Difference between revisions of "Mamsa dhatu"

 
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|title=Mamsa dhatu
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|keywords=Mamsa dhatu,Mamsa dhatu in ayurveda,Mamsa dhatu Meaning,Mamsa dhatu Metabolism and Development,Mamsa dhatu Anatomical and physiological structures,Functions of Mamsa dhatu,charak samhita
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|description=Mamsa literally means flesh or meat. "Mamsa dhatu" is a body component that denotes flesh and includes muscular tissue
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|image=http://www.carakasamhitaonline.com/resources/assets/ogimgs.jpg
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<p style="text-align:justify;">Mamsa literally means flesh or meat. "Mamsa dhatu" is a body component that denotes flesh and includes muscular tissue. Its important function is to cover body (lepana). It provides protective and structural covering above the skeleton. (SAT-B.433)<ref>Available from  http://namstp.ayush.gov.in/#/sat</ref>
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As the name suggests, it is a bulky tissue and denotes the status of nutrition. Due to its solid-state, it provides proper size, shape and dimension to the body.  </p>
  
''Mamsa'' literally means meat or flesh. ''Mamsa dhatu'' is a body component similar to muscular tissue. Its important function is ''lepana'' (to cover body). It provides covering above the skeleton. (SAT-B.433)<ref>Available from  http://namstp.ayush.gov.in/#/sat</ref>
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{{Infobox
  
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.  
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|title = Contributors
  
'''Authors:''' '''Anagha S'''.<sup>1</sup>, '''Deole Y.S.'''<sup>1</sup>, '''Shilawant A.'''<sup>2</sup> '''Reviewed by:'''  '''Basisht G.'''<sup>1</sup>
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|label1 = Section/Chapter/topic
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|data1 = [[Sharira]] / [[Dhatu]] / Mamsa Dhatu
  
<sup>1</sup>'''Charak Samhita Research, Training and Development Centre, I.P.G.T.& R.A., Jamnagar'''
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|label2 = Authors
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|data2 = Anagha S.<sup>1</sup>, [[Yogesh Deole|Deole Y.S.]]<sup>1</sup>, Shilwant A.A.<sup>2</sup>
  
<sup>2</sup>'''Department of Kriya Sharir, G.J.Patel Institute of Ayurvedic Studies and Research, New Vallabh Vidyanagar, Anand, Gujarat, India'''
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|label3 = Reviewed by
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|data3 = [[Gopal Basisht|Basisht G.]]<sup>1</sup>
  
'''Correspondence email:''' [[carakasamhita@gmail.com]]
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|label4 = Affiliations
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|data4 = <sup>1</sup>[[Charak Samhita Research, Training and Development Centre]], I.P.G.T.& R.A., Jamnagar <sup>2</sup> Department of Kriya Sharir, G.J.Patel Institute of Ayurvedic Studies and Research, New Vallabh Vidyanagar, Anand, Gujarat, India
  
==Etymology and derivation: ==
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|label5 = Correspondence email:
The word is derived from Sanskrit root called “Mans” meaning flesh or meat.<ref> Monier Williams (1899), “मांस”, in A Sanskrit–English Dictionary, new edition, Oxford: At the Clarendon Press, OCLC 458052227, page 805</ref>  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.<ref>Jha Srujan. Amarkosha online application</ref>
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|data5 = carakasamhita@gmail.com
  
==Synonyms: ==
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|label6 = Publisher
'''''Pishita''''': Found to be separated in single-single fibers (''Vibhakta'' in ''Peshi svaroopa'')
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|data6 = [[Charak Samhita Research, Training and Development Centre]], I.T.R.A., Jamnagar, India
  
'''''Kravya''''' :Looks aggressive, fearful just be seeing it (''Kuyate anena iti kravyam'')
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|label7 = Date of first publication:
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|data7 = May 21, 2020
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|label8 = DOI
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|data8 = [https://doi.org/10.47468/CSNE.2020.e01.s09.015 10.47468/CSNE.2020.e01.s09.015]
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}}
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== Meaning of term "Mamsa"==
  
'''''Palala''''': Wrapped throughout body and having functional potential. (''Kriya samarthyavaan'')
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=== Etymology and derivation ===
  
'''''Amisha''''' : Creates greed to achieve it or have it.
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The word is derived from Sanskrit root called “Mans” meaning flesh or meat.<ref> Monier Williams (1899), “mamsa”, in A Sanskrit–English Dictionary, new edition, Oxford: At the Clarendon Press, OCLC 458052227, page 805</ref>  Mamsa dhatu is the component which enhances body mass, covers body parts, takes part in movements of joints and various parts of body.<ref>Jha Srujan. Amarkosha online application</ref>
  
'''''Tarasa''''' :Which is responsible for strength within the body (''Bala'')
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=== Synonyms ===
  
'''''Rakta teja, Raktodbhava''''' : Originated and developed from previous [[Rakta dhatu]]
+
'''Pishita''': Found to be separated in single fibers (Vibhakta in Peshi svaroopa)
  
'''''Medaskrut''''' : Involved in origin and development of next [[dhatu]] – [[Medas]]
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'''Kravya''': Looks aggressive, fearful just be seeing it (Kuyate anena iti kravyam)
  
==Meanings in different contexts: ==
+
'''Palala''': Wrapped throughout body and having functional potential. (Kriya samarthyavaan)
• 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/]
+
'''Amisha''' : Creates greed to achieve it or have it.
  
• A dietary preparation of ''mamsarasa – Veshavara''(meat soup) is the best for nourishing body.[Cha. Sa. Sutra Sthana 25/40]
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'''Tarasa''' : Which is responsible for strength within the body (Bala)
  
==Panchabhautika constitution and properties: ==
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'''Rakta teja, Raktodbhava''': Originated and developed from previous [[Rakta dhatu]]
[[Vayu, jala]] and [[agni mahabhuta]] play major role in the formation of ''mamsa''.[Cha. Sa. Chikitsa  Sthana 15/29] ''Mamsa'' have 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]
+
'''Medaskrut''' : Involved in origin and development of next [[dhatu]] – [[Medas]]
  
==Formation and metabolism of mamsa dhatu==
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=== Meanings in different contexts ===
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]
+
* In physiology, the word denotes structural and functional components mainly of muscle tissue.
  
The formation of ''mamsa dhatu'' is enhanced by anabolism in the fifth month of gestation.[Cha. Sa. Sharira  Sthana 4/21]
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* In the classification of dietary articles, a separate group named class of meats ("mamsa varga") 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/]
  
'''Formation of layer during embryogenesis:'''
+
* A dietary preparation of meat soup("mamsarasa – Veshavara") is best for nourishing the body.[Cha. Sa. [[Sutra Sthana]] 25/40]
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.
+
== Fundamental constitution (panchabhautika sanghatana) and properties ==
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):
+
*[[Vayu]], [[jala]] and [[agni mahabhuta]] play major role in the formation of "mamsa". [Cha. Sa. [[Chikitsa Sthana]] 15/29] After formation, it has predominance of [[prithvi mahabhuta]].
'''
 
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]
+
*The physical properties of "mamsa dhatu" are  bulkiness (sthula), stable (sthira), heavy (guru), rough (khara), hard (kathina) and smooth (shlakshna).<ref>Dwarkanath C. Introduction to Kayachikitsa. Chaukhambha Orientalia. Varanasi; 1996. Third edition.pg.322</ref>
  
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]
+
*The physiological properties of flesh after digestion are: moderately cold (na ati sheeta), heavy to digest (na ati guru), and unctuous (na ati snigdha). [Cha.Sa.[[Sutra Sthana]] 27/61]
  
'''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]
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== Metabolism and Development ==
  
'''Time span:'''
+
The mamsa dhatu is formed from its predecessor blood ([[rakta dhatu]]). The nourishing portion of blood ([[rakta dhatu]]) and constituents of nutrient fluid (ahara rasa) are transformed into mamsa dhatu by action of factors responsible for its metabolism (mamsa dhatvagni),[[ vayu]], [[jala]] and [[tejas  mahabhuta]]. [Cha. Sa. [[Chikitsa Sthana]] 15/29]  
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):
+
It gets solid fleshy bulk due to [[prithvi mahabhuta]]. During embryogenesis, bone component ([[asthi dhatu]]) and muscle component (mamsa dhatu) are developed from reproductive tissue ([[shukra]]). This muscle component is differentiated later into ligaments (snayu) during fetal development. [ Ka. Sa. Sharira Sthana 2/2]
'''
 
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 development of mamsa dhatu is enhanced by anabolism in the fifth month of gestation.[Cha. Sa. [[Sharira  Sthana]] 4/21]
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 :'''
+
=== Formation of skin during embryogenesis ===
The ''mamsavaha srotasa'' (nutrient transport system for mamsa) has its roots in ''snayu'' (ligaments) and ''twak'' (skin). [Cha. Sa. Vimana Sthana 5/8]  
+
 +
Seven layers of skin are formed during embryogenesis. The layer holding mamsa dhatu (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 is affected in diseases like bhagandara(fistula), vidradhi(abscess) and arsha(hemorrhoids). [Su. Sa. Sharira Sthana 4/8]
 +
 
 +
This layer can be observed as a deeper reticular layer of dermis.<ref>Kuldeep KumarA Critical Study Of Tvak In The View Of Modern Science Ayurpub.com Mar-Apr 2018 Vol III, Issue 2 available from http://ayurpub.com/wp-content/uploads/2018/04/844-849.pdf</ref>
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 +
=== Metabolic byproducts and waste products (Upadhatu and mala) ===
 +
 
 +
During the process of metabolism and development of mamsa dhatu, muscle fat (vasa) and six layers of  skin (tvacha) are formed as the metabolic byproducts  (upadhatu). [Cha. Sa. [[Chikitsa Sthana]] 15/17] Sharangadhara considered muscle fat (vasa) only as metabolic byproduct.[Sha. 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 the unctuous part of muscles or muscle fat (vasa) is three [[anjali]](personified measurement unit). One Anjali is equal to the quantity that can be filled in a space formed from joining one’s palms together.[Cha.Sa. [[Sharira Sthana]] 7/15]
 +
 
 +
The structural component of mamsa dhatu is responsible for the compactness of the body and covers the skeleton properly with muscles and ligaments. There are 900 snayu (ligaments) and 400 muscles(peshi). [Cha.Sa.[[Sharira Sthana]] 7/14] In addition, Sushruta described 100 muscles and thus enumerated them as 500 in male body and 520 in female body.[Su.Sa. Sharira Sthana 5/37-39]
 +
 
 +
=== Time span ===
 +
 +
The mamsa dhatu is formed on 3rd day from the nutrient fluid (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]
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 +
== Characteristics of best quality or essence (mamsa Sara) ==
 +
 
 +
The persons having essence of mamsa dhatu 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]
 +
 
 +
== Anatomical and physiological structures ==
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 +
The mamsa dhatu is present in various forms as below:
 +
 
 +
=== Channels for transportation and transformation of mamsa dhatu (Mamsavaha srotas) ===
 +
 
 +
This has its roots in ligaments (snayu) and skin (twak). [Cha. Sa. [[Vimana Sthana]] 5/8]
 +
 
 +
In addition, the major arterial trunks (raktavahi dhamani) also serve the purpose of transport. [Su. Sa. Sharira Sthana 9/12]
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 +
There are various other anatomical structures related to mamsa dhatu. These can be included in the system. The structures are as described below:
 +
 
 +
=== Layer of muscles (Mamsadhara kala) ===
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 +
[[Kala]] is the layer in outer coverings of body observed in sagittal section. Mamsadhara kala is the first covering with a network of sira (veins), snayu (ligaments), dhamani(artery) in it. [Su. Sa. Sharira Sthana 4/10]  It is present in the form of a covering of an organ and also carries physiological functions. Ex. Myocardium of Heart
 +
 
 +
It is a membrane that separates two organs or structures. Ex. Membrane of the gastrointestinal tract that separates it from visceral organs.
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 +
=== Muscles (Mamsa peshi) ===
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 +
The well differentiated compact form of flesh (mamsa) is called as muscle(peshi). It is created by division of flesh by [[vayu]] and [[pitta]].  [Su.Sa. Sharira Sthana 4/28]
 +
 
 +
There are 500 muscles in males and 520 muscles in female body. These muscles cover and provide strength to anatomical structures formed by veins, ligaments, bones, and joints. [Su.Sa. Sharira Sthana 5/37-39] Currently, most sources state that there are over 650 named skeletal muscles in the human body<ref>Poole, RM, ed. (1986). The Incredible Machine. Washington, DC: National Geographic Society. pp. 307–311. ISBN 978-0-87044-621-4. Available from https://en.wikipedia.org/wiki/Muscle#cite_note-Poole_1986-14 cited on 23/05/2020</ref>,<ref>Available from https://en.wikipedia.org/wiki/List_of_skeletal_muscles_of_the_human_body cited on 23/05/2020 </ref> although some figures go up to as many as 840.
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 +
The flesh of muscle (mamsa peshi), veins (sira) and ligaments (snayu) are attached to bones to form anatomical structure.[Su.Sa.Sharira Sthana 5/23]
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 +
Assessment of bulk of muscles is useful for nutritional status assessment by Anthropometry.
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 +
=== Anatomical network (Mamsa jala) ===
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 +
There are four types of network-like structures (jala) in body. Muscle network (mamsa jala) is the first one among them, the others being that of veins (sira) , ligaments (snayu) and bones (asthi). There are four such networks formed from each of these types. They are present in wrist and ankle joints and interlinked together.[Su. Sa. Sharira Sthana 5/12].
 +
 
 +
=== Cords (Mamsa rajju) ===
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 +
There are four major cord-like structures attached to the vertebral column. The muscles are weaved and attached to these cords. [Su. Sa. Sharira Sthana 5/14].
 +
 
 +
=== Tendons (Kandara) ===
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 +
The large ligaments are termed as ‘kandara’. There are  16 kandara in body. [Su.Sa. Sharira Sthana 5/11]
 +
 
 +
=== Vital points (Mamsa marma) ===
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 +
There are eleven vital points formed from muscle (mamsa marma). 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 the individual. [Su. Sa. Sharira Sthana 6/7]
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 +
== Functions ==
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 +
Covering and protection (Lepana) is the main function of mamsa dhatu. Providing strength to the body and nourishment to its successor adipose tissue (meda dhatu) are additional functions. [Su. Sa. Sutra Sthana 15/5]. It 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.
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 +
== Assessment == 
 +
 
 +
Normal functions of mamsa dhatu are assessed by examination of different muscle actions such as – flexion (akunchana), extension (prasarana), abduction (utkshepana), adduction (apakshepana) and circumduction (chakra gati). Vyana vata is responsible for carrying out this function. [Cha.Sa.[[Chikitsa Sthana]] 28/9]
 +
 
 +
Mamsa dhatu is known for its pure quality of stability (sthirata). which is manifested by a sort of tension or tautness in a group of muscles and this is seen as – Muscle tone. Any deviation in this may be elicited as – Hypotonia or Hypertonia.
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 +
The proportion of mamsa dhatu can easily be assessed by observation of muscle mass. The qualitative assessment can be done based on the physical properties mentioned above. 
 +
 
 +
== Importance in diagnosis ==
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 +
Mamsa is one of the ten vital seats (dashapranayatana). [Cha. Sa. [[Sharira  Sthana]] 7/9]. Thus it is directly responsible for the vitality of an individual.
 +
 
 +
Any vitiation or direct injury to the channels of transportation and transformation of mamsa dhatu (mamsavaha strotas) can lead to death. [Su.Sha.Sharir Sthana 9/12]
 +
 
 +
=== Causes of vitiation ===
 +
 
 +
The following are causative factors for the vitiation of channels for transport and transformation of mamsa dhatu (mamsavaha srotasa). [Cha. Sa. [[Vimana Sthana]] 5/15]
 +
 
 +
==== Dietary causes ====
 +
 
 +
* Excessive consumption of food that increases secretions and causes obstruction (abhishyandi), bulkiness, heaviness after digestion
 +
 
 +
==== Lifestyle causes ====
 +
 
 +
* Day time sleep
 +
 
 +
==== Action of different rasa(tastes) on mamsadhatu ====
 +
 
 +
The consumption of dietary article with predominant tastes shows physiological and pathogenic actions on mamsa dhatu as below. [Cha. Sa. [[Sutra Sthana]] 26/43]
 +
 
 +
{| class="wikitable"
 +
|-
 +
! Rasa !!Action on mamsa dhatu
 +
|-
 +
| Sweet (madhura)-proportionate use || Promotes growth  (mamsa vardhana)
 +
|-
 +
| Sour (amla)-excess use || Causes inflammation (mamsam vidahati)
 +
|-
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| Salty(lavana)- excess use || Causes sloughing (mamsam kushnati)
 +
|-
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| Pungent (katu)-excess use || Scraping (mamsam vilikhati), reduces bulk of muscles
 +
|-
 +
| Bitter (tikta)-excess use || Absorbs moisture (mamsam shoshayati), reduces the elasticity of muscles
 +
|}
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 +
=== Abnormal states ===
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 +
The increase or decrease in quality and/or quantity of mamsa dhatu can lead to various abnormal conditions. The states can be assessed by the following clinical features.
 +
 
 +
===== Signs of decrease =====
 +
 
 +
* Decrease in circumference and skinfold thickness of hips, neck and belly due to loss of the muscle mass
 +
* wasting of buttocks, cheeks, penis, thighs, chest, axillae, calves
 +
* Dryness
 +
* Pricking pain
 +
* Debility
 +
* Fatigue
 +
* Decreased tone of blood vessels especially in the arterial walls          [Cha. Sa. [[Sutra  Sthana]] 17/65]
 +
 
 +
===== Signs of increase =====
 +
 
 +
* Increase in circumference and skinfold thickness of buttocks, cheeks, lips, penis, thighs, arms and calves
 +
* Heaviness of the body
 +
* Extra muscular growth or Hypertrophied musculature    [Su.Sa.Sutra Sthana 15/9,24]
 +
* The increase can be easily classified into two classes viz. Hypertrophy (increase in size) & Hyperplasia (increase in number of cells).
 +
 +
=== Clinical features of vitiation of channels of transport and transformation of mamsa dhatu ===
 +
 
 +
* Granuloma or polyps (adhimamsa), tumorous growth or myoma (arbuda), piles, skin tags, warts (kila), uvulitis(galashaluka),  galashundika (tonsillitis),  gangrene(putimamsa), boils(alaji),  goiter(ganda), cervical lymphadenitis(gandamala), and inflammation of epiglottis (upajihvika).[Cha.Sa. [[Sutra Sthana]] 28/13-15]
 +
 
 +
* Injury to channels of transport and transformation of mamsa dhatu lead to swelling (shwayathu), wasting (mamsashosha), aneurism (siragranthi) 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 manifested in fever due to pitta dosha lodged in mamsa dhatu (mamsagata jwara). [Cha. Sa. [[Chikitsa  Sthana]] 3/78]
 +
 
 +
=== Role of mamsa dhatu as a vitiating factor in diseases ===
 +
 
 +
Mamsa dhatu is involved as the vitiating tissue (dushya) in the pathogenesis of various diseases as listed below:
 +
 
 +
* Obstinate urinary diseases including diabetes due to obstructive pathogenesis (avruta madhumeha) [Cha. Sa. Sutra  Sthana 17/79]
  
In addition, the ''raktavahi dhamani'' (major arterial trunks) also serve purpose of transport. [Su. Sa. Sharira Sthana 9/12].
+
* Diabetic carbuncles(prameha pidaka) [Cha. Sa. [[Sutra  Sthana]] 17/82]
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:'''
+
*Swelling (shotha) [Cha. Sa. [[Sutra  Sthana]] 18/7]
  
''Kala'' is the layer in outer coverings of body observed in sagittal section.  
+
*Obstinate urinary disorders(prameha) [Cha. Sa. [[Nidana  Sthana]] 4/8]
  
''Mamsadhara kala'' is the firstcovering with a network of ''sira'' (veins), ''snayu'' (ligaments), ''dhamani''(artery) in it. [Su. Sa. Sharira Sthana 4/10]  
+
*Skin disorders (kushtha)[Cha. Sa. [[Nidana  Sthana]] 5/3]
  
It is a membrane that separates two organs or structures. Ex. Membrane is gastrointestinal tract separates it from visceral organs.
+
*Wasting diseases (shosha)[Cha. Sa. [[Nidana  Sthana]] 6/8]
 +
 
 +
*Nodule (granthi) [Cha. Sa. [[Chikitsa  Sthana]] 12/81]
 +
 
 +
*Hemorrhoids (arsha)[Cha. Sa. [[Chikitsa  Sthana]] 14/5]
 
   
 
   
'''Mamsa peshi (muscles):'''
+
*Jaundice (kamala)[Cha. Sa. [[Chikitsa  Sthana]] 16/34]
 +
 
 +
*Erysipelas(visarpa) [Cha. Sa. [[Chikitsa  Sthana]] 21/15]
 +
 
 +
*Abcess (vidradhi)[Su.Sa. Nidana Sthana 9/4]
 +
 
 +
*Tertiary fever (tritiyaka jwara) [Cha. Sa. [[Chikitsa  Sthana]] 3/66]
 +
 
 +
*Retention of moisture (mamsakleda) and inflammation of muscles (mamsadaha) 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 the heaviness of the body, pricking pain and as if beaten by a strong rod, severe pain, and fatigue. [Cha. Sa. [[Chikitsa Sthana]] 28/32]
 +
 
 +
*When [[vata]] [[dosha]] is occluded by vitiation of mamsa dhatu, it causes hard, discolored boils, swellings, horripilation and tingling. [Cha. Sa. [[Chikitsa Sthana]] 28/64]
 +
 
 +
*The discharge (srava) from ulcer (vrana) situated in muscle tissue resembles ghee. 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 increased swelling, the 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]
  
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]  
+
*Suturing is indicated in non-inflammatory ulcers penetrated up to muscles without any other complications. [Su. Sa. Chikitsa Sthana 1/45]
  
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]
+
=== Importance in prognosis ===
  
The ''mamsa'', ''sira'' and ''snayu'' are attached to bones to form anatomical structure. [Su.Sa.Sha.5/23]  
+
* Diminution of muscle mass (as in cachexia) is considered as a bad prognostic feature. [Su. Sa. Sutra Sthana 32/5], [Su. Sa. Sutra Sthana 33/5,18,25]
  
This is useful for nutritional status assessment by Anthropometry.
+
* Ulcer (Vrana) is easily curable when situated in mamsa. [Cha. Sa. [[Chikitsa Sthana]] 25/36]
  
'''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].
+
*From the prognostic aspect, fever due to vitiation of mamsa dhatu (mamsagata jwara) is curable. [Cha. Sa. [[Chikitsa  Sthana]] 3/83]
  
'''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].
+
*In case of fracture, if the inflammation of muscle tissue is noticed, it is difficult to cure. [Su. Sa. Chikitsa Sthana 3/69]
  
'''Kandara (tendons):''' The large ligaments are termed as ''‘kandara’.'' There are  16 ''kandara'' in body. [Su.Sa. Sha.5/11]
+
*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]
  
'''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 the individual. [Su. Sam. Sharira Sthana 6/7].
+
== Importance in the preservation of health and prevention ==
  
'''Functions of mamsa dhatu:'''
+
* Proper musculature (samhanana) is one of the assessment parameters of health. Physical strength directly depends upon musculature.[Cha.Sa.[[Vimana Sthana]] 8/116]
  
''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.  
+
* 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 are in a state of equilibrium. [Cha. Sa. [[Sutra Sthana]] 21/19].
  
''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.  
+
* The qualitative and quantitative decrease in mamsa dhatu is directly related to diminution of strength (bala kshaya) [Su. Sa. Sutra Sthana 28/20] and vitality (oja kshaya)[Su. Sa. Sutra Sthana 15/24]. Thus, the nutrition of mamsa dhatu is related to strength and immunity of a person.
  
Normalcy of ''mamsa dhatu'' is assessed by examination of different muscle actions such as – ''akunchana'' (flexion), ''prasarana'' (extension), ''utkshepana'' (elevation), ''apakshepana'' (depression) and ''chakra gati'' (circumduction). ''Vyana vata'' is responsible for carrying out this function. [Cha.Sa.Chikitsa Sthana 28/9]
+
== Principles of management of diseases ==
  
''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.
+
==== Therapeutic and conservative management ====
  
==Importance in diagnosis=
+
* The disorders of mamsa dhatu should be treated with purification [[shodhana]], surgery (shastra) , application of alkali (kshara) and cauterization (agni karma) [Cha. Sa. [[Sutra  Sthana]] 28/26]
  
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.
+
*In  fever (jwara) affecting mamsa and [[meda dhatu]], therapeutic purgation ([[virechana]]) and fasting ([[upavasa]]) should be done. [Cha. Sa. [[Chikitsa Sthana]] 3/316]
  
Any vitiation or direct injury to the roots of ''mamsavaha strotas'' can lead to death. [Su.Sha.Sharir Sthana 9/12]
+
*When [[vata]] gets occluded by mamsa and [[meda dhatu]], purgation, evacuative enema and palliative measures should be administered. [Cha. Sa. [[Chikitsa  Sthana]] 28/93]
  
===Causes of vitiation===
+
*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]
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]
+
* Enema therapy (Yapana [[ basti]]) is indicated for promoting semen ([[shukra]]) and muscular growth (mamsa) of a person, indulging excessive sexual intercourse. [Cha. Sa. [[Siddhi  Sthana]] 8/21]
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 effect of unctuous enema (anuvasana basti) is observed in terms of unctuousness in mamsa dhatu and [[meda dhatu]] on the sixth day. [Su. Sa. Chikitsa Sthana 37/73]
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
+
*Meat (mamsa) is considered as the best measure for nourishing (brimhana) and habitual use of meat soup of carnivorous animal is the best remedy for curing gastrointestinal disorders (grahani) or curing of assimilation disorders, consumption and piles. [Cha. Sa. [[Sutra Sthana]] 25/40]
(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
+
*The patient of emaciation due to trauma is advised to take the decoction of the meat of a carnivorous animal sizzled with ghee and added with pippali (piper longum) and honey. This helps in promoting muscle tissues and blood. [Cha. Sa. [[Chikitsa  Sthana]] 11/30]
wasting of buttocks, cheeks, penis, thighs, chest, axillae, calves heaviness of the body
+
 
Dryness Extra muscular growth or Hypertrophied musculature
+
*In the management of poisoning due to substances of plant and the mineral origin and 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]
pricking pain
+
 
debility of the body
+
==== Surgical Management ====
Fatigue
+
 
loss of tone of arteries
+
*In muscular parts, the depth of surgical incision should be equal to the size of 1 yava(barley). [Su. Sa. Sharira Sthana 8/9].
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]
+
*Pincers/forceps (Sandamsha yantra) are used to pull foreign bodies lodged in muscles (mamsa). [Su. Sa. Sharira Sthana 7/11].
**[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].
+
* Tempering of instruments should be done using water, for splitting, cutting and tearing of muscles. [Su. Sa. Sharira Sthana 8/12].
• 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:
+
* For thermal cautery (agni karma), a piece of black stone(jambavoshtha), and rods of other metals are used for diseases of mamsa. [Su. Sa. Sharira Sthana 12/4].
• 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]
+
==== Dietary management ====
• 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:
+
Dietary causative factors shall be avoided in case of increased mamsa dhatu and consumed in case of decreased mamsa dhatu. Mamsa dhatu is increased predominantly with the consumption of meat. [Cha. Sa. [[Sharira Sthana]] 6/10]  
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],  
+
==== Lifestyle management ====
• shotha(swelling) [Cha. Sa. Sutra  Sthana 18/7],
+
Daytime sleep shall be avoided in case of increased mamsa dhatu and is advised in case of its decrease.  
• prameha (obstinate urinary disorders) [Cha. Sa. Nidana  Sthana 4/8],
+
• kushtha(skin disorders)[Cha. Sa. Nidana  Sthana 5/3],
+
===== [[Vyayama]] (specific physical exercise) =====
• shosha(wasting diseases)[Cha. Sa. Nidana  Sthana 6/8],
+
 
• granthi(nodule) [Cha. Sa. Chikitsa  Sthana 12/81],
+
Specific physical exercise is intended towards bringing stability (in body) and an increase in strength. It can decrease the morbidities and improve the 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.<ref>Ana E Von Ah Morano et al, The Role of Glucose Homeostasis on Immune Function in Response to Exercise: The Impact of Low or Higher Energetic Conditions,  Journal of Cellular Physiology ; Vol 235, No 4, Apr 2020 ; PP: 3169-3188</ref>
• arsha (hemorrhoids)[Cha. Sa. Chikitsa  Sthana 14/5],  
+
 
• kamala(jaundice) [Cha. Sa. Chikitsa  Sthana 16/34],
+
== Contemporary approach and current researches ==
• visarpa (erysipelas) [Cha. Sa. Chikitsa  Sthana 21/15],
+
 
• vidradhi(abcess)[Su.Sam. Nidana Sthana 9/4],
+
Mamsa dhatu is observed in view of muscular tissue in conventional physiology.  
• 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]
+
=== Types ===
• 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 muscles in the human body are categorized into three main categories:
• 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]
+
# Skeletal muscles 
• Suturing is indicated in non-inflammatory ulcers penetrated upto muscles without any other complications. [Su. Sa. Chikitsa Sthana 1/45]
+
# Smooth muscles
Prognosis:
+
# Cardiac muscles
• 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]
+
About 40 percent of the human body is made up of skeletal muscle, and perhaps another 10 percent is smooth and cardiac muscle.<ref>
In case of fracture, if the inflammation of muscle tissue is noticed, it is difficult to cure. [Su. Sa. Chikitsa Sthana 3/69]
+
Guyton A.C., Hall J.E. Contraction of Skeletal muscle. In: Guyton A.C., Hall J.E., editors. Textbook Of Medical Physiology. 11th ed. Philadelphia, PA : Saunders/Elsevier; 2011. pp. 72-74 </ref>
• 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.  
 
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.  
+
In contrast, skeletal muscle fibers are as much as 30 times greater in diameter and a hundred times longer.  
 +
 
 +
The fundamental principles of contraction are almost the same in skeletal muscles and smooth muscles. However the structural arrangement is different in both groups.<ref> Guyton A.C., Hall J.E. Contraction & Excitation of Smooth muscle. In: Guyton A.C., Hall J.E., editors. Textbook of Medical Physiology. 11th ed. Philadelphia, PA : Saunders/Elsevier; 2011. pp. 92-99</ref>
  
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 to as various types and shapes of peshi and snayu described above.
These can be referred as various types and shapes of peshi and snayu described above.
 
  
Composition of muscles:
+
=== 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.
 
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.  
+
Myoglobin is a protein present in sarcoplasm. It is also called myohemoglobin. Its function is similar to that of hemoglobin, that is, to carry oxygen. It is a conjugated protein with a molecular weight of 17,000.<ref>Essentials of Medical Physiology – Sembulingam – Chapter 29 – Structure of Skeletal muscle</ref>
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.  
+
The components can be referred to as basic pancha bhautika constituents of mamsa dhatu.  
 +
 
 +
=== Origin and development ===
 +
 
 +
==== Stem cells ====
 +
 
 +
Myoblasts are embryonic progenitor cells having the capability to differentiate into muscle cells. The fusion of these myoblasts is 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.  
 
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.  
+
Myoblasts are later differentiated and terminated into the last category of – Myocytes. These are long, elongated tubular embedded with specific property within them.
Embryonic development of muscles:
+
 
 +
This can be referred to 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.  
 
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  
+
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.
1. Electromyography (EMG)
+
 
Purpose
+
==== Myogenesis in a nutshell ====
Electro-diagnostic technique for evaluating and recording electrical activity produced by skeletal muscles.
+
 
Assessment of healthy status of Nerves and Muscles.  
+
The steps involved in myogenesis can be described as below.
2. Muscle magnetic resonance imaging (MMRI)
+
 
Purpose
+
#Myoblasts proliferate under the influence of the Fibroblast growth factor and form Myotubes.
Evaluation of deep muscles inherited myopathies
+
# Division of myoblasts is regulated by the adequate presence of Fibroblast growth factor.
It also provides information about the best sites of muscle biopsy.
+
# The myotubes are fused together under the influence of calcium ions resulting in Myogenesis.
D. Hematological & Serological investigation
+
# Myogenesis is enhanced and regulated by Myocyte enhance factor & steroids.
1. Creatine Kinase (CK) or Creatine Phosphokinase (CPK)–Myopathies
+
# Serum response factor & androgen receptor is responsible for expression for striated actin genes.
2. Aldolase – Identifies weakness of muscle.  
+
 
3. Erythrocyte sedimentation rate (ESR) – Used to measure or assess inflammation of muscles.
+
=== Functions of muscles === 
4. Antibody evaluation for specific diseases – Ex. Anti-Acetylcholine (Ach) antibodies & Anti-Muscle specific kinase (MUSK) antibodies in Myasthenia Gravis  
+
 
 +
About half of the physical and chemical metabolic processes take place in muscle tissue, and at least three fourth of the total metabolism is due to muscle activity during severe exercise.<ref>Dwarkanath C. Introduction to Kayachikitsa. Chaukhambha Orientalia. Varanasi; 1996. Third edition.pg.248</ref>  The muscle proteins called actin and myosin combine to form a complex and highly viscous colloid called actomyosin. But the contraction of muscles is considered truly as a molecular phenomenon.<ref>Dwarkanath C. Introduction to Kayachikitsa. Chaukhambha Orientalia. Varanasi; 1996. Third edition.pg.250</ref>
 +
 
 +
=== Diagnostic investigation methods ===
 +
 
 +
==== I. 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 the pediatric population.
 +
 
 +
==== II. Culture tests ====
 +
 
 +
* Muscle mass biopsy
 +
 
 +
==== III. Electro-diagnostic techniques====
 +
 
 +
'''1. Electromyography (EMG)'''
 +
 
 +
*'''Purpose:''' 
 +
 
 +
*Electro-diagnostic technique for evaluating and recording the electrical activity produced by skeletal muscles.
 +
 
 +
*Assessment of the health 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.
 +
 
 +
==== IV. Hematological & Serological investigation ====
 +
 
 +
#Creatine Kinase (CK) or Creatine Phosphokinase (CPK)–Myopathies
 +
#Aldolase – Identifies the weakness of the muscle.  
 +
#Erythrocyte sedimentation rate (ESR) – Used to measure or assess inflammation of muscles.
 +
#Antibody evaluation for specific diseases – Ex. Anti-Acetylcholine (Ach) antibodies & Anti-Muscle specific kinase (MUSK) antibodies in Myasthenia Gravis  
 +
 
 +
==== V. Genetics ====
 +
 +
'''Exome sequencing'''
 +
 
 +
'''Purpose:'''
 +
 
 +
* Identification of genetic variations at base-pair resolution throughout the human genome which targets the proportion of DNA that codes proteins for capturing and sequencing.
 +
 
 +
=== Pathological conditions ===
 +
 
 +
==== 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 melanized changes. An important result was the significant down-regulation of the anti-inflammatory cytokine IL10 in all red changes.<ref>Havard Bjorgen et al,Immunopathological characterization of red focal changes in Atlantic salmon (Salmo salar) white muscle, Veterinary Immunology and Immunopathology Volume 222, April 2020, 110035,https://doi.org/10.1016/j.vetimm.2020.110035</ref>
 +
 
 +
===List of theses ===
 +
 
 +
1. Pritesh A Dave(2007): A pilot study on sports medicine in ayurveda w.s.r. To sarira bala vrddhi, Department of Basic principles, I P G T & R A , Jamnagar
 +
 
 +
== More information ==
 +
=== Related chapters ===
 +
 
 +
[[Vividhashitapitiya Adhyaya]], [[Sroto Vimana]], [[Grahani Chikitsa]]
 +
 
 +
=== Related articles ===
 +
 
 +
*[[Dhatu]]
 +
 
 +
*[[Rasa dhatu]]
 +
 
 +
*[[Rakta dhatu]]
 +
 
 +
*[[Meda dhatu]]
 +
 
 +
*[[Asthi dhatu]]
 +
 
 +
*[[Majja dhatu]]
 +
 
 +
*[[Shukra dhatu]]
 +
 
 +
=== External links ===
 +
 
 +
[https://en.wikipedia.org/wiki/Muscle Muscle], [https://en.wikipedia.org/wiki/Human_musculoskeletal_system Human musculoskeletal system],
 +
[https://en.wikipedia.org/wiki/Muscle_contraction Muscle physiology], [https://en.wikipedia.org/wiki/List_of_skeletal_muscles_of_the_human_body List of skeletal muscles of the human_body]
 +
 
 +
=== Abbreviations ===
 +
*SAT = Standard Ayurveda Terminology
 +
*Cha. = Charak
 +
*Su. = Sushruta
 +
*Sha. =Sharangadhara
 +
*Sa. = Samhita
 +
 
 +
=== References from [[Charak Samhita]] ===
 +
 
 +
The list of references for mamsa dhatu in Charak Samhita can be seen [[Media:Mamsa_dhatu-_reference_list.pdf|here.]]
 +
 
 +
<big>'''[[Special:ContactMe|Send us your suggestions and feedback on this page.]]'''</big>
 +
 
 +
== References ==
  
E. Genetics
+
<div id="BackToTop"  class="noprint" style="background-color:#DDEFDD; position:fixed;
1. Exome sequencing
+
bottom:32px; left:2%; z-index:9999; padding:0; margin:0;"><span style="color:blue;
Purpose –
+
font-size:8pt; font-face:verdana,sans-serif;  border:0.2em outset #ceebf7;
 Identification of genetic variations at base pair resolution throughout human genome which targets proportion of DNA which codes proteins for capturing and sequencing.
+
padding:0.1em; font-weight:bolder; -moz-border-radius:8px; ">
Hemorrhagic changes in muscles:  
+
[[#top| Back to the Top ]]</span></div>
• 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:
 

Latest revision as of 19:25, 23 February 2024

Cite.png

Mamsa literally means flesh or meat. "Mamsa dhatu" is a body component that denotes flesh and includes muscular tissue. Its important function is to cover body (lepana). It provides protective and structural covering above the skeleton. (SAT-B.433)[1]
As the name suggests, it is a bulky tissue and denotes the status of nutrition. Due to its solid-state, it provides proper size, shape and dimension to the body.

Contributors
Section/Chapter/topic Sharira / Dhatu / Mamsa Dhatu
Authors Anagha S.1, Deole Y.S.1, Shilwant A.A.2
Reviewed by Basisht G.1
Affiliations 1Charak Samhita Research, Training and Development Centre, I.P.G.T.& R.A., Jamnagar 2 Department of Kriya Sharir, G.J.Patel Institute of Ayurvedic Studies and Research, New Vallabh Vidyanagar, Anand, Gujarat, India
Correspondence email: carakasamhita@gmail.com
Publisher Charak Samhita Research, Training and Development Centre, I.T.R.A., Jamnagar, India
Date of first publication: May 21, 2020
DOI 10.47468/CSNE.2020.e01.s09.015

Meaning of term "Mamsa"

Etymology and derivation

The word is derived from Sanskrit root called “Mans” meaning flesh or meat.[2] Mamsa dhatu is the component which enhances body mass, covers body parts, takes part in movements of joints and various parts of body.[3]

Synonyms

Pishita: Found to be separated in single fibers (Vibhakta in Peshi svaroopa)

Kravya: Looks aggressive, fearful just be seeing it (Kuyate anena 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, Raktodbhava: Originated and developed from previous Rakta dhatu

Medaskrut : Involved in origin and development of next dhatuMedas

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 class of meats ("mamsa varga") 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 meat soup("mamsarasa – Veshavara") is best for nourishing the body.[Cha. Sa. Sutra Sthana 25/40]

Fundamental constitution (panchabhautika sanghatana) and properties

  • The physical properties of "mamsa dhatu" are bulkiness (sthula), stable (sthira), heavy (guru), rough (khara), hard (kathina) and smooth (shlakshna).[4]
  • The physiological properties of flesh after digestion are: moderately cold (na ati sheeta), heavy to digest (na ati guru), and unctuous (na ati snigdha). [Cha.Sa.Sutra Sthana 27/61]

Metabolism and Development

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

It gets solid fleshy bulk due to prithvi mahabhuta. During embryogenesis, bone component (asthi dhatu) and muscle component (mamsa dhatu) are developed from reproductive tissue (shukra). This muscle component is differentiated later into ligaments (snayu) during fetal development. [ Ka. Sa. Sharira Sthana 2/2]

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

Formation of skin during embryogenesis

Seven layers of skin are formed during embryogenesis. The layer holding mamsa dhatu (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 is affected in diseases like bhagandara(fistula), vidradhi(abscess) and arsha(hemorrhoids). [Su. Sa. Sharira Sthana 4/8]

This layer can be observed as a deeper reticular layer of dermis.[5]

Metabolic byproducts and waste products (Upadhatu and mala)

During the process of metabolism and development of mamsa dhatu, muscle fat (vasa) and six layers of skin (tvacha) are formed as the metabolic byproducts (upadhatu). [Cha. Sa. Chikitsa Sthana 15/17] Sharangadhara considered muscle fat (vasa) only as metabolic byproduct.[Sha. 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 the unctuous part of muscles or muscle fat (vasa) is three anjali(personified measurement unit). One Anjali is equal to the quantity that can be filled in a space formed from joining one’s palms together.[Cha.Sa. Sharira Sthana 7/15]

The structural component of mamsa dhatu is responsible for the compactness of the body and covers the skeleton properly with muscles and ligaments. There are 900 snayu (ligaments) and 400 muscles(peshi). [Cha.Sa.Sharira Sthana 7/14] In addition, Sushruta described 100 muscles and thus enumerated them as 500 in male body and 520 in female body.[Su.Sa. Sharira Sthana 5/37-39]

Time span

The mamsa dhatu is formed on 3rd day from the nutrient fluid (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 best quality or essence (mamsa Sara)

The persons having essence of mamsa dhatu 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]

Anatomical and physiological structures

The mamsa dhatu is present in various forms as below:

Channels for transportation and transformation of mamsa dhatu (Mamsavaha srotas)

This has its roots in ligaments (snayu) and skin (twak). [Cha. Sa. Vimana Sthana 5/8]

In addition, the major arterial trunks (raktavahi dhamani) also serve the 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. The structures are as described below:

Layer of muscles (Mamsadhara kala)

Kala is the layer in outer coverings of body observed in sagittal section. Mamsadhara kala is the first covering with a network of sira (veins), snayu (ligaments), dhamani(artery) in it. [Su. Sa. Sharira Sthana 4/10] It is present in the form of a covering of an organ and also carries physiological functions. Ex. Myocardium of Heart

It is a membrane that separates two organs or structures. Ex. Membrane of the gastrointestinal tract that separates it from visceral organs.

Muscles (Mamsa peshi)

The well differentiated compact form of flesh (mamsa) is called as muscle(peshi). It is created by division of flesh by vayu and pitta. [Su.Sa. Sharira Sthana 4/28]

There are 500 muscles in males and 520 muscles in female body. These muscles cover and provide strength to anatomical structures formed by veins, ligaments, bones, and joints. [Su.Sa. Sharira Sthana 5/37-39] Currently, most sources state that there are over 650 named skeletal muscles in the human body[6],[7] although some figures go up to as many as 840.

The flesh of muscle (mamsa peshi), veins (sira) and ligaments (snayu) are attached to bones to form anatomical structure.[Su.Sa.Sharira Sthana 5/23]

Assessment of bulk of muscles is useful for nutritional status assessment by Anthropometry.

Anatomical network (Mamsa jala)

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

Cords (Mamsa rajju)

There are four major cord-like structures attached to the vertebral column. The muscles are weaved and attached to these cords. [Su. Sa. Sharira Sthana 5/14].

Tendons (Kandara)

The large ligaments are termed as ‘kandara’. There are 16 kandara in body. [Su.Sa. Sharira Sthana 5/11]

Vital points (Mamsa marma)

There are eleven vital points formed from muscle (mamsa marma). 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 the individual. [Su. Sa. Sharira Sthana 6/7]

Functions

Covering and protection (Lepana) is the main function of mamsa dhatu. Providing strength to the body and nourishment to its successor adipose tissue (meda dhatu) are additional functions. [Su. Sa. Sutra Sthana 15/5]. It 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.

Assessment

Normal functions of mamsa dhatu are assessed by examination of different muscle actions such as – flexion (akunchana), extension (prasarana), abduction (utkshepana), adduction (apakshepana) and circumduction (chakra gati). Vyana vata is responsible for carrying out this function. [Cha.Sa.Chikitsa Sthana 28/9]

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

The proportion of mamsa dhatu can easily be assessed by observation of muscle mass. The qualitative assessment can be done based on the physical properties mentioned above.

Importance in diagnosis

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

Any vitiation or direct injury to the channels of transportation and transformation of mamsa dhatu (mamsavaha strotas) can lead to death. [Su.Sha.Sharir Sthana 9/12]

Causes of vitiation

The following are causative factors for the vitiation of channels for transport and transformation of mamsa dhatu (mamsavaha srotasa). [Cha. Sa. Vimana Sthana 5/15]

Dietary causes

  • Excessive consumption of food that increases secretions and causes obstruction (abhishyandi), bulkiness, heaviness after digestion

Lifestyle causes

  • Day time sleep

Action of different rasa(tastes) on mamsadhatu

The consumption of dietary article with predominant tastes shows physiological and pathogenic actions on mamsa dhatu as below. [Cha. Sa. Sutra Sthana 26/43]

Rasa Action on mamsa dhatu
Sweet (madhura)-proportionate use Promotes growth (mamsa vardhana)
Sour (amla)-excess use Causes inflammation (mamsam vidahati)
Salty(lavana)- excess use Causes sloughing (mamsam kushnati)
Pungent (katu)-excess use Scraping (mamsam vilikhati), reduces bulk of muscles
Bitter (tikta)-excess use Absorbs moisture (mamsam shoshayati), reduces the elasticity of muscles

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 the following clinical features.

Signs of decrease
  • Decrease in circumference and skinfold thickness of hips, neck and belly due to loss of the muscle mass
  • wasting of buttocks, cheeks, penis, thighs, chest, axillae, calves
  • Dryness
  • Pricking pain
  • Debility
  • Fatigue
  • Decreased tone of blood vessels especially in the arterial walls [Cha. Sa. Sutra Sthana 17/65]
Signs of increase
  • Increase in circumference and skinfold thickness of buttocks, cheeks, lips, penis, thighs, arms and calves
  • Heaviness of the body
  • Extra muscular growth or Hypertrophied musculature [Su.Sa.Sutra Sthana 15/9,24]
  • The increase can be easily classified into two classes viz. Hypertrophy (increase in size) & Hyperplasia (increase in number of cells).

Clinical features of vitiation of channels of transport and transformation of mamsa dhatu

  • Granuloma or polyps (adhimamsa), tumorous growth or myoma (arbuda), piles, skin tags, warts (kila), uvulitis(galashaluka), galashundika (tonsillitis), gangrene(putimamsa), boils(alaji), goiter(ganda), cervical lymphadenitis(gandamala), and inflammation of epiglottis (upajihvika).[Cha.Sa. Sutra Sthana 28/13-15]
  • Injury to channels of transport and transformation of mamsa dhatu lead to swelling (shwayathu), wasting (mamsashosha), aneurism (siragranthi) 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 manifested in fever due to pitta dosha lodged in mamsa dhatu (mamsagata jwara). [Cha. Sa. Chikitsa Sthana 3/78]

Role of mamsa dhatu as a vitiating factor in diseases

Mamsa dhatu is involved as the vitiating tissue (dushya) in the pathogenesis of various diseases as listed below:

  • Obstinate urinary diseases including diabetes due to obstructive pathogenesis (avruta madhumeha) [Cha. Sa. Sutra Sthana 17/79]
  • Diabetic carbuncles(prameha pidaka) [Cha. Sa. Sutra Sthana 17/82]
  • Obstinate urinary disorders(prameha) [Cha. Sa. Nidana Sthana 4/8]
  • Abcess (vidradhi)[Su.Sa. Nidana Sthana 9/4]
  • Retention of moisture (mamsakleda) and inflammation of muscles (mamsadaha) 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 the heaviness of the body, pricking pain and as if beaten by a strong rod, severe pain, and fatigue. [Cha. Sa. Chikitsa Sthana 28/32]
  • When vata dosha is occluded by vitiation of mamsa dhatu, it causes hard, discolored boils, swellings, horripilation and tingling. [Cha. Sa. Chikitsa Sthana 28/64]
  • The discharge (srava) from ulcer (vrana) situated in muscle tissue resembles ghee. 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 increased swelling, the 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 up to muscles without any other complications. [Su. Sa. Chikitsa Sthana 1/45]

Importance in prognosis

  • Diminution of muscle mass (as in cachexia) is considered as a bad prognostic feature. [Su. Sa. Sutra Sthana 32/5], [Su. Sa. Sutra Sthana 33/5,18,25]
  • Ulcer (Vrana) is easily curable when situated in mamsa. [Cha. Sa. Chikitsa Sthana 25/36]
  • From the prognostic aspect, fever due to vitiation of mamsa dhatu (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 the preservation of health and prevention

  • Proper musculature (samhanana) 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 are in a state of equilibrium. [Cha. Sa. Sutra Sthana 21/19].
  • The qualitative and quantitative decrease in mamsa dhatu is directly related to diminution of strength (bala kshaya) [Su. Sa. Sutra Sthana 28/20] and vitality (oja kshaya)[Su. Sa. Sutra Sthana 15/24]. Thus, the nutrition of mamsa dhatu is related to strength and immunity of a person.

Principles of management of diseases

Therapeutic and conservative management

  • The disorders of mamsa dhatu should be treated with purification shodhana, surgery (shastra) , application of alkali (kshara) and cauterization (agni karma) [Cha. Sa. Sutra Sthana 28/26]
  • When vata gets occluded by mamsa and meda dhatu, 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]
  • Enema therapy (Yapana basti) is indicated for promoting semen (shukra) and muscular growth (mamsa) of a person, indulging excessive sexual intercourse. [Cha. Sa. Siddhi Sthana 8/21]
  • The effect of unctuous enema (anuvasana basti) is observed in terms of unctuousness in mamsa dhatu and meda dhatu on the sixth day. [Su. Sa. Chikitsa Sthana 37/73]
  • Meat (mamsa) is considered as the best measure for nourishing (brimhana) and habitual use of meat soup of carnivorous animal is the best remedy for curing gastrointestinal disorders (grahani) 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 a carnivorous animal sizzled with ghee and added with pippali (piper longum) 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 the mineral origin and 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].
  • Pincers/forceps (Sandamsha yantra) are used to pull foreign bodies lodged in muscles (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 thermal cautery (agni karma), a piece of black stone(jambavoshtha), and rods of other metals are used for diseases of mamsa. [Su. Sa. Sharira Sthana 12/4].

Dietary management

Dietary causative factors shall be avoided in case of increased mamsa dhatu and consumed in case of decreased mamsa dhatu. Mamsa dhatu is increased predominantly with the consumption of meat. [Cha. Sa. Sharira Sthana 6/10]

Lifestyle management

Daytime sleep shall be avoided in case of increased mamsa dhatu and is advised in case of its decrease.

Vyayama (specific physical exercise)

Specific physical exercise is intended towards bringing stability (in body) and an increase in strength. It can decrease the morbidities and improve the 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.[8]

Contemporary approach and current researches

Mamsa dhatu is observed in view of muscular tissue in conventional physiology.

Types

The muscles in the human body are categorized into three main categories:

  1. Skeletal muscles
  2. Smooth muscles
  3. Cardiac muscles

About 40 percent of the human body is made up of skeletal muscle, and perhaps another 10 percent is smooth and cardiac muscle.[9]

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 a hundred times longer.

The fundamental principles of contraction are almost the same in skeletal muscles and smooth muscles. However the structural arrangement is different in both groups.[10]

These can be referred to 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 present in sarcoplasm. It is also called myohemoglobin. Its function is similar to that of hemoglobin, that is, to carry oxygen. It is a conjugated protein with a molecular weight of 17,000.[11]

The components can be referred to as basic pancha bhautika constituents of mamsa dhatu.

Origin and development

Stem cells

Myoblasts are embryonic progenitor cells having the capability to differentiate into muscle cells. The fusion of these myoblasts is 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 the last category of – Myocytes. These are long, elongated tubular embedded with specific property within them.

This can be referred to 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.

  1. Myoblasts proliferate under the influence of the Fibroblast growth factor and form Myotubes.
  2. Division of myoblasts is regulated by the adequate presence of Fibroblast growth factor.
  3. The myotubes are fused together under the influence of calcium ions resulting in Myogenesis.
  4. Myogenesis is enhanced and regulated by Myocyte enhance factor & steroids.
  5. Serum response factor & androgen receptor is responsible for expression for striated actin genes.

Functions of muscles

About half of the physical and chemical metabolic processes take place in muscle tissue, and at least three fourth of the total metabolism is due to muscle activity during severe exercise.[12] The muscle proteins called actin and myosin combine to form a complex and highly viscous colloid called actomyosin. But the contraction of muscles is considered truly as a molecular phenomenon.[13]

Diagnostic investigation methods

I. 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 the pediatric population.

II. Culture tests

  • Muscle mass biopsy

III. Electro-diagnostic techniques

1. Electromyography (EMG)

  • Purpose:
  • Electro-diagnostic technique for evaluating and recording the electrical activity produced by skeletal muscles.
  • Assessment of the health 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.

IV. Hematological & Serological investigation

  1. Creatine Kinase (CK) or Creatine Phosphokinase (CPK)–Myopathies
  2. Aldolase – Identifies the weakness of the 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

V. Genetics

Exome sequencing

Purpose:

  • Identification of genetic variations at base-pair resolution throughout the human genome which targets the proportion of DNA that codes proteins for capturing and sequencing.

Pathological conditions

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 melanized changes. An important result was the significant down-regulation of the anti-inflammatory cytokine IL10 in all red changes.[14]

List of theses

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

More information

Related chapters

Vividhashitapitiya Adhyaya, Sroto Vimana, Grahani Chikitsa

Related articles

External links

Muscle, Human musculoskeletal system, Muscle physiology, List of skeletal muscles of the human_body

Abbreviations

  • SAT = Standard Ayurveda Terminology
  • Cha. = Charak
  • Su. = Sushruta
  • Sha. =Sharangadhara
  • Sa. = Samhita

References from Charak Samhita

The list of references for mamsa dhatu in Charak Samhita can be seen here.

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References

  1. Available from http://namstp.ayush.gov.in/#/sat
  2. Monier Williams (1899), “mamsa”, in A Sanskrit–English Dictionary, new edition, Oxford: At the Clarendon Press, OCLC 458052227, page 805
  3. Jha Srujan. Amarkosha online application
  4. Dwarkanath C. Introduction to Kayachikitsa. Chaukhambha Orientalia. Varanasi; 1996. Third edition.pg.322
  5. Kuldeep KumarA Critical Study Of Tvak In The View Of Modern Science Ayurpub.com Mar-Apr 2018 Vol III, Issue 2 available from http://ayurpub.com/wp-content/uploads/2018/04/844-849.pdf
  6. Poole, RM, ed. (1986). The Incredible Machine. Washington, DC: National Geographic Society. pp. 307–311. ISBN 978-0-87044-621-4. Available from https://en.wikipedia.org/wiki/Muscle#cite_note-Poole_1986-14 cited on 23/05/2020
  7. Available from https://en.wikipedia.org/wiki/List_of_skeletal_muscles_of_the_human_body cited on 23/05/2020
  8. Ana E Von Ah Morano et al, The Role of Glucose Homeostasis on Immune Function in Response to Exercise: The Impact of Low or Higher Energetic Conditions, Journal of Cellular Physiology ; Vol 235, No 4, Apr 2020 ; PP: 3169-3188
  9. Guyton A.C., Hall J.E. Contraction of Skeletal muscle. In: Guyton A.C., Hall J.E., editors. Textbook Of Medical Physiology. 11th ed. Philadelphia, PA : Saunders/Elsevier; 2011. pp. 72-74
  10. Guyton A.C., Hall J.E. Contraction & Excitation of Smooth muscle. In: Guyton A.C., Hall J.E., editors. Textbook of Medical Physiology. 11th ed. Philadelphia, PA : Saunders/Elsevier; 2011. pp. 92-99
  11. Essentials of Medical Physiology – Sembulingam – Chapter 29 – Structure of Skeletal muscle
  12. Dwarkanath C. Introduction to Kayachikitsa. Chaukhambha Orientalia. Varanasi; 1996. Third edition.pg.248
  13. Dwarkanath C. Introduction to Kayachikitsa. Chaukhambha Orientalia. Varanasi; 1996. Third edition.pg.250
  14. Havard Bjorgen et al,Immunopathological characterization of red focal changes in Atlantic salmon (Salmo salar) white muscle, Veterinary Immunology and Immunopathology Volume 222, April 2020, 110035,https://doi.org/10.1016/j.vetimm.2020.110035