Cissus quadrangularis(Vitaceae): When geometry works on your joints

This is one of the best herbs that can be used for any bone and joint related injury. The mature stem paste is used to dress up fractures and broken bones. The juice of the stem can also be taken internally for helping accelerate the healing.

A note of caution though- The fresh juice as well as the paste does tend to irritate the skin externally. It causes a feeling akin to tiny needles pricking and whilst this would not bother someone with a painful fracture, it might be a major cause of irritation and concern for someone who is taking this herb as a supplement or even trying to harvest this herb after reading about its many beneficial effects on the human body. Though the itching is an unpleasant side effect of the herb, it is not a cause for concern. Usage of gloves while harvesting the herb is recommended.

Scientific name: Cissus quadrangularis L.

Family: Vitaceae (The Grape Family)

Genus: Cissus

Common names: | English: Devil's Backbone, Veldt Grape, Adam's Rib, Asthisanghari | Sanskrit: Asthisanhari, Vajravalli | Hindi: Hadjod, Harbhanga, Hadjora | Tamil: Perandai, Pirantai | Telugu: Nalleru, Vajravalli | Kannada: Mangarballi, Sanduballi | Malayalam: Peranta, Changalam Paranda | Marathi: Kandavela, Hadsanka | Odia: Hadabhanga

Medicinal Uses: Anti-inflammatory, Analgesic (Pain-relieving), Anti-arthritic, Anti-osteoporotic, Bone Fracture Healing ( Healing Injured Ligaments and Tendons too), Osteoporosis, Joint pains and inflammations , Weight Management, High LDL and Triglyceride levels, Liver related issues, Appetite control, Mood disorders, Anxiety, Gastroprotective (Gastric Ulcers caused by Helicobacter pylori,), Antioxidant, Antimicrobial, Antidiabetic, Antiasthmatic.

Phytochemicals specific to the plant and their action:

The remarkable therapeutic properties of Cissus quadrangularis are attributed to a unique combination of phytochemicals found in its stems and leaves.

Here are the main phytochemical constituents responsible for its distinctive healing properties:

Ketosteroids: β-Sitosterol, Stigmasterol, Ecdysterone, 3-Ketosteroid (a unique compound). These are considered the primary agents behind the plant's legendary bone-healing (fracture mending) and anti-osteoporotic properties. They are believed to stimulate the proliferation of osteoblast cells (bone-forming cells), accelerate callus formation, and enhance calcium deposition in bones.

Flavonoids and Phenolic Compounds: Quercetin, Catechin, Epicatechin, Resveratrol. These compounds are potent Antioxidants that protect cells from free radical damage. They contribute significantly to the plant's Anti-inflammatory, Analgesic, and Gastroprotective effects. Resveratrol, also found in grapes, is known for its cardiovascular and anti-aging benefits.

Triterpenoids: α-Amyrin, β-Amyrin, Taraxerol. These compounds synergize with steroids and flavonoids to enhance the Anti-inflammatory and wound-healing actions. They also contribute to the plant's antimicrobial activity.

Ascorbic Acid (Vitamin C): The plant is a rich source of Vitamin C, which is crucial for the synthesis of collagen, a key protein in bones, tendons, and ligaments, thereby supporting the structural framework for bone repair.

Other Bioactive Compounds: The plant contains carotenoids and high levels of calcium, which directly contribute to its bone-strengthening and healing reputation.

Traditional and Ethnobotanical uses:

5. Traditional and Ethnobotanical uses covering the Medicinal uses.

Bhagna (Fractures) & Asthibhagna (Bone Injuries)

Formulation: Fresh stem paste or juice.

Preparation & Use: The fresh stem is crushed to make a paste or its juice is extracted. This is applied externally over the fractured area and bandaged. It is also consumed orally in the form of juice or decoction.

Ayurvedic Reasoning: It is the premier herb in Ayurveda for fractures, earning the name "Asthishrunkhala" (chain for the bones). Its Tikta (bitter), Kashaya (astringent) taste and Ushna (hot) potency help heal damaged bone tissue (Asthi Dhatu) by reducing Vata and Kapha imbalances at the site. It accelerates the union of fractured bones.

Modern Biochemical Perspective: The unique ketosteroids are believed to accelerate the process of fracture healing by stimulating osteoblast activity and promoting the synthesis of collagen and other bone matrix proteins. The Anti-inflammatory and Analgesic properties reduce swelling and pain at the injury site.

Sandhivata (Osteoarthritis) & Amavata (Rheumatoid Arthritis)

Formulation: Stem decoction or powder.

Preparation & Use: The dried stem powder is taken with warm water or milk. A decoction is also used for both drinking and fomentation (local pouring of warm liquid).

Reasoning Ayurvedic view point: Its potent Vata-balancing and anti-inflammatory properties help reduce pain, swelling, and stiffness in the joints. It helps in removing Ama (toxins) from the joints in Amavata.

Biochemical perspective: The high concentration of β-Sitosterol, Quercetin, and triterpenoids (α-Amyrin, β-Amyrin) provides significant Anti-inflammatory and Analgesic relief by inhibiting inflammatory pathways like COX-2 and cytokines.

Ojakshaya (Loss of Immunity) & Daurbalya (Debility)

Formulation: Stem juice with other tonics.

Preparation & Use: The fresh stem juice is mixed with honey or taken with warm milk to improve overall strength, vitality, and immunity, especially after illness or injury.

Reasoning: Its Rasayana (rejuvenative) property helps rebuild the seven bodily tissues (Sapta Dhatu), particularly the Asthi Dhatu (bone), and enhances Ojas (vital essence).

Prameha (Diabetes) & Medoroga (Obesity)

Formulation: Stem powder or juice.

Preparation & Use: The juice of the fresh stem is consumed on an empty stomach. The powder is also taken for its purported benefits in weight management.

Reasoning: Its Tikta (bitter) and Kashaya (astringent) tastes help pacify Kapha and Medas (adipose tissue), and some studies indicate it may have hypoglycemic and lipid-lowering effects.

Modern Biochemical Perspective: Human and animal studies suggest that Cissus quadrangularis can reduce appetite, improve blood lipid profiles, and support weight loss, possibly by influencing serotonin levels and metabolic rate. The exact phytochemical mechanism is still under investigation but is linked to its overall phytochemical matrix.

Gastroprotective (For Peptic Ulcers)

Formulation: Stem juice or powder.

Preparation & Use: The fresh stem juice (10-20 ml) or powdered stem (1-3 grams) is taken with water, often before meals.

Reasoning: The Antioxidant flavonoids (Quercetin, Catechin) help strengthen the gastric mucosal lining and reduce oxidative stress. The plant also exhibits an anti-secretory action, reducing excessive stomach acid production.

Hemorrhoids (Piles)

Formulation: Stem paste or medicated oil.

Preparation & Use: A paste made from the dried stem powder is applied topically to the affected area to reduce inflammation and pain. A medicated oil prepared by boiling the stems in coconut or sesame oil is also used.

Reasoning: The potent Anti-inflammatory and Analgesic properties help shrink swollen veins and provide relief from the discomfort associated with hemorrhoids.

Epistaxis (Nosebleed)

Formulation: Leaf juice or stem juice.

Preparation & Use: A few drops of fresh juice from the leaves or stems are instilled into the nostrils.

Reasoning: The astringent property of the plant helps contract blood vessels, thereby stopping the bleeding.

Asthma and Allergic Conditions

Formulation: Stem decoction.

Preparation & Use: A decoction made from the stems is consumed to relieve symptoms of asthma and allergies.

Reasoning: The Anti-inflammatory and potential antihistaminic properties of the flavonoids help in reducing bronchial inflammation and constriction.

6. Culinary uses- Decoction, teas, juices and Healing recipes:

As for its culinary use it is often used either for making Chutneys or Pickles. There is a specific way to prepare it so as to ensure that it does not itch. Cissus quadrangularis is prepared in specific ways for its medicinal benefits. It is generally considered safe for short-term use in traditional preparations.

1. Traditional Bone-Healing Decoction (Kashayam)

Purpose: To accelerate the healing of bone fractures and reduce pain and inflammation.

Preparation & Use:

1. Take a handful of fresh or dried Cissus quadrangularis stems (approx. 20-30 grams).

2. Chop them into small pieces and boil in 2 cups of water until the volume reduces to about 1 cup.

3. Strain the decoction.

4. This bitter decoction is consumed in 1-2 divided doses (e.g., 50-60 ml twice daily). It can be mixed with a teaspoon of honey to improve the taste.

Note: This is a potent medicinal preparation and should be used under guidance.

2. General Health and Weight Management Juice

Purpose: As a general health tonic, for its anti-inflammatory benefits, and to support metabolism.

Preparation & Use:

1. Clean and chop 2-3 fresh stems of Cissus quadrangularis.

2. Blend them with a cup of water and strain the mixture to extract the juice.

3. Consume about 15-25 ml of this fresh juice once daily, preferably in the morning on an empty stomach.

4. The taste can be strong; it can be mixed with a small amount of aloe vera juice or lemon juice.

3. Healing Bone and Joint Poultice

Purpose: For topical application on fractures, sprains, and arthritic joints.

Preparation & Use:

1. Take a sufficient quantity of fresh stems.

2. Pound them thoroughly in a mortar and pestle to make a soft, moist paste.

3. Warm the paste slightly and apply a thick layer directly onto the affected area.

4. Cover with a clean cloth or bandage and leave it on for 2-4 hours.

5. Repeat this process once daily.

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7. In-Depth Phytochemical Profile and Clinical Significance of Cissus quadrangularis (Asthisamharaka, Hadjod, Devil's Backbone)

Introduction

Cissus quadrangularis is a perennial succulent vine of the Vitaceae (grape) family, characterized by its unique quadrangular (four-sided), segmented stems. It is a legendary plant in Ayurvedic medicine, revered under the name "Asthisamharaka" (meaning "that which saves the bones from destruction") and widely used in other traditional systems across Africa and Asia. Its therapeutic profile is distinct, centered not on volatile oils or simple phenolics, but on a novel class of compounds and a rich mixture of phytoesterols and antioxidants that target musculoskeletal health, making it one of the most potent natural remedies for bone fractures and joint disorders.

1. Ketosterones and Bioactive Stems Compounds (The Primary Therapeutic Class)

Key Compounds:The most critical and unique phytochemicals in C. quadrangularis are a series of ketosterones and related compounds isolated from its stem.

• 3-Ketosteroids: A unique class of compounds including 3-keto-Δ⁴-steroids, which are considered primary markers for the plant's bone-healing activity.

• Cissus Quandrangularis Steroid (CQS): A specific steroid-like compound studied for its anabolic effects on bone and muscle.

• Onitin: A lignin derivative with potential osteogenic properties.

• Asymmetric Centric Diol (& other stilbene derivatives): These compounds contribute to the plant's antioxidant and anti-osteoporotic effects.

Actions and Clinical Relevance:This group of compounds is responsible for the plant's flagship pharmacological actions.

• Osteogenic (Bone-Forming) & Fracture Healing: This is the plant's hallmark effect. The ketosterones are believed to significantly accelerate the fracture healing process by stimulating the proliferation and differentiation of osteoblasts (bone-forming cells), enhancing mineralization, and promoting the synthesis of type-I collagen, the primary protein matrix of bone.

• Analgesic & Anti-inflammatory: These compounds exhibit potent pain-relieving and anti-inflammatory effects, which are crucial for managing the pain and swelling associated with fractures, sprains, and musculoskeletal injuries. This action is comparable to some conventional NSAIDs but with a better safety profile.

• Anabolic & Musculoskeletal Trophic: Extracts have shown to increase muscle mass and strength in studies, likely through an anabolic steroid-like activity, making it valuable for athletes and in conditions of muscle wasting.

2. Phytosterols and Triterpenoids

Key Compounds:

• Phytosterols: β-Sitosterol, Stigmasterol, Campesterol.

• Triterpenoids: α-Amyrin, β-Amyrin, Lupeol, Taraxerol.

Actions and Clinical Relevance:These lipophilic compounds provide critical supportive and synergistic activities.

• Anti-inflammatory & Analgesic (Synergy): β-Sitosterol and lupeol are well-known for their ability to inhibit prostaglandin synthesis and other inflammatory pathways, working synergistically with the ketosterones to reduce pain and inflammation.

• Anti-osteoporotic: Phytosterols like β-Sitosterol have been shown to stimulate osteoblastogenesis and inhibit osteoclast activity, helping to restore bone density in osteoporotic conditions.

• Gastroprotective: The triterpenes, particularly α- and β-amyrin, have demonstrated significant anti-ulcer activity by strengthening the gastric mucosa and reducing acid secretion.

3. Flavonoids and Phenolic Acids

Key Compounds:

• Flavonoids: Quercetin, Kaempferol, Catechin, Epicatechin.

• Phenolic Acids: Gallic acid, Protocatechuic acid, p-Coumaric acid.

Actions and Clinical Relevance:The antioxidant polyphenols play a vital role in creating a favorable environment for healing.

• Potent Antioxidant: These compounds are powerful free radical scavengers. In the context of bone healing, they protect the fragile new blood vessels and cells in the fracture callus from oxidative damage, thereby facilitating a more robust healing process.

• Anti-inflammatory (Further Synergy): Quercetin and other flavonoids inhibit mast cell degranulation and cytokine production, providing another mechanism for reducing inflammation.

• Antimicrobial: The phenolic profile contributes to the plant's traditional use in preventing wound infections when applied topically.

4. Other Critical Compounds

Key Compounds:

• Carotenoids: β-Carotene, Lycopene (present in the fruit).

• Vitamin C: A critical cofactor for collagen synthesis.

• Minerals: The stem ash is rich in Calcium, Magnesium, and Strontium, which are directly incorporated into the bone matrix.

Actions and Clinical Relevance:

• Collagen Synthesis & Bone Matrix Formation: Vitamin C is an essential nutrient for the hydroxylation of proline and lysine in collagen, making it a critical component for building strong bone and connective tissue.

• Direct Mineral Substrate: The high mineral content, especially calcium, provides the raw material necessary for bone mineralization.

• Antioxidant (Synergy): Carotenoids like β-carotene and lycopene further enhance the plant's overall antioxidant capacity.

An Integrated View of Healing in Cissus quadrangularis

The healing power of Cissus quadrangularis is a masterclass in targeted, synergistic phytotherapy, primarily focused on the musculoskeletal system.

• For Fracture Healing and Bone Repair (Asthi Sandhan): The plant orchestrates a multi-stage healing process. The Ketosterones (e.g., CQS) directly stimulate osteoblast proliferation and collagen synthesis, rapidly forming the soft callus. Simultaneously, the Vitamin C and Minerals (Ca, Mg) provide the essential building blocks for collagen cross-linking and subsequent mineralization of this matrix, transforming it into hard callus. The potent Anti-inflammatory and Analgesic actions of the ketosterones, phytosterols, and flavonoids manage pain and swelling, allowing for better mobility and blood flow to the injured site. This makes it a unparalleled natural intervention for accelerating bone union.

• For Osteoporosis and Bone Loss: The plant acts as a dual-action bone tonic. The Ketosterones and Phytosterols (β-Sitosterol) work synergistically to stimulate osteoblast activity (bone formation) while the flavonoids and other compounds help inhibit osteoclast activity (bone resorption). This "anabolic-antiresorptive" profile is the holy grail in osteoporosis management, helping to restore bone mineral density.

• For Musculoskeletal Pain and Inflammation (Amavata - Rheumatoid Arthritis): The combination of Ketosterones, Phytosterols (β-Sitosterol), and Flavonoids (Quercetin) provides a broad-spectrum anti-inflammatory effect by targeting multiple pathways (COX, LOX, cytokines). This, combined with the analgesic and trophic support for connective tissues, makes it highly effective for managing chronic inflammatory conditions like arthritis, tendonitis, and low back pain.

• As a Functional Tonic for Weight and Metabolic Health: Emerging research points to its benefits for weight management and blood sugar control. The anabolic effect helps preserve lean muscle mass during weight loss, while the rich antioxidant and anti-inflammatory profile improves insulin sensitivity, positioning it as a comprehensive metabolic tonic.

Disclaimer: Cissus quadrangularis is a potent medicinal herb. Pregnant and breastfeeding women should avoid its use. It may interact with medications for diabetes, blood pressure, and sedatives. Due to its effect on bone metabolism, long-term use without medical supervision is not advised. Do not attempt to use this herb for medicinal purposes without the direct guidance of a qualified medical practitioner or experienced Ayurvedic/ethnobotanical expert. This information is for educational and academic purposes only and is not a substitute for professional medical advice, diagnosis, or treatment.

Further study: Plants that might interest you due to similar medicinal properties

1. Withania somnifera (Ashwagandha)* Species: Withania somnifera | Family: Solanaceae | Genus: Withania* Similarities: Both are renowned Rasayana (rejuvenative) herbs, specifically Balya (strength-promoting). While Ashwagandha is a general tonic for muscle and nerve tissue (Mamsa and Majja Dhatu), Hadjod is a specific tonic for bone tissue (Asthi Dhatu). Both are used in debility and for promoting tissue healing.

2. Commiphora wightii (Guggulu)* Species: Commiphora wightii | Family: Burseraceae | Genus: Commiphora* Similarities: Both herbs are quintessential for treating musculoskeletal disorders. Guggulu is famous for its deep penetrating (Tikshna) and Vata-pacifying properties, making it excellent for arthritis and obesity. Hadjod shares these anti-arthritic and anti-inflammatory properties, with a specialized focus on bone tissue.

3. Laksha (Laccifer lacca)* Species: Laccifer lacca (a resin from an insect) | Sanskrit: Laksha* Similarities: Laksha is another premier Ayurvedic substance specifically used for bone healing and calcification, often formulated with Hadjod. Both are considered Asthi Sandhanakara (bone union promoters) and are key ingredients in classical fracture-healing formulations like Lakshadi Guggulu.

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