Studies in the Medicine of Ancient India, Part I: Osteology, or the Bones of the Human Body c6.s2: B. The System of Suśruta

Studies in the Medicine of Ancient India, Part I: Osteology, or the Bones of the Human Body c6.s2

Language: English

c6.s2.t1 § 26. Suśruta's Statement and its Recensions — 31 parts
c6.s2.t2 § 29. Difficulties and Inconsistencies of the Traditional Recension — 5 parts
c6.s2.t3 § 30. Continuation — 27 parts
c6.s2.t4 § 31. Continuation — 10 parts
c6.s2.t5 § 32. Continuation — 2 parts
c6.s2.t6 § 33. Continuation — 35 parts
c6.s2.t7 § 36. Suśruta's Statement in other Medical Works — 5 parts

B. The System of Suśruta

§ 26. Suśruta's Statement and its Recensions

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1. Suśruta's system of the bones of the human body is stated in the beginning of the fifth chapter of the third or Anatomical Section (*Śārīra Sthāna*) of his Compendium.

2. There exist two recensions of this statement. One is printed in Jīvānanda's edition of the Compendium, p. 331, paragraphs 15 and 16 (Calcutta, 1889), as well as in all other editions with which I am acquainted; e. g. in the editions of Madhusūdana Gupta, p. 339 (Calcutta, 1834), of Prabhuram Jīvanaram, p. 481, paragraphs 18–21 (Bombay, 1901), Vīrasvāmi (Madras). The other occurs in Gaṅgādhar's Commentary (called *Jalpa-kalpataru*) on the Compendium of Charaka, p. 188, lines 5–14 (Berhampore, 1879, see § 3). These two recensions differ so widely from each other that it becomes necessary once again to inquire into their respective authorization.

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3. The recension which is found in Jīvānanda's and all other prints, and which, in the sequel, will be referred to as the Traditional Recension, has in its favour not only all available manuscripts, but also all ancient commentaries on the Compendium of Suśruta, as well as all such older medical works as adopt Suśruta's system of the skeleton. Or shortly, the Traditional Recension is supported by the whole body of existing witnesses.

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4. As regards manuscripts, I have been able to examine the following eleven copies, in all of which the existence of the Traditional Recension has been verified:

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1. The Alwar Palace Library MS., No. 1703.¹
2. The Benares College MS., No. 23 (old No. 64), fols. 18, 19.¹
3. The Deccan College MS., No. 406, of 1895–8, fols. 37 b, 38 ; dated Saṃvat 1704 = A. D. 1647.
4. The Deccan College MS., No. 948, of 1884–7, fol. 14 ; undated.
5. The Deccan College MS., No. 949, of 1884–7, fols. 53 b, 54, 55 a, with Dallana’s Commentary ; undated.
6. The Deccan College MS., No. 956, of 1891–5, fol. 15 ; undated.
7. The Deccan College MS., No. 224, of 1882–3, fols. 23, 24 a; dated Saṃvat 1640 = A. D. 1583.¹
8. The Bodleian MS. (Hultzsch), No. 349, fol. 31, in Śāradā characters, on paper, undated ; a Kashmir MS.
9. The Bodleian MS., No. 739 (Wilson 290), fol. 19.
10. The India Office MS., No. 72 b (Cat. No. 2645), fol. 17 ; dated Saṃvat 1696 = A. D. 1639 ; contains only the Śārīra Sthāna.
11. The India Office MS., No. 1842 (Cat. No. 2646), fols. 21 b, 22 a; undated, contains Chandraṭa’s revision of the text, based on the Commentary of Jaijjaṭa.

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¹ A copy of the statement on the skeleton from MS. No. 1 was most kindly supplied to me by Major P. T. A. Spence, British Political Agent; from No. 2, by the Principal of the Benares College; and from Nos. 3–7, by Professor K. B. Pathak, of the Deccan College.

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It should be observed that these MSS. come from widely separated Indian localities, and that three of them, Nos. 3, 7, 10, are of a considerable age—facts which enhance the value of their testimony as that of independent witnesses.

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5. As to old commentaries, we have the two works, compiled by Gayadāsa and Dallana (§ 2). Of the former, I have been able to consult the unique MS. preserved in the Cambridge University Library, Add. 2491, fols. 48 b, 49 a; of the latter, the Deccan College MS., No. 949, of 1884–7, fols. 53 b, 54, 55 a (see above, No. 4). Of the latter, there is also the edition published by Jīvānanda, Calcutta, 1891. Both commentaries are based on the Traditional Recension, and contain not the remotest indication of being acquainted with the recension printed by Gaṅgādhar. A number of other old commentaries are known by name, for which Dr. Cordier's *Récentes Découvertes*, pp. 13, 14, may be consulted. But no copies of any of them—so far, at least, as the Anatomical Section (*Śārīra Sthāna*) is concerned—have as yet come to light.

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6. As to older medical works which explicitly adopt Suśruta's system of the skeleton, we have the following two (§ 2):

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(1) The *Śārīra Padminī*, by Bhāskara Bhaṭṭa (*c.* A. D. 1000), a manuscript of which is in the possession of Dr. P. Cordier (*Récentes Découvertes*, p. 30), dated Saṃvat 1735 = A. D. 1678; and from which a copy of the statement on the skeleton was very kindly supplied to me by the owner.

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(2) The *Bhāva Prakāśa*, by Bhāva Miśra, in the sixteenth century, edited by Jīvānanda, and others.

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Both works contain independently versified versions of the prose statement of Suśruta, made by the authors themselves, but based on the Traditional Recension of that statement.

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7. As regards Gaṅgādhar's recension, I have not been able to discover for it any authority whatsoever. It will be shown in the sequel (§§ 29-33) that the Traditional Recension is obnoxious to several very serious difficulties; and it is probable that the recension of Gaṅgādhar (§ 35) is a reconstruction of his own to meet those of the difficulties which he had noticed. Though in some respects, his reconstruction is an improvement on the Traditional Recension, it cannot be accepted as satisfactory, because it fails to meet the most serious of the difficulties of that recension.

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§ 27. The Traditional Recension of Suśruta

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1. The Traditional Recension of Suśruta's statement (Original Text in § 88) on the human skeleton runs as follows:

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‘The professors of General Medicine (*āyurveda*) speak of three hundred and sixty bones.¹ But books on surgical science (*śalya-tantra*) know only of three hundred. Of these there are one hundred and twenty in the extremities; one hundred and seventeen in the pelvic cavity, sides, back, abdomen (*udara*), and breast; and from the neck upwards there are sixty-three. In this wise the total of three hundred bones is made up. Now in each toe of the foot, there are three bones; this makes altogether fifteen. Those bones which constitute the sole, cluster, and ankle are ten. In the heel there is one; in the leg there are two; in the knee there is one; so also in the thigh. Thus there are thirty bones in one lower limb. The same count applies to the other lower limb, as well as to the two upper limbs. In the pelvic cavity there are five bones. Of these there are four in the anus, pubes, and hips; and the fifth constitutes the triangular (trika) sacrum. There are thirty-six bones in one side, and as many in the other. In the back there are thirty; eight in the breast; two in what are called the collar-bones (akṣaka-saṃjñā); nine in the neck; four in the windpipe; and two in the jaws. The teeth number thirty-two. In the nose there are three bones. There is one in the palate; also one each in either cheek, ear, and temple; and there are six in the cranium.’

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¹ The reference here is to the doctrine of Ātreya and his school, preserved for us in the Compendia of Charaka and Bheḍa (§§ 4, 12).

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2. This detailed enumeration works out a total of 300 bones, as shown in the subjoined table:

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¹ Tala, kūrca, and kaṇṭha-nāḍī are identical with Charaka’s śalākā, sthāna, and jatru (§ 4) respectively.

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§ 28. Suśruta’s List compared with Charaka’s

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Comparing Suśruta’s list of bones with that of Charaka the following five points present themselves:

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1. The Principle of Position. Suśruta divides the body into three parts, and explicitly enumerates the bones in accordance with their position in those divisions. Charaka (as representing Ātreya) also refers to this principle, but does not explicitly apply it to his enumeration. In fact, if the Traditional Recension (§ 4) is correct, he does not strictly adhere to it (§ 5).

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2. The Principle of Homology. The osteological system of Suśruta is strictly based on the principle of homology, according to which the several organs of the right and left, and of the upper and lower halves of the body, correspond to each other. This comes out clearly in the Table in § 27, where the bones of the four extremities are succinctly enumerated on that principle. On the other hand, Ātreya-Charaka does not appear to have fully realized the homologies of the skeleton. The order in which he enumerates the bones of the four extremities (Nos. 8-15 in § 14), no doubt, indicates some degree of recognition of the principle of homology; and the manner in which he arrives at his total number of the vertebral column is intelligible only on the implication of the same principle (§§ 59, 61). But in the latter case, it is not applied by him with the thoroughness of Suśruta, and it fails him entirely with respect to the cranial and facial bones, which are treated by Suśruta alone on the homological principle (§§ 63, 66). The clearness with which that principle was recognized by Suśruta is shown by the subjoined statement (Original Text in § 96, cl. 1) in the sixth chapter of his Anatomical Section, which is devoted to an enumeration of the so-called ‘vital spots’ (marman) in the body.

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‘In particular, just as there are in the leg (or lower limb) the three mortal spots: ankle, knee, and ischio-pubic arch,¹ so there are in the arm (or upper limb) the three mortal spots: wrist, elbow (kūrpara), and collar-bone. Just as between the hip-bone and the scrotum there is the ischio-pubic arch, so between the breast-bone and the armpit there is the clavicular arch.’

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¹ The viṭapa, or ischio-pubic arch, is formed by the combined rami of the os pubis and the ischium. See Figs. 4 and 20.

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On the other hand (see §§ 41, 47) Suśruta carries his principle of homology to undue lengths in postulating three joints in each of the phalanges, and (at least, according to the Traditional Recension ¹) the existence of heels in the hand.

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¹ On this point, however, the Traditional Recension is wrong; see § 32.—A neat statement of the homologies of the four extremities occurs in Aruṇadatta's Commentary to the Aṣṭāṅga Hṛdaya, Śārīra Sthāna, ch. 3, verses 14, 15 *b* (vol. ii, p. 549 in the first edition): ‘the bones of the two upper limbs are homologous to those of the two lower limbs. They may be detailed as follows: The hand corresponds to the foot, the base of the hand to the heel, and the wrist to the ankle. The cluster exists alike in both. The forearm corresponds to the leg, the elbow to the knee, and the arm to the thigh.’

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3. Alteration of Terms. The list of Suśruta introduces three new terms. These are No. 2, *tala*, No. 3, *kūrca*, and No. 15, *kaṇṭha-nāḍī*, which take the place, respectively, of Charaka's terms *śalākā*, *sthāna*, and *jatru*. The identity of the organs indicated by these alternative terms will be discussed in the Third Section (§§ 48, 49, 62). A fourth new term, which does not occur in the list, but is mentioned in the passage just quoted, is *kūrpara*, which is an alternative for Charaka's *kapālikā*, elbow-pan (No. 13 in § 4), and for the false term *kapola* of the Non-medical Version (No. 11 in § 16; see § 19, p. 52).

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4. Alteration of Items. Suśruta omits from his list the thirty-two sockets of the teeth which occur in the list of Charaka (No. 2 in § 4). On the other hand, he introduces the two ears (*karṇa*), and (as may be mentioned here in anticipation of § 30) also the two eyes (*akṣi*). The omission of the sockets is due to Suśruta's counting two jaws in the place of Charaka's one (lower) jaw (No. 26 in § 4). The insertion of the ears and eyes is due to Suśruta's counting cartilaginous structures among the bones of the body (§ 30). The whole subject, however, of these alterations, as well as of others affecting the numbers of the bones in each item, will be discussed in full detail in the Third Section.

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5. Alteration respecting Structure. With regard to two points Suśruta's views of the skeleton differ very considerably from those of Ātreya-Charaka. These are the structure of the vertebral column and of the skeletal face. On both points, as will be fully explained in §§ 59, and 65, 66, the system of Suśruta marks a distinct advance in anatomical knowledge.

§ 29. Difficulties and Inconsistencies of the Traditional Recension

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1. The Traditional Recension of the statement of Suśruta is beset with many difficulties and inconsistencies, both in respect of form and matter, which render it impossible to accept it as the genuine production of Suśruta.

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2. As regards the form, there are two points which deserve consideration. In the first place, with reference to the bones of the trunk, the Traditional Recension states that they are distributed over ‘the pelvic cavity, sides, back, abdomen, and breast’ (§ 27). That this is the true reading of the Traditional Recension is proved by the fact that the two medical works, Śārīra Padminī and Bhāva Prakāśa, which adopt the statement of Suśruta, giving it, however, in a versified form of their own (§§ 26, 36), also name the abdomen (udara) in this connexion. The mention of the abdomen as a seat of bones may well cause surprise, and a suspicion that there must be some error in the text. The suspicion is confirmed when we find that in the subsequent enumeration of the bones in their several seats, the collar-bones (akṣaka) take the place of the abdomen (udara). As the collar-bones form a part of the shoulder-girdle, it suggests itself that the Sanskrit text of the statement of Suśruta, in its original and genuine form, must have read amsa, shoulder, instead of udara, abdomen. A very probable explanation of the origin of the error in the Traditional Recension may be given. In the classification of the bones according to their shape (§ 30), the text of the Traditional Recension has the compound word pṛṣṭh-odara (i. e. pṛṣṭha, back, and udara, abdomen). In this connexion the introduction of the term udara, abdomen, has a good reason. It is to indicate the position of the pubic arch (§ 60, cl. 2) as located in the anterior (or ventral) part of the pelvis. The latter organ comprises five bones (§ 27), viz. the two hip-blades (nitamba), the sacrum (trika), the coccyx (guda), and the pubic arch (bhaga). These five bones belong to two different classes: the hip-blades and the sacrum (incl. coccyx) belong to the pan-shaped (kapāla), while the pubic arch belongs to the ornament-like (valaya). Hence, in classifying them according to their shape, the term śroṇi, pelvis, indicative of their common locality, could not be used; but each bone had to be indicated by its peculiar locality. Hence the sacrum and coccyx are indicated by the back (pṛṣṭha), and the pubic arch by the ventral part (udara) of the pelvis. The compiler of the Traditional Recension, failing to understand this, introduced the term pṛṣṭh-odara also into the enumeration of the bones according to their position in the body. But here the term is quite out of place. For the common locality of the five bones is already defined by the term śroṇi, pelvic cavity, while the locality of the bones of the shoulder-girdle (aṃsa) is entirely ignored. It can, therefore, hardly be doubted that the reading pṛṣṭh-odara, back and abdomen, of the Traditional Recension is an erroneous substitute for the true reading pṛṣṭh-āṃsa, back and shoulder.

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3. In the second place, it will be shown in the next paragraph that the Traditional Recension omits all mention of the two shoulder-blades. These have their seat in the shoulder-girdle along with the collar-bones. One expects, therefore, in the enumeration of the 117 bones of the trunk, to find them mentioned in the clause respecting the collar-bones. As a fact, however, the Traditional Recension, while mentioning the two collar-bones, omits the shoulder-blades altogether. But it is noteworthy that the clause in question is worded in a very peculiar way. The Recension says: ‘two in what is called the collar-bone’ (dve akṣaka-saṃjñe).¹ The expression ‘what is called’ (saṃjñā) is not employed in connexion with any other part, or bone, of the body. Yet there is nothing in the name akṣaka, for collar-bone, that calls for the use of the phrase saṃjñā, ‘what is called.’ It suggests itself that that word saṃjñā is a false reading, and that in all probability a word expressive of the missing shoulder-blades originally stood in its place. The ordinary term for shoulder-blade is aṃsa-phalaka; but the shorter word aṃsa-ja, literally ‘shoulder-born’, or ‘issuing from the shoulder’, would not be inappropriate, and might also be used. It is significant that the Non-medical Version of the system of Ātreya employs a synonym of the latter word, *aṃsa-samudbhava*, ‘issuing from the shoulder,’ to denote the shoulder-blade (see No. 13 in § 16). It will be shown in § 33, with respect to another point, that the Non-medical Version betrays marks of having been influenced by the system of Suśruta; and it suggests itself that the author of that Version was led to the choice of the term *aṃsa-samudbhava* by the occurrence of the synonymous term *aṃsa-ja* in the statement of Suśruta. It may be suggested, therefore, that, in the latter statement, in its original form in which we may suppose it to have left the hand of Suśruta, the clause respecting the collar-bones probably ran (not *dve akṣaka-saṃjñe*, but) *dve akṣak-āṃsaje*, ‘two in the collar-bones and shoulder-blades’¹; and that the word *aṃsaje* became corrupted into *saṃjñe*.

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¹ Saṃjñe is here taken as the locative singular. It might also be taken as the nominative dual, ‘two so-called collar-bones.’ The argument is not affected thereby.

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¹ Or alternatively, ‘two collar-bones and two shoulder-blades.’

§ 30. Continuation

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1. In respect of the matter of the statement, the Traditional Recension labours under three great difficulties.

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In the first place, the list is incomplete. It omits two of the most conspicuous bones of the skeleton, namely, the shoulder-blades (*aṃsa-phalaka*, No. 16 of Charaka’s list in § 4). It also omits the two eyeballs (*akṣi-kośa*). In omitting these two items Suśruta’s list, as it stands in the Traditional Recension, is inconsistent with another statement of his. Immediately following the list of bones in which Suśruta enumerates them according to their position in the body, he continues with another list dividing the bones into five classes according to their shape. This class-list (Original Text in §§ 88, 89) runs as follows:

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‘These bones are of five kinds, namely, pans (*kapāla*), sharp-ones (*rucaka*), tender-ones (*taruṇa*), ornaments (*valaya*), and reeds (*nalaka*). From among them the pan-shaped bones occur in the knees, elbows, hips, shoulders (*aṃsa*), cheeks, palate, temples, interiliac space (i.e. sacrum), and cranium. The sharp

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bones are the teeth. The tender bones occur in the nose, ears, neck ¹, and eyeballs (*akṣi-koṣa*). The ornament-shaped bones occur in the hands, feet, sides, back, abdomen, and breast. The remainder of the bones are termed reed-shaped.’

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¹ The reference, of course, is to the *jatru* or *kaṇṭhanāḍī*, the windpipe in the neck; see § 62, cl. 3.

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2. A comparison of the two lists, as given in the subjoined table, shows that all the items of the number-list reappear in the class-list with the exception of two which the latter contains in excess.

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² See the preceding note. The neck contains two organs, the neck-bones or cervical column, and the windpipe. In the class-list, of course, the latter is intended. The former, being a portion of the vertebral column, counts with No. 11, and belongs to the ornament-shaped class. The use of the term *grīvā* here is rather inaccurate, as it is usually employed to denote the cervical column.

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3. Seeing that the class-list is intended to distribute all the items of the number-list into five kinds, it is evident that the number-list, in the form in which it is found in the Traditional Recension, cannot be correct, but that, in its original and genuine form, it must have contained those two additional items: No. 24, shoulder-blades, and No. 25, eyeballs. It is true that, with reference to No. 24 in the class-list, the Traditional Recension employs the term *aṃsa*, which, in the Compendium of Suśruta, ordinarily denotes the collar-bone; but from the context it is quite obvious that, in the present case, it can refer only to the shoulder-blades. For the bones, here called *aṃsa*, are classed as pan-shaped (*kapāla*)—a description which is applicable only to the shoulder-blades. The collar-bones could only be described as reed-shaped (*nalaka*); and these bones, therefore, must be taken as referred to in the last class or the ‘remainder’ of the list. In literary Sanskrit the word *aṃsa* denotes, in a general way, the shoulder; in medical Sanskrit, at least of the Compendium of Suśruta, the several parts of the shoulder have specialized names: *aṃsa* is the collar-bone, *aṃsa-phalaka* (or *aṃsa-ja*), the shoulder-blade; *aṃsa-kūṭa*, the acromion process, and *aṃsa-pīṭha*, the glenoid cavity. The author of the Traditional Recension would seem to have been a person, who was imperfectly familiar with the anatomical terminology of Suśruta, and used the term *aṃsa* in the undefined literary sense; or more probably it is a scribal error for *aṃsa-ja* or *aṃsa-phalaka*. For a fuller discussion, see §§ 55, 56.

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4. As regards the eyeballs, the class-list explicitly enumerates them among the ‘tender’ bones. In agreement herewith, speaking of the structure of the eye in the Supplementary Section (*Uttara Tantra*) of his Compendium, Suśruta describes the sclerotic coat of the eyeball as made of bone (*asthi*). The statement in question, describing the eye as seen in the sagittal section (Fig. 1), runs as follows:

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‘The outer one of the protecting covers¹ of the pupil consists of a luminous fluid, and the next one of flesh. The third is

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¹ *Paṭala* denotes the protecting covers of the *dṛṣṭi*, or pupil, the supposed seat of vision. The composite nature (the ‘tunics’, incl. retina, choroid) of the 4th cover does not seem to have been known to the early Indian anatomists; nor the lens, which they thought to be a morbid accumulation of phlegm.

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made of fat, and beyond it there is one consisting of bone.’ (Original Text in § 96, cl. 2.)

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It may be noticed also as a significant fact that the Non-medical Version of the system of Ātreya (§ 16) includes the eyeballs in the list of bones of the human body. The genuine list of Ātreya, as handed down by Charaka (§ 4) and Bheḍa (§ 12), does not count the eyes among the bones. The author of the Non-medical Version of that list, therefore, must have obtained the eyes from some other source; and this source cannot well have been any other than Suśruta’s statement on the skeleton. If so, it follows that the latter statement, at the time of the

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[Figure: FIG. 1. DIAGRAM OF THE EYE, in Sagittal Section. a-b. Optic Axis.
1. Outer cover, Bāhya paṭala, of luminous fluid, Tejo-jala (Aqueous humour).
2. Cover of muscle, Piśita paṭala (Ciliary body).
3. Cover of fat, Medas paṭala (Vitreous humour).
4. Cover of bone, Asthi paṭala (Sclerotica). 5, 6. Covers of eyelids and eyelashes, Pakṣma-vartma paṭala.]

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composition of the existing Law-book of Yājnavalkya, must have differed from the now existing Traditional Recension, and must have included the eyes in its list of bones.

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5. It is clear, then, that Suśruta’s list of bones of the human body, in its genuine form, must have contained four additional bones; viz. two shoulder-blades and two eyeballs. As regards the shoulder-blades, it has been shown in the preceding paragraph that their omission, in all probability, is due to a misreading of the term samjña for amsaja. As to the eyes, they would appear simply to have dropped out of the penultimate clause (§ 27) which should run: ‘one each in either cheek, eye, ear, and temple.’

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NOTE.—With regard to the terms which occur in the class-list, *nalaka* means a reed, but not necessarily a hollow reed; it may be solid like the male bamboo. As used by the Indian anatomists it denotes any long bone, whether tubular or solid. Suśruta does not specify the bones which he likens to a *nalaka* or reed, but only says that they are ‘the remainder’, that is, that they are all those bones which do not fall into any of the other four classes. The process of exhaustion thus indicated shows that he classed as ‘reed-like’ bones the following—the phalanges, the metacarpals and metatarsals, the bones of the forearms, legs, arms, and thighs, the collar-bones and the jaw-bones. The commentators Dallana (ed. Jīv., p. 576) and Gayadāsa (Cambridge MS., Add. 2491, fol. 49 *a*, line 3), following a doctrine of Bhoja (Original Text in § 96, cl. 3), include the clusters, ankle-bones and wrist-bones among the ‘reed-like’ bones. But seeing that these particular bones have not the smallest resemblance to reeds, their inclusion only proves the total want of experimental knowledge of them on the part of Bhoja and the commentators.

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*Valaya* is the name of a certain kind of personal ornament, such as bracelets, anklets, necklets, waist-bands, &c. They are well seen on the figures of the Bharhut Stūpa (of about the 2nd century A. D.), called Chulakokā and Suchiloma, shown in Figs. 2 and 3.¹ Suśruta states that these *valaya* bones are found in the hands and feet, and in the sides, back, abdomen, and breast. Those in the hands and feet are the clusters (carpus and tarsus), wrist-bones (styloid processes), ankle-bones (malleoli) and heels : they resemble bracelets and anklets. The latter are shown in Fig. 2. The other bones indicated by him are the ribs, the bones of the vertebral column, also the costal cartilages and sternum, all of which resemble a necklace (Fig. 2), and the pubic arch which resembles the bow of a waist-band (Fig. 3).

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¹ Reproduced from Sir A. Cunningham’s Report. See also Professor Hultzsch, in the *Journal of the German Oriental Society*, vol. xl, p. 63, No. 26.

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By the term *taruṇa*, tender bones, cartilages are denoted.

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FIG. 2

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FIG. 3

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Goddess Chulakoka

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Yaksha Suchiloma

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(From the Stûpa of Bharhut)

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The statement of Dr. Wise (*Hindu System of Medicine*, p. 52) that ‘the difference [between Suśruta’s total 300 and Charaka’s total 360] is owing to their counting the cartilages with the bones’ is hardly correct. Both writers include cartilages in their counts, though in different ways. The difference in their totals is mainly due to Charaka’s counting the thirty-two sockets of the teeth as separate bones, and his including the twenty nails, neither of which are admitted in the count of Suśruta. See § 38, col. IV in the Table (p. 93).

§ 31. Continuation

c6.s2.t4.1

1. In the second place the number ten, given in the Traditional Recension as the aggregate of the bones of the sole, cluster, and ankle (Nos. 2, 3, 4 in § 27), is inconsistent with other explicit statements of Suśruta. His commentator Dallana¹ explains that number ten in the following way:

c6.s2.t4.2

¹ The earlier commentator Gayadāsa also mentions ten as the aggregate, though he does not enter into further details.

c6.s2.t4.3

The term sole (*tala*) refers to the five long bones (*śalākā*) and to the single bone that connects them. The cluster (*kūrca*) and the ankle (*gulpha*) contain two bones each. Hence we have ten.’ (Original Text in § 96, cl. 4.)

c6.s2.t4.4

Dallana, therefore, identifies Suśruta’s sole (*tala*) with Charaka’s long bones (*śalākā*) and base (*sthāna*), that is, with Nos. 5 and 6 in § 4. He thus obtains six bones for the sole. Adding to them two cluster-bones and two ankle-bones, he makes up the aggregate ten. It has been pointed out in § 9, cl. 1 *b*, that the terms cluster (*kūrca*) and base (*sthāna*) are merely two different names, employed by Suśruta and Charaka respectively, for the same portion of the hand and foot, viz. the carpus and tarsus. Differentiating them, after the manner of Dallana, argues a want of anatomical knowledge such as cannot be attributed to Suśruta. In fact, as will be shown in § 40, the person responsible for this incongruity is, in all probability, Vāgbhaṭa I. But in any case, it is quite sufficient by itself to discredit the genuineness of the Traditional Recension.

c6.s2.t4.5

2. But further, the aggregate ten conflicts with the explicit statements of Suśruta himself regarding the number of clusters (*kūrca*) and ankle-bones (*gulpha*). On Ḍallaṇa’s theory there would be two clusters and two ankle-bones in either foot, and homologously two clusters and two wrist-bones (*maṇibandha*) in either hand. This results in an aggregate of eight clusters (*kūrca*), four ankle-bones (*gulpha*) and four wrist-bones (*maṇibandha*). On the other hand, Suśruta teaches explicitly that there are only four clusters in the hands and feet, two ankle-bones and two wrist-bones. Thus in the fifth chapter of the Anatomical Section (*Śārīra Sthāna*) he says:

c6.s2.t4.6

‘There are six clusters (*kūrca*) in the hands, feet, neck, and penis : namely, two in the hands, two in the feet, and one each in the neck and penis.’ (Original Text in § 96, cl. 5.)

c6.s2.t4.7

That is to say, there is one cluster in each hand and foot, making four ; also one each in the neck and penis, making two ; or an aggregate of six.¹ Again in the sixth chapter of the same Section, Suśruta says:

c6.s2.t4.8

¹ Kūrca simply means a cluster of something, but not necessarily a cluster of true bones. In the case of the hands and feet, it is a cluster of small bones; but in the case of the neck, it refers to the cluster, or series, of imperfect cartilaginous rings which compose the windpipe (trachea), and apparently a similar view was held of the structure of the penis.—There are several other passages in the Compendium of Suśruta which confirm his doctrine of there being only four clusters in the hands and feet. They occur in the sixth chapter, on the ‘vital spots’. There Suśruta speaks of 27 such spots in the sinews (*snāyu-marmāni*, Jīv. ed., p. 337, cl. 10) and 44 such spots causing weakness (*vaikalya-karaṇī marmāṇi*, Jīv. ed., p. 338, cl. 13). These numbers will not work out correctly, unless the clusters included in them are counted as being only four. The peculiar force of these passages lies in the indirectness of their evidence.

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‘There are two ankle-bones (*gulpha*) and two wrist-bones (*maṇibandha*).’ (Original Text in § 96, cl. 6.)

c6.s2.t4.10

3. It is evident, therefore, that Ḍallaṇa’s explanation of the aggregate ten involves a doctrine which was not held by Suśruta. It is, as will be shown in § 39, in reality the doctrine of Vāgbhaṭa I. An aggregate of ten, in fact, directly conflicts with the explicit doctrine of Suśruta. According to the latter, the sole (*tala*) consists of five long bones (*śalākā*, § 28, cl. 3) ; and there are one cluster (*kūrca*) and one ankle-bone (*gulpha*). The true aggregate, therefore, can be no more than seven; and it follows that Suśruta’s list of the bones, in its genuine form, must have contained that aggregate, but not ten.

§ 32. Continuation

c6.s2.t5.1

1. In the third place, the number one hundred and twenty, given in the Traditional Recension, as the aggregate of the bones of the four extremities, involves (as may be seen from the Table in § 27) the incongruity of counting four heels. That count is based on a misconstruction of the explanatory direction of Suśruta. He enumerates the bones of one lower extremity (*sakthi*) as amounting to thirty, and proceeds to explain that in the same way the count of the bones in the other lower extremity, as well as in the two upper extremities, must be made. Now his aggregate, thirty, of the lower extremity includes the heel bone, but it does not follow, therefore, that the same way of counting, when applied to the upper extremities, must also include a heel bone. In short, Suśruta intended his explanation to be understood *cum grano salis*. In the case of the lower extremities which contain a heel, the aggregate is thirty; but in the case of the upper extremities which do not contain a heel, the aggregate, of course, must be twenty-nine. This means that no more than two heels may be counted, in making up the aggregate of the bones of the four extremities.

c6.s2.t5.2

2. I know of no direct evidence as to the exact number of heels held by Suśruta, such as was available in the case of the two difficulties discussed in §§ 30 and 31. But neither is there any direct evidence for Suśruta’s holding four heels, including two for the hands. It is also worth noting that the list of Charaka includes only two heels; and there is no reason for imputing to Suśruta a more incongruous view than Charaka held. On the whole, therefore, it is only reasonable to believe that the statement of Suśruta, in its genuine form, cannot have been intended to teach the existence of more than two heels.

§ 33. Continuation

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1. The result of the discussion in the preceding paragraphs (§§ 30-2) is the reduction of the total of the bones, as enumerated in the Traditional Recension, from 300 to 290.

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Thus:

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| Total of Traditional Recension (§ 27) . | . | 300 |
| Add 2 shoulder-blades and 2 eyes (§ 30) | . | 4 |
| | Total . | 304 |
| Deduct 4 bases, 4 clusters, 2 ankle-bones, | | |
| 2 wrist-bones (§ 31) . | . | 12 |
| Also deduct 2 heels (§ 32) . | . | 2 |
| | | 14 |
| | Balance | 290 |

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2. This resultant shortage of ten bones, of course, must be compensated in some way. A comparison of the lists of Charaka and Suśruta, as shown in the subjoined Table, suggests a solution of the difficulty.

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| | Charaka (§ 7). | Suśruta (§ 27). |
| 1. Teeth . | 32 | 32 |
| 2. Sockets of teeth | 32 | — |
| 3. Nails . | 20 | — |
| 4. Phalanges . | 60 | 60 |
| 5. Long bones . | 20 | 20 |
| 6. Clusters, or bases . | 4 | 4 |
| 7. Ankle-bones and wrist-bones | 8 | 8 |
| 8. Heels . | 2 | 2 |
| 9. Legs and forearms. | 8 | 8 |
| 10. Knees and elbows . | 4 | 4 |
| 11. Thighs and arms . | 4 | 4 |
| 12. Shoulder-blades | 2 | 2 |
| 13. Collar-bones | 2 | 2 |
| 14. Back and pelvis . | 45 | 35 |
| 15. Breast . | 14 | 8 |
| 16. Ribs, &c. | 72 | 72 |
| 17. Neck and windpipe | 16 | 13 |
| 18. Palate . | 2 | 1 |
| 19. Facial bones | 4 | 9 |
| 20. Temples . | 2 | 2 |
| 21. Cranial bones | 4 | 6 |

c6.s2.t6.6

³ The diverging items in the two lists are Nos. 2, 3, 14, 15, 17, 18, 19, 21. From among these, No. 3, nails, has no place

c6.s2.t6.7

in the system of Suśruta, and the divergences in Nos. 2, 14, 17, 19, 21 depend on differences of anatomical theory which will be satisfactorily explained in the Third Section. There remain Nos. 15 and 18. It is noteworthy that these are precisely the two items in which the Traditional Recension agrees with the list of Vāgbhaṭa I (Nos. 13, 24 in § 37). Seeing that in two other points, already mentioned in § 31, the Traditional Recension has been unfavourably influenced by the list of Vāgbhaṭa I, it suggests itself as probable that in these two items also the same influence has been at work in causing the numbers eight and one to be adopted for the bones of the breast and palate respectively. As regards No. 18, palate, the list of Charaka gives two as the number of the bones of the palate; and there is no apparent reason why Suśruta should be credited with changing it in his list (see § 67). As to No. 15, we have a significant hint in the Non-medical Version of Ātreya’s list of the bones (§ 16). The genuine list of Ātreya, as handed down by Charaka and Bheḍa, has only fourteen bones for the breast (No. 24 in §§ 4, 12, and No. 21 in § 7). The Non-medical Version of that list must have obtained its false number seventeen from some extraneous medical source; and it suggests itself that this source can have been no other than the list of Suśruta, as it stood at the time when the Non-medical Version was composed.

c6.s2.t6.8

4. From these considerations it appears very probable that the original and genuine recension of the list of Suśruta allotted seventeen bones to the breast and two to the palate, instead of eight and one—the numbers which we now find in the Traditional Recension. The difference between these two sets of numbers (17 + 2 = 19, and 8 + 1 = 9) is ten, that is to say, precisely the number we require to make good the shortage that results from the adjustments discussed in §§ 30-2. This coincidence tends to confirm the conclusion that the list of Suśruta, in its genuine form, must have given seventeen bones to the breast, and two bones to the palate.

c6.s2.t6.9

§ 34. Restored Recension of Suśruta’s Statement

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1. We are now in a position to sum up the defects of the Traditional Recension, and restore what must have been the genuine form of the list of Suśruta.

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2. The Traditional Recension is wrong in the following five points:

c6.s2.t6.12

(a) It contains two misreadings (§ 29); viz. abdomen (*udara*) for shoulder (*aṃsa*), and the phrase ‘what is called collar-bone’ (*akṣaka-saṃjñā*) for ‘collar-bone and shoulder-blade’ (*akṣakāṃsaja*).

c6.s2.t6.13

(b) It omits four bones; viz. the two shoulder-blades and the two eyeballs (§ 30).

c6.s2.t6.14

(c) It gives the aggregate of its Nos. 2, 3, 4 wrongly as ten, instead of seven (§ 31), resulting in the wrong aggregate, thirty, for the bones of a lower extremity, instead of twenty-seven.

c6.s2.t6.15

(d) It counts wrongly four heels, instead of two (§ 32), resulting in the false aggregate 120 of the bones of the four extremities, instead of 106.

c6.s2.t6.16

(e) It counts wrongly eight bones of the breast, and one bone of the palate, instead of seventeen and two respectively (§ 33). And these false counts, together with those named in lit. *b*, result in the wrong aggregates 117 of the bones of the trunk, and 63 of the neck and head (§ 27), instead of 128 and 66 respectively.

c6.s2.t6.17

3. Accordingly, the genuine statement of Suśruta must have run as follows, the restorations being in *italics*:

c6.s2.t6.18

‘The professors of General Medicine speak of three hundred and sixty bones; but books on Surgical Science know only of three hundred. Of these there are one hundred and six in the extremities; one hundred and twenty-eight in the pelvic cavity, sides, back, *shoulder*, and breast; and from the neck upwards, *sixty-six*. In this wise the total of the three hundred bones is made up. Now in each toe of the foot there are three bones; this makes altogether fifteen. Those bones which constitute the sole, cluster, and ankle are *seven*. In the heel there is one; there is also one in the thigh. Thus there are twenty-seven bones in one lower limb. The same count applies to the other lower limb, and similarly to the two upper limbs. In the pelvic cavity there are five bones. Of these there are four in the anus, pubes, and hips; and the fifth constitutes the triangular sacrum. There are thirty-six bones in one side, and as many in the other. In the back there are thirty; seventeen in the breast; two each in the *collar-bone* and *shoulder-blades*; nine in the neck; four in the windpipe, and two in the jaws. The teeth number thirty-two. In the nose there are three bones; two in the palate; one each in either cheek, *eye*, ear, and temple; and six in the cranium.’ (Original Text in § 89.)

c6.s2.t6.19

4. The genuine list of bones as thus restored is shown in the subjoined Table:

c6.s2.t6.20

I. Four Extremities.

c6.s2.t6.21

| 1. Phalanges (*aṅguli*) | . | . | 15 × 4 = 60 |
| 2. Soles (*tala*) | 5 | | |
| 3. Cluster (*kūrca*) | 1 | | 7 × 4 = 28 |
| 4. Ankle-bone (*gulpha*) | 1 | | |
| 5. Heel (*pārṣṇi*) | . | . | 1 × 2 = 2 |
| 6. Legs (*jaṅgha*) | . | . | 2 × 4 = 8 |
| 7. Knee (*jānu*) | . | . | 1 × 4 = 4 |
| 8. Thighs (*ūru*) | . | . | 1 × 4 = 4 |
| | | | — 106 |

c6.s2.t6.22

II. Trunk.

c6.s2.t6.23

| 9. Pelvic cavity (*śroṇi*) | . | . | 5 |
| 10. Sides (ribs, *pārśva*) | . | . | 36 × 2 = 72 |
| 11. Back (*pṛṣṭha*) | . | . | 30 |
| 12. Breast (*uras*) | . | . | 17 |
| 13. Collar-bones (*akṣaka*) | . | . | 2 |
| 14. Shoulder-blades (*aṃsaja*) | . | . | 2 |
| | | | — 128 |

c6.s2.t6.24

III. Neck and Head.

c6.s2.t6.25

| 15. Neck (*grīvā*) | . | . | 9 |
| 16. Windpipe (*kaṇṭhanāḍī*) | . | . | 4 |
| 17. Jaws (*hanu*) | . | . | 2 |
| 18. Teeth (*danta*) | . | . | 32 |
| 19. Nose (*nāsā*) | . | . | 3 |
| 20. Palate (*tālu*) | . | . | 2 |
| 21. Cheeks (*gaṇḍa*) | . | . | 2 |
| 22. Eyeballs (*akṣikośa*) | . | . | 2 |
| 23. Ears (*karṇa*) | . | . | 2 |
| 24. Temples (*śaṅkha*) | . | . | 2 |
| 25. Cranium (*śiras*) | . | . | 6 |
| | | | — 66 |
| Grand total | | | 300 |

c6.s2.t6.26

§ 35. Gangādhar's Recension of Suśruta's Statement

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1. Gangādhar's Recension of Suśruta's statement on the skeleton runs as follows:

c6.s2.t6.28

‘In the surgical text-book of Suśruta the number of the bones of the human body is given as only three hundred. Of these there are one hundred and eight in the extremities; one hundred and twenty-six in the pelvic cavity, sides, back, collar-bones (akṣa), and breast; and from the neck upwards, sixty-six. In this wise, the total of three hundred is made up. Now in each toe of the foot there are three bones; this makes altogether fifteen. Those bones which constitute the sole, cluster, and ankle are seven. In the heel there is one; in the leg there are two; in the knee there is one; also in the thigh there is one. Thus there are twenty-seven bones in one lower limb. The same count applies to the other lower limb, as well as to the two upper limbs. This makes up a total of one hundred and eight bones. In the pelvic cavity there are five bones; of these there are two in the hips; and the arms, pubes, and sacrum are constituted each of one bone. In one side there are thirty-six bones, and as many in the other. In the back there are thirty; two are in what is called the collar-bone; seventeen in the breast; eleven in the neck; four in the windpipe; and two in the jaws. The teeth number thirty-two. In the nose there are three bones, two in the palate; one each in either cheek, ear, and temple, making together six; and there are six in the cranium. These make altogether sixty-six. Thus the grand total of three hundred is made up. This is the list of the bones of the skeleton.’ (Original Text in § 90.)

c6.s2.t6.29

2. The list may be shown in tabular form, thus:

c6.s2.t6.30

I. Four Extremities.

c6.s2.t6.31

| 1. Phalanges (aṅguli). | . | . | . | 15 × 4 = 60 |
| 2. Soles (tala) | 5 | | | |
| 3. Clusters (kūrca) | 1 | } | . | 7 × 4 = 28 |
| 4. Ankles (gulpha) | 1 | | | |
| 5. Heels (pārṣṇi) | . | . | . | 1 × 4 = 4 |
| 6. Legs (jaṅgha) | . | . | . | 2 × 4 = 8 |
| 7. Knees (jānu) | . | . | . | 1 × 4 = 4 |
| 8. Thighs (ūru) | . | . | . | 1 × 4 = 4 |
| | | | | — 108 |

c6.s2.t6.32

II. Trunk.
9. Pelvic cavity (*śroṇi*) . . . . . 5
10. Sides (ribs, *pārśva*) . . . 36 × 2 = 72
11. Back (*pṛṣṭha*) . . . . . 30
12. Breast (*uras*) . . . . . 17
13. Collar-bone (*akṣaka*) . . . . 2 — 126

c6.s2.t6.33

III. Neck and Head.
14. Neck (*grīvā*) . . . . . 11
15. Windpipe (*kaṇṭhanāḍī*) . . . . 4
16. Jaws (*hanu*) . . . . . 2
17. Teeth (*danta*) . . . . . 32
18. Nose (*nāsā*) . . . . . 3
19. Palate (*tālu*) . . . . . 2
20. Cheeks (*gaṇḍa*) . . . . 2
21. Ears (*karṇa*) . . . . . 2
22. Temples (*śaṅkha*) . . . . 2
23. Cranium (*śiras*) . . . . 6 — 66 Grand total 300

c6.s2.t6.34

3. Comparing the above list with that given in the preceding paragraph, it will be seen at once that it is really an attempt made by Gaṅgādhar to restore the genuine text of the statement of Suśruta. Moreover, it is made on much the same lines, though some of the more important defects of the Traditional Recension have escaped his attention. Thus he still counts four heels, instead of two, and omits the two shoulder-blades; and consequently his aggregates for the four extremities and the trunk are 108 and 126, instead of the true aggregates 106 and 128. He also fails to notice the omission of the two eyeballs; and hence, to make up the required total 300, he wrongly counts eleven neck-bones instead of nine. On the other hand, he rightly recognizes the error of the Traditional Recension in respect of the true number of the clusters and ankle-bones, and thus arrives at the true aggregates seven and twenty-seven, instead of ten and thirty. Similarly he recognizes the error with respect to the number of the bones of the breast and palate, restoring their true numbers seventeen and two, instead of eight and one. Further, he recognizes the misreading *udara*, abdomen, for which, however, he substitutes the insufficient reading akṣa (short for akṣaka), collar-bone.¹ On the other hand, his failure to realize the omission of the shoulder-blades prevented him from recognizing the misreading involved in the phrase akṣaka-samjñā (§ 29).

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¹ Possibly suggested to him by Chandraṭa's revised text; see below, § 40.

§ 36. Suśruta's Statement in other Medical Works

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1. It has been mentioned in § 26 that the Traditional Recension of the statement of Suśruta is found in the two medical works, Śārīra Padminī and Bhāva Prakāśa.

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2. In the Śārīra Padminī (verses 70 and 71) it runs as follows :

c6.s2.t7.3

‘In the sequel, the skeleton (kikasa) is explained as numbering three hundred bones in accordance with the count of the ancient Surgical Text-book. There are altogether one hundred and twenty bones in the extremities; one hundred and seventeen in the pelvic cavity, sides, abdomen, breast, and back; and sixty-three in the neck and upwards. Counting them, item by item, there are three hundred; but in respect of their shape, they are divisible into five classes.’ (Original Text in § 91.)

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3. In the Bhāva Prakāśa the statement runs as follows :

c6.s2.t7.5

‘In the Surgical Text-book the number of bones is stated to be three hundred. These, as well as their position in the body, are as follows: One hundred and twenty bones are said to be in the extremities. In the two sides, hips, breast, back, and abdomen,—in all these, one should know, there are altogether one hundred and seventeen. In the neck and upwards there exist sixty-three bones.’ (Original Text in § 92.)

Linked texts (7)

Aṣṭāṅgahṛdayasaṃhitā — Vāgbhaṭa, Sanskrit
Carakasaṃhitā — Agniveśa (Āyurveda) & Caraka, Sanskrit
Suśrutasaṃhitā — Suśruta & Nāgārjuna (siddha/alchemist), Sanskrit
Bheḷasaṃhitā — Bheḷa, Sanskrit
Yājñavalkyasmṛti — Yājñavalkya, Sanskrit
Bhāvaprakāśa — Bhāvamiśra 1550, Sanskrit
Bhōja