INFLUENTIAL FACTORS FOR THE NORMALCY AND DEFORMITIES OF ASTHI

hold the body and give a definite shape to every individual. But if this skeletal structure has deformity it surely affects the day-to-day activities as well as social being. Bone disorders are more common and also difficult to treat in geriatric, pediatric, weak patients, under-nourished andvatalarugna. So, modification in diet and regimen can prevent or delay early degenerative changes in bone. For this sake, it is necessary to study the influential factors for the status of health of Asthi.


Tridosha: Vata:
According to Vata-asthiashrya-ashrayiSambandh [2] ,vata resides in asthi while pitta resides in rakta,sweda and kapha resides in the remaining dhatu, upadhatu and mala. Usually dravya that cause vruddhi in ashraya causes vruddhi of ashrayi and vice-a-versa and same goes with kshay but it"s exactly opposite in case of vata and asthi. Vatavruddhi causes asthi-kshay and vatashaman causes asthivruddhi. This is why asthi becomes weak in vrudhawastha, as it is vatapradhan stage of life.
Prakupitvata increases rukshata, laghuta and kharatva in asthi so even the asthi becomes more porous, losses its compactness and leads to breaking of bone into osteophytes. Due to increase in vayumahabhuta, there is decrease in itsparthivatva. Similarly if there is vata-kshay, it leads to decrease in gunasvayumahabhuta and increase in the parthivgunas. So when there is vata-kshay, asthi becomes excess guru, sthira and kathina. Therefore, anything in excess is harmful and it is of pronounced importance to maintain prakrutavata-awastha to have healthy bone condition.

Kapha:
Prakupit kapha causes shubrata, drudhta and guruta of asthi, nakha and danta. It increases the thickness of bones and teeth. Although these qualities are expected in Asthi but anything in excess is an ailment. When Prakupit kapha becomes asthyashrita, it causes stabdhata of asthi [4] . Normalcy of all the tri-Dosha is always favorable for any individual.
In bhagnachikitsa, it is stated that whenever there is pakwa-awasthaofvrana, it is associated with pitta-prakopa and rakta-dushti. To avoid fracture from becoming kruchhra-sadhya, bhagnapachan should be avoided.
Asthividradhi isexplained as-"the Kupita dosha causesdushti in twak, rakta,mamsa and meda and get seated in asthi". Asthividradhicauses severe inflammation and pain. Asthividradhi is elaborated by Sushrutacharya, it says that the paka of majja within the asthi leads to pus formation [6] and when this pus is obstructed by asthi and mamsa, the patient feels burning sensation within. This ushma formed due to majja-paka destroys the asthi like an object is destroyed by burning. Again here we come to conclusion that pus formation has led to asthividradhi and any pus formation is due to rakta dushti.
Trauma leads tovata, rakta and mamsa-dushti. Kotha is the putibhava i.e.necrosis [7] . So even in kotha, the role of rakta is significant. Kotha is either wet (Pus formation) or dry (Necrosis). If there is pus formation, it"s probably due to the vitiation ofkapha-pitta and dry necrosis is due to vitiation of vata-pitta. Prakupit kapha increases the picchilta, sandrata and klinnata while Prakupit vata increases the rukshata, kathinta and kharata, prakupit pitta increases the ushmaat that site and does pachan. Ushma from pitta liquefies the kapha and forms pakawastha while it helps vata to dry up the sneha or apya-bhava from dhatu, mala, sira-snayu-dhamani, etc.
Wheat (godhuma) is said to be best bruhana and sandhankardravya [11] and its properties are swadu and sheeta, which again explains the rakta-prasadakarproperty.
All these references indicate the importance of rakta in asthivikrutiis. Rakta dushti greatly contributes to asthiVikrutis,especially in diseases like bhagna, Kotha andvidradhi.

Meda-dhatuvruddhi:
While explaining Sthoulya [12] , it is stated that in obese patients only medadhatu (fat) is produced in abundance thus the further dhatu are not well formed. This is certainly acceptable as per "kedar-kulyanyaya", as medadhatu is formed in excess due to tikshnameda-dhatwagni, the further dhatus do not receive sufficient poshakansha.
The main cause of both obesity and emaciation is rasa( here rasa means "ahara-rasa", when this rasa is apakwa, it forms "aam"). Even though the agni is dipta, adhyashan causes accumulation of aam-rasa. While flowing in the entire body, the aam-rasa circulates and deposits everywhere in the body leading to margawrodha. Along with it, because of consumption of specific shleshmalahara only, meda is formed in abundant while rests of the dhatus are formed in small quantity. By "shesh-dhatu", it means "asthyadidhatu". This entire pathology leads to obesity, along with which disease like vata-vikara occur. Margawrodha causes vata-prakopa and leads to vata-vikara. So both saamta and meda-dhatuvruddhi contribute to asthi-vikrutis. Therefore to maintain good health of bones, saamta should be avoided and weight should be normal.
Ahara/Rasa-Asthi relation [13] : Food affects every activity and metabolism of the body. Every rasa is necessary for the body and should be consumed as per the right quantity for each person (मात्रावत ्). Excess consumption of any rasa is inappropriate; it definitely affects the dosha-dhatu-malasamyawastha and will land up in vikruti.Rasa and their effects on asthi are as follows Agni deepan, vranaavasadan, krumi-naasha, bandhachhedan, stroto-margavishodhan.