KALA SHARIRA

                            

          The Knowledge of bodily structure is invariably essential for its benefit i.e, for keeping the body healthy. A physician unless & until knows all the intricate secrets of this body, he cannot comprehend the factors that are beneficial for this body.

          Acharya Sushruta pioneer of Rachana Shareera presented the science of Kala Shareera in the chapter “Garbhavyakarana nama shareera” under which he tried to emphasize the concept of kala along with fundamental science.

       While composing the Anatomical and Physiological Sciences Ayurvedic acharya’s thought much for the basic constituents of the body (Dhatu) and their substratum (Ashaya). While considering upon the ashaya they had also thought of the linings making internal walls of the ashaya, designating them as Kala.They presented it in a very silent way.

Definition of Kala According to different Acharya’s,

 According to Sushruta Samhita:        

      Seven kalas are appearing as structure intervening between dhatu and their seat ashayas. Among the seven kalas, fourth is Shleshmadhara-kala is very important amongst all of them which is situated in all the sandhis (joints).Thus the Shlemadhara-kala present in all sandhis facilitates their proper functioning

 According to Ashtanga Samgraha and Ashtanga Hrudaya:

         Both Acharyas given similar description  i.e  The moisture that remains inside the spaces in the dhatus (tissues) gets cooked (processed) by the heat present in them (tissues),   forms into structure similar to those found in the wood (tree) and become covered with snayu (tendenous sheath), shlesma (kapha) and jarayu (chorionic membrane). It is called as kala, because it is formed from very little quantity of rasa, and essence of dhatus (tissues).

 According to Bhavaprakasha Samhita:

 The kleda (lubricating material, moist substances) present inside the dhatu (tissue), ashaya (organ/viscera), and dhatvantara (places in between organs/tissue) which gets cooked by the dehosma (heat of the body tissues) is known as kala.

  According to Sharangadhara Samhita:   

          The moisture present in the dhatus undergo transformation by the heat of the body and forms into structure known as kala. (Lining membranes, sheaths coverings and secreting membranes).

Details of kala According to Sushruta  Samhita:

The kalas too number seven in all and are situated at the extreme borders (forming encasement and support) of different fundamental princeples (DHATUS) OF The organism.

Memorable verses- as the duramen or core of a piece of wood or stem become exposed to view by cutting in to it so the root principles of the body may be removing the successive layers or tissues of its flesh. These kalas are extensively  supplied with snayus (fibrous tissues),bathed in mucous ,and encased in a membranous covering.

branch out.

The moisture present inside the dhatu and asayas cooked by their own heat (of each dhatu and asaya) become transformed in to structures called kala,just as essence gets formed in the trees .these  are covered with sleshman (kapha),snayu(tendenous waxy material) or apara (chorion); these are seven in number .

Identification of these structures known as kala has still remained a problem. These are generally assumed to be thin membrance , responsible for certain specific functions. Their names and details as furnished in susruta samhita chapter 4 of sarirsthana is as follows –

1) Mamsadhara kala- present inside the muscles and allow the formation of net work of veins, arteries, tendons and other tubular structures.

2) Raktadhara kala – present inside the muscls and more in the liver and spleen and holding the blood inside them

3) Medodhara kala – present in abdomen and interior of the bones holding the bone marrow (red marrow in small bones and yellow marrow in big bones)

4) Sleshmadhara kala- present inside the bony joints providing lubrication for easy movement.

5)-Purisadhara kala- present inside the pakvasaya and (intestine) attends to the function of separation the waste (faecal matter) at the unduka.

6) Pittadhara kala- present inside the amasaya (stomach and duodenum) with holds the ingested food for sometimes in the amasaya and attends the cooking of food.

7) Sukradhara kala- present in the right side of the urinary bladder spoken in terms of modern anatomical knowledge, they may be identified as-

Mamsadhara kala- seath or separating membranes of individual muscles

 Raktadhara kala- heamopoitic membranes of liver and spleen.

 Medodhara kala- membrane secreting synovial fluid

Sleshmadhara kala.-is present about all the joint and it is synovial membrane

purisadhara kala- mucus membrane of the intestine attending to absorption

Pittadhara kala –mucus membrane of the stomach ,duodenum and small intestine attending to digestion of food

Sukra dhara kala- membrane inside the testis and seminal ducts,producing and transporting semen

                  Reviw of Shleshmadhara Kalasharir :

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Sushruta has mentioned 7 kalas they are called as boundaries between the Dhatus and Aashaya, named as Dhatvashayantar-Maryada. Kleda which is present in between the dhatu and aashaya metabolized under the influence of dehoshma thus it forms the kala.  

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Shleshmadhara-kala is very important amongst all of them which is situated in all the sandhis (joints).Thus the Shlemadhara-kala present in all sandhis facilitates their proper functioning.

Shleshmadhara kala:

The kala (lining) having importance in the present subject is Sleshmadhara. It is stated to be present in all joints. The shleshma contained in the sac lubricates the joint and enable them to function smoothly like a wheel which easily rotates upon a well greased axile.

Shleshaka kapha:

It is one of the components of Kapha dosha which located at Sandhies to help in their function, these components if the bony joints firmly united, protect their articulatation and oppose their separation. These functions are helped by the qualities of Kapha Dosha such as Snigdha, Shlakshna, Picchila and Mritsna.

                                Synovial membrane

                             

 synovial membrane of the knee joint lines the capsule. Except posterior where it is reflected forward by the cruciate ligaments, forming a common covering for both ligaments.

    In front, it is absent from the patella. Above the patella, it is prolonged upwords for 5 cm .or more as the suprapatellar bursa, belOw the patella, it covers the deep surface of the infrapatellar pad of fat, which separates it from the ligament patellae. A median fold, infrapatellar synovial fold, extends backwards from the pad of fat the intercondylar  fossa of the femur. an alar fold diverges on each side from the median fold to reach the lateral adages of the patella.

Unfolding suprapatellar recess.

Anteriorly, the reflection of the synovial membrane lies on the femur; located at some distance from the cartilage because of the presence of the suprapatellar bursa. Above, the reflection appears lifted from the bone by underlying periosteal connective tissue. In a standing posture, the suprapatellar bursa is seemingly redundant. It is however also referred to as the suprapatellar synovial recess as it gradually unfolds as the knee is flexed; to open up completely when the knee is flexed 130 degrees. The suprapatellar bursa is prevented from being pinched during extension by the articularis genus muscle. On the tibia, the anterior reflection and attachment of the synovial membrane is located near the cartilage.

Anteriorly, the infrapatellar fat pad is inserted below the patella and between the two membranes. It extends from the lower margin of the patella above, to the infrapatellar synovial fold below. With its free upper margin, this fold extends dorsally through the joint space to surround the two cruciate ligaments from the front, thus dividing the surrounding joint space into two chambers. Laterally of this are a pair of alar folds.

Posteriorly, the femoral attachment of the synovial membrane is located at the cartilaginous margin of the lateral and medial femoral condyles, why the joint space has two dorsal extensions. Between these, the synovial membrane passes in front of the anterior and posterior cruciate ligaments, why these ligaments are both intracapsular and extra-articular with their tibial attachment located exactly on the cartilage margin. Both the lateral and medial meniscus is, however, located within the synovial capsule

It is a thin, but strong, fibrous membrane which is strengthened in almost its entire extent by bands inseparably connected with it.

Above and in front, beneath the tendon of the Quadriceps femoris, it is represented only by the synovial membrane.

Its chief strengthening bands are derived from the fascia lata and from the tendons surrounding the joint

Synovial fluid:

        The synovial membrane secretes synovial fluid (ov = egg) which forms a thin film over the surfaces within the articular capsule. This viscous, clear or pale yellow fluid was named for its similarity in appearance and consistency to uncooked egg-white (albumin). Synovial fluid consists of hyaluronic acid, secreted by fibroblast-like cells in the synovial membrane and interstitial fluid filtered from blood plasma. Its several functions include reducing friction by

lubricating the joint and supplying nutrients to and removing metabolic wastes from the chondrocytes within articular cartilage. Synovial fluid also contains phagocytic cells that remove microbes and the debris that results from the normal wear and tear in the joint. When a synovial joint is immovable for a time, the fluid is quite viscous (gel-like) but as the joint movement increases the fluid becomes less viscous

Bursae

 Bursae of the knee joint

The numerous bursae surrounding the knee joint can be divided into the communicating and the non-cummunicating bursae:

     Communicating bursae:

   The suprapatellar bursa, the largest bursa, extends the joint space anteriorly and proximally.

  The subpopliteal recess and semimembranosus bursa are located posteriorly and are much smaller

 The lateral and medial subtendinous bursae of gastrocnemius are located at the origin of the two heads of the gastrocnemius muscle.

 Non-communicating bursae:

 The subcutaneous prepatellar bursa is located in front of the patella.

   The [deep] infrapatellar bursa is located under the patella, between the patellar ligament and the fibrous membrane of the joint capsule. It is communicating with the joint space in particular cases.

  Other less regularly present bursae include the subfascial prepatellar, the subtendinous prepatellar, and the subcutaneous prepatellar bursae.

Adding to the complex structure of the knee space, there are remnants of three embryonic septal divisions of the knee space called synovial plicae:

  The suprapatellar plica dividing the suprapatellar recess

 The infrapatellar plica, in front of the anterior cruciate ligament, reaches from the intercondylar notch to the infrapateller fat pad

 The medial patellar plica, located adjacent to the patella's medial facet, runs vertically along the medial joint capsule