Sushruta Samhita Sharirasthana Chapter 5 Sarira Sankhya Vyakarana Shariram (Enumeration of Body Parts)

The fifth bankruptcy of Sharirasthana of Sushruta Samhita is called as Sarira Sankhya Vyakarana Shariram Adhyaya. This bankruptcy offers with Enumeration of Body Parts.

Sarira Sankhya Vyakarana – Enumeration of frame portions

अथातः शरीरसङ्ख्याव्याकरणं शारीरं व्याख्यास्यामः ||१||
यथोवाच भगवान् धन्वन्तरिः ||२||

We will now expound the bankruptcy by means of identify Sarira Sankhya Vyakarana Sarira- detailed enumeration of the frame and its portions; as printed by means of the venerable Dhanvantari.

 Sarira – the Body

शुक्रशोणितं गर्भाशयस्थमात्मप्रकृतिविकारसम्मूर्च्छितं ‘गर्भ’ इत्युच्यते |
तं चेतनावस्थितं वायुर्विभजति, तेज एनं पचति, आपः क्लेदयन्ति, पृथिवी संहन्ति, आकाशं विवर्धयति; एवं विवर्धितः स यदा हस्तपादजिह्वाघ्राणकर्णनितम्बादिभिरङ्गैरुपेतस्तदा ‘शरीरं’ इति सञ्ज्ञां लभते ||

Definition of Garbha –

Garbha or embryo is shaped when Sukra – sperm and Sonita – ovum (mixture of sukra and sonita – embryo / zygote) found in Garbhashaya – uterus will get blended with Atma – soul, Prakriti – number one subject and Vikara / Vikriti – number one evolutes.

Role of Panchamahabhuta in formation of Sarira (Definition of Sarira) –

Name of the Bhuta – part	Role in formation of Sarira – frame (of the fetus)
Vayu Bhuta – air	Vibhajati – Divides the Garbha – fetus, possessing Cetana – awareness into other portions.
Tejo Bhuta / Agni – hearth	Pacati – chefs, processes and brings adulthood in garbha
Ap / Jala Bhuta – water	Kledayati – moistens it
Prithvi Bhuta – earth	Samhanti – hardens it, offers solidification
Akasa Bhuta – ether	Vivardhayati – enlarges it, reasons its expansion

The similar Garbha derives its identify as Sarira – the frame, when it develops on this way (by means of the function of each and every of the bhutas) and when it turns into endowed with palms, toes, tongue, nostril, ears, buttocks and so forth. portions and organs.

 Anga – primary frame portions

तच्च षडङ्गं- शाखाश्चतस्रो, मध्यं पञ्चमं, षष्ठं शिर इति ||३||

Sarira – the frame is claimed to be made from Sadangas – six primary portions. They are –

–       Sakha – extremities – 2 higher and 2 decrease limbs – 4 in general

–       Madhya, the 5th phase – heart a part of the frame – trunk, comprising of thorax and stomach – one

–       Shiras, the 6th phase – head – one

Pratyanga – minor frame portions

अतः परं प्रत्यङ्गानि वक्ष्यन्ते-मस्तकोदरपृष्ठनाभिललाटनासाचिबुकबस्तिग्रीवा इत्येता एकैकाः, कर्णनेत्रभ्रूशङ्खांसगण्डकक्षस्तनवङ्क्षणवृषणपार्श्वस्फिग्जानुकूर्परबाहूरुप्रभृतयो द्वे द्वे, विंशतिरङ्गुलयः, स्रोतांसि वक्ष्यमाणानि, एष प्रत्यङ्गविभाग उक्तः ||४||After this, the Pratyangas – the minor portions of the frame will likely be described,

The under stated are one each and every in quantity –

–       Mastaka (head),

–       Udara (stomach),

–       Prstha (again),

–       Nabhi (umbilicus),

–       Lalata (brow),

–       Nasa (nostril),

–       Cibuka (chin),

–       Basti (urinary bladder),

–       Griva (neck)

The under discussed are two each and every in quantity –

–       Karna (ears),

–       Netra (eyes), 

–       Bhru (brows),

–       Sankha (temples),

–       Amsa (shoulders),

–       Ganda (cheeks),

–       Kaksa (axilla),

–       Stana (breasts),

–       Vanksana (groins)

–       Vrsana (testes),

–       Parsva (flanks),

–       Sphik (buttocks),

–       Janu (knees),

–       Kurpara (elbows),

–       Bahu (palms),

–       Uru (thighs) and so forth

Anguli – The arms and feet in combination are twenty in quantity.

Srotas – The collection of channels of the frame will likely be detailed later.

Thus, the pratyangas – minor frame portions were enumerated.

Further enumeration of teenybopper portions of the frame

तस्य पुनः सङ्ख्यानं – त्वचः कला धातवो मला दोषा यकृत्प्लीहानौ फुप्फुस उण्डुको हृदयमाशया अन्त्राणि वृक्कौ स्रोतांसि कण्डरा जालानि कूर्चा रज्जवः सेवन्यः सङ्घाताः सीमन्ता अस्थीनि सन्धयः स्नायवः पेश्यो मर्माणि सिरा धमन्यो योगवहानि स्रोतांसि च ||५||

The enumeration of teenybopper portions of the frame is completed once more. They are –

–       Tvaca – pores and skin

–       Kala – membranes

–       Dhatu – the tissues

–       Mala – wastes, excreta,

–       Dosha – vata, pitta and kapha,

–       Yakrt – liver

–       Phupphusa – lungs,

–       Unduke – caecum,

–       Hrdaya – center

–       Asayah – viscera,

–       Antrani – intestines – small and massive,

–       Vrkkau – kidneys,

–       Srotamsi – channels of the frame, (pores, ducts, orifices)

–       Kandara – tendons,

–       Jala – networks

–       Kurca – brush like buildings,

–       Rajju – rope like binders,

–       Sevani – sutures, raphae,

–       Sanghata – confluence of bones,

–       Simanta – borders,

–       Asthi – bones,

–       Sandhi – joints, bony joints, puts of union,

–       Snayu – ligaments,

–       Pesi – muscle mass,

–       Marma – important / deadly spots,

–       Sira – veins,

–       Dhamani – arteries,

–       Yogavahi srotamsi – passages / channels supposed for acting particular purposes

Sankhya – their quantity

त्वचः सप्त, कलाः सप्त, आशयाः सप्त, धातवः सप्त, सप्त सिराशतानि, पञ्च पेशीशतानि, नव स्नायुशतानि, त्रीण्यस्थिशतानि, द्वे दशोत्तरे सन्धिशते, सप्तोत्तरं मर्मशतं, चतुर्विंशतिर्धमन्यः, त्रयो दोषाः, त्रयो मलाः, नव स्रोतांसि, (षोडश कण्डराः, षोडश जालानि, षट् कूर्चाः, चतस्रो रज्जवः, सप्त सेवन्यः, चतुर्दश सङ्घाताः, चतुर्दश सीमन्ताः, द्वाविंशतिर्योगवहानि स्रोतांसि, द्विकान्यन्त्राणि) चेति समासः ||६||

Minor Part	Number
Tvaca (pores and skin)	7
Kala (membranes)	7
Asaya (viscera)	7
Dhatu (tissues)	7
Siras (veins)	700
Pesi (muscle mass)	500
Snayu (ligaments)	900
Asthi (bones)	300
Sandhi (joints)	210
Marma (deadly / important spots)	107
Dhamani (arteries)	24
Doshas	3
Mala (wastes, excreta)	3
Srotas (orifices, exterior)	9
Kandara (tendons)	16
Jala (community)	16
Kurca (brush like buildings)	6
Rajju (binder / rope like buildings)	4
Sevani (sutures, raphae)	7
Sanghata (confluence of bones)	14
Simanta (borderlines)	14
Yogavahi Srotas (channels of particular purposes)	22

 Thus, they’ve been described in short. 

 Further, their detailed description

विस्तारोऽत ऊर्ध्वं- त्वचोऽभिहिताः कला धातवो मला दोषा यकृत्प्लीहानौ फुप्फुस उण्डुको हृदयं वृक्कौ च ||७||

The under discussed were described already within the earlier bankruptcy –

–       Tvaca – pores and skin,

–       Kala – membranes,

–       Dhatu – tissues of the frame,

–       Mala – wastes, excreta,

–       Doshas – vata, pitta and kapha,

–       Yakrt – liver,

–       Pliha – spleen,

–       Pupphusa – lungs,

–       Unduke – caecum,

–       Hrdaya – center and

–       Vrkka – kidneys

Asaya (seats / position of place of dwelling / viscera)

आशयास्तु- वाताशयः, पित्ताशयः, श्लेष्माशयो, रक्ताशय, आमाशयः, पक्वाशयो, मूत्राशयः, स्त्रीणां गर्भाशयोऽष्टम इति ||८||

Asayas (puts of place of dwelling) are –

–       Vatasaya (seat of vata),

–       Pittasaya (seat of Pitta),

–       Slesmasaya (seat of Kapha),

–       Raktasaya (seat of blood),

–       Amasaya (seat of undigested meals),

–       Pakvasaya (seat of digested meals),

–       Mutrasaya (seat of urine) and 

–       Garbhasaya (seat of fetus) – the 8th in girls

Antra – intestines

सार्धत्रिव्यामान्यन्त्राणि पुंसां, स्त्रीणामर्धव्यामहीनानि ||९||

Antras – intestines – are two in quantity,

Dimensions – They are

–       Three and part vyama in males and

–       Half vyama much less i.e. 3 vyama in girls

Nava srotas- 9 exterior orifices

श्रवणनयनवदनघ्राणगुदमेढ्राणि नव स्रोतांसि नराणां बहिर्मुखानि, एतान्येव स्त्रीणामपराणि च त्रीणि द्वे स्तनयोरधस्ताद्रक्तवहं च ||१०||

Below discussed are the 9 Bahirmukha Srotas – exterior orifices – in males

Name of the Bahirmukha Srotas	Number
Sravana – ears	02
Nayana – eyes	02
Vadana – mouth	01
Ghrana – nostril	02
Guda – anus	01
Medhra – penis, urethra	01
Total	09

In girls, with the exception of those srotas, there are 3 extra – 2 in stana – the breasts (one in each and every breast) and one raktavaha srotas (vagina).

Kandara – tendons 

षोडश कण्डराः- तासां चतस्रः पादयोः, तावत्यो हस्तग्रीवापृष्ठेषु; तत्र हस्तपादगतानां कण्डराणां नखा अग्रप्ररोहाः, ग्रीवाहृदयनिबन्धिनीनामधोभागगतानां मेढ्रं, श्रोणिपृष्टनिबन्धिनीनामधोभागगतानां बिम्बं, मूर्धोरुवक्षोंऽसपिण्डादीनां च ||११||

Kandara – tendons, are 16 in quantity. The distribution of those 16 kandaras are as under discussed –

–       4 kandaras – in pada – toes – 2 in proper foot and 2 in left foot

–       4 kandaras – in hasta – palms – 2 in proper hand and 2 in left hand

–       4 kandaras – in griva – neck – 2 on each and every aspect

–       4 kandaras – in prstha – again – 2 on each and every aspect

Nakha – nails – are the guidelines or sprouts rising from the entrance of the kandaras of the palms and toes.

There are some kandaras which bind the griva – neck and hrdaya – center house (chest). The pointers of those kandaras run downwards to the medhra – penis.

Similarly, some kandaras bind the sroni – pelvis and prstha – again (decrease again or waist). The pointers of those kandaras that descend downwards is Bimba – buttocks.

There are few extra kandaras which bind the uru – thigh, vaksa – chest and amsapinda – bulge of shoulder / acromion. The pointers of those kandaras is the Murdha – head.

Jala – networks

मांससिरास्नाय्वस्थिजालानि प्रत्येकं चत्वारि; तानि मणिबन्धगुल्फसंश्रितानि परस्परनिबद्धानि परस्परगवाक्षितानि चेति, यैर्गवाक्षितमिदं शरीरम् ||१२||

The Jala – networks within the frame are 4 in quantity. They are –

–       1 jala of mamsa – muslces

–       1 jala of sira – veins

–       1 jala of snayu – ligaments and

–       1 jala of asthi – bones

These jalas are provide in combination blended with each and every different and shape areas in between them in manibandha – wrist joint and gulpha sandhi – ankle joint.

The whole frame is made gavaksita i.e. ‘that having spaces or window like openings all over’ by means of such mixture made of those 4 sorts of jalas.

Kurca – brush–like buildings

षट् कूर्चाः, ते हस्तपादग्रीवामेढ्रेषु; हस्तयोर्द्वौ, पादयोर्द्वौ, ग्रीवामेढ्रयोरेकैकः ||१३||

Kurca i.e. buildings of the frame which resemble brush in form, are six in quantity. The distribution of kurca within the frame is as under discussed –

–       2 kurca within the palms – 1 in each and every hand

–       2 kurca within the toes – 2 in each and every foot

–       1 kurca within the neck

–       1 kurca within the penis

Mamsa rajju – Muscular bands / ropes

महत्यो मांसरज्जवश्चतस्रः- पृष्ठवंशमुभयतः पेशीनिबन्धनार्थं द्वे बाह्ये, आभ्यन्तरे च द्वे ||१४||

Mahati Mamsa Rajju – are buildings equivalent to large ropes made from muscle mass. They are 4 in quantity. They are supposed for binding the pesi – particular person muscle mass to the bones situated on each side of the vertebral column, two of them out of doors it and two inside of it.

Sevani – sutures / raphae

सप्त सेवन्यः; सिरसि विभक्ताः पञ्च, जिह्वाशेफसोरेकैका; ताः परिहर्तव्याः शस्त्रेण ||१५||

Sevani are seven in quantity. They are sutures or raphae within the frame. The distribution of sevani within the frame is as under discussed –

–       5 sevanis – are situated within the shiras – head

–       1 sevani – within the jihva – tongue

–       1 sevani – within the shephas – scrotum

Surgical tools must no longer be used on those sevanis i.e. surgical operations will be have shyed away from over the raphae.

Asthi Sanghata – confluence of bones

चतुर्दशास्थ्नां सङ्घाताः; तेषां त्रयो गुल्फजानुवङ्क्षणेषु, एतेनेतरसक्थि बाहू च व्याख्यातौ, त्रिकशिरसोरेकैकः ||१६||

Asthi Sanghata – are the spots the place there’s confluence of bones. They are fourteen in quantity. The distribution of asthi sanghata is as under discussed –

–   3 asthi sanghata in a single leg (decrease limb) – 1 in each and every gulpha – ankle joint, janu – knee joint and vankshana – groin

–   3 asthi sanghata in any other decrease limb – 1 in each and every gulpha, janu and vankshana

–   3 asthi sanghata in a single higher limb – 1 in each and every manibandha – wrist joint, kurpara – elbow joint and kaksha – axilla

–   3 asthi sanghata in any other higher limb – 1 in each and every manibandha – wrist joint, kurpara – elbow joint and kaksha – axilla

–   1 asthi sanghata – in trika – higher again and

–   1 asthi sanghata – in siras – head

Simanta – Borders / binding buildings

चतुर्दशैव सीमन्ताः; ते चास्थिसङ्घातवद्गणनीयाः, यतस्तैर्युक्ता अस्थिसङ्घाताः; ये ह्युक्ताः सङ्घातास्ते खल्वष्टादशैकेषाम् ||१७||

Simanta are the buildings which shape the border (boundary). They also are fourteen in quantity. The collection of Simanta may be very similar to the ones of Asthi Sanghata. This is as a result of asthi sanghata are sure by means of those simantas, forming their boundary. According to a couple different government / professionals – the Asthi Sanghata having such Simantas is 18 in quantity.

Asthi Sankhya – collection of bones

त्रीणि सषष्टान्यस्थिशतानि [वेदवादिनो भाषन्ते; शल्यतन्त्रेषु तु त्रीण्येव शतानि |
तेषां सविंशमस्थिशतं शाखासु, सप्तदशोत्तरं शतं श्रोणिपार्श्वपृष्ठोरःसु, ग्रीवां प्रत्यूर्ध्वं त्रिषष्टिः, एवमस्थ्नां त्रीणि शतानि पूर्यन्ते ||१८||

According to Vedavadis – followers of Vedas, there are three hundred and sixty bones in the body. On the other hand, the number of bones is three hundred only, according to Salya Tantra – surgical science.

The distribution of asthi – bones in the body is as below specified –

–   120 asthis – are located in the sakas – extremities (2 upper and 2 lower limbs together)

–   117 asthis – in the sroni – pelvis, parsva – flanks, prstha – back and uras – chest together

–   63 asthis – in griva pratyurdhwa / jatrurdhwa pradesha – region above the neck or collar bone i.e. in the head and neck

In this way, there are in total three hundred bones in the body as per the count above.

एकैकस्यां तु पादाङ्गुल्यां त्रीणि त्रीणि तानि पञ्चदश, तलकूर्चगुल्फसंश्रितानि दश, पार्ष्ण्यामेकं, जङ्घायां द्वे, जानुन्येकम्, एकमूराविति, त्रिंशदेवमेकस्मिन् सक्थ्नि भवन्ति, एतेनेतरसक्थि बाहू च व्याख्यातौ; श्रोण्यां पञ्च, तेषां गुदभगनितम्बेषु चत्वारि, त्रिकसंश्रितमेकं, पार्श्वे षट्त्रिंशदेकस्मिन्, द्वितीयेऽप्येवं, पृष्ठे त्रिंशत्, अष्टावुरसि, द्वे अंसफलके; ग्रीवायां नव, कण्ठनाड्यां चत्वारि, द्वे हन्वोः, दन्ता द्वात्रिंशत्, नासायां त्रीणि, एकं तालुनि, गण्डकर्णशङ्खेष्वेकैकं, षट् शिरसीति ||१९||

Distribution of asthi in lower and upper limb (one side) –

Part of the lower limb	Number of bones
Padanguli – toe	15 all together (3 in each toe)
Padatala – sole, Padakurca – forefoot and Gulpha – ankle together	10
Parsni – heel	01
Jangha – foreleg	02
Janu – knee joint	01
Uru – thigh	01
Total	30

In the same way, there are 30 asthis in the other lower limb also.

The same number of asthi are present in both upper limbs i.e. 30 asthis in each upper limb.

Totally, there are 120 bones all together in all the limbs put together.

Distribution of asthi in pelvis and flanks  –

Part of the body	Number of bones
Sroni – pelvis	05 4 in guda – rectum, anus, bhaga – pubis and nitamba – buttocks 1 in trika – coccyx
Parsva – sides, flanks	72 – 36 in each Parsva – flank

Distribution of asthi in back, chest, neck and head –

Part of the lower limb	Number of bones
Prshta – back	33
Uras – chest	08
Amsaphalaka – scapula	02
Griva – neck	09
Kanta Nadi – trachea	04
Hanu – mandible, lower jaw	02
Danta – teeth	32
Nasa – nose	03
Talu – palate	01
Ganda – cheek bone	02 (1 on each side)
Karna – ears	02 (1 on each side)
Shanka – temples	02 (1 on each side)
Shira – head	06

Asthi Vidha – Kinds of bones

एतानि पञ्चविधानि भवन्ति; तद्यथा- कपालरुचकतरुणवलयनलकसञ्ज्ञानि |
तेषां जानुनितम्बांसगण्डतालुशङ्खशिरःसु कपालानि, दशनास्तु रुचकानि, घ्राणकर्णग्रीवाक्षिकोषेषु तरुणानि, पार्श्वपृष्ठोरःसु वलयानि, शेषाणि नलकसञ्ज्ञानि ||२०||

The bones are of five kinds. They are – 

Type of Asthi – bone	Location
Kapala – flat bones	Janu – knee Nitamba – buttocks Amsa – shoulder Ganda – cheek Talu – palate Sankha – temples Siras – head
Ruchaka – teeth	Teeth
Taruna – cartilages	Ghrana – nose Karna – ear Griva – neck and Aksi kosa – orbit of the eye
Valaya – curved or irregular bones	Parsva – flanks Prstha – back Uras – chest
Nalaka – tubular or long bones	Remaining bones other than those mentioned in the above said four categories

Asthi Pradhanyata – importance of bones

अभ्यन्तरगतैः सारैर्यथा तिष्ठन्ति भूरुहाः |
अस्थिसारैस्तथा देहा ध्रियन्ते देहिनां ध्रुवम् ||२१||
तस्माच्चिरविनष्टेषु त्वङ्मांसेषु शरीरिणाम् |
अस्थीनि न विनश्यन्ति साराण्येतानि देहिनाम् ||२२||
मांसान्यत्र निबद्धानि सिराभिः स्नायुभिस्तथा |
अस्थीन्यालम्बनं कृत्वा न शीर्यन्ते पतन्ति वा ||२३||

The body remains firm and erect by the support of the bones inside it just like the pith inside the trees allows them to remain and firmly hold on the ground. The bones of the body do not get destroyed in spite of the skin and muscles getting destroyed after some time. This is because the bones are the pith like essence of the body. The muscles, veins and ligaments are supported by the bones. Therefore, they do not get broken or fall off from their places.

Asthi Sandhi – joints of bones / articulations

सन्धयस्तु द्विविधाश्चेष्टावन्तः, स्थिराश्च ||२४||
शाखासु हन्वोः कट्यां च चेष्टावन्तस्तु सन्धयः |
शेषास्तु सन्धयः सर्वे विज्ञेया हि स्थिरा बुधैः ||२५||

Sandhis i.e. bony joints of the body are of two kinds. They are –

Type of Sandhi	Location (present in)
Chestavanta Sandhi – movable / mobile joints	Sakha – extremities (upper and lower limbs) Hanu – mandible, lower jaw Kati – waist
Sthira Sandhi – immovable joints	All the other joints of the body other than those mentioned above (in Chestavanta Sandhi)

सङ्ख्यातस्तु दशोत्तरे द्वे शते |
तेषां शाखास्वष्टषष्टिः, एकोनषष्टिः कोष्ठे, ग्रीवां प्रत्यूर्ध्वं त्र्यशीतिः |
एकैकस्यां पादाङ्गुल्यां त्रयस्त्रयः, द्वावङ्गुष्ठे, ते चतुर्दश; जानुगुल्फवङ्क्षणेष्वेकैकः, एवं सप्तदशैकस्मिन् सक्थ्नि भवन्ति; एतेनेतरसक्थि बाहू च व्याख्यातौ; त्रयः कटीकपालेषु, चतुर्विंशतिः पृष्ठवंशे, तावन्त एव पार्श्वयोः, उरस्यष्टौ; तावन्त एव ग्रीवायां, त्रयः कण्ठे, नाडीषु हृदयक्लोमनिबद्धास्वष्टादश, दन्तपरिमाणा दन्तमूलेषु, एकः काकलके नासायां च, द्वौ वर्त्ममण्डलयोर्नेत्राश्रयौ, गण्डकर्णशङ्खेष्वेकैकः, द्वौ हनुसन्धी, द्वावुपरिष्टाद्भ्रुवोः शङ्खयोश्च, पञ्च शिरःकपालेषु, एको मूर्ध्नि ||२६||

There are in total two hundred and ten sandhis – bony joints in the body. The distribution of sandhis are as below mentioned –

–       68 sandhis are in the sakha – extremities

–       59 sandhis are in kostha – trunk

–       83 sandhis are in the neck and head

Joints of the lower limb (one limb)

Part of the lower limb	Number of Sandhis – joints
Padanguli – toes	3 in each toe = 12
Angushta – big toe	02
Janu – knee	01
Gulpha – ankle	01
Vankshana – groin	01
Total	17

The other leg / lower limb also have same number of joints i.e. 17. The upper limbs too have same number of joints i.e. 17 joints in the right and 17 in the left upper limb.

Total number of sandhis in all the limbs put together are 68.

Joints in the other parts of the body – waist, spine, flanks, chest, neck and head

Part of the body	Number of Sandhi – joints
Katikapala – flat part of the waist, pelvic girdle	03
Prstavamsa – vertebral column	24
Parsva – flanks (both flanks together)	24
Uras – chest	08
Griva – neck	08
Kantha – throat (in front)	03
Nadi – tubes, attached to the kloma	18
Dantamula – roots of the teeth, teeth sockets	32
Kakalaka – cricoid bone	01
Nasa – nose	01
Vartma Mandala (eyelids) – present in the eyes	02
Ganda – cheek	01
Karna – ears	01
Shanka – temples	01
Hanu Sandhi – joint between upper and lower jaw	02
Bhru Uparishta – above the eye brows	02
Shankhad Upari – above the temples	02
Sira Kapala – flat bones of the skull	05
Murdha – top of the skull	01

Sandhi Vidha – Kinds of Joints

त एते सन्धयोऽष्टविधाः- कोरोलूखलसामुद्गप्रतरतुन्नसेवनीवायसतुण्डमण्डलशङ्खावर्ताः |
तेषामङ्गुलिमणिबन्धगुल्फजानुकूर्परेषु कोराः सन्धयः, कक्षावङ्क्षणदशनेषूलूखलाः, अंसपीठगुदभगनितम्बेषु सामुद्गाः, ग्रीवापृष्ठवंशयोः प्रतराः, शिरःकटीकपालेषु तुन्नसेवन्यः, हन्वोरुभयतस्तु  वायसतुण्डाः, कण्ठहृदयनेत्रक्लोमनाडीषु मण्डलाः, श्रोत्रशृङ्गाटकेषु शङ्खावर्ताः |
तेषां नामभिरेवाकृतयः प्रायेण व्याख्याताः ||२७||

These Sandhis (joints) are of eight kinds. They are as below mentioned – 

1.   Kora (hinge),
2.   Ulukhala (socket),
3.   Samudga (box with lid),
4.   Pratara (round float, boat),
5.   Tunnasevani (stitch likes suture),
6.   Vayasatunda (crows’ beak),
7.   Mandala (round, circular) and
8.   Sankhavarta (spiral like conch, helical convoluted)

Below mentioned are the examples of these eight kinds of sandhis –

Name of the Sandhi	Examples / found in
Kora Sandhi – hinge joints	Anguli – finger Manibandha – wrist joint Gulpha – ankle joint Janu – knee joint Kurpara – elbow joint
Ulukhala / Udukhala Sandhi – ball and socket joints	Kaksa – axilla Vankshana – groin Dashana – teeth
Samudga Sandhi – box with lid or covering type of joint	Amsapita – scapular, glenoid joint / articulation Guda – rectum or anus Bhaga – vulva, labia Nitamba – buttocks
Pratara Sandhi – round float / boat shaped joints	Griva – neck Prsthavamsa – vertebral column
Tunnasevani Sandhi – stitch or suture like joints	Sirakapala – flat bones of the head Katikapala – flat bones of pelvis
Vayasatunda Sandhi – joints resembling like the beak of the crow	On two sides of the hanu sandhi – lower jaw
Mandala Sandhi – round, circular, ring like joints	Nadi – tubes of the kanta – throat, hrdaya – heart, Netra – eye and kloma – trachea
Sankhavarta Sandhi – spiral shaped, helical, convolute joints	Srota – ears Srngataka – back of the nose inside the head

Generally, the names of the joints themselves explain the shape of the joints.

अस्थ्नां तु सन्धयो ह्येते केवलाः परिकीर्तिताः |
पेशीस्नायुसिराणां तु सन्धिसङ्ख्या न विद्यते ||२८||

So far, only the bony joints have been described. The numbers for joints of the muscles, ligaments and veins do not exist (they are innumerable). 

Snayu Sankhya – ligaments and their number

नव स्नायुशतानि |
तासां शाखासु षट्शतानि, द्वे शते त्रिंशच्च कोष्ठे, ग्रीवां प्रत्यूर्ध्वं सप्ततिः |
एकैकस्यां तु पादाङ्गुल्यां षण्निचितास्तास्त्रिंशत्, तावत्य एव तलकूर्चगुल्फेषु, तावत्य एव जङ्घायां, दश जानुनि, चत्वारिंशदूरौ, दश वङ्क्षणे, शतमध्यर्धमेवमेकस्मिन् सक्थ्नि भवन्ति; एतेनेतरसक्थि बहू च व्याख्यातौ; षष्टिः कट्यां, पृष्ठेऽशीतिः, पार्श्वयोः षष्टिः, उरसि त्रिंशत्; षट्त्रिंशद्ग्रीवायां, मूर्ध्नि चतुस्त्रिंशत्; एवं नव स्नायुशतानि व्याख्यातानि भवन्ति ||२९||

Snayu – ligaments are nine hundred in number. The distribution of snayu in the body is as below enumerated –

–       600 snayu – are present in the sakha – extremities

–       230 snayu – are located in the kostha – trunk

–       70 snayu – are located in the griva and shira – neck and head 

Snayus present in one lower limb

Part of the lower limb	Number of snayu
Anguli – fingers	6 in each finger = 30 snayu
Pada Kurca – sole and arch of the foot	30 snayu
Gulpha – ankle joint	30 snayu
Jangha – calves	30 snayu
Janu – knee joint	10 snayu
Uru – thigh	40 snayu
Vankshana – groins	10 snayu
Total	150 snayu

The other lower limb and both upper limbs too have the same number of snayu i.e. 150 snayu each. Thus, totally there are 150 x 4 = 600 snayu in the limbs (all limbs together).

Distribution of other 300 snayus in the body

Part of the body	Number of snayu
Kati – waist	60 snayu
Prstha – back	80 snayu
Parsva – both flanks	60 snayu
Uras – chest	30 snayu
Griva – neck	36 snayu
Murdha – head	34 snayu
Total	300 snayu

Thus, totally there are 900 snayu – 600 in the limbs + 300 in the other parts of the body.

Snayu vidha – kinds of ligaments

स्नायूश्चतुर्विधा विद्यात्तास्तु सर्वा निबोध मे |
प्रतानवत्यो वृत्ताश्च पृथ्व्यश्च शुषिरास्तथा ||३०||
प्रतानवत्यः शाखासु सर्वसन्धिषु चाप्यथ |
वृत्तास्तु कण्डराः सर्वा विज्ञेयाः कुशलैरिह ||३१||
आमपक्वाशयान्तेषु बस्तौ च शुषिराः खलु |
पार्श्वोरसि तथा पृष्ठे पृथुलाश्च शिरस्यथ ||३२||
नौर्यथा फलकास्तीर्णा बन्धनैर्बहुभिर्युता |
भारक्षमा भवेदप्सु नृयुक्ता सुसमाहिता ||३३||
एवमेव शरीरेऽस्मिन् यावन्तः सन्धयः स्मृताः |
स्नायुभिर्बहुभिर्बद्धास्तेन भारसहा नराः ||३४||
न ह्यस्थीनि न वा पेश्यो न सिरा न च सन्धयः |
व्यापादितास्तथा हन्युर्यथा स्नायुः शरीरिणम् ||३५||
यः स्नायूः प्रविजानाति बाह्याश्चाभ्यन्तरास्तथा |
स गूढं शल्यमाहर्तुं देहाच्छक्नोति देहिनाम् ||३६||

Snayu – there are four kinds of snayu – ligaments. All these snayus are described here. The four kinds of snayu are –

–       Pratanavati Snayu

–       Vrtta Snayu

–       Prthu Snayu and

–       Susira Snayu

Type of Snayu	Present in
Pratanavati Snayu – ligaments which are broad and spread out	Sakha – extremities (upper and lower limbs) Sarva sandhi – in all the bony joints
Vrtta Snayu – round or cylindrical ligaments	These snayus are known as kandaras – tendons by some experts
Susira Snayu – hollow or ringlike ligaments	At the ends of Amasaya – stomach, Pakvasaya – large intestine and Basti – urinary bladder
Pruthula – thick, big ligaments	Parsva – flanks, Uras – chest, Prstha – back and Sira – head

Snayu Prayojana – usefulness of Ligaments

Boat is built by tightly fastening the wooden planks kept side by side with a rope. Such a boat becomes capable of carrying weight in water while it is steered by a boat man. Similarly, the human body will become capable of carrying its own weight as long as the joints of the body are tightly fastened and held in place by the ligaments in many ways. None of the bones, muscles, veins or joints would kill a person when they are injured as ligaments would kill a person when they are injured.

The physician or surgeon, who is well versed in the knowledge of and thoroughly understands all the external and internal ligaments clearly, will become capable of pulling out the salya – foreign body situated (impacted) deep inside the body.

Pesi-Muscles

पञ्च पेशीशतानि भवन्ति |
तासां चत्वारि शतानि शाखासु, कोष्ठे षट्षष्टिः, ग्रीवां प्रत्यूर्ध्वं चतुस्त्रिंशत् |
एकैकस्यां तु पादाङ्गुल्यां तिस्रस्तिस्रस्ताः पञ्चदश, दश प्रपदे, पादोपरि कूर्चसन्निविष्टास्तावत्य एव, दश गुल्फतलयोः, गुल्फजान्वन्तरे विंशतिः, पञ्च जानुनि, विंशतिरूरौ, दश वङ्क्षणे, शतमेवमेकस्मिन् सक्थ्नि भवति; एतेनेतरसक्थि बाहू च व्याख्यातौ; तिस्रः पायौ, एका मेढ्रे, सेवन्यां चापरा, द्वे वृषणयोः, स्फिचोः पञ्च पञ्च, द्वे बस्तिशिरसि, पञ्चोदरे, नाभ्यामेका, पृष्ठोर्ध्वसन्निविष्टाः पञ्च पञ्च दीर्घाः, षट् पार्श्वयोः, दश वक्षसि, अक्षकांसौ प्रति समन्तात् सप्त, द्वे हृदयामाशययोः, षट् यकृत्प्लीहोण्डु(न्दु)केषु; ग्रीवायां चतस्रः, अष्टौ हन्वोः, एकैका काकलकगलयोः, द्वे तालुनि, एका जिह्वायां, द्वे ओष्ठयोः, द्वे नासायां, द्वे नेत्रयोः, गण्डयोश्चतस्रः, कर्णयोर्द्वे, चतस्रो ललाटे, एका शिरसीति; एवमेतानि पञ्च पेशीशतानि ||३७||

Pesi – muscles are five hundred in number. The distribution of pesi in the body is as below mentioned –

–       400 pesis – are located in the Sakas – extremities (upper and lower limbs)

–       66 pesis – are located in the Kostha – trunk and

–       34 pesis – are located in the Griva and Shira – neck and head

Distribution of Pesis in the lower limb (one limb)

Part of the lower limb	No of Pesis
Anguli – toes	3 in each toe = 15 pesi
Prapada – fore foot	10 pesi
Padopari Kurcha Sannivishta – pesis above the upper part of the foot, attached to or nearby to the Kurca (brush like structures)	10 pesi
Gulpha-Pada Tala – ankle joint and soles	10 pesi
Gulpha-janvantara – in between the ankle and knee joint – leg	20 pesi
Janu – knee joint	05
Uru – thigh	20 pesi
Vankshana – groin	10 pesi
Total	100 pesis

Similarly, there are the same number of muscles in the other lower limb and in each of the upper limb i.e. 100 pesis each. Totally, the number of pesis in all four limbs put together sums up to 400 pesis i.e. 100 in each limb x 4 = 400 pesis.

Distribution of Pesis in the other parts of the body – chest, abdomen, neck and head

Part of the lower limb	No of Pesis
Payu – anus	3 pesis
Medhra – penis	1 pesi
Sevani – raphae, beneath the penis	1 pesi
Vrshana – testes	2 pesi
Spik – buttocks	5 pesi in each buttock = 10 pesis
Basti siras – head of the urinary bladder (upper surface)	02 pesi
Udara – abdomen	05 pesi
Nabhi – umbilicus	1 pesi
Prsthordhva – upper back, they are long	05 + 05 = 10 pesi
Parsvas – 2 flanks	06 pesi
Vaksa – chest	10 pesi
Near Aksaja – clavicle and Amsa – scapula / shoulder	07 pesi
Hrdaya – heart	01 pesi
Amashaya – stomach	01 pesi
Yakrt – liver, Pliha – spleen and Unduka – caecum together	06 pesi
Griva – neck	04 pesi
Hanu	08 pesi
Kakalaka	01 pesi
Gala	01 pesi
Talu – palate	02 pesi
Jihva – tongue	01 pesi
Ostha – lips	02 pesi
Nasa – nose	02 pesi
Netra – eyes	02 pesi
Ganda – cheeks	04 pesi
Karna – ears	02 pesi
Lalata – forehead	04 pesi
Siras – head	01 pesi
Total	100 pesis

In this manner Pesi (muscles) are five hundred in number i.e. 400 pesi in extremities + 100 in the rest of the body = 400 pesis.

सिरास्नाय्वस्थिपर्वाणि सन्धयश्च शरीरिणाम् |
पेशीभिः संवृतान्यत्र बलवन्ति भवन्त्यतः ||३८||
स्त्रीणां तु विंशतिरधिका |
दश तासां स्तनयोरेकैकस्मिन् पञ्च पञ्चेति, यौवने तासां परिवृद्धिः; अपत्यपथे चतस्रः- तासां प्रसृते अभ्यन्तरतो द्वे, मुखाश्रिते बाह्ये च वृत्ते द्वे, गर्भच्छिद्रसंश्रितास्तिस्रः, शुक्रार्तवप्रवेशिन्यस्तिस्र एव |
पित्तपक्वाशययोर्मध्ये गर्भशय्या, यत्र गर्भस्तिष्ठति ||३९||

There are twenty more muscles in women. They are –

–       Ten pesis (muscles) – five muscles in each breast. These muscles develop during the adulthood of the woman.

–       Four pesis (muscles) – are present in apatya patha i.e. birth passage (vaginal canal). Among these muscles, two muscles are spread internally. Two more muscles which are round i.e. circular or ring like shape are located externally, near the opening of the passage.

–       Three pesis (muscles) – are attached to the Garbha chidra i.e. mouth of the uterus or cervix.

–       Three pesis (muscles) – are located in Sukra-Artava Pravesini – i.e. in the passage of entry of semen / sperms and menstrual blood / ovum.

Garbha Sayya means a dwelling place for fetus (uterine fundus) is situated between Pittasaya – duodenum (and liver) and Kaphashaya – stomach (and chest). 

Pesi Svarupa – shape of muscles

तासां बहलपेलवस्थूलाणुपृथुवृत्तह्रस्वदीर्घस्थिरमृदुश्लक्ष्णकर्कशभावाः सन्ध्यस्थिसिरास्नायुप्रच्छादका यथाप्रदेशं स्वभावत एव भवन्ति ||४०||

Pesis (muscle) are of different shapes because they cover the joints, bones, veins and ligaments naturally and appropriate to each place and structure.

Pesis are of different shapes –

–       either broad or thin (less),

–       stout or minute,

–       rounded (circular, ring like),

–       short,

–       long,

–       stable (fixed),

–       soft,

–       unctuous (smooth, silky) or

–       rough (coarse)

पुंसां पेश्यः पुरस्ताद्याः प्रोक्ता लक्षणमुष्कजाः |
स्त्रीणामावृत्य तिष्ठन्ति फलमन्तर्गतं हि ताः ||४१||

The same muscles which are present in the laksana – penis and muska – scrotum in men are said to cover the phala – ovaries in women.

मर्मसिराधमनीस्रोतसामन्यत्र प्रविभागः ||४२||

In later chapters, elsewhere, the classification of Marma – vital or fatal spots, sira – veins, dhamani – arteries and srotas – channels etc. will be described.

Yoni akrti – shape of the uterus

शङ्खनाभ्याकृतिर्योनिस्त्र्यावर्ता सा प्रकीर्तिता |
तस्यास्तृतीये त्वावर्ते गर्भशय्या प्रतिष्ठिता ||४३||
यथा रोहितमत्स्यस्य मुखं भवति रूपतः |
तत्संस्थानां तथारूपां गर्भशय्यां विदुर्बुधाः ||४४||

Yoni (actually means vagina, but means uterus in this context) resembles shankha nabhi akriti – spirals of conch shell, having three spirals. The Garbhashaya i.e. seat of the fetus or fundus of the uterus is located in the third spiral (innermost spiral) of the yoni. According to wise men, Garbhashaya resembles the shape and size of the mouth of Rohita Matsya – a kind of fish.

Position of fetus in the uterus

आभुग्नोऽभिमुखः शेते गर्भो गर्भाशये स्त्रियाः |
स योनिं शिरसा याति स्वभावात् प्रसवं प्रति ||४५||

Garbha i.e. the fetus lies in the uterus of the women. The body of the fetus is bent and it faces forward. At the time of delivery, the head of the fetus comes into the yoni – vagina, to be delivered naturally. 

त्वक्पर्यन्तस्य देहस्य योऽयमङ्गविनिश्चयः |
शल्यज्ञानादृते नैष वर्ण्यतेऽङ्गेषु केषुचित् ||४६||

Apart from the Salya Jnana i.e. knowledge of surgical science, no other science and nobody else can give the description of various parts of the body commencing with the skin and all other organs described so far.

Sava cchedana – dissection of the human cadaver

तस्मान्निःसंशयं ज्ञानं हर्त्रा शल्यस्य वाञ्छता |
शोधयित्वा मृतं सम्यग्द्रष्टव्योऽङ्गविनिश्चयः ||४७||
प्रत्यक्षतो हि यद्दृष्टं शास्त्रदृष्टं च यद्भवेत् |
समासतस्तदुभयं भूयो ज्ञानविवर्धनम् ||४८||

Hence, the physician desirous of becoming expert in removal of shalya – foreign bodies should obtain precise and undoubtful knowledge by dissecting and examining the dead body and observing all the organs and understanding them thoroughly.

Effective combination of Shastra Jnana i.e. knowledge obtained by direct observation and Shastradrsta Jnana i.e. the knowledge obtained by studying the science (Ayurveda in this context) will effectively enhance one’s knowledge.

Sava Cchedana Vidhi – procedure of dissection

तस्मात् समस्तगात्रमविषोपहतमदीर्घव्याधिपीडितमवर्षशतिकं निःसृष्टान्त्रपुरीषं पुरुषमावहन्त्यामापगायां निबद्धं पञ्जरस्थं मुञ्जवल्कलकुशशणादीनामन्यतमेनावेष्टिताङ्गमप्रकाशे देशे कोथयेत्, सम्यक्प्रकुथितं चोद्धृत्य, ततो देहं सप्तरात्रादुशीरबालवेणुबल्वजकूर्चानामन्यतमेन शनैः शनैरवघर्षयंस्त्वगादीन् सर्वानेव बाह्याभ्यन्तरानङ्गप्रत्यङ्गविशेषान् यथोक्तान् लक्षयेच्चक्षुषा ||४९||

The dead body of a man selected for dissection should have the below mentioned features –

–   should have all its parts i.e. all parts of the body

–   the person should have not died either by poisoning or chronic disease

–   the person should not be of hundred years of age

The feces present inside the intestines of the dead body shall be removed before dissection. After this, the dead body is wrapped with any one of the Munja grass, Valkala i.e. inner barks of the trees, Kusa grass, Sana – hemp or any other such materials. After wrapping, it should be tied well and placed inside the cage. The cage is now placed in a slow running stream of water, at a hidden place and allowed to undergo purification. After properly purifying the body, it should be taken out and the materials used for covering it should be removed. It should later be investigated for seven days by scrubbing it slowly with brushes prepared from Usira – vetiver grass, Vala – hairs of the tails of animals, Venu – bamboo, Balvaja – type of grass or similar such material and personally observe this process with his own eyes, including all the major and minor parts like skin etc.

Atma Adrsya – soul invisible

न शक्यश्चक्षुषा द्रष्टुं देहे सूक्ष्मतमो विभुः |
दृश्यते ज्ञानचक्षुर्भिस्तपश्चक्षुर्भिरेव च ||५०||

Vibhu i.e. Atma or soul in the body is very minute and is not possible to see with physical eyes. He can be seen only through the Jnana Caksu i.e. eyes of knowledge / wisdom and Tapas Caksu – eye or vision obtained by penance.

शरीरे चैव शास्त्रे च दृष्टार्थः स्याद्विशारदः |
दृष्टश्रुताभ्यां सन्देहमवापोह्याचरेत् क्रियाः ||५१||

Only after observing the body carefully with his own eyes, the physician will become greatly learned. He should carry on his activities by studying science, getting rid of all his doubts by keen personal observation and study of texts.

इति सुश्रुतसंहितायां शारीरस्थाने शरीरसङ्ख्याव्याकरणशारीरं नाम पञ्चमोऽध्यायः ||५||

Thus ends the fifth chapter by name Sarira Sankhya Vyakarana – in Sarira sthana of Susruta Samhita.