DD Series: An effort to differentiate 'Mamsagat-vata' & 'Mamsavrutta-vata'.

 An effort to differentiate 'Mamsagat-vata' & 'Mamsavrutta-vat based on Ch.Chi.28

Sr. No.	VIBHEDAKATVA	MAMSAGATA VATA	MAMSAVRUT VATA
1.	VYADHITVA	Mamasagata Vata is a degenerative condition of Mamsa dhatu mentioned in Charak Samhita Vtavyadhi Chikitsa.	Mamsavrut Vata is a Santarpanjanita condition where increased Vikrita-Mamsa dhatu obstructs the path of Vata dosha.
2.	NIDANA	As per Vatavyadhi	Not mentioned specifically but as per general principal, Santarpan & Dhatu-dushti   causes may be considered.
3.	PURVARUPA	None as per Vatavyadhi	None being Vatavyadhi but clinically increased/ overnutrition of Vaikrita Mamsa dhatu would be observed because it obstructs the path of Vata dosha, leading to signs and symptoms.
4.      INTRODUCTION: Why ‘Mamsa-medogata Vata’-Described together ? and Mamsa / Medasavruta Vata has   separate                  description?		Medo dhatu found in the body in two forms.      1. Baddha Meda (Adipose tissue / Vasa)      2. Abadhha Meda (Fatty acids/ Cholesterol)      In context to Dhatu Gatatva, there is no Abaddha Meda in the presence of Dhatukshaya hence, its pathogenesis as per Mamsagata Vata. Because Mamsa itself has a place of Meda in the form of Vasa being Upadhatu of Mamsa and the adjoining Snayu are upadhatu of Meda. So they are ‘Anyo-anyashrita’. This is the reason that Mamsamedogata Vata mentioned together.  While in Avarana description, Mamsavrut Vata and Medasavrut Vata mentioned separately, because there is a condtion of excessive abnormal baddha & abaddha Meda qualitatively and quantitatively, That physically obstructs the path of Vata. Either in the form of blood/ lymph circulation or nerve conduction or narrowing the vascular lumens.  Mamsamedogata Vata and Mamsavrut Vata:    In consideration of Mamsa-medogata Vata and Mamsavrut Vata there is another classical description available that is Mamsa-pradoshaja Vikara.       Mamsapradoshaja Vikara is totally different or opposite to Mamsamedogata Vata. While it is nearer to Mamsavrut Vata being Mamsa-dushti, a commen factor.       Mamsamedogata Vata is a condition of Aptarpana while Mamsapradoshaja Vikara and Mamsavrut Vata are condition of Santarpana, that can be understood with reviewing the signs and symptoms of all above three. Mamsapradoshaja Vikaras are mainly localised pathology and various disease nomenclatures have been mentioned and all these diseases have been mentioned with specific Nidanas in  Trisothiya Adhyaya (Cha. Su 17) & Svaythu Chikitsa (Cha. Chi 12) While Mamsavrut Vata is generalised pathology with sotha and pidika symptoms. The ‘Anyoanyasritva’ of Mamsa and Meda dhatu is clearly visible in Mamsapradoshaja Vikaras too, where Meda dhatu is also stated as a dushya in Mamsapradoshaja Vikaras.
5.	LAKSHANA	गुर्वङ्गं तुद्यतेऽत्यर्थं दण्डमुष्टिहतं तथा| सरुक् श्रमितमत्यर्थं मांसमेदोगतेऽनिले||   (Cha.Chi 28/32)  Gurvanga – It is due to weakness of ‘Mamsa dhatu’ in presence of dhatukshaya. It should not be taken as Kaphavriddhi symptom.  Tudhyte-atyartham- It is due to degeneration/ Inflammation of Mamsa dhatu where tissues are crying for nutrition or may be because of disorder of nerve, Muscle tissue, Nerve synaptic junction, Chronic-inflammatory Demyelinating Polyneuropathy, Charcot Marie Tooth Disease etc.  Saruka (Pain) - Because of degeneration, Nutritional deficiency or inflammation or lactic acid deposition etc.  Shramitamatyartha- Because of all above mentioned factors.  Note: Excessive hard physical work, over-exercise etc may results signs & symptoms of Mansa-medogata vata but these are self reversible and self limiting, usually nidan-parivarjan, rest etc are sufficient to relieve, but when such symptoms are not recovered then we should focus on mansagat or mansamedogata vata condition.	कठिनाश्च विवर्णाश्च पिडकाः श्वयथुस्तथा| हर्षः पिपीलिकानां च सञ्चार इव मांसगे|   (Cha.Chi.28/64)  Kathina Vivarna Pidika- Because of generalised Santarpana condition specially Mamsa dhatu Vruddhi & Dushti. ‘Prameh-pidaka’ mentioned in Ch.Su.-17 are the best example where Mamsa is also associated with Meda-dhatu being Anyoanyashrita & Shleshma-vargiya Dushya of Prameha. Obstuction of the path of Vata-dosha that usually not take place in initial stage of Prameha; is the main difference. There may be other pathologies like keratin deposits, epidermoid cyst, Nodular cutaneous amyloidosis etc. may be considered similar to this. ‘Granti Visarpa (Cha.Chi 21/39)’ may be taken as advanced stage of Mamsavrut Vata if other suitable Nidanadi associates to it. प्रदूष्य रक्तं सिरास्नायुमांसत्वगाश्रितं ग्रन्थीनां मालां कुरुते Diabetic dermopathy presentation reminds us about the closest relation of dushyas in Prameha, Kushtha and Visarpa.  Svaythu – Because of Santarpan condition, mamsa-dushti-vriddhi and associated Shlehsma Dhatu Vruddhi.  Harsh Pipilikana Sanchara- This may be taken as  Nerve irritation as Hyperasthesia, tingling sensation due to Marghavrodha of Vata dosha by increased Dushta Mamsa Dhatu.
6.	SAMPRAPTI	“ Vayurkopo dhatukshayat…… (Cha. Chi 28/59)	Margasyavaranen Ch….” (Cha. Chi-28/59)
7.	DOSHA	Vata/ Vatapiita   Vata prakopa – Sthansamsraya – Mamsa dhatu	Vata Avruta   Shleshma (Mamsa) Avaraka
8.	Consideration of ‘Gunas’.	Being Generalised Kshaya-condition it may be understood that there is a condition of Shleshma-guna-kshaya esp. Snigdha, Guru, Pichchhila etc and Vata-dosha-guna-vriddhi esp Ruksha, Sheeta, Vishada & Khara etc.	Being a condition of Margavarodha by Vriddha-dushta Mansa-dhatu it may be understood that there is increase of some Shleshma-gunas like Guru, Sthira, Manda, Sheeta, Pichchhila etc and obstructed  Vata also shows decrease in its Chala, Laghu, Ruksha etc Gunas locally. If Obstructed Vata dosha vitiates in Generalised manner involving Marmas or Vital part of the body then Clinical picture may be reversed leading to neurological disorders if not treated properly.
9.	ROGAMARGA	Shakha	Mainly Shakhagata and  Marma in advance stage.
10.	DUSHYA	Rasa, Rakta, Mamsa, Meda	Rasa, Rakta, Mamsa mainly, but may be involvement of other dushya as per progression of disease like Santarpontha Prameha.
11.	SROTAS	Rasavaha. Raktavaha, Mamsavaha, Medavaha	Rasavaha. Raktavaha, Mamsavaha
12.	SROTO DUSHTI LAKSHANA	Sanga Pradhana	Sanga, Vimargagamana, Siragranthi
13.	ADHISTHANA	Sharirika, Mansika	Sharirika
14.	AGNI	Vishama, Manda	Sama, Manda
15.	DHATVAGNI	May be Sama or Tikshana Agni	Manda or Sama Agni.
16.	DHATU GATATVA	As per pattern of Prakrutisamasama Veta: Mamsamedogata	Being Aavaran phenomenon Dhatugatatva is not possible usually. If not identified or treated then it will become any Santarpanjanya condition or Mamsapradaoshaja Vikaras, progress of aavrutta Vata with the help of suitable Nidanas.
17.	ASHAYA	Pakwashaya Samuttha	Initially – Amashaya Samuttha (Being Mansativriddhi) Later – Pakwashaya Samuttha (when aavrutta-vata causes disease manifestation)
18.	SADHYA-SADHYATA	Kruccha Sadhya	Sadhya
19.	CHIKITSA SIDDHANTA	विरेको मांसमेदःस्थे निरूहाः शमनानि च|                           (Cha.Chi 28/92)   Sneha is not indicated because of the presence of metabolic wastes/ degenerative debris/ deposition of lactic acid etc. are there in Mamsamedogata Vata.	स्वेदाभ्यङ्गरसक्षीरस्नेहा मांसावृते हिताः| (Cha. Chi 28/195) Sveda, Abhyanga, Rasa, Kshira, Sneha etc are indicated because of condition of Vata obstruction and this obstructed Vata is causing the signs and symptoms. These principles should be applied step by step. 1st Sveda, 2nd Abhyanga to target/remove the Avaran by Srotoshodhan then Rasa, Kshira, Sneha to pacify the Prakupita vatadosha & Mamsadushti.                                     General principles of Avarana Chikitsa Cha. Chi. 28/240-242 are also applicable here. यापना बस्तयः प्रायो मधुराः सानुवासनाः|...................................... अभयामलकीयोक्तमेकादशसिताशतम् | These are also applicable here, that instructs mainly Srotosodhana/prasadan.
20.	CONCLUSION	1.  Acharya Punarvasu Atreya and Acharya Sushruta both have mentioned the kshaya and vriddhi features of 7 dhatus and both have instructed their management as per ‘Sarvada-sarv-bhavana….’ and ‘Svayoni-vardhan-dravya prayoga…’ and ‘Viprit-gunechha’ principles.    2. Reviewing the features of ‘Sapta dhatu kshaya’ and Dhatugata Vata, it is clear that both pathologies are quite different or opposite to each other because Dhatugata Vata line of treatment is totally different from simple Dhatu kshaya. We can say signs and symptoms of Sapta Dhatu kshaya may be understood as per simple Dhatu kshaya without having specific Vyadhi/disease. While Gatvata features should be taken as Vyadhi/disease as per Dhatu gatatava pattern. If we compare the both conditions in another words, features of Sapta dhatu kshaya are physiological disturbance/imbalance and should not be taken as a Roga/Vyadhi/disease because of absence of clear Nidan-panchaka as seen in other Vyadhis and it is reversible with said principles. While Gatavata features are very specific in presence of specific irreversible Dhatu-kshaya and vataprakopa involving all Nidan-panchaka and not curable with Viprita Guneccha etc. principles.        3. Gatavata pattern may be seen in other diseases or aliments in presence of specific dhatu/dhatus kshaya and other disease may act as Nidanarthkara disease for Gatavata condition. Similarly simple Dhatu kshaya may act as Nidanarthkara condition not only for Vata-vyadhis but also for many other diseases if not treated timely as well as properly.      4.  So we can conclude that simple Dhatu kshaya can not be recognised as disease, while Gatavata and Avrita Vata both are pathological phenomena is totally different from simple kshaya and its description fulfil the Samprapti pattern of Vatavyadhi “Vayurkopo dhatukshayat…..Margasya Avaranena Ch….” Both these conditions may present independently or as a advance condition of Dhatu kshaya in various chronic diseases.    5. Dhatu-pradoshaja Vikaras are real disease entity, starts  with individual Dhatuvah Sroto-dushti having specific Nidan etc mentioned  in Charak Viman-sthan Chapter 5/10-22 and specific line of treatment also instructed, but these are also different from Gatavata as well as Avruta vata. Usually we can say all Dhatupradoshaja Vikaras are ‘Sama Vikaras’ and starts with Specific Sroto-dushti Nidanadi, where dushti of indivisual dhatu has been highlighted without the condition of Vata Prakopa or Margavrita Vata. When there is Dhatu-dushti alongwith abnormal Dhatu Vriddhi (As seen in Vatashonita) and it causes Margavarodh for Vatadosha then it is a condition where dhatu-avritta-vata take place. This way we can understood all simple Dhatukshaya, Gatavata, Avruta vata, Dhatu-pradoshaja Vikaras.        It must also remembered that.........       तेषां प्रकोपात् स्थानस्थाश्चैव मार्गगाश्च शरीरधातवः प्रकोपमापद्यन्ते, इतरेषां प्रकोपादितराणि च । स्रोतांसि स्रोतांस्येव, धातवश्च धातूनेव प्रदूषयन्ति प्रदुष्टाः । तेषां सर्वेषामेव वातपित्तश्लेष्माणः प्रदुष्टा दूषयितारो भवन्ति, दोषस्वभावादिति ॥९॥ Ch. Vi.-5

 

 

Presented by

*Dr Kishor Sathavara 
B.A.M.S, M.D. Final Scholar
P. G. Department of Kaya chikitsa
Goverment Akhandanand Ayurveda College, Bhadra,
Ahmedabad, Gujarat, India.
Email- heykishor1997@gmail.com
M. +91 8160179017

**Prof. Vd. Surendra A. Soni

H.O.D.

P.G. Dept. of Kayachikitsa

Govt. Akhandanand Ayu. College,

Bhadra, Ahmedabad, Gujarat, India.