Difference between revisions of "Mamsa dhatu"
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+ | {{CiteButton}} | ||
+ | {{#seo: | ||
+ | |title=Mamsa dhatu | ||
+ | |titlemode=append | ||
+ | |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 | ||
+ | |description=Mamsa literally means flesh or meat. "Mamsa dhatu" is a body component that denotes flesh and includes muscular tissue | ||
+ | |image=http://www.carakasamhitaonline.com/resources/assets/ogimgs.jpg | ||
+ | |image_alt=carak samhita | ||
+ | |type=article | ||
+ | }} | ||
+ | <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> | ||
+ | <br/> | ||
+ | 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> | ||
− | + | {{Infobox | |
− | + | |title = Contributors | |
− | + | |label1 = Section/Chapter/topic | |
+ | |data1 = [[Sharira]] / [[Dhatu]] / Mamsa Dhatu | ||
− | <sup>1</sup> | + | |label2 = Authors |
+ | |data2 = Anagha S.<sup>1</sup>, [[Yogesh Deole|Deole Y.S.]]<sup>1</sup>, Shilwant A.A.<sup>2</sup> | ||
− | <sup> | + | |label3 = Reviewed by |
+ | |data3 = [[Gopal Basisht|Basisht G.]]<sup>1</sup> | ||
− | + | |label4 = Affiliations | |
+ | |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 | ||
− | = | + | |label5 = Correspondence email: |
− | + | |data5 = carakasamhita@gmail.com | |
− | == | + | |label6 = Publisher |
− | + | |data6 = [[Charak Samhita Research, Training and Development Centre]], I.T.R.A., Jamnagar, India | |
− | + | |label7 = Date of first publication: | |
+ | |data7 = May 21, 2020 | ||
+ | |label8 = DOI | ||
+ | |data8 = [https://doi.org/10.47468/CSNE.2020.e01.s09.015 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.<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> | |
− | + | === 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 [[dhatu]] – [[Medas]] | |
− | == | + | === 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 == | |
− | |||
− | + | *[[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]]. | |
− | |||
− | |||
− | + | *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> | |
− | + | *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] | |
− | The | ||
− | + | 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 === | |
− | The | + | |
+ | 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> | ||
+ | |||
+ | === 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<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. | ||
+ | |||
+ | 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] | ||
+ | |||
+ | {| class="wikitable" | ||
+ | |- | ||
+ | ! 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] | |
− | |||
− | + | *Swelling (shotha) [Cha. Sa. [[Sutra Sthana]] 18/7] | |
− | + | *Obstinate urinary disorders(prameha) [Cha. Sa. [[Nidana Sthana]] 4/8] | |
− | + | *Skin disorders (kushtha)[Cha. Sa. [[Nidana Sthana]] 5/3] | |
− | + | *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] | ||
− | + | *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] | ||
− | + | *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] | |
− | + | *In fever (jwara) affecting mamsa and [[meda dhatu]], therapeutic purgation ([[virechana]]) and fasting ([[upavasa]]) should be done. [Cha. Sa. [[Chikitsa Sthana]] 3/316] | |
− | + | *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] | |
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− | + | *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 | + | |
− | + | *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.<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> | |
− | + | ||
− | + | == 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: | |
− | + | ||
− | + | # Skeletal muscles | |
− | + | # Smooth muscles | |
− | + | # 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.<ref> | |
− | + | 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> | |
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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> | ||
− | + | 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 | + | |
− | 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 | + | 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. | ||
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− | 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 ==== |
− | + | ||
− | + | 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. |
− | + | # Division of myoblasts is regulated by the adequate presence of Fibroblast growth factor. | |
− | + | # The myotubes are fused together under the influence of calcium ions resulting in Myogenesis. | |
− | + | # Myogenesis is enhanced and regulated by Myocyte enhance factor & steroids. | |
− | + | # 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.<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 == | ||
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Latest revision as of 19:25, 23 February 2024
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.
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 dhatu – Medas
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
- 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.
- 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]
- Swelling (shotha) [Cha. Sa. Sutra Sthana 18/7]
- Obstinate urinary disorders(prameha) [Cha. Sa. Nidana Sthana 4/8]
- Skin disorders (kushtha)[Cha. Sa. Nidana Sthana 5/3]
- 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]
- 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]
- 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]
- In fever (jwara) affecting mamsa and meda dhatu, therapeutic purgation (virechana) and fasting (upavasa) should be done. [Cha. Sa. Chikitsa Sthana 3/316]
- 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:
- Skeletal muscles
- Smooth muscles
- 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.
- Myoblasts proliferate under the influence of the 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 the influence of calcium ions resulting in Myogenesis.
- Myogenesis is enhanced and regulated by Myocyte enhance factor & steroids.
- 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
- 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.[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.
References
- ↑ Available from http://namstp.ayush.gov.in/#/sat
- ↑ Monier Williams (1899), “mamsa”, in A Sanskrit–English Dictionary, new edition, Oxford: At the Clarendon Press, OCLC 458052227, page 805
- ↑ Jha Srujan. Amarkosha online application
- ↑ Dwarkanath C. Introduction to Kayachikitsa. Chaukhambha Orientalia. Varanasi; 1996. Third edition.pg.322
- ↑ 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
- ↑ 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
- ↑ Available from https://en.wikipedia.org/wiki/List_of_skeletal_muscles_of_the_human_body cited on 23/05/2020
- ↑ 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
- ↑ 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
- ↑ 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
- ↑ Essentials of Medical Physiology – Sembulingam – Chapter 29 – Structure of Skeletal muscle
- ↑ Dwarkanath C. Introduction to Kayachikitsa. Chaukhambha Orientalia. Varanasi; 1996. Third edition.pg.248
- ↑ Dwarkanath C. Introduction to Kayachikitsa. Chaukhambha Orientalia. Varanasi; 1996. Third edition.pg.250
- ↑ 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