Talu: Meaning, Anatomical location, Functions, Related pathology, Clinical importance

Article by Dr Raghuram Y.S. MD (Ay) & Dr Manasa S, B.A.M.S

“Talu” is a word used to describe the ‘roof of our mouth’ which is called ‘palate’ in modern anatomy.

Anatomically it is an important structure even according to Ayurveda because it forms a major and one of the important parts of the roots of ‘udakavaha srotas’ i.e. water transporting channels in the body.

Haven’t we experienced dryness in the roof of our mouth along with dryness in the tongue and lips when we are thirsty?

So the first signs of thirst are also manifested in the talu vis-à-vis palate. Since thirst is related to water deficit in the body and this water is transported in the water carrying channels and since signs of thirst are first manifested in the palate / talu – by mathematical equation, a part of water conveying channels and their roots are connected to talu.

Dosha relation with Talu

Bodhaka Kapha – Mouth is a seat of Bodhaka Kapha which is related to taste perception and mastication.

Udana Vata – Talu / Palate takes part in speech production and according to Ayurveda, Vak Pravritti is one of the functions of Udana Vata.

Prana Vata – A variant of Prana Vata located in the navel region is said to produce speech when it moves upwards. While doing so, it touches the oral cavity, tongue and palate.

Dhatu relation with Talu

Talu is predominantly made up of Asthi Dhatu (hard palate) and Mamsa Dhatu (soft palate).

Talu as Pratyanga

Talu has been included among 56 Pratyangas enumerated by Master Charaka. Pratyanga means minor organs.

Anatomically, Talu is surrounded by / closely related to jihwa (tongue), danta (teeth), dantamula (gums) and gala / kantha (throat).

Talu connection to Udakavaha Srotas

Udakavaha srotas are the channels in the body which are meant to carry water or control the water balance in the body. This also includes the thirst centers in the body which are located in the brain just above the level of talu.

उदक वहे द्वे, तयोः मूलं तालु क्लोम च।
तत्र विद्धस्य पिपासा सध्यो मरणं च।(सु.श.9/12)
उदक वहानां स्रोतसां तालु मूलं क्लोम च, प्रदुष्टानां तु खलु एषां इदं विशेष विज्ञानं भवति; तध्यथा – जिह्वा तालु ओष्ठ कण्ठ क्लोम शोषं पिपासां च अति प्रवृद्धं
दृष्ट्वा उदक वहानि अस्य स्रोतांसि प्रदुष्टानि इति विध्यात्।(च.वि.५/७)
udaka vahe dve, tayoḥ mūlaṃ tālu kloma ca|
tatra viddhasya pipāsā sadhyo maraṇaṃ ca|(su.śa.9/12)
udaka vahānāṃ srotasāṃ tālu mūlaṃ kloma ca, praduṣṭānāṃ tu khalu eṣāṃ idaṃ viśeṣa vijñānaṃ bhavati; tadhyathā – jihvā tālu oṣṭha kaṇṭha kloma śoṣaṃ pipāsāṃ ca ati pravṛddhaṃ
dṛṣṭvā udaka vahāni asya srotāṃsi praduṣṭāni iti vidhyāt|(ca.vi.5/7)

According to Sushruta, one of the roots of origin of water transporting and regulating channels is talu and the other is kloma.

Talu in this context should be taken as the palate or roof of our mouth cavity which lies in contact with the upper surface of our tongue. Whenever we feel thirsty, the thirst is first manifested in the palate followed by the lips, gums and throat.

The other structure responsible for water transport and regulation in the body is Kloma – a controversial organ. Its detailed explanation is not available in the Ayurveda texts but it has been compared to trachea, pharynx, pancreas, lungs, gall bladder and also water regulating centers in the brain by many experts. We will not be discussing this organ in this context.

Master Charaka too has opined the same about the roots of udakavaha srotas being talu and kloma.

Importance of knowing the Talu

Symptoms of blockage, damage or injury to the Udakavaha srotas and their relationship with talu

Pipasa / Trishna – Thirst is the main symptom manifested as an effect of blockage, damage or injury to the water transporting channels and this thirst, as already said, is manifested in the talu i.e. palate.

Sadhyo Maranam – Death might occur when there is severe life threatening dehydration which has not been compensated for a long duration and which cannot be reversed.

Master Charaka mentions dryness and emaciation of tongue, palate, lips, kloma, throat and severe thirst amongst symptoms of vitiation or damage to udakavaha srotas.

Here we can see that both Charaka and Sushruta have accepted the same roots i.e. talu and kloma.

In this context we will only discuss the talu.

Talu as a root of water conveying system – Here, roots means places of origin or controlling stations regulating water balance in the body. When there is imbalance of water controlling and transportation mechanism to varying proportions the above said symptoms including thirst and dryness in the mentioned regions of the body including talu manifest. The damage may occur to the talu from external injury or internal damage caused by vitiated doshas.

Vitiation of udakavaha srotas reflects mainly in the form of thirst i.e. want of water which might be a reflection of imbalance or deprivation of water in the body in the form of acute or long standing shortage.

The remedy for this is water balance and restoring the water in the body. This can be achieved by regular intake of good quantities of water until dehydration is gone.

The remedy for vitiation of udakavaha srotas is often the same as the remedy / treatment of thirst both targeting restoring the water balance in the body. When this is done, the thirst is quenched. With this the talu once again gets back its moistness.

Dryness of talu, an indicator of water dynamics in the body – So, trishna – thirst is one of the signals which indicate both, water balance and imbalance in the body by reacting to both these conditions. When there is dehydration talu gets dry indicating the thirst reflex. The severity of dryness and thirst depends on the gradient and severity of dehydration in the body. On the other hand, the palate also reacts when water stores are balanced by regaining its wetness signaling the end of thirst episode. This cycle repeats throughout our life and keeps alerting us to keep ourselves hydrated. So, talu is an important parameter to assess the water balance and imbalance in the body and that indicates the necessity of knowing talu as a component of udakavaha srotas.

Talu is a controlling station and water regulator center / meter – Seeing talu as a part and parcel of udakavaha srotas it can either be a controlling station of water regulation or a site where the symptoms of water imbalance is first manifested. The second one looks more logical. If we consider the ‘water regulating or thirst regulating centers located in the brain’ above the level of palate, talu can also be considered as a controlling station of water balance.

Talu is the first indicator of thirst and water imbalance / deficit in the body – Talu or palate is the first part of our body which indicates ‘want of water’ in the form of thirst. When thirst is severe the palate even sticks to the tongue. Lips, gums, throat and tongue also get dried when we are thirsty but the first signals are often given by the palate and hence are considered amongst the roots of water conveying channels. It is interesting to note that lips etc have not been included in the ‘udakavaha srotas mula’.

Any type of dehydration is indicated in the talu – To put it in simple words, thirst caused due to any reason manifests its first signals in the udakavaha srotas. Putting it the other way, ‘all the causes of trishna vis-à-vis thirst are the causes of contamination of water conveying channels and vice versa’. Any type of dehydration produces its initial signs of manifestation in these channels and their roots, talu – palate being one among them.

Therefore the physician should have a comprehensive knowledge of talu (and kloma) to gauge the water levels in the body. This helps him or her to restore water balances and cure various gradients of dehydration, severe forms of which can be lethal. Thirst can also manifest as a disease – trishna roga. Here the aggravated doshas affect talu. Dryness of talu may be a sign / symptom of an underlying disease – an acute one or a chronic one. It can also be a complication of certain diseases and helps in prognosis of diseases.

Causes for vitiation of Udakavaha srotas:

औष्ण्यात् आमात् भयात् पानात् अति शुष्क अन्न सेवनात्।
अम्बु वाहीनि दुष्यन्ति तृष्णायाः च अति पीडनात्॥(च.वि.५/११)
auṣṇyāt āmāt bhayāt pānāt ati śuṣka anna sevanāt|
ambu vāhīni duṣyanti tṛṣṇāyāḥ ca ati pīḍanāt||(ca.vi.5/11)

– hot foods and comforts
– presence of products of undigested food or metabolic toxins in the body or in circulation (ama)
– fear
– excessive consumption of alcohol or dry foods
– habit of withholding the urge for drinking water (thirst urge)

Other causes

– Causes of Trishna
– Causes of Pitta or Vata vitiation
– Causes of kapha vitiation
– Forcibly withholding the urge of reflex of thirst (trishna vega dharana)

The treatment of Udakavaha srotas also will be in managing the above said conditions

Contextually we will discuss the causes of thirst. The same causes contaminate or damage the water conveying channels including talu on the long run.

Causes of Trishna or thirst:

– Physical or mental irritation
– Fear, grief, anger,
– Exertion, Exhaustion
– Fasting in excess
– Excessive consumption of alcohol
– Excessive consumption of Alkalis
– Excessive consumption of sour, salty, spicy, pungent, dry, un-unctuous foods
– Depletion of body tissues
– Being debilitated by a chronic illness
– Excessive administration of treatments like Vamana (therapeutic emesis) etc
– Excessive exposure to Sun
– Decrease of strength or immunity
– Foods and activities which bring about a pathological increase of Pitta

Talu involvement in the cycle of pathogenesis of trishna vis-à-vis thirst

Pathway 1

Pitta and Vata get aggravated in the body (due to the above said causes)
↓
They contaminate soumya dhatus (tissues having more fluidity / water or belonging to kapha group) and deplete their water content
↓
Later they also dry up the Rasavahinis (channels providing nutrition) of the root of the tongue, throat and palate (talu)
↓
This leads to life threatening thirst
↓
Whatever quantity of water is taken is dried up by morbid vata and pitta
↓
The person has urge to drink water frequently but in spite of drinking lot of water repeatedly, his thirst remains un-quenched
↓
Thirst manifests in a severe form when it happens in people suffering from chronic illnesses
↓
Such Trishna is called Aupasargika Trishna

They are thus manifested as a complication of some other underlying disease. So, in any disease in which trishna i.e. thirst is a symptom, talu is invariably involved. Dryness of palate and thirst in any disease demands water replacement.

Pathway 2 (Yogaratnakara)

Consumption of etiological factors
↓
Pitta gets accumulated in the upper portion of the body
↓
This pitta gets vitiated along with vata (in the same region
↓
The vitiated pitta and vata later reach TALU (palate) of the person and afflicts it and
↓
Causes Trishna – thirst

This explanation directly links talu with the pathogenesis of thirst and points that involvement of talu is mandatory in the manifestation of thirst.

Pathway 3 (Charaka)

Etiological factors
↓
Aggravation of doshas
↓
Affliction of udakavaha srotas (talu and kloma)
↓
Manifestation of trishna – thirst

Talu as palate is the seat where thirst is manifested. Talu as hypothalamus located above the level of the palate is the controller of water balance in the body. Here trishna vis-à-vis thirst is a physiological process mediated by hypothalamus.

General symptoms of Trishna

सततं यः पिबेत् तोयं न तृप्तिं अधिगच्छति।
पुनः कांक्षति तोयं च तं तृष्ण अर्दितं आदिशेत्॥(यो.र.तृष्णा चिकित्सा.१,२)
satataṃ yaḥ pibet toyaṃ na tṛptiṃ adhigacchati|
punaḥ kāṃkṣati toyaṃ ca taṃ tṛṣṇa arditaṃ ādiśet||(yo.ra.tṛṣṇā cikitsā.1,2)

Thirst is not satisfied even on repeated drinking of water

The person feels to drink water repeatedly and after a short period of having consumed water

Among other symptoms of thirst, mukha shosha – dryness of the mouth and talu, oshta, kanta, jihva karkashatam i.e. roughness of palate, lips, throat and tongue has been mentioned.

Among the symptoms of doshaja trishna – thirst caused by vitiated vata, pitta and kapha – shushka asyata (dryness of the mouth), pratata shosha (repeated dryness of the mouth) and shushyati cha ati matram (excessive dryness of the mouth) have been mentioned. Though there is no mention of talu in these symptoms we need to understand that talu is also a part of the mouth / oral cavity and these symptoms also point towards changes occurring in talu.

Anana-gala-talu-hridaya shushkata – dryness in the mouth, throat, palate and heart has been mentioned among the symptoms of Upasargaja Trishna.

Prognosis of Trishna

The Trishna with the below said accompanying symptoms is said to have bad prognosis

– Talu-oshta-kanta toda daha – pricking pain and burning sensation in the palate, lips, throat
– Nirgata jihva – tongue protruding out of the mouth
– Trishna – severe intolerable thirst

Management of vitiation of Udakavaha srotas

Contextually we will discuss the management of water conveying channels briefly in this context.

The treatment of vitiation of udakavaha srotas should be done on the lines of treatment of Trishna (thirst) chikitsa (line of treatment of thirst disorder).

Below mentioned are a few recipes which would combat excessive thirst, balance involved doshas and relieve dryness of the palate.

Principles

– Vata alleviating foods and drinks shall be given.
– Consumption of sweet and cold foods and drinks
– Treatment of trishna
– Treatment of daha – burning sensation
– One should not forcibly withhold the urge for thirst
– One should not withhold any urges forcibly
– Drink water and hydrate regularly
– Don’t drink water when you are hungry and do not eat food when you are thirsty

One should not forcibly avoid / withhold the ‘thirst urge’

The symptoms of ‘forcibly withholding the thirst urge’ and symptoms of ‘thirst / thirst disease’ are one and the same. The remedies too are the same for both conditions. One should not withhold the ‘thirst urge’ forcibly.

General line of treatment for dryness of palate / thirst

– Aindra Jalam – rain water mixed with honey for drinking
– Water boiled and prepared with Trinapanchamula and added with sugar
– Laja Mantha – refreshing drink prepared by churning barley flour and honey with Aindra Jala
– Green gram soup fried in ghee
– Hot milk processed with honey and sugar
– Pigeon meat soup fried in ghee added with sugar and honey
– Yavamanda – Barley is boiled with water and its watery part i.e. gruel is collected, mixed with honey and sugar and given for drinking
– Shatadhauta Ghrta should be anointed on the body of the patient and be given tub bath with cold water
– Nasya – nasal drops with milk processed with sweet or bitter tasting herbs having cold potency or Jeevaniya Gana group of herbs, with breast milk or camel milk added with sugar or with sugarcane juice
– Emesis or purgation can be given in severe aggravation of kapha or pitta causing thirst or dryness of palate
– Juices of pomegranate, Garcinia pedunculata orCitrus medica should be given for drink
– Tapta Jala – heated gold, silver, copper, sand, stones, brick or mud balls shall be dipped in water and that water should be given for drinking
– Cold water added with honey and sugar
– Coriander decoction mixed with honey and sugar
– Goat meat soup mixed with sugar, ghee and honey
– Milk processed with sweet or bitter tasting herbs, Jeevaniya gana herbs, herbs having cold potency mixed with honey and sugar should be used for drinking, massage and showering and ghee processed with same herbs should be used for drinking, massage and as nasal drops
– Tapta jala – mixture of curds, jaggery and water dipped with heated mud balls earthen pieces and sand should be given for drinking
– Gargles with – cow milk, sugar water, sugarcane juice, jaggery water, honey, juice of Citrus medica or decoction of mango and Syzygium cumini mixed with honey
– Sparsha (touch and wear) – sponging with cloth dipped in supernatant layer of curd water or fermented medicinal liquid, garland of lotus or gems should be worn in the neck,
– Lepa = paste of pomegranate, Indian jujube, Symplocos racemosa, Limonia acidissima and Citron fruit should be applied on the head / scalp

Formulations

– Milk processed with Jeevaniya Gana groups of herbs (for vata affecting the palate)
– Juice of Indian fig fruit (Udumbara) mixed with sugar or a refreshing drink prepared using parched rice (puffed grains) in milk (for pitta affecting the palate)
– Honey water as refreshing drink i.e. tarpana or herbal confection (avaleha) prepared with pomegranate or tamarind or with milk, honey, sugar and turmeric powder (for kapha affecting the palate)

Other remedies for thirst and dryness of palate

– Meat soup for drinking
– Meat soup with honey
– Milk or honey mixed with water
– Jaggery water
– Drinking lot of milk (for debilitated and weak people having thirst and dryness of palate)
– Addiction to alcohol can cause severe thirst and dryness of palate due to aggravation of pitta and vata. This is called as madhyaja trishna. For these people cold water bath should be given followed by diluted alcohol (alcohol mixed with half quantity of water, sour pomegranate juice, rock salt and other fragrant herbs) or jaggery water.

Pathya – wholesome things for thirst / dryness of palate

Dates, pomegranate, Indian gooseberry, Citrus medica, cow milk, plantain flower, ash gourd, rice grown in sixty days, gruels, flour of puffed grains, rice filterate (anna manda), and sugar are useful.

Apathya – unwholesome things for thirst / dryness of palate

Heavy to digest foods, sour, salty and astringent foods, contaminated water and irritating foods (teekshna ahara) are not beneficial.

Useful herbs

Dates, raisins, vetiver, sandalwood, Indian gooseberry, Citrus medica, pomegranate, coriander, plantain flower, ash gourd, mango, sugarcane, Syzygium cumini

Secondary manifestation of thirst

Thirst and dryness of palate may occur in the form of a symptom, complication, sign or prognosis or premonitory symptom of some other systemic disease. In these conditions the dryness of the palate will be relieved when the disease causing it is treated.

Talugata Roga – Diseases of the palate

तालुगतास्तु – गलशुण्डिका, तुण्डिकेरि, अधुषः, कच्छपः, अर्बुदं मांससङ्घातः, तालुपुप्पुटः, तालुशोषः, तालुपाक इति ॥४०॥
tālugatāstu – galaśuṇḍikā, tuṇḍikeri, adhuṣaḥ, kacchapaḥ, arbudaṃ māṃsasaṅghātaḥ, tālupuppuṭaḥ, tāluśoṣaḥ, tālupāka iti ||40||

Diseases of the palate are as enumerated below –

– Galasundika – uvulitis, elongated uvula
– Tundikeri – Enlarged tonsil / tonsillitis
– Adhrusa – palatitis
– Kacchapa – adenoma of the palate
– Arbuda – sarcoma of the palate
– Mamsasamghata – fibroma
– Talupuppta – epulis of the palate
– Talusosha – dryness of the palate
– Talupaka – suppuration / ulceration of the palate

(Ref – Sushruta Nidana Chapter 16)

Treatment of Talugata Rogas

The treatments for the same have been enumerated in Sushruta Chikitsa Sthana Chapter 22.

Galasundika – With the help of a forceps galasundika should be pulled and then cut with mandalagra sastra (sharp instrument). Later, paste of marica, ativișa, pāțhā, vacā, kustha, kutannata and lavana (saindhava) added with honey should be applied. Gargle should be done with decoction of vacha, ativisa, patha, rasna, katukarohini and pichumanda. Pills made with Ingudi, kinihi, danti, sarala (trivrt) and suradāru should be kept in mouth. Later the patient should inhale kapha mitigating smoke. He should consume food which includes green gram soup added with yavakshara.

InTundikeri, Adhrusa, Kurma (tālukaccapa), Talusanghāta and Tālupuppuța – the same treatments should be adopted and especially surgical operation should be done.

In Tālupaka – pitta mitigating treatments should be done.

In Talusosa – oleation, sudation (fomentation) and vata mitigating treatments should be adopted.

Diseases in which Talu is involved

Talu shosha i.e. dryness of the palate is mentioned as –

1. Purvarupa (premonitory symptom) in Rajayakshma (tuberculosis, phthisis)
2. Upadrava (complication) in Trshna (thirst disease)
3. Symptom of Upasargaja Trshna
4. Symptom of trshnaja, kshayaja and kshataja daha (burning sensation)
5. Symptom of vataja pratishyaya (cold / rhinitis caused by predominantly vitiated vata)

Talu Vidirana i.e. cracks in palate is mentioned as a symptom of dantasaushira which is a disease of dantamula i.e. gum.

Talu – Surgery link

Tala Yantra – is one of the yantras (blunt instruments) explained in Ayurveda. These instruments have a flat disc at their front end, whose shape resembles that of a palate. Tala pertains to talu (palate shaped). (Ref Sushruta Sutra Chapter 7).

तालयन्त्रे द्वदशाङ्गुलेमत्स्यतालवदेकतालद्वितालके,कर्णनासानाडीशल्यानामाहरणर्थम् ॥१२॥
tālayantre dvadaśāṅgulematsyatālavadekatāladvitālake,karṇanāsānāḍīśalyānāmāharaṇartham ||12||

Length – Tala Yantras are of 12 angulas (24 cm) in length.

Types of Tala Yantra – Tala yantras are of two kinds –

1. Eka tala – having one disc resembling the palate of the fish

2. Dwi tala – having two discs resembling the palate of the fish

They are used for removing foreign bodies from the ear, nose and sinuses.

Related Reading – Talu – Modern Aspect