» Khavaigunya: Impairment of srotas as a critical step in pathogenesis

Year: 2021
Language: English, German

There is a very interesting debate in the Vimanasthana of Carakasamhita. An entire chapter has been devoted to the discussion on Srotas called Srotovimana. The chapter opens with the statement that the entire human body can be considered as a network of srotases. The word srotas needs to be carefully interpreted. The terms Srotas and Kha are synonymous. Kha means space and Srotas refers to the entire intricate network of macro and micro spaces in the body.

The Carakasamhita points out that the entire human body is porous with big spaces continuing into smaller and smaller spaces. The smallest spaces are so minute that the physical eye cannot even visualise them. At the microscopic level the body appears to be nothing but a network of space. So much so that the Carakasamhita is posing the question as to whether we should consider the body as srotas itself. Sage Atreya replies that this is not a correct view point but that the body is made of srotas and everything else that passes through it. The body is a porous crucible in which everything is transforming and moving. Srotases serve as the substratum and passage for the transformation of everything that enters the body, mainly the food that we consume to generate the energy for our activities and to rebuild the body continuously.

Caraka has classified the major srotases of the body from a functional perspective into thirteen types. The first three represent the inputs that the body needs to preserve itself - Prana (vital air), Udaka (water) and Anna (food). The next seven srotases represent the stages of transformation that the ingested food undergoes to nourish and preserve the body - Rasa, Rakta, Mamsa, Medas, Asthi, Majja and Sukra. Finally, three srotases represent the outputs that are removed from the body in the form of wastes - Purisha (feces), Mutra (urine) and Sveda (sweat).

From this functional classification of srotases in the Caraksamhita, we can understand that srotases represent the pathways for the entire metabolic processes that happen in the body. An impairment of srotas means impairment in the metabolic processes of the body, which can set the stage for manifestation of diseases.

The changes in the srotases can be subtle or gross. Gross impairments to the srotases manifest when the disease has developed significantly. Excess passage of substances (atipravritti) through a particular srotas (for example excessive urination in case of mutravaha srotas - the passages for transportaion of urine) or blockage (Sanga) of the passage (for example urinary obstruction) can be indication of malfunctioning of a particular srotas. Physical obstruction (granthi) causing restricted passage or complete block of the flow of substances or passage in the wrong direction (vimargagamanam) are all gross signs of malfunction of specific srotases in the body. The subtle signs of srotodusti or impairment of srotases may not be clinically discernible so obviously and the physician has to infer such early changes through careful clinical observation and assessment.

According to Ayurveda, health is synonymous with Sukha. Sukha is usually translated as happiness, but if we look at the derivation of this word in Sanskrit, it becomes clear that sukha indicates normal functioning of the srotases. Su - means in good condition and Kha means srotases or spaces of the body.

When the srotases function normally, there is sukha which is synonymous with Arogya or health. When srotases malfunction, there is dukha which means duḥ - or malfunction and kha or srotas.

In this brief talk, we will discuss how impairment to srotas is an inevitable component of the initiation of pathogenesis of all diseases from the Ayurvedic perspective.