AN ANALYTICAL REVIEW OF AVEDHYA SIRA OF URDHWASHAKHA IN THE CONTEXT OF “VAIKALYAM MARANAM CHA API”

Abstract

Background: In Ayurveda, the concept of Avedhya Sira (non-puncturable veins) is of paramount clinical significance. Among these, the Avedhya Siras located in the Urdhwashakha (upper extremity) are especially emphasized due to their association with life-threatening consequences like Vaikalyam (disability) and Maranam (death). Ancient texts have cautioned strongly against their injury during procedures like Siravyadha (venesection). This review explores the anatomical, physiological, and clinical dimensions of Avedhya Siras of Urdhwashakha, with modern anatomical correlations. Aim & Objectives: To analytically review the concept of Avedhya Sira in Urdhvashakha and evaluate its clinical significance in the context of Vaikalyam and Maranam, with correlation to modern anatomical structures. Materials and Methods: A comprehensive textual review of Sushruta Samhita, Charaka Samhita, Ashtanga Hridaya, and respective commentaries was carried out. Modern anatomical texts and clinical studies were also reviewed. Correlative analysis was employed to match classical descriptions with present-day vascular and neural structures.

Results and Observations: Sushruta described 16 Avedhya Siras in the upper limbs—10 in the hands and 6 in the arms. These are primarily associated with vital vascular and neural structures such as the brachial artery, median nerve, and deep palmar arches. Injury to these structures can result in paralysis, hemorrhage, or death. Modern anatomical correlations reinforce the classical avoidance of invasive procedures in these regions. Conclusion: The concept of Avedhya Sira in Urdhwashakha illustrates the surgical precision and anatomical insight of ancient Ayurvedic scholars. Correlation with modern anatomy affirms the clinical caution advised in ancient texts and highlights the need for integration of classical anatomical knowledge in modern surgical and procedural practices.