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=== ''Vidhi Vimarsha'' / Applied Inferences===

=== ''Vidhi Vimarsha'' / Applied Inferences===

==== Special significance of skin in Ayurveda ====

==== Special significance of skin in [[Ayurveda]] ====

The skin is the biggest organ of the body and makes the integumentary system, comprising of hair, nails etc. It constitutes 16% of body weight. It is a combined product of ectoderm as well as of mesoderm. Akin to the nervous system, epidermis is developed from the ectoderm, whereas dermis is derived from the mesoderm. The skin, from the standpoint of Ayurveda, is the ''upadhatu'' of ''mamsa dhatu'', which may be because of their common germinal base. The muscles and dermis - both are organs of mesoblastic origin. Dermis is a well vascularized structure and is a very active organ. Epidermis has no blood vessels and only its basal layers get nourishment from the source of dermis next to it. The skin is also called ''mamsavaha srotas'' (Ch. Vi. 5/7) since the skin synthesises<ref>Elaine N. Marieb, Human Anatomy and Physiology, 6th edition, pearson Education, Inc. Ch 24.</ref> Vitamin D, a basic source for calcium. Calcium is assimilated and absorbed from the gut with the help of vitamin D. The physiology of action in the muscle is totally calcium dependent. This is why ''twak'' is considered to be the ''mula'' (root) of ''mamsavaha srotas''<ref> Guyton & Hall, textbook of medical Physiology, 10th edition, saunders, Philadelphia, Chapter 6. </ref>.

The skin is the biggest organ of the body and makes the integumentary system, comprising of hair, nails etc. It constitutes 16% of body weight. It is a combined product of ectoderm as well as of mesoderm. Akin to the nervous system, epidermis is developed from the ectoderm, whereas dermis is derived from the mesoderm. The skin, from the standpoint of [[Ayurveda]], is the ''upadhatu'' of ''mamsa dhatu'', which may be because of their common germinal base. The muscles and dermis - both are organs of mesoblastic origin. Dermis is a well vascularized structure and is a very active organ. Epidermis has no blood vessels and only its basal layers get nourishment from the source of dermis next to it. The skin is also called ''mamsavaha srotas'' (Ch. Vi. 5/7) since the skin synthesises<ref>Elaine N. Marieb, Human Anatomy and Physiology, 6th edition, pearson Education, Inc. Ch 24.</ref> Vitamin D, a basic source for calcium. Calcium is assimilated and absorbed from the gut with the help of vitamin D. The physiology of action in the muscle is totally calcium dependent. This is why ''twak'' is considered to be the ''mula'' (root) of ''mamsavaha srotas''<ref> Guyton & Hall, textbook of medical Physiology, 10th edition, saunders, Philadelphia, Chapter 6. </ref>.

The skin is made up of three basic layers:  

The skin is made up of three basic layers:  

Alternative views on this topic could be researched further, since the papillary and reticular layers are the part of dermis and anatomically represent a single organic entity therefore the fifth and sixth layers of Charaka’s ''twacha'' model may correlate with the dermis layer together. The same goes with Sushruta’s ''vedini'' and ''rohini'' layers (excluding Sushruta’s seventh layer from our analysis).  

Alternative views on this topic could be researched further, since the papillary and reticular layers are the part of dermis and anatomically represent a single organic entity therefore the fifth and sixth layers of Charaka’s ''twacha'' model may correlate with the dermis layer together. The same goes with Sushruta’s ''vedini'' and ''rohini'' layers (excluding Sushruta’s seventh layer from our analysis).  

From the standpoint of clinical importance of the ''twacha sharira'', the function of the skin is not described clearly in Ayurveda. However, the functions of skin could be inferred through references in various ''samhitas''. Charaka has presented the characteristics of the ''twaksara purusha'' (excellence of ''twak'') under [[Vimana Sthana]]4, which details the functions and properties of normal skin . The skin of the ''twakasara purusha'' should be unctuous (''snigdha''), smooth (''shlakshna''), soft (''mridu''), clean/glorious (''prasanna''), fine (''sukshma''), close/not loose (''alpa''), thick (''gambhir''), with soft hair (''sukumar loma''), and radiant (''saprabha''). This type of excellent quality of skin is indicative of a lot of qualities in an individual, including happiness, prosperity, splendor, pleasure, intelligence, knowledge, health, contentment and longevity. (Ch. Vi.8/103)  

From the standpoint of clinical importance of the ''twacha sharira'', the function of the skin is not described clearly in [[Ayurveda]]. However, the functions of skin could be inferred through references in various ''samhitas''. Charaka has presented the characteristics of the ''twaksara purusha'' (excellence of ''twak'') under [[Vimana Sthana]]4, which details the functions and properties of normal skin . The skin of the ''twakasara purusha'' should be unctuous (''snigdha''), smooth (''shlakshna''), soft (''mridu''), clean/glorious (''prasanna''), fine (''sukshma''), close/not loose (''alpa''), thick (''gambhir''), with soft hair (''sukumar loma''), and radiant (''saprabha''). This type of excellent quality of skin is indicative of a lot of qualities in an individual, including happiness, prosperity, splendor, pleasure, intelligence, knowledge, health, contentment and longevity. (Ch. Vi.8/103)  

As such, the texture or appearance of the skin is reflective of the inner state of a person. If skin is healthy, it is likely that other organs of the body will be healthy as well. Symptoms of sickness of other systems get reflected on the skin. So, if the skin is taken good care of, or observed carefully, it would help take preventive measures and generally would benefit other bodily systems also. This realization has led to the development of various therapies under the general umbrella of [[Panchakarma]]. According to Sushruta, the skin is the seat of ''bhrajaka pitta'', and because of ''bhrajak pitta''5, the skin catalyzes the metabolic processes related with the therapies of ''abhyanga, parisheka, avagaha, alepana, udvartana'', etc.(Su.Su.21/10)

As such, the texture or appearance of the skin is reflective of the inner state of a person. If skin is healthy, it is likely that other organs of the body will be healthy as well. Symptoms of sickness of other systems get reflected on the skin. So, if the skin is taken good care of, or observed carefully, it would help take preventive measures and generally would benefit other bodily systems also. This realization has led to the development of various therapies under the general umbrella of [[Panchakarma]]. According to Sushruta, the skin is the seat of ''bhrajaka pitta'', and because of ''bhrajak pitta''5, the skin catalyzes the metabolic processes related with the therapies of ''abhyanga, parisheka, avagaha, alepana, udvartana'', etc.(Su.Su.21/10)

''Pranayatana'' (vital sites) in Ashtanga Samgraha: Vagbhata has shown some different features under the heading of ''pranayatana'' (Ashtanga Sangraha). Accordingly he has included ''jihvabandhana'' (root of tongue) as ''pranayatana'' and excluded ''mamsa'' from this account. The site of ''jihvabandhana'' is valuable because of the opening site of respiratory system. Any trauma at this blocking to respiratory passage may cause death, therefore it has been given much importance in anesthesia. In the case of deep coma falling of tongue back in the throat blocks the respiration and leads to death. Exclusion of ''mamsa'' from ''pranayatana'' by Vagbhatta seems to be his personal opinion only perhaps he was not willing to increase the number of ''pranayatana'', otherwise this was easy to justify.

''Pranayatana'' (vital sites) in Ashtanga Samgraha: Vagbhata has shown some different features under the heading of ''pranayatana'' (Ashtanga Sangraha). Accordingly he has included ''jihvabandhana'' (root of tongue) as ''pranayatana'' and excluded ''mamsa'' from this account. The site of ''jihvabandhana'' is valuable because of the opening site of respiratory system. Any trauma at this blocking to respiratory passage may cause death, therefore it has been given much importance in anesthesia. In the case of deep coma falling of tongue back in the throat blocks the respiration and leads to death. Exclusion of ''mamsa'' from ''pranayatana'' by Vagbhatta seems to be his personal opinion only perhaps he was not willing to increase the number of ''pranayatana'', otherwise this was easy to justify.

''Prana'': When ''pranayatana'' are on the table of discussion we have to review ''prana''. Factors which maintain the life are ''prana''. ''Prana'' are said to be 12 in number by Sushruta (Sushruta Sharira 4/2). These ''pranas'' are ''agni, soma, vayu, satva, raja, tama, panchendriya'' and ''bhutatma''. As such these factors are categorically divided in four groups, i.e. ''tridosha, triguna, panchagyanendriya'' and ''bhutatma''. On a biological level tridosha can be seen somewhere in the form of biochemical regulators of life, e.g. hormones, enzymes etc., ''triguna'' in the form of neuro-chemical regulators of life, e.g. acetylcholine, epinephrine, dopamine, melatonin etc., and ''jnanendriya'' in the form of cell receptors and neuroreceptors. Speaking on ''bhutatma'' is a difficult job, whereas a critical evaluation of the same is must at this level. It is a well accepted fact in Ayurveda that all the organic world is ''panchamahabhautic''. At this level a ''bhuta'' could be considered to be an organism – a unicellular bacteria or a cell.  Cell being a ''bhuta'' holds its ''atma'' in it which solely operates its function and development. Since DNA is responsible to control the function and development. The entire metabolism in the cell is basically controlled by DNA. DNA makes RNA by transcription, RNA makes protein by translation, protein is found basically in two types, i.e. structural and functional<ref>Dorothy Luciano, Human Structure & Function.1984 edition, Elsavier, Philadelphia, 1st & 2nd chapter.</ref>. Functional protein means enzyme. Enzyme mediates the biochemical changes in the body. Any change in the cell cannot be caused without the mediation of an enzyme. This is how we can see that DNA is solely controlling the metabolism in the body. Therefore if we refer the DNA to be taken as ''bhutama'', yet this will not be any mistake. [9]

''Prana'': When ''pranayatana'' are on the table of discussion we have to review ''prana''. Factors which maintain the life are ''prana''. ''Prana'' are said to be 12 in number by Sushruta (Sushruta Sharira 4/2). These ''pranas'' are ''agni, soma, vayu, satva, raja, tama, panchendriya'' and ''bhutatma''. As such these factors are categorically divided in four groups, i.e. ''tridosha, triguna, panchagyanendriya'' and ''bhutatma''. On a biological level tridosha can be seen somewhere in the form of biochemical regulators of life, e.g. hormones, enzymes etc., ''triguna'' in the form of neuro-chemical regulators of life, e.g. acetylcholine, epinephrine, dopamine, melatonin etc., and ''jnanendriya'' in the form of cell receptors and neuroreceptors. Speaking on ''bhutatma'' is a difficult job, whereas a critical evaluation of the same is must at this level. It is a well accepted fact in [[Ayurveda]] that all the organic world is ''panchamahabhautic''. At this level a ''bhuta'' could be considered to be an organism – a unicellular bacteria or a cell.  Cell being a ''bhuta'' holds its ''atma'' in it which solely operates its function and development. Since DNA is responsible to control the function and development. The entire metabolism in the cell is basically controlled by DNA. DNA makes RNA by transcription, RNA makes protein by translation, protein is found basically in two types, i.e. structural and functional<ref>Dorothy Luciano, Human Structure & Function.1984 edition, Elsavier, Philadelphia, 1st & 2nd chapter.</ref>. Functional protein means enzyme. Enzyme mediates the biochemical changes in the body. Any change in the cell cannot be caused without the mediation of an enzyme. This is how we can see that DNA is solely controlling the metabolism in the body. Therefore if we refer the DNA to be taken as ''bhutama'', yet this will not be any mistake. [9]

Commentators of present time have very well worked for correlating the ''koshthangas'' presented by Charaka with the structure described in modern anatomy. Research scholars have also done well in this area. Suitable anatomical correlations for all 15 ''koshthangas'' are presented in the following table.

Commentators of present time have very well worked for correlating the ''koshthangas'' presented by Charaka with the structure described in modern anatomy. Research scholars have also done well in this area. Suitable anatomical correlations for all 15 ''koshthangas'' are presented in the following table.