The Sushruta Samhita — trans. Bhishagratna
The text is shown on its own: no facing layer is held for this issue.
Fractures may be divided into twelve different kinds which are known as, Karkatakam, AsVakarnam,Churnitam,Pichchitam,Asthi-chchalitam,Kandabhagnam, Majjagatam, Atipdtitam, Vakram, Chchinnam, Pdtitam and Sphutitam. 6.
General symptoms of K^nda-bhag-
nam : — A violent swelling (about the seat of fracture) with throbbings or pulsations, abnormality in the position (of the fractured limb), which cannot bear the least touch, crepitus under pressure, a looseness or dropping of the limb, the presence of a variety of pain and a sense of discomfort in all positions are the indications which generally mark all kinds of fracture (Kanda-bhagnam). 7. Diagnostic symptoms:— The case where a fractured bone, pressed or bent down at its two articular extremities, bulges out at the middle so as to resemble the shape of a knot (Granthi), is called Karkatam. The case where the fractured bone projects upward like the ear of a horse is called AsVakamam. The fractured bone is found to be shattered into fragments in a case of the Churnitam or comminuted kind which can be detected both by palpation and crepitation. A smashed condition of the fractured bone marks a
Chap. XV.] NIDANA STHANAM. 99
The fractured bone is found to be shattered into fragments in a case of the Churnitam or comminuted kind which can be detected both by palpation and crepitation. A smashed condition of the fractured bone marks a
Chap. XV.] NIDANA STHANAM. 99
case of the Pichcliitain kind which is often found to be marked by a great swelling. The case where the covering or skin of the bone (periosteum) is cast or splintered off is called the Asthi-chchallitam. The case where the completely broken or severed bones are found to project through the local skin, is called Katadabhagnatn (compound). The case where a fragment of the fractured or broken bone is found to pierce into the bone and dig out the marrow, is called Majjsiaugatain, (Impacted fracture). The case where the fractured bone droops or hangs down is called Ati-paititani. The case where the unloosened bone (from its position) is bent down in the form of an arch is called Vakram The case where only one articular extremity of the bone is severed is called Chhinnaoi. The case where the bone is slightly fractured and pierced with a large number of holes, is called PaLtitam, an excruciating pain being the leading indication. The case where the bone largely cracked and swollen becomes painful as if stuffed with the bristles of a Suka insect is called Sphutitam (Greenstick fracture). Of the several kinds of fracture, cures are effected with extreme difficulty in a case of the Churnitam, Chhinnam, Ati-patitam or Majjanugatam kind. A case of displacement or laxation occurring in a child or in an old or weak patient or in one suffering from asthma (Svasa) or from any cutaneous affection (Kushtha) or Kshata-Kshina disease is difficult to cure. 8.
Memorable verses : —The following cases
are to bs given up as hopeless —z^/s. fracture of the pelvic bone (or of bones that are of this description, wherever they may be situated) ; dislocation of the pelvic joints ; compound fracture of the thigh bone or of the flat bones) ; fracture into small pieces of the lOO THE SUSHRUTA SAMHITA. [Chap. XV.
frontal bone or its dislocation ; simple fracture of the breast-bones, back-bone and temporal and cranial bones. If the dislocations and fractures be improperly set from the outset (Adito)* or if the union be anyhow disturbed there is no hope for recovery. 9 — 11.
If the dislocations and fractures be improperly set from the outset (Adito)* or if the union be anyhow disturbed there is no hope for recovery. 9 — 11.
If fractures happen at any time of the first three stages of adalt life which has been described before (vide Sutrasthana Chap, XXXV.) and if they are set up by an able surgeon they have a great chance of being united. 12.
A bending of a gristle or cartilage (Taruna) is called its fracture. A Nalaka (long bone) bone is usually found to be severed. A Kapatla bone is found to be cracked, while a Ruchakaf (tooth) is found to be splintered off. 13.
* The word Adiio may be taicen into the sense of congenital malformation which is beyond remedy.
+ The presence of the particle 'cha' denotes Valya-asthi-
Thus ends the fifteenth Chapter of the Nidana Sthanam in the Sus'ruta amhit^ which treats of the Nidanam of dislocations and fractures.
CHAPTER XVI.
Now we shall discourse on the Nidanam of lYl Uk ha. Tog's. m (diseases which affect the cavity of the mouth in general), i.
General Classifications:— Sixty five* different forms of mouth disease are known in practice. They are found to attack seven different localities viz. the lips, the gums of the teeth, tongue, palate, throat and the entire cavity ; of these eight are peculiar to the lips ; fifteen, to the roots of the teeth; eight to the teeth; five to the tongue ; nine to the palate ; seventeen to the throat; and three to the entire cavity. 2 — 3.
Diseases of the lips :— The eight forms which affect the lips, are either Vataja, Pittaja, Kaphaja, Sannipdtika, Raktaja, M^ns'aja, Medaja or Abhighdtaja (Traumatic). 4.
The Vsitaja Type:— The lips become dry, rough, numbed, black, extremely painful and the affected part seems as if it were smashed and pulled out or cracked by the action of the aggravated Va(yu. In the Pittaja type — the lips become blue or yellow-coloured and studded with (a large number of small) mustardseed-like eruptions, which suppurate and exude a purulent discharge attended with a burning sensation (in the locality). In the Kaphaja type — the affected lips are covered with small eruptions, which are of the same colour as the surrounding part, and become slimy, heavy or thick, cold and swollen. Pain is absent in this type and the patient feels an irresistible inclination to scratch the parts. In the Satnnipaitaja type, the lips change
* According to others sixty-seven-^but Dalian does not support this.
102 THE SUSHRUTA SAMHITA. [Chap. XVI.