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<p style="text-align:justify;">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]<ref name="ref1">National AYUSH Morbidity and Standardized Terminologies Electronic Portal by Ministry of AYUSH Available on http://namstp.ayush.gov.in/#/Ayurveda</ref> 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.<ref name="ref2">A. C. Guyton and J. E. Hall, Textbook of Medical Physiology. 11th edition. Pennsylvania: Elsevier Saunders, 2006.</ref>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.<ref name="ref3">Jéquier E, Constant F. Water as an essential nutrient: the physiological basis of hydration. Eur J ClinNutr. 2010;64(2):115-23.</ref> 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. </p>

<p style="text-align:justify;">Udaka means water. In [[Sharira|body]], water is present in the form of various fluids. Udakavaha srotas 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]<ref name="ref1">National AYUSH Morbidity and Standardized Terminologies Electronic Portal by Ministry of AYUSH Available on http://namstp.ayush.gov.in/#/Ayurveda</ref> 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.<ref name="ref2">A. C. Guyton and J. E. Hall, Textbook of Medical Physiology. 11th edition. Pennsylvania: Elsevier Saunders, 2006.</ref>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.<ref name="ref3">Jéquier E, Constant F. Water as an essential nutrient: the physiological basis of hydration. Eur J ClinNutr. 2010;64(2):115-23.</ref> 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. </p>

{{Infobox

{{Infobox

== Etymology and derivation:==

== Etymology and derivation:==

<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.  

<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 moistens or 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" /> [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> Meaning 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" /> [Dalhan on Su. Sa. Sharira Sthana 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.<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>

'''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,<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" /> [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/>'''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" /> [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]<ref name="ref5" /> 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" /> 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.<ref name="ref7">Nanal VM. The organ kloma: a fresh appraisal. AncSci Life. 1989;9(2):61-5.</ref>

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.<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>

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>

<p style="text-align:justify;">'''Etiological factors behind srotas abnormalities (sroto dushti hetu)'''</p>

<p style="text-align:justify;">'''Causes of abnormalities (sroto dushti [[hetu]])'''</p>

[Cha. Sa. Vimana Sthana 05/11]These factors are:

These factors are:

# Intake of hot food (aushnyat)

# Intake of hot food (aushnyat)

# Indigestion (aamat)

# Indigestion ([[Ama|aam]]<nowiki/>at)

# Fear (bhayat)

# Fear (bhayat)

# Excessive intake of alcohol (panat)

# Excessive intake of alcohol (panat)

# Intake of excessive dry food article (arishuksha anna sevanat)

# Intake of excessive dry food article (arishuksha anna sevanat)

# Habit of withholding the urge in excessive thirst (trishnaya cha atipidanat)

# Habit of withholding the urge in excessive thirst (trishnaya cha atipidanat) [Cha. Sa. [[Vimana Sthana]] 05/11]

All these factors contributed in dysregulation of water regulation.  

All these factors contributed in dysregulation of water regulation.  

[[File:Etiological factor of udakavahasrotodusti.jpg|center]]

[[File:Etiological factor of udakavahasrotodusti.jpg|center]]

<center>''''Figure 01: Etiological factor of udakavahasrotodusti''''</center>

<center>'<nowiki/>'''Figure 01: Etiological factor of udakavaha sroto dushti''''</center>

'''Clinical features of srotas abnormality (srotodushti lakshana)'''[Cha. Sa. Vimana Sthana 05/11]  

'''Clinical features of srotas abnormality (srotodushti lakshana)'''[Cha. Sa. [[Vimana Sthana]] 05/11]  

<p style="text-align:justify;">1. Feeling of dryness of tongue (jihwa), palate (talu), lips (ostha), throat (kantha) and kloma.

<p style="text-align:justify;">1. Feeling of dryness of tongue (jihwa), palate (talu), lips (ostha), throat (kantha) and kloma.

<center>'''Figure 02: Udakavaha srotodushti lakshana'''</center>

<center>'''Figure 02: Udakavaha srotodushti lakshana'''</center>

,,,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 <ref name="ref5" />[Su. Sa. Sharira Sthana 09/12] Signs and symptoms of injury (srotoviddha) are:

<p style="text-align:justify;">Acharya Sushruta defined the clinical signs and symptoms related to injury or trauma to the udakavaha srotas <ref name="ref5" /> [Su. Sa. Sharira Sthana 09/12]  

 

</p><p style="text-align:justify;">Signs and symptoms of injury (srotoviddha) are:

1. Excessive thirst (pipasa)

1. Excessive thirst (pipasa)

2. Sudden death (sdayomarana)

2. Sudden death (sadyo marana)

  </p>

  </p>

'''Disorders of srotas abnormality'''

'''Disorders of srotas abnormality'''

<p style="text-align:justify;">The diseases due to vitiation of udakavaha srotas are:

<p style="text-align:justify;">The diseases due to vitiation of udakavaha srotas are:

1. Prameha  (Urinary diseases including diabetes) [Cha. Sa. Chikitsa Sthana 06/08]

1. Prameha  (Urinary diseases including diabetes) [Cha. Sa. [[Chikitsa Sthana]] 06/08]

2. Trishna (Morbid thirst)[Cha. Sa. Chikitsa Sthana 22/06]

2. Trishna (Morbid thirst)[Cha. Sa. [[Chikitsa Sthana]] 22/06]

3. Atisara (Diarrhea and associated disorders) [Cha. Sa. Chikitsa Sthana 19/05-10]

3. Atisara (Diarrhea and associated disorders) [Cha. Sa. [[Chikitsa Sthana]] 19/05-10]

4. Visuchika (Non-infectious gastroenteritis) [Cha. Sa. Vimana Sthana 02/10-11]

4. Visuchika (Non-infectious gastroenteritis) [Cha. Sa. [[Vimana Sthana]] 02/10-11]

5. Hikka (Hiccups)[Cha. Sa. Chikitsa Sthana 17/21]

5. Hikka (Hiccups)[Cha. Sa. [[Chikitsa Sthana]] 17/21]

6. Shwasa(Dyspnea) [Cha. Sa. Chikitsa Sthana 17/45]

6. Shwasa(Dyspnea) [Cha. Sa. [[Chikitsa Sthana]] 17/45]

7. Udara roga(Generalised enlargement of abdomen)[Cha. Sa. Chikitsa Sthana 13/20] </p>

7. Udara roga (Generalized 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:<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 style="text-align:justify;">Some other diseases may be included under udakavaha srotas 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

'''Dosha governing the water metabolism'''

'''Dosha governing the water metabolism'''

<p style="text-align:justify;">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. </p>

<p style="text-align:justify;">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 [[sweda]]<nowiki/>vaha, doshavaha and ambuvaha or udakavaha srotas. It showed the samana vayu is essential for maintenance of water regulation in human body. Along with samana [[Vata dosha|vayu]], [[Pitta dosha|pitta]] (pachaka) and [[Kapha dosha|kapha]] (bodhaka and kledaka) also help in water homeostasis. </p>

[[File:Dosha helpful in water metabolism.jpg|center|Figure 03: Dosha helpful in water metabolism.]]

[[File:Dosha helpful in water metabolism.jpg|center|Figure 03: Dosha helpful in water metabolism.]]

''Thesis works:'''

''Thesis works:'''

<p style="text-align:justify;">1. Dash Maheshwar (1985): Srotas in ayurveda with special reference to udakavaha srotras, Department of Basic Principles, B.H.U.Varanasi, India  

<p style="text-align:justify;">1. Dash Maheshwar (1985): Srotas in ayurveda with special reference to udakavaha srotras, Department of Basic Principles, B.H.U. Varanasi, India  

2. Kambale V.(1997): Udakavaha srotas mulastana nischiti evam kloma tulanatmaka adhyayan, Department of sharir Rachana, Govt. Ayurveda Mahavidyalaya, Nanded. </p>

2. Kambale V.(1997): Udakavaha srotas mulastana nischiti evam kloma tulanatmaka adhyayan, Department of sharir Rachana, Govt. Ayurveda Mahavidyalaya, Nanded. </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>

<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.<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>

'''Udakavaha srotodushti with special reference to [[Kapha dosha|kapha]] dominant [[Prameha Chikitsa|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 dosha|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 dosha|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>

 

'''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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