HTML Full Text

Introduction

Acharya Charaka has divided Shareera into six Anga(parts) i.e. Shadanga shareer four Shakha, one adyashareera, one Shirogreeva. Kati is one part resembles like  cylindrical region present in the Antharadhi or Madhyashareera. Similarly, according to Acharya Sushruta, body is classified in to six Angas viz. 4 Shakhas, 1 Madyashareera, 1 Shirogreeva. Kati is a cylindrical region present in the Madhyashareera. According to Shabdakalpadruma - Kati is the waist region where the dress is worn.1   In Samhitas, Shroni or Kati is mentioned as a region rather than an organ. While numbering the Siraas, Acharya Vagbhata has explained 32 Siras, among the 136 Siras present in the Antaradhi, are located in Shroni. Thus to infer that Shroni is a region in the Antharadhi.2,3 Asthi forms the prominent part of any Sandhi. In Kati-Trika region 5 Asthis are mentioned to be present in Shronipradesha, 3 Sandhis present in the Kati kapala, 24 Prushtvamshaasthi sandhis are present and Trika is mentioned to have Asthi Samghata.  Five Asthis are present in Kati Pradesha including One Trika Asthi. Tarunasthis are also present in between these Asthis. Asthi is the ashraya for vatadosha, but Asthikshaya can lead to Vata vruddhi & vice versa. Kati is also mentioned as the seat for Vata dosha. Apana vata is mainly present in the Kati pradesha. 4

The body of a vertebra transmits body weight and is connected to the bodies of the adjacent upper and lower vertebrae by the intervertebral discs, which form the secondary cartilaginous joint. The body is enclosed by a shell of compact bone, except at the upper and lower surfaces where it is composed of spongy bone and is covered by a plate of hyaline cartilage. Lumbar Vertebrae are stacked to form a continuous column in order from superior to inferior. There are 5 lumbar vertebrae (denoted as L1-L5) found in adult humans, and they are situated beneath the thoracic vertebrae, being largest in size of all the vertebrae since the lumbar vertebrae must be able to support the weight of the body. The intervertebral discs connect the upper and lower surfaces of the adjacent vertebral bodies, and extend from the axis vertebra to the sacrum.5 Lumbar spondylosis can be described as all degenerative conditions affecting the discs, vertebral bodies. Spondylosis may be applied non-specifically to any and all degenerative conditions affecting the disks, vertebral bodies, or associated joints of the lumbar spine.6

Objective of the study:

1. To review the Rachana Sharir of Kati and Katikasheruka.
2. To interpret the importance of Katikasheruka on the basis its applied aspect.

METHODOLOGY:

Source of Data:

              Data collected for the conceptual study from the Brihatrayees, Laghutrayees, and other classical books including journals, presented papers, previous work done and analysed with the knowledge of contemporary science on the subject.

Review of literature :

In Samhitas, Shroni or Kati are mentioned as a region. Acharya Charaka says pramana includes Utsedha(height),Vistara (diameter, expansion), Ayaama (length), & Parinaaha (circumference) etc. According to Acharya  Charaka, Kati is 16 angula in diameter. Chakrapani comments on this quoting that the height of Katiisnot mentioned since another Sandhi is present between the heights of Uru (thigh) & Antharadhi (thorax & abdomen).7  Acharya Sushruta says, the  Pramana of Kati in males are 18 angulas in vistara (dimension)  which is equal to the vistara of Urahpradesha of females.8

Five Asthis are present in Kati Pradesha including One Trika Asthi. Tarunasthis are also present in between these Asthis. Asthi is the fifth dhatu of the body  and the  main function attributed to this dhatu is the Dharana karma. Kati-Trikaprishthavam shagataas this helps in transmitting the weight from the upper part of

the body to the lower limbs and then maintaining the erect posture of the body.

Disorders in Kati region :

Asthi is the ashraya for vatadosha, but Asthikshaya can lead to Vata vruddhi and vice versa. Kati is also mentioned as the base for Vata dosha. Apana vata is mainly present in the Kati pradesha. 9 Due to vitiated vata dosha and other reasons of posture related or trauma and other etiological factors various disorders are seen in lumbar region.

A prolapsed disc in the lumbar spine can cause radiating nerve pain. This type of pain is usually felt in the lower extremities or groin area. Radiating nerve pain caused by a prolapsed disc can also cause bowel and bladder incontinence.10  Disc herniation’s  may be result from general wear and tear, such as constant sitting or bending, driving, or a sedentary lifestyle. 11 Lumbar disc herniation’s occur in the lower back, most often between the fourth and fifth lumbar vertebral bodies or between the fifth and the sacrum. Symptoms can affect the lower back, buttocks, thigh, anal/genital region (via the perineal nerve), and may radiate into the foot and/or toe.

Lumbar spondylosis is also described as all degenerative conditions affecting the discs, vertebral bodies, and associated joints of the lumbar vertebrae. Spondylosis is not a clinical diagnosis but instead a descriptive term utilized to designate spinal problems. Patients with lumbar spondylosis also have neurologic claudication, which includes: lower back pain, leg pain, numbness when standing and walking. Lumbar spondylosis is a progressive and irreversible degenerative disorder of the lumbar vertebrae, where there will be stiffening and fixation of spine. People over the age of 40 are at the highest risk of developing symptoms of lumbar spondylosis.12

img 1. vertebra anatomy

Discussion

Definite demarcation of the Kati region is not given in Samhitas, but limitations could be inferred with the help of the surrounding structures. Upper limitation – could be taken as Nabhi Lower limitation-could be taken as the Medhra & Mushka. 13 In Most of Samhitas  it is  mentioned that  Kati as the sthana for Vata Dosha.14  Acharya Sushruta has mentioned kati is the moolasthana for Medovaha srotas.15  The kati region was explained in Charaka Siddhi Sthana, Basti chapter, while explaining the definition of the basti. It is the explanation of surface anatomy of lower abdomen.Kati is the region which is affected in many disorders such as,  Katigraha in kshataksheena and vaatajapradara, Katishula in Vaatodara, Vaatajarsha, Vaatajashula,  Kati dourbalya in Darvikara vishavega, Katibhanga in 7th Vishavega. Simlarly Kati shool also observed in  like Gridhrasi and Grahani etc.16-21 In order to get actual pathogenesis various disorder Kati and Katikasheruka  anatomical structure should be understand for better clinical aspect of management.

Conclusion

After over all observation of Anatomy and related pathology where kati and kati kasheruka involved that kati region is an area, where the five lumbar vertebrae positioned which is  the lower part of the vertebral column, in between the thoracic vertebrae and sacrum. The first lumbar vertebra articulates with the twelfth thoracic vertebra superiorly and the fifth lumbar vertebra articulates with the sacrum to form the lumbosacral joint.  So, the region of lumbar vertebrae may be considered as the region of kati. So by understanding its Ayurveda concept and modern corelation it will be  very beneficial while treating the disorder related to kati  or katikasheruka clinically.