Studies in the Medicine of Ancient India, Part I: Osteology, or the Bones of the Human Body c7.s1.t4: § 50. The Heel

c7.s1.t4.1

*Pārṣṇi*, or the heel. See Fig. 7. This term, as used by Charaka, denotes the backward and downward projection of the os calcis, that is, that portion of it which can be superficially seen and felt, and is popularly known as the heel. Accordingly, in Ātreya’s statement of the skeleton, as reported by Charaka and Bheḍa (§§ 4, 12), the number of heels is rightly said to be two. In the list of Vāgbhaṭa I (§ 37), rather grotesquely a heel is ascribed to each of the four extremities, two in the feet and two in the hands, giving a total of four heels. The reason of this incongruous conception has been explained in § 32. It arose from a false construction of Suśruta’s direction regarding the method of counting the bones of the four extremities, and it actually succeeded, probably on the authority of Vāgbhaṭa I himself, in being received into the Traditional Recension of Suśruta’s statement on the skeleton (§ 27). There can hardly be any doubt that the statement of Suśruta, in its original and genuine form, taught no more than two heels. From the general tenor of it, it is evident that Suśruta knew the true nature of the tarsus; namely, that it is a cluster (*kūrca*) of small bones. The two largest of these small bones he distinguished by special names; namely, the astralagus (No. 2) by *kūrca-siras*, or head of the cluster (§ 49), and the os calcis (No. 2), by *pārṣṇi*, or heel. In his detailed list of the bones (§ 27) he did not enumerate the ‘head of the cluster’ separately; for of course it was implicitly included in the term ‘cluster’ (*kūrca*). But the heel (*pārṣṇi*) he counted separately, either as a concession to the older system of Ātreya, and to popular usage, or, perhaps on the whole more probably, because he did not consider the os calcis as constituting one of the component bones of the cluster (*kūrca*). In all probability Suśruta’s real view of the lower portion of the lower extremity (the portion shown in Fig. 7) was that it was formed by five constituents : 1, phalanges (*aṅguli*); 2, metatarsals (*tala* or *śalākā*); 3, tarsal cluster (*kūrca*) of six small bones (Nos. 2–7 ; 4, ankles (*gulpha*); and 5, os calcis or heel-bone (*pārṣṇi*, No. 1). The view of Ātreya-Charaka differed from the view of Suśruta only in considering the tarsus to consist, not of a cluster of bones, but of a single, undivided supporting bone (*adhiṣṭhāna*), which included the body of the os calcis, but excluded its posterior downward projection, the latter being counted separately and named *pārṣṇi*. In § 65 it will be shown that there exists a similar difference of opinion with respect to the term *hanu* between Suśruta and Ātreya-Charaka. The former uses it as denoting the whole lower jaw-bone (inferior maxillary), while with Ātreya it denotes its (roughly) triangular ‘mental protuberance,’ popularly known as the chin (Fig. 31).