International Journal of Recent and Futuristic Ayurveda Science A Peer-reviewed journal IJRFAS 01 (2016) 027-031 Musculoskeletal anatomy Description in Ayurveda; A renowned contribution of Sushrutato ancient world Dr. Dharmendra Mishra 1,*, Dr. Sunil Kumar 2,Dr. ShalineeKumari 3 1.* Department Of Rachana Sharira, JD Ayurvedic Medical College and Hospital, Aligarh, UP, India 2 Post Graduate Department of SharirRachana, National Institute of Ayurveda, Amer Road, Jaipur,India 3 Department of Swasthavritta, IPGT&RA, Jamnagar, India A B S T R A C T : This focuses on the illustrious knowledge of anatomy in ancient India. Anatomical knowledge in ancient India was derived principally from the dissected human dead bodies and explanations made by legends having celestial power to see the minuscule structures of human body as well as of other living creatures. The Vedic philosophies form the basis of the Ayurveda tradition, which is considered to be one of the oldest known systems of medication and wellbeing. Two sets of texts form the foundation of Ayurveda, the Susruta Samhita and the Charaka Samhita. The Sushruta Samhita provided important surgical and anatomical information of the understanding of anatomy by Indians in the 6th century BCE. Here we review the anatomical knowledge related to muscular and skeletal system known to ancient India given by Acharya Sushruta. 2016 A D Publication. All rights reserved Keywords: Anatomy; Ancient India; Sushruta Samhita, Peshi, Asthi 1. Introduction Healing traditions and medical practices are inextricably tied to human history. The oldest known civilizations have healing traditions associated with them and have added to our current knowledge of the medical sciences, particularly anatomy. Areas such as India, Greece, Mesopotamia, Egypt and China have shaped the study of medicine and human anatomy. As one of the oldest civilizations, India is rich in such history and tradition, which includes significant contributions to our understanding of human morphology. The foundation of Ayurveda can be found in ancient Indian texts, some of which predate the Christian era by thousands of the years. The developmental history of ancient India can be divided into three periods: the Vedic (c. 5000 500 BCE), Brahmanic (600 BCE 1000 CE) and finally the Mughal (1000 CE until the 18thcentury) (Persaud, 1997). The ancient Indian name of the science of medicine is Ayurveda, the Veda for lengthening the span of life, which is considered an upanga (subsidiary) to the Atharvaveda. The science of medicine is also called Vaidyasastra and the physician is called vaidya, possessing knowledge (vidya). The Vedic philosophies form the basis of the Ayurveda tradition, which is considered to be one of the oldest known systems of medicine and was compiled during the Vedic period. The Sushruta Samhita was written by the famous physician and surgeon Sushruta in the6th century BCE who taught at the University of Benares (alternatively Kasi or Varanasi) on the Ganga River. He is best known for his tome of surgical wisdom, practices and tools. In Sushruta s work, it is evident that * Corresponding author e-mail: drdmishrania@gmail.com Journal access: www.adpublication.org Tel.: +91 9462743251 2015 A D Publication. All rights reserved ID:IJRFAS2016V1I1130248 Volume 1 Issue 1,2016
28 Dr. Dharmendra Mishra et al/ International Journal of Recent and Futuristic Ayurveda Science considerable thought was given to anatomical structure and function, as Sushruta was a proponent of human dissection; his texts include a systematic method for the dissection of the human cadaver. Acharya Sushrutain Sushruta Samhita described a separate section named Sharir Sthanto elaborate the essential knowledge of anatomy. The concept of anatomy description in Ayurvedais not merely to gain the information of minute structures through dead body dissection but also the physiology along with spiritual notion present in living human [1]. Why anatomy is rather important for a physician and surgeon has already been described in Samhita [2, 3]. 2. Material The fifth chapter of Sharir Sthan in Sushruta Samhita has rich descriptions of gross anatomy. Sushruta has described 500 muscles and 300 bones in human body by the name of Peshi and Asthi respectively [4].He further expanded these numbers according to the regions of body. In Ayurveda the whole body is well divided in six regions named as four Shakha i.e. two upper and two lower limbs, one Antaradhi i.e. thorax, abdomen and back combined and one Urdhvanga i.e. the head and neck [5]. Sushruta gave region wise details of total 500 muscles (Peshi) as [6] Urdhva Shakha(Upper limb) 200 (100*2) Adhah Shakha(Lower limb) 200 (100*2) Antaradhi( Trunk) 66 Urdhvanga( Head and Neck) 34 He further described these numbers and detailed them according to smaller body regions as; Muscles (Peshi) in each Lower limb: [7] Prapad( Foot) 10 Gulph and Gulphatala( Ankle) 20 Sakthi( Leg) 20 Janu(Knee) 05 Uru(Thigh) 20 Vankshana( Groin) 10 Total 100 Muscles (Peshi) in each Upper limb : [8] Hast( Hand) 10 Manibandh and Manibandhmula( Wrist) 20 Prabahu( Forearm) 20 Kurpara(Elbow) 05 Bahu( Arm) 20 Kaksha( Axilla) 10 Total 100
29 Dr. Dharmendra Mishra et al/ International Journal of Recent and Futuristic Ayurveda Science Muscles (Peshi) in Trunk : [9] Payu(Anus) 03 Medhra(Penis) 01 Sevani(Raphe) 01 Vrishana( Testis) 02 Sphicha(Buttocks) 10 (5*2) Bastishirsha( Loin) 02 Udara( Belly) 05 Nabhi(Navel) 01 Prushtha(Back) 10 (5*2) Parshva( Sides) 06 Vaksha(Thorax) 10 Akshakanshau( Shoulder) 07 Hridaya(Heart) 01 Amashaya(Stomach) 01 Yakrita(Liver) 02 Pliha(Spleen) 02 Unduka( Rectum) 02 Total 66 Muscles (Peshi) in Head and Neck: [10] Griva(Neck) 04 Hanu(Mandible) 08 Talu( Palate) 02 Jihva(Tongue) 01 Oshtha(Lips) 02 Nasa(Nose) 02 Netra(Eye) 02 Kapola(Cheeks) 04 Karna(Ears) 04 Lalata(Forehead) 04 Shira( Head or Cranium) 01 Total 34 Sushruta gave region wise details of total 300 bones (Asthi) as [11] UrdhvaShakha(Upper limb) 60 (30*2) AdhahShakha(Lower limb) 60 (30*2) Antaradhi( Trunk) 117 Urdhvanga( Head and Neck) 63 He further described these numbers and detailed them according to smaller body regions as; Bones (Asthi) in each Lower limb: [12] Gulpha and Gulphatala( Foot and Ankle) 10 Parshni( Heel) 01 Jangha( Leg) 02 Janu(Knee) 01 Uru(Thigh) 01 Total 30
30 Dr. Dharmendra Mishra et al/ International Journal of Recent and Futuristic Ayurveda Science Bones (Asthi) in each Upper limb: [13] Bones (Asthi) in Trunk: [14] Hasta( Palm) 04 Manibandh( Wrist) 08 Prabahu(Forearm) 02 Bahu( Arm) 01 Total 30 Shroni/Trik( Hip Bone or Pelvis) 04 Gudasthi( Sacrum) 01 Parshuka( flat bony part of Ribs) 24 Sthalaka( cartilage part of Ribs) 24 Sthalakarbuda( Tubercle of Rib) 24 Prishthasthi( Body and Processes of Vertebrae) 30 Urasthi( Sternum and Clavicles) 08 Amshaphalaka( Scapula) 02 Total 117 Bones (Asthi) in Head and Neck region: [15] Grivasthi( Cervical Vertebrae) 09 Kanthanadi( Cricoid Cartilage and Hyoid) 04 Hanvasthi(Mandible) 02 Shirahkapala( Scalp bones) 06 Talvasthi(Palatine) 01 Shankhasthi( Temporal) 02 Nasasthi(Nasal) 03 Gandakuta( Maxilla) 02 Karnasthi(Ear ossicles) 02 Danta(Teeth) 32 Total 63 3. Discussion To the term Peshi Acharya Sushruta said the derivative of Mansak handa with the help of Vayu [16]. It is difficult to understand the meaning or the structure denoted by Mansak hand but on going through the commentary of Dalhana,he explained it as the tissue having property of differentiation and thus with the help of Vayu this Mansakhand gives off to the Peshiwhich may be striated muscle on skeleton or smooth muscle in visceral organ or anorgan the composition of various musculartissue. That is the reason we find several organs in the description of Peshi. Thus by the term Peshi Ayurveda denotes to all these structures. Further there is an important description of the shapes of Peshi as they may be large, small, thick, thin, flat, dome shaped, sphincter shape, thread shape, short, long, firm, soft, smooth or rough [17]. The number of Peshiin a human male is 500 and additional 20 are there in females as said by Sushruta. This total number is near to the number of skeletal muscles in human body by modern science. But as in Ayurveda the several smooth muscles and some tissues are also included in Peshi thus the exact number of skeletal muscle in comparison is less. The answer of its variation may be due to evolution as well as due to use and disuse law may take some more time for discover.
31 Dr. Dharmendra Mishra et al/ International Journal of Recent and Futuristic Ayurveda Science There are five categories of 300 bones described by Sushruta according to their shapes as Kapala (Flat bones), Ruchaka (Tooth), Taruna (cartilage), Valaya (Circular) and Nalaka (Long bones)[18]. According to modern medical science there are 206 bones in human body as 120 in limbs, 50 in middle of body and 36 in Head and neck. Though the total number of bones does not match with number counted by Sushruta but the total number of bones in limbs resembles with modern era. Why is it so can be said as today s science name a structure as bone on the basis of its composition whereas in Ayurveda on the basis of their degeneration time among all the tissues of body the longest duration taker were called as bone [19]. Conclusion Though there is variation in total numbers of Peshi and Asthi described in Ayurveda relative to modern medical sciences. It does not prove it wrong because of ancient description and in the course of evolution due to use and disuse such variation may aroused. As the complete world is agree on the ancientness of Ayurveda and it proves that such a scientific and well categorized description of musculoskeletal anatomy is a great contribution of Ayurveda and Sushruta to the world. References [1] VruddhaVagbhata, AstangaSamgraha with Shashilekha commentary of Indu, edited by Dr. Shivaprasad Sharma, Chawkhambha Sanskrit Series office, Varanasi, Sharirsthana, chapter 12, verse 37. [2] Sushruta, SushrutaSamhita with the Nibandhasamgraha commentary of Sri Dalhanacharya, Edited by JadavajiTrikamjiAcharya, ChaukhambaSurbharatiPrakashana Varanasi,Sharirasthana, chapter 5, verse 62-63. [3] Agnivesha, CarakaSamhita with the Ayurveda Deepika Commentary By Cakrapaanidatta, Edited by VaidyaJadavajiTrikamjiAcharya, ChaukhambaSurbhartiPrakashana, Varanasi 2009, Sharirsthana, Chapter 7, Verse 19. [4] Sushruta, SushrutaSamhita with the Nibandhasamgraha commentary of Sri Dalhanacharya, Edited by JadavajiTrikamjiAcharya, ChaukhambaSurbharatiPrakashana Varanasi, Sharirasthana, chapter 5, verse 6. [5] Sushruta, SushrutaSamhita with the Nibandhasamgraha commentary of Sri Dalhanacharya, Edited by JadavajiTrikamjiAcharya, ChaukhambaSurbharatiPrakashana Varanasi, Sharirasthana, chapter 6, verse 3. [6] Sushruta, SushrutaSamhita with the Nibandhasamgraha commentary of Sri Dalhanacharya, Edited by JadavajiTrikamjiAcharya, ChaukhambaSurbharatiPrakashana Varanasi, Sharirasthana, chapter 5, verse 45. [7] Sushruta, SushrutaSamhita with the Nibandhasamgraha commentary of Sri Dalhanacharya, Edited by JadavajiTrikamjiAcharya, ChaukhambaSurbharatiPrakashana Varanasi, Sharirasthana, chapter 5, verse 46. 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