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{{Infobox
|title = Sankhya Sharira
|label1 = Section/Chapter
|data1 = [[Sharira Sthana]] Chapter 7
|label2 = Preceding Chapter
|data2 = [[Sharira Vichaya Sharira]]
|label3= Succeeding Chapter
|data3 = [[Jatisutriya Sharira]]
|label5 = Other Sections
|data5 = [[Sutra Sthana]], [[Nidana Sthana]], [[Vimana Sthana]], [[Indriya Sthana]], [[Chikitsa Sthana]], [[Kalpa Sthana]], [[Siddhi Sthana]]
|header3 =
}}
==[[Sharira Sthana]] Chapter 7, Sankhya Sharira (Chapter on the count of Human Anatomical and Physiological Constituents) ==
=== Abstract ===
<div style="text-align:justify;">
This chapter, the [[Sankhya Sharira]], is dedicated to quantification of human anatomical and physiological constituents. It provides comprehensive knowledge about the organization of the body, its gross and subtle structures. The basic ''panchabhautika'' composition of human body is revealed which is helpful in understanding disease pathogenesis and prognosis. In brief, the chapter gives a general picture of how a body is organized by its functional organs, and emphasizes upon the importance of the knowledge of not only gross anatomy but at the cellular and sub cellular level.
'''Keywords''': ''Purusha, Chetana, Koshthanga,'' organs, physiological systems, body constituents.
</div>
=== Introduction ===
<div style="text-align:justify;">
The [[Sharira Sthana]] is a seminal section within [[Charaka Samhita]], with topics ranging from the origin of human beings to embryology, physiology, obstetrics, and neonatology, before delving into a study of the human anatomy. [[Sankhya Sharira]] comprises of a description of ''sharira'' (human body) on the basis of ''dhatubheda'' (different body constituents), the number and measurements of organs and constituting structures. The chapter begins with a description of skin (''twak sharira''), as the identification of a body starts with the skin. When a patient approaches a physician, his skin is the first organ that gets examined for visible signs of disease. The description on skin is followed by a description of the six sections of the body, or ''shadanga sharira'' or six body components, (two upper limbs, two lower limbs, head and the neck, and the torso). Following ''shadanga sharira'' is ''asthi sharira'', or osteology. In the modern system of anatomical schooling, osteology is always considered as the opening chapter of anatomy. ''Asthi sharira'' is followed by ''indriya sharira'', which includes ''panchendriya adhishthana, panchabuddhindriya'' and ''panchakarmendriya'', or the basics of neurology and myology. This is followed by ''chetanadhishthana'' and ''dashavidha pranayatanas'', dealing with expressions of life including action and reaction. This is followed by a description of ''koshthanga'' (viscera). This chapter is analogous to the study of splanchnology in modern texts like, for example, Gray's Anatomy. Following ''koshthanga'' is the study on ''pratyangas,'' or specific body regions. After ''pratyangas'' is the description on nine major openings. This marks the end of body parts or organs that can be counted. The next part of the chapter deals with ligaments, musculature, etc. (''shira, dhamani, snayu'' etc). Subsequently, ''anjali pramana'' of body fluids is described. ''Anjali pramana'' is followed by ''paramanubhediya sharira'', which shows the understanding of microscopic anatomy in ancient times. The chapter ends with a urge to physicians and lay people to study [[Sankhya Sharira]] and gain valuable knowledge in their quest to achieving ultimate salvation.
Though the title of the chapter literally means a numerical study of the body, it is not just about counting organs and structures, as is evident from the description of the various sections presented here. Charaka has logically divided the chapter into a section on “countable” constituents of the human anatomy, followed by a section that cannot be counted, or in some cases, even be seen with the naked eye (''paramanubheda'', or cellular level).
</div>
===Sanskrit text, Transliteration and English Translation===
अथातः शरीरसङ्ख्याशारीरं व्याख्यास्यामः||१||
इति ह स्माह भगवानात्रेयः||२||
athātaḥ śarīrasaṅkhyāśārīraṁ vyākhyāsyāmaḥ||1||
iti ha smāha bhagavānātrēyaḥ||2||
athAtaH sharIrasa~gkhyAshArIraM vyAkhyAsyAmaH||1||
iti ha smAha bhagavAnAtreyaH||2||
Now we will expound the chapter titled ''Sharirasankhyashariram'' (i.e., [[Sankhya Sharira]]). Thus said Lord Atreya. [1-2]
==== Agnivesha’s questions on the human anatomy ====
शरीरसङ्ख्यामवयवशःकृत्स्नंशरीरंप्रविभज्य सर्वशरीरसङ्ख्यानप्रमाणज्ञानहेतोर्भगवन्तमात्रेयमग्निवेशः पप्रच्छ||३||
śarīrasaṅkhyāmavayavaśaḥkr̥tsnaṁśarīraṁ pravibhajyasarvaśarīrasaṅkhyānapramāṇajñānahētōrbhagavantamātrēyamagnivēśaḥ papraccha||3||
sharIrasa~gkhyAmavayavashaHkRutsnaMsharIraM pravibhajyasarvasharIrasa~gkhyAnapramANaj~jAnahetorbhagavantamAtreyamagniveshaH papraccha||3||
Agnivesha asked a question to Lord Atreya, for the sake of gaining knowledge on the human body’s organisation into divisions, subdivisions, structures and organs, so that one can understand the number and magnitude of the organs and structures. [3]
==== Six layers of skin ====
तमुवाच भगवानात्रेयः- शृणु मत्तोऽग्निवेश! सर्वशरीरमाचक्षाणस्य यथा प्रश्नमेकमना यथावत्
शरीरे षट् त्वचः; तद्यथा- उदकधरा त्वग्बाह्या, द्वितीया त्वसृग्धरा, तृतीया सिध्मकिलाससम्भवाधिष्ठाना, चतुर्थीदद्रूकुष्ठसम्भवाधिष्ठाना, पञ्चमी त्वलजीविद्रधिसम्भवाधिष्ठाना, षष्ठी तु यस्यां छिन्नायां ताम्यत्यन्ध इव च तमः प्रविशतियां चाप्यधिष्ठायारूंषि जायन्ते पर्वसु कृष्णरक्तानि स्थूलमूलानि दुश्चिकित्स्यतमानि च; इति षट् त्वच:;
एताः षडङ्गं शरीरमवतत्य तिष्ठन्ति||४||
tamuvāca bhagavānātrēyaḥ- śr̥ṇu mattō'gnivēśa! sarvaśarīramācakṣāṇasya yathā praśnamēkamanāyathāvat|
śarīrē ṣaṭ tvacaḥ; tadyathā- udakadharā tvagbāhyā, dvitīyā tvasr̥gdharā, tr̥tīyāsidhmakilāsasambhavādhiṣṭhānā, caturthī dadrūkuṣṭhasambhavādhiṣṭhānā, pañcamītvalajīvidradhisambhavādhiṣṭhānā, ṣaṣṭhī tu yasyāṁ chinnāyāṁ tāmyatyandha iva ca tamaḥ praviśati yāṁcāpyadhiṣṭhāyārūṁṣi jāyantē parvasu kr̥ṣṇaraktāni sthūlamūlāni duścikitsyatamāni ca; iti ṣaṭ tvacaḥ|
ētāḥ ṣaḍaṅgaṁ śarīramavatatya tiṣṭhanti||4||
tamuvAca bhagavAnAtreyaH- shRuNu matto~agnivesha! sarvasharIramAcakShANasya yathAprashnamekamanA yathAvat|
sharIre ShaT tvacaH; tadyathA- udakadharA tvagbAhyA, dvitIyA tvasRugdharA, tRutIyAsidhmakilAsasambhavAdhiShThAnA, caturthI dadrUkuShThasambhavAdhiShThAnA, pa~jcamItvalajIvidradhisambhavAdhiShThAnA, ShaShThI tu yasyAM chinnAyAM tAmyatyandha iva ca tamaHpravishati yAM cApyadhiShThAyArUMShi jAyante parvasu kRuShNaraktAni sthUlamUlAnidushcikitsyatamAni ca; iti ShaT tvacaH|
etAH ShaDa~ggaM sharIramavatatya tiShThanti||4||
<div style="text-align:justify;">
Lord Atreya replied, “Agnivesha! As you have asked, I am clearly describing the details of the whole body. You may want to focus on these. To start with, there are six layers of skin, i.e.
*''Udakadhara'', the outermost layer, this specially holds water.
*Second is ''asragdhara'', which holds blood.
*Third is seat of ''sidhma'' (fungal infection like ptyriasis versicolor) and ''kilas'' (vitiligo), a type of ''kushtha'' (skin diseases)
*Fourth is that from which ''dadru'' (ring worm infestation) and ''kushtha'' originate.
*Fifth is that in which ''alaji'' (dermoid cyst) and ''vidradhi''(abscess) are formed, and
*Sixth is that which causes severe pain when it is cut, and the person feels like he is sinking in dark. Ulcers are caused in this layer and red-and-black colored boils with hard roots are caused at the unions of the structures (connective tissues), which are very difficult to treat.
These six layers of skin cover up the underlying ''shadanga sharira'' (body of six divisions). [4]
</div>
==== Subdivisions of body ====
तत्रायं शरीरस्याङ्गविभागः; तद्यथा- द्वौ बाहू, द्वे सक्थिनी, शिरोग्रीवम्, अन्तराधिः, इति षडङ्गमङ्गम्||५||
tatrāyaṁ śarīrasyāṅgavibhāgaḥ; tadyathā- dvau bāhū, dvē sakthinī, śirōgrīvam, antarādhiḥ, itiṣaḍaṅgamaṅgam||5||
tatrAyaM sharIrasyA~ggavibhAgaH; tadyathA- dvau bAhU, dve sakthinI, shirogrIvam, antarAdhiH, itiShaDa~ggama~ggam||5||
The body can be divided into six divisions (''shadanga sharira''), i.e., two upper limbs (''bahu''), two lower limbs (''sakthi''), head and the neck (''shira'' and ''griva''), and the torso (''antaradhi''). [5]
==== Number of bones ====
त्रीणि सषष्टीनि शतान्यस्थ्नां सह दन्तोलूखलनखेन | तद्यथा-द्वात्रिंशद्दन्ताः, द्वात्रिंशद्दन्तोलूखलानि, विंशतिर्नखाः, षष्टिः पाणिपादाङ्गुल्यस्थीनि, विंशतिःपाणिपादशलाकाः, चत्वारि पाणिपादशलाकाधिष्ठानानि, द्वे पार्ष्ण्योरस्थिनी, चत्वारः पादयोर्गुल्फाः, द्वौ मणिकौ हस्तयोः, चत्वार्यरत्न्योरस्थीनि, चत्वारि जङ्घयोः, द्वे जानुनी, द्वे जानुकपालिके, द्वावूरुनलकौ, द्वौ बाहुनलकौ, द्वावंसौ,द्वे अंसफलके, द्वावक्षकौ, एकं जत्रु, द्वे तालुके, द्वे श्रोणिफलके, एकं भगास्थि, पञ्चचत्वारिंशत् पृष्ठगतान्यस्थीनि,पञ्चदश ग्रीवायां, चतुर्दशोरसि, द्वयोः पार्श्वयोश्चतुर्विंशतिः पर्शुकाः, तावन्ति स्थालकानि, तावन्ति चैव स्थालकार्बुदानि, एकंहन्वस्थि, द्वे हनुमूलबन्धने, एकास्थि नासिकागण्डकूटललाटं, द्वौ शङ्खौ, चत्वारि शिरःकपालानीति; एवं त्रीणि सषष्टीनिशतान्यस्थ्नां सह दन्तोलूखलनखेनेति||६||
trīṇi saṣaṣṭīni śatānyasthnāṁ saha dantōlūkhalanakhēna |
tadyathā- dvātriṁśaddantāḥ, dvātriṁśaddantōlūkhalāni, viṁśatirnakhāḥ, ṣaṣṭiḥ pāṇipādāṅgulyasthīni,viṁśatiḥ pāṇipādaśalākāḥ, catvāri pāṇipādaśalākādhiṣṭhānāni, dvē pārṣṇyōrasthinī, catvāraḥpādayōrgulphāḥ, dvau maṇikau hastayōḥ, catvāryaratnyōrasthīni, catvāri jaṅghayōḥ, dvē jānunī, dvējānukapālikē, dvāvūrunalakau, dvau bāhunalakau, dvāvaṁsau, dvē aṁsaphalakē, dvāvakṣakau, ēkaṁjatru, dvē tālukē, dvē śrōṇiphalakē, ēkaṁ bhagāsthi, pañcacatvāriṁśat pr̥ṣṭhagatānyasthīni, pañcadaśagrīvāyāṁ, caturdaśōrasi, dvayōḥ pārśvayōścaturviṁśatiḥ parśukāḥ, tāvanti sthālakāni, tāvanti caivasthālakārbudāni, ēkaṁ hanvasthi, dvē hanumūlabandhanē, ēkāsthi nāsikāgaṇḍakūṭalalāṭaṁ, dvauśaṅkhau, catvāri śiraḥkapālānīti; ēvaṁ trīṇi saṣaṣṭīni śatānyasthnāṁ saha dantōlūkhalanakhēnēti||6||
trINi saShaShTIni shatAnyasthnAM saha dantolUkhalanakhena |
tadyathA-dvAtriMshaddantAH, dvAtriMshaddantolUkhalAni, viMshatirnakhAH, ShaShTiHpANipAdA~ggulyasthIni, viMshatiH pANipAdashalAkAH, catvAri pANipAdashalAkAdhiShThAnAni, dvepArShNyorasthinI, catvAraH pAdayorgulphAH, dvau maNikau hastayoH, catvAryaratnyorasthIni, catvArija~gghayoH, dve jAnunI, dve jAnukapAlike, dvAvUrunalakau, dvau bAhunalakau, dvAvaMsau, dveaMsaphalake, dvAvakShakau, ekaM jatru, dve tAluke, dve shroNiphalake, ekaM bhagAsthi,pa~jcacatvAriMshat pRuShThagatAnyasthIni, pa~jcadasha grIvAyAM, caturdashorasi, dvayoHpArshvayoshcaturviMshatiH parshukAH, tAvanti sthAlakAni, tAvanti caiva sthAlakArbudAni, ekaMhanvasthi, dve hanumUlabandhane, ekAsthi nAsikAgaNDakUTalalATaM, dvau sha~gkhau, catvArishiraHkapAlAnIti; evaM trINi saShaShTIni shatAnyasthnAM saha dantolUkhalanakheneti||6||
Including teeth, teeth sockets and the nails, the human bones are 360 in number. A breakdown of this number is as follows:
*Teeth (''danta'') are 32, teeth sockets (''danta udukhal'') are 32
*Nails (''nakha'') are 20
*Bones of fingers (''angulyasthi'') in upper and lower limb are 60
*Metacarpals and metatarsals (''shalakasthi'') are 20
*Distal carpal and distal tarsals (''shalakashraya'') are 4
*Calcaneus (''parshni'') are 2
*Ankle bones/talus and navicular (''gulphasthi'') are 4
*Proximal carpal bones (''manikasthi'') in the hands are 2
*Forearm bones (''aratni'') are 4
*Leg bones (''janghasthi'') are 4
*Knee bones (''janvasthi'') are 2
*Patella (''janukapal'') are 2
*Femur (''urunalaka'') are 2
*Humerus (''bahunalaka'') are 2
*Clavicle (''ansasthi'') are 2
*Scapula (''ansaphalakasthi'') are 2
*Clavicular articular disc (''akshakasthi'') are 2
*Xiphisternum (''jatru'') is 1
*Palatines (''talvasthi'') are 2
*Ilium (''shroniphalaka'') are 2
*Pubis (''bhagasthi'') is 1
*Bones of the back (''prashthagata asthi'') are 45
*Bones of the neck (''grivagat asthi'') are 15
*Bones of the chest (''uroasthi'') are 14
*Both sides ribs (''parshuka'') are 24
*Both sides rib sockets (''parshukasthalaka'') are 24
*Both sides rib tubercles (''parshukarbuda'') are 24
*Mandible (''hanvasthi'') is 1
*Mandibular articular disc (''hanumoolabandhanasthi'') are 2
*Nasal (''nasikasthi'') is 1
*Zygomatic (''gandakutasthi'') is 1
*Frontal (''lalatasthi'') is 1
*Temporal (''shamkhasthi'') are 2 and
*Skull bones (''shirakapalasthi'') are 4. [6]
==== Five ''indriyadhishthana'', five ''buddhindriya'' and five ''karmendriya'' ====
पञ्चेन्द्रियाधिष्ठानानि; तद्यथा- त्वग्, जिह्वा, नासिका, अक्षिणी, कर्णौ च|
पञ्च बुद्धीन्द्रियाणि; तद्यथा- स्पर्शनं, रसनं, घ्राणं, दर्शनं, श्रोत्रमिति|
पञ्च कर्मेन्द्रियाणि; तद्यथा- हस्तौ, पादौ, पायुः, उपस्थः, जिह्वा चेति||७||
pañcēndriyādhiṣṭhānāni; tadyathā- tvag, jihvā, nāsikā, akṣiṇī, karṇau ca|
pañca buddhīndriyāṇi; tadyathā- sparśanaṁ, rasanaṁ, ghrāṇaṁ, darśanaṁ, śrōtramiti|
pañca karmēndriyāṇi; tadyathā- hastau, pādau, pāyuḥ, upasthaḥ, jihvā cēti||7||
pa~jcendriyAdhiShThAnAni; tadyathA- tvag, jihvA, nAsikA, akShiNI, karNau ca|
pa~jca buddhIndriyANi; tadyathA- sparshanaM, rasanaM, ghrANaM, darshanaM, shrotramiti|
pa~jca karmendriyANi; tadyathA- hastau, pAdau, pAyuH, upasthaH, jihvA ceti||7||
Five ''indriyadhishthana'' (seats of ''indriya'') are skin (''twacha''), tongue (''jihva''), nose (''nasika''), eyes (''netra'') and ears (''karna'').
Five ''buddhindriya'' (senses) are touch (''sparshana''), taste (''rasana''), smell (''ghrana''), vision (''darshana'') and hearing (''shrotra'').
Five ''karmendriya'' (motor organs) are hands (''hasta''), feet (''pada''), anus (''payu''), penis (''upastha'') and tongue (''jihva''). [7]
==== Seat of ''chetana'' (consciousness) ====
हृदयं चेतनाधिष्ठानमेकम्||८||
hr̥dayaṁ cētanādhiṣṭhānamēkam||8||
hRudayaM cetanAdhiShThAnamekam||8||
''Hridaya'' (heart) alone is the seat of ''chetana'', or consciousness. [8]
==== Ten vital seats ====
दश प्राणायतनानि; तद्यथा- मूर्धा, कण्ठः, हृदयं, नाभिः, गुदं, बस्तिः, ओजः, शुक्रं, शोणितं, मांसमिति|
तेषु षट् पूर्वाणि मर्मसङ्ख्यातानि||९||
daśa prāṇāyatanāni; tadyathā-mūrdhā, kaṇṭhaḥ, hr̥dayaṁ, nābhiḥ, gudaṁ, bastiḥ, ōjaḥ, śukraṁ, śōṇitaṁ,māṁsamiti|
tēṣu ṣaṭ pūrvāṇi marmasaṅkhyātāni||9||
dasha prANAyatanAni; tadyathA- mUrdhA, kaNThaH, hRudayaM, nAbhiH, gudaM, bastiH, ojaH, shukraM,shoNitaM, mAMsamiti|
teShu ShaT pUrvANi marmasa~gkhyAtAni||9||
<div style="text-align:justify;">
There are ten ''pranayatana'' in the body, i.e. ''murdha'' (head), ''kantha'' (throat), ''hridaya'' (heart), ''nabhi'' (umbilicus), ''guda'' (anus), ''basti'' (urinary bladder), ''oja'' (essence of vitality), ''shukra'' (semen, ovum), ''shonita'' (blood), and ''mamsa'' (muscle tissue). Of these, the first six are the ''marmas''. [9]
</div>
==== ''Koshthanga'' ====
पञ्चदश कोष्ठाङ्गानि; तद्यथा- नाभिश्च, हृदयं च, क्लोम च, यकृच्च, प्लीहा च, वृक्कौ च, बस्तिश्च, पुरीषाधारश्च,आमाशयश्च, पक्वाशयश्च, उत्तरगुदं च, अधरगुदं च, क्षुद्रान्त्रं च, स्थूलान्त्रं च, वपावहनं चेति||१०||
pañcadaśa kōṣṭhāṅgāni; tadyathā-nābhiśca, hr̥dayaṁ ca, klōma ca, yakr̥cca, plīhā ca, vr̥kkau ca, bastiśca,purīṣādhāraśca, āmāśayaśca, pakvāśayaśca, uttaragudaṁ ca, adharagudaṁ ca, kṣudrāntraṁ ca,sthūlāntraṁ ca, vapāvahanaṁ cēti||10||
pa~jcadasha koShThA~ggAni; tadyathA- nAbhishca, hRudayaM ca, kloma ca, yakRucca, plIhA ca, vRukkauca, bastishca, purIShAdhArashca, AmAshayashca, pakvAshayashca, uttaragudaM ca, adharagudaM ca,kShudrAntraM ca, sthUlAntraM ca, vapAvahanaM ceti||10||
<div style="text-align:justify;">
There are fifteen ''koshthangas'', i.e. ''nabhi'' (umbilicus, mesentery), ''hridaya'' (heart), ''kloma'' (pancreas), ''yakrita'' (liver), ''pleeha'' (spleen), ''vrikka'' ( two kidneys), ''basti'' (urinary bladder), ''purishadhara'' (sigmoid colon), ''amashaya'' (stomach), ''pakvashaya'' (cecum), ''uttaraguda'' (rectum), ''adharaguda'' (anus), ''kshudrantra'' (small intestine), ''sthulantra'' (large intestine), and ''vapavahana'' (omentum). [10]
</div>
==== ''Pratyanga varnana'' ====
षट्पञ्चाशत् प्रत्यङ्गानि षट्स्वङ्गेषूपनिबद्धानि, यान्यपरिसङ्ख्यातानि पूर्वमङ्गेषु परिसङ्ख्यायमानेषु, तान्यन्यैःपर्यायैरिह प्रकाश्यानि भवन्ति|
तद्यथा- द्वे जङ्घापिण्डिके, द्वे ऊरुपिण्डिके, द्वौ स्फिचौ, द्वौ वृषणौ, एकं शेफः, द्वे उखे, द्वौ वङ्क्षणौ, द्वौ कुकुन्दरौ, एकंबस्तिशीर्षम्, एकमुदरं, द्वौ स्तनौ, द्वौ श्लेष्मभुवौ , द्वे बाहुपिण्डिके, चिबुकमेकं, द्वावोष्ठौ, द्वे सृक्कण्यौ, द्वौदन्तवेष्टकौ, एकं तालु, एका गलशुण्डिका, द्वे उपजिह्विके, एका गोजिह्विका, द्वौ गण्डौ, द्वे कर्णशष्कुलिके, द्वौ कर्णपुत्रकौ,द्वे अक्षिकूटे, चत्वार्यक्षिवर्त्मानि, द्वे अक्षिकनीनिके, द्वे भ्रुवौ, एकाऽवटुः, चत्वारि पाणिपादहृदयानि||११||
ṣaṭpañcāśat pratyaṅgāni ṣaṭsvaṅgēṣūpanibaddhāni, yānyaparisaṅkhyātāni pūrvamaṅgēṣuparisaṅkhyāyamānēṣu, tānyanyaiḥ paryāyairiha prakāśyāni bhavanti|
tadyathā- dvē jaṅghāpiṇḍikē, dvē ūrupiṇḍikē, dvau sphicau, dvau vr̥ṣaṇau, ēkaṁ śēphaḥ, dvē ukhē, dvauvaṅkṣaṇau, dvau kukundarau, ēkaṁ bastiśīrṣam, ēkamudaraṁ, dvau stanau, dvau ślēṣmabhuvau , dvēbāhupiṇḍikē, cibukamēkaṁ, dvāvōṣṭhau, dvē sr̥kkaṇyau, dvau dantavēṣṭakau, ēkaṁ tālu, ēkā galaśuṇḍikā,dvē upajihvikē, ēkā gōjihvikā, dvau gaṇḍau, dvē karṇaśaṣkulikē, dvau karṇaputrakau, dvē akṣikūṭē,catvāryakṣivartmāni, dvē akṣikanīnikē, dvē bhruvau, ēkā'vaṭuḥ, catvāri pāṇipādahr̥dayāni||11||
ShaTpa~jcAshat pratya~ggAni ShaTsva~ggeShUpanibaddhAni, yAnyaparisa~gkhyAtAnipUrvama~ggeShu parisa~gkhyAyamAneShu, tAnyanyaiH paryAyairiha prakAshyAni bhavanti|
tadyathA- dve ja~gghApiNDike, dve UrupiNDike, dvau sphicau, dvau vRuShaNau, ekaM shephaH, dveukhe, dvau va~gkShaNau, dvau kukundarau, ekaM bastishIrSham, ekamudaraM, dvau stanau, dvaushleShmabhuvau , dve bAhupiNDike, cibukamekaM, dvAvoShThau, dve sRukkaNyau, dvaudantaveShTakau, ekaM tAlu, ekA galashuNDikA, dve upajihvike, ekA gojihvikA, dvau gaNDau, dvekarNashaShkulike, dvau karNaputrakau, dve akShikUTe, catvAryakShivartmAni, dve akShikanInike, dvebhruvau, ekA~avaTuH, catvAri pANipAdahRudayAni||11||
The ''shadanga sharira'' could be divided further into fifty-six ''pratyangas'' (subdivisions). These include constituents or structures that were not described earlier. The fifty-six ''pratyangas'' include
*Two janghanapindaka (calf regions),
*Two ''urupindaka'' (thigh regions),
*Two ''sphik'' (gluteal regions),
*Two ''vrishana'' (testicles),
*One ''shepha'' (penis),
*Two ''ukha'' (axillae),
*Two ''vankshana'' (inguinal regions),
*Two ''kukundara'' (ischial regions),
*One ''bastishirsha'' (mons pubis),
*One ''udara'' (abdomen),
*Two ''stana'' (breasts),
*Two ''sleshmabhuvou'' (thoracobrachial regions),
*Two ''bahupindaka'' (forearms),
*One ''chibuka'' (chin),
*Two ''oshtha'' (lips),
*Two ''srakkani'' (margins of lips),
*Two ''dantaveshtaka'' (gums),
*One ''talu'' (palate),
*One ''galashundika'' (uvula),
*Two ''upajihvika'' (Tonsils),
*One ''gojihvika'' (glottis),
*Two ''ganda'' (cheek regions),
*Two ''karnashashkuli'' (auricles of ear),
*Two ''karnaputraka'' (tregus),
*Two ''akshikuta'' (orbits),
*Four ''akshivartma'' (eye lids),
*Two ''akshikaninika'' (pupils),
*Two ''bhruva'' (eye brows),
*One ''avatu'' (''nucha''),
*Four ''panipadahridaya'' (two palmar heart and two plantar hearts). [11]
==== External orifice of the body ====
नव महन्ति छिद्राणि- सप्त शिरसि, द्वे चाधः||१२||
nava mahanti chidrāṇi- sapta śirasi, dvē cādhaḥ||12||
nava mahanti chidrANi- sapta shirasi, dve cAdhaH||12||
There are nine major orifices or openings in the body, seven of which are located in the head region (two ocular, two nasal, two auditory and one oral) and two in the lower part of the body (one anal and one urethral).[12]
==== ''Pratyaksha sharira'' ====
एतावद्दृश्यं शक्यमपि निर्देष्टुम्||१३||
ētāvaddr̥śyaṁ śakyamapi nirdēṣṭum||13||
etAvaddRushyaM shakyamapi nirdeShTum||13||
As apparent (from skin to palm of the hands and soles of the feet), this is the only demonstrable topographical anatomy (''pratyaksha sharira'') which can be visualized by the normal eyes, and counted with certainty.[13]
==== Rationally computable ''shira, dhamani, snayu,'' etc. ====
अनिर्देश्यमतः परं तर्क्यमेव|
तद्यथा- नव स्नायुशतानि, सप्त सिराशतानि, द्वे धमनीशते, चत्वारि पेशीशतानि, सप्तोत्तरं मर्मशतं, द्वे सन्धिशते,एकोनत्रिंशत्सहस्राणि नव च शतानि षट्पञ्चाशत्कानि सिराधमनीनामणुशः प्रविभज्यमानानां मुखाग्रपरिमाणं, तावन्ति चैवकेशश्मश्रुलोमानीति|
एतद्यथावत्सङ्ख्यातं त्वक्प्रभृति दृश्यं, तर्क्यमतः परम्|
एतदुभयमपि न विकल्पते, प्रकृतिभावाच्छरीरस्य||१४||
anirdēśyamataḥ paraṁ tarkyamēva|
tadyathā- nava snāyuśatāni, sapta sirāśatāni, dvē dhamanīśatē, catvāri pēśīśatāni, saptōttaraṁmarmaśataṁ, dvē sandhiśatē, ēkōnatriṁśatsahasrāṇi nava ca śatāni ṣaṭpañcāśatkānisirādhamanīnāmaṇuśaḥ pravibhajyamānānāṁ mukhāgraparimāṇaṁ, tāvanti caiva kēśaśmaśrulōmānīti|
ētadyathāvatsaṅkhyātaṁ tvakprabhr̥ti dr̥śyaṁ, tarkyamataḥ param|
ētadubhayamapi na vikalpatē, prakr̥tibhāvāccharīrasya||14||
anirdeshyamataH paraM tarkyameva|
tadyathA- nava snAyushatAni, sapta sirAshatAni, dve dhamanIshate, catvAri peshIshatAni, saptottaraMmarmashataM, dve sandhishate, ekonatriMshatsahasrANi nava ca shatAni ShaTpa~jcAshatkAnisirAdhamanInAmaNushaH pravibhajyamAnAnAM mukhAgraparimANaM, tAvanti caivakeshashmashrulomAnIti|
etadyathAvatsa~gkhyAtaM tvakprabhRuti dRushyaM, tarkyamataH param|
etadubhayamapi na vikalpate, prakRutibhAvAccharIrasya||14||
<div style="text-align:justify;">
Starting this verse, the given anatomical descriptions will only be based on logic and reasoning, as the fixity of the count of the “rationally computable” constituents of the body is not possible. These include tissues like ligaments, muscles, veins and arteries. For example, the estimated count of ''snayu'' (ligaments) in this text has been put at 900, ''shira'' (veins) at 700, ''dhamani'' (arteries) at 200, ''peshi'' (muscles) at 400, ''marmas'' (vital parts) at 107, ''sandhi'' (joints) at 200, ''shira dhamani anuroopmukh'' (capillaries) at 29,956 and the same count (29,956) has been put for the number of ''kesh'' (hair), ''smashru'' (beard) and ''loma'' (body hair). Thus, an attempt has been made to enumerate all visible structures within the body - from the skin to the limbs down to all the “rationally computable” (''anumangamya'') structures. As described, these two types (''drashya'' and ''tarkamat'') of numbers do not change in status until an anomaly occurs.[14]
</div>
==== ''Anjali pramana'' (quantum of ''rasadi dhatu'') ====
यत्त्वञ्जलिसङ्ख्येयं तदुपदेक्ष्यामः; तत् परं प्रमाणमभिज्ञेयं, तच्च वृद्धिह्रासयोगि, तर्क्यमेव|
तद्यथा- दशोदकस्याञ्जलयः शरीरे स्वेनाञ्जलिप्रमाणेन, यत्तु प्रच्यवमानं पुरीषमनुबध्नात्यतियोगेन तथा मूत्रं रुधिरमन्यांश्चशरीरधातून्, यत्तु सर्वशरीरचरं बाह्या त्वग्बिभर्ति, यत्तु त्वगन्तरे व्रणगतं लसीकाशब्दं लभते, यच्चोष्मणाऽनुबद्धं लोमकूपेभ्योनिष्पतत् स्वेदशब्दमवाप्नोति, तदुदकं दशाञ्जलिप्रमाणं; नवाञ्जलयः पूर्वस्याहारपरिणामधातोः, यं ‘रस’ इत्याचक्षते; अष्टौशोणितस्य, सप्त पुरीषस्य, षट् श्लेष्मणः, पञ्च पित्तस्य, चत्वारो मूत्रस्य, त्रयो वसायाः, द्वौ मेदसः, एको मज्जायाः,मस्तिष्कस्यार्धाञ्जलिः, शुक्रस्य तावदेव प्रमाणं, तावदेव [१] श्लैष्मिकस्यौजस इति| एतच्छरीरतत्त्वमुक्तम्||१५||
yattvañjalisaṅkhyēyaṁ tadupadēkṣyāmaḥ; tat paraṁ pramāṇamabhijñēyaṁ, tacca vr̥ddhihrāsayōgi,tarkyamēva|
tadyathā- daśōdakasyāñjalayaḥ śarīrē svēnāñjalipramāṇēna, yattu pracyavamānaṁpurīṣamanubadhnātyatiyōgēna tathā mūtraṁ rudhiramanyāṁśca śarīradhātūn, yattu sarvaśarīracaraṁbāhyā tvagbibharti, yattu tvagantarē vraṇagataṁ lasīkāśabdaṁ labhatē, yaccōṣmaṇā'nubaddhaṁlōmakūpēbhyō niṣpatat svēdaśabdamavāpnōti, tadudakaṁ daśāñjalipramāṇaṁ; navāñjalayaḥpūrvasyāhārapariṇāmadhātōḥ, yaṁ ‘rasa’ ityācakṣatē; aṣṭau śōṇitasya, sapta purīṣasya, ṣaṭ ślēṣmaṇaḥ,pañca pittasya, catvārō mūtrasya, trayō vasāyāḥ, dvau mēdasaḥ, ēkō majjāyāḥ, mastiṣkasyārdhāñjaliḥ,śukrasya tāvadēva pramāṇaṁ, tāvadēva ślaiṣmikasyaujasa iti|
ētaccharīratattvamuktam||15||
yattva~jjalisa~gkhyeyaM tadupadekShyAmaH; tat paraM pramANamabhij~jeyaM, taccavRuddhihrAsayogi, tarkyameva|
tadyathA- dashodakasyA~jjalayaH sharIre svenA~jjalipramANena, yattu pracyavamAnaMpurIShamanubadhnAtyatiyogena tathA mUtraM rudhiramanyAMshca sharIradhAtUn, yattusarvasharIracaraM bAhyA tvagbibharti, yattu tvagantare vraNagataM lasIkAshabdaM labhate,yaccoShmaNA~anubaddhaM lomakUpebhyo niShpatat svedashabdamavApnoti, tadudakaMdashA~jjalipramANaM; navA~jjalayaH pUrvasyAhArapariNAmadhAtoH, yaM ‘rasa’ ityAcakShate; aShTaushoNitasya, sapta purIShasya, ShaT shleShmaNaH, pa~jca pittasya, catvAro mUtrasya, trayo vasAyAH,dvau medasaH, eko majjAyAH, mastiShkasyArdhA~jjaliH, shukrasya tAvadeva pramANaM, tAvadeva shlaiShmikasyaujasa iti|
etaccharIratattvamuktam||15||
<div style="text-align:justify;">
Now we will describe the ''anjali pramana'' (literally, measurable by joining both palms. The quantity in it is ''anjali'' of one’s hand) by which bodily constituents or ''rasadi dhatu'', could be quantified in our body. The quantity of ''dhatus'' given here are the maximum quantity of respective constituents in the body and it may increase or decrease. Their variability could be measured logically. Water within a body is equal to ten ''anjalis'' of the person. The elimination of water in feces and sweat is (because of) excess quantity of water. Similarly, water is present in a specific proportion in urine, blood and other ''dhatus'' in the body. ''Jala'' within the whole body is stored in the external layer of the ''twacha'' (''udakadhara''). Water designated as ''lasika'', in the condition of a wound in the skin, is excreted through the hair pockets (sweat glands) as ''sweda'' (sweat). The quantum of water is equal to ten ''anjalis''. After the digestion of food, ''rasa'' (or ''rasa dhatu'') is equal to nine ''anjalis'', ''rakta'' (blood) is eight ''anjalis'', seven ''anjalis'' is ''purisha'' (feces), six ''anjalis'' is ''shleshma'', five ''anjalis'' is ''pitta'', four ''anjalis'' is ''mutra'', three ''anjalis'' is ''vasa'', two ''anjalis'' is ''meda'', one ''anjali'' is ''majja'', half ''anjali'' is ''mastishka'', half ''anjali'' is ''shukra'' and half ''anjali'' is ''slaeshmic ojas''. This concludes the measurement of body constituents. [15]
</div>
==== ''Panchamahabhautic'' (basic elemental) consideration of the body constituents ====
तत्र यद्विशेषतः स्थूलं स्थिरं मूर्तिमद्गुरुखरकठिनमङ्गं नखास्थिदन्तमांसचर्मवर्चःकेशश्मश्रुलोमकण्डरादि तत् पार्थिवं गन्धोघ्राणं च; यद्द्रवसरमन्दस्निग्धमृदुपिच्छिलं रसरुधिरवसाकफपित्तमूत्रस्वेदादि तदाप्यं रसो रसनं च; यत् पित्तमूष्मा च यो या चभाः शरीरे तत् सर्वमाग्नेयं रूपं दर्शनं च; यदुच्छ्वासप्रश्वासोन्मेषनिमेषाकुञ्चनप्रसारणगमनप्रेरणधारणादि तद्वायवीयं स्पर्शःस्पर्शनं च; यद्विविक्तं यदुच्यते महान्ति चाणूनि स्रोतांसि तदान्तरीक्षं शब्दः श्रोत्रं च; यत् प्रयोक्तृ तत् प्रधानं बुद्धिर्मनश्च|
इति शरीरावयवसङ्ख्या यथास्थूलभेदेनावयवानां निर्दिष्टा||१६||
tatrayadviśēṣataḥsthūlaṁsthiraṁ mūrtimadgurukharakaṭhinamaṅgaṁnakhāsthidantamāṁsacarmavarcaḥkēśaśmaśrulōmakaṇḍarādi tat pārthivaṁ gandhō ghrāṇaṁ ca;yaddravasaramandasnigdhamr̥dupicchilaṁ rasarudhiravasākaphapittamūtrasvēdādi tadāpyaṁ rasōrasanaṁ ca; yat pittamūṣmā ca yō yā ca bhāḥ śarīrē tat sarvamāgnēyaṁ rūpaṁ darśanaṁ ca;yaducchvāsapraśvāsōnmēṣanimēṣākuñcanaprasāraṇagamanaprēraṇadhāraṇādi tadvāyavīyaṁ sparśaḥsparśanaṁ ca; yadviviktaṁ yaducyatē mahānti cāṇūni srōtāṁsi tadāntarīkṣaṁ śabdaḥ śrōtraṁ ca; yatprayōktr̥ tat pradhānaṁ buddhirmanaśca|
iti śarīrāvayavasaṅkhyā yathāsthūlabhēdēnāvayavānāṁ nirdiṣṭā||16||
tatra yadvisheShataH sthUlaM sthiraM mUrtimadgurukharakaThinama~ggaMnakhAsthidantamAMsacarmavarcaHkeshashmashrulomakaNDarAdi tat pArthivaM gandho ghrANaM ca;yaddravasaramandasnigdhamRudupicchilaM rasarudhiravasAkaphapittamUtrasvedAdi tadApyaM rasorasanaM ca; yat pittamUShmA ca yo yA ca bhAH sharIre tat sarvamAgneyaM rUpaM darshanaM ca;yaducchvAsaprashvAsonmeShanimeShAku~jcanaprasAraNagamanapreraNadhAraNAdi tadvAyavIyaMsparshaH sparshanaM ca; yadviviktaM yaducyate mahAnti cANUni srotAMsi tadAntarIkShaM shabdaHshrotraM ca; yat prayoktRu tat pradhAnaM buddhirmanashca|
iti sharIrAvayavasa~gkhyA yathAsthUlabhedenAvayavAnAM nirdiShTA||16||
<div style="text-align:justify;">
Specific expressions, structures, and organs of the body could be attributed to specific fundamental elements (''mahabhutas'') that they are made up of and, thus, display the properties of those elements. This verse lists them thus:
*''Bhavas'' (expressions) of the body, specifically, ''sthula'' (solid), ''sthira'' (fixed), ''moortimana'' (visible), ''guru'' (heavy), ''khara'' (rough) and ''kathina'' (hard) are ''parthiva'' (''prithvi tattva pradhan'', or ''prithvi'' predominant properties), and are the qualities of ''nakha'' (nails), ''asthi'' (bones), ''danta'' (teeth), ''mamsa'' (muscle), ''charma'' (skin), ''varchas'' (feces), ''kesha'' (hair), ''smashru'' (beard), ''loma'' (body hair), ''kandara'' (tendons). All ''gandha'' (smells, olfactory senses) are ''parthiva'' (''prithvi guna pradhan'', i.e., of the qualities of ''prithvi'').
*''Dravyas'', especially ''drava'' (liquid), ''sara'' (slight movable), ''manda'' (slow), ''snigdha'' (unctuous), ''mridu'' (soft), and ''pichchhil'' (viscous), are all ''apya bhava'' (''jala tattva pradhan'', or ''jala'' predominant properties), and are the properties of bodily constituents such as ''rasa'' (plasma), ''rakta'' (blood), ''vasa'' (muscle fat), ''kapha, pitta, mootra'' (urine) and ''sweda'' (sweat). Taste (''rasa'') and all gustatory senses are ''apya'' (''jala guna pradhan'', i.e., are predominantly of the qualities of ''jala'').
*Those which are in the form of ''pitta'', and possess properties such as ''ushma'' (hot, warm), ''bha'' (shine or aura around the body), possess ''rupa'' (with a visible form) and are associated with vision sense organs are ''agneya'' (''agni guna pradhan'', or predominantly of the qualities of ''agni'').
*Functions such as ''uchhwas'' (inspiration, or breathing in), ''prashwas'' (expiration, or breathing out), ''unmesh'' (opening of eyes), ''nimesh'' (closing of eyes), ''akunchan'' (flexion), ''prasarana'' (extension), ''gamana'' (movement), ''prerana'' (expulsion), ''dharana'' (retention) and all tactile senses are ''vayaviya bhava'' (''vayu'' predominant expressions).
*Those that are ''vivikta avayava'' (structures with space and openings), major and minor ''srotasas'', sound and hearing sensory organs are all ''akashiya bhava''.
*That which is the owner of all the ''bhavas'' and is the user of them, the ''jeevatma'', which is the head (''pradhana''), the soul. Including the ''buddhi'' and ''mana'', these three are the systemic sources for perception of information and development of knowledge in the body.
Thus, the key organizing/governing components of body have been described briefly. [16]
</div>
==== Innumerability of the organic constituents of the body ====
शरीरावयवास्तु परमाणुभेदेनापरिसङ्ख्येया भवन्ति, अतिबहुत्वादतिसौक्ष्म्यादतीन्द्रियत्वाच्च|
तेषां संयोगविभागे परमाणूनां कारणं वायुः कर्मस्वभावश्च||१७||
śarīrāvayavāstu paramāṇubhēdēnāparisaṅkhyēyā bhavanti, atibahutvādatisaukṣmyādatīndriyatvācca|
tēṣāṁ saṁyōgavibhāgē paramāṇūnāṁ kāraṇaṁ vāyuḥ karmasvabhāvaśca||17||
sharIrAvayavAstu paramANubhedenAparisa~gkhyeyA bhavanti,atibahutvAdatisaukShmyAdatIndriyatvAcca|
teShAM saMyogavibhAge paramANUnAM kAraNaM vAyuH karmasvabhAvashca||17||
<div style="text-align:justify;">
The structures and components of body, if differentiated at micro level (''paramanu bheda''), are innumerable (''aparisankhyeya'') because of abundance (''atibahuta''), highly subtleness (''atisukshma''), and imperceptibility(''atindriya''). The conjoining or cell combination or unification (''samyoga'') and the split or cell division (''vibhaga'') of ''deha paramanu'' - both are caused by ''vayu'' and ''karmaswabhava''. [17]
</div>
==== Importance of the knowledge of the organs and structures of the body ====
तदेतच्छरीरं सङ्ख्यातमनेकावयवं दृष्टमेकत्वेन सङ्गः, पृथक्त्वेनापवर्गः|
तत्र प्रधानमसक्तं सर्वसत्तानिवृत्तौ निवर्तते इति||१८||
tadētaccharīraṁ saṅkhyātamanēkāvayavaṁ dr̥ṣṭamēkatvēna saṅgaḥ, pr̥thaktvēnāpavargaḥ|
tatra pradhānamasaktaṁ sarvasattānivr̥ttau nivartatē iti||18||
tadetaccharIraM sa~gkhyAtamanekAvayavaM dRuShTamekatvena sa~ggaH, pRuthaktvenApavargaH|
tatra pradhAnamasaktaM sarvasattAnivRuttau nivartate iti||18||
<div style="text-align:justify;">
The body can be considered as an organization of organs and systems. The conjunction of all the organs within the body is known as ''sanga'' (attachment) and their detachment is ''apavarga'' (to go away). As such when the owner of the body sees himself detached from the material world and observes his own body as a detached observer, he is free from all passions, emotions and attachments with the creature comforts and the trappings of the material world, and is said to be on the path to salvation. In other words, when the cycle of ''sanyoga'' and ''vibhaga'', or unification and division, comes to an end, the holder (''pradhan'') of the body naturally finds ultimate salvation. [18]
</div>
==== Summary ====
तत्र श्लोकौ-
शरीरसङ्ख्यां यो वेद सर्वावयवशो भिषक्|
तदज्ञाननिमित्तेन स मोहेन न युज्यते||१९||
tatra ślōkau-
śarīrasaṅkhyāṁ yō vēda sarvāvayavaśō bhiṣak|
tadajñānanimittēna sa mōhēna na yujyatē||19||
tatra shlokau-
sharIrasa~gkhyAM yo veda sarvAvayavasho bhiShak|
tadaj~jAnanimittena sa mohena na yujyate||19||
The physician who knows the body as an organization of organs and systems, along with all their constituents, never falls into any ''moha'' (attachment, lure of the body) caused due to ignorance. [19]
अमूढो मोहमूलैश्च न दोषैरभिभूयते|
निर्दोषो निःस्पृहः शान्तः प्रशाम्यत्यपुनर्भवः||२०||
amūḍhō mōhamūlaiśca na dōṣairabhibhūyatē|
nirdōṣō niḥspr̥haḥ śāntaḥ praśāmyatyapunarbhavaḥ||20||
amUDho mohamUlaishca na doShairabhibhUyate|
nirdoSho niHspRuhaH shAntaH prashAmyatyapunarbhavaH||20||
<div style="text-align:justify;">
A truly wise person, one who knows of every aspect of the body, does not fall into the afflictions of ''doshas'' caused due to ignorance. Moreover, after knowing the secrets of life and after becoming free from the trappings of ''raga'' and ''dvesha'' (attachment and detachment), as well as after becoming ''nirdushta'' (fair, neutral, free from the qualities of ''raja'' and ''tama'') and ''sprasharahit'' (unflappable, calm), he becomes free from the cycle of birth and death and gains ultimate lasting peace.[20]
=== ''Tattva Vimarsha'' ===
*The physician who knows the body as an organization of organs and systems, along with all their constituents and has knowledge of not only gross anatomy but of the cellular, sub cellular and deepest level of their function can manage diseases and prevent recurrence. This leads to a disease free status. One who knows of every aspect of the body, does not fall into the afflictions of ''doshas'' caused due to ignorance.
*The knowledge of anatomy and physiology is important to understand prognosis of disease in terms its severity and probable duration of treatment. It also indicates towards the probable receptors for disease specific target oriented drug delivery system.
*The quantification of ''dhatu'' is personified in terms of ''anjali'' measurement. Therefore the standard limits of physiological fluids will vary according to ''anjali'' of a person.
*The basic ''panchabhautik'' composition of body constituents shall be considered while treating a disease.
=== ''Vidhi Vimarsha'' ===
==== Special significance of skin in Ayurveda ====
The skin is the biggest organ of the body and makes the integumentary system, comprising of hair, nails etc. It constitutes 16% of body weight. It is a combined product of ectoderm as well as of mesoderm. Akin to the nervous system, epidermis is developed from the ectoderm, whereas dermis is derived from the mesoderm. The skin, from the standpoint of Ayurveda, is the ''upadhatu'' of ''mamsa dhatu'', which may be because of their common germinal base. The muscles and dermis - both are organs of mesoblastic origin. Dermis is a well vascularized structure and is a very active organ. Epidermis has no blood vessels and only its basal layers get nourishment from the source of dermis next to it. The skin is also called ''mamsavaha srotas'' (Ch. Vi. 5/7) since the skin synthesises<ref>Elaine N. Marieb, Human Anatomy and Physiology, 6th edition, pearson Education, Inc. Ch 24.</ref> Vitamin D, a basic source for calcium. Calcium is assimilated and absorbed from the gut with the help of vitamin D. The physiology of action in the muscle is totally calcium dependent. This is why ''twak'' is considered to be the ''mula'' (root) of ''mamsavaha srotas''<ref> Guyton & Hall, textbook of medical Physiology, 10th edition, saunders, Philadelphia, Chapter 6. </ref>.
The skin is made up of three basic layers:
*Epidermal layer
*Dermal layer, and
*Hypodermal layer
The epidermal layer, also called epidermis, is the outermost layer and is derived from the ectoderm. This provides an overcoat type of an arrangement to the body, so that the internal organs of the body are physically protected. There are two types of skin cells – keratinized (or those that synthesize keratin, a structural protein that is core to the protective properties of skin) and non-keratinized. The epidermis is made up of various layers of keratinized cells, as are nails, hair and wool. From the level of its base (inner side) to the outermost surface the epidermis consists of the following layers:
*Stratum Basale
*Stratum Spinosum
*Stratum Granulosum
*Stratum Lucidum
*Stratum Corneum
The development of skin (''twacha'') and its anatomy is described. (Sushruta sharira-4/3&4).
''Twacha'' (skin) develops during the formation of the human body, in a similar chronological order, just the way a membrane of cream develops over warm milk. He theorized a seven-layer structure of the skin consisting of:
*''Avabhasini'',
*''Lohita'',
*''Sweta'',
*''Tamra'',
*''Vedini'',
*''Rohini'', and
*''Mansadhara twacha''3
These layers of ''twacha'' are analogous with the layers of epidermis, dermis and hypodermis.
There are several dissimilarities in the view points of two texts of [[Charaka Samhita]] and ''Sushruta samhita''. Per Charaka, there are six layers in ''twacha'' whereas seven layers per Sushruta. On the basis of clinical features, the last layer in Charaka’s structural model of the skin is ''vedini'' whereas ''vedini'' is the fifth layer in Sushruta’s model. Next, Charaka did not present any developmental theory on ''twacha'' whereas Sushruta wrote the ''Santanaka Siddhanta'' on this account. Finally, the basis of nomenclatures presented in Charaka’s and Sushruta’s models are also different. Charaka’s model has more clinical aspects while Sushruta’s model has more anatomical and physical aspects considered. The below table is a high-level comparison of the Charaka and the Sushruta models of Skin.
</div>
{| class="wikitable"
! rowspan="1"| Sr. no.
! rowspan="1"| Layers of Twacha (Charaka)
! rowspan="1"| Layers of Twacha (Sushruta)
|-
| 1- || Udakadhara twacha || Awabhasini
|-
| 2- || Asrugdhara twacha || Lohita
|-
| 3- || Tritiya, seat of sidhma & kilas || Shweta
|-
| 4- || Chaturthi, seat of dadru & kushtha || Tamra
|-
| 5- || Panchami, seat of alaji & vidradhi || Vedini
|-
| 6- || Seat of pain (causes pain when cut) || Rohini
|-
| 7- || --------------------------------------------------- || Mamsadhara twacha
|-
|}
<div style="text-align:justify;">
Correlating Charaka’s layers with the modern scientific names for the various layers of skin, we come up with the following mapping:
• The first layer, udakadhara twacha could be the same as stratum corneum.
• The second layer, Asrugdhara twacha could be the same as stratum lucidum,
• The third layer, Tritiya twacha could be the same as stratum granulosum,
• The fourth layer, Chaturthi twacha could be stratum germinosum (combination of spinosum and basale layers),
• The fifth layer, Panchami twacha could be the Papillary layer, and
• The sixth layer, Shashthi twacha could be the Reticular layer.
Alternative views on this topic could be researched further, since the papillary and reticular layers are the part of dermis and anatomically represent a single organic entity therefore the fifth and sixth layers of Charaka’s ''twacha'' model may correlate with the dermis layer together. The same goes with Sushruta’s ''vedini'' and ''rohini'' layers (excluding Sushruta’s seventh layer from our analysis).
From the standpoint of clinical importance of the ''twacha sharira'', the function of the skin is not described clearly in Ayurveda. However, the functions of skin could be inferred through references in various ''samhitas''. Charaka has presented the characteristics of the ''twaksara purusha'' (excellence of ''twak'') under [[Vimana Sthana]]4, which details the functions and properties of normal skin . The skin of the ''twakasara purusha'' should be unctuous (''snigdha''), smooth (''shlakshna''), soft (''mridu''), clean/glorious (''prasanna''), fine (''sukshma''), close/not loose (''alpa''), thick (''gambhir''), with soft hair (''sukumar loma''), and radiant (''saprabha''). This type of excellent quality of skin is indicative of a lot of qualities in an individual, including happiness, prosperity, splendor, pleasure, intelligence, knowledge, health, contentment and longevity. (Ch. Vi.8/103)
As such, the texture or appearance of the skin is reflective of the inner state of a person. If skin is healthy, it is likely that other organs of the body will be healthy as well. Symptoms of sickness of other systems get reflected on the skin. So, if the skin is taken good care of, or observed carefully, it would help take preventive measures and generally would benefit other bodily systems also. This realization has led to the development of various therapies under the general umbrella of [[Panchakarma]]. According to Sushruta, the skin is the seat of ''bhrajaka pitta'', and because of ''bhrajak pitta''5, the skin catalyzes the metabolic processes related with the therapies of ''abhyanga, parisheka, avagaha, alepana, udvartana'', etc.(Su.Su.21/10)
Skin is largely an organ of ectodermal origin, like the nervous system. All sensory organs have the same basis for development and because the nervous system has evolved to ensure the protection/survival of the organism against the changes in internal and external environments (and this explanation could be extended to the evolution of the other sensory organs as well), these are derived from the ectoderm. As such, the skin gives the person his “personality” and identity. Sharangadhara writes that healthy skin enhances wisdom, knowledge and overall health of an individual, while describing the functions of ''pitta''6 (''Sharangadhara purva khanda'' 5/30).[4]
Sushruta has also quoted that the body has six divisions. In the chapter ''Sharirasankhya Vyakarana'', he specially quotes that the ''garbha'' (embryo) is formed after fertilization of ovum with sperm, which is charged with ''chetana'' (consciousness) and in which ''vayu'' functions for division, ''teja'' functions for ''pachana, apa'' functions for ''kledana'' (moisture), ''prithvi'' functions for ''samhanana'' (compactness) and ''akasha'' functions for ''vivardhana'' (growth). Such a ''garbha'', when attains the development of organs and structures like ''hasta, pada, jihva, ghrana, karna, nitamba'' etc. then is called ''sharira''. That ''sharira'' is ''shadanga sharira''7, having four limbs (two upper limb and two lower limbs), fifth is the torso and the sixth is the head (Sushruta Sharira 5/2)[5]
</div>
==== ''Asthi sharira''(description of bones) ====
To add more clarity in topographical knowledge, the bones as said by Charaka are presented in table.
{| class="wikitable"
! rowspan="1"| Ser. no.
! rowspan="1"| Name of the bone by Charaka
! rowspan="1"| Number
! rowspan="1"| Modern consideration
|-
| 1 || Danta (teeth) || 32 || Teeth are not considered as bone
|-
| 2 || Danta Udukhal (teeth sockets) || 32 || Nil
|-
| 3 || Nakha (nails) || 20 || Nails are not considered as bone
|-
| 4 || Angulyasthi (phalanges) || 60 || Phalanges are 56 (thumb has only 2)
|-
| 5 || Shalakasthi(metacarpals, metatarsals) || 20 || Same
|-
| 6 || Shalakashraya (distal carpals & tarsals) || 4 || Distal carpals & tarsals are 4 in each limb (total 16)
|-
| 7 || Parshni (calcaneus) || 2 || Same
|-
| 8 || Gulphasthi (talus & navicular) || 4 || Same
|-
| 9 || Manikasthi (proximal carpal bones) || 2 || Proximal carpal bones are 8 (4 in each side)
|-
| 10|| Aratni (radius & ulna) || 4 || Same
|-
| 11|| Janghasthi (tibia & fibula) || 4 || Same
|-
| 12|| Janvasthi || 2 || Nil (no such bone, menisci may be taken but these are 4 in number, optionally left and right can be taken as one unit)
|-
| 13|| Janukapal (patella) || 2 || Same
|-
| 14|| Urunalaka (femur) || 2 || Same
|-
| 15|| Bahunalaka (humerus) || 2 || Same
|-
| 16|| Ansasthi (clavicle) || 2 || As clavicle is important bone making shoulder, so clavicle is a better option for Ansasthi.
|-
| 17|| Ansaphalakasthi (scapula) || 2 || Same
|-
| 18|| Akshakasthi (sternoclavicular articular disc) || 2 || Amsasthi suits to be said for clavicle & Amsaphalakasthi for scapula, hence the disc suits to be taken for Akshakasthi.
|-
| 19|| Jatru (sternum) || 1 || Same
|-
| 20|| Talvasthi (palatines) || 2 || Same
|-
| 21|| Shroniphalaka (hip bone) || 2 || Same
|-
| 22|| Bhagasthi (pubic articular disc) || 1 || Nil (because pubic articular disc is not a bone)
|-
| 23|| Prashthagata Asthi (thoracic, lumber, sacral and coccygeal vertebrae) || 45 || Only 26 (12 thoracic, 5 lumber, 5 sacral and 4 coccygeal vertebrae)
Note-12 thoracic discs, 5 lumber discs and 2 probable sacral discs (seen sometimes in the lumbarisation of 2 sacral vertebrae these findings are visible) fulfils the lacuna here.
|-
| 24|| Grivagata asthi (cervical vertebrae and other bones) || 15 || Only 8 (7 cervical vertebrae, and 1 hyoid bone), Note-7 cervical discs fulfill the lacuna here.
|-
| 25|| Uroasthi (costal cartilages) || 14 ( 14 costal cartilages) || Nil (cartilage are not the bones)
|-
| 26|| Parshuka (ribs) || 24 || Same
|-
| 27|| Parshukasthalaka (rib sockets) || 24 || Nil (no such bone)
|-
| 28|| Parshukarbuda (rib tubercles) || 24 || Nil (no such bone)
|-
| 29|| Hanvasthi (mandible) || 1 || Same
|-
| 30|| Hanumoolabandhanasthi (mandibular articular disc) || 2 || Nil (disc is not considered as bone)
|-
| 31|| Nasikasthi (nasal) || 1(2) || 2 (nasal bones are 2)
|-
| 32|| Gandakutasthi (zygomatic) || 1(2) || 2 (zygomatic bones are 2)
|-
| 33|| Lalatasthi (frontal) || 1 || Same
|-
| 34|| Shamkhasthi (temporal) || 2 || same
|-
| 35|| Shirakapalasthi (skull bones) || 4 || same (1 sphenoid, 1 occipital and 2 parietal bones)
|-
|}
<div style="text-align:justify;">
Charaka followed the vedic scriptures and rituals, as is evident from his works. Since touching or handling bones was considered inauspicious, he presumably did not verify and count the bones himself but only repeated whatever was quoted in the ''vedas''. In any case, we find at many places that he was very accurate in his assessment of the number of bones in various parts of the body, e.g. bones of ''prashtha bhag, griva bhag, hanu bhag, shroni bhag'' and ''urah'' (if cartilages are counted as bones). It is interesting to note that Charaka considered articular disc of the tempero mandibular joint an ''asthi'' (bone) and designated it ''hanumoolabandhana''.
==== Number of bones in modern anatomy ====
In modern anatomy, the adult human body consists of 206 bones. Divided by different parts of the body, these come to
*Upper limb: fourteen phalanges, five metatarsals, eight carpals, one radius, one ulna, one humerus, one clavicle and one scapula, or 32 bones per limb (64 in all).
*Lower limb: fourteen phalanges, five metatarsals, seven tarsals, one tibia, one fibula, one patella, one femur, one hip bone, or 31 bones per limb (62 in all).
*Torso: 26 bones in the vertebral column (twelve thoracic, five lumbar, one sacrum, one coccyx, 24 ribs (twelve in each side), and one sternum, or 44 bones in all
*Neck region: Seven cervical vertebra, one hyoid bone, or eight bones in all
*Head region: One mandible, one vomer, one ethmoid, one sphenoid, one frontal, one occipital, two palatines, two maxillae, two inferior nasal chonchi, two zygomatics, two nasals, two lacrimals, two temporals, two parietals, or 22 bones in all
*Auditory ossicles: Six bones (malleus, incus and stapes - three bones in each ear)
Sushruta’s presentation on ''asthi sankhya'': Sushruta has presented the number of bones in the body on the basis of ''pratyaksha sharira'', and submitted that bones classified in five types (''kapal, ruchaka, taruna, valaya, nalaka''), and per him, these are 300 in number. Because teeth are considered ''ruchakasthi'' and cartilages are considered ''tarunasthi'', these are counted as bones<ref>Ghanekar, Sushruta Samhita, Sharira Sthan, 2012 edition, Meharchand Laxmandas Publications, New Delhi, 5/22 & 5/17.</ref>, and thus total up to 300 in number (Sushruta Sharira 5/17). On subdividing, these bones are 120 in the extremities (30 in each), 117 in the pelvis region, the sides, back and the chest, and 63 in the region in and above the neck.
==== Major difference between Charaka and Sushruta on the topic of bones ====
#Charaka was a ''vedavadi'' whereas Sushruta was not, he was a ''shalya shastri'' (surgeon), and hence Charaka has not given any classification of bones, while Sushruta has.
#Charaka counted nails as ''asthi'' (bones) whereas Sushruta has not.
#Charaka has counted sacral and coccygial bones under bones of the back (''prashthasthi'') whereas Sushruta has counted them under the bones of ''shroni'' (pelvis).
#Charaka has counted 32 teeth sockets as ''asthi'' whereas Sushruta has not counted them as ''asthi''.
#Charaka has counted ''hanumoola bandhana'' (mandibular disc) under ''asthi'', whereas Sushruta has not.
#In other accounts differences vary on both sides
Gananath Sen<ref> Gananathsen, Pratyaksha Shariram,1st part1941 edition, Kalpataru Press Calcutta, 3rd chapter </ref>, a reputable contemporary authority in the subject of ''sharira'', has submitted some exclusive opinions. Other than the observations on Charaka being a ''vedavadi'', or the inclusion of teeth nails as bones, etc., he points to certain conditions arising because of ossification centers in the bones. According to him, the presence of secondary ossification centers (epiphysis) may increase the number of bones in counting. [6]
Reviewing ''indriya'' requires the review of materials quoted under [[Indriyopakramaniya Adhyaya]] under [[Sutra Sthana]]. Under this chapter, Charaka has presented ''pancha panchaka vigyana''<ref> Bramhanand Tripathi, commentary on Charaka Samhita, Sutra Sthan, 2004 edition, Choukhamba Surbharati Prakashan, Varanasi, 8</ref> and said that there are five ''indriya'', five ''indriya dravya'', five ''indriyaadhishthana'', five ''indriyartha'' and five ''indriyabuddhi''.(Charaka Sutra 8/3)
After an exhaustive modern review, it can be said that ''panchendriya'' are such types of receptor cells which are located at the most peripheral end part of sensory pathway and function to transform the various specific type of energies into electrical energy, since brain cells know only one type of language/energy i.e. electricity. Therefore, every other type of energy is transformed into electricity and this is done by a frontline transforming cell. In every type of sensory organ, there are specific types of energy transforming cells, e.g. pressure sensitive nerve endings in pacinian corpuscle for touch, taste sensitive nerve endings in taste buds for taste, smell sensitive nerve endings in gustatory cells for smell, light sensitive nerve endings in rods and cones for vision and sound sensitive nerve endings in hair cells for hearing. In this account these cells could be considered ''indriya''. Sensory receptors<ref> Guyton & Hall, Textbook of Medical Physiology, 12th edition, saunders, Philadelphia, page no. 560- 569. </ref> could be classified in the following two ways i.e. (a) On the basis of the location of the receptor, and (b) on the basis of the modality of energies. Under the first category, there are three types, i.e. extero-receptors, intero-receptors and proprio-receptors, and under the second category there are several types of receptors, e.g. mechano-receptors, thermo-receptors, vibro-receptors, baro-receptors, proprio-receptors, photo-receptors, chemo-receptors, osmo-receptors, noscireceptors, tickle-receptors etc.)
''Panchendriyadravyani'' are ''panchamahabhutas'', i.e. kha (akasha), vayu, jyoti (agni), apa (jala) and bhu (prithvi). On the account of panchamahabhuta, there could be 26 biologically important elements<ref> Tortora Gerard J, Principles of Anatomy & Physiology, 11th edition, Harper & Row Publishers, New York, 1st chapter.</ref> (Tortora Gerard J., Principles of Anatomy and Physiology)
These elements are H, O, N, C, Ca, Mg, P, Na, K, Cl, S, I, Fl, Cu, Co, Cr, Fe, Se, Si, Vn, Sn,Zn, Mo, Mn, Al & B. As these elements are critical to the formation of life and are found in the animal cell, have some role in the development and function of the cell.
''Panchendriyadhishthana'' is the collective term for the key centers or sources of senses, i.e., skin (''twacha''), tongue (''jihva''), nose (''nasika''), eye (''netra'') and ear (''karna'').
The ''panchendriyartha'' are ''shabda'' (sound), ''sparsha'' (touch), ''rupa'' (shape), ''rasa'' (taste), ''gandha'' (smell). These are also called ''tanamatra'' and are the intrinsic basic energies of the respective materials. These energies are all related to their respective sensory receptor cells, e.g. ''shabda'' with vibro-receptors, ''sparsh'' with mechano-receptor, ''rupa'' with photo-receptors and ''rasa'' and ''gandha'' with chemo-receptors.
</div>
{| class="wikitable"
! rowspan="1"| Serial no.
! rowspan="1"| Indriyartha
! rowspan="1"| Sensory receptor cells
|-
| 1 || Shabda || Mechano/vibro receptors
|-
| 2 || Sparsh || Mechano, baro, thermo, nosci & proprio receptors
|-
| 3 || Roopa || Photo receptor
|-
| 4 || Rasa || Chemo receptor
|-
| 5 || Gandha || Chemo receptor
|-
|}
<div style="text-align:justify;">
''Panchendriyabuddhi'' are the five respective memories and “info-potentials” capable of synthesizing (identifying and translating) information received through the five sense organs, transmitted in the form of electrical energy. ''Indriyabuddhi'' are ''shabdindriyabuddhi'', ''sparshindriyabuddhi, roopindriyabuddhi, rasanindriyabuddhi'' and ''gandhindriyabuddhi''. These ''buddhis'' are located in the form of sensory areas and psychological/association areas.
</div>
{| class="wikitable"
! rowspan="1"| Sr. no.
! rowspan="1"| Indriyabuddhi
! rowspan="1"| sensory areas
! rowspan="1"| psychological/association
|-
| 1 || Shabdindriyabuddhi || Temporal lobe || Psychoauditory area, temporal lobe
|-
| 2 || Sparshindriyabuddhi || Post central gyrus || Psychosomatosensory area, parietal lobe
|-
| 3 || Roopindriyabuddhi || Occipital pole || Psychovisual area, occipital lobe
|-
| 4 || Rasanindriyabuddhi || Insula || Psychogustatory area,insula
|-
| 5 || Gandhindriyabuddhi || Innerside of temporal lobe || Limbic system (specially the hippocampus)
|-
|}
<div style="text-align:justify;">
''Buddhindriya'', as described here, seems to be different than ''panchendriya buddhi''. It can be observed that the ''panchendriya buddhi'' is a part of the cerebrum and is only a component of the ''indriya panchaka''. ''Buddhindriya'', on the other hand, is a part of the sensory system excluding ''indriyaadhishthana''. It implies that this includes all other four components mentioned in the preceding pages, namely ''indriya, indriyadravya, indriyartha'' and ''indriyabuddhi''. As a part of basic developmental embryology we find that most of the parts of a sensory system excluding the mesoblastic derivatives are developed as a part of brain. The same is very obvious in the eye, in which the parts of optic tract beginning from retina are all considered as part of brain. As such as a part of the theory of Charaka on ''gyanendriya'' it should be taken that five sensory systems are made of two components ''indriyadhishthan'' and ''buddhindriya''. ''Indriyadhishthana'' is the peripheral part of the organ connected by connective tissues of mesodermal origin, whereas ''buddhindriya'' stands for the remaining part that continues into the cerebrum as a logical, connected entity and comprises of four sub-factors: ''indriya, indriyadravya, indriyartha'' and ''indritabuddhi''.
''Panchakarmendriya'' (motor systems) are the hands (''hasta''), feet (''pada''), anus (''payu''), penis (''upastha'') and tongue (''jihva''). Here, the question is whether these motor organs are formed by only a group of muscles dealing with a given function or by a group of muscles and their nerves or the group of muscles and their nerves and their controlling part of brain (motor cortex) because muscle itself cannot perform any function alone. The muscle only performs when the nerve supply is intact and the commanding system is properly functioning. When there is failure in performance it is from all the side as a composite failure. Moreover when there is paralysis of motor organs or of a part of the system, it may be due to disruption in the nervous system or degeneration of a nerve or of the motor tract including UMN or cortical neurons. Hence muscles alone cannot be considered responsible for ''karmendriya''. ''Karmendriya'' can only be the complete motor system comprising organs from motor cortex to the muscles. [7]
Sushruta mentions that ''hridaya'' is formed by the ''prasad bhag'' of ''kapha'' and ''shonita/rakta'' (mentioned in Amarkosh, where it is also referred to as ''hridaya'') and is the seat of ''pranavaha dhamani''. Inferior to it are ''pleeha'' (spleen) and ''phuphphus'' (lung) and to its right side are ''yakrit'' (liver) and ''kloma'' (pancreas). As reiterated on multiple occasions, the ''hridaya'' is the seat of chetana<ref> Ghanekar, Sushruta Samhita, Sharira Sthana, 2012 edition, Meharchand Laxmandas Publications, New Delhi, 4/30 </ref>. When it gets covered by ''tama'', the being goes into sleep (Sushruta Sharira 4/30).
In other places within the Amarkosh, the word ''hridaya'' has been used synonymously with mana<ref> 14.Amar singh, Namalinganushashanam Amar Koshah, 1940 edition, Oriental Book Agency, Poona. </ref>. However, the ''hridaya'' is not a proxy of ''mana''. The heart means ''harati raktam'', or ''hriyate raktam anen iti'', i.e., from which blood is taken or given to the body. Arteries are called ''pranavaha'' (or carriers of life-force), because they deliver oxygen-rich blood from the heart, the failure of which most certainly leads to death.
At this point it is also important to delve into the meaning of ''chetana''. ''Chetana'' literally means awareness or consciousness. The root word is ''chit'' (to be conscious), which is also the root word for other Sanskrit terms like ''chitta'' (mind) and ''chaitanya'' (one who has ''chetana''). Physiologically this factor can be seen in the form of action potential<ref> 15.Guyton & Hall, Textbook of Medical Physiology, 10th edition, saunders, Philadelphia, page no.61 </ref>. When a command is given for action it results in the generation of action potential. Action potential when generated is transferred to the next structure and is finally sent to the muscles or other organs. For all this to happen, energy is needed. Energy is made available by ATP, formed in the mitochondria of a cell where energy is produced through oxidation of glucose. Half of the energy produced is diffused to keep the body warm and maintain body temperature, while the remaining half is used to form ATP (ADP+P+7kcal energy=ATP). Adenosine Triphosphate (ATP), the molecule found in all living organisms that is the main immediate source of usable energy for the activities of the cells. Because the energy-exchanging function of ATP and the catalytic (work-boosting) function of enzymes are intimately connected, ATP is characterized as a coenzyme. The adenosine part of the molecule is made up of adenine, a nitrogen-containing compound (also one of the principal components of the gene), and ribose, a five-carbon sugar. Three phosphate units (triphosphate), each made up of one phosphorus atom and four oxygen atoms are attached to the ribose. The two bonds between the three phosphate groups are high-energy bonds, that is, they are relatively weak and yield their energy readily when split by enzymes. With the release of the end phosphate group, 7 kilocalories (7 calories, in common usage) of energy become available for work, and the ATP molecule becomes ADP (adenosine diphosphate). Most of the energy-consuming reactions in cells are powered by the conversion of ATP to ADP. They include the transmission of nerve signals, the movement of muscles, the synthesis of protein, and cell division. Usually, ADP quickly regains the third phosphate unit through the action of cytochrome, a protein that builds it up by using food energy. In vertebrate muscle and brain cells, excess ATP can join with creatine to provide a reserve energy store. The release of two phosphate groups from ATP by the enzyme adenyl cyclase forms AMP (adenosine monophosphate), a nucleotide component of nucleic acids, the material of DNA; this enzyme is important in many of the body's reactions. The American biochemist Earl Sutherland, Jr., won the 1971 Nobel Prize in physiology or medicine for work showing that one form of AMP called cyclic AMP, created by the action of the enzyme adenyl cyclase, is instrumental in the activities of many hormones, including epinephrine and ACTH- Microsoft Encarta.) [8]
''Pranayatana'' (vital sites) in Ashtanga Samgraha: Vagbhata has shown some different features under the heading of ''pranayatana'' (Ashtanga Sangraha). Accordingly he has included ''jihvabandhana'' (root of tongue) as ''pranayatana'' and excluded ''mamsa'' from this account. The site of ''jihvabandhana'' is valuable because of the opening site of respiratory system. Any trauma at this blocking to respiratory passage may cause death, therefore it has been given much importance in anesthesia. In the case of deep coma falling of tongue back in the throat blocks the respiration and leads to death. Exclusion of ''mamsa'' from ''pranayatana'' by Vagbhatta seems to be his personal opinion only perhaps he was not willing to increase the number of ''pranayatana'', otherwise this was easy to justify.
''Prana'': When ''pranayatana'' are on the table of discussion we have to review ''prana''. Factors which maintain the life are ''prana''. ''Prana'' are said to be 12 in number by Sushruta (Sushruta Sharira 4/2). These ''pranas'' are ''agni, soma, vayu, satva, raja, tama, panchendriya'' and ''bhutatma''. As such these factors are categorically divided in four groups, i.e. ''tridosha, triguna, panchagyanendriya'' and ''bhutatma''. On a biological level tridosha can be seen somewhere in the form of biochemical regulators of life, e.g. hormones, enzymes etc., ''triguna'' in the form of neuro-chemical regulators of life, e.g. acetylcholine, epinephrine, dopamine, melatonin etc., and ''jnanendriya'' in the form of cell receptors and neuroreceptors. Speaking on ''bhutatma'' is a difficult job, whereas a critical evaluation of the same is must at this level. It is a well accepted fact in Ayurveda that all the organic world is ''panchamahabhautic''. At this level a ''bhuta'' could be considered to be an organism – a unicellular bacteria or a cell. Cell being a ''bhuta'' holds its ''atma'' in it which solely operates its function and development. Since DNA is responsible to control the function and development. The entire metabolism in the cell is basically controlled by DNA. DNA makes RNA by transcription, RNA makes protein by translation, protein is found basically in two types, i.e. structural and functional<ref>Dorothy Luciano, Human Structure & Function.1984 edition, Elsavier, Philadelphia, 1st & 2nd chapter.</ref>. Functional protein means enzyme. Enzyme mediates the biochemical changes in the body. Any change in the cell cannot be caused without the mediation of an enzyme. This is how we can see that DNA is solely controlling the metabolism in the body. Therefore if we refer the DNA to be taken as ''bhutama'', yet this will not be any mistake. [9]
Commentators of present time have very well worked for correlating the ''koshthangas'' presented by Charaka with the structure described in modern anatomy. Research scholars have also done well in this area. Suitable anatomical correlations for all 15 ''koshthangas'' are presented in the following table.
</div>
{| class="wikitable"
! rowspan="1"| Serial no.
! rowspan="1"| Koshthanga
! rowspan="1"| Anatomical correlation
! rowspan="1"| Controversy if any
! rowspan="1"| Comments
|-
| 1 || Nabhi || Umbilicus || Mesentery || Nabhi being koshthanga should be visceral organ,
|-
| 2 || Hridaya || Heart || --------------- || -------------------------------
|-
| 3 || Kloma || Pancreas || Gall bladder, trachea, pancreas, all 3 in different levels || Sushruta has quoted mandal sandhi under kloma Nadi, and also it’s location with yakrata, Charaka quoted under udakavaha srotas
|-
| 4 || Yakruta || Liver || ---------------- || ----------------------------------------------
|-
| 5 || Pleeha || Spleen || ---------------- || ----------------------------------------------
|-
| 6 || Vrakka || Kidney || ---------------- || ----------------------------------------------
|-
| 7 || Basti || Bladder || ---------------- || ----------------------------------------------
|-
| 8 || Purishadhara || Sigmoid colon || ---------------- || ----------------------------------------------
|-
| 9 || Amashaya || Stomach || ---------------- || ----------------------------------------------
|-
| 10|| Pakvashaya || Duodenum || Caecum || Caecum receives food after complete digestion, & is not repeated in this account, duodenum is the part of small intestine.
|-
| 11|| Uttarguda || Rectum || ---------------- || ----------------------------------------------
|-
| 12|| Adharguda, || Anal canal || ---------------- || ----------------------------------------------
|-
| 13|| Chhudranta || Small intestine || ---------------- || ----------------------------------------------
|-
| 14|| Sthulantra || Large intestine || ---------------- || ----------------------------------------------
|-
| 15|| Vapavahana || Omentum Thoracic duct || In the omentum there is no circulation of vapa, Circulation (vahan) of vapa determine vapavahana.
|-
|}
<div style="text-align:justify;">
Chakrapani on ''koshthanga'': According to Chakrapani<ref> Kashinath Shastri, Chakrapanidatta, Ayurved Dipika, Commentary on Charaka Samhita, 1st part, Sharira Sthan, 2007 edition, Choukhamba Samskrit Samsthan, Varanasi, 7/10 </ref>, ''kloma'' is the seat of thirst, ''basti'' is the seat of urine, ''uttarguda'' is where bowels are retained, through which bowels are evacuated is ''adharaguda'' and ''vapavahana'' (''tailvartika'') is the seat of ''meda''.
Sushruta on ''koshthanga'': Description of ''koshthanga'' is a topographical anatomy. Pattern of presenting topographical anatomy by Sushruta<ref> Ghanekar, Sushruta Samhita, Sharira Sthan, 2012 edition, Meharchand Laxmandas Publications, New Delhi, 5/4</ref> was different than that of Charaka. He has firstly presented the ''pratyanga'' (subdivisions of the regions), then he has presented further components (''gananiya avayava'') of ''pratyangas''. Under ''gananiya'' he has considered the ''koshangas''. Under this he has used composite terms for specific group of organs like ''ashaya'' which includes 7 organs. Among visceral organs he has considered ''unduka'' (caecum) and ''fupfus'' (lungs) under ''gananiya avayava'', which are not given by Charaka.
*''Koshthanga'' as seen by Henry Gray in modern Anatomy: Henry Gray<ref> Gray’s Anatomy, Descriptive & Applied, 29th edition ,1946, Longmans, green & company, London. </ref> father of modern anatomy has adopted a very special order of the distribution for the chapters. In the old edition, we can see that out of many chapters he has devised the presentation of chapters on functional systems like digestive, respiratory, urinary, re-productive and endocrine was different. He has clubbed these systems and put them in one basket and designated it splanchnology. This shows the Gray’s acceptance of Charaka’s idea on putting all visceral organs in one basket. Because this pattern has high amount of applied values this is why it got wide acceptance. [10]
</div>
*For developing more clarity in topographical knowledge, ''pratyangas'' was said by Charaka are presented in table as under.
{| class="wikitable"
|-
| Serial no. || Ayurvedic term || Modern correlation || Numbers
|-
| 1 || Janghanapindaka || Calf regions || 2
|-
| 2 || Urupindaka || Thigh regions || 2
|-
| 3 || Sphik || Gluteal regions || 2
|-
| 4 || Vrushana || Testicles || 2
|-
| 5 || Shepha || Penis || 1
|-
| 6 || Ukha || Axillae || 2
|-
| 7 || Vankshana || Inguinal regions || 2
|-
| 8 || Kukundara || Ischial regions || 2
|-
| 9 || Bastishirsha || Mons pubis || 1
|-
| 10|| Udara || Abdomen || 1
|-
| 11|| Stana || Breasts || 2
|-
| 12 || Shleshmabhuvou || Thoracobrachial region || 2
|-
| 13|| Bahupindaka || Fore arms / Brachial regions || 2
|-
| 14|| Chibuka || Chin || 1
|-
| 15|| Oshtha || Lips || 2
|-
| 16|| Srakkani || Margins of lips || 2
|-
| 17|| Dantaveshtaka || Gums || 2
|-
| 18|| Talu || Palate || 1
|-
| 19|| Galashundika || Uvula || 1
|-
| 20|| Upajihvika || Tonsils || 2
|-
| 21|| Gojihvika || Glottis || 1
|-
| 22|| Ganda || Cheek regions || 2
|-
| 23|| Karnashashkuli || Auricles of ear || 2
|-
| 24|| Karnaputraka || Trigus || 2
|-
| 25|| Akshikuta || Orbits || 2
|-
| 26|| Akshivartma || Eye lids || 4
|-
| 27|| Akshikaninika|| Pupils || 2
|-
| 28|| Bhruva || Eye brows || 2
|-
| 29|| Avatu || Nucha || 1
|-
| 30|| Panipadahridaya || Palmar heart and planter hearts || 4
|-
| --------- || Total || ---------------------------------------------- || 56
|-
|}
Sushruta on pratyanga: Sushruta’s concept was different on the heading of ''pratyanga''
(Sushruta Sharira 5/3).
<div style="text-align:justify;">
*According to him ''pratyangas''<ref> Ghanekar, Sushruta Samhita, Sharira Sthan, 2012 edition, Meharchand Laxmandas Publications, New Delhi, 5/3. </ref> are ''mastaka'' (cranium), ''udar'' (abdomen), ''prashtha'' (back), ''nabhi'' (umbilicus), ''lalat'' (fore head), ''nasa'' (nose), ''chibuka'' (chin), ''basti'' (urinary bladder) and ''greeva'' (neck) each one in number. ''Karna'' (ear), ''netra'' (eye), ''bhru'' (eye brow), ''shankha'' (temporal), ''amsa'' (shoulder), ''ganda'' (Cheek), ''kaksha'' (axilla), ''stana'' (breast), ''vrashana'' (scrotum), ''parshva'' (flank), ''sfig'' (gluteal region), ''janu'' (knee), ''bahu'' (upper arm) and ''uru'' (thigh) each two in number, ''anguli'' (fingers) 20 in number and ''srotasas'' (11 types). [11]
*The openings of the body which are presented by Charaka as major openings (''mahan chhidra''), same are referred by Sushruta<ref> Ghanekar, Sushruta Samhita, Sharira Sthan, 2012 edition, Meharchand Laxmandas Publications, New Delhi, 5/10 </ref> designating as ''bahirmukha srotas''. (Sushruta Sharira 5/10). Sharangadhara<ref> Parasuram Shasthri, Sharangadhara Samhita, Purva Khand,3rd edition 1983Choukhmba Orientalia, Varanasi,5/64. </ref> has presented 10 major openings by adding one opening (''bramha randhra'') in the cranium. (Sharangadhar Purvardha 5/64). In Bhagavad Geeta<ref> Shrimadbhagavat Geeta, 2005 editionGeeta Press Gorakhpur, 5/13 </ref> these ''bahirsrotasas'' are referred by the name of ''navadwara''. (GIta 5/13). [12]
*As presented by Charaka, ''pratyksha sharira'' is limited and accountable. Remaining is the anatomy which can be considered and described only by ''anumana'' and ''aptopadesha''. [13]
</div>
For simplifying the the above material, the same is presented in the table as given under.
• Table: Showing shira, dhamani, snayu etc.
{| class="wikitable"
! rowspan="1"| Serial no.
! rowspan="1"| Ayurvedic term
! rowspan="1"| Modern correlation
! rowspan="1"| Numbers
|-
| 1 || Snayu || Ligaments || 900
|-
| 2 || Sira || Veins || 700
|-
| 3 || Dhamani || Arteries || 200
|-
| 4 || Peshi || Muscles || 400
|-
| 5 || Marmas || Vital parts || 107
|-
| 6 || Sandhi || Joints || 200
|-
| 7 || Sira Dhamani Anuroopa Mukh || Capillaries || 29956
|-
| 8 || Kesha Smashru & Loma. || Hair (all type) || 29956
|-
|}
[14]
<div style="text-align:justify;">
*In the old time under the prevailing Indian systems there were two types of scales for measuring the volume of liquids, i. e. ''Magadha mana''<ref> Bramhanand Tripathi, commentary on Charaka Samhita, Sharir Sthan, 2004 edition, Choukhamba Surbharati Prakashan, Varanasi, 7/15. </ref> and ''Kalinga mana''.
</div>
Magadha Mana Kalinga Mana
{| class="wikitable"
|-
| 4 Karsha || 1 Pala || 10 Masha || 1 Karsha
|-
| 2 Pala || 1 Prasati || 4 Karsha || 1 Pala
|-
| 2 Prasati || 1 Anjali || 4 Pala || 1 Kunava (Anjali)
|-
|}
Table: Anjali pramana presented in table
{| class="wikitable"
|-
| Serial no. || Constituent || Anjali Praman
|-
| 1 || Udaka (water) || 10
|-
| 2 || Rasa || 09
|-
| 3 || Rakta || 08
|-
| 4 || Purisha || 07
|-
| 5 || Shleshma || 06
|-
| 6 || Pitta || 05
|-
| 7 || Mutra || 04
|-
| 8 || Vasa || 03
|-
| 9 || Meda || 02
|-
| 10|| Majja || 01
|-
| 11|| Mastishka
|<span style="font-size:66%; line-height: 1.3em;">1/2</span>
|-
| 12|| Shukra
|<span style="font-size:66%; line-height: 1.3em;">1/2</span>
|-
| 13|| Shlaishmic Oja
|<span style="font-size:66%; line-height: 1.3em;">1/2</span>
|-
|}
[15]
*On the basis of ''panchamahabhuta'' the structures, organs and their functional expressions (''bhavas'') are categorically presented in the under given table.
Table: Showing structures, organs and their functional expressions (Bhavas) on the basis of Panchamahabhoota.
{| class="wikitable"
|-
| Parthiv || Apya || Agneya || Vayaviya || Akashiya || Atmaja
|-
| Sthoola (solid), Sthira (fixed), Moortiman (visible), Guru (heavy), Khara (rough) and Kathin (hard) are Parthiva (Prithvi Tatva pradhan), e.g. Nakha (nails), Asthi (bones), Danta (teeth), Mamsa (muscle), Charma (skin), Varchas (feces), Kesha (hair), Smashru (beard), Loma (body hair), Kandara (tendons), Gandha (smell) and also the olfactory sensory are parthiv (prithvi guna pradhan). || Drava(liquid), Sara (liquidous), Manda (slow), Snigdha(unctuous), Mradu (soft) &Pichchhal(viscous)Guna pradhan; Rasa (plasma), Rakta (blood), Vasa (fat), Kapha (anabolic humor type), Pitta (catabolic humor type), Mootra (urine) and Sweda (sweat) and alsothe taste(rasa) & taste sensory organ. || Pitta (catabolic humor type), Ushma,(heat),Bha (Shining), Roopa(photo)&vision sensory are agneya. || Uchchhwas (inspiration), Praswas (expiration), Unmesh (opening of eye), Nimesh (closing of eye), Akunchan (flexion), Prasarana (extention), Gamana (movement), Prerana (expulsion), Dharana (retention), Sparsha (touch), & touch sensory organ. || ViviktaAvayava (spacefull structures with openings),major and minor Srotasas, sound& hearing sensory organs. || Pradhan (Jivatma),Buddhi (intellect) &Mana (psyche).
|-
|}
[16]
<div style="text-align:justify;">
*When ''deha paramanu'' is put on review we find that Charaka was of clear opinion that like the house is built by the countless number of bricks similarly body is also built by the structural and functional units to which he has referred as ''deha paramanu''. Because Charaka has referred them as ''shariravayava'', as such the same can only be said as structural and functional unit of the body. At this point modern cell theory is quotable, which reveals that, a) all living things are made of cells, and b) smallest living unit of an organism is the cell and cells arise from pre-existing cells only. Designation given by Charaka as ''deha paramanu'' by its meaning refers to all three features of cell theory as above. Charaka has presented the features of ''deha paramanu'', saying that they are ''aparisankhyeya'' (innumerable), ''atibahuta'' (abundant), ''atisukshma'' (microscopic) and ''atindriya'' (unperceivable from common eyes). This equates it with modern cell theory. Modern theory has only one different point, i.e. cells arise from pre-existing cells only, which is also equitable with ''beeja'' and ''beejabhaga'' theory of Charaka.
*It is further described that for all types of ''samyoga'' and ''vibhaga'' the responsible factors are two, i.e. ''vayu'' and ''karmaswabhava''. In this account ''vayu'' can be referred for functional proteins (enzymes). Enzymes function to catalyze all type of metabolic functions in the body. In other words, it can be said that any type of biochemical change in the body can not be caused without the mediation of an enzyme. As such enzymes are the operators of life processes. The same is said about the ''vayu'' (''yatra vayuna niyante tatra gachchhanti vegavata'' (''pitta'' and ''kapha'' are moved by ''vata'' like the clouds move in the direction of wind)). Similarly, ''karmaswabhava'' can be evaluated. ''Karmaswabhava'' means ''karma'' of ''swabhava'' or the action of ''swabhava''. ''Swabhava'' can be referred for genetic code. As ''vayu'' is a biological entity and has the fixity of properties similarly genetic code is also a fixed entity. It is basically universal (except for mitochondria). This is what, we can say it a basic natural force, a law of nature which operates the organic world. Modern science believes that enzymes directly control the changes in the body (metabolism) and genetic code regulates the development and function of the cell or an organism.
*Genetic code: Genetic code<ref> E.D.P. De Robartis, Cell &Molecular Biology,2006 edition, Saunders, Philadelphia </ref> has nine features, i.e. sensibility, universality, unambiguity, redundancy, non-delimited/comma-less, no overlapping, decipherability, collinearity and start and stop codons.1) Sensibility: 3 Nucleotides code for one amino acid. 2) Universality: Same code used by all the organism except for mitochondria.3) Unambiguity: Means specificity, each triplet has only one meaning, specifying to particular amino acid. 4) Redundancy: Some amino acids are coded by more than one codons, (61 for 20 Amino acids, total codons are 64 but only 61 codons code for AA rest are start and stop codons). 5) Comma-less: Punctuationless, means no spaces between words (codons), technical cause of frame shift mutation. 6) Non-overlapping: No overlapping in the sequence of codons 7) Decipherability: Codons are decipherable. 8) Collinearity: sequence in mRNA is perfectly compatible with amino acid sequence in finished protein. 9) Start and stop code: Initiation and termination codons are essential factors- “Start” = AUG (initiation codon), and “Stop” = UAA, UAG, and UGA (termination codon). [17]
*When [[Sankhya Sharira]] is seen as whole this looks like the dissection of the whole body to the level of ''paramanubheda''. Firstly, body was displayed through visceral organs (''koshthanga''), then it was shown through the regional derivatives (''pratyanga''), after that it was shown through it’s very inner systems making core divisions of life including ''hridaya, indriyadhishthan, buddhindriya, karmendriya'' and ''pranadhishthan'', then body was shown through rationally accountable structures and further by liquid constituents. Lastly body was shown through ''paramanubheda'' (microscopic level). This type of description is like opening the window of ''tatvagyan''. What remains in ''tatvagyan'' if the secrets of ''sanyoga'' and ''vibhaga'', i.e. enzymes and genetic code are revealed. At this level, reference specifying the value of ''tatvagyan'' under [[Arthedashmahamooliya Adhyaya]] is quotable, ''Tatvavabodhoharshananam'' (Charaka Sutra- 30/15), this speaks that ''tatvagyan'' is the ultimate source of ''harsha'' (happiness). As such if one observes the body in ultimate split, ''paramanubheda'', or in separated form, he gets the ultimate salvation. [18]
*The anatomical information presented in this chapter by Charaka is devised for the physician not for the surgeon, hence it is said that one who knows the body through the organization of organs and systems, is always enlightened and never falls into any confusion. The knowledge of the anatomy has been always considered essential for a clinician. It was highly acknowledged by Sushruta<ref> Ghanekar, Sushruta Samhita, Sharira Sthan, 2012 edition, Meharchand Laxmandas Publications, New Delhi, 5/60. </ref> particularly for the surgeons.-Su. Sh. 5/60). Sushruta has said that which is observed by the senses (''pratyaksha'') and also which is studied in books, both in combination give much knowledge. [19]
*Knowledge of anatomy on the one side is an essential requisite for a physician on the other side it is also important for a common people for enjoying a good lifestyle. Normally a person with the knowledge of constituents of the body is found different and enlightened in comparison with others. This is the actual theme behind the composition of this quote by Charaka. [20]
==== ''Koshthanga'' ====
''Koshthanga sharira'' presented by Charaka is an exclusive presentation, based on his own ideas and medical values. However he maintained that organs included should be located in the cavities of the trunk specifying to ''koshtha'', just like the clubbing of visceral organs in modern anatomy for practical study. It does not match with Sushruta’s presentation. Among presented fifteen ''koshthangas'' controversial entities are ''nabhi, kloma, pakvashaya'' and ''vapavahan''. For ''nabhi'' opinions available so far are all centered with umbilicus, which is not appropriate because umbilicus is on the body wall it is not located in the ''koshtha''. Mesentery may be most suitable organ to be taken for ''nabhi''. Pancreas having medical relevance related with the symptom of polydipsia seems to be most suitable to be referred for ''kloma'' particularly under Charaka’s ''koshthanga''. Though it is the part of large intestine (''sthulantra'') but caecum is an important structure and a visceral organ, it should be taken for ''pakvashaya''. Some scholars have correlated duodenum with ''pakvashaya'' which is not authentic any way as it does not hold digested food, its function is to deal with likely undigested food (chyme). No doubt ''vapavahana'' as referred by Chakrapani is a ''tailvartika'' but omentum does not fit completely with the description of ''vapavahana''. This is also denied by Prof. V.J. Thakkar<ref> Thakkar V.J., Purusha Vichaya, A. H. Publishers, Gujarat Ayurved University, Jamnagar, India </ref>. He has referred lacteals to be taken for it. Lacteals are also not the better option. Why not thoracic duct because it is found in singular number? As such thoracic duct is recommended here in this account to be taken for ''vapavahana''.
</div>
=== References ===
<references/>
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|title = Sankhya Sharira
|label1 = Section/Chapter
|data1 = [[Sharira Sthana]] Chapter 7
|label2 = Preceding Chapter
|data2 = [[Sharira Vichaya Sharira]]
|label3= Succeeding Chapter
|data3 = [[Jatisutriya Sharira]]
|label5 = Other Sections
|data5 = [[Sutra Sthana]], [[Nidana Sthana]], [[Vimana Sthana]], [[Indriya Sthana]], [[Chikitsa Sthana]], [[Kalpa Sthana]], [[Siddhi Sthana]]
|header3 =
}}
==[[Sharira Sthana]] Chapter 7, Sankhya Sharira (Chapter on the count of Human Anatomical and Physiological Constituents) ==
=== Abstract ===
<div style="text-align:justify;">
This chapter, the [[Sankhya Sharira]], is dedicated to quantification of human anatomical and physiological constituents. It provides comprehensive knowledge about the organization of the body, its gross and subtle structures. The basic ''panchabhautika'' composition of human body is revealed which is helpful in understanding disease pathogenesis and prognosis. In brief, the chapter gives a general picture of how a body is organized by its functional organs, and emphasizes upon the importance of the knowledge of not only gross anatomy but at the cellular and sub cellular level.
'''Keywords''': ''Purusha, Chetana, Koshthanga,'' organs, physiological systems, body constituents.
</div>
=== Introduction ===
<div style="text-align:justify;">
The [[Sharira Sthana]] is a seminal section within [[Charaka Samhita]], with topics ranging from the origin of human beings to embryology, physiology, obstetrics, and neonatology, before delving into a study of the human anatomy. [[Sankhya Sharira]] comprises of a description of ''sharira'' (human body) on the basis of ''dhatubheda'' (different body constituents), the number and measurements of organs and constituting structures. The chapter begins with a description of skin (''twak sharira''), as the identification of a body starts with the skin. When a patient approaches a physician, his skin is the first organ that gets examined for visible signs of disease. The description on skin is followed by a description of the six sections of the body, or ''shadanga sharira'' or six body components, (two upper limbs, two lower limbs, head and the neck, and the torso). Following ''shadanga sharira'' is ''asthi sharira'', or osteology. In the modern system of anatomical schooling, osteology is always considered as the opening chapter of anatomy. ''Asthi sharira'' is followed by ''indriya sharira'', which includes ''panchendriya adhishthana, panchabuddhindriya'' and ''panchakarmendriya'', or the basics of neurology and myology. This is followed by ''chetanadhishthana'' and ''dashavidha pranayatanas'', dealing with expressions of life including action and reaction. This is followed by a description of ''koshthanga'' (viscera). This chapter is analogous to the study of splanchnology in modern texts like, for example, Gray's Anatomy. Following ''koshthanga'' is the study on ''pratyangas,'' or specific body regions. After ''pratyangas'' is the description on nine major openings. This marks the end of body parts or organs that can be counted. The next part of the chapter deals with ligaments, musculature, etc. (''shira, dhamani, snayu'' etc). Subsequently, ''anjali pramana'' of body fluids is described. ''Anjali pramana'' is followed by ''paramanubhediya sharira'', which shows the understanding of microscopic anatomy in ancient times. The chapter ends with a urge to physicians and lay people to study [[Sankhya Sharira]] and gain valuable knowledge in their quest to achieving ultimate salvation.
Though the title of the chapter literally means a numerical study of the body, it is not just about counting organs and structures, as is evident from the description of the various sections presented here. Charaka has logically divided the chapter into a section on “countable” constituents of the human anatomy, followed by a section that cannot be counted, or in some cases, even be seen with the naked eye (''paramanubheda'', or cellular level).
</div>
===Sanskrit text, Transliteration and English Translation===
अथातः शरीरसङ्ख्याशारीरं व्याख्यास्यामः||१||
इति ह स्माह भगवानात्रेयः||२||
athātaḥ śarīrasaṅkhyāśārīraṁ vyākhyāsyāmaḥ||1||
iti ha smāha bhagavānātrēyaḥ||2||
athAtaH sharIrasa~gkhyAshArIraM vyAkhyAsyAmaH||1||
iti ha smAha bhagavAnAtreyaH||2||
Now we will expound the chapter titled ''Sharirasankhyashariram'' (i.e., [[Sankhya Sharira]]). Thus said Lord Atreya. [1-2]
==== Agnivesha’s questions on the human anatomy ====
शरीरसङ्ख्यामवयवशःकृत्स्नंशरीरंप्रविभज्य सर्वशरीरसङ्ख्यानप्रमाणज्ञानहेतोर्भगवन्तमात्रेयमग्निवेशः पप्रच्छ||३||
śarīrasaṅkhyāmavayavaśaḥkr̥tsnaṁśarīraṁ pravibhajyasarvaśarīrasaṅkhyānapramāṇajñānahētōrbhagavantamātrēyamagnivēśaḥ papraccha||3||
sharIrasa~gkhyAmavayavashaHkRutsnaMsharIraM pravibhajyasarvasharIrasa~gkhyAnapramANaj~jAnahetorbhagavantamAtreyamagniveshaH papraccha||3||
Agnivesha asked a question to Lord Atreya, for the sake of gaining knowledge on the human body’s organisation into divisions, subdivisions, structures and organs, so that one can understand the number and magnitude of the organs and structures. [3]
==== Six layers of skin ====
तमुवाच भगवानात्रेयः- शृणु मत्तोऽग्निवेश! सर्वशरीरमाचक्षाणस्य यथा प्रश्नमेकमना यथावत्
शरीरे षट् त्वचः; तद्यथा- उदकधरा त्वग्बाह्या, द्वितीया त्वसृग्धरा, तृतीया सिध्मकिलाससम्भवाधिष्ठाना, चतुर्थीदद्रूकुष्ठसम्भवाधिष्ठाना, पञ्चमी त्वलजीविद्रधिसम्भवाधिष्ठाना, षष्ठी तु यस्यां छिन्नायां ताम्यत्यन्ध इव च तमः प्रविशतियां चाप्यधिष्ठायारूंषि जायन्ते पर्वसु कृष्णरक्तानि स्थूलमूलानि दुश्चिकित्स्यतमानि च; इति षट् त्वच:;
एताः षडङ्गं शरीरमवतत्य तिष्ठन्ति||४||
tamuvāca bhagavānātrēyaḥ- śr̥ṇu mattō'gnivēśa! sarvaśarīramācakṣāṇasya yathā praśnamēkamanāyathāvat|
śarīrē ṣaṭ tvacaḥ; tadyathā- udakadharā tvagbāhyā, dvitīyā tvasr̥gdharā, tr̥tīyāsidhmakilāsasambhavādhiṣṭhānā, caturthī dadrūkuṣṭhasambhavādhiṣṭhānā, pañcamītvalajīvidradhisambhavādhiṣṭhānā, ṣaṣṭhī tu yasyāṁ chinnāyāṁ tāmyatyandha iva ca tamaḥ praviśati yāṁcāpyadhiṣṭhāyārūṁṣi jāyantē parvasu kr̥ṣṇaraktāni sthūlamūlāni duścikitsyatamāni ca; iti ṣaṭ tvacaḥ|
ētāḥ ṣaḍaṅgaṁ śarīramavatatya tiṣṭhanti||4||
tamuvAca bhagavAnAtreyaH- shRuNu matto~agnivesha! sarvasharIramAcakShANasya yathAprashnamekamanA yathAvat|
sharIre ShaT tvacaH; tadyathA- udakadharA tvagbAhyA, dvitIyA tvasRugdharA, tRutIyAsidhmakilAsasambhavAdhiShThAnA, caturthI dadrUkuShThasambhavAdhiShThAnA, pa~jcamItvalajIvidradhisambhavAdhiShThAnA, ShaShThI tu yasyAM chinnAyAM tAmyatyandha iva ca tamaHpravishati yAM cApyadhiShThAyArUMShi jAyante parvasu kRuShNaraktAni sthUlamUlAnidushcikitsyatamAni ca; iti ShaT tvacaH|
etAH ShaDa~ggaM sharIramavatatya tiShThanti||4||
<div style="text-align:justify;">
Lord Atreya replied, “Agnivesha! As you have asked, I am clearly describing the details of the whole body. You may want to focus on these. To start with, there are six layers of skin, i.e.
*''Udakadhara'', the outermost layer, this specially holds water.
*Second is ''asragdhara'', which holds blood.
*Third is seat of ''sidhma'' (fungal infection like ptyriasis versicolor) and ''kilas'' (vitiligo), a type of ''kushtha'' (skin diseases)
*Fourth is that from which ''dadru'' (ring worm infestation) and ''kushtha'' originate.
*Fifth is that in which ''alaji'' (dermoid cyst) and ''vidradhi''(abscess) are formed, and
*Sixth is that which causes severe pain when it is cut, and the person feels like he is sinking in dark. Ulcers are caused in this layer and red-and-black colored boils with hard roots are caused at the unions of the structures (connective tissues), which are very difficult to treat.
These six layers of skin cover up the underlying ''shadanga sharira'' (body of six divisions). [4]
</div>
==== Subdivisions of body ====
तत्रायं शरीरस्याङ्गविभागः; तद्यथा- द्वौ बाहू, द्वे सक्थिनी, शिरोग्रीवम्, अन्तराधिः, इति षडङ्गमङ्गम्||५||
tatrāyaṁ śarīrasyāṅgavibhāgaḥ; tadyathā- dvau bāhū, dvē sakthinī, śirōgrīvam, antarādhiḥ, itiṣaḍaṅgamaṅgam||5||
tatrAyaM sharIrasyA~ggavibhAgaH; tadyathA- dvau bAhU, dve sakthinI, shirogrIvam, antarAdhiH, itiShaDa~ggama~ggam||5||
The body can be divided into six divisions (''shadanga sharira''), i.e., two upper limbs (''bahu''), two lower limbs (''sakthi''), head and the neck (''shira'' and ''griva''), and the torso (''antaradhi''). [5]
==== Number of bones ====
त्रीणि सषष्टीनि शतान्यस्थ्नां सह दन्तोलूखलनखेन | तद्यथा-द्वात्रिंशद्दन्ताः, द्वात्रिंशद्दन्तोलूखलानि, विंशतिर्नखाः, षष्टिः पाणिपादाङ्गुल्यस्थीनि, विंशतिःपाणिपादशलाकाः, चत्वारि पाणिपादशलाकाधिष्ठानानि, द्वे पार्ष्ण्योरस्थिनी, चत्वारः पादयोर्गुल्फाः, द्वौ मणिकौ हस्तयोः, चत्वार्यरत्न्योरस्थीनि, चत्वारि जङ्घयोः, द्वे जानुनी, द्वे जानुकपालिके, द्वावूरुनलकौ, द्वौ बाहुनलकौ, द्वावंसौ,द्वे अंसफलके, द्वावक्षकौ, एकं जत्रु, द्वे तालुके, द्वे श्रोणिफलके, एकं भगास्थि, पञ्चचत्वारिंशत् पृष्ठगतान्यस्थीनि,पञ्चदश ग्रीवायां, चतुर्दशोरसि, द्वयोः पार्श्वयोश्चतुर्विंशतिः पर्शुकाः, तावन्ति स्थालकानि, तावन्ति चैव स्थालकार्बुदानि, एकंहन्वस्थि, द्वे हनुमूलबन्धने, एकास्थि नासिकागण्डकूटललाटं, द्वौ शङ्खौ, चत्वारि शिरःकपालानीति; एवं त्रीणि सषष्टीनिशतान्यस्थ्नां सह दन्तोलूखलनखेनेति||६||
trīṇi saṣaṣṭīni śatānyasthnāṁ saha dantōlūkhalanakhēna |
tadyathā- dvātriṁśaddantāḥ, dvātriṁśaddantōlūkhalāni, viṁśatirnakhāḥ, ṣaṣṭiḥ pāṇipādāṅgulyasthīni,viṁśatiḥ pāṇipādaśalākāḥ, catvāri pāṇipādaśalākādhiṣṭhānāni, dvē pārṣṇyōrasthinī, catvāraḥpādayōrgulphāḥ, dvau maṇikau hastayōḥ, catvāryaratnyōrasthīni, catvāri jaṅghayōḥ, dvē jānunī, dvējānukapālikē, dvāvūrunalakau, dvau bāhunalakau, dvāvaṁsau, dvē aṁsaphalakē, dvāvakṣakau, ēkaṁjatru, dvē tālukē, dvē śrōṇiphalakē, ēkaṁ bhagāsthi, pañcacatvāriṁśat pr̥ṣṭhagatānyasthīni, pañcadaśagrīvāyāṁ, caturdaśōrasi, dvayōḥ pārśvayōścaturviṁśatiḥ parśukāḥ, tāvanti sthālakāni, tāvanti caivasthālakārbudāni, ēkaṁ hanvasthi, dvē hanumūlabandhanē, ēkāsthi nāsikāgaṇḍakūṭalalāṭaṁ, dvauśaṅkhau, catvāri śiraḥkapālānīti; ēvaṁ trīṇi saṣaṣṭīni śatānyasthnāṁ saha dantōlūkhalanakhēnēti||6||
trINi saShaShTIni shatAnyasthnAM saha dantolUkhalanakhena |
tadyathA-dvAtriMshaddantAH, dvAtriMshaddantolUkhalAni, viMshatirnakhAH, ShaShTiHpANipAdA~ggulyasthIni, viMshatiH pANipAdashalAkAH, catvAri pANipAdashalAkAdhiShThAnAni, dvepArShNyorasthinI, catvAraH pAdayorgulphAH, dvau maNikau hastayoH, catvAryaratnyorasthIni, catvArija~gghayoH, dve jAnunI, dve jAnukapAlike, dvAvUrunalakau, dvau bAhunalakau, dvAvaMsau, dveaMsaphalake, dvAvakShakau, ekaM jatru, dve tAluke, dve shroNiphalake, ekaM bhagAsthi,pa~jcacatvAriMshat pRuShThagatAnyasthIni, pa~jcadasha grIvAyAM, caturdashorasi, dvayoHpArshvayoshcaturviMshatiH parshukAH, tAvanti sthAlakAni, tAvanti caiva sthAlakArbudAni, ekaMhanvasthi, dve hanumUlabandhane, ekAsthi nAsikAgaNDakUTalalATaM, dvau sha~gkhau, catvArishiraHkapAlAnIti; evaM trINi saShaShTIni shatAnyasthnAM saha dantolUkhalanakheneti||6||
Including teeth, teeth sockets and the nails, the human bones are 360 in number. A breakdown of this number is as follows:
*Teeth (''danta'') are 32, teeth sockets (''danta udukhal'') are 32
*Nails (''nakha'') are 20
*Bones of fingers (''angulyasthi'') in upper and lower limb are 60
*Metacarpals and metatarsals (''shalakasthi'') are 20
*Distal carpal and distal tarsals (''shalakashraya'') are 4
*Calcaneus (''parshni'') are 2
*Ankle bones/talus and navicular (''gulphasthi'') are 4
*Proximal carpal bones (''manikasthi'') in the hands are 2
*Forearm bones (''aratni'') are 4
*Leg bones (''janghasthi'') are 4
*Knee bones (''janvasthi'') are 2
*Patella (''janukapal'') are 2
*Femur (''urunalaka'') are 2
*Humerus (''bahunalaka'') are 2
*Clavicle (''ansasthi'') are 2
*Scapula (''ansaphalakasthi'') are 2
*Clavicular articular disc (''akshakasthi'') are 2
*Xiphisternum (''jatru'') is 1
*Palatines (''talvasthi'') are 2
*Ilium (''shroniphalaka'') are 2
*Pubis (''bhagasthi'') is 1
*Bones of the back (''prashthagata asthi'') are 45
*Bones of the neck (''grivagat asthi'') are 15
*Bones of the chest (''uroasthi'') are 14
*Both sides ribs (''parshuka'') are 24
*Both sides rib sockets (''parshukasthalaka'') are 24
*Both sides rib tubercles (''parshukarbuda'') are 24
*Mandible (''hanvasthi'') is 1
*Mandibular articular disc (''hanumoolabandhanasthi'') are 2
*Nasal (''nasikasthi'') is 1
*Zygomatic (''gandakutasthi'') is 1
*Frontal (''lalatasthi'') is 1
*Temporal (''shamkhasthi'') are 2 and
*Skull bones (''shirakapalasthi'') are 4. [6]
==== Five ''indriyadhishthana'', five ''buddhindriya'' and five ''karmendriya'' ====
पञ्चेन्द्रियाधिष्ठानानि; तद्यथा- त्वग्, जिह्वा, नासिका, अक्षिणी, कर्णौ च|
पञ्च बुद्धीन्द्रियाणि; तद्यथा- स्पर्शनं, रसनं, घ्राणं, दर्शनं, श्रोत्रमिति|
पञ्च कर्मेन्द्रियाणि; तद्यथा- हस्तौ, पादौ, पायुः, उपस्थः, जिह्वा चेति||७||
pañcēndriyādhiṣṭhānāni; tadyathā- tvag, jihvā, nāsikā, akṣiṇī, karṇau ca|
pañca buddhīndriyāṇi; tadyathā- sparśanaṁ, rasanaṁ, ghrāṇaṁ, darśanaṁ, śrōtramiti|
pañca karmēndriyāṇi; tadyathā- hastau, pādau, pāyuḥ, upasthaḥ, jihvā cēti||7||
pa~jcendriyAdhiShThAnAni; tadyathA- tvag, jihvA, nAsikA, akShiNI, karNau ca|
pa~jca buddhIndriyANi; tadyathA- sparshanaM, rasanaM, ghrANaM, darshanaM, shrotramiti|
pa~jca karmendriyANi; tadyathA- hastau, pAdau, pAyuH, upasthaH, jihvA ceti||7||
Five ''indriyadhishthana'' (seats of ''indriya'') are skin (''twacha''), tongue (''jihva''), nose (''nasika''), eyes (''netra'') and ears (''karna'').
Five ''buddhindriya'' (senses) are touch (''sparshana''), taste (''rasana''), smell (''ghrana''), vision (''darshana'') and hearing (''shrotra'').
Five ''karmendriya'' (motor organs) are hands (''hasta''), feet (''pada''), anus (''payu''), penis (''upastha'') and tongue (''jihva''). [7]
==== Seat of ''chetana'' (consciousness) ====
हृदयं चेतनाधिष्ठानमेकम्||८||
hr̥dayaṁ cētanādhiṣṭhānamēkam||8||
hRudayaM cetanAdhiShThAnamekam||8||
''Hridaya'' (heart) alone is the seat of ''chetana'', or consciousness. [8]
==== Ten vital seats ====
दश प्राणायतनानि; तद्यथा- मूर्धा, कण्ठः, हृदयं, नाभिः, गुदं, बस्तिः, ओजः, शुक्रं, शोणितं, मांसमिति|
तेषु षट् पूर्वाणि मर्मसङ्ख्यातानि||९||
daśa prāṇāyatanāni; tadyathā-mūrdhā, kaṇṭhaḥ, hr̥dayaṁ, nābhiḥ, gudaṁ, bastiḥ, ōjaḥ, śukraṁ, śōṇitaṁ,māṁsamiti|
tēṣu ṣaṭ pūrvāṇi marmasaṅkhyātāni||9||
dasha prANAyatanAni; tadyathA- mUrdhA, kaNThaH, hRudayaM, nAbhiH, gudaM, bastiH, ojaH, shukraM,shoNitaM, mAMsamiti|
teShu ShaT pUrvANi marmasa~gkhyAtAni||9||
<div style="text-align:justify;">
There are ten ''pranayatana'' in the body, i.e. ''murdha'' (head), ''kantha'' (throat), ''hridaya'' (heart), ''nabhi'' (umbilicus), ''guda'' (anus), ''basti'' (urinary bladder), ''oja'' (essence of vitality), ''shukra'' (semen, ovum), ''shonita'' (blood), and ''mamsa'' (muscle tissue). Of these, the first six are the ''marmas''. [9]
</div>
==== ''Koshthanga'' ====
पञ्चदश कोष्ठाङ्गानि; तद्यथा- नाभिश्च, हृदयं च, क्लोम च, यकृच्च, प्लीहा च, वृक्कौ च, बस्तिश्च, पुरीषाधारश्च,आमाशयश्च, पक्वाशयश्च, उत्तरगुदं च, अधरगुदं च, क्षुद्रान्त्रं च, स्थूलान्त्रं च, वपावहनं चेति||१०||
pañcadaśa kōṣṭhāṅgāni; tadyathā-nābhiśca, hr̥dayaṁ ca, klōma ca, yakr̥cca, plīhā ca, vr̥kkau ca, bastiśca,purīṣādhāraśca, āmāśayaśca, pakvāśayaśca, uttaragudaṁ ca, adharagudaṁ ca, kṣudrāntraṁ ca,sthūlāntraṁ ca, vapāvahanaṁ cēti||10||
pa~jcadasha koShThA~ggAni; tadyathA- nAbhishca, hRudayaM ca, kloma ca, yakRucca, plIhA ca, vRukkauca, bastishca, purIShAdhArashca, AmAshayashca, pakvAshayashca, uttaragudaM ca, adharagudaM ca,kShudrAntraM ca, sthUlAntraM ca, vapAvahanaM ceti||10||
<div style="text-align:justify;">
There are fifteen ''koshthangas'', i.e. ''nabhi'' (umbilicus, mesentery), ''hridaya'' (heart), ''kloma'' (pancreas), ''yakrita'' (liver), ''pleeha'' (spleen), ''vrikka'' ( two kidneys), ''basti'' (urinary bladder), ''purishadhara'' (sigmoid colon), ''amashaya'' (stomach), ''pakvashaya'' (cecum), ''uttaraguda'' (rectum), ''adharaguda'' (anus), ''kshudrantra'' (small intestine), ''sthulantra'' (large intestine), and ''vapavahana'' (omentum). [10]
</div>
==== ''Pratyanga varnana'' ====
षट्पञ्चाशत् प्रत्यङ्गानि षट्स्वङ्गेषूपनिबद्धानि, यान्यपरिसङ्ख्यातानि पूर्वमङ्गेषु परिसङ्ख्यायमानेषु, तान्यन्यैःपर्यायैरिह प्रकाश्यानि भवन्ति|
तद्यथा- द्वे जङ्घापिण्डिके, द्वे ऊरुपिण्डिके, द्वौ स्फिचौ, द्वौ वृषणौ, एकं शेफः, द्वे उखे, द्वौ वङ्क्षणौ, द्वौ कुकुन्दरौ, एकंबस्तिशीर्षम्, एकमुदरं, द्वौ स्तनौ, द्वौ श्लेष्मभुवौ , द्वे बाहुपिण्डिके, चिबुकमेकं, द्वावोष्ठौ, द्वे सृक्कण्यौ, द्वौदन्तवेष्टकौ, एकं तालु, एका गलशुण्डिका, द्वे उपजिह्विके, एका गोजिह्विका, द्वौ गण्डौ, द्वे कर्णशष्कुलिके, द्वौ कर्णपुत्रकौ,द्वे अक्षिकूटे, चत्वार्यक्षिवर्त्मानि, द्वे अक्षिकनीनिके, द्वे भ्रुवौ, एकाऽवटुः, चत्वारि पाणिपादहृदयानि||११||
ṣaṭpañcāśat pratyaṅgāni ṣaṭsvaṅgēṣūpanibaddhāni, yānyaparisaṅkhyātāni pūrvamaṅgēṣuparisaṅkhyāyamānēṣu, tānyanyaiḥ paryāyairiha prakāśyāni bhavanti|
tadyathā- dvē jaṅghāpiṇḍikē, dvē ūrupiṇḍikē, dvau sphicau, dvau vr̥ṣaṇau, ēkaṁ śēphaḥ, dvē ukhē, dvauvaṅkṣaṇau, dvau kukundarau, ēkaṁ bastiśīrṣam, ēkamudaraṁ, dvau stanau, dvau ślēṣmabhuvau , dvēbāhupiṇḍikē, cibukamēkaṁ, dvāvōṣṭhau, dvē sr̥kkaṇyau, dvau dantavēṣṭakau, ēkaṁ tālu, ēkā galaśuṇḍikā,dvē upajihvikē, ēkā gōjihvikā, dvau gaṇḍau, dvē karṇaśaṣkulikē, dvau karṇaputrakau, dvē akṣikūṭē,catvāryakṣivartmāni, dvē akṣikanīnikē, dvē bhruvau, ēkā'vaṭuḥ, catvāri pāṇipādahr̥dayāni||11||
ShaTpa~jcAshat pratya~ggAni ShaTsva~ggeShUpanibaddhAni, yAnyaparisa~gkhyAtAnipUrvama~ggeShu parisa~gkhyAyamAneShu, tAnyanyaiH paryAyairiha prakAshyAni bhavanti|
tadyathA- dve ja~gghApiNDike, dve UrupiNDike, dvau sphicau, dvau vRuShaNau, ekaM shephaH, dveukhe, dvau va~gkShaNau, dvau kukundarau, ekaM bastishIrSham, ekamudaraM, dvau stanau, dvaushleShmabhuvau , dve bAhupiNDike, cibukamekaM, dvAvoShThau, dve sRukkaNyau, dvaudantaveShTakau, ekaM tAlu, ekA galashuNDikA, dve upajihvike, ekA gojihvikA, dvau gaNDau, dvekarNashaShkulike, dvau karNaputrakau, dve akShikUTe, catvAryakShivartmAni, dve akShikanInike, dvebhruvau, ekA~avaTuH, catvAri pANipAdahRudayAni||11||
The ''shadanga sharira'' could be divided further into fifty-six ''pratyangas'' (subdivisions). These include constituents or structures that were not described earlier. The fifty-six ''pratyangas'' include
*Two janghanapindaka (calf regions),
*Two ''urupindaka'' (thigh regions),
*Two ''sphik'' (gluteal regions),
*Two ''vrishana'' (testicles),
*One ''shepha'' (penis),
*Two ''ukha'' (axillae),
*Two ''vankshana'' (inguinal regions),
*Two ''kukundara'' (ischial regions),
*One ''bastishirsha'' (mons pubis),
*One ''udara'' (abdomen),
*Two ''stana'' (breasts),
*Two ''sleshmabhuvou'' (thoracobrachial regions),
*Two ''bahupindaka'' (forearms),
*One ''chibuka'' (chin),
*Two ''oshtha'' (lips),
*Two ''srakkani'' (margins of lips),
*Two ''dantaveshtaka'' (gums),
*One ''talu'' (palate),
*One ''galashundika'' (uvula),
*Two ''upajihvika'' (Tonsils),
*One ''gojihvika'' (glottis),
*Two ''ganda'' (cheek regions),
*Two ''karnashashkuli'' (auricles of ear),
*Two ''karnaputraka'' (tregus),
*Two ''akshikuta'' (orbits),
*Four ''akshivartma'' (eye lids),
*Two ''akshikaninika'' (pupils),
*Two ''bhruva'' (eye brows),
*One ''avatu'' (''nucha''),
*Four ''panipadahridaya'' (two palmar heart and two plantar hearts). [11]
==== External orifice of the body ====
नव महन्ति छिद्राणि- सप्त शिरसि, द्वे चाधः||१२||
nava mahanti chidrāṇi- sapta śirasi, dvē cādhaḥ||12||
nava mahanti chidrANi- sapta shirasi, dve cAdhaH||12||
There are nine major orifices or openings in the body, seven of which are located in the head region (two ocular, two nasal, two auditory and one oral) and two in the lower part of the body (one anal and one urethral).[12]
==== ''Pratyaksha sharira'' ====
एतावद्दृश्यं शक्यमपि निर्देष्टुम्||१३||
ētāvaddr̥śyaṁ śakyamapi nirdēṣṭum||13||
etAvaddRushyaM shakyamapi nirdeShTum||13||
As apparent (from skin to palm of the hands and soles of the feet), this is the only demonstrable topographical anatomy (''pratyaksha sharira'') which can be visualized by the normal eyes, and counted with certainty.[13]
==== Rationally computable ''shira, dhamani, snayu,'' etc. ====
अनिर्देश्यमतः परं तर्क्यमेव|
तद्यथा- नव स्नायुशतानि, सप्त सिराशतानि, द्वे धमनीशते, चत्वारि पेशीशतानि, सप्तोत्तरं मर्मशतं, द्वे सन्धिशते,एकोनत्रिंशत्सहस्राणि नव च शतानि षट्पञ्चाशत्कानि सिराधमनीनामणुशः प्रविभज्यमानानां मुखाग्रपरिमाणं, तावन्ति चैवकेशश्मश्रुलोमानीति|
एतद्यथावत्सङ्ख्यातं त्वक्प्रभृति दृश्यं, तर्क्यमतः परम्|
एतदुभयमपि न विकल्पते, प्रकृतिभावाच्छरीरस्य||१४||
anirdēśyamataḥ paraṁ tarkyamēva|
tadyathā- nava snāyuśatāni, sapta sirāśatāni, dvē dhamanīśatē, catvāri pēśīśatāni, saptōttaraṁmarmaśataṁ, dvē sandhiśatē, ēkōnatriṁśatsahasrāṇi nava ca śatāni ṣaṭpañcāśatkānisirādhamanīnāmaṇuśaḥ pravibhajyamānānāṁ mukhāgraparimāṇaṁ, tāvanti caiva kēśaśmaśrulōmānīti|
ētadyathāvatsaṅkhyātaṁ tvakprabhr̥ti dr̥śyaṁ, tarkyamataḥ param|
ētadubhayamapi na vikalpatē, prakr̥tibhāvāccharīrasya||14||
anirdeshyamataH paraM tarkyameva|
tadyathA- nava snAyushatAni, sapta sirAshatAni, dve dhamanIshate, catvAri peshIshatAni, saptottaraMmarmashataM, dve sandhishate, ekonatriMshatsahasrANi nava ca shatAni ShaTpa~jcAshatkAnisirAdhamanInAmaNushaH pravibhajyamAnAnAM mukhAgraparimANaM, tAvanti caivakeshashmashrulomAnIti|
etadyathAvatsa~gkhyAtaM tvakprabhRuti dRushyaM, tarkyamataH param|
etadubhayamapi na vikalpate, prakRutibhAvAccharIrasya||14||
<div style="text-align:justify;">
Starting this verse, the given anatomical descriptions will only be based on logic and reasoning, as the fixity of the count of the “rationally computable” constituents of the body is not possible. These include tissues like ligaments, muscles, veins and arteries. For example, the estimated count of ''snayu'' (ligaments) in this text has been put at 900, ''shira'' (veins) at 700, ''dhamani'' (arteries) at 200, ''peshi'' (muscles) at 400, ''marmas'' (vital parts) at 107, ''sandhi'' (joints) at 200, ''shira dhamani anuroopmukh'' (capillaries) at 29,956 and the same count (29,956) has been put for the number of ''kesh'' (hair), ''smashru'' (beard) and ''loma'' (body hair). Thus, an attempt has been made to enumerate all visible structures within the body - from the skin to the limbs down to all the “rationally computable” (''anumangamya'') structures. As described, these two types (''drashya'' and ''tarkamat'') of numbers do not change in status until an anomaly occurs.[14]
</div>
==== ''Anjali pramana'' (quantum of ''rasadi dhatu'') ====
यत्त्वञ्जलिसङ्ख्येयं तदुपदेक्ष्यामः; तत् परं प्रमाणमभिज्ञेयं, तच्च वृद्धिह्रासयोगि, तर्क्यमेव|
तद्यथा- दशोदकस्याञ्जलयः शरीरे स्वेनाञ्जलिप्रमाणेन, यत्तु प्रच्यवमानं पुरीषमनुबध्नात्यतियोगेन तथा मूत्रं रुधिरमन्यांश्चशरीरधातून्, यत्तु सर्वशरीरचरं बाह्या त्वग्बिभर्ति, यत्तु त्वगन्तरे व्रणगतं लसीकाशब्दं लभते, यच्चोष्मणाऽनुबद्धं लोमकूपेभ्योनिष्पतत् स्वेदशब्दमवाप्नोति, तदुदकं दशाञ्जलिप्रमाणं; नवाञ्जलयः पूर्वस्याहारपरिणामधातोः, यं ‘रस’ इत्याचक्षते; अष्टौशोणितस्य, सप्त पुरीषस्य, षट् श्लेष्मणः, पञ्च पित्तस्य, चत्वारो मूत्रस्य, त्रयो वसायाः, द्वौ मेदसः, एको मज्जायाः,मस्तिष्कस्यार्धाञ्जलिः, शुक्रस्य तावदेव प्रमाणं, तावदेव [१] श्लैष्मिकस्यौजस इति| एतच्छरीरतत्त्वमुक्तम्||१५||
yattvañjalisaṅkhyēyaṁ tadupadēkṣyāmaḥ; tat paraṁ pramāṇamabhijñēyaṁ, tacca vr̥ddhihrāsayōgi,tarkyamēva|
tadyathā- daśōdakasyāñjalayaḥ śarīrē svēnāñjalipramāṇēna, yattu pracyavamānaṁpurīṣamanubadhnātyatiyōgēna tathā mūtraṁ rudhiramanyāṁśca śarīradhātūn, yattu sarvaśarīracaraṁbāhyā tvagbibharti, yattu tvagantarē vraṇagataṁ lasīkāśabdaṁ labhatē, yaccōṣmaṇā'nubaddhaṁlōmakūpēbhyō niṣpatat svēdaśabdamavāpnōti, tadudakaṁ daśāñjalipramāṇaṁ; navāñjalayaḥpūrvasyāhārapariṇāmadhātōḥ, yaṁ ‘rasa’ ityācakṣatē; aṣṭau śōṇitasya, sapta purīṣasya, ṣaṭ ślēṣmaṇaḥ,pañca pittasya, catvārō mūtrasya, trayō vasāyāḥ, dvau mēdasaḥ, ēkō majjāyāḥ, mastiṣkasyārdhāñjaliḥ,śukrasya tāvadēva pramāṇaṁ, tāvadēva ślaiṣmikasyaujasa iti|
ētaccharīratattvamuktam||15||
yattva~jjalisa~gkhyeyaM tadupadekShyAmaH; tat paraM pramANamabhij~jeyaM, taccavRuddhihrAsayogi, tarkyameva|
tadyathA- dashodakasyA~jjalayaH sharIre svenA~jjalipramANena, yattu pracyavamAnaMpurIShamanubadhnAtyatiyogena tathA mUtraM rudhiramanyAMshca sharIradhAtUn, yattusarvasharIracaraM bAhyA tvagbibharti, yattu tvagantare vraNagataM lasIkAshabdaM labhate,yaccoShmaNA~anubaddhaM lomakUpebhyo niShpatat svedashabdamavApnoti, tadudakaMdashA~jjalipramANaM; navA~jjalayaH pUrvasyAhArapariNAmadhAtoH, yaM ‘rasa’ ityAcakShate; aShTaushoNitasya, sapta purIShasya, ShaT shleShmaNaH, pa~jca pittasya, catvAro mUtrasya, trayo vasAyAH,dvau medasaH, eko majjAyAH, mastiShkasyArdhA~jjaliH, shukrasya tAvadeva pramANaM, tAvadeva shlaiShmikasyaujasa iti|
etaccharIratattvamuktam||15||
<div style="text-align:justify;">
Now we will describe the ''anjali pramana'' (literally, measurable by joining both palms. The quantity in it is ''anjali'' of one’s hand) by which bodily constituents or ''rasadi dhatu'', could be quantified in our body. The quantity of ''dhatus'' given here are the maximum quantity of respective constituents in the body and it may increase or decrease. Their variability could be measured logically. Water within a body is equal to ten ''anjalis'' of the person. The elimination of water in feces and sweat is (because of) excess quantity of water. Similarly, water is present in a specific proportion in urine, blood and other ''dhatus'' in the body. ''Jala'' within the whole body is stored in the external layer of the ''twacha'' (''udakadhara''). Water designated as ''lasika'', in the condition of a wound in the skin, is excreted through the hair pockets (sweat glands) as ''sweda'' (sweat). The quantum of water is equal to ten ''anjalis''. After the digestion of food, ''rasa'' (or ''rasa dhatu'') is equal to nine ''anjalis'', ''rakta'' (blood) is eight ''anjalis'', seven ''anjalis'' is ''purisha'' (feces), six ''anjalis'' is ''shleshma'', five ''anjalis'' is ''pitta'', four ''anjalis'' is ''mutra'', three ''anjalis'' is ''vasa'', two ''anjalis'' is ''meda'', one ''anjali'' is ''majja'', half ''anjali'' is ''mastishka'', half ''anjali'' is ''shukra'' and half ''anjali'' is ''slaeshmic ojas''. This concludes the measurement of body constituents. [15]
</div>
==== ''Panchamahabhautic'' (basic elemental) consideration of the body constituents ====
तत्र यद्विशेषतः स्थूलं स्थिरं मूर्तिमद्गुरुखरकठिनमङ्गं नखास्थिदन्तमांसचर्मवर्चःकेशश्मश्रुलोमकण्डरादि तत् पार्थिवं गन्धोघ्राणं च; यद्द्रवसरमन्दस्निग्धमृदुपिच्छिलं रसरुधिरवसाकफपित्तमूत्रस्वेदादि तदाप्यं रसो रसनं च; यत् पित्तमूष्मा च यो या चभाः शरीरे तत् सर्वमाग्नेयं रूपं दर्शनं च; यदुच्छ्वासप्रश्वासोन्मेषनिमेषाकुञ्चनप्रसारणगमनप्रेरणधारणादि तद्वायवीयं स्पर्शःस्पर्शनं च; यद्विविक्तं यदुच्यते महान्ति चाणूनि स्रोतांसि तदान्तरीक्षं शब्दः श्रोत्रं च; यत् प्रयोक्तृ तत् प्रधानं बुद्धिर्मनश्च|
इति शरीरावयवसङ्ख्या यथास्थूलभेदेनावयवानां निर्दिष्टा||१६||
tatrayadviśēṣataḥsthūlaṁsthiraṁ mūrtimadgurukharakaṭhinamaṅgaṁnakhāsthidantamāṁsacarmavarcaḥkēśaśmaśrulōmakaṇḍarādi tat pārthivaṁ gandhō ghrāṇaṁ ca;yaddravasaramandasnigdhamr̥dupicchilaṁ rasarudhiravasākaphapittamūtrasvēdādi tadāpyaṁ rasōrasanaṁ ca; yat pittamūṣmā ca yō yā ca bhāḥ śarīrē tat sarvamāgnēyaṁ rūpaṁ darśanaṁ ca;yaducchvāsapraśvāsōnmēṣanimēṣākuñcanaprasāraṇagamanaprēraṇadhāraṇādi tadvāyavīyaṁ sparśaḥsparśanaṁ ca; yadviviktaṁ yaducyatē mahānti cāṇūni srōtāṁsi tadāntarīkṣaṁ śabdaḥ śrōtraṁ ca; yatprayōktr̥ tat pradhānaṁ buddhirmanaśca|
iti śarīrāvayavasaṅkhyā yathāsthūlabhēdēnāvayavānāṁ nirdiṣṭā||16||
tatra yadvisheShataH sthUlaM sthiraM mUrtimadgurukharakaThinama~ggaMnakhAsthidantamAMsacarmavarcaHkeshashmashrulomakaNDarAdi tat pArthivaM gandho ghrANaM ca;yaddravasaramandasnigdhamRudupicchilaM rasarudhiravasAkaphapittamUtrasvedAdi tadApyaM rasorasanaM ca; yat pittamUShmA ca yo yA ca bhAH sharIre tat sarvamAgneyaM rUpaM darshanaM ca;yaducchvAsaprashvAsonmeShanimeShAku~jcanaprasAraNagamanapreraNadhAraNAdi tadvAyavIyaMsparshaH sparshanaM ca; yadviviktaM yaducyate mahAnti cANUni srotAMsi tadAntarIkShaM shabdaHshrotraM ca; yat prayoktRu tat pradhAnaM buddhirmanashca|
iti sharIrAvayavasa~gkhyA yathAsthUlabhedenAvayavAnAM nirdiShTA||16||
<div style="text-align:justify;">
Specific expressions, structures, and organs of the body could be attributed to specific fundamental elements (''mahabhutas'') that they are made up of and, thus, display the properties of those elements. This verse lists them thus:
*''Bhavas'' (expressions) of the body, specifically, ''sthula'' (solid), ''sthira'' (fixed), ''moortimana'' (visible), ''guru'' (heavy), ''khara'' (rough) and ''kathina'' (hard) are ''parthiva'' (''prithvi tattva pradhan'', or ''prithvi'' predominant properties), and are the qualities of ''nakha'' (nails), ''asthi'' (bones), ''danta'' (teeth), ''mamsa'' (muscle), ''charma'' (skin), ''varchas'' (feces), ''kesha'' (hair), ''smashru'' (beard), ''loma'' (body hair), ''kandara'' (tendons). All ''gandha'' (smells, olfactory senses) are ''parthiva'' (''prithvi guna pradhan'', i.e., of the qualities of ''prithvi'').
*''Dravyas'', especially ''drava'' (liquid), ''sara'' (slight movable), ''manda'' (slow), ''snigdha'' (unctuous), ''mridu'' (soft), and ''pichchhil'' (viscous), are all ''apya bhava'' (''jala tattva pradhan'', or ''jala'' predominant properties), and are the properties of bodily constituents such as ''rasa'' (plasma), ''rakta'' (blood), ''vasa'' (muscle fat), ''kapha, pitta, mootra'' (urine) and ''sweda'' (sweat). Taste (''rasa'') and all gustatory senses are ''apya'' (''jala guna pradhan'', i.e., are predominantly of the qualities of ''jala'').
*Those which are in the form of ''pitta'', and possess properties such as ''ushma'' (hot, warm), ''bha'' (shine or aura around the body), possess ''rupa'' (with a visible form) and are associated with vision sense organs are ''agneya'' (''agni guna pradhan'', or predominantly of the qualities of ''agni'').
*Functions such as ''uchhwas'' (inspiration, or breathing in), ''prashwas'' (expiration, or breathing out), ''unmesh'' (opening of eyes), ''nimesh'' (closing of eyes), ''akunchan'' (flexion), ''prasarana'' (extension), ''gamana'' (movement), ''prerana'' (expulsion), ''dharana'' (retention) and all tactile senses are ''vayaviya bhava'' (''vayu'' predominant expressions).
*Those that are ''vivikta avayava'' (structures with space and openings), major and minor ''srotasas'', sound and hearing sensory organs are all ''akashiya bhava''.
*That which is the owner of all the ''bhavas'' and is the user of them, the ''jeevatma'', which is the head (''pradhana''), the soul. Including the ''buddhi'' and ''mana'', these three are the systemic sources for perception of information and development of knowledge in the body.
Thus, the key organizing/governing components of body have been described briefly. [16]
</div>
==== Innumerability of the organic constituents of the body ====
शरीरावयवास्तु परमाणुभेदेनापरिसङ्ख्येया भवन्ति, अतिबहुत्वादतिसौक्ष्म्यादतीन्द्रियत्वाच्च|
तेषां संयोगविभागे परमाणूनां कारणं वायुः कर्मस्वभावश्च||१७||
śarīrāvayavāstu paramāṇubhēdēnāparisaṅkhyēyā bhavanti, atibahutvādatisaukṣmyādatīndriyatvācca|
tēṣāṁ saṁyōgavibhāgē paramāṇūnāṁ kāraṇaṁ vāyuḥ karmasvabhāvaśca||17||
sharIrAvayavAstu paramANubhedenAparisa~gkhyeyA bhavanti,atibahutvAdatisaukShmyAdatIndriyatvAcca|
teShAM saMyogavibhAge paramANUnAM kAraNaM vAyuH karmasvabhAvashca||17||
<div style="text-align:justify;">
The structures and components of body, if differentiated at micro level (''paramanu bheda''), are innumerable (''aparisankhyeya'') because of abundance (''atibahuta''), highly subtleness (''atisukshma''), and imperceptibility(''atindriya''). The conjoining or cell combination or unification (''samyoga'') and the split or cell division (''vibhaga'') of ''deha paramanu'' - both are caused by ''vayu'' and ''karmaswabhava''. [17]
</div>
==== Importance of the knowledge of the organs and structures of the body ====
तदेतच्छरीरं सङ्ख्यातमनेकावयवं दृष्टमेकत्वेन सङ्गः, पृथक्त्वेनापवर्गः|
तत्र प्रधानमसक्तं सर्वसत्तानिवृत्तौ निवर्तते इति||१८||
tadētaccharīraṁ saṅkhyātamanēkāvayavaṁ dr̥ṣṭamēkatvēna saṅgaḥ, pr̥thaktvēnāpavargaḥ|
tatra pradhānamasaktaṁ sarvasattānivr̥ttau nivartatē iti||18||
tadetaccharIraM sa~gkhyAtamanekAvayavaM dRuShTamekatvena sa~ggaH, pRuthaktvenApavargaH|
tatra pradhAnamasaktaM sarvasattAnivRuttau nivartate iti||18||
<div style="text-align:justify;">
The body can be considered as an organization of organs and systems. The conjunction of all the organs within the body is known as ''sanga'' (attachment) and their detachment is ''apavarga'' (to go away). As such when the owner of the body sees himself detached from the material world and observes his own body as a detached observer, he is free from all passions, emotions and attachments with the creature comforts and the trappings of the material world, and is said to be on the path to salvation. In other words, when the cycle of ''sanyoga'' and ''vibhaga'', or unification and division, comes to an end, the holder (''pradhan'') of the body naturally finds ultimate salvation. [18]
</div>
==== Summary ====
तत्र श्लोकौ-
शरीरसङ्ख्यां यो वेद सर्वावयवशो भिषक्|
तदज्ञाननिमित्तेन स मोहेन न युज्यते||१९||
tatra ślōkau-
śarīrasaṅkhyāṁ yō vēda sarvāvayavaśō bhiṣak|
tadajñānanimittēna sa mōhēna na yujyatē||19||
tatra shlokau-
sharIrasa~gkhyAM yo veda sarvAvayavasho bhiShak|
tadaj~jAnanimittena sa mohena na yujyate||19||
The physician who knows the body as an organization of organs and systems, along with all their constituents, never falls into any ''moha'' (attachment, lure of the body) caused due to ignorance. [19]
अमूढो मोहमूलैश्च न दोषैरभिभूयते|
निर्दोषो निःस्पृहः शान्तः प्रशाम्यत्यपुनर्भवः||२०||
amūḍhō mōhamūlaiśca na dōṣairabhibhūyatē|
nirdōṣō niḥspr̥haḥ śāntaḥ praśāmyatyapunarbhavaḥ||20||
amUDho mohamUlaishca na doShairabhibhUyate|
nirdoSho niHspRuhaH shAntaH prashAmyatyapunarbhavaH||20||
<div style="text-align:justify;">
A truly wise person, one who knows of every aspect of the body, does not fall into the afflictions of ''doshas'' caused due to ignorance. Moreover, after knowing the secrets of life and after becoming free from the trappings of ''raga'' and ''dvesha'' (attachment and detachment), as well as after becoming ''nirdushta'' (fair, neutral, free from the qualities of ''raja'' and ''tama'') and ''sprasharahit'' (unflappable, calm), he becomes free from the cycle of birth and death and gains ultimate lasting peace.[20]
=== ''Tattva Vimarsha'' ===
*The physician who knows the body as an organization of organs and systems, along with all their constituents and has knowledge of not only gross anatomy but of the cellular, sub cellular and deepest level of their function can manage diseases and prevent recurrence. This leads to a disease free status. One who knows of every aspect of the body, does not fall into the afflictions of ''doshas'' caused due to ignorance.
*The knowledge of anatomy and physiology is important to understand prognosis of disease in terms its severity and probable duration of treatment. It also indicates towards the probable receptors for disease specific target oriented drug delivery system.
*The quantification of ''dhatu'' is personified in terms of ''anjali'' measurement. Therefore the standard limits of physiological fluids will vary according to ''anjali'' of a person.
*The basic ''panchabhautik'' composition of body constituents shall be considered while treating a disease.
=== ''Vidhi Vimarsha'' ===
==== Special significance of skin in Ayurveda ====
The skin is the biggest organ of the body and makes the integumentary system, comprising of hair, nails etc. It constitutes 16% of body weight. It is a combined product of ectoderm as well as of mesoderm. Akin to the nervous system, epidermis is developed from the ectoderm, whereas dermis is derived from the mesoderm. The skin, from the standpoint of Ayurveda, is the ''upadhatu'' of ''mamsa dhatu'', which may be because of their common germinal base. The muscles and dermis - both are organs of mesoblastic origin. Dermis is a well vascularized structure and is a very active organ. Epidermis has no blood vessels and only its basal layers get nourishment from the source of dermis next to it. The skin is also called ''mamsavaha srotas'' (Ch. Vi. 5/7) since the skin synthesises<ref>Elaine N. Marieb, Human Anatomy and Physiology, 6th edition, pearson Education, Inc. Ch 24.</ref> Vitamin D, a basic source for calcium. Calcium is assimilated and absorbed from the gut with the help of vitamin D. The physiology of action in the muscle is totally calcium dependent. This is why ''twak'' is considered to be the ''mula'' (root) of ''mamsavaha srotas''<ref> Guyton & Hall, textbook of medical Physiology, 10th edition, saunders, Philadelphia, Chapter 6. </ref>.
The skin is made up of three basic layers:
*Epidermal layer
*Dermal layer, and
*Hypodermal layer
The epidermal layer, also called epidermis, is the outermost layer and is derived from the ectoderm. This provides an overcoat type of an arrangement to the body, so that the internal organs of the body are physically protected. There are two types of skin cells – keratinized (or those that synthesize keratin, a structural protein that is core to the protective properties of skin) and non-keratinized. The epidermis is made up of various layers of keratinized cells, as are nails, hair and wool. From the level of its base (inner side) to the outermost surface the epidermis consists of the following layers:
*Stratum Basale
*Stratum Spinosum
*Stratum Granulosum
*Stratum Lucidum
*Stratum Corneum
The development of skin (''twacha'') and its anatomy is described. (Sushruta sharira-4/3&4).
''Twacha'' (skin) develops during the formation of the human body, in a similar chronological order, just the way a membrane of cream develops over warm milk. He theorized a seven-layer structure of the skin consisting of:
*''Avabhasini'',
*''Lohita'',
*''Sweta'',
*''Tamra'',
*''Vedini'',
*''Rohini'', and
*''Mansadhara twacha''3
These layers of ''twacha'' are analogous with the layers of epidermis, dermis and hypodermis.
There are several dissimilarities in the view points of two texts of [[Charaka Samhita]] and ''Sushruta samhita''. Per Charaka, there are six layers in ''twacha'' whereas seven layers per Sushruta. On the basis of clinical features, the last layer in Charaka’s structural model of the skin is ''vedini'' whereas ''vedini'' is the fifth layer in Sushruta’s model. Next, Charaka did not present any developmental theory on ''twacha'' whereas Sushruta wrote the ''Santanaka Siddhanta'' on this account. Finally, the basis of nomenclatures presented in Charaka’s and Sushruta’s models are also different. Charaka’s model has more clinical aspects while Sushruta’s model has more anatomical and physical aspects considered. The below table is a high-level comparison of the Charaka and the Sushruta models of Skin.
</div>
{| class="wikitable"
! rowspan="1"| Sr. no.
! rowspan="1"| Layers of Twacha (Charaka)
! rowspan="1"| Layers of Twacha (Sushruta)
|-
| 1- || Udakadhara twacha || Awabhasini
|-
| 2- || Asrugdhara twacha || Lohita
|-
| 3- || Tritiya, seat of sidhma & kilas || Shweta
|-
| 4- || Chaturthi, seat of dadru & kushtha || Tamra
|-
| 5- || Panchami, seat of alaji & vidradhi || Vedini
|-
| 6- || Seat of pain (causes pain when cut) || Rohini
|-
| 7- || --------------------------------------------------- || Mamsadhara twacha
|-
|}
<div style="text-align:justify;">
Correlating Charaka’s layers with the modern scientific names for the various layers of skin, we come up with the following mapping:
• The first layer, udakadhara twacha could be the same as stratum corneum.
• The second layer, Asrugdhara twacha could be the same as stratum lucidum,
• The third layer, Tritiya twacha could be the same as stratum granulosum,
• The fourth layer, Chaturthi twacha could be stratum germinosum (combination of spinosum and basale layers),
• The fifth layer, Panchami twacha could be the Papillary layer, and
• The sixth layer, Shashthi twacha could be the Reticular layer.
Alternative views on this topic could be researched further, since the papillary and reticular layers are the part of dermis and anatomically represent a single organic entity therefore the fifth and sixth layers of Charaka’s ''twacha'' model may correlate with the dermis layer together. The same goes with Sushruta’s ''vedini'' and ''rohini'' layers (excluding Sushruta’s seventh layer from our analysis).
From the standpoint of clinical importance of the ''twacha sharira'', the function of the skin is not described clearly in Ayurveda. However, the functions of skin could be inferred through references in various ''samhitas''. Charaka has presented the characteristics of the ''twaksara purusha'' (excellence of ''twak'') under [[Vimana Sthana]]4, which details the functions and properties of normal skin . The skin of the ''twakasara purusha'' should be unctuous (''snigdha''), smooth (''shlakshna''), soft (''mridu''), clean/glorious (''prasanna''), fine (''sukshma''), close/not loose (''alpa''), thick (''gambhir''), with soft hair (''sukumar loma''), and radiant (''saprabha''). This type of excellent quality of skin is indicative of a lot of qualities in an individual, including happiness, prosperity, splendor, pleasure, intelligence, knowledge, health, contentment and longevity. (Ch. Vi.8/103)
As such, the texture or appearance of the skin is reflective of the inner state of a person. If skin is healthy, it is likely that other organs of the body will be healthy as well. Symptoms of sickness of other systems get reflected on the skin. So, if the skin is taken good care of, or observed carefully, it would help take preventive measures and generally would benefit other bodily systems also. This realization has led to the development of various therapies under the general umbrella of [[Panchakarma]]. According to Sushruta, the skin is the seat of ''bhrajaka pitta'', and because of ''bhrajak pitta''5, the skin catalyzes the metabolic processes related with the therapies of ''abhyanga, parisheka, avagaha, alepana, udvartana'', etc.(Su.Su.21/10)
Skin is largely an organ of ectodermal origin, like the nervous system. All sensory organs have the same basis for development and because the nervous system has evolved to ensure the protection/survival of the organism against the changes in internal and external environments (and this explanation could be extended to the evolution of the other sensory organs as well), these are derived from the ectoderm. As such, the skin gives the person his “personality” and identity. Sharangadhara writes that healthy skin enhances wisdom, knowledge and overall health of an individual, while describing the functions of ''pitta''6 (''Sharangadhara purva khanda'' 5/30).[4]
Sushruta has also quoted that the body has six divisions. In the chapter ''Sharirasankhya Vyakarana'', he specially quotes that the ''garbha'' (embryo) is formed after fertilization of ovum with sperm, which is charged with ''chetana'' (consciousness) and in which ''vayu'' functions for division, ''teja'' functions for ''pachana, apa'' functions for ''kledana'' (moisture), ''prithvi'' functions for ''samhanana'' (compactness) and ''akasha'' functions for ''vivardhana'' (growth). Such a ''garbha'', when attains the development of organs and structures like ''hasta, pada, jihva, ghrana, karna, nitamba'' etc. then is called ''sharira''. That ''sharira'' is ''shadanga sharira''7, having four limbs (two upper limb and two lower limbs), fifth is the torso and the sixth is the head (Sushruta Sharira 5/2)[5]
</div>
==== ''Asthi sharira''(description of bones) ====
To add more clarity in topographical knowledge, the bones as said by Charaka are presented in table.
{| class="wikitable"
! rowspan="1"| Ser. no.
! rowspan="1"| Name of the bone by Charaka
! rowspan="1"| Number
! rowspan="1"| Modern consideration
|-
| 1 || Danta (teeth) || 32 || Teeth are not considered as bone
|-
| 2 || Danta Udukhal (teeth sockets) || 32 || Nil
|-
| 3 || Nakha (nails) || 20 || Nails are not considered as bone
|-
| 4 || Angulyasthi (phalanges) || 60 || Phalanges are 56 (thumb has only 2)
|-
| 5 || Shalakasthi(metacarpals, metatarsals) || 20 || Same
|-
| 6 || Shalakashraya (distal carpals & tarsals) || 4 || Distal carpals & tarsals are 4 in each limb (total 16)
|-
| 7 || Parshni (calcaneus) || 2 || Same
|-
| 8 || Gulphasthi (talus & navicular) || 4 || Same
|-
| 9 || Manikasthi (proximal carpal bones) || 2 || Proximal carpal bones are 8 (4 in each side)
|-
| 10|| Aratni (radius & ulna) || 4 || Same
|-
| 11|| Janghasthi (tibia & fibula) || 4 || Same
|-
| 12|| Janvasthi || 2 || Nil (no such bone, menisci may be taken but these are 4 in number, optionally left and right can be taken as one unit)
|-
| 13|| Janukapal (patella) || 2 || Same
|-
| 14|| Urunalaka (femur) || 2 || Same
|-
| 15|| Bahunalaka (humerus) || 2 || Same
|-
| 16|| Ansasthi (clavicle) || 2 || As clavicle is important bone making shoulder, so clavicle is a better option for Ansasthi.
|-
| 17|| Ansaphalakasthi (scapula) || 2 || Same
|-
| 18|| Akshakasthi (sternoclavicular articular disc) || 2 || Amsasthi suits to be said for clavicle & Amsaphalakasthi for scapula, hence the disc suits to be taken for Akshakasthi.
|-
| 19|| Jatru (sternum) || 1 || Same
|-
| 20|| Talvasthi (palatines) || 2 || Same
|-
| 21|| Shroniphalaka (hip bone) || 2 || Same
|-
| 22|| Bhagasthi (pubic articular disc) || 1 || Nil (because pubic articular disc is not a bone)
|-
| 23|| Prashthagata Asthi (thoracic, lumber, sacral and coccygeal vertebrae) || 45 || Only 26 (12 thoracic, 5 lumber, 5 sacral and 4 coccygeal vertebrae)
Note-12 thoracic discs, 5 lumber discs and 2 probable sacral discs (seen sometimes in the lumbarisation of 2 sacral vertebrae these findings are visible) fulfils the lacuna here.
|-
| 24|| Grivagata asthi (cervical vertebrae and other bones) || 15 || Only 8 (7 cervical vertebrae, and 1 hyoid bone), Note-7 cervical discs fulfill the lacuna here.
|-
| 25|| Uroasthi (costal cartilages) || 14 ( 14 costal cartilages) || Nil (cartilage are not the bones)
|-
| 26|| Parshuka (ribs) || 24 || Same
|-
| 27|| Parshukasthalaka (rib sockets) || 24 || Nil (no such bone)
|-
| 28|| Parshukarbuda (rib tubercles) || 24 || Nil (no such bone)
|-
| 29|| Hanvasthi (mandible) || 1 || Same
|-
| 30|| Hanumoolabandhanasthi (mandibular articular disc) || 2 || Nil (disc is not considered as bone)
|-
| 31|| Nasikasthi (nasal) || 1(2) || 2 (nasal bones are 2)
|-
| 32|| Gandakutasthi (zygomatic) || 1(2) || 2 (zygomatic bones are 2)
|-
| 33|| Lalatasthi (frontal) || 1 || Same
|-
| 34|| Shamkhasthi (temporal) || 2 || same
|-
| 35|| Shirakapalasthi (skull bones) || 4 || same (1 sphenoid, 1 occipital and 2 parietal bones)
|-
|}
<div style="text-align:justify;">
Charaka followed the vedic scriptures and rituals, as is evident from his works. Since touching or handling bones was considered inauspicious, he presumably did not verify and count the bones himself but only repeated whatever was quoted in the ''vedas''. In any case, we find at many places that he was very accurate in his assessment of the number of bones in various parts of the body, e.g. bones of ''prashtha bhag, griva bhag, hanu bhag, shroni bhag'' and ''urah'' (if cartilages are counted as bones). It is interesting to note that Charaka considered articular disc of the tempero mandibular joint an ''asthi'' (bone) and designated it ''hanumoolabandhana''.
==== Number of bones in modern anatomy ====
In modern anatomy, the adult human body consists of 206 bones. Divided by different parts of the body, these come to
*Upper limb: fourteen phalanges, five metatarsals, eight carpals, one radius, one ulna, one humerus, one clavicle and one scapula, or 32 bones per limb (64 in all).
*Lower limb: fourteen phalanges, five metatarsals, seven tarsals, one tibia, one fibula, one patella, one femur, one hip bone, or 31 bones per limb (62 in all).
*Torso: 26 bones in the vertebral column (twelve thoracic, five lumbar, one sacrum, one coccyx, 24 ribs (twelve in each side), and one sternum, or 44 bones in all
*Neck region: Seven cervical vertebra, one hyoid bone, or eight bones in all
*Head region: One mandible, one vomer, one ethmoid, one sphenoid, one frontal, one occipital, two palatines, two maxillae, two inferior nasal chonchi, two zygomatics, two nasals, two lacrimals, two temporals, two parietals, or 22 bones in all
*Auditory ossicles: Six bones (malleus, incus and stapes - three bones in each ear)
Sushruta’s presentation on ''asthi sankhya'': Sushruta has presented the number of bones in the body on the basis of ''pratyaksha sharira'', and submitted that bones classified in five types (''kapal, ruchaka, taruna, valaya, nalaka''), and per him, these are 300 in number. Because teeth are considered ''ruchakasthi'' and cartilages are considered ''tarunasthi'', these are counted as bones<ref>Ghanekar, Sushruta Samhita, Sharira Sthan, 2012 edition, Meharchand Laxmandas Publications, New Delhi, 5/22 & 5/17.</ref>, and thus total up to 300 in number (Sushruta Sharira 5/17). On subdividing, these bones are 120 in the extremities (30 in each), 117 in the pelvis region, the sides, back and the chest, and 63 in the region in and above the neck.
==== Major difference between Charaka and Sushruta on the topic of bones ====
#Charaka was a ''vedavadi'' whereas Sushruta was not, he was a ''shalya shastri'' (surgeon), and hence Charaka has not given any classification of bones, while Sushruta has.
#Charaka counted nails as ''asthi'' (bones) whereas Sushruta has not.
#Charaka has counted sacral and coccygial bones under bones of the back (''prashthasthi'') whereas Sushruta has counted them under the bones of ''shroni'' (pelvis).
#Charaka has counted 32 teeth sockets as ''asthi'' whereas Sushruta has not counted them as ''asthi''.
#Charaka has counted ''hanumoola bandhana'' (mandibular disc) under ''asthi'', whereas Sushruta has not.
#In other accounts differences vary on both sides
Gananath Sen<ref> Gananathsen, Pratyaksha Shariram,1st part1941 edition, Kalpataru Press Calcutta, 3rd chapter </ref>, a reputable contemporary authority in the subject of ''sharira'', has submitted some exclusive opinions. Other than the observations on Charaka being a ''vedavadi'', or the inclusion of teeth nails as bones, etc., he points to certain conditions arising because of ossification centers in the bones. According to him, the presence of secondary ossification centers (epiphysis) may increase the number of bones in counting. [6]
Reviewing ''indriya'' requires the review of materials quoted under [[Indriyopakramaniya Adhyaya]] under [[Sutra Sthana]]. Under this chapter, Charaka has presented ''pancha panchaka vigyana''<ref> Bramhanand Tripathi, commentary on Charaka Samhita, Sutra Sthan, 2004 edition, Choukhamba Surbharati Prakashan, Varanasi, 8</ref> and said that there are five ''indriya'', five ''indriya dravya'', five ''indriyaadhishthana'', five ''indriyartha'' and five ''indriyabuddhi''.(Charaka Sutra 8/3)
After an exhaustive modern review, it can be said that ''panchendriya'' are such types of receptor cells which are located at the most peripheral end part of sensory pathway and function to transform the various specific type of energies into electrical energy, since brain cells know only one type of language/energy i.e. electricity. Therefore, every other type of energy is transformed into electricity and this is done by a frontline transforming cell. In every type of sensory organ, there are specific types of energy transforming cells, e.g. pressure sensitive nerve endings in pacinian corpuscle for touch, taste sensitive nerve endings in taste buds for taste, smell sensitive nerve endings in gustatory cells for smell, light sensitive nerve endings in rods and cones for vision and sound sensitive nerve endings in hair cells for hearing. In this account these cells could be considered ''indriya''. Sensory receptors<ref> Guyton & Hall, Textbook of Medical Physiology, 12th edition, saunders, Philadelphia, page no. 560- 569. </ref> could be classified in the following two ways i.e. (a) On the basis of the location of the receptor, and (b) on the basis of the modality of energies. Under the first category, there are three types, i.e. extero-receptors, intero-receptors and proprio-receptors, and under the second category there are several types of receptors, e.g. mechano-receptors, thermo-receptors, vibro-receptors, baro-receptors, proprio-receptors, photo-receptors, chemo-receptors, osmo-receptors, noscireceptors, tickle-receptors etc.)
''Panchendriyadravyani'' are ''panchamahabhutas'', i.e. kha (akasha), vayu, jyoti (agni), apa (jala) and bhu (prithvi). On the account of panchamahabhuta, there could be 26 biologically important elements<ref> Tortora Gerard J, Principles of Anatomy & Physiology, 11th edition, Harper & Row Publishers, New York, 1st chapter.</ref> (Tortora Gerard J., Principles of Anatomy and Physiology)
These elements are H, O, N, C, Ca, Mg, P, Na, K, Cl, S, I, Fl, Cu, Co, Cr, Fe, Se, Si, Vn, Sn,Zn, Mo, Mn, Al & B. As these elements are critical to the formation of life and are found in the animal cell, have some role in the development and function of the cell.
''Panchendriyadhishthana'' is the collective term for the key centers or sources of senses, i.e., skin (''twacha''), tongue (''jihva''), nose (''nasika''), eye (''netra'') and ear (''karna'').
The ''panchendriyartha'' are ''shabda'' (sound), ''sparsha'' (touch), ''rupa'' (shape), ''rasa'' (taste), ''gandha'' (smell). These are also called ''tanamatra'' and are the intrinsic basic energies of the respective materials. These energies are all related to their respective sensory receptor cells, e.g. ''shabda'' with vibro-receptors, ''sparsh'' with mechano-receptor, ''rupa'' with photo-receptors and ''rasa'' and ''gandha'' with chemo-receptors.
</div>
{| class="wikitable"
! rowspan="1"| Serial no.
! rowspan="1"| Indriyartha
! rowspan="1"| Sensory receptor cells
|-
| 1 || Shabda || Mechano/vibro receptors
|-
| 2 || Sparsh || Mechano, baro, thermo, nosci & proprio receptors
|-
| 3 || Roopa || Photo receptor
|-
| 4 || Rasa || Chemo receptor
|-
| 5 || Gandha || Chemo receptor
|-
|}
<div style="text-align:justify;">
''Panchendriyabuddhi'' are the five respective memories and “info-potentials” capable of synthesizing (identifying and translating) information received through the five sense organs, transmitted in the form of electrical energy. ''Indriyabuddhi'' are ''shabdindriyabuddhi'', ''sparshindriyabuddhi, roopindriyabuddhi, rasanindriyabuddhi'' and ''gandhindriyabuddhi''. These ''buddhis'' are located in the form of sensory areas and psychological/association areas.
</div>
{| class="wikitable"
! rowspan="1"| Sr. no.
! rowspan="1"| Indriyabuddhi
! rowspan="1"| sensory areas
! rowspan="1"| psychological/association
|-
| 1 || Shabdindriyabuddhi || Temporal lobe || Psychoauditory area, temporal lobe
|-
| 2 || Sparshindriyabuddhi || Post central gyrus || Psychosomatosensory area, parietal lobe
|-
| 3 || Roopindriyabuddhi || Occipital pole || Psychovisual area, occipital lobe
|-
| 4 || Rasanindriyabuddhi || Insula || Psychogustatory area,insula
|-
| 5 || Gandhindriyabuddhi || Innerside of temporal lobe || Limbic system (specially the hippocampus)
|-
|}
<div style="text-align:justify;">
''Buddhindriya'', as described here, seems to be different than ''panchendriya buddhi''. It can be observed that the ''panchendriya buddhi'' is a part of the cerebrum and is only a component of the ''indriya panchaka''. ''Buddhindriya'', on the other hand, is a part of the sensory system excluding ''indriyaadhishthana''. It implies that this includes all other four components mentioned in the preceding pages, namely ''indriya, indriyadravya, indriyartha'' and ''indriyabuddhi''. As a part of basic developmental embryology we find that most of the parts of a sensory system excluding the mesoblastic derivatives are developed as a part of brain. The same is very obvious in the eye, in which the parts of optic tract beginning from retina are all considered as part of brain. As such as a part of the theory of Charaka on ''gyanendriya'' it should be taken that five sensory systems are made of two components ''indriyadhishthan'' and ''buddhindriya''. ''Indriyadhishthana'' is the peripheral part of the organ connected by connective tissues of mesodermal origin, whereas ''buddhindriya'' stands for the remaining part that continues into the cerebrum as a logical, connected entity and comprises of four sub-factors: ''indriya, indriyadravya, indriyartha'' and ''indritabuddhi''.
''Panchakarmendriya'' (motor systems) are the hands (''hasta''), feet (''pada''), anus (''payu''), penis (''upastha'') and tongue (''jihva''). Here, the question is whether these motor organs are formed by only a group of muscles dealing with a given function or by a group of muscles and their nerves or the group of muscles and their nerves and their controlling part of brain (motor cortex) because muscle itself cannot perform any function alone. The muscle only performs when the nerve supply is intact and the commanding system is properly functioning. When there is failure in performance it is from all the side as a composite failure. Moreover when there is paralysis of motor organs or of a part of the system, it may be due to disruption in the nervous system or degeneration of a nerve or of the motor tract including UMN or cortical neurons. Hence muscles alone cannot be considered responsible for ''karmendriya''. ''Karmendriya'' can only be the complete motor system comprising organs from motor cortex to the muscles. [7]
Sushruta mentions that ''hridaya'' is formed by the ''prasad bhag'' of ''kapha'' and ''shonita/rakta'' (mentioned in Amarkosh, where it is also referred to as ''hridaya'') and is the seat of ''pranavaha dhamani''. Inferior to it are ''pleeha'' (spleen) and ''phuphphus'' (lung) and to its right side are ''yakrit'' (liver) and ''kloma'' (pancreas). As reiterated on multiple occasions, the ''hridaya'' is the seat of chetana<ref> Ghanekar, Sushruta Samhita, Sharira Sthana, 2012 edition, Meharchand Laxmandas Publications, New Delhi, 4/30 </ref>. When it gets covered by ''tama'', the being goes into sleep (Sushruta Sharira 4/30).
In other places within the Amarkosh, the word ''hridaya'' has been used synonymously with mana<ref> 14.Amar singh, Namalinganushashanam Amar Koshah, 1940 edition, Oriental Book Agency, Poona. </ref>. However, the ''hridaya'' is not a proxy of ''mana''. The heart means ''harati raktam'', or ''hriyate raktam anen iti'', i.e., from which blood is taken or given to the body. Arteries are called ''pranavaha'' (or carriers of life-force), because they deliver oxygen-rich blood from the heart, the failure of which most certainly leads to death.
At this point it is also important to delve into the meaning of ''chetana''. ''Chetana'' literally means awareness or consciousness. The root word is ''chit'' (to be conscious), which is also the root word for other Sanskrit terms like ''chitta'' (mind) and ''chaitanya'' (one who has ''chetana''). Physiologically this factor can be seen in the form of action potential<ref> 15.Guyton & Hall, Textbook of Medical Physiology, 10th edition, saunders, Philadelphia, page no.61 </ref>. When a command is given for action it results in the generation of action potential. Action potential when generated is transferred to the next structure and is finally sent to the muscles or other organs. For all this to happen, energy is needed. Energy is made available by ATP, formed in the mitochondria of a cell where energy is produced through oxidation of glucose. Half of the energy produced is diffused to keep the body warm and maintain body temperature, while the remaining half is used to form ATP (ADP+P+7kcal energy=ATP). Adenosine Triphosphate (ATP), the molecule found in all living organisms that is the main immediate source of usable energy for the activities of the cells. Because the energy-exchanging function of ATP and the catalytic (work-boosting) function of enzymes are intimately connected, ATP is characterized as a coenzyme. The adenosine part of the molecule is made up of adenine, a nitrogen-containing compound (also one of the principal components of the gene), and ribose, a five-carbon sugar. Three phosphate units (triphosphate), each made up of one phosphorus atom and four oxygen atoms are attached to the ribose. The two bonds between the three phosphate groups are high-energy bonds, that is, they are relatively weak and yield their energy readily when split by enzymes. With the release of the end phosphate group, 7 kilocalories (7 calories, in common usage) of energy become available for work, and the ATP molecule becomes ADP (adenosine diphosphate). Most of the energy-consuming reactions in cells are powered by the conversion of ATP to ADP. They include the transmission of nerve signals, the movement of muscles, the synthesis of protein, and cell division. Usually, ADP quickly regains the third phosphate unit through the action of cytochrome, a protein that builds it up by using food energy. In vertebrate muscle and brain cells, excess ATP can join with creatine to provide a reserve energy store. The release of two phosphate groups from ATP by the enzyme adenyl cyclase forms AMP (adenosine monophosphate), a nucleotide component of nucleic acids, the material of DNA; this enzyme is important in many of the body's reactions. The American biochemist Earl Sutherland, Jr., won the 1971 Nobel Prize in physiology or medicine for work showing that one form of AMP called cyclic AMP, created by the action of the enzyme adenyl cyclase, is instrumental in the activities of many hormones, including epinephrine and ACTH- Microsoft Encarta.) [8]
''Pranayatana'' (vital sites) in Ashtanga Samgraha: Vagbhata has shown some different features under the heading of ''pranayatana'' (Ashtanga Sangraha). Accordingly he has included ''jihvabandhana'' (root of tongue) as ''pranayatana'' and excluded ''mamsa'' from this account. The site of ''jihvabandhana'' is valuable because of the opening site of respiratory system. Any trauma at this blocking to respiratory passage may cause death, therefore it has been given much importance in anesthesia. In the case of deep coma falling of tongue back in the throat blocks the respiration and leads to death. Exclusion of ''mamsa'' from ''pranayatana'' by Vagbhatta seems to be his personal opinion only perhaps he was not willing to increase the number of ''pranayatana'', otherwise this was easy to justify.
''Prana'': When ''pranayatana'' are on the table of discussion we have to review ''prana''. Factors which maintain the life are ''prana''. ''Prana'' are said to be 12 in number by Sushruta (Sushruta Sharira 4/2). These ''pranas'' are ''agni, soma, vayu, satva, raja, tama, panchendriya'' and ''bhutatma''. As such these factors are categorically divided in four groups, i.e. ''tridosha, triguna, panchagyanendriya'' and ''bhutatma''. On a biological level tridosha can be seen somewhere in the form of biochemical regulators of life, e.g. hormones, enzymes etc., ''triguna'' in the form of neuro-chemical regulators of life, e.g. acetylcholine, epinephrine, dopamine, melatonin etc., and ''jnanendriya'' in the form of cell receptors and neuroreceptors. Speaking on ''bhutatma'' is a difficult job, whereas a critical evaluation of the same is must at this level. It is a well accepted fact in Ayurveda that all the organic world is ''panchamahabhautic''. At this level a ''bhuta'' could be considered to be an organism – a unicellular bacteria or a cell. Cell being a ''bhuta'' holds its ''atma'' in it which solely operates its function and development. Since DNA is responsible to control the function and development. The entire metabolism in the cell is basically controlled by DNA. DNA makes RNA by transcription, RNA makes protein by translation, protein is found basically in two types, i.e. structural and functional<ref>Dorothy Luciano, Human Structure & Function.1984 edition, Elsavier, Philadelphia, 1st & 2nd chapter.</ref>. Functional protein means enzyme. Enzyme mediates the biochemical changes in the body. Any change in the cell cannot be caused without the mediation of an enzyme. This is how we can see that DNA is solely controlling the metabolism in the body. Therefore if we refer the DNA to be taken as ''bhutama'', yet this will not be any mistake. [9]
Commentators of present time have very well worked for correlating the ''koshthangas'' presented by Charaka with the structure described in modern anatomy. Research scholars have also done well in this area. Suitable anatomical correlations for all 15 ''koshthangas'' are presented in the following table.
</div>
{| class="wikitable"
! rowspan="1"| Serial no.
! rowspan="1"| Koshthanga
! rowspan="1"| Anatomical correlation
! rowspan="1"| Controversy if any
! rowspan="1"| Comments
|-
| 1 || Nabhi || Umbilicus || Mesentery || Nabhi being koshthanga should be visceral organ,
|-
| 2 || Hridaya || Heart || --------------- || -------------------------------
|-
| 3 || Kloma || Pancreas || Gall bladder, trachea, pancreas, all 3 in different levels || Sushruta has quoted mandal sandhi under kloma Nadi, and also it’s location with yakrata, Charaka quoted under udakavaha srotas
|-
| 4 || Yakruta || Liver || ---------------- || ----------------------------------------------
|-
| 5 || Pleeha || Spleen || ---------------- || ----------------------------------------------
|-
| 6 || Vrakka || Kidney || ---------------- || ----------------------------------------------
|-
| 7 || Basti || Bladder || ---------------- || ----------------------------------------------
|-
| 8 || Purishadhara || Sigmoid colon || ---------------- || ----------------------------------------------
|-
| 9 || Amashaya || Stomach || ---------------- || ----------------------------------------------
|-
| 10|| Pakvashaya || Duodenum || Caecum || Caecum receives food after complete digestion, & is not repeated in this account, duodenum is the part of small intestine.
|-
| 11|| Uttarguda || Rectum || ---------------- || ----------------------------------------------
|-
| 12|| Adharguda, || Anal canal || ---------------- || ----------------------------------------------
|-
| 13|| Chhudranta || Small intestine || ---------------- || ----------------------------------------------
|-
| 14|| Sthulantra || Large intestine || ---------------- || ----------------------------------------------
|-
| 15|| Vapavahana || Omentum Thoracic duct || In the omentum there is no circulation of vapa, Circulation (vahan) of vapa determine vapavahana.
|-
|}
<div style="text-align:justify;">
Chakrapani on ''koshthanga'': According to Chakrapani<ref> Kashinath Shastri, Chakrapanidatta, Ayurved Dipika, Commentary on Charaka Samhita, 1st part, Sharira Sthan, 2007 edition, Choukhamba Samskrit Samsthan, Varanasi, 7/10 </ref>, ''kloma'' is the seat of thirst, ''basti'' is the seat of urine, ''uttarguda'' is where bowels are retained, through which bowels are evacuated is ''adharaguda'' and ''vapavahana'' (''tailvartika'') is the seat of ''meda''.
Sushruta on ''koshthanga'': Description of ''koshthanga'' is a topographical anatomy. Pattern of presenting topographical anatomy by Sushruta<ref> Ghanekar, Sushruta Samhita, Sharira Sthan, 2012 edition, Meharchand Laxmandas Publications, New Delhi, 5/4</ref> was different than that of Charaka. He has firstly presented the ''pratyanga'' (subdivisions of the regions), then he has presented further components (''gananiya avayava'') of ''pratyangas''. Under ''gananiya'' he has considered the ''koshangas''. Under this he has used composite terms for specific group of organs like ''ashaya'' which includes 7 organs. Among visceral organs he has considered ''unduka'' (caecum) and ''fupfus'' (lungs) under ''gananiya avayava'', which are not given by Charaka.
*''Koshthanga'' as seen by Henry Gray in modern Anatomy: Henry Gray<ref> Gray’s Anatomy, Descriptive & Applied, 29th edition ,1946, Longmans, green & company, London. </ref> father of modern anatomy has adopted a very special order of the distribution for the chapters. In the old edition, we can see that out of many chapters he has devised the presentation of chapters on functional systems like digestive, respiratory, urinary, re-productive and endocrine was different. He has clubbed these systems and put them in one basket and designated it splanchnology. This shows the Gray’s acceptance of Charaka’s idea on putting all visceral organs in one basket. Because this pattern has high amount of applied values this is why it got wide acceptance. [10]
</div>
*For developing more clarity in topographical knowledge, ''pratyangas'' was said by Charaka are presented in table as under.
{| class="wikitable"
|-
| Serial no. || Ayurvedic term || Modern correlation || Numbers
|-
| 1 || Janghanapindaka || Calf regions || 2
|-
| 2 || Urupindaka || Thigh regions || 2
|-
| 3 || Sphik || Gluteal regions || 2
|-
| 4 || Vrushana || Testicles || 2
|-
| 5 || Shepha || Penis || 1
|-
| 6 || Ukha || Axillae || 2
|-
| 7 || Vankshana || Inguinal regions || 2
|-
| 8 || Kukundara || Ischial regions || 2
|-
| 9 || Bastishirsha || Mons pubis || 1
|-
| 10|| Udara || Abdomen || 1
|-
| 11|| Stana || Breasts || 2
|-
| 12 || Shleshmabhuvou || Thoracobrachial region || 2
|-
| 13|| Bahupindaka || Fore arms / Brachial regions || 2
|-
| 14|| Chibuka || Chin || 1
|-
| 15|| Oshtha || Lips || 2
|-
| 16|| Srakkani || Margins of lips || 2
|-
| 17|| Dantaveshtaka || Gums || 2
|-
| 18|| Talu || Palate || 1
|-
| 19|| Galashundika || Uvula || 1
|-
| 20|| Upajihvika || Tonsils || 2
|-
| 21|| Gojihvika || Glottis || 1
|-
| 22|| Ganda || Cheek regions || 2
|-
| 23|| Karnashashkuli || Auricles of ear || 2
|-
| 24|| Karnaputraka || Trigus || 2
|-
| 25|| Akshikuta || Orbits || 2
|-
| 26|| Akshivartma || Eye lids || 4
|-
| 27|| Akshikaninika|| Pupils || 2
|-
| 28|| Bhruva || Eye brows || 2
|-
| 29|| Avatu || Nucha || 1
|-
| 30|| Panipadahridaya || Palmar heart and planter hearts || 4
|-
| --------- || Total || ---------------------------------------------- || 56
|-
|}
Sushruta on pratyanga: Sushruta’s concept was different on the heading of ''pratyanga''
(Sushruta Sharira 5/3).
<div style="text-align:justify;">
*According to him ''pratyangas''<ref> Ghanekar, Sushruta Samhita, Sharira Sthan, 2012 edition, Meharchand Laxmandas Publications, New Delhi, 5/3. </ref> are ''mastaka'' (cranium), ''udar'' (abdomen), ''prashtha'' (back), ''nabhi'' (umbilicus), ''lalat'' (fore head), ''nasa'' (nose), ''chibuka'' (chin), ''basti'' (urinary bladder) and ''greeva'' (neck) each one in number. ''Karna'' (ear), ''netra'' (eye), ''bhru'' (eye brow), ''shankha'' (temporal), ''amsa'' (shoulder), ''ganda'' (Cheek), ''kaksha'' (axilla), ''stana'' (breast), ''vrashana'' (scrotum), ''parshva'' (flank), ''sfig'' (gluteal region), ''janu'' (knee), ''bahu'' (upper arm) and ''uru'' (thigh) each two in number, ''anguli'' (fingers) 20 in number and ''srotasas'' (11 types). [11]
*The openings of the body which are presented by Charaka as major openings (''mahan chhidra''), same are referred by Sushruta<ref> Ghanekar, Sushruta Samhita, Sharira Sthan, 2012 edition, Meharchand Laxmandas Publications, New Delhi, 5/10 </ref> designating as ''bahirmukha srotas''. (Sushruta Sharira 5/10). Sharangadhara<ref> Parasuram Shasthri, Sharangadhara Samhita, Purva Khand,3rd edition 1983Choukhmba Orientalia, Varanasi,5/64. </ref> has presented 10 major openings by adding one opening (''bramha randhra'') in the cranium. (Sharangadhar Purvardha 5/64). In Bhagavad Geeta<ref> Shrimadbhagavat Geeta, 2005 editionGeeta Press Gorakhpur, 5/13 </ref> these ''bahirsrotasas'' are referred by the name of ''navadwara''. (GIta 5/13). [12]
*As presented by Charaka, ''pratyksha sharira'' is limited and accountable. Remaining is the anatomy which can be considered and described only by ''anumana'' and ''aptopadesha''. [13]
</div>
For simplifying the the above material, the same is presented in the table as given under.
• Table: Showing shira, dhamani, snayu etc.
{| class="wikitable"
! rowspan="1"| Serial no.
! rowspan="1"| Ayurvedic term
! rowspan="1"| Modern correlation
! rowspan="1"| Numbers
|-
| 1 || Snayu || Ligaments || 900
|-
| 2 || Sira || Veins || 700
|-
| 3 || Dhamani || Arteries || 200
|-
| 4 || Peshi || Muscles || 400
|-
| 5 || Marmas || Vital parts || 107
|-
| 6 || Sandhi || Joints || 200
|-
| 7 || Sira Dhamani Anuroopa Mukh || Capillaries || 29956
|-
| 8 || Kesha Smashru & Loma. || Hair (all type) || 29956
|-
|}
[14]
<div style="text-align:justify;">
*In the old time under the prevailing Indian systems there were two types of scales for measuring the volume of liquids, i. e. ''Magadha mana''<ref> Bramhanand Tripathi, commentary on Charaka Samhita, Sharir Sthan, 2004 edition, Choukhamba Surbharati Prakashan, Varanasi, 7/15. </ref> and ''Kalinga mana''.
</div>
Magadha Mana Kalinga Mana
{| class="wikitable"
|-
| 4 Karsha || 1 Pala || 10 Masha || 1 Karsha
|-
| 2 Pala || 1 Prasati || 4 Karsha || 1 Pala
|-
| 2 Prasati || 1 Anjali || 4 Pala || 1 Kunava (Anjali)
|-
|}
Table: Anjali pramana presented in table
{| class="wikitable"
|-
| Serial no. || Constituent || Anjali Praman
|-
| 1 || Udaka (water) || 10
|-
| 2 || Rasa || 09
|-
| 3 || Rakta || 08
|-
| 4 || Purisha || 07
|-
| 5 || Shleshma || 06
|-
| 6 || Pitta || 05
|-
| 7 || Mutra || 04
|-
| 8 || Vasa || 03
|-
| 9 || Meda || 02
|-
| 10|| Majja || 01
|-
| 11|| Mastishka
|<span style="font-size:66%; line-height: 1.3em;">1/2</span>
|-
| 12|| Shukra
|<span style="font-size:66%; line-height: 1.3em;">1/2</span>
|-
| 13|| Shlaishmic Oja
|<span style="font-size:66%; line-height: 1.3em;">1/2</span>
|-
|}
[15]
*On the basis of ''panchamahabhuta'' the structures, organs and their functional expressions (''bhavas'') are categorically presented in the under given table.
Table: Showing structures, organs and their functional expressions (Bhavas) on the basis of Panchamahabhoota.
{| class="wikitable"
|-
| Parthiv || Apya || Agneya || Vayaviya || Akashiya || Atmaja
|-
| Sthoola (solid), Sthira (fixed), Moortiman (visible), Guru (heavy), Khara (rough) and Kathin (hard) are Parthiva (Prithvi Tatva pradhan), e.g. Nakha (nails), Asthi (bones), Danta (teeth), Mamsa (muscle), Charma (skin), Varchas (feces), Kesha (hair), Smashru (beard), Loma (body hair), Kandara (tendons), Gandha (smell) and also the olfactory sensory are parthiv (prithvi guna pradhan). || Drava(liquid), Sara (liquidous), Manda (slow), Snigdha(unctuous), Mradu (soft) &Pichchhal(viscous)Guna pradhan; Rasa (plasma), Rakta (blood), Vasa (fat), Kapha (anabolic humor type), Pitta (catabolic humor type), Mootra (urine) and Sweda (sweat) and alsothe taste(rasa) & taste sensory organ. || Pitta (catabolic humor type), Ushma,(heat),Bha (Shining), Roopa(photo)&vision sensory are agneya. || Uchchhwas (inspiration), Praswas (expiration), Unmesh (opening of eye), Nimesh (closing of eye), Akunchan (flexion), Prasarana (extention), Gamana (movement), Prerana (expulsion), Dharana (retention), Sparsha (touch), & touch sensory organ. || ViviktaAvayava (spacefull structures with openings),major and minor Srotasas, sound& hearing sensory organs. || Pradhan (Jivatma),Buddhi (intellect) &Mana (psyche).
|-
|}
[16]
<div style="text-align:justify;">
*When ''deha paramanu'' is put on review we find that Charaka was of clear opinion that like the house is built by the countless number of bricks similarly body is also built by the structural and functional units to which he has referred as ''deha paramanu''. Because Charaka has referred them as ''shariravayava'', as such the same can only be said as structural and functional unit of the body. At this point modern cell theory is quotable, which reveals that, a) all living things are made of cells, and b) smallest living unit of an organism is the cell and cells arise from pre-existing cells only. Designation given by Charaka as ''deha paramanu'' by its meaning refers to all three features of cell theory as above. Charaka has presented the features of ''deha paramanu'', saying that they are ''aparisankhyeya'' (innumerable), ''atibahuta'' (abundant), ''atisukshma'' (microscopic) and ''atindriya'' (unperceivable from common eyes). This equates it with modern cell theory. Modern theory has only one different point, i.e. cells arise from pre-existing cells only, which is also equitable with ''beeja'' and ''beejabhaga'' theory of Charaka.
*It is further described that for all types of ''samyoga'' and ''vibhaga'' the responsible factors are two, i.e. ''vayu'' and ''karmaswabhava''. In this account ''vayu'' can be referred for functional proteins (enzymes). Enzymes function to catalyze all type of metabolic functions in the body. In other words, it can be said that any type of biochemical change in the body can not be caused without the mediation of an enzyme. As such enzymes are the operators of life processes. The same is said about the ''vayu'' (''yatra vayuna niyante tatra gachchhanti vegavata'' (''pitta'' and ''kapha'' are moved by ''vata'' like the clouds move in the direction of wind)). Similarly, ''karmaswabhava'' can be evaluated. ''Karmaswabhava'' means ''karma'' of ''swabhava'' or the action of ''swabhava''. ''Swabhava'' can be referred for genetic code. As ''vayu'' is a biological entity and has the fixity of properties similarly genetic code is also a fixed entity. It is basically universal (except for mitochondria). This is what, we can say it a basic natural force, a law of nature which operates the organic world. Modern science believes that enzymes directly control the changes in the body (metabolism) and genetic code regulates the development and function of the cell or an organism.
*Genetic code: Genetic code<ref> E.D.P. De Robartis, Cell &Molecular Biology,2006 edition, Saunders, Philadelphia </ref> has nine features, i.e. sensibility, universality, unambiguity, redundancy, non-delimited/comma-less, no overlapping, decipherability, collinearity and start and stop codons.1) Sensibility: 3 Nucleotides code for one amino acid. 2) Universality: Same code used by all the organism except for mitochondria.3) Unambiguity: Means specificity, each triplet has only one meaning, specifying to particular amino acid. 4) Redundancy: Some amino acids are coded by more than one codons, (61 for 20 Amino acids, total codons are 64 but only 61 codons code for AA rest are start and stop codons). 5) Comma-less: Punctuationless, means no spaces between words (codons), technical cause of frame shift mutation. 6) Non-overlapping: No overlapping in the sequence of codons 7) Decipherability: Codons are decipherable. 8) Collinearity: sequence in mRNA is perfectly compatible with amino acid sequence in finished protein. 9) Start and stop code: Initiation and termination codons are essential factors- “Start” = AUG (initiation codon), and “Stop” = UAA, UAG, and UGA (termination codon). [17]
*When [[Sankhya Sharira]] is seen as whole this looks like the dissection of the whole body to the level of ''paramanubheda''. Firstly, body was displayed through visceral organs (''koshthanga''), then it was shown through the regional derivatives (''pratyanga''), after that it was shown through it’s very inner systems making core divisions of life including ''hridaya, indriyadhishthan, buddhindriya, karmendriya'' and ''pranadhishthan'', then body was shown through rationally accountable structures and further by liquid constituents. Lastly body was shown through ''paramanubheda'' (microscopic level). This type of description is like opening the window of ''tatvagyan''. What remains in ''tatvagyan'' if the secrets of ''sanyoga'' and ''vibhaga'', i.e. enzymes and genetic code are revealed. At this level, reference specifying the value of ''tatvagyan'' under [[Arthedashmahamooliya Adhyaya]] is quotable, ''Tatvavabodhoharshananam'' (Charaka Sutra- 30/15), this speaks that ''tatvagyan'' is the ultimate source of ''harsha'' (happiness). As such if one observes the body in ultimate split, ''paramanubheda'', or in separated form, he gets the ultimate salvation. [18]
*The anatomical information presented in this chapter by Charaka is devised for the physician not for the surgeon, hence it is said that one who knows the body through the organization of organs and systems, is always enlightened and never falls into any confusion. The knowledge of the anatomy has been always considered essential for a clinician. It was highly acknowledged by Sushruta<ref> Ghanekar, Sushruta Samhita, Sharira Sthan, 2012 edition, Meharchand Laxmandas Publications, New Delhi, 5/60. </ref> particularly for the surgeons.-Su. Sh. 5/60). Sushruta has said that which is observed by the senses (''pratyaksha'') and also which is studied in books, both in combination give much knowledge. [19]
*Knowledge of anatomy on the one side is an essential requisite for a physician on the other side it is also important for a common people for enjoying a good lifestyle. Normally a person with the knowledge of constituents of the body is found different and enlightened in comparison with others. This is the actual theme behind the composition of this quote by Charaka. [20]
==== ''Koshthanga'' ====
''Koshthanga sharira'' presented by Charaka is an exclusive presentation, based on his own ideas and medical values. However he maintained that organs included should be located in the cavities of the trunk specifying to ''koshtha'', just like the clubbing of visceral organs in modern anatomy for practical study. It does not match with Sushruta’s presentation. Among presented fifteen ''koshthangas'' controversial entities are ''nabhi, kloma, pakvashaya'' and ''vapavahan''. For ''nabhi'' opinions available so far are all centered with umbilicus, which is not appropriate because umbilicus is on the body wall it is not located in the ''koshtha''. Mesentery may be most suitable organ to be taken for ''nabhi''. Pancreas having medical relevance related with the symptom of polydipsia seems to be most suitable to be referred for ''kloma'' particularly under Charaka’s ''koshthanga''. Though it is the part of large intestine (''sthulantra'') but caecum is an important structure and a visceral organ, it should be taken for ''pakvashaya''. Some scholars have correlated duodenum with ''pakvashaya'' which is not authentic any way as it does not hold digested food, its function is to deal with likely undigested food (chyme). No doubt ''vapavahana'' as referred by Chakrapani is a ''tailvartika'' but omentum does not fit completely with the description of ''vapavahana''. This is also denied by Prof. V.J. Thakkar<ref> Thakkar V.J., Purusha Vichaya, A. H. Publishers, Gujarat Ayurved University, Jamnagar, India </ref>. He has referred lacteals to be taken for it. Lacteals are also not the better option. Why not thoracic duct because it is found in singular number? As such thoracic duct is recommended here in this account to be taken for ''vapavahana''.
</div>
=== References ===
<references/>
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