Module on “Physio – clinical significance of Dhatu-mala” (Part-1) By- Dr. Vandana Verma

Physio-clinical significance of Dhatumala ( Lecture part -1)

Dr. Vandana Verma , Assistant Professor, Department of Kriya Sharira, Faculty of Ayurveda,IMS, BHU, Varanasi, Email:vandana.verma04@gmail.com

Dhatumala
Dhatumala are the waste products which are produced during tissue metabolism i.e. during transformation of Sapt Dhatu i.e. Rasa, Rakta, Mamsa etc. by action of their respective Dhavaagni. Since Dhatu Mala are derived from the Dhatu so they also get affected in imbalance functional state of Dhatu, either in Vriddhi or Kshya state. They play great role in physiological homeostasis along with Dhatu, for example Malarupi Kapha produced during transformation of the Rasa Dhatu & Pitta produced during the transformation of Rakta Dhatu help in digestion & metabolism, similarly in other physiological activities too. Thus Dhatumala play significant role in diagnosis & clinical presentation of imbalance state either in Vriddhi or Kshya of Dhatu.

In the verse (C. Su 28/4) Charaka has described that Ahara gets completely digested in the GIT with the help of different Dosha i.e. Prana Vata, Smana Vata, Bodhak Kapha & Pachak Pitta & divides into two parts Prasad (Rasa) & Kitta(Mala). The Kitta part replenishes to Sweda, Mutra, Purish, Tridosha, mala present in Karna(ear), Nasika(nose), Aasya(oral cavity), secretions from Loma koop and genitalia. Dhatumala are formed during the tissue metabolism & are replenished by the Kitta part of Ahara(diet). The Sara bhag (nutrient part) nourishes to seven tissues, Oja, Shabd ,Sparsh, Roop, Rasa, Gandh (Panchendriya artha). The food is made up of Panchmaha bhoot, it gets disintegrated into simpler form and replenishes to their respective panchamahbhut Guna in the body tissues, Joints, all the secretions.

Further Charak describes that, similar to Ahara, the Dhatu also gets divided into two parts i. e. Prasad bhaag and Mala bhaag by action of their respective Agni.
Prasad bhaag (nutrient part) nourishes to the respective tissue and it’s very little fraction nourishes to next Dhatu, however the Mala bhaag replenishes to Dhatu mala formed at the level of each dhatu. The transformation of Dhatu (metabolism) depends on respective quantity of dhatu, age of the body and each tissue is replenished as per it’s the normal quantity in the body. So, in this manner the Rasa (nutrient) and Mala (waste) part is produced during digestion and metabolisms in their normal quantity are retained in their respective sites and maintain homeostasis.

The quantity of formed tissue waste product may be in less or excess as per the intake of Ahara(diet). If the Mala is formed in excess, it is excreted out from the body and in state of kshina awastha i.e. when formed in less quantity, the food is advised accordingly to maintain the physiology of the tissue.

तत्राहारप्रसादाख्यो रसः किट्टं च मलाख्यमभिनिर्वर्तते| किट्टात्स्वेदमूत्रपुरीषवातपित्तश्लेष्माणः कर्णाक्षिनासिकास्यलोमकूपप्रजननमलाः केशश्मश्रुलोमनखादयश्चावयवाः पुष्यन्ति|
पुष्यन्तित्वाहाररसाद्रसरुधिरमांसमेदोस्थिमज्जशुक्रौजांसिपञ्चेन्द्रियद्रव्याणि धातुप्रसादसञ्ज्ञकानि शरीरसन्धिबन्धपिच्छादयश्चावयवाः|
ते सर्व एव धातवो मलाख्याः प्रसादाख्याश्च रसमलाभ्यां पुष्यन्तः स्वं मानमनुवर्तन्ते यथावयःशरीरम्|
एवं रसमलौ स्वप्रमाणावस्थितावाश्रयस्य समधातोर्धातुसाम्यमनुवर्तयतः| निमित्ततस्तु क्षीणवृद्धानां प्रसादाख्यानां धातूनां वृद्धिक्षयाभ्यामाहारमूलाभ्यां रसः साम्यमुत्पादयत्यारोग्याय, किट्टं च मलानामेवमेव| स्वमानातिरिक्ताः पुनरुत्सर्गिणः शीतोष्णपर्यायगुणैश्चोपचर्यमाणा मलाः शरीर धातुसाम्यकराः समुपलभ्यन्ते|| (C.Su.28/4)
सप्तभिर्देहधातारो धातवो द्विविधं पुनः| यथास्वमग्निभिः पाकं यान्ति किट्टप्रसादवत् || (C.Ci.15/15)
Dhatumala (waste products of tissue metabolism)
Kitta of Anna (diet): Mutra & Purish

Mala of Rasa: Kapha & Lasika (Vagbhat has considered Lasika as Mala)
Mala of Rakta: Pitta
Mala of Mamsa: Khamal(ear wax), as per Chakrapani, the secretions present in different orifices i.e. eyes, nose, mouth, genitalia, coating over tongue and teeth
Mala of Meda: Sveda
Mala of Asthi: hair on scalp and body, beard and nail
Mala of Majja: unctuousness in eye and skin, feces.

Oja is considered as Mala of Shukra dhatu by Vagbhat. When Shukra dhatu is acted upon by Sukraagni, no Mala formed at all but Vagbhat has considered Oja as its Mala in relation to Garbha(fetus), he says that Garbha is Prasad of Shukra Dhatu and in relation to Garbha Oja is considered as Mala of Shukra Dhatu. Although Oja could not be considered as Mala because if there is Kshaya or Vriddhi of any Dhatu or Mala it causes disorders in the body whereas Oja Kshya causes Vikara but Oja Vriddhi never causes disorders in the body it shows only beneficial effect in the body.

किट्टमन्नस्य विण्मूत्रं, रसस्य तु कफोऽसृजः I पित्तं, मांसस्य खमला, मलः स्वेदस्तु मेदसः II स्यात्किट्टं केशलोमास्थ्नो, मज्ज्ञः स्नेहोऽक्षिविट्त्वचाम् | प्रसादकिट्टे धातूनां पाकादेवंविधर्च्छतः II परस्परोपसंस्तब्धा धातुस्नेहपरम्परा II (C.Chi. 15/18,19,20)

कफः पित्तं मलाः खेषु प्रस्वेदो नखरोम च II स्नेहोऽक्षित्वग्विशामोजो धातूनां क्रमशो मलाः I (A.Hri. Sha.3/63)
According to Sharangradhar: Mala of Sapta dhatu (Sharangdhar Pratham khand 5/13,14,15)

Mala of Rasa: moisture in eye, mouth, tongue
Mala of Rakta: ranjaka pitta
Mala of Mamsa: ear wax
Mala of Meda: sweat, excretions in nose, genital, urethra, coating over tongue
Mala of Asthi: nails and hair
Mala of Majja: unctuousness in eye, feces and skin
Mala of Shukra: yuva pidika (acne in adolescence)

Mechanism of tissue transformation and generation of Dhatumala.

Dalhan has given description about the concept of sequential tissue transformation. He mentioned that when Rasa dhatu is acted upon by Rasa Agni, it gets divided into three parts, first part is Mala i.e. Kapha; second is Sthula part (major portion) nourishes to Rasa dhatu and third part i.e. Anu part (small portion) it nourishes to next dhatu i.e .Rakta dhatu. So in same manner all the tissue which gets acted by their respective Agni gets divided into three parts and there is generation of Dhatumala during tissue transformation.
Further Dalhan has explained that the sequential transformation of tissue doesn’t happen after birth, this transformation or pattern of nourishment refers to embryonic stage of tissue transformation and nutrition. When zygote is formed it is single cell and is pluripotent, it has capacity to differentiate into any kind of cells. In this development phase of embryo all the cells gets nourished by the Rasa and they get differentiated into different kinds of tissue, but once they get differentiated into specific type of tissue they do not get converted or transformed into other kind of tissue. Basically, this refers to the tissue transformation and nutrition during embryonic life or during organogenesis.
Here he says that all the tissues only get nourished and replenished and are not formed from the previous Dhatu. So after birth the Saptadhatu are only replenished by the Ahara rasa. One kind of tissue does not get transformed into other kind of tissue rather it refers to the interdependence of the metabolism of different kind of tissue. For example Asthi Dhatu for its metabolism depends upon Meda. As the formation of bone Vitamin D is required, which get synthesized from cholesterol, which is constituent of Meda and various other hormones eg. leptins , adipokines etc. help in osteogenesis and osteoblastic activities. Therefore, we can say that all the tissue are interdependent on each other for their metabolism & homeostasis but one type of tissue do not get converted into another type of tissue.

Acc. to Shivdas Sen, there is only nourishment and replenishment of dhatu and next dhatu does not get derived from the previous one.

रसाद्रक्तं ततो मांसं मांसान्मेदः प्रजायते | मेदसोऽस्थि ततो मज्जा मज्ज्ञः शुक्रं तु जायते ||१०|| S.Su.14/10
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; ततोऽपि पच्यमानान्मलः केशलोमश्मश्रूणि, स्थूलोऽस्थि, सूक्ष्मस्तु मज्जा; ततोऽपि मज्ज्ञः पावकपच्यमानान्मलो नयनपुरीषत्वचां स्नेहः, स्थूलो भागो मज्जा, सूक्ष्मः शुक्रं; ततः पुनः पच्यमानादुपमलो नोत्पद्यते सहस्रधाध्मातसुवर्णवत्, स्थूलो भागः शुक्रमेव, स्नेहभागः सूक्ष्मस्तेजोभूतमोजः| पूर्वोक्त एवार्थः श्लोकाभ्यां कथ्यते- “स्थूलाण्वंशमलैः सर्वे भिद्यन्ते धातवस्त्रिधा| स्वः स्थूलोंऽशः परं सूक्ष्मस्तन्मलं याति तन्मलः|| स्वाग्निभिः पच्यमानेषु मलः षट्सु रसादिषु| न शुक्रे पच्यमानेऽपि हेमनीवाक्षये मलः – इति| Dalhan on S.Su.14/10
मेदः प्रजायते’ इत्यत्र `प्रवर्तते’ इति पठन्ति, `शुक्रं तु जायते’ इत्यत्र `शुक्रस्य सम्भव’ इति पठन्ति, व्याख्यानयन्ति च- सम्भवाशब्दोऽत्र पोषणे न त्वपूर्वोत्पादने, यतो रसादीनां शुक्रान्तानामागर्भादेवोत्पत्तिरिति I Dalhan on S.Su.14/10
Shivadas Sen commentary जनिश्चायं पोषण एव वर्तते नापूर्वोत्पादे| यतो रक्तादयो गर्भात् प्रभृत्येवोत्पन्ना रसादिभिः पोष्यन्ते|

1. Malarupi Kapha (Vaikrita Kapha)

Kapha is mala of Rasa dhatu produced by action of Rasagni on Rasa dhatu. Acharya Vagbhat has mentioned that Dosha are of two kinds i.e. Prakrit Dosha (Dhaturupi dosha) and Malarupi or Vaikrit dosha. Prakrit Dosha are derived from Sukra(sperm) and Shonita (ovum) gata dosha. The proportion of Prakrit Dosha i.e. Vata, Piita & Kapha, which is formed into the zygote, is retained all through life. This Prakrit dosha is responsible for determination of Prakriti (Psychosomatic constitution) at the time of formation of zygote. Prakrit dosha are considered as Beeja bhoota it means they come from sperm and ova and retain all through life. However the dosha which are produced after birth from Ahaara(diet) during the process of digestion and metabolism are called as Vaikrit Dosha.
Vaikrit dosha are produced from Ahaar as a Mala and they help in maintenance of Prakrit Dosha as well as in the normal physiology of the body. Since the Malarupi Dosha are produced during the process of digestion and metabolism so they are liable to change in their quality and quantity. State of Vaikrit dosha also depends on many factors like Kala, season, age, time factor, code of conduct, quality of food etc.

If they get vititated because of improper diet and activity produce various kind of disorders in the body. Because of it’s property to get vitiated, it is called as Dosha.
Malarupi kapha is released into amashya(stomach) during the first phase of digestion i.e. madhur awastha paka and help in digestion of food. Thus the Malarupi kapha also nourishes to the Prakrit Kapha and helps in its physiological function. The quantity of malarupi kapha changes with the type of diet lifestyle and it follow a circadian rhythm.

तथा च केचिदाऽऽहुः द्विधा वातादयः प्राकृता वैकृताश्च 1|६| तत्र प्रकृताः सप्तविधायाः प्रकृतेर्हेतुभूताः शरीरैकजन्मानः २|६| दोषाख्यानां विकृतानां बीजभूताः मुमूर्षोः स्वरूपाच्चलन्ति ३|६| सर्वेष्वपि च देहे सन्निहितेषु प्रकृतावुल्बणेन व्यपदेशः ४||६|| (Indu teeka- प्राकृताः शरीरैकजन्मत्वाच्छरीरधारणेन धातुसंज्ञां लभन्ते| ते प्राकृता दोषसंज्ञकानां वैकृतानां वातादीनां बीजभूताः| ते च प्राकृताः ये न मुमूर्षुस्तस्य स्वरूपान्न चलन्ति| यावज्जीवितमेतत् स्वरूपरूपा इत्यर्थः| ये तु जन्मन उत्तरकाल सम्भवन्ति ते वैकृताः| ) वैकृतास्तुगर्भादिभिनिस्सृतस्याहाररसस्य मलाः सम्भवन्ति| प्राकृतेष्ववरोहन्ति ||७|| तेकालादिवशेनस्वप्रमाणवृद्धिक्षययोगाद् देहमनुगृह्णन्ति दूषयन्ति च||८|| (A.Hri.8/6, 7,8)
कफोऽवस्थापाकाद् रसमलतया च भवति| (C.Ci.15/18)

LASIKA (Lymph)

Acharya Vagbhat has considered Lasika as Mala of Rasa dhatu, it is understood as Lymph in contemporary sciences. Lasika is like a water, it a fraction of Udaka, which oozes out from injured site in the skin as exudates.

The quantity of Udaka in the body is 10 Anjali and when the fraction of this Udaka comes or oozes out from any injured site over the skin as exudate then that Udaka is called as Lasika. Here Lasika is considered as water like substance, is dwelling site of Pitta dosha. It is also considered as Dushya which gets vitiated in Prameha.

दशोदकस्याञ्जलयः —यत्तु त्वगन्तरे व्रणगतं लसीकाशब्दं लभते I (C.Sha.7/15)
नाभिरामाशयः स्वेदो लसीका रुधिरं रसः| दृक् स्पर्शनं च पित्तस्य, नाभिरत्रविशेषतः||२||(A.Hri.Su.12/2)
लसीका-जलसदृशी सर्वाङ्गसुन्दरी व्याख्या (कृत)

Assessment
Multiple choice Questions

Q.1 Which part of Ahara(diet) replenishes the Dhatumala in the body:
1. Saar bhag
2. Kitta Bhag
3. Both
4. none

Q.2 Ranjak pitta is Mala of—–.
1. Sukra dhatu
2. Rasa dhatu
3. Rakta
4.None

Q.3 Which statement is not true about Oja.

1. Oja is Mala of Sukra dhatu as per Vagbhatt
2. Oja is not considered as Mala as its Vriddhi does not produce any kind of disorder in the body.
3. Oja Kshya produces disorder in the body
4. Oja is not nourished by Ahar(diet)

Q.4 Which fraction of dhatu nourishes to next dhatu—- .
1. Sukshma bhag
2. Sthula bhag
3. Mala bhag
4. None

Q.5. Which statement is not True about Prakrit Dosha.
1. Prakrit dosha are the determinant of Prakriti (psychosomatic constituion)
2. Derived from Sukra and Shonita
3. Proportion of Prakrit dosha does not alter all through the life.
4. None .

Q.6. Which statement is not True about Vaikrita Dosha.
1. Vaikrita dosha are the determinant of Prakriti (psychosomatic constituion)
2. Produced during the digestion and metabolism of food
3. Proportion of Vaikrita dosha alter all through the life.
4. Produce disorders in the body .

Q7. Which statement is not True about Dhatu Mala.
1. Dhatumala are produced during dhatu paka
2. Dhatumal are replenished by Kitta part of Ahara
3. Help in maintenance of physiological homeostasis.
4. Do not produce disorders in the body.

Q8. Which is mala of Rasa Dhatu.
1. Kapah
2. Lasika
3. Netra, Jihwa and Kapol Jala
4. All of the above

Q9. Which is mala of Rakta Dhatu.
1. Kapah
2. Pitta
3. Ranjak pitta
4. Both 2 &3

Q10. Which is Mala of Asthi dhatu.
1. Meda
2. Majja
3. Kesha and Nakha
4. None

Answer sheet for MCQ