Physiology of Vasa, Meda, and Majja
Prof. Sangeeta Gehlot
Dept of Kriya Sharir,
Faculty of Ayurveda,
Ayurveda scholars have mentioned different tissues like Vasa i.e. intermuscular fat, Meda i.e. visceral fat and Majja i.e. bone marrow. These are predominantly rich in adipocytes similar to adipose tissue with different sites, functions, compositions, and pathological outcomes. Adipose tissue is a loose connective tissue comprising of adipocytes including nerve tissue, stromovascular cells, and immune cells which are placed at different places inside the body. A comprehensive description of therapeutic indications of Vasa and Majja under Snehan Karma i.e. oleation therapy illustrates that the clinical physiology of these tissues has been elaborated rather than general physiology. In texts of Ayurveda, description is available regarding the distribution of Meda in different places of the body with different names like in small bones and abdomen around viscera called visceral fat, in long bones known as Majja, while intramuscular fat as Vasa. Their roles in the maintenance of physiology and manifestation of diseases have also been mentioned. The metabolic effects of Meda and Majja dhatu on other tissues like muscle, bone, and reproductive tissue has been mentioned which shows their functional interdependence.
The word Medas is derived from Sneharthaka Trimida Snehana Dhatu. Amarkoshkar has mentioned meda as
It means oleation or to apply oil. Meda Dhatu is the unctuous dhatu like Ghrita.
Which is present inside the bone is known as Majja.
Charak has mentioned that the Vayu produces hollowness in the inner portion of the bone which is filled with Meda and that unctuous substance is called as Majja.
वसामांसस्नेहः( Chakrapani on Ch Sha 7/15)
While commenting Chakrapani has mentioned Vasa as Mansa Sneha.
Dalhana on commenting on Su Su 23/12 considered Vasa as
वसामांसनिर्यासः, मस्तुलुङ्गःअर्धविलीनघृताकारोमस्तकमज्जा|( Dalhana on Su.Su23/12)
Sites of Vasa, Meda and Majja
तृतीयामेदोधरा;मेदोहिसर्वभूतानामुदरस्थमण्वस्थिषुच, महत्सुचमज्जाभवति(Su.Sha. 4/12)
While describing Kala Acharya Sushruta has considered the third Kala as Medodhara Kala. It can be considered as omentum and deep fascia as per contemporary science. Meda Dhatu is present mainly around the abdomen and within the small bones while Majja is present in large bones. Sarakta Meda is present in small bones. During the manifestation of obesity, excess deposition of Meda Dhatu occurs around the buttocks, abdomen, and breast.
शुद्ध्मांसस्य: य: स्नेह: सावसापरिकीर्तिता ।(Su.Sha. 4/13)
Sushruta has mentioned that Vasa is the unctuous part of Shuddha Mansa or the fat content of flesh. Normally abdomen is considered a collecting site of Vasa. During obesity, this collection or aggregation further increases particularly in the abdomen region but this deposition also occurs in some other parts of the body. In the body, deposition takes place below the skin i.e. in subcutaneous tissue. Besides, it is also deposited in omentum which is known also known as“Vapavahan”.Vapa means carrying of Vasa. Charak has considered Vapavahan among fifteen Koshtang.
Chakrapani has mentioned ‘Vapavahanam Medaha Sthanam Tailvartika ‘means considered Vapavahana as the site of Meda. For bodily Sneha, in Ayurveda, four words have been used i.e. Majja, Vasa, Meda, and Sarakta Meda. Majja is present in large bones and is yellow hence, known as yellow marrow. Vasa has been considered an unctuous part of Shuddha Mansa. Vasa is also a updhatu. Both Meda and Vasa chemically come under the fat. After five years of age, all large bones start becoming fatty and after twenty years of age, they are not helpful in R.B.C production. Considering this quality Ayurveda scholars have not described Majja as blood-forming like the liver and spleen and considered it as Dhatu due to its Dharana and Poshana function. nutritive function.
Types of Meda and Majja dhatu
While describing Dushya of Prameha Charak has mentioned Meda as of two types Baddha and Abaddha. Baddha Meda can be considered as visceral adipocytes as they are situated in Udar (stomach) and small bones. Abaddha Meda can be considered as circulating lipids. Majja dhatu can be also classified as Asthigat Majja and Mastishkagat Majja i.e Rakta Majja and Pit Majja.
Composition of Yellow and Red Bone Marrow
Yellow Bone Marrow
Cellular Composition – 95percent fat cells, 5% non-fat cells
Chemical Composition – 80% fat, 15% water, 5% protein
Red Bone Marrow
Cellular composition- 40% fat cells, 60% hematopoietic cells
Chemical composition- 40% fat, 40% water, 20% protein
Anatomical Distribution of Vasa, Meda and Majja
|Ayurveda description||Contemporary description|
|Adipose tissue||Sites||Adipose tissue||Sites|
|Vasa||Unctuousness of well nourished Mamsa dhatu (Shuddha Mansa)||Subcutaneous white adipose||Buttock ,thighs, abdomen|
|Meda||Cavity of small bones and abdomen||Visceral white adipose tissue||Around the omentum, intestine, and per renal areas|
|Brown adipose tissue (BAT)||Cervical axillary interscapular, and supraclavicular regions|
Vasa- accounting for 85% of total adipocytes of body.
Meda- accounting for 10% of total adipocytes of body
|Ayurveda description||Contemporary description|
|Adipose tissue||Sites||Adipose tissue||Sites|
|Majja||Cavities of long bones as Majja Dhatu and in skull bones are termed skull bone marrow (Mastulung/ Mastakgata Majja)||Bone marrow adipose tissue||ribs, sternum, vertebrae, and medullary canal of long bones ( tibia, femur and humerus)
|Rakta Majja||Long bones||Red bone marrow/ Regulated marrow adipose tissue (Rmat)||Interspersed within active hematopoietic sites such as mid to proximal tibia, femur and lumbar vertebrae|
|Peeta Majja||Yellow bone marrow /Constitutive Marrow adipose tissue(cMat)||Distal tibia and caudal vertebrae of the tail|
Panchbhautika composition and quantity
मेदोजलपृथिव्यात्मकम् , मज्जाचाप्यं(Chakrapani on Su.Su. 15/8)
Chakrapani has considered that Meda is composed of Jala and Ptithvi Mahabhuta while Majja is composed of Jala Mahabhuta. Jala Mahabhuta imparts features like Mriduta, Snigdhata and Prithvi Mahabhuta provides Guruta and Snigdhata.
त्रयोवसायाः, द्वौमेदसः, एकोमज्जायाः, मस्तिष्कस्यार्धाञ्जलिः( Ch.Sha. 7/15)
Charak in Sharirsthana has mentioned about the measurement of Vasa as “three Anjali”, Meda as “two Anjali”, Majja as “one Anjali” and of Mastishk Majja as “Ardhanjali”. This different proportion is similar to that of different proportion of subcutaneous white adipose tissue (85%of total adipose tissue), Brown adipose tissue(less than 12%), Visceral adipose tissue ( 10% of total adipose tissue) and Marrow adipose tissue.
Updhatu and Mala of Meda and Majja dhatu
मेदसः स्नायुसम्भवः (Ch.Chi. 15/17)
मलः स्वेदस्तु मेदसः|(Ch.Chi.15/18)
Updhatu of Meda is Snayu (Tendon) while Mala is Sveda. Consideration of Sveda as Mala might be indicating thermoregulation of adipocytes. Profuse perspiration is observed in obese individuals, which demonstrates that more the amount of Meda, more will be formation of Sweda. Sweat maintains the moistness and softness of skin. There is reciprocal relationship between sweat and urine i.e. increased sweating leads to decreased urine formation. Mala of Majja dhatu is Sneha of eyes, feces and skin. Sebum may be considered as unctuousness of skin. Sebum is an oily secretion of sebaceous glands and mixture of triglycerides, cholesterol, protein and inorganic salts. It prevents excessive evaporation of water from the skin and also inhibits the growth of certain bacteria. Sebum coats the surface of the hair and prevents dryness and brittleness of hair.
Physio-anatomical description of Vasa, Meda and Majja
Meda and Majja are dhatu, while Vasa is Updhatu of Mamsa. Meda is made up of Jala and Prithvi Mahabhoot , Majja is made up of Jala Mahabhoot. Meda is present in the cavity of small bones and the abdomen. Majja is present cavity of long bones and skull bone. Vasa is Sneha of muscle. As described previously, Meda is two types Baddha and Abaddha. Majja is two types of red and yellow bone marrow. The quantity of Meda and Majja is 2 and 1 Anjali respectively. Mastulung gata majja quantity is ½ Anjali.
The quantity of Vasa is three Anjali. Meda provides unctuousness, stability, and nourishment to bones. Majja provides unctuousness and nourishment to the reproductive organs and filling of bone.
Nourishment of Meda and Majja Dhatu.
रसाद्रक्तं ततो मांसं मांसान्मेदः प्रजायते |
मेदसोऽस्थि ततो मज्जा मज्ज्ञः शुक्रं तु जायते || (Su.Su. 14/10)
According to Susruta, Majja Dhatu originates from Asthi Dhatu. When Majjagni works on the Majja-producing portion of the Asthi Dhatu then, it results in the production of Majja Dhatu.
तेषां रसादीनां मलस्थूलाणुभागविशेषेण त्रिविधः परिणामो भवति; तद्यथा- अन्नात् पच्यमानाद्विण्मूत्रं मलः, सारो रसः; रसादग्निपक्वान्मलः कफः, स्थूलो भागो रसः, अणुभागो रक्तं; रक्तादग्निपक्वान्मलः पित्तं, स्थूलभागः शोणितम्, अणुभागस्तु मांसमिति; ततोऽप्यात्मपावकपच्यमानान्मलः श्रोत्रनासाकर्णाक्षिप्रजननादिस्रोतोमलः, स्थूलभागो मांसं, सूक्ष्मो मेदः; ततोऽपि निजवह्निपच्यमानान्मलः स्वेदः, स्थूलोंऽशो मेद एव, सूक्ष्मभागोऽस्थि, (Dalhana on Su.Su.14/10)
Dhatus are nourished by Aahar ras. Their nourishment is affected by both qualitative as well as quantitative status of Rasa Dhatu and previous Dhatu. Meda Dhatu and Vasa gets nourished by Mansa Dhatu while Majja gets nourished by Asthi Dhatu. The normal functional state of Mansa dhatu and Mansa Dhatwgni nourishes Meda Dhatu but vitiation disturbs the nourishment of Meda Dhatu. Similarly, the nourishment of Majja Dhatu gets affected by Asthi Dhatu. Previous studies have reported that bone marrow adipocytes and osteoblasts share common precursor and affects genesis of each other. Its nourishment might also get affected by Meda Dhatu. Action of Medagini on poshya portion of Meda Dhatu results in the formation of Meda Dhatu and Sweda as Mala, Asthi from the minute fraction. Under ’Medadhatwagini’ all the hormones affecting fat metabolism like insulin, Cortisol, ACTH, adipokines released from the adipocytes can be included. Action of Majjadhatwagini on the Poshya portion of Majja Dhatu results in the formation of Majja Dhatu. Unctousness in eyes, skin, feces as Mala and formation of Shukra Dhatu.
Medavaha and Majjavaha Srotas.
मेदोवहे द्वे, तयोर्मूलं कटी वृक्कौ च, तत्र विद्धस्य स्वेदागमनं स्निग्धाङ्गता तालुशोषः स्थूलशोफता पिपासा च
मेदोवहानां स्रोतसां वृक्कौ मूलं वपावहनं च| (Ch.Vi. 5/8)
मेदोवाहिनांवृक्कौमांसंच| (Arundatta on A.H. Sha. 3/42)
The roots of Medovaha Srotas are Kati, Vrikka, Vapavahan and Mansa. While that of Majjavaha Srotas are Asthi and Sandhi. Presently, Vapavahan is an unctuous vartika situated the in abdomen. Vapa is considered an Omentum which is a spread structure. The Srotomoola are the primary sites of onset of pathogenesis or the organ through which disease signs and symptoms of a particular Srotas get manifested. These organs too have an important role in pathophysiological conditions related to adipose tissue. Meda has also been considered as moola of Asthivaha Srotas while Majja has been considered as moola of Shukravaha Srotas. Recently, it has been found that osteoplastin secreted by bone affects fat metabolism and insulin sensitivity thus, affecting the functions of adipose tissue. Vrikka, Vasa or Vapavahan, and Kati are also considered as Moola of Medovaha Srotas. Regarding kidney, adiporenal access is established by various autocrine and endocrine secretions i.e. adiponectin and proinflammatory factors released by adipocytes. Chronic kidney diseases are linked with obesity and are one of the risk factors to aggravate primary renal diseases. Hyperlipidemia is present in some kidney disorders like nephritic syndrome. Regarding Mansa as a Moola of Medovaha Srotas. Certainly, studies have reported that myokines released from contracting muscles form a crosstalk between skeletal muscle and adipose tissue. These myokines besides affecting the functioning of skeletal muscle also affect adipose tissue. Vapavahan and Kati as a Moola of Medovaha Srotas i.e. omental fat and waist. In the case of obesity, the adipocytes present in omentum release adiponectin which is responsible for chronic sub-inflammatory reactions leading to metabolic disorders. As per ayurvedic descriptions also main sites of deposition of fat in obesity are buttock, abdomen, and breast.
Since Kati as a moola of Medovaha Srotas has clinical significance and is influential in deciding the of obesity. Hip to waist ratio is considered the best determinant of obesity.
Causes of vitiation of Meda and Majjavaha Srotas
मेदोवाहीनि दुष्यन्ति वारुण्याश्चातिसेवनात् ||
According to Charak, Meda is vitiated because of lack of physical activity, excessive day sleep, overconsumption of fatty substances intake of alcoholic drinks or Varuni.
मज्जवाहीनि दुष्यन्ति विरुद्धानां च सेवनात्||
According to Charak, Majja is vitiated due to crushing, injury, overuse of channel-blocking food substances, trauma, and compression of bone marrow.
Features of vitiation of Medovaha Srotas.
तत्र विद्धस्याक्रोशनविनमनमोहनभ्रमणवेपनानि मरणं वा भवति (Su.Sha. 9/12)
निन्दितानि प्रमेहाणां पूर्वरूपाणि यानि च| (Ch.Su. 28/15)
This includes –
- Unctuousness in the injured area
- Dryness of palate (Taalushosha)
- Obesity (Sthulata)
- Inflammation (Shopha),
- Thirst (Pipasa)
- Prodromal symptoms of prameha.
Features of vitiation of Majjavaha Srotas.
रुक् पर्वणां भ्रमो मूर्च्छा दर्शनं तमसस्तथा|
अरुषां स्थूलमूलानां पर्वजानां च दर्शनम्|| (Ch.Su.28/17)
- Pain in joints
- Darkness in front of eyes
- Deep seated eruptions in joints.
Functions of Meda Dhatu.
मेदः स्नेहस्वेदौ दृढत्वं पुष्टिमस्थ्नां च (Su.Su.15/5(1))
मेदः स्नेहयति स्नेहात् (A.S.Su.9/3)
नेहो-नेत्रादिषु स्निग्धता, मेदसः कर्म| (Arundutta on A.H.Su11/4)
- Meda Dhatu provides unctuousness to whole body
- Provides stability
- Nourishment of bone
Functions of Majja Dhatu.
मज्जा स्नेहं बलं शुक्रपुष्टिं पूरणमस्थ्नां च करोति (Su.Su.15/5)
मज्ज्ञो बलमस्थिपूरणं शुक्रपुष्टिश्च, (Arundutta on A.H.Su11/4)
- Unctuousness and strength to whole body
- Nourishment to Shukra Dhatu
- Fills the cavity of bones.
Meda and Majja Dhatu play an important role in nourishment of bone and reproductive tissues. Their imbalance in state of physiology i.e. Medavriddhi and Majjakshay affects functioning of bone tissues and produces abnormalities. These functions might be indicative of the role of adiponectin and leptins secreted by adipocytes in bone remodeling and reproductive functions. In short-term conditions, bone growth is inhibited due to increased apoptosis and decreased proliferation. While in long-term regulation bone formation is increased by adiponectin.
In the recent past, adipocytes were understood only as an energy depot but nowadays they are well-known endocrine glands that secrete a group of adipokines like Leptin, adiponectin, etc. which have a wide range of physiological roles including food intake, energy homeostasis, inflammation, glucose homeostasis, lipid metabolism, and angiogenesis.
Interdependence of Vasa, Meda, and Majja
Functionally they are interdependent. Recent research has also reported that various chemicals (adipokines) secreted by adipocytes present at different sites of the body help in the functional regulation of tissues like bone, muscle, and reproductive tissue as described in Ayurveda. However, in Ayurveda regulation of reproductive tissues has been explained as a function of Majja Dhatu. Recent studies have reported evidence of induced spermatogenesis from bone marrow adipocytes in azoospermic hamsters.
Features of Meda Kshay
मेदसि क्षीणे कट्याः प्लीह्नो वृद्धिः कृशाङ्गता||(A.H.Su. 11/18)
मेदःक्षये प्लीहाभिवृद्धिः सन्धिशून्यता रौक्ष्यं मेदुरमांसप्रार्थना च (Su.Su. 15/4)
- Splenomegaly: Chakrapani has considered splenomegaly
due to displacement. This can be due to the emaciation of fat surrounding the spleen.
- Sandhi Shunyata: hollowness or lightness in joints due to diminished fat cells in surrounding bones.
- Emaciation of the body.
- Roughness in the body.
- Desirous of eating the flesh of Medasvi animals.
- Numbness or loss of sensation over Kati.
Features of Meda Vriddhi
तद्वन्मेदस्तथा श्रमम्||अल्पेऽपि चेष्टिते श्वासं स्फिक्स्तनोदरलम्बनम्|
- Cardiorespiratory disturbance
- Dyspnea on exertion
- Enlargement of abdomen, buttocks, breast, and flanks due to excess deposition of fat in these areas.
These are features similar to that of obesity.
Features of Majja Kshay
मज्जक्षयेऽल्पशुक्रता पर्वभेदोऽस्थिनिस्तोदोऽस्थिशून्यता च, अस्थ्नां मज्जनि सौषिर्यं भ्रमस्तिमिरदर्शनम्|||(Su.Su. 15/9)
Majja Kshaya results in diminished Shukra, pain in bones and joints, emptiness in bones, porosity in bones, vertigo, and dark specks in the eyes.
Besides these features, Charak has mentioned that blood cell precursors are present in the bone marrow, and a decrease in Majja will cause a decrease in the blood which in turn may cause ‘Vaatprakopa’. Further due to Majja kshay filling of Asthi with Majja may decrease which may also lead to ‘Vaatprakopa’
Features of Majja kshay
मज्जा सर्वाङ्गनेत्रगौरवं च (Su.Su. 15/14)
मज्जा नेत्राङ्गगौरवम्|पर्वसु स्थूलमूलानि कुर्यात्कृच्छ्राण्यरूंषि च| (A.H.Su. 11/12)
Heaviness in whole body and eyes
Deep-seated eruptions in eyes.
In Ashtang Sangraha ‘Raktagaurav’ has been considered a feature of Majja vriddhi which indicates the increased viscosity of blood in conditions of hyperproliferative bone marrow like in polycythemia.
Features of Meda Sara Purusha
वर्णस्वरनेत्रकेशलोमनखदन्तौष्ठमूत्रपुरीषेषु विशेषतः स्नेहो मेदःसाराणाम्|
सा सारता वित्तैश्वर्यसुखोपभोगप्रदानान्यार्जवं सुकुमारोपचारतां चा चष्टे|| (Ch.Vi. 8/106)
Individuals having Meda as constitutional essence has unctuousness of complexion, voice, eyes, hair, body, teeth, urine and feces, well developed body, intolerance to exertion, happiness, enjoyment, luxury, simplicity and tenderness.
Features of Majja Sara Purusha
अकृशमुत्तमबलं स्निग्धगम्भीरस्वरं सौभाग्योपपन्नं महानेत्रं च मज्ज्ञा (Su.Su. 35/16)
मृद्वङ्गा बलवन्तः स्निग्धवर्णस्वराः स्थूलदीर्घवृत्तसन्धयश्च मज्जसाराः|
ते दीर्घायुषो बलवन्तः श्रुतवित्तविज्ञानापत्यसम्मानभाजश्च भवन्ति|(Ch.Vi 8/108)
Individuals having Majja as constitutional essence have soft organs, have unctuous complexion, voice thick, long and rounded joints, they also have longevity, critical understanding, wealth, progeny.
A study by Bredella MA et al, 2011 suggested that visceral adipose tissues are positively associated with bone marrow adipocytes. But while describing the therapeutic properties of Majja, it is mentioned that Majja increases Meda Dhatu also. These explanations suggest the plasticity of bone marrow.
Different therapeutic indications of Vasa and Majja in Snehana
Vasa and Majja have been described under Sneha Dravya but they have different therapeutic indications.
Snehapana has been also advised as per Dosha and circadian rhythm. Intake of Majja and Vasa has been described during spring. Sneha should be taken during the night in summer and conditions of Vata-Pitta excess while during mid-day in winter and excess of Kapha dosha. (Ch. Su.13/18-19)
Selection of specific types of Sneha Dravya i.e. Vasa and Majja as per season and Dosha might be indicating circadian rhythm in fat metabolism. Recent studies have also proven that enzymes involved in fat metabolism behave differently as per circadian rhythm. Diurnal variations in metabolites of fatty acids, steroids, hormones, and glycerophospholipids have also been reported. Recent studies on adipose tissues have also reported that adipocytes present in different body parts have peculiarities in functions and response to environmental cues.
Properties of Vasa and Majja
Vasa and Majja are sweet, aphrodisiacs and promoters of strength. Their hotness and coldness are to be determined as per the nature of the source.
Vasa (adipocytes) of marshy land (Aanupa Desha) possess warm potency (Ushna Veerya) while that of arid land (Jangala Desha) is of cold (Sheeta) potency. (Ch.Su. 27/295)
Contemporary researchers have also reported that on exposure to cold, there is increased browning of white adipose tissue as well as recruitment of Brown adipose tissue at their sites which results in enhanced thermogenesis and mitochondrial activity.
Indications of Vasa
- Persons having good tolerance for cold and wind.
- Persons have strong digestive power.
- Persons have dry and emaciated bodies as a result of overexertion.
- Decreased Shukra, Rakta, Kapha, and Meda.
- Unbearable pain in bone, joints, veins (Sira), ligament (Snayu), abdominal viscera (Koshtha), and vital organs (Marma), Vataprakopa (Ch. Su.13/47-49).
- It is also beneficial in piercing types of injury, prolapsed, disorders of the ear and head, nourishment of Shukra, and enhances reproductive functions (Ch. Su.13/16)
Indications of Majja.
- Strong digestive power
- Ability to bear the stress,
- Regular intake of Sneha
- Disorders due to Vata Dosha
- Krura Kostha(constipated bowel) (Ch.Su13/50)
- It enhances Kapha, Rasa Dhatu, Meda Dhatu, Majja, Shukra, and strength (Bala). Especially because it increases the strength of bone (Ch.SU.13/17).
Fat and marrow should be taken during spring.
Effect of adipokines released by adipocytes in the functioning of other tissues –
Rakta Dhatu – Hemopoitic function, Immunity
Mamsa Dhatu (Muscle tissue) – Myokines released by contracting muscles regulate glucose and lipid metabolism.
Asthi Dhatu (Bones) – Regulates osteoblastogenesis and osteoclastogenesis.
Shukra Dhatu – Leptin regulates signaling to the hypothalamic pituitary adrenal ovarian axis and helps in reproductive maturation. Bone marrow adipocytes induce spermatogenesis in azoospermic hamsters.
- Ayurveda scholars had deep insights regarding the nutrition and metabolism of Meda and Majja as described by their constituents, function, distribution, quantity, vitiating factors, season, and disorders.
- These descriptions are consistent with recent advancements in physiology and bimolecular studies of adipocytes present in different sites of the body.
- Concept of functional and nutritional interdependence of Dhatu has been described by Ayurveda scholars. Majja Dhatu on other tissues like a muscle (Mamsa Dhatu), bone (Asthi Dhatu), and reproductive tissue (Shukra Dhatu) show their functional interdependence which is consistent with the recent research findings of contemporary science.
- The entire discussion clarifies that Ayurveda scholars had a profound understanding of the clinical physiology of Meda and Majja Dhatu.