Sushruta Samhita Sharirasthana Chapter 9 Dhamani Vyäkaraņa Shariram (Description of Arteries)

The 9th chapter of Sharirasthana of Sushruta Samhita is named as Dhamani Vyäkaraņa Shariram Adhyaya. This chapter deals with Description of Arteries.

अथातो धमनीव्याकरणं शारीरं व्याख्यास्यामः ॥१ ॥
यथोवाच भगवान् धन्वन्तरिः ॥२ ॥

We will now expound the chapter by name Dhamanī vyakarana sarira detailed description of Arteries, as revealed by the venerable Dhanvantari. Dhamani pratyekata, distinctness of arteries

Table of Contents

Reasons for differences between dhamanis, siras and srotas

चतुर्विशतिर्धमन्यो नाभिप्रभवा अभिहिताः ।
तत्र केचिदाहुः – सिराधमनीस्रोत सामविभागः,
सिराविकारा एव हि धमन्यः स्रोतांसि चेति ।
तत्तु न सम्यक्,अन्या एव हि धमन्यः
केवलं तु परस्परसन्निकर्षात् सदृशागमकर्मत्वात् सौक्ष्याञ्च विभक्तकर्मणामप्यविभाग इव कर्मसु भवति ॥३ ॥

The fact that there are twenty-four dhamanis arising from nabhi – umbilicus has been stated earlier in 14th chapter of Sutra Sthana of this treatise (Sushruta Samhita).

Commenting on this, some experts opine that there is no difference between sira – veins, dhamanis – arteries and srotas – channels of the body. According to them, dhamani and srotas are modifications of siras only. But this view is incorrect.

Dhamani and srotas are different from the siras.

What is the reason?

They are different because of below mentioned reasons –

– Vyanjananyatva – they have different features which shows that they are different structures

– Mula sanniyama – they differ in their numbers at the place of their origin

– Karma vaisesya – they have separated designated functions i.e. they serve different functions and those functions are special to each of them and

– Agama – description in scriptures i.e. treatises of Ayurveda, which describe them differently

In spite of these structures performing different functions, they appear to be indifferent from each other due to the below mentioned reasons –

– Sannikarsa – due to their proximity, they are so near to each other that they appear to be one and the same,

– Sadrsaagamatva – similarity of description of these structures in texts of Ayurveda

– Sadrsakarmatva – similarity in the functions they render and

– Saukshmya – all structures being minute in nature

Dhamanī Vibhāga – ramifications of arteries

तासां तु खलु नाभिप्रभवाणां धमनीनामूर्ध्वगा दश,दश चाधोगामिन्यः,चतस्त्रस्तिर्यग्गाः ॥४ ॥

The ten dhamanis arising from Nabhi – umbilicus takes different routes. Below mentioned are the different course of these ten dhamanis –

– Ten of them move upwards. They are called Urdhwagami Dhamanis.

– Ten of them spread downwards. They are called Adhoga Dhamanis.

– The other four of them move sideward or take transverse route. They are called Tiryakga Dhamanis.

Urdhvagădhamanī– arteries spreading upward

ऊर्ध्वगाः शब्दस्पर्शरूपरसगन्धप्रश्वासोच्छासजृम्भितक्षुद्धसितकथितरुदितादीन् विशेषानभिवहन्त्यः शरीरं धारयन्ति । तास्तु हृदयमभिप्रपन्नास्त्रिधा जायन्ते,तास्त्रिंशत् । तासांत वातपित्तकफशोणितरसान् द्वे द्वे वहतस्ता दश,शब्दरूपरसगन्धानष्टाभिर्गृह्णीते, द्वाभ्यां भाषते,
द्वाभ्यां घोषं करोति,द्वाभ्यां स्वपिति,द्वाभ्यां प्रतिबुध्यते,द्वे चाश्रुवाहिन्यौ,द्वे स्तन्यं स्त्रिया वहतः स्तनसंश्रिते,ते एव शुक्रं नरस्य स्तनाभ्यामभिवहतः;तास्त्वेतास्त्रिंशत् सविभागा व्याख्याताः ।
एताभिरूचं नाभेरुदरपार्श्वपृष्ठोरःस्कन्धग्रीवाबाहवो धार्यन्ते याप्यन्ते च ॥५॥
ऊर्ध्वंगमास्तु कुर्वन्ति कर्माण्येतानि सर्वशः ॥

Functions of the dhamanis spreading upwards –

The Urdhwaga Dhamanis which are 10 in number and spreading upwards, support and maintain the functions of the body by attending to the below mentioned functions –

– Reception / perception of sensations of sound, touch, sight, taste and smell by their respective sense organs

– Inspiration and expiration of air

– Yawning

– Sneezing

– Laughing,

– Talking,

– Crying and

– Many other such functions

Each of these dhamanis after reaching the heart divide into three branches. Thus, they become thirty in number.

Of these,

– 2 dhamanis carry vata

– 2 dhamanis carry pitta

– 2 dhamanis carry kapha

– 2 dhamanis carry rakta

– 2 dhamanis carry rasa

– 2 dhamanis carry sensation of sound

– 2 dhamanis carry sensation of sight

– 2 dhamanis carry sensation of taste

– 2 dhamanis carry sensation of smell

– 2 dhamanis attend to speaking in words

– 2 dhamanis attend to shouting out loud sounds without words being used

– 2 dhamanis attend to the function of sleeping

– 2 dhamanis attend to function of waking up

– 2 dhamanis carry tears

– 2 dhamanis carry breast milk in the breasts of women and 2 dhamanis carry semen from the breasts in men

Thus, the thirty dhamanis are described based on their divisions and functions.

These dhamanis support and maintain the parts of the body above the umbilicus including abdomen, flanks, back, chest, shoulders, neck, arms etc. The urdhwa dhamanis perform all these mentioned functions throughout the life.

Adhoga Dhamanī – arteries spreading downward

अधोगमास्तु वक्ष्यामि कर्म चासां यथायथम् ॥६ ॥
अधोगमास्तु वातमूत्रपुरीषशुक्रातवादीन्यथो वहन्ति । तास्तु पित्ताशयमभिप्रपन्ना स्तत्रस्थमेवान्नपानरसं विपक्वमौष्ण्याद्विवेचयन्त्योऽभिवहन्त्यः शरीरं तर्पयन्ति,अर्पयन्ति चोर्ध्व गानां तिर्यग्गाणां च,रसस्थानं चाभिपूरयन्ति,मूत्रपुरीषस्वेदांश्च विवेचयन्ति;आमपक्वा शयान्तरे च त्रिधा जायन्ते,तास्त्रिंशत्;तासां तु वातपित्तकफशोणितरसान् द्वे द्वे वहतस्ता दश,द्वे अन्नवाहिन्यावन्त्राश्रिते,तोयवहे द्वे,मूत्रबस्तिमभिप्रपन्ने मूत्रवहे द्वे,शुक्रवहे द्वे,शुक्रप्रादुर्भावाय,द्वे विसर्गाय,ते एव रक्तमभिवहतो विसृजतश्च नारीणामार्तवसंज्ञ,द्वे वर्चोनिरसन्यौ स्थूलान्त्रप्रतिबद्धे,अष्टावन्यास्तिर्यग्गामिनीनां धमनीनां स्वेदमर्पयन्ति;तास्त्वेतास्त्रिंशत् सविभागाव्याख्याताः । एताभिरधोनाभेःपक्वाशयकटीमूत्रपुरीषगुदबस्तिमेढ्रसक्थीनिधार्यन्तेयाप्यन्तेच ॥७॥
भवतिचात्र:-
अधोगमास्तुकुर्वन्तिकर्माण्येतानिसर्वशः ॥

Functions of the dhamanis spreading downwards –

The Adhoga Dhamanis which are 10 in number and spreading downwards, support and maintain the functions of the body by attending to the below mentioned functions –

Conveys flatus etc – The dhamanis spreading in downward direction convey flatus, urine, feces, semen and menstrual blood etc. downwards.

Sara-kitta vibhajana – The essence of foods and drinks that we consume is called as rasa dhatu. This rasa dhatu is formed in the pittashaya i.e. seats of pitta which comprises stomach and small intestine by the action of heat i.e. agni – the digestive fire present therein. The adhoga dhamanis on reaching the pittashaya, act upon this essence of food and drinks and separates it into sara – essential part and kitta – waste parts.

Supply of nutrients – these dhamanis convey the sara i.e. essence of the food throughout the body and nourishes the body by supplying the nutrients present in the rasa. They also supply the essence of food to the urdhwa and tiryakga dhamanis and also fill the seat of rasa i.e. hrdaya – heart.

Bifurcation of mala – these dhamanis also separate the wastes including urine, feces and sweat from the rasa.

Each of these dhamanis divide into three branches in the region between amashaya – stomach and small intestine and pakvasaya – colon. Thus, they become thirty in number.

Of these,

– 2 dhamanis carry vata

– 2 dhamanis carry pitta

– 2 dhamanis carry kapha

– 2 dhamanis carry rakta

– 2 dhamanis carry rasa

– 2 dhamanis present in the intestine carry anna i.e. food undergoing digestion

– 2 dhamanis carry toya – the water portion produced during digestion

– 2 dhamanis present in the urinary bladder carry urine

– 2 dhamanis present in the testes produce sukra – semen (the same number of dhamanis produce artava in women)

– 2 dhamanis present in the testes transport sukra (the same number of dhamanis eliminate artava in women)

– 2 dhamanis are attached to the colon and help in expelling the feces

– 8 dhamanis supply sweat to the tiryak dhamanis

Thus, the thirty branches of adhoga dhamanis have been described.

These dhamanis support and maintain the parts of the body below the umbilicus including large intestine, pelvis, urinary bladder, rectum, anus, penis and legs. The adhoga dhamanis perform all these mentioned functions throughout the life.

Tiryaggā Dhamanī – arteries spreading transversely,

तिर्यग्गाःसंप्रवक्ष्यामिकर्मचासांयथायथम् ॥८॥
तिर्यग्गाणंतुचतसृणांधमनीनामेकैकाशतधासहस्रधाचोत्तरोत्तरंविभज्यन्ते, तास्त्वसङ्ख्चेयाः, ताभिरिदंशरिरंगवाक्षितंविबद्धमाततंच, तासांमुखानिरोमकूपप्रतिबद्धानि, यैःस्वेदमभिवहन्तिरसंचाभैतर्पयन्त्यर्बहिश्च, तैरेवचाभ्यङ्गपरिषेकावगाहालेपनवीर्याण्यन्तःशरीरमप्रतिपद्यन्तेत्वचि, विपक्वानि, तैरेवचस्पर्शंसुखमसुखंवागृह्णीते, तास्त्वेताश्चतधोधमन्यःसर्वाङ्गगताःसविभागाव्याख्याताः ॥९॥

Functions of the dhamanis spreading sideward / transversely –

The Tiryagga Dhamanis which are 4 in number and spreading sideward / transversely, support and maintain the functions of the body by attending to the below mentioned functions –

Each one of the four dhamanī spreads sideward (transversely) successively divided into hundreds and thousands of branches. In this way their branches are innumerable.

The entire body appears to be full of windows by the presence of these tiryagga dhamanis. These dhamanis are knit together broadly. The openings of these transversely spreading dhamanis are attached to the hair follicles. These dhamanis convey sweat to the exterior of the body (skin) and also convey rasa to both, i.e. to the interior and exterior of the body.

The active potency and medicinal properties of medicines used in abhyanga, dhara, lepa etc get processed by the heat in the skin and enter into the interior of the body through these tiryagga dhamanis only.

It is only through these tiryagga dhamanis that both comfortable and uncomfortable sensations of touch are perceived by the body.

Thus, the four tiryagga dhamanis along with their branches which spread throughout the body and their functions have been described.

Analogy of lotus stalk and tuber to explain absorption of nutrients into the dhamanis

यथा स्वभावतः खानि मृणालेषु बिसेषु च ॥
धमनीनां तथा खानि रसो यैरुपचीयते ॥१० ॥

Acharya explains the anatomy of dhamanis with analogy of lotus stalk and tuber. We can see that by nature, the flower stalk and tuber of the lotus plant has many minute pores. Similarly, multiple minute pores are present in the dhamanis also. Through these openings, the rasa gets increased (because of being absorbed through these minute spaces / pores).

Relation between Dhamanis and Pancha Indriyas

पञ्चाभिभूतास्त्वथ पञ्चकृत्वः पञ्चेन्द्रियं पञ्चसु भावयन्ति ॥
पञ्चेन्द्रियं पञ्चसु भावयित्वा पञ्चत्वमायान्ति विनाशकाले ॥११ ॥ १.स. नि.१५–१० च स १२

The dhamanis are composed of Pancabhutas. They pervade the Panca indriyas, five times i.e. once in each indriya. After thus uniting the panca indriyas with the panca indriyarthas, these attain pancatva i.e. merge into the five elements at the time of death of the body.

Srotas Vivarana – description of tissue pores, channels etc

अत ऊर्ध्वं स्रोतसां मूलविद्धलक्षणमुपदेक्ष्यामः ।
तानि तु प्राणान्नोदकरसरक्तमां समेदोमूत्रपुरीषशुक्रार्तववहानि,येष्वधिकारः;एकेषां बहूनि एतेषां विशेषा बहवः ।
तत्र प्राणवहे द्वे,तयोर्मूलं हृदयं रसवाहिन्यश्च धमन्यः,तत्र विद्धस्याक्रोशनविनमनमोहनभ्रमणवेपनानि मरणं वा भवति;अन्नवहे द्वे,तयोर्मूलमामाशयोऽन्नवाहिन्यश्च धमन्यः,तत्र किद्धस्याध्मान शूलोऽन्नद्वेषश्छर्दिः पिपासाऽऽन्ध्यं मरणं च;उदकवहे द्वे,तयोर्मूलं तालुक्लोम च,तत्र विद्धस्य पिपासा सद्योमरणं च;रसवहे द्वे,तयोर्मूलं हृदयं रसवाहिन्यश्च धमन्यः,तत्र विद्धस्य शोषः प्राणवहविद्धवच्च मरणं तल्लिङ्गानि च;रक्तवहे द्वे,तयोर्मूलं यकृत्प्लीहानौ रक्तवाहिन्यश्च धमन्यः,तत्र विद्धस्य श्यावाङ्गता ज्वरो दाहः पाण्डुता शोणितागमनं रक्तनेत्रता च;मांसवहे द्वे,तयोर्मूलं स्नायुत्वचं रक्तवहाश्च धमन्यः,तत्र विद्धस्य श्वयथुर्मासशोषः सिराग्रन्थयो मरणं च;मेदोवहे द्वे,तयोर्मूलं कटी वृक्कौ च,तत्र विद्धस्य स्वेदागमनं स्निग्धाङ्गता तालुशोषः स्थूलशोफता पिपासा च;मूत्रवहे द्वे,तयोर्मूलं बस्तिर्मेद्रं च,तत्र विद्धस्यानद्धबस्तिता मूत्रनिरोधः स्तब्धमेढ़ता च;पुरीषवहे द्वे,तयोर्मूलं पक्वाशयो गुदं च,तत्र विद्धस्यानाहो दुर्गन्धता ग्रथितान्त्रता च;शुक्रवहे द्वे,तयोर्मूलं स्तनौ वृषणौ च,तत्र विद्धस्य क्लीबता चिरात् प्रसेको रक्तशुक्रता च;आर्तववहे द्वे,तयोर्मूलं गर्भाशय आर्तववाहिन्यश्च धमन्यः,तत्र विद्धाया वन्ध्यात्वं मैथुनासहिष्णुत्वमार्तवनाशश्च;सेवनीच्छेदागुजाप्रादुर्भावः;बस्तिगुदविद्धलक्षणं प्रागुक्तमिति । स्रोतोविद्धं तु प्रत्याख्यायोपचरेत्,उद्धृतशल्यं तु क्षतविधानेनोपचरेत् ॥१२ ॥

After this, the srotas – channels of the body will be described. At the same time, the symptoms produced when these srotas get injured at their roots (places of origin) will also be described.

These srotas are responsible for transportation of many things in the body. They include –

– Prana – air

– Anna – food

– Udaka – water

– Rasa – nutrients, plasma

– Rakta – blood

– Mamsa – muscles

– Meda – fat

– Mutra – urine

– Purisa – feces

– Sukra – semen

– Artava – menstrual blood

Only these channels will be explained here because these only are relevant here in Salya Tantra i.e. school of surgery.

Some other authorities opine that srotas are many in number and their varieties are also innumerable.

Further;

Name of the srotas

Mula – roots, chief organs and structures related

Effect of injury

PranavahaSrotas – channels responsible for transportation of air, life element (respiration)

2 in number

Hrdaya – heart

Rasavahidhamanis – arteries carrying rasa dhatu

Crying with pain

Bending of the body

Delusion – loss of consciousness,

Giddiness

Tremors

Death

AnnavahaSrotas – channels responsible for transportation of food,

2 in number

Amashaya – stomach

Annavahinidhamani – arteries / ducts carrying food

Flatulence

Pain in the abdomen

Aversion to food

Vomiting

Thirst

Blindness and

Death

UdakavahaSrotas – channels responsible for transportation of water,

2 in number

Talu – palate

Kloma – pancreas

Profound thirst

Instant death

RasavahaSrotas – channels responsible for transportation of rasa – nutrient tissue,

2 in number

Hrdaya – heart

RasavahiniDhamanis – arteries / ducts carrying rasa

Emaciation

Symptoms of injury to PranavahaSrotas

Death

RaktavahaSrotas – channels responsible for transportation of blood tissue,

2 in number

Yakrit – liver

Pliha – spleen

RaktavahiDhamanis – arteries carrying blood

Bluish coloration of body

Fever

Burning sensation

Anemia

Hemorrhage

Redness of eyes

MamsavahaSrotas – channels responsible for conveying muscle tissue

2 in number

Snayu – ligaments

Tvacha – skin

RaktavahiDhamanis – arteries carrying blood

Swelling

Emaciation / wasting of muscles

Tumors of veins

Death

MedovahaSrotas – channels responsible for carrying fat tissue,

2 in number

Kati – waist

Vrkkau – two kidneys

Excessive sweating

Unctuousness of the body,

Dryness of the palate

Obesity,

Swelling and

Severe thirst

MutravahaSrotas – channels responsible for carrying / voiding urine,

2 in number

Basti – urinary bladder

Medhra – penis

Enlargement of bladder,

Obstruction to urination

Stiffness / loss of movement of the penis

PurisavahaSrotas – channels responsible for carrying / voiding feces,

2 in number

Pakvasaya – large intestine

Guda – rectum

Distension of abdomen

Bad smell

Knotting of intestines

SukravahaSrotas – channels responsible for carrying semen,

2 in number

Stanau – 2 breasts

Vrsanau – testes

Impotence,

Delayed ejaculation

Ejaculation of semen mixed with blood

ArtavavahaSrotas – channels responsible for carrying menstrual blood,

2 in number

Garbhashaya – uterus

Artavavahidhamanis – arteries / ducts carrying menstrual blood

Sterility

Intolerance to copulation

Loss of menstrual blood (amenorrhea)

Sevani Cheda – When sevani i.e. raphae is injured it causes pain.

Basti Guda Viddha – the symptoms caused due to injury to the urinary bladder and rectum have been described earlier.

The physician should first intimate about the incurability of injury to the srotas to the caretakers of the patient and then initiate the treatment for the same. Arrow or any other foreign body should be first removed and then treated on the lines of treating a wound.