Asthi Srunkhala

Asthi Srunkhala [Cissus-quadrangularis] in bonney disorders and IVDP

Cissus quadrangularis [1] has a long leaf less stem with fleshy, glabrous, much contracted at the nodes, quadrangular, tendril climber. Young branches are winged, broadly ovate leaves, denticulate and glabrous, truncate or cuneate at the base. Some aerial roots arising from the nodes grow downwards and strike the soil. Small greenish flowers in shortly peduncled cymes with spreading umbellate branches. It is probably native to India or Sri Lanka, but is also found in Africa, Arabia, and Southeast Asia. It has been imported to Brazil and the southern United States [5].

Uses from Ayurveda: It is used in bone disorders, fractures and as food in chuties and papads. Cissus quadrangular stem resembles the shape of bones and joints in the body. It is mainly used in treatment of fractured bones, asthma and cardiac problems. It is anthelmintic, digestive and analgesic.It is useful in eye and ear diseases and in irregular menstruation. It is useful in colic, leprosy, ulcers, tumours and skin diseases. It is helpful in back and spine problems.
In further it is –
“Vata shleshmahara – Mitigates Vata and Kapha
“Asthiyuk – strengthens bones.
“Krumighna – Acts against worms and infection
“Akshirogahrut – useful in the treatment of eye disorders
“Vrushya – Acts as aphrodisiac.

Cissus Quadrangularis Plant contains two steroidal principles, calcium oxalate, carotene. Fresh plant contains ascorbic acid, vitamin C, triterpenoid, glucoside.
Extract consists of Ketosterones 1.5%, Ketosterones 2% & Ketosterones 2.5% and the Main chemical constituents are tetracyclic triterpenoids, onocer-7-ene-3alpha, 21 beta-diol and onocer-7-ene-3beta, 21 alpha-diol and two steriodal principles I and II, alpha-sitosterol, delta-amyrin [10]
Actions of Ketosterones are –
1. It acts as antagonists to the glucocorticoid receptor and promotes good bone health.
2. It shows anabolic steroid properties for healing of fracture.
3. It increases intramuscular creatinine levels.
4. It blocks the muscle damaging effect of cortisol and leads to the formation of new muscles.
5. It shows significant inhibition in DPPH free radical formation, superoxide radical production and lipid peroxide production in erythrocytes.
6. It shows sedative effect on central nervous system.
7. It protects gastric mucosa against ulceration by its antisecretory and cytoprotective property.
8. It mobilizes fibroblast and chondroblasts to an injured tissue and enhances regenerationClinical study reports
1. It contains a rich source of carotenoids, triterpenoids and ascorbic acid. Compounds that act as receptor antagonists of glucocorticoids have reduced the healing time of broken bones 30 to 50 percent in clinical trials. It has also been used to treat obesity and associated oxidative stress [3].
2. Its bactericidal effects on Helicobacter pylori hold promise as an effective treatment of gastric ulcers and preventative of stomach cancer in conjunction with anti inflammatory therapy [4].
3. Cissus quadrangularis stem is fried in ghee and administered with milk as for the treatment of fractures and osteo arthritis (Chakradutta).
4. Cissus quadrangularis stem is processed in sesame oil is very useful to treat Sandhivata Osteo arthritis (Bhavaprakasha).
5. It is said to have antibacterial, antifungal, antioxidant, anthelmintic, antihemorrhoidal and analgesic activities [6].

6. High doses of the extracts have been shown to have beneficial effects against obesity and associated oxidative stress [7].
7.It’s bactericidal effects on Helicobacter pylori (Amlapitta) hold promise as a potential treatment of gastric ulcers in conjunction with NSAID therapy [8]
8. A weight loss supplement containing Cissus quadrangularis and other ingredients including green tea, soy, selenium, chromium, and B vitamins was evaluated in an 8-week trial. The supplement helped reduce body weight by 4-8% (placebo 2.4%) a clinically significant weight loss [9].
9. Cissus quadrangularis – 2400 mg. per capsule as Bonton Capsule is prepared by Vasu Healthcare, Gujarat, India. According to them it contains high amount of vitamin C, carotene A, anabolic steroidal substances and calcium which showed a marked influence in the rate of fracture. Cissus quadrangularis causes less amount of tissue reaction in the fractured region leading to optimum decalcification in the early stage with minimum of callus formation. Hence deposition of calcium is just enough to join the two broken segments of bone so that it’s remodeling takes much faster. In clinical trials Cissus quadrangularis as per radiological and clinical observations has been found to cause considerable reduction in the healing time of fractures by 55-33 percent. In few of the treated cases, although radiologically only, an early callus formation was observed but clinically the symptoms of fracture such as pain, tenderness, and swelling were significantly absent.

	Angiosperms Eudicots Rosids Order: Vitales Family: Vitaceae Genus: Cissus Species: C. Quadrangularis
Rasa : Katu, Madhura Guna : Laghu, Ruksha, Sara Virya : Usna Vipaka : Madhura Karma : Dipana, vataslesmahara, Asthisandhanakara, Caksusya, Vrsya Ayurvedic uses: Krmi, Arsa, Asthibhanga, Sandhi Cyuta Synonyms: Asthi samharaka, Ashti Shrunkhala, Vajravalli [2]

References:
[1] http://www.ayurvediccommunity.com/Botany.asp?Botname=Cissus%20quadrangularis
[2] http://easyayurveda.com/2010/05/08/strengthen-your-bones-joints-and-cartilages-with-cissus-quadrangularis/
[3] Chopra SS, Patel MR, Awadhiya RP. (1976) “Studies of Cissus quadrangularis in experimental fracture repair: a histopathological study”; Indian Journal of Medical Researches 64(9): 1365-1368.
[4] Austin, A. Jegadeesan, M. Gowrishankar, R. (2004) “Helicobactericidal Activity of Cissus quadrangularis L. Variant I”; Natural Product Sciences 10 (5): 217-219. Korean Society of Pharmacognosy
[5] http://en.wikipedia.org/wiki/Cissus_quadrangularis
[6] Pharmacological and therapeutic activity of Cissus quadrangularis: An overview Mishra G., Srivastava S., Nagori B.P. International Journal of PharmTech Research 2010 2:2 (1298-1310)
[7] Jaw, FS; Yu, SN; Lee, JC; Tsao, HW; Yu, HJ; Yen, CT (1991). “Interactive program for spectral and area analysis of compound action potentials of A-fiber and C-fiber”. Journal of neuroscience methods 40 (2-3): 121-6. PMID 1800848.
[8] Protective effect of Cissus quadrangularis on neutrophil mediated tissue injury induced by aspirin in rats
[9] Greenway, FL; Bray, GA (2010). “Combination drugs for treating obesity”. Current diabetes reports 10 (2): 108-15. doi:10.1007/s11892-010-0096-4. PMID 20425569.
[10] http://www.motherherbs.com/cissus-quadrangularis-extract.html

A special case study with Asthisrunkhala Taila in Osteoporosis

In 1998, when I am working with ALN Rao Ayurvedic Medical College, Koppa, Mr. A. Ramesh Rao, Chairman sent a patient to me. When I examined it is diagnosed case of Osteopenia and the patient is under contemporary treatment for more than 1 year. Osteopenia symptoms include Back pain along with pricking pain in long bones. I apply Ayurveda principles – as Vatahara and Asthiposhana and preapare the Asthisrunkhala + Bala taila for Matravasti. The 40ml of Matravasti is added with 1gm of Shankha Bhasma for 15 days. The result is astonishing apart from the symptomatic relief the BMD is normal at the 16th day. Later on several cases were treated on the same basis.