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== Etymology and derivation:==
 
== Etymology and derivation:==
<p style="text-align:justify;">The word udaka is derived from root “undi kledane”.[4] It implies that thing which is to wet is udaka.  
+
<p style="text-align:justify;">The word udaka is derived from root “undi kledane”.<ref name="ref4">Amarkosha. Amarsimha, Edited by Pt. Haragovindasastri. Reprint Ed. Varanasi:Chaukhambha Sanskrit Sansthan, 2020.</ref> It implies that thing which is to wet is udaka.  
 
<br/>The word srotas is derived from Sanskrit root “sru”.<ref name="ref4">Amarkosha. Amarsimha, Edited by Pt. Haragovindasastri. Reprint Ed. Varanasi:Chaukhambha Sanskrit Sansthan, 2020.</ref> Meaing of sru is to secrete, to flow. Acharya sushruta defines srotas as tubular structures through which fluid material circulates in the body.<ref name="ref5">Sushruta. SushrutaSamhita. Edited by JadavajiTrikamjiAacharya. 8th ed. Varanasi: ChaukhambhaOrientalia; 2005. </ref>[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).<ref name="ref5">Sushruta. SushrutaSamhita. Edited by JadavajiTrikamjiAacharya. 8th ed. Varanasi: ChaukhambhaOrientalia; 2005.</ref> [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/>The word srotas is derived from Sanskrit root “sru”.<ref name="ref4">Amarkosha. Amarsimha, Edited by Pt. Haragovindasastri. Reprint Ed. Varanasi:Chaukhambha Sanskrit Sansthan, 2020.</ref> Meaing of sru is to secrete, to flow. Acharya sushruta defines srotas as tubular structures through which fluid material circulates in the body.<ref name="ref5">Sushruta. SushrutaSamhita. Edited by JadavajiTrikamjiAacharya. 8th ed. Varanasi: ChaukhambhaOrientalia; 2005. </ref>[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).<ref name="ref5">Sushruta. SushrutaSamhita. Edited by JadavajiTrikamjiAacharya. 8th ed. Varanasi: ChaukhambhaOrientalia; 2005.</ref> [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.
 
  </p>
 
  </p>
    
==Synonyms: ==
 
==Synonyms: ==
'''Udaka:''' apa, vari, salil, kamal, jalam, payas, water. [4][6]
+
'''Udaka:''' apa, vari, salil, kamal, jalam, payas, water.<ref name="ref4">Amarkosha. Amarsimha, Edited by Pt. Haragovindasastri. Reprint Ed. Varanasi:Chaukhambha Sanskrit Sansthan, 2020.</ref> <ref name="ref6">Monier-Williams, Monier William's Sanskrit-English Dictionary, 2nd Ed., Oxford University Press;1899.</ref>
<br/>'''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/>'''Srotas:''' ambusarana,svatasan,<ref name="ref4">Amarkosha. Amarsimha, Edited by Pt. Haragovindasastri. Reprint Ed. Varanasi:Chaukhambha Sanskrit Sansthan, 2020.</ref>sira, dhamani, rasayani, rasavahini, nadi, pantha, marga, sharirachhidra, samritasavritta, Sthana, ashaya, niketa[Cha. Sa. Vimana Sthana 05/09], yogvahi<ref name="ref5">Sushruta. SushrutaSamhita. Edited by JadavajiTrikamjiAacharya. 8th ed. Varanasi: ChaukhambhaOrientalia; 2005.</ref>[Su. Sa. Sharira Sthana 05/05], a wave, the flow, a current, the canal of nutrients in the body.<ref name="ref6">Monier-Williams, Monier William's Sanskrit-English Dictionary, 2nd Ed., Oxford University Press;1899.</ref>
 
<br/>'''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/>'''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.
    
==Origin (Srotomula)==
 
==Origin (Srotomula)==
<p style="text-align:justify;"> Acharya described the two roots of every srotas.  In context of udakavaha srotas, the roots are palate (talu) and junction of throat & 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]  
+
<p style="text-align:justify;"> Acharya described the two roots of every srotas.  In context of udakavaha srotas, the roots are palate (talu) and junction of throat & chest (kloma). [Cha. Sa. Vimana Sthana 05/09] [Su. Sa. Sharira Sthana 09/12]<ref name="ref5">Sushruta. SushrutaSamhita. Edited by JadavajiTrikamjiAacharya. 8th ed. Varanasi: ChaukhambhaOrientalia; 2005.</ref> 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]  
The name "kloma" can be applied to mediastinum that is located at above mentioned sites. [7]
+
The name "kloma" can be applied to mediastinum that is located at above mentioned sites.<ref name="ref7">Nanal VM. The organ kloma: a fresh appraisal. AncSci Life. 1989;9(2):61-5.</ref>
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]
+
Contemporary understanding of regulation of water is a feedback process involving the hypothalamus, the neurohypophysis, and the kidneys.<ref name="ref8">Knepper MA, Kwon TH, Nielsen S: Molecular Physiology of Water Balance. N Engl J Med 2015, 373(2):196.</ref>The main hormone that controls how much water the body retains is arginine vasopressin (AVP), commonly known as anti-diuretic hormone.<ref name="ref9">Cuzzo B, Padala SA, Lappin SL. Physiology, Vasopressin. [Updated 2022 Aug 22]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan.  </ref>
 
</p>
 
</p>
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,,,Signs and symptoms of srotas injury(srotoviddha lakshana)'''
 
,,,Signs and symptoms of srotas injury(srotoviddha lakshana)'''
<p style="text-align:justify;">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:
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<p style="text-align:justify;">Acharya Sushruta defined the clinical signs and symptoms related to injury or trauma to the udakavahasrotas <ref name="ref5">Sushruta. SushrutaSamhita. Edited by JadavajiTrikamjiAacharya. 8th ed. Varanasi: ChaukhambhaOrientalia; 2005.</ref>[Su. Sa. Sharira Sthana 09/12] Signs and symptoms of injury (srotoviddha) are:
 
1. Excessive thirst (pipasa)
 
1. Excessive thirst (pipasa)
 
2. Sudden death (sdayomarana)
 
2. Sudden death (sdayomarana)
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7. Udara roga(Generalised enlargement of abdomen)[Cha. Sa. Chikitsa Sthana 13/20] </p>
 
7. Udara roga(Generalised enlargement of abdomen)[Cha. Sa. Chikitsa Sthana 13/20] </p>
   −
<p style="text-align:justify;">Some other diseases may be included under udakavaha stotas disorders: [10]
+
<p style="text-align:justify;">Some other diseases may be included under udakavaha stotas disorders:<ref name="ref10">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.</ref>
 
• Edema
 
• Edema
 
• Hydrocephalus
 
• Hydrocephalus
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3. MRI Scan for hypothalamus abnormality
 
3. MRI Scan for hypothalamus abnormality
 
4. Blood sugar for assessing the abnormality.
 
4. Blood sugar for assessing the abnormality.
5. Dual-energy X-ray absorptiometry (DEXA)[11]
+
5. Dual-energy X-ray absorptiometry (DEXA)<ref name="ref11">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.</ref>
6. Air displacement plethysmography,[12]
+
6. Air displacement plethysmography,<ref name="ref12">Dempster P, Aitkens S. A new air displacement method for the determination of human body composition. Med Sci Sports Exerc. 1995;27:1692–1697.</ref>
7. Nuclear magnetic resonance spectroscopy [13], and  
+
7. Nuclear magnetic resonance spectroscopy <ref name="ref13">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.</ref>, and  
8. Bioelectrical impedance analysis [14] [15]
+
8. Bioelectrical impedance analysis <ref name="ref14">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.</ref> <ref name="ref15">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.</ref>
 
</p>
 
</p>
    
'''Treatment of srotas abnormality'''
 
'''Treatment of srotas abnormality'''
<p style="text-align:justify;"> 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] </p>   
+
<p style="text-align:justify;"> 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]</ref> <ref name="ref16">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&oldid=42725. Accessed April 6, 2023.</ref>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.<ref name="ref16">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&oldid=42725. Accessed April 6, 2023.</ref> </p>   
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'''Current researches:'''
 
'''Current researches:'''
   −
<p style="text-align:justify;"> 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] </p>
+
<p style="text-align:justify;"> 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.<ref name="ref10">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.</ref> </p>
      −
'''Udakavaha srotas and shwasa roga:''' <p style="text-align:justify;">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] </p>
+
'''Udakavaha srotas and shwasa roga:''' <p style="text-align:justify;">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.<ref name="ref17">Teerthashree NS, Chetan M. Understanding of udakavahasrotas in shwasaroga. EPRA International Journal of Multidisciplinary Research (IJMR). 2022 May 12;8(5):63-8.</ref> </p>
 
  −
'''13.3 Udakavaha srotodushti with special reference to kapha dominant prameha (obstinate urinary disorders including diabetes):''' <p style="text-align:justify;"> 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] </p>
  −
 
  −
'''References'''
  −
<p style="text-align:justify;"> 1. National AYUSH Morbidity and Standardized Terminologies Electronic Portal by Ministry of AYUSH Available on http://namstp.ayush.gov.in/#/Ayurveda
  −
2. A. C. Guyton and J. E. Hall, Textbook of Medical Physiology. 11th edition. Pennsylvania: Elsevier Saunders, 2006.
  −
3. Jéquier E, Constant F. Water as an essential nutrient: the physiological basis of hydration. Eur J ClinNutr. 2010;64(2):115-23.
  −
4. Amarkosha. Amarsimha, Edited by Pt. Haragovindasastri. Reprint Ed. Varanasi:Chaukhambha Sanskrit Sansthan, 2020.
  −
5. Sushruta. SushrutaSamhita. Edited by JadavajiTrikamjiAacharya. 8th ed. Varanasi: ChaukhambhaOrientalia; 2005.
  −
6. Monier-Williams, Monier William's Sanskrit-English Dictionary, 2nd Ed., Oxford University Press;1899.
  −
7. Nanal VM. The organ kloma: a fresh appraisal. AncSci Life. 1989;9(2):61-5.
  −
8. Knepper MA, Kwon TH, Nielsen S: Molecular Physiology of Water Balance. N Engl J Med 2015, 373(2):196.
  −
9. Cuzzo B, Padala SA, Lappin SL. Physiology, Vasopressin. [Updated 2022 Aug 22]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan.
  −
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.
  −
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.
  −
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.
  −
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.
  −
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.
  −
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.
  −
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&oldid=42725. Accessed April 6, 2023.
  −
17. Teerthashree NS, Chetan M. Understanding of udakavahasrotas in shwasaroga. EPRA International Journal of Multidisciplinary Research (IJMR). 2022 May 12;8(5):63-8.
  −
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
  −
 
  −
<p/>
      +
'''13.3 Udakavaha srotodushti with special reference to kapha dominant prameha (obstinate urinary disorders including diabetes):''' <p style="text-align:justify;"> 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.<ref name="ref18">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</ref> </p>
     
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