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Lit., "when shank is wrapped around shank" - an idiomatic phrase denoting "the affliction of the present state of existence...combined with that of the final state" (Lane IV, 1471, quoting both the Qamus and the Taj al-'Arus). As pointed out by Zamakhshari, the noun saq (lit., "shank") is often used metaphorically in the sense of "difficulty", "hardship" or "vehemence" (shiddah); hence the well-known phrase, qamat al-harb 'ala saq, "the war broke out with vehemence" (Taj al-'Arus).
When the soul has departed, the legs of the dead body are placed together in position, in preparation for the rites preliminary to the burial. Saq (literally, leg) may also be taken metaphorically to mean a calamity: calamity will be joined to calamity for the poor departed sinner's soul, as his life-story in this world is now done. Willy-nilly, he will now have to go before the Throne of Judgment.