Studies in the Medicine of Ancient India, Part I: Osteology, or the Bones of the Human Body c7.s2.t2: § 56. The Shoulder-blade or Scapula

Studies in the Medicine of Ancient India, Part I: Osteology, or the Bones of the Human Body c7.s2.t2

Language: English

§ 56. The Shoulder-blade or Scapula

c7.s2.t2.1

1. *Aṃsa-phalaka*, flat bone of the shoulder, *aṃsa-ja* or *aṃsa-samudbhava*, (bone) springing from the shoulder. All three terms are employed to denote the shoulder-blade or scapula, but the first-named, *aṃsa-phalaka*, is the term which is commonly used by Ātreya-Charaka, Suśruta, and Vāgbhaṭa I. The term *aṃsa-ja* is conjectural and only occurs in the Compendium of Suśruta (§§ 29, 55). The term *aṃsa-samudbhava* is found only in the Non-medical Version of Ātreya’s statement on the skeleton, and is probably a synonymous variation of the Suśrutiyan term *aṃsa-ja* (§§ 16, 17, 21). The Atharva Veda has the peculiar term *kaphoḍa* to denote the shoulder-blade (§ 43, cl. 6).

c7.s2.t2.2

2. All three lists of Ātreya-Charaka (Bheḍa), Suśruta, and Vāgbhaṭa I, correctly state the number of shoulder-blades to be two; but there is a difficulty attending them which requires a word of explanation. The shoulder-girdle (Fig. 12) comprises two bones, and no more. These are the scapula or shoulder-blade, and the clavicle or collar-bone. Examining the traditional lists of Ātreya-Charaka, Suśruta, and Vāgbhaṭa I, we find a curious state of things. Charaka apparently enumerates three bones (§ 4)—*aṃsa*, shoulder, *aṃsa-phalaka*, shoulder-blade, and *akṣaka*, collar-bone. Vāgbhaṭa I has the same threefold enumeration (§ 37). On the other hand, Suśruta appears to enumerate only a single bone, namely *akṣaka*, or the collar-bone (§ 27). As regards Charaka, it has been shown in § 6 that the separate mention of *aṃsa*, shoulder, is an early error of the manuscript text caused by an inadvertent repetition, by some scribe, of the word *aṃsa* inherent in *aṃsa-phalaka*. In reality, therefore, the genuine list of Charaka (§ 7) knows only two bones as comprised in the shoulder, viz. *akṣaka*, clavicle, and *aṃsa-phalaka*, scapula. It is different with the list of Vāgbhaṭa I. That list deliberately enumerates the shoulder-peak as a third bone by the side of the shoulder-blade and the collar-bone; for otherwise (see § 37) its total of 120 bones does not work out correctly. This, however, is only one of the numerous incongruities and blunders of the list of Vāgbhaṭa I; and how he came to be betrayed into committing it has been explained in § 39, cl. 4.

c7.s2.t2.3

³ As regards Suśruta, it has been shown in §§ 29, 30, 56, that the omission of the shoulder-blades from his list is a textual error, due in all probability to an ancient misreading (or false emendation), by some ignorant scribe who wrote *saṃjña*, so-called, for *aṃsaja*, shoulder-blade; and that, as a matter of fact, Suśruta explicitly mentions the shoulder-blade as one of those bones which he classifies as pan-shaped (*kapāla*). In reality, therefore, the genuine list of Suśruta (§ 34) enumerates both bones which constitute the shoulder-girdle, the clavicle as well as the scapula. His explicit statement regarding the existence of the two bones, together with other evidence on the subject, has already been quoted in the preceding paragraph. An additional piece of evidence, however, may here be adduced. In the sixth chapter of his Anatomical Section (*Śārīra Sthāna*), in which Suśruta enumerates the so-called ‘vital spots’ (*marman*) in the body, he says that ‘there are eight such places in the bones’, and among these eight bones he enumerates the *aṃsa-phalaka*, or shoulder-blades (Original Text in § 97, cl. 4).

c7.s2.t2.4

4. The scapula is a large, flat, triangular bone (Fig. 13). That the ancient Indian anatomists knew it to be a large, flat bone is shown by the fact of their calling it *phalaka*, which word means a board or slab. But it is Suśruta alone who also notes its triangular shape. In the passage quoted in the preceding paragraph he particularly describes it as *trika-sambaddha*, trebly bounded, that is, as being of a triangular form. For the same reason of its triangular shape the sacrum likewise is called

c7.s2.t2.5

FIG. 13. LEFT SCAPULA, *Aṃsa-phalaka*. Posterior View. Showing—a. Acromion process, *Aṃsa-kūṭa*. b. Coracoid process. c. Glenoid cavity, *Aṃsa-pīṭha*.

c7.s2.t2.6

*trika* : see § 60. In this connexion Daḷḷana’s explanation of the Suśrutiyan phrase *trika-sambaddha*, triangular in form, is significant as showing the decay of anatomical knowledge subsequent to the time of Suśruta. He says: ‘The place where the two collar-bones connect with the neck, that place is meant by the term *trika*.’¹ This place, as may be seen by referring to Fig. 4, has no apparent connexion with the scapula, and its mention in a description of the latter bone, accordingly, is quite out of place. The explanation of Dallana, however, would appear to be a tradition of considerable antiquity. For its incongruity would seem to have induced Vāgbhaṭa I to change the text of Suśruta’s description of the scapula. In the seventh chapter of the Anatomical Section of his Summary, quoting Suśruta’s description, Vāgbhaṭa I replaces the Suśrutiyan phrase *trika-sambaddha*, trebly bounded or triangular, by the phrase *bāhumūla-sambaddha*, joined to the root of the arm, i. e. to the head of the humerus. Here we see that Vāgbhaṭa I replaces the incongruous expression ‘junction of the collar-bone with the neck’ by the phrase ‘junction with the head of the humerus’. Though this alteration doubtlessly now states a correct fact—the junction of the scapula with the head of the humerus in the glenoid cavity—it entirely abandons Suśruta’s striking description of the triangular shape of the scapula, apparently because Vāgbhaṭa I also did not know what to make of the Suśrutiyan term *trika*.

c7.s2.t2.7

¹ This explanation is also quoted in the *Bhāva Prakāśa* (Jīv. ed., p. 60). In the Bengali commentary, appended to the edition of that

Linked texts (1)

Bhāvaprakāśa — Bhāvamiśra 1550, Sanskrit