An observational study of anatomical concept of Shadgarbhakarabhava (six procreative factors) in prevalence of Arbuda

Chetan Prakash; Pooja Sabharwal; Rima Dada

doi:10.4103/AYUHOM.AYUHOM_25_22

ORIGINAL ARTICLE

Year : 2022 | Volume : 9 | Issue : 2 | Page : 89-100

An observational study of anatomical concept of Shadgarbhakarabhava (six procreative factors) in prevalence of Arbuda

Chetan Prakash¹, Pooja Sabharwal², Rima Dada³
¹ Assistant Professor, Department of Rachana Sharir, Uttaranchal Ayurvedic College, Dehradun, Uttarakhand, India
² Assistant Professor, Department of Rachana Sharir, Ch. Brahm Prakash Ayurved Charak Sansthan, New Delhi, India
³ Professor, Department of Anatomy, All India Institute of Medical Science, New Delhi, India

Date of Submission	28-Apr-2022
Date of Decision	29-Jul-2022
Date of Acceptance	07-Oct-2022
Date of Web Publication	20-Feb-2023

Correspondence Address:
Chetan Prakash
261, Near PNB, Jat Behror, Alwar, Rajasthan
India

Source of Support: None, Conflict of Interest: None

DOI: 10.4103/AYUHOM.AYUHOM_25_22

Abstract

Background: The fetus is formed out of the combination of six components (Shadbgarbhakarabhava) namely Matrija (maternal), Pitrija (paternal), Atmaja (soul), Satmyja (wholesomeness), Rasaja (nutritional factors), and Sattvaja (mind) are individually responsible to develop different body parts and features. Every factor, in the state of their wholesome combination, is responsible for the creation of living. Aims: This study aims to analyze and explore the concept of Shadbgarbhakarabhava in light of Rachana Sharir and evaluate the utility of the concept in the prevention of Arbuda. Materials and Methods: A retrospective observational study was carried out in two government institutes after the approval of the institutional ethics committee. Thirty cancer patients were included in this study. Results: Among 30 cancer patients, 83% of cases were related to Matrija-bhava and 17% of cases were related to Pitrija-bhava. Conclusions: After the critical study of the concept of Shadgarbhakarabhava through various texts, their testing by different methods, and their discussion and interpretation by logic and reasoning, it is concluded that there is a certain impact of six procreative factors in the prevalence of Arbuda. This concept is very similar to FOAD (Foetal Origin of Adult Disease) in light of the above critical study of cancer patients.

Keywords: Arbuda, atmaja, matrija-pitraja, rasaja, sattvaja, satymaja

How to cite this article:
Prakash C, Sabharwal P, Dada R. An observational study of anatomical concept of Shadgarbhakarabhava (six procreative factors) in prevalence of Arbuda. AYUHOM 2022;9:89-100

How to cite this URL:
Prakash C, Sabharwal P, Dada R. An observational study of anatomical concept of Shadgarbhakarabhava (six procreative factors) in prevalence of Arbuda. AYUHOM [serial online] 2022 [cited 2023 May 30];9:89-100. Available from: http://www.ayuhom.com/text.asp?2022/9/2/89/370085

Introduction

Cancer is the second leading cause of death globally and is responsible for an estimated 9.6 million deaths in 2018. Globally, about 1 in 6 deaths is due to cancer. Approximately 70% of deaths from cancer occur in low- and middle-income countries.^[1] Ayurveda-A complete and holistic health science, not only dealing with preventive and curative aspects of health but also has a strong footing in the field of healthy progeny. Shadgarbhakarabhava (Six procreative factors of progeny) have been propounded in the Ayurvedic classics, namely Matrija (maternal), Pitrija (paternal), Atmaja (Soul), Satmyaja (wholesome practices by the mother), Rasaja (diet of the mother), and Sattvaja (psychological health of the parents). A healthy mother and father, proper diet of the mother, the practice of wholesome living and dietary regimen and healthy mind psychological status of parents and good deeds of Soul in the previous incarnation play a prime role in achieving healthy offspring, thus structuring a healthy family, society, and nation.^[2] The conglomeration of these procreative factors is a must for healthy progeny. The physical, mental, social, and spiritual well-being of the person, proper nutrition of the mother during pregnancy, and practice of a wholesome regimen play a prime role in achieving healthy offspring. Negligence toward any of these factors becomes a cause for unhealthy (diseased) and defective childbirth.^[3] The tendency of many diseases like Arbuda in a later stage of life can occur as the concept of Janambala Pravrita vyadi, Aadibala pravrita vyadhi is present. Sushruta defines the Adibala-pravritta diseases as the diseases produced by improper conduct of the mother and father (Shukra-shonita-dushya) producing diseases like Kushta, Arshas, etc. These Vyadhis are further divided into Matrija and Pitrija Vyadhi.^[4]

Relevance of study

Epidemiologist David Barker was the earliest proponent of the theory of fetal origins of adult disease, prompting the theory to be denoted as “Barker's hypothesis.” In 1986, Barker published findings proposing a direct link between prenatal nutrition and late-onset cancer, heart disease, T2DM, etc. Ayurveda scholars felt the importance of the concept of FOAD (fetal origin of adult diseases) has been attaining considerable attention as not only do unfavorable conditions during life in the womb and affect health in childhood, they also predispose to increased risk of diseases in adulthood.^[5]

Purpose of the study

The present observational study thus focuses mainly on interpreting these observations, based on modern scientific knowledge for the prevalence of Arbuda in adult life. As per the Ayurvedic concepts of Shareer (Embryogenesis), each procreative factor contributed to the physical and mental growth and development of certain structures as well as functions of the body. Perfection of all these procreative factors in turn of their assigned structures and functions leads to a healthy progeny.

Lacunae in existing knowledge

Less relevant study in light of present knowledge related to the prevalence of Arbuda with unhealthy procreative factors is present, though concepts in both streams are available the onset of Arbuda in the later stage of life. Lord Atreya said, “No, the foetus is formed from out of the combination of all these factors.^[6]” All the six components namely Matrija (maternal), Pitrija (paternal), Atmaja (soul), Satmyja (wholesomeness), Rasaja (nutritional factors), and Sattvaja (mind) are individually responsible to develop different body parts and features [Table 1]. “Every same factor, which, in the state of their wholesome combination, are responsible for the creation of living being, in the state of their unwholesome combination are responsible for the various diseases.”^[7]

Table 1: Features developed from six procreative factors

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Effect of diet and mode of life during pregnancy

The fetus is wholly dependent on mother; therefore, her diet and other activities may affect the growing fetus during pregnancy. By keeping this fact in mind, the woman desirous of having an ideal offspring should discard harmful diet and activities. Effect of diet of parents on child is showing in table [Table 2]^[13] and consumption of diet (Vitiating Doshas) by woman and its effect on her Foetus showing in table [Table 3].^[14] This awareness existed even in very early periods. The use of cow's flesh by pregnant woman may also cause a congenital anomaly in the fetus. Charaka Samhita has mentioned that the effect of harmful diet as well as activities of the mother, causes congenital anomalies which are as follows:^[15]

Table 2: Effect of diet of parents on child

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Table 3: Consumption of diet (vitiating Doshas) by woman and its effect on her foetus

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The woman, who sleeps in the open air or is addicted to night walking, gives birth to a congenitally insane offspring
A woman of quarrelling nature gives birth to an epileptic
A nymphomaniac woman gives birth to an ill-formed or shameless, or effeminate offspring.
A hypochondriac woman gives birth to a coward, emaciated, or short-lived offspring
A scheming woman (jealous inwardly but not showing it apparently) woman gives birth to anti-social, envious, or effeminate offspring
A thievish woman gives birth to a fierce, deceitful, and envious offspring
An intolerant woman gives birth to a fierce, deceitful, and envious offspring
A woman, who sleeps so much, gives birth to sluggish, a dullard, or a dyspeptic child
A woman, addicted to wine, gives birth to an offspring with polydipsia, having weak memory, and possessing unbalanced mind
A woman, who eats “iguanas” flesh habitually, gives birth to an offspring suffering from urinary gravel or calculi or having dribbling micturition
A woman, who is addicted to hogs' flesh, gives birth to an offspring suffering from bloodshot eyes, sudden apnea, or coarse hairs
A woman, who is fond of the meats of fish, gives birth to a slow winking or unwinking offspring
A woman, constantly given to eating sweets, given birth to an offspring subject to urinary anomalies or a mute or obese offspring
A woman who is fond of sour things gives birth to an offspring having bleeding diathesis or diseases of the skin and eyes
A woman, who is fond of saltish preparations, gives birth to an offspring whose hair turn gray very early, has a wrinkled face or bald-headed offspring and who is addicted to pungent things, gives birth to a weakling or to one who is a deficiency to semen (Sterile)
A woman, who is addicted to astringent things, gives birth to an offspring having muddy complexion, constipated or suffers from reversed peristalsis. A woman, addicted to any of the recognized causative factors of disease, gives birth to an offspring with a great tendency to suffer from corresponding diseases.

Similarity between Arbuda and Cancer

Many diseases can be correlated with Arbuda, but Cancer is a parallel disease for it. The signs and symptoms of Arbuda can be very well explained in modern terms.^[16],[17]

Gatra-pradeshe-kavachita: Anywhere in the body or any tissue may be damaged
Mamsamabhi pradushyam: Predominantly, it is a disease of the Mamsa that is damage of the muscular connective and epithelial tissues
Vrutam sthiram: The growth is round and stony hard
Manda rujam: Pain is not present except in final stage
Mahantam: It spreads with a deep route
Chira-vridhi: It is chronic in nature and gradual in progress
Apakam: It is nonsuppressive.
Mamshrochhayam: Tumor is formed by unnecessary and uncontrolled abnormal proliferation of tissue
Atyagadham: Very deep routed.

Aims and objectives

To analyze and explore the concept of Shadbgarbhakara-bhava in light of Rachana Sharir
To evaluate the utility of concept in the prevention of Arbuda
To justify and evaluate the utility of concept in the prevention of Arbuda for healthy progeny.

Materials and Methods

The classical literature of Ayurveda as well as modern medical science on the subjects of gynecology, oncology, embryology, and genetics from the library of the two government institutes were explored for this study. The Internet services of the institute, library IT center were also used.

Study methodology

The study was conducted after receiving the approval from Institutional Ethical Committee IEC Code: 2017/01/MD/02, dated June 2017. The purpose of the study was explained to all eligible participants willing to participate in the study and also explained about the voluntary participation, and he/she is free to withdraw from the study in between any time without any justifications. Thirty cancer cases were taken for observational study from two government institutes (All India Institute of Medical Science, New Delhi, and Ch. Brahm Prakash Ayurved Charak Sansthan, New Delhi) to collect the data. The information sheet/case paper pro forma followed by the consent form used to record all the data of an individual with parenteral history included in the study. Information about six procreative factors in different types of cancer patients was recorded in the study pro forma. Then, all the observations were recorded collectively in the table form (Master chart). The data obtained were critically analyzed, interpreted, and presented. Then, all these data are furnished for statistical analysis.

Inclusion criteria

Subjects who were suffering from Arbuda of idiopathic and congenital origin was included in this study, i.e., pulmonary fibrosis, leukemia's, neurogenic tumor, etc
Age - 15–40 years
Nature-Benign, Malignant with stages 1, 2, 3, and 4.

Exclusion Criteria:

Subjects above age >40 and <15
Abscess, cyst, lipoma
Subjects with a history of chronic alcohol intake, smoking, nonvegetarian diet
If the mother and father of the patient were not available.

Study design: Cross-sectional (Observational) study was done on 30 patients
Sampling method: Simple random sample (Probability sampling method).

Discussion

Negligence toward any of these factors becomes a cause for unhealthy and defective child birth and tendency of many diseases like Arbuda in later stage of life can occur as per the Ayurvedic concept of Janambala-pravrita-vyadi, Aadibala-pravrita-vyadhi. Ayurveda scholars felt the importance of the concept of FOAD (fetal origin of adult diseases) has been attaining considerable attention as not only do unfavorable conditions during life in the womb and in childhood affect health in childhood, they also predispose to increased risk of diseases in adulthood.

Discussion on shadgarbhakarabhava

Hereditary factors are known as Shad-bhava Samudaya.

(i) Matrija–Maternal factors, (ii) Pitrija–Paternal factors, (iii) Atmaja–Atma (Soul), (iv) Satmyaja-(Wholesomeness), (v) Rasaja-(Nutritional factors), (vi) Sattvaja (Psych/Mind).

The above six factors are collectively responsible for the development of the embryo. No single factor can form and develop embryo properly. Following body parts or organs develop from respective bhavas. In this way, the Garbha (fetus) maintains a continued relationship with the mother through these Shad-bhavas, according to Aatreya. That's why the Shad-bhavas play an important role in the formation of a fetus. These Shad-bhavas when present together then only they are able to produce a fetus. If they are present alone, they do not have any significance. A single bhava can produce an offspring, rejection of this theory is given below:

Rejection of Mata-pita (mother and father) alone to be the reason in the formation of embryo:-Rishi Bhardwaj presented a doubt here that if the mother and father are known to be the main reason for the development of a fetus then they will produce a baby of their choice. If they want male baby, they will go through the process with will of male child and if want female baby, they will go through the process with will of female child. However, this is practically impossible.

Rejection of Atma alone to be reason in the formation of embryo:- Atma produces Atma, if this theory is accepted then why Atma will enter a yoni which is poorer. It will always try to enter the best. Atma has few Gunas such as Vashi, Vegha, Bala, Varna, and Sattva-yukta and it will choose the same Sharir which is un-diseased, Amara. But practically, this is also impossible because all types of animals, human takes birth on this earth.

Rejection of Satmya alone is the reason in the formation of embryo:- If only persons intaking Satmya-ahara will be able to produce the offspring then those persons who take Asatmya-ahara will not be able to produce offspring. However, it is not so, both types of persons can produce offspring. Hence, this reason was rejected.

Rejection of Rasa alone is the reason for the formation of embryo:- Rasa is able to produce Garbha, this cannot be accepted because all the people eat different types of Rasas. But in general, it is seen that all the people whether they eat best Rasas or worst Rasas, will produce the offspring. It is not seen that if a person eats Kandmool, the worst Aahara described in Ayurveda, will not be able to produce a child.

Rejection of Mana alone to be the reason in the formation of embryo:- If Mana alone is accepted as a reason for the formation of embryo, then all the person must know or remind the events of their previous birth because it is known to all that Mana comes from God and collaborate with Indriyas to express its knowledge. Mana knows all the previous birth events.

Impact of shadgarbhkarabhava in the prevalence of arbuda in adult life

Cancer, like the metabolic syndrome, is a complex and multifactorial disease. Genetic mutations and environmental triggers are not sufficient to explain the pathogenesis and the rising incidence of cancer. Epigenetics, which means “on top of genes,” describes how the environment interacts with the genome to produce heritable changes resulting in phenotypic variation without altering the DNA of the genome. Epigenetic processes include DNA methylation and demethylation and posttranslational processes such as acetylation phosphorylation and methylation of core histones, which result in an altered histone code. The DNA methylation of cytosine-guanine dinucleotides is commonly described in the literature. DNA methyltransferase enzyme isoforms (Dnmt 1, 3a, 3b) methylate DNA, causing the DNA to be tightly coiled or wound (i.e., heterochromatin). This state results in transcriptional repression and is maintained by heterochromatin protein, HP1. Methylation is maintained by the methyl donors, methionine, choline, and various cofactors, such as folic acid. By contrast, loosely wound DNA, known as euchromatin, allows active transcription Epigenetic changes, previously well-described in the field of cancer, are now implicated in the pathogenesis of obesity and insulin resistance. Epigenetic modifications have been implicated in the SGA neonate, affecting promoters of glucose transporter 4, Pdx-1, glucocorticoid receptor, and peroxisomal proliferator-activated receptor-α genes. Whether methyl donor supplementation before or during pregnancy can reverse the SGA phenotype remains to be elucidated. While epigenetic modifications have been described in various animal studies, replications in human samples have proven to be challenging. This is perhaps related to the fact that human samples have been limited to blood cells while most of the epigenetic changes have been observed to be tissue specific. The strongest evidence for cancer and FOAD exists for breast cancer. A case–control study nested within the US Nurses' Study revealed that those individuals at birth who weighed <2.5 kg were half as likely as those who weighed >4 kg to subsequently develop breast cancer. Similarly, in a cohort of 2221 British women, a birth weight >3.5 kg was associated with an increased risk for cancer, specifically premenopausal breast cancer, even after adjusting for confounders. Trichopoulos first proposed that in utero exposure to high levels of estrogens, either endogenous or exogenous increased the number of stem cells and/or mitogenic activity of undifferentiated breast tissue. Consistent with this theory, mothers with advanced age, dizygotic gestations, or macrosomia or preterm babies demonstrate higher concentrations of estrogen. As a consequence, their fetuses are at an increased risk for breast cancer development. Conversely, mothers diagnosed with pregnancy-induced hypertension have decreased estrogen concentrations, and therefore, their offspring are relatively protected from breast cancer. In addition to being at increased risk for developing metabolic derangements, being LGA at birth is associated with an increased risk of cancer. As a result, fetal determinants are receiving new attention. Birth weight has been speculated to be associated with the development of breast, ovarian, prostate, testicular, and colon cancers. While fetal growth factors, such as insulin, are regulated by maternal substrates, it is also known that maternal concentrations of estrogen and testosterone can alter the offspring's hypothalamic-pituitary-testicular/ovarian axis. By altering a specific tissue's exposure to nutrition and steroid hormones, the risk for tissue dysplasia and subsequent cancer can be altered. Unlike insulin resistance, which demonstrates a U-shaped curve with respect to birth weight, colon cancer exhibits a J-shaped curve, with the heaviest babies carrying the largest risk. In a population-based cohort of over 10,000 men and women, macrosomia carried a hazard ratio of 2.57, while VLBW infants carried a modest, yet statistically significant, increase in incidence. Studies have demonstrated that when rats fed excessive calories were then exposed to carcinogens, they exhibited an increased number of colorectal tumors in comparison with similar controls who received a calorically appropriate diet. Thus, six procreative factors create an intrauterine environment for phenotypic changes for the onset of Arbuda in adult life.^[18]

Discussion on observations

Six procreative factors have an important role as causative factors of congenital, hereditary, and genetic anomalies before conception, at the time of conception, and after conception. Concepts and details of congenital anomalies have been described by almost all the scholars of Ayurveda. With the opinion that Arbuda may occur in later stage of life due to the emotional and physical state of parents, the season, and location of our birthplace, parent's nature, their diet and lifestyle as well as the circumstances of the birth. This study deals with observations, analysis, and interpretation in the prevalence of Arbuda. A detailed history of the 30 cancer patients (includes age, gender, religion, occupation, economic status, habitat, marital status, diet pattern, food habits, sleep pattern, bowel habits, addictions, family history [mother and father], maternal factor, paternal factor, Atmaja-bhava, Satmyaja-bhava [wholesomeness], Rasaja-bhava, Satvaja-bhava).

Sample size: Thirty cancer patients for were registered this study to collect data.
Sex ratio: According to a study male:female ratio equals 1.4 with little variation in age groups (1.3–1.5) (Gender differences in cancer susceptibility: an inadequately addressed issue, www.ncbi.nlm.nih.in)
Age group: In this study, the age eligibility criteria taken is the age group between 15 and 40 years. It is observed that the majority of the CA patients belong to 35–40 years. It may be because mostly cancers cases are seen in older adults, but the disease can occur at any age
Religion: It is evident that maximum, i.e., 83% of patients were Hindus and 17% of patients were Muslims. This can be reflecting the geographical predominance of the Hindu community in this particular region and signifies nothing
Marital status: In this study, maximum, i.e., 63% of patients were married and 37% of patients were unmarried. It may be because most cancer occurs in later age (older adults) and is not so significant
Occupation: In this study, 37% homemaker, 30% farmer, 17% students, 7% government servant, 3% mechanic, 3% self-employee and 3% private job employees were included. It could be due to various factors such as lifestyle/lack of awareness and education/workplace unknown exposure to carcinogens/secondary smoking/genetic and environmental factors
Economic status: In this study, maximum 87% of patients were low-income group, 13% patients were middle-income group and none belong to high-income group). It may be because of lack of education/awareness/money/nutrition/hygiene
Region/habitat: In this study, maximum 36% of patients belong to Bihar, 20% patients from Haryana, 17% patients from UP, 10% from Delhi, 10% from Uttarakhand and 7% belongs to Jharkhand. It is because of the availability of the patients in higher centers from different areas for quality treatment which is nearer to the region where the study is conducted
Food habits: In this study, it is observed that 63% of patients have blend food habit and 37% patients have spicy food habits. The probable reason for such findings may be because blend food comprises of all types of food including junk food (Viruddha Aahaar). As per Charaka Samhita, Viruddha-ahar (Blend food) leads to condemned diseases (Nindita Vyadhi) like Arbuda (cancer)
Sleep pattern: In this study, it is observed that 80% of patients have continued sleep pattern whereas disturbed sleep patterns were found 20% of patients. It may be due to fatigue because most of the registered patients undergoing chemotherapy or radiation therapy reported c/o feeling tired and weak, so their sleep pattern may be continued under fatigue and drug therapy effect (The relationship between fatigue and sleep in cancer patients: A review– NCBI)
Bowel habits: In this study, 60% of patients had regular bowel habits while the remaining 40% of patients had irregular bowel habits. The reason may be considered as patients undergoing chemotherapy are prone to intestinal disturbances (toxicity/constipation) and are subjected to some laxative drugs to remove the toxins from intestine
Addiction: In this study, 73% of patients were found nonaddicted and 27% were found addicted to tea and coffee. As per the study methodology, major cancer-causing addictions were kept in the exclusion criteria
Diet pattern of parents: As per this study, 77% of fathers and 50% of mothers were nonvegetarian while 23% fathers and 50% mothers were vegetarian. It indicates that subjects whose fathers were taking nonvegetarian diet are more prone to the prevalence of Arbuda as compared to subjects whose fathers were vegetarian
Addiction of parents: Observation for father parent: 37% tobacco addict, 23% Gutakha addict, 17% alcohol addict, 7% tea addict and 10% nonaddict fathers were found. The subjects whose fathers were addicted to any form of tobacco and alcohol were found to be more prone to prevalence of A as compared to subjects of nonaddicted fathers.
Observation for mother parent: 7% tobacco addicted, 3% betel nut addicted, 10% smoking addicted, 33% tea addicted, and 57% nonaddicted mothers were found. According to a meta-analysis, smoking and tobacco-chewing during pregnancy was associated with increased risk of soft tissue cancer, brain tumor, bone tumor, hepatic cancer (Rumrich IK, Viluksela M, Vahakangas A, Gissler M, Surcel H-M, Hanninen O (2016) Maternal smoking and the risk of cancer in early life – A Meta-analysis. PLoS One 11(11):E0165040. Doi: 10.1371./Journal. pone. 0165040)
The general health of the parents: As per this study, 64% fathers and 83% mothers of the registered patients were healthy while 36% fathers and 17% mothers of the registered patients were diseased (As we all know that inherited cancers make up 5%–10% of all cancers)
Medication taken by parents before pregnancy and during pregnancy by mother: Observations made about Father Parent (PreConception): 3% took medication (treatment) for hemorrhoids, 3% for brain hemorrhage, 3% for bone fracture, 3% for antidepressant, 17% for ATT (anti-tuberculosis treatment), 3% for diabetes, 13% for asthma, 3% for lung cancer were detected whereas 50% were found to be healthy. Observations made about mother parent (pre/postconception): 7% mothers took medication (treatment) for bone fracture, 3% for ATT (anti-tuberculosis treatment), 7% for HTN (hypertension), 3% for uterine fibroid, 3% for renal calculi, 3% for lower respiratory tract infection, 3% for gastritis, 3% for CA of gall bladder were detected whereas 67% were healthy mothers. According to a study, those patients whose parents were exposed to carcinogenic hydrocarbons during and before pregnancy has been linked to an increased risk of childhood ALL and brain tumors (Original Research Paper; Parental exposure to carcinogens and risk for childhood acute lymphoblastic leukemia, Columbia, 2000-2005. Volume 8: NO.5. A106).
Matrija-bhava: As per this study, 83% of cases were related to Matrija-bhava, in which 40% soft tissue carcinoma [Pituitary adenoma, CP Angle schwannoma, Dysgerminoma, Classical PNH, CA RMT (oral cancer), CA Tongue, CA Breast, CA Ovary, Spinal Cord Ependymoma, CA Gall bladder, Lung Carcinoma, RMS (Rhabdomyosarcoma), 30% blood cancer, 7% CA of rectum, 3% CA of large intestine, 3% CA of the liver] was found in registered patients. As per Ayurvedic texts, soft tissue and organs are originated from maternal factors so Matrija-bhava is possibly affecting respectively caused cancer. According to a study, Maternal factors (i.e., maternal age, BMI, social class, marital status, and smoking as well as preeclampsia, antepartum hemorrhage and previous miscarriage, gestational age, birth weight, and Apgar scores) were associated with cancer (Maternal and perinatal risk factors for childhood cancer: Record linkage study; BMJ Open 2014;4: e003656. doi: 10.1136/bmjopen-2013-003656).
Pitrija-bhava: As per this study, 17% of cases were related to Pitrija-bhava all of which were found to be suffering from osteosarcoma. As per Ayurvedic texts, all hard and bony structures are said to be originated from paternal factors so Pitrija-bhava is possibly affecting the respectively caused cancer. According to modern science, paternal factors (i.e., paternal age, nutrition, BMI, behavior, occupation, addiction, social status, lifestyle, and general health) are associated with cancer. According to a study, increased risk of Osteosarcoma was observed among those whose fathers were employed in farming horticulture and animal husbandry (The relationship between paternal occupation and bone cancer risk in offspring; International Journal of Epidemiology 1998; 27:766-771).
Atmaja-bhava: Ayurveda is using four primary factors, i.e., mother, father, soul, and nutrition. Every factor is made up of four elements Earth, water, fire, and air. The soul that enters at the time of fertilization plays a crucial role in the physical and mental nature of the child a couple will create. Despite same family, birth time, nutrition; people differ in their life span, psych-metaphysical aspects. Why do the same initial pathological features produce different diseases in different people, why do they occur quickly in some whereas in others there is a long latent period. Such unexplained, indigenous, or idiopathic factors are due to the Atmaja-bhava. The effect of what is done during the previous life is known as Daiva. The mental state during the period of conception and during the pregnancy impact the nature of the soul that incarnates into the womb. Modern epigenetic research would say that stress measured by cortisol levels impacts gene expression in the early stage of embryogenesis. The thoughts and desires arising from the past karmas of the parents attract a soul of like nature. During the early stages of human development, material ambitious and an egotistical nature are justified because Atma (deeds of previous life) drive us onward and upward. Following [Figure 1], [Figure 2], [Figure 3], [Figure 4], [Figure 5], [Figure 6], [Figure 7], [Figure 8], [Figure 9], [Figure 10] are showing relationship between number of patients in prevalence of Arbuda and various Atamaja-bhava.
Satmyaja-bhava: [Figure 11] Circulation of the uterine fluid, the chemical diversity, and their interaction create a certain environment able to support embryo development. Satmya (habituation) is the use of such things which do not cause harm to the body even though they are opposite of one's own constitution, habitat, time, caste, season, disease, exercise, water, day sleeps, taste, and the like.
Kala-satmya: According to Acharyas, different types of Kala (time) can be interpreted as the age of parents and time of copulation. The predominance of Doshas in body is existent according to age of the parents, for example, in old age, Predominant Dosha is Vata, in middle age predominant Dosha is Pitta and in childhood age predominant Dosha is Kapha. These Doshas affecting whole body also affect Shukra (sperm), Shonita (ovum) and therefore the fetus engendered in different ages of the same parents have different constitutions as said by Acharya Gangadhara
Time of copulation: Copulation is indicated only in Anindya Kala for attainment of a child in the healthy state. So improper time, season, age of conception, all these periodic factors can probably influence the health of the fetus by creating a mutagenic or epigenetic influence
Desha-satmya: The early environment of a developing child can influence to its genome by epigenetic means. Tribal groups in India have their peculiar genetic makeup. They serve as a unique gene pool, which has evolved in the natural setting over thousands of years. Therefore, they have special health problems and genetic abnormalities like sickle cell anemia. The intrauterine environment is also of great importance as far as fetal growth is concerned
Rasaja-bhava: [Figure 12] The observations in this study say 70% of patients have proper manifestation and growth of the body whereas 30% of patients were having improper manifestation and growth of the body. Neonatal size is strongly related to maternal BMI, height, head circumference, and even birth weight. This probably has both genetic and environment components, but strongly suggests that the nutrition of a female throughout her life (during her own fetal life and childhood) as well as during pregnancy, influences the growth of her fetus. Nutritional effects of fetal growth are also shown by the drop-in birth weight observed during famines. There is some evidence that improvement in micronutrients quality of mothers, diets lead to an increase in fetal growth. Childhood leukemia and brain cancer may have environmental components in their development due to pesticides. DES daughters have a risk of cancer and abnormalities in reproductive tract (Fetal origins of adult disease; 10. 5005/jp-journals-10009.1352)
Sattvaja-bhava: [Figure 13] Only the human being has the possibility of living conscious, wide-awake, controlled life. Human being possesses instinct and intelligence. All these things may not happen without the presence of Manasa (psyche). According to research done by Prof. Michel Bett, working at Cambridge University, one cannot claim that the psyche of the fetus totally a derivative of one chromosome or gene because, Psyche of the fetus depends upon the genetic derivatives, gestation derivatives, and environmental derivatives. Dauhrida-avastha of Garbhini is a very candid manifestation of the Sattvaja-bhava. Ayurvedic scholars clearly mentioned that the suppression of desires of Dauhridini may influence the psychology of both the mother and fetus. Ayurveda scholars have regarded Sattva as a linking and integrative force of the various determinants related to the development of the human organism and its personality. Sattva with its association with soul at the time of union of sperm ovum is considered an essential factor for the development of embryo. Thus, we can say that the Sattva of the fetus is molded by three factors: (i) Sattva of parents-Genetic derivatives, (ii) Garbhini-uparjita-karma-Gestation derivatives, and (iii) Janmantara-vishesha-abhyasa-Environmental derivatives.

Figure 1: Relationship between specific complexion (Atmaja-bhava) and no. of patients in prevalence of Arbuda

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Figure 2: Relationship between birth in specific species, knowledge about oneself, impulse, sustenance, retention power, consciousness (Atmaja-bhava) and no. of patients in prevalence of Arbuda

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Figure 3: Relationship between aversion (Atmaja-bhava) and no. of patients in prevalence of Arbuda

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Figure 4: Relationship between intellect (Atmaja-bhava) and no. of patients in prevalence of Arbuda

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Figure 5: Relationship between egotism (Atmaja-bhava) and no. of patients in prevalence of Arbuda

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Figure 6: Relationship between memory (Atmaja-bhava) and no. of patients in prevalence of Arbuda

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Figure 7: Relationship between Prana (Atmaja-bhava) and no. of patients in prevalence of Arbuda

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Figure 8: Relationship between mana (Atmaja-bhava) and no. of patients in prevalence of Arbuda

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Figure 9: Relationship between Apana (Atmaja-bhava) and no. of patients in prevalence of Arbuda

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Figure 10: Relationship between voice (Atmaja-bhava) and number of patients in prevalence of Arbuda

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Figure 11: Relationship between satmyajabhava and no. of patients in prevalence of Arbuda

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Figure 12: Relationship between Rasajabhavas and no. of patients in prevalence of Arbuda

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Figure 13: Relationship between satvajabhava and no. of patients in prevalence of Arbuda

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Fetus in the womb is believed to be able to recognize love, happiness, sadness, and Stress. A pregnant woman's thoughts have a physical connection to her unborn child. Everything the pregnant mother feels and thinks is communicated through neurohormones to her unborn child, just as surely as are alcohol and nicotine. A pregnant woman's thoughts are the precursor for the neuro-hormones. When pregnant mother is anxious, stressed, or in a fearful state, the stress hormones released into her bloodstream cross through the placenta to the body. Stress activates the unborn child's endocrine system and influences fetal brain development. The relationships between psychological variables and the presence of cancer, its prediction, and the prediction of cancer mortality and course of disease have been studied extensively. From a limited list of about 50 such variables, the following have been the focus of the most intensive research and are discussed in this report: Human and animal stress; bereavement; depressed mood; psychosis, especially schizophrenia; suppression of emotions, especially anger; helplessness and hopelessness; social support; and psychotherapeutic intervention. For all of these variables, studies have shown both positive relationships and absence of relationships. The evidence against any such relationship is strongest for human stress, depressed mood, psychosis, and bereavement. Studies of animal stress show that it stimulates the development of cancers of viral origin and exacerbates their growth while inhibiting the development and progression of chemically induced cancers.(The role of psychological factors in cancer incidence and prognosis. Oncology (Williston Park). 1995 Mar; 9(3):245-53; discussion 253-6).

Results

Based on the observational study done results are as following:

Matrija-bhava: In this study, it is observed that 83% of cases were related to Matrija-bhava, in which 40% soft tissue carcinoma (Pituitary adenoma, CP Angle schwannoma, Dysgerminoma, Classical PNH, CA RMT (oral cancer), CA of tongue, CA of breast, CA of Ovary, spinal cord ependymoma, CA of Gall bladder, Lung Cancer, RMS (Rhabdomyosarcoma), 30% blood cancer, 7% CA of rectum, 3% CA of large intestine, 3% CA of liver was found in registered patients. As per Ayurvedic texts, soft tissue and organs are originated from maternal factors so Matrija-bhava is possibly affecting respectively caused cancer [Figure 14]
Pitrija-bhava: In this study, it is observed that 17% of cases were related to Pitrija-bhava, which all were suffering from osteosarcoma. As per Ayurvedic texts, all hard and bony structures are said to be originated from paternal factors so Pitrija-bhava is possibly affecting the respectively caused cancer [Figure 14]. In this study it is observed that 50% cases were related to Raktjarbuda, 30% Vatajarbuda, 10% Medojarbuda, 3% Mamsajarbuda and 3% Kaphajarbuda showing in [Figure 15].

Figure 14: Incidence of Matrija and Pitrija bhavas in prevalence of Arbuda

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Figure 15: Percentage of Arbuda. In 30 number of patients, it is observed that 50% patients were related to benign tumour and 50% related to malignant

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Conclusions

After the critical study of the concept of Shadgarbhakarabhava through various texts, their testing by different methods and their discussion and interpretation by logics and reasoning, it is concluded that there is a certain impact of six procreative factors in the prevalence of Arbuda. This concept is very similar to FOAD (Foetal Origin of Adult Disease), in the light of the above critical study of the cancer patients. Antenatal care, right from the preconception to full-term delivery will certainly play a key role in the prevention of such cancer, diabetes mellitus, obesity, CAD, etc. The essentialities for healthy progeny and safe delivery include proper preparation of parents, Punsavana-samskara, Masanumasik-paricharya, avoidance of Garbhaupghatkarabhava, proper use of Kumara-gara, Sutika-gara, Dhupana, Raksha-karma, Seemantonayana, and Jatkarma-samskara. By applying these principles in our routine practice, we can ensure a natural delivery free from various complications, good maternal health, a healthy progeny with good immunity, and ultimately good lactation which will help in the proper growth of the baby in adult life.

Limitation of the Research: The limitations of this study are the following:

Matrija, Pitrija, and Rasaja-bhava out of the Shadgarbhakarabhava, can be easily assessed. Whereas the remaining 3, i.e., Atmaja, Satmyaja, and Sattvaja-bhava cannot be easily determined
Standardized pro forma to study each aspect is not available to accurately assess each bhava.

Scope for the Research: Thoughts regarding a topic are always evolving so is the scope. The following are forward the scope that can take this research forward:

The sample size can be increased
A similar study can be done on different diseases paving more ways for further exploration of the effect of Shadgarbhakarabhava on adult life
Rather than exploring one center; this study could be multicentral
Each bhava out of the six can be separately studied with separate diseases.

Acknowledgments

The authors are grateful to All India Institute of Medical Science, New Delhi, and Ch. Brahm Prakash Ayurved Charak Sansthan, New Delhi for supporting the study. We also thank all the participants (cancer patients) for their unbiased voluntary participation.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

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