Samhanana

Samhanana means muscularity, firmness, solidity, strength or compactness of body. Classical texts and current research have shown the advantages of a compact body over the incompact body. Samhanana examination is included among the tenfold assessment of patients in Ayurveda. An excellent samhanana is a quality of excellent health. [Ast. Sa. Nidana Sthana 1/3]. Though samhanana and pramana seem similar entities but are different from each other. Pramana quantitatively expresses the magnitudes of human body parts, whereas samhnana expresses their compactness. A person with morbid obesity has a large pramana but most probably has least samhanana. Samhanana helps determine the person's constitution, strength and immunity; prognosis and management of diseases; and to assess excellence of body tissues. This chapter deals with the description of samhanana and its importance in healthcare.

Contributors

Section/Chapter/topic	Concepts/Samhanana
Authors	Bhojani M. K. 1, Rahul Anand 1
Reviewer	Basisht G.2,
Editor	Deole Y.S.3
Affiliations	1 Department of Sharir Kriya, All India Institute of Ayurveda, New Delhi, India 2 Rheumatologist, Orlando, Florida, U.S.A. 3 Department of Kayachikitsa, G. J. Patel Institute of Ayurvedic Studies and Research, New Vallabh Vidyanagar, Gujarat, India
Correspondence emails	meera.samhita@aiia.gov.in, carakasamhita@gmail.com
Publisher	Charak Samhita Research, Training and Development Centre, I.T.R.A., Jamnagar, India
Date of publication	August 25, 2023
DOI	10.47468/CSNE.2023.e01.s09.148

Etymology and derivation

Samhanan, klee, samhanyate itee. Sam+han+lyutt shariram. The Sanskrit word ‘Sam’ stands for symmetrical or compactness and ‘shariram’ indicates body. Thus samhanana indicates compact symmetrical body.

Synonyms used in ayurveda samhita

1. Samhati
2. Samyojana [Cha. Sa. Vimana Sthana 8/116]

Classification

1. Good (su-samhanana/sama-samhanana/pravara): Good compactness.
2. Moderate (madhya-samhanana): Moderate compactness.
3. Poor (heena-samhanana): Least compactness [Cha. Sa. Vimana Sthana 8/116].

Factors affecting samhanana

1. A child's overall health at birth depends on the mother's diet regimen during pregnancy. Ayurveda scholars described a monthly diet regimen (garbhini paricharya) for the care of both the mother as well as the foetus. In the context of samhanana, if a pregnant mother in eighth month of pregnancy drinks ksheera-yavagu (gruel processed with milk), then she gives birth to children with excellence in samhanana [Ast. Sa. Sharira Sthana 3/11]. A women expecting a child of healthy compactness will thus attempt to upgrade the quality of her diet during pregnancy.
2. A person with well-built body muscles often has su-samahata body. With samanya vishesha theory, the muscles of the body can best be nourished by consuming flesh of animals). Thus a person who consumes more meat or meat soup [Su. Sa. Sutra Sthana 46/365] or animal proteins (muscles are formed mainly of proteins) has the probability of developing superior compactness (pravar samhanana).
3. Samhanana of a person often declines if he remains ill for a long duration. Depending on the pathology, he is advised either brimhana (nourishing) or langhana (fasting, reducing). A person who adopts these procedures according to the correct dosage or proportion attains the compactness of body. [Ast. Sa. Sutra Sthana 24/68]

Assessment criteria

The samhanana of an individual can be assessed by inspection (darshana pariksha) and palpation (sparshana pariksha). A compact (su-samhata) body has symmetrical and well-partitioned bones, well-knit joints, and well-bound muscles and blood. A poorly compact (heena-samhata) body has the opposite features as su-samhata. Features of moderate (madhya-samhata) exist between the two.
Samhanana is the aggregate of compactness of all body tissues, including bones, ligaments, body fat, body muscles, etc. The compactness of these body parts can be used to get an estimate of the overall compactness of the body. Some of these tools are Body mass index, Bone mineral density, Body Fat Percentage, Skinfold thickness, Dual Energy X-Ray Absorptiometry, Hydrostatic Weighing, Air Displacement Plethysmography, Bioelectric Impedance Analysis, Bioimpedance Spectroscopy, Electrical Impedance Myography, 3-D scanners, etc.

Importance of concept

In determining the constitution of the person

A person's constitution (prakriti) helps advise medication, therapy, food, etc. The constitution in turn, can be determined by examination of samhanana. Ayurveda describes three constitution types- vata prakriti, pitta prakriti, and kapha prakriti. Among these, kapha prakriti individuals have symmetrical (sama), firm, compact, and stable body (sara-samhata sthira sharira), with all organs are well developed and perfect (upachita), thus representing a su-samhata sharira [Cha. Sa. Vimana Sthana 8/96]. Pitta prakriti individuals have loose, soft joints and muscles (dravatva shithil mridu sandhi mansa) [Cha. Sa. Vimana Sthana 8/97]; while vata prakriti individuals have unsteady joints (anavasthita sandhi), prominent tendons (bahukandara), and prominent veins (bahushira) [Cha. Sa. Vimana Sthana 8/98].
Charak mentioned the standard measurement of each body part. Research shows that the vata prakriti individuals have comparatively more height and more length of individual measurements of the body. In terms of the circumference of different body parts, the kapha prakriti individuals have larger sizes than the other two prakriti individuals.

In diagnosis and prognosis

A person with a good compact (su-samhata) body along with features of proportionate musculature and sound sense organs is recognized as a healthy person. Diseases do not harm such a person severely and can withstand adverse situations. [Cha. Sa. Sutra Sthana 21/18-19] Su-samhata body is firm in contrast to the weak strength of the poorly formed (heena-samhata) body. The moderately compact (madhya-samhata) body has medium strength [Cha. Sa. Viman Sthana 8/116]. Thus, the prognosis of a particular disease has a probability of having a good prognosis for su-samhanana followed by madhya-samhanana; with heena-smhanana assumed to have the bad prognosis. Additionally, a su-samhata body is considered to suffer less harm by an accidental injury than the other two making the prognosis of su-samhana better.
The investigation for the compactness of body, i.e. samhanana pariksha, is included among one of the tenfold examinations of the patient (dashavidha pariksha) [Cha. Sa. Vimana Sthana 8/94].

In determining immunity

An individual whose body is either very overweight or too emaciated or has loose muscle, blood and bone (heena samhata) cannot resist diseases and hence have poor immunity. On the other hand, individuals with the opposite type of physical constitution (su-samhata) can resist diseases, hence considered to have good immune strength [Cha. Sa. Sutra Sthana 28/6].

In the management of diseases

Knowledge of samhanana helps a physician decide the type of procedure or strength and dose of medicine for treating disease. Person with su-samhata body, being equipped with high strength, may be prescribed procedures like teekshna shodhana (strong purgation) or maximum doses of drugs, if needed, in contrast to individuals with heena-samhata.

In determining the excellence of tissues (dhatusarata)

Dhatu sarata is a qualitative, quantitative, and functional assessment of dhatus. For example, an individual having excellence in properties of tissues related to blood is known as rakta (blood) sara purusha (an individual with excellent qualities of rakta dhatu). Among eight saras mentioned by Charak, mamsa (muscles) sara individuals have features of su-samhanana as they have body properly covered with good musculature (mamsopachita) [Cha. Sa. Vimana Sthana 8/105]. Asthi (bone) sara individuals may also be included in su-samhanana as they have a firm body (sara sthira sharira).

In career choices

As samhanana determines the strength of an individual, it helps in determining his endurance too, which may prove helpful in selecting a career according to his built. Sports like sprinting, wrestling, and bodybuilding require individuals with good samhanana. Individuals with the superior samhanana may be allotted to work in hostile conditions as their body build will allow them to resist harsh environments, for example, army personnel posted at high altitudes.

Contemporary approach

The compactness of the body is due to the proper union of body parts. The body measurements infer about the human body composition, physique, and nutrition. Ayurveda clearly described compactness and included it in the diagnostic criteria of diseases. Few researchers have attempted to classify human beings based on compactness in the past few decades. In the 1940s, William Herbert Sheldon claimed that a body type has three types: Ectomorph, endomorph, and mesomorph.
Endomorphic have the characteristics of physically round, wide hips, narrow shoulders, extra fat on their body, arms, and thighs, skinny ankles and wrists that make the rest of their body look even bigger.
Mesomorphic persons have large head and broad shoulders with a narrow waist, attractive and desirable, with strong muscular bodies, arms and legs, and little fat on the body. Ectomorphic persons have narrow shoulders, thin legs and arms, little fat on the body, a narrow face and chest, and always stay skinny.

Current researches

1. Observational study of samhanana as a measuring tool
   An observational study was carried out on 50 subjects from Malad West, Mumbai residential areas. The authors prepared a proforma for the assessment of samhanana. The study results indicated that the strength and immunity of su-samhata individuals is highest.
2. Understanding samhanana based on ayurvedic concepts
   Persons with proportionate musculature and compactness of the body possess very strong sensory and motor organs. As such, they are not overcome by the onslaught of disease. Guna sampat (sara, samhanana etc.) is one of the criteria for maintaining the average life span. Samhanana examination helps to know the body's strength, dosha maintaining the body's physiology and life span.
3. Samhanana-a diagnostic tool for physical health
   The study proposes using specific investigations to assess samhanana, including serological tests, bone mineral density tests, electromyography, and muscle tone tests. The samhanana depends mainly on rakta, mamsa, and asthi dhatu (cardiovascular, muscular, and bone and cartilage tissues of the body, respectively). According to the study, the objective criteria for measuring the individual samhanana of this dhatus are as follows: Rakta dhatu: Hb%, RBC. Mamsa dhatu: Physical strength and muscle tone Asthi dhatru: measurements of nails, teeth, chin etc. by vernier caliper; serum calcium and serum phosphorus, bone mineral density (BMD). The author mentions the relation between samhanana and panchamahabhoot (five fundamental aspects of physical reality) described in Ayurveda. Prithvi (earth) & Aap (water) mahabhuta are responsible for superior compactness (uttama samhanana). Akash (space) and vayu (air) mahabhuta are responsible for poor compactness (hina samhanana).

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