Ayurvedic concept and management of Anaemia. A novel approach

Index

01 Acknowledgement

02 Prologue

03 Chapter 1 (Conceptual study of the principle)

04 Chapter 2 (Disease Review)

05 Chapter 3 (Drug Review)

06 Clinical Study

07 Discussion

08 Conclusion

09 Summary

10 Bibliography

11 Research Proforma

Acknowledgement

At the onset, I acknowledge and thank the God who has always been with me inspired me to undertake and accomplish this task at every stage in my efforts.

I thank my source of inspiration and living legends my father and mother, Mr. and Mrs. Prakash Chandra & Pushpa Devi for their blessings that has enabled the successful accomplishment of this work.

I especially thank and express my deepest sense of gratitude towards my guide, teacher and mentor, Professor Rambabu Dwivedi for his enlightening vision and infathomable support in bringing out the truth.

The co-guide of this work, Dr. Mahesh Vyas needs a special mention as he has been the helping hand in every sphere of my work. The exceptional administrative and academic skills of Dr. Mahesh are commendable and deserve my genuine appreciation.

I also thank the staff and my colleagues of the Basic Principles department of IPGT & RA, Jamnagar for their support throughout my stay at Jamnagar.

I also express my deepest sense of acknowledgement to the patients without whom the work couldn’t have taken any path.

I thank all those who have directly or indirectly assisted me in the completion of this work.

Thanks

Vaibhav Dadu

Prologue

Ayurveda, the science of life aims at the maintenance of health and the cure of the disease. Since time immemorial, the human endeavour has been the eradication of the pain and suffering. The tenets of Ayurveda having a strong foundation in the form of the Basic Principles based on the philosophical principles are the cause of very existence and advancement of the treasure of knowledge. The three major seers or preachers of Ayurveda namely the Acharya Charaka, Sushruta and Vagbhata have shown shown the path to achieve the long coveted goals of a long and healthy life. To maintain the position of Ayurveda for a long period these seers created their own treatises or the Tantras (classics) which serve as the authentic and guiding principle of propagation and enhancement of the Ayurveda know-how. Even the much talked about subject of Research in Ayurveda is based on the illuminating path shown by these seers of Yore.

Albeit a few Samhitas are available today in a better state as many of the original ones are either lost or are in an incomplete or dilapidated state, the Charaka and the Sushruta Samhita enjoy a place of pride and honour among the medical fraternity. This is evident from the number of translations of these in various languages of the world. These treatises are present in the modified form as per the need of the time as revealed in the evolution of the Samhita which underwent a series of Revisions and Redactions. These alterations were meant to facilitate better understanding and interpretation of the texts. In spite of all these efforts for solong the proper understanding and appropriate interpretation of these Samhitas is still a challenge and remains an illusion.

Today, a number of Research works are in progress to unfold the hidden treasure in the classical texts all over the country and abroad. Some satisfactory progress has been made in the comprehension of the Charaka Samhita as the various quartets (Chatushkas) and Sthanas have been studied to enlighten the principles stored and the application of the same.

Thus, the Charaka Samhita has been studied in detail and much of the hidden treasure of knowledge has been unravelled, story is totally different when one comes to the Sushruta Samhita as a very few works have been carried out for its study.The Sushruta Samhita primarily considered as a surgical treatise though, in fact it is a complete Samhita elaborating the eight branches of Ayurveda. Sushruta Samhita has contributed a lot to the fundamentals of Ayurveda.

The fundamental principles of the study of the disease are mentioned in Ayurveda classics including the Sushruta Samhita. The disease as per the Ayurveda philosophy is termed as the imbalance of the three vital humors called as the vata, pitta and kapha. They are termed as dosha in Ayurveda parlance. The dosha is the strongest and independent unit of Ayurveda physiology and pathology. The Ayurveda has propagated the principle of the harmony of the microcosm and the macrocosm in the form of the lok-purusha samya siddhanta (The principle of the similarity of the universe and the living being).

The classics of Ayurveda elaborate on the diseases in the form of increase or decrease of the dosha-dhatu. The Sootra Sthana of Sushruta Samhita is the unique treasure of knowledge elaborating on all the fundamentals of Ayurveda. Though all the forty six chapters of the Sootra Sthana of Sushruta Samhita are unique in their subject and content having wide range of applications to every branch of Ayurveda this work is confined to the study of the Rakta Kshaya (Anaemia) and its management based on the principle of the inter-relation of tissues elaborated in the chapter15th of Sootra Sthana of Sushruta Samhita namely the“Dosha- dhatu- mala Kshaya Vriddhi Vijnaneeya Adhyaya”.

The homeostasis of the body is the equilibrium of these Dosha- dhatu- Mala while theunhealthy state is the disturbance of this equilibrium which is manifested either as Kshaya (diminution) or Vriddhi (increase). This Kshaya and Vriddhi of the Dosha Dhatu Mala is the crux of the chapter fifteen of the Sootra Sthana of the Sushruta Samhita namely “Dosha-dhatu-Mala-kshaya-Vriddhi Vijnaneeya Adhyaya”

The principle of the ‘Poorvah purvo ati vriddhatvat vardhayeddhi param param’ is a very significant theory that envisages the inter relation of the tissues. This means that the increase in one Dhatu leads to increase in the subsequent Dhatu s and sothe diminished Dhatu can be augmented by increasing the previous Dhatu and vice versa.

This concept has a very broad spectrum of application and utility for which the first requirement is to comprehend this fundamental principle by studying the same in detail and then to be applied in the practice.

The application of this principle is done in the condition of Rakta Kshaya (Anaemia) with a unique novel Ayurveda vision.

Thus this study has been selected with the following aims and objectives.

AIMS AND OBJECTIVES

I. To undertake a Comprehensive study of the principle “Poorvah purvo ati vriddhatvat vardhayeddhi param param” in the literary and fundamental aspects.

II. To elaborate the concept of the Anaemia mentioned in Ayurveda classics in all its aspects.

III. Evaluation of the effect of the Shatavari Siddha Ksheera clinically on the patients of Rakta Kshaya (Anaemia).

PREVIOUS RESEARCH WORKS

As mentioned earlier the works on Sushruta Samhita are hard to find. No work till date, with the eye of Basic Principles has been done on the principle “Poorvah purvo ati vriddhatvat vardhayeddhi param param” explained in the Sootra Sthana of the Sushruta Samhita chapter 15 “Dosha Dhatu Mala Kshaya Vriddhi Vijnaneeya Adhyaya”. Thus, this work is the first of its kind which will emphasize on the concept of inter relation of the tissues in general and the same would be applied clinically on the the patients of Anaemia (Rakta Kshaya).

Some Earlier Works On the Rakta Kshaya / Raktalpata (Anaemia)

I. Bhallataka Rasayana Nirmanatmaka evam Raktalpata par Prabhava, K.C.Sharma,1997,NIA Jaipur

II. Mandooradi Yoga Ka Balakon Ke Paripeksya mein Rakta Kshaya par Cikitseeya

Adhyayana.J.P.Nama, 2003, NIA Jaipur

III. Ayurvedokta rasa-Rakta va Adhunikokta blood Ka Vivechanakmaka Adhyayana (Raktalpata Ke Sandarbha Mein). Rupesh Pendem, 2003, Nagpur.

The Assessment of Previous Work and Importance of Present Study:

From above it becomes crystal clear that the topic selected for the present study has remained untouched from the research point of view till now and no work has been conducted on this. The works conducted so far were concerned with the various disciplines but no work has been accomplished from the vision of the Basic Principles. This work has been specially designed in light of the Basic Principles discipline. The importance of the principle selected is enormous as the health depends upon the Homeostasis of the Dhatu s which can be managed by following the above Principle. The conceptual study and the applied study, both are new and thus this research work bears immense importance for the science as well as the Humanity. A humble effort has been made by the Scholar to complete this noble work.

PLAN OF THE STUDY

This study is divided into four parts:

1) Conceptual study
2) Applied study /Clinical study
3) Discussion
4) Summary and Conclusion

CONCEPTUAL STUDY

Materials & Methods:

For this study, the basic and conceptual materials have been collected from the Ayurvedic classics viz Brihattrayee (The major triad) and Laghutrayee (The minor triad) mainly the Sushruta Samhita, Charaka Samhita and other classics with the available commentaries as well as various reference books to bereviewed.Various Publications, Text books, Research papers, proceedings of seminars have been referred to collect the literary material. All these literary materials collected have beencritically analyzed assessed and evaluated as per the hypothesis and problem selected here.Related portion of modern medical science has also been compiled and considered. The discussions with the Senior and renowned academicians have paved the way to reach to some fruitful conclusions.

This conceptual contrive has been further divided into three chapters so as to make a better understanding of the subject. The first chapter deals with a glimpse on the introduction and study of the principle “Poorvah purvo ati vriddhatvat vardhayeddhi param param” followed by the second chapter namely the disease review and then comes the turn of the drug review in the third chapter. All the direct and indirect references related to the disease and the drugs have been collected and compiled. As per the need some innovations with logical reasoning have been done.

APPLIED STUDY /CLINICAL STUDY

In order to apply and evaluate the principle of “Poorvah purvo ati vriddhatvat vardhayeddhi param param” the clinical study has been carried out. For the clinical study the materials and methods include the registration of the Patients as per the criterion of inclusion as wellas exclusion. The special research proforma incorporating all the required examinations and investigations conducted with the use of the Ayurvedic and modern techniques has been made.

The selected patients of Anaemia (Rakta - Kshaya) have been randomly divided into two groups viz.Group A (Treatment group) and B (Standard Control group).

Group A /Treatment Group: Patients has been prescribed the Shatavari Siddha Ksheera with appropriate do’s and don’t’s (Pathyapathya).

Group B /Control Group: Patients have been prescribed the Neera Siddha Ksheera with appropriate do’s and don’t’s (Pathyapathya).

Thus, the work has to be accomplished under the four sections viz the conceptual study, the applied /clinical study, the facts and results obtained to be discussed elaborately under thesection of discussion and lastly the conclusions or final say and the summary of the wholework is stipulated. At the end appendix containing Bibliography, Abbreviation and research proforma will be given.

All the honest efforts are supposed to be made in compiling and collecting the matter withthe due references. All the obtained Data have been evaluated and analyzed with intellectalong with the direction and fruitful suggestion of the guide. Even though the completion ofwork cannot be claimed and some shortcomings are likely to remain, they all are to becredited to scholar himself and for that he may be forgiven. Wise, educated may definitely assess and evaluate the validity of work.

CONCEPTUAL STUDY

Chapter-01 Introduction and study of the principle

“Poorvah purvo ati vriddhatvat vardhayeddhi param param”

Literal meaning:

Excessive increase in a Dhatu (tissue) causes increase of its succeeding Dhatu (tissue).

Extended meaning:

This principle is quoted in reference to the pathological increase in the Dhatu s and their suitable line of treatment. Mild increase and decrease in the Dosha, Dhatu s et al takes place everyday as per the circadian rhythm. This mild increase or decrease is too weak to cause adisease. But, when the increase or decrease is too much (due to Samanya / Vishesha), will lead to increase or decrease of the others as well.

Commentator Dalhana states that the increase in later Dhatu also, will lead to the increase in the previous and similarly, the kshaya of the later will also lead to the kshaya of the previous one.

Thus, this principle has a wide range of applications both, in the Physiology as well as the pathology. The statement stated under one aspect has to be studied under other possible applications as well.

Before going into the details of the aforesaid principle it is essential to understand the general principles of the Dhatu Utpatti (The origin of the tissues as per the science of Ayurveda)

DHATUTPATTI PRAKRIYA (METHOD OF ORIGIN OF TISSUES)

Dhatu s owe their origin to the Ahara/diet which is the cause of survival. The Ahara is Panchabhautika which nourishes the Panchabhautika Dhatu s. This food ingested has to undergo various transformations so as to become suitable to assimilate in the body. This transformation process is termed as the digestion. Ayurveda terms this process as “Ahara Pachana Krama”. The Ahara Rasa formed undergoes various biochemical processes to get metabolised and produce the required energy. This is known as Cayapacaya/ Metabolism.

AHARA –PACHANA KRAMA (The sequence of digestion)

The ingested food is taken into the Koshtha (digestive tract) by the Prana Vayu. This food becomes soft, looses its compactness on contact with the unctuous substance i.e. the Saliva and the Kledaka Kapha. Thereafter, the Agni located in the udara /abdomen is stimulated by the Samana Vayu. This stimulated Agni digests the food taken in appropriate quantity & Kala and is the cause of a long life. As the fire, placed below helps in cooking the raw food material e.g. Rice and Water, so does the Agni located in the Amashaya digests the food ingested. Thus, the Ahara Rasa is produced with the separation of the Mala. This Ahara Rasa acts as the substratum for the formation of all the Dhatu s.

FORMATION OF DHATUS

The first Dhatu to appear after the digestion of food is the Rasa Dhatu. The food/ Ahara which is Panchabhautika (Composed of the five basic elements viz. Akasha, Vayu, Agni, Jala and the Prithvi), Shadrasayukta (composed of the six tastes), Dwividha Virya (Sheeta – Ushna), Ashtavidha Virya (Guru- Laghu, Sheeta – Ushna, Snigdha – Ruksha, Mrdu – Tikshna) or may be composed of many Guna s, undergoes proper digestion as per the above description and the product which is very subtle but potent is called as the Ahara Rasa.

This Ahara Rasa is the substratum for the formation of all the Dhatu s. This Rasa which is the resultant of the proper digestion circulates through the Srotasas/channels and leads to the formation of all the Dhatu s.

It is to be pondered whether the product of the digestion i.e. Ahara Rasa is the substratum for the Rasa Dhatu or is the Rasa Dhatu itself. From the above quotation of Sushrut Acharya it is clear that he hasn’t differentiated the Ahara Rasa and the Rasa Dhatu. He has accepted this Ahara Rasa to circulate throughout the body through the hrdaya as the main centre. This Ahara Rasa produces all the functions of the Rasa Dhatu mentioned by the other Acharyas.

Similarly this Rasa is accepted to produce the successive Rakta Dhatu, making it clear that Sushruta hasn’t differentiated between the Ahara Rasa and Rasa Dhatu.

The Ahara after proper digestion differentiates into the Prasada (utilitarian), Rasa and the Kitta (Non utilitarian), Mala. Charaka has clearly differentiated the AharaRasa with the Rasa Dhatu. In the chapter 28 of the Sootra Sthana he clearly mentions the Rasa and the Rasa Dhatu separately. Charaka attributes the product of digestion, Ahara Rasa, to nourish all the seven Dhatu s viz. Rasa, Rakta, Mamsa, Meda, Asthi, Majja and Shukra; Ojas and others.

Same Charaka, in the “Grahani Dosha Adhyaya”, chapter 15 Chikitsa Sthana doesn’t mention the Ahara Rasa and the Rasa Dhatu separately and mentions the transformation of the Rasa directly into the Rakta Dhatu. Thus, it becomes essential to clarify this ambiguity whether to accept the Ahara Rasa and the Rasa Dhatu same or different.

This query has been solved by the “Charaka Chaturanana”, Chakrapani Dutta.

He considers both the theories logical and divides the Rasa into two, Sthayee (permanent) or the Poshya (nourished) and the other Asthayee (transitory) also called as the Poshaka (Nourisher). The Poshaka (Nourisher) Rasa is the one produced after the digestion of the food also called as the Ahara Rasa while the Poshya (nourished) is the Rasa Dhatu proper. Chakrapani makes it clear that the difference between the Ahara Rasa and the Rasa Dhatu in the chapter 28 of the Sootra Sthana is made to differentiate the Poshaka (Nourisher) and the Poshya (nourished) while the absence of such a difference in the Grahani Dosha Chikitsa states the indifferent nature of the Poshya (nourished) and Poshaka (nourisher) as the duo share the same site.

NOURISHMENT OF THE DHATUS AS PER THE DHATU POSHANA NYAYAS/ MAXIMS

Pramanaih artha pareekshanam nyayah (Vatsyayana)

The examination of the subject with the proper evidences and logic is the Nyaya. The Nyaya s don’t specify the only truth but indicate a route towards the truth. The Siddhanta is the one which is accepted by all after multiple experimentation and observation and is always the truth but the Nyaya is ones view and is the way a person sees a process happening which varies from person to person.

In the case of the “Dhatu Poshana” also a number of theories have been proposed but none of them can be accepted as the sole truth. Thus, all these theories proposed by the Acharyas are to be seen as a view based on the observation and logic. Thus, these theories regarding the nourishment of the Dhatu s are termed as “Dhatu Poshana Nyaya”.

1) KSHEERADADHI NYAYA (MAXIM OF THE MILK & CURD)

Also known as the Law of Transformation, or the Sarvatmana Parinama Paksha, the Ksheeradadhi Nyaya has been the first of the theories placed forward towards the understanding of the DhatuPoshana. It has been propounded by the revered commentator Chakrapani Dutta. According to this Nyaya, the one Dhatu transforms into the other successive Dhatu just as the milk transforms into the curd so is the term “Ksheeradadhi Nyaya”. As per this Nyaya, one Dhatu becomes the nutrient for the other.

This implies the transformation of the Rasa into Rakta, Rakta into Mamsa, and Mamsa into Meda and so on. Thus, the previous Dhatu acts as a substratum for the successive one.

The time taken for transformation of Rasa into the Shukra as per this Nyaya is explained in various ways by the seers of yore.

As per the strength of the Dhatavagni and the Bhootagni, the Rasa Dhatu undergoes transformation into the successive Dhatu s. Some Acharyas say that the Rasa transforms into the Shukra in six days.

Parashara says that the Ahara Rasa transforms into the Rasa Dhatu in 24 hours, Rakta Dhatu is formed on the third day, Mamsa forms on the fourth day, Meda on the fifth, Asthi on the sixth, Majja on the seventh and the Shukra is formed in the eight days.

Sushruta is of the view that the Rasa stays in each Dhatu for a period of 3015 Kalaas, approx. 5 days. Thus, in about a month the Shukra and the Artava are formed in the Male and Female respectively.

Thus, from the above difference of opinions it is hard to pinpoint the time required for the transformation of the Dhatu s. The problem has been solved by the Charakacharya in the commentary of the verse 21 of the Charaka samhita, Chikitsa Sthana chapter 15.

This means that the DhatuPoshana process continues continuously without any pause.

Explaining this with an example of the person drawing out water from a well using a wheel, it is found that the strength of the person turning the wheel is responsible for speed of drawing the water out of the well. The more the strength of the person the more is the speed of drawing the water. Similarly, the strength of the factors like Agni decides the time for the formation of the Dhatu s.

DOUBTS REGARDING THE KSHEERADADHI NYAYA & SOLUTION:

Raising the doubts in the authenticity of the Ksheeradadhi Nyaya, Acharya Chakrapani contends that if this Nyaya is accepted then, if a person performs fast for 3-4 days, the Rasa Dhatu of this individual should be depleted. Similarly a fast of a month shall make the body devoid of all the six Dhatu s and only the Shukra will remain. Clarifying these doubts Vagbhatta and Dalhana say that after the digestion of food the food gets divided into two parts viz. the Sara (potent part) and the Kitta (Excretory part). The Sara is acted upon by the Dhatavagni that again divides this part into two parts, one Sthoola and other Sookshma. The Sthoola part nourishes the Dhatu while the Sookshma part nourishes the Upadhatu and the successive Dhatu.

The Sookshma part of the preceding Dhatu is acted upon by the Agni of the successive Dhatu which produces three parts viz. Sthoola, which nourishes the self (Dhatu); Sookshma, which nourishes the Upadhatu and consecutive Dhatu; Mala which nourishes the excretory portion.

KSHEERADADHI NYAYA W.S.R. TO THE PRINCIPLE

“POORVAH POORVO ATI VRIDDHATVAT VARDHAYEDDHI PARAM PARAM”

The principle “Poorvah poorvoativriddhatvatvardhayeddhi param param” can be easily understood by the application of the Ksheeradadhi Nyaya. According to the principle excessive increase in one Dhatu will lead to the increase in the other and vice versa. The Ksheeradadhi Nyaya also explains the same. The increase in the Rasa Dhatu will automatically lead to an increase in the Rakta Poshakamsha leading to an increase in the Rakta Dhatu. However, this transformation will depend on the status of the Dhatavagni. Similarly the excess increase in the other Dhatu s also will lead to the formation of more Poshakamsha of the consecutive Dhatu and thus increasing the precursors of those Dhatu s.

Likewise, in the case of the excess decrease of a Dhatu, there will be decrease in the other Dhatu s also. The decreased Dhatu will lead to lesser production of the consecutive Dhatu Poshakamsha leading to the diminished consecutive Dhatu s. In this case the increased Vata may also add to the problem by vitiating the Agni, leading to decreased formation of the Dhatu s or by increasing the rate of depletion.

Thus, this Nyaya directly vindicates the principle “Poorvah poorvoativriddhatvatvardhayeddhi param param”

2) KEDARIKULYA NYAYA (MAXIM OF THE FIELD AND THE CANAL) -

This is also known as the Law of Transmission or the Krama Parinama Paksha. The Kedari means the field while the Kulya means the canal. This Nyaya likens the nourishment of the Dhatu s with the irrigation of the different fields with the canal. The water irrigates the nearby field first and then it irrigates the distant ones.

The Rasa Dhatu nourishes the Rakta first. When the Rasa Dhatu contacts with the site of the Rakta Dhatu, the former takes the form of Rakta i.e. the Rasa acquires the odour, colour of the Rakta and nourishes it by the homologous fraction. Similarly, other Dhatu s are nourished. The specialty of this Nyaya is that the Rasa travels through a single path and nourishes all the Dhatu s.171

Harita has also accepted this theory. According to him the Rasa Dhatu undergoes change of the colour to white, grey and green etc. throughout the day before it gets converted to Rakta.

KEDARIKULYA NYAYA W.S.R. TO THE PRINCIPLE "Poorvah poorvoativriddhatvatvardhayeddhi param param" –

This Nyaya is most widely accepted among the Dhatu Poshana theories. This Nyaya explains all the aspects of the DhatuPoshana process. The shortcomings of the Ksheeradadhi Nyaya are also resolved by this Nyaya.

The principle “Poorvah poorvoativriddhatvatvardhayeddhi param param" can be explained with the KedariKulya Nyaya. This can be explained on the basis of some logic.The Rasa in the state of excess will not accept the nutrients just as the field which is completely saturated with water refuses to accept more, thus making more water available for the subsequent fields. Similarly, the increase in one Dhatu may lead to the increase of the nearby Dhatu as the channels of these Dhatu s are very near. The Dhatu in excess will refuse to accept the Panchabhautic raw material in the form of Rasa and makes way for the nourishment of the nearby Dhatu s. From various references it becomes clear that there is physiological relation between the various Dhatu s and their respective Srotasas / Channels and they are influenced by one another as the various canals for nourishment of the field are interlinked.

Similarly, decrease in one Dhatu will lead to the decrease in the other as the diminished one will consume more nutrients just as the field that is dry consumes more water leading to the scarcity of water in the other fields.

In the case of Rajayaksma, the interrelation between the various Dhatu s is clearly visible in the concept of Pratiloma Kshaya. The Pratiloma kshaya means the kshaya of the later Dhatu shall lead to the kshaya of the previous one. Thus, it is to be accepted that the increase in one will also lead to the increase in the other proving the above principle.

Another concept to prove this theory is by applying the Upasneha Nyaya. This Upasneha Nyaya has been explained in the context of foetal development (Su.Sa.3/31). Just as the trees on the banks of a river get nourished with the water, the increased Dhatu also nourishes its nearby Dhatu s. The word Upasneha indicates the mode of the travel of the nutrients like the Osmosis.

3) KHALEKAPOTA NYAYA / MAXIM OF THE BARN & THE BIRD -

This is also known as the Law of Selectivity. According to this Nyaya, the nourishment of the Dhatu s takes place by selection.

The nourishing fluid, Anna Rasa travels to the different Dhatu s through different channels.

In the beginning, the nearby Dhatu draws its nutrient fraction from the nourishing fluid and the distant one gets nourished later. This theory is based on the analogy of the pigeons carrying the grains from a field and moving in different directions to reach their destination, nest. The nest which is near will get the grain first while the nest farther will receive the grain later.

This theory believes that each Dhatu has its specific nutrient, Poshakamsha (Nourishing part).

This theory is accepted in the case of the origin of the disease also as the Dosha s travel in the different Srotasas and the place where there is vitiation, Kha-Vaigunya, produce the diseases.

KHALEKAPOTA NYAYA W.S.R. TO THE PRINCIPLE “Poorvah poorvoativriddhatvatvardhayeddhi param param”

This theory of Dhatu Poshana is also important in understanding the principle of “Poorvah poorvoativriddhatvatvardhayeddhi param param”. Although, it implies the existence of different nourishing entities for different Dhatu s it is well known that these nourishing factors are none other than the various combinations of the panchamahabhoota s.

As in the case of Kedari Kulya Nyaya, here also the precursor Rasa nourishes all the Dhatu s as it contains all the nourishing fractions. In this case the Dhatu which is in excess or Vriddha refuses to accept the precursor and let it go away to the other Srotas. In this way the increase in one Dhatu leads to a subsequent increases in the successive Dhatu and vice versa.

4) EK KALA DHATU POSHANANYAYA (MAXIM OFTHE SIMULTANEOUS NOURISHMENT)

This theory has been propounded by the commentator, Arundutta, as he doesn’t consider any of the theories fully applicable in explaining the Dhatu Poshana.

Arundutta clarifies that the AharaRasa nourishes all the Dhatu s of the body simultaneously by the particular fraction of that Dhatu by entering the respective Srotasa of that Dhatu.

Acharya Charaka has also narrated this in reference to the Vyana Vayu which is said to carry the Rasa Dhatu throughout the body simultaneously.

EK KALA DHATU POSHANA NYAYA W.S.R. TO THE PRINCIPLE “Poorvah poorvoativriddhatvatvardhayeddhi param param”

The Ek Kala Dhatu Poshana Nyaya is not too much accredited in Ayurveda as it appears to be a mere translation of the modern view. It specifies the fact that the body continuously gets nourished as we know that the wear and tear phenomenon continuously occur in the body which is maintained by the nourishment through the food.

The principle “Poorvah poorvoativriddhatvatvardhayeddhi param param” can be understood in the light of this Nyaya also. The VyanaVayu carries the precursors of all the Dhatu s at a time. As per the requirement the Dhatu s get nourished and remaining portion left for the other Dhatu s. Thus, as seen before the increase in the one Dhatu increases the other and vice versa.

ANALYSIS OF THE DHATU POSHANA NYAYAS:

The above description makes one point clear that Ayurveda has accepted the importance of the Rasa in nourishment of all the Dhatu s.

No Nyaya can individually explain the complete mechanism individually. Therefore, these entire hypotheses, in spite of criticisms have prevailed till date. In fact, all the Nyaya s are correct in their approach and there is not much of a difference among them. All the three Nyaya s act as a unit and it is not possible to explain Dhatu - Poshana with the exclusion of any of them. Thus, all the three act in full harmony to show the complete process the Dhatu - Poshana.

The AharaRasa first nourishes the RasaDhatu by the Ksheeradadhi Nyaya. The Rasa Dhatu accepts the required nourishment from the Rasa and the remaining portion by the application of the Kedari - Kulya Nyaya nourishes the Rakta by behaving like the Rakta. The remaining portion moves ahead in the Mamsavaha Srotasa to nourish the Mamsa Dhatu.

Thus, all the three act together to nourish the Dhatu s. In this way the Dhatu s nourish each other and so the increase in one leads to the increase of the other and vice versa proving the principle "Poorvah poorvoativriddhatvatvardhayeddhi param param".

The Ksheeradadhi Nyaya emphasizes on the Dhatavagnipakajanya prasadamsha while the Kedari Kulya Nyaya stresses on the Rasa samvahana and the Khale Kapota on the Srotasas /Channels.

There is no difference in the acceptance of the Dhatu - Paka. The product of the Dhatavagnipaka is circulated through the Srotasas/channels with the medium of Rasa only. Agni and Srotasa, both are essential for the Dhatu - Paka with the medium Rasa.

DHATUPOSHANA AS PER SHAREERA TATTWA DARSHANAM -

The revered Ex-president of the Bharatiya Ayurvidya Shikshana Samiti, VaidhyaPurushottam Shastriji Hirlekar has been a gem of Ayurveda. The widely acclaimed book “Shareera tattwa darshanam nama Vatadi Dosha Vijnanam” is the collection of his original thoughts that explain the concept of DhatuPoshana vividly. Therefore, seeing the importance of this in the present study a short note on the process of DhatuPoshana is being explained below.

The origin, transformation and growth of the Dhatu s depend on the Samyoga (association) and Viyoga (disassociation).

In the beginning of the origin of the Dhatu s the Poshya (nourished) and Poshaka (Nourisher) (nutrients) associate and form a fluid. The subsequent Dhatu and the previous dhatu are also the Poshya (nourished) and Poshaka (Nourisher) respectively.

The nutrition of the seven Dhatu s in Ayurveda is explained in the two ways; Nitya (continuous) and the Kramavat (sequential). The Nitya Poshana is possible by the Ahara Rasa which contains the necessary nutrients to nourish all the Dhatu s simultaneously while the second variety i.e. Kramavat Poshana is the conversion of one Dhatu into the other in a particular sequence.

This two way nutrition of the Dhatu s is not antagonistic as the result of the two is different.

On one hand the Ahara Rasa directly nourishes the Dhatu s while on the other side the deha ushma (body heat) converts one Dhatu to other. This process transforms the Ahara Rasa into all the seven Dhatu s. The increase in the Dhatu is limited and only a part of one Dhatu converts into the other. The transformation of a part of a Dhatu nourished by the Ahara Rasa is associated with the Mala utpatti which is to be thrown out. If this process of transformation is hindered, this will consequently increase the Dhatu s due to the continuous nutrition by the Ahara Rasa.

Example: The failure of conversion of the Meda Dhatu into the Asthi Dhatu leads to increase in the Meda Dhatu leading to the Sthaulya.

The Shukra kshaya leads to the kshaya in all the preceding Dhatu s. Thus, Anavaya vyatireka proves that the conversion of one Dhatu into other occurs in a systematic manner as Charaka clarifies “Dhatavo hi dhatavaaharah”.

Ex. the water provided to the root of the tree reaches each and every part of the plant but the origin of branches, sub branches, leaves, flower and fruit occur in a particular sequence.

Similarly the Rasa Dhatu reaches every nook and corner of the body but the Dhatu s are produced in a particular sequence as the Rakta, Mamsa etc.

From the above description it is clear that there are a number of factors that act together to produce the Dhatu s. A harmony between these factors is very essential to ensure the maintenamce of normal Cayapacaya, Metabolism which is the key to the Healthy existence.

Some of these quintessential factors affecting the Dhatu Utpatti are enumerated below.

FACTORS AFFECTING THE DHATU POSHANA:

Chakrapanidutta and others have pointed out that the most important factors affecting the Dhatu - Poshana are:

1. DHATAVAGNI: If the Dhatavagni s remain in their normal state, then the Dhatu - Poshana also continues normally. These Dhatavagni s undergo illumination and diminution within the accepted range as a part of the biological rhythm. While the illumination and diminution within the normal range is a physiological phenomenon, various dietary, environmental, genetic, and psychological factors derange the status of the Dhatavagni leading to either excessive illumination or excessive diminution.

The excessive illumination of the Dhatavagni may be due to the excessive activation of the Pitta fractions; vitiation of the Vata mainly the Vyana that transmits the Ushma (heat) from the Jatharagni to the Dhatavagni; or the excess supply of nutrients homologous to the Dhatu which in turn first leads to illumination and then diminution of the Dhatavagni which leads to the accumulation of the Ama Dhatu.

2 . VYANA VAYU: Vyana activates the Dhatavagni s by the transmission of the Pitta fractions and Ushma (heat) of the Jatharagni to the Dhatavagni. The Vyana also regulates the movement of the Poshakamsha into the Srotas.

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