An English Translation of the Sushruta Samhita, Vol. II — trans. Kaviraj Kunja Lal Bhishagratna (1911)

fracture attended with ulcer on the part, an astringent plaster plentifully mixed with honey and clarified butter should be applied ; and the rest (diet and regimen of conduct) should be as laid down in the case of a (simple) fracture. 11-12.

PrOgTIOSiS : -A case of fracture occurring in a youth or a person with slightly deranged Doshas or in winter, is held to b2 easily curable (with the help of the aforesaid medicines and diet}. A fractured bone in a youth is joined by the aforesaid treatment in the course of a month, in two months in the case of a middleaged man and in three months in one of old age. 13-14.

An elevated and fractured joint should be reduced by pressing it down, while one hanging down should be set by raising it up, by pulling it in the case of its being pushed aiide, and by reinstating it in its upward (proper) position in the event of its being lowered down. An intelligent physician should set all dislocated (Rhagna) joints, whether fixed or movable, by the mode of reduction, known as Anchhana, Pidana, (pressure), Sankshepa and Vandhana (^bandaging). 15-16.

Treatment :— A crushed or dislocated joint should not be shaken {i.e., should be kept at rest) and cold lotions or washes and medicated plasters (Pradeha) should be applied to the part. A joint is spontaneously reset to its natural or normal state or position after the correction of its deformity incidental to a blow or hurt having been effected. The fractured or dislocated part should be first covered with a piece of linen soaked in clarified butter. Splint should then be placed over it and the part properly bandaged. 17-19.

Treatment of fractures in particular

limbs :^Now we shall discourse on the measures to be adopted in fractures occurring in each particular

p. 36

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limb. In the case of a nail-joint, being in any way crushed or swollen by the accumulation of the deranged blood (in the locality), the incarcerated blood should be first let out with the help of an awl (Ard) and the part should be plastered with a paste of Sdli-rice. A finger or phalanx bone put out of joint or fractured should be first set in its natural position and bandaged with a piece of thin linen and should be then sprinkled over with clarified butter. In the case of a fracture in the foot the fractured part should be first lubricated with clarified butter, then duly splinted up, and bandaged with linen. Such a patient should forego all kinds of locomotion. In the case of a fracture of the knee-joint or thigh-bone the affected part should be lubricated with clarified butter and carefully pulled straight, after which it should be splinted with barks (of Nyagrodha, etc.) and bandaged with clean linen. In case of the fracture projecting out a thigh-bone should be reset with the help of a circular splint and bandaged. In the case of Sphutita (cracked) or Pichchita (bruised) thigh-bone, the part should be also bandaged in the aforesaid manner. 20-24, In a case of a fracture in the Kati (Ilium-bone), it should be reduced by the fractured bone being raised up or pressed down (as the case may be) and the patient should then be treated with Vasti (enematas of medicated oils or Ghritas*}. In the case of a fracture of one of the rib-bones (Pars'aka), the patient should be lubricated with clarified butter. He should then be lifted up (in a standing posture) and the fractured rib (bone), whether left or right, should be relaxed by being rubbed with clarified butter. Strips of bamboo or pad

* In the Nidana-Sthana— Chap. XV., 9— it is stated that a case of fracture in the Kati should be given up (Varjjayet). Jejjata, however, explains "Varjjayet" as "hard to cure."

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(Kavalikaj should ba placed over it and the patient should be carefully laid in a tank or cauldron full of oil with the bamboo splint duly tied up with straps of hide. In the case of a dislocation of the AmsaSandhi (shoulder-joint), the region of the Kaksha (arm-pit) should be raised up with an iron-rod (Mushala) and the wise physician should bandage the part, thus reduced, in the shape of a Svastika (8-shaped) bandage. A dislocated elbow-joint should be first rubbed with the thumb, after which it should be pressed with a view to set it in its right place by fixing and expanding the same. After that the affected part should be sprinkled over with any oleaginous substance. The same measures should be adopted in the case of a dislocation of the knee-joint (Janu-sandhi), the wrist-joint (Gulphasandhi) and the ankle-joint (Mani-vandha). 25-29.