Sushruta Samhita Nidanasthana Chapter 14 Bhag Nidanam (Diseases of the Penis)

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The 15th bankruptcy of Nidanasthana of Sushruta Samhita is known as as Bhagna Nidanam Adhyaya. This bankruptcy offers with Fractures and Dislocations.

अथातो भग्नानां निदानं व्याख्यास्यामः ||१||
यथोवाच भगवान् धन्वन्तरिः ||२||

We will now expound Bhagna Nidana – analysis of Fractures and Dislocations as published by means of the venerable Dhanvantari.

Nidana- Causes

पतनपीडनप्रहाराक्षेपणव्यालमृगदशनप्रभृतिभिरभिघातविशेषैरनेकविधमस्थ्नां भङ्गमुपदिशन्ति ||३||

Below discussed are the reasons for other kinds of bhagna (fracture of bones) –

falling from top,
squeezing the frame a great deal,
assault / hitting,
very full of life actions,
chew by means of wild animals and others attacks / harm

Bheda – Kinds

तत्र भङ्ग(ग्न)जातमनेकविधमनुसार्यमाणं द्विविधमेवोपपद्यते सन्धिमुक्तं, काण्डभग्नं च |
तत्र षड्विधं सन्धिमुक्तं, द्वादशविधं काण्डभग्नं भवति ||४||

There are other sorts of bhagna however these types of are (grossly) of 2 sorts most effective viz

Sandhimukta – it’s of six sorts and
Kandabhagna – it’s of twelve sorts

Sandhimukhta (dislocation of bony joints)

तत्र सन्धिमुक्तम्- उत्पिष्टं, विश्लिष्टं, विवर्तितम्, अवक्षिप्तम्, अतिक्षिप्तं, तिर्यक्क्षिप्तमिति षड्विधम् ||५||

The six sorts of Sandhimukta are –

Utpista,
Vislista,
Vivartita,
Avaksipta,
Atiksipta, and
Tiryak Ksipta

Samanya Laksana – General indicators and Symptoms

तत्र प्रसारणाकुञ्चनविवर्तनाक्षेपणाशक्तिरुग्ररुजत्वं स्पर्शासहत्वं चेति सामान्यं सन्धिमुक्तलक्षणमुक्तम् ||६||

The common signs of Sandhimukta – dislocation of joints are –

Inability to accomplish the beneath discussed movements –

extension,
contraction,
rotation and
fast actions

Other signs come with –

Severe ache
Inability to tolerate contact

Visesa Laksana – Specific signs of every roughly Sandhimukta

वैशेषिकं तूत्पिष्टे सन्धावुभयतः शोफो वेदनाप्रादुर्भावो विशेषतश्च नानाप्रकारा वेदना रात्रौ प्रादुर्भवन्ति; विश्लिष्टेऽल्पः शोफो वेदनासातत्यं सन्धिविक्रिया च; विवर्तिते तु सन्धिपार्श्वापगमनाद्विषमाङ्गता वेदना च; अवक्षिप्ते सन्धिविश्लेषस्तीव्ररुजत्वं च; अतिक्षिप्ते द्वयोः सन्ध्यस्थ्नोरतिक्रान्तता वेदना च; तिर्यक्क्षिप्ते त्वेकास्थिपार्श्वापगमनमत्यर्थं वेदना चेति ||७||

Type of Sandhimukta	Specific signs
Utpista	Swelling on either side of the joint Pain Different sorts of ache, particularly happening at evening time
Vislista	Slight swelling Continuous ache which happens each at day and evening Improper functioning of the joint
Vivartita	Joint shifts to anybody aspect Distortion of that phase which has shifted Pain
Avaksipta	Drooping down of the joint ache
Atiksipta	Both bones making up the joint would transfer aside such {that a} hole is created between those two bones Pain
Tiryak Ksipta	Any one bone forming the joint on my own will get displaced to a facet Pain

Kanda Bhagna – fracture of shafts of bones

काण्डभग्नमत ऊर्ध्वं वक्ष्यामः- कर्कटकम्, अश्वकर्णं, चूर्णितं, पिच्चितम्, अस्थिच्छल्लितं, काण्डभग्नं, मज्जानुगतम्, अतिपातितं, वक्रं, छिन्नं, पाटितं, स्फुटितमिति द्वादशविधम् ||८||

After this, other sorts of Kandabhagna – fracture of the shaft of bones can be defined –

The twelve sorts of Kandabhagna (shaft fractures) are –

Karkataka,
Asvakarna,
Curnita,
Piccita,
Asthicchallita,
Kandabhagana
Majjanugata,
Atipatita,
Vakra,
Chinna,
Patita and
Sphutita

Samanya Laksana – common symptoms-

श्वयथुबाहुल्यं स्पन्दनविवर्तनस्पर्शासहिष्णुत्वमवपीड्यमाने शब्दः स्रस्ताङ्गता विविधवेदनाप्रादुर्भावः सर्वास्ववस्थासु न शर्मलाभ इति समासेन काण्डभग्नलक्षणमुक्तम् ||९||

The common signs of fracture of shaft of bones briefly are –

profound swelling,
incapability to endure tapping, rotating and touching;
generating sound (on the web site) when pulled (or squeezed),
a part of the frame putting down loosely,
look of quite a lot of sorts of ache, and
no longer discovering convenience in any place

Visesa Laksana – particular signs of every type

विशेषस्तु सम्मूढमुभयतोऽस्थि मध्ये भ(ल)ग्नं ग्रन्थिरिवोन्नतं कर्कटकम्, अश्वकर्णवदुद्गतमश्वकर्णकं, स्पृश्यमानं शब्दवच्चूर्णितमवगच्छेत्, पिच्चितं पृथुतां गतमनल्पशोफं, पार्श्वयोरस्थि हीनोद्गतमस्थिच्छलितं, वेल्लते प्रकम्पमानं काण्डभग्नम्, अस्थ्यवयवोऽस्थिमध्यमनुप्रविश्य मज्जानमुन्नह्यतीति मज्जानुगतम्, अस्थि निःशेषतश्छिन्नमतिपातितम्, आभुग्नमविमुक्तास्थि वक्रम्, अन्यतरपार्श्वावशिष्टं छिन्नं, पाटितमणुबहुविदारितं वेदनावच्च, शूकपूर्णमिवाध्मातं विपुलं विस्फुटितं स्फुटितमिति ||१०||

Type of Kandabhagna	Specific signs
Karkataka	The two damaged ends of the bone have moved aside Bulging within the heart, comparable to a tumor
Asvakarna	Ends of the bones are raised up Raised portions resemble ear of the pony
Curnita	The damaged bones produce sounds as even though damaged into items, when felt by means of palms
Piccita	The bone turns into thick and has profound swelling on the web site of fracture
Asthicchallita	One a part of the bone has dropped beneath and the opposite phase is raised above on the web site of fracture
Kanda Bhagna	The fractured bone has tremors / trembles (shaking actions) when shaken
Majjanugata	Part of piece of the bone or heart portion of the bone will get into (pierces into) the bone marrow and displaces it.
Atipatita	Entire bone is damaged into items, with none phase final intact
Vakra	The bone is bent inwards / has transform curved with out getting indifferent
Chinna	Bone has moved to the opposite aspect
Patita	Bone is divided into many items Pain
Sphutita	Bone is extra swollen Feels as though the bone is stuffed with thorns Bone is a great deal break up (chopped off)

Sadhyasadhyata – analysis

तेषु चूर्णितच्छिन्नातिपातितमज्जानुगतानि कृच्छ्रसाध्यानि, कृशवृद्धबालानां क्षतक्षीणकुष्ठिश्वासिनां सन्ध्युपगतं चेति ||११||

The beneath discussed sorts of fractures are tough to remedy –

Curnita
Chinna
Atipatita
Majjanugata

Fractures also are incurable in –

emaciated, outdated elderly individuals and youngsters,
the ones emaciated,
outdated elderly folks and youngsters,
the ones affected by harm to lungs, pores and skin issues and dyspnea,
the ones which happen close to bony joints

भवन्ति चात्र:-

भिन्नं कपालं कट्यां तु सन्धिमुक्तं तथा च्युतम् |
जघनं प्रति पिष्टं च वर्जयेत्तच्चिकित्सकः ||१२||
असंश्लिष्टं कपालं तु ललाटे चूर्णितं च यत् |
भग्नं स्तनान्तरे शङ्खे पृष्ठे मूर्ध्नि च वर्जयेत् ||१३||
आदितो यच्च दुर्जातमस्थि सन्धिरथापि वा |
सम्यग्यमितमप्यस्थि दुर्न्यासाद्दुर्निबन्धनात् [२] ||१४||
सङ्क्षोभाद्वाऽपि यद्गच्छेद्विक्रियां तच्च वर्जयेत् |१५|
मध्यस्य वयसोऽवस्थास्तिस्रो याः परिकीर्तिताः ||१५||
तत्र स्थिरो भवेज्जन्तुरुपक्रान्तो विजानता [१] |१६|

Some extra verses right here

Below discussed stipulations will be rejected by means of the doctor since they’re incurable –

fracture of bones or dislocation of joints and displacement of flat bones of the top and pelvis
beaten pubic bone
fractured items of the flat bones of the top no longer neatly unified
brow bone beaten into items
fractures happening in between the breasts
fractures in temples, again and head
fracture happening within the bone which has no longer shaped correctly proper from the start of his lifestyles,
dislocation happening within the joint which has no longer shaped correctly proper from the start of his lifestyles
fractures happening in bones or dislocation happening in joints that have advanced correctly however these days no longer appearing their serve as correctly as a result of unsuitable hanging or bandaging or because of full of life motion

Among the 3 phases of lifestyles, the individual can be sturdy and solid within the heart age. The remedy of fractures and dislocations will have to be undertaken after taking into account this.

तरुणास्थीनि नम्यन्ते भज्यन्ते नलकानि तु ||१६||
कपालानि विभिद्यन्ते स्फुटन्ति रुचकानि च ||१७||

Below discussed are the impact of attack on other constructions –