A fracture or dislocation (Bhagna) occurring in a person of a Vátika temperament, or of intemperate habits, or in one who is sparing in his diet, or is affected with such supervening disorders (as fever, tympanites, suppression of the stool and urine, etc.) is hard to cure. * A fracture-patient must forego the use of salt, acid, pungent and alkaline substances and must live a life of strictest continence, avoid exposure to the sun and forego physical exercises and parchi-fying (devoid of oleaginous) articles of food. A diet consisting of boiled rice, meat-soup, milk, † clarified butter, soup of Satina pulse and all other nutritive and constructive food and drink, should be discriminately given to a fracture-patient. The barks of Udumbara, Madhuka, As'vattha, Palás'a, Kakubha, Bamboo, Vata or Sála trees should be used as splints (Kus'a). Manji-shthá, Madhaka, red sandal wood and Sáli-rice mixed with S'ata-Dhauta clarified butter (i.e., clarified butter washed one hundred times in succession) should be used for plastering the fracture. 2-6.
* Jejjata does not read the first verse, but Gayi does.
† As a general rule, milk should not be prescribed to a patient suffering from an ulcer (Vrana) in general; but a case of fracture forms an exception thereto. Some authorities hold that tepid milk may be given to a fracture-patient, if there be no ulcer (Vrana). Others, on the contrary, are of opinion that milk should not, in any case, be given to a fracture-patient for fear of suppuration and the setting in of pus.
Others, however, take "Kshua-sarpih" to be a compound word and explain the term to mean the clarified butter prepared from milk (as distinguished from that prepared from curd).
But experience tells us that in cases of excessive weakness or emacia tion, milk may be given without any hesitation - Ed.
Bandage: - Fractures should be (dressed and) bandaged once a week in cold weather, on every fifth day in temperate weather (i.e., in spring and autumn), and on every fourth day in hot weather (i.e., in summer), or the interval of the period for bandaging should be determined by the intensity of the Doshas involved in each individual case. An extremely loose bandage prevents the firm adhesion of a fractured bone, a light bandage gives rise to pain, swelling and suppuration of the local skin, etc. Hence in cases of fractures, experts prefer a bandage which is neither too tight nor too loose. 7-8.
Washings: - A cold decoction of the drugs of the Nyagrodhádi group should be used in washing (the affected part), whereas in the presence of (excessive) pain, (the part) should be washed with milk boiled with the drugs of the (minor) Pancha-mula, or simply with the oil known as the Chakra-taila made lukewarm *. Cold (or warm) lotions and medicinal plasters (Pradehas) of Dosha-subduing drugs should be prescribed with due regard to the nature of the season and the Doshas involved in each case. 9-10.
A preparation of milk † from a cow, delivered for the first time, boiled with the drugs of the Madhurddi group and mixed with powdered shellac and clarified butter (as an afterthrow) should be given (when cold) to a fracture-patient as a beverage every morning. In a case of 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.
* In winter and where the aching pain is present due to Váyu and Kapha.
† Consisting of the drugs of the Kákolyádi group weighing two Tolas, milk sixteen Tolas, water sixty-four Tolas, boiled together with the water entirely evaporated.
Prognosis: - A case of fracture occurring in a youth or a person with slightly deranged Doshas or in winter, is held to be 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 middle-aged 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 aside, and by reinstating it in its upward (proper) position in the event of its being lowered down. An intelligent physician should set all dislocated (Bhagna) 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.