Mesentery – Newly Discovered Organ, Explained 3000 Years Ago in Ayurveda

Introduction

In January 2017, scientists discovered a new abdominal organ, mesentery. This was previously considered as a partial supportive structure to blood vessels, lymph nodes and intestines. But interestingly Ayurveda, the ancient Indian system of medicine has explained in detail about structure and functions of mesentery. 

The new discovery –
Distinctive anatomical and functional features of mesentery have been revealed that justify designation of the mesentery as an organ. Accordingly, it should be subjected to the same investigatory focus that is applied to other organs and systems. (research)

What is mesentery?

It is a fold of membrane that attaches the intestine to the abdominal wall and holds intestines in their place.
It is formed by the double fold of peritoneum. It supplies blood vessels, lymphatics and nerves and storing fat.
It commences from the duodenojejunal flexure (joining part of duodenum with jejunum – first two parts of small intestines) and extended to the level of the distal mesorectum (rectum).

Functions

Functions of mesentery:
It contains lymph vessels, nerves, arteries, and veins creating a communication pathway between the abdominal wall and internal organs (intestines).
The veins and lymph channel within the mesentery help to absorb the fluids and nutrients from the intestines and pass it on to the liver and heart.
It is also responsible for holding the abdominal organs in place.

Ayurvedic perspective

Mesentery as per Ayurveda:
Mesentery is explained as Kloma in Ayurveda.
In Charaka Samhita – an ancient Ayurvedic text book written 2500 years before, Vimana Sthana 5th chapter, 8th Sanskrit verse (written as 5/8), A type of channel called Udakavaha srotas is mentioned. Udaka means water.

Charaka explains that the site of origin of water channels is Talu – palate and Kloma – mesentery.
Dryness of the palate is symptom of thirst. Hence, the external supply of water to the body is through oral cavity and palate is the indicator of it. Hence, the palate as site of origin for water channels in the body is justified.

Similarly, when the fluids and nutrients are absorbed through the veins of mesentery, it creates negative pressure on the gut for water. There is a natural demand for water intake. Hence, mesentery is responsible for the water intake and can be said as the site of origin of water channels in the body.

Kloma and Kapha Dosha

Kloma is explained as a place for Kapha Dosha – Ashtanga Hrudaya Sutrasthana 12th chapter:
Kapha dosha is explained with qualities like stability, compactness, nourishment, cooling nature, softness, fluidity,  etc.
The function of mesentery is to stabilize the intestines in one place, so that they do not move.
The vessels in the mesentery carry the nutrition from the intestines.
Softness and fluidity are also very well exhibited in the mesentery.

Vagbhata explained Kapha Dosha places as
Ura – chest region – heart and lungs
Kantha – throat
Shira – head
Kloma – mesentery
Parva – joints
Amashaya – stomach
Rasa – nutritious part of food.
Here, heart and lungs are covered with the term Ura. Hence, Kloma is an abdominal organ, which is mesentery.

Sadhyo marana – immediate death is one of the symptoms of injury to Udakavaha srotas – water carrying channels.
Injury to mesentery leads to intra abdominal bleeding along with peritonitis, leading to death.
Mesenteric ischemia (cutting off of blood supply) is also very difficult to diagnose because of its deep seated nature.

As seat of thirst

Kloma is explained as seat of Pipasa – thirst. Charaka Sutrasthana 17/101
In the physiological state, when fluids and nutrition is absorbed by the mesenteric vessels, it creates a negative water balance in the intestines. It leads to water demand reflex – the thirst reflex. Hence mesentery causes trushna even in normal physiology.

In the fetal description, Sushruta says Kloma is nearer to the yakrut – liver and lies on the right side along with liver (Sushruta Shareera 4/31) – Of all the other organs considered to be Kloma, nothing is as close to liver as mesentery. Hence, mesentery can be easily considered as Kloma.

In the Udara – ascites explanation by Charaka Samhita Chikitsa Stha,a 13/45, he says, Vata dosha gets lodged in Kloma causing Udara – ascites. This clearly indicates that the kloma is an abdominal organ, more specifically mesentery.

In the same context, the Sanskrit commentator Chakrapani explains Kloma as Hrudaya Avayava – an organ associated with heart. The mesenteric veins and arteries are connected with heart.

As abdominal organ

Vagbhata mentioned Kloma as Koshtanga – an abdominal organ. Hence, the argument that kloma is related with brain or right lung is ruled out. Vagbhata has mentioned phupphusa as lungs and Kloma as mesentery.

Kloma shape is mentioned as Sandhi Mandala – the shape of the mesentery is spiraling and circular.

Charaka Shareera sthana 4th chapter explains Kloma as Matruja organ – derived from maternal side.
Soft organs are derived from maternal side, mesentery.

Pathological evidences

Pathological evidences to prove mesentery as Kloma:
Gambheera granthi – a deep seated cyst can occur in Kloma – Charaka Samhita Sutrasthana, 17/94.
This can be considered as mesenteric ischemia or mesenteric lymphadenitis.

Kloma vitiation symptoms

Vitiation or imbalance of Kloma leads to hiccups, cough and asthma
Mesenteric infection or injury may lead to these symptoms.

In Ashtanga Hrudaya Rajayakshma, there is Samshoshana – drying up of Kloma
This can be compared to tuberculosis of mesenteric lymph glands.

In Ashtanga Hrudaya Nidana sthana chapter 3, Vidradi (abscess), Vruddhi (fluid collection and bulging) and Gulma – tumor can happen in Kloma. Mesentery can be afflicted with all these three pathological manifestations.
Read related: Understanding Kloma And Its Different Meanings With Contexts

Considering all the above points, it can be clearly said that –
Mesentery is associated with water balance, fluid balance and transporting nourishment and Kloma of Ayurveda is the mesentery that the medical world explains.