Understanding the Asthyashraya Vyadhi - in the view of Asthishula Chikitsa

[Find the meaning and references behind the names: Bala, Janu, Main, Mala, Madhu]

REVIEW ARTICLE July-Aug 2020 Journal of Ayurveda and Integrated Medical Sciences | July - Aug 2020 | Vol. 5 | Issue 4 157 Understanding the Asthyashraya Vyadhi - in the view of Asthishula Chikitsa Dr. Madhumalathi BV 1 , Dr. V. A. Chate 2 , Dr. Shreevatsa 3 1 Post Graduate Scholar, 2 Associate Professor, 3 Professor & HOD of PG Studies, Dept. of Ayurveda Samhita & Siddhanta, Govt. Ayurvedic Medical College, Mysuru, Karnataka, INDIA. I NTRODUCTION There are many ways of understanding the diseases and planning the treatments for them. Understanding Vyadhis based on the classification is one method. Vyadhis are divided considering the factors such as Mruduta - Darunata ; Guruta - Laghuta ; Utthana - Gambhirata ; Bala - Sthana etc. of the Vyadhis . Ultimately, all the Vyadhis involve Doshas. Dosha Samyata is the destruction of the Vyadhi i.e. Arogata. Dosha Vaishamya involves either Dosha Vriddhi or Dosha Kshaya. Doshas take shelter in Dhatus , in turn vitiate Dhatus . The vitiated Dhatus produce numerous diseases. Instead of treating the Address for correspondence: Dr. Madhumalathi BV Post Graduate Scholar, Dept. of Ayurveda Samhita & Siddhanta, Govt. Ayurvedic Medical College, Mysuru, Karnataka, INDIA. E-mail: tuvaraka.madhu@gmail.com Submission Date: 13/07/2020 Accepted Date: 05/08/2020 Access this article online Quick Response Code Website: www.jaims.in Published by Maharshi Charaka Ayurveda Organization, Vijayapur, Karnataka (Regd) under the license CCby-NC-SA diseases individually, if the main Dhatu related to the disease is treated, the treatment would win over all the diseases related to the respective Dhatu . In the present article, in view of treating the Katishula and Janushula i.e. forms of Asthishula, an attempt is made to understand the related Dhatu Vikara i.e Asthyashraya Vyadhi. M ATERIALS AND M ETHODS Ayurveda classical texts, particularly Brihattrayee. Shareera is made up of Dosha, Dhatu and Mala . Among these three, Dhatu beholds strength & energy and gives sustenance to Shareera (Dharanat dhaatavaha). Dhatus become Ashraya for Doshas which carry out their respective functions for the maintenance of life in Shareera . Thus Dhatus become ‘ Ashraya’ and Doshas become ‘ Ashrayee’ . The Dosha, i.e. Ashrayee and Dhatu , i.e. Ashraya are inter related closely in such a way that, if Ashrayee is increased, Ashraya gets enhanced and if Ashrayee is decreased, Ashraya gets depleted. This is the general rule Vayu, the Ashraya Dosha takes shelter in Asthi Dhatu, i.e Ashrayee ; There is exception for the Vata Dosha & Asthi Dhatu. [1] If Vata Dosha increases, Asthi A B S T R A C T Understanding the Asthyashraya Vyadhi is mandatory when a physician wants to treat the diseases related to Asthi. Hetu Gnana is obligatory in planning the Chikitsa. Ashraya-Ashrayee Sambandha of Dhatu & Dosha also acts as a prime factor in employing the appropriate treatment for the specific Vyadhi . In the process of treatment of Asthi Shula such as Katishula and Janu Sandhi Shula , the specific treatment/ therapy is required so that the treatment given at the root would give complete relief for the patient. Understanding the disease at the level of Dhatu Pradosha would become the right path in planning the specific treatment. Approaching Asthi Shula through the Dhatu Pradoshaja Vikaras would be more appropriate. The Chikitsa of Dhatu Pradoshaja Vikara corrects the Mula Dhatu Asthi , thereby the treatment of Asthi Shula would become complete. Key words: Asthyashraya Vyadhi, Asthishula, Katishula, Janushula, Dhatu Pradoshaja Vikara.

[Find the meaning and references behind the names: Dhanya, Karma, Vega, Rasa, Chanaka, Rupa]

Dr. Madhumalathi BV et al. Understanding the Asthyashraya Vyadhi - in the view of Asthishula Chikitsa ISSN: 2456-3110 REVIEW ARTICLE July-Aug 2020 Journal of Ayurveda and Integrated Medical Sciences | July - Aug 2020 | Vol. 5 | Issue 4 158 gets depleted and if Vata Dosha decreases, Asthi is nourished. Asthyashrayavyadhis are those diseases which take shelter in the skeletal system, alter the natural structure & functioning of the bones leading to several disorders. The Nidana Panchakas i.e. Nidana , Purvarupa, Rupa, Upashayaanupashaya and Samprapti of Asthyashraya Vyadhi need to be understood before planning the treatment. Nidana Main causative factors for the occurance of Asthyashrayavyadhis [2] are: 1. Ati Vyayama: Ati Vyayama is that activity which is carried out beyond one’s capacity. Doing Vyayama even after sweating on forehead by a person is considered as ‘ Ati Vyayama’ . 2. Ati Sankshobha: Excessive movement of Asthi / Asthi Sandhis is understood as Ati Sankshobha. 3. Ati Vighattana of Asthi: Unusual or additional movements of Asthi / Asthisandhi is Ati Vighattana of Asthi . 4. Vaatala Ahara and Vihara: Food and activities which increase Vata Dosha are termed as Vatala Ahara and Vihara. The overall Nidanas are classified and tabulated as below, Table 1: Showing overall Nidanas of Asthyashraya Vyadhi . Aharaja Nidana Viharaja Nidana Manasika Nidana Anya Nidana ( Viprakrishta Nidana) Katu Rasa Ati Vyayama Chinta Dhatu Kshaya Tikta Rasa Langhana Shoka Margaavarana Kashaya Rasa Plavana Krodha Ati Mamsa Kshaya Rooksha Atyadhwa Bhaya Asrik Kshaya Laghu Pradhavana Rogaatikarshana Sheeta Pratarana Kshudhitambupan a Alpabhojana Atyuccha Bhashana Abhojana Balavadvigrah a Vallora (dry meat) Abhighata Shushka Shaka Marmaghata Uddhalaka Bharaharana Neevara Dukha Shayya Mudga Sheegrayana Chanaka Prapeedana Masura Atyadhyayana Harenu Ati Vyavaya Kalaya Ati/ Ratri Jagarana Trunadhany a Vega Dharana / Udeerana Virudaka Dhanya Vishamopach ara Sahasa Karma Upavasa Purovata Sevana Divaswapna Poorvarupa ▪ There is no specific Purvarupa for Asthyashraya Vyadhi . ▪ Purvarupa of Vatavyadhis are not expressed; they are A vyakta. Chakrapani comments that, “ Avyaktam ” means ‘ Laghuta’ of disease [3]

[Find the meaning and references behind the names: Sakthi]

Dr. Madhumalathi BV et al. Understanding the Asthyashraya Vyadhi - in the view of Asthishula Chikitsa ISSN: 2456-3110 REVIEW ARTICLE July-Aug 2020 Journal of Ayurveda and Integrated Medical Sciences | July - Aug 2020 | Vol. 5 | Issue 4 159 ▪ Vijayarakshita states in Madhava Nidana , “ Na Ati Abhivyakta ” - the symptoms which are not manifested completely or not exhibited completely are the Purvarupa. Thus mild recurrent backache, slight stiffness of joints with mild joint pain, sudden pain of bones on lifting weight or bending down etc. may come under premonitory symptoms of Asthyashraya Vyadhi. Rupa Rupa mentioned in prominent Brihat Samhitas are tabulated as below: Asthi Kshaya and Vikruta Asthivriddhi Lakshanas are considered under Asthyashraya Vyadhis by most of the Samhitas. Table 2: Showing Rupa of Asthyashraya Vyadhi according to different Acharyas. [4-7] Rupa C.S S.S A .H A.S Adhyasthi + + - - Adhidanta + + - - Asthibheda + + - - Asthishula + + + + Asthitoda - - + - Kesha, Loma, Smashru, Nakha Vikara + + - - Sandhishula - - + + Sakthi Shula - - + + Teevra Balakshaya - - + + Deha Rukshata - + - - Danta, Nakha Bhanga - + - - Danta, Kesha, Nakha Shadana - - + - Upashaya- Anupashaya Upashaya (Pacifying factors) ▪ Vatadosha is the Ashrayee that resides in Asthi Dhatu, ‘Vata Prakopana Viparyaya’ Ahara & Viharas pacify the Doshas in Asthi Dhatu . Thus, Vata Prashamana Ahara and Vihara act as Upashaya for Asthyashraya Vyadhi . ▪ Ahara s hould be predominantly consisting of Madhura, Amla and Lavana Rasa along with Snigdhaguna. ▪ Residing in a Nivata Sthana, Pravarana , Veshtana, Bandhana, Abhyanga, Avagaha etc [8] Anupashaya (Aggravating factors) All the factors responsible for Vatadosha Vriddhi aggravate the Asthyashraya Vyadhis. ▪ Vatala Ahara: Ruksha, Sheeta, Laghu, Katu-Tikta- Kashaya Rasa Pradhana Ahara Dravya Sevana etc. ▪ Vatala Vihara: Ati Vyayama, Ati Vyavaya, Ati Jagarana, Chinta, Shoka, Krodha, Vega Dharana etc. Samprapti Ghatakas ▪ Nidana : Vata Prakopaka Nidana ▪ Dosha : Vata ▪ Dushya : Asthi Dhatu; Upadhatu and Malas of Asthidhatu. ▪ Srotas : Asthivaha. ▪ Srotodushti : Sanga, Vimarga gamana, Atipravritti. ▪ Agni : Jataragni and Dhatvagni Mandyata ▪ Doshagati : Marma Asthi Sandhi [9] ▪ Rogamarga : Madhyama [10] ▪ Udbhavasthana : Pakvashaya ▪ Adhisthana : Asthi/ Sandhi/ Kesha/ Danta/ Nakha Vyavacchedaka Nidana The Prakupitavata produces various types of diseases depending on the Hetu i.e.‘causes’ and the Sthana i.e. ‘place of manifestation’ of the diseases

[Find the meaning and references behind the names: Long, Ana, Deep, Ama, Sneha, Supti]

Dr. Madhumalathi BV et al. Understanding the Asthyashraya Vyadhi - in the view of Asthishula Chikitsa ISSN: 2456-3110 REVIEW ARTICLE July-Aug 2020 Journal of Ayurveda and Integrated Medical Sciences | July - Aug 2020 | Vol. 5 | Issue 4 160 Table 3: Showing Vata Prakopa in Inter-related Dhatus. [11] Factors Medodhatu Gata Vata Asthidhatu Gata Vata Majjadhatu Gata Vata Shula Swarupa Dandamushtihata m i.e.Pain of the whole body as if hit by big stick or fist Asthiparva Bheda i.e . breaking type of pain in the joints Santata Ruk i.e.continuou s pain of joints Asthiparva Bheda i.e.breaking type of pain in the joints Santata Ruk i.e. continuous pain of joints Shula Sthana Not particular to joints; pain all over the body present. Sandhi Shula i.e. pain of joints especially weight bearing joints . Sandhi Shula i.e. pain of joints especially involving long bones Nidra Not disturbed Aswapna i.e. sleeplessness Aswapna i.e. sleeplessnes s Other Lakshana s Shrama i.e. tiredness. Anga Gourava i.e.heaviness of body. Anga Toda i.e.pricking sensation of the body Mamsa Bala Kshaya i.e. weaknesss of muscles. Mamsa Bala Kshaya i.e. weaknesss of muscles. Table 4: Showing Vata Prakopa in Inter-related Deha-Avayavas. [12] Factors Snayu Gata Vata Siragata Vata Sandhigata Vata Shula - Mandaruk i.e. mild bodyache Prasaranaakunch ana Savedana Pravritti i.e. pain during flexion & extension of joints Shotha - Shopha i.e. slight swelling of the body Vatapoornadruti Sparsha Shotha i.e. swelling of joints as if filled by the air. Roga Anubandh a Manifestation of diseases such as, Bahyaayaama , Abhyantaraay aama, Khalli, Kubjatwa, Sarvanga Vata, Ekanga Vata Shoshana i.e. emaciated body Spandana, Supti of Sira i.e. pulsatile & numbness of veins - Considering the above points of Vyavacchedaka Nidana , it can be concluded that, the Prakupita Vata taken shelter in Asthidhatu produces the specific Lakshanas such as continuous pain in bones & joints i.e Asthishula ; breaking pain in bones i.e. Asthibheda ; severe tiredness i.e. Balakshaya and Sleeplessness i.e. Anidrata. Upadrava [13] Sandhichyuti, Kunchana, Kubjatha, Angasamshosha, Pangutwa are the possible Upadravas which show poor prognosis. DISCUSSION The science of Ayurveda views the diseases from their basic root of origin. Ultimately, all the diseases should be categorized under the 7 basic components that are responsible for the creation of the body, known as Sapta Dhatus. Asthi is the deep seated Dhatu proved to be the supporting pillar of the body. Asthyashraya Vyadhi is the disease affecting the Asthi Dhatu . All those diseases which take Ashraya in Asthi come under the heading of Asthyashraya Vyadhi. Before treating, Asthyashraya Vyadhi has to be studied conceptually, so that the Chikitsa Siddhanta can be understood and applied with perfection. Ahararasa is the Moola for Sapta Dhatu Nirmana Asthi is formed on 20 th day after the intake of Ahara. In the process of ‘ Dhatu Sneha Parampara’ [14] i.e. the

Dr. Madhumalathi BV et al. Understanding the Asthyashraya Vyadhi - in the view of Asthishula Chikitsa ISSN: 2456-3110 REVIEW ARTICLE July-Aug 2020 Journal of Ayurveda and Integrated Medical Sciences | July - Aug 2020 | Vol. 5 | Issue 4 161 chronological formative heritage of Dhatus one after the other, ‘Medas’ the softer preceding Dhatu gives rise to ‘ Asthi’ the hardest of all Dhatus. Kharatwa of Asthi Dhatu is brought about by the action of Asthidhatwagni. By the Sanghata of Prithwi, Agni and Vayu Mahabhutas , ‘ Shoshana’ Karma takes place i.e. drying out the Dravatva / Kledata of Medas to get modified as harder Asthi. [15] The Dharana Karma of Asthi is mainly supported by the Jaghana or the entire hip region, which balances the upper and lower parts of the body. Jaghana gets affected when Asthivaha Srotodushti occurs. During old age, when degeneration of Asthi Dhatu occurs, primary site of affection is the entire Hip region / Jaghana . It is evident that the neck of femur, the prominent bone of Jaghana Pradesha is most frequently fractured in old age. Even the Basti Chikitsa given is nearer to the Jaghana Pradesha , and it is the specific Chikitsa in treating Asthi related diseases. Therefore, Jaghana is righteously considered as Moola of Asthivaha Srotas. [16] Prakupita Doshas get collected in the Asthivaha Srotas by means of Srotodushti Prakaras such as Sanga, Atipravritti or Vimargamana . Due to Nidanas like Ativyayama, Atisankshobha, Asthi Vighattana and due to Vatakara Ahara & Viharas, Asthivaha Srotodushti takes place which is characterized by either Vriddhi or Kshaya of Asthi Dhatu . Doshas lodged in Asthi Dhatu are not so easily removed because of following reasons. ▪ Since Asthi is the Gambheera Dhatu. ▪ Among the three Rogamargas, Asthi is included under Madhyama Rogamarga which is difficult to treat. ▪ Doshas that have taken shelter in Asthi need well planned specific treatment for their removal. This is the reason behind Charakacharya’s unique design of Tikta Ksheerabasti in Asthyashraya Vyadhi. [17] Rupa of Asthyashraya Vyadhi ▪ Adhyasthi Adhyasthi can be understood as the unhealthy growth or remodeling of the Bone called as Osteophytes, when Asthi undergoes stress as seen in Ativyayama, Atisankshobha or injury ( Asthi Vighattana ). Usually, these Osteophytes / Bony spurs are formed marginally in the joints of Bones. Bone spurs cause pain when rubbed or pressed against the surrounding tissues ▪ Asthibheda Breaks or cracks observed in Bones are another form of expression of Asthyashraya Vyadhi . Increased Rukshata and Shushkata due to Vatavriddhi causes breaks/cracks in Bones or Teeth ▪ Asthishula Pain in the affected Bone is the Pratyatma Lakshana often observed in Asthyashraya Vyadhi. Asthishula is the result of Vatadosha being lodged in Asthi or it may be due to degenerated Asthi. When the activities such as walking, climbing, squatting, stretching, lifting weights etc. are carried out in excess, disproportional to the nourishment of Asthi Dhatu, it results in the depletion of Asthi . Hence, Asthishula is often expressed in Kati, Janu, Prishta, Greeva, Amsa etc. most commonly used Asthi Sandhis in such activities ▪ Asthitoda Asthitoda, the pricking pain in Asthi is also one of the Rupa of Asthyashraya Vyadhi , as told exclusively in Ashtanga Hridaya Samhita . Severity of the Vyadhi may present this Rupa. ▪ Adhidanta The extra unusual growth of Teeth is also one of the Rupa of Asthyashraya Vyadhi. Danta is the Upadhatu of Asthi Dhatu , therefore abnormal growth is also seen in Denture ▪ Dantashula & Dantabheda Because of the under nourished Asthi Dhatu , its Upadhatu Danta also undergoes degeneration Vivarnata & Sadana of Kesha, Loama, Nakha, Smashru Discoloration of Nails/ Hairs and fall of Hairs on Scalp/ body, of Nails, of Moustache are other Rupa of

[Find the meaning and references behind the names: Sri, Ram, Deepika, Hari, Prakashan, Narayan]

Dr. Madhumalathi BV et al. Understanding the Asthyashraya Vyadhi - in the view of Asthishula Chikitsa ISSN: 2456-3110 REVIEW ARTICLE July-Aug 2020 Journal of Ayurveda and Integrated Medical Sciences | July - Aug 2020 | Vol. 5 | Issue 4 162 Asthyashraya Vyadhi . Kesha, Loama, Nakha & Smashru are the Asthi Malas which also exhibit the Rupa of Asthyashraya Vyadhi . Illustration 1: Showing Samprapti of Asthyashraya Vyadhi Upashaya Control over Vatala Ahara and Vihara are the factors of comfort. Anupashaya The activities involving excess movements of Asthi, giving stress to Asthi , usage of Vatala Ahara & Vihara are the triggering factors. CONCLUSION Asthi is the deeper Dhatu which has its Utpatti mula as Medas and Jaghana. Subsequent formation of Sapta Dhatus depends on each person’s Kayagni and hence enhancement of the Kayagni is required for the proper formation of Asthi Dhatu. Asthyashraya Vyadhi is characterized by Asthi Dhatu Vikruti based on ‘ Ashrayashrayee Sambandha’ mainly depending on increased Vata Dosha either by Ahara or Vihara. Contribution of Viharaja Nidanas such as Ativyayama, Ati Sankshobha and Vatala Viharas are more in Asthyashraya Vyadhi. Asthishula is one of the Pratyatma Lakshanas of Asthyashraya Vyadhi expressed very commonly in Kati and Janu due to repeated stress imposed on them As Asthi is the Gambheera Dhatu, Asthyashraya Vyadhi Chikitsa involves Panchakarmas especially Basti. Kharatva / Hardness of Asthi r equires the combination of both ‘ Snigdha and Shoshaka’ Dravyas. REFERENCES 1 Pt. Hari Sadashiva Shastri Paradakara, editor; Commentaries Sarvangasundara of Arunadatta & Ayurvedarasayana of Hemadri; Ashtanga Hridaya of Vagbhata; Sutrasthana, Doshadivignaneeya, Chapter 11, Verse 26-27; Varanasi: Choukhamba Surbharati Prakashan,2017; P.no.186 2 Vaidya Yadavji Trikamji Acharya, editor; Commentary Ayurveda Deepika of Sri Chakrapanidatta; Charaka Samhita of Agnivesha;Vimana sthana, Srotasam Vimanam, Chapter 5, Verse 17; Varanasi: Choukhamba Surbharati Prakashan,2017; P.no.251 3 Vaidya Yadavji Trikamji Acharya, editor; Commentary Ayurveda Deepika of Sri Chakrapanidatta; Charaka Samhita of Agnivesha;Chikitsa sthana, Vatavyadhi chikitsitam, Chapter 28, Verse 19; Varanasi: Choukhamba Surbharati Prakashan,2017; P.no.617 4 Vaidya Yadavji Trikamji Acharya, editor; Commentary Ayurveda Deepika of Sri Chakrapanidatta; Charaka Samhita of Agnivesha; Sutra sthana, Vividhashitapitiyam, Chapter 28, Verse 16; Varanasi: Choukhamba Surbharati Prakashan,2017; P.no.179 5 Vaidya Yadavji Trikamji Acharya and Narayan Ram Acharya Kayatirtha,editor; Commentary Nibandha Sangraha of Sri Dalhanacharya; Sushruta Samhita of Sushruta;Nidanasthana, Vatavyadhi nidanam, Chapter 1, Verse 28; Varanasi: Choukhambha orientalia,1992; P.no.261

[Find the meaning and references behind the names: Sharma, Indu, Nil, Med]

Dr. Madhumalathi BV et al. Understanding the Asthyashraya Vyadhi - in the view of Asthishula Chikitsa ISSN: 2456-3110 REVIEW ARTICLE July-Aug 2020 Journal of Ayurveda and Integrated Medical Sciences | July - Aug 2020 | Vol. 5 | Issue 4 163 6 Pt. Hari Sadashiva Shastri Paradakara, editor; Commentaries Sarvangasundara of Arunadatta & Ayurvedarasayana of Hemadri; Ashtanga Hridaya of Vagbhata; Sutrasthana, Doshadivignaneeya, Chapter 11, Verse 19; Varanasi: Choukhamba Surbharati Prakashan,2017; P.no.185 7 Dr. Shivaprasad Sharma, editor; Commentary Shashilekha by Indu; Ashtanga Sangraha of Vriddha Vagbhata; Sutrasthana, Doshadi vignaneeya, Chapter 19, Verse 9; Varanasi: Chowkhamba Sanskrit Series Office, 2016; P.no.150 8 Vaidya Yadavji Trikamji Acharya and Narayan Ram Acharya Kayatirtha,editor; Commentary Nibandha Sangraha of Sri Dalhanacharya; Sushruta Samhita of Sushruta; Chikitsasthana, Vatavyadhichikitsitam, Chapter 4, Verses 21- 26 ; Varanasi: Choukhambha surbharati prakashana, 2018; P.no.422 9 Vaidya Yadavji Trikamji Acharya, editor; Commentary Ayurveda Deepika of Sri Chakrapanidatta; Charaka Samhita of Agnivesha; Sutra sthana, Kiyantahshirasiyam, Chapter 17, Verse 113; Varanasi: Choukhamba Surbharati Prakashan,2017; P.no.105 10 Vaidya Yadavji Trikamji Acharya, editor; Commentary Ayurveda Deepika of Sri Chakrapanidatta; Charaka Samhita of Agnivesha; Sutra sthana, Tisraishaniyam, Chapter 11, Verse 48; Varanasi: Choukhamba Surbharati Prakashan,2017; P.no.105 11 Vaidya Yadavji Trikamji Acharya, editor; Commentary Ayurveda Deepika of Sri Chakrapanidatta; Charaka Samhita of Agnivesha; Chikitsa sthana, Vatavyadhi chikitsitam, Chapter 28, Verse 32-33; Varanasi: Choukhamba Surbharati Prakashan,2017; P.no.617 12 Vaidya Yadavji Trikamji Acharya, editor; Commentary Ayurveda Deepika of Sri Chakrapanidatta; Charaka Samhita of Agnivesha; Chikitsa sthana, Vatavyadhi chikitsitam, Chapter 28, Verse 35-37; Varanasi: Choukhamba Surbharati Prakashan, 2017; P.no.617, 618 13 Vaidya Yadavji Trikamji Acharya, editor; Commentary Ayurveda Deepika of Sri Chakrapanidatta; Charaka Samhita of Agnivesha;Chikitsa sthana, Vatavyadhi chikitsitam, Chapter 28, Verse 72-74; Varanasi: Choukhamba Surbharati Prakashan, 2017; P.no.620 14 Vaidya Yadavji Trikamji Acharya, editor; Commentary Ayurveda Deepika of Sri Chakrapanidatta; Charaka Samhita of Agnivesha; Chikitsa sthana, Grahani Dosha chikitsitam, Chapter 15, Verse 16; Varanasi: Choukhamba Surbharati Prakashan,2017; P.no.514 15 Vaidya Yadavji Trikamji Acharya, editor; Commentary Ayurveda Deepika of Sri Chakrapanidatta; Charaka Samhita of Agnivesha; Chikitsa sthana, Grahani Dosha chikitsitam, Chapter 15, Verse 30-31; Varanasi: Choukhamba Surbharati Prakashan,2017; P.no.515 16 Vaidya Yadavji Trikamji Acharya, editor; Commentary Ayurveda Deepika of Sri Chakrapanidatta; Charaka Samhita of Agnivesha; Vimana sthana, Srotasam Vimanam, Chapter 5, Verse 8; Varanasi: Choukhamba Surbharati Prakashan,2017; P.no.250 17 Vaidya Yadavji Trikamji Acharya, editor; Commentary Ayurveda Deepika of Sri Chakrapanidatta; Charaka Samhita of Agnivesha; Sutra sthana, Vividhashitapitiyam, Chapter 28, Verse 27; Varanasi: Choukhamba Surbharati Prakashan,2017; P.no.180 ******************************* How to cite this article: Dr. Madhumalathi BV, Dr. V. A. Chate, Dr. Shreevatsa. Understanding the Asthyashraya Vyadhi - in the view of Asthishula Chikitsa. J Ayurveda Integr Med Sci 2020;4:157-163. Source of Support: Nil, Conflict of Interest: None declared. Copyright © 2020 The Author(s); Published by Maharshi Charaka Ayurveda Organization, Vijayapur (Regd). This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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