“MIRACULOUS HEALING POWER OF ABHA GUGGULU IN THE MANAGEMENT OF ‘ANGUSHTHA ASTHI BHAGNA’ – A CASE REPORT”
Dr Santosh Dixit MD (AY), (PhD)
ABSTRACT
Abha guggulu, an Ayurvedic medicine was tried clinically on a patient having ‘fracture of proximal phalanx of left thumb. After the Anatomical reduction, cast was applied on the left hand with thumb. The duration of the treatment was for three weeks and healing of fracture was observed clinically and Radiologically at an interval of 7 days to till 21st day (After application of cast).
After confirming that the fracture healed well, the cast was removed and patient was advised to mobilize the distal interphalengeal joint of the left thumb. It was observed that the healing occurred at a good rate and also movements were restored faster.
The probable mode of action of the medicine may be therefore understood by its ability to speed up the fracture healing, its ability to facilitate the repair of bone fracture by hastening the proliferative physiological process in the body and its ability to increase the rate of regeneration of the bone. Thus, this can be recommended for the treatment of other fractures.
After confirming that the fracture healed well, the cast was removed and patient was advised to mobilize the distal interphalengeal joint of the left thumb. It was observed that the healing occurred at a good rate and also movements were restored faster.
The probable mode of action of the medicine may be therefore understood by its ability to speed up the fracture healing, its ability to facilitate the repair of bone fracture by hastening the proliferative physiological process in the body and its ability to increase the rate of regeneration of the bone. Thus, this can be recommended for the treatment of other fractures.
INTRODUCTION
Bhagna is an epitome where bone or bones get interrupted. This is classified on the basis of its clinical importance in to Avrana (closed fracture) and Savrana (Open fracture). In modern literature, fracture is defined as, a loss of continuity in the substance of the bone. Acharya Sushruta has advocated the principles of reducing fracture; they are Ancchana (traction), pidana (manipulation), sankshepana (opposition) and Bandhana1 (bandaging and immobilization) which is practiced regularly even today.
Abha guggulu, a medicine described in Bhaishajya Ratnavali of Govind Das in the chapter Bhagna chikitsa adhyaya. It is said to speed up the fracture healing. Present study is carried out to confirm and re- establish the efficacy of Abha guggulu in the management of Angushtha Asthi Bhagna.
Abha guggulu, a medicine described in Bhaishajya Ratnavali of Govind Das in the chapter Bhagna chikitsa adhyaya. It is said to speed up the fracture healing. Present study is carried out to confirm and re- establish the efficacy of Abha guggulu in the management of Angushtha Asthi Bhagna.
CASE REPORT
A male patient aged about 21years approached with a fracture of proximal phalanx of left thumb, caused by a traumatic injury during the sports activity. Patient had initially consulted orthopedic surgeons for the same and was suggested k- wire fixation. The patient then approached for a second opinion, and a conservative line of management was suggested instead of k-wiring, as the latter appeared to be the right line of treatment for the given case.
The fracture was reduced anatomically and cast was applied to the region of hand and thumb for immobilization. The patient was advised to take Abha guggulu two tablets twice daily after food with milk during the treatment for three weeks. The follow –ups to observe the healing of the fracture was clinically and radiologically done at an interval 7days till the 21st day (After application of cast). After confirming that the fracture had healed well, the cast was removed on the 21st day. Then, patient was advised to mobilize the distal interphalengeal joint of the left thumb.
The process of fracture healing to regain the usual structure pertaining to it, usually takes about six weeks. In this case the fracture healed within three weeks; with only Abha guggulu as the oral medication.
The fracture was reduced anatomically and cast was applied to the region of hand and thumb for immobilization. The patient was advised to take Abha guggulu two tablets twice daily after food with milk during the treatment for three weeks. The follow –ups to observe the healing of the fracture was clinically and radiologically done at an interval 7days till the 21st day (After application of cast). After confirming that the fracture had healed well, the cast was removed on the 21st day. Then, patient was advised to mobilize the distal interphalengeal joint of the left thumb.
The process of fracture healing to regain the usual structure pertaining to it, usually takes about six weeks. In this case the fracture healed within three weeks; with only Abha guggulu as the oral medication.
Image 1&2. X-ray left thumb AP & oblique view before treatment
Image 3&4. X-ray left thumb AP & oblique view after 7th day of treatment
Image 5&6. X-ray left thumb AP & oblique view after 14th day of treatment
Image 7&8. X-ray left thumb AP & Lateral view after 21st day of treatment
Image 9&10. X-ray left thumb AP & Lateral view after treatment
Image 11, 12, 13 & 14. Images of left thumb after treatment
The mode of Abha guggulu may be explained as follows;
1. It accelerates the fracture healing
2. It is likely to facilitate the repair of fracture by hastening the proliferative physiological process in the body.
3. In addition, it also improves the appetite, absorption of nutrients from the food, and bio-availability of the minerals which are beneficial in bone healing2.
Thus, this medicine enhances the healing power. So, it is highly recommended in the treatment of fractures.
1. It accelerates the fracture healing
2. It is likely to facilitate the repair of fracture by hastening the proliferative physiological process in the body.
3. In addition, it also improves the appetite, absorption of nutrients from the food, and bio-availability of the minerals which are beneficial in bone healing2.
Thus, this medicine enhances the healing power. So, it is highly recommended in the treatment of fractures.
DISCUSSION
Splint can be used to treat undisplaced fracture of the proximal phalanx for up to 4 weeks followed by early mobilization. Incongruous intra-articular fracture requires reduction and fixation.
More than 200-300 of angulation in the latral plane produces an IP joint extensor lag thus one has to undertake reduction in these patients. Less than 200 of angulations in the lateral plane is acceptable. Transverse fractures usually are stable with closed reduction.
Displaced fracture of proximal phalanx may require operative intervention. Displaced spiral or oblique fracture may be treated either with inter fragmentary screws (ORIF) or percutaneous pinning with kirschner wires (K-Wire). Another option is intra medulary kischner wire insertion, retrograde through the distal aspect of the thumb across the thumb IP joint3.
In this case, though the fracture was comminuted intra-articular fracture, displaced fracture was reduced anatomically and cast was applied for three weeks to immobilize the thumb. Patient was advised to take Abha guggulu two tablets twice daily after food with milk during treatment.
Fractured site was observed clinically and Radiologically at an interval 7days to till 21st day (After application of cast). Then the patient was advised to mobilize the distal interphalengeal joint of thumb.
During each observation, an angle of 50 in the lateral plane was seen which is within acceptable range.
The conservative oral medication used i.e. Abha guggulu, a medicine described in Bhaisjyaratnavali of Govind Das in the chapter Bhagna chikitsa adhyaya was selected for the management. Abha guggulu contains following ingredients4,
1. Babula twak (Acacsia Arabika)- 1 part
2. Triphala – 1 part
3. Trikatu – 1 part
4. Guggulu (Commiphora mukul)- 3 parts
5. Ghrita – QS
Dose: 3 grams, in divided dose.
The administration of Abha guggulu was done as described in Bhaisajyaratnavali.
It acts as a natural bone healing agent with anti inflammatory and analgesic effects.
Its anti osteoporotic and anti arthritic effects can protect the bones against several diseases. Usually fracture healing process will take about 6 weeks. In this case the fracture healed within three weeks with the help of Abha gugggulu as oral medication.
More than 200-300 of angulation in the latral plane produces an IP joint extensor lag thus one has to undertake reduction in these patients. Less than 200 of angulations in the lateral plane is acceptable. Transverse fractures usually are stable with closed reduction.
Displaced fracture of proximal phalanx may require operative intervention. Displaced spiral or oblique fracture may be treated either with inter fragmentary screws (ORIF) or percutaneous pinning with kirschner wires (K-Wire). Another option is intra medulary kischner wire insertion, retrograde through the distal aspect of the thumb across the thumb IP joint3.
In this case, though the fracture was comminuted intra-articular fracture, displaced fracture was reduced anatomically and cast was applied for three weeks to immobilize the thumb. Patient was advised to take Abha guggulu two tablets twice daily after food with milk during treatment.
Fractured site was observed clinically and Radiologically at an interval 7days to till 21st day (After application of cast). Then the patient was advised to mobilize the distal interphalengeal joint of thumb.
During each observation, an angle of 50 in the lateral plane was seen which is within acceptable range.
The conservative oral medication used i.e. Abha guggulu, a medicine described in Bhaisjyaratnavali of Govind Das in the chapter Bhagna chikitsa adhyaya was selected for the management. Abha guggulu contains following ingredients4,
1. Babula twak (Acacsia Arabika)- 1 part
2. Triphala – 1 part
3. Trikatu – 1 part
4. Guggulu (Commiphora mukul)- 3 parts
5. Ghrita – QS
Dose: 3 grams, in divided dose.
The administration of Abha guggulu was done as described in Bhaisajyaratnavali.
It acts as a natural bone healing agent with anti inflammatory and analgesic effects.
Its anti osteoporotic and anti arthritic effects can protect the bones against several diseases. Usually fracture healing process will take about 6 weeks. In this case the fracture healed within three weeks with the help of Abha gugggulu as oral medication.
CONCLUSION
The study suggested, Abha Guggulu significantly improves the bone healing process, exerts significant anti inflammatory action and relives pain and swelling. It was observed that healing occurred at good rate and also movements were restored faster.
Owing to the miraculous healing abilities of this medicine “Abha Guggulu”, it can be tried in most fracture cases, either as the main line of management or as supplement during follow-ups, irrespective of closed or open reduction (with/without internal fixation) of the fractures.
Owing to the miraculous healing abilities of this medicine “Abha Guggulu”, it can be tried in most fracture cases, either as the main line of management or as supplement during follow-ups, irrespective of closed or open reduction (with/without internal fixation) of the fractures.
REFERENCES
1. Sushruta Samhita by Kaviraj Kunjalal, edited by Laxmidhas Dwivedi,vol 2, Bhagna Chikitsa adhyaya, published by Chaukambha Sanskrit series office, Varanasi.
2. Abha Guggulu ingredients, brnrfits, uses and side effects by Dr Jagadev Singh.
3. Thumb fracture and dislocation treatment and management Donald.R.Laup. et. All.
4. Baishajyaratnavali of Shri Govind Das, by Bhisagratna Shri Brahmashankar Mishra, edited by Kaviraj Ambikadatta Shastri, published by Chaukamba Prakashana, Varanasi.
2. Abha Guggulu ingredients, brnrfits, uses and side effects by Dr Jagadev Singh.
3. Thumb fracture and dislocation treatment and management Donald.R.Laup. et. All.
4. Baishajyaratnavali of Shri Govind Das, by Bhisagratna Shri Brahmashankar Mishra, edited by Kaviraj Ambikadatta Shastri, published by Chaukamba Prakashana, Varanasi.