Srotas are the empty passageways that originate at the root position and ascend throughout the entire body, serving as a conveyance mechanism to fulfil the organism's nutritional needs. Thus, the Srotas are comparable to the blood capillaries that aid in the body's nutritional transportation.
Raktavaha Srotas from its origin, we can compare it with Haemopoietic system.Liver situated in right hypochondriac region. Location of Yakrit in our Samhitas below and right to Hridya. Spleen situated in left hypochondriac region which is same as mentioned by our Acharyas that is Pleeha located below and left to Hridya. In foetal life both organs are derived from Rakta. So, we can consider Liver and Spleen as Moola Sthana of Raktavaha Srotas.

liver and spleen function as a collection of blood from its original source. Additionally, damaged red blood cells are removed from circulation and destroyed by phagocytic macrophages found in the liver and spleen. The life cycle, degradation, and recycling of red blood cells are primarily mediated by the liver and spleen.
Liver becomes the major hematopoietic organ of the embryo and foetus from 2nd to 7th month of development.
Large nests of proliferating cells, which produce red and white blood cells, lie between hepatic cells and walls of the vessels.
A complex of cell types including hepatoblasts creates the hematopoietic microenvironment in the foetal liver, recently hepatoblasts have been shown to play an important role in regulation of erythropoiesis.
Hepatic Stage - From third month of intrauterine life, liver is the main organ that produces RBCs. Spleen and lymphoid organs are also involved in erythropoiesis.
Myeloid Stage - During the last three months of intrauterine life, the RBCs are produced from red bone marrow and liver.
Hemocytoblasts, which are produced by certain fixed mesenchymal cells in the spleen, give birth to erythroblasts during the fifth month of pregnancy.
Spleen performs immunological functions takes part in destruction of damaged and aged erythrocytes, filters blood, produce b and t lymphocytes and acts as reservoir of the blood.

Large amounts of blood may be kept in the liver's blood arteries due to its expandable nature. Its typical blood volume, which includes the blood in the hepatic sinuses and veins, is around 450 millilitres, or roughly 10% of the body's total blood volume.

Until the age of five, almost every bone's marrow generates red blood cells. After around the age of 20, the marrow of the long bones, with the exception of the proximal sections of the humeri and tibiae, becomes very fatty and stops producing red blood cells. After this age, the majority of red blood cells are still made in the marrow of membranous bones such the ilia, sternum, ribs, and vertebrae. As we age, the marrow becomes less productive, even in these bones.

Haematopoiesis that takes place in organs other than the bone marrow is referred to as extramedullary haematopoiesis. Even the liver and spleen regain their fatal function of hemopoiesis in extramedullary haematopoiesis.

All blood that passes through the pancreas, spleen, and gut is directed into the liver through the portal vein by the splanchnic system. Blood drains into the inferior vena cava from the hepatic veins of the liver. So, we can consider portal vein as Raktavaha Dhamani. [Read less]

Moolasthana of Annavaha Srotas is Stomach, Oesophagus,Small Intestine and vessels of Small Intestine

[Read less]

CONCLUSION
As a result of this thesis work, it has been effectively established that the concept of Ashayas (body cavities or receptacles) is well-explained through authentic references from the Ayurvedic Samhitas, providing a clear and insightful understanding of their nature and significance.
Based on the analysis of Visnupadamrita with reference to Vatashaya, the lungs appear to be the appropriate anatomical correlate for Vatashaya due to their functional and structural relevance.
For Pittashaya, the Yakrit (liver) and Agnashaya (pancreas) are mentioned in Ayurvedic texts as primary sites. However, the findings of this thesis suggest that the duodenum may be a more accurate anatomical structure corresponding to Pittashaya, given its role in digestion and interaction with Pitta.
This work proposes that pleura (lining of the lungs) and pericardium (lining of the heart) may be considered as anatomical representations of Shaleshmashaya, based on their protective and cushioning functions, which align with the characteristics of Kapha Dosha.
As per Ayurvedic authorities, Raktashaya is associated with Yakrit (liver) and Pliha (spleen). This thesis supports this view, correlating it with the formation of Rakta Dhatu (blood tissue) – red blood cells (RBCs) in the liver during foetal life and white blood cells (WBCs) in the spleen.
Regarding Aamashaya, the stomach has been identified as its modern counterpart, in accordance with Acharya Charaka's mention in Vimana Sthana.
Pakwashaya is correlated with the large intestine, including the rectum, which appears to be a valid anatomical representation based on its eliminative function described in Ayurvedic texts.
Mutrashaya is accurately equated with the urinary bladder, as already quoted by Acharya Sharangadhara in the phrase "Mutrasayo Vastirnama".
In females, Garbhashaya is a specialized organ responsible for holding the foetus. On collection of scattered matter available in different Ayurvedic text and correlating it with the modern anatomical text available, it can be concluded that Garbhashaya is nothing but the Uterus. The following points mentioned below helped to reach the said conclusion-
1. Shape of Garbhashaya mentioned by Acharyas is Rohit Matsya Mukhakriti. Just as the Rohitmatsya has constricted mouth, and wider belly above, the Uterus is also wider above (fundus part) and is constricted in lower part (cervix part).
2. The position of Garbhashaya given by Acharya Sushruta in Ashmari Chikitsa states the position of Garbhashaya in accordance with Basti and Pakwashaya. Grossly, Basti can be taken as Bladder. Commenter Gananatha Sena has described the Pakwashaya as Malashya as a part of Bruhadantra. As per modern science also, the uterus lies between bladder and rectum.
3. The role of Aartava Vaha Strotasa described by Aacharya Sushruta in Sharira Sthana chapter 4, Aartvavaha Strotasa can be considered as uterine vessels as these have major role in menstruation and development of foetus. [Read less]

Dermatology is the branch of medicine dealing with the skin and its structure, function and diseases. In present scenario it is a speciality with both medical and surgical aspects.
➢ Twak sharir as the dermatology is the branch of medicine which deals with the structure, function and disease of the skin. In present scenario its significance is seen in both medical and surgical aspects. Therefore it needs to be explored.
➢ Various terminology of Twacha i.e. Chamdi, Chhal, charm, valkal reflect to the meaning of 'to hide' or 'to cover'.
➢ Term Samvaran and Asthipanjar avestan exactly refer to the natural outer covering of human body which is skin.
➢ Panchbhautik constitution of skin such as weight of skin due to prithvi mahabhuta, softness and smoothness of skin due to Jala mahabhuta, lusterness and colour complexion due to Agni mahabhuta, tactile part is due to vayu mahabhuta, Secreting channels and pores with space (Kha guna) due to aakash mahabhuta, makes twacha as an Anatomico- physiological unit to perform its appropriate function.
➢ Twacha as the 'updhatu' of mansa dhatus may be considerd as subtissues or secondary tissues in the body which serves as the important component and have certain fixed function to render. It is supported and nourished by underlying muscles and blood vessels respectively.
➢ According to various scholars twacha is classified as Bahistwak and Antastwak which is taken as Epidermal & dermal layer of skin.Third Uptwacha is subcutaneous tissue or Hypodermis.
➢ Tiryag Dhamani moving in oblique direction and its innumerable branches spread out to whole of the body and connect to sweat pores resembles to deeper dermal vascular plexus around the hair follicles and sweat glands which provide delivery of nutrients and excretion of waste products
➢ Seven layer of twacha described by Acharya Sushrut is now possible to detect and study because of development of microscope which opened many doors of science like study of structure of cell.
• First layer Avbhasini resembles to Stratum corneum due to reflection of skin colour. Its keratin & lipid content prevent the water loss so it is also termed as Udakdhara.
• Due to cluster of pigmented cells and dark appearance in various diseases, second layer is termed as Lohita i.e. Stratum lucidum.
• Granular cells of stratum granulosum or Shweta are in transitional state which may balance the skin's complexion and lightening of darker colours of the inner layers.
• Tamra twacha resembles Malpighian layers which contains the melanin pigment.
• Vedini is the pappilary layer of dermis which contains various corpuscle, receptor,nerve endings for sensation of vibration and pressure.
• Because of the fibre layer Rohini twacha may be considerd as the Reticular layer of dermis which helps in wound healing or ropana karma.
• Mansadhara twacha resembles to Hypodermis (subcutaneous layer or superficial fascia) which provide insulation and cushioning for the integument.
➢ The measurement of skin from superficial to deeper layer i.e 1/18th , 1/16th, 1/12th, 1/8th ,1/5th ,1 and 2 vreehi states the fact that upper epidermis is thin and deeper dermis is thick. It is justified as the Modern Anatomy where epidermis is described as 0.05 to 1.5 mm thick and Dermis is 0.6 mm to 4 mm thick.
• Thin and thick skin have different structure and function in the body.
• Thickness of skin varies according to different body parts depending on the function of that body part.
➢ Twacha as the sparshendriya may be the entity or tools for obtaining the knowledge of touch sensation.
➢ Sparsh indriya Panch panchak appears as the Anatomico-physiological unit resembles for the perception of knowledge of touch sensation.
• Somatosensory system and touch receptors present in the skin and spinothalamus tract are responsible for touch sensation.
➢ Bharajak pitta responsible for colour complexion may be understood as melanin pigment present in skin.
• Different layers of skin is explored on the basis of location of its diseases with the help of histological examination as the following-
➢ Skin diseases like sidhma and padmakantak described in Ayuvedic texts are the Tinea versicolor and squamous cell pappiloma. Both are observed as Epidermal disease. Histologically, Tinea versicolor is justified as seated in Stratum corneum. Squamous cell pappiloma is a benign (non-cancerous) tumor arising from an epithelial surface (Epidermis).
➢ All these disease are epidermal and due to dark coloured appearance of skin (due to cluster of pigmented cells) the second layer may be termed as Lohita i.e. Stratum lucidum.
➢ The third shweta layer of skin(stratum granulosum) is the seat of Ajgallika (Molluscum contagiosum) and charmdala (Atopic dermatitis). The symptoms of these epidermal diseases appears as dry, cracked, scaly skin .
➢ The lesions in Molluscum gives the appearance of white to flesh colored pearly papules on the skin. Probably due to these reasons this third layer is termed as Shweta.
➢ In Dermatitis, keratinocytes move toward the surface that is distal to the basal or deepest layer of skin. Molluscum bodies is observed to occupy the entire cell at the level of granular layer.
➢ Fourth Tamra or Malpighian layer which contests the Bhrajak pitta as the pigment melanin is the seat of kustha (leprosy) and kilas (vitiligo).
➢ In leprosy decreased melanin production and inflamed epidermal layer presents the lighter, darker, pale, pink or reddish patches on the skin. Destruction of melanocytes in vitiligo also gives the appearance of pale, pink, coppery and white macules as skin .Thus symptomatically and histologically this layer is justified as Tamra in Ayurveda.
➢ Vedana or pain is observed as one of the symptom of kustha and visarpa that is due to aggravated vata. Painful skin nodules and possibly nerve pain caused by herpes zoster due to inflamed nerves resembles to kustha and visarpa respectively.
• Pappilary layer abundant with Blood vessels, nerve and receptors is found as inflamed in these diseases.
➢ Due to Histological appearances and resemblance of vata with neurological junction, it is justified.
➢ Apachi as lymphadenopathy,Arbuda as cancer, Galganda as Goitre, Shleepada as Elephantiasis and granthi as cyst is observed symptomatically and histologically located in the sixth rohini or reticular layer of skin. The Anatomical component of Reticular layer, predominantly the lymphatic, lymph node, fat and blood vessels get distributed to produce the above diseases.
• Hence they are described to located in Rohini or reticular layer of skin.
➢ Mansdhara twacha which is considerd as the Hypodermis is observed as the seat of Arsha, Bhagandar and vidradhi in Ayurveda.
• Arsha as the haemorrhoids represents the abnormal downward displacement of the anal cushions, Bhagandar as the subcutaneous tract, vidradhi as the deep subcutaneous abscess are justified as located in Mansdhara twacha.
➢ All the above mentioned skin diseases which are observed ,correlated as viral, bacterial, depigmentation, inflammatory autoimmune, benign or malignant growth denatures the different anatomical components of different layers of skin which are now explored under the light of Modern science with the help of microscopic study.
​Thus it would enlighten the path for better understanding and useful for clinical study.


A Comprehensive Study of Twak Sharir with its Applied Aspect
- Dr. Anjali Rai (M.D. Year - 2023)
[Read less]

4

Term Apara is broadly used in embryology in the reference of Garbha poshan by our acharya.

2 Some author gives the term jarayu as the synonyms of Apara But according to Amarkosha jarayu is a membrane like structure. Description of jarayu in Kashyap Samhita indicate it to be like of peritoneum. Sushrut Samhita indicates it to be kala(membrane). Charak Samhita indicates it to be fetal membrane. On the basis of Samhita, my view regards jarayu as fetal membrane. and according to Sanskrit Kaumudi apara is a structure which provide nutrition.



According to modern anatomy term apara is "placenta" which provide nutrition to the fetus.

Anatomically placenta has two surfaces ie..

Fetal surface-covered with whitish smooth and glistening amniotic membrane and umbilical cord attached at or near the centre. Branches of umbilical vessels are visible on this surface radiating from umbilical cord. Amniotic membrane can be peeled off from underlying chorionic plate except at umbilical cord.

Maternal surface looks dull red and shows 15-20 lobes or maternal cotyledons which are separated by sulci. Each sulcus corresponds to decidual septum.

Maternal surface is covered with a thin greyish layer of decidua-compact layer (basal plate -1 mm) and spongy layer that comes away, with basal plate at time of placental separation. Numerous small greyish calcified white infarcts are visible on the surface.









It weighs 500 gm. It measures from 15-20 cm in diameter and 2.5cm in the centre. Its volume is 500ml: the surface area 243sqcm.

It connects to the foetus by an umbilical cord of approximately 55-60cms in length that contains two arteries and one vein. The umbilical cord inserts into the chorionic plate.

In Avurveda Apara is stated to formed by obstructed Artaval menstrual blood). In modern physiology it is observed that due to increase level of progesterone endometrium does not shed off so Artava is not seen. This unseen Artava/blood does not repel or goes upward, but this Artava which is unshed endometrium and blood, accumulates/collected upward in the blood sinuses and lacunae, which play important role as a maternal component in the formation of placenta

According to acharya Charak Apara or placenta is described as the nourishing part when the body parts of foetus become conspicuous (sanjatsar angapratyang)

Dr. Ghanekar stated that fetus is nourished through the placenta after third month and feto- placental circulation is observe to started from end of 3r month. Placenta is beginning to from 6week of pregnancy and completed at end of 12th week.

1 Normal placental oxygen levels show variations between below 20 mmHg and 60 mmHg during pregnancy. Early onset preeclampsia FGR is associated with increased pO2 in intervillous maternal blood and decreased pO2 of fetal blood.

Before conspicuity of body parts garbha takes its nourishment through Upsneha & Upsweda of Garbhashaya. After conspicuity of body parts Garbha take its nourishment from apara through Nabhinadi attached to the Aparatplacenta), carrying the Maturahar rasa Viryam (essence and potency of mother's diet & placenta hormones) and Garbha grows by obtaining nourishment through apara. We can correlate the following texas

(3) Maturahar Rasa as essence of mother's diet L., Carbohydrate, fat, protein, vitamins, oxygen etc. present in mother's blood.

(b) Viryam

As potency of mother's diet & placental hormones. It includes

hormones- (hCS, hCG, Thyroid hormones etc.). These have influence on maternal metabolism like anti-insulin effect, increase plasma level of glucose and amino acids, that directly influence the growth of foetus

Immunoglobulins that pass from mother's blood to foetal blood, helps to improve the immunity of foctusPlacenta insufficiency is a condition whereby there is a failure of placental vascular remodelling, icading to a failure of placentation resulting in acidosis and fetal hypoxemia. Acharya have highlighted the fact that vitiated vata dries the rasavahi nadi(uterine vessels) nourishment carrying channels in the foetus leading to emaciated fetus. In present scenario low birth weight baby are bom mostly due to placental insufficiency

9 Several factors like chronic hypertension, stress, or blood clotting, anxiety other metabolic disorders have become a major cause of uteroplacental insufficiency leading to complication during pregnancy or birth.

10. Normal expulsion of apara(placenta) within 15-30 min after fetus Vitiation of vayu is main causes for apara Sanga and for vata is shamana best treatment Basti (asthapan, anuvashana or Uttar Basti). So due toConclusion

vulagulomana, along with flatus, faeces and urine adhered placenta also come out.

11 Covering of fetus by abnormal jarayu is termed as jarayu- dosa, jarayu is the membrane which covers the fetus during its intra uterine life.

12 Acharyas have given the importance of healthy diet for normal development of apara as well as normal expulsion of placenta.

13 Environmental stimuli such as maternal stress can disrupt vital aspects of placental organogenesis and function including decidual immune intolerance, vascularisation & utero-placental blood flow, trophoblast, hormone secretion & nutrient exchange with the labyrinth zone causing various complications.

The hypothesis presented by our legendary Acharyas in classics is absolutely justified on modern scientific studies. It is relevant and practically applied in term of wellbeing of foetus and mother as well. [Read less]

This thesis provides a vision on the location size and shape of the garbhashaya from it's normal adult stage to the pregnant stage with correlation of ayurvedic texts. [Read less]