AAMJ / Vol. 3 / Issue 4 / July – August 2017

A A M J Anveshana Ayurveda Medical Journal

www.aamj.in ISSN: 2395-4159

Review Article

Concept Analysis on Asthi Saṅghāta in relation to Kakṣā

N.G.Mulimani 1 Malashri 2

A b s t r a c t

For Implementation of principle of Ayurveda, we must have detail knowledge of Ayur-

vedic Śārīra (Anatomy). In all Ayurvedic samhita (text) Śārīra sthāna is separately de-

scribed. Many structure with their functions are mentioned in it. But some concepts men-

tioned by Aacharya have lot of ambiguities. Detail anatomy & functions are not found.

Such as Sīmanta, Sīvanī & Saṅghāta. Saṅghāta means group & Asthi saṅghāta means

group of bones. Group of bones in Asthi saṅghāta form a special Anatomical structure

different than Sandhi.

Keywords: Śārīra sthāna, Saṅghāta, Asthisaṅghāta

1 Professor & Head, 2 PG scholar, Department of Rachana Śārīra, NKJAMC and PG Cen-

ter, Bidar, Karnataka.

CORRESPONDING AUTHOR

Dr. N.G.Mulimani

Professor & Head,

Department of Rachana Śārīra,

NKJAMC and PG Center,

Bidar, Karnataka, (India).

Email: drnagarajgmulimani@gmail.com

http://aamj.in/wp-content/uploads/Volume3/Issue4/AAMJ_1458_1461.pdf

Mulimani & Malashri : Concept Analysis on Asthi Saṅghāta in relation to Kakṣā

AAMJ / Vol. 3 / Issue 4 / July – August 2017 1459

INTRODUCTION

tility of every science is for the prosperity of hu-

man being Ayurveda is also the greatest science,

evaluation of Ayurveda is for the prosperity of hu-

man being. The main aim of Ayurveda is “Swasthya

Rakshan” i.e. maintaining good health for maintaining

good health and to become successful physician one

should have complete knowledge about Śarīra and

Śārīra.

All samhitakara have described separate section (sthāna)

on Śārīra (Anatomy) in their respective samhita. In Śārīra

sthāna, they described anatomy of various structure and

their importance, function and applied aspects e.g.

Daśaprāṇāyatana, Saptatwacha, Saptakalā, Asthisan-

dhi etc. For treatment point of view, we must know detail

anatomy of every structure related with body. All sam-

hitakara described Asthi saṅghāta as well as Asthi – San-

dhi of same name. Does Asthi-Saṅghāta and Sandhi both

are same? Is there no difference between Asthi-saṅghāta

and Asthi-sandhi? There are lot of ambiguities related

with Asthi-Saṅghāta, to clarify these ambiguities and to

state the anatomy, function, applied aspects it is neces-

sary to throw focus on Asthi-Saṅghāta.

MATERIAL AND METHODS

This is conceptual type of paper or article, textual mate-

rial are used for the study from which various references

have been collected, Main ayurvedic texts used in this

study are Charaka Samhita, Sushrata Samhita, Astanga-

Sangrha, Ashatanghridya and laghutrayee available

Commentaries on it, Literature survey of modern text are

also used. Research article available on internet also

studied.

Review of Literature:

The description of Asthi-Saṅghāta is found in all three

major and minor Samhita i.e. Bruhattryi and laghuttryi.

They mentioned the number and location of Asthi-

Saṅghāta. There are 14 Asthi Saṅghāta, in lower extrem-

ity there are 6 Saṅghāta present they are Right and Left

Vaṁkṣaṇa, Jānu and Gulpha and in the upper extremity

also 6 saṅghāta present. i.e. Right and Left kakṣā,

Kūrpara and maṇibandha. Among the remaining two,

one is found in Śiras and another one is Trika. According

to commentator Dalhana-charya number of As-

thisaṅghāta are eighteen. He described four more along

with above 14 Asthi-saṅghāta. These are one at site of

śrōṇikāṇḍa, second at the site of sternum, third at the

junction of urah and udara, fourth one is present at the

site of aṁsakūṭa. Meaning of saṅghāta is samūha i.e.

Group. Hence Asthi-saṅghāta means group of bones.

Among the asthi saṅghāta, kakṣā is one which may get

injuries frequently either by trauma or accident. Hence

detail study of asthi saṅghāta of kakṣā and its applied

aspect is taken for the study.

Kakṣā

This is a ball and socket variety of joint. The ball is the

head of Humerus. The socket is glenoid cavity of Scap-

ula. On top of this ball and socket joint another bone

i.e., acromion process of scapula articulates with the

acromial end of the clavicle to form acromioclavicular

joint. Glenoid labrum keeps the shoulder in position. The

important muscles which help in the movement and sta-

bility of the joint are four muscles called Rotator cuff mus-

cles.

The ligaments of the shoulder:

The articular capsule,the coracohumeral ligament, the

glenohumeral,the transverse humeral and the glenoid la-

brum .

The muscles of the shoulder:

1. Above – Supraspinatus

2. Below – the long head of Triceps brachii

3. Front – The Subscapularis

4. Behind – The infraspinatus, teres minor.

5. With in – Tendon of long head of the Biceps brachii

6. in front behind and laterally deltoid

The arteries: Anterior and posterior humeral circumflex

arteries transverse scapular artery.

The nerve: Axillary and supra scapular

The clinical symptoms of the shoulder pathologies

1. Pain, weakness – Rotator cuff problem.

2. Popping or clicking – Rotator cuff tear, instability

3. Stiffness – Rotator cuff problem, scar tissue in frozen

shoulder, diabetic shoulder, in adhesive capsulitis

4. Looseness – shoulder instability

The disease of the Shoulder Joint

1. Rotator cuff Disease – Age group 30 and above un-

dergo this disease. It begins with simple tendonitis or bur-

sitis gradually it worsens and leads to rotator cuff tear.

Diagnostic tests –

a) X-ray with contrast dye are used to know the struc-

tural change of the joint with the help of radio-

graphic photos.

b) The photo indicates – spilling out of the dye through

the disturbed rotator cuff muscles. The gap between

the bones also found increased.

U

Mulimani & Malashri : Concept Analysis on Asthi Saṅghāta in relation to Kakṣā

AAMJ / Vol. 3 / Issue 4 / July – August 2017 1460

2. Instability

This is common in young ones. The sensation of coming

out of shoulder from the socket is called instability of

shoulder. This is also called subluxation.

Diagnostic tests –

a) X-ray – The joint space between the shoulder joint

bones will increase

3. Frozen shoulder

It is most common among people above 40 years of age.

The inflammatory condition of the joint is arthritis which

leads to frozen shoulder.

Diagnostic tests –

a) X-ray – shows scarring, thickening, shrinkage of the

capsule, reduced joint space, few osteophytes.

b) MRI scan – The tissues of the joint can be evaluated

by MRI.

Here the joint space is reduced, cartilage thickens, and

scarring and shrinkage articular capsule can be seen.

4. Shoulder bursitis

The bursae of the shoulder sometimes undergo inflamma-

tion called bursitis. This leads to frozen shoulder.

Diagnosis - The x-ray image shows the calcification of the

bursae present in the shoulder joint.

The Movements and Peculiarity of Joint:

The shoulder joint shows almost all varieties of move-

ments. They are –

Flexion, Extension, Abduction, Adduction, Circumduc-

tion and Rotation.

DISCUSSION

Asthi saṅghāta are complex joints and injuries leads to

complication during treatment. Kakṣā is the connecting

part between bahu and urah where the samūha of two

joints are taking place with a involvement of three asthi

i.e.,pragandha asthi, akshakasthi and amsaphalakasthi.

There peculiarities are:

1. The large head of humerus in comparison with depth

of glenoid cavity even when this latter is supplemented

by the "glenoid labrum"

2. The looseness of the capsule of the joint.

3. The intimate connection of the capsule with muscles

attached to the head of humerus.

4. The peculiar relation of the tendon of the long head of

the biceps brachii to the joint.

CONCLUSION

From above mentioned verses from Ayurvedic text it is

clear that Asthi Sandhi and Asthi Sanghata both are to-

tally different structure and function.

The function of each Asthi-Sanghata differs with its posi-

tion. · There are 14 Asthi-Sanghata among them kaksa is

Figure 1 Shows X-ray of Rotatorcuff

Figure 2 Shows X-ray of frozen shoul-der

Figure 3 Shows Hyperextension , Flexion and Extension

Figure 4 Shows Circumduction

Mulimani & Malashri : Concept Analysis on Asthi Saṅghāta in relation to Kakṣā

AAMJ / Vol. 3 / Issue 4 / July – August 2017 1461

one of the most vulnerable sanghata and injury may

leads to complications in the treatment.

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Source of Support: Nil.

Conflict of Interest: None declared

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How to cite this article: Mulimani & Malashri : Concept

Analysis on Asthi Saṅghāta in relation to Kakṣā. AAMJ

2017; 4:1458 – 1461.