Introduction

The importance of understanding the skeletal system has been emphasized since ancient times. As noted by Galen, a renowned physician, knowledge of bones is fundamental because they form the structural foundation of the body. All bodily organs and systems rely on the skeletal framework for support, stability, and function. Without an understanding of bone structure, one's comprehension of many other physiological aspects remains incomplete.

Ayurveda, an eternal science dedicated to human life, encompasses physical, psychological, and spiritual well-being. It provides a holistic approach to health, considering every aspect of existence. The physical world, including the human body, can be broadly categorized into soft and hard components. While soft tissues include organs and muscles, hard structures like bones and teeth form the skeletal system, which provides shape, support, locomotion, and protection for delicate internal organs. According to Acharya Sushruta, a pioneer in Ayurveda, after death, most bodily tissues decay, but Asthi (bones) endure. Even when the body is buried or cremated, bones remain as the last surviving remnants of an individual. The study of bones in Ayurveda can be traced back to the Vedic period, progressing chronologically through various Samhitas. Different Ayurvedic texts offer diverse perspectives on the enumeration, nomenclature, and classification of bones, reflecting evolving thought processes and methodologies.

Literary Review

The Atharva Veda references the study of bones, with Narayana, the author of an Atharva hymn, being associated with the early traditions of medicine. In ancient India, healers often served as both priests and physicians, blending spirituality with medical knowledge. Narayana is also credited with composing the Purusha Sukta (RV.X.90 = AV.XIX.6), which contains numerous anatomical references, including those related to bones. The Atharva Veda (X.2.1-8) explicitly mentions the human skeletal system.

Bones are described as hardest & most enduring part of body, persisting even after death when soft tissues like flesh and muscles have decomposed.

This classification highlights the systematic approach used in Ayurveda to categorize bones based on their function and structure.

Types of Asthi (Bones) in Ayurveda

1. Kapala Asthi^[9] - These are flat bones with two distinct layers separated by a hollow space filled with red bone marrow. Examples include bones in the knee (Janu), hip (Nitamba), shoulder (Amsa), cheeks (Ganda), palate (Talu), temples (Shankha), groin (Vankshana), and the central region of the head (Madhyashira).

2. Valaya Asthi^[10] - These bones are circular or ring-shaped, such as the ribs in the thoracic region. The bones found in the chest (Ura), sides of the torso (Parshva), and back (Prustha) fall under this category.

3. Taruna Asthi^[11] - These are soft Bones^[12], mainly present between vertebral joints. A circular layer of Taruna Asthi exists between two vertebrae, helping absorb shocks before they reach the brain. Bones in the nose (Ghrana), ear (Karna), neck (Greeva), and eye sockets (Akshikuta) are classified as Taruna Asthi.

4. Ruchaka Asthi^[13] - These bones are involved in chewing and tasting food, making them essential for digestion. The teeth (Dashana) are considered Ruchaka Asthi, totaling 28 or 32 in number. Additionally, Sharangadhara describes teeth as Upadhatu (secondary tissue) of Asthi Dhatu.

5. Nalika Asthi^[14] - These are long, tubular bones that are hollow inside and filled with bone marrow (Majja). Up to the age of 20, they appear red, after which they gradually turn yellow. These bones are primarily found in the arms and legs and include all bones that do not fall under the other four categories.

Discussion

The enumeration (Sankhya) of human body parts holds significant importance in Ayurveda, as emphasized by Acharya Charaka. According to Chakrapani, understanding the quantitative aspects of bodily structures is essential in clinical practice, as it serves as a primary source of anatomical knowledge. The seventh chapter of the Sharir Sthana ^[15] in Ayurveda underscores the value of Sharir Sankhya (enumeration of body parts),

This variation in bone enumeration highlights the methodological differences between Ayurvedic and modern anatomical studies. While Ayurveda took a more holistic and functional approach, modern anatomy relies on structural classifications based on embryological and osteological principles.

Enumeration of Bones in Different Texts

Charaka Samhita arrived at a total of 15 cervical bones by categorizing the cervical vertebrae similarly to the vertebral column. On the other hand, Vagbhata's enumeration of 13 cervical bones appears to be a compromise between the classifications of Charaka and Sushruta. Various Ayurvedic texts provide different counts of Asthi (bones),

Understanding the Basis for Bone Classification in Ayurveda

Upon logical reasoning (Tarka) & Pramana (evidence-based analysis), it becomes evident that five primary bone types in Ayurveda serve as major divisions rather than absolute categories. These divisions repr. five distinct ways of classifying bones based on diff. anatomical & functional properties.

1. Ossification-Based Classification

• Taruna Asthi (Soft or undeveloped bones) - Early-stage bones that are not fully hardened.
• Pakva Asthi or Ghanasthi (Fully ossified bones) - Fully developed, hardened bones.

2. Surface Area-Based Classification

• Kapala Asthi (Bones with a broad surface area) - Flat bones like skull bones, which have a greater width than thickness.
• Akapala Asthi (Bones with smaller surface area) - Slender or cylindrical bones, where surface area is relatively lesser (e.g., Nalaka Asthi).

3. Shape-Based Classification

• Vartulakara Asthi (Round/curved bones - Valaya Asthi) - Bones that provide elasticity and support, particularly in respiration (e.g., ribs).
• Avartulakara Asthi (non-round bones) - Bones that lack a circular or curved shape.

4. Length & Function-Based Classification

• Nalaka Asthi (Long bones for locomotion) - Found in the limbs, facilitating movement.
• Analaka Asthi (Non-tubular bones) - Other bones that primarily serve a protective function, such as Kapala and Valaya Asthi.

5. Sensory Function-Based Classification

• Ruchaka Asthi (Bones with sensory properties) - Teeth, which help in tast. food during chewing.
• Kharasthi (Regular bones) - Bones without sensory function.

This fivefold division offers a structured approach to understanding bones in Ayurveda, correlating shape, structure, function, and ossification.

Sushruta’s Observation on Bone Fractures (Bhagna) in Different Asthi Types ^[16]

Acharya Sushruta recognized that bones react differently to trauma, leading to various types of fractures.

• Modern Parallel: Separation fractures occur in rib bones, where they detach or develop cracks under stress.

4. Nalaka Asthi Fractures (Bhajayante) and Comminuted Fractures

• Ayurvedic Insight: Long bones (arms, legs) tend to break into multiple pieces upon trauma.
• Modern Parallel: Comminuted fractures occur when bones shatter into multiple fragments due to severe force.

Final Analysis of Asthi Bhagna and Asthi Prakara

Through the grammatical breakdown of Dhatupada (root words) and their meanings, it becomes evident that Acharyas in Ayurveda provided a clinically relevant classification of bone types (Asthi Prakara) and fractures (Asthi Bhagna). This knowledge can be applied both ways - certain bones are prone to specific types of fractures, and conversely, certain fracture patterns indicate the type of bone affected.

For example:

• Taruna Asthi (soft, cartilaginous bones) are more likely to bend rather than break.
• Kapala Asthi (flat bones) commonly sustain linear or fissure fractures.
• Valaya Asthi (curved bones, such as ribs) tend to detach or shatter upon trauma.
• Nalaka Asthi (long bones) are susceptible to transverse, oblique, or comminuted fractures due to their structural alignment.

Conclusion

The concept of Asthi (bones) has evolved from the Pre-Vedic period to modern times, with shifts in beliefs, methods, and applications. According to Acharya Sushruta, Asthi is the last remaining identity of a person after death, whereas modern anatomy defines bones as connective tissue characterized by the Haversian system. This fundamental difference in definition leads to variations in enumeration, classification, and functions between Ayurveda and modern science. The fivefold classification of bones (Asthi Prakara) in Ayurveda was primarily developed for Shalya Tantra (surgical and orthopedic applications), specifically in the context of fractures and dislocations.