गर्भ पोषण
गर्भ की परिभाषा.
"शुक्र शोणितं जीव संयोगे तु खलु कुक्षिगते गर्भ संज्ञा भवति ।" (च.शा. ४/५)
पुरूष शुक्र (Spermatozoa) और स्त्री शोणित (Ovum) इनका स्त्री के गर्भाशय में संयोग होने पर, जब जीवात्मा प्रवेश करती है, तब ही मनुष्य शरीर के अंकुर की उत्पत्ति होती है। और उसे गर्भ (Embryo) की संज्ञा दी जाती है|आयुर्वेद शास्त्र के अनुसार संसार में उपलब्ध सभी वस्तुएँ पाँचभौतिक हैं। इसलिए मनुष्य के गर्भ की निर्मिति भी पाँचभौतिक ही होती है।
शुक्र शोणितं गर्भाशयस्थं आत्म प्रकृति विकार संमूच्छितं 'गर्भ' इति उच्यते। (सु.शा. ५/३)
शुक्र (Spermatozoa) और शोणित (Ovum) का गर्भाशय (Uterus) में संयोग होने पर उसमें आत्मा, आठ प्रकृतियों (अव्यक्त-महान्-अहंकार-पंच तन्मात्रा) और सोलह विकारों, (एकादश इन्द्रियाँ-पंचमहाभूत) इन सबका संयोग होता है, तब उसे गर्भ कहते हैं।
"तं चेतनावस्थितं वायुर्विभजति, तेज एनं पचति, आपः क्लेदयन्ति, पृथिवी संहति,
आकाशं विवर्धयति; एवं विवर्धितः स यदा हस्तपादजिह्वाघ्राणकर्णनितम्बादिभिरंगैरूपेतः तदा'शरीरं' इति संज्ञांलभते । तच्च षडङ्ग शाखाश्चतस्त्रो, मध्यं पंचमं, षष्ठं शिर इति ।। . . (सु.शा. ५/३)
उसमें चेतना का वास हो तो वायु उसे विभाजित करती है, तेज (पित) इसे पचाता है,
जल क्लिनता पैदा करता है, पृथ्वी तत्व से संहनन और घनता उत्पन्न होती है,
और आकाश तत्त्व द्वारा रिक्तता निर्माण होकर उसका आकार बढ़ता है।
इस प्रकार पाँचों महाभूतों द्वारा गर्भ पर कार्य होने से जब उसे हाथ, पैर, जिह्वा, नाक, कान,
नितम्ब आदि अंग-प्रत्यंग निर्माण होते हैं, तब ही उसे शरीर कहा जाता है।
यह शरीर षडङ्ग होता है, जैसे- चार शाखाएँ, पाँचवा मध्य शरीर और छठा सिर।
इस प्रकार प्रथम इसे 'गर्भ' और अंग-प्रत्यंग निर्माण के बाद 'शरीर' कहा जाता है|
गर्भ पोषण (Nutrition of grabha)
गर्भ निर्माण के पश्चात् प्रमुख कार्य गर्भ का पोषण है। इस प्रक्रिया पर ही गर्भ के सम्पूर्णता निर्भर करती है।
यदि सभी साधन उपयुक्त होते हुए भी घोषणा कर्म उचित न हो तो गर्भ की परिवृद्धि रूक जाती है। एवं वह पूर्ण रूप से निर्मित नहीं हो पाता। अतः गर्भ पोषण क्रम तथा उस क्रम में भाग लेने वाले विशेष अवयवों का भी ज्ञान आवश्यक हो जाता है। शुक्र शोणित का संयोग होने के उपरान्त गर्भाशय में गर्भ का अग्रिम निर्माण कार्य प्रारम्भ हो जाता है। गर्भ की वृद्धि में उसका पोषण प्रमुख है।आयुर्वेद के अनुसार गर्भपोषण प्रक्रिया निम्न प्रकार है-
*"मातस्तु खलु रसवहायां नाड्यां गर्भनाभिनाड़ीप्रतिबद्धा, साऽस्य मातुराहार रसवीर्यमभिवपति। तेनोपस्नेहेनास्याभिवृद्धिर्भवति।" (सु. शा. 2/29)
माता के रसवहा नाड़ी में गर्भ की नाड़ी लगी हुई रहती है। वह नाड़ी माता के आहार रस के वीर्य को गर्भ के लिए पहुँचाती है। उसी उपस्नेह से गर्भ की वृद्धि होती है।
आचार्य चरक के अनुसार
प्यास और भूख से रहित गर्भ माता के अधीन रहता है। माता के आश्रित होकर सूक्ष्म रूप में सत् (वर्तमान), स्थूल रूप में असत् (अवर्तमान) अङ्ग-प्रत्यङ्ग वाला गर्भ गर्भाशय में गर्भाशय के उपस्नेह और उपस्वेद से अपना जीवन निर्वाह करता है। इसके बाद जब सभी अङ्ग प्रत्यङ्ग व्यक्त हो जाते हैं, तब गर्भाशय में गर्भ को उपस्नेह और उपस्वेद रसवाहिनियों द्वारा प्राप्त होता है।गर्भ की नाभि में नाड़ी (Umbilical cord) लगी रहती है। नाड़ी में अपरा (Placenta) लगी रहती है। और अपरा मातृ हृदय (Uterus) से लगी रहती है।
अतः मातृ हृदय की उससे सम्बन्धित सिराओं द्वारा अपरा को रस से परिपूर्ण करता है। उसी रस के कारण गर्भ में बल तथा वर्ण की उत्पत्ति होती है।सभी रसों से युक्त वह आहार रस गर्भिणी स्त्री के शरीर में तीन भागों में विभक्त होता है-
तीसरा भाग पुनः गर्भ पुष्टि दो प्रकार से करता है-
* उपस्वेद (Moisture, sweat)- का अर्थ वाष्प, आर्द्रता से है। जब तक अपरा नहीं बनती, तब तक गर्भ का पोषण बीज द्वारा स्वयं ग्रहण किए गए आहार से होता है। यह आहार उसे गर्भस्थमार्ग स्थित मातृ रस और रक्त से मिलता है। अथवा गर्भाधान के बाद जब प्रत्यंग अव्यक्त रहते हैं तथा अपरा और नाभिनाड़ी नहीं बनी होती है, तो गर्भ का पोषण गर्भस्थ रसवाहिनी धमनी के परिस्रवण करने वाली आर्द्रता, वाष्प (उपस्वेद) से होता है।
* उपस्नेह (To become wet)- अपरा तथा नाभिनाड़ी से युक्त गर्भ का पोषण प्रसव पर्यन्त अपरा की अनुसरण करने वाली रसवाहिनियों (Uterine vessels) के अंकुर (choronic villi) से होता है।माता की रसवहानाड़ी (placenta and uterine vessels) के साथ गर्भ की नाभिनाड़ी (Umbilical cord) प्रतिबद्ध रहती है, वही माता के आहार रस के वीर्य (शक्ति) का संवहन करती है। और उसके उपस्नेह से गर्भ की वृद्धि होती है।
Nutritional Aid to the Embryo and foetus throughout their successive development
•Starting from unicelular organism to a multicellular complexity, it is necessary to maintain the nutritional and gaseous exchange to remain alive both in vivo and in vitro.
* This is an universal phenomenon and is applicable where principle of life and growth come into existence.
* In case of fertilised human egg which is believed to enter the uterine cavity early on the fourth day of the ovulation till its full term delivery, the nutritional and gaseous exchange maintained for its maintenance and growth, is dealt under the two distinct headings, recognised as Embryonic nutrition and foetal circulation according to modern science.
•The period spent by the developing human egg in the uterus as a free morula and blastocyst, varies considerable among mammals; in man it is two to three days.
•While free in the uterine cavity the blastocyst embibes fluid from the uterine secretion, in which it is immersed and expands to a diameter of about 0.2 mm.
•This secretion, expelled from the uterine glands, also supplies oxygen and some nutrients to the blastocyst
.* Shortly, before implantation begins, the stretched and thinned zona-pellucida disappears.
•The human blastocyst probably begins to be attached late in the sixth day after ovulation
.•Both sets of co-ordinated changes lead to the production of a specialised organ-the placenta, which is the medium for physiological interchanges between the mother and foetus throughout the remainder of pregnancy.
•The trophoblastic wall gets specialised and there appears irregular cavities called trophoblastic lacunae, leads to a beginning of future intervillous space of placenta.
•Entire requirement necessary for the development of embryo and foetus is made by Rasa-dhatu'according to Ayurveda.
*It is dependent upon the mother for all its activities. It lives upon
thenourishment by the process of 'Upasneha' (exudation) and "Upasveda" (conduction of heat).
•It draws nourishment by the process of exudation sometimes through the hole the hair follicles and sometimes through the channels of umbilical cord.
•The umbilical cord of the foetus is attached to the umbilicus and the placenta to the umbilical cord
.•The placenta is in its turn connected with the heart of the mother.
This 'Rasa (nutritive fluid) promotes strength and complexion of the foetus because it is composed of material having all tastes.
"Rasa" (digestive product of food) of the pregnant woman serves three purposes,
(1) nourishment of her own body
(ii) Lactation
(iii) growth of the foetus.
Being supported by that food, the foetus who is dependent upon the mother keeps living inside the uterus.
•The statement of Maharsi Kasyapa that the ‘Bija’after entering into the body gets encircled the 'Rakta" (blood), if reviewed in context of nutritional supply in embryo, it exactly satisfies the histotrophic nutritional phase of the modern science.
•The term 'Bija" here, is taken in the sense of fertilised egg which when descends down and enters the body (uterine cavity) and finds a site over there for attachment.
•The modern has recognised the nutritional supply in two phases, the first one, 'histotrophic' and the second one "haemotrophic', where the latter is maintained by placental circulation.
•The histotrophic nutrition is maintained by damaged maternal tissues, containing extravasated blood, and the stagnant blood in the trophoblastic lacunae which meets the nutritional supply of embryo before chorionic development. This is the blood which probably represents the term 'Rakta' mentioned by Kasyapa.
•According to Vrddha Vagbhata there happens two types of nutritional supply termed "Upasneha' and 'Upasveda', to start from the day of fertilisation till full term delivery
.•The term "Upasneha 'represents the histotrophic nutritional supply, is maintained by the process of osmosis involving the permeability of the concerned cellular wall and is found before the chorionic establishment.
•The 'Upasveda' is the process by which vascular communication in between the foetus and mother is established and maintained by the placental circulation.
•This umbilical cord remains linked with placenta which has indirect communication with the heart of the mother through the blood vessels.
•Thus the 'Rasa-dhatu' (nutritional material) prepared in the mother reaches to the pulsatile placenta from the heart of the mother through the arterial communication. Then subsequently it reaches to the foetus through the umbilical cord and gets metabolised in the concerned body tissues (Pakvasaya) with his own body metabolic processes (Kayagni);
*Thus the nutritional material obtained by the foetus being enriched with excess of essence (Prasadabhaga) maintains the growth and development of the foetus. The next way of nutritional supply to the foetus is maintained by the process of 'Upasneha' of 'Rasa-dhatu" (the buffer amniotic fluid) through the hair-pores and after delivery. the same 'Rasa-dhatu meets the need of the newly born baby through breast milk.…
•The approach put forth by Maharşi Susruta in connection with the foetal circulation, though exhibits a gross structure but carries very comprehensive ideas. In his views, the umbilical cord is attached to the Rasavaha Nadi' (maternal part of the placenta) of the mother and this carries 'Ahararasa-virya' (nutrition) from the mother to the foetus. The loetus grows by this indirect supply of nutrition. From the time of conception till the different parts of the body and their divisions get manifested, this (embryo) gets nutrition from the obliquely running Rasavaha-dhamanis' which course through all Parts of the body and imparts life (to the embryo).
•In another context, impressing upon the 'Rasa-dhatu' of the mother and the 'Vayu' (a factor responsible for the motion, movement and pulsation), he states that the foetus develops due to the 'Rasa' (of the mother) and flow of 'Vata' in it. This is definite that 'Agni' is situated in the umbilical region of the foetus and the 'Vata' blows this 'Agni' (fire), due to which the body develops.
•Vagbhata also has given a synoptic view as regards the nutritional supply of the foetus. He has recorded the entity of foetus, heart of the mother and the umbilical cord.
•He states that the foetus remains connected with the mother through the umbilical cord. This is the channel through which foetus gets nutrition in the same way as a dry field gets saturated with the water flowing through the furrows.
Placental and other changes occurring in the mother after gestation:
developing placenta includes :
(i)chorionic villi
(ii)a cavernous intervillous space
(iii) decidua basalis with blood vessels that supply the early intervillous space.
*By the beginning of the fourth month, the placenta has two components :
(ii)maternal portion formed by the decidual basalis.
On the foetal side, the placenta is bordered by the chorionic plate: on its maternal side by the decidual basalis of which the decidual place is most intimately incorporated into the placenta. The space in between these two plates is the junctional zone consisting mainly the trophoblast and the decidual cells. The intervillous space is primarily of foetal origin but it grows also at the expense of eroded decidual substance.
•The placenta serves primarily as an organ that permits the interchange of materials carried in the blood streams of the mother and foetus. The functions of the placenta can fall in nutrition -where the exchange of carbohydrates, proteins, fats, vitamins, water and sup inone form or other from the mother's blood to the foetus,
(ii!) exchange of gases-the gases like O, CO, and CO get exchanged by simple diffusion and thus the placenta acts like a lung. (excretion-fluid waste products of foetal metabolism escape through the placenta, which exerts a kidney like function,
(iv) the barrier-the placenta is impermeable to particulate matter he bacteria and certain viruses having large molecules. The maternal antibodies like IGg and other Gamma globulins against various infectious diseases and the passive immunity against the diphtheria, small-pox, measles and Rh factors get transmitted from mother to foetus through placenta, and
(v) synthesis-hormones (oestrogen; progesteron and gonadotrophin) are produced in important amounts; certain food stuffs are synthesized and local enzymes are employed.
•The cessation of menstrual blood, the development of the breast and other changes prevalent in pregnant woman, though interlinked with hormonal secretions in view of the modern science, have been distinctly described in Ayurveda also.
Maharsi Susruta has said that in those who have conceived, menstrual discharge is absent because even though the 'Artavavaha Srotasas' are present, these get obstructed by the presence of foetus. Also, because the flow is obstructed below, it goes up and forms the placenta and residual portion of the flow still going up reaches the breasts.
•After delivery the same menstrual blood influences the lactating glands in the breast and comes out in the form of milk during post-puerperal period and gets finally connected with the ‘Ras-dhatu’of mother, resulting from her diets.
•Maharsi Susruta has given a thorough thought and viewed them in the prospect of certain Ayurvedic fundamentals which control the growth and development in both the extra and intra-uterine life.
There is no respiration in the foetus and their waste products, if at all a little bit is there, they get excreted through the placenta.
•The oxygen supply required for the growth and maintenance of a foetus is maintained by a mother through the placental circulation.
•The foetus does not cry because the air passage is blocked by membranes covering the mouth and ‘Kapha’ in the throat.
•Maharsi Caraka has considered the true labour pain and indicated certain signs denoting the exact time of delivery.
•After enumerating a series of signs which in true sense represent the proper time of delivery but if there is no tear of amniotic membrane and discharge of fluid, it is difficult to ascertain the right time hence emphasising upon the exact time and trof labour pain he states that apart from the signs indicated for the approach of the time of delivery, the true labour pain always remains associated with the excretion of the amniotic fluid.
•He has recognised the true labour pain and the discharge of amniotic fluid as separate entity but closely associated and have a definite sequence. In his view, the pregnant woman in addition to exhibiting certain signs of near term delivery, at first hand develops labour pain which is ultimately followed by discharge of amniotic fluid.
Extrinsic and Intrinsic factors involved in development of the foetus:
•From the preceding description, it is clear that a fully grown embryo is not only the outcome of the mere conjugation of sperm and ovum but there are many other factors which contribute a lot in this respect.
•After fertilisation and implantation, it is the nutritional supply, the role of placenta and inherited genetic factors, which contribute and control the growth of an embryo and foetus according to modern science.
•In his view, the following factors help in the growth of the foetus in the pelvis of the mother: (i) excellence of the factors responsible for the production of the foetus, viz., mother (ovum), father (sperm), "Satmya' (wholesome-ness), 'Rasa' (digestive product of the mother's food) and "Sattva" (mind),
(ii) adoption of proper regimen by the mother during pregnancy
, (iii) availability of nourishment and heat through 'Upasneha' (transudation) and 'Upasveda (conduction). respectively,
(iv) proper time, and
(v) instinctive or natural tendencies.
•Recognising the importance of 'Pranah', Bhavamisra has enumerated and specified the role on growth and development of the foetus in respect of its viability. According to him, the 'Agni" (energy element), 'Soma' (liquid element), 'Mahi' (solid element), 'Vayu' (gaseous element), 'Nabha' (the space element), the 'Sattva', 'Rajas' and 'Tamas': 'Pancendriyani' (five sensory organs) and 'Bhutatma' (embobied consciousness) have been stated as 'Pranah and said to contribute the viability in foetus. Susruta has also enumerated the same number of 'Pranah' and linked their role to life principle of the foetus.
Research paper on Garbh poshan and Nutritional Aid to the embryo and foetus development.
Abstract
The science of Garbha Vyakaran has been always a subject of great interest for the persons devoted to it. The matter related to the concept of Garbha Vyakaran is systematically described in Ayurvedic literature. Nutrition of embryo mainly concerned with the mechanism involved in both the parts of mother and foetus to meet the requirements for growth and development during intra-uterine life.
According to Ayurveda, it is the cessation of menses during pregnancy which affects the mammary glands of the breast and causes lactation for the post-natal feeding of the baby. Apart from the concept of nutritional supply through placenta which is well established in modern science, the relationship in between the changes occurring in the mother and in their body organs, have been tried to explain in the light of present knowledge.
Citation
Singhal, Tina, et al. "Physio-Anatomical consideration of Upsneha & Upsweda with special reference to Garbh Poshan in Ayurveda-A Review." Journal of Ayurveda and Integrated Medical Sciences 6.4 (2021): 199-203.