Fracture Ayurveda Managaement(bhagna)

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THE INCIDENCE

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The agricultural sector(194.5per10,000 workers),

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The mining (168.8 per 10,000 workers),

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The construction (111.7 per 10,000 workers)

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The manufacturing (87.5 per 10,000 workers).

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The males had significantly higher incidence rate than females except for the educational sector. SUSHRUTA'S TECHNIQUE

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RESEARCHES 

27 P.G. dissertations



1Ph.D. works

From 1966 to 1996,

棧An approach to human ailments is as old as the evolution of human being. The most ancient practiced medical science is Ayurveda. 棧Orthopedic surgery - Bhagna Chikitsa SUSHRUTA'S TECHNIQUE

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ASTHI SHAREERA Asthi - Stable and Strong.  Develops during third month of intrauterine life.  Pitrujabhava is responsible for the formation of Asthi.  Asthivaha srothasa is the channel through which the nutrients are being circulated within the asthidhatu. SUSHRUTA'S TECHNIQUE

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• ASTHI SANKHYA • ASTHI PRAKARA • ASTHI KARYA

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SHABDHOTPATTI Bhanjayatithibhagna| | (Shabdasthoma ) PARYAYA Bhagna, Bheda, Bhedana, Bhanjana, Vibhaga. NIDANA Patana,Peedana,Praharena,Akshepana,Vyalamruga dashana, Balavadnigraha, Abhipatanishesha EFFECT OF TRAUMA ON BONES : 1. Cartilage's Bend 2. Long bones -Break 3. Flat bones - Crack 4. Teeth - Fragmented 5. Curved bones - Crack or Break. SUSHRUTA'S TECHNIQUE

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CLASSIFICATION OF BHAGNA [A] 1) Sandhimukta

2) Kandabhagna. (Sushruta)

[B] 1) Sandhibhagna 2) Asandhibhagna.(Vagbhata) [C] 1)Savrana bhagna 2) Avrana bhagna.(Madhukosha)

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Classification of Kandabhagna Name of Sushruta Vagbhata Vagbhata Charaka Bhava Madhava Sharang Bhagna A.H. A.S. Prakasha Nidana adhara Karkataka + + + --+ + --Ashwakarana + + + --+ + --Choornita Vichoorni Vichoorn + + + ----ta ita Picchita + + + --+ + --Asthichallita Asthichall + + + --+ --ika Kandabhagna Vellita Vellita + --+ + --Majjanugata Majjagata --+ + + --+ Atipatita + + + --+ + --Vakra + + + --+ + --Chinna Shoshita Shoshita + --+ + --Patita Darita Darita + --+ + --Sphutita Visphutita + + + --+ ---

GENERAL FEATURES OF 'KANDABHAGNA' ⇒ Shvyathubahulyam ⇒ Sparshasahisnutvam ⇒ Avapidyamane shabda ⇒ Vividhavedanapradurbhavah ⇒ Sarvasu Avasthasu Na Sharmalabha

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SPECIFIC FEATURES OF INDIVUDAL 'KANDABHAGNA' 1)Karkataka -- Depressed Fracture

(2)Ashwakarana - Complete Oblique Fracture

(3) Churnitam-- Comminuted Fracture

(4) Pichhitam- Compressed Fracture

(5) Asthichallita--Periosteal Avulsion

(6) Kanda bhagna -- Complete Spiral Fracture

(7) Majjanugatam-- Impacted fracture

(8) Atipatitam -- Complete compound fracture

(9) Vakra -- Greenstick Fracture

(10) Chinnam -- Incomplete Fracture

(11) Patitam --Cracked fracture of Flat Bones

12) Sputita -- Fissured Fracture

SUSHRUTA'S CLASSIFICATIONWITH NEAREST MODERN COMPARISON ⇒

Karkataka: Depressed fracture.

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Ashwakarana:Complete oblique fracture.

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Churnitam: Comminuted fracture

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Pichhitam: Fracture by compression.

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Asthichallita : Sub periosteal avulsion. Kandabhagna: Complete spiral fracture.

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Majjanugatam: Impacted fracture.

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Atipatitam: Complete compound fracture. ⇒

Vakra : Green stick fracture.

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Chinnam: Incomplete fracture.

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Patitam: Comminuted fracture flat bones. ⇒

Sputita: Fissured fracture.

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PROGNOSIS S EASONAL VARIATION

STATUS OF PATIENT

AGE

SITE OF FRACTURE

STATUS OF BONE

TYPE OF FRACTURE SUSHRUTA'S TECHNIQUE

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(1) Local

(2) Systemic.

(1) Local complications Malunion Fragmented Fracture. Swelling, pain, Avascularization Gangrene

Due to tight bandaging

(2) Systemic complications ⇒ Fever, ⇒ Abdominal distension, ⇒ Cessation of passages of excreta SUSHRUTA'S TECHNIQUE

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(1)

Principles of Bhagna Chikitsa.

(2)

General Management of Bhagna.

(3)

Specific Management for different types of fractures.

(4)

Medicinal preparations for different kinds of fractures

(5) Pathyaa-Pathya. (6)

Clinical criteria of fracture healing.

Four Principles of Treatment

1) Anchana (Traction)

2) Peedana( Manipulation)

3) Sankshepan(Opposition

4)Bandhana(Immobilization)

and stabilization)

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General Treatment of Bhagna. 1) Pariseka 2) Lepana.

Specific Rx for different types of fractures ⇒

Fracture with the wound / compound fracture Wash with 'Nyagrodhadi gana dravyas' Honey and Ghee should be applied. Rest is as in case of general management.

⇒ Phalanx fracture or dislocation, First set in its natural position Bandaged with pieces of thin linen Sprinkled with ghee. Etc.

Rehabilitation 1) MritapindaDharan 2) LavanaDharana

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3) PashanaDharna

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THE LIST OF DRUGS IN THE MANAGEMENT OF FRACTURES 1.Gandha Taila

2. Gandhaprasarini Taila

3. Chakrataila

4. BhagnasandhanaTaila

5. BhagnasandhanaVati 7.LashunadiVati,

6. Laksha Guggulu

8.MadhuyasthiKsheerapaka

9. Pravala Panchamruta 10. Rajata Bhasma

Rejuvenators 1. Haritaki

2. Yastimadhu

3. Amalaki

4. Lashuna

5. Pippali

6. Kakoli, Ksheera Kakoli etc..

7. Shilajitu

8. Godhooma

9. Priyangu

10. Kapitha Phala Majja.

Lavana, Katu Rasa, Kshara and Alma article of food Live on strictest continence, Over exposure to sun Physical exercises.

Shali rice, meat soup, Milk, ghee, soup of pulse and Nutritive and constructive food and drink, CLINICAL SIGNS OF IDEALLY UNITED BONE 1) No swelling or hardness on palpation. 2) Absence of shortening and deformity. 3) Painless and easy movements

MANJ ISTHA

YASHTI MADHU

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SHALI

SHATADHOUTA-GRITHA

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RAKTA CHANDANA

DRUGS USED FOR KSHEERAPAKA GHRISHTA-KSHEERA

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LAKSHA

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DRUGS USED FOR THE SPLINTS UDUMBAR

ASHWATTHA

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PALASHA

VANSHA

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Drugs Used for LEPA Drugs

Rasa

Guna

Veerya

Vipaka

Manjistha

Kashaya,

Guru

Ushna

Katu.

Tikta

Ruksha

Yesthimadhu

Madhura

Guru

Sheeta

Madhura

Raktachandana

Madhura

Guru

Sheeta.

Katu

Shalipisti

Madhura

Snigda

Sheeta

Madhura

Snigdha

Anushna

Katu

Sheeta

Madhura

Kashaya Drugs Used for KSHEERAPAKA Laksha

Kashaya

Laghu Shatadhautaghrita Madhura

Guru

Drugs required for lepa and ksheera paka : 1) Lepa

2) Ksheerapaka i) Ksheera ii) Yashti madhu iii) Laksha iv) Ghee.

Source of data Criteria of selection of Patients : i ) Male or Female

ii) Hospitalized or Ambulant. iii) Simple or Closed Fractures. iv)

Fractures of Humerus, Radius, Ulna, Femur, Tibia, Fibula, Metacarpals, Metatarsals, and Phalanges which can be reduced by closed reduction method with or without general Anesthesia.

v) Stable fractures i.e. fractures in which the alignment of bony ends can be maintained without internal fixation.

Criteria of Exclusion of patients : i) Open or compound fractures. ii) Simple fractures with wounds were excluded. iii) Pathological fractures, Stress Fractures, and complicated fractures. iv) Fractures requiring open reduction and internal fixation. v) Fractures associated with other debilitating diseases like Diabetes, Tuberculosis, Leprosy, Asthma is excluded. vi) Patients suggestive of Osteomyelitis and other bone diseases. vii) Patients above the age of 75 years.

Trial Procedure Investigations X- RAY Laboratory investigations MANAGEMENT OF FRACTURES IN GROUP -A.

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Drug Supply and Dosage: Lakshaksheera Paka was given 100ml. Daily in the morning.

Ahara : Patient's usual vegetarian and non vegetarian diet was continued with restrictions of Lavana, Katu, Amla rasa, Kshara and Ruksha dravyas. Vihara: Atapa sevana and Vyayama were restricted. SUSHRUTA'S TECHNIQUE

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Follow up: Parameters of assessment a) Subjective improvement. b) Objective improvement.

RADIOGRAPHS SHOWING HEALING OF BONE

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