Vaidya Vilas Nanal
The article was published in the journal Ancient of Life published from Coimbatore in English and in Madhujeevan bimonthly from Mumbai in Marathi
To review Kloma, the controversial organ, the prevalent opinions are to be taken into consideration. So, let us examine the prevalent definitions of Kloma which are enumerated under.
- Kloma = Pittaas`haya = Gall bladder
- Kloma = Agnyaas`haya = Pancreas
- Kloma = Yakrit = Liver
- Kloma = Dakshin`a Phupphusa = Right Lung
Any organaccording to the Samhitaa should fulfill the following criteria to be labeled as Kloma.
Udakavahaanaam Srotasaam Taalu Moolam Kloma Cha| C.V.5/8
Udakavahe Dve, Tayormoolam Taalu Kloma Cha| S.Sha.9/12
The Udakavaha Srotas, the various channels which maintain the fluid balance of the internal environment derive their origin from two places – Taalu (The hard and soft palates) and Kloma.
An abnormal vitiated state of these is indicated by:
Pradusht`aanaam Tu Khalveshaamidam Vis`heshavidnyaanam Bhavati, Tadyathaa jihvaatalvost`haklomas`hosam Pipasaam Chaatipravriddhaam Drisht`vodakavahaanyasya Srotaamsi Pradusht`aaneeti Vidyaat | C. V. 5/8
An excessive dryness of the lips, tongue, palate, Kloma and an insatiable thirst indicate malfunctioning Udakavaha Srotas.
A Vidradhi of the Kloma is indicated by :-
- KlomaJaayam (Vidradhyam) Pipaasaamukhas`hoshagalagrahah| C. Su. 17/29
- S`hvaaso Yakriti Trishn`aa Cha Pipaasaa Klomaje Adhikaa |S. Ni. 9/22
- S`hvaaso Yakriti, Rodhatstu Pleehnyuchs`hvaasasya, Trit Punah Galagrahshcha Klomni Syaat Sarvaang pragraho Hridi | A. H. Ni. 11/14
A disorder characterized by a rapid onset and progress arising from affliction the Kloma makes its presence felt by producing the following symptoms:
- Marked thirst
- Dryness of mouth
- Choking sensation in the throat.
Adhvapras`hoshee Strastaangah Sambhrusht`acchavih|
Prasupta Gaatraavayavah S`hushkaklomagalaananah|| A. H. U.41/21
A person who has walked in sun for a certain period of time and is now suffering from Adhva S`hosha exhibits a laxity of the musculature, lethargy, a roasted tanned dry complexion, an impaired tactile perception and a dry Kloma, pharynx and mouth.
Kloma is an organ which is connected to Yakrit inferiorly and the Hridaya and it is situated in the chest. It should surround the heart from all sides, without being attached to it and be mainly on the right side of the chest cavity. This is the gist of the above discussion.
Now if we try and fit one of the previously enumerated hypotheses, each one of them falls short on one or more important aspects. We therefore need to view the issue from a fresh angle in an objective manner.
In modern Anatomy, we find an organ described which fulfills most of the criteria admirably and can safely be termed as Kloma. It is the Mediastinum.
These and many more examples, in the same vein, indicate the control of the fluid balance of the body.
- Kloma is one of the fifteen Kosht`haanga described and derives its origin from the mother.
- Panchadas`ha Kost`haangaani; Tadyathaa Nabhishcha, Hridayam Cha, Kloma Cha, , Yakrit Cha, Pleehaa Cha, Vrikkau Cha, Bastishcha, Pureeshaadhaarashcha, Aamaas`hayashcha. Pakvaas`hayashcha, Uttaragudam Cha, Adhargudam Cha, Kshudraantram Cha, Sthoolaantram Cha, Vapaavahanam Cheti| C. Sha. 7/10
- Kosht`haangaani Sthitaanyeshu Hridayam, Kloma, Phupphusam|
Yakritpleehondukam Vrikkau Naabhid`imbhaantrabastayah|| A.H.Sha. 3/12
It should be related to the heart:
Hridayasya Dakshin`ato Yakrit Kloma Cha| S. Sha. 4/31
The Hridaya is that organ which has on its right upper and lateral side Kloma, right lower lateral side, Yakrit on the left superior laterally, Phupphusa and left inferior laterally, Pleehaa.
It should be manifested from the Raktadhaatu:
Samanavaayau Praddhmaataat Draktaaddehoshmapaachitaat|
Kinchiduchchritaroopastu Jaayate Klomasadnyakah|| A.H.Sha. 3/12/ T`eekaayaam
When the fetal Rakta is being converted by the fetal Jaat`haraagni and this conversion is being aided by the fetal Samaana Vaayu, the resultant is an organ related to Hridaya but slightly separated and situated supero-laterally in the Kost`ha on the right side.
It should have Sandhi -joints in it:
Kloma Nibaddhastu Tadasya (Sandhayah)| S.Sha. 5/29
Kant`ha Hridaya Netra Klomanaad`eeshu Man`d`alaah | S. Sha. 5/24
The organ Kloma should have eighteen Joints of the Man`d`ala variety, which are mobile. It should be situated in the Vaksha (Chest, Thorax).
Yakrita Hridaya Paars`hvam Cha Kloma Vakshasthitam Viduh / (Hastyaayurvedah Sha. 7/11)
Now we shall briefly consider some abnormalities based on the foregoing hypothesis.
Trit` – Thirst is the main indicator of the malfunctioning Udakavaha Srotas of which Kloma is one of the origins.
A progressive fluid loss as a result of exercise, hyper ventilation, vomit or purging results in loss of fluidity of the circulating Rasa, Udaka and Rakta – the fluid Dhaatu of the body. The Hridaya (heart) has to exert more to pump the dense fluid and natural urge drink water is produced. As a result of overworking of the Hridaya the fluid in its covering is also depleted and the Hridaya has to work against resistance offered by the all encompassing, oppressive sac which has turned its foe due to fluid density. This results in a feeling of dryness of the mouth first, throat later, and much later in a considerable thirst which is not quenched easily. It is the common experience of a cool sip which induces a sense of well being.
A diagonally opposite thirst appears as a result of heavy food (Guru Anna), a heavy substance causes the Aahaara Parin`aamakara Bhaava upset requiring more Kaala (time), Kleda (fluids), Ushn`a (heat) it would otherwise need. The time can be adjusted by observing fast, but the Kleda or fluid has to be supplemented from outside – in order to render it fluid and absorbable – the cold water taken aggravates the thirst as it helps to put out or douse the Ushn`a which in its first place is unable to convert it. Thus the guru Rasa which is absorbed from the Mahaasrotas reaches the heart and again it has to work against the resistance of the heavy Rasa and the excess fluid state of the Udaka Rasavaha Srotas.
The problem could be easily tackled by taking sips of hot water which due to its heat would penetrate the heavy food material and render it more subtle. It is observed at the end of some time, even the residue is dealt with effectively, without causing clogging, water logging and thirst which is aggravated by cold water.
Kloma-Aakarshan`a – Charaka describes the grave disorder arising out of the cardiac involvement which results in, ultimately collapse of a lung either by external trauma or internal Doshika activity.
The median Kloma is critically balanced by the positive pressures exerted by the lungs on it from either side. The space of the Kloma offers passage to various fluids like Rasa, Rakta, Udaka to and from the heart along with the incessant rhythmic activity of the heart in its pericardium.
Should a lung collapse as a result of either trauma in an acute manner, the balance displaces the mediastinum along with its contents, e.g.. Esophagus, trachea, bronchi, and may even cause kinks in the great vessels. If the lung is not inflated and the balance restored, the life of the person could be in jeopardy.
In more chronic cases like Jaraa S`hosha and Jalaja Paars`hvas`hoola the affected lung may succumb slowly causing gradual impairment in the form of lost or impaired elasticity and hampering the function of mediastinal organs.
An affliction of the heart by vitiated Dosha thus affects the Kloma adversely and causes amongst others, a mediastinal shift which can be fatal.
The Kloma is an organ, due to its anatomical position and its contents which are the esophagus, trachea, heart and vessels. The circulating fluid volume of the body passes through it at one time or the other during the cyclic movement either in the form of Rasa, Rakta (Blood) or Udaka (Lymph) and Anna (Bolus).
Therefore, any abnormality of these channels results in subsequent impairment, either functional or structural of the Kloma, or conversely, an acute or chronic functional or structural impairment of the Kloma subsequently results in the impaired functioning of either Rasavaha, Praan`avaha, Raktavaha, Udakavaha and Annavaha Srotas.
The author discusses in this paper presents the much debated and controversial organ of Kloma in an objective manner and establishes its relevancy by interpreting various classical texts.
Vaidya Vilas Nanal
Last updated on February 9th, 2021 at 07:25 am