Bull. Ind. Inst. Hist. Mad. Vol. XIX. pp. 1 to 20 .~ LIBRAC2\~\.dt', \..

NEW LIGHT ON ANCIENT INDIAN ANATOMY '~)'~f,RAi t

A. NAGARATNAM 8. A. MADHAV'*

ABSTRACT

Ayurveda is the ancient Indian system of medicine. Its antiquityis prehistoric and approximates with that of Veda, In Ayurveda CarakaSamhita is the oldest document representing the medical school andSusruta Samhita representing the surgical school.

In India it is our tradition to transmit knowledge from Guru toSisya. The gurukula system of education is lost with the beginning ofthe Christian era, due to continuous foreign invasions, After sometime,the Ayurvedic texts went into the hands of literary scholars. who werenot trained practically in the Ayurvedic scientific teachings. Hencethe commentaries written by them interpreted Ayurveda as a literarywork and thus the scientific technicality was missed by them.Dalhana's commentary on Susruta Samhita and Cakrapanidatta'scommentary on Caraka Samhita are no exceptions.

During the second part of the 19th century and early part of the20th century, foreign writers wrote critical works on the Ayurvedicsystem of medicine. Similarly some of the Indian scholars renderedEnglish translations to Caraka Samhita and Susruta Samhita. Certainoriginal texts were also compiled based on the Samhitas. All thesewriters gave importance to the available commentaries and neverbothered themselves to compare and contrast with the original texts.Thus the medical science became a literary work. The net result isthat Ayurveda has been considered to be a primitive science. containingfanciful numerations and incohate notions. Till to-day no attempt hasbeen made to critically judge and establish the scientific basis on whichthe Ayurvedic system of medicine rests.

An important new hypothesis has been advanced in this researchpaper as a result of 8 critical study made on some of the anatomicalfindings given in the Susruta Samhita.

Through this article a positive identification of the terms: Hrdaya.Phupphusa. Cloma, Sira and Dhamani is made. All the Asayas areidentified and proper synonyms suggested.

*24/150, Mulapet, l\ellora-524 003.

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GENERAL INTRODUCTION

Bull. Ind. Inst. Hist. Med. Vol. XIX

Medicine of ancient India is cal-led Ayurveda. It is a compound wordformed out of two terms ••AyuQ." and"Veda", and means the Veda of AyuQ..Veda means knowledge about anybranch of science, including meta-physics, which was revealed to theseeker, through his extra perception.That is the reason why Vedas arecalled Apourusaeva. In learningknowledge, in the vedic style, thenormal instruments of perception andmind are not used. Thus the name"Veda" - the knowledge- is the recei-ved name for the highest spiritualtruth of which the human mind iscapable, says Sri Aurobindo. Thereare four Vedas, the I~gveda, theSarnave da. the Yajurveda and theAtharvaveda. The Avurveda is app-ended to the Atharvaveda. Each Vedasta nds as an authority for the revealedknowledge during the time span of aYuga and thus Kaliyuga being thefourth in the present round of time,we were provided with four Vedas,and Atharvaveda is of more impor-tance.

To explain the nature and impor-tance of the knowledge contained inVeda we are tempted to quote fromSri Aurobindo. He said that "Fromthe historical view point the l~gvedamay be regarded as a record of greatadvance made by humanity by specialmeans at a certa in period of its colle-ctive progress. Veda, then, is the

creation of an age anterior to ourintellectual philosophies. In thatoriginal epoch thought proceeded byother methods than those of our logi-cal reasoning and speech acceptedmodes of expression which in ourmodern habits would be inadmissible.

"The wisest then depended oninner experience and the suggestionsof the initiative mind, for all know-ledge that ranged beyond mankind'sordinary perceptions and daily activi-ties. Their aim was illumination, notlogical conviction; their ideal, theinspired seer, not the accurate rea-soner. Indian tradition has faithfullypreserved this account of the originof the Vedas. The Rsl was not theindividual composer of the Hymn,but the seer (Dr~ta) of an eternaltruth and an impersonal knowledge.The langunge of Veda itself is Srutia rhythm not composed by the intellectbut heard, a devine word that camevibrating out of the infinite to theinner audience of the man who hadpreviously made himself fit for theimpersonal knowledge. The wordsthemselves, Drst i and Sruti, sight andhearing, are vedic expressions; theseand cognate words signify, in theesoteric terminology of the Hymns,revelatory kno JVledgeand the contentsof inspiration. Hence the Vedaceases to be merely an interestingremnant of barbarism and takes rankamong the most importa nt of theworld's early scriptures".

Ancient Indian Anatomy - Nagaratnam & Madhavi

The very originals of the presentCaraka and Susruta Samhitas fallinto this category. This fact is sym-bolically expressed in the texts bysaying Brahrna provaca etc. As timeadvanced, mental faculties dwindledand the Vedic knowledge becameuntenable not only to the commonman but also to the intellectual.

"The human mind in its progressmarches from knowledge to knowle-dge, or it renews and enlarges previousknowledge that has been obscuredand overlaid, or it seizes an oldimperfect clue and is led by them tonew discoveries. The thought of theUpanishads supposes great originsanterior to itself."

"The Rsis of the Upanisads follo-wed another method. They soughtto recover the lost or waningknowledge by meditation and spiritualexperiences and they used the text ofthe ancient mantras as a prop or anauthority for their own institutionsand perceptions; or else the Vedicword was a seed of thought andvision by which they recovered oldtruths in new forms. What they found,they expressed, in other terms moreintelligible to the age in which theylived. Thus contemperanous withthe Upanisads. the originals of theAyurvedic texts, viz. the AqnivesaSarnhita and Susruta Samhita arecomposed by the Rsis. This fact issymbolically represented when, both:'.,treya and Dhanvantari said that

3

they learnt from Indra. Indra standsfor Indrias and in turn to Manas.The truth-conscious mind has thecorresponding faculties Drst i, Srutiand Viveka, the direct vision of thetruth, the direct hearing of its words,the direct discrimination of the wright.Whoever is in possession of thistruth consciousness or is open to theaction of these faculties, is the Rsi ,sage or seer".

As age advanced. the mentalfaculties are further dwindled andhence the subject matter if>simplifiedand minimised to suit the age. Theresult is our present Caraka andSusruta Samhitas, which are datedto have been written arou nd 6thcentury B. C. and they are againredacted at a later date.

The ancient Indian medical classics,written exclusively in Sanskrit, arenot easily accessible to any otherthan the direct disciple of that Guruparampara or that particular school.Sometimes the knowledge of medicineis held as a close preserve in a fewfamilies of Hereditary vaidyas. Indianhistory mentions about great educa-tional centres at Taksasila, Nalandaand Kiisi which attracted studentsfrom all over the world. With thebeginning of Christian era we lostthese educational centres as well asthe traditional methods of transferringknowledge from Guru to Sisva. Hencethe study of Indian sciences had aset back and among them Ir.dianmedicine suffered the maximum.

4

The method of expounding allIndian knowledge in the form ofsutra is speciality of Sanskritlanguage. The word "Sutrarh"means a thread. This primary meaninggives rise to the secondary meaningof Sutrarn as an Aphorism. Justlike a thread binds together a numberof beads in a rosary; in language theSutra forms the underlying continuityof idea that binds together in outlinethe essentials of the subject. Themost important characteristic of thismethod is the utmost condensationconsistent with clear exposition of allessential aspects and continuity ofthe underlying theme inspite of theapparent discontinuity of the ideaspresented. The latter characteristicis worth noting because. the effortto discover the hidden thread of rea-soning beneath the apparently unco-nnected ideas. very often providesthe clue to the meaning of manySiitras. It should be rememberedthat this method is prevalent whenprinting was unknown and the entiretext has to be memorised by thestudent. Hence the condensation ismade to the utmost limit. In doingso nothing that is essential is left outand everything which a student isexpected to be familiar with orwhich he cou Id easily infer from thecontext is ruthlessly cut out. Thestudent will find. on careful study.what a tremendous amount of scien-tific knowledge, the author has mana-ged to incorporate in such sutras.Also it is the custom in our Sarnhitas

Bull. Ind. Inst. Hist. Mad. Vol. XIX

to give every thing necessary for theproper understanding of the subjectat one place or other in a skeletalform. The student with the help ofa hereditary Guru has to dig out therequisite knowledge. to know themeaning of it in its entirety. Unfor-tunately this Guru Sisva Pararnpara-nugataril or the hereditary system oftransmission of knowledge is lost dueto reasons best known to thehistorians.

The Palm leaf manuscripts werepreserved with great difficulty andafter a lull of many centuries, therearose an overwhelming enthusiasmfrom different corners of the country,to study and interpret the ancientIndian medicine. By the time suchenthusiasm arose. no proper Guru isavailable. Thus Indian sciences fellinto the hands of persons not fullyqualified for the job. They are onlyliterary scholars. They are not awarethat in Sanskrit. the technical termsused in sciences, do have separatescientific meaning. in addition totheir literary sense. Hence the comme-ntaries written to the samhitas aremore literary in explanations than

. scientific. The result is the presentcrippled and disfigured Avurveda.During the British rule, many foreignscholars evinced great interest in thestudy of Ayurveda. They gave toomuch importance to the commentariesand they never went beyond them intrying to understand the system of}I.yurveda. The original texts are not

Ancient Indian Anatomy - Nagaratnam & Madhavi

consulted properly. Thus the apparentunscientific nature attributed to Ayu-rveda is continued. The Indian review-ers. authors and translators on thesubject, followed these foreign versi-ons and the commentaries and wrotetheir works without considering theoriginal text. All other commentariesin regional languages are nothing butverbatum translations of the Sanskritcommentaries. Till to-date, the studentand the master are alike in giving apassive reading to the Ayurvedic texts.The subject is learnt without tryingto know the correct meaning of thesutras based on the traditional scien-tific terminology.

The two Samhitas of Ayurveda,start with the metaphysical cosmo-genesis and continue into the physicalanthrapogenesis. In many instances,for example, the text in Susruta Sam-hila - Sareera sthana chapter One,each sutra refers both to cosmogene-

5

sis and anthrapogenesis. All theseaspects are left out by the commen-tators in Sanskrit and hence omittedby all later authors. Unless one isfamiliar with these aspects, the phy-siology and anatomy, as given in theSarnhitas is not understandable withits original scientific meaning.

With this background we setforthto suggest the correct interpretationto some of the Sutras and properidentification of the organs and organsystems recorded in the original textson Avurveda. We do not propose touse a negative and destructive methoddirected against the received solutions,but simply to present positively andconstructively. a larger and, in somesort a complementary hypothesisbuilt upon broader foundations - ahypothesis which in addition, mayshed light on the important problemsin anatomy and physiology anddiagnosis in .:\yurveda.

SPECIAL INTRODUCTION

Classical Ayurveda rests on cer-tain basic and fundamental truths,acceptance of which depends on theunderstanding of the subject in itsscientific wholeness and richness.

Ayurveda, and as a matter of factall ancient Indian knowledge has itsbeginning only from Metaphysics,which deals with cosmogenesis andanthropogenesis alike and relatesone to the other.

In Avurveda, birth is a union ofcertain groups of ingredients, bothphysical and metaphysical. Death isonly apparent and is the result ofdissolution or resolution of the ingre-dients and life is nothing but thecontinuity of the union of the ingre-dients. Nothing in this universe ispermanent or constant. On the otherhand every thing is changing, limitedby the cycle of Birth-life and Pr318ya(dissolution).

There is nothing lifeless. Thereare only two categories. The one iscalled Cetana, the other is calledAcetana, the difference being thepresence or absence of functionalIndria. Acetana is a word coined forliterary use and not for scientific1erminology.

The terms Sthavara and JaI)gamaused in Ayurveda have aprimarymetaphysicat meaning and a secon-dary physical meaning. The termsshould be understood based on thecontext.

It is a rarity in A.yurveda to use

Bull. Ind. In st. Hist. Med. Vol. XIX

synonyms for technical terms. Whentwo or more dtfferent terms are used forthe same technical point, one will bea common titerary term and the otherwill be a technical term. Every termwill have its own minor and subtledifferentiation. Similarlv when twoterms are used to denote the samemeaning (true synonyms) the authorclarifies the point at some place orother and gives the details, Of ana-tomical importance, only a few setsof true synonyms are noted in theAyurvedic texts. They are Miitrasayaand Vasti; Yakruta and Kalakhan<;ia.atc.

Ayurveda defines the human entity from different stand points.

General & Metaphysicat :

"~fcf;) f~ fiIfCJ~:- ~~ \lfs;lfq~:q"

Ayurveda & Metaphysics :

"3ff~.;r"Ci9TF~ q'~Il~~Q ~,)f'{ ~Jf"ifTlf: ~ ~(1!:Clfct'·

Genetical and Biological:

"~fcf;) f~ fiIfCJCTRJf<ti ~ 3lTT.flf: ~T~lf~:q"

Physical Science:

••(f ~~lfHcrTff q'3=:qT(Jf<i,T ar""' " ~

Bio-Chemical :

"~~\iI' ~~r5f'.

Embryological:The Chapter on embryological development viz. Susruta Sarnhita -

Sareera sthana - Third Chapter.

Ancient Indian Anatomy - Nagaratnam & Madhavi 7

Anatomical:

~~Cfqp~f\jf~CfT~r1JfCf)uTf.,oJ:CfTf~f~"(s;~~itCfHr~T ~HT"(fJTfo ~~t

~~ij' I cr:;;:q ~~~-~T~~i'fCf~). J:fc::licrs:qlfl~lS~ f~~ ~fcr II

External Anatomy:a. 3fCf: crt STclfs-lfTf., cr~lf'ij'-J:ffCfCfi)ft~cr~"Tf~~('?rc:"Hfrf:qij'Cfi-

"' e, '"

qfHrmCfT ~~lfcrT Q;~CfiT:; CfiuT ;r?f "HfT~~s;~te-~Cfi&Hcr'1

,!~1JfcrT~cffplil;;rr,!ij'rR~ST~Cf~) [if, fcr~fo"(s;~~~:, ~)otfu

cre-1:fJITUfrf'1,~ STclfs;lffcr~TlT ~Ofo: II

b. ~q1Jf"~"q'ftrl~T1Jf~~rfur .,Cf ~)Cftf~ ~rurt qf~1{~f.:r,

~i'fF~cr f?fTurrJT~rf1Jf :q ?lTfcrr if ~cr.,~)"(a-~aT~OfOcr~:q II

Internal Anatomy:

o~~ '1:.,~~s;,,§lfFr1f - ~cr:q: Cfi~T CTTacr) J:f~T ~)1:fT lT~C!.t~T-

~1'1T~;:~B~u~Cfi) ~ct~JTT~lTT ari'?I'Tfur crCfCfiT~)aif~ CfiUs~T\jff~Tf.,

Cfi:qf "{\iJ'Cf: ~'f~ll': ~S:~CfT: e-rJT;:7fT ar~~rf., e-;:a-lf: ~.,TlTCf: it~~)~ "'J:fl1Tfurf~"(T '!1q;:ll') IT)lfC.f~Tf., ~)Cftfe-:;:r II

Many of the above technical termsare meagerly understood and in manyinstances misunderstood. Further. adetailed and analytical study of anci-ent Indian anatomy and physiologyreveals the absence of the considera-tion and hence the lack of importanceto the Blood Vascular system, Respi-ratory system and Nervous system.Metabolic, Excretory and Reproduc-tive systems are the only systemsconsidered in physiology with detail.Bio-Chemistry and bio-energetics aredeveloped to the maximum and thepathology is based only on Bio-che-mistry and hence the treatment is alsobased on bio-chemistry. The absence

of certain systems is not due to thelack of knowledge but due to theirunconnectedness in diagnosis andtreatment.

The diseases of mind, lungs andnervous system (considering in termsof modern medicine) are perceived byAyurveda to different origins basedon bio-chemistry. The classificationof manasika vvadhl, of whose treat-ment is omitted from the Avurvedictexts. are not mental and psychologicaldiseases as enumerated in modernmedicine. Similarly the diseasesApasrnara and Unmada are not conne-cted with brain. The diseases classi-

8

fied as hrdava vyadhi are not heartdiseases; Rajayak~ma is not Tubercu-losis; Dhanurvata is not Tetanus, alsoVata is not synonymous with wind;Pitta with Bile; Kapha with Phlegm.The Tridosa theory is not humoraltheory of the ancient Greeks.

Thus the classical Ayurveda is

Bull. Ind. Inst. Hist. Med. Vol. XIX

presented in the texts in a nut shellwhich is not easy to creak and chew.You will understand and appreciateonly when you creak the shell andbe able to chew the kernal. Until then,as Dr. P.Kutumbayya puts it, Ayurvedacontains inchoate notions. In thefollowing few lines we present someof the truths, on anatomy.

H~DAYA IN AYURVEDA Vs HEART IN MODERN MEDICINE

.\ yurveda said that hrdava is apart (Upanqa) of an organ systemcalled maha srotas or kostharn, andthis organ system is synonymouswith the digestive system of modernmedicine. Hrdava is the seat ofPurusa, the metaphysical animatingpart of the living human entity. WhenPurusa is present. the body is calledSareera and when Purusa is absent.the body is called Kalebara. Hrdavais the seat for "Ojas". Hrdava is theorgan which receives the essence ofdigested food called "Rasa" which isnot the first Dhatu out of the SaptaDhatus. of which the body is madeup of. and which is also called asRasa. Hrdava is provided with a setof 24 Dhamanis and these Dhamanisdistribute Rasa to the entire body.Hrdava functions during the wakefulstate of the person and rests during theresting period of the person. It actsas an entrance to Amasaya (Stomach).It is vulnerable for a set diseases called

H rdav a Vy adh i.

Allopathy said that heart is anorgan acting as the pumping houseof the organ system called BloodVascular system. Heart receives impureblood through a set of blood vesselscalled veins; pumps it the lungs thro-ugh its Pulmonary Artery and afterpurification in the lungs. the blood isreceived back through the Pulmonaryvein and distributed throughout thebody by another network of vesselscalled Arteries. Blood is a liquidtissue during its journey in the body.it collects gaseous and nitrogenouswaste products from the places offormation and eleminates through theorq ans of excretion,

Thus the reader will find for him-self that the organs identified asHrdava and heart are not one and thesame. Not even a single point is incommon. Some how the modernauthors on Ayurveda and the moderncommentators mistook these twoorgans, confused themselves and

Ancient Indian Anatomy - Nagaratnam & Madhavi

brought disgrace to the Ayurvedicanatomist. For about a century andhalf this verbal blunder is being taughtby the teacher and learnt by all thestudents of Ayurveda. unchanged andbeing transmitted to the progeny. Allthis happened because. modern edu-cation gave the science student apicture of heart and its circulation fromthe very beginning of his study ofBiological Sciences and with this basicknowledge the student enters theAyurvedic college and during hisstudy of anatomy. could not find theorgan heart and blood circulation. Inan attempt to compromise himself. hecame upon the term Hrdava, andhe got satisfied by thinking it to bethe heart. The first teacher andthe first pupil went wrong alike andno guru was there to correct them.Nowadays, the teacher who wasalso a student. never had any doubt

9

with this subject and hence neversearched for a solution. This traditionwas and is being continued, because.the student is not interested in adetailed and fulfledged knowledgeof Ayurveda, other than what isnecessary to pass his examination,Even if some doubts arose they hadno time to read the originals andarrive at the real solution. Now let ussee the correct position of both heartand hrdava in Avurvedic anatomy.

Internal anatomy is summed upin one sloka in Susruta Sareerasthanaastquoted earlier which reads tasyapunah sanhkyanoID etc., S. ~a. 5.4.In this slok a. a set of organs arecalrr d as\sayas. These asayas areeight in number and seven asavas arecommon to the male and female. theeighth a~aya,qarbhaiava. is additionalto the Iemz le.

3TT~lfT~~ CfmT~lf:, fqnT~lI': ,~~ISI1T5TlI').

~'lffT~lI': 3TTI1T~lf: q'l:rT~q). tr?rr~lf:·<'>

f~')1Jft ~'q'T~lf)SlScl1 ~f:,I,,A..sayais a technica I term which

means an Adhara to something andthe name of this something is addedas 21 prefix to denote the nature ofthe asaya. In literature and in usagewe got a term [alasava which meansan adhara to jala (water). This ana-logy makes us to understand better,the nature of an asaya. Thus iisayais a store house of something, which

is produced somewhere and utilisedelsewhere, The asaya acts as a recei-ving. storing and distribution centre.Here in the human body there areasayas which are seven in male andeight in female. acting as reservoirsfor different substances and hence.they are not called as ariga. An arigais an organ or a part of an orga n,that is capable of doing a particular

10

function, in which, it, itself partakes.Thus hand is an organ, leg is an organ,liver and spleen etc. are also organs.

Now let us identify what thesea~ayas are, according to modernanatomy,

Vata~aya identifies itself with theRectum. Pittasaya is Gall bladder/Slesrnasava is Lungs; Raktasava isHeart; Amasaya is Stomach, with partof Oesophagus and a part of the smallIntestine upto lleo- jejunal junctionwhich is called as Nabhi (antranabhi).

Bull. Ind. Inst. Hist. Med. Vol, XIX

medicine, without scientific andpractical support, went wrong inidentifying them. They identifiedonly some of them and could notidentify the others. Out of theunidentified Asayas, Raktasava andSlesmasava are of importance. Thiserror of not identifying the Hak ta-iav aand Slesrnasava. is continued allthrough the ages and all later com-mentators, translators and writers on;\yurveda, in all the languages,skipped over the subject by verbatumtrans literatinq the terms.

Now we identify R'lktasaya asHeart and Sle smasava as Lungs. TheAvurvadic anatomist and physiologist,has ruthlessly avoided the details ofblood circulation and respiration.1his is not because of lack of under-standing but because of lack ofimportance for them in Avurveda.The merit of not giving importanceto the above two systems, as well tothe nervous system are not discussed

Though the texts are perfect in here. Thus identifying Heart andgiving the details in the form of Lungs of modern anatomy andSutras. it is here, in identIfying these equating them with the Raktasava},sayas, the first commentator and and Slesrnasava of Ayurveda, nowthe first student who had their we pass on to the organ called Hrdavaeducation not through a Gurukula in .\yurveda, and let us identify andSampradava and who had got only find out its synonym in moderntheorit ica I and lltersrv education of i1 n +tornv.

~ff;:P:r)1l~lP1fur;oT<irt~llrQ"m:q;rT~~ I~~'~~rHflf~p1fgfSoT;:f ~~[f rrTl:r II

Pakvasava is Colon: MiitrasayaUrinary bladder and Garbhasava isUterus. If we carefully follow, we willfind that in every instance, the con-tents of the 1-saya are not producedin it or retained in it for more than afixed limit of time or utilised by it.The details of the functions of theabove Asavas are not necessary here.

The above::;ftreerasthana,

sloka in Susrutachapter-B. gives a

~ OfT 31" ~/'todescription of the organ calledHr dava. Anatornicallv it is midsternal

· \

Ancient Indian Anatomy - Nagar atnam & Madhavi....

~11" .• >

in position (Stanayor Madya't),) andacts as an entrance to Amasaya. It

is the seat of Sattva, Rajes and TamogUI).as.

;;Tf'l1~crrlFCf~ ;;r;:CfT'Ul=fmlf ~fCf ~I=fCf:e,

:;:r. fer 3T. ~ / ~ '"

Caraka Sarnhita in Virnana sthanadescribed Arnasava, as that part ofthe alimentary canal bounded by thetransnippular plane above and by the

lIeo-jejunal junction below, thusconfi·rming the position of Hrdava asthe entrance part of Amasaya whichis midsternal in position .

••3TUT f.,!S'm ferCfH~Va- ;;T'+lfT ~qf~fCf!SofCf"

i1T~TlI'urlqf;:r~Cf..•lF~~!Sq-~1 ~

This sloka from Mantrapuspagives the correct dimentional positionto the organ Hrdava. The Hrdava isbelow the Thyroid cartilage or Adam'sapple (Nishti) and above Nabhi.When you draw a straight line alongthe midsternal plane, the Thyroid carti-lage and Nabhi (Umbilicus) falls in astraight line. Since Nabhyam is induel number, it implies that theorgan is above the two points calledNabhi viz., External Umbilicus andinternal Ileo-jejunal junction. Againit says, Hrdaya is at a distance ofVitasthi - from Thyroid cartilage andis below it. Vitasthi is the distancebetween the ends of the thumb andthe little finger. This distance varies

from person to person and age to ageand hence everyone has to measurethe position of Hrdava with his ownhand, from the Thyroid cartilage,downward, along the midsternal line,it roughly synchronises with the,Sterrio-Xvphoid cartilage junction.This slok a thus confirms the midster-nal position of Hrdava and pinpointsits position to the end of Sternum.

IV. Caraka Samhita in giving themeasurements of all the constituentsof the body, gives the measurement ofHrdava as Dwe Anguli, which meanstwo digits of the finger and to eachperson with his finger digits only.

"[lI' S:lT~ ~~lI'l1'" .•. -:;. ". '"'

"T. f.;-· cl ~~\.9

12

Comparisons to Hrdava :

Bull. Ind. tnst. Hist, Med. Vol. XIX

q<qCfi)~srcfrOfiT~ ~Gli '9T(lfg)1!~

l=!;"f~ISq-- ~

This sloka from Mantrapuspagives two characters of Hrdava bysaying that it is similar to Padmakosarnand that its face is downwards. Pad-makosa means the bud of Lotus andMukha means entrance. The slokadid not specify in what respect it is

similar to Lotus bud. But the otherpart says that the entry into the organHrdava is directed downwards.

A similar sloka is found inSusruta Samhita Sareerasthana, Chap-ter-4. sloka-25.

~u~~Wiur ~~~ ~ ~lfTGg)1!~Jt I

;;rHfffHff[Cfie'fcr fqqff~~ f;:n::rT('?fffII

Here it is said that Hrdava issimilar to Pundareeka i. e. whiteLotus. Its face is downwards. Anadditional quality given here is thatit opens (Vikasati) during the wake-full state (Jagrutlj and Closes(Nimeeteti) during resting state(Swapatah) which means that thisorgan Hrdeva functions when theperson is awake and rests when theperson sleeps. Thus the similarity ofHrdava to PunQareeka is explained.It is a well known fact that Lotus

blossoms during the day when thesun is present (The presence of sunis the state of wakefullness or Jagrutito the world and the absence of sunis the opposite of it) and closes.during the night when the sun isabsent. This similarity is once againstressed by another sloka in SusrutaSamhita Sutrasthana. last Chapter.Explaining the rules regarding food

intake (\hara Vidhi) there is a ~Iokawhich reads as follows.

fGCfr fCJ~ ~G~ i:jrHTff:~u~(TCfiq~ II

~fG ~~Tf('?~ U"fT >r~(fftlf fCJ~I':i('f: II

This sloka means that Hidev ebeing similar to white Lotus (Punda-reeka) functions during the day and

rests during the night. Thus thesimilarity of Hidev e to Pl."Qf.lareekais clarified and established.

Relative Anatomy:

Ancient Indian Anatomy - Nagaratnam & Madhavi 13

a-~~ (~Glf:) arcr) CfP::rCf: t~T~T ~C~~~:q,~~um) If'!iCf Cf~)ll :q I

"'

We have already established thatHrdava occupies, anatomically mid-sternal plane. This sloka says that,to the right of Hrdava two organscalled Yakrut and Cloma and to itsleft, two more organs called Plihaand Phupphusa are present. Furtherall these organs are below Hrdava inthe horizontal plane. Now havingproved that the Hrdava is the entrancepart of Amasaya occupying to mid-sternal position, it is not difficult toidentify the above four organs. TheYakrut is Liver and Cloma is Pylorusand occupies a position right of themidsternal plane. Similarly Pliha isSpleen and Phupphusa is Pancreas,which occupy the left side of themidsternal plane

Hitherto the commentators andtranslators of the original samhitas,as well those who wrote independenttreatises on Avurveda. identifiedPhupphusa as lungs and did not

VII. Functions Attributed to H! daya :

identify Cloma. The fact thatPhupphusa is in ths singular numberand said to occupy a position belowHrdava dequalifies its identificationwith the lungs and qualifies ouridentification with Pancreas. Wehave already identified Lungs in theAsavas and proved them to beSlesrnasava. Thus the age olddiscrepancy about the identificationof Cloma is set right and the wrongidentification of Phupphusa correctedby properly identifying the Hrdava asthe entrance part of the stomach.

To sum up, all the referencescited above prove that, the organcalled Hrdava is a part of the alimen-tary canal (Kostharn) ; occupies themidsternal position; acts as anentrance part of the ;\masaya;functions only when the person isawake and it allows its contents onlydownwards (Adhomukha).

a) ~)<;f~f':r~"Jf f Rr-;o~T~r~ll\jf~: <fifer:

f<:P:f~~cfllcr~~llft ~~r.r~Cf~~~FCfcn 11

ll"?f:!lSq-~

14 Bull. Ind. Inst. Hist. Med. Vol. XIX

Cffl£ (W:) ~ ~~Toi. ~ ~G'l£T:;;~i!f~:(Tfcrg+r;:ftvnTfq~l£)~rrT G'~ G'~rg)rrTf+i'rl£~"lcr~~q:q lotinn: ~cf;:f ~~:'t~~~r~~foq.l£fcrqdl£fcr a-Hl£fcr l£Pll£fff :qp~"l'~~~'f CfillurTI

~ ~. 3f. rl{/~

b)

From the above, we understandthat there is a substance called Rasa,which finds its place in the Hrdavaand gets distributed through anetwork of 24 Dharnanis. In thiscontext Rasa is translated by Sri KLBhishagratna in his Susruta Samhita,as lymph chyle. Dhamani is simplytransliterated and people are ofopinion that they are one set of bloodvessels. Our findings are that Rasais not lymph chyle and by Rasa,Ayurveda proposes a pool of bio-chemical fragments, the details ofwhich are not essential and hencenot given in this context. Similarly,

VIII. Pathology of Hrdava :

The organ Hrdava is susceptibleto a class of diseases called HrdavaVyadhi. Among them Krimija (Caused

Dhamanis are neither veins nor arteriesand they are not conducting tubes.On the other hand they represent atissue channel system, the details ofwhich are also withheld in thiscontext. The significance of 24Dhamanis is not discussed here. Thefunctions of Hrdava falls underphysiology for which we propose aseperate article and hence it issufficient here to point out that thefunctions of Hrdava are not connectedwith blood and its circulation andhence should not be confused withheart. The fact thut it is connectedto Rasa, confirm its relation with theAmasaya and digestive system.

by worms) Hrdroga is one. Itssymptoms are given as follows:

f'5fG')~\ir~ ~~)if 'l) !;Uc~nfil~q~ Ifn~~T'DT~TG'Tf'f ~r.~~cr~l£)q\irr~~ II+r~ifi~~ '" ~~~ ~q:qrC'lq<f'i'i~fCf I~Cf~G'ro~~l£q:qrfl£ ~:r<H':Tq2'ilTc+r'f:II

" -e ~

This sloka explains, that due toeating food stuffs, such as gingiliseeds, milk and jaggary by a personalready suffering from Hrdroqaof Sannipata origin, a swellingdevelops inside the Hrdava and invites

propagation of Krimi, which resultsin further complications. This pointproves that Hrdaya is a partconnected to Amasaya and not toheart and blood circulation.

IX. Additional Evidence:

Ancient Indian Anatomv - Nagaratnam & Madhavi 15

a) ~~Ten:t<rTq,!Cfcr~<r ~if ~ !1~lr1urT~ I~<rT(H f\ifccTT iI~cr ~cr~fn ~:;:;~l ~crm~~ \ifTlI'~ II

f[crT~ ~q~: ~n~) GT~: <f,Uol;\if: cr~T Ifcr~I1TJfT~<r5fTccj ~l;~ ~fG ~Grrl ~ II

The above sloka from SusrutaSamhita, Kalpasthana gives thesymptometology of poisoning bySthavara Visa (Vegetable and mineralpoisons). Since the poisons aretaken by mouth, the symptometologystarts with the tongue and extendsfurther. When the poison enters theAmasaya, the author savs that pain

is felt in the Hrdava, In this instancethe poison has not entered the bloodcirculation yet and hence blood andits circulating system requires somemore time to get affected. As suchpain in Hrdava can only mean painin that part of the Ama~aya whichgoes by the name Hrdava.

b) ~cf Gcr1~cj ~if ~lSi f<rTr:~ ~~G~~ ~lI'TcrcrT~Fi

crCJ~Ti.~"Tfrqlj";:crTcr :q CfiTcCfiT:f[crTIT <;f;C1lfT~iTq:crTlT ~f~rr if"'h:cr~ ~ ~;:C1T ~~fqCf~G~:q~~lSCTqrf-crfl1: ~fr'afcr~B-~ut cr;:iH q~'ifi:r q'chrG;:f, GT~) f~C;l1T :;;r

~lS3" :;;r ~cfT~T ifT~ifl~:r~ li~r fqqTCfi)sfcr~F: 5fTclf~~;:('f ~crlr ~o/erqlScCficT~if: ~:r<t~1ScTfrr;;njCfi:l

-.:l v e.

This sloka from Vi~a VaidyaCintamar;i gives the svmptornetoloqvof poisoning by Darveekara Vi~a(snake poison) In this, he clearlysays that the poison enters the bloodcirculation immediately after a bite.But pain in the Hrdava is reported inthe sixth Vega only, since the poisonwhile circulating enters the gastricartery, only after the lapse of sometime. Had Hrdava been heart.immediately after the poison enters

the blood, pain ought to have beenreported in the first Vega itself. Thushere also we conclude that Hrdava isconnected to ;\masaya.

X. Now coming to the knowledgeof salya that finds its place in Hrdavaand to remove it, the method sugge-sted, makes us understand thatHrdava can only mean a part ofAmasaya and not heart.

16 Bull. Ind. Inst. Hist. Med. Vol. XIX

~~~ ~ff¥fci ~(Wli ~Tf~dflf fQ:IlT1=~<iTI

ercr: f¥ffifl;:cr~ srT(crqr~=t~~~Tlf~i! II

31" ~. ~.

The fact that, drinking cold waterdisplaces the selva obstructing theHrdava, to a convenient place,(stomach in this instance) from whereit can be easily removed by suitable

methods, makes us understand thatHrdava is connected with A.maAayaonly. Otherwise if Hrdava were tobe heart, how can drinking waterdisplace it to a convenient place?

fCf~'llCfcrTll ~~T:;;:q ~~p:ft~cb{cHa~T I'" '"~~+ierT-;r~\if: cpT~ ffe11~ ~fir~Tc·g~II

\(~ ~f~ efef: ~prr ~li ~uj~lf ~Plif~ II

3f. ~. ~. \9/~ ~. ~\9

XI.

The above slokas from A$taiJ.ga-hrdava, Sutrasthana, chapter 7,Slokas - 26 and 27 gives the treat-ment for food poisoning. He saysthat, to get rid of the effects ofpoison on Hrdava, a small quantityof finely powdered copper has to belicked along with Honey (It bringsabout vomiting, empties the Amasaya

XII. The term Hrdavodqara meanseructation. Hrdavodqara means thatUdgara that came from the Hrdava orthrough Hrdava. Eructation takes

XIII. The term Hrllasa meansnausea. Nausea is a reflex action of

and thus cleans Hrdava connectedto it). When the Hrdava is thuspurified, again gold bhasma has tobe licked with honey to counteractthe side effects of copper, previouslygiven. Thus this sloka also provesthat Hrdaya is a part of the :\.masayaand not heart.

its origin only from the stomach andnot from the heart. Hence the termHrdava identifies itself with a part ofAmasaya only.

the stomach and hence here alsoHrdava is connected to Amasaya.

XIV. fCf~~ lfflf C! ~Cf~IlT~ ~Wa- I

~C!cp)t:Glf~ :q lf~lf II

Ancient indian Anatomy - Nagaratnam & Madhavi

Vidaha means heart-burn. Ingiving the symptoms, the author saysthat the burning sensation passesthrough or extends from Hrdava toGalam through Kest ham. HereKostharn is that part of oesophaguswhich conr.ects the throat above andHrdava below. The relation ofHrdava in this sloka clearly establishesits connection to c\masaya.

We now sum up, the nature,position and functions of the organidentified as Hrdava in the .\yurvedicanatomy and try to see what themodern medicine says about it andcalls it with what name in its anato-mical nomenclature.

Hrdava is an upanqa of Kosrharn.( Kostharn = alimentary canal.) Itforms the upper boundary of that partof Kostham, which is called asAmasaya. It occupies a position inbetween the two stana. It acts as aDwaram to .\masaya. Its function isvolvular. allowinq its contents down-wards. It functions during thewakeful state and rests during therestful state of the human being andhence it is compared to the whitelotus which blossoms during the dayand fades away during the night. Itreceives the quintessence of thedigested food, called Rasa anddistributes it to the entire bodythrough a network of Dhamanis whichnumber 24. It occupies a positionalong a straight line connectingNishti with Nabhi and at a distance

17

of one Vitas!hi from the Nistidownwards a nd measures TwoAnquli, the measurements being withones own hand.

Now talking in terms of modernanatomy Hrdava is a part of thealimentary canal. It connects thecardiac end of the stomach and theoesophagus. It acts as a valvecontrolling the entry of food into thestomach. The entry of food isdirected downwards only. It ismidsternal in position. It falls in aline along the midsternal line in,between the Thyroid cartilage andUmbelicus, at a distance of onemeasure (the distance between theend of the thumb and the little finger)with his own measurement. Itmeasures two finger digits with hisown finger. It is at the end of ster-num according to the above mea-surement.

Technically speaking this partHrdava must and should be a part ofthe oesophagus vv ith the abovequalities and position.

Now to quote from Grey'sAnatomy, Edition 36, page 1316 - '8,Splanchnology:

OESOPHAGUS:- "The oesophagusis a muscular tube, about 25 emlong, connecting Pharynx to thestomach". It is divided into acervical. a thoracic and the abdominalparts. "Radiological studies show

18

that swallowed food is momentarilyheld up in the lower gastric end ofthe oesophagus, prior to entry intothe stomach. I t is hence certain thatsome form of sphincter mechanism,capable of contraction and relaxation,must be present at the oesophagoga-stric junction." Hence that pint ofthe oesophagus that occupies aposition from the end of the sternumdownwards, which measures 2.5 ern.roughly coincides with the descriptionof Hrdava.

The bio-chemical nature and thephysiology of Rasa, the nature an::!modus operandi of Dhamani cannotbe interpreted in terms of modernmedicine. Also the importance givento this part of the body called Hrdavain Ayurveda has no parallel in modernmedicine. The literature available onthe functions of the oesophagus ismeagre to judge its importance. Adetailed expositien of Rasa and itscirculation threuqh Dhamani as givenin Ayurveda follows as a seperate

Bull. Ind. lnst. Hist . Med. Vul. XI X

article. The merits and demerits ofthe \yurvedic system in giving somuch importance to this part of theoesophagus need not stand on theway to identify it.

Thus the identification of Hrdavaas the cardiac end of the oesophagusand Hak tasaya as heart helped us toidentify 51esmasaya as lungs, Clomaas pylorus and Phupphusa as pancreas.One can understand and appreciatethese, when he understands andappreciates the Rasa and its circula-tion. In identifying the above, wehave not resorted to any correctionsto the original slokas, or strained togive created meanings. What wedid is only a correct rendering of theoriginal text. The others missedbecause they studied the text with apreconceived notion of modernanatomy and strained to fit it withthe ;\yurvedic anatomy. If you readthem seperately, then try to compareand contrast, one can arrive at theTruth, which is presented above.

Ancient Indian Anatomy - Nagaratnam & Madhavi 19

BIBLIOGRAPHY

1. BLAVATSKY, H. D. 'The Secret Doctrine' Adayar Edition in 6 Vol..Adayar, Madras, India, 1971.

2. SRI AUROBINDO, 'The Secret of Veda', Sri Aurobindo Ashram,Pondicherry, 1971.

3. SABDA KALPADRUMAM, Chaukhamba Sanskrit Series. Varanasi.

4. SUSRUTA 'SA~IHIT.\', V. Harnuswarnv Sastrulu & Sons, Madras, 1969.

5. K. L. BHISHGRATNA, English translation to Suerutasarnhita in 3 Vol.,Chaukhamba Sanskrit Series, Varanasi.

6. 'CARAKA SAAIHITA', V. Ramaswamy Sastrulu & Sons., Madras.

7. 'A~TAl\'GA HB,DAY Mil' -do-

B. 'Vr:;;A VAIDYA CINTAMANI -do-9. 'MANTRA PU$PA~l' -do-

10. 'GREY's ANATOMY', Edition 36.

11. AMARAKO~AM, V. Ramaswamy Sastrulu & Sons, Madras.

12. M.\DHAVANIDANA:\I, Pandit D. Gopalachari, Madras.

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