Kostha & Kosthanga

Introduction :-

Before constructing a house for selves or transforming them into homes , we all should remember that we are all blessed with a beautiful home of our own immediately when the destiny plans that we are going to descend as tenants into the creation. That home is called  Physical home’.

  The human body resembles a home with bones and muscles forming the protecting walls .The interiors comprise of huge cavities which accommodate various organs designed and assigned to be located in the place alotted to them, designed to perform an assigned set of activities and comprising of ingredients and amenities to acomplish these functions.

  The large spaces (cavities or rooms) of our body which accommodate the  organs (koshtangas or ashayas) are called koshta.

    Example: Thoracic cavity is a large space which accomodates lungs   and heart,a part of food pipe etc..and doesn’t allow any other organ because the space is designed to accommodate only these set of organs.

    The abdominal cavity or cavity of our tummy gives place to digestive   organs like stomach, intestines,gall bladder,glands like liver,spleen and pancreas, urinary apparatus including kidneys and ureters etc.. The pelvic cavity  located just below the abdominl cavity accomodates urinary bldder,uterus (womb),lower part of intestinesetc. The thoracic cavity,abdominal cavity and pelvic cavity are the large spaces and accommodate the above said organs. Thus, they can be included under Kostha.

The organs located within the Kostha are called Koshtangas. They are known as Ashayas.

Definition :-

“Sthaanani aama agni pakvaanam mutrasaya rudhirasya cha Hrut unduka puphusaha cha koshta iti abhidheeyte”. Sushruta Chikitsa Sthan 2/12

    Sushruta explains Koshta  as a place or cavity  occupied by the below said organs :-

  A) Amashaya:-

  “ Aama  ana mananah amasaya”.

  The amashaya lays Urdhva (proximal) to the Pittashaya (seat  of Pitta)  above the Nabhi . It is a receptacle for all the kinds of food due to the activity of Slesma and its moistening  properties ,the food gets moist and going to be easilydigestible . According to Dalhana , the Amashaya primarily  meant for the adhisthana (seat) of all type of food. It is the place where the process of digestion occurs . According to Chakrapani, Amashaya is also known as Slesmasaya as it is the chief sthana ( place) of Slesma.

  B) Agni –Ashaya:-

  Agni-ashaya is the site of fire , through Pittasthana(place of pitta) i.e.the entire digestive tract involving the function of digestion of food  should be taken as place for Agni or fire (Agni in the body represented in the form of Pitta)i.e. stomach,small intestine,pancreas,liver,etc..,we should mainly consider Pancreas as the site of agni.

C) Pakwashaya:-

     “Tatrapi pakwashayo viseshana vatasthanam”.

       Pakwashaya is the main site of Vatasthan. It can be considered as Colon. Since movement of Vata takes place in upward and downward so it is mainly found in transverse colon. The term also includes small and large intestine put together i.e. Starting from the end part of the stomach to the anal opening.

D) Mutrashaya:-

     Organ holding urine, mainly the term Mutrashaya includes urinary bladder. It is situated between Nabhi and Prstha (back) in the region of Kati(Pelvis) and Vanksana Pradesa(Pelvic region) and it is closely related with Muska (Andakosa, Guda, Sepha). Mutrashaya is situated in Gudasthivivara Pradesa and it is closely related with the Paurusam, Vrsana (scrotum), Guda.

E) Rudhira ashaya or Rakta ashaya:-

                       “Sonitasya sthanam yakrit pleehanoh”. Su.Sutra.2/7

   Organs related to formation of rakta(blood), yakrit(liver) and Pleeha(spleen) should be considered as Rakta ashaya.

F) Hrut/Hridaya:-

  Ahar rasya yah sarah sa rasa iti uchayate. Tasya cha hridayam sthanam”. Su. Sutra. 14

    Hridaya is organ of circulation of Rasa(plasma) and Rakta(blood), Hridaya being place for Chetana(consciousness), it gets active while in wakefulness in comparison to asleep condition. It has mentioned as Adhisthana(seat) for the Manas and Buddhi by Sushruta in the context of development of various Avayava.  It is the Avayava of Urah Pradesa (Thoracic region) and situated in between the two stanya(breast) which are seen externally. It is situated in Kostha(abdomen) with relation of other Avayava like Yakrit(liver), Kloma(gall bladder), Pleeha(spleen) and Amasaya. These all are surrounds to Hridaya by keeping it in center.

G)Unduka:-

      It is an Avayava of Madhyam Anga (kostha) which has relation with mala (waste material) especially with Aharamala(stool). So, it should be situated below the Nabhi(umbilicus) and in Pakwasaya(large intestine) because Nabhi is defined as place of Agni and below this, discrimination of food starts in Pakwashaya.

  According to Dalhana’s opinion, Unduka is situated in the Pakwashaya and provides storage place for the separated mala(which was separated from the rest part). Word Unduka represents the proximal part of Guda(rectum) according to Dalhana.

H)Phupphusa:-

Udaanvayoradharah phuphusah pryochyate budhaih ” -Sharangadhar

         Phuphusa is also a Koshtanga which lies in relation to Hridaya ,as mention in Sharira sthana ,Adah(lower) and Vama(in left) to Hridaya along with Pliha,Phupphusa is placed. As per Dalhana , Phupphusa has been defined as Avayava which is attached with Hrdayanadika (attached to heart).


Analysis of Koshta explained by Sushruta :-

    When we see the koshtangas explained by sushruta ,the list of organs looks incomplete . We can justify by telling that Sushruta has intelligently given a few examples of the organs comrising of Koshta without giving an entire list of the organs. He has included Hridaya and Phupphusa i.e. lungs and heart which are the main organs occupying the uroguha(thoracic cavity).

     Sushruta has mentioned Mutrashaya as organ of pelvic cavity. If we classify the pakwashaya (large intestine) into an abdominal part and a pelvic part ,we get sigmoid colon and rectum into the pelvic cavity.

    But Sushruta mentioned Unduka or caecum separately because being the first part of large intestine and large in shape,there is very possibility for Sushruta to have taken it as a separate organ.

    Considering Unduka as a separate organ ,he would have taken the small intestine and the part of large intestine as above ileocecal junction(junction of lastpart of small intestine and first pat of large intestine )as pakwashaya.

     There is a possibility of the author clubbing certain organs and giving a broader meaning of an organ .Example there is a possibility of sushruta clubbing the oral cavity and oesophagus under te term Amashaya . Even the small intestine mght clubbed in the term Amashaya or Agnyshaya oreven Pakwashaya. Thus ,he has not skipped mentioning ‘organ representation ‘of any majorcavity(koshta). Thus Sushruta’s explaination of Koshta becomes clear and valid.

Kosthanga :-

     “ Pancha dasha koshta angaani- Naabhi cha ,hridayam cha, kloma cha , yakrit cha ,pleeha cha ,vrukka cha ,vastihi cha, pureesh aadhaaraha cha, aamaashayaha cha, pakwashayaha cha, uttaragudamm cha, adharagudam cha, kshudra antram cha,sthoola antram cha, vapaavahanam cha”.   -Ca.Sa. 7/10.

Charaka has given a big list of koshtangas:-

They are as below mentioned:-

Ashaya  Considered as

Nabhi  –    Naval region or umbilicus region

Hridaya  –    Heart

Kloma  –    Pancreas,Lungs or Trachea

Yakrit  –    Liver

Pleeha  –    Spleen

Vrukka  –    Kidneys

Vasti  –    Urinary bladder

Pureeshaadhara  –    Ceacum

Aamashaya  –    Stomach

Pakwashaya  –    Large Intestine

Uttara Guda  –    Sigmoid colon and Rectum.

Adhara Guda   –    Anal canal andAnal Opening

Kshudrantram  –    Small intestine

Sthoolantram  –    Largeintestine

Vapa vahanam  –    Peritoneum(Layers covering  and protecting         abdominal viscera).

Analysis of Koshta explained by Charaka:-

        Though there is some similarity with respect to some organs mentioned by Sushruta ,Charaka has mentioned some more organs or pats of organs which lead to confusions. Hridaya, yakrit, pliha, vasti (Mutrashaya by Sushruta), Pakwashaya ,Amashaya, Pureshadhara (unduka by Sushruta) are explained in the list of koshtangas by both Charaka and Sushruta.

The other organs mentioned by Charaka are as follows:-

  Nabhi (umbilicus) or navel region :- it cannot be considered as organ. The word Nabhi is often used interchangeably with Pitta sthana. Since we do not find the mention of Grahani(duodenum) or Agnyshaya (Pancreas) or Pittashaya (gall bladder) in the list of Koshtangas,it is wiseto includeall these organs underthe term ‘Nabhi’. Kloma is a contraversial organ .It is one of the Udakavaha Srots i.e. water balancing or carrying channels in the body.Kloma is often related to pancreas,lungs or trachea or thirst regulating centers in the brain.

Another reference from Charaka:-

  “Koshtaha punaha uchyate mhaa srotaha shareera madhyammahaa nimnam aamapakwashayaha cha iti.”                                                      –Ca.Su.11/48

              Charaka tells that Koshta is also called Maha srotas (Antaha srotas) which means the largest channel of the body. It is locatedinthe deep recess in the middle portion of the body and is comprisedof Amashaya and Pakwashaya.

According to this definition . The term Koshta comprises of Amashaya and Pakwashaya . Charaka in a latercontext (Shareera sthna, which comes after Sutra sthana in the treatise),explains Koshtangas without defining What is Koshta becausehe had already quoted it in Sutra sthana.

This also gives us an idea that according to Charaka ,Amashaya and Pakwashaya are the major components of Koshta and all other visecera surrounding them are called Koshtangas or organs in the vicinity of Koshta.

Amashaya sits in a place allotted it in for the abdominal cavity.This space or cavity is termed as Koshta for Amashaya .Similarly,the space allotted for Pakwashaya is Koshta for Pakwashaya.

If we take Amashaya as the central cavity of digestive tract (Maha Srotas) to be a cavity extending from mouth to the end part of stomach and pakwashaya comprising of the lumen within the small intestine and large intestine put together . The pakwashaya mentioned in the koshtanga list would still be intestine or the whole part of digestive tract where the food is thoroughly digested.

The confusion still doesn’t end because of  the use of anotherterm called sthoolantra which means large intestine.

Some clarifiction by different authors:-

            Bhela,the author of Bhela Samhita, who was a very contemporary of agnivesha ,who has written Charaka Smhita ,has not mentioned Pakwashaya in the list of Koshtangas. Instead of Pakwashaya ,he has mentioned an organ as Avahana.In the treatise Yagnavlkya Smriti too, we can find the word Avahana.

           Vapavahana or peritoneum is a sac covering the visceral organs, lubricating and protecting them. They also help the organs to expand and contract to the other .Peritoneum is actually not an organ but since it is large enough and covers most of the abdominal cavity and is also different from the large cavities (Koshta), Ayurvedic teachers might have seen it as organ.

Types of Kostha :-

            According to Astanga Hridaya, KOSHTA has three main categories according to  the dominance of the Dosha in the body or ayurvedic body type.

          KOSHTA Type                           Dominant Dosha

                             KRURA (Hard)                                    VataDosha

                             MRIDU (Soft)               PittaDosha

                             MADHYA (Moderate)               KaphaDosha

A)KRURA (Hard) KOSHTA:-                                                                                                                                                                            KRURA KOSHTA means Vata is more dominant in the alimentary canal,which  reduces liquid content in the stool and resulting in elimination of hard stools.It causes difficulty in elimination and may also dry the stool.LAGHU (Light) and RUKSHA (Dry) qualities of Vata reduces softness, stickiness, and oiliness of the stool. However, these qualities are also required in harmony with others for proper elimination of the fecal matter and preventing the loose stools, but in KRURA KOSHTA, these qualities are more than the usual, Which may result in:-

                   a)Difficulty in defecation

                   b)Hard and dry Stool

                   c)Constipation commonly occurs

   It is not necessary that KRURA KOSHTA causes these symptoms or problems,

but  people with it are more prone to these problems

B)MRIDU (Soft) KOSHTA:-

     MRIDU KOSHTA means Pitta is predominant in the alimentary canal, which slightly increases the liquid content due to its DRAVA (liquid) quality in the fecal matter resulting  in semi- solid discharge of fecal matter.People with MRIDU KOSHTA are more prone to following health conditions:

   a)  Loose stools or semi-solid stools

    b)  Increased frequency of defecation

   c)   Diarrhea can commonly occur

            It is not necessary that MRIDU KOSHTA causes these symptoms or

problems, but people with MRIDU KOSHTA are more prone to these problems.

C)MADHYA (Moderate) KOSHTA:-

           MADHYA KOSHTA means Kapha is more predominant in the alimentary canal resulting in passage soft and solid stool, which is desirable and ideal. The optimum level of Kapha keeps the VATA and PITTA under control and prevents loose and hard stools.When Kapha is excess in the alimentary canal, mucus content is observed in the stool.It is more common problem in people with MADHYA KOSHTA.

BENEFITS OF KNOWING KOSHTHA:-

            Sharira Rachana or Human Anatomy is the basis for any medical science.We neeed to know about the construction of human body which includes the cell,The tissues ,organs and organ systems.The knowledge of Koshta gives us a precise anatomical knowledge of the cavities of the human body and the viscera’s included them.

           The physiology related to the human body ,according to Ayurvedic basics are governed by the actions of Tridosas i,.e. Vata, Pitta ,Kapha. These three forms of energies controol the entire activities of the body in a smooth way,provided the are in a state of equilibrium.

  These 3 dosas are moving around  the entire body .Each dosha has certain tissues and ororgans as their abode.They stay in those organs and control the activities.E.g.Phuphusa,Amashaya etc are important sites of Kapha.Pakwashaya is an importnt abode and controlling centre for vayu.Nabhi,Amashaya,Agnyshaya,Hridaya etc..are the sites of Pitta.

  Many of the organs of koshta from the ashaya or residence or place ofstay for many elements. The name of the organ itself explains to relationshipwith  that elements.

  E.g. the term Amashaya means an abode for Ama or improperly processed or semi digested food.Pakwashaya is an abodeof digested food and holds it until it is converted into faces and excreted.

  Mutrashaya holds the urine until it is voided . We need to understand the anatomical and physiological relationships between these ashayas (abode)and the elements staying in them. For this the knowledge of Koshta is essential.

  Many of the organs of the koshta from the root or point of origin for srotas(channel or duct or transportation system in the body). It is said that the whole body is composed of millions of srotas.

  They cannot each and every tissue of the body and also carry on almost  all the functions of the body. They are also related to one or more of the organs forming the Koshta.

   Srotodushti or blocking or clogging  or morbility of the srotas is essential for the diseases to be formed in the body which also includes the diseases occurring in various organs forming the koshta.

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