> |Smriti (memory)<br /> |Smaranena (ability to recollect things)<br /> |-<br /> |Dhriti (self restraint)<br /> |Alaulyama (not being carried away by own greed)<br /> |-<br /> |Amala sattva (purity of mind)<br /> |Avikara (free of delusions or illusionary attachments)<br /> |}<br /> This inferential knowledge can help an individual become self-aware of his own psyche (sattva). A self-aware individual has an upper hand at avoiding mental illness because these often go unnoticed until they develop some organic manifestations.<br /> &lt;br /&gt;Thus, by means of above discussed assessment methodologies, a physician can assess the degree of derangement in mental faculties and hence the manovaha srotas, irrespective of development of specific signs and symptoms of any psychiatric disorder (vyadhi lakshana).<br /> <br /> ==Treatment Guidelines==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Manovaha srotas disorders follow the line of treatment same as described for disorders of manas (mind). Following are therapeutic and preventive practices beneficial for both vitiated manovaha srotas (channels of psyche) and manas obscured by rajas - tamas dosha.&lt;/p&gt;<br /> Manas dosha can be alleviated through a comprehensive five-fold psychotherapeutic regimen - jnana (spiritual knowledge or self-awareness), vijnana (scriptural or scientific knowledge), dhairya (mental fortitude), smriti (recollection of past successes to regain faith in own abilities) and samadhi (spiritual healing practices to focus mind inwards away from negative external stimuli). [Cha.Sa. Sutra Sthana 1/58]<br /> Restoration of dhi (intellect), dhairya (mental fortitude) and atmadi vijnana (knowledge of self-consciousness) has therapeutic effect in alleviating disorders of manovaha srotas obstructed by manas dosha.<br /> <br /> '''*Sattvavajaya chikitsa (treatment to regulate mind)'''<br /> Sattvavajaya chikitsa is a non-invasive therapeutic module for psychological derangements and psychosomatic ailments, analogous to contemporary psychotherapy. ‘Sattva’ stands for mind and ‘avajaya’ translates to win over. Hence, it emphasizes withdrawing the mind from unwholesome objects of senses (factors vitiating rajas and tamas) and diverting it to positive sensory and emotional stimuli. Thereby consciously negating disturbed emotions and behavioural patterns. [Cha.Sa. Sutra Sthana 11/54]<br /> <br /> '''*Ashtanga yoga (eight steps of yoga)'''<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Ashtanga yoga can be considered as one of the dimensions of satvavajaya chikitsa. It integrates eight steps of yoga to tame mind from traversing paths in life which are spiritually and mentally harmful for that individual. Of the eight steps, first four viz. yama (principles for moral code), niyama (observances for personal discipline), asana (yogic postures) and pranayama (regulating breath) are termed as bahiranga yoga (external path). These practices gradually alleviate aggravated manas dosha, making the mind less reactive towards external stimuli. The last three limbs viz. dharana (concentration), dhyana (meditation) and samadhi (enlightenment or complete realisation) are termed as antaranga yoga (internal paths). These practices transform the mind, eliminating the fluctuations of mind, thereby strengthening positive habits and outlook on life as well as inner self. Ashtanga yoga maintains a harmonious balance between inner environment (mind and spirit) and external environment (objects of sensory perception). Mind thus gets liberated from worldly pursuits and all psychological sufferings in a stepwise manner.&lt;/p&gt;<br /> '''*Achara rasayana (rejuvenating codes of behavioural conduct)'''<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Achara rasayana is an adravyabhuta (non-pharmacological) rasayana (practices rejuvenating physical and mental health). It includes behavioural conducts which aim to enhance health and longevity by teaching practical methods to potentiate sattva guna of mind. [Cha.Sa. Chikitsa Sthana 1, 4th pada, shloka 30-35] An individual can imbibe easy lifestyle modifications to develop a positive and strong character of mind, thereby avoiding potential etiological factors (for dosha aggravation) and negative psychosocial patterns. Achara rasayana can be divided into five domains of good mental, social, personal, moral and religious conduct. [6]&lt;/p&gt;<br /> '''*Sadvritta (good codes of conduct)'''<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Sadvritta refers to good code of conduct. These are a set of practices, which serve as lifestyle guidelines to prevent mind from falling prey to temporary material pleasures and impulsive thoughts and actions that cause impairment of manas dosha and manovaha srotas. It encompasses guidelines over personal hygiene, personality development as well as for social hygiene and peaceful social interactions. [Cha.Sa. Sutra Sthana 8/18]&lt;/p&gt;<br /> Both achara rasayana and sadvritta help to maintain control over sense organs. They majorly add to the preventive and promotive aspect of mental health. <br /> '''*Medhya dravya (medicines enhancing intellectual functions)'''<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Medhya dravyas are the plant based pharmacological agents that promote prajna i.e., dhi (intellect), dhriti (perseverance) and smriti (memory). Researches conducted prove their efficacy in minimizing the cognitive decline among individuals with neural abnormalities. For example, ushna (hot potency) and tikshna nature drugs like jyotishmati and vacha are said to remove blockages caused by kapha, ama or tamas dosha in the manovaha srotas. Once purified, manas can regain unvitiated connect with indriya via manovaha srotas. [8] <br /> &lt;br/&gt;Ayurveda thus provides a bird’s eye view over different aspects of manovaha srotas through interconnected references in the classics highlighting its physiological importance like the other thirteen major srotas systems in the human body.&lt;/p&gt;<br /> <br /> ==Contemporary view==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Mind as per contemporary literature is debatable concept because in some contexts it is identified as conscience, while in others it is seen as the function of conscience. The philosophical dimension of mind was conceived by Plato who considered mind as an inner (soul’s) experience. [11]<br /> &lt;br/&gt;The western system of medicine addresses brain at the core of majority of psychological distresses, whereas western philosophy involves the concept of psyche (which denotes mind). ‘Psyche’ is a Greek word meaning ‘soul in a living man’. <br /> &lt;br/&gt;William James, referred to as the father of American Psychology, laid the foundations of physiological aspect of mind. To him mind was a function of brain which conducts mental life in the form of a constant stream of consciousness.[9] At some places he too admitted mind to bear consciousness and tried to assign attributes to consciousness as a separate psychological function thus formulating the Theory of Functionalism which established causal relationship between internal states (perception) and external reactions or behaviour (sensation). He concluded that repeated actions cause adaptive changes in nervous system. This is the fundamental ideology behind the concept of Neuroplasticity – i.e. adaptive structural and functional changes in brain by development of new neuronal pathways due to intrinsic or extrinsic stimuli. [12]<br /> &lt;br/&gt;James’ counterpart Titchener, an English Psychologist, proposed that consciousness is mind’s awareness of its own functions. Consciousness is something superior to mind itself. He formulated the Theory of Structuralism which aimed at analysing the interrelationship between mental experiences, feelings, and sensations. He used introspection as a tool to break down these complex phenomena of consciousness down to their basic elements without breaking their original structure. <br /> &lt;br/&gt;Mind is hence regarded as the cumulative effect of all mental processes that have occurred in the lifetime while the consciousness can be understood as the cumulative effect of all mental processes occurring in present moment. Eventually brain was somehow regarded to control the neural activity responsible for accumulating all this sensory data.<br /> &lt;br/&gt;Many theories were formulated and overruled by their successors with time. Today the concept of mind and consciousness remains yet to be clearly defined. It is observed that mind is often identified as consciousness and they both are accepted as individual closely linked entities. Mind bears synonymity towards consciousness, spirit, and psyche. Some theories view both mind and consciousness as spirit. But mind is invariably understood as the interaction between psychological personality and the external environment, i.e., a subject – object relationship.<br /> &lt;br/&gt;The neurophysiological basis of minds and the channels of transport of its constituents is yet a challenge in field of neuroscience. In order to bridge this gap, contemporary scientists hypothesise that mental representations and their contents are represented by neural network and their supporting cells thus hinting towards Central Nervous System and it’s peripheral nerves as the channels of mind. [13]&lt;/p&gt; <br /> <br /> ==Research works on manovaha srotas==<br /> Various review articles have been published and researches been carried out in the domain of Ayurveda to understand the conceptual as well as pathophysiological aspect of manovaha srotas. Few of them are as follows :-<br /> '''# Critical Review of Concept of manovaha Srotas with special reference to Brain''' <br /> This review article conceptualizes the contemporary understanding of manovaha srotas in context to CNS due to functional similarity between manas and brain obtained after an extensive research and analysis throughout ayurveda treatises. Further brain was considered as synonymous to hridya ie. mulasthana (site of origin) of manovaha srotas and ‘dasha dhamani’ as the cranial nerves exiting from the 10 major foramen at base of skull. Sanskrit literature considers hridaya as regarded as a central organ similar to brain. 14<br /> '''# Circumstantial view on clinical knowing of manovaha srotasa &amp; its physiology''' <br /> The review article reconstructs a comprehensive picture of manovaha srotas from the scattered references available in Ayurveda texts, supplementing it with additional information from contemporary science as follows-<br /> '''*'''A detailed description of neuroanatomy and physiology has been drawn parallel to Ayurveda point of view about manas’ rachna and kriya sharir. <br /> '''*'''Effect of Triguna and tridosha (especially vata) in context of physiological functions and disorders of manas and manovaha srotas have been discussed.<br /> '''*'''Correlations between functions of five subtypes of vata and both CNS and ANS has been attempted Pariksha krama (examination of nervous system) has been exemplified taking into consideration both Ayurveda and modern methodologies that can be employed for manovaha srotas (nervous system) examination.10 <br /> '''*'''Concept of stress factor assessment concerning ‘perseverance test’ in light of ayurveda” – a review This article highlights the importance of understanding the etiological factors of vitiation of manovaha srotas and manas in all kinds of psychiatric as well as psychosomatic disorders. Imbalance of manas dosha can be treated by means of yoga, meditation and pranayama. Often emotional disturbances remain unattended in diagnosed cases of psychiatric illness which can be managed at home by incorporating wholesome diet (pathya ahara) and moral code of conduct (sadvrutta) in daily routine. Lack of peace and chronic stressors have been observed as major causes of vitiation of channels of mind. 15<br /> <br /> <br /> &lt;big&gt;'''[[Special:ContactMe|Send us your suggestions and feedback on this page.]]'''&lt;/big&gt;<br /> <br /> ==References==<br /> <br /> &lt;div id=&quot;BackToTop&quot; class=&quot;noprint&quot; style=&quot;background-color:#DDEFDD; position:fixed;<br /> bottom:32px; left:2%; z-index:9999; padding:0; margin:0;&quot;&gt;&lt;span style=&quot;color:blue;<br /> font-size:8pt; font-face:verdana,sans-serif; border:0.2em outset #ceebf7;<br /> padding:0.1em; font-weight:bolder; -moz-border-radius:8px; &quot;&gt;<br /> [[#top| Back to the Top ]]&lt;/span&gt;&lt;/div&gt;</div>

Manishdubey https://www.carakasamhitaonline.com/index.php?title=Manovaha_srotas&diff=44192 2023-10-16T10:31:09Z

<p>Manishdubey: </p> <hr /> <div>{{CiteButton}}<br /> {{#seo:<br /> |title= Manovaha srotas<br /> (Channels of transport and transformation of mind and mental factors)<br /> |titlemode=append<br /> |keywords= Manovaha srotas,Hrudya, Sattva pariksha, Sattvavajaya chikitsa, Bhojani M. K.,Deole Y.S., Basisht G<br /> |description=Mana means mind, or psyche. Srotas means channels of transport and transformation. The description and understanding of channels for activities of mind (manovaha srotas) is scattered in ayurveda classics and has not been completely elucidated. Manovaha srotas are considered as channels through which mind and body interact with each other. <br /> |image=http://www.carakasamhitaonline.com/mediawiki-1.32.1/resources/assets/ogimgs.jpg<br /> |image_alt=carak samhita<br /> |type=article<br /> }}<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Mana means mind, or psyche. Srotas means channels of transport and transformation. The description and understanding of channels for activities of mind (manovaha srotas) is scattered in ayurveda classics and has not been completely elucidated. Manovaha srotas are considered as channels through which mind and body interact with each other. These channels pervade throughout the body. [Chakrapani on Cha.Sa. Indriya Sthana 5/41-42] They are responsible for flow of thoughts, emotions, and other psychological functions. This article deals with various aspects of manovaha srotasa i.e. the channels of activities of mind and its development.&lt;/p&gt;<br /> <br /> {{Infobox<br /> |title = Contributors<br /> |label1 = Section/Chapter/topic<br /> |data1 = Concepts/[[Srotas]]/[[Manovaha Srotas]] <br /> |label2 = Authors<br /> |data2 = Bhojani M. K.&lt;sup&gt;1&lt;/sup&gt; Varma Swati &lt;sup&gt;1&lt;/sup&gt; Deole Y.S.&lt;sup&gt;2&lt;/sup&gt;<br /> |label3 = Reviewer &amp; Editor<br /> |data3 = Basisht G.&lt;sup&gt;3&lt;/sup&gt;, <br /> |label4 = Affiliations<br /> |data4 = &lt;sup&gt;1&lt;/sup&gt; Department of Sharir Kriya, All India Institute of Ayurveda, New Delhi, India<br /> &lt;sup&gt;2&lt;/sup&gt; Department of Kayachikitsa, G. J. Patel Institute of Ayurvedic Studies and Research, New Vallabh Vidyanagar, Gujarat, India <br /> &lt;sup&gt;3&lt;/sup&gt; Rheumatologist, Orlando, Florida, U.S.A.<br /> |label5 = Correspondence emails<br /> |data5 = meera.samhita@aiia.gov.in, carakasamhita@gmail.com<br /> |label6 = Publisher <br /> |data6 = [[Charak Samhita Research, Training and Development Centre]], I.T.R.A., Jamnagar, India<br /> |label7 = Date of publication:<br /> |data7 =October 12, 2023<br /> |label8 = DOI<br /> |data8 = In process<br /> }}<br /> <br /> ==Etymology and derivation:==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Srotas originates from Sanskrit root ‘Sru’ that translates to oozing, flow or secretion. It has been defined as ‘sravanat strotamsi’ [Cha. Sa. Sutra Sthana 30/12] which indicates structures designated for conveyance of material inside body. <br /> &lt;br/&gt;Grossly defining, thirteen major types of srotas have been mentioned that transport substances undergoing biotransformation (parinamam aapadyamanam) from the place of origin to their destination. [Cha. Sa. Vimana Sthana 5/3] Similarly in physiological state, manovaha srotas might be responsible for processing and transformation of ‘doshayukta’ (irrational under influence of rajas and tamas) emotions and thoughts into unbiased reasoning before reaching a conclusion by our intellect (buddhi). &lt;/p&gt;<br /> <br /> ==Synonyms of manovaha srotas==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Following terms are used for ‘manovaha srotas’ in different Ayurveda classics : &lt;/p&gt;<br /> # Manovaha dhamani [Chakrapani on Cha. Sa. Indriya sthana 12/42] and [Vijayarakshita in Ma.Ni.Purva Khanda 20/1]<br /> # Chetanavaha srotas [Shivadas Sen on Cha.Sa. Chikitsa sthana 9/5] <br /> # Chetovaha marga [Bhel Samhita Nidana Sthana 7/2]<br /> # Manobuddhivaha sira [ Cha.Sa.Chikitsa Sthana 10/58]<br /> # Sanjnavaha srotas [Su.Sa.Uttar Tantra 61/8]<br /> # Sanjnavaha nadi [Su.Sa. Uttar Tantra 46/7]<br /> &lt;p style=&quot;text-align:justify;&quot;&gt; &lt;br/&gt;Use of terms like sira, nadi and dhamani, refers to different channels and pathways concerned with maintenance of physiological flow of information. [Cha.Sa. Vimana Sthana 5/8] &lt;/p&gt;<br /> <br /> ==Origin==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt; Every srotas is localized within the hollow space in the body originating from a root (mula) and spreading throughout the body to reach a final structure. Srotas are said to be hollow structures in different shapes and sizes The root (mula) is majorly responsible for regulation and control of functions of that srotas.<br /> &lt;br/&gt;The channels carrying mind (manovaha srotas) are not exclusively listed. It is however stated that the entire conscious body is abode of mind. Hence these channels are spread throughout the body. [Chakrapani on Cha.Sa. Indriya Sthana 5/41]. <br /> &lt;br/&gt;However, hridaya (heart) has a universal acceptance as the site of origin (mula) of manovaha srotas. Hence a special mention has been made about ten arteries of heart, probably being the manovaha srotas (visheshen tu hrudya ashritvat manah tadashrita dasha dhamanyo manovaha abhidhiyante) [Chakrapani on Cha.Sa. Indriya Sthana 5/41-42]. These get afflicted by vitiated dosha either all at once or individually. [Chakrapani on Cha.Sa. Indriya Sthana 12/42]<br /> &lt;/p&gt;<br /> <br /> ==Decoding hridaya (heart)==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt; The interpretation of the term ‘hridaya’ has been of confusion among scholars since decades. The first interpretation of the term given by texts of Shatpada Brahmana which highlighted functional aspect of hridaya. The word being composed of three letters viz ‘hri’ (hra harane)- to acquire; ‘Da’ (da dane) – to give; ‘Ya’ (Ya gatau)- which transports. The hridaya thus displays three phases of cardiac cycle i.e., receives, gives, and transports body constituents through it. [2]<br /> &lt;br/&gt;Hridaya is the site of rasa (plasma), sattva (psychic factor/mind), buddhi (intellect) and atma (soul) in conjugation with all sensory organs (jnanendriya).[Cha.Sa. Chikitsa Sthana 24/35] Sadhaka pitta situated in heart (hridaya) regulates proper functioning of intellect (buddhi) and ego (ahamkara). Hridaya is located in between breasts (stanayormadhya) of thoracic region [A. H. Sutra Sthana 12/13-14] [Su. Sa. Sharira Sthana 6/25]. <br /> &lt;br/&gt;Vedic era was well versed with heart (hridaya) and brain (mastishka) being two distinct entities, with interdependent functional relationship [Atharvaveda Book X. Hymn 2.26]. Kashyap Samhita quotes that all sense and motor organs (indriya) together with mind (manas) emerge from heart (hridaya) [Ka.Sa. Chikitsa Sthana 8/6]. Primary site of action of mind (manas) is brain (shira).[3] It can be concluded that mind (manas) being seated in heart (hridaya) connects to brain (shiras) through manovaha srotas and controls all senses (indriya). Also, any damage pertaining to marma (vital points) of shiras (head) causes loss of consciousness (cheshtanasha). [Cha.Sa. Sidhhi Sthana 9/6] Hence heart (hridaya) and brain (shirasor mastishka) are sites of manovaha srotasa. <br /> &lt;br/&gt; This approach of understanding hridaya goes well along with the contemporary view of understanding the triguna based psycho-functional principles of Ayurveda within the neural framework. Various research has been conducted which demonstrate that heart continuously sends nervous signals to brain to coordinate higher centres responsible for cognition and emotions. [1] The neuro- psychological as well as circulatory functions of hridaya mentioned in the classics can thus be explained. &lt;/p&gt; <br /> <br /> ==Relation between rasavaha and manovaha srotas==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Heart is the abode of mind (mana) and consciousness (chetana) or soul (atma). [Cha. Sa. Sidhhi Sthana 9/4] It is a site for physical, psychological, and spiritual components. Heart is origin for channels of transportation and transformation of rasa dhatu, too. Both heart and brain are considered under the umbrella term hridaya in terms of anatomical structure and higher-centre functions respectively. <br /> &lt;br/&gt;Heart (residence of manas) and brain (workplace of manas) are functionally co-dependent upon each other. Manas regulates the cognitive and conative functions of brain in conjunction with soul (atma) under the influence of vata dosha. [Cha. Sa. Sharira Sthana 1/22-23]. Brain is a structural entity needing continuous supply of nourishment and oxygen. This is feasible by heart through circulation (rasa-rakta samvahana kriya) via the ten major vessels (rasavahi dhamani). [A. H. Sharira Sthana 3/18] Heart is a highly vascular organ being surrounded by ten major dhamani (blood vessels) like spokes of a wheel which are known as ‘rasavaha strotomula’ (site of origin of channels of nutrition). These channels are comparable to manovaha srotas. [Chakrapani on Cha. Sa. Chikitsa Sthana 9/4] Manas thus acts like a medium between heart and brain wherein brain is responsible for all sensory and motor functions while heart has been assigned emotional aspect of psyche (manas).<br /> &lt;br/&gt;One of the factors for vitiation of rasavaha srotas is excessive thinking or worry (atichintan). [Cha. Sa. Vimana Sthana 5/13] Contemporary researchers have found evidence to support the interaction between circulatory system and psyche. The monograph of German professor Ludwig Braun is a pioneer in exploring the psychological and emotional aspect of cardiac diseases especially angina. He presented a correlation between cardiac diseases and ‘Angst’ (a constrictive, tightening and crushing sensation which manifests dread in the patient thereby changing his entire emotional outlook on life), analogous to anxiety. He explains that the cardiac tissue has a special apparatus receptive towards anxiety which manifests as an inner tactile sensation. That region is well supplied with nerve endings that gets irritated by anxiety. This phenomenon of emotional influence over cardiac tissues is termed as cardiac psyche. [4] <br /> &lt;/p&gt; <br /> <br /> ==Factors vitiating manovaha srotas==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt; Manovaha srotas are the prime site of abnormalities of channels in all psychological disorders. [Cha.Sa. Nidana Sthana 6/4] Alongside any of the eight factors that are either attributed to hridaya or manas viz. mana (mind), buddhi (intellect), sanjna-jnana (self-awareness), smriti (memory), bhakti (devotion), sheela (habits), cheshta (psychomotor activities) and achara (code of conduct). [Cha.Sa. Nidana Sthana 7/5] <br /> &lt;br/&gt;These factors when deranged cause vitiation of manas dosha (rajas and tamas), deterioration of sattva guna of manas and gradual derangement of tridosha. Foods, activities and excessive expression of emotions like anger, grief, lust, fear etc and mental traumas are the fundamental etiological factors for the same. [Cha.Sa. Nidana Sthana 7/4] Vitiated tridosha further vitiates rasavaha srotas, which apparently has the same site of origin as of manovaha srotas i.e., hridaya and dasha dhamani (ten great vessels). [Cha. Sa. Vimana Sthana 5/10] Hridaya is seat of manas [Cha.Sa. Sutra Sthana 30/4]. Hence, all the factors vitiating rasa dhatu (nutritive fluid), rasavaha srotas (channels carrying nutritive fluid) and manas dosha viz. rajas and tamas will affect manas and eventually vitiating manovaha srotas. Even the structural derangements of heart (abode of mind) affect manovaha srotas due to their ashrayashrayibhava (state of interdependency). [Cha.Sa. Chikitsa Sthana 9/5]&lt;/p&gt;<br /> <br /> ==Pathologies of manovaha srotas==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Manovaha srotas is important factor in understanding disorders like unmada (psychosis), apasmara (epilepsy) and extreme emotional reactions. &lt;/p&gt;<br /> <br /> *'''Unmada (psychosis)'''<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;When an individual experiences extreme emotions – lust (kama), anger (krodha), fear (bhaya), greed (lobha), happiness or pleasure (harsha), affection (moha), grief (shoka), excessive worry (chinta), they initially harm the intellect which aggravates manas dosha (rajas and tamas) and tridosha (vata, pitta and kapha). These vitiated dosha invade heart and obstruct manovaha srotas (channels transporting psychic impulses) thereby causing unmada. [Dalhan on Su. Sa. Uttar Tantra 62/3]<br /> *'''Apasmara (epilepsy)'''<br /> Overindulging in sensory pleasures, incompatible diet, withholding natural urges and giving into immoral activities under emotional influences (kama, krodha, lobha among others), vitiates rajas and tamas. They poorly influence the manas (mind) and sanjnavaha srotas (manovaha srotas) causing apasmara. [Su.Sa. Uttar Tantra 61/6]<br /> * Mada (intoxication), murchha (syncope), sanyasa (coma) are caused by vitiation of channels of consciousness (chetanavaha srotas or manovaha srotas). [Shivadas Sen on Cha. Sa. Chikitsa Sthana 9/5] <br /> *'''Atattvabhinivesha (perverted state of mind)'''<br /> Considered as mahagada (difficult to treat mental disorder), the person’s conscience gets afflicted by rajas and tamas, which cause complete derangement of intellect (buddhi vibhramsha) as the predominant symptom. The vitiated dosha get lodged in heart (hridaya) to afflict channels of mind and intellect (manobuddhivaha sira in manovaha srotas). [Cha.Sa. Chikitsa Sthana 10/57-60]<br /> * Physiology of nightmares (swapna)<br /> Nightmares are dreams occurring in REM phase of sleep which causes mental projections in the form of feelings of fear, despair, and anxiety. Ayurveda defines REM phase as ‘Natiprasupta’ - the state characterised to be midway between states of deep sleep and fully awake. During any ominous situation, tridosha in their highly aggravated state tend to fill-up the manovaha srotas. This results in terrifying dreams. [Cha.Sa. Indriya Sthana 5/41]. &lt;/p&gt;<br /> <br /> ==Assessment and diagnosis of disorders of manovaha srotas==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Srotas are micro-channels transporting various metabolites across cells throughout the body. It can be deduced that manovaha srotas has different characteristics structurally and functionally from the major thirteen srotas, because it transports and transforms thoughts and feelings. This is evident from objects of mind (manas), viz- thought (chintyam), consideration (vicharyam), hypothesis (uhyam), aims (dhyeyam) and determination (sankalpam). [Cha.Sa. Sharira Sthana 1/20]. Assessment of manovaha srotas can be done via assessment of manas and the degree of derangement of its functions. Ayurveda considers manas as material entity (dravya) which is a super sense and not perceivable by ordinary senses (atindriya) [Cha. Sa. Sutra Sthana 8/4]. Manas is under direct control of vata dosha [Cha. Sa. Sutra Sthana 12/8] and is the mediator between atma (soul) and indriyartha (objects of senses). <br /> &lt;br/&gt;The contemporary physiological aspects of mind, senses, brain, nervous system and consciousness can be considered for assessment of manovaha srotas. <br /> &lt;br/&gt; A thorough neurological examination by means of interrogation (prashna pariksha), inspection (darshana pariksha) and assessment of mental strength (sattva bala pariksha) [Cha.Sa. Vimana Sthana 8/119] can be used for assessment and diagnosis of disorders of manovaha srotas.&lt;/p&gt;<br /> <br /> ''' a. Interrogation (prashna pariksha)'''<br /> A formal interview of the patient can be conducted for overall and precise diagnosis. The questions related to chief complaints with duration, chronological development, nurturing of patient, family history, addiction, hobbies, interests, daily routine, major life events, achievements, mental traumas, emotional quotient and intellectual quotient is recorded from the patient. If the patient is not in state of giving correct answers, then the relatives or attendants who know patients history are interviewed. <br /> <br /> '''b. Darshan pariksha (Direct observation)'''<br /> While interviewing the patient, a physician should pay attention to following attributes that can signify features mentioned for certain psychiatric ailments (manovaha srotodushti)..<br /> <br /> # '''Appearance '''– Unusual dressing preferences, use of cosmetics, perfumes or accessories or flamboyant appearance. e.g;- ‘Priye tanu rakta vastradhari’ (liking for adorning clothes made of thin red fabric) is seen in yakshagraha unmada (Su.Sa. Uttara tantra 60/11)<br /> # '''Activity and co-ordination''' - Behaviour, Gait, gestures, patient’s facial expression and body language should be observed during probing them with questions. Eg;- 'Satatama akshano’ (rapid and constant eye movements) is one of the prodromal feature of apasmara (epilepsy) [ Cha.Sa. Nidana sthana 8/6]. Udhasta (patient keeps his hands raised) is a feature of pishacha grahavishta unmada [Su.Sa. Uttara Tantra 60/15]<br /> # '''Conversation style''' – Coherence of speech, articulation, emphasise over certain issue, hesitation and duration of response. E.g. ‘Chitram sa jalpati’ (Patient does irrelevant absurd talks) is seen in patients of manas unmada [Su.Sa. Uttara Tantra 62/13].<br /> #'''Emotional expression''' – Patients may express a wide range of emotions during interview with the physician. E.g. Asthana rodana (Sudden crying) is a feature in vataja unmada while amarsha (intolerance) is seen in patients of pittaja unmada. [Cha.Sa. Chikitsa Sthana 9/11-12] Fleeting ideas, incoherent speech is an important sign for lacking proper emotions. <br /> #'''Cognition''' – Orientation to person, place, time and circumstances, level of intellect, level of understanding, common sense and memory can be identified under the domain of cognition by observing patient’s behaviour as well as by asking questions to them using validated scientific questionnaires. Short term memory and long-term memory shall be assessed properly. <br /> &lt;br/&gt;All observations gathered from every method of assessment should be simultaneously analysed to reach the diagnosis.<br /> <br /> '''c. Sattva pariksha (assessment of quality of excellence of mind)'''<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Sattva pariksha assesses the quality of excellence of mind imparted by extent of dominance of sattva guna. Mind (manas) is composed of three attributes (triguna) viz. sattva, rajas and tamas. These impart three types of mental constitutions – Shuddha (pure) (sattvika), rajasika and tamasika. [Cha.Sa. Sharira Sthana 4/36]. Sattvika guna is full of auspiciousness and is considered the healthy (amala) state of mind. Rajasika guna imparts momentum in terms of furious temperament. Whereas tamas guna promotes inertia and moral ignorance. Hence, rajas and tamas are considered inauspicious and called manas dosha. Triguna are present in dynamically varying proportions at any given time and influenced by body (i.e. tridosha) and vice versa. [Chakrapani on Cha.Sa. Vimana Sthana 4/8]. Optimum levels of sattva guna are essential for promoting desired physical and mental strength irrespective of morphological features. [Cha.Sa. Vimana Sthana 8/119]&lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Sattva bala (strength of psyche) is of three types as per strength – pravara (superior), madhyama (moderate) and avara (poor). Pravara sattva persons possess great courage. Despite poor morphological features they seem to be unmoved in the face of adversities. Madhyama sattva persons need some additional moral support to sustain themselves in times of distress. While avara sattva displays catastrophic reactions even during little inconveniences and can neither be sustained by themselves nor by others despite having good quality morphological features. Avara sattva is constantly plagued by inferior emotions like grief, fear, greed, conceit and confusion. When confronted with fierce, ugly, disgusting narratives or flesh and blood, they are prone to become depressed, pale, unconscious or semiconscious, giddy, anxious and can even succumb to death in worst case scenarios. [Cha. Sa. Vimana Sthana 8/119].<br /> &lt;br/&gt;Manovaha srotas associated with avara sattva bala is most likely to be vitiated by manas dosha leading to various psychiatric and psychosomatic disorders [Cha.Sa. Chikitsa Sthana 9/5]. It has been observed that avara sattva individuals are more likely to commit prajnaparadha (intellectual defects) [10] thereby voluntarily indulging in various etiological factors for respective psychological as well as somatic disorders.<br /> &lt;br?&gt;Thus, assessment of sattva bala can help rule out the predisposition towards manovaha srotodushti and subsequent development of symptoms of psychiatric ailments.&lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;'''d. Anumana pariksha (knowledge by inference)''' to determine normalcy of faculties of manas (mind) [Cha.Sa. Vimana Sthana 4/8] Since manas is atindriya ( supersence or imperceivable by ordinary senses), so are it’s faculties which can serve as potential markers for assessment of its functions. [10] The proper functioning of manas itself is inferred by altered or inappropriate mental perceptions even in presence of appropriately functioning indriya (senses) and their respective sense objects whereas the mental faculties can be inferred as follows:-&lt;/p&gt;<br /> {| class=&quot;wikitable&quot;<br /> |'''Faculty''' <br /> |'''object for inference''' <br /> |-<br /> |Vijnanam (expertise/skills )<br /> |Vyavsayena (occupation )<br /> |-<br /> |Dhairyam (fortitude)<br /> |avishadena (courage in face of adversity)<br /> |-<br /> |Viryam (bravery)<br /> |Uthhanena (initiating difficult tasks and enduring them)<br /> |-<br /> |Avasthanama (stability)<br /> |Avibhramana (absence of confusion)<br /> |-<br /> |Shradhha (faith)<br /> |Abhiprayena (purposiveness)<br /> |-<br /> |Medha (intellect)<br /> |Grahanena (grasping power)<br /> |-<br /> |Sanjna (recognition or consciousness level)<br /> |Namagrahanena (ability to recognise or name things)<br /> |-<br /> |Smriti (memory)<br /> |Smaranena (ability to recollect things)<br /> |-<br /> |Dhriti (self restraint)<br /> |Alaulyama (not being carried away by own greed)<br /> |-<br /> |Amala sattva (purity of mind)<br /> |Avikara (free of delusions or illusionary attachments)<br /> |}<br /> This inferential knowledge can help an individual become self-aware of his own psyche (sattva). A self-aware individual has an upper hand at avoiding mental illness because these often go unnoticed until they develop some organic manifestations.<br /> &lt;br /&gt;Thus, by means of above discussed assessment methodologies, a physician can assess the degree of derangement in mental faculties and hence the manovaha srotas, irrespective of development of specific signs and symptoms of any psychiatric disorder (vyadhi lakshana).<br /> <br /> ==Treatment Guidelines==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Manovaha srotas disorders follow the line of treatment same as described for disorders of manas (mind). Following are therapeutic and preventive practices beneficial for both vitiated manovaha srotas (channels of psyche) and manas obscured by rajas - tamas dosha.&lt;/p&gt;<br /> Manas dosha can be alleviated through a comprehensive five-fold psychotherapeutic regimen - jnana (spiritual knowledge or self-awareness), vijnana (scriptural or scientific knowledge), dhairya (mental fortitude), smriti (recollection of past successes to regain faith in own abilities) and samadhi (spiritual healing practices to focus mind inwards away from negative external stimuli). [Cha.Sa. Sutra Sthana 1/58]<br /> Restoration of dhi (intellect), dhairya (mental fortitude) and atmadi vijnana (knowledge of self-consciousness) has therapeutic effect in alleviating disorders of manovaha srotas obstructed by manas dosha.<br /> <br /> '''*Sattvavajaya chikitsa (treatment to regulate mind)'''<br /> Sattvavajaya chikitsa is a non-invasive therapeutic module for psychological derangements and psychosomatic ailments, analogous to contemporary psychotherapy. ‘Sattva’ stands for mind and ‘avajaya’ translates to win over. Hence, it emphasizes withdrawing the mind from unwholesome objects of senses (factors vitiating rajas and tamas) and diverting it to positive sensory and emotional stimuli. Thereby consciously negating disturbed emotions and behavioural patterns. [Cha.Sa. Sutra Sthana 11/54]<br /> <br /> '''*Ashtanga yoga (eight steps of yoga)'''<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Ashtanga yoga can be considered as one of the dimensions of satvavajaya chikitsa. It integrates eight steps of yoga to tame mind from traversing paths in life which are spiritually and mentally harmful for that individual. Of the eight steps, first four viz. yama (principles for moral code), niyama (observances for personal discipline), asana (yogic postures) and pranayama (regulating breath) are termed as bahiranga yoga (external path). These practices gradually alleviate aggravated manas dosha, making the mind less reactive towards external stimuli. The last three limbs viz. dharana (concentration), dhyana (meditation) and samadhi (enlightenment or complete realisation) are termed as antaranga yoga (internal paths). These practices transform the mind, eliminating the fluctuations of mind, thereby strengthening positive habits and outlook on life as well as inner self. Ashtanga yoga maintains a harmonious balance between inner environment (mind and spirit) and external environment (objects of sensory perception). Mind thus gets liberated from worldly pursuits and all psychological sufferings in a stepwise manner.&lt;/p&gt;<br /> '''*Achara rasayana (rejuvenating codes of behavioural conduct)'''<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Achara rasayana is an adravyabhuta (non-pharmacological) rasayana (practices rejuvenating physical and mental health). It includes behavioural conducts which aim to enhance health and longevity by teaching practical methods to potentiate sattva guna of mind. [Cha.Sa. Chikitsa Sthana 1, 4th pada, shloka 30-35] An individual can imbibe easy lifestyle modifications to develop a positive and strong character of mind, thereby avoiding potential etiological factors (for dosha aggravation) and negative psychosocial patterns. Achara rasayana can be divided into five domains of good mental, social, personal, moral and religious conduct. [6]&lt;/p&gt;<br /> '''*Sadvritta (good codes of conduct)'''<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Sadvritta refers to good code of conduct. These are a set of practices, which serve as lifestyle guidelines to prevent mind from falling prey to temporary material pleasures and impulsive thoughts and actions that cause impairment of manas dosha and manovaha srotas. It encompasses guidelines over personal hygiene, personality development as well as for social hygiene and peaceful social interactions. [Cha.Sa. Sutra Sthana 8/18]&lt;/p&gt;<br /> Both achara rasayana and sadvritta help to maintain control over sense organs. They majorly add to the preventive and promotive aspect of mental health. <br /> '''*Medhya dravya (medicines enhancing intellectual functions)'''<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Medhya dravyas are the plant based pharmacological agents that promote prajna i.e., dhi (intellect), dhriti (perseverance) and smriti (memory). Researches conducted prove their efficacy in minimizing the cognitive decline among individuals with neural abnormalities. For example, ushna (hot potency) and tikshna nature drugs like jyotishmati and vacha are said to remove blockages caused by kapha, ama or tamas dosha in the manovaha srotas. Once purified, manas can regain unvitiated connect with indriya via manovaha srotas. [8] <br /> &lt;br/&gt;Ayurveda thus provides a bird’s eye view over different aspects of manovaha srotas through interconnected references in the classics highlighting its physiological importance like the other thirteen major srotas systems in the human body.&lt;/p&gt;<br /> <br /> ==Contemporary view==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Mind as per contemporary literature is debatable concept because in some contexts it is identified as conscience, while in others it is seen as the function of conscience. The philosophical dimension of mind was conceived by Plato who considered mind as an inner (soul’s) experience. [11]<br /> &lt;br/&gt;The western system of medicine addresses brain at the core of majority of psychological distresses, whereas western philosophy involves the concept of psyche (which denotes mind). ‘Psyche’ is a Greek word meaning ‘soul in a living man’. <br /> &lt;br/&gt;William James, referred to as the father of American Psychology, laid the foundations of physiological aspect of mind. To him mind was a function of brain which conducts mental life in the form of a constant stream of consciousness.[9] At some places he too admitted mind to bear consciousness and tried to assign attributes to consciousness as a separate psychological function thus formulating the Theory of Functionalism which established causal relationship between internal states (perception) and external reactions or behaviour (sensation). He concluded that repeated actions cause adaptive changes in nervous system. This is the fundamental ideology behind the concept of Neuroplasticity – i.e. adaptive structural and functional changes in brain by development of new neuronal pathways due to intrinsic or extrinsic stimuli. [12]<br /> &lt;br/&gt;James’ counterpart Titchener, an English Psychologist, proposed that consciousness is mind’s awareness of its own functions. Consciousness is something superior to mind itself. He formulated the Theory of Structuralism which aimed at analysing the interrelationship between mental experiences, feelings, and sensations. He used introspection as a tool to break down these complex phenomena of consciousness down to their basic elements without breaking their original structure. <br /> &lt;br/&gt;Mind is hence regarded as the cumulative effect of all mental processes that have occurred in the lifetime while the consciousness can be understood as the cumulative effect of all mental processes occurring in present moment. Eventually brain was somehow regarded to control the neural activity responsible for accumulating all this sensory data.<br /> &lt;br/&gt;Many theories were formulated and overruled by their successors with time. Today the concept of mind and consciousness remains yet to be clearly defined. It is observed that mind is often identified as consciousness and they both are accepted as individual closely linked entities. Mind bears synonymity towards consciousness, spirit, and psyche. Some theories view both mind and consciousness as spirit. But mind is invariably understood as the interaction between psychological personality and the external environment, i.e., a subject – object relationship.<br /> &lt;br/&gt;The neurophysiological basis of minds and the channels of transport of its constituents is yet a challenge in field of neuroscience. In order to bridge this gap, contemporary scientists hypothesise that mental representations and their contents are represented by neural network and their supporting cells thus hinting towards Central Nervous System and it’s peripheral nerves as the channels of mind. [13]&lt;/p&gt; <br /> <br /> ==Research works on manovaha srotas==<br /> Various review articles have been published and researches been carried out in the domain of Ayurveda to understand the conceptual as well as pathophysiological aspect of manovaha srotas. Few of them are as follows :-<br /> '''# Critical Review of Concept of manovaha Srotas with special reference to Brain''' <br /> This review article conceptualizes the contemporary understanding of manovaha srotas in context to CNS due to functional similarity between manas and brain obtained after an extensive research and analysis throughout ayurveda treatises. Further brain was considered as synonymous to hridya ie. mulasthana (site of origin) of manovaha srotas and ‘dasha dhamani’ as the cranial nerves exiting from the 10 major foramen at base of skull. Sanskrit literature considers hridaya as regarded as a central organ similar to brain. 14<br /> '''# Circumstantial view on clinical knowing of manovaha srotasa &amp; its physiology''' <br /> The review article reconstructs a comprehensive picture of manovaha srotas from the scattered references available in Ayurveda texts, supplementing it with additional information from contemporary science as follows-<br /> '''*'''A detailed description of neuroanatomy and physiology has been drawn parallel to Ayurveda point of view about manas’ rachna and kriya sharir. <br /> '''*'''Effect of Triguna and tridosha (especially vata) in context of physiological functions and disorders of manas and manovaha srotas have been discussed.<br /> '''*'''Correlations between functions of five subtypes of vata and both CNS and ANS has been attempted Pariksha krama (examination of nervous system) has been exemplified taking into consideration both Ayurveda and modern methodologies that can be employed for manovaha srotas (nervous system) examination.10 <br /> '''*'''Concept of stress factor assessment concerning ‘perseverance test’ in light of ayurveda” – a review This article highlights the importance of understanding the etiological factors of vitiation of manovaha srotas and manas in all kinds of psychiatric as well as psychosomatic disorders. Imbalance of manas dosha can be treated by means of yoga, meditation and pranayama. Often emotional disturbances remain unattended in diagnosed cases of psychiatric illness which can be managed at home by incorporating wholesome diet (pathya ahara) and moral code of conduct (sadvrutta) in daily routine. Lack of peace and chronic stressors have been observed as major causes of vitiation of channels of mind. 15<br /> <br /> <br /> &lt;big&gt;'''[[Special:ContactMe|Send us your suggestions and feedback on this page.]]'''&lt;/big&gt;<br /> <br /> ==References==<br /> <br /> &lt;div id=&quot;BackToTop&quot; class=&quot;noprint&quot; style=&quot;background-color:#DDEFDD; position:fixed;<br /> bottom:32px; left:2%; z-index:9999; padding:0; margin:0;&quot;&gt;&lt;span style=&quot;color:blue;<br /> font-size:8pt; font-face:verdana,sans-serif; border:0.2em outset #ceebf7;<br /> padding:0.1em; font-weight:bolder; -moz-border-radius:8px; &quot;&gt;<br /> [[#top| Back to the Top ]]&lt;/span&gt;&lt;/div&gt;</div>

Manishdubey https://www.carakasamhitaonline.com/index.php?title=Manovaha_srotas&diff=44191 2023-10-16T10:26:35Z

<p>Manishdubey: </p> <hr /> <div>{{CiteButton}}<br /> {{#seo:<br /> |title= Manovaha srotas<br /> (Channels of transport and transformation of mind and mental factors)<br /> |titlemode=append<br /> |keywords= Manovaha srotas,Hrudya, Sattva pariksha, Sattvavajaya chikitsa, Bhojani M. K.,Deole Y.S., Basisht G<br /> |description=Mana means mind, or psyche. Srotas means channels of transport and transformation. The description and understanding of channels for activities of mind (manovaha srotas) is scattered in ayurveda classics and has not been completely elucidated. Manovaha srotas are considered as channels through which mind and body interact with each other. <br /> |image=http://www.carakasamhitaonline.com/mediawiki-1.32.1/resources/assets/ogimgs.jpg<br /> |image_alt=carak samhita<br /> |type=article<br /> }}<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Mana means mind, or psyche. Srotas means channels of transport and transformation. The description and understanding of channels for activities of mind (manovaha srotas) is scattered in ayurveda classics and has not been completely elucidated. Manovaha srotas are considered as channels through which mind and body interact with each other. These channels pervade throughout the body. [Chakrapani on Cha.Sa. Indriya Sthana 5/41-42] They are responsible for flow of thoughts, emotions, and other psychological functions. This article deals with various aspects of manovaha srotasa i.e. the channels of activities of mind and its development.&lt;/p&gt;<br /> <br /> {{Infobox<br /> |title = Contributors<br /> |label1 = Section/Chapter/topic<br /> |data1 = Concepts/[[Srotas]]/[[Manovaha Srotas]] <br /> |label2 = Authors<br /> |data2 = Bhojani M. K.&lt;sup&gt;1&lt;/sup&gt; Varma Swati &lt;sup&gt;1&lt;/sup&gt; Deole Y.S.&lt;sup&gt;2&lt;/sup&gt;<br /> |label3 = Reviewer &amp; Editor<br /> |data3 = Basisht G.&lt;sup&gt;3&lt;/sup&gt;, <br /> |label4 = Affiliations<br /> |data4 = &lt;sup&gt;1&lt;/sup&gt; Department of Sharir Kriya, All India Institute of Ayurveda, New Delhi, India<br /> &lt;sup&gt;2&lt;/sup&gt; Department of Kayachikitsa, G. J. Patel Institute of Ayurvedic Studies and Research, New Vallabh Vidyanagar, Gujarat, India <br /> &lt;sup&gt;3&lt;/sup&gt; Rheumatologist, Orlando, Florida, U.S.A.<br /> |label5 = Correspondence emails<br /> |data5 = meera.samhita@aiia.gov.in, carakasamhita@gmail.com<br /> |label6 = Publisher <br /> |data6 = [[Charak Samhita Research, Training and Development Centre]], I.T.R.A., Jamnagar, India<br /> |label7 = Date of publication:<br /> |data7 =October 12, 2023<br /> |label8 = DOI<br /> |data8 = In process<br /> }}<br /> <br /> ==Etymology and derivation:==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Srotas originates from Sanskrit root ‘Sru’ that translates to oozing, flow or secretion. It has been defined as ‘sravanat strotamsi’ [Cha. Sa. Sutra Sthana 30/12] which indicates structures designated for conveyance of material inside body. <br /> &lt;br/&gt;Grossly defining, thirteen major types of srotas have been mentioned that transport substances undergoing biotransformation (parinamam aapadyamanam) from the place of origin to their destination. [Cha. Sa. Vimana Sthana 5/3] Similarly in physiological state, manovaha srotas might be responsible for processing and transformation of ‘doshayukta’ (irrational under influence of rajas and tamas) emotions and thoughts into unbiased reasoning before reaching a conclusion by our intellect (buddhi). &lt;/p&gt;<br /> <br /> ==Synonyms of manovaha srotas==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Following terms are used for ‘manovaha srotas’ in different Ayurveda classics : &lt;/p&gt;<br /> # Manovaha dhamani [Chakrapani on Cha. Sa. Indriya sthana 12/42] and [Vijayarakshita in Ma.Ni.Purva Khanda 20/1]<br /> # Chetanavaha srotas [Shivadas Sen on Cha.Sa. Chikitsa sthana 9/5] <br /> # Chetovaha marga [Bhel Samhita Nidana Sthana 7/2]<br /> # Manobuddhivaha sira [ Cha.Sa.Chikitsa Sthana 10/58]<br /> # Sanjnavaha srotas [Su.Sa.Uttar Tantra 61/8]<br /> # Sanjnavaha nadi [Su.Sa. Uttar Tantra 46/7]<br /> &lt;p style=&quot;text-align:justify;&quot;&gt; &lt;br/&gt;Use of terms like sira, nadi and dhamani, refers to different channels and pathways concerned with maintenance of physiological flow of information. [Cha.Sa. Vimana Sthana 5/8] &lt;/p&gt;<br /> <br /> ==Origin==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt; Every srotas is localized within the hollow space in the body originating from a root (mula) and spreading throughout the body to reach a final structure. Srotas are said to be hollow structures in different shapes and sizes The root (mula) is majorly responsible for regulation and control of functions of that srotas.<br /> &lt;br/&gt;The channels carrying mind (manovaha srotas) are not exclusively listed. It is however stated that the entire conscious body is abode of mind. Hence these channels are spread throughout the body. [Chakrapani on Cha.Sa. Indriya Sthana 5/41]. <br /> &lt;br/&gt;However, hridaya (heart) has a universal acceptance as the site of origin (mula) of manovaha srotas. Hence a special mention has been made about ten arteries of heart, probably being the manovaha srotas (visheshen tu hrudya ashritvat manah tadashrita dasha dhamanyo manovaha abhidhiyante) [Chakrapani on Cha.Sa. Indriya Sthana 5/41-42]. These get afflicted by vitiated dosha either all at once or individually. [Chakrapani on Cha.Sa. Indriya Sthana 12/42]<br /> &lt;/p&gt;<br /> <br /> ==Decoding hridaya (heart)==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt; The interpretation of the term ‘hridaya’ has been of confusion among scholars since decades. The first interpretation of the term given by texts of Shatpada Brahmana which highlighted functional aspect of hridaya. The word being composed of three letters viz ‘hri’ (hra harane)- to acquire; ‘Da’ (da dane) – to give; ‘Ya’ (Ya gatau)- which transports. The hridaya thus displays three phases of cardiac cycle i.e., receives, gives, and transports body constituents through it. [2]<br /> &lt;br/&gt;Hridaya is the site of rasa (plasma), sattva (psychic factor/mind), buddhi (intellect) and atma (soul) in conjugation with all sensory organs (jnanendriya).[Cha.Sa. Chikitsa Sthana 24/35] Sadhaka pitta situated in heart (hridaya) regulates proper functioning of intellect (buddhi) and ego (ahamkara). Hridaya is located in between breasts (stanayormadhya) of thoracic region [A. H. Sutra Sthana 12/13-14] [Su. Sa. Sharira Sthana 6/25]. <br /> &lt;br/&gt;Vedic era was well versed with heart (hridaya) and brain (mastishka) being two distinct entities, with interdependent functional relationship [Atharvaveda Book X. Hymn 2.26]. Kashyap Samhita quotes that all sense and motor organs (indriya) together with mind (manas) emerge from heart (hridaya) [Ka.Sa. Chikitsa Sthana 8/6]. Primary site of action of mind (manas) is brain (shira).[3] It can be concluded that mind (manas) being seated in heart (hridaya) connects to brain (shiras) through manovaha srotas and controls all senses (indriya). Also, any damage pertaining to marma (vital points) of shiras (head) causes loss of consciousness (cheshtanasha). [Cha.Sa. Sidhhi Sthana 9/6] Hence heart (hridaya) and brain (shirasor mastishka) are sites of manovaha srotasa. <br /> &lt;br/&gt; This approach of understanding hridaya goes well along with the contemporary view of understanding the triguna based psycho-functional principles of Ayurveda within the neural framework. Various research has been conducted which demonstrate that heart continuously sends nervous signals to brain to coordinate higher centres responsible for cognition and emotions. [1] The neuro- psychological as well as circulatory functions of hridaya mentioned in the classics can thus be explained. &lt;/p&gt; <br /> <br /> ==Relation between rasavaha and manovaha srotas==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Heart is the abode of mind (mana) and consciousness (chetana) or soul (atma). [Cha. Sa. Sidhhi Sthana 9/4] It is a site for physical, psychological, and spiritual components. Heart is origin for channels of transportation and transformation of rasa dhatu, too. Both heart and brain are considered under the umbrella term hridaya in terms of anatomical structure and higher-centre functions respectively. <br /> &lt;br/&gt;Heart (residence of manas) and brain (workplace of manas) are functionally co-dependent upon each other. Manas regulates the cognitive and conative functions of brain in conjunction with soul (atma) under the influence of vata dosha. [Cha. Sa. Sharira Sthana 1/22-23]. Brain is a structural entity needing continuous supply of nourishment and oxygen. This is feasible by heart through circulation (rasa-rakta samvahana kriya) via the ten major vessels (rasavahi dhamani). [A. H. Sharira Sthana 3/18] Heart is a highly vascular organ being surrounded by ten major dhamani (blood vessels) like spokes of a wheel which are known as ‘rasavaha strotomula’ (site of origin of channels of nutrition). These channels are comparable to manovaha srotas. [Chakrapani on Cha. Sa. Chikitsa Sthana 9/4] Manas thus acts like a medium between heart and brain wherein brain is responsible for all sensory and motor functions while heart has been assigned emotional aspect of psyche (manas).<br /> &lt;br/&gt;One of the factors for vitiation of rasavaha srotas is excessive thinking or worry (atichintan). [Cha. Sa. Vimana Sthana 5/13] Contemporary researchers have found evidence to support the interaction between circulatory system and psyche. The monograph of German professor Ludwig Braun is a pioneer in exploring the psychological and emotional aspect of cardiac diseases especially angina. He presented a correlation between cardiac diseases and ‘Angst’ (a constrictive, tightening and crushing sensation which manifests dread in the patient thereby changing his entire emotional outlook on life), analogous to anxiety. He explains that the cardiac tissue has a special apparatus receptive towards anxiety which manifests as an inner tactile sensation. That region is well supplied with nerve endings that gets irritated by anxiety. This phenomenon of emotional influence over cardiac tissues is termed as cardiac psyche. [4] <br /> &lt;/p&gt; <br /> <br /> ==Factors vitiating manovaha srotas==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt; Manovaha srotas are the prime site of abnormalities of channels in all psychological disorders. [Cha.Sa. Nidana Sthana 6/4] Alongside any of the eight factors that are either attributed to hridaya or manas viz. mana (mind), buddhi (intellect), sanjna-jnana (self-awareness), smriti (memory), bhakti (devotion), sheela (habits), cheshta (psychomotor activities) and achara (code of conduct). [Cha.Sa. Nidana Sthana 7/5] <br /> &lt;br/&gt;These factors when deranged cause vitiation of manas dosha (rajas and tamas), deterioration of sattva guna of manas and gradual derangement of tridosha. Foods, activities and excessive expression of emotions like anger, grief, lust, fear etc and mental traumas are the fundamental etiological factors for the same. [Cha.Sa. Nidana Sthana 7/4] Vitiated tridosha further vitiates rasavaha srotas, which apparently has the same site of origin as of manovaha srotas i.e., hridaya and dasha dhamani (ten great vessels). [Cha. Sa. Vimana Sthana 5/10] Hridaya is seat of manas [Cha.Sa. Sutra Sthana 30/4]. Hence, all the factors vitiating rasa dhatu (nutritive fluid), rasavaha srotas (channels carrying nutritive fluid) and manas dosha viz. rajas and tamas will affect manas and eventually vitiating manovaha srotas. Even the structural derangements of heart (abode of mind) affect manovaha srotas due to their ashrayashrayibhava (state of interdependency). [Cha.Sa. Chikitsa Sthana 9/5]&lt;/p&gt;<br /> <br /> ==Pathologies of manovaha srotas==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Manovaha srotas is important factor in understanding disorders like unmada (psychosis), apasmara (epilepsy) and extreme emotional reactions. &lt;/p&gt;<br /> <br /> *'''Unmada (psychosis)'''<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;When an individual experiences extreme emotions – lust (kama), anger (krodha), fear (bhaya), greed (lobha), happiness or pleasure (harsha), affection (moha), grief (shoka), excessive worry (chinta), they initially harm the intellect which aggravates manas dosha (rajas and tamas) and tridosha (vata, pitta and kapha). These vitiated dosha invade heart and obstruct manovaha srotas (channels transporting psychic impulses) thereby causing unmada. [Dalhan on Su. Sa. Uttar Tantra 62/3]<br /> *'''Apasmara (epilepsy)'''<br /> Overindulging in sensory pleasures, incompatible diet, withholding natural urges and giving into immoral activities under emotional influences (kama, krodha, lobha among others), vitiates rajas and tamas. They poorly influence the manas (mind) and sanjnavaha srotas (manovaha srotas) causing apasmara. [Su.Sa. Uttar Tantra 61/6]<br /> * Mada (intoxication), murchha (syncope), sanyasa (coma) are caused by vitiation of channels of consciousness (chetanavaha srotas or manovaha srotas). [Shivadas Sen on Cha. Sa. Chikitsa Sthana 9/5] <br /> *'''Atattvabhinivesha (perverted state of mind)'''<br /> Considered as mahagada (difficult to treat mental disorder), the person’s conscience gets afflicted by rajas and tamas, which cause complete derangement of intellect (buddhi vibhramsha) as the predominant symptom. The vitiated dosha get lodged in heart (hridaya) to afflict channels of mind and intellect (manobuddhivaha sira in manovaha srotas). [Cha.Sa. Chikitsa Sthana 10/57-60]<br /> * Physiology of nightmares (swapna)<br /> Nightmares are dreams occurring in REM phase of sleep which causes mental projections in the form of feelings of fear, despair, and anxiety. Ayurveda defines REM phase as ‘Natiprasupta’ - the state characterised to be midway between states of deep sleep and fully awake. During any ominous situation, tridosha in their highly aggravated state tend to fill-up the manovaha srotas. This results in terrifying dreams. [Cha.Sa. Indriya Sthana 5/41]. &lt;/p&gt;<br /> <br /> ==Assessment and diagnosis of disorders of manovaha srotas==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Srotas are micro-channels transporting various metabolites across cells throughout the body. It can be deduced that manovaha srotas has different characteristics structurally and functionally from the major thirteen srotas, because it transports and transforms thoughts and feelings. This is evident from objects of mind (manas), viz- thought (chintyam), consideration (vicharyam), hypothesis (uhyam), aims (dhyeyam) and determination (sankalpam). [Cha.Sa. Sharira Sthana 1/20]. Assessment of manovaha srotas can be done via assessment of manas and the degree of derangement of its functions. Ayurveda considers manas as material entity (dravya) which is a super sense and not perceivable by ordinary senses (atindriya) [Cha. Sa. Sutra Sthana 8/4]. Manas is under direct control of vata dosha [Cha. Sa. Sutra Sthana 12/8] and is the mediator between atma (soul) and indriyartha (objects of senses). <br /> &lt;br/&gt;The contemporary physiological aspects of mind, senses, brain, nervous system and consciousness can be considered for assessment of manovaha srotas. <br /> &lt;br/&gt; A thorough neurological examination by means of interrogation (prashna pariksha), inspection (darshana pariksha) and assessment of mental strength (sattva bala pariksha) [Cha.Sa. Vimana Sthana 8/119] can be used for assessment and diagnosis of disorders of manovaha srotas.&lt;/p&gt;<br /> <br /> ''' a. Interrogation (prashna pariksha)'''<br /> A formal interview of the patient can be conducted for overall and precise diagnosis. The questions related to chief complaints with duration, chronological development, nurturing of patient, family history, addiction, hobbies, interests, daily routine, major life events, achievements, mental traumas, emotional quotient and intellectual quotient is recorded from the patient. If the patient is not in state of giving correct answers, then the relatives or attendants who know patients history are interviewed. <br /> <br /> '''b. Darshan pariksha (Direct observation)'''<br /> While interviewing the patient, a physician should pay attention to following attributes that can signify features mentioned for certain psychiatric ailments (manovaha srotodushti)..<br /> <br /> # '''Appearance '''– Unusual dressing preferences, use of cosmetics, perfumes or accessories or flamboyant appearance. e.g;- ‘Priye tanu rakta vastradhari’ (liking for adorning clothes made of thin red fabric) is seen in yakshagraha unmada (Su.Sa. Uttara tantra 60/11)<br /> # '''Activity and co-ordination''' - Behaviour, Gait, gestures, patient’s facial expression and body language should be observed during probing them with questions. Eg;- 'Satatama akshano’ (rapid and constant eye movements) is one of the prodromal feature of apasmara (epilepsy) [ Cha.Sa. Nidana sthana 8/6]. Udhasta (patient keeps his hands raised) is a feature of pishacha grahavishta unmada [Su.Sa. Uttara Tantra 60/15]<br /> # '''Conversation style''' – Coherence of speech, articulation, emphasise over certain issue, hesitation and duration of response. E.g. ‘Chitram sa jalpati’ (Patient does irrelevant absurd talks) is seen in patients of manas unmada [Su.Sa. Uttara Tantra 62/13].<br /> #'''Emotional expression''' – Patients may express a wide range of emotions during interview with the physician. E.g. Asthana rodana (Sudden crying) is a feature in vataja unmada while amarsha (intolerance) is seen in patients of pittaja unmada. [Cha.Sa. Chikitsa Sthana 9/11-12] Fleeting ideas, incoherent speech is an important sign for lacking proper emotions. <br /> #'''Cognition''' – Orientation to person, place, time and circumstances, level of intellect, level of understanding, common sense and memory can be identified under the domain of cognition by observing patient’s behaviour as well as by asking questions to them using validated scientific questionnaires. Short term memory and long-term memory shall be assessed properly. <br /> &lt;br/&gt;All observations gathered from every method of assessment should be simultaneously analysed to reach the diagnosis.<br /> <br /> '''c. Sattva pariksha (assessment of quality of excellence of mind)'''<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Sattva pariksha assesses the quality of excellence of mind imparted by extent of dominance of sattva guna. Mind (manas) is composed of three attributes (triguna) viz. sattva, rajas and tamas. These impart three types of mental constitutions – Shuddha (pure) (sattvika), rajasika and tamasika. [Cha.Sa. Sharira Sthana 4/36]. Sattvika guna is full of auspiciousness and is considered the healthy (amala) state of mind. Rajasika guna imparts momentum in terms of furious temperament. Whereas tamas guna promotes inertia and moral ignorance. Hence, rajas and tamas are considered inauspicious and called manas dosha. Triguna are present in dynamically varying proportions at any given time and influenced by body (i.e. tridosha) and vice versa. [Chakrapani on Cha.Sa. Vimana Sthana 4/8]. Optimum levels of sattva guna are essential for promoting desired physical and mental strength irrespective of morphological features. [Cha.Sa. Vimana Sthana 8/119]&lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Sattva bala (strength of psyche) is of three types as per strength – pravara (superior), madhyama (moderate) and avara (poor). Pravara sattva persons possess great courage. Despite poor morphological features they seem to be unmoved in the face of adversities. Madhyama sattva persons need some additional moral support to sustain themselves in times of distress. While avara sattva displays catastrophic reactions even during little inconveniences and can neither be sustained by themselves nor by others despite having good quality morphological features. Avara sattva is constantly plagued by inferior emotions like grief, fear, greed, conceit and confusion. When confronted with fierce, ugly, disgusting narratives or flesh and blood, they are prone to become depressed, pale, unconscious or semiconscious, giddy, anxious and can even succumb to death in worst case scenarios. [Cha. Sa. Vimana Sthana 8/119].<br /> &lt;br/&gt;Manovaha srotas associated with avara sattva bala is most likely to be vitiated by manas dosha leading to various psychiatric and psychosomatic disorders [Cha.Sa. Chikitsa Sthana 9/5]. It has been observed that avara sattva individuals are more likely to commit prajnaparadha (intellectual defects) [10] thereby voluntarily indulging in various etiological factors for respective psychological as well as somatic disorders.<br /> &lt;br?&gt;Thus, assessment of sattva bala can help rule out the predisposition towards manovaha srotodushti and subsequent development of symptoms of psychiatric ailments.&lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;'''d. Anumana pariksha (knowledge by inference)''' to determine normalcy of faculties of manas (mind) [Cha.Sa. Vimana Sthana 4/8] Since manas is atindriya ( supersence or imperceivable by ordinary senses), so are it’s faculties which can serve as potential markers for assessment of its functions. [10] The proper functioning of manas itself is inferred by altered or inappropriate mental perceptions even in presence of appropriately functioning indriya (senses) and their respective sense objects whereas the mental faculties can be inferred as follows:-&lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;This inferential knowledge can help an individual become self-aware of his own psyche (sattva). A self-aware individual has an upper hand at avoiding mental illness because these often go unnoticed until they develop some organic manifestations.<br /> &lt;br/&gt;Thus, by means of above discussed assessment methodologies, a physician can assess the degree of derangement in mental faculties and hence the manovaha srotas, irrespective of development of specific signs and symptoms of any psychiatric disorder (vyadhi lakshana).&lt;/p&gt;<br /> <br /> ==Treatment Guidelines==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Manovaha srotas disorders follow the line of treatment same as described for disorders of manas (mind). Following are therapeutic and preventive practices beneficial for both vitiated manovaha srotas (channels of psyche) and manas obscured by rajas - tamas dosha.&lt;/p&gt;<br /> '''*'''Manas dosha can be alleviated through a comprehensive five-fold psychotherapeutic regimen - jnana (spiritual knowledge or self-awareness), vijnana (scriptural or scientific knowledge), dhairya (mental fortitude), smriti (recollection of past successes to regain faith in own abilities) and samadhi (spiritual healing practices to focus mind inwards away from negative external stimuli). [Cha.Sa. Sutra Sthana 1/58]<br /> Restoration of dhi (intellect), dhairya (mental fortitude) and atmadi vijnana (knowledge of self-consciousness) has therapeutic effect in alleviating disorders of manovaha srotas obstructed by manas dosha.<br /> '''*Sattvavajaya chikitsa (treatment to regulate mind)'''<br /> Sattvavajaya chikitsa is a non-invasive therapeutic module for psychological derangements and psychosomatic ailments, analogous to contemporary psychotherapy. ‘Sattva’ stands for mind and ‘avajaya’ translates to win over. Hence, it emphasizes withdrawing the mind from unwholesome objects of senses (factors vitiating rajas and tamas) and diverting it to positive sensory and emotional stimuli. Thereby consciously negating disturbed emotions and behavioural patterns. [Cha.Sa. Sutra Sthana 11/54]<br /> '''*Ashtanga yoga (eight steps of yoga)'''<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Ashtanga yoga can be considered as one of the dimensions of satvavajaya chikitsa. It integrates eight steps of yoga to tame mind from traversing paths in life which are spiritually and mentally harmful for that individual. Of the eight steps, first four viz. yama (principles for moral code), niyama (observances for personal discipline), asana (yogic postures) and pranayama (regulating breath) are termed as bahiranga yoga (external path). These practices gradually alleviate aggravated manas dosha, making the mind less reactive towards external stimuli. The last three limbs viz. dharana (concentration), dhyana (meditation) and samadhi (enlightenment or complete realisation) are termed as antaranga yoga (internal paths). These practices transform the mind, eliminating the fluctuations of mind, thereby strengthening positive habits and outlook on life as well as inner self. Ashtanga yoga maintains a harmonious balance between inner environment (mind and spirit) and external environment (objects of sensory perception). Mind thus gets liberated from worldly pursuits and all psychological sufferings in a stepwise manner.&lt;/p&gt;<br /> '''*Achara rasayana (rejuvenating codes of behavioural conduct)'''<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Achara rasayana is an adravyabhuta (non-pharmacological) rasayana (practices rejuvenating physical and mental health). It includes behavioural conducts which aim to enhance health and longevity by teaching practical methods to potentiate sattva guna of mind. [Cha.Sa. Chikitsa Sthana 1, 4th pada, shloka 30-35] An individual can imbibe easy lifestyle modifications to develop a positive and strong character of mind, thereby avoiding potential etiological factors (for dosha aggravation) and negative psychosocial patterns. Achara rasayana can be divided into five domains of good mental, social, personal, moral and religious conduct. [6]&lt;/p&gt;<br /> '''*Sadvritta (good codes of conduct)'''<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Sadvritta refers to good code of conduct. These are a set of practices, which serve as lifestyle guidelines to prevent mind from falling prey to temporary material pleasures and impulsive thoughts and actions that cause impairment of manas dosha and manovaha srotas. It encompasses guidelines over personal hygiene, personality development as well as for social hygiene and peaceful social interactions. [Cha.Sa. Sutra Sthana 8/18]&lt;/p&gt;<br /> Both achara rasayana and sadvritta help to maintain control over sense organs. They majorly add to the preventive and promotive aspect of mental health. <br /> '''*Medhya dravya (medicines enhancing intellectual functions)'''<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Medhya dravyas are the plant based pharmacological agents that promote prajna i.e., dhi (intellect), dhriti (perseverance) and smriti (memory). Researches conducted prove their efficacy in minimizing the cognitive decline among individuals with neural abnormalities. For example, ushna (hot potency) and tikshna nature drugs like jyotishmati and vacha are said to remove blockages caused by kapha, ama or tamas dosha in the manovaha srotas. Once purified, manas can regain unvitiated connect with indriya via manovaha srotas. [8] <br /> &lt;br/&gt;Ayurveda thus provides a bird’s eye view over different aspects of manovaha srotas through interconnected references in the classics highlighting its physiological importance like the other thirteen major srotas systems in the human body.&lt;/p&gt;<br /> <br /> ==Contemporary view==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Mind as per contemporary literature is debatable concept because in some contexts it is identified as conscience, while in others it is seen as the function of conscience. The philosophical dimension of mind was conceived by Plato who considered mind as an inner (soul’s) experience. [11]<br /> &lt;br/&gt;The western system of medicine addresses brain at the core of majority of psychological distresses, whereas western philosophy involves the concept of psyche (which denotes mind). ‘Psyche’ is a Greek word meaning ‘soul in a living man’. <br /> &lt;br/&gt;William James, referred to as the father of American Psychology, laid the foundations of physiological aspect of mind. To him mind was a function of brain which conducts mental life in the form of a constant stream of consciousness.[9] At some places he too admitted mind to bear consciousness and tried to assign attributes to consciousness as a separate psychological function thus formulating the Theory of Functionalism which established causal relationship between internal states (perception) and external reactions or behaviour (sensation). He concluded that repeated actions cause adaptive changes in nervous system. This is the fundamental ideology behind the concept of Neuroplasticity – i.e. adaptive structural and functional changes in brain by development of new neuronal pathways due to intrinsic or extrinsic stimuli. [12]<br /> &lt;br/&gt;James’ counterpart Titchener, an English Psychologist, proposed that consciousness is mind’s awareness of its own functions. Consciousness is something superior to mind itself. He formulated the Theory of Structuralism which aimed at analysing the interrelationship between mental experiences, feelings, and sensations. He used introspection as a tool to break down these complex phenomena of consciousness down to their basic elements without breaking their original structure. <br /> &lt;br/&gt;Mind is hence regarded as the cumulative effect of all mental processes that have occurred in the lifetime while the consciousness can be understood as the cumulative effect of all mental processes occurring in present moment. Eventually brain was somehow regarded to control the neural activity responsible for accumulating all this sensory data.<br /> &lt;br/&gt;Many theories were formulated and overruled by their successors with time. Today the concept of mind and consciousness remains yet to be clearly defined. It is observed that mind is often identified as consciousness and they both are accepted as individual closely linked entities. Mind bears synonymity towards consciousness, spirit, and psyche. Some theories view both mind and consciousness as spirit. But mind is invariably understood as the interaction between psychological personality and the external environment, i.e., a subject – object relationship.<br /> &lt;br/&gt;The neurophysiological basis of minds and the channels of transport of its constituents is yet a challenge in field of neuroscience. In order to bridge this gap, contemporary scientists hypothesise that mental representations and their contents are represented by neural network and their supporting cells thus hinting towards Central Nervous System and it’s peripheral nerves as the channels of mind. [13]&lt;/p&gt; <br /> <br /> ==Research works on manovaha srotas==<br /> Various review articles have been published and researches been carried out in the domain of Ayurveda to understand the conceptual as well as pathophysiological aspect of manovaha srotas. Few of them are as follows :-<br /> '''# Critical Review of Concept of manovaha Srotas with special reference to Brain''' <br /> This review article conceptualizes the contemporary understanding of manovaha srotas in context to CNS due to functional similarity between manas and brain obtained after an extensive research and analysis throughout ayurveda treatises. Further brain was considered as synonymous to hridya ie. mulasthana (site of origin) of manovaha srotas and ‘dasha dhamani’ as the cranial nerves exiting from the 10 major foramen at base of skull. Sanskrit literature considers hridaya as regarded as a central organ similar to brain. 14<br /> '''# Circumstantial view on clinical knowing of manovaha srotasa &amp; its physiology''' <br /> The review article reconstructs a comprehensive picture of manovaha srotas from the scattered references available in Ayurveda texts, supplementing it with additional information from contemporary science as follows-<br /> '''*'''A detailed description of neuroanatomy and physiology has been drawn parallel to Ayurveda point of view about manas’ rachna and kriya sharir. <br /> '''*'''Effect of Triguna and tridosha (especially vata) in context of physiological functions and disorders of manas and manovaha srotas have been discussed.<br /> '''*'''Correlations between functions of five subtypes of vata and both CNS and ANS has been attempted Pariksha krama (examination of nervous system) has been exemplified taking into consideration both Ayurveda and modern methodologies that can be employed for manovaha srotas (nervous system) examination.10 <br /> '''*'''Concept of stress factor assessment concerning ‘perseverance test’ in light of ayurveda” – a review This article highlights the importance of understanding the etiological factors of vitiation of manovaha srotas and manas in all kinds of psychiatric as well as psychosomatic disorders. Imbalance of manas dosha can be treated by means of yoga, meditation and pranayama. Often emotional disturbances remain unattended in diagnosed cases of psychiatric illness which can be managed at home by incorporating wholesome diet (pathya ahara) and moral code of conduct (sadvrutta) in daily routine. Lack of peace and chronic stressors have been observed as major causes of vitiation of channels of mind. 15<br /> <br /> <br /> &lt;big&gt;'''[[Special:ContactMe|Send us your suggestions and feedback on this page.]]'''&lt;/big&gt;<br /> <br /> ==References==<br /> <br /> &lt;div id=&quot;BackToTop&quot; class=&quot;noprint&quot; style=&quot;background-color:#DDEFDD; position:fixed;<br /> bottom:32px; left:2%; z-index:9999; padding:0; margin:0;&quot;&gt;&lt;span style=&quot;color:blue;<br /> font-size:8pt; font-face:verdana,sans-serif; border:0.2em outset #ceebf7;<br /> padding:0.1em; font-weight:bolder; -moz-border-radius:8px; &quot;&gt;<br /> [[#top| Back to the Top ]]&lt;/span&gt;&lt;/div&gt;</div>

Manishdubey https://www.carakasamhitaonline.com/index.php?title=Talk:Manovaha_srotas&diff=44185 2023-10-13T12:14:56Z

<p>Manishdubey: </p> <hr /> <div>{{CiteButton}}<br /> {{#seo:<br /> |title= Manovaha srotas<br /> (Channels of transport and transformation of mind and mental factors)<br /> |titlemode=append<br /> |keywords= Manovaha srotas,Hrudya, Sattva pariksha, Sattvavajaya chikitsa, Bhojani M. K.,Deole Y.S., Basisht G<br /> |description=Mana means mind, or psyche. Srotas means channels of transport and transformation. The description and understanding of channels for activities of mind (manovaha srotas) is scattered in ayurveda classics and has not been completely elucidated. Manovaha srotas are considered as channels through which mind and body interact with each other. <br /> |image=http://www.carakasamhitaonline.com/mediawiki-1.32.1/resources/assets/ogimgs.jpg<br /> |image_alt=carak samhita<br /> |type=article<br /> }}<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Mana means mind, or psyche. Srotas means channels of transport and transformation. The description and understanding of channels for activities of mind (manovaha srotas) is scattered in ayurveda classics and has not been completely elucidated. Manovaha srotas are considered as channels through which mind and body interact with each other. These channels pervade throughout the body. [Chakrapani on Cha.Sa. Indriya Sthana 5/41-42] They are responsible for flow of thoughts, emotions, and other psychological functions. This article deals with various aspects of manovaha srotasa i.e. the channels of activities of mind and its development.&lt;/p&gt;<br /> <br /> {{Infobox<br /> |title = Contributors<br /> |label1 = Section/Chapter/topic<br /> |data1 = Concepts/[[Srotas]]/[[Manovaha Srotas]] <br /> |label2 = Authors<br /> |data2 = Bhojani M. K.&lt;sup&gt;1&lt;/sup&gt; Varma Swati &lt;sup&gt;1&lt;/sup&gt; Deole Y.S.&lt;sup&gt;2&lt;/sup&gt;<br /> |label3 = Reviewer &amp; Editor<br /> |data3 = Basisht G.&lt;sup&gt;3&lt;/sup&gt;, <br /> |label4 = Affiliations<br /> |data4 = &lt;sup&gt;1&lt;/sup&gt; Department of Sharir Kriya, All India Institute of Ayurveda, New Delhi, India<br /> &lt;sup&gt;2&lt;/sup&gt; Department of Kayachikitsa, G. J. Patel Institute of Ayurvedic Studies and Research, New Vallabh Vidyanagar, Gujarat, India <br /> &lt;sup&gt;3&lt;/sup&gt; Rheumatologist, Orlando, Florida, U.S.A.<br /> |label5 = Correspondence emails<br /> |data5 = meera.samhita@aiia.gov.in, carakasamhita@gmail.com<br /> |label6 = Publisher <br /> |data6 = [[Charak Samhita Research, Training and Development Centre]], I.T.R.A., Jamnagar, India<br /> |label7 = Date of publication:<br /> |data7 =October 12, 2023<br /> |label8 = DOI<br /> |data8 = In process<br /> }}<br /> <br /> ==Etymology and derivation:==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Srotas originates from Sanskrit root ‘Sru’ that translates to oozing, flow or secretion. It has been defined as ‘sravanat strotamsi’ [Cha. Sa. Sutra Sthana 30/12] which indicates structures designated for conveyance of material inside body. <br /> &lt;br/&gt;Grossly defining, thirteen major types of srotas have been mentioned that transport substances undergoing biotransformation (parinamam aapadyamanam) from the place of origin to their destination. [Cha. Sa. Vimana Sthana 5/3] Similarly in physiological state, manovaha srotas might be responsible for processing and transformation of ‘doshayukta’ (irrational under influence of rajas and tamas) emotions and thoughts into unbiased reasoning before reaching a conclusion by our intellect (buddhi). &lt;/p&gt;<br /> <br /> ==Synonyms of manovaha srotas==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Following terms are used for ‘manovaha srotas’ in different Ayurveda classics : &lt;/p&gt;<br /> # Manovaha dhamani [Chakrapani on Cha. Sa. Indriya sthana 12/42] and [Vijayarakshita in Ma.Ni.Purva Khanda 20/1]<br /> # Chetanavaha srotas [Shivadas Sen on Cha.Sa. Chikitsa sthana 9/5] <br /> # Chetovaha marga [Bhel Samhita Nidana Sthana 7/2]<br /> # Manobuddhivaha sira [ Cha.Sa.Chikitsa Sthana 10/58]<br /> # Sanjnavaha srotas [Su.Sa.Uttar Tantra 61/8]<br /> # Sanjnavaha nadi [Su.Sa. Uttar Tantra 46/7]<br /> &lt;p style=&quot;text-align:justify;&quot;&gt; &lt;br/&gt;Use of terms like sira, nadi and dhamani, refers to different channels and pathways concerned with maintenance of physiological flow of information. [Cha.Sa. Vimana Sthana 5/8] &lt;/p&gt;<br /> <br /> ==Origin==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt; Every srotas is localized within the hollow space in the body originating from a root (mula) and spreading throughout the body to reach a final structure. Srotas are said to be hollow structures in different shapes and sizes The root (mula) is majorly responsible for regulation and control of functions of that srotas.<br /> &lt;br/&gt;The channels carrying mind (manovaha srotas) are not exclusively listed. It is however stated that the entire conscious body is abode of mind. Hence these channels are spread throughout the body. [Chakrapani on Cha.Sa. Indriya Sthana 5/41]. <br /> &lt;br/&gt;However, hridaya (heart) has a universal acceptance as the site of origin (mula) of manovaha srotas. Hence a special mention has been made about ten arteries of heart, probably being the manovaha srotas (visheshen tu hrudya ashritvat manah tadashrita dasha dhamanyo manovaha abhidhiyante) [Chakrapani on Cha.Sa. Indriya Sthana 5/41-42]. These get afflicted by vitiated dosha either all at once or individually. [Chakrapani on Cha.Sa. Indriya Sthana 12/42]<br /> &lt;/p&gt;<br /> <br /> ==Decoding hridaya (heart)==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt; The interpretation of the term ‘hridaya’ has been of confusion among scholars since decades. The first interpretation of the term given by texts of Shatpada Brahmana which highlighted functional aspect of hridaya. The word being composed of three letters viz ‘hri’ (hra harane)- to acquire; ‘Da’ (da dane) – to give; ‘Ya’ (Ya gatau)- which transports. The hridaya thus displays three phases of cardiac cycle i.e., receives, gives, and transports body constituents through it. [2]<br /> &lt;br/&gt;Hridaya is the site of rasa (plasma), sattva (psychic factor/mind), buddhi (intellect) and atma (soul) in conjugation with all sensory organs (jnanendriya).[Cha.Sa. Chikitsa Sthana 24/35] Sadhaka pitta situated in heart (hridaya) regulates proper functioning of intellect (buddhi) and ego (ahamkara). Hridaya is located in between breasts (stanayormadhya) of thoracic region [A. H. Sutra Sthana 12/13-14] [Su. Sa. Sharira Sthana 6/25]. <br /> &lt;br/&gt;Vedic era was well versed with heart (hridaya) and brain (mastishka) being two distinct entities, with interdependent functional relationship [Atharvaveda Book X. Hymn 2.26]. Kashyap Samhita quotes that all sense and motor organs (indriya) together with mind (manas) emerge from heart (hridaya) [Ka.Sa. Chikitsa Sthana 8/6]. Primary site of action of mind (manas) is brain (shira).[3] It can be concluded that mind (manas) being seated in heart (hridaya) connects to brain (shiras) through manovaha srotas and controls all senses (indriya). Also, any damage pertaining to marma (vital points) of shiras (head) causes loss of consciousness (cheshtanasha). [Cha.Sa. Sidhhi Sthana 9/6] Hence heart (hridaya) and brain (shirasor mastishka) are sites of manovaha srotasa. <br /> &lt;br/&gt; This approach of understanding hridaya goes well along with the contemporary view of understanding the triguna based psycho-functional principles of Ayurveda within the neural framework. Various research has been conducted which demonstrate that heart continuously sends nervous signals to brain to coordinate higher centres responsible for cognition and emotions. [1] The neuro- psychological as well as circulatory functions of hridaya mentioned in the classics can thus be explained. &lt;/p&gt; <br /> <br /> ==Relation between rasavaha and manovaha srotas==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Heart is the abode of mind (mana) and consciousness (chetana) or soul (atma). [Cha. Sa. Sidhhi Sthana 9/4] It is a site for physical, psychological, and spiritual components. Heart is origin for channels of transportation and transformation of rasa dhatu, too. Both heart and brain are considered under the umbrella term hridaya in terms of anatomical structure and higher-centre functions respectively. <br /> &lt;br/&gt;Heart (residence of manas) and brain (workplace of manas) are functionally co-dependent upon each other. Manas regulates the cognitive and conative functions of brain in conjunction with soul (atma) under the influence of vata dosha. [Cha. Sa. Sharira Sthana 1/22-23]. Brain is a structural entity needing continuous supply of nourishment and oxygen. This is feasible by heart through circulation (rasa-rakta samvahana kriya) via the ten major vessels (rasavahi dhamani). [A. H. Sharira Sthana 3/18] Heart is a highly vascular organ being surrounded by ten major dhamani (blood vessels) like spokes of a wheel which are known as ‘rasavaha strotomula’ (site of origin of channels of nutrition). These channels are comparable to manovaha srotas. [Chakrapani on Cha. Sa. Chikitsa Sthana 9/4] Manas thus acts like a medium between heart and brain wherein brain is responsible for all sensory and motor functions while heart has been assigned emotional aspect of psyche (manas).<br /> &lt;br/&gt;One of the factors for vitiation of rasavaha srotas is excessive thinking or worry (atichintan). [Cha. Sa. Vimana Sthana 5/13] Contemporary researchers have found evidence to support the interaction between circulatory system and psyche. The monograph of German professor Ludwig Braun is a pioneer in exploring the psychological and emotional aspect of cardiac diseases especially angina. He presented a correlation between cardiac diseases and ‘Angst’ (a constrictive, tightening and crushing sensation which manifests dread in the patient thereby changing his entire emotional outlook on life), analogous to anxiety. He explains that the cardiac tissue has a special apparatus receptive towards anxiety which manifests as an inner tactile sensation. That region is well supplied with nerve endings that gets irritated by anxiety. This phenomenon of emotional influence over cardiac tissues is termed as cardiac psyche. [4] <br /> &lt;/p&gt; <br /> <br /> ==Factors vitiating manovaha srotas==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt; Manovaha srotas are the prime site of abnormalities of channels in all psychological disorders. [Cha.Sa. Nidana Sthana 6/4] Alongside any of the eight factors that are either attributed to hridaya or manas viz. mana (mind), buddhi (intellect), sanjna-jnana (self-awareness), smriti (memory), bhakti (devotion), sheela (habits), cheshta (psychomotor activities) and achara (code of conduct). [Cha.Sa. Nidana Sthana 7/5] <br /> &lt;br/&gt;These factors when deranged cause vitiation of manas dosha (rajas and tamas), deterioration of sattva guna of manas and gradual derangement of tridosha. Foods, activities and excessive expression of emotions like anger, grief, lust, fear etc and mental traumas are the fundamental etiological factors for the same. [Cha.Sa. Nidana Sthana 7/4] Vitiated tridosha further vitiates rasavaha srotas, which apparently has the same site of origin as of manovaha srotas i.e., hridaya and dasha dhamani (ten great vessels). [Cha. Sa. Vimana Sthana 5/10] Hridaya is seat of manas [Cha.Sa. Sutra Sthana 30/4]. Hence, all the factors vitiating rasa dhatu (nutritive fluid), rasavaha srotas (channels carrying nutritive fluid) and manas dosha viz. rajas and tamas will affect manas and eventually vitiating manovaha srotas. Even the structural derangements of heart (abode of mind) affect manovaha srotas due to their ashrayashrayibhava (state of interdependency). [Cha.Sa. Chikitsa Sthana 9/5]&lt;/p&gt;<br /> <br /> ==Pathologies of manovaha srotas==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Manovaha srotas is important factor in understanding disorders like unmada (psychosis), apasmara (epilepsy) and extreme emotional reactions. &lt;/p&gt;<br /> <br /> *'''Unmada (psychosis)'''<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;When an individual experiences extreme emotions – lust (kama), anger (krodha), fear (bhaya), greed (lobha), happiness or pleasure (harsha), affection (moha), grief (shoka), excessive worry (chinta), they initially harm the intellect which aggravates manas dosha (rajas and tamas) and tridosha (vata, pitta and kapha). These vitiated dosha invade heart and obstruct manovaha srotas (channels transporting psychic impulses) thereby causing unmada. [Dalhan on Su. Sa. Uttar Tantra 62/3]<br /> *'''Apasmara (epilepsy)'''<br /> Overindulging in sensory pleasures, incompatible diet, withholding natural urges and giving into immoral activities under emotional influences (kama, krodha, lobha among others), vitiates rajas and tamas. They poorly influence the manas (mind) and sanjnavaha srotas (manovaha srotas) causing apasmara. [Su.Sa. Uttar Tantra 61/6]<br /> * Mada (intoxication), murchha (syncope), sanyasa (coma) are caused by vitiation of channels of consciousness (chetanavaha srotas or manovaha srotas). [Shivadas Sen on Cha. Sa. Chikitsa Sthana 9/5] <br /> *'''Atattvabhinivesha (perverted state of mind)'''<br /> Considered as mahagada (difficult to treat mental disorder), the person’s conscience gets afflicted by rajas and tamas, which cause complete derangement of intellect (buddhi vibhramsha) as the predominant symptom. The vitiated dosha get lodged in heart (hridaya) to afflict channels of mind and intellect (manobuddhivaha sira in manovaha srotas). [Cha.Sa. Chikitsa Sthana 10/57-60]<br /> * Physiology of nightmares (swapna)<br /> Nightmares are dreams occurring in REM phase of sleep which causes mental projections in the form of feelings of fear, despair, and anxiety. Ayurveda defines REM phase as ‘Natiprasupta’ - the state characterised to be midway between states of deep sleep and fully awake. During any ominous situation, tridosha in their highly aggravated state tend to fill-up the manovaha srotas. This results in terrifying dreams. [Cha.Sa. Indriya Sthana 5/41]. &lt;/p&gt;<br /> <br /> ==Assessment and diagnosis of disorders of manovaha srotas==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Srotas are micro-channels transporting various metabolites across cells throughout the body. It can be deduced that manovaha srotas has different characteristics structurally and functionally from the major thirteen srotas, because it transports and transforms thoughts and feelings. This is evident from objects of mind (manas), viz- thought (chintyam), consideration (vicharyam), hypothesis (uhyam), aims (dhyeyam) and determination (sankalpam). [Cha.Sa. Sharira Sthana 1/20]. Assessment of manovaha srotas can be done via assessment of manas and the degree of derangement of its functions. Ayurveda considers manas as material entity (dravya) which is a super sense and not perceivable by ordinary senses (atindriya) [Cha. Sa. Sutra Sthana 8/4]. Manas is under direct control of vata dosha [Cha. Sa. Sutra Sthana 12/8] and is the mediator between atma (soul) and indriyartha (objects of senses). <br /> &lt;br/&gt;The contemporary physiological aspects of mind, senses, brain, nervous system and consciousness can be considered for assessment of manovaha srotas. <br /> &lt;br/&gt; A thorough neurological examination by means of interrogation (prashna pariksha), inspection (darshana pariksha) and assessment of mental strength (sattva bala pariksha) [Cha.Sa. Vimana Sthana 8/119] can be used for assessment and diagnosis of disorders of manovaha srotas.&lt;/p&gt;<br /> <br /> ''' a. Interrogation (prashna pariksha)'''<br /> A formal interview of the patient can be conducted for overall and precise diagnosis. The questions related to chief complaints with duration, chronological development, nurturing of patient, family history, addiction, hobbies, interests, daily routine, major life events, achievements, mental traumas, emotional quotient and intellectual quotient is recorded from the patient. If the patient is not in state of giving correct answers, then the relatives or attendants who know patients history are interviewed. <br /> <br /> '''b. Darshan pariksha (Direct observation)'''<br /> While interviewing the patient, a physician should pay attention to following attributes that can signify features mentioned for certain psychiatric ailments (manovaha srotodushti)..<br /> <br /> # '''Appearance '''– Unusual dressing preferences, use of cosmetics, perfumes or accessories or flamboyant appearance. e.g;- ‘Priye tanu rakta vastradhari’ (liking for adorning clothes made of thin red fabric) is seen in yakshagraha unmada (Su.Sa. Uttara tantra 60/11)<br /> # '''Activity and co-ordination''' - Behaviour, Gait, gestures, patient’s facial expression and body language should be observed during probing them with questions. Eg;- 'Satatama akshano’ (rapid and constant eye movements) is one of the prodromal feature of apasmara (epilepsy) [ Cha.Sa. Nidana sthana 8/6]. Udhasta (patient keeps his hands raised) is a feature of pishacha grahavishta unmada [Su.Sa. Uttara Tantra 60/15]<br /> # '''Conversation style''' – Coherence of speech, articulation, emphasise over certain issue, hesitation and duration of response. E.g. ‘Chitram sa jalpati’ (Patient does irrelevant absurd talks) is seen in patients of manas unmada [Su.Sa. Uttara Tantra 62/13].<br /> #'''Emotional expression''' – Patients may express a wide range of emotions during interview with the physician. E.g. Asthana rodana (Sudden crying) is a feature in vataja unmada while amarsha (intolerance) is seen in patients of pittaja unmada. [Cha.Sa. Chikitsa Sthana 9/11-12] Fleeting ideas, incoherent speech is an important sign for lacking proper emotions. <br /> #'''Cognition''' – Orientation to person, place, time and circumstances, level of intellect, level of understanding, common sense and memory can be identified under the domain of cognition by observing patient’s behaviour as well as by asking questions to them using validated scientific questionnaires. Short term memory and long-term memory shall be assessed properly. <br /> &lt;br/&gt;All observations gathered from every method of assessment should be simultaneously analysed to reach the diagnosis.<br /> <br /> '''c. Sattva pariksha (assessment of quality of excellence of mind)'''<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Sattva pariksha assesses the quality of excellence of mind imparted by extent of dominance of sattva guna. Mind (manas) is composed of three attributes (triguna) viz. sattva, rajas and tamas. These impart three types of mental constitutions – Shuddha (pure) (sattvika), rajasika and tamasika. [Cha.Sa. Sharira Sthana 4/36]. Sattvika guna is full of auspiciousness and is considered the healthy (amala) state of mind. Rajasika guna imparts momentum in terms of furious temperament. Whereas tamas guna promotes inertia and moral ignorance. Hence, rajas and tamas are considered inauspicious and called manas dosha. Triguna are present in dynamically varying proportions at any given time and influenced by body (i.e. tridosha) and vice versa. [Chakrapani on Cha.Sa. Vimana Sthana 4/8]. Optimum levels of sattva guna are essential for promoting desired physical and mental strength irrespective of morphological features. [Cha.Sa. Vimana Sthana 8/119]&lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Sattva bala (strength of psyche) is of three types as per strength – pravara (superior), madhyama (moderate) and avara (poor). Pravara sattva persons possess great courage. Despite poor morphological features they seem to be unmoved in the face of adversities. Madhyama sattva persons need some additional moral support to sustain themselves in times of distress. While avara sattva displays catastrophic reactions even during little inconveniences and can neither be sustained by themselves nor by others despite having good quality morphological features. Avara sattva is constantly plagued by inferior emotions like grief, fear, greed, conceit and confusion. When confronted with fierce, ugly, disgusting narratives or flesh and blood, they are prone to become depressed, pale, unconscious or semiconscious, giddy, anxious and can even succumb to death in worst case scenarios. [Cha. Sa. Vimana Sthana 8/119].<br /> &lt;br/&gt;Manovaha srotas associated with avara sattva bala is most likely to be vitiated by manas dosha leading to various psychiatric and psychosomatic disorders [Cha.Sa. Chikitsa Sthana 9/5]. It has been observed that avara sattva individuals are more likely to commit prajnaparadha (intellectual defects) [10] thereby voluntarily indulging in various etiological factors for respective psychological as well as somatic disorders.<br /> &lt;br?&gt;Thus, assessment of sattva bala can help rule out the predisposition towards manovaha srotodushti and subsequent development of symptoms of psychiatric ailments.&lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;'''d. Anumana pariksha (knowledge by inference)''' to determine normalcy of faculties of manas (mind) [Cha.Sa. Vimana Sthana 4/8] Since manas is atindriya ( supersence or imperceivable by ordinary senses), so are it’s faculties which can serve as potential markers for assessment of its functions. [10] The proper functioning of manas itself is inferred by altered or inappropriate mental perceptions even in presence of appropriately functioning indriya (senses) and their respective sense objects whereas the mental faculties can be inferred as follows:-&lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;This inferential knowledge can help an individual become self-aware of his own psyche (sattva). A self-aware individual has an upper hand at avoiding mental illness because these often go unnoticed until they develop some organic manifestations.<br /> &lt;br/&gt;Thus, by means of above discussed assessment methodologies, a physician can assess the degree of derangement in mental faculties and hence the manovaha srotas, irrespective of development of specific signs and symptoms of any psychiatric disorder (vyadhi lakshana).&lt;/p&gt;<br /> <br /> ==Treatment Guidelines==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Manovaha srotas disorders follow the line of treatment same as described for disorders of manas (mind). Following are therapeutic and preventive practices beneficial for both vitiated manovaha srotas (channels of psyche) and manas obscured by rajas - tamas dosha.&lt;/p&gt;<br /> '''*'''Manas dosha can be alleviated through a comprehensive five-fold psychotherapeutic regimen - jnana (spiritual knowledge or self-awareness), vijnana (scriptural or scientific knowledge), dhairya (mental fortitude), smriti (recollection of past successes to regain faith in own abilities) and samadhi (spiritual healing practices to focus mind inwards away from negative external stimuli). [Cha.Sa. Sutra Sthana 1/58]<br /> Restoration of dhi (intellect), dhairya (mental fortitude) and atmadi vijnana (knowledge of self-consciousness) has therapeutic effect in alleviating disorders of manovaha srotas obstructed by manas dosha.<br /> '''*Sattvavajaya chikitsa (treatment to regulate mind)'''<br /> Sattvavajaya chikitsa is a non-invasive therapeutic module for psychological derangements and psychosomatic ailments, analogous to contemporary psychotherapy. ‘Sattva’ stands for mind and ‘avajaya’ translates to win over. Hence, it emphasizes withdrawing the mind from unwholesome objects of senses (factors vitiating rajas and tamas) and diverting it to positive sensory and emotional stimuli. Thereby consciously negating disturbed emotions and behavioural patterns. [Cha.Sa. Sutra Sthana 11/54]<br /> '''*Ashtanga yoga (eight steps of yoga)'''<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Ashtanga yoga can be considered as one of the dimensions of satvavajaya chikitsa. It integrates eight steps of yoga to tame mind from traversing paths in life which are spiritually and mentally harmful for that individual. Of the eight steps, first four viz. yama (principles for moral code), niyama (observances for personal discipline), asana (yogic postures) and pranayama (regulating breath) are termed as bahiranga yoga (external path). These practices gradually alleviate aggravated manas dosha, making the mind less reactive towards external stimuli. The last three limbs viz. dharana (concentration), dhyana (meditation) and samadhi (enlightenment or complete realisation) are termed as antaranga yoga (internal paths). These practices transform the mind, eliminating the fluctuations of mind, thereby strengthening positive habits and outlook on life as well as inner self. Ashtanga yoga maintains a harmonious balance between inner environment (mind and spirit) and external environment (objects of sensory perception). Mind thus gets liberated from worldly pursuits and all psychological sufferings in a stepwise manner.&lt;/p&gt;<br /> '''*Achara rasayana (rejuvenating codes of behavioural conduct)'''<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Achara rasayana is an adravyabhuta (non-pharmacological) rasayana (practices rejuvenating physical and mental health). It includes behavioural conducts which aim to enhance health and longevity by teaching practical methods to potentiate sattva guna of mind. [Cha.Sa. Chikitsa Sthana 1, 4th pada, shloka 30-35] An individual can imbibe easy lifestyle modifications to develop a positive and strong character of mind, thereby avoiding potential etiological factors (for dosha aggravation) and negative psychosocial patterns. Achara rasayana can be divided into five domains of good mental, social, personal, moral and religious conduct. [6]&lt;/p&gt;<br /> '''*Sadvritta (good codes of conduct)'''<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Sadvritta refers to good code of conduct. These are a set of practices, which serve as lifestyle guidelines to prevent mind from falling prey to temporary material pleasures and impulsive thoughts and actions that cause impairment of manas dosha and manovaha srotas. It encompasses guidelines over personal hygiene, personality development as well as for social hygiene and peaceful social interactions. [Cha.Sa. Sutra Sthana 8/18]&lt;/p&gt;<br /> Both achara rasayana and sadvritta help to maintain control over sense organs. They majorly add to the preventive and promotive aspect of mental health. <br /> '''*Medhya dravya (medicines enhancing intellectual functions)'''<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Medhya dravyas are the plant based pharmacological agents that promote prajna i.e., dhi (intellect), dhriti (perseverance) and smriti (memory). Researches conducted prove their efficacy in minimizing the cognitive decline among individuals with neural abnormalities. For example, ushna (hot potency) and tikshna nature drugs like jyotishmati and vacha are said to remove blockages caused by kapha, ama or tamas dosha in the manovaha srotas. Once purified, manas can regain unvitiated connect with indriya via manovaha srotas. [8] <br /> &lt;br/&gt;Ayurveda thus provides a bird’s eye view over different aspects of manovaha srotas through interconnected references in the classics highlighting its physiological importance like the other thirteen major srotas systems in the human body.&lt;/p&gt;<br /> <br /> ==Contemporary view==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Mind as per contemporary literature is debatable concept because in some contexts it is identified as conscience, while in others it is seen as the function of conscience. The philosophical dimension of mind was conceived by Plato who considered mind as an inner (soul’s) experience. [11]<br /> &lt;br/&gt;The western system of medicine addresses brain at the core of majority of psychological distresses, whereas western philosophy involves the concept of psyche (which denotes mind). ‘Psyche’ is a Greek word meaning ‘soul in a living man’. <br /> &lt;br/&gt;William James, referred to as the father of American Psychology, laid the foundations of physiological aspect of mind. To him mind was a function of brain which conducts mental life in the form of a constant stream of consciousness.[9] At some places he too admitted mind to bear consciousness and tried to assign attributes to consciousness as a separate psychological function thus formulating the Theory of Functionalism which established causal relationship between internal states (perception) and external reactions or behaviour (sensation). He concluded that repeated actions cause adaptive changes in nervous system. This is the fundamental ideology behind the concept of Neuroplasticity – i.e. adaptive structural and functional changes in brain by development of new neuronal pathways due to intrinsic or extrinsic stimuli. [12]<br /> &lt;br/&gt;James’ counterpart Titchener, an English Psychologist, proposed that consciousness is mind’s awareness of its own functions. Consciousness is something superior to mind itself. He formulated the Theory of Structuralism which aimed at analysing the interrelationship between mental experiences, feelings, and sensations. He used introspection as a tool to break down these complex phenomena of consciousness down to their basic elements without breaking their original structure. <br /> &lt;br/&gt;Mind is hence regarded as the cumulative effect of all mental processes that have occurred in the lifetime while the consciousness can be understood as the cumulative effect of all mental processes occurring in present moment. Eventually brain was somehow regarded to control the neural activity responsible for accumulating all this sensory data.<br /> &lt;br/&gt;Many theories were formulated and overruled by their successors with time. Today the concept of mind and consciousness remains yet to be clearly defined. It is observed that mind is often identified as consciousness and they both are accepted as individual closely linked entities. Mind bears synonymity towards consciousness, spirit, and psyche. Some theories view both mind and consciousness as spirit. But mind is invariably understood as the interaction between psychological personality and the external environment, i.e., a subject – object relationship.<br /> &lt;br/&gt;The neurophysiological basis of minds and the channels of transport of its constituents is yet a challenge in field of neuroscience. In order to bridge this gap, contemporary scientists hypothesise that mental representations and their contents are represented by neural network and their supporting cells thus hinting towards Central Nervous System and it’s peripheral nerves as the channels of mind. [13]&lt;/p&gt; <br /> <br /> ==Research works on manovaha srotas==<br /> Various review articles have been published and researches been carried out in the domain of Ayurveda to understand the conceptual as well as pathophysiological aspect of manovaha srotas. Few of them are as follows :-<br /> '''# Critical Review of Concept of manovaha Srotas with special reference to Brain''' <br /> This review article conceptualizes the contemporary understanding of manovaha srotas in context to CNS due to functional similarity between manas and brain obtained after an extensive research and analysis throughout ayurveda treatises. Further brain was considered as synonymous to hridya ie. mulasthana (site of origin) of manovaha srotas and ‘dasha dhamani’ as the cranial nerves exiting from the 10 major foramen at base of skull. Sanskrit literature considers hridaya as regarded as a central organ similar to brain. 14<br /> '''# Circumstantial view on clinical knowing of manovaha srotasa &amp; its physiology''' <br /> The review article reconstructs a comprehensive picture of manovaha srotas from the scattered references available in Ayurveda texts, supplementing it with additional information from contemporary science as follows-<br /> '''*'''A detailed description of neuroanatomy and physiology has been drawn parallel to Ayurveda point of view about manas’ rachna and kriya sharir. <br /> '''*'''Effect of Triguna and tridosha (especially vata) in context of physiological functions and disorders of manas and manovaha srotas have been discussed.<br /> '''*'''Correlations between functions of five subtypes of vata and both CNS and ANS has been attempted Pariksha krama (examination of nervous system) has been exemplified taking into consideration both Ayurveda and modern methodologies that can be employed for manovaha srotas (nervous system) examination.10 <br /> '''*'''Concept of stress factor assessment concerning ‘perseverance test’ in light of ayurveda” – a review This article highlights the importance of understanding the etiological factors of vitiation of manovaha srotas and manas in all kinds of psychiatric as well as psychosomatic disorders. Imbalance of manas dosha can be treated by means of yoga, meditation and pranayama. Often emotional disturbances remain unattended in diagnosed cases of psychiatric illness which can be managed at home by incorporating wholesome diet (pathya ahara) and moral code of conduct (sadvrutta) in daily routine. Lack of peace and chronic stressors have been observed as major causes of vitiation of channels of mind. 15<br /> <br /> <br /> &lt;big&gt;'''[[Special:ContactMe|Send us your suggestions and feedback on this page.]]'''&lt;/big&gt;<br /> <br /> ==References==<br /> <br /> &lt;div id=&quot;BackToTop&quot; class=&quot;noprint&quot; style=&quot;background-color:#DDEFDD; position:fixed;<br /> bottom:32px; left:2%; z-index:9999; padding:0; margin:0;&quot;&gt;&lt;span style=&quot;color:blue;<br /> font-size:8pt; font-face:verdana,sans-serif; border:0.2em outset #ceebf7;<br /> padding:0.1em; font-weight:bolder; -moz-border-radius:8px; &quot;&gt;<br /> [[#top| Back to the Top ]]&lt;/span&gt;&lt;/div&gt;</div>

Manishdubey https://www.carakasamhitaonline.com/index.php?title=Talk:Manovaha_srotas&diff=44184 2023-10-13T12:11:47Z

<p>Manishdubey: </p> <hr /> <div>{{CiteButton}}<br /> {{#seo:<br /> |title= Manovaha srotas<br /> (Channels of transport and transformation of mind and mental factors)<br /> |titlemode=append<br /> |keywords= Manovaha srotas,Hrudya, Sattva pariksha, Sattvavajaya chikitsa, Bhojani M. K.,Deole Y.S., Basisht G<br /> |description=Mana means mind, or psyche. Srotas means channels of transport and transformation. The description and understanding of channels for activities of mind (manovaha srotas) is scattered in ayurveda classics and has not been completely elucidated. Manovaha srotas are considered as channels through which mind and body interact with each other. <br /> |image=http://www.carakasamhitaonline.com/mediawiki-1.32.1/resources/assets/ogimgs.jpg<br /> |image_alt=carak samhita<br /> |type=article<br /> }}<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Mana means mind, or psyche. Srotas means channels of transport and transformation. The description and understanding of channels for activities of mind (manovaha srotas) is scattered in ayurveda classics and has not been completely elucidated. Manovaha srotas are considered as channels through which mind and body interact with each other. These channels pervade throughout the body. [Chakrapani on Cha.Sa. Indriya Sthana 5/41-42] They are responsible for flow of thoughts, emotions, and other psychological functions. This article deals with various aspects of manovaha srotasa i.e. the channels of activities of mind and its development.&lt;/p&gt;<br /> <br /> {{Infobox<br /> |title = Contributors<br /> |label1 = Section/Chapter/topic<br /> |data1 = Concepts/[[Srotas]]/[[Manovaha Srotas]] <br /> |label2 = Authors<br /> |data2 = Bhojani M. K.&lt;sup&gt;1&lt;/sup&gt; Varma Swati &lt;sup&gt;1&lt;/sup&gt; Deole Y.S.&lt;sup&gt;2&lt;/sup&gt;<br /> |label3 = Reviewer &amp; Editor<br /> |data3 = Basisht G.&lt;sup&gt;3&lt;/sup&gt;, <br /> |label4 = Affiliations<br /> |data4 = &lt;sup&gt;1&lt;/sup&gt; Department of Sharir Kriya, All India Institute of Ayurveda, New Delhi, India<br /> &lt;sup&gt;2&lt;/sup&gt; Department of Kayachikitsa, G. J. Patel Institute of Ayurvedic Studies and Research, New Vallabh Vidyanagar, Gujarat, India <br /> &lt;sup&gt;3&lt;/sup&gt; Rheumatologist, Orlando, Florida, U.S.A.<br /> |label5 = Correspondence emails<br /> |data5 = meera.samhita@aiia.gov.in, carakasamhita@gmail.com<br /> |label6 = Publisher <br /> |data6 = [[Charak Samhita Research, Training and Development Centre]], I.T.R.A., Jamnagar, India<br /> |label7 = Date of publication:<br /> |data7 =October 12, 2023<br /> |label8 = DOI<br /> |data8 = In process<br /> }}<br /> <br /> ==Etymology and derivation:==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Srotas originates from Sanskrit root ‘Sru’ that translates to oozing, flow or secretion. It has been defined as ‘sravanat strotamsi’ [Cha. Sa. Sutra Sthana 30/12] which indicates structures designated for conveyance of material inside body. <br /> &lt;br/&gt;Grossly defining, thirteen major types of srotas have been mentioned that transport substances undergoing biotransformation (parinamam aapadyamanam) from the place of origin to their destination. [Cha. Sa. Vimana Sthana 5/3] Similarly in physiological state, manovaha srotas might be responsible for processing and transformation of ‘doshayukta’ (irrational under influence of rajas and tamas) emotions and thoughts into unbiased reasoning before reaching a conclusion by our intellect (buddhi). &lt;/p&gt;<br /> <br /> ==Synonyms of manovaha srotas==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Following terms are used for ‘manovaha srotas’ in different Ayurveda classics : &lt;/p&gt;<br /> # Manovaha dhamani [Chakrapani on Cha. Sa. Indriya sthana 12/42] and [Vijayarakshita in Ma.Ni.Purva Khanda 20/1]<br /> # Chetanavaha srotas [Shivadas Sen on Cha.Sa. Chikitsa sthana 9/5] <br /> # Chetovaha marga [Bhel Samhita Nidana Sthana 7/2]<br /> # Manobuddhivaha sira [ Cha.Sa.Chikitsa Sthana 10/58]<br /> # Sanjnavaha srotas [Su.Sa.Uttar Tantra 61/8]<br /> # Sanjnavaha nadi [Su.Sa. Uttar Tantra 46/7]<br /> &lt;p style=&quot;text-align:justify;&quot;&gt; &lt;br/&gt;Use of terms like sira, nadi and dhamani, refers to different channels and pathways concerned with maintenance of physiological flow of information. [Cha.Sa. Vimana Sthana 5/8] &lt;/p&gt;<br /> <br /> ==Origin==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt; Every srotas is localized within the hollow space in the body originating from a root (mula) and spreading throughout the body to reach a final structure. Srotas are said to be hollow structures in different shapes and sizes The root (mula) is majorly responsible for regulation and control of functions of that srotas.<br /> &lt;br/&gt;The channels carrying mind (manovaha srotas) are not exclusively listed. It is however stated that the entire conscious body is abode of mind. Hence these channels are spread throughout the body. [Chakrapani on Cha.Sa. Indriya Sthana 5/41]. <br /> &lt;br/&gt;However, hridaya (heart) has a universal acceptance as the site of origin (mula) of manovaha srotas. Hence a special mention has been made about ten arteries of heart, probably being the manovaha srotas (visheshen tu hrudya ashritvat manah tadashrita dasha dhamanyo manovaha abhidhiyante) [Chakrapani on Cha.Sa. Indriya Sthana 5/41-42]. These get afflicted by vitiated dosha either all at once or individually. [Chakrapani on Cha.Sa. Indriya Sthana 12/42]<br /> &lt;/p&gt;<br /> <br /> ==Decoding hridaya (heart)==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt; The interpretation of the term ‘hridaya’ has been of confusion among scholars since decades. The first interpretation of the term given by texts of Shatpada Brahmana which highlighted functional aspect of hridaya. The word being composed of three letters viz ‘hri’ (hra harane)- to acquire; ‘Da’ (da dane) – to give; ‘Ya’ (Ya gatau)- which transports. The hridaya thus displays three phases of cardiac cycle i.e., receives, gives, and transports body constituents through it. [2]<br /> &lt;br/&gt;Hridaya is the site of rasa (plasma), sattva (psychic factor/mind), buddhi (intellect) and atma (soul) in conjugation with all sensory organs (jnanendriya).[Cha.Sa. Chikitsa Sthana 24/35] Sadhaka pitta situated in heart (hridaya) regulates proper functioning of intellect (buddhi) and ego (ahamkara). Hridaya is located in between breasts (stanayormadhya) of thoracic region [A. H. Sutra Sthana 12/13-14] [Su. Sa. Sharira Sthana 6/25]. <br /> &lt;br/&gt;Vedic era was well versed with heart (hridaya) and brain (mastishka) being two distinct entities, with interdependent functional relationship [Atharvaveda Book X. Hymn 2.26]. Kashyap Samhita quotes that all sense and motor organs (indriya) together with mind (manas) emerge from heart (hridaya) [Ka.Sa. Chikitsa Sthana 8/6]. Primary site of action of mind (manas) is brain (shira).[3] It can be concluded that mind (manas) being seated in heart (hridaya) connects to brain (shiras) through manovaha srotas and controls all senses (indriya). Also, any damage pertaining to marma (vital points) of shiras (head) causes loss of consciousness (cheshtanasha). [Cha.Sa. Sidhhi Sthana 9/6] Hence heart (hridaya) and brain (shirasor mastishka) are sites of manovaha srotasa. <br /> &lt;br/&gt; This approach of understanding hridaya goes well along with the contemporary view of understanding the triguna based psycho-functional principles of Ayurveda within the neural framework. Various research has been conducted which demonstrate that heart continuously sends nervous signals to brain to coordinate higher centres responsible for cognition and emotions. [1] The neuro- psychological as well as circulatory functions of hridaya mentioned in the classics can thus be explained. &lt;/p&gt; <br /> <br /> ==Relation between rasavaha and manovaha srotas==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Heart is the abode of mind (mana) and consciousness (chetana) or soul (atma). [Cha. Sa. Sidhhi Sthana 9/4] It is a site for physical, psychological, and spiritual components. Heart is origin for channels of transportation and transformation of rasa dhatu, too. Both heart and brain are considered under the umbrella term hridaya in terms of anatomical structure and higher-centre functions respectively. <br /> &lt;br/&gt;Heart (residence of manas) and brain (workplace of manas) are functionally co-dependent upon each other. Manas regulates the cognitive and conative functions of brain in conjunction with soul (atma) under the influence of vata dosha. [Cha. Sa. Sharira Sthana 1/22-23]. Brain is a structural entity needing continuous supply of nourishment and oxygen. This is feasible by heart through circulation (rasa-rakta samvahana kriya) via the ten major vessels (rasavahi dhamani). [A. H. Sharira Sthana 3/18] Heart is a highly vascular organ being surrounded by ten major dhamani (blood vessels) like spokes of a wheel which are known as ‘rasavaha strotomula’ (site of origin of channels of nutrition). These channels are comparable to manovaha srotas. [Chakrapani on Cha. Sa. Chikitsa Sthana 9/4] Manas thus acts like a medium between heart and brain wherein brain is responsible for all sensory and motor functions while heart has been assigned emotional aspect of psyche (manas).<br /> &lt;br/&gt;One of the factors for vitiation of rasavaha srotas is excessive thinking or worry (atichintan). [Cha. Sa. Vimana Sthana 5/13] Contemporary researchers have found evidence to support the interaction between circulatory system and psyche. The monograph of German professor Ludwig Braun is a pioneer in exploring the psychological and emotional aspect of cardiac diseases especially angina. He presented a correlation between cardiac diseases and ‘Angst’ (a constrictive, tightening and crushing sensation which manifests dread in the patient thereby changing his entire emotional outlook on life), analogous to anxiety. He explains that the cardiac tissue has a special apparatus receptive towards anxiety which manifests as an inner tactile sensation. That region is well supplied with nerve endings that gets irritated by anxiety. This phenomenon of emotional influence over cardiac tissues is termed as cardiac psyche. [4] <br /> &lt;/p&gt; <br /> <br /> ==Factors vitiating manovaha srotas==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt; Manovaha srotas are the prime site of abnormalities of channels in all psychological disorders. [Cha.Sa. Nidana Sthana 6/4] Alongside any of the eight factors that are either attributed to hridaya or manas viz. mana (mind), buddhi (intellect), sanjna-jnana (self-awareness), smriti (memory), bhakti (devotion), sheela (habits), cheshta (psychomotor activities) and achara (code of conduct). [Cha.Sa. Nidana Sthana 7/5] <br /> &lt;br/&gt;These factors when deranged cause vitiation of manas dosha (rajas and tamas), deterioration of sattva guna of manas and gradual derangement of tridosha. Foods, activities and excessive expression of emotions like anger, grief, lust, fear etc and mental traumas are the fundamental etiological factors for the same. [Cha.Sa. Nidana Sthana 7/4] Vitiated tridosha further vitiates rasavaha srotas, which apparently has the same site of origin as of manovaha srotas i.e., hridaya and dasha dhamani (ten great vessels). [Cha. Sa. Vimana Sthana 5/10] Hridaya is seat of manas [Cha.Sa. Sutra Sthana 30/4]. Hence, all the factors vitiating rasa dhatu (nutritive fluid), rasavaha srotas (channels carrying nutritive fluid) and manas dosha viz. rajas and tamas will affect manas and eventually vitiating manovaha srotas. Even the structural derangements of heart (abode of mind) affect manovaha srotas due to their ashrayashrayibhava (state of interdependency). [Cha.Sa. Chikitsa Sthana 9/5]&lt;/p&gt;<br /> <br /> ==Pathologies of manovaha srotas==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Manovaha srotas is important factor in understanding disorders like unmada (psychosis), apasmara (epilepsy) and extreme emotional reactions. &lt;/p&gt;<br /> <br /> *'''Unmada (psychosis)'''<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;When an individual experiences extreme emotions – lust (kama), anger (krodha), fear (bhaya), greed (lobha), happiness or pleasure (harsha), affection (moha), grief (shoka), excessive worry (chinta), they initially harm the intellect which aggravates manas dosha (rajas and tamas) and tridosha (vata, pitta and kapha). These vitiated dosha invade heart and obstruct manovaha srotas (channels transporting psychic impulses) thereby causing unmada. [Dalhan on Su. Sa. Uttar Tantra 62/3]<br /> *'''Apasmara (epilepsy)'''<br /> Overindulging in sensory pleasures, incompatible diet, withholding natural urges and giving into immoral activities under emotional influences (kama, krodha, lobha among others), vitiates rajas and tamas. They poorly influence the manas (mind) and sanjnavaha srotas (manovaha srotas) causing apasmara. [Su.Sa. Uttar Tantra 61/6]<br /> * Mada (intoxication), murchha (syncope), sanyasa (coma) are caused by vitiation of channels of consciousness (chetanavaha srotas or manovaha srotas). [Shivadas Sen on Cha. Sa. Chikitsa Sthana 9/5] <br /> *'''Atattvabhinivesha (perverted state of mind)'''<br /> Considered as mahagada (difficult to treat mental disorder), the person’s conscience gets afflicted by rajas and tamas, which cause complete derangement of intellect (buddhi vibhramsha) as the predominant symptom. The vitiated dosha get lodged in heart (hridaya) to afflict channels of mind and intellect (manobuddhivaha sira in manovaha srotas). [Cha.Sa. Chikitsa Sthana 10/57-60]<br /> * Physiology of nightmares (swapna)<br /> Nightmares are dreams occurring in REM phase of sleep which causes mental projections in the form of feelings of fear, despair, and anxiety. Ayurveda defines REM phase as ‘Natiprasupta’ - the state characterised to be midway between states of deep sleep and fully awake. During any ominous situation, tridosha in their highly aggravated state tend to fill-up the manovaha srotas. This results in terrifying dreams. [Cha.Sa. Indriya Sthana 5/41]. &lt;/p&gt;<br /> <br /> ==Assessment and diagnosis of disorders of manovaha srotas==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Srotas are micro-channels transporting various metabolites across cells throughout the body. It can be deduced that manovaha srotas has different characteristics structurally and functionally from the major thirteen srotas, because it transports and transforms thoughts and feelings. This is evident from objects of mind (manas), viz- thought (chintyam), consideration (vicharyam), hypothesis (uhyam), aims (dhyeyam) and determination (sankalpam). [Cha.Sa. Sharira Sthana 1/20]. Assessment of manovaha srotas can be done via assessment of manas and the degree of derangement of its functions. Ayurveda considers manas as material entity (dravya) which is a super sense and not perceivable by ordinary senses (atindriya) [Cha. Sa. Sutra Sthana 8/4]. Manas is under direct control of vata dosha [Cha. Sa. Sutra Sthana 12/8] and is the mediator between atma (soul) and indriyartha (objects of senses). <br /> &lt;br/&gt;The contemporary physiological aspects of mind, senses, brain, nervous system and consciousness can be considered for assessment of manovaha srotas. <br /> &lt;br/&gt; A thorough neurological examination by means of interrogation (prashna pariksha), inspection (darshana pariksha) and assessment of mental strength (sattva bala pariksha) [Cha.Sa. Vimana Sthana 8/119] can be used for assessment and diagnosis of disorders of manovaha srotas.&lt;/p&gt;<br /> <br /> ''' a. Interrogation (prashna pariksha)'''<br /> A formal interview of the patient can be conducted for overall and precise diagnosis. The questions related to chief complaints with duration, chronological development, nurturing of patient, family history, addiction, hobbies, interests, daily routine, major life events, achievements, mental traumas, emotional quotient and intellectual quotient is recorded from the patient. If the patient is not in state of giving correct answers, then the relatives or attendants who know patients history are interviewed. <br /> <br /> '''b. Darshan pariksha (Direct observation)'''<br /> While interviewing the patient, a physician should pay attention to following attributes that can signify features mentioned for certain psychiatric ailments (manovaha srotodushti)..<br /> <br /> # '''Appearance '''– Unusual dressing preferences, use of cosmetics, perfumes or accessories or flamboyant appearance. e.g;- ‘Priye tanu rakta vastradhari’ (liking for adorning clothes made of thin red fabric) is seen in yakshagraha unmada (Su.Sa. Uttara tantra 60/11)<br /> # '''Activity and co-ordination''' - Behaviour, Gait, gestures, patient’s facial expression and body language should be observed during probing them with questions. Eg;- 'Satatama akshano’ (rapid and constant eye movements) is one of the prodromal feature of apasmara (epilepsy) [ Cha.Sa. Nidana sthana 8/6]. Udhasta (patient keeps his hands raised) is a feature of pishacha grahavishta unmada [Su.Sa. Uttara Tantra 60/15]<br /> # '''Conversation style''' – Coherence of speech, articulation, emphasise over certain issue, hesitation and duration of response. E.g. ‘Chitram sa jalpati’ (Patient does irrelevant absurd talks) is seen in patients of manas unmada [Su.Sa. Uttara Tantra 62/13].<br /> #'''Emotional expression''' – Patients may express a wide range of emotions during interview with the physician. E.g. Asthana rodana (Sudden crying) is a feature in vataja unmada while amarsha (intolerance) is seen in patients of pittaja unmada. [Cha.Sa. Chikitsa Sthana 9/11-12] Fleeting ideas, incoherent speech is an important sign for lacking proper emotions. <br /> #'''Cognition''' – Orientation to person, place, time and circumstances, level of intellect, level of understanding, common sense and memory can be identified under the domain of cognition by observing patient’s behaviour as well as by asking questions to them using validated scientific questionnaires. Short term memory and long-term memory shall be assessed properly. <br /> &lt;br/&gt;All observations gathered from every method of assessment should be simultaneously analysed to reach the diagnosis.<br /> <br /> =='''c. Sattva pariksha (assessment of quality of excellence of mind)'''==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Sattva pariksha assesses the quality of excellence of mind imparted by extent of dominance of sattva guna. Mind (manas) is composed of three attributes (triguna) viz. sattva, rajas and tamas. These impart three types of mental constitutions – Shuddha (pure) (sattvika), rajasika and tamasika. [Cha.Sa. Sharira Sthana 4/36]. Sattvika guna is full of auspiciousness and is considered the healthy (amala) state of mind. Rajasika guna imparts momentum in terms of furious temperament. Whereas tamas guna promotes inertia and moral ignorance. Hence, rajas and tamas are considered inauspicious and called manas dosha. Triguna are present in dynamically varying proportions at any given time and influenced by body (i.e. tridosha) and vice versa. [Chakrapani on Cha.Sa. Vimana Sthana 4/8]. Optimum levels of sattva guna are essential for promoting desired physical and mental strength irrespective of morphological features. [Cha.Sa. Vimana Sthana 8/119]&lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Sattva bala (strength of psyche) is of three types as per strength – pravara (superior), madhyama (moderate) and avara (poor). Pravara sattva persons possess great courage. Despite poor morphological features they seem to be unmoved in the face of adversities. Madhyama sattva persons need some additional moral support to sustain themselves in times of distress. While avara sattva displays catastrophic reactions even during little inconveniences and can neither be sustained by themselves nor by others despite having good quality morphological features. Avara sattva is constantly plagued by inferior emotions like grief, fear, greed, conceit and confusion. When confronted with fierce, ugly, disgusting narratives or flesh and blood, they are prone to become depressed, pale, unconscious or semiconscious, giddy, anxious and can even succumb to death in worst case scenarios. [Cha. Sa. Vimana Sthana 8/119].<br /> &lt;br/&gt;Manovaha srotas associated with avara sattva bala is most likely to be vitiated by manas dosha leading to various psychiatric and psychosomatic disorders [Cha.Sa. Chikitsa Sthana 9/5]. It has been observed that avara sattva individuals are more likely to commit prajnaparadha (intellectual defects) [10] thereby voluntarily indulging in various etiological factors for respective psychological as well as somatic disorders.<br /> &lt;br?&gt;Thus, assessment of sattva bala can help rule out the predisposition towards manovaha srotodushti and subsequent development of symptoms of psychiatric ailments.&lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;'''d. Anumana pariksha (knowledge by inference)''' to determine normalcy of faculties of manas (mind) [Cha.Sa. Vimana Sthana 4/8] Since manas is atindriya ( supersence or imperceivable by ordinary senses), so are it’s faculties which can serve as potential markers for assessment of its functions. [10] The proper functioning of manas itself is inferred by altered or inappropriate mental perceptions even in presence of appropriately functioning indriya (senses) and their respective sense objects whereas the mental faculties can be inferred as follows:-&lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;This inferential knowledge can help an individual become self-aware of his own psyche (sattva). A self-aware individual has an upper hand at avoiding mental illness because these often go unnoticed until they develop some organic manifestations.<br /> &lt;br/&gt;Thus, by means of above discussed assessment methodologies, a physician can assess the degree of derangement in mental faculties and hence the manovaha srotas, irrespective of development of specific signs and symptoms of any psychiatric disorder (vyadhi lakshana).&lt;/p&gt;<br /> <br /> ==Treatment Guidelines==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Manovaha srotas disorders follow the line of treatment same as described for disorders of manas (mind). Following are therapeutic and preventive practices beneficial for both vitiated manovaha srotas (channels of psyche) and manas obscured by rajas - tamas dosha.&lt;/p&gt;<br /> '''*'''Manas dosha can be alleviated through a comprehensive five-fold psychotherapeutic regimen - jnana (spiritual knowledge or self-awareness), vijnana (scriptural or scientific knowledge), dhairya (mental fortitude), smriti (recollection of past successes to regain faith in own abilities) and samadhi (spiritual healing practices to focus mind inwards away from negative external stimuli). [Cha.Sa. Sutra Sthana 1/58]<br /> Restoration of dhi (intellect), dhairya (mental fortitude) and atmadi vijnana (knowledge of self-consciousness) has therapeutic effect in alleviating disorders of manovaha srotas obstructed by manas dosha.<br /> '''*Sattvavajaya chikitsa (treatment to regulate mind)'''<br /> Sattvavajaya chikitsa is a non-invasive therapeutic module for psychological derangements and psychosomatic ailments, analogous to contemporary psychotherapy. ‘Sattva’ stands for mind and ‘avajaya’ translates to win over. Hence, it emphasizes withdrawing the mind from unwholesome objects of senses (factors vitiating rajas and tamas) and diverting it to positive sensory and emotional stimuli. Thereby consciously negating disturbed emotions and behavioural patterns. [Cha.Sa. Sutra Sthana 11/54]<br /> '''*Ashtanga yoga (eight steps of yoga)'''<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Ashtanga yoga can be considered as one of the dimensions of satvavajaya chikitsa. It integrates eight steps of yoga to tame mind from traversing paths in life which are spiritually and mentally harmful for that individual. Of the eight steps, first four viz. yama (principles for moral code), niyama (observances for personal discipline), asana (yogic postures) and pranayama (regulating breath) are termed as bahiranga yoga (external path). These practices gradually alleviate aggravated manas dosha, making the mind less reactive towards external stimuli. The last three limbs viz. dharana (concentration), dhyana (meditation) and samadhi (enlightenment or complete realisation) are termed as antaranga yoga (internal paths). These practices transform the mind, eliminating the fluctuations of mind, thereby strengthening positive habits and outlook on life as well as inner self. Ashtanga yoga maintains a harmonious balance between inner environment (mind and spirit) and external environment (objects of sensory perception). Mind thus gets liberated from worldly pursuits and all psychological sufferings in a stepwise manner.&lt;/p&gt;<br /> '''*Achara rasayana (rejuvenating codes of behavioural conduct)'''<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Achara rasayana is an adravyabhuta (non-pharmacological) rasayana (practices rejuvenating physical and mental health). It includes behavioural conducts which aim to enhance health and longevity by teaching practical methods to potentiate sattva guna of mind. [Cha.Sa. Chikitsa Sthana 1, 4th pada, shloka 30-35] An individual can imbibe easy lifestyle modifications to develop a positive and strong character of mind, thereby avoiding potential etiological factors (for dosha aggravation) and negative psychosocial patterns. Achara rasayana can be divided into five domains of good mental, social, personal, moral and religious conduct. [6]&lt;/p&gt;<br /> '''*Sadvritta (good codes of conduct)'''<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Sadvritta refers to good code of conduct. These are a set of practices, which serve as lifestyle guidelines to prevent mind from falling prey to temporary material pleasures and impulsive thoughts and actions that cause impairment of manas dosha and manovaha srotas. It encompasses guidelines over personal hygiene, personality development as well as for social hygiene and peaceful social interactions. [Cha.Sa. Sutra Sthana 8/18]&lt;/p&gt;<br /> Both achara rasayana and sadvritta help to maintain control over sense organs. They majorly add to the preventive and promotive aspect of mental health. <br /> '''*Medhya dravya (medicines enhancing intellectual functions)'''<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Medhya dravyas are the plant based pharmacological agents that promote prajna i.e., dhi (intellect), dhriti (perseverance) and smriti (memory). Researches conducted prove their efficacy in minimizing the cognitive decline among individuals with neural abnormalities. For example, ushna (hot potency) and tikshna nature drugs like jyotishmati and vacha are said to remove blockages caused by kapha, ama or tamas dosha in the manovaha srotas. Once purified, manas can regain unvitiated connect with indriya via manovaha srotas. [8] <br /> &lt;br/&gt;Ayurveda thus provides a bird’s eye view over different aspects of manovaha srotas through interconnected references in the classics highlighting its physiological importance like the other thirteen major srotas systems in the human body.&lt;/p&gt;<br /> <br /> ==Contemporary view==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Mind as per contemporary literature is debatable concept because in some contexts it is identified as conscience, while in others it is seen as the function of conscience. The philosophical dimension of mind was conceived by Plato who considered mind as an inner (soul’s) experience. [11]<br /> &lt;br/&gt;The western system of medicine addresses brain at the core of majority of psychological distresses, whereas western philosophy involves the concept of psyche (which denotes mind). ‘Psyche’ is a Greek word meaning ‘soul in a living man’. <br /> &lt;br/&gt;William James, referred to as the father of American Psychology, laid the foundations of physiological aspect of mind. To him mind was a function of brain which conducts mental life in the form of a constant stream of consciousness.[9] At some places he too admitted mind to bear consciousness and tried to assign attributes to consciousness as a separate psychological function thus formulating the Theory of Functionalism which established causal relationship between internal states (perception) and external reactions or behaviour (sensation). He concluded that repeated actions cause adaptive changes in nervous system. This is the fundamental ideology behind the concept of Neuroplasticity – i.e. adaptive structural and functional changes in brain by development of new neuronal pathways due to intrinsic or extrinsic stimuli. [12]<br /> &lt;br/&gt;James’ counterpart Titchener, an English Psychologist, proposed that consciousness is mind’s awareness of its own functions. Consciousness is something superior to mind itself. He formulated the Theory of Structuralism which aimed at analysing the interrelationship between mental experiences, feelings, and sensations. He used introspection as a tool to break down these complex phenomena of consciousness down to their basic elements without breaking their original structure. <br /> &lt;br/&gt;Mind is hence regarded as the cumulative effect of all mental processes that have occurred in the lifetime while the consciousness can be understood as the cumulative effect of all mental processes occurring in present moment. Eventually brain was somehow regarded to control the neural activity responsible for accumulating all this sensory data.<br /> &lt;br/&gt;Many theories were formulated and overruled by their successors with time. Today the concept of mind and consciousness remains yet to be clearly defined. It is observed that mind is often identified as consciousness and they both are accepted as individual closely linked entities. Mind bears synonymity towards consciousness, spirit, and psyche. Some theories view both mind and consciousness as spirit. But mind is invariably understood as the interaction between psychological personality and the external environment, i.e., a subject – object relationship.<br /> &lt;br/&gt;The neurophysiological basis of minds and the channels of transport of its constituents is yet a challenge in field of neuroscience. In order to bridge this gap, contemporary scientists hypothesise that mental representations and their contents are represented by neural network and their supporting cells thus hinting towards Central Nervous System and it’s peripheral nerves as the channels of mind. [13]&lt;/p&gt; <br /> <br /> ==Research works on manovaha srotas==<br /> Various review articles have been published and researches been carried out in the domain of Ayurveda to understand the conceptual as well as pathophysiological aspect of manovaha srotas. Few of them are as follows :-<br /> '''# Critical Review of Concept of manovaha Srotas with special reference to Brain''' <br /> This review article conceptualizes the contemporary understanding of manovaha srotas in context to CNS due to functional similarity between manas and brain obtained after an extensive research and analysis throughout ayurveda treatises. Further brain was considered as synonymous to hridya ie. mulasthana (site of origin) of manovaha srotas and ‘dasha dhamani’ as the cranial nerves exiting from the 10 major foramen at base of skull. Sanskrit literature considers hridaya as regarded as a central organ similar to brain. 14<br /> '''# Circumstantial view on clinical knowing of manovaha srotasa &amp; its physiology''' <br /> The review article reconstructs a comprehensive picture of manovaha srotas from the scattered references available in Ayurveda texts, supplementing it with additional information from contemporary science as follows-<br /> '''*'''A detailed description of neuroanatomy and physiology has been drawn parallel to Ayurveda point of view about manas’ rachna and kriya sharir. <br /> '''*'''Effect of Triguna and tridosha (especially vata) in context of physiological functions and disorders of manas and manovaha srotas have been discussed.<br /> '''*'''Correlations between functions of five subtypes of vata and both CNS and ANS has been attempted Pariksha krama (examination of nervous system) has been exemplified taking into consideration both Ayurveda and modern methodologies that can be employed for manovaha srotas (nervous system) examination.10 <br /> '''*'''Concept of stress factor assessment concerning ‘perseverance test’ in light of ayurveda” – a review This article highlights the importance of understanding the etiological factors of vitiation of manovaha srotas and manas in all kinds of psychiatric as well as psychosomatic disorders. Imbalance of manas dosha can be treated by means of yoga, meditation and pranayama. Often emotional disturbances remain unattended in diagnosed cases of psychiatric illness which can be managed at home by incorporating wholesome diet (pathya ahara) and moral code of conduct (sadvrutta) in daily routine. Lack of peace and chronic stressors have been observed as major causes of vitiation of channels of mind. 15<br /> <br /> <br /> &lt;big&gt;'''[[Special:ContactMe|Send us your suggestions and feedback on this page.]]'''&lt;/big&gt;<br /> <br /> ==References==<br /> <br /> &lt;div id=&quot;BackToTop&quot; class=&quot;noprint&quot; style=&quot;background-color:#DDEFDD; position:fixed;<br /> bottom:32px; left:2%; z-index:9999; padding:0; margin:0;&quot;&gt;&lt;span style=&quot;color:blue;<br /> font-size:8pt; font-face:verdana,sans-serif; border:0.2em outset #ceebf7;<br /> padding:0.1em; font-weight:bolder; -moz-border-radius:8px; &quot;&gt;<br /> [[#top| Back to the Top ]]&lt;/span&gt;&lt;/div&gt;</div>

Manishdubey https://www.carakasamhitaonline.com/index.php?title=Talk:Manovaha_srotas&diff=44182 2023-10-13T12:06:47Z

<p>Manishdubey: </p> <hr /> <div>{{CiteButton}}<br /> {{#seo:<br /> |title= Manovaha srotas<br /> (Channels of transport and transformation of mind and mental factors)<br /> |titlemode=append<br /> |keywords= Manovaha srotas,Hrudya, Sattva pariksha, Sattvavajaya chikitsa, Bhojani M. K.,Deole Y.S., Basisht G<br /> |description=Mana means mind, or psyche. Srotas means channels of transport and transformation. The description and understanding of channels for activities of mind (manovaha srotas) is scattered in ayurveda classics and has not been completely elucidated. Manovaha srotas are considered as channels through which mind and body interact with each other. <br /> |image=http://www.carakasamhitaonline.com/mediawiki-1.32.1/resources/assets/ogimgs.jpg<br /> |image_alt=carak samhita<br /> |type=article<br /> }}<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Mana means mind, or psyche. Srotas means channels of transport and transformation. The description and understanding of channels for activities of mind (manovaha srotas) is scattered in ayurveda classics and has not been completely elucidated. Manovaha srotas are considered as channels through which mind and body interact with each other. These channels pervade throughout the body. [Chakrapani on Cha.Sa. Indriya Sthana 5/41-42] They are responsible for flow of thoughts, emotions, and other psychological functions. This article deals with various aspects of manovaha srotasa i.e. the channels of activities of mind and its development.&lt;/p&gt;<br /> <br /> {{Infobox<br /> |title = Contributors<br /> |label1 = Section/Chapter/topic<br /> |data1 = Concepts/[[Srotas]]/[[Manovaha Srotas]] <br /> |label2 = Authors<br /> |data2 = Bhojani M. K.&lt;sup&gt;1&lt;/sup&gt; Varma Swati &lt;sup&gt;1&lt;/sup&gt; Deole Y.S.&lt;sup&gt;2&lt;/sup&gt;<br /> |label3 = Reviewer &amp; Editor<br /> |data3 = Basisht G.&lt;sup&gt;3&lt;/sup&gt;, <br /> |label4 = Affiliations<br /> |data4 = &lt;sup&gt;1&lt;/sup&gt; Department of Sharir Kriya, All India Institute of Ayurveda, New Delhi, India<br /> &lt;sup&gt;2&lt;/sup&gt; Department of Kayachikitsa, G. J. Patel Institute of Ayurvedic Studies and Research, New Vallabh Vidyanagar, Gujarat, India <br /> &lt;sup&gt;3&lt;/sup&gt; Rheumatologist, Orlando, Florida, U.S.A.<br /> |label5 = Correspondence emails<br /> |data5 = meera.samhita@aiia.gov.in, carakasamhita@gmail.com<br /> |label6 = Publisher <br /> |data6 = [[Charak Samhita Research, Training and Development Centre]], I.T.R.A., Jamnagar, India<br /> |label7 = Date of publication:<br /> |data7 =October 12, 2023<br /> |label8 = DOI<br /> |data8 = In process<br /> }}<br /> <br /> ==Etymology and derivation:==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Srotas originates from Sanskrit root ‘Sru’ that translates to oozing, flow or secretion. It has been defined as ‘sravanat strotamsi’ [Cha. Sa. Sutra Sthana 30/12] which indicates structures designated for conveyance of material inside body. <br /> &lt;br/&gt;Grossly defining, thirteen major types of srotas have been mentioned that transport substances undergoing biotransformation (parinamam aapadyamanam) from the place of origin to their destination. [Cha. Sa. Vimana Sthana 5/3] Similarly in physiological state, manovaha srotas might be responsible for processing and transformation of ‘doshayukta’ (irrational under influence of rajas and tamas) emotions and thoughts into unbiased reasoning before reaching a conclusion by our intellect (buddhi). &lt;/p&gt;<br /> <br /> ==Synonyms of manovaha srotas==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Following terms are used for ‘manovaha srotas’ in different Ayurveda classics : &lt;/p&gt;<br /> # Manovaha dhamani [Chakrapani on Cha. Sa. Indriya sthana 12/42] and [Vijayarakshita in Ma.Ni.Purva Khanda 20/1]<br /> # Chetanavaha srotas [Shivadas Sen on Cha.Sa. Chikitsa sthana 9/5] <br /> # Chetovaha marga [Bhel Samhita Nidana Sthana 7/2]<br /> # Manobuddhivaha sira [ Cha.Sa.Chikitsa Sthana 10/58]<br /> # Sanjnavaha srotas [Su.Sa.Uttar Tantra 61/8]<br /> # Sanjnavaha nadi [Su.Sa. Uttar Tantra 46/7]<br /> &lt;p style=&quot;text-align:justify;&quot;&gt; &lt;br/&gt;Use of terms like sira, nadi and dhamani, refers to different channels and pathways concerned with maintenance of physiological flow of information. [Cha.Sa. Vimana Sthana 5/8] &lt;/p&gt;<br /> <br /> ==Origin==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt; Every srotas is localized within the hollow space in the body originating from a root (mula) and spreading throughout the body to reach a final structure. Srotas are said to be hollow structures in different shapes and sizes The root (mula) is majorly responsible for regulation and control of functions of that srotas.<br /> &lt;br/&gt;The channels carrying mind (manovaha srotas) are not exclusively listed. It is however stated that the entire conscious body is abode of mind. Hence these channels are spread throughout the body. [Chakrapani on Cha.Sa. Indriya Sthana 5/41]. <br /> &lt;br/&gt;However, hridaya (heart) has a universal acceptance as the site of origin (mula) of manovaha srotas. Hence a special mention has been made about ten arteries of heart, probably being the manovaha srotas (visheshen tu hrudya ashritvat manah tadashrita dasha dhamanyo manovaha abhidhiyante) [Chakrapani on Cha.Sa. Indriya Sthana 5/41-42]. These get afflicted by vitiated dosha either all at once or individually. [Chakrapani on Cha.Sa. Indriya Sthana 12/42]<br /> &lt;/p&gt;<br /> <br /> ==Decoding hridaya (heart)==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt; The interpretation of the term ‘hridaya’ has been of confusion among scholars since decades. The first interpretation of the term given by texts of Shatpada Brahmana which highlighted functional aspect of hridaya. The word being composed of three letters viz ‘hri’ (hra harane)- to acquire; ‘Da’ (da dane) – to give; ‘Ya’ (Ya gatau)- which transports. The hridaya thus displays three phases of cardiac cycle i.e., receives, gives, and transports body constituents through it. [2]<br /> &lt;br/&gt;Hridaya is the site of rasa (plasma), sattva (psychic factor/mind), buddhi (intellect) and atma (soul) in conjugation with all sensory organs (jnanendriya).[Cha.Sa. Chikitsa Sthana 24/35] Sadhaka pitta situated in heart (hridaya) regulates proper functioning of intellect (buddhi) and ego (ahamkara). Hridaya is located in between breasts (stanayormadhya) of thoracic region [A. H. Sutra Sthana 12/13-14] [Su. Sa. Sharira Sthana 6/25]. <br /> &lt;br/&gt;Vedic era was well versed with heart (hridaya) and brain (mastishka) being two distinct entities, with interdependent functional relationship [Atharvaveda Book X. Hymn 2.26]. Kashyap Samhita quotes that all sense and motor organs (indriya) together with mind (manas) emerge from heart (hridaya) [Ka.Sa. Chikitsa Sthana 8/6]. Primary site of action of mind (manas) is brain (shira).[3] It can be concluded that mind (manas) being seated in heart (hridaya) connects to brain (shiras) through manovaha srotas and controls all senses (indriya). Also, any damage pertaining to marma (vital points) of shiras (head) causes loss of consciousness (cheshtanasha). [Cha.Sa. Sidhhi Sthana 9/6] Hence heart (hridaya) and brain (shirasor mastishka) are sites of manovaha srotasa. <br /> &lt;br/&gt; This approach of understanding hridaya goes well along with the contemporary view of understanding the triguna based psycho-functional principles of Ayurveda within the neural framework. Various research has been conducted which demonstrate that heart continuously sends nervous signals to brain to coordinate higher centres responsible for cognition and emotions. [1] The neuro- psychological as well as circulatory functions of hridaya mentioned in the classics can thus be explained. &lt;/p&gt; <br /> <br /> ==Relation between rasavaha and manovaha srotas==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Heart is the abode of mind (mana) and consciousness (chetana) or soul (atma). [Cha. Sa. Sidhhi Sthana 9/4] It is a site for physical, psychological, and spiritual components. Heart is origin for channels of transportation and transformation of rasa dhatu, too. Both heart and brain are considered under the umbrella term hridaya in terms of anatomical structure and higher-centre functions respectively. <br /> &lt;br/&gt;Heart (residence of manas) and brain (workplace of manas) are functionally co-dependent upon each other. Manas regulates the cognitive and conative functions of brain in conjunction with soul (atma) under the influence of vata dosha. [Cha. Sa. Sharira Sthana 1/22-23]. Brain is a structural entity needing continuous supply of nourishment and oxygen. This is feasible by heart through circulation (rasa-rakta samvahana kriya) via the ten major vessels (rasavahi dhamani). [A. H. Sharira Sthana 3/18] Heart is a highly vascular organ being surrounded by ten major dhamani (blood vessels) like spokes of a wheel which are known as ‘rasavaha strotomula’ (site of origin of channels of nutrition). These channels are comparable to manovaha srotas. [Chakrapani on Cha. Sa. Chikitsa Sthana 9/4] Manas thus acts like a medium between heart and brain wherein brain is responsible for all sensory and motor functions while heart has been assigned emotional aspect of psyche (manas).<br /> &lt;br/&gt;One of the factors for vitiation of rasavaha srotas is excessive thinking or worry (atichintan). [Cha. Sa. Vimana Sthana 5/13] Contemporary researchers have found evidence to support the interaction between circulatory system and psyche. The monograph of German professor Ludwig Braun is a pioneer in exploring the psychological and emotional aspect of cardiac diseases especially angina. He presented a correlation between cardiac diseases and ‘Angst’ (a constrictive, tightening and crushing sensation which manifests dread in the patient thereby changing his entire emotional outlook on life), analogous to anxiety. He explains that the cardiac tissue has a special apparatus receptive towards anxiety which manifests as an inner tactile sensation. That region is well supplied with nerve endings that gets irritated by anxiety. This phenomenon of emotional influence over cardiac tissues is termed as cardiac psyche. [4] <br /> &lt;/p&gt; <br /> <br /> ==Factors vitiating manovaha srotas==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt; Manovaha srotas are the prime site of abnormalities of channels in all psychological disorders. [Cha.Sa. Nidana Sthana 6/4] Alongside any of the eight factors that are either attributed to hridaya or manas viz. mana (mind), buddhi (intellect), sanjna-jnana (self-awareness), smriti (memory), bhakti (devotion), sheela (habits), cheshta (psychomotor activities) and achara (code of conduct). [Cha.Sa. Nidana Sthana 7/5] <br /> &lt;br/&gt;These factors when deranged cause vitiation of manas dosha (rajas and tamas), deterioration of sattva guna of manas and gradual derangement of tridosha. Foods, activities and excessive expression of emotions like anger, grief, lust, fear etc and mental traumas are the fundamental etiological factors for the same. [Cha.Sa. Nidana Sthana 7/4] Vitiated tridosha further vitiates rasavaha srotas, which apparently has the same site of origin as of manovaha srotas i.e., hridaya and dasha dhamani (ten great vessels). [Cha. Sa. Vimana Sthana 5/10] Hridaya is seat of manas [Cha.Sa. Sutra Sthana 30/4]. Hence, all the factors vitiating rasa dhatu (nutritive fluid), rasavaha srotas (channels carrying nutritive fluid) and manas dosha viz. rajas and tamas will affect manas and eventually vitiating manovaha srotas. Even the structural derangements of heart (abode of mind) affect manovaha srotas due to their ashrayashrayibhava (state of interdependency). [Cha.Sa. Chikitsa Sthana 9/5]&lt;/p&gt;<br /> <br /> ==Pathologies of manovaha srotas==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Manovaha srotas is important factor in understanding disorders like unmada (psychosis), apasmara (epilepsy) and extreme emotional reactions. &lt;/p&gt;<br /> <br /> *'''Unmada (psychosis)'''<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;When an individual experiences extreme emotions – lust (kama), anger (krodha), fear (bhaya), greed (lobha), happiness or pleasure (harsha), affection (moha), grief (shoka), excessive worry (chinta), they initially harm the intellect which aggravates manas dosha (rajas and tamas) and tridosha (vata, pitta and kapha). These vitiated dosha invade heart and obstruct manovaha srotas (channels transporting psychic impulses) thereby causing unmada. [Dalhan on Su. Sa. Uttar Tantra 62/3]<br /> *'''Apasmara (epilepsy)'''<br /> Overindulging in sensory pleasures, incompatible diet, withholding natural urges and giving into immoral activities under emotional influences (kama, krodha, lobha among others), vitiates rajas and tamas. They poorly influence the manas (mind) and sanjnavaha srotas (manovaha srotas) causing apasmara. [Su.Sa. Uttar Tantra 61/6]<br /> * Mada (intoxication), murchha (syncope), sanyasa (coma) are caused by vitiation of channels of consciousness (chetanavaha srotas or manovaha srotas). [Shivadas Sen on Cha. Sa. Chikitsa Sthana 9/5] <br /> *'''Atattvabhinivesha (perverted state of mind)'''<br /> Considered as mahagada (difficult to treat mental disorder), the person’s conscience gets afflicted by rajas and tamas, which cause complete derangement of intellect (buddhi vibhramsha) as the predominant symptom. The vitiated dosha get lodged in heart (hridaya) to afflict channels of mind and intellect (manobuddhivaha sira in manovaha srotas). [Cha.Sa. Chikitsa Sthana 10/57-60]<br /> * Physiology of nightmares (swapna)<br /> Nightmares are dreams occurring in REM phase of sleep which causes mental projections in the form of feelings of fear, despair, and anxiety. Ayurveda defines REM phase as ‘Natiprasupta’ - the state characterised to be midway between states of deep sleep and fully awake. During any ominous situation, tridosha in their highly aggravated state tend to fill-up the manovaha srotas. This results in terrifying dreams. [Cha.Sa. Indriya Sthana 5/41]. &lt;/p&gt;<br /> <br /> ==Assessment and diagnosis of disorders of manovaha srotas==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Srotas are micro-channels transporting various metabolites across cells throughout the body. It can be deduced that manovaha srotas has different characteristics structurally and functionally from the major thirteen srotas, because it transports and transforms thoughts and feelings. This is evident from objects of mind (manas), viz- thought (chintyam), consideration (vicharyam), hypothesis (uhyam), aims (dhyeyam) and determination (sankalpam). [Cha.Sa. Sharira Sthana 1/20]. Assessment of manovaha srotas can be done via assessment of manas and the degree of derangement of its functions. Ayurveda considers manas as material entity (dravya) which is a super sense and not perceivable by ordinary senses (atindriya) [Cha. Sa. Sutra Sthana 8/4]. Manas is under direct control of vata dosha [Cha. Sa. Sutra Sthana 12/8] and is the mediator between atma (soul) and indriyartha (objects of senses). <br /> &lt;br/&gt;The contemporary physiological aspects of mind, senses, brain, nervous system and consciousness can be considered for assessment of manovaha srotas. <br /> &lt;br/&gt; A thorough neurological examination by means of interrogation (prashna pariksha), inspection (darshana pariksha) and assessment of mental strength (sattva bala pariksha) [Cha.Sa. Vimana Sthana 8/119] can be used for assessment and diagnosis of disorders of manovaha srotas.&lt;/p&gt;<br /> <br /> ''' a. Interrogation (prashna pariksha)'''<br /> A formal interview of the patient can be conducted for overall and precise diagnosis. The questions related to chief complaints with duration, chronological development, nurturing of patient, family history, addiction, hobbies, interests, daily routine, major life events, achievements, mental traumas, emotional quotient and intellectual quotient is recorded from the patient. If the patient is not in state of giving correct answers, then the relatives or attendants who know patients history are interviewed. <br /> <br /> '''b. Darshan pariksha (Direct observation)'''<br /> While interviewing the patient, a physician should pay attention to following attributes that can signify features mentioned for certain psychiatric ailments (manovaha srotodushti)..<br /> <br /> '''#Appearance '''– Unusual dressing preferences, use of cosmetics, perfumes or accessories or flamboyant appearance. e.g;- ‘Priye tanu rakta vastradhari’ (liking for adorning clothes made of thin red fabric) is seen in yakshagraha unmada (Su.Sa. Uttara tantra 60/11)<br /> '''#Activity and co-ordination''' - Behaviour, Gait, gestures, patient’s facial expression and body language should be observed during probing them with questions. Eg;- 'Satatama akshano’ (rapid and constant eye movements) is one of the prodromal feature of apasmara (epilepsy) [ Cha.Sa. Nidana sthana 8/6]. Udhasta (patient keeps his hands raised) is a feature of pishacha grahavishta unmada [Su.Sa. Uttara Tantra 60/15]<br /> '''#Conversation style''' – Coherence of speech, articulation, emphasise over certain issue, hesitation and duration of response. E.g. ‘Chitram sa jalpati’ (Patient does irrelevant absurd talks) is seen in patients of manas unmada [Su.Sa. Uttara Tantra 62/13].<br /> '''#Emotional expression''' – Patients may express a wide range of emotions during interview with the physician. E.g. Asthana rodana (Sudden crying) is a feature in vataja unmada while amarsha (intolerance) is seen in patients of pittaja unmada. [Cha.Sa. Chikitsa Sthana 9/11-12] Fleeting ideas, incoherent speech is an important sign for lacking proper emotions. <br /> '''#Cognition''' – Orientation to person, place, time and circumstances, level of intellect, level of understanding, common sense and memory can be identified under the domain of cognition by observing patient’s behaviour as well as by asking questions to them using validated scientific questionnaires. Short term memory and long-term memory shall be assessed properly. <br /> &lt;br/&gt;All observations gathered from every method of assessment should be simultaneously analysed to reach the diagnosis.<br /> <br /> =='''c. Sattva pariksha (assessment of quality of excellence of mind)'''==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Sattva pariksha assesses the quality of excellence of mind imparted by extent of dominance of sattva guna. Mind (manas) is composed of three attributes (triguna) viz. sattva, rajas and tamas. These impart three types of mental constitutions – Shuddha (pure) (sattvika), rajasika and tamasika. [Cha.Sa. Sharira Sthana 4/36]. Sattvika guna is full of auspiciousness and is considered the healthy (amala) state of mind. Rajasika guna imparts momentum in terms of furious temperament. Whereas tamas guna promotes inertia and moral ignorance. Hence, rajas and tamas are considered inauspicious and called manas dosha. Triguna are present in dynamically varying proportions at any given time and influenced by body (i.e. tridosha) and vice versa. [Chakrapani on Cha.Sa. Vimana Sthana 4/8]. Optimum levels of sattva guna are essential for promoting desired physical and mental strength irrespective of morphological features. [Cha.Sa. Vimana Sthana 8/119]&lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Sattva bala (strength of psyche) is of three types as per strength – pravara (superior), madhyama (moderate) and avara (poor). Pravara sattva persons possess great courage. Despite poor morphological features they seem to be unmoved in the face of adversities. Madhyama sattva persons need some additional moral support to sustain themselves in times of distress. While avara sattva displays catastrophic reactions even during little inconveniences and can neither be sustained by themselves nor by others despite having good quality morphological features. Avara sattva is constantly plagued by inferior emotions like grief, fear, greed, conceit and confusion. When confronted with fierce, ugly, disgusting narratives or flesh and blood, they are prone to become depressed, pale, unconscious or semiconscious, giddy, anxious and can even succumb to death in worst case scenarios. [Cha. Sa. Vimana Sthana 8/119].<br /> &lt;br/&gt;Manovaha srotas associated with avara sattva bala is most likely to be vitiated by manas dosha leading to various psychiatric and psychosomatic disorders [Cha.Sa. Chikitsa Sthana 9/5]. It has been observed that avara sattva individuals are more likely to commit prajnaparadha (intellectual defects) [10] thereby voluntarily indulging in various etiological factors for respective psychological as well as somatic disorders.<br /> &lt;br?&gt;Thus, assessment of sattva bala can help rule out the predisposition towards manovaha srotodushti and subsequent development of symptoms of psychiatric ailments.&lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;'''d. Anumana pariksha (knowledge by inference)''' to determine normalcy of faculties of manas (mind) [Cha.Sa. Vimana Sthana 4/8] Since manas is atindriya ( supersence or imperceivable by ordinary senses), so are it’s faculties which can serve as potential markers for assessment of its functions. [10] The proper functioning of manas itself is inferred by altered or inappropriate mental perceptions even in presence of appropriately functioning indriya (senses) and their respective sense objects whereas the mental faculties can be inferred as follows:-&lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;This inferential knowledge can help an individual become self-aware of his own psyche (sattva). A self-aware individual has an upper hand at avoiding mental illness because these often go unnoticed until they develop some organic manifestations.<br /> &lt;br/&gt;Thus, by means of above discussed assessment methodologies, a physician can assess the degree of derangement in mental faculties and hence the manovaha srotas, irrespective of development of specific signs and symptoms of any psychiatric disorder (vyadhi lakshana).&lt;/p&gt;<br /> <br /> ==Treatment Guidelines==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Manovaha srotas disorders follow the line of treatment same as described for disorders of manas (mind). Following are therapeutic and preventive practices beneficial for both vitiated manovaha srotas (channels of psyche) and manas obscured by rajas - tamas dosha.&lt;/p&gt;<br /> '''*'''Manas dosha can be alleviated through a comprehensive five-fold psychotherapeutic regimen - jnana (spiritual knowledge or self-awareness), vijnana (scriptural or scientific knowledge), dhairya (mental fortitude), smriti (recollection of past successes to regain faith in own abilities) and samadhi (spiritual healing practices to focus mind inwards away from negative external stimuli). [Cha.Sa. Sutra Sthana 1/58]<br /> Restoration of dhi (intellect), dhairya (mental fortitude) and atmadi vijnana (knowledge of self-consciousness) has therapeutic effect in alleviating disorders of manovaha srotas obstructed by manas dosha.<br /> '''*Sattvavajaya chikitsa (treatment to regulate mind)'''<br /> Sattvavajaya chikitsa is a non-invasive therapeutic module for psychological derangements and psychosomatic ailments, analogous to contemporary psychotherapy. ‘Sattva’ stands for mind and ‘avajaya’ translates to win over. Hence, it emphasizes withdrawing the mind from unwholesome objects of senses (factors vitiating rajas and tamas) and diverting it to positive sensory and emotional stimuli. Thereby consciously negating disturbed emotions and behavioural patterns. [Cha.Sa. Sutra Sthana 11/54]<br /> '''*Ashtanga yoga (eight steps of yoga)'''<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Ashtanga yoga can be considered as one of the dimensions of satvavajaya chikitsa. It integrates eight steps of yoga to tame mind from traversing paths in life which are spiritually and mentally harmful for that individual. Of the eight steps, first four viz. yama (principles for moral code), niyama (observances for personal discipline), asana (yogic postures) and pranayama (regulating breath) are termed as bahiranga yoga (external path). These practices gradually alleviate aggravated manas dosha, making the mind less reactive towards external stimuli. The last three limbs viz. dharana (concentration), dhyana (meditation) and samadhi (enlightenment or complete realisation) are termed as antaranga yoga (internal paths). These practices transform the mind, eliminating the fluctuations of mind, thereby strengthening positive habits and outlook on life as well as inner self. Ashtanga yoga maintains a harmonious balance between inner environment (mind and spirit) and external environment (objects of sensory perception). Mind thus gets liberated from worldly pursuits and all psychological sufferings in a stepwise manner.&lt;/p&gt;<br /> '''*Achara rasayana (rejuvenating codes of behavioural conduct)'''<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Achara rasayana is an adravyabhuta (non-pharmacological) rasayana (practices rejuvenating physical and mental health). It includes behavioural conducts which aim to enhance health and longevity by teaching practical methods to potentiate sattva guna of mind. [Cha.Sa. Chikitsa Sthana 1, 4th pada, shloka 30-35] An individual can imbibe easy lifestyle modifications to develop a positive and strong character of mind, thereby avoiding potential etiological factors (for dosha aggravation) and negative psychosocial patterns. Achara rasayana can be divided into five domains of good mental, social, personal, moral and religious conduct. [6]&lt;/p&gt;<br /> '''*Sadvritta (good codes of conduct)'''<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Sadvritta refers to good code of conduct. These are a set of practices, which serve as lifestyle guidelines to prevent mind from falling prey to temporary material pleasures and impulsive thoughts and actions that cause impairment of manas dosha and manovaha srotas. It encompasses guidelines over personal hygiene, personality development as well as for social hygiene and peaceful social interactions. [Cha.Sa. Sutra Sthana 8/18]&lt;/p&gt;<br /> Both achara rasayana and sadvritta help to maintain control over sense organs. They majorly add to the preventive and promotive aspect of mental health. <br /> '''*Medhya dravya (medicines enhancing intellectual functions)'''<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Medhya dravyas are the plant based pharmacological agents that promote prajna i.e., dhi (intellect), dhriti (perseverance) and smriti (memory). Researches conducted prove their efficacy in minimizing the cognitive decline among individuals with neural abnormalities. For example, ushna (hot potency) and tikshna nature drugs like jyotishmati and vacha are said to remove blockages caused by kapha, ama or tamas dosha in the manovaha srotas. Once purified, manas can regain unvitiated connect with indriya via manovaha srotas. [8] <br /> &lt;br/&gt;Ayurveda thus provides a bird’s eye view over different aspects of manovaha srotas through interconnected references in the classics highlighting its physiological importance like the other thirteen major srotas systems in the human body.&lt;/p&gt;<br /> <br /> ==Contemporary view==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Mind as per contemporary literature is debatable concept because in some contexts it is identified as conscience, while in others it is seen as the function of conscience. The philosophical dimension of mind was conceived by Plato who considered mind as an inner (soul’s) experience. [11]<br /> &lt;br/&gt;The western system of medicine addresses brain at the core of majority of psychological distresses, whereas western philosophy involves the concept of psyche (which denotes mind). ‘Psyche’ is a Greek word meaning ‘soul in a living man’. <br /> &lt;br/&gt;William James, referred to as the father of American Psychology, laid the foundations of physiological aspect of mind. To him mind was a function of brain which conducts mental life in the form of a constant stream of consciousness.[9] At some places he too admitted mind to bear consciousness and tried to assign attributes to consciousness as a separate psychological function thus formulating the Theory of Functionalism which established causal relationship between internal states (perception) and external reactions or behaviour (sensation). He concluded that repeated actions cause adaptive changes in nervous system. This is the fundamental ideology behind the concept of Neuroplasticity – i.e. adaptive structural and functional changes in brain by development of new neuronal pathways due to intrinsic or extrinsic stimuli. [12]<br /> &lt;br/&gt;James’ counterpart Titchener, an English Psychologist, proposed that consciousness is mind’s awareness of its own functions. Consciousness is something superior to mind itself. He formulated the Theory of Structuralism which aimed at analysing the interrelationship between mental experiences, feelings, and sensations. He used introspection as a tool to break down these complex phenomena of consciousness down to their basic elements without breaking their original structure. <br /> &lt;br/&gt;Mind is hence regarded as the cumulative effect of all mental processes that have occurred in the lifetime while the consciousness can be understood as the cumulative effect of all mental processes occurring in present moment. Eventually brain was somehow regarded to control the neural activity responsible for accumulating all this sensory data.<br /> &lt;br/&gt;Many theories were formulated and overruled by their successors with time. Today the concept of mind and consciousness remains yet to be clearly defined. It is observed that mind is often identified as consciousness and they both are accepted as individual closely linked entities. Mind bears synonymity towards consciousness, spirit, and psyche. Some theories view both mind and consciousness as spirit. But mind is invariably understood as the interaction between psychological personality and the external environment, i.e., a subject – object relationship.<br /> &lt;br/&gt;The neurophysiological basis of minds and the channels of transport of its constituents is yet a challenge in field of neuroscience. In order to bridge this gap, contemporary scientists hypothesise that mental representations and their contents are represented by neural network and their supporting cells thus hinting towards Central Nervous System and it’s peripheral nerves as the channels of mind. [13]&lt;/p&gt; <br /> <br /> ==Research works on manovaha srotas==<br /> Various review articles have been published and researches been carried out in the domain of Ayurveda to understand the conceptual as well as pathophysiological aspect of manovaha srotas. Few of them are as follows :-<br /> '''# Critical Review of Concept of manovaha Srotas with special reference to Brain''' <br /> This review article conceptualizes the contemporary understanding of manovaha srotas in context to CNS due to functional similarity between manas and brain obtained after an extensive research and analysis throughout ayurveda treatises. Further brain was considered as synonymous to hridya ie. mulasthana (site of origin) of manovaha srotas and ‘dasha dhamani’ as the cranial nerves exiting from the 10 major foramen at base of skull. Sanskrit literature considers hridaya as regarded as a central organ similar to brain. 14<br /> '''# Circumstantial view on clinical knowing of manovaha srotasa &amp; its physiology''' <br /> The review article reconstructs a comprehensive picture of manovaha srotas from the scattered references available in Ayurveda texts, supplementing it with additional information from contemporary science as follows-<br /> '''*'''A detailed description of neuroanatomy and physiology has been drawn parallel to Ayurveda point of view about manas’ rachna and kriya sharir. <br /> '''*'''Effect of Triguna and tridosha (especially vata) in context of physiological functions and disorders of manas and manovaha srotas have been discussed.<br /> '''*'''Correlations between functions of five subtypes of vata and both CNS and ANS has been attempted Pariksha krama (examination of nervous system) has been exemplified taking into consideration both Ayurveda and modern methodologies that can be employed for manovaha srotas (nervous system) examination.10 <br /> '''*'''Concept of stress factor assessment concerning ‘perseverance test’ in light of ayurveda” – a review This article highlights the importance of understanding the etiological factors of vitiation of manovaha srotas and manas in all kinds of psychiatric as well as psychosomatic disorders. Imbalance of manas dosha can be treated by means of yoga, meditation and pranayama. Often emotional disturbances remain unattended in diagnosed cases of psychiatric illness which can be managed at home by incorporating wholesome diet (pathya ahara) and moral code of conduct (sadvrutta) in daily routine. Lack of peace and chronic stressors have been observed as major causes of vitiation of channels of mind. 15<br /> <br /> <br /> &lt;big&gt;'''[[Special:ContactMe|Send us your suggestions and feedback on this page.]]'''&lt;/big&gt;<br /> <br /> ==References==<br /> <br /> &lt;div id=&quot;BackToTop&quot; class=&quot;noprint&quot; style=&quot;background-color:#DDEFDD; position:fixed;<br /> bottom:32px; left:2%; z-index:9999; padding:0; margin:0;&quot;&gt;&lt;span style=&quot;color:blue;<br /> font-size:8pt; font-face:verdana,sans-serif; border:0.2em outset #ceebf7;<br /> padding:0.1em; font-weight:bolder; -moz-border-radius:8px; &quot;&gt;<br /> [[#top| Back to the Top ]]&lt;/span&gt;&lt;/div&gt;</div>

Manishdubey https://www.carakasamhitaonline.com/index.php?title=Talk:Manovaha_srotas&diff=44177 2023-10-13T11:49:42Z

<p>Manishdubey: </p> <hr /> <div>{{CiteButton}}<br /> {{#seo:<br /> |title= Manovaha srotas<br /> (Channels of transport and transformation of mind and mental factors)<br /> |titlemode=append<br /> |keywords= Manovaha srotas,Hrudya, Sattva pariksha, Sattvavajaya chikitsa, Bhojani M. K.,Deole Y.S., Basisht G<br /> |description=Mana means mind, or psyche. Srotas means channels of transport and transformation. The description and understanding of channels for activities of mind (manovaha srotas) is scattered in ayurveda classics and has not been completely elucidated. Manovaha srotas are considered as channels through which mind and body interact with each other. <br /> |image=http://www.carakasamhitaonline.com/mediawiki-1.32.1/resources/assets/ogimgs.jpg<br /> |image_alt=carak samhita<br /> |type=article<br /> }}<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Mana means mind, or psyche. Srotas means channels of transport and transformation. The description and understanding of channels for activities of mind (manovaha srotas) is scattered in ayurveda classics and has not been completely elucidated. Manovaha srotas are considered as channels through which mind and body interact with each other. These channels pervade throughout the body. [Chakrapani on Cha.Sa. Indriya Sthana 5/41-42] They are responsible for flow of thoughts, emotions, and other psychological functions. This article deals with various aspects of manovaha srotasa i.e. the channels of activities of mind and its development.&lt;/p&gt;<br /> <br /> {{Infobox<br /> |title = Contributors<br /> |label1 = Section/Chapter/topic<br /> |data1 = Concepts/[[Srotas]]/[[Manovaha Srotas]] <br /> |label2 = Authors<br /> |data2 = Bhojani M. K.&lt;sup&gt;1&lt;/sup&gt; Varma Swati &lt;sup&gt;1&lt;/sup&gt; Deole Y.S.&lt;sup&gt;2&lt;/sup&gt;<br /> |label3 = Reviewer &amp; Editor<br /> |data3 = Basisht G.&lt;sup&gt;3&lt;/sup&gt;, <br /> |label4 = Affiliations<br /> |data4 = &lt;sup&gt;1&lt;/sup&gt; Department of Sharir Kriya, All India Institute of Ayurveda, New Delhi, India<br /> &lt;sup&gt;2&lt;/sup&gt; Department of Kayachikitsa, G. J. Patel Institute of Ayurvedic Studies and Research, New Vallabh Vidyanagar, Gujarat, India <br /> &lt;sup&gt;3&lt;/sup&gt; Rheumatologist, Orlando, Florida, U.S.A.<br /> |label5 = Correspondence emails<br /> |data5 = meera.samhita@aiia.gov.in, carakasamhita@gmail.com<br /> |label6 = Publisher <br /> |data6 = [[Charak Samhita Research, Training and Development Centre]], I.T.R.A., Jamnagar, India<br /> |label7 = Date of publication:<br /> |data7 =October 12, 2023<br /> |label8 = DOI<br /> |data8 = In process<br /> }}<br /> <br /> ==Etymology and derivation:==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Srotas originates from Sanskrit root ‘Sru’ that translates to oozing, flow or secretion. It has been defined as ‘sravanat strotamsi’ [Cha. Sa. Sutra Sthana 30/12] which indicates structures designated for conveyance of material inside body. <br /> &lt;br/&gt;Grossly defining, thirteen major types of srotas have been mentioned that transport substances undergoing biotransformation (parinamam aapadyamanam) from the place of origin to their destination. [Cha. Sa. Vimana Sthana 5/3] Similarly in physiological state, manovaha srotas might be responsible for processing and transformation of ‘doshayukta’ (irrational under influence of rajas and tamas) emotions and thoughts into unbiased reasoning before reaching a conclusion by our intellect (buddhi). &lt;/p&gt;<br /> <br /> ==Synonyms of manovaha srotas==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Following terms are used for ‘manovaha srotas’ in different Ayurveda classics : &lt;/p&gt;<br /> # Manovaha dhamani [Chakrapani on Cha. Sa. Indriya sthana 12/42] and [Vijayarakshita in Ma.Ni.Purva Khanda 20/1]<br /> # Chetanavaha srotas [Shivadas Sen on Cha.Sa. Chikitsa sthana 9/5] <br /> # Chetovaha marga [Bhel Samhita Nidana Sthana 7/2]<br /> # Manobuddhivaha sira [ Cha.Sa.Chikitsa Sthana 10/58]<br /> # Sanjnavaha srotas [Su.Sa.Uttar Tantra 61/8]<br /> # Sanjnavaha nadi [Su.Sa. Uttar Tantra 46/7]<br /> &lt;p style=&quot;text-align:justify;&quot;&gt; &lt;br/&gt;Use of terms like sira, nadi and dhamani, refers to different channels and pathways concerned with maintenance of physiological flow of information. [Cha.Sa. Vimana Sthana 5/8] &lt;/p&gt;<br /> <br /> ==Origin==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt; Every srotas is localized within the hollow space in the body originating from a root (mula) and spreading throughout the body to reach a final structure. Srotas are said to be hollow structures in different shapes and sizes The root (mula) is majorly responsible for regulation and control of functions of that srotas.<br /> &lt;br/&gt;The channels carrying mind (manovaha srotas) are not exclusively listed. It is however stated that the entire conscious body is abode of mind. Hence these channels are spread throughout the body. [Chakrapani on Cha.Sa. Indriya Sthana 5/41]. <br /> &lt;br/&gt;However, hridaya (heart) has a universal acceptance as the site of origin (mula) of manovaha srotas. Hence a special mention has been made about ten arteries of heart, probably being the manovaha srotas (visheshen tu hrudya ashritvat manah tadashrita dasha dhamanyo manovaha abhidhiyante) [Chakrapani on Cha.Sa. Indriya Sthana 5/41-42]. These get afflicted by vitiated dosha either all at once or individually. [Chakrapani on Cha.Sa. Indriya Sthana 12/42]<br /> &lt;/p&gt;<br /> <br /> ==Decoding hridaya (heart)==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt; The interpretation of the term ‘hridaya’ has been of confusion among scholars since decades. The first interpretation of the term given by texts of Shatpada Brahmana which highlighted functional aspect of hridaya. The word being composed of three letters viz ‘hri’ (hra harane)- to acquire; ‘Da’ (da dane) – to give; ‘Ya’ (Ya gatau)- which transports. The hridaya thus displays three phases of cardiac cycle i.e., receives, gives, and transports body constituents through it. [2]<br /> &lt;br/&gt;Hridaya is the site of rasa (plasma), sattva (psychic factor/mind), buddhi (intellect) and atma (soul) in conjugation with all sensory organs (jnanendriya).[Cha.Sa. Chikitsa Sthana 24/35] Sadhaka pitta situated in heart (hridaya) regulates proper functioning of intellect (buddhi) and ego (ahamkara). Hridaya is located in between breasts (stanayormadhya) of thoracic region [A. H. Sutra Sthana 12/13-14] [Su. Sa. Sharira Sthana 6/25]. <br /> &lt;br/&gt;Vedic era was well versed with heart (hridaya) and brain (mastishka) being two distinct entities, with interdependent functional relationship [Atharvaveda Book X. Hymn 2.26]. Kashyap Samhita quotes that all sense and motor organs (indriya) together with mind (manas) emerge from heart (hridaya) [Ka.Sa. Chikitsa Sthana 8/6]. Primary site of action of mind (manas) is brain (shira).[3] It can be concluded that mind (manas) being seated in heart (hridaya) connects to brain (shiras) through manovaha srotas and controls all senses (indriya). Also, any damage pertaining to marma (vital points) of shiras (head) causes loss of consciousness (cheshtanasha). [Cha.Sa. Sidhhi Sthana 9/6] Hence heart (hridaya) and brain (shirasor mastishka) are sites of manovaha srotasa. <br /> &lt;br/&gt; This approach of understanding hridaya goes well along with the contemporary view of understanding the triguna based psycho-functional principles of Ayurveda within the neural framework. Various research has been conducted which demonstrate that heart continuously sends nervous signals to brain to coordinate higher centres responsible for cognition and emotions. [1] The neuro- psychological as well as circulatory functions of hridaya mentioned in the classics can thus be explained. &lt;/p&gt; <br /> <br /> ==Relation between rasavaha and manovaha srotas==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Heart is the abode of mind (mana) and consciousness (chetana) or soul (atma). [Cha. Sa. Sidhhi Sthana 9/4] It is a site for physical, psychological, and spiritual components. Heart is origin for channels of transportation and transformation of rasa dhatu, too. Both heart and brain are considered under the umbrella term hridaya in terms of anatomical structure and higher-centre functions respectively. <br /> &lt;br/&gt;Heart (residence of manas) and brain (workplace of manas) are functionally co-dependent upon each other. Manas regulates the cognitive and conative functions of brain in conjunction with soul (atma) under the influence of vata dosha. [Cha. Sa. Sharira Sthana 1/22-23]. Brain is a structural entity needing continuous supply of nourishment and oxygen. This is feasible by heart through circulation (rasa-rakta samvahana kriya) via the ten major vessels (rasavahi dhamani). [A. H. Sharira Sthana 3/18] Heart is a highly vascular organ being surrounded by ten major dhamani (blood vessels) like spokes of a wheel which are known as ‘rasavaha strotomula’ (site of origin of channels of nutrition). These channels are comparable to manovaha srotas. [Chakrapani on Cha. Sa. Chikitsa Sthana 9/4] Manas thus acts like a medium between heart and brain wherein brain is responsible for all sensory and motor functions while heart has been assigned emotional aspect of psyche (manas).<br /> &lt;br/&gt;One of the factors for vitiation of rasavaha srotas is excessive thinking or worry (atichintan). [Cha. Sa. Vimana Sthana 5/13] Contemporary researchers have found evidence to support the interaction between circulatory system and psyche. The monograph of German professor Ludwig Braun is a pioneer in exploring the psychological and emotional aspect of cardiac diseases especially angina. He presented a correlation between cardiac diseases and ‘Angst’ (a constrictive, tightening and crushing sensation which manifests dread in the patient thereby changing his entire emotional outlook on life), analogous to anxiety. He explains that the cardiac tissue has a special apparatus receptive towards anxiety which manifests as an inner tactile sensation. That region is well supplied with nerve endings that gets irritated by anxiety. This phenomenon of emotional influence over cardiac tissues is termed as cardiac psyche. [4] <br /> &lt;/p&gt; <br /> <br /> ==Factors vitiating manovaha srotas==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt; Manovaha srotas are the prime site of abnormalities of channels in all psychological disorders. [Cha.Sa. Nidana Sthana 6/4] Alongside any of the eight factors that are either attributed to hridaya or manas viz. mana (mind), buddhi (intellect), sanjna-jnana (self-awareness), smriti (memory), bhakti (devotion), sheela (habits), cheshta (psychomotor activities) and achara (code of conduct). [Cha.Sa. Nidana Sthana 7/5] <br /> &lt;br/&gt;These factors when deranged cause vitiation of manas dosha (rajas and tamas), deterioration of sattva guna of manas and gradual derangement of tridosha. Foods, activities and excessive expression of emotions like anger, grief, lust, fear etc and mental traumas are the fundamental etiological factors for the same. [Cha.Sa. Nidana Sthana 7/4] Vitiated tridosha further vitiates rasavaha srotas, which apparently has the same site of origin as of manovaha srotas i.e., hridaya and dasha dhamani (ten great vessels). [Cha. Sa. Vimana Sthana 5/10] Hridaya is seat of manas [Cha.Sa. Sutra Sthana 30/4]. Hence, all the factors vitiating rasa dhatu (nutritive fluid), rasavaha srotas (channels carrying nutritive fluid) and manas dosha viz. rajas and tamas will affect manas and eventually vitiating manovaha srotas. Even the structural derangements of heart (abode of mind) affect manovaha srotas due to their ashrayashrayibhava (state of interdependency). [Cha.Sa. Chikitsa Sthana 9/5]&lt;/p&gt;<br /> <br /> ==Pathologies of manovaha srotas==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Manovaha srotas is important factor in understanding disorders like unmada (psychosis), apasmara (epilepsy) and extreme emotional reactions. &lt;/p&gt;<br /> <br /> *'''Unmada (psychosis)'''<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;When an individual experiences extreme emotions – lust (kama), anger (krodha), fear (bhaya), greed (lobha), happiness or pleasure (harsha), affection (moha), grief (shoka), excessive worry (chinta), they initially harm the intellect which aggravates manas dosha (rajas and tamas) and tridosha (vata, pitta and kapha). These vitiated dosha invade heart and obstruct manovaha srotas (channels transporting psychic impulses) thereby causing unmada. [Dalhan on Su. Sa. Uttar Tantra 62/3]<br /> *'''Apasmara (epilepsy)'''<br /> Overindulging in sensory pleasures, incompatible diet, withholding natural urges and giving into immoral activities under emotional influences (kama, krodha, lobha among others), vitiates rajas and tamas. They poorly influence the manas (mind) and sanjnavaha srotas (manovaha srotas) causing apasmara. [Su.Sa. Uttar Tantra 61/6]<br /> * Mada (intoxication), murchha (syncope), sanyasa (coma) are caused by vitiation of channels of consciousness (chetanavaha srotas or manovaha srotas). [Shivadas Sen on Cha. Sa. Chikitsa Sthana 9/5] <br /> *'''Atattvabhinivesha (perverted state of mind)'''<br /> Considered as mahagada (difficult to treat mental disorder), the person’s conscience gets afflicted by rajas and tamas, which cause complete derangement of intellect (buddhi vibhramsha) as the predominant symptom. The vitiated dosha get lodged in heart (hridaya) to afflict channels of mind and intellect (manobuddhivaha sira in manovaha srotas). [Cha.Sa. Chikitsa Sthana 10/57-60]<br /> * Physiology of nightmares (swapna)<br /> Nightmares are dreams occurring in REM phase of sleep which causes mental projections in the form of feelings of fear, despair, and anxiety. Ayurveda defines REM phase as ‘Natiprasupta’ - the state characterised to be midway between states of deep sleep and fully awake. During any ominous situation, tridosha in their highly aggravated state tend to fill-up the manovaha srotas. This results in terrifying dreams. [Cha.Sa. Indriya Sthana 5/41]. &lt;/p&gt;<br /> <br /> ==Assessment and diagnosis of disorders of manovaha srotas==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Srotas are micro-channels transporting various metabolites across cells throughout the body. It can be deduced that manovaha srotas has different characteristics structurally and functionally from the major thirteen srotas, because it transports and transforms thoughts and feelings. This is evident from objects of mind (manas), viz- thought (chintyam), consideration (vicharyam), hypothesis (uhyam), aims (dhyeyam) and determination (sankalpam). [Cha.Sa. Sharira Sthana 1/20]. Assessment of manovaha srotas can be done via assessment of manas and the degree of derangement of its functions. Ayurveda considers manas as material entity (dravya) which is a super sense and not perceivable by ordinary senses (atindriya) [Cha. Sa. Sutra Sthana 8/4]. Manas is under direct control of vata dosha [Cha. Sa. Sutra Sthana 12/8] and is the mediator between atma (soul) and indriyartha (objects of senses). <br /> &lt;br/&gt;The contemporary physiological aspects of mind, senses, brain, nervous system and consciousness can be considered for assessment of manovaha srotas. <br /> &lt;br/&gt; A thorough neurological examination by means of interrogation (prashna pariksha), inspection (darshana pariksha) and assessment of mental strength (sattva bala pariksha) [Cha.Sa. Vimana Sthana 8/119] can be used for assessment and diagnosis of disorders of manovaha srotas.&lt;/p&gt;<br /> <br /> ''' a. Interrogation (prashna pariksha)'''<br /> A formal interview of the patient can be conducted for overall and precise diagnosis. The questions related to chief complaints with duration, chronological development, nurturing of patient, family history, addiction, hobbies, interests, daily routine, major life events, achievements, mental traumas, emotional quotient and intellectual quotient is recorded from the patient. If the patient is not in state of giving correct answers, then the relatives or attendants who know patients history are interviewed. <br /> <br /> '''b. Darshan pariksha (Direct observation)'''<br /> While interviewing the patient, a physician should pay attention to following attributes that can signify features mentioned for certain psychiatric ailments (manovaha srotodushti)..<br /> <br /> '''#Appearance '''– Unusual dressing preferences, use of cosmetics, perfumes or accessories or flamboyant appearance. e.g;- ‘Priye tanu rakta vastradhari’ (liking for adorning clothes made of thin red fabric) is seen in yakshagraha unmada (Su.Sa. Uttara tantra 60/11)<br /> '''#Activity and co-ordination''' - Behaviour, Gait, gestures, patient’s facial expression and body language should be observed during probing them with questions. Eg;- 'Satatama akshano’ (rapid and constant eye movements) is one of the prodromal feature of apasmara (epilepsy) [ Cha.Sa. Nidana sthana 8/6]. Udhasta (patient keeps his hands raised) is a feature of pishacha grahavishta unmada [Su.Sa. Uttara Tantra 60/15]<br /> '''#Conversation style''' – Coherence of speech, articulation, emphasise over certain issue, hesitation and duration of response. E.g. ‘Chitram sa jalpati’ (Patient does irrelevant absurd talks) is seen in patients of manas unmada [Su.Sa. Uttara Tantra 62/13].<br /> '''#Emotional expression''' – Patients may express a wide range of emotions during interview with the physician. E.g. Asthana rodana (Sudden crying) is a feature in vataja unmada while amarsha (intolerance) is seen in patients of pittaja unmada. [Cha.Sa. Chikitsa Sthana 9/11-12] Fleeting ideas, incoherent speech is an important sign for lacking proper emotions. <br /> '''#Cognition''' – Orientation to person, place, time and circumstances, level of intellect, level of understanding, common sense and memory can be identified under the domain of cognition by observing patient’s behaviour as well as by asking questions to them using validated scientific questionnaires. Short term memory and long-term memory shall be assessed properly. <br /> &lt;br/&gt;All observations gathered from every method of assessment should be simultaneously analysed to reach the diagnosis.<br /> <br /> =='''c. Sattva pariksha (assessment of quality of excellence of mind)'''<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Sattva pariksha assesses the quality of excellence of mind imparted by extent of dominance of sattva guna. Mind (manas) is composed of three attributes (triguna) viz. sattva, rajas and tamas. These impart three types of mental constitutions – Shuddha (pure) (sattvika), rajasika and tamasika. [Cha.Sa. Sharira Sthana 4/36]. Sattvika guna is full of auspiciousness and is considered the healthy (amala) state of mind. Rajasika guna imparts momentum in terms of furious temperament. Whereas tamas guna promotes inertia and moral ignorance. Hence, rajas and tamas are considered inauspicious and called manas dosha. Triguna are present in dynamically varying proportions at any given time and influenced by body (i.e. tridosha) and vice versa. [Chakrapani on Cha.Sa. Vimana Sthana 4/8]. Optimum levels of sattva guna are essential for promoting desired physical and mental strength irrespective of morphological features. [Cha.Sa. Vimana Sthana 8/119]&lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Sattva bala (strength of psyche) is of three types as per strength – pravara (superior), madhyama (moderate) and avara (poor). Pravara sattva persons possess great courage. Despite poor morphological features they seem to be unmoved in the face of adversities. Madhyama sattva persons need some additional moral support to sustain themselves in times of distress. While avara sattva displays catastrophic reactions even during little inconveniences and can neither be sustained by themselves nor by others despite having good quality morphological features. Avara sattva is constantly plagued by inferior emotions like grief, fear, greed, conceit and confusion. When confronted with fierce, ugly, disgusting narratives or flesh and blood, they are prone to become depressed, pale, unconscious or semiconscious, giddy, anxious and can even succumb to death in worst case scenarios. [Cha. Sa. Vimana Sthana 8/119].<br /> &lt;br/&gt;Manovaha srotas associated with avara sattva bala is most likely to be vitiated by manas dosha leading to various psychiatric and psychosomatic disorders [Cha.Sa. Chikitsa Sthana 9/5]. It has been observed that avara sattva individuals are more likely to commit prajnaparadha (intellectual defects) [10] thereby voluntarily indulging in various etiological factors for respective psychological as well as somatic disorders.<br /> &lt;br?&gt;Thus, assessment of sattva bala can help rule out the predisposition towards manovaha srotodushti and subsequent development of symptoms of psychiatric ailments.&lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;'''d. Anumana pariksha (knowledge by inference)''' to determine normalcy of faculties of manas (mind) [Cha.Sa. Vimana Sthana 4/8] Since manas is atindriya ( supersence or imperceivable by ordinary senses), so are it’s faculties which can serve as potential markers for assessment of its functions. [10] The proper functioning of manas itself is inferred by altered or inappropriate mental perceptions even in presence of appropriately functioning indriya (senses) and their respective sense objects whereas the mental faculties can be inferred as follows:-&lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;This inferential knowledge can help an individual become self-aware of his own psyche (sattva). A self-aware individual has an upper hand at avoiding mental illness because these often go unnoticed until they develop some organic manifestations.<br /> &lt;br/&gt;Thus, by means of above discussed assessment methodologies, a physician can assess the degree of derangement in mental faculties and hence the manovaha srotas, irrespective of development of specific signs and symptoms of any psychiatric disorder (vyadhi lakshana).&lt;/p&gt;<br /> <br /> ==Treatment Guidelines==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Manovaha srotas disorders follow the line of treatment same as described for disorders of manas (mind). Following are therapeutic and preventive practices beneficial for both vitiated manovaha srotas (channels of psyche) and manas obscured by rajas - tamas dosha.&lt;/p&gt;<br /> '''*'''Manas dosha can be alleviated through a comprehensive five-fold psychotherapeutic regimen - jnana (spiritual knowledge or self-awareness), vijnana (scriptural or scientific knowledge), dhairya (mental fortitude), smriti (recollection of past successes to regain faith in own abilities) and samadhi (spiritual healing practices to focus mind inwards away from negative external stimuli). [Cha.Sa. Sutra Sthana 1/58]<br /> Restoration of dhi (intellect), dhairya (mental fortitude) and atmadi vijnana (knowledge of self-consciousness) has therapeutic effect in alleviating disorders of manovaha srotas obstructed by manas dosha.<br /> '''*Sattvavajaya chikitsa (treatment to regulate mind)'''<br /> Sattvavajaya chikitsa is a non-invasive therapeutic module for psychological derangements and psychosomatic ailments, analogous to contemporary psychotherapy. ‘Sattva’ stands for mind and ‘avajaya’ translates to win over. Hence, it emphasizes withdrawing the mind from unwholesome objects of senses (factors vitiating rajas and tamas) and diverting it to positive sensory and emotional stimuli. Thereby consciously negating disturbed emotions and behavioural patterns. [Cha.Sa. Sutra Sthana 11/54]<br /> '''*Ashtanga yoga (eight steps of yoga)'''<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Ashtanga yoga can be considered as one of the dimensions of satvavajaya chikitsa. It integrates eight steps of yoga to tame mind from traversing paths in life which are spiritually and mentally harmful for that individual. Of the eight steps, first four viz. yama (principles for moral code), niyama (observances for personal discipline), asana (yogic postures) and pranayama (regulating breath) are termed as bahiranga yoga (external path). These practices gradually alleviate aggravated manas dosha, making the mind less reactive towards external stimuli. The last three limbs viz. dharana (concentration), dhyana (meditation) and samadhi (enlightenment or complete realisation) are termed as antaranga yoga (internal paths). These practices transform the mind, eliminating the fluctuations of mind, thereby strengthening positive habits and outlook on life as well as inner self. Ashtanga yoga maintains a harmonious balance between inner environment (mind and spirit) and external environment (objects of sensory perception). Mind thus gets liberated from worldly pursuits and all psychological sufferings in a stepwise manner.&lt;/p&gt;<br /> '''*Achara rasayana (rejuvenating codes of behavioural conduct)'''<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Achara rasayana is an adravyabhuta (non-pharmacological) rasayana (practices rejuvenating physical and mental health). It includes behavioural conducts which aim to enhance health and longevity by teaching practical methods to potentiate sattva guna of mind. [Cha.Sa. Chikitsa Sthana 1, 4th pada, shloka 30-35] An individual can imbibe easy lifestyle modifications to develop a positive and strong character of mind, thereby avoiding potential etiological factors (for dosha aggravation) and negative psychosocial patterns. Achara rasayana can be divided into five domains of good mental, social, personal, moral and religious conduct. [6]&lt;/p&gt;<br /> '''*Sadvritta (good codes of conduct)'''<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Sadvritta refers to good code of conduct. These are a set of practices, which serve as lifestyle guidelines to prevent mind from falling prey to temporary material pleasures and impulsive thoughts and actions that cause impairment of manas dosha and manovaha srotas. It encompasses guidelines over personal hygiene, personality development as well as for social hygiene and peaceful social interactions. [Cha.Sa. Sutra Sthana 8/18]&lt;/p&gt;<br /> Both achara rasayana and sadvritta help to maintain control over sense organs. They majorly add to the preventive and promotive aspect of mental health. <br /> '''*Medhya dravya (medicines enhancing intellectual functions)'''<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Medhya dravyas are the plant based pharmacological agents that promote prajna i.e., dhi (intellect), dhriti (perseverance) and smriti (memory). Researches conducted prove their efficacy in minimizing the cognitive decline among individuals with neural abnormalities. For example, ushna (hot potency) and tikshna nature drugs like jyotishmati and vacha are said to remove blockages caused by kapha, ama or tamas dosha in the manovaha srotas. Once purified, manas can regain unvitiated connect with indriya via manovaha srotas. [8] <br /> &lt;br/&gt;Ayurveda thus provides a bird’s eye view over different aspects of manovaha srotas through interconnected references in the classics highlighting its physiological importance like the other thirteen major srotas systems in the human body.&lt;/p&gt;<br /> <br /> ==Contemporary view==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Mind as per contemporary literature is debatable concept because in some contexts it is identified as conscience, while in others it is seen as the function of conscience. The philosophical dimension of mind was conceived by Plato who considered mind as an inner (soul’s) experience. [11]<br /> &lt;br/&gt;The western system of medicine addresses brain at the core of majority of psychological distresses, whereas western philosophy involves the concept of psyche (which denotes mind). ‘Psyche’ is a Greek word meaning ‘soul in a living man’. <br /> &lt;br/&gt;William James, referred to as the father of American Psychology, laid the foundations of physiological aspect of mind. To him mind was a function of brain which conducts mental life in the form of a constant stream of consciousness.[9] At some places he too admitted mind to bear consciousness and tried to assign attributes to consciousness as a separate psychological function thus formulating the Theory of Functionalism which established causal relationship between internal states (perception) and external reactions or behaviour (sensation). He concluded that repeated actions cause adaptive changes in nervous system. This is the fundamental ideology behind the concept of Neuroplasticity – i.e. adaptive structural and functional changes in brain by development of new neuronal pathways due to intrinsic or extrinsic stimuli. [12]<br /> &lt;br/&gt;James’ counterpart Titchener, an English Psychologist, proposed that consciousness is mind’s awareness of its own functions. Consciousness is something superior to mind itself. He formulated the Theory of Structuralism which aimed at analysing the interrelationship between mental experiences, feelings, and sensations. He used introspection as a tool to break down these complex phenomena of consciousness down to their basic elements without breaking their original structure. <br /> &lt;br/&gt;Mind is hence regarded as the cumulative effect of all mental processes that have occurred in the lifetime while the consciousness can be understood as the cumulative effect of all mental processes occurring in present moment. Eventually brain was somehow regarded to control the neural activity responsible for accumulating all this sensory data.<br /> &lt;br/&gt;Many theories were formulated and overruled by their successors with time. Today the concept of mind and consciousness remains yet to be clearly defined. It is observed that mind is often identified as consciousness and they both are accepted as individual closely linked entities. Mind bears synonymity towards consciousness, spirit, and psyche. Some theories view both mind and consciousness as spirit. But mind is invariably understood as the interaction between psychological personality and the external environment, i.e., a subject – object relationship.<br /> &lt;br/&gt;The neurophysiological basis of minds and the channels of transport of its constituents is yet a challenge in field of neuroscience. In order to bridge this gap, contemporary scientists hypothesise that mental representations and their contents are represented by neural network and their supporting cells thus hinting towards Central Nervous System and it’s peripheral nerves as the channels of mind. [13]&lt;/p&gt; <br /> <br /> ==Research works on manovaha srotas==<br /> Various review articles have been published and researches been carried out in the domain of Ayurveda to understand the conceptual as well as pathophysiological aspect of manovaha srotas. Few of them are as follows :-<br /> '''# Critical Review of Concept of manovaha Srotas with special reference to Brain''' <br /> This review article conceptualizes the contemporary understanding of manovaha srotas in context to CNS due to functional similarity between manas and brain obtained after an extensive research and analysis throughout ayurveda treatises. Further brain was considered as synonymous to hridya ie. mulasthana (site of origin) of manovaha srotas and ‘dasha dhamani’ as the cranial nerves exiting from the 10 major foramen at base of skull. Sanskrit literature considers hridaya as regarded as a central organ similar to brain. 14<br /> '''# Circumstantial view on clinical knowing of manovaha srotasa &amp; its physiology''' <br /> The review article reconstructs a comprehensive picture of manovaha srotas from the scattered references available in Ayurveda texts, supplementing it with additional information from contemporary science as follows-<br /> '''*'''A detailed description of neuroanatomy and physiology has been drawn parallel to Ayurveda point of view about manas’ rachna and kriya sharir. <br /> '''*'''Effect of Triguna and tridosha (especially vata) in context of physiological functions and disorders of manas and manovaha srotas have been discussed.<br /> '''*'''Correlations between functions of five subtypes of vata and both CNS and ANS has been attempted Pariksha krama (examination of nervous system) has been exemplified taking into consideration both Ayurveda and modern methodologies that can be employed for manovaha srotas (nervous system) examination.10 <br /> '''*'''Concept of stress factor assessment concerning ‘perseverance test’ in light of ayurveda” – a review This article highlights the importance of understanding the etiological factors of vitiation of manovaha srotas and manas in all kinds of psychiatric as well as psychosomatic disorders. Imbalance of manas dosha can be treated by means of yoga, meditation and pranayama. Often emotional disturbances remain unattended in diagnosed cases of psychiatric illness which can be managed at home by incorporating wholesome diet (pathya ahara) and moral code of conduct (sadvrutta) in daily routine. Lack of peace and chronic stressors have been observed as major causes of vitiation of channels of mind. 15<br /> <br /> <br /> &lt;big&gt;'''[[Special:ContactMe|Send us your suggestions and feedback on this page.]]'''&lt;/big&gt;<br /> <br /> ==References==<br /> <br /> &lt;div id=&quot;BackToTop&quot; class=&quot;noprint&quot; style=&quot;background-color:#DDEFDD; position:fixed;<br /> bottom:32px; left:2%; z-index:9999; padding:0; margin:0;&quot;&gt;&lt;span style=&quot;color:blue;<br /> font-size:8pt; font-face:verdana,sans-serif; border:0.2em outset #ceebf7;<br /> padding:0.1em; font-weight:bolder; -moz-border-radius:8px; &quot;&gt;<br /> [[#top| Back to the Top ]]&lt;/span&gt;&lt;/div&gt;</div>

Manishdubey https://www.carakasamhitaonline.com/index.php?title=Talk:Manovaha_srotas&diff=44175 2023-10-13T11:32:55Z

<p>Manishdubey: </p> <hr /> <div>{{CiteButton}}<br /> {{#seo:<br /> |title= Manovaha srotas<br /> (Channels of transport and transformation of mind and mental factors)<br /> |titlemode=append<br /> |keywords= Manovaha srotas,Hrudya, Sattva pariksha, Sattvavajaya chikitsa, Bhojani M. K.,Deole Y.S., Basisht G<br /> |description=Mana means mind, or psyche. Srotas means channels of transport and transformation. The description and understanding of channels for activities of mind (manovaha srotas) is scattered in ayurveda classics and has not been completely elucidated. Manovaha srotas are considered as channels through which mind and body interact with each other. <br /> |image=http://www.carakasamhitaonline.com/mediawiki-1.32.1/resources/assets/ogimgs.jpg<br /> |image_alt=carak samhita<br /> |type=article<br /> }}<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Mana means mind, or psyche. Srotas means channels of transport and transformation. The description and understanding of channels for activities of mind (manovaha srotas) is scattered in ayurveda classics and has not been completely elucidated. Manovaha srotas are considered as channels through which mind and body interact with each other. These channels pervade throughout the body. [Chakrapani on Cha.Sa. Indriya Sthana 5/41-42] They are responsible for flow of thoughts, emotions, and other psychological functions. This article deals with various aspects of manovaha srotasa i.e. the channels of activities of mind and its development.&lt;/p&gt;<br /> <br /> {{Infobox<br /> |title = Contributors<br /> |label1 = Section/Chapter/topic<br /> |data1 = Concepts/[[Srotas]]/[[Manovaha Srotas]] <br /> |label2 = Authors<br /> |data2 = Bhojani M. K.&lt;sup&gt;1&lt;/sup&gt; Varma Swati &lt;sup&gt;1&lt;/sup&gt; Deole Y.S.&lt;sup&gt;2&lt;/sup&gt;<br /> |label3 = Reviewer &amp; Editor<br /> |data3 = Basisht G.&lt;sup&gt;3&lt;/sup&gt;, <br /> |label4 = Affiliations<br /> |data4 = &lt;sup&gt;1&lt;/sup&gt; Department of Sharir Kriya, All India Institute of Ayurveda, New Delhi, India<br /> &lt;sup&gt;2&lt;/sup&gt; Department of Kayachikitsa, G. J. Patel Institute of Ayurvedic Studies and Research, New Vallabh Vidyanagar, Gujarat, India <br /> &lt;sup&gt;3&lt;/sup&gt; Rheumatologist, Orlando, Florida, U.S.A.<br /> |label5 = Correspondence emails<br /> |data5 = meera.samhita@aiia.gov.in, carakasamhita@gmail.com<br /> |label6 = Publisher <br /> |data6 = [[Charak Samhita Research, Training and Development Centre]], I.T.R.A., Jamnagar, India<br /> |label7 = Date of publication:<br /> |data7 =October 12, 2023<br /> |label8 = DOI<br /> |data8 = In process<br /> }}<br /> <br /> ==Etymology and derivation:==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Srotas originates from Sanskrit root ‘Sru’ that translates to oozing, flow or secretion. It has been defined as ‘sravanat strotamsi’ [Cha. Sa. Sutra Sthana 30/12] which indicates structures designated for conveyance of material inside body. <br /> &lt;br/&gt;Grossly defining, thirteen major types of srotas have been mentioned that transport substances undergoing biotransformation (parinamam aapadyamanam) from the place of origin to their destination. [Cha. Sa. Vimana Sthana 5/3] Similarly in physiological state, manovaha srotas might be responsible for processing and transformation of ‘doshayukta’ (irrational under influence of rajas and tamas) emotions and thoughts into unbiased reasoning before reaching a conclusion by our intellect (buddhi). &lt;/p&gt;<br /> <br /> ==Synonyms of manovaha srotas==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Following terms are used for ‘manovaha srotas’ in different Ayurveda classics : &lt;/p&gt;<br /> # Manovaha dhamani [Chakrapani on Cha. Sa. Indriya sthana 12/42] and [Vijayarakshita in Ma.Ni.Purva Khanda 20/1]<br /> # Chetanavaha srotas [Shivadas Sen on Cha.Sa. Chikitsa sthana 9/5] <br /> # Chetovaha marga [Bhel Samhita Nidana Sthana 7/2]<br /> # Manobuddhivaha sira [ Cha.Sa.Chikitsa Sthana 10/58]<br /> # Sanjnavaha srotas [Su.Sa.Uttar Tantra 61/8]<br /> # Sanjnavaha nadi [Su.Sa. Uttar Tantra 46/7]<br /> &lt;p style=&quot;text-align:justify;&quot;&gt; &lt;br/&gt;Use of terms like sira, nadi and dhamani, refers to different channels and pathways concerned with maintenance of physiological flow of information. [Cha.Sa. Vimana Sthana 5/8] &lt;/p&gt;<br /> <br /> ==Origin==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt; Every srotas is localized within the hollow space in the body originating from a root (mula) and spreading throughout the body to reach a final structure. Srotas are said to be hollow structures in different shapes and sizes The root (mula) is majorly responsible for regulation and control of functions of that srotas.<br /> &lt;br/&gt;The channels carrying mind (manovaha srotas) are not exclusively listed. It is however stated that the entire conscious body is abode of mind. Hence these channels are spread throughout the body. [Chakrapani on Cha.Sa. Indriya Sthana 5/41]. <br /> &lt;br/&gt;However, hridaya (heart) has a universal acceptance as the site of origin (mula) of manovaha srotas. Hence a special mention has been made about ten arteries of heart, probably being the manovaha srotas (visheshen tu hrudya ashritvat manah tadashrita dasha dhamanyo manovaha abhidhiyante) [Chakrapani on Cha.Sa. Indriya Sthana 5/41-42]. These get afflicted by vitiated dosha either all at once or individually. [Chakrapani on Cha.Sa. Indriya Sthana 12/42]<br /> &lt;/p&gt;<br /> <br /> ==Decoding hridaya (heart)==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt; The interpretation of the term ‘hridaya’ has been of confusion among scholars since decades. The first interpretation of the term given by texts of Shatpada Brahmana which highlighted functional aspect of hridaya. The word being composed of three letters viz ‘hri’ (hra harane)- to acquire; ‘Da’ (da dane) – to give; ‘Ya’ (Ya gatau)- which transports. The hridaya thus displays three phases of cardiac cycle i.e., receives, gives, and transports body constituents through it. [2]<br /> &lt;br/&gt;Hridaya is the site of rasa (plasma), sattva (psychic factor/mind), buddhi (intellect) and atma (soul) in conjugation with all sensory organs (jnanendriya).[Cha.Sa. Chikitsa Sthana 24/35] Sadhaka pitta situated in heart (hridaya) regulates proper functioning of intellect (buddhi) and ego (ahamkara). Hridaya is located in between breasts (stanayormadhya) of thoracic region [A. H. Sutra Sthana 12/13-14] [Su. Sa. Sharira Sthana 6/25]. <br /> &lt;br/&gt;Vedic era was well versed with heart (hridaya) and brain (mastishka) being two distinct entities, with interdependent functional relationship [Atharvaveda Book X. Hymn 2.26]. Kashyap Samhita quotes that all sense and motor organs (indriya) together with mind (manas) emerge from heart (hridaya) [Ka.Sa. Chikitsa Sthana 8/6]. Primary site of action of mind (manas) is brain (shira).[3] It can be concluded that mind (manas) being seated in heart (hridaya) connects to brain (shiras) through manovaha srotas and controls all senses (indriya). Also, any damage pertaining to marma (vital points) of shiras (head) causes loss of consciousness (cheshtanasha). [Cha.Sa. Sidhhi Sthana 9/6] Hence heart (hridaya) and brain (shirasor mastishka) are sites of manovaha srotasa. <br /> &lt;br/&gt; This approach of understanding hridaya goes well along with the contemporary view of understanding the triguna based psycho-functional principles of Ayurveda within the neural framework. Various research has been conducted which demonstrate that heart continuously sends nervous signals to brain to coordinate higher centres responsible for cognition and emotions. [1] The neuro- psychological as well as circulatory functions of hridaya mentioned in the classics can thus be explained. &lt;/p&gt; <br /> <br /> ==Relation between rasavaha and manovaha srotas==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Heart is the abode of mind (mana) and consciousness (chetana) or soul (atma). [Cha. Sa. Sidhhi Sthana 9/4] It is a site for physical, psychological, and spiritual components. Heart is origin for channels of transportation and transformation of rasa dhatu, too. Both heart and brain are considered under the umbrella term hridaya in terms of anatomical structure and higher-centre functions respectively. <br /> &lt;br/&gt;Heart (residence of manas) and brain (workplace of manas) are functionally co-dependent upon each other. Manas regulates the cognitive and conative functions of brain in conjunction with soul (atma) under the influence of vata dosha. [Cha. Sa. Sharira Sthana 1/22-23]. Brain is a structural entity needing continuous supply of nourishment and oxygen. This is feasible by heart through circulation (rasa-rakta samvahana kriya) via the ten major vessels (rasavahi dhamani). [A. H. Sharira Sthana 3/18] Heart is a highly vascular organ being surrounded by ten major dhamani (blood vessels) like spokes of a wheel which are known as ‘rasavaha strotomula’ (site of origin of channels of nutrition). These channels are comparable to manovaha srotas. [Chakrapani on Cha. Sa. Chikitsa Sthana 9/4] Manas thus acts like a medium between heart and brain wherein brain is responsible for all sensory and motor functions while heart has been assigned emotional aspect of psyche (manas).<br /> &lt;br/&gt;One of the factors for vitiation of rasavaha srotas is excessive thinking or worry (atichintan). [Cha. Sa. Vimana Sthana 5/13] Contemporary researchers have found evidence to support the interaction between circulatory system and psyche. The monograph of German professor Ludwig Braun is a pioneer in exploring the psychological and emotional aspect of cardiac diseases especially angina. He presented a correlation between cardiac diseases and ‘Angst’ (a constrictive, tightening and crushing sensation which manifests dread in the patient thereby changing his entire emotional outlook on life), analogous to anxiety. He explains that the cardiac tissue has a special apparatus receptive towards anxiety which manifests as an inner tactile sensation. That region is well supplied with nerve endings that gets irritated by anxiety. This phenomenon of emotional influence over cardiac tissues is termed as cardiac psyche. [4] <br /> &lt;/p&gt; <br /> <br /> ==Factors vitiating manovaha srotas==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt; Manovaha srotas are the prime site of abnormalities of channels in all psychological disorders. [Cha.Sa. Nidana Sthana 6/4] Alongside any of the eight factors that are either attributed to hridaya or manas viz. mana (mind), buddhi (intellect), sanjna-jnana (self-awareness), smriti (memory), bhakti (devotion), sheela (habits), cheshta (psychomotor activities) and achara (code of conduct). [Cha.Sa. Nidana Sthana 7/5] <br /> &lt;br/&gt;These factors when deranged cause vitiation of manas dosha (rajas and tamas), deterioration of sattva guna of manas and gradual derangement of tridosha. Foods, activities and excessive expression of emotions like anger, grief, lust, fear etc and mental traumas are the fundamental etiological factors for the same. [Cha.Sa. Nidana Sthana 7/4] Vitiated tridosha further vitiates rasavaha srotas, which apparently has the same site of origin as of manovaha srotas i.e., hridaya and dasha dhamani (ten great vessels). [Cha. Sa. Vimana Sthana 5/10] Hridaya is seat of manas [Cha.Sa. Sutra Sthana 30/4]. Hence, all the factors vitiating rasa dhatu (nutritive fluid), rasavaha srotas (channels carrying nutritive fluid) and manas dosha viz. rajas and tamas will affect manas and eventually vitiating manovaha srotas. Even the structural derangements of heart (abode of mind) affect manovaha srotas due to their ashrayashrayibhava (state of interdependency). [Cha.Sa. Chikitsa Sthana 9/5]&lt;/p&gt;<br /> <br /> ==Pathologies of manovaha srotas==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Manovaha srotas is important factor in understanding disorders like unmada (psychosis), apasmara (epilepsy) and extreme emotional reactions. &lt;/p&gt;<br /> <br /> *'''Unmada (psychosis)'''<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;When an individual experiences extreme emotions – lust (kama), anger (krodha), fear (bhaya), greed (lobha), happiness or pleasure (harsha), affection (moha), grief (shoka), excessive worry (chinta), they initially harm the intellect which aggravates manas dosha (rajas and tamas) and tridosha (vata, pitta and kapha). These vitiated dosha invade heart and obstruct manovaha srotas (channels transporting psychic impulses) thereby causing unmada. [Dalhan on Su. Sa. Uttar Tantra 62/3]<br /> *'''Apasmara (epilepsy)'''<br /> Overindulging in sensory pleasures, incompatible diet, withholding natural urges and giving into immoral activities under emotional influences (kama, krodha, lobha among others), vitiates rajas and tamas. They poorly influence the manas (mind) and sanjnavaha srotas (manovaha srotas) causing apasmara. [Su.Sa. Uttar Tantra 61/6]<br /> * Mada (intoxication), murchha (syncope), sanyasa (coma) are caused by vitiation of channels of consciousness (chetanavaha srotas or manovaha srotas). [Shivadas Sen on Cha. Sa. Chikitsa Sthana 9/5] <br /> *'''Atattvabhinivesha (perverted state of mind)'''<br /> Considered as mahagada (difficult to treat mental disorder), the person’s conscience gets afflicted by rajas and tamas, which cause complete derangement of intellect (buddhi vibhramsha) as the predominant symptom. The vitiated dosha get lodged in heart (hridaya) to afflict channels of mind and intellect (manobuddhivaha sira in manovaha srotas). [Cha.Sa. Chikitsa Sthana 10/57-60]<br /> * Physiology of nightmares (swapna)<br /> Nightmares are dreams occurring in REM phase of sleep which causes mental projections in the form of feelings of fear, despair, and anxiety. Ayurveda defines REM phase as ‘Natiprasupta’ - the state characterised to be midway between states of deep sleep and fully awake. During any ominous situation, tridosha in their highly aggravated state tend to fill-up the manovaha srotas. This results in terrifying dreams. [Cha.Sa. Indriya Sthana 5/41]. &lt;/p&gt;<br /> <br /> ==Assessment and diagnosis of disorders of manovaha srotas==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Srotas are micro-channels transporting various metabolites across cells throughout the body. It can be deduced that manovaha srotas has different characteristics structurally and functionally from the major thirteen srotas, because it transports and transforms thoughts and feelings. This is evident from objects of mind (manas), viz- thought (chintyam), consideration (vicharyam), hypothesis (uhyam), aims (dhyeyam) and determination (sankalpam). [Cha.Sa. Sharira Sthana 1/20]. Assessment of manovaha srotas can be done via assessment of manas and the degree of derangement of its functions. Ayurveda considers manas as material entity (dravya) which is a super sense and not perceivable by ordinary senses (atindriya) [Cha. Sa. Sutra Sthana 8/4]. Manas is under direct control of vata dosha [Cha. Sa. Sutra Sthana 12/8] and is the mediator between atma (soul) and indriyartha (objects of senses). <br /> &lt;br/&gt;The contemporary physiological aspects of mind, senses, brain, nervous system and consciousness can be considered for assessment of manovaha srotas. <br /> &lt;br/&gt; A thorough neurological examination by means of interrogation (prashna pariksha), inspection (darshana pariksha) and assessment of mental strength (sattva bala pariksha) [Cha.Sa. Vimana Sthana 8/119] can be used for assessment and diagnosis of disorders of manovaha srotas.&lt;/p&gt;<br /> <br /> ''' a. Interrogation (prashna pariksha)'''<br /> A formal interview of the patient can be conducted for overall and precise diagnosis. The questions related to chief complaints with duration, chronological development, nurturing of patient, family history, addiction, hobbies, interests, daily routine, major life events, achievements, mental traumas, emotional quotient and intellectual quotient is recorded from the patient. If the patient is not in state of giving correct answers, then the relatives or attendants who know patients history are interviewed. <br /> <br /> '''b. Darshan pariksha (Direct observation)'''<br /> While interviewing the patient, a physician should pay attention to following attributes that can signify features mentioned for certain psychiatric ailments (manovaha srotodushti)..<br /> <br /> '''#Appearance '''– Unusual dressing preferences, use of cosmetics, perfumes or accessories or flamboyant appearance. e.g;- ‘Priye tanu rakta vastradhari’ (liking for adorning clothes made of thin red fabric) is seen in yakshagraha unmada (Su.Sa. Uttara tantra 60/11)<br /> '''#Activity and co-ordination''' - Behaviour, Gait, gestures, patient’s facial expression and body language should be observed during probing them with questions. Eg;- 'Satatama akshano’ (rapid and constant eye movements) is one of the prodromal feature of apasmara (epilepsy) [ Cha.Sa. Nidana sthana 8/6]. Udhasta (patient keeps his hands raised) is a feature of pishacha grahavishta unmada [Su.Sa. Uttara Tantra 60/15]<br /> '''#Conversation style''' – Coherence of speech, articulation, emphasise over certain issue, hesitation and duration of response. E.g. ‘Chitram sa jalpati’ (Patient does irrelevant absurd talks) is seen in patients of manas unmada [Su.Sa. Uttara Tantra 62/13].<br /> '''#Emotional expression''' – Patients may express a wide range of emotions during interview with the physician. E.g. Asthana rodana (Sudden crying) is a feature in vataja unmada while amarsha (intolerance) is seen in patients of pittaja unmada. [Cha.Sa. Chikitsa Sthana 9/11-12] Fleeting ideas, incoherent speech is an important sign for lacking proper emotions. <br /> '''#Cognition''' – Orientation to person, place, time and circumstances, level of intellect, level of understanding, common sense and memory can be identified under the domain of cognition by observing patient’s behaviour as well as by asking questions to them using validated scientific questionnaires. Short term memory and long-term memory shall be assessed properly. <br /> &lt;br/&gt;All observations gathered from every method of assessment should be simultaneously analysed to reach the diagnosis.<br /> <br /> =='''c. Sattva pariksha (assessment of quality of excellence of mind)'''<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Sattva pariksha assesses the quality of excellence of mind imparted by extent of dominance of sattva guna. Mind (manas) is composed of three attributes (triguna) viz. sattva, rajas and tamas. These impart three types of mental constitutions – Shuddha (pure) (sattvika), rajasika and tamasika. [Cha.Sa. Sharira Sthana 4/36]. Sattvika guna is full of auspiciousness and is considered the healthy (amala) state of mind. Rajasika guna imparts momentum in terms of furious temperament. Whereas tamas guna promotes inertia and moral ignorance. Hence, rajas and tamas are considered inauspicious and called manas dosha. Triguna are present in dynamically varying proportions at any given time and influenced by body (i.e. tridosha) and vice versa. [Chakrapani on Cha.Sa. Vimana Sthana 4/8]. Optimum levels of sattva guna are essential for promoting desired physical and mental strength irrespective of morphological features. [Cha.Sa. Vimana Sthana 8/119]&lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Sattva bala (strength of psyche) is of three types as per strength – pravara (superior), madhyama (moderate) and avara (poor). Pravara sattva persons possess great courage. Despite poor morphological features they seem to be unmoved in the face of adversities. Madhyama sattva persons need some additional moral support to sustain themselves in times of distress. While avara sattva displays catastrophic reactions even during little inconveniences and can neither be sustained by themselves nor by others despite having good quality morphological features. Avara sattva is constantly plagued by inferior emotions like grief, fear, greed, conceit and confusion. When confronted with fierce, ugly, disgusting narratives or flesh and blood, they are prone to become depressed, pale, unconscious or semiconscious, giddy, anxious and can even succumb to death in worst case scenarios. [Cha. Sa. Vimana Sthana 8/119].<br /> &lt;br/&gt;Manovaha srotas associated with avara sattva bala is most likely to be vitiated by manas dosha leading to various psychiatric and psychosomatic disorders [Cha.Sa. Chikitsa Sthana 9/5]. It has been observed that avara sattva individuals are more likely to commit prajnaparadha (intellectual defects) [10] thereby voluntarily indulging in various etiological factors for respective psychological as well as somatic disorders.<br /> &lt;br?&gt;Thus, assessment of sattva bala can help rule out the predisposition towards manovaha srotodushti and subsequent development of symptoms of psychiatric ailments.&lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;'''d. Anumana pariksha (knowledge by inference)''' to determine normalcy of faculties of manas (mind) [Cha.Sa. Vimana Sthana 4/8] Since manas is atindriya ( supersence or imperceivable by ordinary senses), so are it’s faculties which can serve as potential markers for assessment of its functions. [10] The proper functioning of manas itself is inferred by altered or inappropriate mental perceptions even in presence of appropriately functioning indriya (senses) and their respective sense objects whereas the mental faculties can be inferred as follows:-&lt;/p&gt;</div>

Manishdubey https://www.carakasamhitaonline.com/index.php?title=Talk:Manovaha_srotas&diff=44173 2023-10-13T11:22:16Z

<p>Manishdubey: </p> <hr /> <div>{{CiteButton}}<br /> {{#seo:<br /> |title= Manovaha srotas<br /> (Channels of transport and transformation of mind and mental factors)<br /> |titlemode=append<br /> |keywords= Manovaha srotas,Hrudya, Sattva pariksha, Sattvavajaya chikitsa, Bhojani M. K.,Deole Y.S., Basisht G<br /> |description=Mana means mind, or psyche. Srotas means channels of transport and transformation. The description and understanding of channels for activities of mind (manovaha srotas) is scattered in ayurveda classics and has not been completely elucidated. Manovaha srotas are considered as channels through which mind and body interact with each other. <br /> |image=http://www.carakasamhitaonline.com/mediawiki-1.32.1/resources/assets/ogimgs.jpg<br /> |image_alt=carak samhita<br /> |type=article<br /> }}<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Mana means mind, or psyche. Srotas means channels of transport and transformation. The description and understanding of channels for activities of mind (manovaha srotas) is scattered in ayurveda classics and has not been completely elucidated. Manovaha srotas are considered as channels through which mind and body interact with each other. These channels pervade throughout the body. [Chakrapani on Cha.Sa. Indriya Sthana 5/41-42] They are responsible for flow of thoughts, emotions, and other psychological functions. This article deals with various aspects of manovaha srotasa i.e. the channels of activities of mind and its development.&lt;/p&gt;<br /> <br /> {{Infobox<br /> |title = Contributors<br /> |label1 = Section/Chapter/topic<br /> |data1 = Concepts/[[Srotas]]/[[Manovaha Srotas]] <br /> |label2 = Authors<br /> |data2 = Bhojani M. K.&lt;sup&gt;1&lt;/sup&gt; Varma Swati &lt;sup&gt;1&lt;/sup&gt; Deole Y.S.&lt;sup&gt;2&lt;/sup&gt;<br /> |label3 = Reviewer &amp; Editor<br /> |data3 = Basisht G.&lt;sup&gt;3&lt;/sup&gt;, <br /> |label4 = Affiliations<br /> |data4 = &lt;sup&gt;1&lt;/sup&gt; Department of Sharir Kriya, All India Institute of Ayurveda, New Delhi, India<br /> &lt;sup&gt;2&lt;/sup&gt; Department of Kayachikitsa, G. J. Patel Institute of Ayurvedic Studies and Research, New Vallabh Vidyanagar, Gujarat, India <br /> &lt;sup&gt;3&lt;/sup&gt; Rheumatologist, Orlando, Florida, U.S.A.<br /> |label5 = Correspondence emails<br /> |data5 = meera.samhita@aiia.gov.in, carakasamhita@gmail.com<br /> |label6 = Publisher <br /> |data6 = [[Charak Samhita Research, Training and Development Centre]], I.T.R.A., Jamnagar, India<br /> |label7 = Date of publication:<br /> |data7 =October 12, 2023<br /> |label8 = DOI<br /> |data8 = In process<br /> }}<br /> <br /> ==Etymology and derivation:==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Srotas originates from Sanskrit root ‘Sru’ that translates to oozing, flow or secretion. It has been defined as ‘sravanat strotamsi’ [Cha. Sa. Sutra Sthana 30/12] which indicates structures designated for conveyance of material inside body. <br /> &lt;br/&gt;Grossly defining, thirteen major types of srotas have been mentioned that transport substances undergoing biotransformation (parinamam aapadyamanam) from the place of origin to their destination. [Cha. Sa. Vimana Sthana 5/3] Similarly in physiological state, manovaha srotas might be responsible for processing and transformation of ‘doshayukta’ (irrational under influence of rajas and tamas) emotions and thoughts into unbiased reasoning before reaching a conclusion by our intellect (buddhi). &lt;/p&gt;<br /> <br /> ==Synonyms of manovaha srotas==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Following terms are used for ‘manovaha srotas’ in different Ayurveda classics : &lt;/p&gt;<br /> # Manovaha dhamani [Chakrapani on Cha. Sa. Indriya sthana 12/42] and [Vijayarakshita in Ma.Ni.Purva Khanda 20/1]<br /> # Chetanavaha srotas [Shivadas Sen on Cha.Sa. Chikitsa sthana 9/5] <br /> # Chetovaha marga [Bhel Samhita Nidana Sthana 7/2]<br /> # Manobuddhivaha sira [ Cha.Sa.Chikitsa Sthana 10/58]<br /> # Sanjnavaha srotas [Su.Sa.Uttar Tantra 61/8]<br /> # Sanjnavaha nadi [Su.Sa. Uttar Tantra 46/7]<br /> &lt;p style=&quot;text-align:justify;&quot;&gt; &lt;br/&gt;Use of terms like sira, nadi and dhamani, refers to different channels and pathways concerned with maintenance of physiological flow of information. [Cha.Sa. Vimana Sthana 5/8] &lt;/p&gt;<br /> <br /> ==Origin==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt; Every srotas is localized within the hollow space in the body originating from a root (mula) and spreading throughout the body to reach a final structure. Srotas are said to be hollow structures in different shapes and sizes The root (mula) is majorly responsible for regulation and control of functions of that srotas.<br /> &lt;br/&gt;The channels carrying mind (manovaha srotas) are not exclusively listed. It is however stated that the entire conscious body is abode of mind. Hence these channels are spread throughout the body. [Chakrapani on Cha.Sa. Indriya Sthana 5/41]. <br /> &lt;br/&gt;However, hridaya (heart) has a universal acceptance as the site of origin (mula) of manovaha srotas. Hence a special mention has been made about ten arteries of heart, probably being the manovaha srotas (visheshen tu hrudya ashritvat manah tadashrita dasha dhamanyo manovaha abhidhiyante) [Chakrapani on Cha.Sa. Indriya Sthana 5/41-42]. These get afflicted by vitiated dosha either all at once or individually. [Chakrapani on Cha.Sa. Indriya Sthana 12/42]<br /> &lt;/p&gt;<br /> <br /> ==Decoding hridaya (heart)==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt; The interpretation of the term ‘hridaya’ has been of confusion among scholars since decades. The first interpretation of the term given by texts of Shatpada Brahmana which highlighted functional aspect of hridaya. The word being composed of three letters viz ‘hri’ (hra harane)- to acquire; ‘Da’ (da dane) – to give; ‘Ya’ (Ya gatau)- which transports. The hridaya thus displays three phases of cardiac cycle i.e., receives, gives, and transports body constituents through it. [2]<br /> &lt;br/&gt;Hridaya is the site of rasa (plasma), sattva (psychic factor/mind), buddhi (intellect) and atma (soul) in conjugation with all sensory organs (jnanendriya).[Cha.Sa. Chikitsa Sthana 24/35] Sadhaka pitta situated in heart (hridaya) regulates proper functioning of intellect (buddhi) and ego (ahamkara). Hridaya is located in between breasts (stanayormadhya) of thoracic region [A. H. Sutra Sthana 12/13-14] [Su. Sa. Sharira Sthana 6/25]. <br /> &lt;br/&gt;Vedic era was well versed with heart (hridaya) and brain (mastishka) being two distinct entities, with interdependent functional relationship [Atharvaveda Book X. Hymn 2.26]. Kashyap Samhita quotes that all sense and motor organs (indriya) together with mind (manas) emerge from heart (hridaya) [Ka.Sa. Chikitsa Sthana 8/6]. Primary site of action of mind (manas) is brain (shira).[3] It can be concluded that mind (manas) being seated in heart (hridaya) connects to brain (shiras) through manovaha srotas and controls all senses (indriya). Also, any damage pertaining to marma (vital points) of shiras (head) causes loss of consciousness (cheshtanasha). [Cha.Sa. Sidhhi Sthana 9/6] Hence heart (hridaya) and brain (shirasor mastishka) are sites of manovaha srotasa. <br /> &lt;br/&gt; This approach of understanding hridaya goes well along with the contemporary view of understanding the triguna based psycho-functional principles of Ayurveda within the neural framework. Various research has been conducted which demonstrate that heart continuously sends nervous signals to brain to coordinate higher centres responsible for cognition and emotions. [1] The neuro- psychological as well as circulatory functions of hridaya mentioned in the classics can thus be explained. &lt;/p&gt; <br /> <br /> ==Relation between rasavaha and manovaha srotas==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Heart is the abode of mind (mana) and consciousness (chetana) or soul (atma). [Cha. Sa. Sidhhi Sthana 9/4] It is a site for physical, psychological, and spiritual components. Heart is origin for channels of transportation and transformation of rasa dhatu, too. Both heart and brain are considered under the umbrella term hridaya in terms of anatomical structure and higher-centre functions respectively. <br /> &lt;br/&gt;Heart (residence of manas) and brain (workplace of manas) are functionally co-dependent upon each other. Manas regulates the cognitive and conative functions of brain in conjunction with soul (atma) under the influence of vata dosha. [Cha. Sa. Sharira Sthana 1/22-23]. Brain is a structural entity needing continuous supply of nourishment and oxygen. This is feasible by heart through circulation (rasa-rakta samvahana kriya) via the ten major vessels (rasavahi dhamani). [A. H. Sharira Sthana 3/18] Heart is a highly vascular organ being surrounded by ten major dhamani (blood vessels) like spokes of a wheel which are known as ‘rasavaha strotomula’ (site of origin of channels of nutrition). These channels are comparable to manovaha srotas. [Chakrapani on Cha. Sa. Chikitsa Sthana 9/4] Manas thus acts like a medium between heart and brain wherein brain is responsible for all sensory and motor functions while heart has been assigned emotional aspect of psyche (manas).<br /> &lt;br/&gt;One of the factors for vitiation of rasavaha srotas is excessive thinking or worry (atichintan). [Cha. Sa. Vimana Sthana 5/13] Contemporary researchers have found evidence to support the interaction between circulatory system and psyche. The monograph of German professor Ludwig Braun is a pioneer in exploring the psychological and emotional aspect of cardiac diseases especially angina. He presented a correlation between cardiac diseases and ‘Angst’ (a constrictive, tightening and crushing sensation which manifests dread in the patient thereby changing his entire emotional outlook on life), analogous to anxiety. He explains that the cardiac tissue has a special apparatus receptive towards anxiety which manifests as an inner tactile sensation. That region is well supplied with nerve endings that gets irritated by anxiety. This phenomenon of emotional influence over cardiac tissues is termed as cardiac psyche. [4] <br /> &lt;/p&gt; <br /> <br /> ==Factors vitiating manovaha srotas==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt; Manovaha srotas are the prime site of abnormalities of channels in all psychological disorders. [Cha.Sa. Nidana Sthana 6/4] Alongside any of the eight factors that are either attributed to hridaya or manas viz. mana (mind), buddhi (intellect), sanjna-jnana (self-awareness), smriti (memory), bhakti (devotion), sheela (habits), cheshta (psychomotor activities) and achara (code of conduct). [Cha.Sa. Nidana Sthana 7/5] <br /> &lt;br/&gt;These factors when deranged cause vitiation of manas dosha (rajas and tamas), deterioration of sattva guna of manas and gradual derangement of tridosha. Foods, activities and excessive expression of emotions like anger, grief, lust, fear etc and mental traumas are the fundamental etiological factors for the same. [Cha.Sa. Nidana Sthana 7/4] Vitiated tridosha further vitiates rasavaha srotas, which apparently has the same site of origin as of manovaha srotas i.e., hridaya and dasha dhamani (ten great vessels). [Cha. Sa. Vimana Sthana 5/10] Hridaya is seat of manas [Cha.Sa. Sutra Sthana 30/4]. Hence, all the factors vitiating rasa dhatu (nutritive fluid), rasavaha srotas (channels carrying nutritive fluid) and manas dosha viz. rajas and tamas will affect manas and eventually vitiating manovaha srotas. Even the structural derangements of heart (abode of mind) affect manovaha srotas due to their ashrayashrayibhava (state of interdependency). [Cha.Sa. Chikitsa Sthana 9/5]&lt;/p&gt;<br /> <br /> ==Pathologies of manovaha srotas==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Manovaha srotas is important factor in understanding disorders like unmada (psychosis), apasmara (epilepsy) and extreme emotional reactions. &lt;/p&gt;<br /> <br /> *'''Unmada (psychosis)'''<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;When an individual experiences extreme emotions – lust (kama), anger (krodha), fear (bhaya), greed (lobha), happiness or pleasure (harsha), affection (moha), grief (shoka), excessive worry (chinta), they initially harm the intellect which aggravates manas dosha (rajas and tamas) and tridosha (vata, pitta and kapha). These vitiated dosha invade heart and obstruct manovaha srotas (channels transporting psychic impulses) thereby causing unmada. [Dalhan on Su. Sa. Uttar Tantra 62/3]<br /> *'''Apasmara (epilepsy)'''<br /> Overindulging in sensory pleasures, incompatible diet, withholding natural urges and giving into immoral activities under emotional influences (kama, krodha, lobha among others), vitiates rajas and tamas. They poorly influence the manas (mind) and sanjnavaha srotas (manovaha srotas) causing apasmara. [Su.Sa. Uttar Tantra 61/6]<br /> * Mada (intoxication), murchha (syncope), sanyasa (coma) are caused by vitiation of channels of consciousness (chetanavaha srotas or manovaha srotas). [Shivadas Sen on Cha. Sa. Chikitsa Sthana 9/5] <br /> *'''Atattvabhinivesha (perverted state of mind)'''<br /> Considered as mahagada (difficult to treat mental disorder), the person’s conscience gets afflicted by rajas and tamas, which cause complete derangement of intellect (buddhi vibhramsha) as the predominant symptom. The vitiated dosha get lodged in heart (hridaya) to afflict channels of mind and intellect (manobuddhivaha sira in manovaha srotas). [Cha.Sa. Chikitsa Sthana 10/57-60]<br /> * Physiology of nightmares (swapna)<br /> Nightmares are dreams occurring in REM phase of sleep which causes mental projections in the form of feelings of fear, despair, and anxiety. Ayurveda defines REM phase as ‘Natiprasupta’ - the state characterised to be midway between states of deep sleep and fully awake. During any ominous situation, tridosha in their highly aggravated state tend to fill-up the manovaha srotas. This results in terrifying dreams. [Cha.Sa. Indriya Sthana 5/41]. &lt;/p&gt;<br /> <br /> ==Assessment and diagnosis of disorders of manovaha srotas==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Srotas are micro-channels transporting various metabolites across cells throughout the body. It can be deduced that manovaha srotas has different characteristics structurally and functionally from the major thirteen srotas, because it transports and transforms thoughts and feelings. This is evident from objects of mind (manas), viz- thought (chintyam), consideration (vicharyam), hypothesis (uhyam), aims (dhyeyam) and determination (sankalpam). [Cha.Sa. Sharira Sthana 1/20]. Assessment of manovaha srotas can be done via assessment of manas and the degree of derangement of its functions. Ayurveda considers manas as material entity (dravya) which is a super sense and not perceivable by ordinary senses (atindriya) [Cha. Sa. Sutra Sthana 8/4]. Manas is under direct control of vata dosha [Cha. Sa. Sutra Sthana 12/8] and is the mediator between atma (soul) and indriyartha (objects of senses). <br /> &lt;br/&gt;The contemporary physiological aspects of mind, senses, brain, nervous system and consciousness can be considered for assessment of manovaha srotas. <br /> &lt;br/&gt; A thorough neurological examination by means of interrogation (prashna pariksha), inspection (darshana pariksha) and assessment of mental strength (sattva bala pariksha) [Cha.Sa. Vimana Sthana 8/119] can be used for assessment and diagnosis of disorders of manovaha srotas.&lt;/p&gt;<br /> <br /> ''' a. Interrogation (prashna pariksha)'''<br /> A formal interview of the patient can be conducted for overall and precise diagnosis. The questions related to chief complaints with duration, chronological development, nurturing of patient, family history, addiction, hobbies, interests, daily routine, major life events, achievements, mental traumas, emotional quotient and intellectual quotient is recorded from the patient. If the patient is not in state of giving correct answers, then the relatives or attendants who know patients history are interviewed. <br /> <br /> '''b. Darshan pariksha (Direct observation)'''<br /> While interviewing the patient, a physician should pay attention to following attributes that can signify features mentioned for certain psychiatric ailments (manovaha srotodushti)..</div>

Manishdubey https://www.carakasamhitaonline.com/index.php?title=Talk:Udakavaha_Srotas&diff=44104 2023-10-11T05:08:50Z

<p>Manishdubey: </p> <hr /> <div>{{CiteButton}}<br /> {{#seo:<br /> |title= UDAKAVAHA SROTAS (Channels for transport and transformation of watery components)<br /> |titlemode=append<br /> |keywords=Udakavaha Srotas, Water metabolism, Bhojani M. K., Tanwar Ankur Kumar, Basisht G, Deole Y.S.<br /> |description=Udaka means water. In body, water is present in the form of various fluids. Udakavaha srotasa are the channels for transport and transformation of fluid (water) and its circulation. <br /> |image=http://www.carakasamhitaonline.com/mediawiki-1.32.1/resources/assets/ogimgs.jpg<br /> |image_alt=carak samhita<br /> |type=article<br /> }}<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Udaka means water. In [[Sharira|body]], water is present in the form of various fluids. Udakavaha srotasa are the channels for transport and transformation of fluid (water) and its circulation. They are the pathways that originate from the palate (talu) or kloma (an internal organ controlling thirst) through which fluids circulate throughout the body. [Code:SAT-B.475]&lt;ref name=&quot;ref1&quot;&gt;National AYUSH Morbidity and Standardized Terminologies Electronic Portal by Ministry of AYUSH Available on http://namstp.ayush.gov.in/#/Ayurveda&lt;/ref&gt; A water-based solution of ions and other compounds makes up most of the adult human body's 60% fluid content. Water makes up most of a cell's primary fluid medium except fat cells. It is present in most cells at a concentration of between 70 and 85 percent.&lt;ref name=&quot;ref2&quot;&gt;A. C. Guyton and J. E. Hall, Textbook of Medical Physiology. 11th edition. Pennsylvania: Elsevier Saunders, 2006.&lt;/ref&gt;The human body uses water as a construction material, a lubricant, a shock absorber, a solvent, a reaction medium, and a reactant. It also serves as a transporter for nutrients and waste products. Water balance must be managed for the preservation of health and life.&lt;ref name=&quot;ref3&quot;&gt;Jéquier E, Constant F. Water as an essential nutrient: the physiological basis of hydration. Eur J ClinNutr. 2010;64(2):115-23.&lt;/ref&gt; So udakavaha srotas are the channels for regulating the water homeostasis in the human body, and failure to do the same can lead to death. This article deals with physiological, pathological and therapeutic aspects of udakavaha srotasa. &lt;/p&gt;<br /> <br /> {{Infobox<br /> |title = Contributors<br /> |label1 = Section/Chapter/topic<br /> |data1 = Concepts/[[Srotas]][[Udakavaha Srotas]] <br /> |label2 = Authors<br /> |data2 = Bhojani M. K. &lt;sup&gt;1&lt;/sup&gt;, Tanwar Ankur Kumar &lt;sup&gt;1&lt;/sup&gt; <br /> |label3 = Reviewer <br /> |data3 = Basisht G.&lt;sup&gt;2&lt;/sup&gt;<br /> |label3 = Editor<br /> |data3 = Deole Y.S.&lt;sup&gt;3&lt;/sup&gt;<br /> |label4 = Affiliations<br /> |data4 = &lt;sup&gt;1&lt;/sup&gt; Department of Sharir Kriya, All India Institute of Ayurveda, New Delhi, India<br /> &lt;sup&gt;2&lt;/sup&gt; Rheumatologist, Orlando, Florida, U.S.A.<br /> &lt;sup&gt;3&lt;/sup&gt; Department of Kayachikitsa, G. J. Patel Institute of Ayurvedic Studies and Research, New Vallabh Vidyanagar, Gujarat, India <br /> |label5 = Correspondence emails<br /> |data5 = [mailto:meera.samhita@aiia.gov.in meera.samhita@aiia.gov.in],&lt;br/&gt; [mailto:carakasamhita@gmail.com carakasamhita@gmail.com]<br /> |label6 = Publisher <br /> |data6 = [[Charak Samhita Research, Training and Development Centre]], I.T.R.A., Jamnagar, India<br /> |label7 = Date of publication:<br /> |data7 = October 10, 2023<br /> |label8 = DOI<br /> |data8 = {{DoiWithLink}}<br /> }}<br /> <br /> == Etymology and derivation:==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;The word udaka is derived from root “undi kledane”.&lt;ref name=&quot;ref4&quot;&gt;Amarkosha. Amarsimha, Edited by Pt. Haragovindasastri. Reprint Ed. Varanasi:Chaukhambha Sanskrit Sansthan, 2020.&lt;/ref&gt; It implies that thing which is to wet is udaka. <br /> &lt;br/&gt;The word srotas is derived from Sanskrit root “sru”.&lt;ref name=&quot;ref4&quot;&gt;Amarkosha. Amarsimha, Edited by Pt. Haragovindasastri. Reprint Ed. Varanasi:Chaukhambha Sanskrit Sansthan, 2020.&lt;/ref&gt; Meaing of sru is to secrete, to flow. Acharya sushruta defines srotas as tubular structures through which fluid material circulates in the body.&lt;ref name=&quot;ref5&quot;&gt;Sushruta. SushrutaSamhita. Edited by JadavajiTrikamjiAacharya. 8th ed. Varanasi: ChaukhambhaOrientalia; 2005. &lt;/ref&gt;[Su. Sa. Sharira Sthana 09/13] Dalhana mentioned two important characteristics of srotas: 1. Passage for fluid (abhivahanshila) and 2. Hollow space to flow (avakash).&lt;ref name=&quot;ref5&quot;&gt;Sushruta. SushrutaSamhita. Edited by JadavajiTrikamjiAacharya. 8th ed. Varanasi: ChaukhambhaOrientalia; 2005.&lt;/ref&gt; [Dalhan on Su. Sa. ShariraSthana 09/13] Srotas, according to acharya Charak, is a structure through which anything is conveyed or flows. [Cha. Sa. Sutra Sthana 30/12] Udakavaha srotas are the channels for water regulation.<br /> &lt;/p&gt;<br /> <br /> ==Synonyms: ==<br /> '''Udaka:''' apa, vari, salil, kamal, jalam, payas, water.&lt;ref name=&quot;ref4&quot;&gt;Amarkosha. Amarsimha, Edited by Pt. Haragovindasastri. Reprint Ed. Varanasi:Chaukhambha Sanskrit Sansthan, 2020.&lt;/ref&gt; &lt;ref name=&quot;ref6&quot;&gt;Monier-Williams, Monier William's Sanskrit-English Dictionary, 2nd Ed., Oxford University Press;1899.&lt;/ref&gt;<br /> &lt;br/&gt;'''Srotas:''' ambusarana,svatasan,&lt;ref name=&quot;ref4&quot;&gt;Amarkosha. Amarsimha, Edited by Pt. Haragovindasastri. Reprint Ed. Varanasi:Chaukhambha Sanskrit Sansthan, 2020.&lt;/ref&gt;sira, dhamani, rasayani, rasavahini, nadi, pantha, marga, sharirachhidra, samritasavritta, Sthana, ashaya, niketa[Cha. Sa. Vimana Sthana 05/09], yogvahi&lt;ref name=&quot;ref5&quot;&gt;Sushruta. SushrutaSamhita. Edited by JadavajiTrikamjiAacharya. 8th ed. Varanasi: ChaukhambhaOrientalia; 2005.&lt;/ref&gt;[Su. Sa. Sharira Sthana 05/05], a wave, the flow, a current, the canal of nutrients in the body.&lt;ref name=&quot;ref6&quot;&gt;Monier-Williams, Monier William's Sanskrit-English Dictionary, 2nd Ed., Oxford University Press;1899.&lt;/ref&gt;<br /> &lt;br/&gt;'''Udakavaha srotas:''' ambuvaha[Cha. Sa. Vimana Sthana 05/9] [Cha. Sa. Chikitsa Sthana 28/8], rasavahini [Cha. Sa. Chikitsa Sthana 22/06], water regulating system.<br /> <br /> ==Origin (Srotomula)==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt; Acharya described the two roots of every srotas. In context of udakavaha srotas, the roots are palate (talu) and junction of throat &amp; chest (kloma). [Cha. Sa. Vimana Sthana 05/09] [Su. Sa. Sharira Sthana 09/12]&lt;ref name=&quot;ref5&quot;&gt;Sushruta. SushrutaSamhita. Edited by JadavajiTrikamjiAacharya. 8th ed. Varanasi: ChaukhambhaOrientalia; 2005.&lt;/ref&gt; Acharya described these sites as root because in water imbalance, these organs first manifest the sign of thirst. The exact site of kloma is not defined but it’s the main controlling center for water regulation in the body. Acharya chakrapani described kloma as the site of thirst and mentioned that it is situated near the heart (hridyastha pipasa sthana).[Chakrapani on Cha. Sa. Vimana Sthana 05/08] Acharya Gangadhara described the site of kloma as the junction of throat and chest (Kantha urso sandhi). [Gangadhara on Cha. Sa. Vimana Sthana 05/08] <br /> The name &quot;kloma&quot; can be applied to mediastinum that is located at above mentioned sites.&lt;ref name=&quot;ref7&quot;&gt;Nanal VM. The organ kloma: a fresh appraisal. AncSci Life. 1989;9(2):61-5.&lt;/ref&gt;<br /> Contemporary understanding of regulation of water is a feedback process involving the hypothalamus, the neurohypophysis, and the kidneys.&lt;ref name=&quot;ref8&quot;&gt;Knepper MA, Kwon TH, Nielsen S: Molecular Physiology of Water Balance. N Engl J Med 2015, 373(2):196.&lt;/ref&gt;The main hormone that controls how much water the body retains is arginine vasopressin (AVP), commonly known as anti-diuretic hormone.&lt;ref name=&quot;ref9&quot;&gt;Cuzzo B, Padala SA, Lappin SL. Physiology, Vasopressin. [Updated 2022 Aug 22]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan. &lt;/ref&gt;<br /> &lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;'''Etiological factors behind srotas abnormalities (sroto dushti hetu)'''&lt;/p&gt;<br /> [Cha. Sa. Vimana Sthana 05/11]These factors are:<br /> # Intake of hot food (aushnyat)<br /> # Indigestion (aamat)<br /> # Fear (bhayat)<br /> # Excessive intake of alcohol (panat)<br /> # Intake of excessive dry food article (arishuksha anna sevanat)<br /> # Habit of withholding the urge in excessive thirst (trishnaya cha atipidanat)<br /> All these factors contributed in dysregulation of water regulation. <br /> <br /> [[File:Etiological factor of udakavahasrotodusti.jpg|center]]<br /> &lt;center&gt;''''Figure 01: Etiological factor of udakavahasrotodusti''''&lt;/center&gt;<br /> <br /> <br /> '''Clinical features of srotas abnormality (srotodushti lakshana)'''[Cha. Sa. Vimana Sthana 05/11] <br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;1. Feeling of dryness of tongue (jihwa), palate (talu), lips (ostha), throat (kantha) and kloma.<br /> 2. Excessive thirst (pipasa) &lt;/p&gt;<br /> <br /> [[File:Figure 02- Udakavaha srotodushti lakshana..jpg|center]]<br /> &lt;center&gt;'''Figure 02: Udakavaha srotodushti lakshana'''&lt;/center&gt;<br /> <br /> ,,,Signs and symptoms of srotas injury(srotoviddha lakshana)'''<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Acharya Sushruta defined the clinical signs and symptoms related to injury or trauma to the udakavahasrotas &lt;ref name=&quot;ref5&quot;&gt;Sushruta. SushrutaSamhita. Edited by JadavajiTrikamjiAacharya. 8th ed. Varanasi: ChaukhambhaOrientalia; 2005.&lt;/ref&gt;[Su. Sa. Sharira Sthana 09/12] Signs and symptoms of injury (srotoviddha) are:<br /> 1. Excessive thirst (pipasa)<br /> 2. Sudden death (sdayomarana)<br /> <br /> &lt;/p&gt;<br /> <br /> '''Disorders of srotas abnormality'''<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;The diseases due to vitiation of udakavaha srotas are:<br /> 1. Prameha (Urinary diseases including diabetes) [Cha. Sa. Chikitsa Sthana 06/08]<br /> 2. Trishna (Morbid thirst)[Cha. Sa. Chikitsa Sthana 22/06]<br /> 3. Atisara (Diarrhea and associated disorders) [Cha. Sa. Chikitsa Sthana 19/05-10]<br /> 4. Visuchika (Non-infectious gastroenteritis) [Cha. Sa. Vimana Sthana 02/10-11]<br /> 5. Hikka (Hiccups)[Cha. Sa. Chikitsa Sthana 17/21]<br /> 6. Shwasa(Dyspnea) [Cha. Sa. Chikitsa Sthana 17/45]<br /> 7. Udara roga(Generalised enlargement of abdomen)[Cha. Sa. Chikitsa Sthana 13/20] &lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Some other diseases may be included under udakavaha stotas disorders:&lt;ref name=&quot;ref10&quot;&gt;Al-Shura AN. 12 - Channels receiving food, prana, and water. In: Al-Shura AN, editor. Ayurvedic Perspectives in Integrative Healthcare: Academic Press; 2020. p. 109-15.&lt;/ref&gt;<br /> • Edema<br /> • Hydrocephalus<br /> • Increased intracranial pressure<br /> • Diarrhea<br /> • Craving for sour and pungent food Excessive use of salt and sugar<br /> • Diabetes<br /> • Excessive thirst with dry mouth<br /> • Dry skin<br /> • Profuse sweating<br /> • Profuse urination<br /> • Glaucoma &lt;/p&gt;<br /> <br /> '''Diagnostic and assessment tools:'''<br /> &lt;p style=&quot;text-align:justify;&quot;&gt; The condition of udakavaha srotas can be assessed by subjective methods like questionnaires and objective methods like blood investigations etc.. Udakavaha srotodushti can be assessed through a subjective questionnaire by which an ayurvedic physicians assess the normalcy and abnormality based on ayurvedic principles of examination (pariksha). Some of the objective methods which may be used to assess the normal functioning of udakavaha srotas are:<br /> 1. Urine routine examination for specific gravity, volume, ph etc.<br /> 2. Serum electrolyte (Sodium and potassium)<br /> 3. MRI Scan for hypothalamus abnormality<br /> 4. Blood sugar for assessing the abnormality.<br /> 5. Dual-energy X-ray absorptiometry (DEXA)&lt;ref name=&quot;ref11&quot;&gt;Mazess RB, Barden HS, Bisek JP, Hanson J. Dual-energy x-ray absorptiometry for total-body and regional bone-mineral and soft-tissue composition. Am J ClinNutr. 1990;51:1106–1112.&lt;/ref&gt;<br /> 6. Air displacement plethysmography,&lt;ref name=&quot;ref12&quot;&gt;Dempster P, Aitkens S. A new air displacement method for the determination of human body composition. Med Sci Sports Exerc. 1995;27:1692–1697.&lt;/ref&gt; <br /> 7. Nuclear magnetic resonance spectroscopy &lt;ref name=&quot;ref13&quot;&gt;Rebouche CJ, Pearson GA, Serfass RE, Roth CW, Finley JW. Evaluation of nuclear magnetic resonance spectroscopy for determination of deuterium abundance in body fluids: application to measurement of total-body water in human infants. Am J ClinNutr. 1987;45:373–380.&lt;/ref&gt;, and <br /> 8. Bioelectrical impedance analysis &lt;ref name=&quot;ref14&quot;&gt;NIH Consensus Statement. Bioelectrical impedance analysis in body composition measurement. National Institutes of Health Technology Assessment Conference Statement. December 12-14, 1994. Nutrition. 1996;12:749–762.&lt;/ref&gt; &lt;ref name=&quot;ref15&quot;&gt;Beertema W, van Hezewijk M, Kester A, Forget PP, van Kreel B. Measurement of total body water in children using bioelectrical impedance: a comparison of several prediction equations. J PediatrGastroenterolNutr. 2000;31:428–432.&lt;/ref&gt;<br /> &lt;/p&gt;<br /> <br /> '''Treatment of srotas abnormality'''<br /> &lt;p style=&quot;text-align:justify;&quot;&gt; The treatment for the viation of udakavaha srotas should be done on the principles of management of thirst disorder (trishna chikitsa). [Cha. Sa. Vimana Sthana 05/26]&lt;/ref&gt; &lt;ref name=&quot;ref16&quot;&gt;Sharma R..Trishna Chikitsa Adhyaya. In: Ojha S.N., Deole Y.S., Basisht G., eds. CharakSamhita New Edition. 1st ed. Jamnagar, Ind: CSRTSDC; 2020. https://www.carakasamhitaonline.com/mediawiki-1.32.1/index.php?title=Trishna_Chikitsa&amp;oldid=42725. Accessed April 6, 2023.&lt;/ref&gt;The signs and symptoms of udakavaha srotas vitiation are comparable to morbid thirst (trishna), which develops as a result of vata and pitta vitiation. Because both doshas have absorbent (shoshaka) properties that degrade the rasavaha and udakavaha srotas. This leads to persistent desire for water. Rain water is the best way to quench thirst. However, nowadays rainwater is rarely stored and used for drinking. Therefore water with a mild astringent flavour, light to digest, cold characteristics, nice scent and taste, and no channel obstructing qualities should be deemed comparable to rain water in effect.&lt;ref name=&quot;ref16&quot;&gt;Sharma R..Trishna Chikitsa Adhyaya. In: Ojha S.N., Deole Y.S., Basisht G., eds. CharakSamhita New Edition. 1st ed. Jamnagar, Ind: CSRTSDC; 2020. https://www.carakasamhitaonline.com/mediawiki-1.32.1/index.php?title=Trishna_Chikitsa&amp;oldid=42725. Accessed April 6, 2023.&lt;/ref&gt; &lt;/p&gt; <br /> <br /> <br /> '''Dosha governing the water metabolism'''<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Dosha are the physiological entity in human body governing all systems. For maintenance of water balance different dosha work in synergy to each other. Acharya Charak clearly described the relation between samana vayu and ambuvaha srotas. [Cha. Sa. Chikitsa Sthana 28/8] Samana vayu is situated in swedavaha, doshavaha and ambuvaha or udakavaha srotas. It showed the samana vayu is essential for maintainance of water regulation in human body. Along with samana vayu, pitta (pachaka) and kapha (bodhaka and kledaka) also help in water homeostasis. &lt;/p&gt;<br /> <br /> [[File:Dosha helpful in water metabolism.jpg|center|Figure 03: Dosha helpful in water metabolism.]]<br /> <br /> '''Future area of research'''<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;The future area of research is the preparation of a validated and standardized questionnaire for assessing the normalcy and abnormality of functioning of udakavaha srotas. Assessment of udakavaha srotas condition in various disease may be helpful in prognosis and treatment outcome. In various physiological conditions like pregnancy, lactation, childhood, old age, space, deep sea and high altitude, the udakavaha srotas assessment may be helpful to understand the dynamic changes occurred within the body. Animal studies to understand the anatomy and physiology of kloma may be helpful for future researches related to udakavaha srotas. &lt;/p&gt;<br /> <br /> ''Thesis works:'''<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;1. Dash Maheshwar (1985): Srotas in ayurveda with special reference to udakavaha srotras, Department of Basic Principles, B.H.U.Varanasi, India <br /> 2. Kambale V.(1997): Udakavaha srotas mulastana nischiti evam kloma tulanatmaka adhyayan, Department of sharir Rachana, Govt. Ayurveda Mahavidyalaya, Nanded. &lt;/p&gt;<br /> <br /> '''Current researches:'''<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt; Contemporary understanding of udakavaha srotas: The cerebrospinal fluid, salivary amylase, and digestive/hepatobiliary system secretions such HCL, bile, pancreatic lipase, and pancreatic amylase are all included in the udaka/ambuvaha srotas. It is also associated with rasa dhatu, which provides the fluid and oiliness needed to transport the necessary nutrients, lubricate various body processes, and support thermodynamic control.&lt;ref name=&quot;ref10&quot;&gt;Al-Shura AN. 12 - Channels receiving food, prana, and water. In: Al-Shura AN, editor. Ayurvedic Perspectives in Integrative Healthcare: Academic Press; 2020. p. 109-15.&lt;/ref&gt; &lt;/p&gt;<br /> <br /> <br /> '''Udakavaha srotas and shwasa roga:''' &lt;p style=&quot;text-align:justify;&quot;&gt;Shwasa roga (dysnoea) occurrs due to vitiation of prana, anna and udakavaha srotas. But understanding the role of udakavaha srotas is difficult. In causative factors of shwasa (nidana), the majority causes of udakavaha srotas dushti are covered. The five varieties of shwasa exhibit its clinical features. In shwasa chikitsa, additional liquid preparations are suggested in order to correct the body's water balance. So, this review helps to understand the role of udakavaha srotas in shwasa roga.&lt;ref name=&quot;ref17&quot;&gt;Teerthashree NS, Chetan M. Understanding of udakavahasrotas in shwasaroga. EPRA International Journal of Multidisciplinary Research (IJMR). 2022 May 12;8(5):63-8.&lt;/ref&gt; &lt;/p&gt;<br /> <br /> '''13.3 Udakavaha srotodushti with special reference to kapha dominant prameha (obstinate urinary disorders including diabetes):''' &lt;p style=&quot;text-align:justify;&quot;&gt; In order to comprehend the notion of looseness of body components (sharira shaithilya) in the pathogenesis (samprapti) of kapha dominant prameha and to assess the application of the essential ayurveda principles of udakavaha stroto dushti, a clinical research on 40 clinically confirmed patients of kapha dominant prameha was done. The study came to the conclusion that srotodushti and pathogenic factors should be taken into account while treating diabetic patients, so that we can focus on treating sroto dushti and its root as well as the illness.&lt;ref name=&quot;ref18&quot;&gt;Rahangdale D, Kumar B, Dave HH, A Conceptual and Clinical Study to Understand The Principle of Sharira-Shaithilyata and UdakavahaSrotodushtiw.s.r. to KaphajaPrameha (Type II Diabetes Mellitus) JOA XIII-3, 2019; 14 - 21&lt;/ref&gt; &lt;/p&gt;<br /> <br /> <br /> <br /> <br /> <br /> <br /> &lt;big&gt;'''[[Special:ContactMe|Send us your suggestions and feedback on this page.]]'''&lt;/big&gt;<br /> <br /> ==References==<br /> <br /> &lt;div id=&quot;BackToTop&quot; class=&quot;noprint&quot; style=&quot;background-color:#DDEFDD; position:fixed;<br /> bottom:32px; left:2%; z-index:9999; padding:0; margin:0;&quot;&gt;&lt;span style=&quot;color:blue;<br /> font-size:8pt; font-face:verdana,sans-serif; border:0.2em outset #ceebf7;<br /> padding:0.1em; font-weight:bolder; -moz-border-radius:8px; &quot;&gt;<br /> [[#top| Back to the Top ]]&lt;/span&gt;&lt;/div&gt;</div>

Manishdubey https://www.carakasamhitaonline.com/index.php?title=Talk:Udakavaha_Srotas&diff=44100 2023-10-11T04:40:07Z

<p>Manishdubey: </p> <hr /> <div>{{CiteButton}}<br /> {{#seo:<br /> |title= UDAKAVAHA SROTAS (Channels for transport and transformation of watery components)<br /> |titlemode=append<br /> |keywords=Udakavaha Srotas, Water metabolism, Bhojani M. K., Tanwar Ankur Kumar, Basisht G, Deole Y.S.<br /> |description=Udaka means water. In body, water is present in the form of various fluids. Udakavaha srotasa are the channels for transport and transformation of fluid (water) and its circulation. <br /> |image=http://www.carakasamhitaonline.com/mediawiki-1.32.1/resources/assets/ogimgs.jpg<br /> |image_alt=carak samhita<br /> |type=article<br /> }}<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Udaka means water. In [[Sharira|body]], water is present in the form of various fluids. Udakavaha srotasa are the channels for transport and transformation of fluid (water) and its circulation. They are the pathways that originate from the palate (talu) or kloma (an internal organ controlling thirst) through which fluids circulate throughout the body. [Code:SAT-B.475]&lt;ref name=&quot;ref1&quot;&gt;National AYUSH Morbidity and Standardized Terminologies Electronic Portal by Ministry of AYUSH Available on http://namstp.ayush.gov.in/#/Ayurveda&lt;/ref&gt; A water-based solution of ions and other compounds makes up most of the adult human body's 60% fluid content. Water makes up most of a cell's primary fluid medium except fat cells. It is present in most cells at a concentration of between 70 and 85 percent.&lt;ref name=&quot;ref2&quot;&gt;A. C. Guyton and J. E. Hall, Textbook of Medical Physiology. 11th edition. Pennsylvania: Elsevier Saunders, 2006.&lt;/ref&gt;The human body uses water as a construction material, a lubricant, a shock absorber, a solvent, a reaction medium, and a reactant. It also serves as a transporter for nutrients and waste products. Water balance must be managed for the preservation of health and life.&lt;ref name=&quot;ref3&quot;&gt;Jéquier E, Constant F. Water as an essential nutrient: the physiological basis of hydration. Eur J ClinNutr. 2010;64(2):115-23.&lt;/ref&gt; So udakavaha srotas are the channels for regulating the water homeostasis in the human body, and failure to do the same can lead to death. This article deals with physiological, pathological and therapeutic aspects of udakavaha srotasa. &lt;/p&gt;<br /> <br /> {{Infobox<br /> |title = Contributors<br /> |label1 = Section/Chapter/topic<br /> |data1 = Concepts/[[Srotas]][[Udakavaha Srotas]] <br /> |label2 = Authors<br /> |data2 = Bhojani M. K. &lt;sup&gt;1&lt;/sup&gt;, Tanwar Ankur Kumar &lt;sup&gt;1&lt;/sup&gt; <br /> |label3 = Reviewer <br /> |data3 = Basisht G.&lt;sup&gt;2&lt;/sup&gt;<br /> |label3 = Editor<br /> |data3 = Deole Y.S.&lt;sup&gt;3&lt;/sup&gt;<br /> |label4 = Affiliations<br /> |data4 = &lt;sup&gt;1&lt;/sup&gt; Department of Sharir Kriya, All India Institute of Ayurveda, New Delhi, India<br /> &lt;sup&gt;2&lt;/sup&gt; Rheumatologist, Orlando, Florida, U.S.A.<br /> &lt;sup&gt;3&lt;/sup&gt; Department of Kayachikitsa, G. J. Patel Institute of Ayurvedic Studies and Research, New Vallabh Vidyanagar, Gujarat, India <br /> |label5 = Correspondence emails<br /> |data5 = [mailto:meera.samhita@aiia.gov.in meera.samhita@aiia.gov.in],&lt;br/&gt; [mailto:carakasamhita@gmail.com carakasamhita@gmail.com]<br /> |label6 = Publisher <br /> |data6 = [[Charak Samhita Research, Training and Development Centre]], I.T.R.A., Jamnagar, India<br /> |label7 = Date of publication:<br /> |data7 = October 10, 2023<br /> |label8 = DOI<br /> |data8 = {{DoiWithLink}}<br /> }}<br /> <br /> == Etymology and derivation:==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;The word udaka is derived from root “undi kledane”.[4] It implies that thing which is to wet is udaka. <br /> &lt;br/&gt;The word srotas is derived from Sanskrit root “sru”.&lt;ref name=&quot;ref4&quot;&gt;Amarkosha. Amarsimha, Edited by Pt. Haragovindasastri. Reprint Ed. Varanasi:Chaukhambha Sanskrit Sansthan, 2020.&lt;/ref&gt; Meaing of sru is to secrete, to flow. Acharya sushruta defines srotas as tubular structures through which fluid material circulates in the body.&lt;ref name=&quot;ref5&quot;&gt;Sushruta. SushrutaSamhita. Edited by JadavajiTrikamjiAacharya. 8th ed. Varanasi: ChaukhambhaOrientalia; 2005. &lt;/ref&gt;[Su. Sa. Sharira Sthana 09/13] Dalhana mentioned two important characteristics of srotas: 1. Passage for fluid (abhivahanshila) and 2. Hollow space to flow (avakash).&lt;ref name=&quot;ref5&quot;&gt;Sushruta. SushrutaSamhita. Edited by JadavajiTrikamjiAacharya. 8th ed. Varanasi: ChaukhambhaOrientalia; 2005.&lt;/ref&gt; [Dalhan on Su. Sa. ShariraSthana 09/13] Srotas, according to acharya Charak, is a structure through which anything is conveyed or flows. [Cha. Sa. Sutra Sthana 30/12] Udakavaha srotas are the channels for water regulation.<br /> &lt;/p&gt;<br /> <br /> ==Synonyms: ==<br /> '''Udaka:''' apa, vari, salil, kamal, jalam, payas, water. [4][6]<br /> &lt;br/&gt;'''Srotas:''' ambusarana,svatasan, [4]sira, dhamani, rasayani, rasavahini, nadi, pantha, marga, sharirachhidra, samritasavritta, Sthana, ashaya, niketa[Cha. Sa. Vimana Sthana 05/09], yogvahi[5] [Su. Sa. Sharira Sthana 05/05], a wave, the flow, a current, the canal of nutrients in the body.[6]<br /> &lt;br/&gt;'''Udakavaha srotas:''' ambuvaha[Cha. Sa. Vimana Sthana 05/9] [Cha. Sa. Chikitsa Sthana 28/8], rasavahini [Cha. Sa. Chikitsa Sthana 22/06], water regulating system.<br /> <br /> ==Origin (Srotomula)==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt; Acharya described the two roots of every srotas. In context of udakavaha srotas, the roots are palate (talu) and junction of throat &amp; chest (kloma). [Cha. Sa. Vimana Sthana 05/09] [Su. Sa. Sharira Sthana 09/12] [5]Acharya described these sites as root because in water imbalance, these organs first manifest the sign of thirst. The exact site of kloma is not defined but it’s the main controlling center for water regulation in the body. Acharya chakrapani described kloma as the site of thirst and mentioned that it is situated near the heart (hridyastha pipasa sthana).[Chakrapani on Cha. Sa. Vimana Sthana 05/08] Acharya Gangadhara described the site of kloma as the junction of throat and chest (Kantha urso sandhi). [Gangadhara on Cha. Sa. Vimana Sthana 05/08] <br /> The name &quot;kloma&quot; can be applied to mediastinum that is located at above mentioned sites. [7]<br /> Contemporary understanding of regulation of water is a feedback process involving the hypothalamus, the neurohypophysis, and the kidneys.[8] The main hormone that controls how much water the body retains is arginine vasopressin (AVP), commonly known as anti-diuretic hormone.[9]<br /> &lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;'''Etiological factors behind srotas abnormalities (sroto dushti hetu)'''&lt;/p&gt;<br /> [Cha. Sa. Vimana Sthana 05/11]These factors are:<br /> # Intake of hot food (aushnyat)<br /> # Indigestion (aamat)<br /> # Fear (bhayat)<br /> # Excessive intake of alcohol (panat)<br /> # Intake of excessive dry food article (arishuksha anna sevanat)<br /> # Habit of withholding the urge in excessive thirst (trishnaya cha atipidanat)<br /> All these factors contributed in dysregulation of water regulation. <br /> <br /> [[File:Etiological factor of udakavahasrotodusti.jpg|center]]<br /> &lt;center&gt;''''Figure 01: Etiological factor of udakavahasrotodusti''''&lt;/center&gt;<br /> <br /> <br /> '''Clinical features of srotas abnormality (srotodushti lakshana)'''[Cha. Sa. Vimana Sthana 05/11] <br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;1. Feeling of dryness of tongue (jihwa), palate (talu), lips (ostha), throat (kantha) and kloma.<br /> 2. Excessive thirst (pipasa) &lt;/p&gt;<br /> <br /> [[File:Figure 02- Udakavaha srotodushti lakshana..jpg|center]]<br /> &lt;center&gt;'''Figure 02: Udakavaha srotodushti lakshana'''&lt;/center&gt;<br /> <br /> ,,,Signs and symptoms of srotas injury(srotoviddha lakshana)'''<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Acharya Sushruta defined the clinical signs and symptoms related to injury or trauma to the udakavahasrotas.[5 ][Su. Sa. Sharira Sthana 09/12] Signs and symptoms of injury (srotoviddha) are:<br /> 1. Excessive thirst (pipasa)<br /> 2. Sudden death (sdayomarana)<br /> <br /> &lt;/p&gt;<br /> <br /> '''Disorders of srotas abnormality'''<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;The diseases due to vitiation of udakavaha srotas are:<br /> 1. Prameha (Urinary diseases including diabetes) [Cha. Sa. Chikitsa Sthana 06/08]<br /> 2. Trishna (Morbid thirst)[Cha. Sa. Chikitsa Sthana 22/06]<br /> 3. Atisara (Diarrhea and associated disorders) [Cha. Sa. Chikitsa Sthana 19/05-10]<br /> 4. Visuchika (Non-infectious gastroenteritis) [Cha. Sa. Vimana Sthana 02/10-11]<br /> 5. Hikka (Hiccups)[Cha. Sa. Chikitsa Sthana 17/21]<br /> 6. Shwasa(Dyspnea) [Cha. Sa. Chikitsa Sthana 17/45]<br /> 7. Udara roga(Generalised enlargement of abdomen)[Cha. Sa. Chikitsa Sthana 13/20] &lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Some other diseases may be included under udakavaha stotas disorders: [10]<br /> • Edema<br /> • Hydrocephalus<br /> • Increased intracranial pressure<br /> • Diarrhea<br /> • Craving for sour and pungent food Excessive use of salt and sugar<br /> • Diabetes<br /> • Excessive thirst with dry mouth<br /> • Dry skin<br /> • Profuse sweating<br /> • Profuse urination<br /> • Glaucoma &lt;/p&gt;<br /> <br /> '''Diagnostic and assessment tools:'''<br /> &lt;p style=&quot;text-align:justify;&quot;&gt; The condition of udakavaha srotas can be assessed by subjective methods like questionnaires and objective methods like blood investigations etc.. Udakavaha srotodushti can be assessed through a subjective questionnaire by which an ayurvedic physicians assess the normalcy and abnormality based on ayurvedic principles of examination (pariksha). Some of the objective methods which may be used to assess the normal functioning of udakavaha srotas are:<br /> 1. Urine routine examination for specific gravity, volume, ph etc.<br /> 2. Serum electrolyte (Sodium and potassium)<br /> 3. MRI Scan for hypothalamus abnormality<br /> 4. Blood sugar for assessing the abnormality.<br /> 5. Dual-energy X-ray absorptiometry (DEXA)[11]<br /> 6. Air displacement plethysmography,[12]<br /> 7. Nuclear magnetic resonance spectroscopy [13], and <br /> 8. Bioelectrical impedance analysis [14] [15]<br /> &lt;/p&gt;<br /> <br /> '''Treatment of srotas abnormality'''<br /> &lt;p style=&quot;text-align:justify;&quot;&gt; The treatment for the viation of udakavaha srotas should be done on the principles of management of thirst disorder (trishna chikitsa). [Cha. Sa. Vimana Sthana 05/26] [16] The signs and symptoms of udakavaha srotas vitiation are comparable to morbid thirst (trishna), which develops as a result of vata and pitta vitiation. Because both doshas have absorbent (shoshaka) properties that degrade the rasavaha and udakavaha srotas. This leads to persistent desire for water. Rain water is the best way to quench thirst. However, nowadays rainwater is rarely stored and used for drinking. Therefore water with a mild astringent flavour, light to digest, cold characteristics, nice scent and taste, and no channel obstructing qualities should be deemed comparable to rain water in effect. [16] &lt;/p&gt; <br /> <br /> <br /> '''Dosha governing the water metabolism'''<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Dosha are the physiological entity in human body governing all systems. For maintenance of water balance different dosha work in synergy to each other. Acharya Charak clearly described the relation between samana vayu and ambuvaha srotas. [Cha. Sa. Chikitsa Sthana 28/8] Samana vayu is situated in swedavaha, doshavaha and ambuvaha or udakavaha srotas. It showed the samana vayu is essential for maintainance of water regulation in human body. Along with samana vayu, pitta (pachaka) and kapha (bodhaka and kledaka) also help in water homeostasis. &lt;/p&gt;<br /> <br /> [[File:Dosha helpful in water metabolism.jpg|center|Figure 03: Dosha helpful in water metabolism.]]<br /> <br /> '''Future area of research'''<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;The future area of research is the preparation of a validated and standardized questionnaire for assessing the normalcy and abnormality of functioning of udakavaha srotas. Assessment of udakavaha srotas condition in various disease may be helpful in prognosis and treatment outcome. In various physiological conditions like pregnancy, lactation, childhood, old age, space, deep sea and high altitude, the udakavaha srotas assessment may be helpful to understand the dynamic changes occurred within the body. Animal studies to understand the anatomy and physiology of kloma may be helpful for future researches related to udakavaha srotas. &lt;/p&gt;<br /> <br /> ''Thesis works:'''<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;1. Dash Maheshwar (1985): Srotas in ayurveda with special reference to udakavaha srotras, Department of Basic Principles, B.H.U.Varanasi, India <br /> 2. Kambale V.(1997): Udakavaha srotas mulastana nischiti evam kloma tulanatmaka adhyayan, Department of sharir Rachana, Govt. Ayurveda Mahavidyalaya, Nanded. &lt;/p&gt;<br /> <br /> '''Current researches:'''<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt; Contemporary understanding of udakavaha srotas: The cerebrospinal fluid, salivary amylase, and digestive/hepatobiliary system secretions such HCL, bile, pancreatic lipase, and pancreatic amylase are all included in the udaka/ambuvaha srotas. It is also associated with rasa dhatu, which provides the fluid and oiliness needed to transport the necessary nutrients, lubricate various body processes, and support thermodynamic control.[10] &lt;/p&gt;<br /> <br /> <br /> '''Udakavaha srotas and shwasa roga:''' &lt;p style=&quot;text-align:justify;&quot;&gt;Shwasa roga (dysnoea) occurrs due to vitiation of prana, anna and udakavaha srotas. But understanding the role of udakavaha srotas is difficult. In causative factors of shwasa (nidana), the majority causes of udakavaha srotas dushti are covered. The five varieties of shwasa exhibit its clinical features. In shwasa chikitsa, additional liquid preparations are suggested in order to correct the body's water balance. So, this review helps to understand the role of udakavaha srotas in shwasa roga. [17] &lt;/p&gt;<br /> <br /> '''13.3 Udakavaha srotodushti with special reference to kapha dominant prameha (obstinate urinary disorders including diabetes):''' &lt;p style=&quot;text-align:justify;&quot;&gt; In order to comprehend the notion of looseness of body components (sharira shaithilya) in the pathogenesis (samprapti) of kapha dominant prameha and to assess the application of the essential ayurveda principles of udakavaha stroto dushti, a clinical research on 40 clinically confirmed patients of kapha dominant prameha was done. The study came to the conclusion that srotodushti and pathogenic factors should be taken into account while treating diabetic patients, so that we can focus on treating sroto dushti and its root as well as the illness.[18] &lt;/p&gt;<br /> <br /> '''References'''<br /> &lt;p style=&quot;text-align:justify;&quot;&gt; 1. National AYUSH Morbidity and Standardized Terminologies Electronic Portal by Ministry of AYUSH Available on http://namstp.ayush.gov.in/#/Ayurveda<br /> 2. A. C. Guyton and J. E. Hall, Textbook of Medical Physiology. 11th edition. Pennsylvania: Elsevier Saunders, 2006.<br /> 3. Jéquier E, Constant F. Water as an essential nutrient: the physiological basis of hydration. Eur J ClinNutr. 2010;64(2):115-23.<br /> 4. Amarkosha. Amarsimha, Edited by Pt. Haragovindasastri. Reprint Ed. Varanasi:Chaukhambha Sanskrit Sansthan, 2020.<br /> 5. Sushruta. SushrutaSamhita. Edited by JadavajiTrikamjiAacharya. 8th ed. Varanasi: ChaukhambhaOrientalia; 2005.<br /> 6. Monier-Williams, Monier William's Sanskrit-English Dictionary, 2nd Ed., Oxford University Press;1899.<br /> 7. Nanal VM. The organ kloma: a fresh appraisal. AncSci Life. 1989;9(2):61-5.<br /> 8. Knepper MA, Kwon TH, Nielsen S: Molecular Physiology of Water Balance. N Engl J Med 2015, 373(2):196.<br /> 9. Cuzzo B, Padala SA, Lappin SL. Physiology, Vasopressin. [Updated 2022 Aug 22]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan. <br /> 10. Al-Shura AN. 12 - Channels receiving food, prana, and water. In: Al-Shura AN, editor. Ayurvedic Perspectives in Integrative Healthcare: Academic Press; 2020. p. 109-15.<br /> 11. Mazess RB, Barden HS, Bisek JP, Hanson J. Dual-energy x-ray absorptiometry for total-body and regional bone-mineral and soft-tissue composition. Am J ClinNutr. 1990;51:1106–1112.<br /> 12. Dempster P, Aitkens S. A new air displacement method for the determination of human body composition. Med Sci Sports Exerc. 1995;27:1692–1697.<br /> 13. Rebouche CJ, Pearson GA, Serfass RE, Roth CW, Finley JW. Evaluation of nuclear magnetic resonance spectroscopy for determination of deuterium abundance in body fluids: application to measurement of total-body water in human infants. Am J ClinNutr. 1987;45:373–380.<br /> 14. NIH Consensus Statement. Bioelectrical impedance analysis in body composition measurement. National Institutes of Health Technology Assessment Conference Statement. December 12-14, 1994. Nutrition. 1996;12:749–762.<br /> 15. Beertema W, van Hezewijk M, Kester A, Forget PP, van Kreel B. Measurement of total body water in children using bioelectrical impedance: a comparison of several prediction equations. J PediatrGastroenterolNutr. 2000;31:428–432. <br /> 16. Sharma R..Trishna Chikitsa Adhyaya. In: Ojha S.N., Deole Y.S., Basisht G., eds. CharakSamhita New Edition. 1st ed. Jamnagar, Ind: CSRTSDC; 2020. https://www.carakasamhitaonline.com/mediawiki-1.32.1/index.php?title=Trishna_Chikitsa&amp;oldid=42725. Accessed April 6, 2023.<br /> 17. Teerthashree NS, Chetan M. Understanding of udakavahasrotas in shwasaroga. EPRA International Journal of Multidisciplinary Research (IJMR). 2022 May 12;8(5):63-8.<br /> 18. Rahangdale D, Kumar B, Dave HH, A Conceptual and Clinical Study to Understand The Principle of Sharira-Shaithilyata and UdakavahaSrotodushtiw.s.r. to KaphajaPrameha (Type II Diabetes Mellitus) JOA XIII-3, 2019; 14 - 21<br /> <br /> &lt;p/&gt;<br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> &lt;big&gt;'''[[Special:ContactMe|Send us your suggestions and feedback on this page.]]'''&lt;/big&gt;<br /> <br /> ==References==<br /> <br /> &lt;div id=&quot;BackToTop&quot; class=&quot;noprint&quot; style=&quot;background-color:#DDEFDD; position:fixed;<br /> bottom:32px; left:2%; z-index:9999; padding:0; margin:0;&quot;&gt;&lt;span style=&quot;color:blue;<br /> font-size:8pt; font-face:verdana,sans-serif; border:0.2em outset #ceebf7;<br /> padding:0.1em; font-weight:bolder; -moz-border-radius:8px; &quot;&gt;<br /> [[#top| Back to the Top ]]&lt;/span&gt;&lt;/div&gt;</div>

Manishdubey https://www.carakasamhitaonline.com/index.php?title=Talk:Udakavaha_Srotas&diff=44075 2023-10-10T13:38:09Z

<p>Manishdubey: </p> <hr /> <div>{{CiteButton}}<br /> {{#seo:<br /> |title= UDAKAVAHA SROTAS (Channels for transport and transformation of watery components)<br /> |titlemode=append<br /> |keywords=Udakavaha Srotas, Water metabolism, Bhojani M. K., Tanwar Ankur Kumar, Basisht G, Deole Y.S.<br /> |description=Udaka means water. In body, water is present in the form of various fluids. Udakavaha srotasa are the channels for transport and transformation of fluid (water) and its circulation. <br /> |image=http://www.carakasamhitaonline.com/mediawiki-1.32.1/resources/assets/ogimgs.jpg<br /> |image_alt=carak samhita<br /> |type=article<br /> }}<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Udaka means water. In [[Sharira|body]], water is present in the form of various fluids. Udakavaha srotasa are the channels for transport and transformation of fluid (water) and its circulation. They are the pathways that originate from the palate (talu) or kloma (an internal organ controlling thirst) through which fluids circulate throughout the body. [Code:SAT-B.475]&lt;ref name=&quot;ref1&quot;&gt;National AYUSH Morbidity and Standardized Terminologies Electronic Portal by Ministry of AYUSH Available on http://namstp.ayush.gov.in/#/Ayurveda&lt;/ref&gt; A water-based solution of ions and other compounds makes up most of the adult human body's 60% fluid content. Water makes up most of a cell's primary fluid medium except fat cells. It is present in most cells at a concentration of between 70 and 85 percent.[2] The human body uses water as a construction material, a lubricant, a shock absorber, a solvent, a reaction medium, and a reactant. It also serves as a transporter for nutrients and waste products. Water balance must be managed for the preservation of health and life.[3] So udakavaha srotas are the channels for regulating the water homeostasis in the human body, and failure to do the same can lead to death. This article deals with physiological, pathological and therapeutic aspects of udakavaha srotasa. &lt;/p&gt;<br /> <br /> {{Infobox<br /> |title = Contributors<br /> |label1 = Section/Chapter/topic<br /> |data1 = Concepts/[[Srotas]][[Udakavaha Srotas]] <br /> |label2 = Authors<br /> |data2 = Bhojani M. K. &lt;sup&gt;1&lt;/sup&gt;, Tanwar Ankur Kumar &lt;sup&gt;1&lt;/sup&gt; <br /> |label3 = Reviewer <br /> |data3 = Basisht G.&lt;sup&gt;2&lt;/sup&gt;<br /> |label3 = Editor<br /> |data3 = Deole Y.S.&lt;sup&gt;3&lt;/sup&gt;<br /> |label4 = Affiliations<br /> |data4 = &lt;sup&gt;1&lt;/sup&gt; Department of Sharir Kriya, All India Institute of Ayurveda, New Delhi, India<br /> &lt;sup&gt;2&lt;/sup&gt; Rheumatologist, Orlando, Florida, U.S.A.<br /> &lt;sup&gt;3&lt;/sup&gt; Department of Kayachikitsa, G. J. Patel Institute of Ayurvedic Studies and Research, New Vallabh Vidyanagar, Gujarat, India <br /> |label5 = Correspondence emails<br /> |data5 = [mailto:meera.samhita@aiia.gov.in meera.samhita@aiia.gov.in],&lt;br/&gt; [mailto:carakasamhita@gmail.com carakasamhita@gmail.com]<br /> |label6 = Publisher <br /> |data6 = [[Charak Samhita Research, Training and Development Centre]], I.T.R.A., Jamnagar, India<br /> |label7 = Date of publication:<br /> |data7 = October 10, 2023<br /> |label8 = DOI<br /> |data8 = {{DoiWithLink}}<br /> }}<br /> <br /> == Etymology and derivation:==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;The word udaka is derived from root “undi kledane”.[4] It implies that thing which is to wet is udaka. <br /> &lt;br/&gt;The word srotas is derived from Sanskrit root “sru”.[4] Meaing of sru is to secrete, to flow. Acharya sushruta defines srotas as tubular structures through which fluid material circulates in the body.[5] [Su. Sa. Sharira Sthana 09/13] Dalhana mentioned two important characteristics of srotas: 1. Passage for fluid (abhivahanshila) and 2. Hollow space to flow (avakash).[5] [Dalhan on Su. Sa. ShariraSthana 09/13] Srotas, according to acharya Charak, is a structure through which anything is conveyed or flows. [Cha. Sa. Sutra Sthana 30/12] Udakavaha srotas are the channels for water regulation.<br /> &lt;/p&gt;<br /> <br /> ==Synonyms: ==<br /> '''Udaka:''' apa, vari, salil, kamal, jalam, payas, water. [4][6]<br /> &lt;br/&gt;'''Srotas:''' ambusarana,svatasan, [4]sira, dhamani, rasayani, rasavahini, nadi, pantha, marga, sharirachhidra, samritasavritta, Sthana, ashaya, niketa[Cha. Sa. Vimana Sthana 05/09], yogvahi[5] [Su. Sa. Sharira Sthana 05/05], a wave, the flow, a current, the canal of nutrients in the body.[6]<br /> &lt;br/&gt;'''Udakavaha srotas:''' ambuvaha[Cha. Sa. Vimana Sthana 05/9] [Cha. Sa. Chikitsa Sthana 28/8], rasavahini [Cha. Sa. Chikitsa Sthana 22/06], water regulating system.<br /> <br /> ==Origin (Srotomula)==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt; Acharya described the two roots of every srotas. In context of udakavaha srotas, the roots are palate (talu) and junction of throat &amp; chest (kloma). [Cha. Sa. Vimana Sthana 05/09] [Su. Sa. Sharira Sthana 09/12] [5]Acharya described these sites as root because in water imbalance, these organs first manifest the sign of thirst. The exact site of kloma is not defined but it’s the main controlling center for water regulation in the body. Acharya chakrapani described kloma as the site of thirst and mentioned that it is situated near the heart (hridyastha pipasa sthana).[Chakrapani on Cha. Sa. Vimana Sthana 05/08] Acharya Gangadhara described the site of kloma as the junction of throat and chest (Kantha urso sandhi). [Gangadhara on Cha. Sa. Vimana Sthana 05/08] <br /> The name &quot;kloma&quot; can be applied to mediastinum that is located at above mentioned sites. [7]<br /> Contemporary understanding of regulation of water is a feedback process involving the hypothalamus, the neurohypophysis, and the kidneys.[8] The main hormone that controls how much water the body retains is arginine vasopressin (AVP), commonly known as anti-diuretic hormone.[9]<br /> &lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;'''Etiological factors behind srotas abnormalities (sroto dushti hetu)'''&lt;/p&gt;<br /> [Cha. Sa. Vimana Sthana 05/11]These factors are:<br /> # Intake of hot food (aushnyat)<br /> # Indigestion (aamat)<br /> # Fear (bhayat)<br /> # Excessive intake of alcohol (panat)<br /> # Intake of excessive dry food article (arishuksha anna sevanat)<br /> # Habit of withholding the urge in excessive thirst (trishnaya cha atipidanat)<br /> All these factors contributed in dysregulation of water regulation. <br /> <br /> [[File:Etiological factor of udakavahasrotodusti.jpg|center]]<br /> &lt;center&gt;''''Figure 01: Etiological factor of udakavahasrotodusti''''&lt;/center&gt;<br /> <br /> <br /> '''Clinical features of srotas abnormality (srotodushti lakshana)'''[Cha. Sa. Vimana Sthana 05/11] <br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;1. Feeling of dryness of tongue (jihwa), palate (talu), lips (ostha), throat (kantha) and kloma.<br /> 2. Excessive thirst (pipasa) &lt;/p&gt;<br /> <br /> [[File:Figure 02- Udakavaha srotodushti lakshana..jpg|center]]<br /> &lt;center&gt;'''Figure 02: Udakavaha srotodushti lakshana'''&lt;/center&gt;<br /> <br /> ,,,Signs and symptoms of srotas injury(srotoviddha lakshana)'''<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Acharya Sushruta defined the clinical signs and symptoms related to injury or trauma to the udakavahasrotas.[5 ][Su. Sa. Sharira Sthana 09/12] Signs and symptoms of injury (srotoviddha) are:<br /> 1. Excessive thirst (pipasa)<br /> 2. Sudden death (sdayomarana)<br /> <br /> &lt;/p&gt;<br /> <br /> '''Disorders of srotas abnormality'''<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;The diseases due to vitiation of udakavaha srotas are:<br /> 1. Prameha (Urinary diseases including diabetes) [Cha. Sa. Chikitsa Sthana 06/08]<br /> 2. Trishna (Morbid thirst)[Cha. Sa. Chikitsa Sthana 22/06]<br /> 3. Atisara (Diarrhea and associated disorders) [Cha. Sa. Chikitsa Sthana 19/05-10]<br /> 4. Visuchika (Non-infectious gastroenteritis) [Cha. Sa. Vimana Sthana 02/10-11]<br /> 5. Hikka (Hiccups)[Cha. Sa. Chikitsa Sthana 17/21]<br /> 6. Shwasa(Dyspnea) [Cha. Sa. Chikitsa Sthana 17/45]<br /> 7. Udara roga(Generalised enlargement of abdomen)[Cha. Sa. Chikitsa Sthana 13/20] &lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Some other diseases may be included under udakavaha stotas disorders: [10]<br /> • Edema<br /> • Hydrocephalus<br /> • Increased intracranial pressure<br /> • Diarrhea<br /> • Craving for sour and pungent food Excessive use of salt and sugar<br /> • Diabetes<br /> • Excessive thirst with dry mouth<br /> • Dry skin<br /> • Profuse sweating<br /> • Profuse urination<br /> • Glaucoma &lt;/p&gt;<br /> <br /> '''Diagnostic and assessment tools:'''<br /> &lt;p style=&quot;text-align:justify;&quot;&gt; The condition of udakavaha srotas can be assessed by subjective methods like questionnaires and objective methods like blood investigations etc.. Udakavaha srotodushti can be assessed through a subjective questionnaire by which an ayurvedic physicians assess the normalcy and abnormality based on ayurvedic principles of examination (pariksha). Some of the objective methods which may be used to assess the normal functioning of udakavaha srotas are:<br /> 1. Urine routine examination for specific gravity, volume, ph etc.<br /> 2. Serum electrolyte (Sodium and potassium)<br /> 3. MRI Scan for hypothalamus abnormality<br /> 4. Blood sugar for assessing the abnormality.<br /> 5. Dual-energy X-ray absorptiometry (DEXA)[11]<br /> 6. Air displacement plethysmography,[12]<br /> 7. Nuclear magnetic resonance spectroscopy [13], and <br /> 8. Bioelectrical impedance analysis [14] [15]<br /> &lt;/p&gt;<br /> <br /> '''Treatment of srotas abnormality'''<br /> &lt;p style=&quot;text-align:justify;&quot;&gt; The treatment for the viation of udakavaha srotas should be done on the principles of management of thirst disorder (trishna chikitsa). [Cha. Sa. Vimana Sthana 05/26] [16] The signs and symptoms of udakavaha srotas vitiation are comparable to morbid thirst (trishna), which develops as a result of vata and pitta vitiation. Because both doshas have absorbent (shoshaka) properties that degrade the rasavaha and udakavaha srotas. This leads to persistent desire for water. Rain water is the best way to quench thirst. However, nowadays rainwater is rarely stored and used for drinking. Therefore water with a mild astringent flavour, light to digest, cold characteristics, nice scent and taste, and no channel obstructing qualities should be deemed comparable to rain water in effect. [16] &lt;/p&gt; <br /> <br /> <br /> '''Dosha governing the water metabolism'''<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Dosha are the physiological entity in human body governing all systems. For maintenance of water balance different dosha work in synergy to each other. Acharya Charak clearly described the relation between samana vayu and ambuvaha srotas. [Cha. Sa. Chikitsa Sthana 28/8] Samana vayu is situated in swedavaha, doshavaha and ambuvaha or udakavaha srotas. It showed the samana vayu is essential for maintainance of water regulation in human body. Along with samana vayu, pitta (pachaka) and kapha (bodhaka and kledaka) also help in water homeostasis. &lt;/p&gt;<br /> <br /> [[File:Dosha helpful in water metabolism.jpg|center|Figure 03: Dosha helpful in water metabolism.]]<br /> <br /> '''Future area of research'''<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;The future area of research is the preparation of a validated and standardized questionnaire for assessing the normalcy and abnormality of functioning of udakavaha srotas. Assessment of udakavaha srotas condition in various disease may be helpful in prognosis and treatment outcome. In various physiological conditions like pregnancy, lactation, childhood, old age, space, deep sea and high altitude, the udakavaha srotas assessment may be helpful to understand the dynamic changes occurred within the body. Animal studies to understand the anatomy and physiology of kloma may be helpful for future researches related to udakavaha srotas. &lt;/p&gt;<br /> <br /> ''Thesis works:'''<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;1. Dash Maheshwar (1985): Srotas in ayurveda with special reference to udakavaha srotras, Department of Basic Principles, B.H.U.Varanasi, India <br /> 2. Kambale V.(1997): Udakavaha srotas mulastana nischiti evam kloma tulanatmaka adhyayan, Department of sharir Rachana, Govt. Ayurveda Mahavidyalaya, Nanded. &lt;/p&gt;<br /> <br /> '''Current researches:'''<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt; Contemporary understanding of udakavaha srotas: The cerebrospinal fluid, salivary amylase, and digestive/hepatobiliary system secretions such HCL, bile, pancreatic lipase, and pancreatic amylase are all included in the udaka/ambuvaha srotas. It is also associated with rasa dhatu, which provides the fluid and oiliness needed to transport the necessary nutrients, lubricate various body processes, and support thermodynamic control.[10] &lt;/p&gt;<br /> <br /> <br /> '''Udakavaha srotas and shwasa roga:''' &lt;p style=&quot;text-align:justify;&quot;&gt;Shwasa roga (dysnoea) occurrs due to vitiation of prana, anna and udakavaha srotas. But understanding the role of udakavaha srotas is difficult. In causative factors of shwasa (nidana), the majority causes of udakavaha srotas dushti are covered. The five varieties of shwasa exhibit its clinical features. In shwasa chikitsa, additional liquid preparations are suggested in order to correct the body's water balance. So, this review helps to understand the role of udakavaha srotas in shwasa roga. [17] &lt;/p&gt;<br /> <br /> '''13.3 Udakavaha srotodushti with special reference to kapha dominant prameha (obstinate urinary disorders including diabetes):''' &lt;p style=&quot;text-align:justify;&quot;&gt; In order to comprehend the notion of looseness of body components (sharira shaithilya) in the pathogenesis (samprapti) of kapha dominant prameha and to assess the application of the essential ayurveda principles of udakavaha stroto dushti, a clinical research on 40 clinically confirmed patients of kapha dominant prameha was done. The study came to the conclusion that srotodushti and pathogenic factors should be taken into account while treating diabetic patients, so that we can focus on treating sroto dushti and its root as well as the illness.[18] &lt;/p&gt;<br /> <br /> '''References'''<br /> &lt;p style=&quot;text-align:justify;&quot;&gt; 1. National AYUSH Morbidity and Standardized Terminologies Electronic Portal by Ministry of AYUSH Available on http://namstp.ayush.gov.in/#/Ayurveda<br /> 2. A. C. Guyton and J. E. Hall, Textbook of Medical Physiology. 11th edition. Pennsylvania: Elsevier Saunders, 2006.<br /> 3. Jéquier E, Constant F. Water as an essential nutrient: the physiological basis of hydration. Eur J ClinNutr. 2010;64(2):115-23.<br /> 4. Amarkosha. Amarsimha, Edited by Pt. Haragovindasastri. Reprint Ed. Varanasi:Chaukhambha Sanskrit Sansthan, 2020.<br /> 5. Sushruta. SushrutaSamhita. Edited by JadavajiTrikamjiAacharya. 8th ed. Varanasi: ChaukhambhaOrientalia; 2005.<br /> 6. Monier-Williams, Monier William's Sanskrit-English Dictionary, 2nd Ed., Oxford University Press;1899.<br /> 7. Nanal VM. The organ kloma: a fresh appraisal. AncSci Life. 1989;9(2):61-5.<br /> 8. Knepper MA, Kwon TH, Nielsen S: Molecular Physiology of Water Balance. N Engl J Med 2015, 373(2):196.<br /> 9. Cuzzo B, Padala SA, Lappin SL. Physiology, Vasopressin. [Updated 2022 Aug 22]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan. <br /> 10. Al-Shura AN. 12 - Channels receiving food, prana, and water. In: Al-Shura AN, editor. Ayurvedic Perspectives in Integrative Healthcare: Academic Press; 2020. p. 109-15.<br /> 11. Mazess RB, Barden HS, Bisek JP, Hanson J. Dual-energy x-ray absorptiometry for total-body and regional bone-mineral and soft-tissue composition. Am J ClinNutr. 1990;51:1106–1112.<br /> 12. Dempster P, Aitkens S. A new air displacement method for the determination of human body composition. Med Sci Sports Exerc. 1995;27:1692–1697.<br /> 13. Rebouche CJ, Pearson GA, Serfass RE, Roth CW, Finley JW. Evaluation of nuclear magnetic resonance spectroscopy for determination of deuterium abundance in body fluids: application to measurement of total-body water in human infants. Am J ClinNutr. 1987;45:373–380.<br /> 14. NIH Consensus Statement. Bioelectrical impedance analysis in body composition measurement. National Institutes of Health Technology Assessment Conference Statement. December 12-14, 1994. Nutrition. 1996;12:749–762.<br /> 15. Beertema W, van Hezewijk M, Kester A, Forget PP, van Kreel B. Measurement of total body water in children using bioelectrical impedance: a comparison of several prediction equations. J PediatrGastroenterolNutr. 2000;31:428–432. <br /> 16. Sharma R..Trishna Chikitsa Adhyaya. In: Ojha S.N., Deole Y.S., Basisht G., eds. CharakSamhita New Edition. 1st ed. Jamnagar, Ind: CSRTSDC; 2020. https://www.carakasamhitaonline.com/mediawiki-1.32.1/index.php?title=Trishna_Chikitsa&amp;oldid=42725. Accessed April 6, 2023.<br /> 17. Teerthashree NS, Chetan M. Understanding of udakavahasrotas in shwasaroga. EPRA International Journal of Multidisciplinary Research (IJMR). 2022 May 12;8(5):63-8.<br /> 18. Rahangdale D, Kumar B, Dave HH, A Conceptual and Clinical Study to Understand The Principle of Sharira-Shaithilyata and UdakavahaSrotodushtiw.s.r. to KaphajaPrameha (Type II Diabetes Mellitus) JOA XIII-3, 2019; 14 - 21<br /> <br /> &lt;p/&gt;<br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> &lt;big&gt;'''[[Special:ContactMe|Send us your suggestions and feedback on this page.]]'''&lt;/big&gt;<br /> <br /> ==References==<br /> <br /> &lt;div id=&quot;BackToTop&quot; class=&quot;noprint&quot; style=&quot;background-color:#DDEFDD; position:fixed;<br /> bottom:32px; left:2%; z-index:9999; padding:0; margin:0;&quot;&gt;&lt;span style=&quot;color:blue;<br /> font-size:8pt; font-face:verdana,sans-serif; border:0.2em outset #ceebf7;<br /> padding:0.1em; font-weight:bolder; -moz-border-radius:8px; &quot;&gt;<br /> [[#top| Back to the Top ]]&lt;/span&gt;&lt;/div&gt;</div>

Manishdubey https://www.carakasamhitaonline.com/index.php?title=Talk:Udakavaha_Srotas&diff=44074 2023-10-10T13:36:14Z

<p>Manishdubey: </p> <hr /> <div>{{CiteButton}}<br /> {{#seo:<br /> |title= UDAKAVAHA SROTAS (Channels for transport and transformation of watery components)<br /> |titlemode=append<br /> |keywords=Udakavaha Srotas, Water metabolism, Bhojani M. K., Tanwar Ankur Kumar, Basisht G, Deole Y.S.<br /> |description=Udaka means water. In body, water is present in the form of various fluids. Udakavaha srotasa are the channels for transport and transformation of fluid (water) and its circulation. <br /> |image=http://www.carakasamhitaonline.com/mediawiki-1.32.1/resources/assets/ogimgs.jpg<br /> |image_alt=carak samhita<br /> |type=article<br /> }}<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Udaka means water. In [[Sharira|body]], water is present in the form of various fluids. Udakavaha srotasa are the channels for transport and transformation of fluid (water) and its circulation. They are the pathways that originate from the palate (talu) or kloma (an internal organ controlling thirst) through which fluids circulate throughout the body. [Code:SAT-B.475]&lt;ref name=&quot;ref1&quot;&gt;National AYUSH Morbidity and Standardized Terminologies Electronic Portal by Ministry of AYUSH Available on http://namstp.ayush.gov.in/#/Ayurveda&lt;/ref&gt; A water-based solution of ions and other compounds makes up most of the adult human body's 60% fluid content. Water makes up most of a cell's primary fluid medium except fat cells. It is present in most cells at a concentration of between 70 and 85 percent.[2] The human body uses water as a construction material, a lubricant, a shock absorber, a solvent, a reaction medium, and a reactant. It also serves as a transporter for nutrients and waste products. Water balance must be managed for the preservation of health and life.[3] So udakavaha srotas are the channels for regulating the water homeostasis in the human body, and failure to do the same can lead to death. This article deals with physiological, pathological and therapeutic aspects of udakavaha srotasa. &lt;/p&gt;<br /> <br /> {{Infobox<br /> |title = Contributors<br /> |label1 = Section/Chapter/topic<br /> |data1 = Concepts/[[Srotas]][[Udakavaha Srotas]] <br /> |label2 = Authors<br /> |data2 = Bhojani M. K. &lt;sup&gt;1&lt;/sup&gt;, Tanwar Ankur Kumar &lt;sup&gt;1&lt;/sup&gt; <br /> |label3 = Reviewer <br /> |data3 = Basisht G.&lt;sup&gt;2&lt;/sup&gt;<br /> |label3 = Editor<br /> |data3 = Deole Y.S.&lt;sup&gt;3&lt;/sup&gt;<br /> |label4 = Affiliations<br /> |data4 = &lt;sup&gt;1&lt;/sup&gt; Department of Sharir Kriya, All India Institute of Ayurveda, New Delhi, India<br /> &lt;sup&gt;2&lt;/sup&gt; Rheumatologist, Orlando, Florida, U.S.A.<br /> &lt;sup&gt;3&lt;/sup&gt; Department of Kayachikitsa, G. J. Patel Institute of Ayurvedic Studies and Research, New Vallabh Vidyanagar, Gujarat, India <br /> |label5 = Correspondence emails<br /> |data5 = [mailto:meera.samhita@aiia.gov.in meera.samhita@aiia.gov.in],&lt;br/&gt; [mailto:carakasamhita@gmail.com carakasamhita@gmail.com]<br /> |label6 = Publisher <br /> |data6 = [[Charak Samhita Research, Training and Development Centre]], I.T.R.A., Jamnagar, India<br /> |label7 = Date of publication:<br /> |data7 = October 10, 2023<br /> |label8 = DOI<br /> |data8 = {{DoiWithLink}}<br /> }}<br /> <br /> == Etymology and derivation:==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;The word udaka is derived from root “undi kledane”.[4] It implies that thing which is to wet is udaka. <br /> &lt;br/&gt;The word srotas is derived from Sanskrit root “sru”.[4] Meaing of sru is to secrete, to flow. Acharya sushruta defines srotas as tubular structures through which fluid material circulates in the body.[5] [Su. Sa. Sharira Sthana 09/13] Dalhana mentioned two important characteristics of srotas: 1. Passage for fluid (abhivahanshila) and 2. Hollow space to flow (avakash).[5] [Dalhan on Su. Sa. ShariraSthana 09/13] Srotas, according to acharya Charak, is a structure through which anything is conveyed or flows. [Cha. Sa. Sutra Sthana 30/12] Udakavaha srotas are the channels for water regulation.<br /> &lt;/p&gt;<br /> <br /> ==Synonyms: ==<br /> '''Udaka:''' apa, vari, salil, kamal, jalam, payas, water. [4][6]<br /> &lt;br/&gt;'''Srotas:''' ambusarana,svatasan, [4]sira, dhamani, rasayani, rasavahini, nadi, pantha, marga, sharirachhidra, samritasavritta, Sthana, ashaya, niketa[Cha. Sa. Vimana Sthana 05/09], yogvahi[5] [Su. Sa. Sharira Sthana 05/05], a wave, the flow, a current, the canal of nutrients in the body.[6]<br /> &lt;br/&gt;'''Udakavaha srotas:''' ambuvaha[Cha. Sa. Vimana Sthana 05/9] [Cha. Sa. Chikitsa Sthana 28/8], rasavahini [Cha. Sa. Chikitsa Sthana 22/06], water regulating system.<br /> <br /> ==Origin (Srotomula)==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt; Acharya described the two roots of every srotas. In context of udakavaha srotas, the roots are palate (talu) and junction of throat &amp; chest (kloma). [Cha. Sa. Vimana Sthana 05/09] [Su. Sa. Sharira Sthana 09/12] [5]Acharya described these sites as root because in water imbalance, these organs first manifest the sign of thirst. The exact site of kloma is not defined but it’s the main controlling center for water regulation in the body. Acharya chakrapani described kloma as the site of thirst and mentioned that it is situated near the heart (hridyastha pipasa sthana).[Chakrapani on Cha. Sa. Vimana Sthana 05/08] Acharya Gangadhara described the site of kloma as the junction of throat and chest (Kantha urso sandhi). [Gangadhara on Cha. Sa. Vimana Sthana 05/08] <br /> The name &quot;kloma&quot; can be applied to mediastinum that is located at above mentioned sites. [7]<br /> Contemporary understanding of regulation of water is a feedback process involving the hypothalamus, the neurohypophysis, and the kidneys.[8] The main hormone that controls how much water the body retains is arginine vasopressin (AVP), commonly known as anti-diuretic hormone.[9]<br /> &lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;'''Etiological factors behind srotas abnormalities (sroto dushti hetu)'''&lt;/p&gt;<br /> [Cha. Sa. Vimana Sthana 05/11]These factors are:<br /> # Intake of hot food (aushnyat)<br /> # Indigestion (aamat)<br /> # Fear (bhayat)<br /> # Excessive intake of alcohol (panat)<br /> # Intake of excessive dry food article (arishuksha anna sevanat)<br /> # Habit of withholding the urge in excessive thirst (trishnaya cha atipidanat)<br /> All these factors contributed in dysregulation of water regulation. <br /> <br /> [[File:Etiological factor of udakavahasrotodusti|thumb]]<br /> &lt;center&gt;''''Figure 01: Etiological factor of udakavahasrotodusti''''&lt;/center&gt;<br /> <br /> <br /> '''Clinical features of srotas abnormality (srotodushti lakshana)'''[Cha. Sa. Vimana Sthana 05/11] <br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;1. Feeling of dryness of tongue (jihwa), palate (talu), lips (ostha), throat (kantha) and kloma.<br /> 2. Excessive thirst (pipasa) &lt;/p&gt;<br /> <br /> [[File:Figure 02- Udakavaha srotodushti lakshana..jpg|center]]<br /> &lt;center&gt;'''Figure 02: Udakavaha srotodushti lakshana'''&lt;/center&gt;<br /> <br /> ,,,Signs and symptoms of srotas injury(srotoviddha lakshana)'''<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Acharya Sushruta defined the clinical signs and symptoms related to injury or trauma to the udakavahasrotas.[5 ][Su. Sa. Sharira Sthana 09/12] Signs and symptoms of injury (srotoviddha) are:<br /> 1. Excessive thirst (pipasa)<br /> 2. Sudden death (sdayomarana)<br /> <br /> &lt;/p&gt;<br /> <br /> '''Disorders of srotas abnormality'''<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;The diseases due to vitiation of udakavaha srotas are:<br /> 1. Prameha (Urinary diseases including diabetes) [Cha. Sa. Chikitsa Sthana 06/08]<br /> 2. Trishna (Morbid thirst)[Cha. Sa. Chikitsa Sthana 22/06]<br /> 3. Atisara (Diarrhea and associated disorders) [Cha. Sa. Chikitsa Sthana 19/05-10]<br /> 4. Visuchika (Non-infectious gastroenteritis) [Cha. Sa. Vimana Sthana 02/10-11]<br /> 5. Hikka (Hiccups)[Cha. Sa. Chikitsa Sthana 17/21]<br /> 6. Shwasa(Dyspnea) [Cha. Sa. Chikitsa Sthana 17/45]<br /> 7. Udara roga(Generalised enlargement of abdomen)[Cha. Sa. Chikitsa Sthana 13/20] &lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Some other diseases may be included under udakavaha stotas disorders: [10]<br /> • Edema<br /> • Hydrocephalus<br /> • Increased intracranial pressure<br /> • Diarrhea<br /> • Craving for sour and pungent food Excessive use of salt and sugar<br /> • Diabetes<br /> • Excessive thirst with dry mouth<br /> • Dry skin<br /> • Profuse sweating<br /> • Profuse urination<br /> • Glaucoma &lt;/p&gt;<br /> <br /> '''Diagnostic and assessment tools:'''<br /> &lt;p style=&quot;text-align:justify;&quot;&gt; The condition of udakavaha srotas can be assessed by subjective methods like questionnaires and objective methods like blood investigations etc.. Udakavaha srotodushti can be assessed through a subjective questionnaire by which an ayurvedic physicians assess the normalcy and abnormality based on ayurvedic principles of examination (pariksha). Some of the objective methods which may be used to assess the normal functioning of udakavaha srotas are:<br /> 1. Urine routine examination for specific gravity, volume, ph etc.<br /> 2. Serum electrolyte (Sodium and potassium)<br /> 3. MRI Scan for hypothalamus abnormality<br /> 4. Blood sugar for assessing the abnormality.<br /> 5. Dual-energy X-ray absorptiometry (DEXA)[11]<br /> 6. Air displacement plethysmography,[12]<br /> 7. Nuclear magnetic resonance spectroscopy [13], and <br /> 8. Bioelectrical impedance analysis [14] [15]<br /> &lt;/p&gt;<br /> <br /> '''Treatment of srotas abnormality'''<br /> &lt;p style=&quot;text-align:justify;&quot;&gt; The treatment for the viation of udakavaha srotas should be done on the principles of management of thirst disorder (trishna chikitsa). [Cha. Sa. Vimana Sthana 05/26] [16] The signs and symptoms of udakavaha srotas vitiation are comparable to morbid thirst (trishna), which develops as a result of vata and pitta vitiation. Because both doshas have absorbent (shoshaka) properties that degrade the rasavaha and udakavaha srotas. This leads to persistent desire for water. Rain water is the best way to quench thirst. However, nowadays rainwater is rarely stored and used for drinking. Therefore water with a mild astringent flavour, light to digest, cold characteristics, nice scent and taste, and no channel obstructing qualities should be deemed comparable to rain water in effect. [16] &lt;/p&gt; <br /> <br /> <br /> '''Dosha governing the water metabolism'''<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Dosha are the physiological entity in human body governing all systems. For maintenance of water balance different dosha work in synergy to each other. Acharya Charak clearly described the relation between samana vayu and ambuvaha srotas. [Cha. Sa. Chikitsa Sthana 28/8] Samana vayu is situated in swedavaha, doshavaha and ambuvaha or udakavaha srotas. It showed the samana vayu is essential for maintainance of water regulation in human body. Along with samana vayu, pitta (pachaka) and kapha (bodhaka and kledaka) also help in water homeostasis. &lt;/p&gt;<br /> <br /> [[File:Dosha helpful in water metabolism.jpg|center|Figure 03: Dosha helpful in water metabolism.]]<br /> <br /> '''Future area of research'''<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;The future area of research is the preparation of a validated and standardized questionnaire for assessing the normalcy and abnormality of functioning of udakavaha srotas. Assessment of udakavaha srotas condition in various disease may be helpful in prognosis and treatment outcome. In various physiological conditions like pregnancy, lactation, childhood, old age, space, deep sea and high altitude, the udakavaha srotas assessment may be helpful to understand the dynamic changes occurred within the body. Animal studies to understand the anatomy and physiology of kloma may be helpful for future researches related to udakavaha srotas. &lt;/p&gt;<br /> <br /> ''Thesis works:'''<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;1. Dash Maheshwar (1985): Srotas in ayurveda with special reference to udakavaha srotras, Department of Basic Principles, B.H.U.Varanasi, India <br /> 2. Kambale V.(1997): Udakavaha srotas mulastana nischiti evam kloma tulanatmaka adhyayan, Department of sharir Rachana, Govt. Ayurveda Mahavidyalaya, Nanded. &lt;/p&gt;<br /> <br /> '''Current researches:'''<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt; Contemporary understanding of udakavaha srotas: The cerebrospinal fluid, salivary amylase, and digestive/hepatobiliary system secretions such HCL, bile, pancreatic lipase, and pancreatic amylase are all included in the udaka/ambuvaha srotas. It is also associated with rasa dhatu, which provides the fluid and oiliness needed to transport the necessary nutrients, lubricate various body processes, and support thermodynamic control.[10] &lt;/p&gt;<br /> <br /> <br /> '''Udakavaha srotas and shwasa roga:''' &lt;p style=&quot;text-align:justify;&quot;&gt;Shwasa roga (dysnoea) occurrs due to vitiation of prana, anna and udakavaha srotas. But understanding the role of udakavaha srotas is difficult. In causative factors of shwasa (nidana), the majority causes of udakavaha srotas dushti are covered. The five varieties of shwasa exhibit its clinical features. In shwasa chikitsa, additional liquid preparations are suggested in order to correct the body's water balance. So, this review helps to understand the role of udakavaha srotas in shwasa roga. [17] &lt;/p&gt;<br /> <br /> '''13.3 Udakavaha srotodushti with special reference to kapha dominant prameha (obstinate urinary disorders including diabetes):''' &lt;p style=&quot;text-align:justify;&quot;&gt; In order to comprehend the notion of looseness of body components (sharira shaithilya) in the pathogenesis (samprapti) of kapha dominant prameha and to assess the application of the essential ayurveda principles of udakavaha stroto dushti, a clinical research on 40 clinically confirmed patients of kapha dominant prameha was done. The study came to the conclusion that srotodushti and pathogenic factors should be taken into account while treating diabetic patients, so that we can focus on treating sroto dushti and its root as well as the illness.[18] &lt;/p&gt;<br /> <br /> '''References'''<br /> &lt;p style=&quot;text-align:justify;&quot;&gt; 1. National AYUSH Morbidity and Standardized Terminologies Electronic Portal by Ministry of AYUSH Available on http://namstp.ayush.gov.in/#/Ayurveda<br /> 2. A. C. Guyton and J. E. Hall, Textbook of Medical Physiology. 11th edition. Pennsylvania: Elsevier Saunders, 2006.<br /> 3. Jéquier E, Constant F. Water as an essential nutrient: the physiological basis of hydration. Eur J ClinNutr. 2010;64(2):115-23.<br /> 4. Amarkosha. Amarsimha, Edited by Pt. Haragovindasastri. Reprint Ed. Varanasi:Chaukhambha Sanskrit Sansthan, 2020.<br /> 5. Sushruta. SushrutaSamhita. Edited by JadavajiTrikamjiAacharya. 8th ed. Varanasi: ChaukhambhaOrientalia; 2005.<br /> 6. Monier-Williams, Monier William's Sanskrit-English Dictionary, 2nd Ed., Oxford University Press;1899.<br /> 7. Nanal VM. The organ kloma: a fresh appraisal. AncSci Life. 1989;9(2):61-5.<br /> 8. Knepper MA, Kwon TH, Nielsen S: Molecular Physiology of Water Balance. N Engl J Med 2015, 373(2):196.<br /> 9. Cuzzo B, Padala SA, Lappin SL. Physiology, Vasopressin. [Updated 2022 Aug 22]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan. <br /> 10. Al-Shura AN. 12 - Channels receiving food, prana, and water. In: Al-Shura AN, editor. Ayurvedic Perspectives in Integrative Healthcare: Academic Press; 2020. p. 109-15.<br /> 11. Mazess RB, Barden HS, Bisek JP, Hanson J. Dual-energy x-ray absorptiometry for total-body and regional bone-mineral and soft-tissue composition. Am J ClinNutr. 1990;51:1106–1112.<br /> 12. Dempster P, Aitkens S. A new air displacement method for the determination of human body composition. Med Sci Sports Exerc. 1995;27:1692–1697.<br /> 13. Rebouche CJ, Pearson GA, Serfass RE, Roth CW, Finley JW. Evaluation of nuclear magnetic resonance spectroscopy for determination of deuterium abundance in body fluids: application to measurement of total-body water in human infants. Am J ClinNutr. 1987;45:373–380.<br /> 14. NIH Consensus Statement. Bioelectrical impedance analysis in body composition measurement. National Institutes of Health Technology Assessment Conference Statement. December 12-14, 1994. Nutrition. 1996;12:749–762.<br /> 15. Beertema W, van Hezewijk M, Kester A, Forget PP, van Kreel B. Measurement of total body water in children using bioelectrical impedance: a comparison of several prediction equations. J PediatrGastroenterolNutr. 2000;31:428–432. <br /> 16. Sharma R..Trishna Chikitsa Adhyaya. In: Ojha S.N., Deole Y.S., Basisht G., eds. CharakSamhita New Edition. 1st ed. Jamnagar, Ind: CSRTSDC; 2020. https://www.carakasamhitaonline.com/mediawiki-1.32.1/index.php?title=Trishna_Chikitsa&amp;oldid=42725. Accessed April 6, 2023.<br /> 17. Teerthashree NS, Chetan M. Understanding of udakavahasrotas in shwasaroga. EPRA International Journal of Multidisciplinary Research (IJMR). 2022 May 12;8(5):63-8.<br /> 18. Rahangdale D, Kumar B, Dave HH, A Conceptual and Clinical Study to Understand The Principle of Sharira-Shaithilyata and UdakavahaSrotodushtiw.s.r. to KaphajaPrameha (Type II Diabetes Mellitus) JOA XIII-3, 2019; 14 - 21<br /> <br /> &lt;p/&gt;<br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> &lt;big&gt;'''[[Special:ContactMe|Send us your suggestions and feedback on this page.]]'''&lt;/big&gt;<br /> <br /> ==References==<br /> <br /> &lt;div id=&quot;BackToTop&quot; class=&quot;noprint&quot; style=&quot;background-color:#DDEFDD; position:fixed;<br /> bottom:32px; left:2%; z-index:9999; padding:0; margin:0;&quot;&gt;&lt;span style=&quot;color:blue;<br /> font-size:8pt; font-face:verdana,sans-serif; border:0.2em outset #ceebf7;<br /> padding:0.1em; font-weight:bolder; -moz-border-radius:8px; &quot;&gt;<br /> [[#top| Back to the Top ]]&lt;/span&gt;&lt;/div&gt;</div>

Manishdubey https://www.carakasamhitaonline.com/index.php?title=Talk:Udakavaha_Srotas&diff=44073 2023-10-10T13:34:20Z

<p>Manishdubey: </p> <hr /> <div>{{CiteButton}}<br /> {{#seo:<br /> |title= UDAKAVAHA SROTAS (Channels for transport and transformation of watery components)<br /> |titlemode=append<br /> |keywords=Udakavaha Srotas, Water metabolism, Bhojani M. K., Tanwar Ankur Kumar, Basisht G, Deole Y.S.<br /> |description=Udaka means water. In body, water is present in the form of various fluids. Udakavaha srotasa are the channels for transport and transformation of fluid (water) and its circulation. <br /> |image=http://www.carakasamhitaonline.com/mediawiki-1.32.1/resources/assets/ogimgs.jpg<br /> |image_alt=carak samhita<br /> |type=article<br /> }}<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Udaka means water. In [[Sharira|body]], water is present in the form of various fluids. Udakavaha srotasa are the channels for transport and transformation of fluid (water) and its circulation. They are the pathways that originate from the palate (talu) or kloma (an internal organ controlling thirst) through which fluids circulate throughout the body. [Code:SAT-B.475]&lt;ref name=&quot;ref1&quot;&gt;National AYUSH Morbidity and Standardized Terminologies Electronic Portal by Ministry of AYUSH Available on http://namstp.ayush.gov.in/#/Ayurveda&lt;/ref&gt; A water-based solution of ions and other compounds makes up most of the adult human body's 60% fluid content. Water makes up most of a cell's primary fluid medium except fat cells. It is present in most cells at a concentration of between 70 and 85 percent.[2] The human body uses water as a construction material, a lubricant, a shock absorber, a solvent, a reaction medium, and a reactant. It also serves as a transporter for nutrients and waste products. Water balance must be managed for the preservation of health and life.[3] So udakavaha srotas are the channels for regulating the water homeostasis in the human body, and failure to do the same can lead to death. This article deals with physiological, pathological and therapeutic aspects of udakavaha srotasa. &lt;/p&gt;<br /> <br /> {{Infobox<br /> |title = Contributors<br /> |label1 = Section/Chapter/topic<br /> |data1 = Concepts/[[Srotas]][[Udakavaha Srotas]] <br /> |label2 = Authors<br /> |data2 = Bhojani M. K. &lt;sup&gt;1&lt;/sup&gt;, Tanwar Ankur Kumar &lt;sup&gt;1&lt;/sup&gt; <br /> |label3 = Reviewer <br /> |data3 = Basisht G.&lt;sup&gt;2&lt;/sup&gt;<br /> |label3 = Editor<br /> |data3 = Deole Y.S.&lt;sup&gt;3&lt;/sup&gt;<br /> |label4 = Affiliations<br /> |data4 = &lt;sup&gt;1&lt;/sup&gt; Department of Sharir Kriya, All India Institute of Ayurveda, New Delhi, India<br /> &lt;sup&gt;2&lt;/sup&gt; Rheumatologist, Orlando, Florida, U.S.A.<br /> &lt;sup&gt;3&lt;/sup&gt; Department of Kayachikitsa, G. J. Patel Institute of Ayurvedic Studies and Research, New Vallabh Vidyanagar, Gujarat, India <br /> |label5 = Correspondence emails<br /> |data5 = [mailto:meera.samhita@aiia.gov.in meera.samhita@aiia.gov.in],&lt;br/&gt; [mailto:carakasamhita@gmail.com carakasamhita@gmail.com]<br /> |label6 = Publisher <br /> |data6 = [[Charak Samhita Research, Training and Development Centre]], I.T.R.A., Jamnagar, India<br /> |label7 = Date of publication:<br /> |data7 = October 10, 2023<br /> |label8 = DOI<br /> |data8 = {{DoiWithLink}}<br /> }}<br /> <br /> == Etymology and derivation:==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;The word udaka is derived from root “undi kledane”.[4] It implies that thing which is to wet is udaka. <br /> &lt;br/&gt;The word srotas is derived from Sanskrit root “sru”.[4] Meaing of sru is to secrete, to flow. Acharya sushruta defines srotas as tubular structures through which fluid material circulates in the body.[5] [Su. Sa. Sharira Sthana 09/13] Dalhana mentioned two important characteristics of srotas: 1. Passage for fluid (abhivahanshila) and 2. Hollow space to flow (avakash).[5] [Dalhan on Su. Sa. ShariraSthana 09/13] Srotas, according to acharya Charak, is a structure through which anything is conveyed or flows. [Cha. Sa. Sutra Sthana 30/12] Udakavaha srotas are the channels for water regulation.<br /> &lt;/p&gt;<br /> <br /> ==Synonyms: ==<br /> '''Udaka:''' apa, vari, salil, kamal, jalam, payas, water. [4][6]<br /> &lt;br/&gt;'''Srotas:''' ambusarana,svatasan, [4]sira, dhamani, rasayani, rasavahini, nadi, pantha, marga, sharirachhidra, samritasavritta, Sthana, ashaya, niketa[Cha. Sa. Vimana Sthana 05/09], yogvahi[5] [Su. Sa. Sharira Sthana 05/05], a wave, the flow, a current, the canal of nutrients in the body.[6]<br /> &lt;br/&gt;'''Udakavaha srotas:''' ambuvaha[Cha. Sa. Vimana Sthana 05/9] [Cha. Sa. Chikitsa Sthana 28/8], rasavahini [Cha. Sa. Chikitsa Sthana 22/06], water regulating system.<br /> <br /> ==Origin (Srotomula)==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt; Acharya described the two roots of every srotas. In context of udakavaha srotas, the roots are palate (talu) and junction of throat &amp; chest (kloma). [Cha. Sa. Vimana Sthana 05/09] [Su. Sa. Sharira Sthana 09/12] [5]Acharya described these sites as root because in water imbalance, these organs first manifest the sign of thirst. The exact site of kloma is not defined but it’s the main controlling center for water regulation in the body. Acharya chakrapani described kloma as the site of thirst and mentioned that it is situated near the heart (hridyastha pipasa sthana).[Chakrapani on Cha. Sa. Vimana Sthana 05/08] Acharya Gangadhara described the site of kloma as the junction of throat and chest (Kantha urso sandhi). [Gangadhara on Cha. Sa. Vimana Sthana 05/08] <br /> The name &quot;kloma&quot; can be applied to mediastinum that is located at above mentioned sites. [7]<br /> Contemporary understanding of regulation of water is a feedback process involving the hypothalamus, the neurohypophysis, and the kidneys.[8] The main hormone that controls how much water the body retains is arginine vasopressin (AVP), commonly known as anti-diuretic hormone.[9]<br /> &lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;'''Etiological factors behind srotas abnormalities (sroto dushti hetu)'''&lt;/p&gt;<br /> [Cha. Sa. Vimana Sthana 05/11]These factors are:<br /> # Intake of hot food (aushnyat)<br /> # Indigestion (aamat)<br /> # Fear (bhayat)<br /> # Excessive intake of alcohol (panat)<br /> # Intake of excessive dry food article (arishuksha anna sevanat)<br /> # Habit of withholding the urge in excessive thirst (trishnaya cha atipidanat)<br /> All these factors contributed in dysregulation of water regulation. <br /> <br /> [[File:Figure 01-Etiological factor of udakavahasrotodusti.jpg|center]]<br /> &lt;center&gt;''''Figure 01: Etiological factor of udakavahasrotodusti''''&lt;/center&gt;<br /> <br /> <br /> '''Clinical features of srotas abnormality (srotodushti lakshana)'''[Cha. Sa. Vimana Sthana 05/11] <br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;1. Feeling of dryness of tongue (jihwa), palate (talu), lips (ostha), throat (kantha) and kloma.<br /> 2. Excessive thirst (pipasa) &lt;/p&gt;<br /> <br /> [[File:Figure 02- Udakavaha srotodushti lakshana..jpg|center]]<br /> &lt;center&gt;'''Figure 02: Udakavaha srotodushti lakshana'''&lt;/center&gt;<br /> <br /> ,,,Signs and symptoms of srotas injury(srotoviddha lakshana)'''<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Acharya Sushruta defined the clinical signs and symptoms related to injury or trauma to the udakavahasrotas.[5 ][Su. Sa. Sharira Sthana 09/12] Signs and symptoms of injury (srotoviddha) are:<br /> 1. Excessive thirst (pipasa)<br /> 2. Sudden death (sdayomarana)<br /> <br /> &lt;/p&gt;<br /> <br /> '''Disorders of srotas abnormality'''<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;The diseases due to vitiation of udakavaha srotas are:<br /> 1. Prameha (Urinary diseases including diabetes) [Cha. Sa. Chikitsa Sthana 06/08]<br /> 2. Trishna (Morbid thirst)[Cha. Sa. Chikitsa Sthana 22/06]<br /> 3. Atisara (Diarrhea and associated disorders) [Cha. Sa. Chikitsa Sthana 19/05-10]<br /> 4. Visuchika (Non-infectious gastroenteritis) [Cha. Sa. Vimana Sthana 02/10-11]<br /> 5. Hikka (Hiccups)[Cha. Sa. Chikitsa Sthana 17/21]<br /> 6. Shwasa(Dyspnea) [Cha. Sa. Chikitsa Sthana 17/45]<br /> 7. Udara roga(Generalised enlargement of abdomen)[Cha. Sa. Chikitsa Sthana 13/20] &lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Some other diseases may be included under udakavaha stotas disorders: [10]<br /> • Edema<br /> • Hydrocephalus<br /> • Increased intracranial pressure<br /> • Diarrhea<br /> • Craving for sour and pungent food Excessive use of salt and sugar<br /> • Diabetes<br /> • Excessive thirst with dry mouth<br /> • Dry skin<br /> • Profuse sweating<br /> • Profuse urination<br /> • Glaucoma &lt;/p&gt;<br /> <br /> '''Diagnostic and assessment tools:'''<br /> &lt;p style=&quot;text-align:justify;&quot;&gt; The condition of udakavaha srotas can be assessed by subjective methods like questionnaires and objective methods like blood investigations etc.. Udakavaha srotodushti can be assessed through a subjective questionnaire by which an ayurvedic physicians assess the normalcy and abnormality based on ayurvedic principles of examination (pariksha). Some of the objective methods which may be used to assess the normal functioning of udakavaha srotas are:<br /> 1. Urine routine examination for specific gravity, volume, ph etc.<br /> 2. Serum electrolyte (Sodium and potassium)<br /> 3. MRI Scan for hypothalamus abnormality<br /> 4. Blood sugar for assessing the abnormality.<br /> 5. Dual-energy X-ray absorptiometry (DEXA)[11]<br /> 6. Air displacement plethysmography,[12]<br /> 7. Nuclear magnetic resonance spectroscopy [13], and <br /> 8. Bioelectrical impedance analysis [14] [15]<br /> &lt;/p&gt;<br /> <br /> '''Treatment of srotas abnormality'''<br /> &lt;p style=&quot;text-align:justify;&quot;&gt; The treatment for the viation of udakavaha srotas should be done on the principles of management of thirst disorder (trishna chikitsa). [Cha. Sa. Vimana Sthana 05/26] [16] The signs and symptoms of udakavaha srotas vitiation are comparable to morbid thirst (trishna), which develops as a result of vata and pitta vitiation. Because both doshas have absorbent (shoshaka) properties that degrade the rasavaha and udakavaha srotas. This leads to persistent desire for water. Rain water is the best way to quench thirst. However, nowadays rainwater is rarely stored and used for drinking. Therefore water with a mild astringent flavour, light to digest, cold characteristics, nice scent and taste, and no channel obstructing qualities should be deemed comparable to rain water in effect. [16] &lt;/p&gt; <br /> <br /> <br /> '''Dosha governing the water metabolism'''<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Dosha are the physiological entity in human body governing all systems. For maintenance of water balance different dosha work in synergy to each other. Acharya Charak clearly described the relation between samana vayu and ambuvaha srotas. [Cha. Sa. Chikitsa Sthana 28/8] Samana vayu is situated in swedavaha, doshavaha and ambuvaha or udakavaha srotas. It showed the samana vayu is essential for maintainance of water regulation in human body. Along with samana vayu, pitta (pachaka) and kapha (bodhaka and kledaka) also help in water homeostasis. &lt;/p&gt;<br /> <br /> [[File:Dosha helpful in water metabolism.jpg|center|Figure 03: Dosha helpful in water metabolism.]]<br /> <br /> '''Future area of research'''<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;The future area of research is the preparation of a validated and standardized questionnaire for assessing the normalcy and abnormality of functioning of udakavaha srotas. Assessment of udakavaha srotas condition in various disease may be helpful in prognosis and treatment outcome. In various physiological conditions like pregnancy, lactation, childhood, old age, space, deep sea and high altitude, the udakavaha srotas assessment may be helpful to understand the dynamic changes occurred within the body. Animal studies to understand the anatomy and physiology of kloma may be helpful for future researches related to udakavaha srotas. &lt;/p&gt;<br /> <br /> ''Thesis works:'''<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;1. Dash Maheshwar (1985): Srotas in ayurveda with special reference to udakavaha srotras, Department of Basic Principles, B.H.U.Varanasi, India <br /> 2. Kambale V.(1997): Udakavaha srotas mulastana nischiti evam kloma tulanatmaka adhyayan, Department of sharir Rachana, Govt. Ayurveda Mahavidyalaya, Nanded. &lt;/p&gt;<br /> <br /> '''Current researches:'''<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt; Contemporary understanding of udakavaha srotas: The cerebrospinal fluid, salivary amylase, and digestive/hepatobiliary system secretions such HCL, bile, pancreatic lipase, and pancreatic amylase are all included in the udaka/ambuvaha srotas. It is also associated with rasa dhatu, which provides the fluid and oiliness needed to transport the necessary nutrients, lubricate various body processes, and support thermodynamic control.[10] &lt;/p&gt;<br /> <br /> <br /> '''Udakavaha srotas and shwasa roga:''' &lt;p style=&quot;text-align:justify;&quot;&gt;Shwasa roga (dysnoea) occurrs due to vitiation of prana, anna and udakavaha srotas. But understanding the role of udakavaha srotas is difficult. In causative factors of shwasa (nidana), the majority causes of udakavaha srotas dushti are covered. The five varieties of shwasa exhibit its clinical features. In shwasa chikitsa, additional liquid preparations are suggested in order to correct the body's water balance. So, this review helps to understand the role of udakavaha srotas in shwasa roga. [17] &lt;/p&gt;<br /> <br /> '''13.3 Udakavaha srotodushti with special reference to kapha dominant prameha (obstinate urinary disorders including diabetes):''' &lt;p style=&quot;text-align:justify;&quot;&gt; In order to comprehend the notion of looseness of body components (sharira shaithilya) in the pathogenesis (samprapti) of kapha dominant prameha and to assess the application of the essential ayurveda principles of udakavaha stroto dushti, a clinical research on 40 clinically confirmed patients of kapha dominant prameha was done. The study came to the conclusion that srotodushti and pathogenic factors should be taken into account while treating diabetic patients, so that we can focus on treating sroto dushti and its root as well as the illness.[18] &lt;/p&gt;<br /> <br /> '''References'''<br /> &lt;p style=&quot;text-align:justify;&quot;&gt; 1. National AYUSH Morbidity and Standardized Terminologies Electronic Portal by Ministry of AYUSH Available on http://namstp.ayush.gov.in/#/Ayurveda<br /> 2. A. C. Guyton and J. E. Hall, Textbook of Medical Physiology. 11th edition. Pennsylvania: Elsevier Saunders, 2006.<br /> 3. Jéquier E, Constant F. Water as an essential nutrient: the physiological basis of hydration. Eur J ClinNutr. 2010;64(2):115-23.<br /> 4. Amarkosha. Amarsimha, Edited by Pt. Haragovindasastri. Reprint Ed. Varanasi:Chaukhambha Sanskrit Sansthan, 2020.<br /> 5. Sushruta. SushrutaSamhita. Edited by JadavajiTrikamjiAacharya. 8th ed. Varanasi: ChaukhambhaOrientalia; 2005.<br /> 6. Monier-Williams, Monier William's Sanskrit-English Dictionary, 2nd Ed., Oxford University Press;1899.<br /> 7. Nanal VM. The organ kloma: a fresh appraisal. AncSci Life. 1989;9(2):61-5.<br /> 8. Knepper MA, Kwon TH, Nielsen S: Molecular Physiology of Water Balance. N Engl J Med 2015, 373(2):196.<br /> 9. Cuzzo B, Padala SA, Lappin SL. Physiology, Vasopressin. [Updated 2022 Aug 22]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan. <br /> 10. Al-Shura AN. 12 - Channels receiving food, prana, and water. In: Al-Shura AN, editor. Ayurvedic Perspectives in Integrative Healthcare: Academic Press; 2020. p. 109-15.<br /> 11. Mazess RB, Barden HS, Bisek JP, Hanson J. Dual-energy x-ray absorptiometry for total-body and regional bone-mineral and soft-tissue composition. Am J ClinNutr. 1990;51:1106–1112.<br /> 12. Dempster P, Aitkens S. A new air displacement method for the determination of human body composition. Med Sci Sports Exerc. 1995;27:1692–1697.<br /> 13. Rebouche CJ, Pearson GA, Serfass RE, Roth CW, Finley JW. Evaluation of nuclear magnetic resonance spectroscopy for determination of deuterium abundance in body fluids: application to measurement of total-body water in human infants. Am J ClinNutr. 1987;45:373–380.<br /> 14. NIH Consensus Statement. Bioelectrical impedance analysis in body composition measurement. National Institutes of Health Technology Assessment Conference Statement. December 12-14, 1994. Nutrition. 1996;12:749–762.<br /> 15. Beertema W, van Hezewijk M, Kester A, Forget PP, van Kreel B. Measurement of total body water in children using bioelectrical impedance: a comparison of several prediction equations. J PediatrGastroenterolNutr. 2000;31:428–432. <br /> 16. Sharma R..Trishna Chikitsa Adhyaya. In: Ojha S.N., Deole Y.S., Basisht G., eds. CharakSamhita New Edition. 1st ed. Jamnagar, Ind: CSRTSDC; 2020. https://www.carakasamhitaonline.com/mediawiki-1.32.1/index.php?title=Trishna_Chikitsa&amp;oldid=42725. Accessed April 6, 2023.<br /> 17. Teerthashree NS, Chetan M. Understanding of udakavahasrotas in shwasaroga. EPRA International Journal of Multidisciplinary Research (IJMR). 2022 May 12;8(5):63-8.<br /> 18. Rahangdale D, Kumar B, Dave HH, A Conceptual and Clinical Study to Understand The Principle of Sharira-Shaithilyata and UdakavahaSrotodushtiw.s.r. to KaphajaPrameha (Type II Diabetes Mellitus) JOA XIII-3, 2019; 14 - 21<br /> <br /> &lt;p/&gt;<br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> &lt;big&gt;'''[[Special:ContactMe|Send us your suggestions and feedback on this page.]]'''&lt;/big&gt;<br /> <br /> ==References==<br /> <br /> &lt;div id=&quot;BackToTop&quot; class=&quot;noprint&quot; style=&quot;background-color:#DDEFDD; position:fixed;<br /> bottom:32px; left:2%; z-index:9999; padding:0; margin:0;&quot;&gt;&lt;span style=&quot;color:blue;<br /> font-size:8pt; font-face:verdana,sans-serif; border:0.2em outset #ceebf7;<br /> padding:0.1em; font-weight:bolder; -moz-border-radius:8px; &quot;&gt;<br /> [[#top| Back to the Top ]]&lt;/span&gt;&lt;/div&gt;</div>

Manishdubey https://www.carakasamhitaonline.com/index.php?title=Talk:Udakavaha_Srotas&diff=44072 2023-10-10T13:30:48Z

<p>Manishdubey: </p> <hr /> <div>{{CiteButton}}<br /> {{#seo:<br /> |title= UDAKAVAHA SROTAS (Channels for transport and transformation of watery components)<br /> |titlemode=append<br /> |keywords=Udakavaha Srotas, Water metabolism, Bhojani M. K., Tanwar Ankur Kumar, Basisht G, Deole Y.S.<br /> |description=Udaka means water. In body, water is present in the form of various fluids. Udakavaha srotasa are the channels for transport and transformation of fluid (water) and its circulation. <br /> |image=http://www.carakasamhitaonline.com/mediawiki-1.32.1/resources/assets/ogimgs.jpg<br /> |image_alt=carak samhita<br /> |type=article<br /> }}<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Udaka means water. In [[Sharira|body]], water is present in the form of various fluids. Udakavaha srotasa are the channels for transport and transformation of fluid (water) and its circulation. They are the pathways that originate from the palate (talu) or kloma (an internal organ controlling thirst) through which fluids circulate throughout the body. [Code:SAT-B.475]&lt;ref name=&quot;ref1&quot;&gt;National AYUSH Morbidity and Standardized Terminologies Electronic Portal by Ministry of AYUSH Available on http://namstp.ayush.gov.in/#/Ayurveda&lt;/ref&gt; A water-based solution of ions and other compounds makes up most of the adult human body's 60% fluid content. Water makes up most of a cell's primary fluid medium except fat cells. It is present in most cells at a concentration of between 70 and 85 percent.[2] The human body uses water as a construction material, a lubricant, a shock absorber, a solvent, a reaction medium, and a reactant. It also serves as a transporter for nutrients and waste products. Water balance must be managed for the preservation of health and life.[3] So udakavaha srotas are the channels for regulating the water homeostasis in the human body, and failure to do the same can lead to death. This article deals with physiological, pathological and therapeutic aspects of udakavaha srotasa. &lt;/p&gt;<br /> <br /> {{Infobox<br /> |title = Contributors<br /> |label1 = Section/Chapter/topic<br /> |data1 = Concepts/[[Srotas]][[Udakavaha Srotas]] <br /> |label2 = Authors<br /> |data2 = Bhojani M. K. &lt;sup&gt;1&lt;/sup&gt;, Tanwar Ankur Kumar &lt;sup&gt;1&lt;/sup&gt; <br /> |label3 = Reviewer <br /> |data3 = Basisht G.&lt;sup&gt;2&lt;/sup&gt;<br /> |label3 = Editor<br /> |data3 = Deole Y.S.&lt;sup&gt;3&lt;/sup&gt;<br /> |label4 = Affiliations<br /> |data4 = &lt;sup&gt;1&lt;/sup&gt; Department of Sharir Kriya, All India Institute of Ayurveda, New Delhi, India<br /> &lt;sup&gt;2&lt;/sup&gt; Rheumatologist, Orlando, Florida, U.S.A.<br /> &lt;sup&gt;3&lt;/sup&gt; Department of Kayachikitsa, G. J. Patel Institute of Ayurvedic Studies and Research, New Vallabh Vidyanagar, Gujarat, India <br /> |label5 = Correspondence emails<br /> |data5 = [mailto:meera.samhita@aiia.gov.in meera.samhita@aiia.gov.in],&lt;br/&gt; [mailto:carakasamhita@gmail.com carakasamhita@gmail.com]<br /> |label6 = Publisher <br /> |data6 = [[Charak Samhita Research, Training and Development Centre]], I.T.R.A., Jamnagar, India<br /> |label7 = Date of publication:<br /> |data7 = October 10, 2023<br /> |label8 = DOI<br /> |data8 = {{DoiWithLink}}<br /> }}<br /> <br /> == Etymology and derivation:==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;The word udaka is derived from root “undi kledane”.[4] It implies that thing which is to wet is udaka. <br /> &lt;br/&gt;The word srotas is derived from Sanskrit root “sru”.[4] Meaing of sru is to secrete, to flow. Acharya sushruta defines srotas as tubular structures through which fluid material circulates in the body.[5] [Su. Sa. Sharira Sthana 09/13] Dalhana mentioned two important characteristics of srotas: 1. Passage for fluid (abhivahanshila) and 2. Hollow space to flow (avakash).[5] [Dalhan on Su. Sa. ShariraSthana 09/13] Srotas, according to acharya Charak, is a structure through which anything is conveyed or flows. [Cha. Sa. Sutra Sthana 30/12] Udakavaha srotas are the channels for water regulation.<br /> &lt;/p&gt;<br /> <br /> ==Synonyms: ==<br /> '''Udaka:''' apa, vari, salil, kamal, jalam, payas, water. [4][6]<br /> &lt;br/&gt;'''Srotas:''' ambusarana,svatasan, [4]sira, dhamani, rasayani, rasavahini, nadi, pantha, marga, sharirachhidra, samritasavritta, Sthana, ashaya, niketa[Cha. Sa. Vimana Sthana 05/09], yogvahi[5] [Su. Sa. Sharira Sthana 05/05], a wave, the flow, a current, the canal of nutrients in the body.[6]<br /> &lt;br/&gt;'''Udakavaha srotas:''' ambuvaha[Cha. Sa. Vimana Sthana 05/9] [Cha. Sa. Chikitsa Sthana 28/8], rasavahini [Cha. Sa. Chikitsa Sthana 22/06], water regulating system.<br /> <br /> ==Origin (Srotomula)==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt; Acharya described the two roots of every srotas. In context of udakavaha srotas, the roots are palate (talu) and junction of throat &amp; chest (kloma). [Cha. Sa. Vimana Sthana 05/09] [Su. Sa. Sharira Sthana 09/12] [5]Acharya described these sites as root because in water imbalance, these organs first manifest the sign of thirst. The exact site of kloma is not defined but it’s the main controlling center for water regulation in the body. Acharya chakrapani described kloma as the site of thirst and mentioned that it is situated near the heart (hridyastha pipasa sthana).[Chakrapani on Cha. Sa. Vimana Sthana 05/08] Acharya Gangadhara described the site of kloma as the junction of throat and chest (Kantha urso sandhi). [Gangadhara on Cha. Sa. Vimana Sthana 05/08] <br /> The name &quot;kloma&quot; can be applied to mediastinum that is located at above mentioned sites. [7]<br /> Contemporary understanding of regulation of water is a feedback process involving the hypothalamus, the neurohypophysis, and the kidneys.[8] The main hormone that controls how much water the body retains is arginine vasopressin (AVP), commonly known as anti-diuretic hormone.[9]<br /> &lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;'''Etiological factors behind srotas abnormalities (sroto dushti hetu)'''&lt;/p&gt;<br /> [Cha. Sa. Vimana Sthana 05/11]These factors are:<br /> # Intake of hot food (aushnyat)<br /> # Indigestion (aamat)<br /> # Fear (bhayat)<br /> # Excessive intake of alcohol (panat)<br /> # Intake of excessive dry food article (arishuksha anna sevanat)<br /> # Habit of withholding the urge in excessive thirst (trishnaya cha atipidanat)<br /> All these factors contributed in dysregulation of water regulation. <br /> <br /> [[File:Figure 01-Etiological factor of udakavahasrotodusti..jpg|center]]<br /> &lt;center&gt;''''Figure 01: Etiological factor of udakavahasrotodusti''''&lt;/center&gt;<br /> <br /> <br /> '''Clinical features of srotas abnormality (srotodushti lakshana)'''[Cha. Sa. Vimana Sthana 05/11] <br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;1. Feeling of dryness of tongue (jihwa), palate (talu), lips (ostha), throat (kantha) and kloma.<br /> 2. Excessive thirst (pipasa) &lt;/p&gt;<br /> <br /> [[File:Figure 02- Udakavaha srotodushti lakshana..jpg|center]]<br /> &lt;center&gt;'''Figure 02: Udakavaha srotodushti lakshana'''&lt;/center&gt;<br /> <br /> ,,,Signs and symptoms of srotas injury(srotoviddha lakshana)'''<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Acharya Sushruta defined the clinical signs and symptoms related to injury or trauma to the udakavahasrotas.[5 ][Su. Sa. Sharira Sthana 09/12] Signs and symptoms of injury (srotoviddha) are:<br /> 1. Excessive thirst (pipasa)<br /> 2. Sudden death (sdayomarana)<br /> <br /> &lt;/p&gt;<br /> <br /> '''Disorders of srotas abnormality'''<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;The diseases due to vitiation of udakavaha srotas are:<br /> 1. Prameha (Urinary diseases including diabetes) [Cha. Sa. Chikitsa Sthana 06/08]<br /> 2. Trishna (Morbid thirst)[Cha. Sa. Chikitsa Sthana 22/06]<br /> 3. Atisara (Diarrhea and associated disorders) [Cha. Sa. Chikitsa Sthana 19/05-10]<br /> 4. Visuchika (Non-infectious gastroenteritis) [Cha. Sa. Vimana Sthana 02/10-11]<br /> 5. Hikka (Hiccups)[Cha. Sa. Chikitsa Sthana 17/21]<br /> 6. Shwasa(Dyspnea) [Cha. Sa. Chikitsa Sthana 17/45]<br /> 7. Udara roga(Generalised enlargement of abdomen)[Cha. Sa. Chikitsa Sthana 13/20] &lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Some other diseases may be included under udakavaha stotas disorders: [10]<br /> • Edema<br /> • Hydrocephalus<br /> • Increased intracranial pressure<br /> • Diarrhea<br /> • Craving for sour and pungent food Excessive use of salt and sugar<br /> • Diabetes<br /> • Excessive thirst with dry mouth<br /> • Dry skin<br /> • Profuse sweating<br /> • Profuse urination<br /> • Glaucoma &lt;/p&gt;<br /> <br /> '''Diagnostic and assessment tools:'''<br /> &lt;p style=&quot;text-align:justify;&quot;&gt; The condition of udakavaha srotas can be assessed by subjective methods like questionnaires and objective methods like blood investigations etc.. Udakavaha srotodushti can be assessed through a subjective questionnaire by which an ayurvedic physicians assess the normalcy and abnormality based on ayurvedic principles of examination (pariksha). Some of the objective methods which may be used to assess the normal functioning of udakavaha srotas are:<br /> 1. Urine routine examination for specific gravity, volume, ph etc.<br /> 2. Serum electrolyte (Sodium and potassium)<br /> 3. MRI Scan for hypothalamus abnormality<br /> 4. Blood sugar for assessing the abnormality.<br /> 5. Dual-energy X-ray absorptiometry (DEXA)[11]<br /> 6. Air displacement plethysmography,[12]<br /> 7. Nuclear magnetic resonance spectroscopy [13], and <br /> 8. Bioelectrical impedance analysis [14] [15]<br /> &lt;/p&gt;<br /> <br /> '''Treatment of srotas abnormality'''<br /> &lt;p style=&quot;text-align:justify;&quot;&gt; The treatment for the viation of udakavaha srotas should be done on the principles of management of thirst disorder (trishna chikitsa). [Cha. Sa. Vimana Sthana 05/26] [16] The signs and symptoms of udakavaha srotas vitiation are comparable to morbid thirst (trishna), which develops as a result of vata and pitta vitiation. Because both doshas have absorbent (shoshaka) properties that degrade the rasavaha and udakavaha srotas. This leads to persistent desire for water. Rain water is the best way to quench thirst. However, nowadays rainwater is rarely stored and used for drinking. Therefore water with a mild astringent flavour, light to digest, cold characteristics, nice scent and taste, and no channel obstructing qualities should be deemed comparable to rain water in effect. [16] &lt;/p&gt; <br /> <br /> <br /> '''Dosha governing the water metabolism'''<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Dosha are the physiological entity in human body governing all systems. For maintenance of water balance different dosha work in synergy to each other. Acharya Charak clearly described the relation between samana vayu and ambuvaha srotas. [Cha. Sa. Chikitsa Sthana 28/8] Samana vayu is situated in swedavaha, doshavaha and ambuvaha or udakavaha srotas. It showed the samana vayu is essential for maintainance of water regulation in human body. Along with samana vayu, pitta (pachaka) and kapha (bodhaka and kledaka) also help in water homeostasis. &lt;/p&gt;<br /> <br /> [[File:Dosha helpful in water metabolism.jpg|center|Figure 03: Dosha helpful in water metabolism.]]<br /> <br /> '''Future area of research'''<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;The future area of research is the preparation of a validated and standardized questionnaire for assessing the normalcy and abnormality of functioning of udakavaha srotas. Assessment of udakavaha srotas condition in various disease may be helpful in prognosis and treatment outcome. In various physiological conditions like pregnancy, lactation, childhood, old age, space, deep sea and high altitude, the udakavaha srotas assessment may be helpful to understand the dynamic changes occurred within the body. Animal studies to understand the anatomy and physiology of kloma may be helpful for future researches related to udakavaha srotas. &lt;/p&gt;<br /> <br /> ''Thesis works:'''<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;1. Dash Maheshwar (1985): Srotas in ayurveda with special reference to udakavaha srotras, Department of Basic Principles, B.H.U.Varanasi, India <br /> 2. Kambale V.(1997): Udakavaha srotas mulastana nischiti evam kloma tulanatmaka adhyayan, Department of sharir Rachana, Govt. Ayurveda Mahavidyalaya, Nanded. &lt;/p&gt;<br /> <br /> '''Current researches:'''<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt; Contemporary understanding of udakavaha srotas: The cerebrospinal fluid, salivary amylase, and digestive/hepatobiliary system secretions such HCL, bile, pancreatic lipase, and pancreatic amylase are all included in the udaka/ambuvaha srotas. It is also associated with rasa dhatu, which provides the fluid and oiliness needed to transport the necessary nutrients, lubricate various body processes, and support thermodynamic control.[10] &lt;/p&gt;<br /> <br /> <br /> '''Udakavaha srotas and shwasa roga:''' &lt;p style=&quot;text-align:justify;&quot;&gt;Shwasa roga (dysnoea) occurrs due to vitiation of prana, anna and udakavaha srotas. But understanding the role of udakavaha srotas is difficult. In causative factors of shwasa (nidana), the majority causes of udakavaha srotas dushti are covered. The five varieties of shwasa exhibit its clinical features. In shwasa chikitsa, additional liquid preparations are suggested in order to correct the body's water balance. So, this review helps to understand the role of udakavaha srotas in shwasa roga. [17] &lt;/p&gt;<br /> <br /> '''13.3 Udakavaha srotodushti with special reference to kapha dominant prameha (obstinate urinary disorders including diabetes):''' &lt;p style=&quot;text-align:justify;&quot;&gt; In order to comprehend the notion of looseness of body components (sharira shaithilya) in the pathogenesis (samprapti) of kapha dominant prameha and to assess the application of the essential ayurveda principles of udakavaha stroto dushti, a clinical research on 40 clinically confirmed patients of kapha dominant prameha was done. The study came to the conclusion that srotodushti and pathogenic factors should be taken into account while treating diabetic patients, so that we can focus on treating sroto dushti and its root as well as the illness.[18] &lt;/p&gt;<br /> <br /> '''References'''<br /> &lt;p style=&quot;text-align:justify;&quot;&gt; 1. National AYUSH Morbidity and Standardized Terminologies Electronic Portal by Ministry of AYUSH Available on http://namstp.ayush.gov.in/#/Ayurveda<br /> 2. A. C. Guyton and J. E. Hall, Textbook of Medical Physiology. 11th edition. Pennsylvania: Elsevier Saunders, 2006.<br /> 3. Jéquier E, Constant F. Water as an essential nutrient: the physiological basis of hydration. Eur J ClinNutr. 2010;64(2):115-23.<br /> 4. Amarkosha. Amarsimha, Edited by Pt. Haragovindasastri. Reprint Ed. Varanasi:Chaukhambha Sanskrit Sansthan, 2020.<br /> 5. Sushruta. SushrutaSamhita. Edited by JadavajiTrikamjiAacharya. 8th ed. Varanasi: ChaukhambhaOrientalia; 2005.<br /> 6. Monier-Williams, Monier William's Sanskrit-English Dictionary, 2nd Ed., Oxford University Press;1899.<br /> 7. Nanal VM. The organ kloma: a fresh appraisal. AncSci Life. 1989;9(2):61-5.<br /> 8. Knepper MA, Kwon TH, Nielsen S: Molecular Physiology of Water Balance. N Engl J Med 2015, 373(2):196.<br /> 9. Cuzzo B, Padala SA, Lappin SL. Physiology, Vasopressin. [Updated 2022 Aug 22]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan. <br /> 10. Al-Shura AN. 12 - Channels receiving food, prana, and water. In: Al-Shura AN, editor. Ayurvedic Perspectives in Integrative Healthcare: Academic Press; 2020. p. 109-15.<br /> 11. Mazess RB, Barden HS, Bisek JP, Hanson J. Dual-energy x-ray absorptiometry for total-body and regional bone-mineral and soft-tissue composition. Am J ClinNutr. 1990;51:1106–1112.<br /> 12. Dempster P, Aitkens S. A new air displacement method for the determination of human body composition. Med Sci Sports Exerc. 1995;27:1692–1697.<br /> 13. Rebouche CJ, Pearson GA, Serfass RE, Roth CW, Finley JW. Evaluation of nuclear magnetic resonance spectroscopy for determination of deuterium abundance in body fluids: application to measurement of total-body water in human infants. Am J ClinNutr. 1987;45:373–380.<br /> 14. NIH Consensus Statement. Bioelectrical impedance analysis in body composition measurement. National Institutes of Health Technology Assessment Conference Statement. December 12-14, 1994. Nutrition. 1996;12:749–762.<br /> 15. Beertema W, van Hezewijk M, Kester A, Forget PP, van Kreel B. Measurement of total body water in children using bioelectrical impedance: a comparison of several prediction equations. J PediatrGastroenterolNutr. 2000;31:428–432. <br /> 16. Sharma R..Trishna Chikitsa Adhyaya. In: Ojha S.N., Deole Y.S., Basisht G., eds. CharakSamhita New Edition. 1st ed. Jamnagar, Ind: CSRTSDC; 2020. https://www.carakasamhitaonline.com/mediawiki-1.32.1/index.php?title=Trishna_Chikitsa&amp;oldid=42725. Accessed April 6, 2023.<br /> 17. Teerthashree NS, Chetan M. Understanding of udakavahasrotas in shwasaroga. EPRA International Journal of Multidisciplinary Research (IJMR). 2022 May 12;8(5):63-8.<br /> 18. Rahangdale D, Kumar B, Dave HH, A Conceptual and Clinical Study to Understand The Principle of Sharira-Shaithilyata and UdakavahaSrotodushtiw.s.r. to KaphajaPrameha (Type II Diabetes Mellitus) JOA XIII-3, 2019; 14 - 21<br /> <br /> &lt;p/&gt;<br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> &lt;big&gt;'''[[Special:ContactMe|Send us your suggestions and feedback on this page.]]'''&lt;/big&gt;<br /> <br /> ==References==<br /> <br /> &lt;div id=&quot;BackToTop&quot; class=&quot;noprint&quot; style=&quot;background-color:#DDEFDD; position:fixed;<br /> bottom:32px; left:2%; z-index:9999; padding:0; margin:0;&quot;&gt;&lt;span style=&quot;color:blue;<br /> font-size:8pt; font-face:verdana,sans-serif; border:0.2em outset #ceebf7;<br /> padding:0.1em; font-weight:bolder; -moz-border-radius:8px; &quot;&gt;<br /> [[#top| Back to the Top ]]&lt;/span&gt;&lt;/div&gt;</div>

Manishdubey https://www.carakasamhitaonline.com/index.php?title=Talk:Udakavaha_Srotas&diff=44071 2023-10-10T13:28:27Z

<p>Manishdubey: </p> <hr /> <div>{{CiteButton}}<br /> {{#seo:<br /> |title= UDAKAVAHA SROTAS (Channels for transport and transformation of watery components)<br /> |titlemode=append<br /> |keywords=Udakavaha Srotas, Water metabolism, Bhojani M. K., Tanwar Ankur Kumar, Basisht G, Deole Y.S.<br /> |description=Udaka means water. In body, water is present in the form of various fluids. Udakavaha srotasa are the channels for transport and transformation of fluid (water) and its circulation. <br /> |image=http://www.carakasamhitaonline.com/mediawiki-1.32.1/resources/assets/ogimgs.jpg<br /> |image_alt=carak samhita<br /> |type=article<br /> }}<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Udaka means water. In [[Sharira|body]], water is present in the form of various fluids. Udakavaha srotasa are the channels for transport and transformation of fluid (water) and its circulation. They are the pathways that originate from the palate (talu) or kloma (an internal organ controlling thirst) through which fluids circulate throughout the body. [Code:SAT-B.475]&lt;ref name=&quot;ref1&quot;&gt;National AYUSH Morbidity and Standardized Terminologies Electronic Portal by Ministry of AYUSH Available on http://namstp.ayush.gov.in/#/Ayurveda&lt;/ref&gt; A water-based solution of ions and other compounds makes up most of the adult human body's 60% fluid content. Water makes up most of a cell's primary fluid medium except fat cells. It is present in most cells at a concentration of between 70 and 85 percent.[2] The human body uses water as a construction material, a lubricant, a shock absorber, a solvent, a reaction medium, and a reactant. It also serves as a transporter for nutrients and waste products. Water balance must be managed for the preservation of health and life.[3] So udakavaha srotas are the channels for regulating the water homeostasis in the human body, and failure to do the same can lead to death. This article deals with physiological, pathological and therapeutic aspects of udakavaha srotasa. &lt;/p&gt;<br /> <br /> {{Infobox<br /> |title = Contributors<br /> |label1 = Section/Chapter/topic<br /> |data1 = Concepts/[[Srotas]][[Udakavaha Srotas]] <br /> |label2 = Authors<br /> |data2 = Bhojani M. K. &lt;sup&gt;1&lt;/sup&gt;, Tanwar Ankur Kumar &lt;sup&gt;1&lt;/sup&gt; <br /> |label3 = Reviewer <br /> |data3 = Basisht G.&lt;sup&gt;2&lt;/sup&gt;<br /> |label3 = Editor<br /> |data3 = Deole Y.S.&lt;sup&gt;3&lt;/sup&gt;<br /> |label4 = Affiliations<br /> |data4 = &lt;sup&gt;1&lt;/sup&gt; Department of Sharir Kriya, All India Institute of Ayurveda, New Delhi, India<br /> &lt;sup&gt;2&lt;/sup&gt; Rheumatologist, Orlando, Florida, U.S.A.<br /> &lt;sup&gt;3&lt;/sup&gt; Department of Kayachikitsa, G. J. Patel Institute of Ayurvedic Studies and Research, New Vallabh Vidyanagar, Gujarat, India <br /> |label5 = Correspondence emails<br /> |data5 = [mailto:meera.samhita@aiia.gov.in meera.samhita@aiia.gov.in],&lt;br/&gt; [mailto:carakasamhita@gmail.com carakasamhita@gmail.com]<br /> |label6 = Publisher <br /> |data6 = [[Charak Samhita Research, Training and Development Centre]], I.T.R.A., Jamnagar, India<br /> |label7 = Date of publication:<br /> |data7 = October 10, 2023<br /> |label8 = DOI<br /> |data8 = {{DoiWithLink}}<br /> }}<br /> <br /> == Etymology and derivation:==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;The word udaka is derived from root “undi kledane”.[4] It implies that thing which is to wet is udaka. <br /> &lt;br/&gt;The word srotas is derived from Sanskrit root “sru”.[4] Meaing of sru is to secrete, to flow. Acharya sushruta defines srotas as tubular structures through which fluid material circulates in the body.[5] [Su. Sa. Sharira Sthana 09/13] Dalhana mentioned two important characteristics of srotas: 1. Passage for fluid (abhivahanshila) and 2. Hollow space to flow (avakash).[5] [Dalhan on Su. Sa. ShariraSthana 09/13] Srotas, according to acharya Charak, is a structure through which anything is conveyed or flows. [Cha. Sa. Sutra Sthana 30/12] Udakavaha srotas are the channels for water regulation.<br /> &lt;/p&gt;<br /> <br /> ==Synonyms: ==<br /> '''Udaka:''' apa, vari, salil, kamal, jalam, payas, water. [4][6]<br /> &lt;br/&gt;'''Srotas:''' ambusarana,svatasan, [4]sira, dhamani, rasayani, rasavahini, nadi, pantha, marga, sharirachhidra, samritasavritta, Sthana, ashaya, niketa[Cha. Sa. Vimana Sthana 05/09], yogvahi[5] [Su. Sa. Sharira Sthana 05/05], a wave, the flow, a current, the canal of nutrients in the body.[6]<br /> &lt;br/&gt;'''Udakavaha srotas:''' ambuvaha[Cha. Sa. Vimana Sthana 05/9] [Cha. Sa. Chikitsa Sthana 28/8], rasavahini [Cha. Sa. Chikitsa Sthana 22/06], water regulating system.<br /> <br /> ==Origin (Srotomula)==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt; Acharya described the two roots of every srotas. In context of udakavaha srotas, the roots are palate (talu) and junction of throat &amp; chest (kloma). [Cha. Sa. Vimana Sthana 05/09] [Su. Sa. Sharira Sthana 09/12] [5]Acharya described these sites as root because in water imbalance, these organs first manifest the sign of thirst. The exact site of kloma is not defined but it’s the main controlling center for water regulation in the body. Acharya chakrapani described kloma as the site of thirst and mentioned that it is situated near the heart (hridyastha pipasa sthana).[Chakrapani on Cha. Sa. Vimana Sthana 05/08] Acharya Gangadhara described the site of kloma as the junction of throat and chest (Kantha urso sandhi). [Gangadhara on Cha. Sa. Vimana Sthana 05/08] <br /> The name &quot;kloma&quot; can be applied to mediastinum that is located at above mentioned sites. [7]<br /> Contemporary understanding of regulation of water is a feedback process involving the hypothalamus, the neurohypophysis, and the kidneys.[8] The main hormone that controls how much water the body retains is arginine vasopressin (AVP), commonly known as anti-diuretic hormone.[9]<br /> &lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;'''Etiological factors behind srotas abnormalities (sroto dushti hetu)'''&lt;/p&gt;<br /> [Cha. Sa. Vimana Sthana 05/11]These factors are:<br /> # Intake of hot food (aushnyat)<br /> # Indigestion (aamat)<br /> # Fear (bhayat)<br /> # Excessive intake of alcohol (panat)<br /> # Intake of excessive dry food article (arishuksha anna sevanat)<br /> # Habit of withholding the urge in excessive thirst (trishnaya cha atipidanat)<br /> All these factors contributed in dysregulation of water regulation. <br /> [[File:Etiological factor of udakavahasrotodusti.jpg|center]]<br /> [[File:Figure 01-Etiological factor of udakavahasrotodusti..jpg|center]]<br /> &lt;center&gt;''''Figure 01: Etiological factor of udakavahasrotodusti''''&lt;/center&gt;<br /> <br /> <br /> '''Clinical features of srotas abnormality (srotodushti lakshana)'''[Cha. Sa. Vimana Sthana 05/11] <br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;1. Feeling of dryness of tongue (jihwa), palate (talu), lips (ostha), throat (kantha) and kloma.<br /> 2. Excessive thirst (pipasa) &lt;/p&gt;<br /> <br /> [[File:Figure 02- Udakavaha srotodushti lakshana..jpg|center]]<br /> &lt;center&gt;'''Figure 02: Udakavaha srotodushti lakshana'''&lt;/center&gt;<br /> <br /> ,,,Signs and symptoms of srotas injury(srotoviddha lakshana)'''<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Acharya Sushruta defined the clinical signs and symptoms related to injury or trauma to the udakavahasrotas.[5 ][Su. Sa. Sharira Sthana 09/12] Signs and symptoms of injury (srotoviddha) are:<br /> 1. Excessive thirst (pipasa)<br /> 2. Sudden death (sdayomarana)<br /> <br /> &lt;/p&gt;<br /> <br /> '''Disorders of srotas abnormality'''<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;The diseases due to vitiation of udakavaha srotas are:<br /> 1. Prameha (Urinary diseases including diabetes) [Cha. Sa. Chikitsa Sthana 06/08]<br /> 2. Trishna (Morbid thirst)[Cha. Sa. Chikitsa Sthana 22/06]<br /> 3. Atisara (Diarrhea and associated disorders) [Cha. Sa. Chikitsa Sthana 19/05-10]<br /> 4. Visuchika (Non-infectious gastroenteritis) [Cha. Sa. Vimana Sthana 02/10-11]<br /> 5. Hikka (Hiccups)[Cha. Sa. Chikitsa Sthana 17/21]<br /> 6. Shwasa(Dyspnea) [Cha. Sa. Chikitsa Sthana 17/45]<br /> 7. Udara roga(Generalised enlargement of abdomen)[Cha. Sa. Chikitsa Sthana 13/20] &lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Some other diseases may be included under udakavaha stotas disorders: [10]<br /> • Edema<br /> • Hydrocephalus<br /> • Increased intracranial pressure<br /> • Diarrhea<br /> • Craving for sour and pungent food Excessive use of salt and sugar<br /> • Diabetes<br /> • Excessive thirst with dry mouth<br /> • Dry skin<br /> • Profuse sweating<br /> • Profuse urination<br /> • Glaucoma &lt;/p&gt;<br /> <br /> '''Diagnostic and assessment tools:'''<br /> &lt;p style=&quot;text-align:justify;&quot;&gt; The condition of udakavaha srotas can be assessed by subjective methods like questionnaires and objective methods like blood investigations etc.. Udakavaha srotodushti can be assessed through a subjective questionnaire by which an ayurvedic physicians assess the normalcy and abnormality based on ayurvedic principles of examination (pariksha). Some of the objective methods which may be used to assess the normal functioning of udakavaha srotas are:<br /> 1. Urine routine examination for specific gravity, volume, ph etc.<br /> 2. Serum electrolyte (Sodium and potassium)<br /> 3. MRI Scan for hypothalamus abnormality<br /> 4. Blood sugar for assessing the abnormality.<br /> 5. Dual-energy X-ray absorptiometry (DEXA)[11]<br /> 6. Air displacement plethysmography,[12]<br /> 7. Nuclear magnetic resonance spectroscopy [13], and <br /> 8. Bioelectrical impedance analysis [14] [15]<br /> &lt;/p&gt;<br /> <br /> '''Treatment of srotas abnormality'''<br /> &lt;p style=&quot;text-align:justify;&quot;&gt; The treatment for the viation of udakavaha srotas should be done on the principles of management of thirst disorder (trishna chikitsa). [Cha. Sa. Vimana Sthana 05/26] [16] The signs and symptoms of udakavaha srotas vitiation are comparable to morbid thirst (trishna), which develops as a result of vata and pitta vitiation. Because both doshas have absorbent (shoshaka) properties that degrade the rasavaha and udakavaha srotas. This leads to persistent desire for water. Rain water is the best way to quench thirst. However, nowadays rainwater is rarely stored and used for drinking. Therefore water with a mild astringent flavour, light to digest, cold characteristics, nice scent and taste, and no channel obstructing qualities should be deemed comparable to rain water in effect. [16] &lt;/p&gt; <br /> <br /> <br /> '''Dosha governing the water metabolism'''<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Dosha are the physiological entity in human body governing all systems. For maintenance of water balance different dosha work in synergy to each other. Acharya Charak clearly described the relation between samana vayu and ambuvaha srotas. [Cha. Sa. Chikitsa Sthana 28/8] Samana vayu is situated in swedavaha, doshavaha and ambuvaha or udakavaha srotas. It showed the samana vayu is essential for maintainance of water regulation in human body. Along with samana vayu, pitta (pachaka) and kapha (bodhaka and kledaka) also help in water homeostasis. &lt;/p&gt;<br /> <br /> [[File:Dosha helpful in water metabolism.jpg|center|Figure 03: Dosha helpful in water metabolism.]]<br /> <br /> '''Future area of research'''<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;The future area of research is the preparation of a validated and standardized questionnaire for assessing the normalcy and abnormality of functioning of udakavaha srotas. Assessment of udakavaha srotas condition in various disease may be helpful in prognosis and treatment outcome. In various physiological conditions like pregnancy, lactation, childhood, old age, space, deep sea and high altitude, the udakavaha srotas assessment may be helpful to understand the dynamic changes occurred within the body. Animal studies to understand the anatomy and physiology of kloma may be helpful for future researches related to udakavaha srotas. &lt;/p&gt;<br /> <br /> ''Thesis works:'''<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;1. Dash Maheshwar (1985): Srotas in ayurveda with special reference to udakavaha srotras, Department of Basic Principles, B.H.U.Varanasi, India <br /> 2. Kambale V.(1997): Udakavaha srotas mulastana nischiti evam kloma tulanatmaka adhyayan, Department of sharir Rachana, Govt. Ayurveda Mahavidyalaya, Nanded. &lt;/p&gt;<br /> <br /> '''Current researches:'''<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt; Contemporary understanding of udakavaha srotas: The cerebrospinal fluid, salivary amylase, and digestive/hepatobiliary system secretions such HCL, bile, pancreatic lipase, and pancreatic amylase are all included in the udaka/ambuvaha srotas. It is also associated with rasa dhatu, which provides the fluid and oiliness needed to transport the necessary nutrients, lubricate various body processes, and support thermodynamic control.[10] &lt;/p&gt;<br /> <br /> <br /> '''Udakavaha srotas and shwasa roga:''' &lt;p style=&quot;text-align:justify;&quot;&gt;Shwasa roga (dysnoea) occurrs due to vitiation of prana, anna and udakavaha srotas. But understanding the role of udakavaha srotas is difficult. In causative factors of shwasa (nidana), the majority causes of udakavaha srotas dushti are covered. The five varieties of shwasa exhibit its clinical features. In shwasa chikitsa, additional liquid preparations are suggested in order to correct the body's water balance. So, this review helps to understand the role of udakavaha srotas in shwasa roga. [17] &lt;/p&gt;<br /> <br /> '''13.3 Udakavaha srotodushti with special reference to kapha dominant prameha (obstinate urinary disorders including diabetes):''' &lt;p style=&quot;text-align:justify;&quot;&gt; In order to comprehend the notion of looseness of body components (sharira shaithilya) in the pathogenesis (samprapti) of kapha dominant prameha and to assess the application of the essential ayurveda principles of udakavaha stroto dushti, a clinical research on 40 clinically confirmed patients of kapha dominant prameha was done. The study came to the conclusion that srotodushti and pathogenic factors should be taken into account while treating diabetic patients, so that we can focus on treating sroto dushti and its root as well as the illness.[18] &lt;/p&gt;<br /> <br /> '''References'''<br /> &lt;p style=&quot;text-align:justify;&quot;&gt; 1. National AYUSH Morbidity and Standardized Terminologies Electronic Portal by Ministry of AYUSH Available on http://namstp.ayush.gov.in/#/Ayurveda<br /> 2. A. C. Guyton and J. E. Hall, Textbook of Medical Physiology. 11th edition. Pennsylvania: Elsevier Saunders, 2006.<br /> 3. Jéquier E, Constant F. Water as an essential nutrient: the physiological basis of hydration. Eur J ClinNutr. 2010;64(2):115-23.<br /> 4. Amarkosha. Amarsimha, Edited by Pt. Haragovindasastri. Reprint Ed. Varanasi:Chaukhambha Sanskrit Sansthan, 2020.<br /> 5. Sushruta. SushrutaSamhita. Edited by JadavajiTrikamjiAacharya. 8th ed. Varanasi: ChaukhambhaOrientalia; 2005.<br /> 6. Monier-Williams, Monier William's Sanskrit-English Dictionary, 2nd Ed., Oxford University Press;1899.<br /> 7. Nanal VM. The organ kloma: a fresh appraisal. AncSci Life. 1989;9(2):61-5.<br /> 8. Knepper MA, Kwon TH, Nielsen S: Molecular Physiology of Water Balance. N Engl J Med 2015, 373(2):196.<br /> 9. Cuzzo B, Padala SA, Lappin SL. Physiology, Vasopressin. [Updated 2022 Aug 22]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan. <br /> 10. Al-Shura AN. 12 - Channels receiving food, prana, and water. In: Al-Shura AN, editor. Ayurvedic Perspectives in Integrative Healthcare: Academic Press; 2020. p. 109-15.<br /> 11. Mazess RB, Barden HS, Bisek JP, Hanson J. Dual-energy x-ray absorptiometry for total-body and regional bone-mineral and soft-tissue composition. Am J ClinNutr. 1990;51:1106–1112.<br /> 12. Dempster P, Aitkens S. A new air displacement method for the determination of human body composition. Med Sci Sports Exerc. 1995;27:1692–1697.<br /> 13. Rebouche CJ, Pearson GA, Serfass RE, Roth CW, Finley JW. Evaluation of nuclear magnetic resonance spectroscopy for determination of deuterium abundance in body fluids: application to measurement of total-body water in human infants. Am J ClinNutr. 1987;45:373–380.<br /> 14. NIH Consensus Statement. Bioelectrical impedance analysis in body composition measurement. National Institutes of Health Technology Assessment Conference Statement. December 12-14, 1994. Nutrition. 1996;12:749–762.<br /> 15. Beertema W, van Hezewijk M, Kester A, Forget PP, van Kreel B. Measurement of total body water in children using bioelectrical impedance: a comparison of several prediction equations. J PediatrGastroenterolNutr. 2000;31:428–432. <br /> 16. Sharma R..Trishna Chikitsa Adhyaya. In: Ojha S.N., Deole Y.S., Basisht G., eds. CharakSamhita New Edition. 1st ed. Jamnagar, Ind: CSRTSDC; 2020. https://www.carakasamhitaonline.com/mediawiki-1.32.1/index.php?title=Trishna_Chikitsa&amp;oldid=42725. Accessed April 6, 2023.<br /> 17. Teerthashree NS, Chetan M. Understanding of udakavahasrotas in shwasaroga. EPRA International Journal of Multidisciplinary Research (IJMR). 2022 May 12;8(5):63-8.<br /> 18. Rahangdale D, Kumar B, Dave HH, A Conceptual and Clinical Study to Understand The Principle of Sharira-Shaithilyata and UdakavahaSrotodushtiw.s.r. to KaphajaPrameha (Type II Diabetes Mellitus) JOA XIII-3, 2019; 14 - 21<br /> <br /> &lt;p/&gt;<br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> &lt;big&gt;'''[[Special:ContactMe|Send us your suggestions and feedback on this page.]]'''&lt;/big&gt;<br /> <br /> ==References==<br /> <br /> &lt;div id=&quot;BackToTop&quot; class=&quot;noprint&quot; style=&quot;background-color:#DDEFDD; position:fixed;<br /> bottom:32px; left:2%; z-index:9999; padding:0; margin:0;&quot;&gt;&lt;span style=&quot;color:blue;<br /> font-size:8pt; font-face:verdana,sans-serif; border:0.2em outset #ceebf7;<br /> padding:0.1em; font-weight:bolder; -moz-border-radius:8px; &quot;&gt;<br /> [[#top| Back to the Top ]]&lt;/span&gt;&lt;/div&gt;</div>

Manishdubey https://www.carakasamhitaonline.com/index.php?title=File:Etiological_factor_of_udakavahasrotodusti.jpg&diff=44070 2023-10-10T13:27:55Z

<p>Manishdubey: </p> <hr /> <div>Figure 02- Etiological factor of udakavahasrotodusti</div>

Manishdubey https://www.carakasamhitaonline.com/index.php?title=Talk:Udakavaha_Srotas&diff=44069 2023-10-10T13:24:43Z

<p>Manishdubey: </p> <hr /> <div>{{CiteButton}}<br /> {{#seo:<br /> |title= UDAKAVAHA SROTAS (Channels for transport and transformation of watery components)<br /> |titlemode=append<br /> |keywords=Udakavaha Srotas, Water metabolism, Bhojani M. K., Tanwar Ankur Kumar, Basisht G, Deole Y.S.<br /> |description=Udaka means water. In body, water is present in the form of various fluids. Udakavaha srotasa are the channels for transport and transformation of fluid (water) and its circulation. <br /> |image=http://www.carakasamhitaonline.com/mediawiki-1.32.1/resources/assets/ogimgs.jpg<br /> |image_alt=carak samhita<br /> |type=article<br /> }}<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Udaka means water. In [[Sharira|body]], water is present in the form of various fluids. Udakavaha srotasa are the channels for transport and transformation of fluid (water) and its circulation. They are the pathways that originate from the palate (talu) or kloma (an internal organ controlling thirst) through which fluids circulate throughout the body. [Code:SAT-B.475]&lt;ref name=&quot;ref1&quot;&gt;National AYUSH Morbidity and Standardized Terminologies Electronic Portal by Ministry of AYUSH Available on http://namstp.ayush.gov.in/#/Ayurveda&lt;/ref&gt; A water-based solution of ions and other compounds makes up most of the adult human body's 60% fluid content. Water makes up most of a cell's primary fluid medium except fat cells. It is present in most cells at a concentration of between 70 and 85 percent.[2] The human body uses water as a construction material, a lubricant, a shock absorber, a solvent, a reaction medium, and a reactant. It also serves as a transporter for nutrients and waste products. Water balance must be managed for the preservation of health and life.[3] So udakavaha srotas are the channels for regulating the water homeostasis in the human body, and failure to do the same can lead to death. This article deals with physiological, pathological and therapeutic aspects of udakavaha srotasa. &lt;/p&gt;<br /> <br /> {{Infobox<br /> |title = Contributors<br /> |label1 = Section/Chapter/topic<br /> |data1 = Concepts/[[Srotas]][[Udakavaha Srotas]] <br /> |label2 = Authors<br /> |data2 = Bhojani M. K. &lt;sup&gt;1&lt;/sup&gt;, Tanwar Ankur Kumar &lt;sup&gt;1&lt;/sup&gt; <br /> |label3 = Reviewer <br /> |data3 = Basisht G.&lt;sup&gt;2&lt;/sup&gt;<br /> |label3 = Editor<br /> |data3 = Deole Y.S.&lt;sup&gt;3&lt;/sup&gt;<br /> |label4 = Affiliations<br /> |data4 = &lt;sup&gt;1&lt;/sup&gt; Department of Sharir Kriya, All India Institute of Ayurveda, New Delhi, India<br /> &lt;sup&gt;2&lt;/sup&gt; Rheumatologist, Orlando, Florida, U.S.A.<br /> &lt;sup&gt;3&lt;/sup&gt; Department of Kayachikitsa, G. J. Patel Institute of Ayurvedic Studies and Research, New Vallabh Vidyanagar, Gujarat, India <br /> |label5 = Correspondence emails<br /> |data5 = [mailto:meera.samhita@aiia.gov.in meera.samhita@aiia.gov.in],&lt;br/&gt; [mailto:carakasamhita@gmail.com carakasamhita@gmail.com]<br /> |label6 = Publisher <br /> |data6 = [[Charak Samhita Research, Training and Development Centre]], I.T.R.A., Jamnagar, India<br /> |label7 = Date of publication:<br /> |data7 = October 10, 2023<br /> |label8 = DOI<br /> |data8 = {{DoiWithLink}}<br /> }}<br /> <br /> == Etymology and derivation:==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;The word udaka is derived from root “undi kledane”.[4] It implies that thing which is to wet is udaka. <br /> &lt;br/&gt;The word srotas is derived from Sanskrit root “sru”.[4] Meaing of sru is to secrete, to flow. Acharya sushruta defines srotas as tubular structures through which fluid material circulates in the body.[5] [Su. Sa. Sharira Sthana 09/13] Dalhana mentioned two important characteristics of srotas: 1. Passage for fluid (abhivahanshila) and 2. Hollow space to flow (avakash).[5] [Dalhan on Su. Sa. ShariraSthana 09/13] Srotas, according to acharya Charak, is a structure through which anything is conveyed or flows. [Cha. Sa. Sutra Sthana 30/12] Udakavaha srotas are the channels for water regulation.<br /> &lt;/p&gt;<br /> <br /> ==Synonyms: ==<br /> '''Udaka:''' apa, vari, salil, kamal, jalam, payas, water. [4][6]<br /> &lt;br/&gt;'''Srotas:''' ambusarana,svatasan, [4]sira, dhamani, rasayani, rasavahini, nadi, pantha, marga, sharirachhidra, samritasavritta, Sthana, ashaya, niketa[Cha. Sa. Vimana Sthana 05/09], yogvahi[5] [Su. Sa. Sharira Sthana 05/05], a wave, the flow, a current, the canal of nutrients in the body.[6]<br /> &lt;br/&gt;'''Udakavaha srotas:''' ambuvaha[Cha. Sa. Vimana Sthana 05/9] [Cha. Sa. Chikitsa Sthana 28/8], rasavahini [Cha. Sa. Chikitsa Sthana 22/06], water regulating system.<br /> <br /> ==Origin (Srotomula)==<br /> &lt;p style=&quot;text-align:justify;&quot;&gt; Acharya described the two roots of every srotas. In context of udakavaha srotas, the roots are palate (talu) and junction of throat &amp; chest (kloma). [Cha. Sa. Vimana Sthana 05/09] [Su. Sa. Sharira Sthana 09/12] [5]Acharya described these sites as root because in water imbalance, these organs first manifest the sign of thirst. The exact site of kloma is not defined but it’s the main controlling center for water regulation in the body. Acharya chakrapani described kloma as the site of thirst and mentioned that it is situated near the heart (hridyastha pipasa sthana).[Chakrapani on Cha. Sa. Vimana Sthana 05/08] Acharya Gangadhara described the site of kloma as the junction of throat and chest (Kantha urso sandhi). [Gangadhara on Cha. Sa. Vimana Sthana 05/08] <br /> The name &quot;kloma&quot; can be applied to mediastinum that is located at above mentioned sites. [7]<br /> Contemporary understanding of regulation of water is a feedback process involving the hypothalamus, the neurohypophysis, and the kidneys.[8] The main hormone that controls how much water the body retains is arginine vasopressin (AVP), commonly known as anti-diuretic hormone.[9]<br /> &lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;'''Etiological factors behind srotas abnormalities (sroto dushti hetu)'''&lt;/p&gt;<br /> [Cha. Sa. Vimana Sthana 05/11]These factors are:<br /> # Intake of hot food (aushnyat)<br /> # Indigestion (aamat)<br /> # Fear (bhayat)<br /> # Excessive intake of alcohol (panat)<br /> # Intake of excessive dry food article (arishuksha anna sevanat)<br /> # Habit of withholding the urge in excessive thirst (trishnaya cha atipidanat)<br /> All these factors contributed in dysregulation of water regulation. <br /> <br /> [[File:Figure 01-Etiological factor of udakavahasrotodusti..jpg|center]]<br /> &lt;center&gt;''''Figure 01: Etiological factor of udakavahasrotodusti''''&lt;/center&gt;<br /> <br /> <br /> '''Clinical features of srotas abnormality (srotodushti lakshana)'''[Cha. Sa. Vimana Sthana 05/11] <br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;1. Feeling of dryness of tongue (jihwa), palate (talu), lips (ostha), throat (kantha) and kloma.<br /> 2. Excessive thirst (pipasa) &lt;/p&gt;<br /> <br /> [[File:Figure 02- Udakavaha srotodushti lakshana..jpg|center]]<br /> &lt;center&gt;'''Figure 02: Udakavaha srotodushti lakshana'''&lt;/center&gt;<br /> <br /> ,,,Signs and symptoms of srotas injury(srotoviddha lakshana)'''<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Acharya Sushruta defined the clinical signs and symptoms related to injury or trauma to the udakavahasrotas.[5 ][Su. Sa. Sharira Sthana 09/12] Signs and symptoms of injury (srotoviddha) are:<br /> 1. Excessive thirst (pipasa)<br /> 2. Sudden death (sdayomarana)<br /> <br /> &lt;/p&gt;<br /> <br /> '''Disorders of srotas abnormality'''<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;The diseases due to vitiation of udakavaha srotas are:<br /> 1. Prameha (Urinary diseases including diabetes) [Cha. Sa. Chikitsa Sthana 06/08]<br /> 2. Trishna (Morbid thirst)[Cha. Sa. Chikitsa Sthana 22/06]<br /> 3. Atisara (Diarrhea and associated disorders) [Cha. Sa. Chikitsa Sthana 19/05-10]<br /> 4. Visuchika (Non-infectious gastroenteritis) [Cha. Sa. Vimana Sthana 02/10-11]<br /> 5. Hikka (Hiccups)[Cha. Sa. Chikitsa Sthana 17/21]<br /> 6. Shwasa(Dyspnea) [Cha. Sa. Chikitsa Sthana 17/45]<br /> 7. Udara roga(Generalised enlargement of abdomen)[Cha. Sa. Chikitsa Sthana 13/20] &lt;/p&gt;<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Some other diseases may be included under udakavaha stotas disorders: [10]<br /> • Edema<br /> • Hydrocephalus<br /> • Increased intracranial pressure<br /> • Diarrhea<br /> • Craving for sour and pungent food Excessive use of salt and sugar<br /> • Diabetes<br /> • Excessive thirst with dry mouth<br /> • Dry skin<br /> • Profuse sweating<br /> • Profuse urination<br /> • Glaucoma &lt;/p&gt;<br /> <br /> '''Diagnostic and assessment tools:'''<br /> &lt;p style=&quot;text-align:justify;&quot;&gt; The condition of udakavaha srotas can be assessed by subjective methods like questionnaires and objective methods like blood investigations etc.. Udakavaha srotodushti can be assessed through a subjective questionnaire by which an ayurvedic physicians assess the normalcy and abnormality based on ayurvedic principles of examination (pariksha). Some of the objective methods which may be used to assess the normal functioning of udakavaha srotas are:<br /> 1. Urine routine examination for specific gravity, volume, ph etc.<br /> 2. Serum electrolyte (Sodium and potassium)<br /> 3. MRI Scan for hypothalamus abnormality<br /> 4. Blood sugar for assessing the abnormality.<br /> 5. Dual-energy X-ray absorptiometry (DEXA)[11]<br /> 6. Air displacement plethysmography,[12]<br /> 7. Nuclear magnetic resonance spectroscopy [13], and <br /> 8. Bioelectrical impedance analysis [14] [15]<br /> &lt;/p&gt;<br /> <br /> '''Treatment of srotas abnormality'''<br /> &lt;p style=&quot;text-align:justify;&quot;&gt; The treatment for the viation of udakavaha srotas should be done on the principles of management of thirst disorder (trishna chikitsa). [Cha. Sa. Vimana Sthana 05/26] [16] The signs and symptoms of udakavaha srotas vitiation are comparable to morbid thirst (trishna), which develops as a result of vata and pitta vitiation. Because both doshas have absorbent (shoshaka) properties that degrade the rasavaha and udakavaha srotas. This leads to persistent desire for water. Rain water is the best way to quench thirst. However, nowadays rainwater is rarely stored and used for drinking. Therefore water with a mild astringent flavour, light to digest, cold characteristics, nice scent and taste, and no channel obstructing qualities should be deemed comparable to rain water in effect. [16] &lt;/p&gt; <br /> <br /> <br /> '''Dosha governing the water metabolism'''<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;Dosha are the physiological entity in human body governing all systems. For maintenance of water balance different dosha work in synergy to each other. Acharya Charak clearly described the relation between samana vayu and ambuvaha srotas. [Cha. Sa. Chikitsa Sthana 28/8] Samana vayu is situated in swedavaha, doshavaha and ambuvaha or udakavaha srotas. It showed the samana vayu is essential for maintainance of water regulation in human body. Along with samana vayu, pitta (pachaka) and kapha (bodhaka and kledaka) also help in water homeostasis. &lt;/p&gt;<br /> <br /> [[File:Dosha helpful in water metabolism.jpg|center|Figure 03: Dosha helpful in water metabolism.]]<br /> <br /> '''Future area of research'''<br /> &lt;p style=&quot;text-align:justify;&quot;&gt;The future area of research is the preparation of a validated and standardized questionnaire for assessing the normalcy and abnormality of functioning of udakavaha srotas. Assessment of udakavaha srotas condition in various disease may be helpful in prognosis and treatment outcome. In various physiological conditions like pregnancy, lactation, childhood, old age, space, deep sea and high altitude, the udakavaha srotas assessment may be helpful to understand the dynamic changes occurred within the body. Animal studies to understand the anatomy and physiology of kloma may be helpful for future researches related to udakavaha srotas. &lt;/p&gt;<br /> <br /> ''Thesis works:'''<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt;1. Dash Maheshwar (1985): Srotas in ayurveda with special reference to udakavaha srotras, Department of Basic Principles, B.H.U.Varanasi, India <br /> 2. Kambale V.(1997): Udakavaha srotas mulastana nischiti evam kloma tulanatmaka adhyayan, Department of sharir Rachana, Govt. Ayurveda Mahavidyalaya, Nanded. &lt;/p&gt;<br /> <br /> '''Current researches:'''<br /> <br /> &lt;p style=&quot;text-align:justify;&quot;&gt; Contemporary understanding of udakavaha srotas: The cerebrospinal fluid, salivary amylase, and digestive/hepatobiliary system secretions such HCL, bile, pancreatic lipase, and pancreatic amylase are all included in the udaka/ambuvaha srotas. It is also associated with rasa dhatu, which provides the fluid and oiliness needed to transport the necessary nutrients, lubricate various body processes, and support thermodynamic control.[10] &lt;/p&gt;<br /> <br /> <br /> '''Udakavaha srotas and shwasa roga:''' &lt;p style=&quot;text-align:justify;&quot;&gt;Shwasa roga (dysnoea) occurrs due to vitiation of prana, anna and udakavaha srotas. But understanding the role of udakavaha srotas is difficult. In causative factors of shwasa (nidana), the majority causes of udakavaha srotas dushti are covered. The five varieties of shwasa exhibit its clinical features. In shwasa chikitsa, additional liquid preparations are suggested in order to correct the body's water balance. So, this review helps to understand the role of udakavaha srotas in shwasa roga. [17] &lt;/p&gt;<br /> <br /> '''13.3 Udakavaha srotodushti with special reference to kapha dominant prameha (obstinate urinary disorders including diabetes):''' &lt;p style=&quot;text-align:justify;&quot;&gt; In order to comprehend the notion of looseness of body components (sharira shaithilya) in the pathogenesis (samprapti) of kapha dominant prameha and to assess the application of the essential ayurveda principles of udakavaha stroto dushti, a clinical research on 40 clinically confirmed patients of kapha dominant prameha was done. The study came to the conclusion that srotodushti and pathogenic factors should be taken into account while treating diabetic patients, so that we can focus on treating sroto dushti and its root as well as the illness.[18] &lt;/p&gt;<br /> <br /> '''References'''<br /> &lt;p style=&quot;text-align:justify;&quot;&gt; 1. National AYUSH Morbidity and Standardized Terminologies Electronic Portal by Ministry of AYUSH Available on http://namstp.ayush.gov.in/#/Ayurveda<br /> 2. A. C. Guyton and J. E. Hall, Textbook of Medical Physiology. 11th edition. Pennsylvania: Elsevier Saunders, 2006.<br /> 3. Jéquier E, Constant F. Water as an essential nutrient: the physiological basis of hydration. Eur J ClinNutr. 2010;64(2):115-23.<br /> 4. Amarkosha. Amarsimha, Edited by Pt. Haragovindasastri. Reprint Ed. Varanasi:Chaukhambha Sanskrit Sansthan, 2020.<br /> 5. Sushruta. SushrutaSamhita. Edited by JadavajiTrikamjiAacharya. 8th ed. Varanasi: ChaukhambhaOrientalia; 2005.<br /> 6. Monier-Williams, Monier William's Sanskrit-English Dictionary, 2nd Ed., Oxford University Press;1899.<br /> 7. Nanal VM. The organ kloma: a fresh appraisal. AncSci Life. 1989;9(2):61-5.<br /> 8. Knepper MA, Kwon TH, Nielsen S: Molecular Physiology of Water Balance. N Engl J Med 2015, 373(2):196.<br /> 9. Cuzzo B, Padala SA, Lappin SL. Physiology, Vasopressin. [Updated 2022 Aug 22]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan. <br /> 10. Al-Shura AN. 12 - Channels receiving food, prana, and water. In: Al-Shura AN, editor. Ayurvedic Perspectives in Integrative Healthcare: Academic Press; 2020. p. 109-15.<br /> 11. Mazess RB, Barden HS, Bisek JP, Hanson J. Dual-energy x-ray absorptiometry for total-body and regional bone-mineral and soft-tissue composition. Am J ClinNutr. 1990;51:1106–1112.<br /> 12. Dempster P, Aitkens S. A new air displacement method for the determination of human body composition. Med Sci Sports Exerc. 1995;27:1692–1697.<br /> 13. Rebouche CJ, Pearson GA, Serfass RE, Roth CW, Finley JW. Evaluation of nuclear magnetic resonance spectroscopy for determination of deuterium abundance in body fluids: application to measurement of total-body water in human infants. Am J ClinNutr. 1987;45:373–380.<br /> 14. NIH Consensus Statement. Bioelectrical impedance analysis in body composition measurement. National Institutes of Health Technology Assessment Conference Statement. December 12-14, 1994. Nutrition. 1996;12:749–762.<br /> 15. Beertema W, van Hezewijk M, Kester A, Forget PP, van Kreel B. Measurement of total body water in children using bioelectrical impedance: a comparison of several prediction equations. J PediatrGastroenterolNutr. 2000;31:428–432. <br /> 16. Sharma R..Trishna Chikitsa Adhyaya. In: Ojha S.N., Deole Y.S., Basisht G., eds. CharakSamhita New Edition. 1st ed. Jamnagar, Ind: CSRTSDC; 2020. https://www.carakasamhitaonline.com/mediawiki-1.32.1/index.php?title=Trishna_Chikitsa&amp;oldid=42725. Accessed April 6, 2023.<br /> 17. Teerthashree NS, Chetan M. Understanding of udakavahasrotas in shwasaroga. EPRA International Journal of Multidisciplinary Research (IJMR). 2022 May 12;8(5):63-8.<br /> 18. Rahangdale D, Kumar B, Dave HH, A Conceptual and Clinical Study to Understand The Principle of Sharira-Shaithilyata and UdakavahaSrotodushtiw.s.r. to KaphajaPrameha (Type II Diabetes Mellitus) JOA XIII-3, 2019; 14 - 21<br /> <br /> &lt;p/&gt;<br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> &lt;big&gt;'''[[Special:ContactMe|Send us your suggestions and feedback on this page.]]'''&lt;/big&gt;<br /> <br /> ==References==<br /> <br /> &lt;div id=&quot;BackToTop&quot; class=&quot;noprint&quot; style=&quot;background-color:#DDEFDD; position:fixed;<br /> bottom:32px; left:2%; z-index:9999; padding:0; margin:0;&quot;&gt;&lt;span style=&quot;color:blue;<br /> font-size:8pt; font-face:verdana,sans-serif; border:0.2em outset #ceebf7;<br /> padding:0.1em; font-weight:bolder; -moz-border-radius:8px; &quot;&gt;<br /> [[#top| Back to the Top ]]&lt;/span&gt;&lt;/div&gt;</div>

Manishdubey