Sushruta Samhita Sharirasthana Chapter 7 Sira Varna Vibhakti Shariram (Classification of Veins)

The 7th chapter of Sharirasthana of Sushruta Samhita is named as Sira Varna Vibhakti Shariram. This chapter deals with Classification of Veins.

अथातःसिरावर्णविभक्तिशरीरंव्याख्यास्यामः॥१॥
यथोवाचभगवान्‌धन्वन्तरिः॥२॥

 We will now expound the chapter by name Sira Varna Vibhakti Sarira- classification of veins based on their color; as revealed by the venerable Dhanvantari.

 Sira Sankhya – Pratana – number and distribution of veins

सप्तसिराशतानिभवन्ति;याभिरिदंशरीरमाराम‌इवजलहारिणीभिःकेदार‌इवच्‌कुल्याभिरुपस्निह्यतेऽनुह्यते चाकुञ्चनप्रसारणादिभिर्विशेषैः; द्रुमपत्रसेवनीनामिवतासांप्रतानाः; तासांनाभिर्मूलं, ततश्चप्रसरन्त्यूर्ध्वमधस्तिर्यकच ॥३॥

Numbers of Siras – There are in total seven hundred siras in the body.

Functions of siras –

–        They constantly nourish the body

–        They keep the body constantly lubricated and moistened so that the functions such as flexion, extension etc can be performed with utmost ease

Analogy – The siras nourish and lubricate the body in a way similar to a large field (human body in this context) being nourished by small channels of water (sira in this context).

Distribution – In the body, the siras spread out just like the ribs of the leaf.

Mula – The place of origin for all the siras in the body is nabhi – umbilicus / navel. After taking their origin from nabhi, the siras spread upwards, downwards and sideward.

Nabhimula – Umbilicus, their origin

भवतश्चात्र श्र्लोकौ-
यावत्यस्तुसिराःकायेसंभवन्तिशरीरिणाम् ॥
नाभ्यांसर्वानोबद्धास्ताःप्रतन्वतिसमन्ततः ॥४॥
नाभिस्थाःप्राणिनांप्राणाः प्राणान्नाभिर्व्युपाश्रिता॥
सिराभिरावृतानाभिश्चक्रनाभिरिवारकैः ॥५॥

Two verses here:

All Siras in the body are connected to the Nabhi – umbilicus. Taking origin from here, the siras spread out to all the places by travelling in all directions, upwards, downwards and side ward.

Prana – the vital life element resides in the siras of the nabhi and on the other hand, the nabhi is the seat of all the siras. The nabhi is surrounded by a network of siras just like the axle hole of the wheel is surrounded by the spokes.

Mula Sira Vibhijana – Branching of root veins

तासांमूलसिराश्चत्वारिंशतु; तासांवातवाहिन्योदश, पित्तवाहिन्योदश, कफवाहिन्योदश, रक्तवाहिन्यः।  तासांतुवातवाहिनीनांवातवाहिनीनांवातस्थानगतानांपञ्चसप्ततिशतंभवति, तावत्य‌एवपित्तवाहिन्यःपित्तस्थाने,कफवाहिन्यश्चकफवाहिन्यश्चकफस्थाने,रक्तवाहिन्यश्र्च यकृतत्प्लीह्रोः एवमेतानिसप्तसिराशतानि॥६॥

Among the siras, there are forty mula siras i.e. root veins.

Of these forty mula siras –

–        Ten siras carry vata

–        Ten siras carry pitta

–        Ten siras carry kapha and

–        Ten siras carry rakta

The ten Vata carrying Sira (veins) further divide into one hundred and seventy-five branches on reaching the seat of Vata.

The ten Pitta carrying Sira (veins) divide into one hundred and seventy-five branches on reaching the seat of Pitta.

The ten Kapha carrying Sira (veins) divide into one hundred and seventy-five branches on reaching the seat of Kapha.

The ten Rakta (blood) carrying Siras (veins) divide into one hundred and seventy-five branches on reaching the seat of rakta i.e. yakrt (liver) and pliha (spleen).

In total four kinds of siras finally dividing into one hundred and seventy-five branches each, together make up seven hundred numbers of siras.

Classification of Vatavaha Siras and other Siras

तत्रवातवाहिन्यःसिरा‌एकास्मिन्‌सक्थ्निपञ्चविंशतिःएतेनेतरसक्थिबाहूचव्याख्यातौ। विशेषतस्तु कोष्ठे चतुस्त्रिंशतूःतासांगुदमेढ्राश्रिताः  श्रोण्यामष्टौ,द्वे द्वे पार्श्वयोः,षट्पृष्ठे,तावत्य‌एवोदरे, दशवक्षसि। एकचत्वारिंशज्जत्रुण‌ऊर्ध्वं; तासांचतुर्दशग्रीवायां,  कर्णयोश्चतस्रः,  नवजिह्वायां,षट् नासिकायां,अष्टौ नेत्रयोः , एवमेतत्‌पञ्चसप्ततिशतंवातवाहिनीनांसिराणांव्याख्यातंभवति। एष‌एवविभागःशेषाणामपि। विशेषतस्तुपित्तवाहिन्यो नेत्रयोर्दश,कर्णयोर्द्वे;एवंरक्तवहाःकफवहाश्च।एवमेतानिसप्तसिराशतानिसविभागानि व्याख्यातानि॥७॥

Below mentioned are the divisions and distributions of Vatavaha Siras. The distribution of other Siras too should be understood in a similar way / pattern. Acharya has only described the divisions of 175 Vata carrying Siras as examples.

Division and Distribution of 175 Vatavaha Siras

Thus, one hundred and seventy-five siras which carry vata have been described with their divisions and distribution in the body.

The remaining siras carrying pitta, kapha and rakta too shall be classified in the same manner.

Changes in distribution of siras –

–        In case of Pittavaha Siras – there are ten siras in the eyes i.e. five in each eye, against 8 vatavaha siras in the eyes. Similarly, there are only 2 siras in the ears i.e. one in each ear, against 4 vatavaha siras in the ears.

–        The number of siras in case of kaphavaha and raktavaha siras as distributed in the eyes and ear are similar to pittavaha siras.

Thus, in total, seven hundred siras are described along with their divisions and distribution in the body.

 Sira karma – functions of veins

भवन्तिचात्र
क्रियाणामप्रतीघातममोहंबुद्धिकर्मणाम् ॥
करोत्यन्यान्‌गुणांश्र्चपिस्वाःसिराःपवनश्चरन् ॥८॥
यदातुकुपितोवायुःस्वाःसिराःप्रपिपद्यते ॥
तदाऽस्यविविधारोगा‌आयन्तेवातसंभवाः॥९॥
भ्राजिष्णुतामन्नरुचिमग्रिदीप्तिमरोगताम्॥
संसर्पत्‌स्वाःसिराःपित्तंकुर्याचान्यान्‌गुणानपि ॥१०॥
यदाप्रकुपितंपित्तंसेवतेस्ववहाःसिराः॥
तदऽस्यविविधारोगाजायन्तेपित्तसंभवाः ॥११॥
स्नेहमङ्गेषुसन्धीनांस्थैर्यंबलमुदीर्णताम् ॥।
करोत्यन्यान्‌गुणाश्चापिबलासःस्वाःसिराश्चरन् ॥१२॥
यदातुकुपितः श्र्लेष्मास्वाःसिराःप्रतिपद्यते॥
तदाऽस्यविविधारोगाजायन्ते श्र्लेष्मसंभवाः॥१३॥
धातूनांपूरणंवर्णंस्पर्शज्ञानमसंशयम् ॥
स्वाःसिराःसम्चरद्रक्तंकुर्याच्चान्यान्‌गुणानपि ॥१४॥
यदातुकुपितंरक्तंसेवतेस्ववहाःसिराः ॥
तदाऽस्यविविधारोगाजायन्तेरक्तसंभवाः॥१५॥

Some verses here:-

While moving in its own siras (vatavaha sira), vata enables all activities of the body to go on smoothly without any hindrance. It also enables smooth functions of the mind without causing any delusion and confusion. It also enables many other activities apart from these. But on the other hand, when the same vata gets aggravated and accumulates in its own siras i.e. vatavaha siras, many diseases of vata origin get manifested in the body.

Similarly, the pitta moving in its own siras i.e. pittavaha siras enables smooth conduction of the below mentioned functions –

–        imparts brightness of color / complexion of the skin

–        helps in taste perception

–        enables keenness of the digestive fire (keeps it activated)

–        helps keep away the diseases and in maintenance of health and enables many such activities

On the other hand, when aggravated, Pitta accumulates inits ownSirai.e. Pittavaha Siras. This leads to development of many diseases of pitta origin in the body.

Kapha too, while moving in its own siras i.e. kaphavaha siras bestows the below mentioned functions smoothly –

–        bestows lubrication of the body parts

–        provides stability and strength to the joints of the body

–        augments strength of the body and

–        enables many such beneficial activities

The same kapha when aggravated would accumulate in its own siras i.e. kaphavaha siras which would lead to manifestation of many diseases of kapha origin in the body.

Similarly, Rakta too moving in its own siras i.e. raktavaha siras helps in smooth conduction of below said functions –

–        nourishing the tissues

–        bestowing color and complexion

–        maintaining good tactile sensation and

–        many such beneficial activities

When the same rakta gets aggravated, it accumulates in its own siras i.e. raktavaha siras and this eventually leads to manifestation of many raktaja diseases in the body.

Siras carry all the doshas

नहिवातंसिराः काश्र्चन्न पित्तंकेवलंतथा॥
श्र्लेष्माणंवावहन्त्येता‌अतःसर्ववहाःस्मृताः ॥१६॥

Siras do not carry any one dosha. They do not carry vata, pitta or kapha alone. In fact, all the siras would carry all the doshas.

प्रदुष्टानां हिदोषाणांमूर्च्छितानांप्रधावताम् ॥
ध्रुवमुन्मार्गगमनमतःसर्ववहाःस्मूताः ॥१७॥

When the doshas get aggravated, they intimately get mixed with one another, circulate in the siras and would surely leave their normal seats and encroach into other routes so as to reach other seats. Therefore, the veins are considered to be sarvavaha i.e. carriers of all the doshas.

Features of different kinds of Siras

तत्रारुणावातवहाःपूर्यन्तेवायुनासिराः ॥
पित्तादुष्णाश्चनीलाश्र्च, शीतागौर्यःस्थिराःकफात् ॥
असृग्वहास्तुरोहिण्यःसिरानात्युष्णशीतलाः ॥१८॥

Avedhya Sira – veins not to be punctured

अत‌ऊर्ध्वंप्रवक्ष्यामिनविध्येद्याःसिराभिषक् ॥
वैकल्यंमरणंचापिव्यधात्तासांध्रुवंभवेत्॥१९॥
सिराशतानिचत्वारिविद्याच्छाखासुबुद्धिमान् ॥
षट्त्रिंशच्चशतं कोष्ठेचतुःषष्टं चमूर्धनि ॥२०॥
शाखासुषोडशसिराःकोष्ठे द्वात्रिंशदेव तु ॥
पञ्चाशज्जत्रुणश्र्चोर्ध्वमव्यध्याःपरिकीर्तिताः ॥२१॥

Avedhya Siras are those veins which should not be punctured while conducting siravedha – a type of raktamokshana i.e. bloodletting therapy.

Further on, those avedhya siras i.e. veins which should not be punctured by the physician shall be mentioned. If these siras are punctured, they would definitely lead to deformity or death.

Regarding the number of siras distributed in various parts of the body, the wise physician should know that there are –

–        four hundred siras in the limbs / extremities (upper and lower limbs put together)

–        one hundred and thirty-six siras in the trunk (thorax and abdomen put together)

–        one hundred and sixty-four siras in the parts above the shoulders (head and neck)

Among these seven hundred siras, the below mentioned number of siras should be considered as avedya siras i.e. veins not suitable for puncturing –

–        16 siras in the extremities

–        32 siras in the trunk and

–        50 siras above the level of shoulder i.e. in the head and neck

तत्रसिराशतमेकस्मिन्‌सक्थ्निभवति; तासांजालधरात्वेका, तिस्रश्चाभ्यन्तराः- तत्रोर्वीसंज्ञे द्वे,लोहिताक्षसंज्ञा चैका, तास्त्वव्यध्याः; एतेनेतरसक्थिबाहूचव्याख्यातौ; एवमशस्त्रकृत्याःषोडशशाखमु॥ द्वात्रिंशच्छ्रोण्यां, तासामष्टावशस्त्रकृत्याः- द्वेद्वे विटपयोः, कटीकतरुणयोश्र्चे,अष्टावष्टावेकैकास्मिन् पार्श्वे, तासामेकैकामूर्ध्वगांपरिहरेत्, पार्श्वशन्धिगतेच द्वे; चतस्त्रोविंशतिश्चपृष्ठे पृष्ठवंशमुभयत्ः, तासामूर्ध्वगामिन्यौ द्वे द्वेपरिहरेद्धहतीसिरे; तावत्य‌एवोदरे, तासांमेढ्रोपरि

रोमराजीमुभयतो द्वे द्वेपरिहरेत्; चत्वारिंशद्वक्षसि, तासांचतुर्दशाशत्रकृत्या: –

हृदये द्वे, द्वे द्वेस्तनमूले, स्तनरोहितापलापस्तम्भेषूभयतोऽष्ठौ; एवं द्वात्रिंशदशस्त्रकृत्याः पृष्ठोदरोरःसुभवन्ति । चतुःषष्ट सिराशतंजत्रुण‌ऊर्ध्वंभवति; तत्रषट्पञ्चाशच्छिरोधरायां, तासामष्टौ चतस्रश्र्चमर्मसंज्ञाःपरिहरेत्, द्वे कृकाटिकयोः द्वे विधुरयोः, एवंग्रीवायांषोडशाव्यध्याः; हन्वोरुभयतोऽष्ठावष्टौ, तासांतुसन्धिधमन्यौ द्वेद्वे परिहरेत्; षट्त्रिंशज्जिह्वायां, तासमधःषोडशाशस्त्रकृत्याः,

रसवहे द्वे, वाग्वहेच द्वे; द्विर्द्वादश नासायां, तासामौपनासिक्यश्चतस्त्रःपरिहरेत्, तासामेवचतालुन्येकांमृदावुद्देशो; अष्टत्रिंशदुभयोर्नेत्रयोः,तासामेकैकामपाड्गयोःपरिहरेत्; कर्णयोर्दश, तासांशब्दवाहिनीमैकैकांपरिहरेत्; नासानेत्रगततास्तुललाटे षष्टिः, तासांकेशन्तानुगताश्चतस्त्र, आवर्तयोरेकैका, स्थापन्यांचैकापरिहर्तव्या; शङ्खयोर्दश, तासांशङ्खसन्घिगतामेकैकांपरिहरेत्; द्वादश मूर्ध्नि, तासामुत्क्षेपयोर्द्वे परिहरेत्, सीमन्तेष्वेकैकाम्, एकामधिपताविति; एवमशस्त्रकृत्याःपञ्चाशज्जत्रण‌ऊर्ध्वमिति॥२२॥

16 Avedhya Siras in the limbs –

Total number of siras in one leg / lower limb = 100

Number of siras not to be punctured = 4

The siras not to be punctured are –

–        1 sira by name Jaladhara

–        2 siras named Urvi which are situated deep in the limb

–        1 sira named Lohitaksha

The same siras by name and number should not be punctured in the other lower limb as well as both upper limbs. Thus sixteen siras (four in each limb) in the sakhas – extremities should not be punctured or hurt / damaged by sharp instruments.

8 Avedhya Siras in the pelvis –

Total number of siras in the sroni – pelvis = 32

Number of siras not to be punctured – 8

The siras not to be punctured are –

–        2 siras – in each Vitapa (marma) = 4 siras

–        2 siras – in each Katikataruna (marma) = 4 siras

4 Avedhya Siras in the flanks –

Total number of siras in parsva i.e. flanks = 16 siras (8 siras in each parsva)

Number of siras not to be punctured = 4

The siras not to be punctured are –

–        2 siras – spreading upwards (1 on each flank)

–        2 siras – in Parsvasandhi marma (joint of the flanks) (1 in each flank)

2 Avedhya Siras in the back –

Total number of siras in Prstha – back = 24 (in both sides of the vertebral column)

Number of siras not to be punctured = 2

The siras not to be punctured –

–        2 Siras – by name Brhati, one on each side spreading upwards

4 Avedhya Siras in the abdomen –

Total number of siras in the udara – abdomen = 24

Number of siras not to be punctured = 4

The siras not to be punctured –

–        2 siras – on each side of the abdomen, situated above the penis, near the line of hairs

14 Avedhya Siras in the chest –

Total number of siras in the ura – chest = 40

Number of siras not to be punctured = 14

The siras not to be punctured –

–        2 siras – in the heart

–        2 siras – on each side in stanamula marma (base of breast) = 4

–        2 siras – on each side in stanarohita marma (nipples) = 4

–        1 sira – one on each side in apalapa marma = 2

–        1 sira – one on each side in apastambha marma = 2

Thus, the 32 siras located in the back, abdomen and chest which should not be punctured have been enumerated.

16 Avedhya Siras above the level of shoulders –

Total number of siras in jatrurdhwa pradesha – above the level of shoulders = 164,

Among them,

Total Number of Siras in the neck = 56

Number of siras not to be punctured = 16

The siras not to be punctured –

–        8 siras and 4 siras = 12 siras – known as Marmas (vital spots)

–        2 siras – in Krikatika

–        2 siras – in Vidhura

4 Avedhya Siras in the lower jaw –

Total number of siras in the hanu – lower jaw = 16 (8 on each side of the jaw)

Number of siras not to be punctured = 4

The siras not to be punctured –

–        4 siras – located in the sandhis (jaw joint) – 2 on each side

4 Avedhya Siras in the tongue –

Total number of siras in the jihva – tongue = 36

(Out of these 36) Total number of siras located below the tongue = 16

Number of siras not to be punctured = 4

The siras not to be punctured –

–        2 siras – named rasavaha siras, which carry rasa

–        2 sitas – named vakvaha, responsible for production of speech

5 Avedhya Siras in the nose –

Total number of siras in the nasa – nose = 24

Number of siras not to be punctured = 5

The siras not to be punctured –

–        4 siras–which are aupanasika i.e. near the nose or base of the nose

–        1 sira – in the soft palate

2 Avedhya Siras in the eyes –

Total number of siras in the eyes – 38 – 19 in each eye

Number of siras not to be punctured = 2

The siras not to be punctured –

–        2 siras – 1 sira in each apanga – outer canthus

2 Avedhya Siras in the ears –

Total number of siras in the ears = 10 – 2 in each ear

Number of siras not to be punctured = 2

The siras not to be punctured –

–        2 siras – named Sabdavahini Sira, one in each ear

3 Avedhya Siras in the forehead –

Total number of siras in the forehead = 60 (siras spreading to the nose and eyes = 20, nose = 4 and of the eyes = 36 = 60 siras), these siras follow the border of the hairs

Number of siras not to be punctured = 3

The siras not to be punctured –

–        2 siras – in Avarta – 1 on each side

–        1 sira – in Sthapani

2 Avedhya Siras in the temples –

Total number of siras in the Sankha – temples = 10 (5 in each temple)

Number of siras not to be punctured = 2

The siras not to be punctured –

–        2 siras – one on each side situated at the joint of Sankha

8 Avedhya Siras in the head –

Total number of siras in the head = 12

Number of siras not to be punctured = 8

The siras not to be punctured –

–        2 siras – in utkshepa – 1 on each side

–        5 siras – in Simanta – 1 in each simanta

–        1 sira – in Adhipati

Thus, the fifty siras located in the jatrurdhwa desha i.e. above the level of shoulders which should not be punctured or injured by sharp instruments are explained.

भवतिचात्र

One verse here:-

व्याप्नुवन्त्यभितोदेहंनाभितःप्रस्रुताःसिराः ॥
प्रतानाः पद्मिनीकन्दाद्विसादीनां यथाजलम॥२३॥

Analogy of spread of siras – Just like the water spreads from the rhizome of the lotus plant to its stalk etc parts of the flower, the siras taking their origin from the nabhi – navel spread out through the entire body.

इति श्रीसुश्रुतसंहितायांशारीरस्थानेसिरावर्णभक्तिशारीरंनामसप्तमोऽध्यायः॥७॥

Thus ends the seventh chapter by name Siravarana Vibhakti- in Sarira Sthana of Susruta Samhita.