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Studies in the Medicine of Ancient India, Part I: Osteology, or the Bones of the Human Body c7.s3.t1: § 61. The Cervical Vertebrae, or Neck-bones

Studies in the Medicine of Ancient India, Part I: Osteology, or the Bones of the Human Body c7.s3.t1

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§ 61. The Cervical Vertebrae, or Neck-bones

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1. *Grīvā*, neck. This term is used in all the three lists, of Ātreya-Charaka, Suśruta, and Vāgbhaṭa I, to denote the cervical column in the posterior part of the neck. The list in the Atharva Veda (§ 43) uses the term *skandha* in the plural number to denote the neck-bones.

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FIG. 21. THE ATLAS, viewed from above. a. Arch.

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FIG. 22. THE AXIS. Anterior View. a. Body. b. Odontoid process.

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2. There is no part of the skeleton with regard to the number of bones of which the lists differ more widely. The list of Ātreya-Charaka (§ 4) makes the number of neck-bones to be fifteen. The Traditional Recension of the list of Suśruta (§ 27) makes it to be only nine, while the list of Vāgbhaṭa I (§ 37) makes it to be thirteen. As a matter of fact, the number of the cervical vertebrae is seven; but they greatly differ among themselves in some respects. The first vertebra, called the atlas (Fig. 21), is practically a mere ring. It lacks the body and spinous process of the normal vertebra. The second vertebra, called the axis (Fig. 22) consists practically only of a large strong body, surmounted by the odontoid process, on which as a pivot the atlas rotates.¹ The remaining five vertebrae possess the normal type (§ 59, cl. 3), and consist of a body and three (one spinous and two transverse) processes; but these processes, in all except the seventh, are short and bifid at the extremity (Fig. 23), and hence not very prominent. The seventh vertebra is exceptional: it approaches in shape the upper thoracic

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¹ See Dr. Gerrish’s *Textbook of Anatomy*, 2nd ed., p. 117. The odontoid process, in fact, is the body of the atlas from which it has become separated, and become ankylosed to the axis.

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[Figure: FIG. 23. A CERVICAL VERTEBRA, viewed from above. a. Body. b. Bifid spinous process. c, c. Transverse processes.]

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vertebrae, having a very long spinous process, whence it is called vertebra prominens, as well as large transverse processes.²

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² *Ibid.*, pp. 117, 124, ‘The spinous processes of the upper vertebrae are not readily felt in the living body, until we reach the 7th or sometimes the 6th spine.’

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3. These considerations fully explain Suśruta’s count of nine neck-bones. He counted each of the six upper vertebrae as a single bone; but the seventh he treated in the same way as he treated the thoracic vertebrae (§ 59, cl. 3), that is to say, he counted it as consisting of three bones; viz. a body plus spine, and two transverse processes. He thus obtained 6 + 3 = 9 bones.

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4. Ātreya-Charaka obtained his total of fifteen bones by treating the cervical column somewhat similarly to the vertebral column (§ 59). He gave two transverse processes to each vertebra, counting them as separate bones, and looked upon the bodies of the vertebrae as constituting together a single columnar bone. He thus had twice seven transverse processes, or fourteen bones, plus one columnar body, or a total of fifteen bones. That this was really Ātreya's procedure is shown by a statement of the Śatapatha Brāhmaṇa, which is evidently based on Ātreya's theory of the cervical bones, and which says (§ 42, cl. 3) of the neck-bones, ‘Fourteen are the transverse processes, and their strength (or strong bone) is the fifteenth; hence by means of them, though they are very small, man can bear a heavy load.’ At the same time, Ātreya's procedure shows that his knowledge of the structure of the cervical bones was not so intimate as that of Suśruta; for there is no single central columnar bone in the neck, and the transverse processes of the vertebrae are far less prominent in the neck than in the back¹ (Fig. 18).

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¹ ‘The transverse processes are rather short.’—Ib., p. 116.

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4. As regards the count of Vāgbhaṭa I, his total of thirteen bones probably represents, as usual, a compromise between the systems of Ātreya-Charaka and Suśruta. He appears to have counted two bones (transverse processes) for each of the cervical vertebrae, except the first, which, being a mere bony ring, without body and spinous process, was reckoned as a single bone. He would thus obtain his total of thirteen bones (i.e. 6 × 2 = 12 + 1 = 13).

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