Manish Patel MD, PhD in Kayachikitsa, works as Professor and Head of the Postgraduate Department of Kayachikitsa, J. S. Ayurveda College, Nadiad, India, where he works closely with Prof. Dr. S.N. Gupta. He has more than 20 years of clinical experience and has been actively teaching since 2007. Among other things, he gives practical/clinical training to students of the European Academy of Ayurveda and other institutions from Germany, Austria and Switzerland. Numerous publications about his research in areas that were only sporadically present in Ayurvedic clinical research, such as chronic renal failure, nephrotic syndrome, liver cirrhosis, ulcerative colitis, diabetic neuropathy and Parkinsonism.
Kleda is a body component with physiological, pathological and therapeutic importance. It has different meanings in different context. According to the texts, kleda is a factor responsible for moisture. Thus it may be considered as water in the body, present in various forms. Generally, water (udaka) is moisturizing agent. Kleda and udaka may be synonymous but water when performs a specific function of kledana (moisturizing, wetting or liquifying) then it is known as kleda. Water which is absorbed from the alimentary canal and remains in different body compartments is udaka. Transitional part of it which moisturizes the tissues is kleda. Transportation of electrolytes, nutrients and waste products at cellular level is because of this function. Hence, it is the moisture which useful for replenishment and nourishment of every dhātu. The importance of kleda as water in the body is well established. Kleda is mentioned as one of the essential factors for digestion of food as well as metabolism in tissues.
According to Ayurveda, mūtra and sveda are the malas. Kleda is eliminated through mutra while sveda holds it in the body tissues. Thus the status of kleda, sveda and mūtra is interdependent. If kleda is water portion then in this context, sveda is solute part in sweat and mūtra is solutes in the urine. Hence, the term ‘mūtra’ mentioned in Ayurveda classics can be considered as the solutes in the urine such as creatinine, uric acid, electrolytes, urea and other nitrogenous wastes. Similarly, sveda can be considered as mainly sodium, chlorine and other wastes inside the sweat. Sveda (the solid contents of sweat) is considered to retain kleda while mūtra (solutes in urine) to eliminate. This concept is applied practically in the treatment.
In classics, word “kleda” also used for secretion or oozing from wound or skin lesions as a symptom in various disorders. Because in diabetes, excessive urine is an important feature, kleda is considered one of the dūṣyas. Exudates which are inflammatory products are also common in skin diseases (kuṣṭha and visarpa), therefore kleda is considered dūṣya in these clinical conditions too. Excess of kleda suppress the agni (factor responsible for digestion and metabolism), obstructs the srotas and produce various disorders. Mūtrala auṣadha, apatarpaṇa in the form of rukṣaṇa, śoṣaṇa or saṁśodhana are the main line of treatment to reduce and correct the kleda.