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Studies in the Medicine of Ancient India, Part I: Osteology, or the Bones of the Human Body c7.s7.t3: § 97. Suśruta on the Position of Cluster and Cluster-head

Studies in the Medicine of Ancient India, Part I: Osteology, or the Bones of the Human Body c7.s7.t3

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§ 97. Suśruta on the Position of Cluster and Cluster-head

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1. The statement of *Suśruta* on the position of the cluster and of the cluster-head, in the *Śārīra Sthāna*, ch. VI, cl. 28, referred to in § 49, and edited from Bd¹ (fol. 25 *b*), Bd² (fol. 24 *b*), IO¹ (fol. 22 *a*), IO² (fol. 29 *b*), and EJ (p. 340), runs as follows:

c7.s7.t3.2

Pādasy=aṅguṣṭh=aṅgulyor=madhye kṣipram=iti marma | kṣiprasy=opariṣṭād=ubhayataḥ kūrcaḥ ¹ | gulpha-sandher=adho 'nubhayataḥ ² kūrca-śiraḥ ¹ ||

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¹ Bd¹, Bd², EJ kūrco nāma, and kūrcaśiro nāma.

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² So IO¹; but IO² adhaḥ ubhayataḥ, Bd¹, Bd² only ubhayataḥ.

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*Translation.* Between the great toe and the toe next to it, there lies the vital spot, called *kṣipra*. Upwards of this *kṣipra*, both ways (i. e. externally and internally), there lies the *kūrca*, or cluster. Below the ankle-joint, but not both ways, there lies the *kūrca-śiras*, or cluster-head (astragalus).

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Ḍallaṇa*, *Gaṅgādhar* and *Nanda Paṇḍita* on the Collar-bone

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2. The statement of *Ḍallaṇa* on the collar-bone, in his Commentary on *Suśruta*’s Compendium, referred to in § 55, extracted from *Jīvānanda*’s edition, pp. 663, 665, runs as follows:

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Akṣakaḥ amsa-sandher=upariṣṭād=bhavati || Akṣakaḥ amsa-sandher=uparibhāgaḥ ||

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*Translation.* The *akṣaka*, or collar-bone, is located above the shoulder-joint. It is the upper part of the shoulder-joint.

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*Gaṅgādhar*’s statement, in his commentary on the Compendium of *Charaka*, p. 187, l. 14, is as follows:

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Dvāv=akṣakau kaṇṭhād=adho 'ṃsakau ॥

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The two akṣaka, or collar-bones, are the shoulder-bones (which lie) below the throat.

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Nanda Paṇḍita, in his commentary on the Institutes of Vishnu (Professor Jolly’s ed., p. 197), has the following statement : Akṣaḥ karṇa-netrayor=madhya-bhavaḥ śaṅkh-ādhobhāgaḥ.

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*Translation.*

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Akṣa is the lower portion of the temple which lies between the eye and the ear.

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Suśruta* and *Vāgbhaṭa* on the Position of the Scapula and Clavicle

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3. The statement of Suśruta on the position of the shoulder-blade and collar-bone, in the Śārīra Sthāna, ch. VI, cl. 31, referred to in § 55, and edited from Bd¹ (fol. 26 b), Bd² (fol. 26 a), IO¹ (fol. 23 a), IO² (fol. 32 b), and EJ (p. 342), runs as follows : Pṛṣṭh-opari pṛṣṭhavaṃśam=ubhayatas=trika-saṃbaddhe aṃsaphalake nāma । bāhumūrdha-grīvā-madhye 'ṃsapīṭha-skandha-¹ nibandhanāv=aṃsau nāma ॥

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¹ Bd¹ bandha.

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*Translation.*

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In the upper part of the back, on both sides of the vertebral column, there lie the two so-called shoulder-blades, being of triangular form. Between the head of the arms and the neck, there lie the two so-called collar-bones, connecting the shoulder-seat, or glenoid cavity, with the nape of the neck.

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The comment of Daḷḷana on the preceding statement, referred to in § 56, and extracted from Jīvānanda’s edition, p. 588, runs as follows : ‘Trika-saṃbaddhe’ iti । grīvāyā aṃsa-dvayasya ca yaḥ saṃyogaḥ sa trikaḥ । tatra saṃbaddhe aṃsaphalake ॥

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*Translation.*

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Regarding the phrase trika-saṃbaddha, trebly joined, the place where the two collar-bones connect with the neck, that is the *trika*, and in that place the (two) shoulder-blades are joined.

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The same statement, as given in the Summary of Vāgbhaṭa I, *Śārīra Sthāna*, ch. VII, vol. I, p. 234, l. 9, referred to in § 56, runs as follows:

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Pṛṣṭhavaṃsam=ubhayato bāhumūla-saṃbaddhe aṃsaphalake |
grīvā-bāhuśiro-madhye 'ṃsapīṭha-skandha-bandhanāv=aṃsau ||

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*Translation.*

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On both sides of the vertebral column there are the two shoulder-blades, joined on to the base of the arms. Between the neck and the head of the arms there lie the two collar-bones, connecting the shoulder-seat, or glenoid cavity, with the nape of the neck.

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Suśruta* on the Number of the Scapula and Clavicle

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4. The statements of *Suśruta* on the number of the shoulder-blades and collar-bones, in the *Śārīra Sthāna*, ch. V, cl. 34 and ch. VI, cl. 3, 11, 18, referred to in §§ 55 and 56, and edited from Bd¹ (fols. 21 *a*, 23 *a*, 23 *b*, 24 *a*), Bd² (fols. 20*b*, 22 *a*, 22 *b*, 23 *b*), IO¹ (fols. 18 *b*, 21 *a*), IO² (fols. 24 *a*, 26 *b*, 27 *a*, 28 *a*), and EJ (pp. 334, 336-8), runs as follows:

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(1) Akṣak-āṃsau¹ prati samantāt=sapta || 34 ||
(2) ²Aṣṭāv=asthi-marmāṇi || 3 || kaṭika-taruṇa-nitamb-āṃsaphalaka-śaṅkhāsv=asthi-marmāṇi || 11 ||
(3) Aṃs-āṃsaphalak-āpāṅga-nīla-manye³ phaṇau⁴ tathā || 18 ||

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¹ Read akṣak-āṃsajau.

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² Bd² om. this clause.

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³ Bd¹, Bd², EJ nīle manye.

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⁴ IO² phaṇe.

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*Translation.*

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(1) All round about the collar-bones and shoulder-blades there are seven (muscles).

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(2) There are eight vital spots in the bones. These are, two each in the *kaṭika-taruṇa*, the hips, the shoulder-blades, and the temples ⁵.

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⁵ The places referred to appear to be the attachment areas of the

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(3) There are two (vital spots) each in the collar-bones, shoulder-blades, *apāṅga*, *nīla*, *manya*, and *phaṇa*.

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Suśruta* on *Aṃsakūṭa

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5. The statement of *Suśruta* on *aṃsakūṭa*, in the *Śārīra Sthāna*, ch. VI, cl. 30, referred to in § 55, and edited from Bd¹ (fol. 26 *b*), Bd² (fol. 26 *b*), IO¹ (fol. 23 *a*), IO² (fol. 31 *a*), and EJ (p. 341), runs as follows:

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*Aṃsakūṭayor=adhastāt=pārśv-oparibhāgayor=apalāpau nāma*¹ ||

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*Translation.*

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Below the two summits of the shoulder, in the upper part of the two sides (of the thoracic cage) there are two (vital spots) called *Apalāpa*.

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Suśruta* on *Aṃsapīṭha

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6. The statement of *Suśruta* on *aṃsapīṭha*, in the *Śārīra Sthāna*, ch. V, cl. 23, referred to in § 55, and edited from Bd¹ (fol. 20 *b*), Bd² (fol. 19 *b*), IO¹ (fol. 18 *a*), IO² (fol. 23 *a*), and EJ (p. 332), runs as follows:

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¹ IO¹.² apālāpau, om. nāma.

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*Aṃsapīṭha-guda-bhaga*²-*nitambeṣu sāmudgāḥ* ||

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² Bd² pāda-guda-bhaga; Bd¹ pāda-guda and IO¹ guda-pāda, om. bhaga.

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*Translation.*

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There are (two) casket-shaped (joints): (one is) the shoulder-seat (glenoid cavity), (the other is formed by) the anal, pubic, and hip-bones (acetabulum).

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Rājanighaṇṭu* and *Amarakoṣa* on *Bhaga

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7. The definition of *bhaga* in the *Rājanighaṇṭu*, referred to in p. 153, footnote 1, occurs in the Supplement (*pariśiṣṭa*) of that work, chap. xviii, verses 43 and 44 (*Ānandāśrama* ed., p. 399), runs as follows:

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rotator muscles of the thighs about the ischio-pubic arch, of their flexor muscles in the ilium, of the rotator muscles of the arms, and of the temporal muscles of mastication.

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Guda-muṣkadvayor=madhye puṃsām=aṅgaṃ bhagaḥ smṛtaḥ

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. . . . . | yonir=bhago varāṅgaṃ syād=upasthaṃ smara-mandiram ॥ 44 ॥

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*Translation.*

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[Verse 43.] The member of the male between the anus and the bipartite scrotum is known as *bhaga*.

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[Verse 44.] The vulva is (called) *bhaga*, or *varāṅga* (lit. choice part), or *upastha* (underlying), or *smara-mandira* (lit. Cupid's shrine).

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In the edition, published by Ashu Bodha and Nitya Bodha Bhattacharjya (Calcutta, 1899), verse 43 (there numbered 72, p. 389) runs as follows:

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Guda-muṣkadvayor=madhye yo bhāgaḥ sa bhagaḥ smṛtaḥ ॥ 72 ॥

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That is, That part which lies between the anus and the bipartite scrotum is known as *bhaga*.

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In this reading there is no explicit mention of the male, but, of course, the reference to it is implied in the mention of the scrotum. The reading of the Ānandāśrama edition is supported by the Bodleian MS., No. 765 (Wilson, 297), fl. 106 *a*, l. 2.

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The teaching of the *Amarakoṣa* on the subject occurs in its Section II, Chapter vi, verse 76 (in Dr. R. G. Bhandarkar's 5th ed., p. 150, Bombay, 1896), and runs as follows:

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Bhagaṃ yonir=dvayoḥ, śiśno meḍhro mehana-śephasī ॥

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*Translation.*

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The vulva (*yoni*) has also the other name *bhaga*, and the penis (*śephas*) or urinary organ (*mehana*) is (also called) urethra (*meḍhra*), and the ‘piercer’ (*śiśna*).

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The manner in which the two words are contrasted is significant.

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§ 98. *Suśruta and Vāgbhaṭa on Jatru and Grīvā*

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¹ The statements of Suśruta on *jatru*, windpipe, and *grīvā*, neck, in the *Śārīra Sthāna*, ch. VI, cl. 4, 32, referred to in § 62

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(p. 160), and edited from IO¹ (fols. 20 *a*, 23 *b*, 24 *a*), IO² (fols. 26 *b*, 33 *a*, 34 *b*), and EJ (pp. 336, 342, 343), are as follows :

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(1) Grīvāyām¹ praty-ūrdhvaṁ saptatriṁśat ‖ 4 ‖

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¹ EJ grīvām.

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(2) Ata ūrdhvam²=ūrdhvajatru-gatāny=anuvyākhyāsyāmaḥ ³ ‖ tatra kaṇṭhanāḍīm=ubhayataś=catasro dhamanyaḥ . . . . ‖ grīvāyām=ubhayataś=catasraḥ sirāḥ . . . . . . evam=etāni saptatriṁśad=ūrdhvajatru-gatāni marmāṇi vyākhyātāni ‖ 32 ‖

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³ EJ vyākhyāsyāmaḥ.

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*Translation.*

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(1) In the neck and upwards there are thirty-seven (vital spots).

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(2) Now, further on, we shall describe in detail (the vital spots) occurring from the neck upwards. In that region, in the windpipe there are four *dhamanī*, &c., and in the cervical column there are four blood-vessels, &c. . . . . . Thus, these thirty-seven vital spots which occur from the neck upwards have been described.

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In the Compendium of Vāgbhaṭa II (*Aṣṭāṅga Hṛdaya*, *Śārīra Sthāna*, ch. IV, verse 2 *a*, in 1st ed., vol. I, p. 592) the first-quoted statement runs as follows :

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Pṛṣṭhe caturdaś=ordhvaṁ tu jatros=triṁśac=ca sapta ca ‖

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*Translation.*

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In the back there are fourteen (vital spots); but from the neck upwards there are thirty and seven.

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Suśruta, Vāgbhaṭa, and Mādhava on the Valmīka Disease

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2. The statement of Suśruta on the *Valmīka* disease, in the *Nidāna Sthāna*, ch. XIII, verses 7, 8, referred to in § 62 (p. 161), and edited from IO² (fol. 48 *b*) and EJ (p. 286), runs as follows :

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² IO¹ om. ūrdhvam.

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Pāṇi-pāda-tale sandhau grīvāyām=ūrdhva-jatruṇi ‖

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granthir=valmīkavad=yaś=ca śanaiḥ samupacīyate ‖ 7 ‖

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Toda-kleda-parīdāha-kaṇḍūmadbhir=vraṇair=vṛtaḥ | vyādhir=Valmīka ity=eṣa kapha-pitt-ānil-odbhavaḥ || 8 ||

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*Translation.*

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An anthill-like swelling which gradually grows up in the palm of the hand, in the sole of the foot, in a joint, in the neck, or anywhere above the windpipe, and which turns into pricking, running, burning, and itching ulcers—such a disease is called Valmīka, and is caused by disorders in the phlegm, bile, and air humours.

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The same statement in the Summary of Vāgbhaṭa I, *Uttara Sthāna*, ch. XXXVII, vol. II, p. 316, l. 2, runs as follows:

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Pāṇi-pāda-tale sandhau jatrūrdhvaṁ c=opacīyate | valmīkavac=chhanair=granthis=tad-vad=bahv-aṇubhir=mukhaiḥ || Rug=dāha-kaṇḍū-kled-āḍhyair=Valmīko 'sau samasta-jaḥ ||

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*Translation.*

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An anthill-like swelling with numerous minute apertures, which gradually grows up in the palm of the hand, in the sole of the foot, in a joint, or anywhere above the neck, and is full of burning and itching discharges—such a disease is called Valmīka, and is caused by all (the three) humours.

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The same statement in the Pathology of Mādhava (*Nidāna*, ch. LV, cl. 6, ed. Jīv., 1901, p. 276) runs as follows:

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Grīv-āṃsa-kakṣā-kara-pāda-deśe sandhau gale vā tribhir=eva doṣaiḥ | Granthiḥ sa valmīka-vad=akriyāṇāṃ jātaḥ krameṇ=aiva gataḥ pravṛddhim || Mukhair=anekaiḥ śruti-toda-vadbhir=visarpa-vat=sarpati c=onnat-āgraiḥ | Valmīkam=āhur=bhiṣajo vikāraṃ niṣpratyanīkaṃ cira-jaṃ viśeṣāt || 6 ||

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*Translation.*

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An anthill-like swelling, which has arisen from all the three humours (when disordered) in the neck, shoulder, armpit, and flat of the hand or foot, or in a joint, or in the throat, and which has gradually grown to a size, with numerous raised orifices running and pricking, and which spreads like erysipelas—such a disease the physicians call Valmīka, especially if it has been neglected and is of long standing.

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Suśruta* on *Ūrdhvajatru* and *Jatrūrdhva

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3. The use by Suśruta of the terms ūrdhvajatru and jatrūrdhva, referred to in § 62 (p. 162), is further illustrated by the following two passages. The first occurs in Sūtra Sthāna, ch. I, cl. 5, and, extracted from EJ (p. 2), runs as follows:

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Śālākyam nāma ūrdhvajatru-gatānām rogānām śravaṇa-nayana-vadana-ghrāṇ-ādi-saṃśritānām vyādhīnām ≀ upaśamanārtham ‖

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*Translation.*

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(The branch of medical science) called Minor Surgery is concerned with the cure of the diseases seated in the body from the neck upwards, that is, of the maladies affecting the ears, eyes, mouth, nose, and other organs.

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Chakrapāṇidatta’s comment on this passage in the Bhānumatī (Calcutta edition, p. 20) runs as follows:

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(1) Jatru grīvā-mūlam ≀ jatruṇa ūrdhvam ≀ ūrdhvajatru ‖

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The comment of Ḍallaṇa, in Jīvānanda’s edition, p. 7, is:

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(2) Jatru grīvā-mūlam ≀ anye vakṣo-’ṃsa-sandhim ≀ āhuḥ ‖

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*Translation.*

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(1) The term jatru signifies the base of the neck; hence the term ūrdhvajatru denotes the body from the neck upwards.

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(2) The term jatru signifies the base of the neck. Others explain it as the joint of breast-bone and collar-bone.

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The second passage occurs in the Nidāna Sthāna, ch. I, verse 14, and, edited from IO² (fol. 3 a, l. 3) and EJ (p. 244), runs as follows:

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Tena bhāṣita-gīt-ādi-viśeṣo ’bhipravartate ≀ ūrdhvajatru-gatān ≀ rogān ≀ karoti ca viśeṣataḥ ‖ 14 ‖

c7.s7.t3.113

By means of it (i. e. the *udāna* or uprising air humour) speaking, singing, and other functions (such as breathing) are performed ; and in particular (when disordered) it causes the diseases which are seated in the body from the neck upwards.

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The comment of Daḷḷana on the term *ūrdhvajatru* in this passage (Jīv. ed., p. 459) runs as follows : ‘Ūrdhvajatru-gatān’ iti nayana-vadana-ghrāṇa-śravaṇa-śiraḥ-saṃśrayān ॥

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*Translation.* The phrase ‘seated in the *ūrdhvajatru*’ refers to those diseases which have their seat in the eyes, mouth, nose, ears, and the cranium.

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The similar comment of Aruṇadatta, also referred to in § 62, occurs in the *Aṣṭāṅga Hṛdaya*, *Sūtra Sthāna*, ch. I, verse 1 (1st ed., vol. I, p. 368), and runs as follows : Ūrdhvajatru-vikāreṣu śiro-rog-ādiṣu.

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*Translation.* The phrase ‘in diseases of the *ūrdhvajatru*’ means ‘in diseases which affect the cranium and other parts of the head’.

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