Sushruta Samhita, volume 3: Sharirasthana

by Kaviraj Kunja Lal Bhishagratna | 1911 | 36,821 words

This current book, the Sharira-sthana (english translation), deals with anatomy, the human body, cosmology, embryology and various other subjects. The Sushruta Samhita is the most representative work of the Hindu system of medicine. It embraces all that can possibly appertain to the science of medicine. Susruta-samhita is recognized as the first a...

Chapter V - The anatomy of the human body

Now we shall discourse on the Sharira which treats of the anatomy of the human body (Sharira- Shankhya-Vyakarana). 1.

Definition of Garbha and Sharira:—

The combined semen and ovum (Sukra and Sonita) in the womb, mixed with (the eight categories known as) the Prakriti and (her sixteen modifications known as) Vikara, and ridden in by the Atma (self-consicous self), is called the fetus. There is consciousness in the embryo. The Vayu (or the vital force) divides it into Dosha, Dhatu, Mala, etc., limbs, and organs, etc. The Teja (or the heat latent in the fecundated matter) gives rise to the metabolism of the tissues; the Apa (water) keeps it in a liquid state; the Kshiti (earth) is embodied in the shape of its species; and the Akasha (ether) contributes to its growth and development. A fully developed fetus with all its parts, such as the hands, feet, tongue, nose, ears, buttocks etc. and the sense-organs, is called Sharira or body. The body is composed of six main parts, namely, the four extremities (upper and lower), the trunk or middle body, and the head. 2.

Different members of the body:—

Now we shall describe the Pratyangas or members of the body. The head, the belly (Epigastrium), the back, the navel (umbilical region), the forehead, the nose, the chin, the bladder, and the throat (neck), occur singly; the ears, the eyes, the nostrils, the eye-brows, the temples, the shoulders, the cheek, the armpits, the breasts, the testes, the sides, the buttocks, the arms, the thighs, and the knee-joints, etc., occur in pairs. The fingers and toes which number twenty in all, and the interior channels (Shrotas) of the body, to be presently described, are likewise included within the Pratyangas. These are the different Pratyangas or members. 3.

Enumeration of the different limbs and members of the body:—

The different layers of the skin, the Kalas, the Dhatus (root principles, such as blood, chyle, etc.), the Mala (excrements, the Doshas (morbific principles, such as the Vayu, Pitta, or Kapha), the spleen, the liver, the lungs, the colon and cecum (Unduka), the heart, the cavities or viscera (asayas), the intestines (Antras), the Vrikkau (Kidneys) the Srotas (internal passages or ducts), the Kandara (nerve trunks), the Jalas (membranes), the Kurchas,[1] the Rajjus (tendons) the Sevanis (sutures), the Sanghatas (facets), the Simanta, the bones, the joints, the Snayu (ligament), the Peshi (muscles), the Marmas (vital parts, such as anastomosis of veins and arteries, etc.), the Sira (veins), the Dhamani (arteries), and the Yogavahini Shrotas[2], constitute what is collectively called the organism. 4.

Their number:—

The layers of skin (Tvaka) number seven in all. There are seven connective tissues or fascia (Kalas). The cavities or viscera (Asayas) are seven in all. The root principles (Dhatu) of the body are seven in number. There are seven hundred Shira (veins), five hundred Peshi (muscles), nine hundred Snayu (ligaments), three hundred bones, two hundred and ten Sandhi (joints), one hundred and seven Marmas (vital parts), twenty-four Dhamanis (arteries etc.), three Doshas (morbific principle—such as the Vayu, Pitta, and Kapha), three kinds of Mala (excrements) and nine Srota (canals) in all in the human organism, which will be described in detail later on. 5.

The skin, Kala, the root principles of the body, (Dhatus) the morbific principles (Doshas) such as the Vayu etc., of the body, liver, spleen, lungs, Unduka (colons), heart and the Vrikkas (kidneys) have been already described (in the preceding chapter). 6.

The Asayas (cavities or viscera):—

They are named as

  1. the Vatashaya (the receptacle of the bodily Vayu),
  2. Pittashaya (the receptacle of the Pitta),
  3. Sleshmashaya (the receptacle of Sleshma or Kapha),
  4. Raktashaya (the receptacle of the blood),
  5. Amashaya (stomach),
  6. Pakvashaya (intestines),
  7. and the Mutrashaya (bladder).

Females have another ashaya (receptacle) in addition to these which is called the Garbhashaya (uterus). The intestines (of an adult) male, measure fourteen cubits (three and a half Vyamas) in length, while those of an adult female measure only twelve cubits. 7—8.

The Srotas or Channels:—

The nine canals (Srotas) of the body, such as the ears, the eyes, the mouth, the nostrils, the anus and the urethra, open on the outside. Females have three more such ducts or canals as the two breasts (milk channels) and the one which carries off the menstrual blood. 9.

The Kandaras:—

The Kandaras number sixteen in all, of which four are in the legs, four in the hands, four in the neck, and four in the back. The Kandaras of the four extremeties extend to the roots of the nails of the fingers and toes. The four Kandaras of the neck, connecting it with the heart, extend down to the penis. The four Kandaras at the back and in the region of the Sröni extend down to the buttocks (Vimba). These Kandaras terminate above in the head, the thighs, the breast and in the balls of the shoulders respectively (i.e. the Kandaras of the neck terminate above in the head, those of the legs in the thighs, those of the dorsum in the chest, and those of the arms in the shoulders), 10.

The Jala or Plexuses The jala or plexuses are of four kinds, such as the muscular plexuses, the Vascular plexuses, ligamentous plexuses, and bony plexuses. One of each of the four kinds of plexuses, is found about each of the Manibandda (wrists) and Gulfa (ankles). These four kinds of plexuses intermingle and cross one another in the form of a net-work. The whole body is a chain-work of plexuses. 11.

The kurchas:—

There are six Kurchas[3] in all ; of which two are in the hands, two in the feet, one in the neck, and one in the penis. There are four great muscular cords or Kajjus which originate from either side of the spinal column, one pair going inwards and another outwards for the purpose of binding the muscles together.[4] 12–13.

The Sevanis or Sutures:—[5]

They are seven in number, e. g. five in the head, one in the tongue and one in the genital. An incision should not be made into any of these sevanis. 14.

The Asthi-Sanghatas The Asthi-sangh-atas (collection of a number of bones) are fourteen in number. Of these one is found in each of the following positions, viz. the two ankles, the two knees and the two groins ; of the remaining eight, six are to be found in similar positions of the upper extremities, namely one in each of the wrists, elbows and axillas ; one is in the cranium and another in the regions of the Trika[6] (thus making up fourteen in all). 15.

The Sīmantas:—

The Simantas number fourteen in all, and are respectively situated about the place of each of the aforesaid Asthi-sanghata. Several authorities assert that there are eighteen Sanghatas.[7] 16.

The Bones:—

According to the followers of the Ayurveda (general medicine), the entire number of bones in the human body is three hundred and sixty ; whereas Salya-Tantra (the present work) counts only three hundred. Of these, one hundred and twenty are to be found in the (four) extremities, one hundred and seventeen in the pelvis (Shroni), sides (Parshva), back, chest (Urah) and the region of the abdomen (Udara), and sixty-three in the neck and the regions above ; thus numbering three hundred in the aggregate. 17.

(note on bones)

Pundita Gangadhara Kaviratna of Murshidabad in his famous commentary, known as the Tika-jalpa-kalpa-taru, in the 7th. chapter of Sarira Sthana in the Charaka Samhita states:—

“In the surgical text-book of Sushruta the number of bones in the human body is given to be three hundred in all. Of these, one hundred and eight bones are in the four extremeties; one hundred and twenty-six in the pelvic cavity (Shroni), sides (Parshva), back (Prishtha), (Aksha) collar-bones and breast (Urah) ; and sixty-six in the region upward the neck. Thus the total number of three hundred is made up.

Now there are three bones in each toe of the feet; this makes fifteen altogether.

Seven bones constitute the sole (Tala), clutter (Kurcha), and the ankle (Gulfa).

There is one bone in the heel (Pashni), two in the leg (Jangha), one in the knee (Janu), and one in the thigh (Uru). Thus there are twenty-seven bones in one lower limb.

The same number applies to the other lower limb as well as to the two upper limbs. Thus a total number of one hundred and eight bones is made up.

There are five bones in the pelvic cavity (Shroni) ; of these there are two in the hips (Nitamba), and the pubes (Bhaga), anus (Guda) and sacrum (Trika) is constituted with one bone each.

There are thirty-six bones in one side (Parshva) and the same count applies to the other.

There are thirty bones in the back (Prishtha) ; two in the collarbone (Akshasanjna) ; seventeen in the breast (Ura) ; eleven in the neck (Griva); four in the wind-pipe (Kantha-nadi) ; and two in the jaws (Hanu).

There are thirty-two teeth. There are three bones in the nose (Nasa) ; two in the palate (Talu) ; one each in either cheek (Ganda), ear (Kama) and temple (Shankha), making six together; and six in the cranium (Sira). Thus a total number of sixty-six bones is made up.

(Hence) the total number of three hundred bones is made (with the grand total of the three foregoing totals). Thus the list of bones of a skeleton is described.”

Bones of the four Extremities:—

There are three bones in each toe of the foot, thus making fifteen bones altogether (in the toes of each leg). Ten bones constitute the Tala (sole), Kurcha (cluster), and Gulpha (ankle) of each leg, and one forms the Pashni (heel) ; two bones are found in the Jangha (leg) ; one in the Janu (knee), and one in the Uru (thigh) ; thus making thirty bones in one lower extremity. The same number holds good in the case of the other leg as well as in that of the two upper limbs. (Thus the bones in the four extremities are one hundred and twenty in all). 18.

Bones of the Trunk:—

Five bones form the Sronî (pelvic cavity) ; of these four are found about the Guda (anus), Bhaga (pubis), and the Nitamva (hips), and the fifth one is the Trika or triangular bone (the sacrum). There are thirty-six bones in one Parshva (side), and the same number in the other ; thirty in the Prishtha (back), eight in the Urah (chest) ; and two more known as Akshaka (collar-bone). (Thus making one hundred and seventeen in all). 19.

Bones above the Clavicles:—

There are nine bones in the Griva (neck) ; four in the Kantha-nadi[8] (wind-pipe) ; two in the Hanu (Jaws). The teeth number thirty-two. There are three bones in the nose ; one in the Talu (palate); also one in each Kama (ear), Sankha (temple), and Ganda (cheek), (thus making six in all) ; six bones form the Sira (cranium). [Thus making sixty-three in all]. 20.

Different kinds of Bones and their Situations:—

These bones may be divided into five classes (according to tfieir character), such as the Kapala, Rucaka, Taruna, Valaya and the Nalaka. The bones, situated in the knee-joints, shoulders (Ansa†), hips (Nitamvas), cheeks (Ganda), palate, temples, and the cranium belong to the Kapala kind (flat bones). The teeth belong to the Rucaka class. The bones in the nose, ears, throat (trachea) and the socket of the eyes (Akshi-kosha[9]) are called Taruna (cartilages); while those which are found in the palm (wrist), foot (ankle), sides back, chest and regions of the abdomen, belong to the Valaya (irregular or curved) class. The remaining bones belong to Nalaka class (long-bones, lit.—reed-like or cylindrical). 21.

Memorable Verses:—

As trees are supported by the hard core inside their trunks, so the body is supported (and kept erect) by the firm bones (which are found in its inside). And since these bones form the pith (Sara) of the human organism, they are not destroyed even after the destruction and falling off of the attached flesh, skin, etc. of the body. Muscles are attached strongly to the bones by means of the veins (Shiras) and ligaments (Snayus), and are thus kept in position and do not fall off.. 22.

The Sandhis or Joints—(M. T.):—

The joints may be divided into two kinds according as they are immovable (synarthrosis) and movable (diarthrosis). Those which are situated at the four extremities as well as in the Kati (waist) and Hanus (jaws) are movable ; the others are known to be unmovable by the learned. There are two hundred and ten articulations (Sandhis) in the human body. Of these sixty-eight -re in the four extremities ; fifty-nine in the trunk (Koshtha); and eighty-three in the neck and in the region above it. 23.

Sandhis of the four Extremities:—

Three joints are found in each toe, two only in the great toe, thus making fourteen in each leg ; one is placed in each ankle, knee-joint and groin, thus making seventeen Sandhis in each leg or thirty-four in the two lower extremities. A similar number is to be found in each of the two upper extremities. 24–25.

Sandhis of the koshtha and Clavicles:—

There are three Sandhis about the Kapala or flat bone in the Kati (waist, hence pelvis); twenty-four in the vertibral column ; twenty-four in the sides ; eight in the chest ; eight in the Griva (neck) ; three in the Kanthas (windpipe); eighteen in the cords or bands (Nadi) binding the Kloma and the heart ; thirty-two about the roots of the teeth, one in the region of the thyroid (Kakalaka); one in the nose ; two in the eyes ; one in each of the two ears, temples and cheeks (thus making six in all) ; two about the joints of the jaw-bones ; two over the eyebrows ; two above the temples ; five in the Kapala bone of the fore-head and one in the head. 26-27.

Their forms, distinctions, and locations:—

These joints may be divided into eight different classes (named after the objects which they respectively resemble in shape), namely

  1. Kora (hinged or lap-shaped),
  2. Udukhala (ball and socket),
  3. Samudga (back of the palm),
  4. Pratara (raft),
  5. Tunna-sevani (seam-like or dove-tailed),
  6. Vayasa-tunda (crow-beak),
  7. Mandala (circular), and
  8. Sankha-vartah (involutions of conch-shell).

The joints in the fingers, wrists, ankles knee-joints and elbows (Karpura) belong to the Kora group. Those in the axilla or shoulder-joint (Kaksha). teeth, and hip (Vankshana) are of the Udukhala type. The joints in the region of the anus, vagina, shoulders (Ansa-pitha—i.e. glenoid cavity) and hips, belong to the Samudga form. The joints in the neck and the spinal columns, belong to the Pratara (irregular) type ; while those found in the Kapala bones of the pelvis (Kati) and the forehead, are of Tunna-sevani (suture) form. The joints on either side of the cheek-bones (temporomandibular) belong to the Vayasa-tunda type. The Mandala joints occur in the encircling Nadi of the heart, throat, eyes and Kloma. Shankha-varta joints occur in the bones of the ears and the nostrils. The peculiar features of these different kinds of joints (Sandhis) are evident from their names. 28,

Metrical Text:—

Only the bone-joints have been enumerated and described ; the joints of muscles ligaments and veins are innumerable. 29.

The Ligaments (Snayu) —

There are nine hundred ligaments (Snayus) in the human body, of which six hundred occur in the four extremities ; two hundred and thirty in the trunk (Kos’itha) and seventy in the neck and upwards. (Of the six hundred ligaments in the four extremities), six ligaments are situated in each toe making thirty (in the toes of each foot); thirty in the Tala (soles), Gulpha (ankles), and the Kurcha (ankle-joint) ; thirty in the leg (Jangha) ; ten in the knee-joints (Janu) ; forty in the Udara (abdomen) ; ten in the groin (Vankshana) ; thus making one hundred and fifty in each leg. The same number is found in the other lower limb and in each of the two upper extremities. (Of the two hundred and thirty ligaments in the trunk\ there are sixty in the lumbar region (Kati) ; eighty in the back ; sixty in the sides ; and thirty in the chest. (Of the seventy ligaments to be found in the region above the clavicles) there are thirty six in the neck (Griva) and thirty-four in the head. Thus the total number of ligaments in a human body is nine hundred. 30—33.

Memorable Verses:—

Now hear me describe the ligaments (Snayus). They may be grouped under four distinct heads, viz., Pratanavati (ramifying or branching), Vritta (ring-shaped or circular), Prithu (thick or broad), and Shushira (perforated). The ligaments (Snayus) which present in the four extremities and the joints belong to the Pratanavati type. The Kandaras or large ligaments are of the Vritta type ; while those which arc found in the stomach (Amashaya) or in the intestines (Pakvashaya). and in the bladder belong to the Shushira type. The ligaments of the chest, back, sides and head are of the Prithu type. 34–35*

As a boat made of planks and timber fastened together by means of a large number of bindings is enabled to float on the water and to carry cargo; so the human frame being bound and fastened at the Sandhis or joints by a large number of ligaments. (Snayu) is enabled to bear pressure. An injury to, or diseases of, the bones, veins, joints or muscles are not so detrimental to the system as is the case if the Snayus are affected in any way. Only the physician, who is acquainted with the internal and external ligaments (Snayus) of the body, is qualified to extract a hidden and imbedded Shalya (extraneous matter etc.) from any part of the body. 36.

The Muscles (Peshis):—

The muscles (Peshis) number five hundred in all, of which four hundred are in the four extremities; Sixty-six[10] in. the trunk (Koshtha) and thirty-four in the region above the clavicles. 37.

Muscles in the Extremities:—

There are three muscles in each of the toes, thus making fifteen in the toes of one leg; ten in the anterior part of the foot and the same number (ten) attached to the Kurcca; ten in the sole and the ankle-bone (Gulpha,—malledi); twenty in the region between the Gulpha and the knee- joint; five in the knee-joint (Janu); twenty in the thigh (Uru); and ten in the groin (Vankshana); thus making one hundred muscles in all in each leg. The same number is found in each of the other three extremities; (thus making four hundred in all). 38.

Muscles in the Koshtha:—

(Of the sixty- six muscles in the trunk), three are in the region of the anus (Payu); one in the penis; one in the perineum (Sevani); two in the scrotum; five in each of the haunches (Sphik); two in the top or head of the bladder; five in the abdomen (Udara); one about the umbilicus; five along each side (of the spinal column), on the upper part of the back (making ten in all); six in the sides; ten in the chest; seven around the armpits and shoulders (Akshaka-Ansa); two in the region of heart and stomach (Amashaya); and six in the region of the liver, spleen and colon (Unduka). 39.

Muscles of the Head and Neck:—

(Of the thirty-four muscles found in this region), four are in the throat (Griva); eight in the two jaw-bones (Hanu); one each in the regions of the throat (Kakalaka and Gala); two in the palate; one in the tongue; two in the lips: two in the nose; two in the eyes; four in the cheeks; two in the ears; four in the forehead; and one in the head. Thus the positions and distributions of the five hundred muscles (Peshis) have been described. 40.

Metrical Text:—

The ligaments, veins, bones and joints etc., of a human body, derive their strength from the fact of their being supported by or covered over by the muscles. 41.

Extra Muscles in Women:—

Females have twenty extra muscles; ten muscles are to be found about the two breasts, five in each, which (muscles) attain their full growth during puberty; four muscles are present about the parturient passage; and of these (four) two are about the external and two in the internal orifices (of the vagina); three about the region of the os, and three along the passages of the ovum and sperm. The Garbhasaya or uterus is situated in the space bounded by the Pittashaya (small intestine) and Pakvashaya (large intestine) and the fetus lies in this during the period of gestation.[11] 42–43.

According to their position in the system, these muscles are found to be thick, slender, small, expanded, circular, short, long, hard, soft, smooth or rough. The muscles cover the veins, ligaments, bones and joints; hence their shape and size are determined by the exigencies (organic structures) of their positions. 44.

Memorable Verses:—

The muscles which are found in the penis and scrotum of a man as described before correspond to the covering of the uterus in the case of a woman owing to the absence of those organs in her body. The positions and classifications of the veins, channels, Marmas and arteries will be dealt with in a separate chapter. 45-46.

The vagina of a woman resembles the navel of a conch-shell in shape and is possessed of three involuted turns (Avartas) like the interior of mollusc. The uterus (Garbhashaya—fetal bed) is situated at the third posterior involuted turn. The shape of the uterus resembles the mouth of a Rohit-fish (narrow at the mouth and expanded in the upper end). The fetus lies in a crouched or doubled up posture in the uterus and thus naturally at the time of parturition its head is presented at the entrance to the vagina. 47-48.

Superiority of Shalya-Tantra:—

The different parts or members of the body as mentioned before including even the skin cannot be correctly described by any one who is not versed in Anatomy. Hence, any one desirous of acquiring a thorough knowledge of anatomy should prepare a dead body and carefully observe (by dissecting it) and examine its different parts. For a thorough knowledge can only be acquired by comparing the accounts given in the Shastras (books on the subject) by direct personal observation. 49.

Mode of dissection:—

A dead body selected for this purpose should not be wanting in any of its parts, should not be a person who had lived up to a hundred years (i. e. too old age) or of one who died from any protracted disease or of poison. The excrementa should be first removed from the entrails and the body should be left to decompose in the water of a solitary and still pool, and securely placed in a cage (so that it may not be eaten away by fish nor drift away), after having covered it entirely with the outer sheaths of Munja, grass, Kusha grass, hemp or with rope etc. After seven days the body would be thoroughly decomposed, when the observer should slowly scrape off the decomposed skin etc. with a whisk made of grass-roots, hair, Kusha blade or with a strip of split bamboo and carefully observe with his own eyes all the various different organs, external and internal, beginning with the skin as described before. 50—56.

Memorable Verses:—

The Self, the occult or invisible Lord of the body cannot be detected except with the psychic eye or with that of the mind. He, who has observed the internal mechanism of the human body and is well read in the works bearing on these subjects and has thus all his doubts expelled from his mind is alone qualified in the science of Ayurveda and has a rightful claim to practise the art of healing. 57.

 

Thus ends the fifth Chapter of the Sharira-sthana in the Sushruta Samhita which treats of the anatomy of the human body.

Footnotes and references:

1.

Meetings of muscles, ligament?, veins, nerves and bones as at the annular ligament.

2.

Those, that are in connection with the Dhamani.

3.

The Kurchas (clusters or groups) may be made up of muscles, bones, vessels and ligamentous structure–Dallana.

4.

According to Gayadasa four such cords are found on each side of the spinal column and thus totalling eight in all.

5.

Sevani evidently means the central tendinous band which looks like a structure from which the muscles on either side arise.

6.

“Trika” generally means the sacral region, but Dallanan says that here it refers to the meeting of the two clavicles with the breastbone.

7.

According to them four more Asthi-sangatás are to be found over and above the fourteen already mentioned; these are—one above the sacrum, one above the chest, one at the junction of the thorax and abdomen, and one at the acromial end (of the Scapula).

8.

Tala, Kurcha, and Kantha-nadi are identical with Charak’s Salaka, Sthana and Jatru respectively.

9.

Though it is asserted here that there exists Taruna bones in the sockets of the eyes (Akshi-kosha) but there is no mention at all in the text, of the presence of any such therein. There is no mention of the shoulder-blade (Ansa) here though it is a part of the skeleton.

10.

Gayadasa reads sixty in the trunks and forty above the clavicles.

11.

If we read Mutrashaya (bladder) in place of Pittashaya it explains the anatomy better.—Ed.

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