Concept of māṃsa vriddhi and its surgical implications in granthi chikitsā

Ayurveda, the timeless science of life, provides a holistic understanding of health and disease rooted in tridoṣa theory and dhātu dynamics. Among the seven dhātus, Māṃsa Dhātu (muscle tissue) holds prime importance in structural integrity and organ protection. Māṃsa Vriddhi, the pathological increase of muscle tissue, is discussed in Ayurvedic texts as a contributory factor in the manifestation of abnormal growths such as Granthi-encapsulated, palpable masses with varying consistency and symptomatology. This paper explores the concept of Māṃsa Vriddhi as per classical Ayurvedic granthas and its direct surgical implications in the understanding and management of Granthi Roga. The formation of Granthi is considered a product of doṣa-dūṣya sammūrchana, predominantly involving Kapha and Meda, with Māṃsa Dhātu serving as a primary dūṣya. Suśruta identifies Granthi as a non-suppurative, nodular swelling with distinct doṣika predominance, often requiring śastrakarma (surgical intervention) for effective management. By analyzing references from Caraka Saṃhitā, Suśruta Saṃhitā, and Aṣṭāṅga Hṛdaya, this paper delves into the etiology, types, and progression of Granthi, correlating it with modern benign neoplasms, lipomas, fibromas, and sebaceous cysts. Additionally, the relevance of Ayurvedic surgical procedures such as Chedana, Kṣārasūtra, Agnikarma, and Lekhana karma is discussed with supportive clinical illustrations. The study underscores the need to integrate Ayurvedic tissue pathology with contemporary surgical techniques for better outcomes in localized abnormal growths. Understanding Māṃsa Vriddhi as a pathological entity enriches both the diagnostic and therapeutic perspectives in Granthi Chikitsā, offering a well-rounded approach to surgical management within an Ayurvedic framework.