Pramana unni-sr

A COMPREHENSIVE STUDY OF PRAMANA SHAREERA

WITH SPECIAL REFERENCE TO ANGULI PRAMANA OF

BAHYA KARNA-SHAREERA

DISSERTATION SUBMITTED TO THE

RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES, KARNATAKA, BANGALORE

IN PARTIAL FULFILMENT OF THE REQUIREMENTS FOR THE AWARD OF THE DEGREE OF

AYURVEDA VACHASPATI (M.D) IN

RACHANA SHAREERA

By

Dr. VIVEK UNNI.K.K

Under the Guidance of

Dr. B. N Mishra M.D (Ayu)

Professor

DEPARTMENT OF POST GRADUATE STUDIES

IN RACHANA SHAREERA

ALVA’S AYURVEDA MEDICAL COLLEGE MOODBIDRI ‐ 574227

2010

ALVA’S AYURVEDA MEDICAL COLLEGE

DEPARTMENT OF POST GRADUATE STUDIES IN RACHANA SHAREERA MOODBIDRI, KARNATAKA

DECLARATION

I hereby declare that this dissertation entitled “A Comprehensive

Study of Pramana Shareera With Special Reference to Anguli Pramana

of Bahya KarnaShareera” is a bona‐fide and genuine research work

carried out by me under the guidance of Dr. B. N Mishra M.D (Ayu) Dept. of

P.G Studies in Rachana Shareera, Alva’s Ayurveda Medical College

Moodbidri.

Dr.VivekUnni. K.K

III Year P.G.Scholar

Dept. of RACHANA SHAREERA

dical College Alva’s Ayurveda Me

Moodbidri 574227

DP

ate: lace: Moodbidri


DEPARTMENT OF POST GRADUATE STUDIES IN RACHANA SHAREERA MOODBIDRI, KARNATAKA.

CERTIFICATE

This is to certify that the dissertation entitled “A Comprehensive Study

Of Pramana Shareera With Special Reference To Anguli Pramana Of

Bahya KarnaShareera” submitted by Dr.VivekUnni. K.K in partial

fulfilment for the degree of Ayurveda Vachaspathi (M.D) in Rachana

Shareera, of Rajiv Gandhi University of Health Sciences, Bangalore, is a

record of research work done by him during the period of his study in this

institute, under my guidance and supervision and the dissertation has not

previously formed the basis to the award of any degree, diploma, fellowship

or other similar titles.

I recommend this dissertation for the above degree to the University for

the approval.

Guide

Dr. B. N Mishra M.D (Ayu) Professor

s in Rachana Shareera edical College

Dept. of P.G StudieAlva’s Ayurveda Modbidri ‐ 574227

Date: MoPlace: Moodbidri


DEPARTMENT OF POST GRADUATE STUDIES IN RACHANA SHAREERA

MOODBIDRI, KARNATAKA.

CERTIFICATE

This is to certify that the dissertation entitled “A Comprehensive Study Of

Pramana Shareera With Special Reference To Anguli Pramana Of Bahya

KarnaShareera” is a bona‐fide research work done by Dr. VivekUnni. K.K

under the guidance of Dr. B. N Mishra M.D (Ayu), Dept. of P.G Studies in

Rachana Shareera, for partial fulfilment of the requirement for the award

of the degree in Ayurveda Vachaspathi(M.D) in Rachana Shareera, of Rajiv

Gandhi University of Health Sciences, Karnataka Bangalore.

DP

ate: lace: Moodbidri

DR. RAMA BHAT. K. M. M.D (Ayu)

areera, Professor and H.O.D.,

in Rachana Shdical College

Dept. of P.G StudiesAlva’s Ayurveda MeMoodbidri 574227


DEPARTMENT OF POST GRADUATE STUDIES IN RACHANA SHAREERA

MOODBIDRI, KARNATAKA.

ENDORSEMENT

This is to certify that the dissertation entitled “A Comprehensive Study Of

Pramana Shareera With Special Reference To Anguli Pramana Of Bahya

KarnaShareera” is a bona‐fide research work done by Dr. VivekUnni. K.K

under the guidance of Dr. B. N Mishra M.D (Ayu),Dept. of P.G Studies in

Rachana Shareera, for partial fulfilment of the requirement for the award

of the degree in Ayurveda Vachaspathi(M.D) in Rachana Shareera, of Rajiv

andhi University of Health Sciences, Karnataka Bangalore. G

PRINCIPALAlva’s Ayurveda Medical College

Moodbidri 574227

Date: Place: Moodbidri

COPYRIGHT

I hereby declare that the Rajiv Gandhi University of Health Sciences,

Karnataka shall have the rights to preserve, use and disseminate this

issertation in print or electronic format for academic/research purpose. d

Date: Place: Moodbidri

© Rajiv Gandhi University of Health Sciences, Karnataka

Dr. VivekUnni.K.K

Dept. o a III Year P.G.Scholar

f P.G. Studies in hareerAlva’s Ayurveda Medical College

Rachana s

Moodbidri 574227

ACKNOWLEDGEMENT

First of all I would like to dedicate this work to my parents. My mother, Dr. T.V.

Aysha, who knows me better than myself, inspired to be a better person. My

father, K.R.Kalesan, who is my role model, guided me well to stay focused and

chieve my goals. a

I express my deepest feeling of veneration towards my beloved teacher & guide, Dr.

B N Mishra, Professor, Dept. of Shareera Rachana whose heartening inspiration,

relentless guidance heightened me to contrive this obscure task. Besides this, his

piquant affluence always provided me enough courage to cop up with each & every

task.

I express my heartfelt respect and gratitude to my honorable teacher, Dr. G. M. Kanti

whose masterly suggestions & ablest guidance at every step which has molded,

shaped, and enlightened my petite work into accomplishment.

I am highly grateful to Dr. Rama Bhat. M.D (AYU). Professor and Head of dept. P.G.

Studies in Shareera Rachana, Alva’s Ayurveda Medical College, Moodbidri, for his

kind support, suggestions and valuable guidance which helped me in completing

his work . t

It is my duty to thank Dr. Mohan Alva, Chairman, Alva’s Educational

Foundation, for providing me an opportunity in his institution for Post Graduate

Studies.

I am indebted to express my thanks to Dr. K L Upadhya, Former Principal Alva’s

Ayurveda Medical College and Dr. Suresh Negalguli, Former Dean for Post

Graduate faculty and Dr. Vinaya Chandra Shetty, of Alva’s Ayuveda Medical

College for their encouragement and support.

It is my privilege to articulate my heartfelt thanks to Dr.Mohan Kumar, former Prof.

Dept of ShalyaTantra, whose optimistic views, magnanimous nature, always put

veheme e to overcome the obstacles. nce in m

I solely thank my senior Dr.Arun.S.Kumar, for his valuable suggestions and

support.

I express my thanks to my classmates Dr.Bini, Dr.Gisha and Dr.Sreekumar for

their timely help and immense support during my study. I am really thankful to

Dr.Deepak.D, Dr. ArunBhaskaran, Dr. Anuprabha, Dr. Benoy and

r.MadanKumar.M.K for their support. D

I express my thanks to my juniors Dr. Binu Balachandran and

r.Krishnanad.C for his timely help and immense support during my study. D

I wish to express my deep sense of gratitude to my wife Dr.Deepthi and my

daughter Devika, for her love and affections. Nothing can ever absolve me of my

ndebtedness to her sacrifices. i

I would like to express my thanks to the Librarian & Staff for providing me with

ecessary books during the study. n

In addition there are numerous people who have helped me during the course of

this study, either directly or indirectly. My profound gratitude goes to all those

onderful people too. w

e had showered on me. Above all I thank the Almighty for the blessings, h

Dr. VivekUnni.K.K

Date:

Place: Moodbidri

List of Abbreviations

A.H. : Ashtanga Hrudaya

A.H.Sa. : Ashtanga Hrudaya Shareera Sthana

A.H.U : Ashtanga Hrudaya Uthara Sthana

A.H.Chi : Ashtanga Hrudaya Chikitsa Sthana

A.S. : Ashtanga Sangraha

A.S.Sa : Ashtanga Sangraha Shareera Sthana

A.S.U : Ashtanga Sangraha Uthara Sthana

B. L. : Bhela Samhita

C.S. : Charaka Samhita

C. Chi. : Charaka Samhita Chikitsa Sthana

C. I. : Charaka Samhita Indriya Sthana

C. Sa : Charaka Samhita Shareera Sthana

Ka.S.Sa. : Kasyapa Samhita Shareera Sthana

Ka.S.Su : Kasyapa Samhita Sutra Sthanas

S.K.D. : Shabda Kalpa Druma

Sha.S : Sharangadhara Samhita

Su.Su : Susruta Samhita Sutra Sthana

Su. Sa : Susruta Samhita Shareera Sthana

Su. Chi. : Susruta Chikitsa Sthana

ABSTRACT

Anguli Pramana demeanor of anatomical connotation is one of the imperative concepts in

Ayurveda. It elaborates ample references from the samhitas narrating that pramana

shareera has a foremost position in the fortitude of life span of an individual. It is attired

that a person having appropriate measurements will attain long life.

In the concept of Ayurveda, Karna(s) is an important organ among the

panchagyanendriyas. Its shape and size are variable depending on the ages, sex, height,

and geographical phase too. The external ear’s shape and size are also an important

parameter for one person’s aesthetic build. The outer ear is the most external portion of

the ear. The external ear includes the pinna (also called auricle), the ear canal, and the

very most superficial layer of the ear drum (also called the tympanic membrane). In

humans, and almost all vertebrates, the only visible portion of the ear is the outer ear.

Although literary the word "ear" may properly refer to the pinna (the flesh covered

cartilage appendage on either side of the head), this portion of the ear is not vital for

hearing but helps direct sound through the ear canal to the tympanic membrane

(eardrum).

The framework of the auricle consists of a single piece of yellow fibro-cartilage with a

complicated relief on the anterior, concave side and a fairly smooth configuration on the

posterior, convex side.

Though Acharya Susruta noted anguli pramana of karna as 4 angula and that of karna

mula as 2-angula, but In Ayurveda detailed description of the anguli pramana of karna is

not adequately described.

Hence the present study is undertaken to add some input and to have ready description of

the anthropometric (so called anguli pramana) measurement of the external anatomical

structure of the karna by following the anguli pramana concept.

LIST OF CONTENTS

Sl. No. Contents Page No.

1. Introduction 1 – 5

2. Objective 6

3. Review of literatures 7 – 56

4. Materials and Methods 57 – 61

5. Observations and Result 62 – 97

6. Discussion 98 – 107

7. Conclusion 108 – 111

8. Summary 112 – 114

9. Referred Shlokas 115 – 119

10. Bibliography 120 – 136

11. Annexure

a. Proforma

b. Master Chart

c. Measurement Chart

137 – 138

139 – 140

141 - 149

LIST OF GRAPH

Table

no.

Description Page no.

1. Breadth of proximal interphalangeal joint of right middle finger 62

2. Breadth of metacarpophalangeal joint of right hand 63

3. Length of right middle finger 64

4. Length of right ear measured with the help of

Proximal interphalangeal joint of right middle finger in anguli

65


Breadth of right metacarpaophalangeal joint in anguli

66


Length of right middle finger in anguli

67

7. Width of right ear measured with the help of


68



69



70

10. Circumference of right ear measured with the help of


71


Breadth of right metacarpophalangeal joint in anguli

72



73

13. Root anterior of right ear measured with the help of Breadth of right

interphalangeal joint of right middle finger in anguli

74

14. Root anterior of right ear measured with the help of


75



76

16. Root posterior of right ear measured with the help of


77



78



79

19. Breadth of proximal interphalangeal joint of left middle finger

in cm.

80

20. Breadth of metacarpophalangeal joint of left hand in cm. 81

21. Length of left middle finger in cm. 82


Proximal interphalangeal joint of left middle finger in anguli

83


Breadth of left metacarpophalangeal joint in anguli

84


Length of left middle finger in anguli

85



86

Width of right ear measured with the help of 26.


87



88



89



90


Length left middle finger in anguli

91



92



93



94



95

35. Root posterior of right ear measured with the help of 96




97

LIST OF TABLES

Table

no.

Description Page no.

1. Breadth of proximal interphalangeal joint of right middle finger 62

2. Breadth of metacarpophalangeal joint of right hand 63

3. Length of right middle finger 64



65


Breadth of right metacarpaophalangeal joint in anguli

66



67



68



69



70



71



72



73

13. Root anterior of right ear measured with the help of Breadth of right

interphalangeal joint of right middle finger in anguli

74



75



76



77



78


Legth of right middle finger in anguli

79

19. Breadth of proximal interphalangeal joint of left middle finger

in cm.

80

20. Breadth of metacarpophalangeal joint of left hand in cm. 81

21. Length of left middle finger in cm. 82



83



84



85



86



87


Legnth of left middle finger in anguli

88



89



90


Length left middle finger in anguli

91



92



93



94



95



96



97

LIST OF PICTURES

Picture No Description Page No

Picture No I Embryology of Ear 53

Picture No II External Ear 54

Picture No III External Acoustic Meatus 55

Picture No IV Middle & Inner Ear 56

Picture V Screw Gauge 61

Picture VI VernierCalipers 61

Introduction

1.0 INTRODUCTION

Concept of Pramana is included in Shareera for understanding the physical built and

mental constitution. Pramana shareera, requires immense perceptive of measurement of

various body part, and in many instances explains the quality of life. Ample references

from classics explain that Pramana shareera can play a major role in determination of

life span of a person1. It described that the person having appropriate measurement may

attain a long span of life. Out of the Pramanas described in the classics, Anguli pramana

bears the prime important. Anguli pramana is a salutary anthropometric concept as

described in Ayurveda, where Anguli is the unit of measurement of a body part and

structure2.

Pramana shareera can be correlated with physical anthropology, popularly known as

anthropometry that describes measurement of ideal height and age. Whereas in Ayurveda,

Pramana shareera in addition to above concept, also correlates the measurements of

various body parts with life span, and health status of an individual3.

Acharya Charaka had included Pramana among tenfold of examine that guides to assess

the physical and mental built of an individual4.

The concept of Pramana shareera refers the ways of meaning to attain knowledge5. It

explains the processes of measurement of various human body parts6 and marks the sign

for longevity of an individual and mimics the qualities of Dirghayou, for longer healthy

life span.

A Comprehensive Study of PramanaShareera with Special Reference to AnguliPramanof BahyaKarna-Shareera

1

Introduction

Acharya Charaka and Sushruta explained about Swaanguli pramana for evaluating the

extremities and other physical constitution by using own finger as the measuring utility7,2.

Various conceptual terms like Ayama, Vistara and Parinama are described under the

sphere of Swaanguli pramana8. For examination of Ayu, Anguli pramana is one of the

prime criteria of the measurement, from which we can measure and understand the

quality and span of the life1. It is noted that Ayu will be more or less based on the various

measurement of the body parts. The Swaanguli pramana is considered by accepting the

finger breadth of an individual as the unit of measurement.

The visible part of the human ear is a rather modest concern. During the course of

evolution, it has lost its long pointed tip and its mobility like the ear as visible in animals.

In today’s era, the ear is fine; the sensitive edges have been evaluated, with ‘rolled rim’ . 9

The main function of the external ear remains that of a sound gatherer- flesh- and blood

ear trumpet. We may not be able to prick our ears like other animals, or twist and turn

them when seeking the direction of a sudden noise, but we are still capable of detecting

the source of a sound. During the evolution of ear in human, what we have lost in ear

mobility, have made up for with head mobility. When a deer or an antelope hears an

alarming sound, it raises its head and twists its ears in various directions, but when we

hear such a sound, we turn our heads and it works almost as well .10

The shape of our external ear is important in delivering undistorted sound to our

eardrums. A minor function of our ear is temperature control. Elephants flap their huge


2

Introduction

ears when they are overheated and this helps to cool the animal down. There is a

profusion of blood vessels near the surface of the skin and heat loss through this route can

be important to many of the species. For us it may only play a trivial role in thermo

regulation, but it has become a social signal. When someone overheats in a moment of

emotional conflict, their ears may go bright red. This ear blushing has been the subject of

comment since ancient times . 11

Finally, our ear appears to have acquired a new erotic function with the development of

soft fleshy lobes. These are absent in our nearest relatives and appear to be a uniquely

human feature, evolved as part of our increased sexuality. Early anatomists dismissed

them as functionless: ‘a new feature which apparently serves no useful purpose, unless it

is pierced for the carrying of ornaments’; but recent observations of sexual behavior have

revealed that during intense arousal, the earlobes become swollen and engorged with

blood. This makes them unusually sensitive to touch. In rare instances, according to

Kinsey and his colleagues at the institute for sex research in Indiana, ‘a female or male

reach orgasm as a result of stimulation of the ear’ .12

At the centre of the external ear is the ‘ear hole’ which leads to a narrow canal about an

inch long. The canal twists slightly, giving it a design that helps to keep the air inside it

warm. This warmth is important for the proper functioning of the eardrum at its inner

end. The eardrum itself is an extremely delicate organ, and the canal not only keeps it

snugly warm but also protects it from physical damage. Evolution has provided the


3

Introduction

answer in the shape of hair to keep out larger insects, and ear-wax to defeat smaller

creatures .13

Briefly, the sound vibrations which strike the eardrum are converted into nervous

impulses for transmission of the brain. The eardrum is incredibly sensitive, capable of

detecting a vibration so faint that it only displaces the surface of the drum a thousand-

millionth of a centimetre. This displacement is then transmitted through three ear ossicles

in the middle ear, which amplify the pressure twenty-two times. The enhanced signal is

then passed on to the inner ear. Vibration is enhanced that impinges on hair-like nerve

cells. There are thousands of these nerve cells – each one tuned to a particular vibration –

and they send their messages to the brain via the auditory nerve .14

The inner ear also contains vital organs of balance, three semicircular canals. The

importance of these organs grew dramatically when our ancestors first stood up on their

hind legs and adopted bipedal locomotion. An animal standing on four legs is reasonably

stable, but vertical living creates an almost non-stop demand for subtle balancing

adjustments .15

One of the sad aspects of our sense of hearing is that it starts to go into decline as soon as

we are born. The human infant can detect sound wave frequencies from 16 cycles a

second up to 30,000. At adolescence, the upper limit has already dropped to 20,000

cycles a second. By the age of sixty this has declined to about 12,000 and the upper pitch

that we can detect continues to fall further and further as we become more elderly .16


4

Introduction

It has long been argued that it is possible to identify every individual by his or her ear

shape. In the last century it was suggested that this feature could be used to detect

criminals, but another method, finger-printing won the day and ear- typing was forgotten.

It remains true, however, that it is impossible to find two people with precisely the same

ear details .17


5

Objectives

2.0 OBJECTIVE OF THE STUDY

1. To measure the variable measurement of anatomical descriptions of Bahya-

karna by using of the fundamentals of Anguli pramana in healthy volunteers.

2. To correlate of the justification narrated by different Acharyas.

3. To evaluate the relevance of Pramana shareera from ancient literature in

context with modern anthropometry.

2.1 Previous Work Done –

Mishra P C- A study of Dehika Prakrutis w.s.r. to Anguli Pramana. Lucknow

State Ayurvedic College, University of Lucknow-1983.

Manakar Atul S- A study of Suthra given by Acharaya Sushrutha about Anguli

pramana. B .V Ayurveda College Pune, Pune University-2002.

Viswanath.K.Channappanavar-Concept of Pramana Shareera w.s.r. to

determination of the stature from Prabahu (brachium) under taken at S D M

College of Ayurveda, Udupi, R G U H S, Bangalore 2006.

Shyny Thankachan- Comparative study of Anguli pramana & Prakruti w.s.r.

to Bahu, S D M College of Ayurveda, Udupi, R G U H S, Bangalore 2009

A Comprehensive Study of Pramana Shareera with Special Reference to Anguli Praman of Bahya Karna-Shareera 6

Literature Evaluation

3.0 LITERATURE EVALUATION

Literature evaluation also known as literature review includes the extensive study of

current and relevant references with consistent and appropriate explanation.

Proper use of terminology and comprehensive study of various researches and analysis of

the easement are noted criteria for literature review. The measuring of literature review is

to present and explain up to date knowledge with current literature and justification for

feature result in the particular area.

Pramana refers to the various means of gaining knowledge. Pramana is that which

provides us with knowledge5. It specifically destined to the measurements of human body

that express quantitatively its dimensions6. Pramana is one among the ten folds of

examination of a patient explained by Charaka4. It marks its significance in the fact that it

helps to unearth the Ayu, viz. longevity of an individual. A person having appropriate

Pramana of Anga-prathyanga’s is considered to have Dirghayou.

In the era of Susrutacharya and Charakacharya Swaanguli Pramana is used for estimating

the Anga-pratyanga and other body constituents7, 3. Ayama, Vistara and Parinama etc are

measured by the exploit of Swaanguli Pramana where as other body constituents

including the fluid are considered by applying the knowledge of Swa-anjali Pramana8.

A Comprehensive Study of Pramana Shareera with Special Reference to Anguli Pramana of Bahya Karna-Shareera

7


According to Susrutacharya before starting a treatment for an Atura, physician has to

examine many things including Ritu, Agni, Vaya, Deha, Bala, Satva, Satmya, Prakruti,

Bheshaja and Desha18. For the examination of Ayu, Anguli Pramana is one of the

criteria1. Here Pramana of Anga-pratyanga has to be taken, the individuals with

appropriate Anguli-Pramana have Dirghayou, and Ayu will be more or less if there is

difference of Pramana3.

Pramana is one among the ten folds of examinations of a patient explained by

Charakacharya. That is the patient has to be examined with reference to the measurement

of his Anga-Pratyanga. This is resolute by measuring the height, length & breadth of the

Anga-Pratyanga by taking the finger breadth of the individual as the unit measurement7.

Technical terms used in the context

Anguli

It is the distal and movable part of the upper limb & lower limb; they are of twenty in

number & of five types19.

a) Angushta

b) Tarjani/ Pradeshini

c) Madhyamanguli

d) Anamika

e) Kanishta


8


Pramana

It is the parameter or tool used through which valid knowledge is obtained4.

Anguli pramana: is a relative unit to denote length, breadth and circumference.

Angula can be taken as;

1) Width of the madhyama parva of the madhyama angula20.

2) Measurement obtained by taking the length of the madhyama angula and dividing it by

five21.

3) Measurement obtained by taking the width of the palm and then dividing by Four22.

4) Nakhatalabhaga of angushtha23.

3.1 Synonyms

The Karna is also known by other names as Sabdhagraha, Sruth, and Sravana.24

“Sravana- Sruyathe anena ithi sravana” that means the organ which is engaged in

perception of the sound is sravana, or known as Karna . 25

3.2 Chronological review

9

Since time immemorial, a general inquiry regarding Pramanas was in prevalence which

can be traced even up to pre historic era. This is evident from its notion in the earliest

literature i.e. Vedas and the oldest medical texts.



The chronological review may be noted as below –

Karna is considered as Gyanendriya that is helpful us to listen to the sound of various

intensities. Even for the diagnosis of diseases a physician has to depend on

Panchendriyas and Prasna .26

3.2.1 Description in Samhita period:

3.2.1.1 Sushruta Samhita

In Susrutha samhita, Karna is described as one among the Pratyangas . Sukra and

Sronita present in the Garbhasaya combined with Atma, Prakrti and Vikara is known as

Garbha. Vayu mahabhuta divides this mass possessing Chetana; Tejas mahabhuta cooks

it; Aap mahabhuta moistens it; Prithvi mahabhuta hardens it, and Akasa mahabhuta

enlarges it. Developed in this manner, when it becomes endowed with hands, feet,

tongue, nose ear, buttocks etc, we call the same as Sarira .

27

28

Acharya Sushruta, described that:

1. Karna is one among the Srotas29

2. Karna is made of one Asthi and two Sandhi . 30 31

3. Asthi in Karna is of taruna type and type of Sandhi in Karna is Sankhavartha .32, 33

4. Two Mamsa pehsi are present in Karna .34


10


5. Sabda vahini sira, one of the ten Siras as described, should not be incised as these

any incision may lead to hearing loss .35

Acharya Sushruta advises to practice Karna sandhi bandhana in Mrudu mamsa,

fabricating the ear, joining the severed ear and bandaging by using soft skin, muscles and

hollow stalk of lily plant . 36

Acahrya Sushruta also described that “Svastika” is the type of Bandhana mentioned for

Karna . 37

Acahrya Sushruta described that “Aharya” is the method used for removing Karna

mala . 38

He also described the methodology of ear-piercing, known classically as ‘Karna

vyadhana vidhi’. This methodology is aimed to protect the child for protection and bears

the cosmetic approach. The usual time for Karna vyadhana is sixth or seventh month on

full moon day (Shukla pakhsa) on any auspicious day. In male child, the right side ear has

to be pierced, in Daivakrita chhidra .Improper ear-piercing can lead harm to kalika sira

resulting fever, burning, swelling, pain; harm to Marmarika sira resulting pain, fever,

swelling in the vessels; and harm to Lohitika sira resulting in Manyastambha, Apatanaka,

Sirograha, Karnasoola .

39

40

11

Repair of Karna is bears the moral significance in all the surgical process. Fifteen types

of procedures are explained for repairing the injured earlobe . The ear lobule injury is

repaired by taking skin from the surrounding neck region . Mismanage in repair or

41

42



bandaging can result in complications like Paripatika, Karnapati upadrava (Utpataka,

Utputaka, Avamantha, Granthika, Jambala, Kanduka, Sravi, and Syava) .43

Twenty-eight types of karna vyadhis are described by Acharya Sushruta Susrutha such as

Karnasula, Karnapranada, Badhirya, Karnaksweda, Karnasrava, Karnakandu,

Karnagutha, Karnapratinaha, Krimikarna, Karnavidradhi (Kshataabhighataga and

Doshja), Karnapaka, Putikarna, Karnaarsa (Vataja, Pittaja, Kaphaja and Sannipadaja),

Karnaarbutha (Vataja, Pittaja, Kaphaja, Sannipadaja, Raktaja, Mamsaja and Medhaja)

and Karnasopha (Vataja, Pittaja, Kaphaja and Sannipadaja) . 44

3.2.1.2 Charaka Samhita:

Acharya Charaka noted about five attributes for Panchamahabhuta are Sabha, Sparsha,

Rupa, Rasa and Gandha . 45

Acharya Charaka said that Sabdha, Srothra, Laghava, Soushmya are derived from

Akasha mahabutha .46

Acharya Charaka said that Karna is one of the Panchendriyaadishatana and Sabda is the

Panchendriabudhi . He describes the number of Karna and Karnaputraka are of two

in number . The Sabda, and Sabendriya are of Akasha predomient .

47, 48

49 50

3.2.1.3 Kashyapa Samhita

Acahrya Kashyapa described about the diagnostic process for various disorders of Karna

even in the children that signifies the importance of the Karna. As per him one should


12


doubt for the pain in the ear when child touches ear with both hands, roll head too much,

has dullness, anorexia and insomnia . 51

Acharya Kashyapa also described about the measures to increase ear lobe, which

signifies the cosmetic importance of Karna . He emphasized the importance of expert

for ear-piercing. He described the quality of the physician for earlobe piercing and

cautioned to keep away from the unskilled person for ear lobe piercing as wrongful

process can create permanent deformity or can harm to the ear. He explained that

52

quack

should not pierce the ear of children of royal families or other great person . The

physician should know where, how and when to pierce, and what is beneficial, non-

beneficial & its complication the ear lobe. This signifies the importance of anatomical

knowledge of Karna in those days .

53, 54

55, 56

3.2.1.4 Vagabhatta Samhita

Even piercing of ear is prescribed as one of the importance Samskara . Protection from

demons is one of the major indications for this Sanskara. It is also believed that piercing

of Karna increase the immunity.

57

He described the development of all Angas in fourth month of the gestational period ,

and Karna may be counted as one of the major Anga. Fleshly and adherent ear indicate of

long span of life .

59

60


13


Karnapurana, a process is mentioned where ear is to be filled with medicated oily

simultaneously massaging the root of ear and is to be retained till the pain subsides, in a

healthy person . 61

Acharya Vagabhatta described three Marmas related to Karna, and those are:

1. Vidhuramarma: It is situated below the Karna and injury to this causes loss of

hearing .62

2. Shankamarma: It is situated between ear and end of the eye brow and injury to

this marma cause immediate death .63

3. Srinkadakamarma: It is situated at the congregation of orifices of mouth, ear, nose

and eyes . 64

Karna is site in which Abhyanga should be performed particularly . Snana [bath] is

contra indicated for person affected by ear diseases .

65

66

He described that swelling in the Karna-mula occurs in Sannipathajwara .67

Acharya described about Karnavedha (puncturing the ear lobe). It should be preferably

completed done in Daivakritachidra to avoid injury to Sira in either sixth, seventh and

eighth month of the baby .68

14

Acharya described about the diseases, and their etiology of the ear .69 Acahrya described

the various types of diseases of Karna like Vatajakarnasula, Pittajakarnasula,

KaphajakarnaSula, Raktajakarnasula, Sannipatajakarnasula, Karnanada, Krichrachuthi,



Pratinaha, Kandushopha, Poothikarna, Krimikarna, Kuchikarna, Karnapippali,

Karnavidarika, Palishosha, Tantrika, Paripod, Ulpata, Umanunmantho/gallira,

Dhukhavardhana and Lihyapidaka. He also described about the treatment from various

Karnavyadhis.

3.3 Concept of Anthropometry

Anthropometry is a Greek word literally means "measurement of humans". In physical

anthropology it refers to the measurement of living human individuals for the purposes of

understanding human physical variations70.

It is a series of systematized measuring techniques that express quantitatively the

dimensions of the human body and skeleton. Anthropometry is often viewed as a

traditional and perhaps the basic tool of biological anthropology, but it has a long

tradition of use in forensic sciences and it is finding increased use in medical sciences

especially in the discipline of forensic medicine71.

By this, we can obtain measurement of the human body in terms of the dimensions of

bone, muscle, and adipose (fat) tissue. Measures of subcutaneous adipose tissue are

important because individuals with large values are reported to be at increased risks for

hypertension, adult-onset diabetes mellitus, cardiovascular disease, gallstones, arthritis,

and other disease, and forms of cancer72.

15

In the 19th and early 20th centuries, anthropometry was a pseudoscience used mainly to

classify potential criminals by facial characteristics. It is also called Bertillan system. For


http://en.wikipedia.org/wiki/Physical_anthropology

http://en.wikipedia.org/wiki/Physical_anthropology


example, Cesare Lombroso's criminal anthropology (1895) claimed that murderers have

prominent jaws and pickpockets have long hands and scanty beards. The work of Eugene

Vidocq, which identifies criminals by facial characteristics, is still used nearly a century

after its introduction in France. The most infamous use of Anthropometry was by the

Nazis, who’s Bureau for Enlightenment on Population Policy and Racial Welfare

recommended the classification of Aryans and non-Aryans on the basis of measurements

of the skull and other physical features. Craniometric certification was required by law.

The Nazis set up certification institutes to further their racial policies. Not measuring up

meant denial of permission to marry or work, and for many it meant the death camps. It

was applicable only to the adult since it was based on the principal that after 21 years of

age, no changes occurs in the dimensions of the skeleton & that the ratio in the size of the

different parts to one another varies considerable in different individuals73.

Today, Anthropometry plays an important role in industrial design, clothing design,

ergonomics, and architecture, where statistical data about the distribution of body

dimensions in the population are used to optimize products. Changes in life styles,

nutrition and ethnic composition of populations lead to changes in the distribution of

body dimensions (e.g., the obesity epidemic) 70.

Anthropometry can be subdivided into somatometry including cephalometry and

osteometry including craniometry74.


16

http://en.wikipedia.org/wiki/Industrial_design

http://en.wikipedia.org/wiki/Clothing

http://en.wikipedia.org/wiki/Ergonomics

http://en.wikipedia.org/wiki/Architecture

http://en.wikipedia.org/wiki/Obesity


Somatometry75: It is the measurement of the living body and cadaver including head and

face. Somatometry is useful in the study of the estimation of stature from different body

segments age, sex, ethnic group, geographic location, etc.

Osteometry76: It includes the measurements of the skeleton and its parts i.e. the

measurements of the bones including skull.

3.4Utility of anthropometry

Forensic anthropometry incorporates most of the techniques originating with the

analysis of human skeletal material from Archaeological sites;

Applicable to evolutionary interpretation.

Applicable to clinical evaluation.

Useful in industrial design.

Studies of morphological variation, by their very nature have a comparative focus

in which variation within and among populations is the central theme.

Somatometry is useful in the study of age estimation from different body

segments in a given set of individuals.

Somatometry is extensively used in the estimation of stature from different body

segments.

Can study variation in bony skeleton of different populations of the world.

Used in the estimation of sex and race in forensic and legal sciences.

Helps in understanding of comparative anatomy of primates.


17


Helps in orthopedic surgery in fractures, dislocation, and amputation, and in

construction of artificial limbs i.e. prosthesis.

It also helps in construction of artificial teeth in dentistry.

Helps in forensic science to identify the individual.

To identify the monozygotic & dizygotic twins.

Today, anthropometry has many practical uses, most of them benign. For

example, it is used to assess nutritional status, to monitor the growth of children,

and to assist in the design of office furniture.

3.5 Embryology

The three morphological subdivisions of the ear [namely the external, middle and internal

ear] each have a separate origin77.

3.5.1 External ear78

The external acoustic meatus is derived from the dorsal part of the first ectodermal cleft.

However, its deeper part is formed by proliferation of its lining epithelium, which grows

towards the middle ear. This proliferation is at fist solid [meatal plug], but is later

canalized.

18

The auricle, or pinna, is formed from about six mesodermal thickenings [called tubercles

or hillocks] that appear on the mandibular and hyoid arches, around the opening of the

dorsal of the first ectodermal cleft [i.e. around the opening of the external acoustic

meatus].



The mandibular arch forms only the tragus and a small area around it, the rest of the

auricle being formed from the hyoid arch. This is consistent with the fact that the

auricular muscles are supplied by the facial nerve.

3.5.2 Tympanic membrane79

This is formed by apposition of the tubo-tympanic recess and the first ectodermal cleft,

these two formations the inner [endodermal] and outer [ectodermal] epithelial linings of

the membrane. The intervening mesoderm forms the connective tissue basis.

Two points worth noting are as follows:

1. The handle of the malleus grows into the connective tissue from above.

2. The chorda tympani nerve is at first outside the membrane but later comes to lie

within its layers, because of upward extension of the membranes.

3.5.3 Middle ear80

The epithelial lining of the middle ear and of the pharyngo-tympanic tube is derived from

the tubo-tympanic recess. This recess develops from the dorsal part of the first

pharyngeal pouch, and also receives a contribution from the second pouch. The tympanic

antrum and mastoid air cells are formed by extensions from the middle ear.

The malleus and incus are derived from the dorsal end of Meckel’s cartilage, while the

stapes is formed from the dorsal end of the cartilage of the second pharyngeal arch. The


19


ossicles are at first outside the mucous membrane of the developing middle ear. They

invaginate the mucous membranes, which covers them throughout life. The ossicles of

the ear fully ossify in the fourth month of intrauterine life. They are the first bone in the

body to do so.

The tensor tympani is derived from the mesoderm of the first pharyngeal arch and the

stapedius from that of the second arch.

3.5.4 Internal ear81

The membranous labyrinth is derived from a specialized area of surface ectoderm

overlying the developing hind brain. This area is first apparent as a thickening called the

oticplacode. The oticplacode soon becomes depressed to form the otic pit.

The otic vesicle is at first an oval structure. By differential growth of various parts of its

wall, it gives rise to the structures comprising the membranous labyrinth.

Localized areas of the epithelium of the membranous labyrinth undergo differentiation to

form specialized sensory end organs of hearing, and of equilibrium [cristae of

semicircular ducts; maculae of utricle and saccule; organ of corti of cochlea]. These are

innervated by peripheral processes of the cells of the vestibulocochlear ganglion. This

ganglion is derived from the neural crest. Its cells are peculiar in that they remain bipolar

throughout life.


20


The bony labyrinth is formed from the mesenchyme surrounding the membranous

labyrinth. This mesenchyme becomes condensed to form the otic capsule. The

mesenchymal condensation is soon converted into cartilage. Between this cartilage and

the membranous labyrinth there is a layer of loose periotic tissue. The space of the bony

labyrinth is created by the disappearance of this periotic tissue. The membranous

labyrinth is filled with a fluid called endolymph, while the periotic spaces surrounding it

are filled with perilymph.

The periotic tissue, around the utricle and saccule, disappears to form a space called the

vestibule. The periotic tissue, around the semicircular ducts also disappears to form the

semicircular canals. Two distinct spaces are formed, one on either side of the cochlear

duct. These are the scala tympani and the scalavestibuli. The scalavestibuli communicates

with the vestibule while the scala tympani grows towards the tympanic cavity, from

which it remains separated by a membrane. The cartilaginous labyrinth is subsequently

ossified to form the bony labyrinth.

3.5.5 Cronology of ear development82

22nd day – oticplacode is seen.

5th week – auricle starts forming

6th week – the cochlea and semicircular canals starts forming.


21


8th week – the cochlea and semicircular canals assume their definitive external

form.

10th week – scalavestibuli and scala tympani appear.

7th month – external acoustic meatus gets canalized.

The ear is most sensitive to teratogens during the 4th to 9th week, and can be

affected up to the 12th week.

3.6 Anomalies of the ear

3.6.1 Anomalies of the auricle83

1. The development of the auricle may get arrested at any stage. As a result of this, it

may be totally, or partially, absent; it may be represented by isolated nodules; or it

may be very small. Alternatively it may be very large.

2. The migration of the auricle from its primitive caudo-ventral position may remain

incomplete. We have seen that this migration occurs as a result of the growth of

the maxillary and mandibular processes. This explains the association of caudo-

ventral displacement of the auricle with mandibulofacial dysostosis.

3.6.2 Anomalies of the External Auditory Meatus84


22


1. There may stenosis, or atresia, of the meatus over its whole length or over part

of it. The lumen may be closed by fibrous tissue, by cartilage, or by bone.

2. The normal curvature of the meatus may be accentuated as a resullt of which

the tympanic membranes cannot be fully seen from the outside.

3.6.3 Anomalies of the middle ear85

1. The ossicles may be malformed. They may show abnormal fusion to one another

or to the wall of the middle ear. The stapes may be fused to the margins of the

fenestra vestibuli.

2. The facial nerve may bulge into the middle ear and may follow an abnormal

course.

3. The stapedial artery, which normally disappears, may persist.

3.7 Anatomy of ear

The ear is an organ of hearing. It is also concerned in managing the equilibrium of the

body. It consists of three parts like the external ear, the middle ear, and the internal ear89.

3.7.1 The External ear

The external ear consists of the auricle or pinna and the external acoustic meatus.

3.7.1.1 The Auricle or pinna90


23


This is the part seen on the surface. The greater part of it is made up a single crumpled

plate of cartilage which is lined on both sides by skin. The lowest part of the auricle is

soft and consists only of connective tissue covered by skin. This part is called the lobule.

The lateral surface of the auricle is irregularly concave, faces slightly forwards and

displays numerous eminences and depressions. It has a prominent curved rim, helix. This

usually bears a small tubercle postero-superiorly, Darwan`s tubercle. The anti-helix is a

curved prominent paraller and anterior to the posterior part of the helix. It divided above

into two cura which flank a depressed triangular fossa. The curved depression between

helix and antihelix is the scaphoid fossa. The antihelix encircles the deep, capacious

concha of the auricle, which is incompletely divided by the cura or anterior end of the

helix. The conchal area above this, the cymba conchae, overlies the super meatal triangle

of the temporal bone which can be felt through it, and which overlies the mastoid antrum.

The tragus is a small curved flap below the cura of helix and in front of the concha, it

project posteriorly, partly over lapping the meatal orifice. The anti-tragus is a small

tubercle opposite the tragus and separated from it by the inter-tragic incisures or notch.

3.7.1.2 The Skin91

The skin of the auricle continues into external auditory meatus to cover the outer surface

of the tympanic membranes. It is thin, has no dermal papillae, and is closely adherent to

the cerumen. The secretary cell are columnar which active but cuboidal when quiescent,

there are covered externally by myoepithelial cells. Ducts open either on to the epithelial


24


surface or into the nearby sebaceous gland of a hair follicle .Cerumen prevents the

maceration of meatal skin by trapped water.

3.7.1.3 The Cartilaginous frame work92

The auricle is a single thin plate of elastic fibro cartilage covered by skin, It surface

moulded by eminences and depressions .It is connected to the surrounding part by

ligament and muscles and is continous with the cartilage of the external auditory meatus.

There is no cartilage in the louble or between the tragus anti crux of the helix, where the

gap is filled by dense fibrous tissue. Anteriorly, where the helix curves upwards, there is

a small cartilaginous projection, the spin of the helix. Its other extremity is prolonged

inferiorly as the tail of the helix and it is separated from the anti-helix by the fissura anti

tragahelixina. The cranial aspect of the cartilage bears the eminentia conchae and

eminentiascaphae, which correspond to the depression on the lateral surface. The two

eminences are separated crus of the antihelix on the lateral surface. The eminentia

conchae are crossed by an oblique ridge, the ponticulus, for the attachment of auricularis

posterior. There are two fissures in the auricular cartilage, one behind the crux of the

helix and another in the tragus.

3.7.1.4 Ligaments93

25

Anterior and posterior extrinsic ligament connect the auricle with the temporal bone .The

anterior ligament extends from the tragus and the spin of the helix to the root of the

zygomatic process of the temporal bone. The posterior ligament passes from the posterior



surface of the concha to the lateral surface of the mastoid process to main intrestic

ligament connect individual auricular cartilage: a strong fibrous band passes from the

tragus to the helix, there by completing the meatus anteriorly and forming part of the

boundary of the concha and another band passes between the antihelix and the tail of the

helix. Less prominent bands are seen on the cranial aspect of the auricle.

3.7.1.5 Auricular muscles94

Extrinsic auricular muscles connect the auricle to the skull and scalp and move the auricle

as a whole. Intrinsic auricular muscles connect the different parts of the auricle.

3.7.1.5.1 Extrinsic muscles

The extrinsic auricular muscles are the auricularis anterior, superior and posterior. The

smallest of the three is auricularis anterior, a thin fan of pale fibres which arise from the

alateral edge of the epicranialaponeurosis and converge to attach to the spine of the helix.

The largest of the three, auricularis superior, is also thin and fan-shaped and converges

from the epicranialaponeurosis via a thin, flat tendon to attach to the upper part of the

cranial surface of the auricle. The auricularis posterior consists of two or three fleshy

fasciculi which arise by short aponeurotic fibres from the mastoid part of the temporal

bone and insert into the ponticulus on the eminentia conchae.

Vascular supply


26


The arterial supply of the extrinsic auricular muscles is derived mainly from the posterior

Innervation. Auricularis posterior is supplied by the posterior auricular branch of the

facial nerve.

Action

In man these muscles have very little obvious effect. However, despite the paucity of

auricular movement, auditory stimuli may evoke patterned responses from these small

muscles and electromyography can detect the crossed acoustic response, used to

determine auditory threshold levels and brainstem latencies, which is elicited by this

means in investigative clinical neurology.

3.7.1.5.2 Intrinsic muscles

The intrinsic auricular muscles are helicis major and minor, tragicus, antitragicus,

transversusauriculae and obliqusauriculae. Helicis major is a narrow vertical band on the

anterior margin of the helix, passing from its spine to its anterior border, where the helix

is about to curve back. Helicis minor is an oblique fasciculus covering the crus of the

helix. Tragicus is a short, flattened, vertical band on the lateral aspect of the tragus.

Antitragicus passes from the outer part of the antitragus to the tail of the helix and the

antihelix. Transversusauriculae, located on the cranial aspect of the auricle, consists of

scattered fibres, partly tendinous, partly muscular, which extend between the eminentia

conchae and the eminentia fibres which extend from the upper and posterior parts of the

aminentia conchae to eminentiascaphae.


27


Vascular supply

The intrinsic auricular muscles are supplied by branches of the posterior auricular and

superficial temporal arteries.

The intrinsic auricular muscles on the lateral aspect of the auricle are innervated by the

temporal branches of the facial nerve, and those on the cranial aspect of the auricle are

innervated by the posterior auricular branch of the facial nerve.

Actions

The intrinsic muscles modify auricular shape minimally, if at all, in most human ears:

helicis major can draw the auricle forwards and upwards. Rare individuals can modify the

shape and position of their external ear.

3.7.1.6 Vascular supply & lymphatic drainage95

Arteries

The posterior auricular branch of the external carotid artery is the dominant blood supply.

It supplies three or four branches to the cranial surface of the auricle: twigs from these

arteries reach the lateral surface, some through fissures in the cartilage, other round the

margin of the helix. The posterior auricular artery ascends between the parotid gland and

the styloid process to the groove between the auricular cartilage and mastoid process. The

superior auricular artery has a constant course and connects the superior temporal artery

and the posterior auricular arterial network: this branch can provide a reliable vascular


28


pedicle for retro-auricular flaps .The auricle is also supplied by anterior auricular

branches of the occipital

Veins

Auricular veins correspond to the arteries of the auricle. Arterio-venous anastomoses are

numerous in the skin of the auricles and are thought to be important in the regulation of

core temperature.

Lymphatic drainage

The posterior aspect of the pinna drains to nodes at the mastoid tip. The tragus and upper

part of the pinna drain into pre-auricular nodes, while the remainder of the pinna drains to

upper deep cervical lymph nodes.

3.7.1.7 Innervation96

The sensory innervation of the auricle is complex and not fully determined. This is

perhaps because the external ear represents an area where skin originally derived from a

brachial region meets skin originally derived from a post brachial region. The sensory

nerve involved are the great auricular nerve, which supplies most of the cranial surface

and the posterior part of the lateral surface [helix, anti-helix, louble] the lesser occipital

nerve , which supplies the upper part of the cranial surface; the auricular branch of the

vagus, which supplies the concavity of the cocha and posterior part of the eminentia; the

auriculotemporal nerve, which supplies the tragus, crux of the helix and the adjacent part


29


of the helix and the facial nerve, which together with the auricular branch of the vagus

probably supplies small areas on both aspects of the auricles, in the depression of the

concha and over its eminence. The details of the cutaneous innervation derived from the

facial nerve require further clarification. It is possible that as the auricular branch of the

vagus probably supplies small area on both aspects of the auricle, in the depression of the

concha, and over its eminence. The details of the cutaneous innervation derived from the

facial nerve require farther clarification. It is possible that as the auricular branch of the

vagus traverses the temporal bone and crosses the facial canal, approximately 4 mm

above the stylomastoid foramen, it contributes an ascending branch to the facial nerve

and that in this way fibers of the vagus are carried via the facial nerve to pinna.

3.8 External Acoustic Meatus97

30

The external acoustic meatus extends from the concha to the tympanic membrane: it is

approximately 2.5 cm from the floor of the concha and approximately 4 cm from the

tragus. It has two structurally different parts: its lateral third is cartilaginous and its

medial two third is osseous .It forms an S-shape curve, directed at first medially,

anteriorly, and slightly up [pars externa], then posteromedially and up [pars media] and

lastly anteromedially and slightly down [pars interna]. It is oval in section, its greatest

diameter is obliquely inclined posteroinferiorly at the external orifice, but is nearly

horizontal at its medial and. There are two constrictions, one near the medial end of the

cartilaginous part, the other, the isthmus, in the osseous part about 2 cm from the bottom

of the concha. The tympanic membranes, which closes its medial end, is obliquely set,



which means that the floor and the anterior wall of the meatus are longer than its roof and

posterior wall.

The lateral, cartilaginous part is approximately 8 mm long. It is continuous with the

auricular cartilage and attached by fibrous tissue to the circumference of the osseous part.

The meatel cartilage is deficient posterosuperiorly, and the gap is occupied by a sheet of

collagen. Two or three deep fissure [of santorini] exists in its anterior part: tumours of the

external acoustic meatus escape the confines of the canal through these fissures and

spread into the adjacent soft tissue.

The osseous part is approximately 16 mm long, and is narrower than the cartilaginous

part. In sagittal section it is oval or elliptical and it is directed anteromedially and slightly

downwards, with a slight posterosuperior convexity. Its medial end is smaller than the

lateral end and it terminates obliquely. The anterior wall projects medially approximately

4 mm. beyond the posterior and is marked, except above, by a narrow tympanic sulcus or

anulus, to which the perimeter of the tympanic membrane is attached. Its lateral end is

dilated and mostly rough for the attachment of the meatal cartilage. The anterior, inferior

and most plate of the temporal bone, which in the foetus is only a tympanic plate of the

temporal bone, which in the foetus is only a tympanic ring. The posterosuperior region is

formed by the squamous part of the temporal bone. The outer wall of the meatus is

bounded above by the posterior zygomatic root, below which there may be a suprameatal

spine.


31


3.8.1 Relations of the meatus

The condylar process of the mandible lies anterior to the meatus and is partially separated

from the cartilaginous part by a small portion of the parotid gland. A blow on the chin

may cause the condyle to break into the meatus. The middle cranial fossa lies above the

osseous meatus and the mastoid air cell are posterior to it, separated from the meatus only

by a thin layer of bone. Its deepest part is situated below the epitympanic recess, and is

anteroinferior to the mastoid antrum: the lamina of bone which separates it from the

antrum is only 1-2 mm thick and provides the transmeatal approach of aural surgery.

3.8.2 Vasculature and lymphatic drainage

The arterial supply of the external acoustic meatus is derived from the posterior auricular

artery, the deep auricular branch of the maxillary artery and the auricular branches of the

superficial temporal artery. Associated veins drain into the external jugular and maxillary

veins and the pterygoid plexus. The lymphatics drain into those associated with the pinna.

3.8.3 Innervation

The sensory innervation of the external acoustic meatus is derived from the

auriculotemporal branch of the mandibular nerve, which supplies the anterior and

superior wall, and the auricular branch of the vagus, which supplies the posterior and

inferior wall. The facial nerve may also contribute via its communication with the vagus

nerve.


32


3.9 Middle ear98

The middle ear is an air-filled, mucous membrane-lined space in the temporal bone

between the tympanic membrane laterally and the lateral wall of the internal ear medially.

It is described as consisting of two parts.

• Tympanic cavity immediately adjacent to the tympanic membrane.

• Epitympanic recess superiorly.

The middle ear communicates with the mastoid area posteriorly and the nasopharynx [via

the pharyngotympanic tube] anteriorly. Its basic function is to transmit vibrations of the

tympanic membrane across the cavity of the middle ear to the internal ear. It

accomplishes this through three interconnected but movable bones that bridge the space

between the tympanic membrane and the internal ear. These bones are the malleus

[connected to the tympanic membranes], the incus [connected to the malleus], and the

stapes [connected to the incus and the lateral wall of the internal ear at the oval window]

3.9.1 Boundaries

The middle ear has a roof and a floor, and anterior, posterior, medial and lateral walls.

Tegmental wall [Roof]

33

The tegmentalwall of the middle ear consists of a thin layer of bone, which separates the

middle ear from the middle cranial fossa. This layer of bone is the tegmen tympani on the

anterior surface of the petrous part of the temporal bone.



Jugular wall [Floor]

The jugular wall of the middle ear consists of a thin layer of bone that separates it from

the internal jugular vein. Occasionally, the floor is thickened by the presence of mastoid

air cells.

Near the medial border of the floor is a small aperture, through which the tympanic

branch from the glossopharyngeal nerve [9] enters the middle ear.

Anterior wall

The anterior wall of the middle ear is only partially complete. The lower part consists of a

thin layer of bone that separates the tympanic cavity from the internal carotid artery.

Superiorly, the wall is deficient due to the presence of:

A large opening for the entrance of the pharyngotympanic tube into the middle

ear:

A smaller opening for the canal containing the tensor tympani muscle.

The foramen for exit of the chorda tympani nerve from the middle ear is also associated

with this wall.

Mastoid wall [Posterior]


34


The mastoid wall of the middle ear is only partially complete. The lower part of this wall

consists of a bony partition between the tympanic cavity and mastoid air cells.

Superiorly, the epitympanic recess is continuous with the aditus to the mastoid antrum

Associated with the mastoid wall are:

The pyramidal eminence, a small elevation through which the tendon of the

stapedius muscle enters the middle ear.

The opening through which the chorda tympani nerve, a branch of the facial nerve

[7], enters the middle ear.

Labyrinthine wall [Medial]

The labyrinthine wall of the middle ear is also the lateral wall of the internal ear. A

prominent structure on this wall is a rounded bulge [the promontory] produced by the

basal coil of the cochlea, which is an internal ear structure involved with hearing.

Associated with the mucous membrane covering the promontory is a plexus of nerves

[the tympanic plexus], which consists primarily of contributions from the tympanic

branch of the glossopharyngeal nerve [9] and branches from the internal carotid plexus. It

supplies the mucous membrane of the middle ear, the mastoid area, and the

pharyngotympanic tube.


35


Additionally, a branch of the tympanic plexus [the lesser petrosal nerve] leaves the

promontory and the middle ear, travels across the anterior surface of the petrous part of

the temporal bone, and leaves the middle cranial fossa through the foramen ovale to enter

the middle cranial fossa through the foramen ovale to enter the otic ganglion. Other

structures associated with the labyrinthine wall are two openings, the oval and round

windows, and two prominent elevations.

The oval window is posterosuperior to the promontory, is the point of attachment

for the base of stapes [footplate], and end the chain of bones that transfer

vibrations initiated by the tympanic membrane to the cochlea of the internal ear.

The round window is posteroinferior to the promontory.

Posterior and superior to the oval window on the medial wall is the prominence of

facial canal, which is a ridge of bone produced by the facial nerve [7] in its canal

as it passes through the temporal bone.

Just above and posterior to the prominence of facial canal is a broader ridge of

bone [prominence of lateral semicircular canal] produced by the lateral

semicircular canal, which is a structure involved in detecting motion.

Membranous wall [Lateral]

The membranous wall of the middle ear consists almost entirely of the tympanic

membrane, but because the tympanic membrane does not extend superiorly into the


36


epitympanic recess, the upper part of the membranous wall of the middle ear is the bony

lateral wall of the epitympanic recess.

3.9.2 Mastoid area99

Posterior to the epitympanic recess of the middle ear is the aditus to mastoid antrum,

which is the opening to the mastoid antrum.

The mastoid antrum is a cavity continuous with collections of air-filled spaces [the

mastoid cells], throughout the mastoid part of the temporal bone, including the mastoid

process. The mastoid antrum is separated from the middle cranial fossa above by only

the thin tegmen tympani.

The mucous membrane lining the mastoid air cells is continuous with the mucous

membrane throughout the middle ear.

3.9.3 Pharyngotympanic tube100

The Pharyngotympanic tube connects the middle ear with the nasopharynx and equalizes

pressure on both sides of the tympanic membrane. Its opening in the middle ear is on the

anterior wall, and from here it extends forward, medially, and downward to enter the

nasopharynx just posterior to the inferior meatus to the nasal cavity. It consists of:

A bony part [the one-third nearest the middle ear].

A cartilaginous part [the remaining two-thirds].


37


The opening of the bony part is clearly visible on the inferior surface of the skull at the

junction of the squamous and petrous parts of the temporal bone immediately posterior

to the foramen ovale and foramen spinosum.

Vessels

The arterial supply to the pharyngotympanic tube is from several sources. Branches arise

from the ascending pharyngeal artery [a branch of the external carotid artery] and from

two branches of the maxillary artery [the middle meningeal artery and the artery of the

pterygoid canal].

Venous drainage of the pharyngotympanic tube is to the pterygoid plexus of veins in the

infratemporal fossa.

Innervations

Innervation of the mucous membrane lining the pharyngotympanic tube is primarily

from the tympanic plexus because it is continuous with the mucous membrane lining the

tympanic cavity, the internal surface of the tympanic membrane, and the mastoid antrum

and mastoid cells. This plexus receives its major contribution from the tympanic nerve, a

branch of the glossopharyngeal [9].

3.9.4 Auditory ossicles101


38


The bones of the middle ear consist of the malleus, incus, and stapes. They form an

osseous chain across the middle ear from the tympanic membrane to the oval window of

the internal ear.

Muscles associated with the auditory ossicles modulate movement during the

transmission of vibrations.

Malleus

The malleus is the largest of the auditory ossicles and is attached to the tympanic

membrane. Identifiable parts include the head of malleus, neck of malleus, anterior and

lateral processes and handle of malleus. The head of malleus is the rounded upper part of

the malleus in the epitympanic recess. Its posterior surface articulates with the incus.

Inferior to the head of malleus is the constricted neck of malleus, and below this are the

anterior and lateral processes:

The anterior process is attached to the anterior wall of the middle ear by a

ligament.

The lateral process is attached to the anterior and posterior malleolar folds of the

tympanic membrane.

The downward extension of the malleus, below the anterior and lateral processes, is the

handle of malleus, which is attached to the tympanic membrane.

Incus


39


The second bone in the series of auditory ossicles is the incus. It consists of the body of

incus and long and short limbs:

The enlarged body of incus articulates with the head of malleus and is in the

epitympanic recess;

The long limb extends downward from the body, paralleling the handle of the

malleus, and by bending medially to articulate with the stapes;

The short limb extends posteriorly and is attached by a ligament to the upper

posterior wall of the middle ear.

Stapes

The stapes is the most medial bone in the osseous chain and is attached to the oval

window. It consists of the head of stapes, anterior and posterior limbs, and the base of

stapes:

The head of stapes is directed laterally and articulates with the long process of the

incus.

The two limbs separate from each other and attach to the oval base.

The base of stapes fits into the oval window on the labyrinthine wall of the middle

ear.

3.9.5 Muscles associated with the ossicles


40


Two muscles are associated with the bony ossicles of the middle ear:

• Tensor tympani

• Stapedius

Tensor tympani

The tensor tympani muscle lies in a bony canal above the pharyngotympanic tube. It

originates from the cartilaginous part of the pharyngotympanic tube, the greater wing of

the sphenoid, and its own bony canal, and passes through its canal in a posterior

direction, ending in a rounded tendon that inserts into the upper part of the handle of the

malleus.

Innervation of the tensor tympani is by a branch from the mandibular nerve.

Contraction of the tensor tympani pulls the handle of the malleus medially. This tenses

the tympanic membrane, reducing the force of vibrations in response to loud noises.

Stapedius

The stapedius muscle is a very small muscle that originates from inside the pyramidal

eminence, which is a small projection on the mastoid wall of the middle ear. Its tendon

emerges from the apex of the pyramidal eminence and passes in a forward direction to

attach to the posterior surface of the neck of stapes.


41


Stapedius is innervated by a branch from the facial nerve. Contraction of the stapedius

muscle, usually in response to loud noise, pulls the stapes posteriorly and prevents

excessive oscillation.

3.9.6 Vessels102

Numerous arteries supply the structures in the middle ear:

The two largest branches are the tympanic branch of the maxillary artery and

the mastoid branch of the occipital or posterior auricular arteries;

Smaller branches come from the middle meningeal artery, the ascending

pharyngeal artery, the artery of the pterygoid canal, and tympanic branches

from the internal carotid artery.

Venous drainage of the middle ear returns to the pterygoid plexus of veins and the

superior petrosal sinus.

3.9.7 Innervations102

The tympanic plexus innervates the mucous membrane lining the walls and contents of

the middle ear, which includes the mastoid area and the pharyngotympanic tube. It is

formed by the tympanic nerve, a branch of the glossopharyngeal nerve [9] and from

branches of the internal carotid plexus in the mucous membrane covering the

promontory, which is the rounded bulge on the labyrinthine wall of the middle ear.


42


As the glossopharyngeal nerve [9] exits the skull through the jugular foramen, it gives off

the tympanic nerve. This branch re-enters the skull through a small foramen and passes

through the bone to the middle ear.

Once in the middle ear, the tympanic nerve forms the tympanic plexus, along with

branches from the plexus of nerves surrounding the internal carotid artery, in the mucous

membrane covering the promontory. Branches from the tympanic plexus supply the

mucous membranes of the middle ear, including the pharyngotympanic tube and the

mastoid area.

The tympanic plexus also gives off a major branch [the lesser petrosal nerve], which

supplies preganglionic parasympathetic fibers to the otic ganglion.

The lesser petrosal nerve leaves the area of the promontory, exits the middle ear, travels

through the petrous part of the temporal bone, and exits onto the anterior surface of the

petrous part of the temporal bone through a hiatus just below the hiatus for the greater

petrosal nerve. It continues diagonally across the anterior surface of the temporal bone

before exiting the middle cranial fossa through the foramen ovale. Once outside the skull

it enters the otic ganglion.

3.10 Internal ear103


43


The internal ear consists of a series of bony cavity [the bony labyrinth] and membranous

duct and [the membranous labyrinth] within these cavities. All these structures are in the

petrous part of the temporal bone between the middle ear laterally and the internal

acoustic meatus medially.

The bony labyrinth consists of the vestibule, three semicircular canal and the cochlea.

These bony cavities are lined with periosteum and contain a clear fluid [the perilymph].

Suspended within the perilymph but not filling all spaces of the bony labyrinth is the

membranous labyrinth, which consists of the semicircular ducts, the cochlear duct, and

two sacs [the utricle and the saccule]. These membranous spaces are filled with

endolymph.

The structures in the internal ear convey information to the brain about balance and

hearing:

The cochlear duct is the organ of hearing.

The semicircular duct, utricle, and saccule are the organs of balance.

The nerve responsible for this function is the vestibulocochlear nerve [8], which divides

into vestibular [balance] and cochlear [hearing] parts after entering the internal acoustic

meatus.

3.10.1 Bony labyrinth104


44


The vestibule, which contains the oval window in its lateral wall, is the central part of the

bony labyrinth. It communicates anteriorly with the cochlea and posterosuperiorly with

the semicircular canals.

A narrow canal [the vestibular aqueduct] leaves the vestibule, and passes through the

temporal bone to open on the posterior surface of the petrous part of the temporal bone.

3.10.1.1 Semicircular canal

Projecting in a posterosuperior direction from the vestibule are the anterior, posterior, and

lateral semicircular canals. Each of these canal forms two-thirds of a circle connected at

both ends to the vestibule and with one end dilated to form the ampulla. The canals are

oriented so that each canal is at right angles to the other two.

3.10.1.2 Cochlea

Projecting in an anterior direction from the vestibule is the cochlea, which is a bony

structure that twists on itself two and one-half to two and three-quarter times around a

central column of bone [the modiolus]. This arrangement produces a cone-shaped

structure with a base of cochlea that faces posteromedially and an apex that faces

anterolaterally. This positions the wide base of the modiolous near the internal acoustic

meatus, where it is entered by branches of the cochlear part of the vestibule-cochlear

nerve [8].


45


Extending laterally throughout the length of the modiolus is a thin lamina of bone [the

position by its attachment to the lamina of modiolus, is the cochlear duct, which is a

component of the membranous labyrinth.

Attached peripherally to the outer wall of the cochlea, the cochlear duct creates two

canals [the scala vestibule and the scala tympani], which extend throughout the cochlea

and are continuous with each other at the apex through a narrow slit [the helicotrema]:

• The scala vestibuli is continuous with the vestibule.

• The scala tympani, is separated from the middle ear by the secondary

tympanic membrane covering the round window finally, near the round

window is a small channel [the cochlear canaliculus], which passes

through the temporal bone and opens on its inferior surface into the

posterior cranial fossa. This provides a connection between the perilymph-

containing cochlea and the subarachnoid space.

3.10.2 Membranous labyrinth105

The membranous labyrinth is a continuous system of ducts and sacs within the bony

labyrinth. It is filled with endolymph and separated from the periosteum that covers the

walls of the bony labyrinth by perilymph.


46


Consisting of two sacs [the utricle and the saccule] and four ducts [the three semicircular

ducts and the cochlear duct], the membranous labyrinth has unique functions related to

balance and hearing:

The utricle, saccule, and three semicircular ducts are part of the vestibular

apparatus [i.e. organ of balance].

The cochlear duct is the organ of hearing.

The general organization of the parts of the membranous labyrinth place:

The cochlear duct within the cochlea of the bony labyrinth, anteriorly.

The three semicircular ducts, within the three semicircular canals of the bony

labyrinth, posteriorly.

The saccule and utricle, within the vestibule of the bony labyrinth, in the middle.

3.10.2.1 Organs of balance

Five of the six components of the membranous labyrinth are concerned with balance.

These are the two sacs [the utricle and the saccule] and three ducts [the anterior, posterior

and lateral semicircular ducts].

Utricle, saccule, and endolymphatic duct.

The utricle is the larger of the two sacs. It is oval, elongated and irregular in shape and is

in the posterosuperior part of the vestibule of the bony labyrinth.


47


The three semicircular ducts empty into the utricle. Each semicircular duct is similar in

shape, including a dilated end forming the ampulla, to its complimentary bony

semicircular canal only much smaller.

The saccule is a smaller, rounded sac lying in the anteroinferior part of the vestibule of

the bony labyrinth. The cochlear duct empties into it.

The atriculosaccular duct establishes continuity between all components of the

membranous labyrinth and connects the utricle and saccule. Branching from this small

duct is the endolymphatic duct, which enters the vestibular aqueduct [a channel through

the temporal bone] to emerge onto the posterior surface of the petrous part of the

temporal bone in the posterior cranial fossa. Here the endolymphatic duct expands into

the endolymphatic sac, which is an extradural pouch.

3.10.2.2 Sensory receptors

Functionally, sensory receptors for balance are organized into unique structures and in

each of the components of the vestibular apparatus. In the utricle and saccule this sense

organ is the macula of utricle and macula of saccule, respectively, and in the ampulla of

each of the three semicircular ducts it the crista.

The utricle responds to centrifugal and vertical acceleration, while the saccule responds

to linear acceleration. In contrast, the receptors in the three semicircular ducts respond to

movement in any direction.


48


3.10.2.2 Organ of hearing

Cochlear duct

The cochlear duct has a central position in the cochlea of the bony labyrinth dividing it

into two canals [the scala vestibule and the scala tympani]. It is maintained in this

position by being attached centrally to the lamina of modiolus, which is a thin lamina of

bone extending from the modiolus [the central bony core of the cochlea], and peripherally

to the outer wall of the cochlea.

Thus, the triangular-shaped cochlear duct has:

An outer wall against the bony cochlea consisting of thickened, epithelial-lined

periosteum [the spiral ligament].

A roof [the vestibular surface membranes], which separates the endolymph in the

scala vestibule and consists of a membrane with a connective tissue core lined on

either side with epithelium.

A floor, which separates the endolymph in the cochlear duct from the perilymph

in the scala tympani and consists of the free edge of the lamina of modiolus, and a

membrane [the basilar membrane] extending from this free edge of the lamina of

modiolus to an extension of the spiral ligament covering the outer wall of the

cochlea.


49


The spiral organ is the organ of hearing, rests on the basilar membrane, and projects into

the enclosed, endolymph-filled cochlear duct.

3.10.3 Vessels106

The arterial supply to the internal ear is divided between vessels supplying the bony

labyrinth and the membranous labyrinth.

The bony labyrinth is supplied by the same arteries that supply the surrounding temporal

bone these include an anterior tympanic branch from the maxillary artery, a stylomastoid

branch from the posterior auricular artery, and a petrosal branch from the middle

meningeal artery.

The membranous labyrinth is supplies by the labyrinthine artery, which either arises from

the anterior inferior cerebellar artery or is a direct branch of the basilar artery, whatever

its origin, it enters the internal acoustic meatus with the facial [7] and glossopharyngeal

[9] nerves and eventually divides into:

A cochlear branch, which passes through the modiolus and supplies the cochlear

duct.

One or two vestibular branches, which supply the vestibular apparatus.

Venous drainage of the membranous labyrinth is through vestibular veins and cochlear

veins, which follow the arteries. These come together to form a labyrinthine vein, which

eventually empties into either the inferior petrosal sinus or the sigmoid sinus.

3.10.4 Innervations107


50


The vestibulocochlear nerve [8] caries special afferent fibres for hearing [the cochlear

component] and balance [the vestibular component]. It enters the lateral surface of the

brainstem, between the pons and medulla, after exiting the temporal bone through the

internal acoustic meatus and crossing the posterior cranial fossa.

Inside the temporal bone, at the distal end of the internal acoustic meatus, the

vestibulocochlear nerve divides to form:

The cochlear nerve.

The vestibular nerve.

The vestibular nerve enlarges to form the vestibular ganglion, before dividing into

superior and inferior parts, which distribute to the three semicircular ducts and the utricle

and saccule.

The cochlear nerve enters the base of the cochlea and passes upwards through the

modiolus. The ganglion cells of the lamina of modiolus as it winds around the base of the

lamina of modiolus. Branches of the cochlear nerve pass through the lamina of modiolus

to innervate the receptors in the spiral organ.

3.4.5 Facial nerve [7] in the temporal bone

51

The facial nerve is closely associated with the vestibulocochlear nerve as it enters the

internal acoustic meatus of the temporal bone. Travelling through the temporal bone, its

path and several of its branches are directly related to the internal and middle ears.



The facial nerve enters the internal acoustic meatus in the petrous part of the temporal

bone. The vestibulocochlear nerve and the labyrinthine artery accompany it.

At the distal end of the internal acoustic meatus, the facial nerve enters the facial canal

and continues laterally between the internal and middle ears. At this point the facial nerve

enlarges and bends posteriorly and laterally. The enlargement is the sensory geniculate

ganglion. As the facial canal continues, the facial nerve turns sharply downward and

running in an almost vertical direction, it exits the skull through the stylomastoid

foramen.

Branches

Greater petrosal nerve.

Nerve to stapedius and chorda tympani

Greater petrosal nerve

At the geniculate ganglion, the facial nerve gives off the greater petrosal nerve. This is

the first branch of the facial nerve. The greater petrosal nerve leaves the geniculate

ganglion, travels anteromedially through the temporal bone, and emerges through the

hiatus for the greater petrosal nerve on the anterior surface of the petrous part of the

temporal bone. The greater petrosal nerve carries preganglionic parasympathetic fibers to

the pterygopalatine ganglion.


52


Continuing beyond the bend, the position of the facial nerve is indicated on the medial

wall of the middle ear by a bulge.

Nerve to stapedius and chorda tympani

Near the beginning of its vertical descent, the facial nerve gives off a small branch, the

nerve to stapedius, which innervates the stapedius muscle, and just before it exits the

skull the facial nerve gives off the chorda tympani nerve.

The chorda tympani does not immediately exit the temporal bone, but ascends to enter

the middle ear through its posterior wall, passing near the upper aspect of the tympanic

membrane between the malleus and incus. It then exits the middle ear through a canal

leading to the petrotympanic fissure and exits the skull through this fissure to join the

lingual nerve in the infratemporal fossa.


53



54


Picture-1 Embryology of the Ear

55



Picture-2 External Ear


56


Picture No. 3 Ear with acoustic meatus


57


Picture-4 Middle & Inner Ear


58

Methodology

4.0 METHODOLOGY

One hundred healthy volunteers in and around the Alva’s Ayurveda Medical College,

Moodbidri are selected to be included in this present study.

4.1 Instruments

The following instruments are used to complete the present study.

Measuring tape

Measuring callipers

Micrometre

Weighing machine

4.2 Inclusion criteria

Healthy individuals from both sexes without any visible abonromalities ranging from 15-

45 years of age are included in this present study.

4.3 Exclusion criteria

During this present study, special care is considered to exclude the individuals with the

following features which may impact on the result of the study.

Individuals with visible congenital and acquired external ear deformities.

Individuals with any known pathological conditions of the external ear.

57

Wearing heavy ornaments in ears as it may resultant in pathological

disfigurement.


Methodology

4.4 Assessment criteria

4.4.1 Anguli Praman (Anthropometry)

Width of madhyama parva of madhyama angulii, (width of proximal inter-

phalangeal joint of middle finger).

Width of the palm at the level of metacarpophalangeal joints (2nd -5th) and

dividing it by four.

Length of the madhyama anguli i.e. from tip of middle finger to metacarpo-

phalangeal joint of middle finger which is then divided by five.

4.4.2 Bahyakarna (External Ear)

The following anatomical parts of the external ear are considered to be measured by

using own anguli.

a) Circumference: The distance between curve of helix and intertragus notch

crossing through auricular tubercle and lobule of auricle across the pinna.

b) Length: The distance between upper portion of helix and lower portion of lobule

of auricle.

c) Width: The distance between tragus and proximal part of helix at 1800

denominator.

d) Root posterior: The distance between posterior part of pinna with petrous part of

the temporal bone posteriorly.


58

Methodology

e) Root anterior: The distance between anterior part of pinna with petrous part of

the temporal bone anteriorly.

4.5 Methodology

The healthy volunteers after following the inclusion and exclusion criteria are prepared

for the anthropometric study of Bahya Karna using anguli praman. The measurement

was taken preferably in the early morning.

Prior to initiation of the study carefully, investigation was carried out to ensure the

normal stature and anatomical configuration of ear. Emphasis was also drawn to exclude

any use of heavy ornaments that has the possibility to interfere the normal investigation.

After thorough investigation ensuring normal anatomorphological structure of the ear, the

individual was advised to swipe the external ear using sterile solution prepared from 10%

of Dettol.

The middle finger is accepted as the tool of measurement. The middle finger is

premeasured with screw gauge and converted into centimetre to arrive at uniform

standardized result. Along with this, metacarpophlangeal joint is also consider as a tool of

measurement of the external ear.

The measurements were carried out for circumference, length, width, root posterior, root

anterior of both external ears (Bahyakarna).


59

Methodology

The data received are recorded in the specific forms they are noted with age, sex, height,

occupation, and education.

The following points are noted during measuring procedure to enable accurate and

minimal error free result and interpretation.

1. Clothing that might interfere with

measurement procedure are removed and the volunteers are advised dressed in

simple cloth.

2. Measurements were preferable taken

in the early morning between 8-10 AM.

3. Minimal compressions to the skin

surface were taken care.

4. Profoma is prepared with observation

of 100 health individuals for the present study.


60

Methodology

Picture-5 Screw gauge

Picture-6 Vernier callipers


61

Observations and results

Table 1

BREADTH OF PROXIMAL INTERPHALANGEAL JOINT OF RIGHT MIDDLE FINGER

Breadth of proximal interphalangeal joint of right middle finger in (cm) Volunteer age group 1.6 – 1.8 1.9 – 2.1 2.2 – 2.4 16 - 20 2 6 0 21 – 25 25 55 2 26 – 30 2 6 0 31 – 35 2 0 0

Breadth of proximal interphalangeal joint varies from 1.6 - 2.2 cm with the mean 1.896 cm and

Standard deviation (SD) as 0.141 cm and median as 1.900 cm.

A Comprehensive Study of Pramana Shareera with Special Reference to Anguli Praman of Bahya Karna-Shareera

Page 62


Table 2

BREADTH OF METACARPOPHALANGEAL JOINT OF RIGHT HAND

[ Breadth of Metacarpo Phalangeal joint of Right hand( 2nd – 5th ) ] / 4 in cm

Volunteer age group

1.6 – 1.89 1.9 – 2.19 2.2 – 2.49 16 - 20 1 6 1 21 – 25 6 74 2 26 – 30 3 4 1 31 – 35 2 0 0

Breadth of metacarpophalangeal joint varies from 1.73 - 2.33 cm with the mean as 1.977 cm and

Standard deviation (SD) as 0.107 cm. The median breadth is noted as 1.970 cm.


Page 63


Table 3

LENGTH OF RIGHT MIDDLE FINGER

[ Length of right middle finger ] / 5 in cms Volunteer age group 1.6 – 1.89 1.9 – 2.19 2.2 – 2.49

16 - 20 3 5 0 21 – 25 44 38 0 26 – 30 4 4 0 31 – 35 1 1 0

Length of middle finger varies from 1.60 - 2.02 cm with the mean 1.868 cm and Standard

deviation (SD) as 0.0935 cm, with median length is 1.880 cm.


Page 64


Table 4

LENGTH OF RIGHT EAR MEASURED WITH THE HELP OF

PROXIMAL INTERPHALANGEAL JOINT OF RIGHT MIDDLE FINGER IN ANGULI

Length of right ear measured with the help of proximal interphalangeal joint of right middle finger

Volunteers age group

3.00 – 3.59 3.60 – 4.09 4.10 – 4.59 4.60 – 5.09 16 – 20 3 3 2 0 21 – 25 13 58 8 3 26 – 30 3 2 2 1 31 – 35 0 1 0 1

Length varies from 3.17 – 4.60 anguli with the mean as 3.858 and standard deviation (SD) as

0.373 anguli and median length is 3.838 anguli.


Page 65


Table 5


BREADTH OF RIGHT METACARPAOPHALANGEAL JOINT IN ANGULI

[ Length of right ear in anguli with breadth of right metacarpo phalangeal joint[ (2nd – 5th) / 4] . anguli

Volunteer age group

3.00 – 3.59 3.60 – 4.09 4.10 – 4.59 16 - 20 2 6 0 21 – 25 26 49 7 26 – 30 3 5 0 31 – 35 0 1 1

Length of right ear measured varies from 3.15 – 4.54 anguli with the mean 3.703 and standard

deviation(SD) as 0.336 anguli, median 3.700 anguli


Page 66


Table 6


LENGTH OF RIGHT MIDDLE FINGER IN ANGULI

Length of right ear with length of right middle finger / 5 – anguli Volunteers age group 3.00 – 3.59 3.60 – 4.09 4.10 – 4.59 4.60 – 5.09

16 – 20 2 5 1 0 21 – 25 11 51 17 3 26 – 30 3 2 3 0 31 – 35 0 1 1 0

Length of right year varies from 3.20 – 4.82 anguli with the mean 3.886 and standard deviation

(SD) as 0.375 anguli, median 3.890 anguli


Page 67


Table 7

WIDTH OF RIGHT EAR MEASURED WITH THE HELP OF


Width of right ear with proximal interphalangeal joint of right middle finger in anguli

Volunteer age group

1.0 – 1.59 1.6 – 2.09 2.1 – 2.59 16 - 20 4 4 0 21 – 25 51 28 3 26 – 30 5 2 1 31 – 35 1 1 0

Width of right ear varies from 1.14 – 2.40 anguli with the mean 1.558 and standard deviation

(SD) as 0.236 anguli, median 1.570 anguli.


Page 68


Table 8


BREADTH OF RIGHT METACARPOPHALANGEAL JOINT IN ANGULI

[Width of right ear in anguli with breadth of right metacarpo phalangeal joint [(2nd – 5th ) / 4] – anguli


1.0 – 1.59 1.6 – 2.09 16 – 20 6 2 21 – 25 66 16 26 – 30 6 2 31 – 35 1 1




Page 69


Table 9



[ Width of right ear in anguli with length of right middle finger ] / 5 – anguli

Volunteer age group

1.0 – 1.59 1.6 – 2.09 2.1 – 2.59 16 - 20 3 5 0 21 – 25 48 32 2 26 – 30 4 3 1 31 – 35 1 1 0




Page 70


Table 10

CIRCUMFERENCE OF RIGHT EAR MEASURED WITH THE HELP OF


Circumference of right ear in anguli with proximal inter phalangeal joint of right middle finger – anguli


4.1 – 5.09 5.1 – 6.09 6.1 – 7.09 7.1 – 8.09 16 – 20 1 3 4 0 21 – 25 8 28 36 10 26 – 30 0 2 4 2 31 – 35 0 0 1 1

Circumference of the right ear varies from 4.71 – 8.00 anguli with the mean 6.235 and

standard deviation (SD) as 0.737 anguli, median 6.230 anguli


Page 71


Table 11



[ Circumference of right ear in anguli with breadth of right metacarpo phalangeal joint [(2nd – 5th ) / 4] – anguli


4.1 – 5.09 5.1 – 6.09 6.1 – 7.09 7.1 – 8.09 16 – 20 1 5 2 0 21 – 25 12 32 37 1 26 – 30 0 2 6 0 31 – 35 0 0 2 0

Circumference of right ear varies from 4.46 – 7.34 anguli with the mean 5.958 and standard deviation (SD) as 0.631 anguli, median 6.070 anguli


Page 72


Table 12



[ Circumference of right ear with length of right middle finger ] / 5 – anguliVolunteers age group 4.1 – 5.09 5.1 – 6.09 6.1 – 7.09 7.1 – 8.09

16 – 20 0 5 2 1 21 – 25 3 17 56 6 26 – 30 0 3 2 3 31 – 35 0 0 2 0

Circumference of right ear varies from 4.57 – 7.65 anguli with the mean 6.295 and standard deviation (SD) as 0.595 anguli, median 6.295 anguli.


Page 73


Table 13

ROOT ANTERIOR OF RIGHT EAR MEASURED WITH THE HELP OF

BREADTH OF PROXIMAL INTERPHALANGEAL JOINT OF RIGHT MIDDLE FINGER

IN ANGULI

Root anterior of right ear in anguli with proximal inter phalangeal joint of right middle finger – anguli

Volunteer age group

1.5 – 2.49 2.5 – 3.49 3.5 – 4.49 16 - 20 3 5 0 21 – 25 36 44 2 26 – 30 3 5 0 31 – 35 0 2 0

Page 74

Root anterior of the right ear varies from 2.00 – 3.54 anguli with the mean 2.604 and standard

deviation (SD) as 0.326 anguli, median 2.530 anguli



Table 14



[ Root anterior of right ear in anguli with breadth of right metacarpo phalangeal joint [(2nd - 5th )/ 4] – anguli


1.5 – 2.49 2.5 – 3.49 16 – 20 4 4 21 – 25 42 40 26 – 30 5 3 31 – 35 0 2

Root anterior of the right ear varies from 2.07 – 3.38 anguli with the mean 2.497 and

standard deviation (SD) as 0.300 anguli, median 2.490 anguli,


Page 75


Table 15



Root anterior of right ear in anguli with length of right middle finger - anguliVolunteer age group 1.5 – 2.49 2.5 – 3.49 3.5 – 4.49

16 - 20 3 4 1 21 – 25 28 50 4 26 – 30 3 5 0 31 – 35 0 2 0

Root anterior of the right ear varies from 2.08 – 3.66 anguli with the mean 2.652 and

standard deviation (SD) as 0.393 anguli, median 2.650 anguli


Page 76


Table 16

ROOT POSTERIOR OF RIGHT EAR MEASURED WITH THE HELP OF


Root posterior of right ear in anguli with proximal interphalangeal joint of right middle finger – anguli

Volunteer age group

3.0 – 3.99 4.0 – 4.99 5.0 – 5.99 16 - 20 4 4 0 21 – 25 21 56 5 26 – 30 0 7 1 31 – 35 1 1 0

Root posterior of right ear varies from 3.43 – 5.33 anguli with the mean 4.234 and standard deviation (SD) as 0.441 anguli, median 4.210 anguli


Page 77


Table 17



[ Root posterior of right ear in anguli with breadth of right metacarpo phalangeal joint (2nd – 5th) ] /4 – anguli

Volunteer age group

3.0 – 3.99 4.0 – 4.99 5.0 – 5.99 16 - 20 6 2 0 21 – 25 36 45 1 26 – 30 0 8 0 31 – 35 1 1 0

Root posterior of the right ear varies from 3.23 – 5.08 anguli with the mean 4.056 and standard



Page 78


Table 18


LEGTH OF RIGHT MIDDLE FINGER IN ANGULI

[ Root posterior of right ear in anguli with length of right middle finger ] / 5 – anguli

Volunteer age group

3.0 – 3.99 4.0 – 4.99 5.0 – 5.99 16 – 20 6 2 0 21 – 25 36 45 1 26 – 30 0 8 0 31 – 35 1 1 0

Root posterior of the right ear varies from 3.60 – 5.29 anguli with the mean 4.302 and standard



Page 79


Table 19

BREADTH OF PROXIMAL INTERPHALANGEAL JOINT OF LEFT MIDDLE FINGER

IN CMs.

Breadth of proximal interphalangeal joint of left middle finger in cms Volunteers age group 1.6 – 1.89 1.9 – 2.19

16 – 20 3 5 21 – 25 50 32 26 – 30 7 1 31 – 35 2 0

Breadth of proximal interphalangeal joint of left hand varies from 1.6 -2.1 cm with the mean

1.822 cm and standard deviation (SD) as 0.122 cm, median1.800 cm.


Page 80


Table 20

BREADTH OF METACARPOPHALANGEAL JOINT OF LEFT HAND IN CMs.

[ Breadth of metacarpo phalangeal joint of left hand (2nd – 5th) ] / 4 in cmsVolunteer age group 1.60 – 1.89 1.90 – 2.19 2.20 – 2.49

16 - 20 1 7 0 21 – 25 10 70 2 26 – 30 3 4 1 31 – 35 2 0 0

Breadth of metacarpophalangeal joint varies from 1.7 – 2.2 cm with the mean 1.955 cm and

standard deviation (SD) as 0.103cm, median 1.950 cm


Page 81


Table 21

LENGTH OF LEFT MIDDLE FINGER IN CMs.

Length of left middle finger / 5 in cms Volunteer age group 1.60 – 1.89 1.90 – 2.19 2.20 – 2.49

16 - 20 4 4 0 21 – 25 46 36 0 26 – 30 4 4 0 31 – 35 1 1 0

Length of middle finger varies from 1.6 – 2.02 cm with the mean 1.862 cm and standard

deviation (SD) as 0.0932 cm, median 1.880 cm


Page 82


Table 22


PROXIMAL INTERPHALANGEAL JOINT OF LEFT MIDDLE FINGER IN ANGULI

Length of right ear in anguli with proximal inter phalangeal joint of left middle finger – anguli


3.00 – 3.59 3.60 – 4.09 4.10 – 4.59 4.60 – 5.09 16 – 20 2 4 2 0 21 – 25 5 40 34 3 26 – 30 2 3 2 1 31 – 35 0 0 0 2

Length of right ear varies from 3.33 – 4.88 anguli with the mean 3.991 and standard deviation

(SD) as 0.302 anguli , median 4.000 anguli


Page 83


Table 23


BREADTH OF LEFT METACARPOPHALANGEAL JOINT IN ANGULI

[ Length of right ear with breadth of left metacarpo phalangeal joint (2nd – 5th) ] / 4 - anguli

Volunteer age group

3.00 – 3.59 3.60 – 4.09 4.10 – 4.59 16 - 20 3 5 0 21 – 25 23 52 7 26 – 30 4 4 0 31 – 35 0 2 0

Page 84





Table 24


LENGTH OF LEFT MIDDLE FINGER IN ANGULI

[ Length of right ear in anguli with Length of left middle finger ] / 5 – anguli Volunteers age group 3.00 – 3.59 3.60 – 4.09 4.10 – 4.59 4.60 – 5.09

16 – 20 1 6 1 0 21 – 25 13 47 19 3 26 – 30 3 2 3 0 31 – 35 0 1 1 0




Page 85


Table 25



Width of right ear with proximal interphalangeal joint of left middle finger – anguli Volunteer age group 1.00 – 1.59 1.60 – 2.09 2.10 – 2.59

16 - 20 4 4 0 21 – 25 45 35 2 26 – 30 4 3 1 31 – 35 1 1 0

Width of the right ear varies from 1.25 – 2.40 anguli with the mean 1.621 and standard



Page 86


Table 26



[Width of right ear in anguli with breadth of left metacarpo phalangeal joint (2nd – 5th ) ] / 4 – anguli


1.00 – 1.59 1.60 – 2.09 16 – 20 5 3 21 – 25 59 23 26 – 30 4 4 31 – 35 1 1

Width of right ear varies from 1.14 – 2 .02 anguli with the mean 1.506 and standard deviation (SD) as 0.189 anguli, median 1.490 anguli


Page 87


Table 27


LEGNTH OF LEFT MIDDLE FINGER IN ANGULI

[ Width of right ear with length of left middle finger ] / 5 - anguli Volunteer age group 1.00 – 1.59 1.6 – 2.09 2.10 – 2.59

16 – 20 3 5 0 21 – 25 47 33 2 26 – 30 5 2 1 31 – 35 1 1 0

Width of the right ear varies from 1.20 – 2.25 anguli with the mean 1.583 and standard deviation



Page 88


Table 28



Circumference of right ear with proximal inter phalangeal joint left middle finger – anguli


4.1 – 5.09 5.1 – 6.09 6.1 – 7.09 7.1 – 8.09 s16 – 20 1 2 5 0 21 – 25 1 17 53 11 26 – 30 0 2 3 3 31 – 35 0 0 1 1

Circumference of the right ear varies from 4.95 – 8.00 anguli with the mean 6.454 and standard



Page 89


Table 29



[ Circumference of right ear with bredth of left metacarpo phalangeal joint (2nd – 5th ) ] / 4 – anguli


4.1 – 5.09 5.1 – 6.09 6.1 – 7.09 7.1 – 8.09 16 – 20 1 5 2 0 21 – 25 7 38 33 4 26 – 30 0 2 6 0 31 – 35 0 0 1 1

Circumference of right ear varies from 4.53 – 7.14 anguli with the mean 6.020 and standard



Page 90


Table 30



[ Circumference of right ear with length of left middle finger ] / 5 – anguli


4.1 – 5.09 5.1 – 6.09 6.1 – 7.09 7.1 – 8.09 16 – 20 0 5 2 1 21 – 25 3 17 56 6 26 – 30 0 3 2 3 31 – 35 0 0 2 0

Circumference of right ear varies from 4.57 – 7.65 anguli with the mean 6.314 and standard



Page 91


Table 31



Root anterior of right ear with proximal inter phalangeal joint of left middle finger anguli

Volunteer age group

1.50 – 2.49 2.50 – 3.49 3.50 – 4.49 16 - 20 2 6 8 21 – 25 21 58 3 26 – 30 0 8 0 31 – 35 0 2 0

It varies from 2.20 – 3.59 anguli with the mean 2.722 and standard deviation (SD) as 0.367

anguli, median 2.650 anguli


Page 92


Table 32



[ Root anterior of right ear in anguli with breadth of left metacarpo phalangeal joint (2nd - 5th ) ] / 4 – anguli


1.50 – 2.49 2.50 – 3.49 16 – 20 4 4 21 – 25 40 42 26 – 30 4 4 31 – 35 0 2




Page 93


Table 33



Root anterior of right ear in anguli with length of left middle finger - anguli Volunteer age group 1.50 – 2.49 2.50 – 3.49 3.50 – 4.49

16 - 20 3 5 0 21 – 25 30 49 3 26 – 30 2 6 0 31 – 35 0 2 0




Page 94


Table 34



Root posterior of right ear in anguli with proximal interphalangeal joint of left middle finger – anguli

Volunteer age group

3.00 – 3.99 4.00 – 4.99 5.00 – 5.99 16 - 20 3 5 0 21 – 25 13 62 7 26 – 30 0 5 3 31 – 35 0 2 0




Page 95


Table 35



[ Root posterior of right ear in anguli with breadth of left metacarpo phalangeal joint (2nd – 5th) ] /4 – anguli

Volunteer age group

3.0 – 3.99 4.0 – 4.99 5.0 – 5.99 16 - 20 5 3 0 21 – 25 31 50 1 26 – 30 0 8 0 31 – 35 1 1 0




Page 96


Table 36



[ Root posterior of right ear in anguli with length of left middle finger ] / 5 – anguli

Volunteer age group

3.0 – 3.99 4.0 – 4.99 5.0 – 5.99 16 – 20 2 5 1 21 – 25 16 60 6 26 – 30 0 7 1 31 – 35 2 0 0




Page 97



Page 98

Discussion

6.0 DISCUSSION

This present anthropometric study of the bahya- karma (so called the external ear) was

really challenging. The cause is lack of definite descriptions related to the relative

comparisons of various parts of the external ear in the view of their measurement as well

as the proper methodologies for measuring the external ear.

Hence, the present study is aimed to explore the details of the bahya-karna based on the

swanguli pramana. The study is planned to compare the anguli pramana of karna

described by Acharya Charaka and Sushruta.

The study was planned with healthy volunteers (n=100, with age group of 16 to 35) in

and around Alva’s Ayurveda Medical College, Moodbidri, Karnataka. The study is

conducted in the early morning with maintenance of complete hygiene.

All the healthy volunteers are grouped in 5-years of interval for easier understanding and

graphical presentation. The details of the measurements are noted in the master table

attached as annexure.


98

Discussion

Right and left middle finger is selected for the study. The measurements were carried out

after proper cleaning of the external ear, after ensuring that all the ear-ornaments are

taken out.

Breadth of proximal inter-phalangeal joint of right middle finger is explained in the table-

1. The mean breadth is 1.896 cm with standard deviation (SD) is 0.141 cm and median is

1.900 cm. The breadth of the proximal inter-phalangeal joint of right middle finger varies

from 1.6 cm to 2.2 cm.

Breadth of metacarpo-phalangeal joint of right hand is explained in the table-2. The mean

breadth is 1.977 cm with standard deviation (SD) is 0.107cm and median is 1.970 cm.

The breadth of the metacarpo-phalangeal joint of right hand varies from 1.73- 2.33 cm.

Length of middle finger of right hand is explained in the table-3. The mean length is

1.868 cm with standard deviation (SD) is 0.0935 cm and median is 1.880 cm. The length

of middle finger of right hand varies from 1.60 - 2.02 cm.

Length of right ear measured with proximal interphalangeal joint of right middle finger is

explained in table-4. The mean length is 3.858 anguliwith standard deviation (SD) is

0.373 anguliand median is 3.838 anguli. Length of right ear varies between 3.17 – 4.60

anguli.


99

Discussion

Length of right ear measured with breadth of right metacarpo phalangeal joint of right

hand is explained in table-5. The mean length is 3.703 anguli with standard deviation

(SD) is 0.336 anguliand median is 3.700 anguli. Length of right ear varies between 3.15

– 4.54 anguli.

Length of right ear measured with length of right middle finger is explained in table-6.

The mean length is 3.886 anguli with standard deviation (SD) is 0.375 anguliand median

is 3.890 anguli. Length of right ear varies between 3.20 – 4.82 anguli.

Width of right ear measured by proximal interphalangeal joint of right middle finger is

explained in table-7. The mean length is 1.558 anguli with standard deviation (SD) is

0.236 anguliand median is 1.570 anguli. Width of right ear varies between 1.14 – 2.40

anguli.

Width of right ear measured by breadth of metacarpo phalangeal joint of right hand is


0.180 anguliand median is 1.465 anguli. Width of right ear varies between 1.12-2.08

anguli.


100

Discussion

Width of right ear measured by length of right middle finger is explained in table-9. The

mean length is 1.579 anguli with standard deviation (SD) is 0. 0.210 anguliand median is

1.560 anguli. Width of right ear varies between 1.20 – 2.25 anguli.

Circumference of right ear measured with proximal inter phalangeal joint of right middle

finger is explained in table-10. The mean length is 6.235 anguli with standard deviation

(SD) is 0. 0.737anguliand median is 6.230anguli. Circumference of right ear varies

between 4.71 – 8.00 anguli.

Circumference of right ear measured with breadth of metacarpo phalangeal joint of right

hand is explained in table-11. The mean length is 5.958 anguli with standard deviation

(SD) is 0. 0. 631 anguliand median is 6.070 anguli. Circumference of right ear varies

between 4.46 – 7.34 anguli.

Circumference of right ear measured with length of right middle finger is explained in

table-12. The mean length is 6.295 anguli with standard deviation (SD) is 0.595

anguliand median is 6.295 anguli. Circumference of right ear varies between 4.57 – 7.65

anguli.

Root anterior of right ear measured with proximal inter-phalangeal joint of right middle

finger is explained in table-13. The mean length of root anterior is 2.604 anguli with


101

Discussion

standard deviation (SD) is 0.326 anguliand median is 2.530 anguli. Root anterior of right

ear varies between 2.00 – 3.54 anguli.

Root anterior of right ear measured with breadth of right metacarpo phalangeal joint is

explained in table-14. The mean length of root anterior is 2.497 anguli with standard

deviation (SD) is 0.300 anguliand median is 2.490 anguli. Root anterior of right ear

varies between 2.07 – 3.38 anguli.

Root anterior of right ear measured with length of right middle finger is explained in

table-15. The mean length of root anterior is 2.652 anguli with standard deviation (SD) is

0.393 anguli and median is 2. 650 anguli. Root anterior of right ear varies between 2.08

– 3.66 anguli.

Root posterior of right ear measured with proximal interphalangeal joint of right middle

finger is explained in table-16. The mean length of root posterior is 4.234 anguli with

standard deviation (SD) is 0.441 anguliand median is 4.210 anguli. Root posterior of

right ear varies between 3.43 – 5.33anguli.

Root posterior of right ear measured with breadth of right metacarpo phalangeal of is

explained in table-17. The mean of root posterior is 4.056 anguli with standard deviation

(SD) is 0.332 anguliand median is 4.04anguli. Root posterior of right ear varies between

3.23-5.08 anguli.


102

Discussion

Root posterior of right ear measured with length of right middle finger is explained in

table-18. The mean of root posterior is 4.302 anguli with standard deviation (SD) is 0.402

anguliand median is 4.245 anguli. Root posterior of right ear varies between 3.60 –

5.29anguli.

Breadth of proximal inter-phalangeal joint of left middle finger is explained in the table-

19. The mean breadth is 1.822 cm with standard deviation (SD) is 0.122 cm and median

is 1.800 cm. The breadth of the proximal inter-phalangeal joint of left middle finger

varies from 1.6 cm to 2.1 cm.

Breadth of metacarpo-phalangeal joint of left hand is explained in the table-20. The mean

breadth is 1.955 cm with standard deviation (SD) is 0.103 cm and median is 1.950 cm.

The breadth of the metacarpo-phalangeal joint of left hand varies from 1.70- 2.22 cm.

Length of middle finger of left hand is explained in the table-21. The mean length is

1.862 cm with standard deviation (SD) is 0.0932 cm and median is 1.880 cm. The length

of middle finger of left hand varies from 1.60 - 2.02 cm.

Length of right ear measured with proximal interphalangeal joint of left middle finger is



103

Discussion

0.302 anguliand median is 4.0anguli. Length of right ear varies between 3.33 – 4.88

anguli.

Length of right ear measured with breadth of left metacarpo phalangeal joint is explained

in table-23. The mean length is 3.714anguli with standard deviation (SD) is

0.249anguliand median is 3.740 anguli. Length of right ear varies between 3.18 –

4.51anguli.

Length of right ear measured with length of left middle finger is explained in table-24.

The mean length is 3.906anguli with standard deviation (SD) is 0.304anguliand median

is 3.890 anguli. Length of right ear varies between 3.20 – 4.82 anguli.

Width of right ear measured by proximal interphalangeal joint of left middle finger is

explained in table-25. The mean length is 1.621anguli with standard deviation (SD) is

0.230anguliand median is 1.590 anguli. Width of right ear varies between 1.25 – 2.40

anguli.

Width of right ear measured by breadth of left metacarpo phalangeal joint is explained in

table-26. The mean length is 1.506anguli with standard deviation (SD) is 0.189anguliand

median is 1.490anguli. Width of right ear varies between 1.14-2.02 anguli.


104

Discussion

Width of right ear measured by length of left middle finger is explained in table-27. The

mean length is 1.583anguli with standard deviation (SD) is 0.210 anguliand median is

1.570 anguli. Width of right ear varies between 1.20 – 2.25 anguli.

Circumference of right ear measured with proximal inter phalangeal joint of left middle

finger is explained in table-28. The mean length is 6.454anguli with standard deviation

(SD) is 0.711anguliand median is 6.470anguli. Circumference of right ear varies between

4.95 – 8.00 anguli.

Circumference of right ear measured with breadth of left metacarpo phalangeal joint is

explained in table-29. The mean length is 6.020anguli with standard deviation (SD) is 0.

633anguliand median is 6.130anguli. Circumference of right ear varies between 4.53 –

7.14 anguli.

Circumference of right ear measured with length of left middle finger is explained in

table-30. The mean length is 6.314 anguli with standard deviation (SD) is 0.596anguliand

median is 6.265 anguli. Circumference of right ear varies between 4.57 – 7.65 anguli.

Root anterior of right ear measured with proximal interphalangeal joint of left middle

finger is explained in table-31. The mean of root anterior is 2.722anguli with standard


105

Discussion

deviation (SD) is 0.367anguliand median is 2.650anguli. Root anterior of right ear varies

between 2.20 – 3.59anguli.

Root anterior of right ear measured with breadth of left metacarpo phalangeal joint is

explained in table-32. The mean of root anterior is 2.516anguli with standard deviation

(SD) is 0.295anguliand median is 2.530anguli. Root anterior of right ear varies between

1.95 – 3.38 anguli.

Root anterior of right ear measured with length of left middle finger is explained in table-

33. The mean of root anterior is 2.644anguli with standard deviation (SD) is

0.395anguliand median is 2.635anguli. Root anterior of right ear varies between 2.14 –

3.66 anguli.

Root posterior of right ear measured with proximal interphalangeal joint of left middle

finger is explained in table-34. The mean of root posterior is 4.398anguli with standard

deviation (SD) is 0.418anguliand median is 4.440anguli. Root posterior of right ear

varies between 3.60 – 5.63 anguli.

Root posterior of right ear measured with breadth of left metacarpo phalangeal joint is

explained in table-35. The mean of root posterior is 4.067anguli with standard deviation


106

Discussion

(SD) is 0.444anguliand median is 4.07anguli. Root posterior of right ear varies between

3.27-5.14anguli.

Root posterior of right ear measured with of left middle finger is explained in table-36.

The mean length of root posterior is 4.293anguli with standard deviation (SD) is

0.374sanguliand median is 4.245 anguli. Root posterior of right ear varies between 3.60

– 5.29 anguli.


107

Conclusion

7.0 CONCLUSION

Science always encompasses principles and facts that are methodically attested and

undeniably accepted. It is a matter of nosiness voyage along with dim little corridors of

scientific theory and exhumes the dust-leaden precious gems through experiments &

discussion. Hence I have chosen such a topic of interest, to explore the anthrometry of

Bahyakarna by using own anguli (so called as swangula pramana) as standard of

measurement.

Pramana forms one of the relevant aspects in the study of the structural and functional

make up of human body. Pramana gives an idea of the stature, and their life span

including the quality of life. This is important in diagnosis, prognosis and management of

Vyadhi.

The characteristic features of various aspects of Bahyakarna like length and root as

assessed during the study are found to have been in concurrence with those mentioned in

the classics. In addition to this, measurements of other parts of the bahya karma are also

included to get the complete anthrometry of the bahyakarna.


Conclusion

The anguli is subjected to different versions of the authors. However the parameter taken

as the width of madhyamaparva of madhyamanguli was conforming in all one hundred

subjects.

Measurements are taken for both the Bahyakarnas (External ear)- right and left ear. The

measurements of both left and right ears are equal across all the parameters. The details

of the measurements are captured in the master chart.

Modi, 1997 described in his text book of medical jurisprudence and toxicology that

anthropometry is adopted in personal identity with measurements of the length and width

of right ear. Hence, I have also vividly discussed various measurements of the right

external ear.

The measurements taken with the help of angula pramanausing the width of the proximal

inter-phalangeal joint (madhyama parva of the madhyama anguli), is found to be more

accurate than the two other parameters used for measuring the angula pramana.

The anterior root of the external earis resulted with mean of 2.604 angula(with standard

deviation 0.326 angula)whenmeasured by middle finger of right hand and 2.722(with

standard deviation 0.367 angula)angula when measured in middle finger of the left hand.

This measurement though not exactly matches with the classical references, but may be

compared to nearby.


Conclusion

The length of the right ear measured by proximal interphalangeal joint, breadth of

metacarpophalangeal joint and length of the middle finger of left hand is resulted with

3.991angula (with standard deviation 0.302), 3.714angula (with standard deviation 0.249)

and 3.906 angula (with standard deviation 0.304) respectively. Whereas the length of the

right ear measured by proximal interphalangeal joint and length of the middle finger of

right hand is resulted with 3.858angula (with standard deviation 0.373), 3.703angula

(with standard deviation 0.336) and 3.886 angula (with standard deviation 0.375)

respectively. The measurements as perceived by the use of left hand middle finger-

interphalangeal joint is more nearby to the classical reference of karna as described of 4

in angula.

The width of the right ear measured by proximal interphalangeal joint, breadth of


1.621angula (with standard deviation 0.230), 1.506angula (with standard deviation

0.189)and 1.583 angula (with standard deviation 0.210) respectively. Where as the width

of the right ear measured by proximal interphalangeal joint, breadth of

metacarpopalangeal joint and length of the middle finger of right hand is resulted with


and 1.579 angula (with standard deviation 0.210) respectively. This measurement is not

described in the classics nor is any papers available in modern anatomy.


Conclusion

The circumference of the right ear measured by proximal interphalangeal joint, breadth of


6.454angula (with standard deviation 0.711), 6.020angula (with standard deviation

0.633)and 6.314 angula (with standard deviation 0.596) respectively. Whereas the

circumference of the right ear measured by proximal interphalangeal joint, breadth of

metacarpophalangeal joint and length of the middle finger of right hand is resulted with

6.235 angula (with standard deviation 0.737),5.958 angula (with standard deviation

0.631) and6.295 angula (with standard deviation 0.595) respectively. This measurement

is not described in the classics nor is any papers available in modern anatomy.

The posterior root of the right ear measured by proximal interphalangeal joint, breadth of



and 4.293 angula (with standard deviation 0.374) respectively. Whereas the length of the

right ear measured by proximal interphalangeal joint and length of the middle finger of

right hand is resulted with 4.234angula (with standard deviation 0.441), 4.056angula

(with standard deviation 0.332) and 4.302 angula (with standard deviation 0.402)

respectively. This measurement is not described in the classics nor is any papers available

in modern anatomy about this measurement.

Further studies with large sample size may be required for a better understanding of the

anguli pramana.


Summary

8.0 SUMMARY

The study entitled “A comprehensive study of pramana shareera with special reference to

anguli praman of bahyakarna-shareera” comprises of eight chapters namely

Introduction, objectives, review of literature, methodology, observations and result,

discussion, conclusion and summary. It also includes other additional complementary

chapters like references, bibliography, and annexure containing the master chart, and

proforma.

Chapter-1: Introduction

It gives a general idea concerning the subject of discussion namely pramana and

anthropometric concept. The relevance of these topics especially based on their

anatomical importance is also highlighted.

Chapter-2: Objectives

It is presented with aims and objectives of this study.

Chapter-3: Review of literature

It includes important aspects like historical review, ayurvedic review and applied

anthropometric review.


112

Summary

Vivid discussions related to the karna in Ayurveda, their importance in clinical practice,

prognosis, embryology and anatomy of the ear anthropometric measurements in own

fingers (swanguli), modern review of anthropometric concept & their importance are

presented, which give us the consequence and need of the full topic of study.

Descriptions are narrated with the help of various pictures for better perceptive.

Review:

Historical review: Mentions regarding pramana in various ancient literatures have been

dealt with.

Ayurvedic Review: Encloses explanations regarding the details & importance of Pramana

& Prakruti dealt in various classics.

Modern Review: It itemizes details of anthropometry and its close association with

Pramana.

Chapter-4: Methodology

It spells out method of collection of data, inclusion criteria, exclusion criteria, and

assessment criteria.


113

Summary

Chapter-5: Observations & Result

It embraces the inference drawn based on the studies.

This chapter is explained in detail of various measurements of the ear and narrates about

the study in detail. The chapter contains thirty six tables along with graphical

presentations that ease to understand the topic of study in a descriptive manner.

Chapter-6: Discussion

It comprises the details of comparison of the collected data from the pool of the

observation and results. The details are compared with the help of statistics that includes

mean, median and standard deviation.

Chapter-7: Conclusion

Conclusion drawn from the various sections of the work is enumerated. Comparisons

with the ancient references explained by the classics are also explained and justified.

Chapter-8: Summary

It summarizes the entire work.


114

Reference Sloka

9.0 Referred Shlokas

1.AjÉmÉÑlÉUÉrÉÑwÉÉåÌuÉ¥ÉÉlÉÉjÉïÇ

A…¡ûmÉëirÉ…¡ûmÉëqÉÉhÉxÉÉUÉlÉÑmÉSå¤rÉÉqÉ || | xÉÑ.xÉÔ.35\11 |

2. SåWû:xuÉæUXçaÉÑsÉæUåwÉrÉjÉÉuÉSlÉÑMüÐÌiÉïiÉ: ||

rÉÑ£ü: mÉëqÉÉhÉålÉÉlÉålÉmÉÔqÉÉlÉuÉÉrÉÌSuÉÉÅXçaÉlÉÉ |

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qÉkrÉqÉÇqÉkrÉqÉæUÉrÉÑÌuÉï¨ÉÇWûÏlÉæxjÉÉÅuÉUqÉç || (xÉÑ.xÉÔ

35\15 )

3.iÉ§ÉÉrÉÑoÉïsÉqÉÉåeÉ: xÉÑZÉqÉæµÉrÉïÇÌuÉ¨ÉÍqÉ¹¶ÉÉmÉUå

pÉÉuÉÉpÉuÉlirÉÉrÉ¨ÉÉ: mÉëqÉÉhÉuÉÌiÉzÉUÏUå;

ÌuÉmÉrÉïrÉxiuÉiÉÉåWûÏlÉåÅÍkÉMåüuÉÉ || ( cÉ. ÌuÉ. 7\117 )

4.

iÉxqÉÉSÉiÉÑUÇmÉUÏ¤ÉåiÉmÉëM×üÌiÉiÉ¶ÉÌuÉM×üÌiÉiÉ¶ÉxÉÉUiÉ¶ÉxÉÇW

ûlÉlÉiÉ¶ÉmÉëqÉÉhÉÉiÉ¶ÉxÉÉiqrÉiÉ¶É

xÉiuÉiÉ¶ÉAÉWûÉUzÉÌ£üiÉ¶ÉurÉÉrÉÉqÉzÉÌ£üiÉ¶ÉuÉrÉxiÉ¶ÉåÌiÉoÉsÉ

mÉëqÉÉhÉÌuÉzÉåwÉaÉëWûhÉWåûiÉÉå :|( cÉç.ÌuÉ. 8\94)

5.mÉëqÉÏrÉiÉåAlÉålÉåÌiÉmÉëqÉÉhÉÇ ¥ÉÉlÉqÉÉ§ÉqÉÏÎmxÉiÉqÉç || (cÉ.

ÌuÉ. 8\7)

6.qÉÉlÉqÉ | (cÉ. vÉÉ. 7\15 cÉ¢ümÉÉhÉÏ )

7.

mÉëqÉÉhÉ¶ÉåÌiÉzÉUÏUmÉëqÉÉhÉÇmÉÑlÉrÉïjÉÉxuÉålÉÉ…¡ÓûÍsÉmÉëqÉ

hÉålÉÉåmÉSå¤rÉiÉåEixÉåkÉÌuÉxiÉÉUÉrÉÉqÉærÉïjÉÉ¢üqÉqÉç|

(cÉç.ÌuÉ 8\117)

8. rÉiuÉgeÉÍsÉxÉÇZrÉårÉÇiÉSÒmÉSå¤rÉÉqÉ:

iÉiÉ:mÉUÇmÉëqÉÉhÉqÉÍpÉgeÉårÉÇ, iÉ¶É uÉ×Î®¾ûÉxÉrÉÉåÌaÉ

iÉYrÉïqÉåuÉ | ( cÉ. vÉÉ. 7\15 )


115

Reference Sloka

18.

AÉiÉÑUqÉÑmÉ¢üqÉÉhÉålÉÍpÉwÉeÉÉÅrÉÑUÉSÉuÉåuÉmÉUÏÍ¤ÉiÉurÉÉqÉ

ç |

xÉirÉÉrÉÑÌwÉurÉÉkrÉ×iuÉÎalÉuÉrÉÉåSåWÇûoÉsÉÇ |

xÉiuÉÇxÉÉiqrÉmÉëM×üÌiÉpÉåwÉeÉSåzÉÉlÉçmÉUÏ¤ÉåiÉ || (

xÉÑ.xÉÔ.35\2)

19.

WûxiÉmÉÉSvÉÉZÉÉxiÉÑmÉëirÉÇaÉ,mÉëÌiÉvÉÉZÉÉrÉÉÇmÉgcÉÍqÉÍsÉiuÉ

ÉÌuÉÇvÉÌiÉ | ( xÉÑ.vÉÉ.5\4 )

20. केिचतम्ध्यमाङ्गुिलकायास्तुमध्यमपर्विभताङ्गलुिभित । (आढमल्ल. श. सं. प्र. १/३५-३६) 21. मध्यमाङ्गुल्यौप ाङ्गुले । (सु. सु. ३५/१२) 22. तलंषट्चतुरङ्गुलायामिवस्तारम ्। (सु. सु. ३५/१२) 23. अङ्गलुशब्दनेा ाङ्गुषठ्नखतलभागगंहृ्णिन्त । (आढमल्ल. श. सं. प्र. १/३५-३६) 24.शब्द ाह, ोत्रम्, ुित, श्रवनम ् [शब्दकल्प मुम्] 25. शर्वनम् - ुयतेअनेनइितश्रवनम् [शब्दकल्प मुम्] 26. तत्र ो िेन् यिवजेयािवशेषारोगेषुव्रणा ाविवज्ञानीयािदषवुक््षयन्ते- तत्रसफेनमर्क्तमीरयन्निनल: सशब्दोिनर्गचछ्ित । (सुसु १०/५) 27. कर्णनेत्र ु शङ्खाम्सगणड्क्षस्तनङ्क्षणवॄषणपाश्र्विस्फग्जानुकुर्परबाहुरुप्रभॄतयो े ।े (सु श ५/४) 28. स यदाहस्तपादिजह्वा ाणकर्णिनतम्बािदिभरड्.घाड्.गैरुपेतस्तदा ’शरीरम्इितसंज्ञलभते । (सु श. ५/३) 29. श्रवणनयनवदन ाणगदुमे ािणनव ोतािम्सनराणाबंिहमुर्खािन । (सु. श .५/१०) 30. गण्डकर्णशङ्खेष्वेकैकं,......(सु.श. ५/१९) 31. गण्डकर्णशङ्खेष्वेकैकः ौ.....(सु.श. ५/२३) 32. ाणकर्ण ीवािक्षकोषेषतुरुणािन । (सु. श. ५/२०) 33. ोतर्शॄङ्गाटकेषुशड्.खावतार्: । (सु. श. ५/२७) 34. पञ्चपेशीशतािनभविन्त .........कर्णयोद्र्व, चत ोललाटे, एकािशरसीित; एवमेतािनपञ्चपेशीशतािन । (सु .श. ५/३७)


116

Reference Sloka

35. कर्णय दशतासामश्ब्दवािहनीमेकैकम्पिरहरेत् । (सु. श ७/२२) 36. मॄदचुर्ममामस्पेशीषूत्पलनालेष ुच कर्णसिन्धबन्धयोग्याम् । (सु. सु. ९. ४) 37. सिन्धकूर्चक ूस्तनान्तरतलकर्णषुस्विस्तकम् । (सु. सु १८/ १८) 38. आहायार्: शर्करािस्त ोदन्तकर्णमलोअश्मरी। शल्यािनमढूगभार्शच्वर्चश्चिनिचतम्गुद े॥ (सु. सु. २५/११) 39. रक्षाभूषणिनिम ंबालस्यकण िवध्यतेे । तौष मेािससप्तमेवाशुक्लपक्षेप्रशस्तेषु ितिथकरणमुहूर्तनक्ष ेषुकृतमङ्गलस्विस्तवाचनं धा ्यङ्केकुमारधराङ्केवाकुमारमपुवेश्यबाल-

ीडनकैःप्रलोभ्यािभसान्त्वयिन्भषग्वामहस्तेनाकृष्य कणदवैकृतेिछदर्आिदतय्करवभािसत ेशनैःशनैर्दिक्षणहस्तेनजुर्िवध्येत, प्रतनुकंसुच्या, बहलमारयाःपूर्वदिक्षणंकुमारस्य, वाम ंकुमायार्ःततःिपचवुितप्रवेशयेत्॥ (सुसु १६/३) 40. त ाज्ञेनयदचृछ्यािव ासुिसरासुकिलका- मर्मिरकालोिहितकासूपदर्वाभविन्त। तत्र, कािलकायांजव्रोदाहःश्वयथुवदना च भविन्त; मर्मिरकायांवेदनेाजव्रोग्रन्थयशच्; लोिहितकायांमन्यास्तम्भापतानकिशरोग्रह- कर्णशूलािनभविन्त । तेषुयथास्वंप्रितकुव त। (सु.सु १६/५) 41. त सेमासनेपञ्चदशकर्णबन्धाकृतयः । तद्ध्यथानेिमसन्धानकउल्पलमेद्धय्कोवल्लूरक आसिङ्गमोगण्डकर्णआहाय िनविधमो ायोिजमः कपाटसिन्धकोअर्धकपाटसिन्धकःसंिक्ष ोहीनकण वल्लीकण यि कणर्ःकाकौष्ठकइित । (सु. सु १६/१०) 42. गण्डादतु्पाट्यमांसेनसानुनन्धेनजीवता । कर्णपालीमपालेस्तुकुयार्ि िलख्यशास्त्रिवत् ॥(सु. सु. १६/१४) 43. अतऊध्वनामिलङ्गैर्व येपाल्यामपुदर्वान् । उत्पाटक ोत्पटुका: श्याव: कण्डूयुतोभृशम् ॥ अवमन्थ: सकण्डूकोगर्िन्थकोजम्बुलस्तथा ।


117

Reference Sloka

ावी च दाहवां ैवशृण्वेषांक्रमश: ि याम् ॥ (सु. सू. १६/२६)

44. कर्णशूलप्रणादश्चबािधय वेडएव च । कर्णपकःपूितकर्णस्तथैवार्शश्चतुिवधम् ॥ कणार्बुर्दसंप्तिवधंशोफ ािपचतुिवधः । एतेकर्णगतारोगाअ ािवशितरीिरताः ॥ (सु.ऊ २०/४ – ५)

45. महाभूतािनखंवायुरि रापःिक्षितस्तथा । शब्दःसप्र्शश्चरुपं च रसोगन्धश्चतद्गुणाः ॥ (च.श. १/२७) 46.त ास्याकाशात्मकंशब्दः ो ंलाघवंसौ म्यंिववेकश्च(च.श.४/१२) 47.प ेिन् यािध ानािनःद्ध्यथा- त्वग्, िजह्वा, नािसका, अिक्षणी, कण च ।(च.श.७/७) 48. पञ्चबु ीिन् यािणःतद्ध्यथा- स्पर्शनं, रसनं, ाणं, दर्शनं, ोत्रिमित। (च.श.७/८) 49. केर्णशष्कुिलके, ौकर्णपुत्रकौ(च.श.७/११) 50. यि िव ं यदचुय्तेमहािन्तचाणुिन ोतांिसतदान्तरीक्षंशब्दः ो चंः (च.श.७/१६) 51. कण स्पृशितहस्ताभ्यांिशरोभ्रमयतेभृशम ्। अरत्यरोचकास्व ैजार्नीयात्कर्णवेदनम् ॥ (क. सु. १२/७) 52. रोिहणीसव्यङ्गुल्तामलूम् हेिर बृेहतीफलरसैघृर्तार्धवत्पचेत्पच्यमानेआपामार्गचावपेत् । िस नेकर्णपालीमहन्यहिनम्रक्षयेि मृ ीयाचच्, आशुवर्धतेपीनसमा च पालीभवित । मधुिच्छषट्सर्जरस....(क सु २१/१) 53. नािभष ाजपु ाणामन्येषांवामहात्मनाम् । कणार्िन्वध्येत्सुख ेप्सुिरहलोकेपरत्र च ॥ (क.सु.२१/२) 54. आमच्छेदअेत्ययोह्यत्रकुवेधा ोपजायते । अिभषक्तत्रमन्दात्मा ककिरष्यत्यशास्त्रिवत् ॥ (क. सु. २१/३) 55. कदावेध्यंकुत्रवेध्यंकुत्रवेध्यंकथंव्यध:। िहतोअिहतोअत्यय: कशच्त ाजञ्: कप्रपत्सते ॥ (क. सु. २१/४) 56. तस्माि षक्सुकुशल: कर्णिवध्येि चक्षण: । िशशोर्हर्षप्रमत्तस्त्यधर्मकामार्थिसदध्ये ॥ (क. सु. २१/ ५)


118

Reference Sloka

57.षट्स ाष्टममासेषुनीरुजस्यशुभऽेहिन । कण िहमागमेिवध्ये ा ्यङ्कस्थस्यसान्त्वयन् ॥(अ हृ. उ. १/२८) 59.चतुथव्यक्तताअङ्गानां, चतेनायाशच्पञ्चमे । (अ हृ.श.१/५७) 60. कण नीचोन्नतौप ान्महान्तौि षट्मासंलौ । ने ेव्य ािसतिसतेसुबदध्घनपक्ष्मणी ॥ (अ हृ. श.३/१०८) 61.धारयेत्पुरणंकर्णकर्णमलूंिवमर्दयन् । रूजःस्थानमार्दवयावत्मात्रशतंअवेदने ॥ (अ हृ. श ३२) 62.अधस्तात्कर्णयोिन ेिवधुरे ुितहािरणी ।(अ हृ. श ४/२९) 63. अनुकणललाटान्तेशङ्खौस ोिवनासशनौ । (अ हृ.श ४/३२) 64.िजह्वािक्षनािसका ोत्रखचतुष्टयसङ्गमे । तालुन्यास्यािनचत्वािर ोतसां, तेषुमर्मसु ॥ िव ः ृङ्गाटकाख्येषुसद्ध्यस्त्यजितजीिवतम्। (अ हृ.श ४/३४-३५) 65. अभ्यङ्गमाचरेि त्यं, स जराश्रमवातहा । हृि पर्सादपुष् ायुःस्वपन्सुत्व ् वदाढ्र्यकृत् ॥ िशरःशर्वणपादषेुतंिवशेषणेशीलयेत् । वज्य्य अभ्यङ्गःकफगर्स्तकृतसंशुदय्जीिणिभः ॥ (अ हृ.सु. २\८-९) 66. ानम दतने ास्यकर्णरोगाितसािरषु । आध्मानपीनसाजीर्णभुक्तवत्सु च गिहतम् ॥ (अ हृ. सु. २/१८) 67. सि पातजव्रस्यान्तेकर्णमूलेसुदारुणः । शोफःस ायतेयेनकिश्कदवेिवमुचय्ते ॥ (अ हॄ. िच १/१४९) 68. षड्स ाष्टममासेषुनीरुजस्यशुमअेहिन्त । कण िहमागमेिवध्येत्धा ्यङ्कस्थस्यसान्त्वयन् ॥ (अ,हृ.ऊ १/२८) 69. प्रितश्यायजल ीडाकर्णकण्डुयनैर्मरुत् । िमथ्यायोगनेशब्दस्यकुिपतोन्यैश्चकोपनैः ॥ (अ.हृ.ऊ१७/१) 77. द्वय्ङ्गुलािनवृषणिचबुकदशननासापुटभागकर्णमूल ूनयनान्तरािणः।। (सु. सु.३५/१२) 78. चतुरङ्गुलािनमहेनवदनान्तरनासाकर्णललाट ीवोच्छायदृ ्यन्तरािणः ॥ (सु.सु.३५/१२) 79. िचबुकौषठ्कणार्िक्षमध्यनािसकाललाटंचतुरङ्गुल,ं ॥( च.िव.८/११७)


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136

PROFORMA

A COMPREHENSIVE STUDY OF PRAMANA SHAREERA WITH SPECIAL

REFERENCE TO ANGULI PRAMAN OF BAHYA KARNA SHAREERA

Scholar: Dr. Vivek Unni K K Guide: Dr. B. N. Mishra, M.D (Ay)

Name of the Person: Address:

Age: Date:

Sex: Male / Female Religion: H / M / C / Others

Habitat: Urban / Rural Education:-UE/PR/H/HS/G/PG.

Occu: Stud /Empl /H w /Labors Socio Economic Status: P/ M/ R

Place of Birth: Marital status: Married/ Unmarried

Present illness (if any):

Past history (if any):

Measurement of Anguli (in c. m.):

Right hand

A R) Breadth of proximal interphalyngeal

Joint of middle finger :

BB R) Breadth of metacarpophalyngeal

Joints (2nd to5th) ÷ 4 :

CR) Height of the middle finger ÷ 5 :

Left hand

AL) Breadth of proximal interphalyngeal

Joint of middle finger :

BB L) Breadth of metacarpophalyngeal

Joints (2nd to5th) ÷ 4 :

C L) Height of the middle finger ÷ 5 :

137

138

Measurement of Ear:

Conversion of centimeter into Anguli pramana (Right hand)

RIGHT EAR LEFT EAR

Anguli Anguli Measurement c. m

AR BBR CR

c. m AL BBL CL

CIRCUMFERENCE

LENGTH

WIDTH ROOT POSTERIOR

ROOT ANTERIOR

Conversion of centimeter into Anguli pramana (Left hand)

RIGHT EAR LEFT EAR

Anguli Anguli Measurement c. m

AR BBR CR

c. m AL BBL CL

CIRCUMFERENCE

LENGTH

WIDTH

ROOT POSTERIOR

ROOT ANTERIOR

Signature of the volunteer Signature of the scholar

MASTER CHART

CONVERSION OF CENTIMETER TO ANGULI (Right hand)

A B C

Mean - 1.977 cm

SD-0.107cm

Mean - 1.896 cm SD - 0.141 cm

Mean - 1.868 cm SD-0.0935 cm

Anguli

Length of the right ear

Mean - 3.858 SD-0.373Angula

Mean - 3.703 Mean - 3.886 SD-0.336 Angula SD-0.375 Angula

Width of the right ear

Mean - 1.558 SD-0.236Angula


Circumference of the right ear

Mean - 6.235 SD-0.737 Angula


Mean – 2.497 Mean - 2.604 Mean - 2.652 Root anterior of the right ear SD-0.300 Angula SD-0.326Angula SD-0.393 Angula

Mean - 4.056 Mean-4.234 Mean - 4.302 Root posterior of the right ear SD-0.441Angula SD-0.332 Angula SD-0.402 Angula

139

140

CONVERSION OF CENTIMETER TO ANGULI

(Left hand)

A B C

Mean - 1.955 cm Mean - 1.862 cm Mean - 1.822 cm Anguli

SD - 0.103cm SD - 0.0932 cm SD - 0.122 cm

Length of the right ear

Mean - 3.991 Mean - 3.714 Mean - 3.906 SD-0.302Angula SD-0.249 Angula SD-0.304 Angula

Mean - 1.621 Mean - 1.506 Width of the right ear

Mean - 1.583 SD-0.230Angula SD-0.189 Angula SD-0.210 Angula

Circumference of the right ear

Mean - 6.454 Mean 6.020 Mean 6.314 SD-0.711Angula SD-0.633 Angula SD-0.596 Angula

Root anterior of the right ear

Mean - 2.722 Mean 2.516 Mean 2.644 SD-0.367Angula SD-0.295 Angula SD-0.395 Angula

Root posterior of the right ear

Mean - 4.398 Mean - 4.067 Mean - 4.293 SD-0.418Angula SD-0.444 Angula SD-0.374 Angula

Anguli

Rt. Lt.

Right Ear L Left Ear

No. Name Age Sex

A B C A B C I II III IV V I II III IV V

1 Mathew 22 M 2.0 2.08 1.66 1.9 2.05 1.64 10.3 7.9 3 8 6 10.3 7.9 3 8 6

2 Jith 20 M 2.1 2.02 1.96 2.0 2.0 1.96 13.3 7.6 2.9 8 4.4 13.3 7.6 2.9 8 4.4

3 Jeespoul 22 M 2.0 1.95 1.94 1.9 1.93 1.92 12.0 8 2.8 7.2 4.4 12.0 8 2.8 7.2 4.4

4 Pooja 24 F 1.9 2.0 1.88 1.8 1.98 1.88 11.1 7.4 3 7.8 5.7 11.1 7.4 3 7.8 5.7

5 Shiny 23 F 1.8 1.85 1.74 1.7 1.82 1.74 13.0 7.6 2.7 7.8 4.2 13.0 7.6 2.7 7.8 4.2

6 Nithi 21 F 1.9 1.97 1.82 1.8 1.95 1.82 11.8 7.6 3 7.9 5 11.8 7.6 3 7.9 5

7 Ashitha 21 F 1.9 1.95 1.92 1.8 1.93 1.92 11.8 6.7 2.3 8.1 4.4 11.8 6.7 2.3 8.1 4.4

8 Nafisa 22 F 1.7 1.93 1.88 1.6 1.9 1.88 8.6 6.8 3 7.6 4.1 8.6 6.8 3 7.6 4.1

9 Swapna 21 F 1.9 1.97 1.92 1.8 1.95 1.92 12.0 6.6 2.7 8.2 4.2 12.0 6.6 2.7 8.2 4.2

10 Maya 35 F 1.8 1.83 1.84 1.7 1.8 1.84 12.9 8.3 2.8 7 5.3 12.9 8.3 2.8 7 5.3

141

11 Manoj 25 F 1.9 1.98 1.96 1.8 1.95 1.94 13.3 7.4 3.3 7.6 4.8 13.3 7.4 3.3 7.6 4.8

12 Sudeep 23 M 1.9 1.98 1.84 1.8 1.95 1.82 12.3 7.4 3.3 7.6 4.8 12.3 7.4 3.3 7.6 4.8

13 Prajith 23 M 2.0 1.98 1.86 1.9 1.95 1.86 10.0 7.4 2.9 7.6 5 10.0 7.4 2.9 7.6 5

14 Anish 21 M 1.8 1.92 1.9 1.7 1.92 1.88 12.1 6.7 2.8 8.1 4.1 12.1 6.7 2.8 8.1 4.1

15 Chithira 24 F 1.7 1.93 1.88 1.6 1.9 1.88 8.6 6.8 3 7.6 4.1 8.6 6.8 3 7.6 4.1

16 Deepu 24 M 1.8 1.98 1.84 1.8 1.95 1.82 12.3 7.4 3.3 7.6 4.8 12.3 7.4 3.3 7.6 4.8

17 Divin 25 M 1.9 1.98 1.8 1.8 1.93 1.78 10.0 7.4 2.6 6.6 5.0 10.0 7.4 2.6 6.6 5.0

18 Anand 23 M 2.0 1.98 1.86 1.9 1.95 1.86 10.0 7.4 2.9 7.6 5.0 10.0 7.4 2.9 7.6 5.0

19 Deva 24 M 1.9 2.05 1.82 1.8 2.02 1.82 11.3 7.6 3.2 7.2 5.7 11.3 7.6 3.2 7.2 5.7

20 Jaya 22 F 1.8 1.85 1.74 1.7 1.82 1.74 13.0 7.6 2.7 7.8 4.2 13.0 7.6 2.7 7.8 4.2

21 Vaishak 21 M 1.9 1.9 1.8 1.9 1.88 1.8 12.5 7.0 3 7.1 4.5 12.5 7.0 3 7.1 4.5

22 Jeevan 23 M 1.9 1.95 1.92 1.8 1.93 1.92 11.8 6.7 2.3 8.1 4.4 11.8 6.7 2.3 8.1 4.4

23 Krishnan 20 M 2.1 2.13 1.98 2.1 2.1 1.98 11.5 7 3.4 7.5 6.3 11.5 7 3.4 7.5 6.3

142

24 Dinesh 24 M 1.9 1.9 1.88 1.8 1.9 1.86 11.0 7 2.6 8.1 4.3 11.0 7 2.6 8.1 4.3

25 Girijan 24 M 1.9 1.93 1.88 1.8 1.93 1.88 11.5 7.2 2.8 8.1 4.5 11.5 7.2 2.8 8.1 4.5

26 Anil 21 M 1.8 1.9 1.94 1.8 1.88 1.94 11.0 6.2 2.8 7 4.2 11.0 6.2 2.8 7 4.2

27 Soumya 22 F 1.7 1.95 1.96 1.7 1.93 1.96 12.0 6.7 3.6 8 4.3 12.0 6.7 3.6 8 4.3

28 Gopinath 24 M 1.7 1.92 1.9 1.7 1.92 1.88 12.1 6.7 2.8 8.1 4.1 12.1 6.7 2.8 8.1 4.1

29 Nandhu 23 M 2.1 2.17 1.92 2.0 2.15 1.92 13.0 7.4 3 7.8 4.2 13.0 7.4 3 7.8 4.2

30 Anjana 21 F 1.9 1.98 1.9 1.8 1.98 1.9 12.2 7.4 3.2 8 6.7 12.2 7.4 3.2 8 6.7

31 Soumya 21 F 1.6 1.73 1.6 1.6 1.7 1.6 12.0 6.9 3.6 8 4.3 12.0 6.9 3.6 8 4.3

32 Suneeb 21 M 2.2 2 1.92 2.1 1.98 1.92 11.0 7 2.5 7.5 5.3 11.0 7 2.5 7.5 5.3

33 Arun 27 M 2.0 2.23 1.92 1.8 2.2 1.92 11.5 7 2.5 8 5.2 11.5 7 2.5 8 5.2

34 Sophy 21 M 1.8 1.9 1.84 1.7 1.87 1.84 11.5 7.1 2.6 7.9 5 11.5 7.1 2.6 7.9 5

35 Arun 27 M 1.9 1.85 1.9 1.8 1.83 1.88 12.0 6.1 3.1 8 5.5 12.0 6.1 3.1 8 5.5

36 Sriraj 23 M 2.0 2.33 2.02 2.0 2.2 2.0 11.7 7.1 2.5 9.9 6.6 11.7 7.1 2.5 9.9 6.6

143

37 Bindhya 21 F 1.9 1.9 1.86 1.8 1.9 1.86 11.5 7.2 2.8 8.1 4.5 11.5 7.2 2.8 8.1 4.5

38 Mamitha 20 F 1.9 1.9 1.88 1.8 1.9 1.86 11.0 7 2.6 8.1 4.3 11.0 7 2.6 8.1 4.3

39 Shamina 23 F 1.7 1.93 1.92 1.7 1.93 1.92 12.5 7 3.1 7.8 4.1 12.5 7 3.1 7.8 4.1

40 Bindya 24 F 1.9 1.93 1.88 1.8 1.93 1.88 11.5 7.2 2.8 8.1 4.5 11.5 7.2 2.8 8.1 4.5

41 Navya 24 F 1.7 1.92 1.9 1.7 1.92 1.88 12.1 6.7 2.8 8.1 4.1 12.1 6.7 2.8 8.1 4.1

42 Shan 21 M 1.9 1.98 1.8 1.8 1.95 1.8 12.2 7 2.8 8 5.1 12.2 7 2.8 8 5.1

43 Ajay 21 M 1.8 2.05 1.78 1.8 2.03 1.76 11.0 7 2.9 8.3 5.7 11.0 7 2.9 8.3 5.7

44 Remi 24 F 1.8 1.93 1.86 1.7 1.9 1.86 12.0 7.1 2.7 7.8 4 12.0 7.1 2.7 7.8 4

45 Deena 24 F 1.9 1.95 1.9 1.8 1.93 1.9 11.4 7.1 2.6 8.2 4.1 11.4 7.1 2.6 8.2 4.1

46 Deepak 24 F 1.7 1.8 1.92 1.7 1.77 1.9 11.0 6.3 2.7 8 4.8 11.0 6.3 2.7 8 4.8

47 Vidya 33 F 1.8 1.83 1.92 1.8 1.8 1.92 12.3 7.3 3.1 7.5 5 12.3 7.3 3.1 7.5 5

48 Vishal 20 F 1.9 2.2 1.94 1.9 2.17 1.94 12.1 7.9 3.2 8.2 5.3 12.1 7.9 3.2 8.2 5.3

49 Varsha 23 F 1.7 1.93 1.92 1.7 1.93 1.9 12.9 7.5 3 8.7 4 12.9 7.5 3 8.7 4

144

50 Jithendra 24 M 1.8 1.9 2.02 1.8 1.95 2.02 12.0 8 2.6 8.3 5.7 12.0 8 2.6 8.3 5.7

51 Anvar 24 M 2 1.95 2 1.9 1.95 2 12.5 7.6 2.8 7.5 5.4 12.5 7.6 2.8 7.5 5.4

52 Krishna 24 M 1.9 1.95 1.98 1.9 1.95 1.98 12.5 7.6 2.8 7.8 5 12.5 7.6 2.8 7.8 5

53 Abdul 25 M 2.1 2.15 1.96 2 2.13 1.96 12.0 8.2 3.4 8.5 5.6 12.0 8.2 3.4 8.5 5.6

54 Jeevan 24 M 2.1 2.23 1.96 2 2.2 1.96 11.0 7.6 2.8 7.2 5 11.0 7.6 2.8 7.2 5

55 Aravind 23 M 2 2.15 1.78 1.9 2.1 1.78 11.7 7.6 3.4 7.8 5.9 11.7 7.6 3.4 7.8 5.9

56 Durga 21 M 1.9 1.95 1.9 1.9 1.93 1.9 13.0 7.5 3 8 5 13.0 7.5 3 8 5

57 Jeeson 23 M 2.1 2.1 2.02 2 2.13 2 14.0 7 2.5 9 5 14.0 7 2.5 9 5

58 Mohamad 23 M 2 1.95 2 1.9 1.95 2 12.5 7.6 2.8 7.5 5.4 12.5 7.6 2.8 7.5 5.4

59 Sofia 26 F 1.5 1.73 1.6 1.5 1.7 1.6 12.0 6.9 3.6 8 4.3 12.0 6.9 3.6 8 4.3

60 Arun 29 M 1.9 2.1 1.84 1.8 2.02 1.84 13.5 7.9 3.3 9 6.1 13.5 7.9 3.3 9 6.1

61 Sumesh 22 M 1.9 1.98 1.96 1.8 1.95 1.94 12.3 7.4 3.3 7.6 4.8 12.3 7.4 3.3 7.6 4.8

62 Ragavenda 25 M 1.9 1.98 1.8 1.8 1.93 1.78 10.0 7.4 2.6 6.6 5 10.0 7.4 2.6 6.6 5

145

63 Pradeep 25 M 1.9 1.98 1.84 1.8 1.95 1.82 12.3 7.4 3.3 7.6 4.8 12.3 7.4 3.3 7.6 4.8

64 Somunath 23 M 2 1.98 1.86 1.9 1.95 1.86 10.0 7.4 2.9 7.6 5 10.0 7.4 2.9 7.6 5

65 Praveen 22 M 1.9 2.05 1.82 1.8 2.02 1.82 11.3 7.6 3.2 7.2 5.7 11.3 7.6 3.2 7.2 5.7

66 Anish 24 M 2 2.15 1.78 1.9 2.1 1.78 11.7 7.6 3.4 7.8 5.9 11.7 7.6 3.4 7.8 5.9

67 Subin 24 M 2.1 2.15 1.96 2 2.13 1.96 12.0 8.2 3.4 8.5 5.6 12.0 8.2 3.4 8.5 5.6

68 Shahir 23 M 2 1.95 2 1.9 1.95 2 12.5 7.6 2.8 7.5 5.4 12.5 7.6 2.8 7.5 5.4

69 Sunil 22 M 1.7 1.93 1.92 1.7 1.93 1.9 12.9 7.5 3 8.7 4 12.9 7.5 3 8.7 4

70 Renesh 26 M 1.9 1.95 1.9 1.8 1.93 1.9 11.4 7.1 2.6 8.2 4.1 11.4 7.1 2.6 8.2 4.1

71 Sudha 21 F 1.8 1.93 1.86 1.7 1.9 1.86 12 7.1 2.7 7.8 4 12 7.1 2.7 7.8 4

72 Shini 21 F 1.9 1.97 1.92 1.8 1.95 1.92 12.0 6.6 2.7 8.2 4.2 12.0 6.6 2.7 8.2 4.2

73 Jisha 22 F 1.7 1.77 1.7 1.6 1.75 1.7 13.0 7.4 2.7 9 4.1 13.0 7.4 2.7 9 4.1

74 Maveen 22 M 1.9 1.95 1.88 1.8 1.93 1.88 21.0 7.9 3.1 5.3 8.2 21.0 7.9 3.1 5.3 8.2

75 Shambu 21 M 2 2.05 1.94 1.9 2.02 1.94 10.8 7.2 3.5 8.3 5.1 10.8 7.2 3.5 8.3 5.1

146

76 Sreejith 20 M 1.7 1.95 1.92 1.7 1.95 1.9 11.0 7.1 3.1 7.5 3.5 11.0 7.1 3.1 7.5 3.5

77 Albert 22 M 2.1 1.98 1.8 2.0 1.93 1.8 11.5 7.2 2.6 8.5 5 11.5 7.2 2.6 8.5 5

78 Vivek 23 M 2 2.02 1.86 1.9 2 1.84 11.5 7.5 2.5 8 5.1 11.5 7.5 2.5 8 5.1

79 Manjuraj 23 M 1.8 2.05 1.78 1.8 2.03 1.76 11.0 7 2.9 8.3 5.7 11.0 7 2.9 8.3 5.7

80 Rupesh 24 M 1.6 1.73 1.6 1.6 1.7 1.6 12.0 6.9 3.6 8 4.3 12.0 6.9 3.6 8 4.3

81 Smitha 25 F 1.9 1.98 1.9 1.8 1.98 1.9 12.2 7.4 3.2 8 6.7 12.2 7.4 3.2 8 6.7

82 Manjusha 24 F 1.9 2 1.88 1.8 1.98 1.88 11.1 7.4 3 7.8 5.7 11.1 7.4 3 7.8 5.7

83 Jinimol 25 F 2 1.95 1.94 1.9 1.93 1.92 12.0 8 2.8 7.2 4.4 12.0 8 2.8 7.2 4.4

84 Sujith 23 M 2.1 2.02 1.96 2 2 1.96 13.3 7.6 2.9 8 4.4 13.3 7.6 2.9 8 4.4

85 Jenish 24 M 1.9 1.95 1.9 1.9 1.93 1.9 13.0 7.5 3 8 5 13.0 7.5 3 8 5

86 Babu 24 M 2 2 1.9 1.9 1.97 1.9 12.0 7.4 3.4 9.5 4.8 12.0 7.4 3.4 9.5 4.8

87 Ramnath 25 M 1.8 1.9 1.7 1.8 1.88 1.7 12.5 7 3.1 8.9 5.1 12.5 7 3.1 8.9 5.1

88 Hari 24 M 2.1 2.13 1.7 2 2.1 1.7 9.9 6.7 2.5 7.7 5.1 9.9 6.7 2.5 7.7 5.1

147

89 Anoop 24 M 2.1 1.98 1.8 2 1.93 1.8 11.5 7.2 2.6 8.5 5 11.5 7.2 2.6 8.5 5

90 Veekshan 21 M 2 2.02 1.86 1.9 2 1.84 11.5 7.5 2.5 8 5.1 11.5 7.5 2.5 8 5.1

91 Deepthi 30 M 1.7 1.8 1.92 1.7 1.77 1.9 11.0 6.3 2.7 8 4.8 11.0 6.3 2.7 8 4.8

92 Sarath 27 M 1.9 2.1 1.86 1.8 2.07 1.84 13.3 7.9 2.9 9 4.5 13.3 7.9 2.9 9 4.5

93 Thomas 21 M 1.9 2.08 1.66 1.9 2.05 1.64 10.3 7.9 3 8 6 10.3 7.9 3 8 6

94 Nikesh 17 M 2.1 1.9 1.84 1.9 1.9 1.84 11.0 7 3 7.5 5.5 11.0 7 3 7.5 5.5

95 Krishna 29 M 2.1 2.1 2.02 2 2.13 2 14 7 2.5 9 5 14 7 2.5 9 5

96 Afsal 20 M 2.1 2.13 1.7 2 2.1 1.7 9.9 6.7 2.5 7.7 5.1 9.9 6.7 2.5 7.7 5.1

97 Harish 20 M 1.8 1.9 1.7 1.8 1.88 1.7 12.5 7 3.1 8.9 5.7 12.5 7 3.1 8.9 5.7

98 Anil 24 M 2 2 1.9 1.9 1.97 1.9 12.0 7.4 3.4 9.5 4.8 12.0 7.4 3.4 9.5 4.8

99 Najeeb 24 M 1.7 1.93 1.88 1.6 1.9 1.88 8.6 6.8 3 7.6 4.1 8.6 6.8 3 7.6 4.1

100 Nikhil 25 M 1.9 1.97 1.82 1.8 1.95 1.82 11.8 7.6 3 7.9 5 11.8 7.6 3 7.9 5

148

Key words

A)Breadth of proximal interphalyngeal Joint of middle finger.

B)Breadth of metacarpophalyngeal Joints (2nd to5th)÷ 4

C)Height of the middle finger÷5

I. Circumference

II. Length

III. Width

IV. Root posterior

V. Root anterior

149

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