Studies in the Medicine of Ancient India, Part I: Osteology, or the Bones of the Human Body c7.s3.t2.7

Language: English

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4. In the earliest medical compendia the term *jatru* is either synonymous with *grīvā*, neck, or signifies more especially a particular aspect of it. The neck contains two structures, posteriorly the cervical column, denoted more particularly by the term *grīvā*, and anteriorly the windpipe, denoted more particularly by the term *jatru*. As the latter term, in a general way, also denotes the whole neck, Suśruta prefers, in his list of bones (§ 27), to employ the more specialized term *kaṇṭhanāḍī*, throat-pipe, to indicate the windpipe as distinguished from the cervical column. On the other hand, outside his list, he frequently uses the two terms *jatru* and *grīvā* as practically synonymous, to denote sometimes the windpipe, sometimes the neck generally. Thus in his class-list of the bones (§ 30), enumerating the cartilages, or tender bones (*taruṇa*), he makes them to include ‘the nose, ears, neck (*grīvā*), and eyeballs’ (Original Text in § 88). Here obviously the term *grīvā* cannot refer to the cervical column, but must denote the windpipe. Again in the sixth chapter of the Anatomical Section (*Śārīra Sthāna*), speaking of certain thirty-seven ‘vital spots’ (*marman*), he says (Jīv. ed., p. 336, cl. 4) that they are situated ‘from the neck (*grīvā*) upwards’; but afterwards (Jīv., pp. 342–3, cl. 32), mentioning them in detail, he describes them as ‘situated from the neck (*jatru*) upwards’;

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and then, enumerating them, he mentions among their number some which are situated in the windpipe (*kaṇṭhanāḍī*) and others in the cervical column (*grīvā*). Here we have Suśruta employing the term *jatru* as synonymous with *grīvā*, neck, in a general way, and, again, specializing, he uses *grīvā* for the posteriorly-lying cervical column, but *kaṇṭhanāḍī* for the anteriorly-lying windpipe. Similarly Vāgbhaṭa II (in his *Aṣṭāṅga-Hṛdaya*, II. 4, verse 2, in 1st ed., vol. I, p. 592), speaking of the same thirty-seven vital spots, says that they are situated *ūrdhvaṃ jatroḥ*, or upwards of the neck, using *jatru* synonymously with *grīvā*. Again in the fifth chapter of the Pathological Section (*Nidāna Sthāna*), speaking of the rheumatic disease *manyā-stambha*, or rigidity of the neck, Suśruta says (Jīv. ed., p. 249, verse 69) *grīvā apavartate*, ‘the neck becomes awry.’ Similarly Charaka, or rather Dṛḍhabala¹ (VI. 26, verse 41a, Jīv. ed., 1896, p. 775), referring to the same disease, says grīvā antar-āyamyate, ‘the neck becomes bent inward.’ On the other hand, Vāgbhaṭa I (Aṣṭāṅga Saṃgraha, III. 15, vol. I, p. 300, last line, quoted by Vāgbhaṭa II in Aṣṭāṅga Hṛdaya, III. 15, verse 22, in 1st ed., vol. I, p. 831), says jatrur-āyamyate.¹ This shows that grīvā and jatru are synonymous terms. Again, in the thirteenth chapter of the same section, speaking of the Valmīka disease,² Suśruta tells us (Jīv. ed., p.

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286) that, among other places, it occurs grīvāyām-ūrdhva-jatruṇi, in the cervical column and upwards of the windpipe, that is, in the neck generally. Vāgbhaṭa I, speaking on the same subject (Aṣṭāṅga Saṃgraha, VI. 36, vol. II, p. 316, l. 3, quoted by Vāgbhaṭa II, in Aṣṭāṅga Hṛdaya, VI. 31, in 1st ed., vol. II, p. 682, verse 19b), says simply jatrūrdhvam, from the neck upwards, omitting grīvā, and therefore using jatru as indicating the neck generally. On the other hand, Mādhava, in his Nidāna (Jīv. ed., p. 276), paraphrasing the statement of Suśruta, uses the two terms grīvā, cervical column, and gala, windpipe, instead of Suśruta’s grīvā and jatru, thus showing that he took jatru to be synonymous with gala, windpipe. Again, in the fifteenth chapter of the Supplementary Section (Uttara Tantra), speaking of hikkā, or hiccough, Suśruta uses the term jatru-mūlāt, ‘from the base of the neck’ (Jīv. ed., p. 849, verse 9, quoted by Mādhava, in his Nidāna, p. 105). The same phrase is used by Charaka (or rather Dṛḍhabala, VI. 19, in Jīv. ed., 1896, p. 689, verse 30a) and Vāgbhaṭa I (Aṣṭāṅga Saṃgraha, III. 5, vol. I, p. 270, l. 6, quoted by Vāgbhaṭa II in Aṣṭāṅga Hṛdaya, III. 4, verse 22, in 1st ed., vol. I, p. 716). Gayadāsa, in his commentary on the Compendium of Suśruta (according to Vijaya Rakshita, in the Madhukoṣa, Jīv. ed., p. 105), explains here jatru by grīvā, neck, or kaṇṭha, throat.

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The two terms ūrdhva-jatru and jatrūrdhva are synonymous, and denote one of the three parts into which the body is divided. These three parts are: (1) the four extremities (*śākhā*), (2) the trunk or middle (*antarādhi* or *madhya*), and (3) the neck and head (*śiro-grīvā*). It is the last-named portion which is also called *ūrdhva-jatru* or *jatrūrdha*, i.e. ‘the portion from the neck upwards’, and inclusive of the neck. Both forms of the term are frequently met with. Thus Suśruta, describing the respective scope of the various parts of Medical Science, in the first chapter of the Introductory Section (*Sūtra Sthāna*, Jīv. ed., p. 2), says of Minor Surgery, that it concerns itself with ‘the cure of the diseases which have their seat in the portion of the body from the neck upwards (*ūrdhva-jatru*), that is, those maladies which affect the ears, eyes, mouth, nose, and other organs’. Chakrapāṇidatta, in his Commentary (*Bhānumati*, p. 20), here says that the term *jatru* means ‘the base of the neck’ (*grīvā-mūla*), and explains the phrase *ūrdhva-jatru* to mean ‘from the neck (base of the neck) upwards’ (*jatruṇa ūrdhvam*). Daḷḷana, in his comment on the same phrase (Jīv. ed., p. 7), says that according to some ‘*jatru* means the base of the neck, and according to others, the point of junction of the sternum and clavicles’. In accordance with this definition, Suśruta, in the Anatomical Section, chap. III, cl. 7 (Jīv. ed., p.

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337), enumerates certain vital spots (*marman*) as situated in the body from the neck upwards (*jatrūrdhvam*). In the Pathological Section, chap. I, verse 14, Suśruta again speaks of ‘diseases seated in the organs from the neck upwards (*ūrdhva-jatru*); and Daḷḷana (Jīv., p. 459) once more explains those diseases to be ‘those affecting the eyes, mouth, nose, ears, and cranium’. Many other examples of this use of the phrase *ūrdhva-jatru* might be quoted from the Compendium of Suśruta, e.g. *Sūtra Sthāna*, XXI. 30 (Jīv. ed., p. 68, l. 20); *Cikitsita Sthāna*, XXXVI, 24 (Jīv., p. 569), &c. The same usage is very common in the Summary of Vāgbhaṭa I. The following examples may be quoted: the form *jatrūrdhva* occurs in *Sūtra Sthāna*, chap. XXIX (vol. I, p. 153, l. 14), and chap. XXXVI, (vol. I, p. 176, l. 19); *Nidāna Sthāna*, chap. XV (vol. I, p. 304, l. 5), and *Uttara Sthāna*, chap. XXXVI (vol. II, p. 315, l. 21), quoted by Vāgbhaṭa II in his Compendium (*Aṣṭāṅga Hṛdaya*), *Sūtra Sthāna*, chap. XX, verse 17; chap. XXVII, verse 11; *Nidāna Sthāna*, chap. XVI, verse 22; *Uttara Sthāna*, chap. XXXI, verse 16 (in 1st ed., vol. I, pp. 373, 433, 842; vol. II, p. 681). The other form *ūrdhva-jatru* occurs in the Compendium of Vāgbhaṭa II, *Sūtra Sthāna*, chap. XX, verse 1 (vol. I, p.

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368), where he refers to *ūrdhva-jatru-vikāra*, that is, ‘diseases affecting the body upwards from the neck.’ The commentary of Aruṇadatta here explains the phrase to refer to ‘headache and similar diseases’. (For the original texts of the passages quoted above, see § 98.)