Review article An Exploration on physiology of Vasa, Meda, Majja in Ayurveda w.s.r. to adipose tissue. Sonam Agrawal1, Vandana Verma2, Sangeeta Gehlot3 1Senior Resident, Ph.D. Scholar, Department of Kriya Sharir, Faculty of Ayurveda, Institute of Medical Sciences, Varanasi, India. 2Assistant professor, Department of Kriya Sharir, Faculty of Ayurveda, Institute of Medical Sciences, Varanasi, India. 3Professor and Head, Department of Kriya Sharir, Faculty of Ayurveda, Institute of Medical Sciences, Varanasi, India. ABSTRACT Recent researches on adipocytes in human and mice model have reported that the adipocytes are not only the fat depots but having role in maintenance of physiology and metabolism through adipokines released by them in accordance to their anatomical location. Ayurveda scholars too have mentioned different tissues like Vasa (inter muscular fat), Meda (visceral fat) and Majja (bone marrow) which are predominantly rich in adipocytes similar to adipose tissues, with a different sites, functions, compositions and pathological outcomes. The metabolic effect of Meda and Majja Dhatu on other tissues like muscle (Mamsa Dhatu), bone (Asthi Dhatu) and reproductive tissue (Shukra Dhatu) shows their functional interdependence. The detailed description of therapeutic indications of Vasa and Majja under Snehakarma (oleation therapy) illustrates that clinical physiology of these tissues have been elaborated rather than general physiology. This article is an attempt to comprehend the physiological aspect of Vasa, Meda and Majja retrospectively on the basis of their therapeutic indication for the management of variety of disorders, in the form of Sneha through different therapeutic procedures. An effort has been also taken to distinguish Vasa, Meda, Majja based on the functional peculiarities of adipocytes present in different sites of body like omentum, muscle and bone marrow. Critical observation of explanations of Vasa, Meda and Majja in Ayurveda compendia and advanced research in field of adipocytes reflected that Ayurveda scholars had deep insights regarding the various dimensions of adipocytes, most of which are in consistent with the advanced physiology and biomolecular studies of adipocytes. Keywords Vasa, Meda, Majja, Asthi, Snehana, adipocytes, tissue nutrition INTRODUCTION intermuscular fat is termed as Vasa (muscle fat) (Sushruta Samhita Sharirasthana 4/12-13) and its role in maintenance of In recent past the adipose tissue has been considered as depot physiology and manifestation of diseases also. In Ayurveda, of extra energy but at present numerous researchers have Meda and Majja have been considered as Dhatu (tissue) while documented a variety of homeostatic functions, along with Vasa as Upadhatu (subsidiary tissue) (Charak Samhita functional peculiarities of adipocytes based on their distribution Chikitsasthana 15/16-17). They have not only identified in different parts of body. Recent past researches have different anatomical distribution but difference in their documented that adipocytes have endocrine functions and play composition, quantity, functions and role in manifestation of a great role in regulation of numbers of physiological process different diseases (Table No.1), treatment modalities on like bone metabolism, immune mechanism, reproductive vitiation etc. Although physiology and anatomy of these have functions by releasing adipokines. Adipose tissue is basically not been elaborated much but applied physiology has been a loose connective tissue comprised of mainly adipocytes enumerated in detail by all Ayurvedic scholars under including nerve tissue, stromovascular cells and immune cells therapeutic uses as Sneha in different disorders, as per Dosha (Kershaw EE and Flier JS, 2004) which are present in different and seasons etc. Any disturbance in normal status of Dosha, places of the body. Ayurvedic scholars have mentioned Dhatu and Mala leads to pathology (Charak Samhita distribution of Meda in different places of the body with Sutrasthana 9/4) and for the maintenance of homeostasis, different names like when it is present in small bones and application of treatment modalities has been described based on abdomen i.e. around viscera called as Meda (visceral fat), in principle of homologue and analogue(Samanya Vishesha long bones is known as Majja (bone marrow) while Siddhant) (Charak Samhita Sutrasthana 1/44, Charak Samhita Sharirasthana 6/9). For example in case of Meda Kshaya *Corresponding author: Vandana Verma substances increasing Meda have been advised (Charak E-mail: [email protected] Samhita Sharirasthana 6/10). These all indicate that Ayurveda Received Jul 13, 2019; Accepted Aug 13, 2019; Published Aug 31, scholar had an insight regarding different dimensions of 2019 adipose tissue, many of which are still under current trends of doi: http://dx.doi.org/10.5667/tang.2019.0011 research. This article is an attempt to comprehend the ©2019 by Association of Humanitas Medicine physiological aspect of Vasa, Meda and Majja retrospectively This is an open access article under the CC BY-NC license. (http://creativecommons.org/licenses/by-nc/3.0/) based on their description found under the management of a TANG / www.e-tang.org 2019 / Volume 9 / Issue 3 / e3 1 An Exploration on physiology of Vasa, Meda, Majja in Ayurveda w.s.r. to adipose tissue. variety of disorders in the form of Sneha in different different depots of the body exhibit different functions which therapeutic procedures. Along with this we have tried to can be understood through the metabolic interdependence of differentiate Vasa, Meda, Majja based on functional Vasa, Meda, Majja and patho-physiological pathways of peculiarities of adipocytes present in different sites of body like diseases manifested by them. omentum, muscle and bone marrow. Adipocytes present in MAJJA(bone marrow/brain S. No. MEDA(adipose tissue) VASA(inter muscular fat) marrow) 1. Description Dhatu Dhatu Upadhatu of Mamsa Panchabhautika composition Jala(water)+ Prithvi(earth) Jala (water) Not described 2. (Chakrapani on Sushruta Samhita Sutrasthana 15/8) Sites (Sushruta Samhita Cavity of small bones and Cavities of long bone and Sneha or unctuousness 3. Sharirasthana 4/12-13) abdomen (Udara), red bone- skull bones (Mastakgata of muscle (Shuddha Mamsa) marrow (Saraktameda) Majja) Types Deposited fat (Baddha) and Red and yellow bone - circulating lipid (Abaddha marrow(Rakta and Peeta Meda) (Charak Samhita Majja ) in Nidanasthana 4/7) Bone and brain marrow (Asthigata and Mastulung Majja) (Ashtanga Sangraha 4. Sharirasthana 5/33). Dalhan has described that skull bone marrow (brain) gets nourished by Tarpaka Kapha (Dalhana on Sushruta Samhita Sutrasthana 21/14) Quantity (Ashtanga Sangraha 2 Anjali Majja (bone marrow)-1 3 Anjali Sharirasthana 5/91) Anjali, Mastulunga Gata 5. Majja (brain marrow)-1/2 Anjali Functions (Sushruta Samhita Provides unctuousness Provides unctuousness - Sutrasthana 15/5,Ashtanga (Sneha), sweat (Sveda) (Sneha), strength (Bala) 6. Sangraha Sharirasthana 19/3) Stability and nourishment of Nourishment of reproductive bones organ (Shukrampushti) filling of bone. Role in organogenesis Rakta along with Meda forms - - (Sushruta Samhita kidney (~Vrikka) while 7. Sharirasthana 4/31) Mamsa, Rakta, Meda and Kapha together forms testes (Vrishana) Table 1. Physio-anatomical description of Vasa, Meda and Majja. MATERIALS AND METHODS Majja and Vasa are also enumerated as Sneha Dravya (substances predominant in unctuous property) of animal origin A thorough screening of Ayurvedic literature has been done for (Charak Samhita Sutrasthana 1/86).Their physio-pathological the description regarding the Vasa, Meda and Majja in different as well as therapeutic potential in different diseases have been contexts like Dhatu, Srotas, Dhatu Poshana, Snehapana etc. also identified. As the physiology of Vasa, Meda and Majja has Most recent contemporary research articles related to adipose not been much elaborated but functions and role in tissue were thoroughly screened in standard e-databases like physiological homeostasis can be ascertained from their PubMed, Science Direct, Web of Science, Medline plus by therapeutic indication in reverse order (reverse pharmacology). using suitable keywords like developmental origin, For example, recommendation of Vasa in case of emaciation differentiation, endocrine functions and biochemistry of might be due to provision of direct nourishment to the muscles adipose tissue, leptin, adipokines, myokines, marrow adipose (Mamsa) and Meda. All these depiction associated with Vasa, tissue, adipogenesis and osteoblastogenesis, adipogenesis and Meda and Majja have been scrutinized and précised under myogenesis etc. and incorporated for the possible relevant following captions: interpretations of Ayurveda description to explore the 1. Physio-anatomical description physiology of Vasa, Meda and Majja. 2. Panchabhautika composition 3. Distribution of fat in body 4. Nourishment and development REVIEW AND DISCUSSION 5. Difference in response to various factors Ayurveda scholars have identified different tissues which are 6. Different therapeutic indications of Vasa and Majja the primary sites of fat (Sneha) as Vasa, Meda and Majja. Meda in Snehankarma (oleation therapy) and Majja have been considered as tissue (Dhatu) while Vasa as 7. Functional aspects of Meda and Majja Dhatu inter-muscular adipose tissue under accessory tissue 8. Interdependence of Vasa, Meda and Majja in physio- (Upadhatu) of muscle tissue (Mamsa Dhatu) (Charak Samhita pathological