Review of Structural and Functional Anatomy of Kidney in Ayurvedic Literature with Special Reference to Diseases of the Kidney

Abstract

Description of organs and their treatment in Ayurvedic texts is very brief. In today’s world when the diseases of organs like kidneys, heart, liver, and brain etc., are becoming very common, Ayurvedic practitioners find these descriptions inadequate to treat patients with such diseases. An effort was made to assess whether critical analysis of references related to kidneys in classical Ayurvedic texts provide inputs to an Ayurvedic Practitioner to understand the pathogenesis of Chronic Kidney Disease (CKD). Tantrayukti based interpretation of references of kidneys in classical Ayurvedic texts establishes that kidneys were known to, and are elaborately described in Ayurveda, with their anatomical details such as embryological origin, name, number, relation with other abdominal organs, location etc. They are known by the name of Vrukka, which are the abdominal organs that are two in number and are described as Basti Marma (which includes the kidneys, ureter, and Bladder) for the purpose of diagnosis, prognosis, and treatment of all urine related diseases. Basti Marma is one of the three Maha Marmas i.e., most important vital organs of the body viz., Shiro (~brain), Hridaya (~heart) and Basti (~bladders). Vrukka (kidney) is formed from the nutritious part of Kapha, Meda and Rakta, gives the inputs to the practitioner to consider the metabolism of these factors in diagnosis and treatment of CKD. Physiology of formation of urine is also elaborately described in Ayurveda. The reference of Sushruta which discusses about Sahastrshaha Sukshma mukhani (~ thousands of minute openings invisible to naked eye) where urine is formed resembles the description of glomerular filtration. Formation and processing by Samaana, role of Jathar Agni, Dhatvagni and Bhutagni in formation of Mutra (~urine), storage and excretion at the level of Bladder, by Apaana is defined clearly, and this description is of immense value for practitioners. Relation of Basti Marma to Kleda (~body fluids) and its pathological connection with specific diseases is also evident. Understanding of various factors viz., Kleda (~body fluids), Marma (~vital organs), Prana (~life force), Oja (~vitality), Kalaa (~Internal membranes) Jathar Agni, Dhatvagni, Bhutagni etc., and their role in pathogenesis of CKD provides Vaidyas with inputs to devise the line of treatment of patients suffering from CKD, taking into consideration the individual condition of each patient.