# koṣṭha (कोष्ठ) > Canonical version of this page: https://nighantu.ageayurveda.com/lexicon/koshtha/ An Ayurvedic technical term, rendered into English in 7 different ways. The renderings do not agree, and the difference between them changes what the term is taken to mean. ## Identification | Field | Value | | --- | --- | | Transliteration | koṣṭha | | Devanagari | कोष्ठ | | Also written | mahāsrotas, antaḥkoṣṭha, śarīramadhya, mahānimna, āmapakvāśaya, ābhyantara rogamārga, mṛdu / madhyama / krūra koṣṭha | | Category, as gathered | anatomy-physiology (central cavity; also bowel-habit type) | | Grouped under | Body: tissues, wastes and channels | | Classical citations | 3 | | Citations checked | 2026-10-08 | ## How it is translated, and whether the translation holds Each rendering is given with the source that uses it. The assessment is ours. ### Bowel habit WHO International Standard Terminologies on Ayurveda (2022) · ITA-2.6.37; description: 'Depending on the predominant dosha, the bowel habit of an individual can be classified physiologically as normal bowel, soft bowel or costive bowel. The term koshta also denotes abdomen.' · who-ista WHO's PRIMARY rendering is functional (bowel habit), with the anatomical sense demoted to a trailing remark. The classical primary sense in CS Sū. 11.48 is the opposite way round. Reproduced unaltered and attributed from the WHO International Standard Terminologies on Ayurveda, which is what that licence permits, and deliberately absent from the downloadable dataset, which is CC BY 4.0. ### The major inner cavity of the body from the mouth to anus WHO International Standard Terminologies on Ayurveda (2022) · ITA.3.11.1; description 'Comprises both stomach and large intestine'; Sanskrit terms listed: 'mahāsrotas, antaḥkoṣṭhaḥ, koṣṭhaḥ, śarīramadhyam, mahānimnam' · who-ista The synonym list here is lifted straight from CS Sū. 11.48, WHO has effectively standardised Charaka's own paryāya list. Note the internal inconsistency: the head-term says 'mouth to anus' while the description says only stomach and large intestine. Reproduced unaltered and attributed from the WHO International Standard Terminologies on Ayurveda, which is what that licence permits, and deliberately absent from the downloadable dataset, which is CC BY 4.0. ### Normal bowel habit (madhyama-koṣṭhaḥ) / Soft bowel habit (mṛdukoṣṭhaḥ) / Costive bowel habit (krūra-koṣṭhaḥ) WHO International Standard Terminologies on Ayurveda (2022) · ITA-2.6.38, ITA-2.6.39, ITA-2.6.40; madhyama attributed to kapha dominance or tridoṣa balance, mṛdu to pitta, krūra to vāta · who-ista 'Costive' is archaic English for constipated; WHO's choice here is notably old-fashioned and may confuse non-native readers. Reproduced unaltered and attributed from the WHO International Standard Terminologies on Ayurveda, which is what that licence permits, and deliberately absent from the downloadable dataset, which is CC BY 4.0. ### 1. A closed space or area, typically indicative of organs in the abdominal, thoracic and pelvic cavities 2. Physiologically, koṣṭha is also indicative of gastro intestinal tract. National Institute of Ayurveda / WHO-APW non-clinical terminologies glossary · SK0104 · glossary The Indian draft glossary puts the cavity sense FIRST and adds the thoracic and pelvic cavities, which WHO's 'mouth to anus' excludes. A real disagreement about the boundaries of the referent. Reproduced unaltered and attributed from the WHO International Standard Terminologies on Ayurveda, which is what that licence permits, and deliberately absent from the downloadable dataset, which is CC BY 4.0. ### [left untranslated] 'Koshtha is otherwise called the great Stream within the body. The great cavity below, the cavity containing undigested food, the cavity where digestion takes place... are also used for Koshtha. Koshtha is the Internal seat of disease.' Charaka Samhita, tr. Kaviratna · Sūtrasthāna ch. 11, his verse 47 (= CS Sū. 11.48) · public-domain-translation Kaviratna refuses an English equivalent (see his footnote at the śākhā record) and renders mahāsrotas as 'the great Stream within the body'. ### abdominal cavity (Koshtha) Sushruta Samhita, tr. Kaviraj Kunja Lal Bhishagratna · Vol. I, in the description of an ulcer 'seated in the abdominal cavity (Koshtha)' · public-domain-translation Bhishagratna, unlike Kaviratna, does supply an English equivalent, and it is purely anatomical, with no bowel-habit sense. ### gut / gastrointestinal tract / alimentary canal Standard Indian BAMS textbook and journal usage · pervasive · textbook · our paraphrase of the source, not its words Convenient and now dominant; loses the fact that CS Sū. 11.48's synonym list includes śarīramadhya ('middle of the body'), which is a region, not a tube. ## The classical passages ### Charaka Samhita Sūtrasthāna 11 (Tistraiṣaṇīya):11.48, checked against the source > कोष्ठः पुनरुच्यते महास्रोतः शरीरमध्यं महानिम्नमामपक्वाशयश्चेति पर्यायशब्दैस्तन्त्रे, स रोगमार्ग आभ्यन्तरः tr. none (Sanskrit mūla) · https://www.carakasamhitaonline.com/index.php/Tistraishaniya_Adhyaya That Charaka defines koṣṭha OSTENSIVELY, by a list of synonyms used in the treatise (mahāsrotas, śarīramadhya, mahānimna, āmapakvāśaya), and assigns it the role of internal disease-pathway. He gives no boundary definition, which is why WHO and the NIA glossary can disagree about whether the thorax is included. ### Charaka Samhita Sūtrasthāna 28:28.31 and 28.33, checked against the source > koṣṭhācchākhā malā yānti drutatvānmarutasya ca ... śākhā muktvā malāḥ koṣṭhaṃ yānti vāyośca nigrahāt tr. none (Sanskrit mūla) · https://gretil.sub.uni-goettingen.de/gretil/corpustei/transformations/plaintext/sa_agniveza-carakasaMhitA-parts-comm.txt Koṣṭha as the destination to which doṣas must be brought before elimination, the therapeutic rationale for the whole of pūrvakarma. ### Aṣṭāṅga Hṛdaya (referenced, NOT quoted — no public-domain English translation exists) Sūtrasthāna 18:18/53-55 (for krūra koṣṭha); 12/46 cited for koṣṭha's extent 'stomach to large intestines'; 18/15 cited for the purpose of assessing koṣṭha, address only, nothing quoted to check That the mṛdu/madhyama/krūra triad and the practical purpose of koṣṭha assessment are treated in Aṣṭāṅga Hṛdaya. The verse numbers are as cited on the retrieved page; I did NOT open an Aṣṭāṅga Hṛdaya text to confirm them. ## Not to be confused with - **agni.** Koṣṭha is the site; agni is the transformative capacity. Mṛdu/krūra koṣṭha is classified by stool consistency and doṣa dominance, not by digestive power, though the NIA glossary entry for krūra koṣṭha does fold in 'irregular digestive ability', blurring the two. - **mahāsrotas.** Charaka lists mahāsrotas as a SYNONYM of koṣṭha (Sū. 11.48), which is why the two are interchangeable there, but mahāsrotas is also the name of a srotas, and srotas elsewhere is a distinct category from rogamārga. - **āmāśaya / pakvāśaya.** These are parts of koṣṭha (āmapakvāśaya is one of its synonyms as a dvandva), not the whole. WHO ITA.3.11.1's description, which names only stomach and large intestine, effectively reduces koṣṭha to this pair. - **prakṛti.** Koṣṭha type (mṛdu/madhya/krūra) is doṣa-determined and is often called a constitutional feature, but it is assessed from present stool behaviour and can be altered; it is not the same as janma-prakṛti. - **koṣṭhāṅga.** The viscera contained in the koṣṭha (WHO ITA.3.11.2), not the cavity itself. ## Renderings that do not hold - stomach. The commonest single-word error. Koṣṭha's synonym list is a set of cavities and a body-region; āmāśaya alone is the stomach. - colon. Narrower still, and drives a false equation of krūra koṣṭha with constipation as a bowel disease rather than a physiological type. - bowel habit (as the primary sense). WHO's choice. It is a legitimate secondary sense, but a reader who meets koṣṭha first in CS Sū. 11.48 as the ābhyantara rogamārga and then looks it up in WHO will find only a description of stool frequency. - digestive fire. Confuses koṣṭha with agni; nothing in Sū. 11.48 mentions agni. ## Open questions Recorded rather than resolved. - Does koṣṭha include the thoracic cavity? The NIA glossary says yes; WHO's 'mouth to anus' description says effectively no. Charaka's śarīramadhya is indeterminate on the point. - The primary classical locus for the mṛdu/madhyama/krūra triad, which text states it first, and in which verse. I located it in Aṣṭāṅga Hṛdaya via a secondary page but did not verify. - Whether any study has tested inter-rater agreement on koṣṭha classification, which is used to dose purgatives. None found. ## Citation Age Ayurveda Nighantu, "koṣṭha", https://nighantu.ageayurveda.com/lexicon/koshtha/, CC BY 4.0. Whole lexicon: https://nighantu.ageayurveda.com/lexicon.json and https://nighantu.ageayurveda.com/lexicon.csv. Educational reference only. A term entry explains what a word means and how it has been translated. Nothing here is advice.