Madhava Nidana Chapter 44 Bhagna Nidanam

This article explains Madava nidana 44th chapter “Bhagna Nidanam”. Causes, pathology and symptoms of Bhagna are explained in this chapter.

Table of Contents

Bhagna Bheda

Types of fractures
Bhagna (fracture) is, in brief, of two kinds;

Kanda Bhagna – that which occurs at the shaft or body of the bones and
Sandhi Bhagna – that which occurs at the sandhi – bony joints (meeting place of two bones)

Types of Sandhi Bhagna (fracture at the meeting place of two bones or sutures) – Sandhi Bhagnas are of six types, they are –

Utpista
Vislista
Vivartita
Tiryak Ksipta
Ksipta and
Adhah Ksipta (1)
Read – Asthi Shareera – Definition, Anatomy, Types Of Bones

Sandhi Bhagna Samanya Lakshana

General Symptoms of Sandhi Bhagna
The general symptoms of sandhi bhagna are – severe pain during extension, contraction and rotation, and tenderness.

Symptoms of types of Sandhi Bhagna / Sandhi Vislesa
Utpista – In this condition there will be swelling all around the joint and severe pain at nights.
Vislista – This condition will also have the above mentioned two symptoms (swelling around the joint and severe pain at night) but the pain will be constantly present all through the day (day and night), but the swelling will be less
Vivartita – In this type severe pain will be present on both sides of the fracture site (joint)
Tiryak Ksipta – In this type there will be severe pain.
Ksipta – In this type there will be overlapping (overriding) of the bones involved in the fracture leading to curvature of the bones and pain.
Adhah Ksipta – In this type there will be severe pain and abnormal activities (functions) in the joints. According to yet another opinion, the bones at the seat of fracture of joints will slip / slide downwards. (2-3)
Read – Low Bone Density Causes, Ayurvedic Treatment, Diet

Kanda Bhagna

Fracture of the bone shaft
Kaanda Bhagna (fracture of shafts or body of bones) is of twelve kinds namely – Karkataka, Ashvakarna, Vichoornita, Piccita, Asthichallikaa, Kaandabhagna, Atipaatita, Majjaagata, Sphutita, Vakra, and two types of Chinna.
In all these kinds, the general features are – looseness / laxity of the body parts (drooping of the part), swelling and severe pain, crackling sounds at the site of fracture, tenderness, pulsations, pricking pain, pain, and not feeling comfort in any position.
Apart from these twelve types of fractures there might also occur many other types of kanda bhagna i.e., fracture of shafts. They are either included in these types or shall be understood by similarity with its meaning. (4-7)
Read – Veldt Grape – Hadjod Remedies: Fracture, Burns, Joint Pain\

Symptoms of incurability of Bhagna

Fractures heal with difficulty in persons who take very little (non-nutritious) quantity of food, in those who do not have self control or those who are habitually indulged in unsuitable foods and activities, in those of vata constitution and in the fractures associated with complications. (8)
Read – Diet And Lifestyle Advice For Vata Dosha Body Type

Other symptoms of incurability of fractures
Fracture of the skull / hip bone, fracture of the hip bone, dislocation, Cyuta or Adhahksipta type of fractures, Utpista fracture of hip / pelvic bones (at the sutures of the hip bones), fracture / dislocation of cranial sutures, crushing / cracking of forehead, fracture occurring between the breasts (centre of the chest), fracture of the back, temples and head (skull, vault of the head) are to be rejected considering them as incurable. (9-10)
Fractures which have once healed but happening again and again due to bad positioning, bandaging or violent activity and creating loss of functions should also be refused treatment since it is incurable. (11)

Fractures presenting in different forms (presentation) in different bones
Young bones (cartilages) bend and the long bones break in the middle. Flat bones crack in their body while the teeth (which are also considered as bones in Ayurveda) splinter off. (12)