Mamsa dhatu

Mamsa literally means meat or flesh. Mamsa dhatu is a body component similar to muscular tissue. Itsimportant function is lepana (to cover body). It provides covering above the skeleton. (SAT-B.433) As the name suggests, it is a bulky tissue and denotes status of nutrition. Due to its solid state, it provides proper size, shape and dimension to body.

Authors: Anagha S.¹, Deole Y.S.¹, Shilawant A.² Reviewed by: Basisht G.¹

¹Charak Samhita Research, Training and Development Centre, I.P.G.T.& R.A., Jamnagar

²Department of Kriya Sharir, G.J.Patel Institute of Ayurvedic Studies and Research, New Vallabh Vidyanagar, Anand, Gujarat, India

Correspondence email: carakasamhita@gmail.com

Etymology and derivation:

The word is derived from Sanskrit root called “Mans” meaning flesh or meat. Mamsa dhatu is the component which enhances body mass, covers body parts, takes part in flexion and extension movements of joints with muscles and tendons attached to it.

Synonyms:

Pishita: Found to be separated in single-single fibers (Vibhakta inPeshi svaroop)

Kravya :Looks aggressive, fearful just be seeing it (Kuyate anen iti kravyam)

Palala: Wrapped throughout body and having functional potential. (Kriya samarthyavaan)

Amisha : Creates greed to achieve it or have it.

Tarasa :Which is responsible for strength within the body (Bala)

Rakta teja, Rakta udbhav : Originated and developed from previous Rakta dhatu

Medaskrut : Involved in origin and development of next dhatu – Meda

Meanings in different contexts:

• In physiology, the word denotes structural and functional components mainly of muscle tissue.

• In the classification of dietary articles, a separate group named ‘mamsa varga’ (class of meats) is described. It includes properties of meat of various animals and birds recommended for specific dietary and therapeutic purposes.[Cha. Sa. Sutra Sthana 27/35-87/]

• A dietary preparation of mamsarasa – Veshavar(meat soup) is the best for nourishing body.[Cha. Sa. Sutra Sthana 25/40]

Panchabhautika constitution and properties:

Vayu, jala and agni mahabhuta play major role in the formation of mamsa.[Cha. Sa. Chikitsa Sthana 15/29] Mamsahave predominance of prithvi mahabhuta.

The physical properties of mamsa dhatu are sthula(bulky),sthira(stable),guru(heavy), khara(rough),kathina(hard) and shlakshna(smooth). The biological properties of mamsa dhatu are moderately cold (na ati sheeta), heavy to digest (na ati guru), and moderately unctuous (na ati snigdha). [Cha.Sa.Sutra Sthana 27/61]

Formation and metabolism of mamsa dhatu

The mamsa dhatu is formed from rakta dhatu. The nourishing portion of rakta dhatu and constituents of ahara rasa are transformed into mamsa dhatu by action of mamsa dhatvagni (metabolic factors of mamsa), vayu, jala and tejas mahabhuta . [Cha. Sa. Chikitsa Sthana 15/29]

It gets solid fleshy bulk due to prithvi mahabhuta. During embryogenesis, asthi and mamsa dhatu of embryo are developed from shukra. This mamsa dhatu is differentiated later into snayu (ligaments) during fetal development. [ Kas. Sam. Sharira Sthana 2/2]

The formation of mamsa dhatu is enhanced by anabolism in the fifth month of gestation.[Cha. Sa. Sharira Sthana 4/21]

Formation of layer during embryogenesis: Seven layers of skin are formed during embryogenesis. Mamsadhara is the seventh and innermost layer. It is estimated to have thickness of 1 to 3 mm or two vrihi(grains of paddy). [One vrihi = 0.5 to 1.5 mm] This layer can be observed as deeper reticular layer of dermis. This layer is affected in diseases like bhagandara(fistula), vidradhi(abscess) and arsha(hemorrhoids). [Su. Sam. Sharira Sthana 4/8]

• Upadhatu and mala (metabolic byproducts and waste products):

During the process of metabolism and formation of mamsa dhatu, vasa (muscle fat) and six layers of tvacha (skin)are formed as the upadhatu(metabolic byproducts). [Cha. Sa. Chikitsa Sthana 15/17] Sharangadhara considered vasa as the upadhatu of mamsa dhatu.[Sharangadhara Sa. Purva khanda chapter 5]Various secretions accumulated as wastes in external openings of ear and nostrils are waste products of metabolism of mamsa dhatu. [Cha.Sa. Sutra Sthana 15/18]

Quantity of mamsa dhatu:

The quantity of vasa (unctuous part of muscles or muscle fat) is three anjali. [Cha.Sa. Sharira Sthana 7/15]. The structural component of mamsa dhatu is responsible for compactness of body and covers the skeleton properly with musclesand ligaments. There are 900 snayu (ligaments) and 400 peshi (muscles). [Cha.Sa.Sharira Sthana 7/14] Sushruta added 100 more peshi and thus enumerated them as 500 in male body and 520 in female body.[Su.Sa. Sha.5/37-39]

Time span: • The mamsa dhatu is formed on 3rd day from ahara rasa. [Cha.Sa. Chikitsa Sthana 15/20-21] However, Sushruta opines that the mamsa dhatu is formed in a time span of 6030 kala (ten days). [Su. Sa. Sutra Sthana 14/14]

Characteristics of mamsa sara (best quality of muscular tissue):

The persons having essence of mamsa have their temples (shankha), forehead (lalata), nape (krikatika), eyes (akshi), cheek (ganda), jaws (hanu), neck (griva), shoulder (skandha), abdomen (udara), axillae (kaksha), chest (vaksha), hands (pani), feet (pada)and joints (sandhi) well developed with firm, heavy and good looking muscles. This essence indicates forbearance, restraint, and lack of greed, wealth, knowledge, happiness, simplicity, health, strength and longevity.[Cha.Sa. Vimana Sthana 8/105]

Existence of Mamsa dhatu in body:

The mamsa dhatu is present in various forms as below: Palala (muscular sheath or coat): It is present in the form of covering of an organ and also carries physiological functions.ex. Myocardium of Heart

Mamsavaha srotas : • The mamsavaha srotasa (nutrient transport system for mamsa) has its roots in snayu (ligaments) and twak (skin). [Cha. Sa. Vimana Sthana 5/8]

• In addition, the raktavahi dhamani (major arterial trunks) also serve purpose of transport. [Su. Sa. Sharira Sthana 9/12]. There are various other anatomical structures related to mamsa dhatu. These can be included in the system of mamsavaha srotasa.The structures are as described below:

Mamsadhara kala:

• Kala is the layer in outer coverings of body observed in sagittal section. Mamsadhara kala is the firstcovering with a network of sira (veins), snayu (ligaments), dhamani(artery) in it. [Su. Sa. Sharira Sthana 4/10] It is a membrane that separates two organs or structures. Ex. Membrane is gastrointestinal tract separates it from visceral organs.

• Mamsa peshi (muscles):

The well differentiated compact form of mamsa(flesh) is called as peshi(muscles). It is created by division of mamsa by vayu and pitta. [Su.Sam. Sharir Stahna 4/28]

There are 500 peshi in males and 520 peshi in female body.These peshi cover and provide strength to anatomical structures formed by veins, ligaments, bones, and their joints. [Su.Sa. Sha.5/37-39]The mamsa, sira and snayu are attached to bones to form anatomical structure. [Su.Sa.Sha.5/23]

This is useful for nutritional status assessment by Anthropometry.

• Mamsa jala(network): There are four types of jala(network like structures) in body. Mamsa jala(muscle network) is the first one among them, the others being that of sira(veins),snayu(ligaments) and asthi(bones). There are four such networks formed from each of these types. They are present in wrist and ankle joints and interlinked together.[Su. Sam. Sharira Sthana 5/12].

• Mamsa rajju(cords): There are four major cord like structures attached to the vertebral column. The muscles are weaved and attached to these cords. [Su. Sam. Sharira Sthana 5/14].

• Kandara (tendons): The large ligaments are termed as ‘kandara’. There are 16 kandara in body. [Su.Sa. Sha.5/11]

• Mamsa marma :There are eleven mamsa marma(vital spots formed from muscle).These are four talahridaya (vital point in middle of palms and soles), four indrabasti(vital point in middle of forearms and upper part of calf region), guda (vital point in anus), and two stanarohita(vital point in upper part of breast nipples). If these marma are injured, then it can affect vitality of individual. [Su. Sam. Sharira Sthana 6/7].

Functions of mamsa dhatu:

Lepana(covering) is the main function of mamsa dhatu. Providing strength to the body and nourishment of meda dhatu are additional functions. [Su. Sam. Sutra Sthana 15/5]. Mamsa dhatu provides support for various movements and protection to the inner organs too. Mamsa dhatu is also inevitably involved in sustaining the strength of the body (bala) due to which there is inculcation of potential to perform physical activities.

Normalcy of mamsa dhatu is assessed by examination of different muscle actions such as – akunchan (flexion), Prasarana (extension), Utkshepan (elevation), Apakshepan (depression) and chakra gati (circumduction). Vyana vata is responsible for carrying out this function. [Cha.Sa.Chikitsa Sthana 28/9]

Mamsa dhatu is known for his pure quality of sthira guna which is manifested by a sort of tension or tautness in group of muscles and this is seen as – Muscle tone. Any deviation in this may be elicited as – Hypotonia or Hypertonia.

=Importance in diagnosis

• Mamsa is one among the dashapranayatana(ten vital seats). [Cha. Sa. Sharira Sthana 7/9]. Mamsa dhatu is directly responsible for vitality of an individual.

• Any vitiation or direct injury to the roots of mamsavaha strotascan lead to death. [Su.Sha.Sharir Sthana 9/12]

Causes of vitiation

Excessive consumption abhishyandi(increasing secretions and causing obstruction), bulky, heavy to digest food and day time sleep are causative factor for vitiation of mamsavaha srotasa. [Cha. Sa. Vimana Sthana 5/15]  Action of different rasa(tastes) on mamsadhatu[Cha. Sa. Sutra Sthana 26/43] Rasa Action on mamsa dhatu Madhura (sweet) Promotes growth (mamsa vardhana) Amla (sour) (excess use) Causes inflammation (mamsam vidahati) Lavana (salty) (excess use) Causes sloughing (mamsam kushnati) Katu (pungent) (excess use) Scraping (mamsam vilikhati), reduces bulk of mamsa Tikta (bitter) (excess use) Absorbsmoisture (mamsam shoshayati), reduces elasticity of mamsa

Abnormal states

The increase or decrease in quality and/or quantity of mamsa dhatu can lead to various abnormal conditions. The states can be assessed by following clinical features. Symptoms of mamsa kshaya (decrease of mamsa dhatu)* Symptoms of mamsa vriddhi (increase in mamsa dhatu)** Decrease in circumference and skin fold thickness ofhips, neck and belly due to loss of bulk of muscles Increase in circumference and skin fold thickness of buttocks, cheeks, lips, penis, thighs, arms and calves wasting of buttocks, cheeks, penis, thighs, chest, axillae, calves heaviness of the body Dryness Extra muscular growth or Hypertrophied musculature pricking pain debility of the body Fatigue loss of tone of arteries Hypotonia in vessels specially in arterial wall just due to having thick muscular coat in it as compared to veins and capillaries

• [Cha. Sa. Sutra Sthana 17/65], [Su. Sam. Sutra Sthana 15/9]
  • [Su. Sam. Sutra Sthana 15/24]

• Mamsa kshaya (diminution of muscle tissue) is generally considered as a bad prognostic feature. [Su. Sam. Sutra Sthana 32/5],[Su. Sam. Sutra Sthana 33/5,18,25]. • Mamsa vruddhi can be easily classified into two classes as – Hypertrophy & Heaviness. Hypertrophy can also be understood in terms of – Arbuda (tumorous growth or myoma); Granthi (nodular growth) – Lump, Cyst, Polypous growth; and Adhimamsa (excess fleshy growth layer by layer) Clinical features of vitiation of mamsavaha srotas: • Adhimamsa (granuloma or polyps), arbuda (tumorous growth or myoma), kila (piles, skin tags, warts), galashaluka (uvulitis), galashundika (tonsillitis), putimamsa (gangrene), alaji (boils), ganda (goiter), gandamala (cervical lymphadenitis), and upajihvika (inflammation of epiglottis).[Cha.Sa. Sutra Sthana 28/13-15] • The symptoms produced due to injury to mamsavaha srotas are shwayathu(edema),mamsashosha(wasting), siragrandhi(aneurism) and death.[ Su.Sa. Sharir Sthana 9/12] • Burning sensation inside the body, thirst, unconsciousness, weakness, diarrhea, foul smell from the body and convulsive movements of the limbs are the features manifesting in mamsagata jwara. [Cha. Sa. Chikitsa Sthana 3/78] Role of mamsa dhatu as vitiated factor in diseases: Mamsa dhatu is involved as the dushya(vitiated tissue) in the pathogenesis of various diseases as listed below: • Avruta madhumeha(diabetes due to obstructive pathogenesis) [Cha. Sa. Sutra Sthana 17/79],prameha pidaka(diabetic carbuncles) [Cha. Sa. Sutra Sthana 17/82], • shotha(swelling) [Cha. Sa. Sutra Sthana 18/7], • prameha (obstinate urinary disorders) [Cha. Sa. Nidana Sthana 4/8], • kushtha(skin disorders)[Cha. Sa. Nidana Sthana 5/3], • shosha(wasting diseases)[Cha. Sa. Nidana Sthana 6/8], • granthi(nodule) [Cha. Sa. Chikitsa Sthana 12/81], • arsha (hemorrhoids)[Cha. Sa. Chikitsa Sthana 14/5], • kamala(jaundice) [Cha. Sa. Chikitsa Sthana 16/34], • visarpa (erysipelas) [Cha. Sa. Chikitsa Sthana 21/15], • vidradhi(abcess)[Su.Sam. Nidana Sthana 9/4], • Tritiyaka jwara [Cha. Sa. Chikitsa Sthana 3/66] • Mamsakleda(retention of moisture) and mamsadaha (inflammation) are included among the 40 disorders due to pitta. [Cha. Sa. Sutra Sthana 20/16] • When vitiated vata is located in muscles and fat, it manifests as heaviness of body, pricking pain and as if beaten by a strong rod,severe pain and fatigue. [Cha. Sa. Chikitsa Sthana 28/32] • When vata gets occluded by mamsa,it causes hard,discolored boils,swellings, horripilation and tingling. [Cha. Sa. Chikitsa Sthana 28/64] • The strava(discharge) from a vrana situated in muscle tissue resemblesghee. It is thick, white and slimy. [Su. Sa. Sutra Sthana 22/8] • If a foreign body gets lodged in mamsa, it produces the symptoms like increase of swelling, appearance of new growth in the path of foreign body, intolerance on pressure , sucking pain and formation of pus. [Su. Sa. Sutra Sthana 26/10] • Suturing is indicated in non-inflammatory ulcers penetrated upto muscles without any other complications. [Su. Sa. Chikitsa Sthana 1/45] Prognosis: • Vrana (ulcer) is easily curable when situated in mamsa. [Cha. Sa. Chikitsa Sthana 25/36] • From prognosticaspect, mamsagata jwara is curable. [Cha. Sa. Chikitsa Sthana 3/83] • In case of fracture, if the inflammation of muscle tissue is noticed, it is difficult to cure. [Su. Sa. Chikitsa Sthana 3/69] • Formation of muscular sprout like structure on the surgical site is considered as a sign of improper surgical management. [Su. Sa. Sutra Sthana 5/15]

Importance in preservation of health and prevention

Samhanana (proper musculature) is one of the assessment parameters of health. Physical strength directly depends upon musculature.[Cha.Sa.Vimana Sthana 8/116]A person with a balanced proportion of muscles and compactness of the body and firmness in sense organs is not affected by diseases. Such people can tolerate hunger, thirst, the heat of the sun, cold and physical exercise. Their digestion, assimilation of food and muscle metabolism is in a state of equilibrium. [Cha. Sa. Sutra Sthana 21/19]. Qualitative and quantitative decrease in mamsa dhatu is directly related to balakshaya(diminution of strength) [Su. Sam. Sutra Sthana 28/20] and ojakshaya[Su. Sam. Sutra Sthana 15/24]. Thus, the nutrition of mamsa dhatu is related to strength and immunity of a person.

Management of disease:

 The disordersof mamsa dhatu should be treated with shodhana(purification), shastra(surgery), application of kshara (alkali) and agnikarma (cauterization) [Cha. Sa. Sutra Sthana 28/26]  In jwara, affecting mamsa and meda dhatu , virechana (therapeutic purgation) and upavasa (fasting) should be done. [Cha. Sa. Chikitsa Sthana 3/316]  When vata gets occluded by mamsa and medas, purgation, evacuative enema and palliative measures should be administered. [Cha. Sa. Chikitsa Sthana 28/93]  The poisonous effects on mamsa dhatu are treated with roots of khadira (Acacia catechu), nimba (Azadiracta indica) and kutaja (Holarrhena antidysentrica) mixed with honey and water. [Cha. Sa. Chikitsa Sthana 23/187]  Yapana basti (a type of enema) is indicated for promoting shukra and mamsa (semen and muscular tissue) of a person, indulging excessive sexual intercourse. [Cha. Sa. Siddhi Sthana8/21]  The effect of anuvasana basti(unctuous enema) is observed in terms of unctuousness in mamsa and medas on the sixth day. [Su. Sam. Chikitsa Sthana 37/73]  Mamsa (meat) is considered as the best measure for brimhana(nourishing) and habitual use of meat soup of carnivorous animal is the best remedy for curing grahani (gastrointestinal disorders) or curing of assimilation disorders, consumption and piles. [Cha. Sa. Sutra Sthana 25/40]  The patient of emaciation due to trauma is advised to take the decoction of the meat of carnivorous animal sizzled with ghee and added with pippali and honey. This helps in promoting muscle tissues and blood. [Cha. Sa. Chikitsa Sthana 11/30]  In the management of poisoning due to substances of plant and mineral originand snake bite, the use of flesh with fresh blood is used to keep on the incision made at the vertex region of the person. [Su. Sa. chikitsa Sthana 2 /43, Su. Sa. Chikitsa Sthana 3 /24] Surgical Management:  In muscular parts, the depth of surgical incision should be equal to the size of 1 yava(barley). [Su. Sa. Sharira Sthana 8/9].  Sandamshayantra(pincers/forceps) are used to pull foreign bodies lodged in mamsa. [Su. Sa. Sharira Sthana 7/11].  Tempering of instruments should be done using water, for splitting, cutting and tearing of muscles. [Su. Sa. Sharira Sthana 8/12].  For agnikarma(thermal cautery), jambavoshtha( a piece of black stone), and rods of other metals are used for diseases of mamsa. [Su. Sa. Sharira Sthana 12/4]. Dietary management: Mamsa dhatu is increased predominantly with the consumption of meat. [Cha. Sa. Sharira Sthana 6/10] Lifestyle management: Vyayama (specific physical exercise): Vyayama isintended towards bringing stability (in body) and increase in strength. It can decrease the morbidities and improve functions of agni. [Cha.Sa,Sutra Sthana 7/31]. Current researches recognized exercise as a primary strategy to control hyperglycaemic disorders, also it induces a coordinated immune-neuro-endocrine response that acutely modulates cardiovascular, respiratory, and muscle functions and the immune response to exercise are widely dependent on the intensity and volume.

Current researches

Contemporary approach: The muscles in human body are categorized in three main categories: 1. Skeletal muscles 2. Smooth muscles 3. Cardiac muscles About 40 per cent of the human body is made up of skeletal muscle, and perhaps another 10 per cent is smooth and cardiac muscle. () Smooth muscle is composed of far smaller fibers – usually 1 to 5 micrometers in diameter and only 20 to 500 micrometers in length. In contrast, skeletal muscle fibers are as much as 30 times greater in diameter and hundred times longer.

The fundamental principles of contraction are almost same in skeletal muscles and smooth muscles. However the structural arrangement is different in both groups. These can be referred as various types and shapes of peshi and snayu described above.

Composition of muscles:

Skeletal muscle is formed by 75% of water and 25% of solids. Solids are 20% of proteins and 5% of organic substances other than proteins and inorganic substances. Myoglobin is a protein presentin sarcoplasm. It is also called myohemoglobin. Itsfunction is similar to that of hemoglobin, that is, to carryoxygen. It is a conjugated protein with a molecularweight of 17,000. The components can be referred as basic pancha bhautika constituents of mamsa dhatu. Stem cells: Myoblasts are embryonic progenitor cell having capability to differentiate into muscle cells. Fusion of these myoblasts are specially confined only with the skeletal muscle cells. Cells unable to differentiate are pulled back within sarcolemma and endomysium and called as – satellite cells. In normal and undamaged muscle, these satellite cells are quiescent and do not involve in cell division. But just after facing mechanical strain, proliferates as skeletal myoblasts prior to undergoing differentiation. Myoblasts are later differentiated and terminated into last category of – Myocytes. These are long, elongated tubular embedded with specific property within them. This can be referred in view of sthayi or poshya part of mamsa dhatu. Embryonic development of muscles: Muscle tissue committed cell line – myocytes are originated from the myoblasts under the influence of concerned factor fibroblast growth factor, calcium ions. It is mesodermal in origin basically from pluripotent embryonic stem cells later undergoing differentiation process committed towards myocyte cell lineage. Initially the myoblasts fuse with each other attaining tubular and multi-nucleated form. Later on these are specialized as per location, control and final appearances. Myogenesis in a nutshell: The steps involved in myogenesis can be described as below. • Myoblasts proliferate under influence of Fibroblast growth factor and form Myotubes. • Division of myoblasts is regulated by the adequate presence of Fibroblast growth factor. • The myotubes are fused together under influence of calcium ions resulting inMyogenesis. • Myogenesis is enhanced and regulated by Myocyte enhance factor & steroids. • Serum response factor & androgen receptor is responsible for expression for striated actin genes. Functions: About half of the physical and chemical metabolic processes take place in muscle tissue, and at least three forth of the total metabolism is due to muscle activity during severe exercise. The muscle proteins called actin and myocin combine to form a complex and highly viscous colloid called actomyocin. But the contraction of muscles is considered truly as a molecular phenomenon. Diagnostic investigation methods: A. Radiological investigation 1. Scanning electron microscopy (SEM) Purpose –  Obtain 2D and 3D images of skeletal muscle  Quantification of morphological measure of microvasculature based on segmented RBC  RBC spacing within the muscle tissue – 3D distance mapping  Tissue oxygenation 2. Muscle ultrasound Purpose –  Non-invasive technique for assessment of muscular dystrophies & skeletal muscle disorders in pediatric population. B. Culture tests Muscle mass biopsy

C. Electro-diagnostic techniques 1. Electromyography (EMG) Purpose –  Electro-diagnostic technique for evaluating and recording electrical activity produced by skeletal muscles.  Assessment of healthy status of Nerves and Muscles. 2. Muscle magnetic resonance imaging (MMRI) Purpose –  Evaluation of deep muscles inherited myopathies  It also provides information about the best sites of muscle biopsy. D. Hematological & Serological investigation 1. Creatine Kinase (CK) or Creatine Phosphokinase (CPK)–Myopathies 2. Aldolase – Identifies weakness of muscle. 3. Erythrocyte sedimentation rate (ESR) – Used to measure or assess inflammation of muscles. 4. Antibody evaluation for specific diseases – Ex. Anti-Acetylcholine (Ach) antibodies & Anti-Muscle specific kinase (MUSK) antibodies in Myasthenia Gravis

E. Genetics 1. Exome sequencing Purpose –  Identification of genetic variations at base pair resolution throughout human genome which targets proportion of DNA which codes proteins for capturing and sequencing. Hemorrhagic changes in muscles: • A well-known but so far poorly understood condition is the focal red changes in muscle, often referred to as haemorrhages. Such changes are characterized by muscle necrosis, haemorrhages and acute inflammation. In situ hybridization(ISH) studies on IgM showed few to moderate amounts of B-cells in red focal changes. Trends in the RT-qPCR showed up regulation of genes related to innate immunity in the red changes, whereas genes related to adaptive immunity were upregulated in the melanised changes. An important result was the significant down regulation of the anti-inflammatory cytokine IL10 in all red changes.

List of theses done

1.Pritesh A Dave(2007): A pilot study on sports medicine in ayurveda w.s.r. To sarira bala vrddhi, Department of Basic principles, IPGT &RA, Jamnagar

More information

Vividhashitapitiya Adhyaya Grahani Chikitsa References: