Administrators, Editors, Bots, Bureaucrats, Charaksamhita, Moderators (CommentStreams), Interface administrators, Administrators
10,232
edits
Changes
no edit summary
Asthi literally means bone or that entity which stays or doesn’t get destroyed easily. Asthi dhatu is a body component similar to bone (osseous) tissue. Its important function is to hold body frame (dharana). It provides stability to the body and forms skeleton. (SAT-B.436)
{{CiteButton}}
{{#seo:
|title=Asthi dhatu
|titlemode=append
|keywords=Asthi dhatu, Asthi dhatu meaning, Asthi dhatu in ayurveda, Asthi dhatu defination, Asthi dhatu Importance in diagnosis, Asthi dhatu treatment
|description=Asthi dhatu is a body component similar to bone (osseous) tissue
|image=http://www.carakasamhitaonline.com/resources/assets/ogimgs.jpg
|image_alt=carak samhita
|type=article
}}
<p style='text-align:justify;'>Asthi literally means bone or that entity which stays or doesn’t get destroyed easily. Asthi dhatu is a body component similar to bone (osseous) tissue. Its important function is to hold body frame (dharana). It provides stability to the body and forms skeleton.<ref>Available from http://namstp.ayush.gov.in/#/sat</ref>(SAT-B.436)</p>
{{Infobox
{{Infobox
|label2 = Authors
|label2 = Authors
|data2 = Anagha S.<sup>1</sup>, Deole Y.S.<sup></sup>
|data2 = Anagha S., [[Yogesh Deole|Deole Y.S.]]
|label3 = Reviewed by
|label3 = Reviewed by
|data3 = Basisht G.<sup>1</sup>
|data3 = [[Gopal Basisht|Basisht G.]]
|label4 = Affiliations
|label4 = Affiliations
|data4 = <sup>1</sup>[[Charak Samhita Research, Training and Development Centre]], I.P.G.T.& R.A., Jamnagar <sup>2</sup>
|data4 = [[Charak Samhita Research, Training and Development Centre]], I.P.G.T.& R.A., Jamnagar
|label5 = Correspondence email:
|label5 = Correspondence email:
|data5 = carakasamhita@gmail.com
|data5 = carakasamhita@gmail.com
|label6 = Date of first publication:
|label6 = Publisher
|data6 = June 2, 2020
|data6 = [[Charak Samhita Research, Training and Development Centre]], I.T.R.A., Jamnagar, India
|label7 = Date of first publication:
|data7 = June 2, 2020
|label8 = DOI
|data8 = [https://doi.org/10.47468/CSNE.2020.e01.s09.017 10.47468/CSNE.2020.e01.s09.017]
}}
}}
=== Etymology and derivation ===
=== Etymology and derivation ===
The word Asthi is a combination of two Sanskrit words "as” and “kthin”. They together give the meaning “stability”. It denotes a bone or the kernel of a fruit.
The word Asthi is a combination of two Sanskrit words "as” and “kthin”. They together give the meaning “stability”.<ref>Jha Srujan. Shabdakalpadruma online application</ref> It denotes a bone or the kernel of a fruit.<ref>Monier Williams (1899), “अस्थि”, in A Sanskrit–English Dictionary,new edition, Oxford: At the Clarendon Press, OCLC 458052227, page 122.</ref>
=== Definition ===
=== Definition ===
Asthi is a body component which stays for a longer time (asyate) and which takes part in movements (kshipyate) with muscles. It is also termed as the extract (sara) of the body which remains even after the destruction of all other body components. [Su.Sa.Sharira Sthana5/21-22]
Asthi is a body component which stays for a longer time (asyate) and which takes part in movements (kshipyate) with muscles. It is also termed as the extract (sara) of the body which remains even after the destruction of all other body components. [Su.Sa.Sharira Sthana 5/21-22]
=== Synonyms ===
=== Synonyms ===
1. '''Kikasam''': round structures
1. '''Kikasam''': round structures
2. '''Kulyam''': tubularor canal like structure
2. '''Kulyam''': tubular or canal like structure
3. '''Svadayitam''': animals like dogs like it
3. '''Svadayitam''': animals like dogs like it
9. '''Karkaram''': rough
9. '''Karkaram''': rough
===Meanings in different contexts: ===
=== Meanings in different contexts===
*In physiology, the word denotes structural and functional components mainly of osseous or bone tissue.
*It is a substance of animal origin (jangamadravya) [Cha. Sa. [[Sutra Sthana]] 1/69]
*In the contexts of some pharmaceutical preparations, seedless fruits (ansathi) are to be used. Hence it denotes seeds or kernel of fruits. E.g. seedless fruit of Embelica officinalis (Amalaki) [Cha. Sa. [[Chikitsa Sthana]] 1/1/58]
*In the dietary preparation of meat soup (vesavara) bones should be removed. (nirasthi) [Cha. Sa. [[Sutra Sthana]] 27/ 269]
== Fundamental constitution (panchabhautika sanghatana) and properties ==
== Fundamental constitution (panchabhautikasanghatana) and properties ==
Fundamental constitution of asthi dhatu shows predominance of [[Prithvi mahabhuta]].
Fundamental constitution of asthi dhatu shows predominance of [[Prithvi mahabhuta]].
*The physical properties of "asthi dhatu" are heaviness (guru), roughness (khara), hardness (kathina), bulkiness (sthula), static (sthira), with a definite physical form (murtimanta).
*The physical properties of "asthi dhatu" are heaviness (guru), roughness (khara), hardness (kathina), bulkiness (sthula), static (sthira), with a definite physical form (murtimanta).<ref>Dwarkanath C. Introduction to Kayachikitsa. Chaukhambha Orientalia. Varanasi; 1996. Third edition.pg.322-3</ref>
== Metabolism and Development ==
== Metabolism and Development ==
The asthi dhatu is formed from its predecessor adipose tissue ([[meda dhatu]]). The nourishing portion of adipose tissue ([[meda dhatu]]) and constituents of nutrient fluid (ahara rasa) are transformed into asthi dhatu by action of factors responsible for its metabolism (asthi dhatvagni). [[Agni mahabhuta]] and [[vayu mahabhuta]] play a major role in the solidification and roughness of asthi by acting upon [[Prithvi mahabhuta]] components of adipose tissue ([[meda dhatu]]).[Cha. Sa. [[Chikitsa Sthana]] 15/30]
The asthi dhatu is formed from its predecessor adipose tissue ([[meda dhatu]]). The nourishing portion of adipose tissue ([[meda dhatu]]) and constituents of nutrient fluid (ahara rasa) are transformed into asthi dhatu by action of factors responsible for its metabolism (asthi dhatvagni). [[Agni mahabhuta]] and [[vayu mahabhuta]] play a major role in the solidification and roughness of asthi by acting upon [[prithvi mahabhuta]] components of adipose tissue ([[meda dhatu]]).[Cha. Sa. [[Chikitsa Sthana]] 15/30]
Porosity in bones are due to actions of [[vayu]] and [[akasha]] mahabhuta. [Cha. Sa. [[Chikitsa Sthana]] 15/30]
Porosity in bones are due to actions of [[vayu]] and [[akasha]] mahabhuta. [Cha. Sa. [[Chikitsa Sthana]] 15/30]
Scalp hair (kesha) and body hair(loma) are waste products of metabolism of asthi dhatu. [Cha.Sa. [[Sutra Sthana]] 15/18]
Scalp hair (kesha) and body hair(loma) are waste products of metabolism of asthi dhatu. [Cha.Sa. [[Sutra Sthana]] 15/18]
=== Quantity of asthi dhatu ===
=== Quantity and measurement ===
There are total 360 well-formed asthi in human body. [Cha. Sa.[[Sharira Sthana]] 7/6].
There are total 360 well-formed asthi in human body. [Cha. Sa.[[Sharira Sthana]] 7/6].
Sushruta opines the total number as 300. [Su.Sa Sharira Sthana 5/18]
Sushruta opines the total number as 300. [Su.Sa. Sharira Sthana 5/18]
Currently, most sources state that there are total 270 bones in human body at the time of birth. Many bones fuse together and the count comes to 206 separate bones. This number does not include small sesamoid bones.
Currently, most sources state that there are total 270 bones in human body at the time of birth. Many bones fuse together and the count comes to 206 separate bones. This number does not include small sesamoid bones. <ref>Steele, D. Gentry; Claud A. Bramblett (1988). The Anatomy and Biology of the Human Skeleton. Texas A&M University Press. p. 4. ISBN 978-0-89096-300-5 Available from https://en.wikipedia.org/wiki/Bone#cite_note-1 cited on28/05/2020.</ref><ref>Mammal anatomy : an illustrated guide. New York: Marshall Cavendish. 2010. p. 129. ISBN 9780761478829. Available from https://en.wikipedia.org/wiki/Human_skeleton#cite_note-1 cited on 28/05/2020.</ref>
The reason behind the difference in counting has been well discussed in [[Sharira Sankhya Sharira]] chapter of [[Sharira Sthana]].
The reason behind the difference in counting has been well discussed in [[Sharira Sankhya Sharira]] chapter of [[Sharira Sthana]].
=== Time span ===
=== Time span ===
The asthi dhatu is formed on 5th day from the nutrient fluid (ahara rasa). [Cha.Sa. [[Chikitsa Sthana]] 15/20-21] However, Sushruta opines that the asthi dhatu is formed in a time span of 12060 kala (twenty days). [Su. Sa. Sutra Sthana 14/14]
The asthi dhatu is formed on 5th day from the nutrient fluid (ahara rasa). [Cha.Sa. [[Chikitsa Sthana]] 15/20-21] However, Sushruta opines that the asthi dhatu is formed in a time span of 12060 kala (twenty days). [Su.Sa.Sutra Sthana 14/14]
== Characteristics of best quality or essence (asthisara) ==
== Characteristics of best quality or essence (asthisara) ==
The persons with essence of asthi dhatu have prominent heels (''parshni''), ankles (gulpha), knee joint (janu), elbows (aratni), collarbones (jatru), chin (chibuka), head (shira), flanks (parshva) and joints and also bones and teeth.
The persons with essence of asthi dhatu have prominent heels (parshni), ankles (gulpha), knee joint (janu), elbows (aratni), collarbones (jatru), chin (chibuka), head (shira), flanks (parshva) and joints and also bones and teeth.
Such persons are highly enthusiastic, active, enduring, having strong and firm body as well as longevity.[Cha.Sa. [[Vimana Sthana]] 8/107]
Such persons are highly enthusiastic, active, enduring, having strong and firm body as well as longevity.[Cha.Sa. [[Vimana Sthana]] 8/107]
== Anatomical and physiological structures ==
== Anatomical and physiological structures ==
The asthi dhatu is present in various forms as below:
=== Channels for transportation and transformation of asthi dhatu (asthivahasrotas) ===
The asthi dhatu is present in various forms as below.
=== Channels for transportation and transformation of asthi dhatu (asthivaha srotas) ===
The channels originate from predecessor meda dhatu and buttocks (jaghana). [Cha. Sa. [[Vimana Sthana]] 5/8]
The channels originate from predecessor meda dhatu and buttocks (jaghana). [Cha. Sa. [[Vimana Sthana]] 5/8]
There are various other anatomical structures related to asthi dhatu. These can be included in the system. The structures are as described below:
There are various other anatomical structures related to asthi dhatu. These can be included in the system. The structures are as described below.
=== Layer of bone tissue (Asthidhara kala) ===
=== Layer of bone tissue (Asthidhara kala) ===
Kala is the layer in outer coverings of body observed in sagittal section. Some scholars opine that the inner layer of large intestine that holds fecal matter (purishadhara kala) has relation with the layer of bone tissue (asthidhara kala).
Kala is the layer in outer coverings of body observed in sagittal section. Some scholars opine that the inner layer of large intestine that holds fecal matter (purishadhara kala) has relation with the layer of bone tissue (asthidhara kala).
The layer of adipose tissue (medodhara kala) is present in small bones(anu asthi) where it is known as red fat (saraktameda). The layer inside long bones is known as majja (marrow). [Su. Sa.ShariraSthana 4/13].
The layer of adipose tissue (medodhara kala) is present in small bones(anu asthi) where it is known as red fat (saraktameda). The layer inside long bones is known as [[majja]] (marrow). [Su.Sa.Sharira Sthana 4/13].
=== Bones (Asthi) ===
=== Bones (asthi) ===
The well differentiated compact form of osseous tissue (asthi) is bone.
The well differentiated compact form of osseous tissue (asthi) is bone.
===Types of bones ===
===Types of bones ===
There are five types of bones in human body. [Su .SaShariraSthana 5/20]
Sl.No: Type Site
There are five types of bones in human body. [Su .Sa Sharira Sthana 5/20]
1. Flat bones (kapala)(flat bones) Knee (Janu), jaghana(pelvic), shoulder(amsa),
{| class="wikitable"
|-
!Sl.No: !!Type !!Site
|-
|1. || Flat bones (kapala)||Knee (Janu), jaghana(pelvic), shoulder(amsa),
Cheek(ganda),palate(talu),temples(shankha),skull(shiras)
Cheek(ganda),palate(talu),temples(shankha),skull(shiras)
2. Teeth(ruchaka) (teeth) Teeth
|-
3. Cartilages(taruna) Nose(Ghrana), Ear(karna), Neck(griva),orbit of the eye(akshikosha)
|2. || Teeth(ruchaka) || Teeth
4. curved/Annular bones(valaya) Ribs(Parshuka), vertebrae (prushthakasheruka),
|-
5. Tubular bones (nalaka) All other long bones
|3. || Cartilages(taruna) || Nose(Ghrana), Ear(karna), Neck(griva),orbit of the eye(akshikosha)
|-
|4. || curved/Annular bones(valaya) || Ribs(Parshuka), vertebrae (prushthakasheruka)
|-
|5. || Tubular bones (nalaka) || All other long bones
|}
The contemporary anatomical views also categorize bones under five categories like long bones, short bones, flat bones, sesamoid bones, and irregular bones.<ref>Available from https://en.wikipedia.org/wiki/Bone#Types cited on 29/05/2020</ref>
=== Anatomical network (asthi jala) ===
There are four types of network-like structures (jala) in body including, bone network (asthijala).The others are muscles (mamsa), veins (sira) and ligaments (snayu). There are four such networks formed from each of these types. They are present in wrist and ankle joints and interlinked together.[Su. Sa. Sharira Sthana 5/12].
=== Confluence of bones (asthi sanghata)===
The places where many bones are present is called confluences. The confluences of bones are fourteen in number. They include ankle(gulpha), knee(janu), and groin(vankshana ) in lower limbs and their counter parts wrist(manibandha), elbow(kurpara) and axilla(kaksha) in upper limbs on each side. One is in the lower back(trika) and the other on the skull(shira) [Su. Sa. Sharira Sthana 5/16]
=== Vital points (asthi marma) ===
There are eight vital points formed from bones (asthi [[Marma|marma]]). [Su. Sa. Sharira Sthana 6/4]
These are katikataruna(vital spots on both sides of the vertebral column above and near the pelvic crest), nitamba(vital points above the two pelvic bones meeting the flank), amsaphalaka (vital points on scapula- one on each side of the vertebral column in the upper back region) and shankha(vital spots on each side between the outer end of the brow and the ear)[Su.Sa.Sharira Sthana 6/7]
== Functions ==
== Functions ==
The important function of asthi dhatu is providing structure and support to the body.It also nourishes the successor bone marrow tissue (majja dhatu).[Su. Sa. Sutra Sthana 15/5]
In addition, contemporary physiology states that bone tissue carries out following functions too.
The important function of asthi dhatu is providing structure and support to the body. It also nourishes the successor bone marrow tissue ([[majja dhatu]]).[Su. Sa. Sutra Sthana 15/5]
Mechanical:
In addition, contemporary physiology states that bone tissue carries out the following functions too.
=== Mechanical ===
Synthesis:
*Protection : It protect internal organs
The cancellous part of bone contains bone marrow. It produces blood cells including red blood cells, platelets and white blood cells. This process is called as hematopoiesis.
*Movement: facilitate movement
Metabolism:
*Hearing: Facilitate hearing through sound transduction
The bone tissue regulatesacid-base balance, store calcium and fat cells. It acts as endocrine organ by controlling the phosphate metabolism. It releasesfibroblast growth factor – 23 (FGF-23), which acts on kidneys to reduce phosphate reabsorption. The bone cells also release a hormone called osteocalcin. This contributes to the regulation of blood sugar (glucose) and fat deposition. Osteocalcin increases both the insulin secretion and sensitivity, in addition to boosting the number of insulin-producing cells and reducing stores of fat.
==Importance in diagnosis==
===Synthesis ===
===Causes of vitiation===
The cancellous part of the bone contains bone marrow. It produces blood cells including red blood cells, platelets and white blood cells. This process is called as hematopoiesis.<ref>Fernández, KS; de Alarcón, PA (December 2013). "Development of the hematopoietic system and disorders of hematopoiesis that present during infancy and early childhood". Pediatric Clinics of North America. 60 (6): 1273–89. doi:10.1016/j.pcl.2013.08.002. PMID 24237971</ref>
=== Metabolism ===
The bone tissue regulates acid-base balance, stores calcium, and fat cells. It acts as an endocrine organ by controlling the phosphate metabolism. It release fibroblast growth factor – 23 (FGF-23), which acts on kidneys to reduce phosphate reabsorption. The bone cells also release a hormone called osteocalcin. This contributes to the regulation of blood sugar (glucose) and fat deposition. Osteocalcin increases both insulin secretion and sensitivity, in addition to boosting the number of insulin-producing cells and reducing stores of fat.<ref> Lee, Na Kyung; et al. (10 August 2007). "Endocrine Regulation of Energy Metabolism by the Skeleton". Cell. 130 (3): 456–469. doi:10.1016/j.cell.2007.05.047. PMC 2013746. PMID 17693256</ref>
== Importance in diagnosis ==
===Causes of vitiation ===
The following are causative factors for the vitiation of channels for transport and transformation of asthi dhatu (asthivahasrotasa). [Cha. Sa. [[Vimana Sthana]] 5/17]
The following are causative factors for the vitiation of channels for transport and transformation of asthi dhatu (asthivahasrotasa). [Cha. Sa. [[Vimana Sthana]] 5/17]
==== Dietary causes ====
==== Dietary causes ====
* Excessive consumption of food that aggravates vatadosha in body. This includes the dietary items which possess properties like light to digest (laghu), dry(ruksha), cold(sheeta), rough(khara), highly penetrating or subtle (sukshma), mobile(chala).
* Excessive consumption of food that aggravates vatadosha in body. This includes the dietary items which possess properties like light to digest (laghu), dry(ruksha), cold(sheeta), rough(khara), highly penetrating or subtle (sukshma), mobile(chala).
==== Lifestyle causes ====
==== Lifestyle causes ====
* Excessive physical exercise
* Excessive physical exercise
*Excessive jerks to the body or jerky movements
*Excessive jerks to the body or jerky movements
*Excessive pressure on bones.
*Excessive pressure on bones.
===Abnormal states===
===Abnormal states===
The increase or decrease in quality and/or quantity of asthi dhatu can lead to various abnormal conditions. The states can be assessed by the following clinical features.
The increase or decrease in quality and/or quantity of asthi dhatu can lead to various abnormal conditions. The states can be assessed by the following clinical features.
==== Signs of decrease ====
*loss of scalp and body-hair, beard, nails and teeth
*loss of scalp and body-hair, beard, nails and teeth
*fatigue
*fatigue
*dryness
*dryness
*breaking of teeth and nails
*breaking of teeth and nails
[Cha. Sa. [[Sutra Sthana]] 17/67], [Su. Sa. [[Sutra Sthana]] 15/9]
[Cha. Sa. [[Sutra Sthana]] 17/67], [Su. Sa. Sutra Sthana 15/9]
==== Signs of increase ====
* extra tooth and bony growth [Su. Sa. Sutra Sthana 15/14]
* extra tooth and bony growth [Su. Sa. Sutra Sthana 15/14]
Clinical features of vitiation ofchannels of transport and transformation on asthi dhatu:
The features of vitiation of asthi dhatu are visible on teeth(danta), hairs(kesha) and nails(nakha). These are extra growth of bones(adhyasthi) and teeth(adhidanta), splitting(bheda) and severe pain in teeth and bones(shula), discoloration(vivarnata), abnormalities of body hair(kesha), nail(nakha) and beard(shmashru). [Cha. Sa. Sutra Sthana 28/16]
=== Clinical features of vitiation of channels of transport and transformation on asthi dhatu ===
Fracture of bone:
The features of the vitiation of asthi dhatu are visible on teeth(danta), hairs(kesha) and nails(nakha). These are extra growth of bones(adhyasthi) and teeth(adhidanta), splitting(bheda) and severe pain in teeth and bones(shula), discoloration(vivarnata), abnormalities of body hair(kesha), nail(nakha) and beard(shmashru). [Cha. Sa. [[Sutra Sthana]] 28/16]
==== Fracture of bone ====
*Constant and severe pain
*Constant and severe pain
*Discomfort in any posture or position
*Discomfort in any posture or position
*Thirst
*Thirst
*Weakness
*Weakness
*Swelling
*Swelling [Su. Sa. Sutra Sthana 25/39]
Signs of foreign body piercing bones:
==== Signs of foreign body piercing bones ====
*Different kinds of pain and swelling
*Different kinds of pain and swelling
Signs of foreign body in bone cavity:
==== Signs of foreign body in bone cavity ====
* Sense of fullness in the bones
* Sense of fullness in the bones
*constant pricking pain
*constant pricking pain
* profound horripilation. [ Su. Sa. Sutra Sthana 26/10]
* profound horripilation. [Su. Sa. Sutra Sthana 26/10]
=== Role of asthi dhatu as a vitiating factor in diseases ===
=== Role of asthi dhatu as a vitiating factor in diseases ===
*When the vitiated doshas afflict bone tissue(asthi dhatu), the tertiary fever (tritiyakajwara)is manifested. [Cha. Sa.[[Chikitsa Sthana]] 3/64]
*In fever, when the dosha are located in bone tissue (asthigatajwara) , they cause diarrhea, vomiting, pain in the bones, production of kujana (a sort of cooing sound), convulsive movement of the body. [Cha. Sa.[[Chikitsa Sthana]] 3/80]
*Bone tissue is one of the eight locations of wounds (vrana). The other sites are skin, blood vessels, flesh, fat, ligament, vital parts and viscera. [Cha. Sa.[[Chikitsa Sthana]] 25/26]
*When vitiated vata is located in bones and marrow, it leads to splitting pain of bones and joints, arthralgia, loss of muscle strength, insomnia, and continuous pain. [Cha. Sa. [[Chikitsa Sthana]] 28/33]
*When the vata is occluded by the osseous tissue, the patient likes hot touch (local sudation) and pressing. He has splitting pain and feels as though his body is being pricked with needles. [Cha. Sa. [[Chikitsa Sthana]] 28/66]
*When the wound(vrana) is deep to affect bones due to different types of injuries or destruction by the aggravated doshas, it looks like an oyster shell. There is discharge(srava) mixed with marrow and blood.[Su. Sa. Sutra Sthana 22/8]
=== Importance in prognosis ===
=== Importance in prognosis ===
==Importance in preservation of health and prevention: ==
*The fever (jwara) in which doshas are located in the bone tissue (asthi dhatu) is difficult to treat.[Cha Sa [[Chikitsa Sthana]] 3/83]
Bone tissue (asthi dhatu) is considered as the essence of body tissue which remains even after destruction of all other tissues. [ Su. Sa. ShariraSthana 5/21-22]
The enthusiasm, endurance, strength, body structure, firmness and longevity depend upon quality of asthi dhatu. [Cha. Sa. Vimana Sthana 8/107]
*Among the types of fractures, those broken into multiple pieces(churnita), moved to the other side(chhinna), entire bone is broken into pieces without any tissue remaining (atipatita) and piece of bone pierces into the marrow(majjanugata) are difficult to cure. [Su. Sa. Nidana Sthana 15/11]
== Importance in preservation of health and prevention ==
Bone tissue (asthi dhatu) is considered as the essence of body tissue which remains even after destruction of all other tissues. [Su. Sa. Sharira Sthana 5/21-22]
The enthusiasm, endurance, strength, body structure, firmness, and longevity depend upon quality of asthi dhatu. [Cha. Sa. [[Vimana Sthana]] 8/107]
== Principles of management of diseases ==
== Principles of management of diseases ==
==== Surgical management ====
=== Therapeutic and conservative management ===
*The disorders of asthi dhatu are treated with [[panchakarma]], especially enema prepared with bitter drugs, milk, and ghee(tiktaksheerabasti).[Cha. Sa. [[Sutra Sthana]] 28/27]
*When a foreign body is concealed in bone, the patient should be treated with oleation (snehana), fomentation(swedana) and then the bones should be tied with bandage(bandha) tightly or squeezed hard. [ Su. Sa. Sutra Sthana 26/12]
*The qualitative and quantitative decrease in bone tissue is managed by the supplements having similar properties. E.g. the calcinated powder of eggshell (kukkutandatwakbhasma), calcinated powder of goat bones (ajasthibhasma), coral (pravalbhasma).
=== Surgical management ===
*A type of surgical instrument with crossed blades (swastika yantra)was used to remove foreign bodies from bone tissues. [Su.Sa. Sutra Sthana 7/10]
*Details management of fractures is described in a separate chapter “bhagna chikitsita” by Sushruta. [Su.Sa.Chikitsa Sthana 3]
*Many remarkable advances in the surgical management of disorders of bones have been observed including the artificial bone grafting, total joint replacement.
== Contemporary approach and current researches ==
== Contemporary approach and current researches ==
Asthi dhatu is observed in view of bone or osseous tissue in conventional physiology. Bone is the dense and hard connective tissue. Its hardness is due to the deposition of inorganic salts like calcium phosphate and calcium sulphate in an organic matrix. There are three types of bone cells – osteoblast, osteocyte and osteoclast.
Probable connection in Ayurvedic view of asthi dhatu and conventional views of bone tissue:
Asthi dhatu is observed in view of bone or osseous tissue in conventional physiology. Bone is the dense and hard connective tissue. Its hardness is due to the deposition of inorganic salts like calcium phosphate and calcium sulphate in an organic matrix. There are three types of bone cells – osteoblast, osteocyte and osteoclast.<ref>Dwarkanath C. Introduction to Kayachikitsa. Chaukhambha Orientalia. Varanasi; 1996. Third edition.pg.346</ref>
Sr.No. Concept of Asthi dhatu Bone tissue
1. Role of [[prithvimahabhuta]] in asthi dhatu Minerals including inorganic salts like calcium phosphate and calcium sulphate make the matrix more dense
=== Probable connection in Ayurvedic view of asthi dhatu and conventional views of bone tissue ===
2. Role of adipose tissue (meda dhatu) Marrow adipose tissue (MAT) is stored in bones.
{| class="wikitable"
3. Composition of Asthi dhatu Support cells, namely, osteoblasts and osteocytes ;
|-
Remodeling cells, namely, osteoclasts ;
|Sr.No. || Concept of Asthi dhatu ||Bone tissue
Non-mineral matrix of collagen and noncollagenous proteins called osteoid, with inorganic mineral salts deposited within matrix
|-
4. Factors responsible for transformation and metabolism of bone (asthi dhatu agni) Factors responsible for skeletal metabolism:
|1. || Role of [[Prithvi mahabhuta]] in asthi dhatu || Minerals including inorganic salts like calcium phosphate and calcium sulphate make the matrix more dense
|-
|2. || Role of adipose tissue (meda dhatu) || Marrow adipose tissue (MAT) is stored in bones.
|-
|3. || Composition of Asthi dhatu || Support cells, namely, osteoblasts and osteocytes ;
Remodeling cells, namely, osteoclasts ;Non-mineral matrix of collagen and noncollagenous proteins called osteoid, with inorganic mineral salts deposited within matrix
|-
|4. || Factors responsible for transformation and metabolism of bone (asthi dhatu agni) || Factors responsible for skeletal metabolism:
Calcitropichormones, Parathyroid hormone (PTH), Calcitonin (CT), Vitamin D [1,25(OH 2)D], PTHrP, other hormones, gonadal and adrenal steroids, Thyroid hormones, Growth factors and cytokines
Calcitropichormones, Parathyroid hormone (PTH), Calcitonin (CT), Vitamin D [1,25(OH 2)D], PTHrP, other hormones, gonadal and adrenal steroids, Thyroid hormones, Growth factors and cytokines
5. Formation of asthi dhatu Processes of bone formation, bone resorption and remodeling
|-
6. Nutrition, growth and development (poshana) The factors responsible for skeletal metabolism are responsible for longitudinal and radial growth of boneuptothe age of skeletal maturity (18 to 25 years)
|5. || Formation of asthi dhatu || Processes of bone formation, bone resorption and remodeling
|-
| 6.|| Nutrition, growth and development (poshana) || The factors responsible for skeletal metabolism are responsible for longitudinal and radial growth of boneuptothe age of skeletal maturity (18 to 25 years)
|-
|7.|| Disorders of channels of transport and transformation on asthi dhatu – extra growth of bones || osteoma, osteoid osteoma, osteochondroma, osteoblastoma, enchondroma, giant cell tumor of bone, aneurysmal bone cyst, leukemia
|}
=== Assessment and investigations ===
==== Radiological investigations ====
*X ray, Ultrasound, CT scan and MRI scan are methods used for scanning structural abnormalities, fractures of bones.
*X ray, Ultrasound, CT scan and MRI scan are methods used for scanning structural abnormalities, fractures of bones.
*Nuclear imaging technique ‘Bone scan’ is used to detect the bone cancers.
*Nuclear imaging technique ‘Bone scan’ is used to detect the bone cancers.
*Dual Energy X-ray Absorptiometry (DEXA) scan is used to measure bone mineral density. It is used to diagnose osteopenia and osteoporosis.
Current researches :
*Dual Energy X-ray Absorptiometry (DEXA) scan is used to measure bone mineral density. It is used to diagnose osteopenia and osteoporosis.
Growth factors produced by stem cells aid in the bone repair process. Current researches investigated the ability of encapsulated rat adipose‐derived stem cells (rASCs) treated with osteogenic media (OM) to produce growth factors, and determined the optimal combination of OM components that will lead to the production of both osteogenic and angiogenic factors. The results demonstrate that microencapsulated stem cells were able to produce vascular endothelial growth factor (VEGF), fibroblast growth factor‐2, and bone morphogenetic protein‐2 (BMP2) necessary for bone regeneration.
Bone tissue engineering:
== Current researches ==
Scope of further research: Osteoarthritis (OA) is degenerative joint disorder, represents failure of the diarthrodial (movable, synovial-lined) joint. OA of knee joint comes under the inflammatory group which is almost identical to sandhigatavata described in Ayurveda with respect to etiology, pathology, and clinical features.Agnikarma (therapeutic heat burn)is observed effective nonpharmacological, parasurgical procedure for pain management in SandhigataVata (OA of knee joint). ,
Growth factors produced by stem cells aid in the bone repair process. Current researches investigated the ability of encapsulated rat adipose‐derived stem cells (rASCs) treated with osteogenic media (OM) to produce growth factors, and determined the optimal combination of OM components that will lead to the production of both osteogenic and angiogenic factors. The results demonstrate that microencapsulated stem cells were able to produce vascular endothelial growth factor (VEGF), fibroblast growth factor‐2, and bone morphogenetic protein‐2 (BMP2) necessary for bone regeneration.<ref>Shirae K. Leslie et al,Production of osteogenic and angiogenic factors by microencapsulated adipose stem cells varies with culture conditions,Journal of Biomedical Materials Research Part B: Applied Biomaterial ; Vol 108, No 5, Jul 2020 ; PP: 1857-1867</ref>
=== Bone tissue engineering ===
*The successful regeneration of bone tissue to replace areas of bone loss in large defects or at load-bearing sites remains a significant clinical challenge. Over the past few decades, major progress is achieved in the field of bone tissue engineering to provide alternative therapies, particularly through approaches that are at the interface of biology and engineering.<ref>Li JJ, Ebied M, Xu J, Zreiqat H. Current Approaches to Bone Tissue Engineering: The Interface between Biology and Engineering. Adv Healthc Mater. 2018;7(6):e1701061. doi:10.1002/adhm.201701061</ref> The major components of bone tissue engineering are the scaffold, cells, and growth factors. The recent advancements in developing scaffolds that can mimic the natural extracellular matrix of bone using two main fabrication techniques, electrospinning and thermally-induced phase separation, and incorporating bone-like minerals, such as hydroxyapatite, composite nanofibrous scaffolds can improve cell adhesion, stem cell differentiation, and tissue formation.<ref>Holzwarth, J. M., & Ma, P. X. (2011). Biomimetic nanofibrous scaffolds for bone tissue engineering. Biomaterials, 32(36), 9622–9629. https://doi.org/10.1016/j.biomaterials.2011.09.009</ref>
=== Scope of further research ===
Osteoarthritis (OA) is a degenerative joint disorder, represents failure of the diarthrodial (movable, synovial-lined) joint. OA of knee joint comes under the inflammatory group which is almost identical to sandhigatavata described in Ayurveda with respect to etiology, pathology, and clinical features. Agnikarma (therapeutic heat burn)is an observed effective nonpharmacological, para surgical procedure for pain management in SandhigataVata (OA of knee joint).<ref>Jethava NG, Dudhamal TS, Gupta SK. Role of Agnikarma in Sandhigata Vata (osteoarthritis of knee joint). Ayu. 2015;36(1):23‐28. doi:10.4103/0974-8520.169017</ref> <ref>Sharma A, Shalini TV, Sriranjini SJ, Venkatesh BA. Management strategies for Janu Sandhigata Vata vis-a-vis osteoartheritis of knee: A narrative review. Ayu. 2016;37(1):11‐17. doi:10.4103/ayu.AYU_24_16</ref>
* The role of enema therapy in various disorders of bone tissue is an important topic of research. Many researches are carried out in this area as listed below. However precise studies are required to be done for the effect of enema therapy at various levels of bone metabolism and factors responsible for growth.
* The role of enema therapy in various disorders of bone tissue is an important topic of research. Many researches are carried out in this area as listed below. However precise studies are required to be done for the effect of enema therapy at various levels of bone metabolism and factors responsible for growth.
===List of theses done===
1.Alpesh Joshi(2004) : A clinical study on the role of matrabasti and shamana yoga in the management of sandhivata (osteoarthritis), Department of Kayachikitsa, IPGT &RA Jamnagar.
=== List of theses ===
1.Patel Kalapi B (2001) : A clinical study on the development of subtype of abhyanga with reference to its role in the management of griva-hundana (cervical spondylosis) , Department of Panchakarma, I.P.G.T. & R.A., Jamnagar.
2.Alpesh Joshi(2004) : A clinical study on the role of matra basti and shamana yoga in the management of sandhivata (osteoarthritis), Department of Kayachikitsa, I.P.G.T. & R.A., Jamnagar.
7.Jayadipkumar P Shah(2008): Effect of tiktakshirabasti and patrapindasweda in the management of cervical spondylosis (asthigatavata), Department of Panchakarma, IPGT &RA Jamnagar.
3.Praveen Kumar KC (2005):Effect of vachadi upanaha and vachadi ghana-vati in sandhigata-vata w.s.r. to osteoarthritis, department of Panchakarma, I.P.G.T. & R.A., Jamnagar.
8.Ajay K Gupta (2010):Effect of majjabasti&asthishrinkhala in the management of osteoporosis w.s.r. to asthi-majjakshaya-a clinical study, Department of Panchakarma, IPGT &RA Jamnagar.
9.Saurabh R Bhuva(2012) : A comparative study of matrabasti and brimhanasnehana by asthishrinkhalaghrita in the management of asthi-majjakshayaw.s.r. to osteopenia / osteoporosis, Department of Panchakarma, IPGT &RA Jamnagar.
4.Mayuri Shah (2006):A comparative study of matra basti and some indigenous compound drug in the management of sandhigata vata (osteoarthritis), Department of Kayachikitsa, I.P.G.T. & R.A., Jamnagar.
10.Chugh Deepa Surender Pal (2014): A comparative study of shwadanshtradibasti and chitrakadighrita in management of sandhivata with special reference to osteoarthritis, Department of Panchakarma, IPGT &RA Jamnagar.
==More information ==
5.Md. Babul akter(2006) : Clinical study on sandhigata vata with special reference to osteoarthritis and its management by panchatiktaghritaguggulu, Department of Kayachikitsa, I.P.G.T. & R.A., Jamnagar.
[[ GrahaniChikitsa]]
6.Dhaval M Dholakiya(2012) : A clinical study on sandhigata vata (osteoarthritis) and its management with dashmoola ghrita and nirgundi tail, Department of Kayachikitsa, I.P.G.T. & R.A., Jamnagar.
7.Jayadipkumar P Shah(2008): Effect of tikta kshira basti and patra pinda sweda in the management of cervical spondylosis (asthigata vata), Department of Panchakarma, I.P.G.T. & R.A., Jamnagar.
8.Ajay K Gupta (2010):Effect of majjabasti&asthishrinkhala in the management of osteoporosis w.s.r. to asthi-majjakshaya-a clinical study, Department of Panchakarma, I.P.G.T. & R.A., Jamnagar.
9.Saurabh R Bhuva(2012) : A comparative study of matra basti and brimhana snehana by asthishrinkhala ghrita in the management of asthi-majjakshaya w.s.r. to osteopenia / osteoporosis, Department of Panchakarma, I.P.G.T. & R.A., Jamnagar.
10.Chugh Deepa Surender Pal (2014): A comparative study of shwadanshtradibasti and chitrakadighrita in management of sandhivata with special reference to osteoarthritis, Department of Panchakarma, I.P.G.T. & R.A., Jamnagar.
== More information ==
[[ Vividhashitapitiya Adhyaya]], [[ Grahani Chikitsa]]
=== Related articles ===
*[[Dhatu]]
*[[Rasa dhatu]]
*[[Rakta dhatu]]
*[[Mamsa dhatu]]
*[[Meda dhatu]]
*[[Majja dhatu]]
*[[Shukra dhatu]]
== External links ==
== External links ==
[[Bone]], [[Human skeleton]], [[Artificial bone]], [[Joint replacement]]
[[Bone]], [[Human skeleton]], [[Artificial bone]], [[Joint replacement]]
=== Abbreviations ===
*SAT = Standard Ayurveda Terminology
*Cha. = Charak
*Su. = Sushruta
*Sha. =Sharangadhara
*Sa. = Samhita
=== References from [[Charak Samhita]] ===
The list of references for asthi dhatu in Charak Samhita can be seen [[Media:Asthi_dhatu-_reference_list.pdf|here.]]
<big>'''[[Special:ContactMe|Send us your suggestions and feedback on this page.]]'''</big>
==References==
==References==
<div id="BackToTop" class="noprint" style="background-color:#DDEFDD; position:fixed;
bottom:32px; left:2%; z-index:9999; padding:0; margin:0;"><span style="color:blue;
font-size:8pt; font-face:verdana,sans-serif; border:0.2em outset #ceebf7;
padding:0.1em; font-weight:bolder; -moz-border-radius:8px; ">
[[#top| Back to the Top ]]</span></div>