Review Article Analytical Study Of Heart In Ayurveda

International Journal of Research and Reviewwww.ijrrjournal.comE-ISSN: 2349-9788; P-ISSN: 2454-2237Review ArticleAnalytical Study of Heart in AyurvedaDas Tripti1, Chakraborty Swapan Kumar21PG Scholar, 2Professor,Department of Roga Nidan, Govt. Ayurvedic College, Guwahati, Assam, India.Corresponding Author: Das TriptiABSTRACTThe heart, the pumping organ of the circulatory system, is situated in middle mediastinum, enclosedwithin the pericardium along with the great vessels. Optimum and efficient circulation of bloodthroughout the body ensures proper nutrition, excretion, gaseous exchange, thermoregulation andhaemostasis, digestion and metabolism, intelligence, immunity and life in the body. This fairlyexplains the importance of this four chambered organ in our body and its vulnerability to any kind ofdisturbances in the body and reason of CVD being leading cause of death. It is important tounderstand this organ thoroughly for fair understanding and management of that each and every caseof CVD.In Ayurveda hridaya is considered under trimarma and dasa prana ayatana which duly signifies theimportance of this organ in causation of grave diseases. However, the term Hridaya mentioned inAyurveda is denoting an organ which controls the passage of prana by collecting, distributing in arhythm. This definition indicates that hridaya is the heart and hridaya is the brain as well. Hridaya,however, is considered one among the kosthangas by Acharya Charak and one among kosthas byAcharya Susruta. These descriptions are surely appreciating about the “uruhstha hridaya”.The present review article encompasses the concept of heart in Ayurveda i.e., hridaya (urahstha) inAyurveda; including its nirukty (etymology), sharira rachana (anatomy), sharir kriya (physiology)with modern insights where ever relevance is there.Keywords: heart, hridaya, trimarma, ayurveda, uruhsthaINTRODUCTIONThe human heart is responsible forproviding tissues with vital nutrients, andfacilitating waste excretion. Consequently,cardiac dysfunction causes devastatingphysiologic consequences. Disruption ofany element of the heart - myocardium,valves, conduction system, and coronaryvasculature, can adversely affect pumpingefficiency thus leading to morbidity andmortality. [1] Cardiovascular diseases(including coronary artery diseases) isnumber one cause of worldwide mortality,with about 80% of the burden occurring indeveloping countries. [2]In Ayurvedic classics heart is the“Urastha Hridaya”. [3] It is considered oneamong the three organs (trimarma) whichneeds constant vigilance and a keen eye onlifestyle and gastronomy, in order to avoiddiseases with poor prognosis. [4]NIRUKTI:The word “hridaya” in Ayurveda is asynonymous for the word heart. “Hridaya”is derived from three verbs (as persatpathbrahman and brihadaranyak). “Hrun”which means to abduct, “dad” which meansto donate and “in gatou” self generatedrhythmicity for contraction and relaxation.[5]The hridaya thus means an organ whichInternational Journal of Research & Review (www.ijrrjournal.com)Vol.5; Issue: 11; November 20181

Das Tripti et.al. Analytical Study of Heart in Ayurvedadraws fluid including blood from all overthe body and then supplies it to all the partsof the body. [6] The hridaya is a vital organand if affected, may cause instantaneousdeath. [7]DEFINITION OF HRIDAYA:The marma located in the thorax(uras) in between the two breast (stanyormadhye) and near to that of esophagealorifice (amashaya-dwar), where resides thetamas, rajas and sattva guna, is known ashridaya. [3]SYNONYMS:According to Amarkosha: cheta,swantam, hrit and manas [8]According to Charak : mahaphala,mahat and artha [9]Hridaya and dasha dhamaniANATOMY (RACHANA):BruhadaranyakaUpanishaddescribes the hridaya as a fleshy muscularorgan (mamsa-pesichayo) [10] resembling ared lotus bud and hangs with its apexdownwards; [11] from which vessels andcapillaries spread all over the body. [6] Tenmajor blood vessels originate from it. [12]Location: Uras (thorax) [13]Hridaya is located on left side ofkloma and above yakri and pleeha and to theright of phupphusa [14]Hridaya is located in the thorax(uras) in between the two breasts (stanyormadhye) and near to that of esophagealorifice (amashaya-dwar). [3]Kala:Kala is the fine structure that separates thedhatus from their asayas. [15] Thus themamsa dhara kala is stated to separate andsupport the mamsa dhatu, in which latter areto found siras, dhananis, snayus, andsrotamsi. [16]Marma:Hridaya is a type of sira marma. [17]sadyo-prana hara marma, [7] one amongtrimarma and dasa vishesa ayatana, [18] anasaya, [19] and a Kostha [20] as per Susrutaand a Kosthanga [21] as per Charaka andVagbhata.Sandhi:There are three sandhis in hridayam. [22] Andthe type of sandhi present in hridaya is“mandala sandhi”. [23]Peshi:Hridaya consists of two peshis. s from the essence of shonita andkapha tissues and develops into a muscularorgan. [14] Genetically, in the developmentof the hridaya maternal influence dominate.[25]Hence in an individual with hridroga, itis particularly important to inquire regardinghridroga on the maternal side. Hridayabecome more obvious by the 4th month ofgarbha utpatti krama. [26] According toCharak, it starts functioning in the thirdfoetal month. [27]PHYSIOLOGY (KRIYA):The hridaya is a very sensitive organhaving its own inherent rhythm. It keeps oncontracting and relaxing on its own. [28] Thevata system also controls its rhythmicitywhich continues lifelong in a cyclic manner.[29]The hridaya is more active during theday.Hridaya provides rasa, rakta and ojato entire srotas of the body through siras likethat of the mountain ranges which providewater and there by nutrition and life to theentire world through rivers. [30]Circulation of the body fluids i.e. rasa inthe body:The body fluids i.e. the first dhatu(rasa) are derived from the diet. [31] Afterdigestion and absorption, the food isconverted into “rasa” which carries thenutrients for all the tissues of the body. Itpasses from intestines into blood vessels andthen to the hridaya by the action of samanvayu. From the hridaya, it is pumpedInternational Journal of Research & Review (www.ijrrjournal.com)Vol.5; Issue: 11; November 20182

Das Tripti et.al. Analytical Study of Heart in Ayurvedathrough its main blood vessels by the actionof vyan vayu into millions of capillaries. [28]The circulation is controlled by autonomicnervous system i.e. by vyana vayu [32]mainly and also by samana vayu. Fromcapillaries, rasa penetrates all the tissues andcells of the body. The fluid from the tissuesis brought back to the hridaya by capillariesand veins. [33]Rakta is derived from rasa [34] and itcirculates together with rasa. [35] Ayurvedicliterature emphasizes on the circulation ofrasa whose prime function is to supplynutrients to tissues. [36] Rakta floats in rasain the blood vessels and transports oxygento tissues. [37] The hridaya pumps raktaalong with rasa all over the body. [28]Circulation of oja:Hridaya is the seat of the vital fluidoja. Rasa is derived from diet. [31] All thenutrients in rasa cannot be directly utilizedby tissues as such. These nutrients aremodified by the Agni and converted intovital fluids which can be utilized by all thetissues. Oja is the essence of the vital fluidsof all the tissues of the body which suppliesenergy to different tissues. [38] Oja iscirculated into all tissues by the hridayathrough blood vessels. Life as well as healthand happiness depend on oja. [39]In regards the mode of transport andcirculation of this Oja, to which all dhatusare stated to make a contribution,Cakrapanidatta notes that, “Param tejawhich is the sara of all dhatus (comparableto the ghee of the milk and the honey of theflowers and fruits), being located in thehridayam, mixes with rasa, and circulatesthrough the dhamanis and performs (actionsspoken of as) tarpana of the entire body. Itrepresents the Bala of all the dhatus and ispresent in the organism, from the time of thefertilization of the shonita by shukra, due toits swakarma (properties). [40]Describing the vital role heart andcirculation play in the distribution ofsleishmika oja to all of the body, Charakasays: “The dasa mahamukla dhamanis arethe channels of transport of ojas to entirebody. They are spoken of as dhamanyahbecause, they pulsate; as srotamsi, because,they permit the exudation (filteration,diffusion, permeation) and sira because,they maintain a steady (and continuous)flow of rasa-rakta. [39]The heart thus pumps „rasa‟ i.e.fluids and nutrients, rakta and oja i.e. vitalfluids to all the tissues and organs of thebody. [28] Hence life, vitality, consciousness,functioning of sense organs, mind andintellect and indirectly happiness andsorrow depend on the proper functioning orotherwise of the heart.Hridaya And Primary Dhatus In It:The hridaya, itself being a muscularorgan, [24] derives its nutrition from rasa, itsnutition from Rakta [41] and its vital energyfrom Oja. [42] Its movements are controlledby vyana vayu (Autonomic nervoussystem). [43]Sadhaka pitta resides at Hridaya. [44]Its functions are: shourya (courage,bravery), bhaya (fear), krodhra (anger,rage), harsha (excitation, cheerfulness),moha (delusion, fainting). [45] Also AtharvaVeda has mentioned that hridaya and Shirasare sutured together, because of thisrelationship, [46] vayu is located in the upperportion of mastishka and it controlseverything. [46] Again, the terms manas,chitta, buddhi and hridaya representdifferent functional aspects of the mind andare not distinctly different organs located invarious parts of the body. [47] So everydisturbance or involvement of hridayaaffects sadhakpitta.Avalambaka kapha bear a strikingresemblance to the mode or supply ofnutrition to the hridaya from rasa; supportlubrication provided to hridaya by the pericardial fluid and synovial fluid to thethoracic joints (trik pradesha), and thereplenishment of fluid to the fluid systemsof the body. [48]Any of the eight basic elements viz.rasa, rakta, muscular tissue, Oja, pranavayu, vyana-vayu, sadhaka pitta andavalambaka kapha when affected, candisturb the function of the hridaya and causehridroga. [49] On the other hand theseInternational Journal of Research & Review (www.ijrrjournal.com)Vol.5; Issue: 11; November 20183