Content uploaded by Rakesh Roushan
Author content
All content in this area was uploaded by Rakesh Roushan on Aug 09, 2020
Content may be subject to copyright.
© 2020 |Published by Scholars Middle East Publishers, Dubai, United Arab Emirates 72
Scholars International Journal of Anatomy and Physiology
Abbreviated Key Title: Sch Int J Anat Physiol
ISSN 2616-8618 (Print) |ISSN 2617-345X (Online)
Scholars Middle East Publishers, Dubai, United Arab Emirates
Journal homepage: https://saudijournals.com/sijap
Review Article
A Critical Appraisal on Digestive System (Avastha Paka) of Ayurveda in the
Modern Physiological Perspective
Dr. Ritesh1, Dr. Rakesh Roushan2*
1M.D. Scholar, Kriya Sharir, CBPACS, New Delhi, India
2Assistant Professor, Kriya Sharir, CBPACS, New Delhi, India
DOI: 10.36348/sijap.2020.v03i08.002 | Received: 30.07.2020 | Accepted: 06.08.2020 | Published: 09.08.2020
*Corresponding author: Dr. Rakesh Roushan
Abstract
In Ayurveda, ahara (food), swapna (sleep) and brahmacharya (celibacy) are considered as tryo-upasthambhas or sub-
supporting pillars of life. Food is critical for the sustenance of life; it is the first of the three, followed by sleep
and brahmacharya. Foods are any substances containing nutrients, such as carbohydrate, proteins and fats that can be
ingested by a living organism and metabolized into energy and bodily tissues. Digestion is the process of breakdown of
complex form of food into simplest monomers through enzymatic process in gastrointestinal tract. In Ayurveda,
conversion of hetrogenous panchbhautic ahara (complex food) into its basic homogenous panchmahabhuta (simplest
monomers) is directed by the synchronization of three sets of agni; jathragni, dhatwagni and bhutagni. The process of
digestion, metabolism and assimilation is mainly accomplished by agni. The site of jathragni is grahani or
pakvamashaya better known as pittadhara kala. Samana vayu, Pachaka pitta and kledaka kapha helps in digestion.
Samana vayu which is present near the vicinity of agni stimulate the pachakagni for the digestion and separation of food.
Kledaka kapha is present in the stomach which softens the food materials. Ayurvedic classics explains the whole process
of digestion that starts with the intake of food, takes place in three stages called as Avastha paka, these are Madhur
avastha paka, Amla avastha paka and katu avastha paka. Few works have been mentioned on conceptual features of
avastha paka in relation to modern physiology. In this article correlation of the physiological concept of avastha paka
with modern medical science has been stated. For this study, the basic materials have been collected from the Ayurvedic
classics with the available commentaries, as well as Text books of modern medical science better understanding of the
concept and its comparison with contemporary science.
Keywords: Avastha paka, madhur avastha paka, amla avastha paka, katu avastha paka, digestion.
Copyright @ 2020: This is an open-access article distributed under the terms of the Creative Commons Attribution license which permits unrestricted
use, distribution, and reproduction in any medium for non-commercial use (NonCommercial, or CC-BY-NC) provided the original author and source
are credited.
INTRODUCTION
Ahara (diet) plays an important role in
maintaining a good energy level among human beings.
The purpose of Ayurved science is to maintain the
health of the healthy and cure disease of diseased.
In Ayurveda health is a state where dosha,
agni, dhatus, waste products, all physiological functions
should be in homeostatic state and soul, sense organ
and mind should be in a state of total wellbeing [1]
Ahara (diet) plays an important role in
maintaining the health of a person, Acharya charak has
stated that the food taken in right quantity certainly
provides strength, complexion, happiness and longevity
to the person without disturbing the normalcy [2].
Individual should consume the right quantity of food
that helps to maintain proper digestive power. The
amount of food consumed depends on the properties of
food materials, gurutava (heaviness) and laghutava
(lightness) of food stuff. Acharya Vagbhata has
mentioned half of the stomach is to be filled with food
and one fourth with water. The rest of the stomach is to
be left empty for the activity of doshas to aid normal
physiology of digestion [3]. Acharya charak has
advised several dietary regimens to remain healthy. It is
related to the types and quantity of food to be
consumed. One should divide the total capacity of his
stomach into three parts – one third portion of the space
should be allocated to solid food articles, one third for
the liquid food substances and the remaining one third
should be left for the movement of vata, pitta and
kapha[4]. Acharyas has advised several regimes to keep
in mind related to food habit and everyone should
follow these basic thumb-rules during dietary intake to
maintain health. This doesn’t cause any adverse effect
Ritesh & Rakesh Roushan; Sch Int J Anat Physiol, August, 2020; 3(8): 72-76
© 2020 |Published by Scholars Middle East Publishers, Dubai, United Arab Emirates 73
arising out of improper amount of diet. Food taken in
right quantity at right time (kalabhojanam) is also
important. Intake of food in excess quantity
(Atimatrasana) causes indigestion or ama formation
whereas intake of food according to power of digestion
(yatha agnya abhyavahara) promotes digestion (agni
sandhukshnanam). Intake of food at right time
(kalabhojana) promotes health (arogyakaranam).
Intake of heavy food items (guru bhojana) causes
indigestion or late digestion (durvipaka). Intake of food
once in ahoratra (ekashanbhojana) brings about to easy
digestion and assimilation (sukha parinama karanam).
Fasting or abstinence from food (anashana) tends to
reduces longevity (ayusho hrasakaranan). Under eating
or intake of food in reduced quantity (pramitashanam)
tend to reduce a person’s weight or causes emaciation
(karshaniyanam). Intake of meal before the digestion of
previous meal (ajirna adhyashana) induces the
assimilation disorder or causes impairment of grahani
(grahani dushana). Intake of irregular meal
(vishamashana) causes irregularity in digestive power
(agnivaishamyakaranam). Intake of food having
mutually antagonostic property (viruddha viryashana)
leads to eight censurable diseases (nindita
vyadhikaranam). Regular intake of diet having all tastes
(sarvarasa abhyasa) promotes strength (balakaranam).
Regular intake of food having only one taste (eka
rasabhyas) causes weakness (daurbalyakaranam) [5].
This consumed foodstuff passes through a sequence of
biochemical process in human gastrointestinal tract to
make it a usable source of energy is called digestion.
This process allows the food to interact with various
secretions, enzymes, emulsifying agents, acids or
alkaline substances thereby facilitating the breakdown
of complex molecules into simpler molecules under
optimum pH [6]. Similarly, according to classical
literature of Ayurvedic science, Jatharagni lies in the
gastrointestinal tract. It initiates the process of digestion
by conversing food into nutrient fluid (ahara rasa). In
the process of conversion of ahara into nutrient fluid,
food undergoes three stages of digestion namely;
madhura, amla and katu awastha paka and three
biological substances kapha, pitta and vata are
produced respectively.
The foods that have all the six tastes and of
with different properties is consumed, it undergoes the
first stage of digestion known as madhura avastha paka
during which kapha is produced which is thin and
foamy in nature[7]. Madhura means sweet,
carbohydrate splitting salivary amylase is the first
enzyme to start digestion of carbohydrate in
gastrointestinal tract (GIT). The name madhura is
appropriate for this stage. Salivary juice and mucus
secreted from the surface mucus cells and mucus neck
cells in the stomach serve many protective functions.
Therefore, these may be included under froth like
kapha.
Afterwards, the food undergo digestion in its
partially digested form chyme moving downwards to
small intestine from the amashaya (stomach) stimulates
the production and secretion of various digestive
enzymes along with accha pitta (bile).
Several proteolytic, lipolytic and amylolytic
enzymes are secreted. On functional understanding
pachaka pitta may be correlated with digestive enzymes
[8]. The end products of digestion are formed in the
form of peptone, proteoses, fatty acids and glycerol.
These are derivatives of alcohol, aldehyde and
carboxylic acid. This may be considered as the amla
avastha paka. It occurs in pachymanasaya i.e.,
proximal part of the small intestine (duodenum and
jejunum). When the pakva part (the non-absorbable
remnant part after the absorption of the nutrients),
reaches the pakvashaya. There it gets further digested
and absorption of water and other nutrients due to the
presence of agni in that region and the drying effect
of agni converts it into a solid mass. There also occurs
the production of tremendous amount of different types
of gases (vata) which is katu (pungent) in smell called
as katu avastha paka.
PROCESS OF DIGESTION
The alimentary tract provides a continuous
supply of water, electrolytes, vitamins and nutrients.
This requires:
Prana vayu helps in ingestion of food into the
esophagus and samana vata facilitates the
peristaltic movement in alimentary tract.
Secretion of digestive juices and digestion of food
can be compared with the action of samana vayu
and jathragni. Samana vayu intensifies the action
of jathragni and pachak pitta.
Absorption of water, various electrolytes, vitamins
and digestive end products which can be compared
with the vivechan action of samana vata[9].
Circulation of blood through the gastrointestinal
organs to carry away the absorbed substances, this
process is facilitated by the action of samana vayu
which takes the nutrient fluid (Ahara rasa) to the
heart and brought to the systemic circulation by the
action of vyana vayu.
The process of excretion of waste product out of
the body is felicitated by apana vayu.
Avastha-paka
Jatharagni paka, i.e., gastrointestinal digestion
of food has been described under Avasthapaka or the
change in the state or form of food substance in the
Amashaya, Pachyamaanaasaya and Pakwasaya in the
course of digestive process. Two phases of this paka,
the prapaka and vipaka have been envisaged. The term
―Prapaka‖ has been defined by the commentator
Chakrapani Dutta as Pratham paka or the first change.
The term ―Vipaka‖ is defined as the final transformed
state of the food that has undergone its interaction with
jatharagni. Prathampaka is again subjected to further
Ritesh & Rakesh Roushan; Sch Int J Anat Physiol, August, 2020; 3(8): 72-76
© 2020 |Published by Scholars Middle East Publishers, Dubai, United Arab Emirates 74
changes under the influence of Jatharagni[10]. This is a
process, in which biochemical & physical
transformation takes place in three stages of food
digestion in gastro-intestinal tract. During the process
of digestion, madhur, amla & katu become dominant in
different phases of digestion. On this basis, digestion
has been classified into three phases i.e. Madhura
avastha paka, amla avastha paka and katu avastha
paka[11].
i) Madhura avastha-paka
As soon as the food consisting of various
compositions of either panchbhautic type, or of four
types of food (peya, lehya, bhakshya and bhojya) or of
two types of veerya, or of with various qualities or six
rasas is taken, madhur (sweetness) is manifested during
the first stage of avastha-paka resulting in the
production of thin & frothy kapha. This aspect of
digestion takes place in amashaya is comprehended by
madhur bhava. Madhura awastha paka is accomplished
by the combined action of kledaka kapha, samana vayu,
agni and pH of stomach. Ayurveda is a science based on
the functional understanding of physical, physiological
and psychological functions. Based on the functional
understanding, it appears that the digestion of
carbohydrate type of food starts in the buccal cavity by
salivary secretions as the carbohydrates are sugar like
substances they are meant for the production of kapha
in first stage. The presence of food in the oral cavity
starts secretion of saliva and mucus. The principal
salivary glands are parotid, submandibular and
sublingual glands. The parotid glands secrete mainly
serous type of secretion, whereas the submandibular
and sublingual glands secrete both serous secretion and
mucus. Saliva contains α-amylase (ptyalin), water and
bicarbonate ions. Saliva has pH 6.0 to 7.0 which is
favorable for the digestive action of the ptyalin. The
process of digestion especially of carbohydrates starts at
oral cavity. Ptyalin does 5% of the carbohydrate
digestion during the churning movement till the food
swallowed. Saliva present in the mouth does pachana
and kledana of carbohydrate types of food. After this
process, prana vayu and samana vayu helps in the
deglutition of chewed food to the stomach
(amashaya)[12]. Starch digestion continues in the
stomach for as long as for one hour before the chewed
food mixes with gastric secretions. The chewed food in
the stomach has a stimulatory effect on the gastrin cells
of the pyloric gland to cause release of gastrin to be
transported to the ECL cells of the stomach. The ECL
cells than causing release of histamine. The histamine
then acts quickly to stimulate the secretion of
hydrochloric acid. This stimulation keeps on increasing
and causes vigorous mixing of food with acidic
secretion and pH of the stomach food content start to
decreasing below 4.0. Activity of salivary amylase is
then blocked by the acid of gastric secretion [13].
Mixing of food in the stomach with gastric secretions
form a semi fluid mixture called chyme. Chyme
resembles the formation of phenbhut (semi fluid
mixtures) production of kapha. Nevertheless, on
average, 30-40% of the starches will have been
hydrolyzed mainly to form maltose until the food and
its accompanying saliva mixes completely with the
acidic secretions. Carbohydrates are almost totally
converted into maltose, sucrose and lactose before
passing beyond the duodenum and upper jejunum.
These glucose polymers are sweet in nature, so this
stage of digestion is called as madhur avastha pak.
Amla Avastha-Paka
Major portion of ahaar undergo the process of
madhur avastha paka in the amasaya only. After this
process, food reaches to pachmanasaya in the form of
chyme. The complete digestion of remaining food
(carbohydrate) occurs in the pachmansaya by the action
of pancreatic amylase/α-amylase within 15-30 minutes.
So, some portion of madhur awastha paka also undergo
in pachmanasaya, though the chief site of madhur
avastha pak is amasaya and partially in pachmanasya.
The Madhur Avasthapaka is seen to be
brought to partial end by the secretion of hydrochloric
acid (HCl) by the parietal cells of the stomach. Activity
of salivary amylase is blocked by the acid of the gastric
secretions, when pH of the medium falls below 4.0.
Acharya Charaka has stated that during amla avastha
pak, the food remains in vidagdha (partial digested
form) form in the pachmanasaya. Amlabhava develops
due to action of acidic medium of the chyme (pH 2-3)
results in sourness. Commencement of amlabhava takes
place during this phase. Complete digestion of partially
digested food occurs during this phase.
Pachak pitta, agni is secreted in the form of
various pancreatic digestive enzymes, functions
collectively at grahni. According to Acharya Charaka,
grahani is located above the umbilical region & it is the
seat of agni. Grahani holds the undigested food on
which agni acts and vigorously digest the food and
samana vayu helps in absorption of sara bhag and
remaining undigested food is propelled forward by the
peristaltic movement [13]. Acharya Sushruta has stated
that grahni is situated between amashya & pakvashya,
also called as pachyamanashya. Internally, it is covered
with a special type of membrane named as Pittadhara-
kala & it is the seat of agni. Various secretions are
secreted from different ashaya like pancreas, intestine
& liver. I-cells of duodenum and jejunum secrete
cholecystokinin which increases pancreatic enzyme
secretion to contract gall bladder and relax sphincter of
oddi to release bile (achchha pitta). Achchha pitta plays
an important role to bring pH at optimum level so that
various enzymatic secretions of small intestine (agni)
acts on partially digested food. As a result end products
like peptone, proteoses, fatty acids and glycerol is
formed, thereafter food becomes vidagdha & retaining
the properties of amla rasa so, it called as amlavastha.
After digestion, the ahararasa is absorbed through the
pittadharakala (mucosal membrane of duodenum and
Ritesh & Rakesh Roushan; Sch Int J Anat Physiol, August, 2020; 3(8): 72-76
© 2020 |Published by Scholars Middle East Publishers, Dubai, United Arab Emirates 75
jejunum) & remaining apakva food is expelled into
pakvashaya with the help of samana vayu.
In parlance to the modern physiology,
pepsinogen secreted from the peptic cells of the gastric
glands of the stomach. It becomes activated to form
pepsin after coming in contact with HCL. Pepsin
becomes activated around average pH of 2.0-3.0 and
inactive at a pH above 5. This activated pepsin cause
partial digestion of protein in the stomach to form
acidic chyme. Pepsin does only 10-20% of total protein
digestion. Most protein digestion occurs in
pachmanasya (duodenum and jejunum) under the
influence of proteolytic enzymes from pancreatic
secretions. The acidified chyme enters into the
duodenum (Grahni) acts as a stimulus to secretion of
various digestive enzymes and juices. This stimulus is
shown to be responsible for the secretion of bile and
pancreatic juices to the duodenum for further digestion
of partially digested chyme. It would seem that the
Vidagdha Ahara (partly digested food) present in the
pachhmanasaya activates the secretion of achcha pitta.
The concept of Accha Pitta includes the bile and
pancreatic secretions which together have been shown
to be responsible for digestion of fats, proteins and
carbohydrates. In the parlance of modern physiology,
the steps involved in digestion of proteins and fats
occurs during amla avastha pak. In stomach, enzyme
pepsin (active at pH 2-3) does only 10-20% of protein
digestion. Pepsin converts the protein to proteoses,
peptones and a few polypeptides. Most of protein
digestion occurs in small intestine under the influence
of proteolytic enzymes from pancreatic secretions,
viz., chymotrypsin, trypsin, carboxypolypeptidase,
elastases. Only a small percentage of protein gets
digested all the way to their constituent amino acids.
Mostly protein remains as dipeptides and polypeptides.
The last stage of protein digestion by peptidases in the
enterocytes that lines small intestine leads to formation
of amino acids. Finally, most of large polypeptides are
digested to dipeptides, tripeptides and single amino
acids [15]. Emulsification of fat occurs in the
duodenum under the influence of bile. Bile contains
large quantity of bile salts as well as the phospholipids
which is extremely important for emulsification of fat.
Most of the triglycerides of the diet are split by
pancreatic lipase into free fatty acids and two
monoglycerides [16].
iii) Katu avastha-paka
The third avasthapka, digested food materials
reaches to pakvashaya. Residual products of the food
undergo fermentation by the intestinal bacteria. This
stimulates the production of vayu. When the digested
food stuff pass from pachya-manashaya to pakvashaya,
then shoshymanasya i.e., being dry up by absorption of
water content. Thereafter, the waste products i.e., feces
take a bolus form, because of drying effect of Agni. The
term Pari pindita Pakwasya means bolus from of fecal
matter. The term Vayusyat Katubhavatah describes
the production of odoriferous products and pungent
gases[17].
In the parlance of modern physiology,
maximum process of digestion and absorption is
completed in small intestine. As the contents reach the
large intestine, absorption of remaining water and
electrolytes get started. The large intestine can absorb
maximum of 5-8 liters of fluids and electrolytes per
day. Bacterial action occurs in pakvashaya (colon).
They are capable of digesting small amount of
cellulose, in this way providing a few calories of extra
nutrition for the body. Other substances formed as a
result of bacterial activity are vitamin K, vit B12,
thiamine, riboflavin and various gases that contribute to
flatus in the colon, specially Carbon dioxide, hydrogen
and methane. The odor of fecal matter is due to the
presence of odoriferous (katu bhava) products include
indole, sketole, mercaptans and hydrogen sulphide.
The foregoing modern contribution is seen not
only to confirm but also amplify the ancient Ayurvedic
version of events that take place in the large intestine
and the formation of feces with production of pungent
Vayu. Gases can enter the gastrointestinal tract from
three ways: (1) inhaled air, (2) gases formed in the gut
by bacterial action, or (3) gases that diffuse from the
blood into the gastrointestinal tract. The amount of
gases forming in the large intestine everyday averages 7
to 10 liters (vayusyaat). Only about 0.6 liter expelled
through the anus usually. The remainder is normally
absorbed into the blood through the intestinal mucosa
and expelled through the lung. In the large intestine,
bacterial action generates most of the gases, including
especially carbon dioxide, methane, and hydrogen.
Some of the food items are known to cause greater
expulsion of flatus through the anus than others—
beans, cabbage, onion, cauliflower, corn, and vinegar.
These foods provide a suitable medium for gas-forming
bacteria, especially unabsorbed fermentable types of
carbohydrates. For instance, beans contain an
indigestible carbohydrate that passes down to the colon
and becomes a suitable food for colonic bacteria.
Irritation of large intestine causes excess expulsion of
gases, which promotes rapid peristaltic expulsion of
gases through the anus before they can be absorbed
[18].
DISCUSSION
Avasthapaka refers to series of changes which
Ahara dravyas (food) undergo in the Kostha
(alimentary tract). Agni is the only chemical agency
responsible for Ahara Pachana (digestion) in the
kostha. In the first stage of digestion (Madhura
Avasthapaka), the food in amashaya attains Madhura
bhava by action of salivary amylase on starch, digestion
of carbohydrates occur into simpler forms of glucose
rendering it fit for absorption. Mixing of food in the
stomach with gastric secretions form a semi fluid
Ritesh & Rakesh Roushan; Sch Int J Anat Physiol, August, 2020; 3(8): 72-76
© 2020 |Published by Scholars Middle East Publishers, Dubai, United Arab Emirates 76
mixture called chyme. Chyme resembles the formation
of phenbhut (semi fluid mixtures) production of kapha.
In the second stage (Amla Avasthapaka), the
Ahara is stated to undergo vigorous digestion in
pachhmanasaya. Amlabhava develops due to action of
acidic medium of the chyme (pH 2-3) results in
sourness. In parallel to modern physiology, vigorously
digestion and absorption of partially digested food takes
place in the pachymanasaya.
In the third phase (Katu Avasthapaka), the
absorption of water and electrolytes occurs in the large
intestine. Usually 5-8 liters of water and electrolytes get
absorbed per day from the pakwasaya. The term Pari
pindita Pakwasya means, the bolus from of fecal matter
after maximum water absorption. The term Vayusyat
Katubhavatah describes the production of odoriferous
products and pungent gases like carbon dioxide,
methane, and hydrogen.
CONCLUSION
Ayurveda science is one of the best gifts of the
sages of ancient India to mankind. Food is basic support
to life just as oxygen which is essential for life. Agni is
usually employed for digestion and metabolism of food
and rendering if fit for utilization of the body. In
Ayurved the process of digestion has been classified
into three phases i.e. Madhura avastha paka, amla
avastha paka and katu avastha paka. These stages of
avastha paka can be compared with contemporary
modern physiology. The first stage of avastha-paka,
digestion of carbohydrate type of food by salivary
amylase continues in the amasaya till the pH became 4.
Mixing of food in the stomach with gastric secretions
form a semi fluid mixture called chyme. Chyme
resembles the formation of phenbhut (semi fluid
mixtures) production of kapha. During amla avastha
pak, the food remains in vidagdha (partial digested
form) form in the pachmanasaya. Amlabhava develops
due to the secretion of extremely acidic HCL (pH o.8)
in the stomach. The acidic chyme enters into the
pachmanasya (pH 2-3) results in sourness.
Commencement of amlabhava takes place during this
phase. At the same time gall bladder starts to empty
achha pitta (bile) when the fatty food reaches into the
pachmanasya. Vigorous digestion and absorption of
partially digested food occurs during this phase. The
third avasthapka, digested food material reaches to
pakvashaya. Residual products of the food undergo
fermentation by the intestinal bacteria. This stimulates
the production of about 7-10 liters of gases every day.
Pari pindita Pakwasya means, the bolus from of fecal
matter after maximum water absorption. The term
Vayusyat Katubhavatah describes the production of
odoriferous products and pungent gases. Hence, the
concept of Aaharapaka/avastha paka in Ayurvedic
sciences signifies its relevance with modern physiology
of digestion and metabolism in the present scenario.
REFFERENCE
1. Moharana, P., & Roushan, R. (2018). A Critical
Review of Samana Vayu in the Modern Perspective,
9. 188-197.
2. Pandey, K., Chaturvedi, G. (2015). Eds Matrashitiya
adhyaya, Charak samhita. Varansi, India:
Chaukambha bharati academy, 105.
3. Moharana, P., Rawat, N., & Roushan, R. (2018). A
Critical Review of SamanaVayu in the Modern
Perspective. Int J Ayu Pharm Chem, 9(2), 188-197.
4. Pandey, K., Chaturvedim G. (2015). Eds
Trividhkukshivimaniya adhyaya, Charak samhita.
Varansi, India:Chaukambha bharati academy, 686.
5. Pandey, K., chaturvedi, G. (2015). eds
Yajyapurushiya adhyaya, Charak samhita. Varansi,
India:Chaukambha bharati academy, 467-469.
6. Hall, J. E. (2010). Guyton and Hall textbook of
medical physiology e-Book. Elsevier Health Sciences.
7. Singh, A., Yadav, C. R., & Dadhich, O. P. (2013).
Analysis of Concept of Aaharpaka in
Ayurveda. Journal of AYUSH:-Ayurveda, Yoga,
Unani, Siddha and Homeopathy, 2(1), 17-24.
8. Moharana, P., & Roushan, R. (2019). A critical
review of pachaka pitta in modern physiological
perspective. Int. J. Res. Ayurveda Pharm, 10(1), 18-
20.
9. Moharana, P., & Roushan, R. (2019). A critical
review of pachaka pitta in modern physiological
perspective. Int. J. Res. Ayurveda Pharm, 10(1), 18-
20.
10. Moharana, P., & Roushan, R. (2018). Role of Agni in
Digestion and Metabolism-A Critical Review, 9;
2018.
11. Pandey, K., Chaturvedi, G. (2015). eds Grahani
chikitsa adhyaya, Charak samhita.Varansi, India:
Chaukambha bharati academy, 454.
12. Pandey, K., Chaturvedi, G. (2015). Eds Grahani
chikitsa adhyaya, Charak samhita.Varansi,
India:Chaukambha bharati academy; 453.
13. Hall, J. E. (2010). Guyton and Hall textbook of
medical physiology e-Book. Elsevier Health Sciences.
14. Pandey, K., Chaturvedi, G. (2015). eds Grahani
chikitsa adhyaya, Charak samhita. Varansi,
India:Chaukambha bharati academy, 462.
15. Hall, J.E. (2010). Guyton and Hall Textbook of
Medical Physiology E-Book: with STUDENT
CONSULT Online Access. Elsevier Health Sciences;
19, 453-455.
16. Hall, J.E. (2010). Guyton and Hall Textbook of
Medical Physiology E-Book: with STUDENT
CONSULT Online Access. Elsevier Health Sciences,
19; 457-459.
17. Pandey, K., Chaturvedi, G. (2015). eds Grahani
chikitsa adhyaya, Charak samhita.Varansi, India:
Chaukambha bharati academy, 454.
18. Hall, J.E. (2010). Guyton and Hall Textbook of
Medical Physiology E-Book: with STUDENT
CONSULT Online Access. Elsevier Health Sciences,
19; 479.
