Asthisamharaka (Cissus quadrangularis) The Sanskrit word asthisamharaka literally means that which saves the bones from their destruction. Precisely, it is also named as asthisandhani, which describes its peculiar quality of healing the bone fractures. Denoting the same property, is has few synonyms, like vafravati, asthisrnkhala, vajrangi, granthimala etc. The plant has been mentioned in all ancient scriptures of Ayurveda. It is used in folklore medicine to heal bone fractures, throughout India. The Sanskrit names, mentioned above, also hint at the same use by ancient physicians.
The plant grows throughout India, especially, in gotter regions and in Sri Lanka, The tendril climber has quadrangular stems with ridges. The stems are often leafless, when old. Few aerial roots arise from the joined nodes and grow towards the soil, The leaves are small, simple, heart – shaped and toothed. The flowers are small, greenish white, in short cymes. The fruits are globose or ovoid berries, red when ripe. The author of Nighantu Ratnakara mentions the there are two varieties of this climber, namely, of four – sided and three – sided stems. But only one variety of four – sided stem is reported; which at times may be seen shooting out branches having three sides. A two – sided horticultural variety is also grown in gardens.
The botanical name of asthisamharaka is Cissus quadrangularis and it belongs to family Vitaceae. From the plant stems, 3- ketosteroids have been isolated. The steroid contained in this plant has an anabolic property. Two new unsymmetric tetracyclic triterpenoiks onocer – 7- en- 3 along with sitosterol, delta amyrin and delta amyrone were isolated.
Asthisamharaka is sweet in taste sour in the post digestive effect and has hot potency. It alleviates vata and kapha dosas. It possessed dry , light and mild laxative attributes. It is an appetizer, digestant, an aphrodisiac and healer of bone fractures. Mainly it is used in the diseases like piles, fractures, asthma, cough and loss of appetite. (Kaiyadeva Nighantu)
The stem and leaves of asthisamharaka have great medicinal value. The plant is used both, internally as well as externally. As it is a healing gerb and styptic (rakta stambhana) one, it is used to promote the healing of bone fractures. For that purpose, externally, the crushed stems are used as a poultice over bone fractures, along with the juice of its roasted stems, orally, is given with ghee. In epistaxix, the stem juice is instilled nasally, to arrest the nose bleed. The powdered stem is missed with pulses and fried in sesame oil, as a remedy for several vata diseases.
Orally, the plant is recommended with vakeri (Caesalpinia digya) root powder, in veneral diseases. In loss of appetite and indigestion, the cooked leaved are advised or their burnt ash is used. In menorrhagia, the stem juice, combined with gopicandana, is prescribed with ghee and honey. The fresh juice of the plant is benevolent in asthma. As a blood purifier, it is said to be beneficial in blood disorders in scurvy also. Asthisamharaka is also used as a general tonic.
Classical Ayurvedic Preparations
Asthisamharaka decoction of dried stalks.
Using Cissus Quadrangularis for Bone HealthAn Ancient Herbal Remedy for Osteoporosis and Healing of Fractures
Cissus Quadrangularis Promotes Bone Health -Osteoporosis and other bone disorders affect millions of people. Cissus quadrangularis is an herbal remedy that speeds healing of fractures and promotes bone strength.
Cissus quadrangularis is a rambling shrub native to the hotter parts of India and Ceylon. It has been used in traditional herbal medicine since ancient times as a general tonic and analgesic, but its most highly valued property is as a bone healer. To treat fractures and associated swelling, a paste made from the stem of Cissus is applied directly over the injury.
Research on the Bone-Healing Properties of CissusCissus quadrangularis has been studied extensively to verify its bone-healing properties. Clinical trials and animal studies have shown that treatment with Cissus facilitates the remodeling process of the healing bone, speeding the restoration of bone tensile strength. In clinical trials, Cissus shortened fracture healing time between 33% and 55%. In a number of studies, the effect of Cissus was observed in bones that were weakened by cortisol. When Cissus extracts were given, cortisol-induced weakening was halted, and the healing process began.
Animal studies have allowed more insight into the process by which Cissus promotes bone healing. In one such study, a phytosterol fraction isolated from Cissus demonstrated significant bone-healing activity in experimental bone fractures of the right humerus of young rats. When this extract was injected daily for six weeks, increases in total body weight, and substantially improved bone healing rates were observed. Researchers concluded that Cissus acts by enhancing regeneration of connective tissue and mineralization.
How Cissus Acts to Improve Bone StrengthCissus also improved the healing rate of experimental fractures of the femurs of dogs. Bone ossification rates in treated animals was significantly faster than in untreated animals. After three weeks of treatment, the callus in untreated animals contained cartilaginous tissue with only a few, thin and sparse bony trabeculae, whereas treated animals had considerably advanced ossification and the callus consisted of a network of bony trabeculae. After six weeks, ossification was complete and remodelling was advanced in the treated animals in comparison to the untreated animals, in which ossification was still in progress.
An aqueous extract of Cissus, applied topically or given by injection, hastened the healing of fractures as measured by a reduction in convalescence time. The extract improved the strengthening of bones as much as 90% over a six week period, and had an influence on both the organic and mineral phases of fracture healing. Ca45 uptake studies also demonstrated a speedier completion of the calciferous process, suggesting Cissus may be useful not only in building up bones but in improving functional efficiency as well. An extract of the plant was found to neutralize the antianabolic effect of cortisone in healing of fractures, possibly due to its high vitamin C content.
Cissus quadrangularis is an ancient medicinal plant native to the hotter parts of Ceylon and India. It was prescribed in the ancient Ayurvedic texts as a general tonic and analgesic, with specific bone fracture healing properties. Modern research has shed light on Cissus' ability to speed bone healing by showing it acts as a glucocorticoid antagonist (1,2). Since anabolic/androgenic compounds are well known to act as antagonists to the glucocorticoid receptor as well as promote bone growth and fracture healing, it has been postulated that Cissus possesses anabolic and/or androgenic properties (1,3). In addition to speeding the remodeling process of the healing bone, Cissus also leads to a much faster increase in bone tensile strength. In clinical trials Cissus has led to a fracture healing time on the order of 55 to 33 percent of that of controls. That cissus exerts antiglucocorticoid properties is suggested by a number of studies where bones were weakend by treatment with cortisol, and upon administration of Cissus extract the cortisol induced weakening was halted, and the healing process begun.
While the increased rate of bone healing may be of great significance to persons suffering from chronic diseases like osteoporosis (4), the antiglucocorticoid properties of Cissus are likely of much more interest to the average bodybuilder or athlete, since endogenous glucocorticoids, particularly cortisol, are not only catabolic to bone, but catabolize muscle tissue as well. Numerous studies over the years have suggested that glucorticoids, including the body's endogenous hormone cortisol activate pathways that degrade not only bone, but skeletal muscle tissue as well. A recently published report documented exactly how glucocorticoids (including cortisol) induce muscle breakdown: They activate the so-called ubiquitin-proteasome pathway of proteolysis (5). This pathway of tissue breakdown is important for removing damaged and non-functional proteins. However, when it is overactive during periods of elevated cortisol (e.g disease states, stress, and overtraining) excess amounts of normal tissue are broken down as well. By exerting an anabolic, antiglucorticoid effect cissus helps preserve muscle tissue during times of physical and emotional stress.
Although the bulk of the research on Cissus centers around bone healing, the possibility exists that Cissus may act to improve bone healing it may improve the healing rate of connective tissue in general, including tendons. If this is the case it would be of great benefit to bodybuilders and athletes.
Besides the above-mentioned properties of Cissus, the plant is also rich in the vitamins/antioxidants vitamin C and beta-carotene. As analyzed, Cissus quadrangularis contained ascorbic acid 479 mg, and carotene 267 units per 100g of freshly prepared paste in addition to calcium oxalate (6).
The typical recommended daily dosage of Cissus extract is between 100 and 500 mg, depending on the concentration of the extract and the severity of symptoms. For the powder of the dried plant, the Ayurvedic texts recommend a dosage of 3 to 6 grams to accelerate fracture healing. Safety studies in rats showed no toxic effects at dosages as high as 2000 mg/kg of body weight. So not only is Cissus efficacious, it is also quite safe, in either the dried powder form or the commercially available extract.
Cissus also possess analgesic properties on a mg per mg basis comparable to aspirin or anti-inflammatory drugs like ibuprofen. Cissus quadrangularis constitutes one of the ingredients of an Ayurvedic preparation, `Laksha Gogglu', which has been proved to be highly effective in relieving pain, reduction of swelling and promoting the process of healing of the simple fractures as well as in curing the allied disorders associated with fractures (7). The mechanism through which Cissus exerts its analgesic and anti-inflammatory properties has not been well characterized. It may act centrally, but the anti-inflammatory features suggest that it acts by preventing the conversion of arachidonic acid to inflammatory prostaglandins.
1) Chopra SS, Patel MR, Awadhiya RP. Studies of Cissus quadrangularis in experimental fracture repair : a histopathological study Indian J Med Res. 1976 Sep;64(9):1365-8
2) Chopra SS, Patel MR, Gupta LP, Datta IC. Studies on Cissus quadrangularis in experimental fracture repair: effect on chemical parameters in blood Indian J Med Res. 1975 Jun;63(6):824-8.
3) PRASAD GC, UDUPA KN. EFFECT OF CISSUS QUADRANGULARIS ON THE HEALING OF CORTISONE TREATED FRACTURES. Indian J Med Res. 1963 Jul;51:667-76.
4) Shirwaikar A, Khan S, Malini S. Antiosteoporotic effect of ethanol extract of Cissus quadrangularis Linn. on ovariectomized rat. J Ethnopharmacol. 2003 Dec;89(2-3):245-50.
5) Combaret L, Taillandier D, Dardevet D, Bechet D, Ralliere C, Claustre A, Grizard J, Attaix D Glucocorticoids regulate mRNA levels for subunits of the 19 S regulatory complex of the 26 S proteasome in fast-twitch skeletal muscles. Biochem J. 2004 Feb 15;378(Pt 1):239-46.
6) Chidambara Murthy KN, Vanitha A, Mahadeva Swamy M, Ravishankar GA. Antioxidant and antimicrobial activity of Cissus quadrangularis L. J Med Food. 2003 Summer;6(2):99-105.