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Conceptual study of Conceptual study of MootravahaMootravaha Srotas Srotas

Prof. Dr. K. Shiva Rama PrasadProf. Dr. K. Shiva Rama PrasadM.D (KC), M.A. Ph.D. (M.D (KC), M.A. Ph.D. (JyoJyo))


Doctor Doctor ……I am passing more urine more time what to do?I am passing more urine more time what to do?I am getting abdominal bloat and not passing I am getting abdominal bloat and not passing urine what to do? urine what to do? I am getting lots of burning sensation while I am getting lots of burning sensation while passing urine, help me. passing urine, help me. My urine is green in colour. Is it a disease?My urine is green in colour. Is it a disease?I get the sensation but not able to pass urine, I get the sensation but not able to pass urine, what to do? what to do? All these questions are common for practitioner. All these questions are common for practitioner. What to do? How to understand these What to do? How to understand these problems? problems? What is the natures mystery behind it? What is the natures mystery behind it?


Natures existence survival phenomenon Natures existence survival phenomenon checks the beings nutrient input and checks the beings nutrient input and waste material output forms very well waste material output forms very well before to the birth in the womb. before to the birth in the womb. Out of many Out of many -- first one is dependent upon first one is dependent upon the water which is a major part of the life the water which is a major part of the life existence. existence. We can not think the life with out water We can not think the life with out water inside body and out side in the world. inside body and out side in the world.


The human body contains trillions of cells The human body contains trillions of cells bathed in extrabathed in extra--cellular fluid. cellular fluid. Cells in the body make mess and Cells in the body make mess and generate piles of garbage.generate piles of garbage.Most of the organic waste products are Most of the organic waste products are removed and excreted by the urinary removed and excreted by the urinary system, discussed and focused in this system, discussed and focused in this symposia. symposia. The water drains the waste from the body The water drains the waste from the body as URINE and the system concerned to it as URINE and the system concerned to it is is MootravahaMootravaha srotassrotas..


MootraMootra (Urine ) (Urine ) The Water of LifeThe Water of Life

UrineUrine is liquid waste produced by an is liquid waste produced by an animal'sanimal's kidneykidney. It is used to extract . It is used to extract wastes from the body in liquid form. Urine wastes from the body in liquid form. Urine can also play a role in animal behavior.can also play a role in animal behavior.urine urine -- waste fluid secreted by the waste fluid secreted by the kidneys and discharged from the bladder. kidneys and discharged from the bladder. Medically speaking Medically speaking -- The fluid and The fluid and dissolved substances excreted by the dissolved substances excreted by the kidney.kidney.


Some how the clone get the water and asked Some how the clone get the water and asked the king the king –– dear sir, what you can pay for this dear sir, what you can pay for this water, king replied half of my kingdom. OK, if water, king replied half of my kingdom. OK, if this water doesnthis water doesn’’t come out, then? The king t come out, then? The king replied as usual half of my kingdom. Then the replied as usual half of my kingdom. Then the clone said to king clone said to king –– is it not ridiculous to fight is it not ridiculous to fight such sort of kingdoms. such sort of kingdoms.

There was a King There was a King ““TymoreTymore”” –– once he went to forest for once he went to forest for hunting. There he miss the hunting. There he miss the road and only the clone is road and only the clone is behind him. He was thirsty. He behind him. He was thirsty. He wants the water.wants the water.


But for us the excessive or less use But for us the excessive or less use of the system both are problematic. of the system both are problematic.

The history of drinking urine for therapeutic purposes dates back

at least to the Holy Roman Empire when

great urinal troths were erected in the

public squares of each city-state for residents

to both contribute to, and benefit from.


Urine for Mouth wash, Cure for Urine for Mouth wash, Cure for Jaundice and Antiseptic too ..Jaundice and Antiseptic too ..An 18th century French dentist praised An 18th century French dentist praised urine as a valuable mouthwash. urine as a valuable mouthwash. In England during the 1860In England during the 1860--70s, the 70s, the drinking of one's own urine was a drinking of one's own urine was a common cure for jaundice. common cure for jaundice. In more modern times, the Alaskan In more modern times, the Alaskan Eskimos have used urine as an antiseptic Eskimos have used urine as an antiseptic to treat wounds. to treat wounds. Not only these but many more uses. Not only these but many more uses.


The idea of using and recycling urine is not new, The idea of using and recycling urine is not new, it is practiced in Ayurveda for long time with the it is practiced in Ayurveda for long time with the precautions. precautions. There is a $500There is a $500--millionmillion--aa--year market for urine year market for urine ingredients. Enzymes of America plans to market ingredients. Enzymes of America plans to market its first major urine product called its first major urine product called urokinaseurokinase, an , an enzyme that enzyme that dissolves blood clotsdissolves blood clots and is used and is used to treat victims of to treat victims of heart attacksheart attacks. .

Urine is known to contain minute Urine is known to contain minute amounts of proteins made by the body, amounts of proteins made by the body, including medically important ones including medically important ones such as growth hormone and insulin.such as growth hormone and insulin.


Normal functions of the Normal functions of the MootravahaMootravaha srotassrotas

Regulating blood volume and blood Regulating blood volume and blood pressure by pressure by ––

(1) adjusting the volume of (1) adjusting the volume of water lost in the urine, water lost in the urine, (2) releasing erythropoietin, (2) releasing erythropoietin, and and (3) releasing (3) releasing reninrenin. .


Regulating plasma concentrations of Regulating plasma concentrations of electrolytes electrolytes -- sodium, potassium, chloride, sodium, potassium, chloride, and other ions by controlling the and other ions by controlling the quantities lost in the urine and controlling quantities lost in the urine and controlling calcium ion levels by the synthesis of calcium ion levels by the synthesis of calcitriolcalcitriol. .


Contributing to the stabilization of blood Contributing to the stabilization of blood pH pH -- by controlling the loss of hydrogen by controlling the loss of hydrogen ions and bicarbonate ions in the urine. ions and bicarbonate ions in the urine. Conserving valuable nutrients by Conserving valuable nutrients by preventing their excretion in the urine preventing their excretion in the urine while eliminating organic waste products, while eliminating organic waste products, especially nitrogenous wastes, such as especially nitrogenous wastes, such as ureaurea and and uric acid.uric acid.Assisting the liver in detoxifying poisons Assisting the liver in detoxifying poisons and, during starvation, deand, during starvation, de--aminatingaminatingamino acids so that they can be broken amino acids so that they can be broken down by other tissues. down by other tissues.


Four fold functionFour fold function

Forms of Sroto dusti

• Atipravrutti

• Apravrutti

• Sanga

• Sira Granthi

Four fold problem Four fold problem


glucose in urine, Bedglucose in urine, Bed--wetting or cessation of wetting or cessation of urine production in cardiovascular shock is urine production in cardiovascular shock is common common Many of the body physiology leads and alters Many of the body physiology leads and alters the urine out put. the urine out put. AtipravruttiAtipravrutti –– excess urination as in Prameha, excess urination as in Prameha, AmavataAmavata etc. etc. ApravruttiApravrutti –– diminishing urination as in diminishing urination as in MootrkruchraMootrkruchra, ,


SangaSanga -- as in as in MootraghataMootraghataSiraSira grandhigrandhi which indicates the involvement which indicates the involvement of vascular intervention of vascular intervention All of these are with different aetiology and All of these are with different aetiology and even with different components of disease even with different components of disease manifestation manifestation But But –– the common is the tract the common is the tract –– Srotas and Srotas and the management to the tract along with the management to the tract along with rectifying pathology is the present task. rectifying pathology is the present task.


What we drain out ? What we drain out ?

Urea. Urea. Urea is the most abundant Urea is the most abundant organic waste. organic waste. We generate roughly 21 g of We generate roughly 21 g of urea each day. Most of it is urea each day. Most of it is produced during the produced during the breakdown of amino acids. breakdown of amino acids.


What we drain out ? What we drain out ? CreatinineCreatinine. . CreatinineCreatinine is generated in skeletal is generated in skeletal muscle tissue by the breakdown of muscle tissue by the breakdown of creatinecreatine phosphate,phosphate, a higha high--energy energy compound that plays an important compound that plays an important role in muscle contraction (Vata role in muscle contraction (Vata activity?). activity?). Our body generates roughly 1.8 g of Our body generates roughly 1.8 g of creatininecreatinine each day, and virtually all each day, and virtually all of it is excreted in the urine. of it is excreted in the urine.


Metabolism and excretion of Metabolism and excretion of CreatinineCreatinine


What we drain out ? What we drain out ? Uric acid. Uric acid. Uric acid is formed by the Uric acid is formed by the recycling of nitrogenous bases recycling of nitrogenous bases (Kapha associations?) from (Kapha associations?) from RNA molecules. RNA molecules. We produce approximately We produce approximately 480 mg of uric acid each day. 480 mg of uric acid each day.


Proteinuria


Factors to be noticedFactors to be noticedVasti in terms of Vasti in terms of MootravahaMootravaha srotassrotas is a is a SadyahpranaharaSadyahpranahara MarmaMarmaExercises (Exercises (VyayamaVyayama) and sex act () and sex act (PrasangaPrasanga) ) ––Vata activity disturbs the KUB systemsVata activity disturbs the KUB systemsLiquids such as Liquids such as MadyaMadya (alcohol) and (alcohol) and jalajala sevanasevana(water consumption) of Kapha concerns also (water consumption) of Kapha concerns also vitiates the vitiates the srotassrotasVegadharanaVegadharana enhances (inhibited neural enhances (inhibited neural reflexes) the Vata (Apanavata) is the prime reflexes) the Vata (Apanavata) is the prime factor to vitiate the factor to vitiate the MootravahaMootravaha srotassrotasWe can not deny in some of the occasions even We can not deny in some of the occasions even the role of Cathe role of Ca+ ion + ion or other electrolytes. or other electrolytes.


EFFECTS OF NEPHRON LOSS ON RENAL EXCRETORY MECHANISMSThe volume of urine excreted (averaging 1.5 L/d or roughly 1 mL/min) represents the sum of two large, directionally opposite processes¾namely, ultrafiltration of 180 L/d or more of plasma water (or 125 mL/min) and reabsorption of more than 99% of this filtrate by transport processes in the renal tubules. While renal blood flow accounts for about 20% of resting cardiac output, the kidneys comprise only about 1% of total body weight. This disproportionate allocation of cardiac output, greatly exceeding blood flow per gram of brain, heart or liver, is required for the process of ultrafiltration


Biologic Consequences of Sustained Reductions in GFR Although nephron loss can proceed, to some extent, without equivalent loss of GFR due to the compensatory mechanisms, determination of the total GFR of both kidneys remains the most reliable clinical index of overall excretory function. The effects of impaired GFR are to reduce the total rate of delivery of solute into the glomerular filtrate.When accompanied by comparably reduced rates of urinary excretion, retention and accumulation of the unexcreted solute occurs, resulting in increased concentrations of the substance in the plasma and other body fluids.


EFFECTS OF NEPHRON LOSS ON WATER REABSORPTION IN SURVIVING NEPHRONS

TUBULE TRANSPORT OF PHOSPHATE WITH NORMAL AND REDUCED NEPHRON MASSAlterations in Vitamin D MetabolismHyperparathyroidism in Chronic Renal FailureHYDROGEN AND BICARBONATE TRANSPORT WITH NORMAL AND REDUCED RENAL MASSTUBULE POTASSIUM TRANSPORT WITH NORMAL AND REDUCED NEPHRON MASS


Transport functions of the various anatomic segments


Absorption, metabolism, and excretion of urea


RhabdomyolysisRhabdomyolysis is is -- An acute, fulminating, An acute, fulminating, potentially fatal disease of skeletal muscle potentially fatal disease of skeletal muscle that entails destruction of skeletal muscle that entails destruction of skeletal muscle as evidenced by as evidenced by myoglobinemiamyoglobinemia and and myoglobinuriamyoglobinuria –– which is an excess which is an excess urination resultant connected to that of urination resultant connected to that of the Vata involvement in the Vata involvement in MootravahaMootravahasrotassrotas..Microalbuminuria in patients with diabetes mellitus is a common situation in KUB system.Such conditions are innumerable to be Such conditions are innumerable to be evaluated from observation based evaluated from observation based Ayurvedic transformed to Evidence based Ayurvedic transformed to Evidence based medicine. medicine.


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