REVIEW ARTICLE May-June 2021

Clinical significance of Meda and Medovaha Srotas

in present scenario - A Comprehensive Study
Dr. Uma Raikwar1, Dr. Pankaj Gupta2
*1
Post Graduate Scholar, Dept. of Rachna Sharir, Pt. Khushilal Sharma Govt. Auto. Ayurvedic College and Hospital,
Bhopal, Madhyapradesh, India.
2
Associate Professor, Dept. of Rachna Sharir, Pt. Khushilal Sharma Govt. Auto. Ayurvedic College and Hospital,
Bhopal, Madhyapradesh, India.

ABSTRACT
The explanation of Sharir in Ayurvedic texts states that the existence of Dosha, Dhatu and Mala together is Sharir.
Basically, there are Tridosha, Saptdhatu and Trimala. Meda is one among the Saptdhatu. The internal transport
system which is used to carry these Dhatus (Parinampradh) is Srotas. Vitiation and depletion of Srotas can lead to
many pathological conditions in body. If Medovaha Srotas is vitiated it will cause Medo Dushti which may be
expressed as either Prameha Poorvaroopa or the Sthoulya Vyadhi. And in present era they are compared with
diabetes and obesity respectively. The epidemiology of obesity and diabetes is increasing day by day and having
serious effect on our current as well as upcoming generations. Obesity has become a worldwide epidemic, and its
prevalence has been projected to grow by 40% in the next decade. This increasing prevalence has implications for
the risk of diabetes, cardiovascular diseases and also for chronic kidney diseases (CKD) – CKJ OXFORD. In 2017,
about 72 million people and 20% of the urban population were diabetic in India - international diabetes federation
(IDF). Health service use and medical cost associated with obesity, diabetes and related diseases have risen
dramatically and are expected to continue to grow. The above mention data necessitates throw knowledge of the
basic concept of the Meda Dhatu, Medovaha Srotas. Thus the present study deals with the understanding of Meda
Dhatu, Medovaha Srotas along with its Moola Sthana and the disease that may occur from its vitiation. Similar
concept from the contemporary science have been analysed for a better understanding.

Key words: Ayurveda, Meda, Medovaha Srotas, Sthoulya, Prameha.

INTRODUCTION i.e., support and nourishment. Out of Saptdhatu,

Ayurveda mentioned that “Doshdhatumalamoolamhi Medodhatu which is the fourth is of more clinical
Shariram” i.e., the basic constituent of human body is importance now-a-days because it plays a significance
Tridosha (Vata, Pitta, Kapha), Saptdhatu (Rasa, Rakta, role in developing many metabolic disorders like
Mamsa, Meda, Asthi, Majja and Sukra) and Trimala Sthoulya, Prameha etc.
(Sweda, Mutra and Purish).[1] The term Dhatu is Meda is present mainly in Udar but when it is present
derived from Sanskrit root Du-Dhajya-Dharan Posanya inside Anuasthi it is called Sarakta Meda and when in
Address for correspondence: sthoola Asthi the same is called Majja.[2] The pure
Dr. Uma Raikwar form of Meda present in Mamsa (Peshi) is called
Post Graduate Scholar, Dept. of Rachna Sharir, Pt. Khushilal
Sharma Govt. Auto. Ayurvedic College and Hospital, Bhopal,
Vasa. Thus, all form of lipids in body is present mainly
Madhyapradesh, India. in Meda Dhatu. The transporting system to carry the
E-mail: raikwaruma1992@[Link] Parinampradh Meda dhatu from the site of
Submission Date: 13/05/2021 Accepted Date: 18/06/2021
Access this article online
production to the site of action is Medovaha Srotas
Quick Response Code i.e., the channels through which the Poshak Dhatu
Website: [Link] passes to form the Sthayi Dhatu.
In order to maintain the state of health it is necessary
Published by Maharshi Charaka to have normalcy at level of Dosha, Agni, Dhatu, Mala
Ayurveda Organization, Vijayapur, along with Prasanna Indriya and Manaha.[3] When
Karnataka (Regd) under the license CC-
by-NC-SA there is Vikruti in any of the Dhatus, whether it is

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Pramantaha or Guntaha, then it surely effect both the Meda which is Present inside small bone is called as
body and the mind. According to the definition of Sarakta Meda and when it is present inside the long
Swasthya (health) it is important to have normalcy at bone is called Majja.[7]
the level of Dhatu. By the term Dhatu, here we
There are two type of Medo Dhatu – Poshak
considered both Meda and Medovaha Srotas because
(nourishing) and Poshya (which get nourishment).
Meda Dhatu formation alone can’t perform any
Among these two Poshak Medodhatu is mobile in
function without proper circulatory system i.e.,
nature, which circulates in the whole body along with
Medovaha Srotas.
Rasa, Rakta Dhatu to give nutrition to Poshya
Thus, clearance and obstruction of the Srotas is the Medodhatu. The Poshya Medodhatu which is
condition of health and disease accordingly. Hence, in immobile in nature is stored in Medodhara Kala. The
the maintenance of health the importance of Srotas is site of Medodhara Kala is Udar and Anuasthi.[8] Udar,
very obvious.[4] The disturbance in Medodhatu and Sphik, Sthan are also depot of Poshya Medadhatu.
Medavaha Srotas is very common in present era Meda dhatu is the predominant Dushya in most of the
because of increase craving towards fast food. About Santarpanjanya Vyadhi like Prameha and Sthaulya.[9]
80% of the food on the shelves of supermarket today
The channels which give nutrition to the Medo Dhatu
didn’t exist 100 year ago – Larry Mc Caleary MD
or the vessels carrying the nutritive material up to the
AIM AND OBJECTIVES site of Medodhatu can be considered as Medovaha
Srotas
▪ To study the concept of Meda Dhatu and
Medovaha Srotas through Samhita Granths. Function of Medodhatu

▪ To study scientific corelation of Medovaha ▪ Charaka Samhita - Asthi Pushti

Srotomoola with that of contemporary science ▪ Sushruta Samhita - Sneha, Sweda, Dradhatva and
concept. Asthi Pushti
▪ To study classical concept of Medoroga and ▪ Astanga Samgraha - Sneha, Sweda, Dradhatva,
Medovaha Sroto Dushti Lakshana with that of Asthi Pushti, Netra and Gatra Snigdhata
modern allopathic science concept (contemporary
▪ Bhavprakash - Sneha
science).
▪ Astanga Hridaya - Sneha
MATERIAL AND METHODS
Srotas
It is a conceptutal study. The material is collected
The internal transport system of body is represented
from the classical Ayurvedic texts, modern literature
as Srotas. It has been given a place of fundamental
and various research papers etc.
importance in Ayurveda both in health and disease
REVIEW OF LITERATURE condition. The term Srotas is etymologically derived
from the Sanskrit root ‘sru sravane’ i.e., to move, to
Meda Dhatu
flow, to permeate, to ooze, to filter, to exude, to
The word Meda is derived from root ‘Jihimida secret, to leak. According to Acharya Charaka, Strotas
Snehana’ i.e., substance which is having the is defined as the channel or structure through which
Snigdhatva property like- Sneha, fat, oil etc. Medyati Sravanam i.e., oozing, moving and permeation of
Snihatiiti Meda – Shabdkalpadruma. Meda Dhatu is different constituents and nutrients takes place.[10]
formed from the Mamsa Dhatu by the action of Again, it is described as channels of circulation that
Mamsagni along with Updhatu.[5] It is composed by transport the Dhatus which are constantly subjected
relative predominance of Jala and Prithvi to metabolic transformation
Mahabhoota.[6] It is Derivative of Matraj Bhava. The (Parinamamapdyamananam). [11]
They work as
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communicating channels for nutrient tissues (Asthayi Types of Srotas

Dhatus) which are to be utilized for formation of
Bahirmukha Srotas [16] – They are nine in male and
permanent Dhatus (Sthayi Dhatus).
twelve in female. Netra – 2, Karna – 2, Nasa – 1,
Acharya Sushruta describes that Srotas are the Mukha – 1, Guda – 1, Medhra – 1. In female’s Yoni – 1
channels of the body having originated from organ and Stana - 2
cavity i.e., Khadantarm spread throughout the body
Antarmukha Srotas
excluding Sira and Dhamani.[12]
Srotas described in Charaka Samhita
Acharya Vagbhat compared Srotas to the extremely
fine passages and pores present in the lotus stem. He ▪ Pranavaha Srotas
observes, “Rasa spreads throughout the body through ▪ Udakvaha Srotas
very fine dwaras (pores) of Srotamsi which are
▪ Annavaha Srotas
distributed extensively in the body, very much like
minute channels, present in the lotus stem.” [13] ▪ Rasavaha Srotas

According to Chakrapanidatta Srotas are the channel ▪ Raktavaha Srotas

which serves as vehicles of transport of both Prasad ▪ Mamsavaha Srotas
and Mala Dhatus and also serve as the place of their
entry (or exit). ▪ Medovaha Srotas

Dalhana the commentator of Sushruta Samhita has ▪ Asthivaha Srotas

described that all the structures through which Prana, ▪ Majjavaha Srotas
Anna, Udaka, Rasa, Rakta, Mansa, Meda etc. circulate
▪ Shukravaha Srotas
are called Srotas.
▪ Mutravaha Srotas
In short according to contemporary science we can
consider Srotasas as the micro and macro channels of ▪ Swedavaha Srotas
circulations and pathways, carrying out all the ▪ Purishavaha Srotas.
physiological functions of the body. They carry solid,
liquid and gaseous type of substances, nerve Srotas described in Sushruta Samhita
impulses, nutrients, secretions, enzymes, hormones, ▪ Pranavaha Srotas
waste product etc. in and out of the system.
▪ Annavaha Srotas
The healthy and diseased condition of the body
depends on proper structure and function of these ▪ Udakvaha Srotas
macro and micro channels. As long as these channels ▪ Rasavaha Srotas
of circulations perform their normal functions, the
body is void of diseases.[14] ▪ Raktavaha Srotas

Swaroopa (characteristics and qualities) of Srotas ▪ Mansavaha Srotas

The Srotas has the colour of the Dhatu (tissue) that ▪ Medovaha Srotas
they are carrying or transporting. They are of different
▪ Mutravaha Srotas
shapes and sizes viz, round, thick, large, small,
microscopic, elongated and form network and ▪ Purishavaha Srotas
branches.[15] With this description, each and every cell
▪ Shukravaha Srotas
can be considered as a Srotas since the transportation
mechanism occurs within the cell and between cells. ▪ Artavavaha Srotas

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Medovaha Srotas stated that Vrikka nourishes the Medodhatu of the

Jatharpradesh.[20]
Dhatu are nourished through their respective
Srotasas. The Medodhatu gets its nutrition from the The upper part of the kidney – supra renal gland,
Srotas called Medovaha Srotas. As per Dr. C which control the secretion of epinephrine and non-
Dwarkanath, the channels through which nutrition to epinephrine hormones actively participate in the
the adipose tissue is transported are to be termed as breakdown process of the triglyceride.
the Medovaha Srotas. Dr Ghanekar B G considered
Kidney does not filter the lipids. Kidney protects the
the Medovaha Srotas as the capillaries of the
lipids but the fact that filtration of fat does not occur
perinephric tissue and omentum.
and protections of lipids through kidney enhance fat
Concept of Moolasthana in the body. This type of action is not seen with
protein and carbohydrate, they are filtered and
In classical Ayurvedic texts concept of Moolasthana is
absorbed. Kidney is set to give special importance to
focused. Although they have different opinion
lipids. If kidney will not filter urea the increase blood
regarding Moolasthana, they considered it to be
urea would have been cause inhibition of fat
Prabhavasthanam i.e., from where all the activities of
deposition. Approving the fact that it strengthens and
that particular Srotas take place and also which is
built fat deposition in the body especially abdomen,
affected most during pathological conditions.
which exactly is said by Acharya Sharangadhara. The
Moolamiti Prabhavasthanam is explains by the
other point to be considered is – hormones from
commentator of Charaka Samhita Acharya
adrenal cortex and medulla influence lipid
Chakrapani - ‘If root of the tree is destroyed, it will
metabolism. Glucocorticoids from adrenal cortex
cause harm to the whole tree. Likewise, if harm is
influence fat metabolism by influencing sterol
caused to Srotomoola, it will lead to damage to whole
metabolism and adipose tissue synthesis.[21]
srotas.[17]
Vapavahan
Moolasthana
It is mentioned as Koshtanga and Moolasthana of
The Medovaha Srotomoola means the organ which
Medovaha Srotas. Vapavahan means the transporter
may be closely related to Medodhatu functions or
or carrier of Vapa (fat). Acharya Chakrapani has
which are important sites related to beginning or
considered it as Tailavartika while Dr. Ghanekar has
ending of the channels of Medodhatu.
considered it as omentum, where the maximum Meda
Acharya Moolasthana is stored.
Omentum is appeared as a thin fenestrated
Acharya Charaka Vrikka and Vapavahan
membrane with varying amount of fat deposition. The
Acharya Sushruta Vrikka and Kati size of omentum varies from individual to individual. It
is composed of two mesothelial sheets which enclose
Acharya Vagbhat Vrikka and Mamsa
predominantly adipocytes embedded in a loose
connective tissue. This adipose tissue plays an
Vrikka
important immune role but can also serve as a source
One of the Koshtanga formed by the Sara of Rakta of chronic inflammation in obese individual possibly
and Medodhatu.[18] According to Dalhana contributing to metabolic syndrome.[22]
commentator of Sushruta Samhita stated that Vrikka
Kati
looks like Mamsapinda and are two in number which
are situates in left and right side of the quadrum.[19] Kati is the region where large amount of fat
By the word Parshva he probably means deposition occurs. In modern it is corelated with loan
retroperitoneal situation. Acharya Sharangadhara region whose exact side is lower part of back between

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the ribs and pelvic according to Taber’s Cyclopedia Medovahsrotodushti Lakshana Medovahsrotoviddha
medical Dictionary. Lakshana

These days waist circumference – height ratio (WHtR) Ashtanindita Swedagmana (excessive
is recommended in screening cardiometabolic sweating)
Pramehapoorvaroopam
syndrome. Also, a number of studies on WHtR, WC Snigdhangata (oily
and BMI have been proved valuable in prediction skin/organs)
various metabolic syndromes like obesity, DM etc.[23] Talushosha (dry mouth)

Mamsa Sthaulya (obesity)

Sopha (inflamation)
Acharya Vagbhat has considered Mamsa as
moolasthana of Medovaha Srotas. The probable Pipasa (thirst)
reason may be due to its physiological role. Muscles,
especially the skeletal muscles are known to store fat
(IMCL- Intramyocellular Lipids). Ashtanindita Medoroga

Clinical Significance Atidheerga (excessive tallness) Medagranthi

Atiharshva (dwarfism) Antravriddhi

Meda Dhatu Dushti Lakshana
Atiloma (excessive hairs) Medovriddhi
Acharya Medokshaya Medovriddhi Aloma (lack of body hairs) Galaganda

Atikrishna (extreme dark colour) Arbooda

Charaka Sandhisphootan, Ninditani,
Akshglani, Ayasa, Pramehapoorvaroopam Atigaur (extreme fair colour) Prameha
Udartanutvam
Atisthula (obesity) Sthaulya

Sushruta Pleehavriddhi, Snigdhangata, Atikarshya (underweight) Atisweda

Sandhisunyata, Udarparshva Vriddhi,
Raukshya, Kasa, Swasa, As per Acharya Sushruta by the study of a single
Medurmamsa Dourgandhyam Shastra, a man can never catch the true importance of
Prathana this (science of medicine). Therefore, a physician
should study as many as allied branches related with
Ashtanga Katiswapa, Tadvat, Alpacheshtite
this science. Hence, to understand the concept of
Hridaya Pleehavriddhi, Sranam, Swasa, Sphik-
Krishangata Stana-Udar Lambanam Moolasthana lets throw some tight on modern
literature.[24]
Ashtanga Pleehavriddhi, Prameha Poorvaroopam,
Swedagmana - Adrenal gland disorder can cause the
Samgraha Katiswapa, Sthoulya, Sleshma
Sandhisunyata, Mamsa, Rakta Vikara
adrenal medulla to produce increased level of
Angaroukshaya, epinephrine and norepinephrine. These hormones act
Karshya, Srama, on the sympathetic nervous system, leading to
Sosha, Medurmamsa excessive sweating.
Abhilasha, Mamsa
Kshayokta Lakshan Swasa - Numerous respiratory complications are
associated with obesity. Obese individual has an
Medovahsroto Dushti and Sroto Viddha Lakshana increase demand for ventilation and breathing
workload, respiratory muscle insufficiency, decreased
Acharya Charka has described Srotodushti Lakshana
functional reserve capacity and respiratory reserve
while Acharya Sushruta has explained Srotoviddha
volume and closure of peripheral lung units. Obesity is
Lakshana
a classical cause of alveolar hypoventilation.[25]
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Taalu Sosha - The sensation of dry mouth including and 20% of the urban population was diabetic in India
palate will occur when the salivary flow rate is less (International Diabetes Federation (IDF).[28] According
than the rate of water absorption from the mouth. A to Diabetes Foundation of India, people suffering from
dry mouth is a symptom as well as cause of high blood diabetes are likely to go up to 80 million by 2025,
sugar. making India the ‘Diabetes Capital’ of the world.[29]
Pipasa - The cause of Pipasa is may be due to Over nutrition has been found to be a major risk
decrease blood volume without reducing the factor for a number of diseases such as diabetes,
intracellular fluid. The decreased blood volume is hypertension, heart diseases, certain type of cancers,
distinguished by cells in the kidney and elicits thirst etc.[30] Huffman et al consider a cohort sample of 1100
for both water and salt via the rennin-angiotensin women in South Delhi and show that an increase in
mechanism. BMI has a statistically significant impact on diabetes
among married women in Delhi, India.[31] The study by
Sopha - Abnormal and excessive accumulation of free
Ramachandran et al. finds a positive association
fluid in the interstitial tissue space and serous cavities.
between diabetes and BMI for the urban population
Extra renal mechanism involves the secretion of
across six cities in India using the National Urban
aldosterone, a sodium retaining hormone by the renin
Diabetes Survey.[32]
angiotensin aldosterone system
Sthoulya - In obeys individual two distinct phenotypes DISCUSSION
are apparent – generalised obesity and abdominal In metabolic syndrome, the abnormal Meda, when
obesity. Of this abdominal obesity is strong indicator deposited into subcutaneous tissue, it gives the
for development of coronary artery disease, insulin clinical presentation of obesity and similarly when
resistance and consequently type -2 diabetes mellitus Abaddha Meda extracted to Basti it creates the
and many comorbid conditions.[26] manifestation of Prameha and when this Meda is
A BMI between 18.5 and 25 kg/m2 is considered by unnaturally deposited in the arterial wall and increase
the World Health Organization (WHO) to be normal the peripheral resistance
weight, a BMI between 25 and 30 kg/m2 as (Dhamnipratichaya/arteriosclerosis) it shows clinical
overweight, and a BMI of>30 kg/m2 as obese. manifestations like HTN and when these unnatural
Alternative parameters to more accurately capture Meda present in the Rakta Vaha Srotas leads to
visceral fat include waist circumference (WC) and a increase level of unwanted fat level -
waist hip ratio (WHR) of >102cm and 0.9, respectively, hypercholesterolemia. The formation of Meda not
for men and >88cm and >0.8, respectively, for only depends on over consumption but also due to
women. WHR has been shown to be superior to BMI less utilization. The modern life style makes the
for the correct classification of obesity in CKD. human being more comfortable.
Obesity has become a worldwide epidemic, and its The management of disease caused due to vitiation of
prevalence has been projected to grow by 40% in the Medovaha Srotas should be done on the basis of line
next decade. This increasing prevalence has of treatment of Medo Roga.[33] Nidana Parivarjana,
implications for the risk of diabetes, cardiovascular Samshaman and Samsodhana Chikitsa should be
diseases and also for chronic kidney diseases (CKD) – done. In the treatment of obesity Guru Aptarpana
CKJ OXFORD. This increasing prevalence of obesity has should be done. And in the treatment of Prameha it is
implications for cardiovascular disease (CVD) and also said that - The basic concept of utilization of excess
for CKD. A high BMI is one of the strongest risk factors energy should be done through physical exercise. It is
for new-onset CKD.[27] mention by Acharya Sushruta that – walking without
Prameha - In 2017, about 72 million people (8.8% of rest for a distance of hundred Yojana, is one of the
the total population having age 18 years or above) best remedies for Sthula Pramehi.

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The same management criteria which have been CONCLUSION

described by our Acharyas hundreds of year back has
been proven scientifically now a days on the basis of On the basis of the above facts, it may be concluded
modern research which the world is obeying. The that assessment of Moolasthana of Medovaha Srotas
following are the few examples- and scientifically consideration of Moola Sthana of
Medovaha Srotas i.e., Vrikka, Vapavahan, Mamsa and
In overweight or obese diabetic patients, a lifestyle Kati is true scientific explanation. The two Vrikka are
intervention including caloric restriction and increased the Moola of Medovaha Srotas located in the Kostha
physical activity compared with a standard follow up near the Prustavansh same as kidney within the
based on education and support to sustain diabetes paranephric fat present in the posterior abdominal
treatment reduced the risk for incident CKD by cavity parallel to vertebral column. Vapavahan can be
30%.[34] correlated with omentum as it is present in Udar
In a recent meta-analysis collating experimental where the excess amount of Meda (triglyceride) is
studies in obese CKD patients, interventions aimed at stored. Kati is the area same as lumbar region, where
reducing body weight showed coherent reductions in storage of Meda (triglyceride) takes place.
blood pressure, glomerular hyper-filtration and The fact that the intra- abdominal adipocyte is more
proteinuria.[35] lypolytically active than those from other depots. This
Globally, these experimental findings provide a proof mechanism is vivid in the mind of our acharyas.
of concept for the usefulness of weight reduction Hence, they considered the depots of intra-abdominal
interventions in the treatment of CKD in the obese.[36] fat as the Moola Sthana of Medovaha Srotas
considering Vrikka, Vapavahan, Kati and Mamsa. The
Population-wide interventions to control obesity
concept of Sroto vitiation and management which has
could have beneficial effects in preventing the
been explained in our texts thousands of years back
development, or delaying the progression, of CKD,
are being scientifically proven by the contemporary
CVD, and DM etc. It is incumbent upon the entire
medical science in the form of researches and
healthcare community to devise long-ranging
statistically calculated results. Thus, complete
strategies toward improving the understanding of the
knowledge of Srotas is must for an Ayurvedic
links between obesity and related diseases, and to
Physician to approach a patient in a holistic way and
determine optimal strategies to stem the tide.
to cure the disease from its roots.
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