The twenty seventh chapter of Uttara Sthanam of Ashtanga Hridayam is known as as Bhanga Pratishedha. This chapter offers with the reason of ‘Treatment of fractures.’
The subjects coated on this chapter embrace –
- Nirukti Bheda – definition and sorts
- Nirukti Bheda – definition and sorts
- Asadhya Lakshana
- Fracture of pelvic and pubic bone
- Sorts of fracture in numerous bones
- Chikitsa of Sandhigata Bhanga
- Phalinyadi Churna
- Shayana – bedding for fracture sufferers
- Remedy of dislocation
- Remedy of mal-union of fractures
- Ripening of fractures
- Use of medicated fat talked about in Vata Vyadhi Cikitsa
- Helpful meals
- Unwholesome meals and actions
- Gandha Taila
Pledge by the writer(s)
अथातो भङ्गप्रतिषेधं व्याख्यास्याम: ।
इति ह स्माहुरात्रेयादयो महर्षय: ।
After having supplied prayers to the God, henceforth we’re going to clarify the chapter pertaining to the reason of ‘Remedy of fractures. Thus, say (pledge) Atreya and different sages.
Nirukti Bheda: Definition and sorts
पातघातादिभिर्द्वेधा भङ्गोऽस्थ्नां सन्ध्यसन्धितः ।
प्रसारणाकुञ्चनयोरशक्तिः सन्धिमुक्तता ॥ १ ॥
इतरस्मिन् भृशं शोफः सर्वावस्थास्वतिव्यथा ।
अशक्तिश्चेष्टितेऽल्पेऽपि पीड्यमाने सशब्दता ॥ २ ॥
समासादिति भङ्गस्य लक्षणं बहुधा तु तत् ।
भिद्यते भङ्गभेदेन
Bones get damaged (fractured) from a fall from peak, assault and so forth.; it’s of two sorts, a. Sandhigata- localized within the joint and b. Asandhigata – in locations apart from the joints; incapability for growth (extension) and contraction (flexion and so forth.) and dislocation of the joint are the options of the primary type; whereas within the second type, profound swelling and extreme ache in all positions, incapability even for slight motion, manufacturing of cracking sound on rubbing are the options of fractures briefly. It’s of many sorts, categorised primarily based on the character of fractures.
Remedy
तस्य सर्वस्य साधनम् ॥ ३ ॥
यथा स्यादुपयोगाय तथा तदुपदेक्ष्यते ।
These remedies that are widespread to every kind and that are helpful as a routine shall be described right here.
Asadhya Lakshana
प्राज्याणुदारि यत्त्वस्थि स्पर्शे शब्दं करोति यत् ॥४॥
यत्रास्थिलेशः प्रविशेन्मध्यमस्थ्नो विदारितः ।
भग्नं यच्चाभिघातेन किञ्चिदेवावशेषितम् ॥ ५ ॥
उन्नम्यमानं क्षतवद्यच्च मज्जनि मज्जति ।
तद्दुःसाध्यं कृशाशक्तवातलाल्पाशिनामपि ॥ ६ ॥
The bone which has been crushed into very small items, that which causes sound on touching, by which items of bones which might be damaged have entered into the marrow cavity, the fracture which is prompted resulting from damage, the fractured portion of bone is left contained in the physique, that situation by which the fractured portion is raised much like an damage, makes it sink into the marrow all these sorts are troublesome to treatment; so additionally these present in individuals who’re emaciated, debilitated, having predominance of Vata of their physique and who eat little or no meals.
Fracture of pelvic and pubic bone
भिन्नं कपालं यत्कट्यां सन्धिमुक्तं च्युतं च यत् ।
जघनं प्रति पिष्टं च भग्नं यत्तद्विवर्जयेत् ॥ ७ ॥
Fracture of the pelvic bone in flat portion, dislocation of joints of the waist and crushing fracture of pubic bone needs to be refused.
Asadhya Lakshana
असंश्लिष्टकपालं च ललाटं चूर्णितं तथा ।
यच्च भग्नं भवेच्छङ्खशिरःपृष्ठस्तनान्तरे ॥ ८ ॥
Cranium bones, not knit collectively and the brow getting crushed into powder, fracture which has occurred in the course of the temples, head, again and between the breasts needs to be rejected.
सम्यग्यमितमप्यस्थि दुर्न्यासाद्दुर्निबन्धनात् ।
सङ्क्षोभादपि यद्गच्छेद्विक्रियां तद्विवर्जयेत् ॥ ९ ॥
आदितो यच्च दुर्जातमस्थि सन्धिरथापि वा ।
That bone, which despite correct management (by way of splints and so forth.) turns into irregular (distorted) by improper becoming a member of, bandaging and exertion (functioning of the affected artwork) needs to be refused remedy; so additionally the bone and the joint which is ill-formed from the start itself.
Sorts of fracture in numerous bones
तरुणास्थीनि भुज्यन्ते भज्यन्ते नलकानि तु ॥१०॥
कपालानि विभिद्यन्ते स्फुटन्त्यन्यानि भूयसा ।
Cartilages bend, tubular bones break, flat bones get punctured and others get cracked more often than not.
Chikitsa of Sandhigata Bhanga
अथावनतमुन्नम्यमुन्नतं चावपीडयेत् ॥११॥
आञ्छेदतिक्षिप्तमधोगतं चोपरि वर्तयेत् ।
आञ्छनोत्पीडनोन्नामचर्मसङ्क्षेपबन्धनैः ॥१२॥
The portion of bone which is displaced down, needs to be raised up and that which is displaced up needs to be pulled down; that which has moved away to different locations needs to be pulled to its regular place, that which is displaced beneath needs to be introduced up by pulling, kneading, elevating, constricting the pores and skin and banding.
सन्धीञ्छरीरगान् सर्वांश्चलानप्यचलानपि ।
इत्येतैः स्थापनोपायैः सम्यक् संस्थाप्य निश्चलम् ॥१३॥
पट्टैः प्रभूतसर्पिर्भिः वेष्टयित्वा सुखैस्ततः ।
कदम्बोदुम्बराश्वत्थसर्जार्जुनपलाशजैः ॥ १४ ॥
वंशोद्भवैर्वा पृथुभिस्तनुभिः सुनिवेशितैः ।
सुश्लक्ष्णैः सप्रतिस्तम्भैर्वल्कलैः शकलैरपि ॥ १५ ॥
कुशाह्वयैः समं बन्धं पट्टस्योपरि योजयेत् ।
शिथिलेन हि बन्धेन सन्धिस्थैर्यं न जायते ॥ १६ ॥
गाढेनाति रुजादाहपाकश्वयथुसम्भवः ।
All of the joints of the physique, whether or not movable or immovable needs to be positioned of their regular place by these strategies and immobilized by bands of material soaked in loads of ghee, unfold out (coated with) comfortably massive, skinny and clean items of interior bark of kadamba – Neolamarckia cadamba, udumbara – Ficus racemosa, aśvattha – Ficus religiosa, sarja – resin of Vateria indica, arjuna – Terminalia arjuna and palāśajaiḥ – Butea monosperma and even items of Bambusa bambos, are positioned evenly upon the material; bandage as kusha (splints) after which bandaged once more, as if urgent firmly over it. By unfastened bandaging, stability (immobility) of the joint just isn’t achieved and by very tight bandaging there may be the potential of ache, burning sensation, ripening, ulceration/suppuration, or manifestation of swelling.
Removing of bandage
त्र्यहात्त्र्यहादृतौ घर्मे सप्ताहान् मोक्षयेद्धिमे ॥ १७ ॥
साधारणे तु पञ्चाहाद्भङ्गदोषवशेन वा ।
In summer time, bandages needs to be eliminated each third day, in chilly season as soon as in seven days, in reasonable season as soon as in 5 days or at such intervals relying on the situation of the fracture and the dosha.
Chikitsa of Sandhigata Bhanga
न्यग्रोधादिकषायेण ततः शीतेन सेचयेत् ॥ १८ ॥
तं पञ्चमूलपक्वेन पयसा तु सवेदनम् ।
It (fracture) needs to be bathed both with chilly decoction of herbs of Nyagrodhadi Gana (chapter 15 of Sutrasthan) and when there may be ache, with milk boiled with herbs of Panchamula.
सुखोष्णं वावचार्यं स्याच्चक्रतैलं विजानता ॥ १९ ॥
विभज्य देशं कालं च वातघ्नौषधसंयुतम् ।
प्रततं सेकलेपांश्च विदध्याद्भृशशीतलान् ॥ २० ॥
Or after rigorously contemplating the character of the land and season, chakrataila added with herbs which mitigate Vata, could also be poured over the place comfortably heat, pouring decoctions and software of paste of herbs needs to be steady each in very chilly state.
गृष्टिक्षीरं ससर्पिष्कं मधुरौषधसाधितम् ।
प्रातः प्रातः पिबेद्भग्नः शीतलं लाक्षया युतम् ॥२१॥
The affected person of fracture ought to drink Gristikshira (milk of the cow which has delivered the calf inside seven days) each morning, added with ghee and boiled with herbs of candy style lākṣayā – and Laccifer lacca after which cooled.
सव्रणस्य तु भग्नस्य व्रणो मधुघृतोत्तरैः ।
कषायैः प्रतिसार्योऽथ शेषो भङ्गोदितः क्रमः ॥ २२ ॥
In case of fracture with a wound, the wound needs to be bathed with decoction of herbs of astringent style added with extra of honey and ghee. remaining remedy is like that described for fractures.
लम्बानि व्रणमांसानि प्रलिप्य मधुसर्पिषा ।
सन्दधीत व्रणान् वैद्यो बन्धनैश्चोपपादयेत् ॥ २३ ॥
Muscle groups that are hanging unfastened within the wound needs to be smeared with honey and ghee after which the injuries are minimize, sutured and bandaged appropriately by the physicians.
Phalinyadi Churna
तान् समान् सुस्थिताञ्ज्ञात्वा फलिनीलोध्रकट्फलैः ।
समङ्गाधातकीयुक्तैश्चूर्णितैरवचूर्णयेत् ॥ २४ ॥
धातकीलोध्रचूर्णैर्वा रोहन्त्याशु तथा व्रणाः ।
Observing that these are nicely adhered, advantageous powder of both phalinī – Callicarpa macrophylla, lodhra – Symplocos racemosa, kaṭphalaiḥ - Myrica nagi, samaṅgā – Rubia cordifolia and dhātakīyuktai: – Woodfordia fruticosa; or powder of dhātakī – Woodfordia fruticosa and lodhra – Symplocos racemosa needs to be sprinkled over them; by this the injuries heal rapidly.
इति भङ्ग उपक्रान्तः स्थिरधातोरृतौ हिमे ॥ २५ ॥
मांसलस्याल्पदोषस्य सुसाध्यो दारुणोऽन्यथा ।
Thus, was described the remedy of Bhanga; it’s simply curable in those that have robust tissue, throughout autumn, in individuals who’re muscular and who’ve delicate aggravation of dosha; the alternative of all these are both very troublesome or not possible to treatment.
पूर्वमध्यान्तवयसामेकद्वित्रिगुणैः क्रमात् ॥ २६ ॥
मासैः स्थैर्यं भवेत्सन्धेर्यथोक्तं भजतां विधिम् ।
By adopting the remedy described earlier,individuals of early, center and late ages ought to attain power within the (fractured) joints in a single, two and three months respectively.
Shayana: Bedding for fracture sufferers
कटीजङ्घोरुभग्नानां कपाटशयनं हितम् ॥२७॥
यन्त्रणार्थं तथा कीलाः पञ्च कार्या निबन्धनाः ।
जङ्घोर्वोः पार्श्वयोर्द्वौ द्वौ तल एकश्च कीलकः॥२८॥
श्रोण्यां वा पृष्ठवंशे वा वक्षस्यक्षकयोस्तथा ।
For fractures of the waist, forelegs and thighs, it’s useful to lie on a tough wood field fitted with 5 pegs to regulate (immobilise the leg), two every for the forelegs (calves) and thighs and one for the only. In the identical approach (in fractures) of the pelvis, vertebral column, chest or the collar bone.
विमोक्षे भग्नसन्धीनां विधिमेवं समाचरेत् ॥ २९ ॥
This technique could also be adopted in instances of dislocation and fracture of the joints.
Remedy of dislocation
सन्धींश्चिरविमुक्तांस्तु स्निग्धस्विन्नान् मृदूकृतान् ।
उक्तैर्विधानैर्बुद्ध्या च यथास्वं स्थानमानयेत् ॥ ३० ॥
Dislocation of the joints which has turn out to be previous, needs to be made comfortable by anointing with oil and fomentation after which positioned within the regular place by the strategies described above by utilizing intelligence.
Remedy of mal-union of fractures
असन्धिभग्ने रूढे तु विषमोल्बणसाधिते ।
आपोथ्य भङ्गं यमयेत्ततो भग्नवदाचरेत् ॥ ३१ ॥
A fracture which isn’t positioned within the joints and has healed improperly (malunion) and aggravated, needs to be handled by breaking (compressing) the fracture once more, made to restrain and deal with on the strains of treating fractures correctly.
Ripening of fractures
भग्नं नैति यथा पाकं प्रयतेत तथा भिषक् ।
पक्वमांससिरास्नायुः सन्धिः श्लेषं न गच्छति ॥३२॥
The doctor ought to make all makes an attempt, in order to not enable ripening (suppuration) within the fracture website; since muscle, veins, tendons, joints which develop pus don’t stick collectively.
Use of medicated fat talked about in Vata Vyadhi Chikitsa
वातव्याधिविनिर्दिष्टान् स्नेहान् भग्नस्य योजयेत् ।
चतुष्प्रयोगान् बल्यांश्च वस्तिकर्म च शीलयेत् ॥३३॥
In remedy of fractures, medicated fats described within the remedy of Vata Vyadhi (chapter 21 of Cikitsa Sthana) needs to be made use for the 4 therapies (ingesting, nasal drops, anointing and enema), which give power to the physique and enema remedy needs to be adopted.
Helpful meals
शाल्याज्यरसदुग्धाद्यैः पौष्टिकैरविदाहिभिः ।
मात्रयोपचरेद्भग्नं सन्धिसंश्लेषकारिभिः ॥ ३४ ॥
The affected person of fracture needs to be served with correct portions of meals comparable to rice, ghee, juice of meat, milk and so forth. that are nourishing the physique, which don’t trigger heartburn and which bestow sturdiness to the joints.
Unwholesome meals and actions
ग्लानिर्न शस्यते तस्य सन्धिविश्लेषकृद्धि सा |
लवणं कटुकं क्षारमम्लं मैथुनमातपम् |
व्यायामं च न सेवेत भग्नो रूक्षं च भोजनम् ॥३५॥
Exertion (over-activity of the fractured half) just isn’t good for him; for it’s going to produce dislocation of the joint. The affected person of fracture mustn’t take pleasure in issues that are salty, pungent, alkaline and bitter; copulation, publicity to daylight, train and dry (non-fatty).
Gandha Taila
कृष्णांस्तिलान् विरजसो दृढवस्त्रबद्धान् सप्त क्षपा वहति वारिणि वासयेत् ।
संशोषयेदनुदिनं प्रविसार्य चैतान् क्षीरे तथैव मधुकक्वथिते च तोये ॥ ३६ ॥
पुनरपि पीतपयस्कांस्तान् पूर्ववदेव शोषितान् बाढम् ।
विगततुषानरजस्कान् सञ्चूर्ण्य सुचूर्णितैर्युञ्ज्यात्॥३७॥नलदवालकलोहितयष्टिकानखमिशिप्लवकुष्ठबलात्रयैः ।
अगुरुकुङ्कुमचन्दनसारिवासरलसर्जरसामरदारुभिः॥३८॥
पद्मकादिगणोपेतैस्तिलपिष्टं ततश्च तत् ।
समस्तगन्धभैषज्यसिद्धदुग्धेन पीडयेत् ॥ ३९ ॥
शैलेयरास्नांशुमतीकसेरुकालानुसारीनतपत्रलोध्रैः ।
सक्षीरशुक्लैः सपयः सदूर्वैस्तैलं पचेत्तन्नलदादिभिश्च ॥ ४० ॥
गन्धतैलमिदमुत्तममस्थिस्थैर्यकृज्जयति चाशु विकारान् ।
वातपित्तजनितानतिवीर्यान् व्यापिनोऽपि विविधैरुपयोगैः ॥ ४१ ॥
kṛṣṇān tilān – Black sesamum indicum, nicely cleaned is tied right into a bundle with a thick material and allowed to remain in flowing water for seven days. Then it’s soaked in milk and decoction of Glycyrrhiza glabra every day and dried within the shade. This continued for seven days; as soon as once more it’s soaked in milk and decoction of Glycyrrhiza glabra every day and dried within the shade as completed beforehand, eliminated of its husk free from impurity and powdered, it’s then blended with the advantageous powder of nalada – Nardostachys jatamamsi, vālaka – Coleus vettiveroides, lohita yaṣṭikā – Rubia cordifolia, nakha – Capparis sepiaria, miśi – Peucedanum graveolens, plava – Cyperus bulbosus, kuṣṭha – Saussurea lappa, balātrayaiḥ – Bala – Sida cordifolia, Atibala – Abutilon indicum and Nagabala – Sida veronicaefolia, aguru – Aquilaria agallocha, kuṅkuma – Crocus sativus, candana – Santalum album, sārivā – Hemidesmus indicus, sarala – Pinus longifolia, sarjarasā – Resin of Vateria indica, maradārubhiḥ – Cedrus deodara and the herbs of Padmakadi Gana and likewise paste of tila (sesame seeds), all herb of aromatic odor (Eladigana) and macerated with milk; naladādi– With Nelumbo nucifera, medicated oil ought to then be cooked with the above herbs, added with the paste of śaileya – Parmelia perlata, rāsnā – Pluchea lanceolata, aṃśumatī – Desmodium gangeticum, kaseru – Scirpus grossus, kālānusārī – Trigonella foenum graecum, nata – Valeriana wallicii, patra – Cinnamomum tamala, lodhraiḥ – Symplocos racemosa, sakṣīra śuklaiḥ – Pueraria tuberosa, sapayaḥ – Roscoea purpurea, sadūrvai: – Cynodon dactylon, This oil generally known as Gandha Taila is nice for durability to the bones, cures illness produced by Vata and Pitta rapidly, although highly effective and unfold all around the physique by utilizing it in numerous strategies of therapies.
इति श्री वैद्यपति सिंहगुप्तसूनु श्रीमद्वाग्भटविरचितायामष्टाङ्गहृदयसंहितायां षष्ठे उत्तरस्थाने भङ्गप्रतिषेधो नाम सप्तविंशोऽध्याय:॥२७॥
Thus, finish the chapter- Bhanga Pratishedha the twenty seventh in Uttarasthana of Ashanga Hridaya Samhita, composed by Srimad Vagbhata, son of Vaidypati Simhagupta.
