Difference between revisions of "Shvayathu Chikitsa"

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|title=Shvayathu Chikitsa
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|titlemode=append
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|keywords=Shvayathu, shotha, shopha, edema, swelling, langhana, amapachana, shodhana, Ayurveda, charak samhita, Indian system of medicine.
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|description=Chikitsa Sthana Chapter 12. Management of Shvayathu (Various types of Swellings)
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|image=http://www.carakasamhitaonline.com/resources/assets/ogimgs.jpg
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|image_alt=charak samhita
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|type=article
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}}
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<big>'''[[Chikitsa Sthana]] Chapter 12. Management of Shvayathu (Various types of Swellings) </big>'''
 
{{Infobox
 
{{Infobox
 
|title = Shvayathu Chikitsa
 
|title = Shvayathu Chikitsa
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|label5 = Other Sections
 
|label5 = Other Sections
 
|data5 = [[Sutra Sthana]], [[Nidana Sthana]],  [[Vimana Sthana]],  [[Sharira Sthana]], [[Indriya Sthana]], [[Kalpa Sthana]], [[Siddhi Sthana]]
 
|data5 = [[Sutra Sthana]], [[Nidana Sthana]],  [[Vimana Sthana]],  [[Sharira Sthana]], [[Indriya Sthana]], [[Kalpa Sthana]], [[Siddhi Sthana]]
 
+
|label6 = Translator and commentator
|header3 =  
+
|data6 = Goyal M.
 
+
|label7 = Reviewer
 +
|data7  = Singh G.
 +
|label8 = Editors
 +
|data8  = Singh G., Goyal M., [[Yogesh Deole|Deole Y.S.]], [[Gopal Basisht|Basisht G.]]
 +
|label9 = Year of publication
 +
|data9 =  2020
 +
|label10 = Publisher
 +
|data10 =  [[Charak Samhita Research, Training and Skill Development Centre]]
 +
|label11 = DOI
 +
|data11 = [https://doi.org/10.47468/CSNE.2020.e01.s06.013 10.47468/CSNE.2020.e01.s06.013]
 
}}
 
}}
 +
<big>'''Abstract</big>'''
 +
<p style="text-align:justify;">This chapter deals with the treatment of various types of swellings like generalized edema and local eruptions including pustules, nodules and tumors. The etiological factors for these swellings can be endogenous (''nija'') or exogenous (''agantuja''). In all types of swellings, three ''[[dosha]]s'' are involved but it is named according to the dominance of the ''[[dosha]]''. After describing general symptoms and signs of the swelling, specific symptoms and signs of ''[[vata]], [[pitta]]'' and ''[[kapha]]'' as well as of incurable and curable swellings are explained.
 +
<br/>
 +
Line of treatment depends upon type of swelling as well as involved parts of the body; wholesome and unwholesome diet and lifestyle for the benefit of the patient is explained. Detailed treatments along with drug preparations, internal and external therapeutic measures are discussed according to ''[[vata]], [[pitta]]'' and ''[[kapha]]'' types of swelling.
 +
<br/>
 +
Local swellings occurring in the various parts of the body in the form of papules, pustules, nodules, tumors etc are described in the last part of the chapter. It includes ''shaluka'' (quinsy), ''Bidalika'' (Ludwig’s angina), ''Taluvidradhi'' (palatal abscess), ''Upajihivika'' (superficial glossitis), ''Upakusha'' (gingivitis) and ''Danta-Vidradhi'' (dental abscess) which occurs in buccal cavity and generally included in Śālākya specialty. ''Galaganda'' is goiter and ''gandamala'' and ''granthi'' are mainly related with various types of swellings of lymph nodes. ''Arbuda'' (tumor), ''alaji'' (inflammation of eye), ''akshata'' (whitlow), ''vidarika'' (lymphadenitis), ''visphotaka'' (eruption), ''kaksha'' (herpes zoster), ''romantika'' (measles), ''masurika'' (chickenpox), ''bradhna'' (hernia), ''bhagandara'' (fistula-in-ano), ''shleepada'' (elephantiasis), ''jalakagardabha'' (acute sprading inflammation), ''abhighataja'' (traumatic) and ''vishaja'' (poisonous) swellings along with their medical treatment and wherever necessary surgical measures are also described. Difference and similarity between ''granthi'' and ''arbuda'' are also mentioned.
 +
<br/>
 +
'''Keywords''': ''Shvayathu, shotha, shopha,'' edema, swelling, ''[[langhana]], ama[[pachana]], [[shodhana]]''. </p>
  
== [[Chikitsa Sthana]] Chapter 12, Chapter on Management of ''Shwayathu'' (Various types of Swellings) ==
+
== Introduction ==
 
+
<div style="text-align:justify;">
=== Abstract ===
+
This chapter on [[Shvayathu Chikitsa]] (treatment of swelling) follows the chapter on ''kshata-kshina'' because in both the diseases vital organs are involved. ''Charaka'' defines ''shvayathu'' as bulging (''utsedha'') from the skin and this chapter mainly deals with the management of various types of general swellings and  local swellings such as ''pidika'' (papules and pustules), nodules (including ''gandhamala''), large swellings like [[galaganda]] (goiter), tumor etc are also described.   
 
 
This chapter deals with the treatment of various types of swellings like generalized edema and local eruptions including pustules, nodules and tumors. The etiological factors for these swellings can be endogenous (''nija'') or exogenous (''agantuja''). In all types of swellings, three ''doshas'' are involved but it is named according to the dominance of the ''dosha''. After describing general symptoms and signs of the swelling, specific symptoms and signs of ''vata, pitta'' and ''kapha'' as well as of incurable and curable swellings are explained.
 
 
 
Line of treatment depends upon type of swelling as well as involved parts of the body; wholesome and unwholesome diet and lifestyle for the benefit of the patient is explained. Detailed treatments along with drug preparations, internal and external therapeutic measures are discussed according to ''vata, pitta'' and ''kapha'' types of swelling.
 
 
 
Local swellings occurring in the various parts of the body in the form of papules, pustules, nodules, tumors etc are described in the last part of the chapter. It includes ''shaluka'' (quinsy), ''Bidalika'' (Ludwig’s angina), ''Taluvidradhi'' (palatal abscess), ''Upajihivika'' (superficial glossitis), ''Upakusha'' (gingivitis) and ''Danta-Vidradhi'' (dental abscess) which occurs in buccal cavity and generally included in Śālākya specialty. ''Galagandha'' is goiter and ''gandhamala'' and ''granthi'' are mainly related with various types of swellings of lymph nodes. ''Arbuda'' (tumor), ''alaji'' (inflammation of eye), ''akshata'' (whitlow), ''vidarika'' (lymphadenitis), ''visphotaka'' (eruption), ''kaksha'' (herpes zoster), ''romantika'' (measles), ''masurika'' (chickenpox), ''bradhna'' (hernia), ''bhagandara'' (fistula-in-ano), ''shleepada'' (elephantiasis), ''jalakagardabha'' (acute sprading inflammation), ''abhighataja'' (traumatic) and ''vishaja'' (poisonous) swellings along with their medical treatment and wherever necessary surgical measures are also described. Difference and similarity between ''granthi'' and ''arbuda'' are also mentioned.
 
 
 
 
 
'''Keywords''': ''Shvayathu, shotha, shopha,'' edema, swelling, ''langhana, amapachana, shodhana''.
 
 
 
=== Introduction ===
 
 
 
This chapter on [[Shvayathu Chikitsa]] (treatment of swelling) follows the chapter on ''kshata-kshina'' because in both the diseases vital organs are involved. ''Charaka'' defines ''shvayathu'' as bulging (''utsedha'') from the skin and this chapter mainly deals with the management of various types of general swellings and  local swellings such as ''pidika'' (papules and pustules), nodules (including ''gandhamala''), large swellings like ''galagandha'' (goiter), tumor etc are also described.   
 
 
   
 
   
Chapter 18th of [[Sutra Sthana]] deals with diagnostic aspects of swelling under the name of ''tri-shothiya''. Therein the word ''shopha'' is frequently used for sotha. Thus, the words ''shvayathu, shotha'' and ''shopha'' are used as synonyms and all denote edema or swelling. For inflammatory swelling Sushruta has used the word ''vrana-shotha''.
+
Chapter 18th of [[Sutra Sthana]] deals with diagnostic aspects of swelling under the name of ''[[trishothiya]]''. Therein the word ''shopha'' is frequently used for shotha. Thus, the words ''shvayathu, shotha'' and ''shopha'' are used as synonyms and all denote edema or swelling. For inflammatory swelling Sushruta has used the word ''vrana-shotha''.
 
    
 
    
In the [[Sutra Sthana]], Charaka classified ''shotha'' in many ways but in this chapter which is mainly on the treatment, only those classifications are given which are important from treatment point of view, such as three types according to ''dosha'' viz, ''vata, pitta'' and ''kapha''; two types viz. ''nija'' (endogenous) and ''agantuja'' (exogenous) as well as ''ekanga'' (local) and ''sarvanga'' (generalized ) types.
+
In the [[Sutra Sthana]], Charaka classified ''shotha'' in many ways but in this chapter which is mainly on the treatment, only those classifications are given which are important from treatment point of view, such as three types according to ''[[dosha]]'' viz, ''[[vata]], [[pitta]]'' and ''[[kapha]]''; two types viz. ''nija'' (endogenous) and ''agantuja'' (exogenous) as well as ''ekanga'' (local) and ''sarvanga'' (generalized ) types.
  
===Sanskrit text, Transliteration and English Translation===
+
== Sanskrit text, Transliteration and English Translation ==
 +
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अथातः श्वयथुचिकित्सितं व्याख्यास्यामः||१||  
 
अथातः श्वयथुचिकित्सितं व्याख्यास्यामः||१||  
  
 
इति ह स्माह भगवानात्रेयः||२||     
 
इति ह स्माह भगवानात्रेयः||२||     
 +
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athātaḥ śvayathucikitsitaṁ vyākhyāsyāmaḥ||1||  
 
athātaḥ śvayathucikitsitaṁ vyākhyāsyāmaḥ||1||  
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iti ha smAha bhagavAnAtreyaH||2||
 
iti ha smAha bhagavAnAtreyaH||2||
 +
</div></div>
  
Herefrom the treatment of swelling will be described. Thus said Lord Atreya [1-2]
+
Now we shall expound the chapter "Shvayathu chikitsa" (Management of different types of swelling). Thus said Lord Atreya. [1-2]
 +
<div class="mw-collapsible mw-collapsed">
  
भिषग्वरिष्ठं सुरसिद्धजुष्टं मुनीन्द्रमत्र्यात्मजमग्निवेशः|  
+
भिषग्वरिष्ठं सुरसिद्धजुष्टं मुनीन्द्रमत्र्यात्मजमग्निवेशः| <br />
महागदस्य श्वयथोर्यथावत् प्रकोपरूपप्रशमानपृच्छत्||३||  
+
महागदस्य श्वयथोर्यथावत् प्रकोपरूपप्रशमानपृच्छत्||३|| <br />
 +
<div class="mw-collapsible-content">
  
bhiṣagvariṣṭhaṁ surasiddhajuṣṭaṁ munīndramatryātmajamagnivēśaḥ|  
+
bhiṣagvariṣṭhaṁ surasiddhajuṣṭaṁ munīndramatryātmajamagnivēśaḥ| <br />
mahāgadasya śvayathōryathāvat prakōparūpapraśamānapr̥cchat||3||
+
mahāgadasya śvayathōryathāvat prakōparūpapraśamānapr̥cchat||3||<br />
  
bhiShagvariShThaM surasiddhajuShTaM munIndramatryAtmajamagniveshaH|  
+
bhiShagvariShThaM surasiddhajuShTaM munIndramatryAtmajamagniveshaH| <br />
mahAgadasya shvayathoryathAvat prakoparUpaprashamAnapRucchat||3||
+
mahAgadasya shvayathoryathAvat prakoparUpaprashamAnapRucchat||3||<br />
 +
</div></div>
  
Agnivesha approached the best physician and great sage, the son of Atri sitting midst of gods and saints and requested him to elaborate on the etiology, signs and symptoms and treatment of the major disease- ''svayathu'' [3]
+
Agnivesha approached the best physician and great sage, the son of Atri sitting midst of gods and saints and requested him to elaborate on the etiology, signs and symptoms and treatment of the major disease- ''shvayathu'' [3]
 +
<div class="mw-collapsible mw-collapsed">
  
तस्मै जगादागदवेदसिन्धुप्रवर्तनाद्रिप्रवरोऽत्रिजस्तान्|  
+
तस्मै जगादागदवेदसिन्धुप्रवर्तनाद्रिप्रवरोऽत्रिजस्तान्| <br />
वातादिभेदात्त्रिविधस्य सम्यङ्निजानिजैकाङ्गजसर्वजस्य||४||  
+
वातादिभेदात्त्रिविधस्य सम्यङ्निजानिजैकाङ्गजसर्वजस्य||४|| <br />
 +
<div class="mw-collapsible-content">
  
tasmai jagādāgadavēdasindhupravartanādripravarō'trijastān|  
+
tasmai jagādāgadavēdasindhupravartanādripravarō'trijastān| <br />
vātādibhēdāttrividhasya samyaṅnijānijaikāṅgajasarvajasya||4||
+
vātādibhēdāttrividhasya samyaṅnijānijaikāṅgajasarvajasya||4||<br />
  
tasmai jagAdAgadavedasindhupravartanAdripravaro~atrijastAn|  
+
tasmai jagAdAgadavedasindhupravartanAdripravaro~atrijastAn| <br />
vAtAdibhedAttrividhasya samya~gnijAnijaikA~ggajasarvajasya||4||
+
vAtAdibhedAttrividhasya samya~gnijAnijaikA~ggajasarvajasya||4||<br />
 +
</div></div>
  
 
Sage Atreya who is like Himalaya from which flows out the Indus of the science of healing, fully expounded the subject of swellings of three types based on ''tridosha, nija'' and ''agantuja'' based on etiology and ''ekanga'' and ''sarvanga'' type according to location [4]
 
Sage Atreya who is like Himalaya from which flows out the Indus of the science of healing, fully expounded the subject of swellings of three types based on ''tridosha, nija'' and ''agantuja'' based on etiology and ''ekanga'' and ''sarvanga'' type according to location [4]
 
   
 
   
==== Causative factors of ''nija'' (endogenous) swelling/edema ====
+
=== Causative factors of ''nija'' (endogenous) swelling/edema ===
 +
<div class="mw-collapsible mw-collapsed">
  
शुद्ध्यामयाभक्तकृशाबलानां क्षाराम्लतीक्ष्णोष्णगुरूपसेवा|  
+
शुद्ध्यामयाभक्तकृशाबलानां क्षाराम्लतीक्ष्णोष्णगुरूपसेवा| <br />
दध्याममृच्छाकविरोधिदुष्टगरोपसृष्टान्ननिषेवणं च||५||  
+
दध्याममृच्छाकविरोधिदुष्टगरोपसृष्टान्ननिषेवणं च||५|| <br />
  
अर्शांस्यचेष्टा न च देहशुद्धिर्मर्मोपघातो विषमा प्रसूतिः|  
+
अर्शांस्यचेष्टा न च देहशुद्धिर्मर्मोपघातो विषमा प्रसूतिः| <br />
मिथ्योपचारः प्रतिकर्मणां च निजस्य हेतुः श्वयथोः प्रदिष्टः||६||
+
मिथ्योपचारः प्रतिकर्मणां च निजस्य हेतुः श्वयथोः प्रदिष्टः||६||<br />
 +
<div class="mw-collapsible-content">
  
śuddhyāmayābhaktakr̥śābalānāṁ kṣārāmlatīkṣṇōṣṇagurūpasēvā|  
+
śuddhyāmayābhaktakr̥śābalānāṁ kṣārāmlatīkṣṇōṣṇagurūpasēvā| <br />
dadhyāmamr̥cchākavirōdhiduṣṭagarōpasr̥ṣṭānnaniṣēvaṇaṁ ca||5||  
+
dadhyāmamr̥cchākavirōdhiduṣṭagarōpasr̥ṣṭānnaniṣēvaṇaṁ ca||5|| <br />
  
arśāṁsyacēṣṭā na ca dēhaśuddhirmarmōpaghātō viṣamā prasūtiḥ|  
+
arśāṁsyacēṣṭā na ca dēhaśuddhirmarmōpaghātō viṣamā prasūtiḥ| <br />
mithyōpacāraḥ pratikarmaṇāṁ ca nijasya hētuḥ śvayathōḥ pradiṣṭaḥ||6||
+
mithyōpacāraḥ pratikarmaṇāṁ ca nijasya hētuḥ śvayathōḥ pradiṣṭaḥ||6||<br />
  
shuddhyAmayAbhaktakRushAbalAnAM kShArAmlatIkShNoShNagurUpasevA|  
+
shuddhyAmayAbhaktakRushAbalAnAM kShArAmlatIkShNoShNagurUpasevA| <br />
dadhyAmamRucchAkavirodhiduShTagaropasRuShTAnnaniShevaNaM ca||5||  
+
dadhyAmamRucchAkavirodhiduShTagaropasRuShTAnnaniShevaNaM ca||5|| <br />
  
arshAMsyaceShTA na ca dehashuddhirmarmopaghAto viShamA prasUtiH|  
+
arshAMsyaceShTA na ca dehashuddhirmarmopaghAto viShamA prasUtiH| <br />
mithyopacAraH pratikarmaNAM ca nijasya hetuH shvayathoH pradiShTaH||6||
+
mithyopacAraH pratikarmaNAM ca nijasya hetuH shvayathoH pradiShTaH||6||<br />
 +
</div></div>
  
Excessive use of ''kshara'' (alkali) or food articles having sour, sharply acting, hot and heavy properties by an emaciated or weak person due to excessive ''shodhana'', fasting or disease.  
+
Excessive use of ''kshara'' (alkali) or food articles having sour, sharply acting, hot and heavy properties by an emaciated or weak person due to excessive ''[[shodhana]]'', fasting or disease.  
  
Excessive intake of curd, raw food articles, soil, leafy vegetables, mutually contradictory food articles (''virodhi''), spoiled or mixed with toxic substance (such as pesticide), or a person suffering from piles, having sedentary life style, nonperforming of ''shodhana'' therapy even if indicated, injury to vital organs (''marma''), abnormal delivery, due to improper treatment and as complication of improper purification treatment [5-6]
+
Excessive intake of curd, raw food articles, soil, leafy vegetables, mutually contradictory food articles (''virodhi''), spoiled or mixed with toxic substance (such as pesticide), or a person suffering from piles, having sedentary life style, nonperforming of ''[[shodhana]]'' therapy even if indicated, injury to vital organs (''marma''), abnormal delivery, due to improper treatment and as complication of improper purification treatment [5-6]
  
==== Causative factors of ''agantuka'' (exogenous) swelling ====
+
=== Causative factors of ''agantuka'' (exogenous) swelling ===
 +
<div class="mw-collapsible mw-collapsed">
  
 
बाह्यास्त्वचो दूषयिताऽभिघातः काष्ठाश्मशस्त्राग्निविषायसाद्यैः [१] |  
 
बाह्यास्त्वचो दूषयिताऽभिघातः काष्ठाश्मशस्त्राग्निविषायसाद्यैः [१] |  
  
 
आगन्तुहेतुःत्रिविधो निजश्च सर्वार्धगात्रावयवाश्रितत्वात्||७||
 
आगन्तुहेतुःत्रिविधो निजश्च सर्वार्धगात्रावयवाश्रितत्वात्||७||
 +
<div class="mw-collapsible-content">
  
 
bāhyāstvacō dūṣayitā'bhighātaḥ kāṣṭhāśmaśastrāgniviṣāyasādyaiḥ [1] |  
 
bāhyāstvacō dūṣayitā'bhighātaḥ kāṣṭhāśmaśastrāgniviṣāyasādyaiḥ [1] |  
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AgantuhetuH trividho nijashca sarvArdhagAtrAvayavAshritatvAt||7||
 
AgantuhetuH trividho nijashca sarvArdhagAtrAvayavAshritatvAt||7||
 +
</div></div>
  
 
External causative factors of swelling are trauma to skin with wood, stone, weapon, fire, poison etc.  
 
External causative factors of swelling are trauma to skin with wood, stone, weapon, fire, poison etc.  
Line 116: Line 146:
 
Endogenous swelling is of three types i.e. of whole body, half body or limited to one part or organ [7]
 
Endogenous swelling is of three types i.e. of whole body, half body or limited to one part or organ [7]
  
==== Pathogenesis of swelling ====
+
=== Pathogenesis of swelling ===
 +
<div class="mw-collapsible mw-collapsed">
  
बाह्याः सिराः प्राप्य यदा कफासृक्पित्तानि सन्दूषयतीह वायुः|  
+
बाह्याः सिराः प्राप्य यदा कफासृक्पित्तानि सन्दूषयतीह वायुः| <br />
तैर्बद्धमार्गः स तदा विसर्पन्नुत्सेधलिङ्गं श्वयथुं करोति||८||  
+
तैर्बद्धमार्गः स तदा विसर्पन्नुत्सेधलिङ्गं श्वयथुं करोति||८|| <br />
  
उरःस्थितैरूर्ध्वमधस्तु [१] वायोः स्थानस्थितैर्मध्यगतैस्तु मध्ये|  
+
उरःस्थितैरूर्ध्वमधस्तु [१] वायोः स्थानस्थितैर्मध्यगतैस्तु मध्ये| <br />
सर्वाङ्गगः सर्वगतैः क्वचित्स्थैर्दोषैः क्वचित् स्याच्छ्वयथुस्तदाख्यः||९||
+
सर्वाङ्गगः सर्वगतैः क्वचित्स्थैर्दोषैः क्वचित् स्याच्छ्वयथुस्तदाख्यः||९||<br />
 +
<div class="mw-collapsible-content">
  
bāhyāḥ sirāḥ prāpya yadā kaphāsr̥kpittāni sandūṣayatīha vāyuḥ|  
+
bāhyāḥ sirāḥ prāpya yadā kaphāsr̥kpittāni sandūṣayatīha vāyuḥ| <br />
tairbaddhamārgaḥ sa tadā visarpannutsēdhaliṅgaṁ śvayathuṁ karōti||8||  
+
tairbaddhamārgaḥ sa tadā visarpannutsēdhaliṅgaṁ śvayathuṁ karōti||8|| <br />
  
uraḥsthitairūrdhvamadhastu [1] vāyōḥ sthānasthitairmadhyagataistu madhyē|  
+
uraḥsthitairūrdhvamadhastu [1] vāyōḥ sthānasthitairmadhyagataistu madhyē| <br />
sarvāṅgagaḥ sarvagataiḥ kvacitsthairdōṣaiḥ kvacit syācchvayathustadākhyaḥ||9||
+
sarvāṅgagaḥ sarvagataiḥ kvacitsthairdōṣaiḥ kvacit syācchvayathustadākhyaḥ||9||<br />
  
bAhyAH sirAH prApya yadA kaphAsRukpittAni sandUShayatIha vAyuH|  
+
bAhyAH sirAH prApya yadA kaphAsRukpittAni sandUShayatIha vAyuH| <br />
tairbaddhamArgaH sa tadA visarpannutsedhali~ggaM shvayathuM karoti||8||
+
tairbaddhamArgaH sa tadA visarpannutsedhali~ggaM shvayathuM karoti||8||<br />
  
uraHsthitairUrdhvamadhastu [1] vAyoH sthAnasthitairmadhyagataistu madhye|  
+
uraHsthitairUrdhvamadhastu [1] vAyoH sthAnasthitairmadhyagataistu madhye| <br />
sarvA~ggagaH sarvagataiH kvacitsthairdoShaiH kvacit syAcchvayathustadAkhyaH||9||
+
sarvA~ggagaH sarvagataiH kvacitsthairdoShaiH kvacit syAcchvayathustadAkhyaH||9||<br />
 +
</div></div>
  
Morbid ''vata'' is obstructed by vitiated ''kapha, rakta'' and ''pitta'' aggravated at the site of peripheral superficial vessels. This vitiated ''vata'' (due to obstruction) spreads to the various places causing swelling as its cardinal symptom.   
+
Morbid ''[[vata]]'' is obstructed by vitiated ''[[kapha]], [[rakta]]'' and ''[[pitta]]'' aggravated at the site of peripheral superficial vessels. This vitiated ''[[vata]]'' (due to obstruction) spreads to the various places causing swelling as its cardinal symptom.   
  
If the ''vata'' lodges in the chest, then it causes edema of upper parts of the body; if it lodges in its own place i.e. lower parts then it causes edema of lower parts and if it lodges in middle then it causes edema of middle parts.
+
If the ''[[vata]]'' lodges in the chest, then it causes edema of upper parts of the body; if it lodges in its own place i.e. lower parts then it causes edema of lower parts and if it lodges in middle then it causes edema of middle parts.
  
If ''vata'' spreads in the entire body then it causes edema all over the body but if it lodges in one place then it causes local swelling of that part or organ. These swellings are named after the particular region that it affects [8-9]
+
If ''[[vata]]'' spreads in the entire body then it causes edema all over the body but if it lodges in one place then it causes local swelling of that part or organ. These swellings are named after the particular region that it affects [8-9]
  
==== Prodromal symptoms of edema ====
+
=== Prodromal symptoms of edema ===
 +
<div class="mw-collapsible mw-collapsed">
  
 
ऊष्मा तथा स्याद्दवथुः सिराणामायाम इत्येव च पूर्वरूपम्|  
 
ऊष्मा तथा स्याद्दवथुः सिराणामायाम इत्येव च पूर्वरूपम्|  
 +
<div class="mw-collapsible-content">
  
 
ūṣmā tathā syāddavathuḥ sirāṇāmāyāma ityēva ca pūrvarūpam|  
 
ūṣmā tathā syāddavathuḥ sirāṇāmāyāma ityēva ca pūrvarūpam|  
  
 
UShmA tathA syAddavathuH sirANAmAyAma ityeva ca pUrvarUpam|
 
UShmA tathA syAddavathuH sirANAmAyAma ityeva ca pUrvarUpam|
 +
</div></div>
  
 
Rise in temperature, burning sensation as if burnt by fire and dilation of the vessels are the prodromal symptoms of swelling [9½]
 
Rise in temperature, burning sensation as if burnt by fire and dilation of the vessels are the prodromal symptoms of swelling [9½]
  
==== Swelling is ''tridoshaja'' ====
+
=== ''Tridoshaja'' nature of all swellings ===
 +
<div class="mw-collapsible mw-collapsed">
  
 
सर्वस्त्रिदोषोऽधिकदोषलिङ्गैस्तच्छब्दमभ्येति भिषग्जितं च||१०||  
 
सर्वस्त्रिदोषोऽधिकदोषलिङ्गैस्तच्छब्दमभ्येति भिषग्जितं च||१०||  
 +
<div class="mw-collapsible-content">
  
 
sarvastridōṣō'dhikadōṣaliṅgaistacchabdamabhyēti bhiṣagjitaṁ ca||10||
 
sarvastridōṣō'dhikadōṣaliṅgaistacchabdamabhyēti bhiṣagjitaṁ ca||10||
  
 
sarvastridoSho~adhikadoShali~ggaistacchabdamabhyeti bhiShagjitaM ca||10||
 
sarvastridoSho~adhikadoShali~ggaistacchabdamabhyeti bhiShagjitaM ca||10||
 +
</div></div>
  
All types of swelling are produced by involvement of all the three ''dosha'' but they are named based on the predominance of that particular ''dosha''. The line of treatment is also according to the dominant ''dosha'' [10]
+
All types of swelling are produced by involvement of all the three ''[[dosha]]'' but they are named based on the predominance of that particular ''[[dosha]]''. The line of treatment is also according to the dominant ''[[dosha]]'' [10]
  
==== General symptoms of swelling ====
+
=== General symptoms of swelling ===
 +
<div class="mw-collapsible mw-collapsed">
  
सगौरवं स्यादनवस्थितत्वं सोत्सेधमुष्माऽथ सिरातनुत्वम्|  
+
सगौरवं स्यादनवस्थितत्वं सोत्सेधमुष्माऽथ सिरातनुत्वम्| <br />
सलोमहर्षाऽङ्गविवर्णता च सामान्यलिङ्गं श्वयथोः प्रदिष्टम्||११||  
+
सलोमहर्षाऽङ्गविवर्णता च सामान्यलिङ्गं श्वयथोः प्रदिष्टम्||११|| <br />
 +
<div class="mw-collapsible-content">
  
sagauravaṁ syādanavasthitatvaṁ sōtsēdhamuṣmā'tha sirātanutvam|  
+
sagauravaṁ syādanavasthitatvaṁ sōtsēdhamuṣmā'tha sirātanutvam| <br />
salōmaharṣā'ṅgavivarṇatā ca sāmānyaliṅgaṁ śvayathōḥ pradiṣṭam||11||
+
salōmaharṣā'ṅgavivarṇatā ca sāmānyaliṅgaṁ śvayathōḥ pradiṣṭam||11||<br />
  
sagauravaM syAdanavasthitatvaM sotsedhamuShmA~atha sirAtanutvam|  
+
sagauravaM syAdanavasthitatvaM sotsedhamuShmA~atha sirAtanutvam| <br />
salomaharShA~a~ggavivarNatA ca sAmAnyali~ggaM shvayathoH pradiShTam||11||
+
salomaharShA~a~ggavivarNatA ca sAmAnyali~ggaM shvayathoH pradiShTam||11||<br />
 +
</div></div>
  
 
Heaviness, movability, bulging, heat, thinning of the vessels, horripilation and discoloration of the affected skin are the general signs and symptoms of edema [11]  
 
Heaviness, movability, bulging, heat, thinning of the vessels, horripilation and discoloration of the affected skin are the general signs and symptoms of edema [11]  
 
    
 
    
==== Symptoms of ''vataja'' dominant edema/swelling ====
+
=== Symptoms of ''[[vata]]ja'' dominant edema/swelling ===
 +
<div class="mw-collapsible mw-collapsed">
  
चलस्तनुत्वक्परुषोऽरुणोऽसितः प्रसुप्तिहर्षार्तियुतोऽनिमित्ततः|  
+
चलस्तनुत्वक्परुषोऽरुणोऽसितः प्रसुप्तिहर्षार्तियुतोऽनिमित्ततः| <br />
प्रशाम्यति प्रोन्नमति प्रपीडितो दिवाबली च श्वयथुः समीरणात्||१२||  
+
प्रशाम्यति प्रोन्नमति प्रपीडितो दिवाबली च श्वयथुः समीरणात्||१२|| <br />
 +
<div class="mw-collapsible-content">
  
calastanutvakparuṣō'ruṇō'sitaḥ prasuptiharṣārtiyutō'nimittataḥ|  
+
calastanutvakparuṣō'ruṇō'sitaḥ prasuptiharṣārtiyutō'nimittataḥ| <br />
praśāmyati prōnnamati prapīḍitō divābalī ca śvayathuḥ samīraṇāt||12||
+
praśāmyati prōnnamati prapīḍitō divābalī ca śvayathuḥ samīraṇāt||12||<br />
  
calastanutvakparuSho~aruNo~asitaH prasuptiharShArtiyuto~animittataH|  
+
calastanutvakparuSho~aruNo~asitaH prasuptiharShArtiyuto~animittataH| <br />
prashAmyati pronnamati prapIDito divAbalI ca shvayathuH samIraNAt||12||
+
prashAmyati pronnamati prapIDito divAbalI ca shvayathuH samIraNAt||12||<br />
 +
</div></div>
  
Skin of the effected part in ''vata'' dominant swelling becomes thin and rough and dry (''parusha''), dusky-brown colored with horripilation and feeling of numbness and discomfort. The swelling is moveable and pitting on pressure but it attains normal position immediately, increases during the day time and often subsides without appreciable reason [12]
+
Skin of the effected part in ''[[vata]]'' dominant swelling becomes thin and rough and dry (''parusha''), dusky-brown colored with horripilation and feeling of numbness and discomfort. The swelling is moveable and pitting on pressure but it attains normal position immediately, increases during the day time and often subsides without appreciable reason [12]
 
   
 
   
==== Symptoms of ''pitta'' dominant swelling (inflammation) ====
+
=== Symptoms of ''[[pitta]]'' dominant swelling (inflammation) ===
 +
<div class="mw-collapsible mw-collapsed">
  
मृदुः सगन्धोऽसितपीतरागवान् भ्रमज्वरस्वेदतृषामदान्वितः|  
+
मृदुः सगन्धोऽसितपीतरागवान् भ्रमज्वरस्वेदतृषामदान्वितः| <br />
य उष्यते स्पर्शरुगक्षिरागकृत् [१] स पित्तशोथो भृशदाहपाकवान्||१३||  
+
य उष्यते स्पर्शरुगक्षिरागकृत् [१] स पित्तशोथो भृशदाहपाकवान्||१३|| <br />
 +
<div class="mw-collapsible-content">
  
mr̥duḥ sagandhō'sitapītarāgavān bhramajvarasvēdatr̥ṣāmadānvitaḥ|  
+
mr̥duḥ sagandhō'sitapītarāgavān bhramajvarasvēdatr̥ṣāmadānvitaḥ| <br />
ya uṣyatē sparśarugakṣirāgakr̥t [1] sa pittaśōthō bhr̥śadāhapākavān||13||
+
ya uṣyatē sparśarugakṣirāgakr̥t [1] sa pittaśōthō bhr̥śadāhapākavān||13||<br />
  
mRuduH sagandho~asitapItarAgavAn bhramajvarasvedatRuShAmadAnvitaH|  
+
mRuduH sagandho~asitapItarAgavAn bhramajvarasvedatRuShAmadAnvitaH| <br />
ya uShyate sparsharugakShirAgakRut [1] sa pittashotho bhRushadAhapAkavAn||13||
+
ya uShyate sparsharugakShirAgakRut [1] sa pittashotho bhRushadAhapAkavAn||13||<br />
 +
</div></div>
  
The ''pitta''-dominant swelling is soft, painful to touch, with specific odor and blackish, yellow or red colored skin and has tendency of turning to abscess. It is accompanied with excessive burning sensation, fever, perspiration, giddiness, thirst, redness in eyes and intoxication [13]   
+
The ''[[pitta]]''-dominant swelling is soft, painful to touch, with specific odor and blackish, yellow or red colored skin and has tendency of turning to abscess. It is accompanied with excessive burning sensation, fever, perspiration, giddiness, thirst, redness in eyes and intoxication [13]   
  
==== Symptoms of ''kapha''-dominant edema ====
+
=== Symptoms of ''[[kapha]]''-dominant edema ===
 +
<div class="mw-collapsible mw-collapsed">
  
गुरुः स्थिरः पाण्डुररोचकान्वितः प्रसेकनिद्रावमिवह्निमान्द्यकृत्|  
+
गुरुः स्थिरः पाण्डुररोचकान्वितः प्रसेकनिद्रावमिवह्निमान्द्यकृत्| <br />
स कृच्छ्रजन्मप्रशमो निपीडितो न चोन्नमेद्रात्रिबली कफात्मकः||१४||  
+
स कृच्छ्रजन्मप्रशमो निपीडितो न चोन्नमेद्रात्रिबली कफात्मकः||१४|| <br />
 +
<div class="mw-collapsible-content">
  
guruḥ sthiraḥ pāṇḍurarōcakānvitaḥ prasēkanidrāvamivahnimāndyakr̥t|  
+
guruḥ sthiraḥ pāṇḍurarōcakānvitaḥ prasēkanidrāvamivahnimāndyakr̥t| <br />
sa kr̥cchrajanmapraśamō nipīḍitō na cōnnamēdrātribalī kaphātmakaḥ||14||
+
sa kr̥cchrajanmapraśamō nipīḍitō na cōnnamēdrātribalī kaphātmakaḥ||14||<br />
  
guruH sthiraH pANDurarocakAnvitaH prasekanidrAvamivahnimAndyakRut|  
+
guruH sthiraH pANDurarocakAnvitaH prasekanidrAvamivahnimAndyakRut| <br />
sa kRucchrajanmaprashamo nipIDito na connamedrAtribalI kaphAtmakaH||14||
+
sa kRucchrajanmaprashamo nipIDito na connamedrAtribalI kaphAtmakaH||14||<br />
 +
</div></div>
  
''Kapha''-dominant swelling is heavy and firm/immovable. It is associated with anemia, anorexia, low digestion, water-brash, vomiting and sleepiness. It appears and disappears very slowly and on pressing it takes long time to attain its normal position and increases at the night time [14]
+
''[[Kapha]]''-dominant swelling is heavy and firm/immovable. It is associated with anemia, anorexia, low digestion, water-brash, vomiting and sleepiness. It appears and disappears very slowly and on pressing it takes long time to attain its normal position and increases at the night time [14]
 
    
 
    
==== Symptoms of bad prognostic of edema ====
+
=== Symptoms of bad prognostic of edema ===
 +
<div class="mw-collapsible mw-collapsed">
  
कृशस्य रोगैरबलस्य यो भवेदुपद्रवैर्वा वमिपूर्वकैर्युतः|  
+
कृशस्य रोगैरबलस्य यो भवेदुपद्रवैर्वा वमिपूर्वकैर्युतः| <br />
स हन्ति मर्मानुगतोऽथ राजिमान् परिस्रवेद्धीनबलस्य सर्वगः||१५||  
+
स हन्ति मर्मानुगतोऽथ राजिमान् परिस्रवेद्धीनबलस्य सर्वगः||१५|| <br />
 +
<div class="mw-collapsible-content">
  
kr̥śasya rōgairabalasya yō bhavēdupadravairvā vamipūrvakairyutaḥ|  
+
kr̥śasya rōgairabalasya yō bhavēdupadravairvā vamipūrvakairyutaḥ| <br />
sa hanti marmānugatō'tha rājimān parisravēddhīnabalasya sarvagaḥ||15||
+
sa hanti marmānugatō'tha rājimān parisravēddhīnabalasya sarvagaḥ||15||<br />
  
kRushasya rogairabalasya yo bhavedupadravairvA vamipUrvakairyutaH|  
+
kRushasya rogairabalasya yo bhavedupadravairvA vamipUrvakairyutaH| <br />
sa hanti marmAnugato~atha rAjimAn parisraveddhInabalasya sarvagaH||15||
+
sa hanti marmAnugato~atha rAjimAn parisraveddhInabalasya sarvagaH||15||<br />
 +
</div></div>
  
 
The edema/swelling of the patient, whose body is emaciated and weakened by a disease or is debilitated, or having complications or associated with vomiting, involving vital organs or whole body or spread with prominent vessels or in which profuse discharge oozes out, leads to death [15]
 
The edema/swelling of the patient, whose body is emaciated and weakened by a disease or is debilitated, or having complications or associated with vomiting, involving vital organs or whole body or spread with prominent vessels or in which profuse discharge oozes out, leads to death [15]
  
==== Symptoms of easily curable swelling ====
+
=== Symptoms of easily curable swelling ===
 +
<div class="mw-collapsible mw-collapsed">
  
अहीनमांसस्य य एकदोषजो नवो बलस्थस्य सुखः स साधने|  
+
अहीनमांसस्य य एकदोषजो नवो बलस्थस्य सुखः स साधने| <br />
निदानदोषर्तुविपर्ययक्रमैरुपाचरेत्तं बलदोषकालवित्||१६||  
+
निदानदोषर्तुविपर्ययक्रमैरुपाचरेत्तं बलदोषकालवित्||१६|| <br />
 +
<div class="mw-collapsible-content">
  
ahīnamāṁsasya ya ēkadōṣajō navō balasthasya sukhaḥ sa sādhanē|  
+
ahīnamāṁsasya ya ēkadōṣajō navō balasthasya sukhaḥ sa sādhanē|<br />
nidānadōṣartuviparyayakramairupācarēttaṁ baladōṣakālavit||16||
+
nidānadōṣartuviparyayakramairupācarēttaṁ baladōṣakālavit||16||<br />
  
ahInamAMsasya ya ekadoShajo navo balasthasya sukhaH sa sAdhane|
+
ahInamAMsasya ya ekadoShajo navo balasthasya sukhaH sa sAdhane|<br />
nidAnadoShartuviparyayakramairupAcarettaM baladoShakAlavit||16||
+
nidAnadoShartuviparyayakramairupAcarettaM baladoShakAlavit||16||<br />
 +
</div></div>
  
The swelling of a patient who is neither emaciated nor weak; that involved single ''dosha'' or is of recent origin is easily curable.
+
The swelling of a patient who is neither emaciated nor weak; that involved single ''[[dosha]]'' or is of recent origin is easily curable.
The physician expert in the knowledge of strength, ''dosha'' and proper time of treatment should treat the curable patients by prescribing such measures which are opposite to cause, ''dosha'' and season [16]
+
The physician expert in the knowledge of strength, ''[[dosha]]'' and proper time of treatment should treat the curable patients by prescribing such measures which are opposite to cause, ''[[dosha]]'' and season [16]
  
==== Line of treatment of edema/swelling ====
+
=== Principles of treatment of edema/swelling ===
 +
<div class="mw-collapsible mw-collapsed">
  
अथामजं लङ्घनपाचनक्रमैर्विशोधनैरुल्बणदोषमादितः|  
+
अथामजं लङ्घनपाचनक्रमैर्विशोधनैरुल्बणदोषमादितः| <br />
शिरोगतं शीर्षविरेचनैरधो [४] विरेचनैरूर्ध्वहरैस्तथोर्ध्वजम्||१७||  
+
शिरोगतं शीर्षविरेचनैरधो [४] विरेचनैरूर्ध्वहरैस्तथोर्ध्वजम्||१७|| <br />
  
उपाचरेत् स्नेहभवं विरूक्षणैः प्रकल्पयेत् स्नेहविधिं च रूक्षजे|  
+
उपाचरेत् स्नेहभवं विरूक्षणैः प्रकल्पयेत् स्नेहविधिं च रूक्षजे| <br />
विबद्धविट्केऽनिलजे निरूहणं घृतं तु पित्तानिलजे सतिक्तकम्||१८||  
+
विबद्धविट्केऽनिलजे निरूहणं घृतं तु पित्तानिलजे सतिक्तकम्||१८|| <br />
  
पयश्च मूर्च्छारतिदाहतर्षिते विशोधनीये तु समूत्रमिष्यते|  
+
पयश्च मूर्च्छारतिदाहतर्षिते विशोधनीये तु समूत्रमिष्यते| <br />
कफोत्थितं क्षारकटूष्णसंयुतैः समूत्रतक्रासवयुक्तिभिर्जयेत्||१९||  
+
कफोत्थितं क्षारकटूष्णसंयुतैः समूत्रतक्रासवयुक्तिभिर्जयेत्||१९|| <br />
 +
<div class="mw-collapsible-content">
  
athāmajaṁ laṅghanapācanakramairviśōdhanairulbaṇadōṣamāditaḥ|  
+
athāmajaṁ laṅghanapācanakramairviśōdhanairulbaṇadōṣamāditaḥ| <br />
śirōgataṁ śīrṣavirēcanairadhō [4] virēcanairūrdhvaharaistathōrdhvajam||17||  
+
śirōgataṁ śīrṣavirēcanairadhō [4] virēcanairūrdhvaharaistathōrdhvajam||17|| <br />
  
upācarēt snēhabhavaṁ virūkṣaṇaiḥ prakalpayēt snēhavidhiṁ ca rūkṣajē|  
+
upācarēt snēhabhavaṁ virūkṣaṇaiḥ prakalpayēt snēhavidhiṁ ca rūkṣajē| <br />
vibaddhaviṭkē'nilajē nirūhaṇaṁ ghr̥taṁ tu pittānilajē satiktakam||18||  
+
vibaddhaviṭkē'nilajē nirūhaṇaṁ ghr̥taṁ tu pittānilajē satiktakam||18|| <br />
  
payaśca mūrcchāratidāhatarṣitē viśōdhanīyē tu samūtramiṣyatē|  
+
payaśca mūrcchāratidāhatarṣitē viśōdhanīyē tu samūtramiṣyatē| <br />
kaphōtthitaṁ kṣārakaṭūṣṇasaṁyutaiḥ samūtratakrāsavayuktibhirjayēt||19||
+
kaphōtthitaṁ kṣārakaṭūṣṇasaṁyutaiḥ samūtratakrāsavayuktibhirjayēt||19||<br />
  
athAmajaM la~gghanapAcanakramairvishodhanairulbaNadoShamAditaH|  
+
athAmajaM la~gghanapAcanakramairvishodhanairulbaNadoShamAditaH| <br />
shirogataM shIrShavirecanairadho [4] virecanairUrdhvaharaistathordhvajam||17||  
+
shirogataM shIrShavirecanairadho [4] virecanairUrdhvaharaistathordhvajam||17|| <br />
  
upAcaret snehabhavaM virUkShaNaiH prakalpayet snehavidhiM ca rUkShaje|  
+
upAcaret snehabhavaM virUkShaNaiH prakalpayet snehavidhiM ca rUkShaje| <br />
vibaddhaviTke~anilaje nirUhaNaM ghRutaM tu pittAnilaje satiktakam||18||  
+
vibaddhaviTke~anilaje nirUhaNaM ghRutaM tu pittAnilaje satiktakam||18|| <br />
  
payashca mUrcchAratidAhatarShite vishodhanIye tu samUtramiShyate|  
+
payashca mUrcchAratidAhatarShite vishodhanIye tu samUtramiShyate| <br />
kaphotthitaM kShArakaTUShNasaMyutaiH samUtratakrAsavayuktibhirjayet||19||
+
kaphotthitaM kShArakaTUShNasaMyutaiH samUtratakrAsavayuktibhirjayet||19||<br />
 +
</div></div>
  
If swelling is associated with ''ama'' it should be managed first by prescribing lightening therapy (''langhana'') and digestive drugs and only then ''shodhana'' therapy should be undertaken according to dominant ''dosha''. General lines of treatment of ''doshaja'' swelling are as follows:
+
If swelling is associated with ''ama'' it should be managed first by prescribing lightening therapy (''[[langhana]]'') and digestive drugs and only then ''[[shodhana]]'' therapy should be undertaken according to dominant ''[[dosha]]''. General lines of treatment of ''[[dosha]]ja'' swelling are as follows:
  
 
*If it involves head then ''shiro-virechana'' is prescribed;
 
*If it involves head then ''shiro-virechana'' is prescribed;
*If it involves lower parts of the body then ''virechana'' (therapeutic purgation) is prescribed;
+
*If it involves lower parts of the body then ''[[virechana]]'' (therapeutic purgation) is prescribed;
*If it involves upper parts of the body then ''vamana'' (therapeutic emesis)is prescribed;
+
*If it involves upper parts of the body then ''[[vamana]]'' (therapeutic emesis)is prescribed;
*If it is caused by unctuous then ''rukshana'' (drying) therapy is done;
+
*If it is caused by unctuous then ''[[rukshana]]'' (drying) therapy is done;
*If it is caused by un-unctuous (''ruksha'') then unctuous (''snehana'') therapy is done;
+
*If it is caused by un-unctuous (''ruksha'') then unctuous (''[[snehana]]'') therapy is done;
*If ''vata'' swelling is associated with constipation then it should be treated with ''niruha basti'';
+
*If ''[[vata]]'' swelling is associated with constipation then it should be treated with ''niruha [[basti]]'';
*If it is caused by ''vata-pitta'' then it should be treated with ghee prepared with bitter drugs;
+
*If it is caused by ''[[vata]]-[[pitta]]'' then it should be treated with ghee prepared with bitter drugs;
 
*If the patient is suffering from associated symptoms such as fainting, pain, burning sensation and thirst then it should be treated with intake of milk;
 
*If the patient is suffering from associated symptoms such as fainting, pain, burning sensation and thirst then it should be treated with intake of milk;
*If the patient is suffering from swelling where ''shodhana'' is required then milk mixed with cow’s urine should be given.
+
*If the patient is suffering from swelling where ''[[shodhana]]'' is required then milk mixed with cow’s urine should be given.
*If the patient is suffering from ''kapha'' swelling then ''kshara'' or pungent and hot articles mixed in cow’s urine or buttermilk or ''asava'' are given [17-19]
+
*If the patient is suffering from ''[[kapha]]'' swelling then ''kshara'' or pungent and hot articles mixed in cow’s urine or buttermilk or ''asava'' are given [17-19]
  
==== ''Apathya'' (to be avoided) for swelling/edema ====
+
=== ''Apathya'' (unwholesome) for swelling/edema ===
 +
<div class="mw-collapsible mw-collapsed">
  
ग्राम्याब्जानूपं पिशितमबलं शुष्कशाकं नवान्नं  
+
ग्राम्याब्जानूपं पिशितमबलं शुष्कशाकं नवान्नं <br />
गौडं पिष्टान्नं दधि तिलकृतं [५] विज्जलं [६] मद्यमम्लम्|  
+
गौडं पिष्टान्नं दधि तिलकृतं [५] विज्जलं [६] मद्यमम्लम्| <br />
धाना वल्लूरं समशनमथो गुर्वसात्म्यं विदाहि  
+
धाना वल्लूरं समशनमथो गुर्वसात्म्यं विदाहि <br />
स्वप्नं चारात्रौ श्वयथुगदवान् वर्जयेन्मैथुनं च||२०||  
+
स्वप्नं चारात्रौ श्वयथुगदवान् वर्जयेन्मैथुनं च||२०|| <br />
 +
<div class="mw-collapsible-content">
  
grāmyābjānūpaṁ piśitamabalaṁ śuṣkaśākaṁ navānnaṁ  
+
grāmyābjānūpaṁ piśitamabalaṁ śuṣkaśākaṁ navānnaṁ <br />
gauḍaṁ piṣṭānnaṁ dadhi tilakr̥taṁ [5] vijjalaṁ [6] madyamamlam|  
+
gauḍaṁ piṣṭānnaṁ dadhi tilakr̥taṁ [5] vijjalaṁ [6] madyamamlam| <br />
dhānā vallūraṁ samaśanamathō gurvasātmyaṁ vidāhi  
+
dhānā vallūraṁ samaśanamathō gurvasātmyaṁ vidāhi <br />
svapnaṁ cārātrau śvayathugadavān varjayēnmaithunaṁ ca||20||
+
svapnaṁ cārātrau śvayathugadavān varjayēnmaithunaṁ ca||20||<br />
  
grAmyAbjAnUpaM pishitamabalaM shuShkashAkaM navAnnaM  
+
grAmyAbjAnUpaM pishitamabalaM shuShkashAkaM navAnnaM <br />
gauDaM piShTAnnaM dadhi tilakRutaM [5] vijjalaM [6] madyamamlam|  
+
gauDaM piShTAnnaM dadhi tilakRutaM [5] vijjalaM [6] madyamamlam| <br />
dhAnA vallUraM samashanamatho gurvasAtmyaM vidAhi  
+
dhAnA vallUraM samashanamatho gurvasAtmyaM vidAhi <br />
svapnaM cArAtrau shvayathugadavAn varjayenmaithunaM ca||20||
+
svapnaM cArAtrau shvayathugadavAn varjayenmaithunaM ca||20||<br />
 +
</div></div>
  
Meat of domestic, aquatic and wet-land animals or weak animals; dry vegetables, fresh grains, molasses, fine flour products, curd, products of sesame, slimy and sour food articles, wine, roasted barley, dried meat, ''samashana'' (taking of mixture of wholesome and unwholesome food), taking of unwholesome, heavy and irritant diet articles, day sleep and sexual acts should be avoided by the patient of edema/swelling [20]
+
Meat of domestic, aquatic and wet-land animals or weak animals; dry vegetables, fresh grains, molasses, fine flour products, curd, products of sesame, slimy and sour food articles, wine, roasted barley, dried meat, ''samashana'' (taking of mixture of wholesome and unwholesome food), taking of unwholesome, heavy and irritant diet articles, day sleep and sexual acts should be avoided by the patient of edema/swelling [20]
+
 
==== ''Vyoshadi churna'' for ''kapha'' swelling/edema ====
+
=== ''Vyoshadi churna'' for ''[[kapha]]'' swelling/edema ===
 +
<div class="mw-collapsible mw-collapsed">
  
व्योषं त्रिवृत्तिक्तकरोहिणी च सायोरजस्का त्रिफलारसेन|  
+
व्योषं त्रिवृत्तिक्तकरोहिणी च सायोरजस्का त्रिफलारसेन| <br />
पीतं कफोत्थं शमयेत्तु शोफं गव्येन मूत्रेण हरीतकी च||२१||  
+
पीतं कफोत्थं शमयेत्तु शोफं गव्येन मूत्रेण हरीतकी च||२१|| <br />
 +
<div class="mw-collapsible-content">
  
vyōṣaṁ trivr̥ttiktakarōhiṇī ca sāyōrajaskā triphalārasēna|  
+
vyōṣaṁ trivr̥ttiktakarōhiṇī ca sāyōrajaskā triphalārasēna| <br />
pītaṁ kaphōtthaṁ śamayēttu śōphaṁ gavyēna mūtrēṇa harītakī ca||21||  
+
pītaṁ kaphōtthaṁ śamayēttu śōphaṁ gavyēna mūtrēṇa harītakī ca||21|| <br />
  
vyoShaM trivRuttiktakarohiNI ca sAyorajaskA triphalArasena|  
+
vyoShaM trivRuttiktakarohiNI ca sAyorajaskA triphalArasena| <br />
pItaM kaphotthaM shamayettu shophaM gavyena mUtreNa harItakI ca||21||   
+
pItaM kaphotthaM shamayettu shophaM gavyena mUtreNa harItakI ca||21||  <br />
 +
</div></div>
 
 
Mixture of powders of ''trikatu, trivrit, katuka'' and ''lauha-bhasma'' taken with juice of ''triphala''; or ''haritaki'' powder taken by mixing with cow’s urine relieves ''kapha'' edema/swelling [21]
+
Mixture of powders of ''trikatu, trivrit, katuka'' and ''lauha-bhasma'' taken with juice of ''triphala''; or ''haritaki'' powder taken by mixing with cow’s urine relieves ''[[kapha]]'' edema/swelling [21]
  
==== Recipe for ''tridoshaja'' edema ====
+
=== Remedy for ''tridoshaja'' edema ===
 +
<div class="mw-collapsible mw-collapsed">
  
हरीतकीनागरदेवदारु सुखाम्बुयुक्तं सपुनर्नवं वा|  
+
हरीतकीनागरदेवदारु सुखाम्बुयुक्तं सपुनर्नवं वा| <br />
सर्वं पिबेत्त्रिष्वपि मूत्रयुक्तं स्नातश्च जीर्णे पयसाऽन्नमद्यात्||२२||  
+
सर्वं पिबेत्त्रिष्वपि मूत्रयुक्तं स्नातश्च जीर्णे पयसाऽन्नमद्यात्||२२|| <br />
 +
<div class="mw-collapsible-content">
  
harītakīnāgaradēvadāru sukhāmbuyuktaṁ sapunarnavaṁ vā|  
+
harītakīnāgaradēvadāru sukhāmbuyuktaṁ sapunarnavaṁ vā| <br />
sarvaṁ pibēttriṣvapi mūtrayuktaṁ snātaśca jīrṇē payasā'nnamadyāt||22||
+
sarvaṁ pibēttriṣvapi mūtrayuktaṁ snātaśca jīrṇē payasā'nnamadyāt||22||<br />
  
harItakInAgaradevadAru sukhAmbuyuktaM sapunarnavaM vA|  
+
harItakInAgaradevadAru sukhAmbuyuktaM sapunarnavaM vA| <br />
sarvaM pibettriShvapi mUtrayuktaM snAtashca jIrNe payasA~annamadyAt||22||
+
sarvaM pibettriShvapi mUtrayuktaM snAtashca jIrNe payasA~annamadyAt||22||<br />
 +
</div></div>
  
Mixture of ''haritaki'', dried ginger and ''devadaru'' taken with lukewarm water, or ''punarnava'' mixed with all the above drugs taken with cow‘s urine relieves swelling produced by all the three ''dosha''. On digestion of the drug and after taking bath, the patient should take food with milk [22]
+
Mixture of ''haritaki'', dried ginger and ''devadaru'' taken with lukewarm water, or ''punarnava'' mixed with all the above drugs taken with cow‘s urine relieves swelling produced by all the three ''[[dosha]]''. On digestion of the drug and after taking bath, the patient should take food with milk [22]
  
==== Recipe for ''vata'' edema/swelling ====
+
=== Remedy for ''[[vata]]'' edema/swelling ===
 +
<div class="mw-collapsible mw-collapsed">
  
पुनर्नवानागरमुस्तकल्कान् प्रस्थेन धीरः पयसाऽक्षमात्रान्|  
+
पुनर्नवानागरमुस्तकल्कान् प्रस्थेन धीरः पयसाऽक्षमात्रान्| <br />
मयूरकं मागधिकां समूलां सनागरां वा प्रपिबेत् सवाते||२३||  
+
मयूरकं मागधिकां समूलां सनागरां वा प्रपिबेत् सवाते||२३|| <br />
 +
<div class="mw-collapsible-content">
  
punarnavānāgaramustakalkān prasthēna dhīraḥ payasā'kṣamātrān|  
+
punarnavānāgaramustakalkān prasthēna dhīraḥ payasā'kṣamātrān| <br />
mayūrakaṁ māgadhikāṁ samūlāṁ sanāgarāṁ vā prapibēt savātē||23||  
+
mayūrakaṁ māgadhikāṁ samūlāṁ sanāgarāṁ vā prapibēt savātē||23|| <br />
  
punarnavAnAgaramustakalkAn prasthena dhIraH payasA~akShamAtrAn|  
+
punarnavAnAgaramustakalkAn prasthena dhIraH payasA~akShamAtrAn| <br />
mayUrakaM mAgadhikAM samUlAM sanAgarAM vA prapibet savAte||23||  
+
mayUrakaM mAgadhikAM samUlAM sanAgarAM vA prapibet savAte||23|| <br />
 +
</div></div>
  
The 500 ml of milk prepared with paste of 10 gm each ''punarnava'', dried ginger and ''mustaka''; or milk prepared with ''mayuraka, pippalimula'' and dried ginger taken orally relieves swelling due to ''vata'' [23]
+
The 500 ml of milk prepared with paste of 10 gm each ''punarnava'', dried ginger and ''mustaka''; or milk prepared with ''mayuraka, pippalimula'' and dried ginger taken orally relieves swelling due to ''[[vata]]'' [23]
  
==== Recipe for ''vata-pitta'' swelling/edema ====
+
=== Remedy for ''[[vata]]-[[pitta]]'' swelling/edema ===
 +
<div class="mw-collapsible mw-collapsed">
  
दन्तीत्रिवृत्त्र्यूषणचित्रकैर्वा पयः शृतं दोषहरं पिबेन्ना|  
+
दन्तीत्रिवृत्त्र्यूषणचित्रकैर्वा पयः शृतं दोषहरं पिबेन्ना| <br />
द्विप्रस्थमात्रं तु पलार्धिकैस्तैरर्धावशिष्टं पवने सपित्ते||२४||  
+
द्विप्रस्थमात्रं तु पलार्धिकैस्तैरर्धावशिष्टं पवने सपित्ते||२४|| <br />
 +
<div class="mw-collapsible-content">
  
dantītrivr̥ttryūṣaṇacitrakairvā payaḥ śr̥taṁ dōṣaharaṁ pibēnnā|  
+
dantītrivr̥ttryūṣaṇacitrakairvā payaḥ śr̥taṁ dōṣaharaṁ pibēnnā| <br />
dviprasthamātraṁ tu palārdhikaistairardhāvaśiṣṭaṁ pavanē sapittē||24||  
+
dviprasthamātraṁ tu palārdhikaistairardhāvaśiṣṭaṁ pavanē sapittē||24|| <br />
  
dantItrivRuttryUShaNacitrakairvA payaH shRutaM doShaharaM pibennA|  
+
dantItrivRuttryUShaNacitrakairvA payaH shRutaM doShaharaM pibennA| <br />
dviprasthamAtraM tu palArdhikaistairardhAvashiShTaM pavane sapitte||24||   
+
dviprasthamAtraM tu palArdhikaistairardhAvashiShTaM pavane sapitte||24||  <br />
 +
</div></div>
  
One liter of milk prepared with 20 gm each of ''danti, trivrit, trikatu'' and ''chitraka'' added with one liter of water reduced to half, taken orally relieves edema caused by combination of ''vata'' and ''pitta'' [24]
+
One liter of milk prepared with 20 gm each of ''danti, trivrit, trikatu'' and ''chitraka'' added with one liter of water reduced to half, taken orally relieves edema caused by combination of ''[[vata]]'' and ''[[pitta]]'' [24]
  
==== General recipes for edema ====
+
=== General remedies for edema ===
 +
<div class="mw-collapsible mw-collapsed">
  
सशुण्ठिपीतद्रुरसं प्रयोज्यं श्यामोरुबूकोषणसाधितं वा|  
+
सशुण्ठिपीतद्रुरसं प्रयोज्यं श्यामोरुबूकोषणसाधितं वा| <br />
त्वग्दारुवर्षाभुमहौषधैर्वा गुडूचिकानागरदन्तिभिर्वा||२५||    
+
त्वग्दारुवर्षाभुमहौषधैर्वा गुडूचिकानागरदन्तिभिर्वा||२५||     <br />
 +
<div class="mw-collapsible-content">
 
                        
 
                        
saśuṇṭhipītadrurasaṁ prayōjyaṁ śyāmōrubūkōṣaṇasādhitaṁ vā|  
+
saśuṇṭhipītadrurasaṁ prayōjyaṁ śyāmōrubūkōṣaṇasādhitaṁ vā| <br />
tvagdāruvarṣābhumahauṣadhairvā guḍūcikānāgaradantibhirvā||25||  
+
tvagdāruvarṣābhumahauṣadhairvā guḍūcikānāgaradantibhirvā||25|| <br />
  
sashuNThipItadrurasaM prayojyaM shyAmorubUkoShaNasAdhitaM vA|  
+
sashuNThipItadrurasaM prayojyaM shyAmorubUkoShaNasAdhitaM vA| <br />
tvagdAruvarShAbhumahauShadhairvA guDUcikAnAgaradantibhirvA||25||  
+
tvagdAruvarShAbhumahauShadhairvA guDUcikAnAgaradantibhirvA||25|| <br />
 +
</div></div>
  
 
Milk prepared with dry ginger and ''daruharidra'' or prepared with ''shyama'', castor root and black pepper, or prepared with cinnamon, ''devadaru, punarnava'' and dry ginger; or prepared with ''guduchi'', dry ginger and ''danti''; taken orally relieves edema [25]
 
Milk prepared with dry ginger and ''daruharidra'' or prepared with ''shyama'', castor root and black pepper, or prepared with cinnamon, ''devadaru, punarnava'' and dry ginger; or prepared with ''guduchi'', dry ginger and ''danti''; taken orally relieves edema [25]
 +
<div class="mw-collapsible mw-collapsed">
  
सप्ताहमौष्ट्रं त्वथवाऽपि मासं पयः पिबेद्भोजनवारिवर्जी|  
+
सप्ताहमौष्ट्रं त्वथवाऽपि मासं पयः पिबेद्भोजनवारिवर्जी| <br />
गव्यं समूत्रं महिषीपयो वा क्षीराशनो मूत्रमथो गवां वा||२६||                
+
गव्यं समूत्रं महिषीपयो वा क्षीराशनो मूत्रमथो गवां वा||२६|| <br />               
 +
<div class="mw-collapsible-content">
  
saptāhamauṣṭraṁ tvathavā'pi māsaṁ payaḥ pibēdbhōjanavārivarjī|  
+
saptāhamauṣṭraṁ tvathavā'pi māsaṁ payaḥ pibēdbhōjanavārivarjī| <br />
gavyaṁ samūtraṁ mahiṣīpayō vā kṣīrāśanō mūtramathō gavāṁ vā||26||  
+
gavyaṁ samūtraṁ mahiṣīpayō vā kṣīrāśanō mūtramathō gavāṁ vā||26|| <br />
  
saptAhamauShTraM tvathavA~api mAsaM payaH pibedbhojanavArivarjI|  
+
saptAhamauShTraM tvathavA~api mAsaM payaH pibedbhojanavArivarjI| <br />
gavyaM samUtraM mahiShIpayo vA kShIrAshano mUtramatho gavAM vA||26||  
+
gavyaM samUtraM mahiShIpayo vA kShIrAshano mUtramatho gavAM vA||26|| <br />
 +
</div></div>
  
 
The patient by avoiding all other food and drinks if remains only on camel’s milk for a week or month or similarly remains on cow’s milk mixed with equal quantity of cow’s urine or on buffalo’s milk mixed with an equal quantity of cow’s urine or other milk with cow’s urine, then edema is cured [26]   
 
The patient by avoiding all other food and drinks if remains only on camel’s milk for a week or month or similarly remains on cow’s milk mixed with equal quantity of cow’s urine or on buffalo’s milk mixed with an equal quantity of cow’s urine or other milk with cow’s urine, then edema is cured [26]   
 +
<div class="mw-collapsible mw-collapsed">
  
तक्रं पिबेद्वा गुरुभिन्नवर्चाः सव्योषसौवर्चलमाक्षिकं च|  
+
तक्रं पिबेद्वा गुरुभिन्नवर्चाः सव्योषसौवर्चलमाक्षिकं च| <br />
गुडाभयां वा गुडनागरं वा सदोषभिन्नामविबद्धवर्चाः||२७||                
+
गुडाभयां वा गुडनागरं वा सदोषभिन्नामविबद्धवर्चाः||२७||   <br />             
 +
<div class="mw-collapsible-content">
  
takraṁ pibēdvā gurubhinnavarcāḥ savyōṣasauvarcalamākṣikaṁ ca|  
+
takraṁ pibēdvā gurubhinnavarcāḥ savyōṣasauvarcalamākṣikaṁ ca| <br />
guḍābhayāṁ vā guḍanāgaraṁ vā sadōṣabhinnāmavibaddhavarcāḥ||27||  
+
guḍābhayāṁ vā guḍanāgaraṁ vā sadōṣabhinnāmavibaddhavarcāḥ||27|| <br />
  
takraM pibedvA gurubhinnavarcAH savyoShasauvarcalamAkShikaM ca|  
+
takraM pibedvA gurubhinnavarcAH savyoShasauvarcalamAkShikaM ca| <br />
guDAbhayAM vA guDanAgaraM vA sadoShabhinnAmavibaddhavarcAH||27||  
+
guDAbhayAM vA guDanAgaraM vA sadoShabhinnAmavibaddhavarcAH||27|| <br />
 +
</div></div>
 
   
 
   
 
Patient of edema if passes heavy (with mucous) and loose stools may drink butter milk mixed with ''trikatu, sauvarchala''-salt and honey; or if the stool is morbid, loose, with ''ama'' or hard stool, then jaggery and ''haritaki'' or jaggery with dry ginger are given [27]     
 
Patient of edema if passes heavy (with mucous) and loose stools may drink butter milk mixed with ''trikatu, sauvarchala''-salt and honey; or if the stool is morbid, loose, with ''ama'' or hard stool, then jaggery and ''haritaki'' or jaggery with dry ginger are given [27]     
 +
<div class="mw-collapsible mw-collapsed">
  
 
विड्वातसङ्गे पयसा रसैर्वा प्राग्भक्तमद्यादुरुबूकतैलम् [७] |  
 
विड्वातसङ्गे पयसा रसैर्वा प्राग्भक्तमद्यादुरुबूकतैलम् [७] |  
  
 
स्रोतोविबन्धेऽग्निरुचिप्रणाशे मद्यान्यरिष्टांश्च पिबेत् सुजातान्||२८||  
 
स्रोतोविबन्धेऽग्निरुचिप्रणाशे मद्यान्यरिष्टांश्च पिबेत् सुजातान्||२८||  
 +
<div class="mw-collapsible-content">
  
 
viḍvātasaṅgē payasā rasairvā prāgbhaktamadyādurubūkatailam [7] |  
 
viḍvātasaṅgē payasā rasairvā prāgbhaktamadyādurubūkatailam [7] |  
Line 400: Line 486:
 
   
 
   
 
srotovibandhe~agnirucipraNAshe madyAnyariShTAMshca pibet sujAtAn||28||   
 
srotovibandhe~agnirucipraNAshe madyAnyariShTAMshca pibet sujAtAn||28||   
 +
</div></div>
  
 
If there is retention of feces and flatus, the patient may be given castor oil with milk or with meat-soup before meal; and if there is occlusion of channels or loss of digestion power and appetite, then the patient may be given simple or medicated wines [28]
 
If there is retention of feces and flatus, the patient may be given castor oil with milk or with meat-soup before meal; and if there is occlusion of channels or loss of digestion power and appetite, then the patient may be given simple or medicated wines [28]
  
==== ''Gandeeradyarishtha'' ====
+
=== ''Gandeeradyarishta'' ===
 +
<div class="mw-collapsible mw-collapsed">
  
गण्डीरभल्लातकचित्रकांश्च व्योषं विडङ्गं बृहतीद्वयं च|  
+
गण्डीरभल्लातकचित्रकांश्च व्योषं विडङ्गं बृहतीद्वयं च| <br />
द्विप्रस्थिकं गोमयपावकेन द्रोणे पचेत् कूर्चिकमस्तुनस्तु [८] ||२९||  
+
द्विप्रस्थिकं गोमयपावकेन द्रोणे पचेत् कूर्चिकमस्तुनस्तु [८] ||२९|| <br />
  
त्रिभागशेषं च सुपूतशीतं द्रोणेन तत् प्राकृतमस्तुना च|  
+
त्रिभागशेषं च सुपूतशीतं द्रोणेन तत् प्राकृतमस्तुना च| <br />
सितोपलायाश्च शतेन युक्तं लिप्ते घटे चित्रकपिप्पलीनाम्||३०||  
+
सितोपलायाश्च शतेन युक्तं लिप्ते घटे चित्रकपिप्पलीनाम्||३०|| <br />
  
वैहायसे स्थापितमादशाहात् प्रयोजयंस्तद्विनिहन्ति शोफान्|  
+
वैहायसे स्थापितमादशाहात् प्रयोजयंस्तद्विनिहन्ति शोफान्| <br />
भगन्दरार्शःक्रिमिकुष्ठमेहान् वैवर्ण्यकार्श्यानिलहिक्कनं च||३१||  
+
भगन्दरार्शःक्रिमिकुष्ठमेहान् वैवर्ण्यकार्श्यानिलहिक्कनं च||३१|| <br />
  
इति गण्डीराद्यरिष्टः                          
+
इति गण्डीराद्यरिष्टः <br />                         
 +
<div class="mw-collapsible-content">
  
gaṇḍīrabhallātakacitrakāṁśca vyōṣaṁ viḍaṅgaṁ br̥hatīdvayaṁ ca|  
+
gaṇḍīrabhallātakacitrakāṁśca vyōṣaṁ viḍaṅgaṁ br̥hatīdvayaṁ ca| <br />
dviprasthikaṁ gōmayapāvakēna drōṇē pacēt kūrcikamastunastu [8] ||29||  
+
dviprasthikaṁ gōmayapāvakēna drōṇē pacēt kūrcikamastunastu [8] ||29|| <br />
  
tribhāgaśēṣaṁ ca supūtaśītaṁ drōṇēna tat prākr̥tamastunā ca|  
+
tribhāgaśēṣaṁ ca supūtaśītaṁ drōṇēna tat prākr̥tamastunā ca| <br />
sitōpalāyāśca śatēna yuktaṁ liptē ghaṭē citrakapippalīnām||30||  
+
sitōpalāyāśca śatēna yuktaṁ liptē ghaṭē citrakapippalīnām||30|| <br />
  
vaihāyasē sthāpitamādaśāhāt prayōjayaṁstadvinihanti śōphān|  
+
vaihāyasē sthāpitamādaśāhāt prayōjayaṁstadvinihanti śōphān| <br />
bhagandarārśaḥkrimikuṣṭhamēhān vaivarṇyakārśyānilahikkanaṁ ca||31||  
+
bhagandarārśaḥkrimikuṣṭhamēhān vaivarṇyakārśyānilahikkanaṁ ca||31|| <br />
  
iti gaṇḍīrādyariṣṭaḥ
+
iti gaṇḍīrādyariṣṭaḥ <br />
  
gaNDIrabhallAtakacitrakAMshca vyoShaM viDa~ggaM bRuhatIdvayaM ca|  
+
gaNDIrabhallAtakacitrakAMshca vyoShaM viDa~ggaM bRuhatIdvayaM ca| <br />
dviprasthikaM gomayapAvakena droNe pacet kUrcikamastunastu [8] ||29||  
+
dviprasthikaM gomayapAvakena droNe pacet kUrcikamastunastu [8] ||29|| <br />
  
tribhAgasheShaM ca supUtashItaM droNena tat prAkRutamastunA ca|  
+
tribhAgasheShaM ca supUtashItaM droNena tat prAkRutamastunA ca| <br />
sitopalAyAshca shatena yuktaM lipte ghaTe citrakapippalInAm||30||  
+
sitopalAyAshca shatena yuktaM lipte ghaTe citrakapippalInAm||30|| <br />
  
vaihAyase sthApitamAdashAhAt prayojayaMstadvinihanti shophAn|  
+
vaihAyase sthApitamAdashAhAt prayojayaMstadvinihanti shophAn| <br />
bhagandarArshaHkrimikuShThamehAn vaivarNyakArshyAnilahikkanaM ca||31||  
+
bhagandarArshaHkrimikuShThamehAn vaivarNyakArshyAnilahikkanaM ca||31|| <br />
  
iti gaNDIrAdyariShTaH
+
iti gaNDIrAdyariShTaH <br />
 +
</div></div>
  
 
Take 1.280 Kg of ''gandeera, bhallataka, chitraka, trikatu, vidnaga, kantakari'' and ''brihati'' and add 1.024 Kg of ''kurchika-mastu'' (prepared by adding hot water in curd) and boil on cow-dung fire till one-third remains and then filter. On cooling add to it 1.024 Kg natural-''mastu'' (prepared by adding water in curd), 4 kg of sugar-candy and put in a pitcher lined with paste of ''chitraka'' and ''pippali'' and leave this pot at a high-open place for 10 days for fermentation to prepare ''arishta''.  
 
Take 1.280 Kg of ''gandeera, bhallataka, chitraka, trikatu, vidnaga, kantakari'' and ''brihati'' and add 1.024 Kg of ''kurchika-mastu'' (prepared by adding hot water in curd) and boil on cow-dung fire till one-third remains and then filter. On cooling add to it 1.024 Kg natural-''mastu'' (prepared by adding water in curd), 4 kg of sugar-candy and put in a pitcher lined with paste of ''chitraka'' and ''pippali'' and leave this pot at a high-open place for 10 days for fermentation to prepare ''arishta''.  
  
Oral administration of ''gandeeradyarishtha'' cures edema, fistula-in-ano, piles, helminthiasis, ''kushtha''(obstinate skin diseases), polyuria, discoloration, emaciation and hiccup due to ''vata''. Thus ''gandeeradyarishtha'' is described [29-31]
+
Oral administration of ''gandeeradyarishtha'' cures edema, fistula-in-ano, piles, helminthiasis, ''kushtha''(obstinate skin diseases), polyuria, discoloration, emaciation and hiccup due to ''[[vata]]''. Thus ''gandeeradyarishtha'' is described [29-31]
  
==== ''Ashthashato arishtha'' ====
+
=== ''Ashtashato arishta'' ===
 +
<div class="mw-collapsible mw-collapsed">
  
काश्मर्यधात्रीमरिचाभयाक्षद्राक्षाफलानां [९] च सपिप्पलीनाम्|  
+
काश्मर्यधात्रीमरिचाभयाक्षद्राक्षाफलानां [९] च सपिप्पलीनाम्| <br />
शतं शतं जीर्णगुडात्तुलां [१०] च सङ्क्षुद्य कुम्भे मधुना प्रलिप्ते||३२||  
+
शतं शतं जीर्णगुडात्तुलां [१०] च सङ्क्षुद्य कुम्भे मधुना प्रलिप्ते||३२|| <br />
  
सप्ताहमुष्णे द्विगुणं तु शीते स्थितं जलद्रोणयुतं पिबेन्ना|  
+
सप्ताहमुष्णे द्विगुणं तु शीते स्थितं जलद्रोणयुतं पिबेन्ना| <br />
शोफान् विबन्धान् कफवातजांश्च निहन्त्यरिष्टोऽष्टशतोऽग्निकृच्च||३३||
+
शोफान् विबन्धान् कफवातजांश्च निहन्त्यरिष्टोऽष्टशतोऽग्निकृच्च||३३|| <br />
 
   
 
   
इत्यष्टशतोऽरिष्टः                        
+
इत्यष्टशतोऽरिष्टः <br />                     
 +
<div class="mw-collapsible-content">
  
kāśmaryadhātrīmaricābhayākṣadrākṣāphalānāṁ [9] ca sapippalīnām|  
+
kāśmaryadhātrīmaricābhayākṣadrākṣāphalānāṁ [9] ca sapippalīnām| <br />
śataṁ śataṁ jīrṇaguḍāttulāṁ [10] ca saṅkṣudya kumbhē madhunā praliptē||32||  
+
śataṁ śataṁ jīrṇaguḍāttulāṁ [10] ca saṅkṣudya kumbhē madhunā praliptē||32|| <br />
  
saptāhamuṣṇē dviguṇaṁ tu śītē sthitaṁ jaladrōṇayutaṁ pibēnnā|  
+
saptāhamuṣṇē dviguṇaṁ tu śītē sthitaṁ jaladrōṇayutaṁ pibēnnā| <br />
śōphān vibandhān kaphavātajāṁśca nihantyariṣṭō'ṣṭaśatō'gnikr̥cca||33||  
+
śōphān vibandhān kaphavātajāṁśca nihantyariṣṭō'ṣṭaśatō'gnikr̥cca||33|| <br />
  
ityaṣṭaśatō'riṣṭaḥ
+
ityaṣṭaśatō'riṣṭaḥ <br />
  
kAshmaryadhAtrImaricAbhayAkShadrAkShAphalAnAM [9] ca sapippalInAm|  
+
kAshmaryadhAtrImaricAbhayAkShadrAkShAphalAnAM [9] ca sapippalInAm| <br />
shataM shataM jIrNaguDAttulAM [10] ca sa~gkShudya kumbhe madhunA pralipte||32||  
+
shataM shataM jIrNaguDAttulAM [10] ca sa~gkShudya kumbhe madhunA pralipte||32|| <br />
  
saptAhamuShNe dviguNaM tu shIte sthitaM jaladroNayutaM pibennA|  
+
saptAhamuShNe dviguNaM tu shIte sthitaM jaladroNayutaM pibennA| <br />
shophAn vibandhAn kaphavAtajAMshca nihantyariShTo~aShTashato~agnikRucca||33||  
+
shophAn vibandhAn kaphavAtajAMshca nihantyariShTo~aShTashato~agnikRucca||33|| <br />
  
ityaShTashato~ariShTaH
+
ityaShTashato~ariShTaH <br />
 +
</div></div>
  
Take 100 ''pala'' each of ''kashmarya, amalaki,'' black pepper, ''haritaki, vibhitaki, pippali'' and grapes, add to it 100 ''pala'' of old jaggery and two ''drona'' of water, then put the mixture in a vessel lined with honey for 7 days in summer or for 14 days in winter for fermentation. Thus fermented ''asava'' is known as ''ashtashato-arishtha''. Its oral administration cures edema and constipation due to ''kapha'' and ''vata'' and stimulates digestion and metabolism (''agni''). Thus ''ashthato-arishta'' is described [32-33]
+
Take 100 ''pala'' each of ''kashmarya, amalaki,'' black pepper, ''haritaki, vibhitaki, pippali'' and grapes, add to it 100 ''pala'' of old jaggery and two ''drona'' of water, then put the mixture in a vessel lined with honey for 7 days in summer or for 14 days in winter for fermentation. Thus fermented ''asava'' is known as ''ashtashato-arishtha''. Its oral administration cures edema and constipation due to ''[[kapha]]'' and ''[[vata]]'' and stimulates digestion and metabolism (''agni''). Thus ''ashthato-arishta'' is described [32-33]
  
==== ''Punarnavadi arishta'' ====
+
=== ''Punarnavadi arishta'' ===
 +
<div class="mw-collapsible mw-collapsed">
  
पुनर्नवे द्वे च बले सपाठे दन्तीं [११] गुडूचीमथ चित्रकं च|  
+
पुनर्नवे द्वे च बले सपाठे दन्तीं [११] गुडूचीमथ चित्रकं च| <br />
निदिग्धिकां च त्रिपलानि पक्त्वा द्रोणावशेषे सलिले ततस्तम्||३४||  
+
निदिग्धिकां च त्रिपलानि पक्त्वा द्रोणावशेषे सलिले ततस्तम्||३४|| <br />
  
पूत्वा रसं द्वे च गुडात् पुराणात्तुले मधुप्रस्थयुतं सुशीतम्|  
+
पूत्वा रसं द्वे च गुडात् पुराणात्तुले मधुप्रस्थयुतं सुशीतम्| <br />
मासं निदध्याद्घृतभाजनस्थं पल्ले यवानां परतस्तु मासात्||३५||  
+
मासं निदध्याद्घृतभाजनस्थं पल्ले यवानां परतस्तु मासात्||३५|| <br />
  
चूर्णीकृतैरर्धपलांशिकैस्तं पत्रत्वगेलामरिचाम्बुलोहैः [१२] |  
+
चूर्णीकृतैरर्धपलांशिकैस्तं पत्रत्वगेलामरिचाम्बुलोहैः [१२] | <br />
गन्धान्वितं क्षौद्रघृतप्रदिग्धे जीर्णे पिबेद् व्याधिबलं समीक्ष्य||३६||  
+
गन्धान्वितं क्षौद्रघृतप्रदिग्धे जीर्णे पिबेद् व्याधिबलं समीक्ष्य||३६|| <br />
  
हृत्पाण्डुरोगं श्वयथुं प्रवृद्धं प्लीहज्वरारोचकमेहगुल्मान्|  
+
हृत्पाण्डुरोगं श्वयथुं प्रवृद्धं प्लीहज्वरारोचकमेहगुल्मान्| <br />
भगन्दरं षड्जठराणि कासं श्वासं ग्रहण्यामयकुष्ठकण्डूः||३७||  
+
भगन्दरं षड्जठराणि कासं श्वासं ग्रहण्यामयकुष्ठकण्डूः||३७|| <br />
  
शाखानिलं बद्धपुरीषतां च हिक्कां किलासं च हलीमकं च|  
+
शाखानिलं बद्धपुरीषतां च हिक्कां किलासं च हलीमकं च| <br />
क्षिप्रं जयेद्वर्णबलायुरोजस्तेजोन्वितो मांसरसान्नभोजी||३८||  
+
क्षिप्रं जयेद्वर्णबलायुरोजस्तेजोन्वितो मांसरसान्नभोजी||३८|| <br />
  
इति पुनर्नवाद्यरिष्टः                      
+
इति पुनर्नवाद्यरिष्टः <br />                     
 +
<div class="mw-collapsible-content">
  
punarnavē dvē ca balē sapāṭhē dantīṁ [11] guḍūcīmatha citrakaṁ ca|  
+
punarnavē dvē ca balē sapāṭhē dantīṁ [11] guḍūcīmatha citrakaṁ ca|<br />
nidigdhikāṁ ca tripalāni paktvā drōṇāvaśēṣē salilē tatastam||34||  
+
nidigdhikāṁ ca tripalāni paktvā drōṇāvaśēṣē salilē tatastam||34|| <br />
  
pūtvā rasaṁ dvē ca guḍāt purāṇāttulē madhuprasthayutaṁ suśītam|  
+
pūtvā rasaṁ dvē ca guḍāt purāṇāttulē madhuprasthayutaṁ suśītam| <br />
māsaṁ nidadhyādghr̥tabhājanasthaṁ pallē yavānāṁ paratastu māsāt||35||
+
māsaṁ nidadhyādghr̥tabhājanasthaṁ pallē yavānāṁ paratastu māsāt||35||<br />
  
cūrṇīkr̥tairardhapalāṁśikaistaṁ patratvagēlāmaricāmbulōhaiḥ [12] |  
+
cūrṇīkr̥tairardhapalāṁśikaistaṁ patratvagēlāmaricāmbulōhaiḥ [12] | <br />
gandhānvitaṁ kṣaudraghr̥tapradigdhē jīrṇē pibēd vyādhibalaṁ samīkṣya||36||  
+
gandhānvitaṁ kṣaudraghr̥tapradigdhē jīrṇē pibēd vyādhibalaṁ samīkṣya||36|| <br />
  
hr̥tpāṇḍurōgaṁ śvayathuṁ pravr̥ddhaṁ plīhajvarārōcakamēhagulmān|  
+
hr̥tpāṇḍurōgaṁ śvayathuṁ pravr̥ddhaṁ plīhajvarārōcakamēhagulmān| <br />
bhagandaraṁ ṣaḍjaṭharāṇi kāsaṁ śvāsaṁ grahaṇyāmayakuṣṭhakaṇḍūḥ||37||  
+
bhagandaraṁ ṣaḍjaṭharāṇi kāsaṁ śvāsaṁ grahaṇyāmayakuṣṭhakaṇḍūḥ||37|| <br />
  
śākhānilaṁ baddhapurīṣatāṁ ca hikkāṁ kilāsaṁ ca halīmakaṁ ca|  
+
śākhānilaṁ baddhapurīṣatāṁ ca hikkāṁ kilāsaṁ ca halīmakaṁ ca| <br />
kṣipraṁ jayēdvarṇabalāyurōjastējōnvitō māṁsarasānnabhōjī||38||  
+
kṣipraṁ jayēdvarṇabalāyurōjastējōnvitō māṁsarasānnabhōjī||38|| <br />
  
iti punarnavādyariṣṭaḥ
+
iti punarnavādyariṣṭaḥ <br />
  
punarnave dve ca bale sapAThe dantIM [11] guDUcImatha citrakaM ca|  
+
punarnave dve ca bale sapAThe dantIM [11] guDUcImatha citrakaM ca| <br />
nidigdhikAM ca tripalAni paktvA droNAvasheShe salile tatastam||34||
+
nidigdhikAM ca tripalAni paktvA droNAvasheShe salile tatastam||34||<br />
 
   
 
   
pUtvA rasaM dve ca guDAt purANAttule madhuprasthayutaM sushItam|  
+
pUtvA rasaM dve ca guDAt purANAttule madhuprasthayutaM sushItam| <br />
mAsaM nidadhyAdghRutabhAjanasthaM palle yavAnAM paratastu mAsAt||35||  
+
mAsaM nidadhyAdghRutabhAjanasthaM palle yavAnAM paratastu mAsAt||35|| <br />
  
cUrNIkRutairardhapalAMshikaistaM patratvagelAmaricAmbulohaiH [12] |  
+
cUrNIkRutairardhapalAMshikaistaM patratvagelAmaricAmbulohaiH [12] | <br />
gandhAnvitaM kShaudraghRutapradigdhe jIrNe pibed vyAdhibalaM samIkShya ||36||  
+
gandhAnvitaM kShaudraghRutapradigdhe jIrNe pibed vyAdhibalaM samIkShya ||36|| <br />
  
hRutpANDurogaM shvayathuM pravRuddhaM plIhajvarArocakamehagulmAn|  
+
hRutpANDurogaM shvayathuM pravRuddhaM plIhajvarArocakamehagulmAn| <br />
bhagandaraM ShaDjaTharANi kAsaM shvAsaM grahaNyAmayakuShThakaNDUH ||37||  
+
bhagandaraM ShaDjaTharANi kAsaM shvAsaM grahaNyAmayakuShThakaNDUH ||37|| <br />
  
shAkhAnilaM baddhapurIShatAM ca hikkAM kilAsaM ca halImakaM ca|  
+
shAkhAnilaM baddhapurIShatAM ca hikkAM kilAsaM ca halImakaM ca| <br />
kShipraM jayedvarNabalAyurojastejonvito mAMsarasAnnabhojI||38||
+
kShipraM jayedvarNabalAyurojastejonvito mAMsarasAnnabhojI||38||<br />
 
   
 
   
iti punarnavAdyariShTaH
+
iti punarnavAdyariShTaH <br />
 +
</div></div>
  
 
Make a decoction of 120 gm each of two types of ''punarnavā, balā, pāṭhā, dantī, guḍūchī, chitraka, kantakāri'' and ''triphalā'' by adding water (about 4.1 liters) and reducing it to 1.024 liter. Add to this decoction 8 kg of jaggery and 640 gm of honey and keep it in a vessel lined with ghee and place it in a heap of barley for a month. Thereafter to make it fragrant, add 20 gm powders each of ''tejapatra'', cinnamon, cardamom, black pepper, couscous and iron ''bhasma'' and store in a pot lined with honey and ghee. It is to be taken after the digestion of the meal in a dose according to the strength of the disease. In diet, food with meat soup may be given.
 
Make a decoction of 120 gm each of two types of ''punarnavā, balā, pāṭhā, dantī, guḍūchī, chitraka, kantakāri'' and ''triphalā'' by adding water (about 4.1 liters) and reducing it to 1.024 liter. Add to this decoction 8 kg of jaggery and 640 gm of honey and keep it in a vessel lined with ghee and place it in a heap of barley for a month. Thereafter to make it fragrant, add 20 gm powders each of ''tejapatra'', cinnamon, cardamom, black pepper, couscous and iron ''bhasma'' and store in a pot lined with honey and ghee. It is to be taken after the digestion of the meal in a dose according to the strength of the disease. In diet, food with meat soup may be given.
  
It provides quick cure in heart disease, anemia, severe edema, splenic disorders, fever, anorexia, polyuria, ''gulma'', fistula-in-ano, six types of ''udararoga'', cough, dyspnea, assimilation disorders (''grahani''), dermatosis (''kushtha''), pruritis, ''vata'' disorders of limbs, constipation, hiccup, leukoderma and ''halimaka'' (greenish coloration of skin). It also improves complexion, strength, oja and vitality. Thus ''punarnavadi arishta'' is described [34-38]
+
It provides quick cure in heart disease, anemia, severe edema, splenic disorders, fever, anorexia, polyuria, ''gulma'', fistula-in-ano, six types of ''udararoga'', cough, dyspnea, assimilation disorders (''grahani''), dermatosis (''kushtha''), pruritis, ''[[vata]]'' disorders of limbs, constipation, hiccup, leukoderma and ''halimaka'' (greenish coloration of skin). It also improves complexion, strength, [[ojas]] and vitality. Thus ''punarnavadi arishta'' is described [34-38]
  
==== ''Triphaladyarishtha'' ====
+
=== ''Triphaladyarishta'' ===
 +
<div class="mw-collapsible mw-collapsed">
  
फलत्रिकं दीप्यकचित्रकौ च सपिप्पलीलोहरजो विडङ्गम्|  
+
फलत्रिकं दीप्यकचित्रकौ च सपिप्पलीलोहरजो विडङ्गम्| <br />
चूर्णीकृतं कौडविकं द्विरंशं क्षौद्रं पुराणस्य तुलां गुडस्य||३९||  
+
चूर्णीकृतं कौडविकं द्विरंशं क्षौद्रं पुराणस्य तुलां गुडस्य||३९|| <br />
  
मासं निदध्याद्घृतभाजनस्थं यवेषु तानेव निहन्ति रोगान्|  
+
मासं निदध्याद्घृतभाजनस्थं यवेषु तानेव निहन्ति रोगान्| <br />
ये चार्शसां पाण्डुविकारिणां च प्रोक्ता हिताः शोफिषु तेऽप्यरिष्टाः||४०||  
+
ये चार्शसां पाण्डुविकारिणां च प्रोक्ता हिताः शोफिषु तेऽप्यरिष्टाः||४०|| <br />
  
इति त्रिफलाद्यरिष्टः                                
+
इति त्रिफलाद्यरिष्टः <br />                               
 +
<div class="mw-collapsible-content">
  
phalatrikaṁ dīpyakacitrakau ca sapippalīlōharajō viḍaṅgam|  
+
phalatrikaṁ dīpyakacitrakau ca sapippalīlōharajō viḍaṅgam| <br />
cūrṇīkr̥taṁ kauḍavikaṁ dviraṁśaṁ kṣaudraṁ purāṇasya tulāṁ guḍasya||39||  
+
cūrṇīkr̥taṁ kauḍavikaṁ dviraṁśaṁ kṣaudraṁ purāṇasya tulāṁ guḍasya||39|| <br />
  
māsaṁ nidadhyādghr̥tabhājanasthaṁ yavēṣu tānēva nihanti rōgān|  
+
māsaṁ nidadhyādghr̥tabhājanasthaṁ yavēṣu tānēva nihanti rōgān| <br />
yē cārśasāṁ pāṇḍuvikāriṇāṁ ca prōktā hitāḥ śōphiṣu tē'pyariṣṭāḥ||40||  
+
yē cārśasāṁ pāṇḍuvikāriṇāṁ ca prōktā hitāḥ śōphiṣu tē'pyariṣṭāḥ||40|| <br />
  
iti triphalādyariṣṭaḥ
+
iti triphalādyariṣṭaḥ <br />
  
phalatrikaM dIpyakacitrakau ca sapippalIloharajo viDa~ggam|  
+
phalatrikaM dIpyakacitrakau ca sapippalIloharajo viDa~ggam| <br />
cUrNIkRutaM kauDavikaM dviraMshaM kShaudraM purANasya tulAM guDasya||39||  
+
cUrNIkRutaM kauDavikaM dviraMshaM kShaudraM purANasya tulAM guDasya||39|| <br />
  
mAsaM nidadhyAdghRutabhAjanasthaM yaveShu tAneva nihanti rogAn|  
+
mAsaM nidadhyAdghRutabhAjanasthaM yaveShu tAneva nihanti rogAn| <br />
ye cArshasAM pANDuvikAriNAM ca proktA hitAH shophiShu te~apyariShTAH||40||  
+
ye cArshasAM pANDuvikAriNAM ca proktA hitAH shophiShu te~apyariShTAH||40|| <br />
  
iti triphalAdyariShTaH
+
iti triphalAdyariShTaH <br />
 +
</div></div>
  
 
Make decoction from the coarse powder of 160 gm each of ''triphala, ajawan, chitraka, pippali,'' iron bhasma and ''vidanga''. To this decoction add 320 ml of honey and 4 kg of jaggery and put it in a vessel lined with ghee and place in a heap of barley for a month. Its oral administration cures all the diseases mentioned above. Thus ''triphaladyarishtha'' is described.
 
Make decoction from the coarse powder of 160 gm each of ''triphala, ajawan, chitraka, pippali,'' iron bhasma and ''vidanga''. To this decoction add 320 ml of honey and 4 kg of jaggery and put it in a vessel lined with ghee and place in a heap of barley for a month. Its oral administration cures all the diseases mentioned above. Thus ''triphaladyarishtha'' is described.
Line 557: Line 656:
 
The ''asava'' and ''arishtha'' mentioned for the treatment of piles and anemia are also beneficial for relieving the edema [39-40]
 
The ''asava'' and ''arishtha'' mentioned for the treatment of piles and anemia are also beneficial for relieving the edema [39-40]
  
==== Powder preparations for edema ====
+
=== Powder preparations for edema ===
 +
<div class="mw-collapsible mw-collapsed">
  
कृष्णा सपाठा गजपिप्पली च निदिग्धिका चित्रकनागरे च|  
+
कृष्णा सपाठा गजपिप्पली च निदिग्धिका चित्रकनागरे च| <br />
सपिप्पलीमूलरजन्यजाजीमुस्तं च चूर्णं सुखतोयपीतम्||४१||  
+
सपिप्पलीमूलरजन्यजाजीमुस्तं च चूर्णं सुखतोयपीतम्||४१|| <br />
  
हन्यात्त्रिदोषं चिरजं च शोफं कल्कश्च भूनिम्बमहौषधस्य|  
+
हन्यात्त्रिदोषं चिरजं च शोफं कल्कश्च भूनिम्बमहौषधस्य| <br />
अयोरजस्त्र्यूषणयावशूकचूर्णं च पीतं त्रिफलारसेन||४२||  
+
अयोरजस्त्र्यूषणयावशूकचूर्णं च पीतं त्रिफलारसेन||४२|| <br />
 +
<div class="mw-collapsible-content">
  
kr̥ṣṇā sapāṭhā gajapippalī ca nidigdhikā citrakanāgarē ca|  
+
kr̥ṣṇā sapāṭhā gajapippalī ca nidigdhikā citrakanāgarē ca| <br />
sapippalīmūlarajanyajājīmustaṁ ca cūrṇaṁ sukhatōyapītam||41||  
+
sapippalīmūlarajanyajājīmustaṁ ca cūrṇaṁ sukhatōyapītam||41|| <br />
  
hanyāttridōṣaṁ cirajaṁ ca śōphaṁ kalkaśca bhūnimbamahauṣadhasya|  
+
hanyāttridōṣaṁ cirajaṁ ca śōphaṁ kalkaśca bhūnimbamahauṣadhasya| <br />
ayōrajastryūṣaṇayāvaśūkacūrṇaṁ ca pītaṁ triphalārasēna||42||
+
ayōrajastryūṣaṇayāvaśūkacūrṇaṁ ca pītaṁ triphalārasēna||42||<br />
  
kRuShNA sapAThA gajapippalI ca nidigdhikA citrakanAgare ca|  
+
kRuShNA sapAThA gajapippalI ca nidigdhikA citrakanAgare ca| <br />
sapippalImUlarajanyajAjImustaM ca cUrNaM sukhatoyapItam||41||  
+
sapippalImUlarajanyajAjImustaM ca cUrNaM sukhatoyapItam||41|| <br />
  
hanyAttridoShaM cirajaM ca shophaM kalkashca bhUnimbamahauShadhasya|  
+
hanyAttridoShaM cirajaM ca shophaM kalkashca bhUnimbamahauShadhasya| <br />
ayorajastryUShaNayAvashUkacUrNaM ca pItaM triphalArasena||42||
+
ayorajastryUShaNayAvashUkacUrNaM ca pItaM triphalArasena||42||<br />
 +
</div></div>
  
Use of any one of the following powder preparations cures chronic edema caused by all the three ''dosha'':
+
Use of any one of the following powder preparations cures chronic edema caused by all the three ''[[dosha]]'':
  
 
The mixture of the powders of ''pippali, pippalimula, pāthā, gajapippali,'' cumin, ''kantakāri, chitraka,'' dried ginger, turmeric, cumin and ''mustaka'' taken with lukewarm water, or paste of ''bhumyāmalaki'' and dried ginger taken with lukewarm water or  
 
The mixture of the powders of ''pippali, pippalimula, pāthā, gajapippali,'' cumin, ''kantakāri, chitraka,'' dried ginger, turmeric, cumin and ''mustaka'' taken with lukewarm water, or paste of ''bhumyāmalaki'' and dried ginger taken with lukewarm water or  
 
''bhasma'' of iron, ''trikatu'' and ''yavakshara'' taken with decoction of ''triphala'' [41-42]
 
''bhasma'' of iron, ''trikatu'' and ''yavakshara'' taken with decoction of ''triphala'' [41-42]
  
==== ''Ksharagudika'' ====
+
=== ''Ksharagudika'' ===
 +
<div class="mw-collapsible mw-collapsed">
  
क्षारद्वयं स्याल्लवणानि चत्वार्ययोरजो व्योषफलत्रिके च|  
+
क्षारद्वयं स्याल्लवणानि चत्वार्ययोरजो व्योषफलत्रिके च| <br />
सपिप्पलीमूलविडङ्गसारं मुस्ताजमोदामरदारुबिल्वम्||४३||  
+
सपिप्पलीमूलविडङ्गसारं मुस्ताजमोदामरदारुबिल्वम्||४३|| <br />
  
कलिङ्गकाश्चित्रकमूलपाठे यष्ट्याह्वयं सातिविषं पलांशम्|  
+
कलिङ्गकाश्चित्रकमूलपाठे यष्ट्याह्वयं सातिविषं पलांशम्| <br />
सहिङ्गुकर्षं त्वणुशुष्कचूर्णं द्रोणं तथा मूलकशुण्ठकानाम्||४४||  
+
सहिङ्गुकर्षं त्वणुशुष्कचूर्णं द्रोणं तथा मूलकशुण्ठकानाम्||४४|| <br />
  
स्याद्भस्मनस्तत् सलिलेन साध्यमालोड्य यावद्घनमप्रदग्धम्|  
+
स्याद्भस्मनस्तत् सलिलेन साध्यमालोड्य यावद्घनमप्रदग्धम्| <br />
स्त्यानं ततः कोलसमां तु मात्रां कृत्वा सुशुष्कां विधिनोपयुञ्ज्यात्||४५||  
+
स्त्यानं ततः कोलसमां तु मात्रां कृत्वा सुशुष्कां विधिनोपयुञ्ज्यात्||४५|| <br />
  
प्लीहोदरश्वित्रहलीमकार्शःपाण्ड्वामयारोचकशोषशोफान्|  
+
प्लीहोदरश्वित्रहलीमकार्शःपाण्ड्वामयारोचकशोषशोफान्| <br />
विसूचिकागुल्मगराश्मरीश्च सश्वासकासाः प्रणुदेत् सकुष्ठाः||४६||  
+
विसूचिकागुल्मगराश्मरीश्च सश्वासकासाः प्रणुदेत् सकुष्ठाः||४६|| <br />
  
इति क्षारगुडिका   
+
इति क्षारगुडिका  <br />
 +
<div class="mw-collapsible-content">
 
                    
 
                    
kṣāradvayaṁ syāllavaṇāni catvāryayōrajō vyōṣaphalatrikē ca|  
+
kṣāradvayaṁ syāllavaṇāni catvāryayōrajō vyōṣaphalatrikē ca| <br />
sapippalīmūlaviḍaṅgasāraṁ mustājamōdāmaradārubilvam||43||  
+
sapippalīmūlaviḍaṅgasāraṁ mustājamōdāmaradārubilvam||43|| <br />
  
kaliṅgakāścitrakamūlapāṭhē yaṣṭyāhvayaṁ sātiviṣaṁ palāṁśam|  
+
kaliṅgakāścitrakamūlapāṭhē yaṣṭyāhvayaṁ sātiviṣaṁ palāṁśam| <br />
sahiṅgukarṣaṁ tvaṇuśuṣkacūrṇaṁ drōṇaṁ tathā mūlakaśuṇṭhakānām||44||  
+
sahiṅgukarṣaṁ tvaṇuśuṣkacūrṇaṁ drōṇaṁ tathā mūlakaśuṇṭhakānām||44|| <br />
  
syādbhasmanastat salilēna sādhyamālōḍya yāvadghanamapradagdham|  
+
syādbhasmanastat salilēna sādhyamālōḍya yāvadghanamapradagdham| <br />
styānaṁ tataḥ kōlasamāṁ tu mātrāṁ kr̥tvā suśuṣkāṁ vidhinōpayuñjyāt||45||
+
styānaṁ tataḥ kōlasamāṁ tu mātrāṁ kr̥tvā suśuṣkāṁ vidhinōpayuñjyāt||45||<br />
  
plīhōdaraśvitrahalīmakārśaḥpāṇḍvāmayārōcakaśōṣaśōphān|  
+
plīhōdaraśvitrahalīmakārśaḥpāṇḍvāmayārōcakaśōṣaśōphān| <br />
visūcikāgulmagarāśmarīśca saśvāsakāsāḥ praṇudēt sakuṣṭhāḥ||46||  
+
visūcikāgulmagarāśmarīśca saśvāsakāsāḥ praṇudēt sakuṣṭhāḥ||46|| <br />
  
iti kṣāraguḍikā ||  
+
iti kṣāraguḍikā || <br />
  
kShAradvayaM syAllavaNAni catvAryayorajo vyoShaphalatrike ca|  
+
kShAradvayaM syAllavaNAni catvAryayorajo vyoShaphalatrike ca| <br />
sapippalImUlaviDa~ggasAraM mustAjamodAmaradArubilvam||43||  
+
sapippalImUlaviDa~ggasAraM mustAjamodAmaradArubilvam||43|| <br />
  
kali~ggakAshcitrakamUlapAThe yaShTyAhvayaM sAtiviShaM palAMsham|  
+
kali~ggakAshcitrakamUlapAThe yaShTyAhvayaM sAtiviShaM palAMsham| <br />
sahi~ggukarShaM tvaNushuShkacUrNaM droNaM tathA mUlakashuNThakAnAm||44||  
+
sahi~ggukarShaM tvaNushuShkacUrNaM droNaM tathA mUlakashuNThakAnAm||44|| <br />
  
syAdbhasmanastat salilena sAdhyamAloDya yAvadghanamapradagdham|  
+
syAdbhasmanastat salilena sAdhyamAloDya yAvadghanamapradagdham| <br />
styAnaM tataH kolasamAM tu mAtrAM kRutvA sushuShkAM vidhinopayu~jjyAt||45||  
+
styAnaM tataH kolasamAM tu mAtrAM kRutvA sushuShkAM vidhinopayu~jjyAt||45|| <br />
  
plIhodarashvitrahalImakArshaHpANDvAmayArocakashoShashophAn|  
+
plIhodarashvitrahalImakArshaHpANDvAmayArocakashoShashophAn| <br />
visUcikAgulmagarAshmarIshca sashvAsakAsAH praNudet sakuShThAH||46||  
+
visUcikAgulmagarAshmarIshca sashvAsakAsAH praNudet sakuShThAH||46|| <br />
  
iti kShAraguDikA
+
iti kShAraguDikA <br />
 +
</div></div>
  
 
Take 40 gm fine powder each of ''svarajjikā'' and ''yava-kshara'', four varieties of salt, iron ''bhasma, trikatu, triphala, pippalimula,'' pealed seeds of ''vidanga, mustaka, ajamodā, devadāru, bilva, indrayava,'' root of ''chitraka, pāthā, ativishā'' and liquorice; 10 gm of asafetida and 1.024 Kg of dried radish and dried ginger. Add water to it and heat the mixture till it becomes thick taking care that it should not seared and from it make pills of 5 gm each and dry them.  
 
Take 40 gm fine powder each of ''svarajjikā'' and ''yava-kshara'', four varieties of salt, iron ''bhasma, trikatu, triphala, pippalimula,'' pealed seeds of ''vidanga, mustaka, ajamodā, devadāru, bilva, indrayava,'' root of ''chitraka, pāthā, ativishā'' and liquorice; 10 gm of asafetida and 1.024 Kg of dried radish and dried ginger. Add water to it and heat the mixture till it becomes thick taking care that it should not seared and from it make pills of 5 gm each and dry them.  
Line 630: Line 735:
 
Properly administered pills cure splenomegaly, leukoderma, ''halimaka'' (greenish coloration of the skin), piles, anemia, anorexia, emaciation, edema, gastroenteritis, ''gulma'', synthetic poisoning, lithiasis, dyspnea, cough and dermatosis. Thus ''ksharagudika'' is described [43-46]
 
Properly administered pills cure splenomegaly, leukoderma, ''halimaka'' (greenish coloration of the skin), piles, anemia, anorexia, emaciation, edema, gastroenteritis, ''gulma'', synthetic poisoning, lithiasis, dyspnea, cough and dermatosis. Thus ''ksharagudika'' is described [43-46]
  
==== Course of ''gud-adraka'' ====
+
=== Course of ''gud-adraka'' ===
 +
<div class="mw-collapsible mw-collapsed">
  
प्रयोजयेदार्द्रकनागरं वा तुल्यं गुडेनार्धपलाभिवृद्ध्या|  
+
प्रयोजयेदार्द्रकनागरं वा तुल्यं गुडेनार्धपलाभिवृद्ध्या| <br />
मात्रा परं पञ्चपलानि मासं जीर्णे पयो यूषरसाश्च भक्तम्||४७||
+
मात्रा परं पञ्चपलानि मासं जीर्णे पयो यूषरसाश्च भक्तम्||४७||<br />
 
   
 
   
गुल्मोदरार्शःश्वयथुप्रमेहाञ् श्वासप्रतिश्यालसकाविपाकान्|  
+
गुल्मोदरार्शःश्वयथुप्रमेहाञ् श्वासप्रतिश्यालसकाविपाकान्| <br />
सकामलाशोषमनोविकारान् कासं कफं चैव जयेत् प्रयोगः||४८||  
+
सकामलाशोषमनोविकारान् कासं कफं चैव जयेत् प्रयोगः||४८|| <br />
 +
<div class="mw-collapsible-content">
  
prayōjayēdārdrakanāgaraṁ vā tulyaṁ guḍēnārdhapalābhivr̥ddhyā|  
+
prayōjayēdārdrakanāgaraṁ vā tulyaṁ guḍēnārdhapalābhivr̥ddhyā| <br />
mātrā paraṁ pañcapalāni māsaṁ jīrṇē payō yūṣarasāśca bhaktam||47||  
+
mātrā paraṁ pañcapalāni māsaṁ jīrṇē payō yūṣarasāśca bhaktam||47|| <br />
  
gulmōdarārśaḥśvayathupramēhāñ śvāsapratiśyālasakāvipākān|  
+
gulmōdarārśaḥśvayathupramēhāñ śvāsapratiśyālasakāvipākān| <br />
sakāmalāśōṣamanōvikārān kāsaṁ kaphaṁ caiva jayēt prayōgaḥ||48||
+
sakāmalāśōṣamanōvikārān kāsaṁ kaphaṁ caiva jayēt prayōgaḥ||48||<br />
  
prayojayedArdrakanAgaraM vA tulyaM guDenArdhapalAbhivRuddhyA|  
+
prayojayedArdrakanAgaraM vA tulyaM guDenArdhapalAbhivRuddhyA| <br />
mAtrA paraM pa~jcapalAni mAsaM jIrNe payo yUSharasAshca bhaktam||47||  
+
mAtrA paraM pa~jcapalAni mAsaM jIrNe payo yUSharasAshca bhaktam||47|| <br />
  
gulmodarArshaHshvayathupramehA~j shvAsapratishyAlasakAvipAkAn|  
+
gulmodarArshaHshvayathupramehA~j shvAsapratishyAlasakAvipAkAn| <br />
sakAmalAshoShamanovikArAn kAsaM kaphaM caiva jayet prayogaH||48||
+
sakAmalAshoShamanovikArAn kAsaM kaphaM caiva jayet prayogaH||48||<br />
 +
</div></div>
  
 
Mix equal quantity of jaggery and ginger and take it in 20 gm dose initially and then increase its dose by 20 gm daily till the dose becomes 200 gm per day. Then this dose is to be continued for the remaining days of the month. During this treatment, on digestion of the drug, rice gruel and milk or meat soup should be given to eat.   
 
Mix equal quantity of jaggery and ginger and take it in 20 gm dose initially and then increase its dose by 20 gm daily till the dose becomes 200 gm per day. Then this dose is to be continued for the remaining days of the month. During this treatment, on digestion of the drug, rice gruel and milk or meat soup should be given to eat.   
 
    
 
    
The one month course cures ''gulma, udararoga,'' piles, edema, polyuria, dyspnea, coryza, cough, ''alasaka,'' indigestion, jaundice, consumption, mental disorders and kapha disorders [47-48]
+
The one month course cures ''gulma, udararoga,'' piles, edema, polyuria, dyspnea, coryza, cough, ''alasaka,'' indigestion, jaundice, consumption, mental disorders and [[kapha]] disorders [47-48]
 
    
 
    
==== Course of ''shilajatu'' ====
+
=== Course of ''shilajatu'' ===
 +
<div class="mw-collapsible mw-collapsed">
  
रसस्तथैवार्द्रकनागरस्य पेयोऽथ जीर्णे पयसाऽन्नमद्यात्|  
+
रसस्तथैवार्द्रकनागरस्य पेयोऽथ जीर्णे पयसाऽन्नमद्यात्| <br />
जत्वश्मजं [१३] च त्रिफलारसेन हन्यात्त्रिदोषं श्वयथुं प्रसह्य||४९||  
+
जत्वश्मजं [१३] च त्रिफलारसेन हन्यात्त्रिदोषं श्वयथुं प्रसह्य||४९|| <br />
  
इति शिलाजतुप्रयोगः  
+
इति शिलाजतुप्रयोगः <br />
 +
<div class="mw-collapsible-content">
  
rasastathaivārdrakanāgarasya pēyō'tha jīrṇē payasā'nnamadyāt| j
+
rasastathaivārdrakanāgarasya pēyō'tha jīrṇē payasā'nnamadyāt| <br />
atvaśmajaṁ [13] ca triphalārasēna hanyāttridōṣaṁ śvayathuṁ prasahya||49||  
+
jatvaśmajaṁ [13] ca triphalārasēna hanyāttridōṣaṁ śvayathuṁ prasahya||49|| <br />
  
iti śilājatuprayōgaḥ
+
iti śilājatuprayōgaḥ <br />
  
rasastathaivArdrakanAgarasya peyo~atha jIrNe payasA~annamadyAt|  
+
rasastathaivArdrakanAgarasya peyo~atha jIrNe payasA~annamadyAt| <br />
jatvashmajaM [13] ca triphalArasena hanyAttridoShaM shvayathuM prasahya||49||  
+
jatvashmajaM [13] ca triphalArasena hanyAttridoShaM shvayathuM prasahya||49|| <br />
  
iti shilAjatuprayogaH
+
iti shilAjatuprayogaH <br />
 +
</div></div>
  
 
Similarly juice of ginger may be taken with ''shilajatu'' for one month in the doses and manner mentioned above. On getting the hunger food should be taken with milk.
 
Similarly juice of ginger may be taken with ''shilajatu'' for one month in the doses and manner mentioned above. On getting the hunger food should be taken with milk.
  
A month’s course of ''shilājatu'' with juice of ''triphalā'' will completely cure the edema/swelling caused by all the three ''dosha''. Thus course of ''shilājatu'' is described [49]
+
A month’s course of ''shilājatu'' with juice of ''triphalā'' will completely cure the edema/swelling caused by all the three ''[[dosha]]''. Thus course of ''shilājatu'' is described [49]
  
==== ''Kamsaharitaki'' ====
+
=== ''Kamsa haritaki'' ===
 +
<div class="mw-collapsible mw-collapsed">
  
द्विपञ्चमूलस्य पचेत् कषाये कंसेऽभयानां च शतं गुडस्य|  
+
द्विपञ्चमूलस्य पचेत् कषाये कंसेऽभयानां च शतं गुडस्य| <br />
लेहे सुसिद्धेऽथ विनीय चूर्णं व्योषं त्रिसौगन्ध्यमुषास्थिते च||५०||  
+
लेहे सुसिद्धेऽथ विनीय चूर्णं व्योषं त्रिसौगन्ध्यमुषास्थिते च||५०|| <br />
  
प्रस्थार्धमात्रं मधुनः सुशीते किञ्चिच्च चूर्णादपि यावशूकात्|  
+
प्रस्थार्धमात्रं मधुनः सुशीते किञ्चिच्च चूर्णादपि यावशूकात्| <br />
एकाभयां प्राश्य ततश्च लेहाच्छुक्तिं निहन्ति श्वयथुं प्रवृद्धम्||५१||  
+
एकाभयां प्राश्य ततश्च लेहाच्छुक्तिं निहन्ति श्वयथुं प्रवृद्धम्||५१|| <br />
  
श्वासज्वरारोचकमेहगुल्मप्लीहत्रिदोषोदरपाण्डुरोगान्|  
+
श्वासज्वरारोचकमेहगुल्मप्लीहत्रिदोषोदरपाण्डुरोगान्| <br />
कार्श्यामवातावसृगम्लपित्तवैवर्ण्यमूत्रानिलशुक्रदोषान्||५२||  
+
कार्श्यामवातावसृगम्लपित्तवैवर्ण्यमूत्रानिलशुक्रदोषान्||५२|| <br />
  
इति कंसहरीतकी                    
+
इति कंसहरीतकी <br />                 
 +
<div class="mw-collapsible-content">
  
dvipañcamūlasya pacēt kaṣāyē kaṁsē'bhayānāṁ ca śataṁ guḍasya|  
+
dvipañcamūlasya pacēt kaṣāyē kaṁsē'bhayānāṁ ca śataṁ guḍasya| <br />
lēhē susiddhē'tha vinīya cūrṇaṁ vyōṣaṁ trisaugandhyamuṣāsthitē ca||50||  
+
lēhē susiddhē'tha vinīya cūrṇaṁ vyōṣaṁ trisaugandhyamuṣāsthitē ca||50|| <br />
  
prasthārdhamātraṁ madhunaḥ suśītē kiñcicca cūrṇādapi yāvaśūkāt|  
+
prasthārdhamātraṁ madhunaḥ suśītē kiñcicca cūrṇādapi yāvaśūkāt| <br />
ēkābhayāṁ prāśya tataśca lēhācchuktiṁ nihanti śvayathuṁ pravr̥ddham||51||  
+
ēkābhayāṁ prāśya tataśca lēhācchuktiṁ nihanti śvayathuṁ pravr̥ddham||51|| <br />
  
śvāsajvarārōcakamēhagulmaplīhatridōṣōdarapāṇḍurōgān|  
+
śvāsajvarārōcakamēhagulmaplīhatridōṣōdarapāṇḍurōgān| <br />
kārśyāmavātāvasr̥gamlapittavaivarṇyamūtrānilaśukradōṣān||52||  
+
kārśyāmavātāvasr̥gamlapittavaivarṇyamūtrānilaśukradōṣān||52|| <br />
  
iti kaṁsaharītakī
+
iti kaṁsaharītakī <br />
  
dvipa~jcamUlasya pacet kaShAye kaMse~abhayAnAM ca shataM guDasya|  
+
dvipa~jcamUlasya pacet kaShAye kaMse~abhayAnAM ca shataM guDasya| <br />
lehe susiddhe~atha vinIya cUrNaM vyoShaM trisaugandhyamuShAsthite ca||50||  
+
lehe susiddhe~atha vinIya cUrNaM vyoShaM trisaugandhyamuShAsthite ca||50|| <br />
  
prasthArdhamAtraM madhunaH sushIte ki~jcicca cUrNAdapi yAvashUkAt|  
+
prasthArdhamAtraM madhunaH sushIte ki~jcicca cUrNAdapi yAvashUkAt| <br />
ekAbhayAM prAshya tatashca lehAcchuktiM nihanti shvayathuM pravRuddham||51||  
+
ekAbhayAM prAshya tatashca lehAcchuktiM nihanti shvayathuM pravRuddham||51|| <br />
  
shvAsajvarArocakamehagulmaplIhatridoShodarapANDurogAn|  
+
shvAsajvarArocakamehagulmaplIhatridoShodarapANDurogAn| <br />
kArshyAmavAtAvasRugamlapittavaivarNyamUtrAnilashukradoShAn||52||  
+
kArshyAmavAtAvasRugamlapittavaivarNyamUtrAnilashukradoShAn||52|| <br />
  
iti kaMsaharItakI
+
iti kaMsaharItakI <br />
 +
</div></div>
  
 
Make 2.56 liter decoction of ''dashamula'' and add to it ''haritaki'' 100 in number and 4.0 kg of jaggery and powder of ''trikatu'' and ''trijata'' (three aromatics- leaves and bark of cinnamon and cardamom). Leave it overnight and next morning on cooling adds 320 gm of honey and little quantity of ''yavakshara''.  
 
Make 2.56 liter decoction of ''dashamula'' and add to it ''haritaki'' 100 in number and 4.0 kg of jaggery and powder of ''trikatu'' and ''trijata'' (three aromatics- leaves and bark of cinnamon and cardamom). Leave it overnight and next morning on cooling adds 320 gm of honey and little quantity of ''yavakshara''.  
  
Take it in the dose of 10 gm along with one ''haritaki''. It will cure  severe edema and also dyspnea, fever, anorexia, polyuria, ''gulma'', splenic-disorders, ''sannipātika-udararoga,'' anemia, emaciation, rheumatoid arthritis, bleeding disorders, hyperchlorhydria, discoloration of skin and ''vāta'' disorders of urine and semen. Thus ''kaṁsaharītakī'' is described [50-52]
+
Take it in the dose of 10 gm along with one ''haritaki''. It will cure  severe edema and also dyspnea, fever, anorexia, polyuria, ''gulma'', splenic-disorders, ''sannipātika-udararoga,'' anemia, emaciation, rheumatoid arthritis, bleeding disorders, hyperchlorhydria, discoloration of skin and ''[[vata]]'' disorders of urine and semen. Thus ''kaṁsaharītakī'' is described [50-52]
  
==== ''Patolādi kaṣāya'' ====
+
=== Patoladi kashaya ===
 +
<div class="mw-collapsible mw-collapsed">
  
पटोलमूलामरदारुदन्तीत्रायन्तिपिप्पल्यभयाविशालाः|  
+
पटोलमूलामरदारुदन्तीत्रायन्तिपिप्पल्यभयाविशालाः| <br />
यष्ट्याह्वयं तिक्तकरोहिणी च सचन्दना स्यान्निचुलानि दार्वी||५३||  
+
यष्ट्याह्वयं तिक्तकरोहिणी च सचन्दना स्यान्निचुलानि दार्वी||५३|| <br />
  
कर्षोन्मितैस्तैः क्वथितः कषायो घृतेन पेयः कुडवेन युक्तः|  
+
कर्षोन्मितैस्तैः क्वथितः कषायो घृतेन पेयः कुडवेन युक्तः| <br />
वीसर्पदाहज्वरसन्निपाततृष्णाविषाणि श्वयथुं च हन्ति||५४||  
+
वीसर्पदाहज्वरसन्निपाततृष्णाविषाणि श्वयथुं च हन्ति||५४|| <br />
 +
<div class="mw-collapsible-content">
  
paṭōlamūlāmaradārudantītrāyantipippalyabhayāviśālāḥ|  
+
paṭōlamūlāmaradārudantītrāyantipippalyabhayāviśālāḥ| <br />
yaṣṭyāhvayaṁ tiktakarōhiṇī ca sacandanā syānniculāni dārvī||53||  
+
yaṣṭyāhvayaṁ tiktakarōhiṇī ca sacandanā syānniculāni dārvī||53|| <br />
  
karṣōnmitaistaiḥ kvathitaḥ kaṣāyō ghr̥tēna pēyaḥ kuḍavēna yuktaḥ|  
+
karṣōnmitaistaiḥ kvathitaḥ kaṣāyō ghr̥tēna pēyaḥ kuḍavēna yuktaḥ| <br />
vīsarpadāhajvarasannipātatr̥ṣṇāviṣāṇi śvayathuṁ ca hanti||54||
+
vīsarpadāhajvarasannipātatr̥ṣṇāviṣāṇi śvayathuṁ ca hanti||54||<br />
  
paTolamUlAmaradArudantItrAyantipippalyabhayAvishAlAH|  
+
paTolamUlAmaradArudantItrAyantipippalyabhayAvishAlAH| <br />
yaShTyAhvayaM tiktakarohiNI ca sacandanA syAnniculAni dArvI||53||  
+
yaShTyAhvayaM tiktakarohiNI ca sacandanA syAnniculAni dArvI||53|| <br />
  
karShonmitaistaiH kvathitaH kaShAyo ghRutena peyaH kuDavena yuktaH|  
+
karShonmitaistaiH kvathitaH kaShAyo ghRutena peyaH kuDavena yuktaH| <br />
vIsarpadAhajvarasannipAtatRuShNAviShANi shvayathuM ca hanti||54||
+
vIsarpadAhajvarasannipAtatRuShNAviShANi shvayathuM ca hanti||54||<br />
 +
</div></div>
  
 
Make decoction of 10 gm each of roots of ''patola, devadāru, danti, trāyamānā, pippali, haritaki, indrāyana,'' liquorices, sandal wood, ''katukā, dāruhridrā'' and ''samudraphala''. This decoction should be taken with 160 gm of ghee. It cures ''visarpa'' (erysipelas), burning sensation, fever, ''sannipāta'' thirst, poisoning and edema [53-54]
 
Make decoction of 10 gm each of roots of ''patola, devadāru, danti, trāyamānā, pippali, haritaki, indrāyana,'' liquorices, sandal wood, ''katukā, dāruhridrā'' and ''samudraphala''. This decoction should be taken with 160 gm of ghee. It cures ''visarpa'' (erysipelas), burning sensation, fever, ''sannipāta'' thirst, poisoning and edema [53-54]
  
==== ''Chitraka ghrita'' ====
+
=== ''Chitraka ghrita'' ===
 +
<div class="mw-collapsible mw-collapsed">
  
सचित्रकं [१४] धान्ययवान्यजाजीसौवर्चलं त्र्यूषणवेतसाम्लम्|  
+
सचित्रकं [१४] धान्ययवान्यजाजीसौवर्चलं त्र्यूषणवेतसाम्लम्| <br />
बिल्वात् फलं दाडिमयावशूकौ सपिप्पलीमूलमथापि चव्यम्||५५||  
+
बिल्वात् फलं दाडिमयावशूकौ सपिप्पलीमूलमथापि चव्यम्||५५|| <br />
  
पिष्ट्वाऽक्षमात्राणि जलाढकेन पक्त्वा घृतप्रस्थमथ प्रयुञ्ज्यात्|  
+
पिष्ट्वाऽक्षमात्राणि जलाढकेन पक्त्वा घृतप्रस्थमथ प्रयुञ्ज्यात्| <br />
अर्शांसि गुल्मं श्वयथुं  कृच्छ्रं निहन्ति वह्निं च करोति दीप्तम्||५६||  
+
अर्शांसि गुल्मं श्वयथुं  कृच्छ्रं निहन्ति वह्निं च करोति दीप्तम्||५६|| <br />
 +
<div class="mw-collapsible-content">
  
sacitrakaṁ [14] dhānyayavānyajājīsauvarcalaṁ tryūṣaṇavētasāmlam|  
+
sacitrakaṁ [14] dhānyayavānyajājīsauvarcalaṁ tryūṣaṇavētasāmlam| <br />
b0ilvāt phalaṁ dāḍimayāvaśūkau sapippalīmūlamathāpi cavyam||55||  
+
b0ilvāt phalaṁ dāḍimayāvaśūkau sapippalīmūlamathāpi cavyam||55|| <br />
  
piṣṭvā'kṣamātrāṇi jalāḍhakēna paktvā ghr̥taprasthamatha prayuñjyāt|  
+
piṣṭvā'kṣamātrāṇi jalāḍhakēna paktvā ghr̥taprasthamatha prayuñjyāt| <br />
arśāṁsi gulmaṁ śvayathuṁ ca kr̥cchraṁ nihanti vahniṁ ca karōti dīptam||56||  
+
arśāṁsi gulmaṁ śvayathuṁ ca kr̥cchraṁ nihanti vahniṁ ca karōti dīptam||56|| <br />
  
sacitrakaM [14] dhAnyayavAnyajAjIsauvarcalaM tryUShaNavetasAmlam|  
+
sacitrakaM [14] dhAnyayavAnyajAjIsauvarcalaM tryUShaNavetasAmlam| <br />
bilvAt phalaM dADimayAvashUkau sapippalImUlamathApi cavyam||55||  
+
bilvAt phalaM dADimayAvashUkau sapippalImUlamathApi cavyam||55|| <br />
  
piShTvA~akShamAtrANi jalADhakena paktvA ghRutaprasthamatha prayu~jjyAt|  
+
piShTvA~akShamAtrANi jalADhakena paktvA ghRutaprasthamatha prayu~jjyAt|<br />
arshAMsi gulmaM shvayathuM ca kRucchraM nihanti vahniM ca karoti dIptam||56||   
+
arshAMsi gulmaM shvayathuM ca kRucchraM nihanti vahniM ca karoti dIptam||56||<br />  
 +
</div></div>
  
 
Make paste of 10 gm each of ''chitraka,'' coriander, ajawan, cumin, ''sauvarchala''-salt, ''trikatu, amlavetasa, bilva,'' pomegranate, ''yavakṣāra, pippalimula'' and ''chavya''; add to it 640 gm of ghee and 2.56 liter of water. Prepare ''ghrita'' as per ''sneha pāka'' method.  
 
Make paste of 10 gm each of ''chitraka,'' coriander, ajawan, cumin, ''sauvarchala''-salt, ''trikatu, amlavetasa, bilva,'' pomegranate, ''yavakṣāra, pippalimula'' and ''chavya''; add to it 640 gm of ghee and 2.56 liter of water. Prepare ''ghrita'' as per ''sneha pāka'' method.  
  
 
Oral administration of ''chitraka'' ghee cures edema/swelling even if it is difficult to cure as well as piles and ''gulma'' and stimulate the digestion and metabolism (''agni''). [55-56]
 
Oral administration of ''chitraka'' ghee cures edema/swelling even if it is difficult to cure as well as piles and ''gulma'' and stimulate the digestion and metabolism (''agni''). [55-56]
 +
<div class="mw-collapsible mw-collapsed">
 
    
 
    
पिबेद्घृतं वाऽष्टगुणाम्बुसिद्धं सचित्रकक्षारमुदारवीर्यम्|  
+
पिबेद्घृतं वाऽष्टगुणाम्बुसिद्धं सचित्रकक्षारमुदारवीर्यम्| <br />
कल्याणकं वाऽपि सपञ्चगव्यं तिक्तं महद्वाऽप्यथ तिक्तकं वा||५७||  
+
कल्याणकं वाऽपि सपञ्चगव्यं तिक्तं महद्वाऽप्यथ तिक्तकं वा||५७|| <br />
 +
<div class="mw-collapsible-content">
  
pibēdghr̥taṁ vā'ṣṭaguṇāmbusiddhaṁ sacitrakakṣāramudāravīryam|  
+
pibēdghr̥taṁ vā'ṣṭaguṇāmbusiddhaṁ sacitrakakṣāramudāravīryam| <br />
kalyāṇakaṁ vā'pi sapañcagavyaṁ tiktaṁ mahadvā'pyatha tiktakaṁ vā||57||
+
kalyāṇakaṁ vā'pi sapañcagavyaṁ tiktaṁ mahadvā'pyatha tiktakaṁ vā||57||<br />
  
pibedghRutaM vA~aShTaguNAmbusiddhaM sacitrakakShAramudAravIryam|  
+
pibedghRutaM vA~aShTaguNAmbusiddhaM sacitrakakShAramudAravIryam| <br />
kalyANakaM vA~api sapa~jcagavyaM tiktaM mahadvA~apyatha tiktakaM vA||57||
+
kalyANakaM vA~api sapa~jcagavyaM tiktaM mahadvA~apyatha tiktakaM vA||57||<br />
 +
</div></div>
  
 
Prepare a ''ghrita'' with eight times of water with paste of ''chitraka'' and ''yavakshara''. It has great potency. The patient may also take the ''kalyānaka ghrita'' or ''panchagavya ghrita'' or ''mahātikta ghrita'' or ''tikta ghrita'' [57]  
 
Prepare a ''ghrita'' with eight times of water with paste of ''chitraka'' and ''yavakshara''. It has great potency. The patient may also take the ''kalyānaka ghrita'' or ''panchagavya ghrita'' or ''mahātikta ghrita'' or ''tikta ghrita'' [57]  
 +
<div class="mw-collapsible mw-collapsed">
  
क्षीरं घटे चित्रककल्कलिप्ते दध्यागतं साधु विमथ्य तेन|  
+
क्षीरं घटे चित्रककल्कलिप्ते दध्यागतं साधु विमथ्य तेन| <br />
तज्जं घृतं चित्रकमूलगर्भं तक्रेण सिद्धं श्वयथुघ्नमग्र्यम्||५८||  
+
तज्जं घृतं चित्रकमूलगर्भं तक्रेण सिद्धं श्वयथुघ्नमग्र्यम्||५८|| <br />
  
अर्शोऽतिसारानिलगुल्ममेहांश्चैतन्निहन्त्यग्निबलप्रदं [१५] च|  
+
अर्शोऽतिसारानिलगुल्ममेहांश्चैतन्निहन्त्यग्निबलप्रदं [१५] च| <br />
तक्रेण चाद्यात् सघृतेन तेन भोज्यानि सिद्धामथवा यवागूम्||५९||  
+
तक्रेण चाद्यात् सघृतेन तेन भोज्यानि सिद्धामथवा यवागूम्||५९|| <br />
  
इति चित्रकघृतम्                              
+
इति चित्रकघृतम् <br />                           
 +
<div class="mw-collapsible-content">
  
kṣīraṁ ghaṭē citrakakalkaliptē dadhyāgataṁ sādhu vimathya tēna|  
+
kṣīraṁ ghaṭē citrakakalkaliptē dadhyāgataṁ sādhu vimathya tēna| <br />
tajjaṁ ghr̥taṁ citrakamūlagarbhaṁ takrēṇa siddhaṁ śvayathughnamagryam||58||  
+
tajjaṁ ghr̥taṁ citrakamūlagarbhaṁ takrēṇa siddhaṁ śvayathughnamagryam||58|| <br />
  
arśō'tisārānilagulmamēhāṁścaitannihantyagnibalapradaṁ [15] ca|  
+
arśō'tisārānilagulmamēhāṁścaitannihantyagnibalapradaṁ [15] ca| <br />
takrēṇa cādyāt saghr̥tēna tēna bhōjyāni siddhāmathavā yavāgūm||59||  
+
takrēṇa cādyāt saghr̥tēna tēna bhōjyāni siddhāmathavā yavāgūm||59|| <br />
  
iti citrakaghr̥tam
+
iti citrakaghr̥tam <br />
  
kShIraM ghaTe citrakakalkalipte dadhyAgataM sAdhu vimathya tena|  
+
kShIraM ghaTe citrakakalkalipte dadhyAgataM sAdhu vimathya tena| <br />
tajjaM ghRutaM citrakamUlagarbhaM takreNa siddhaM shvayathughnamagryam||58||  
+
tajjaM ghRutaM citrakamUlagarbhaM takreNa siddhaM shvayathughnamagryam||58|| <br />
  
arsho~atisArAnilagulmamehAMshcaitannihantyagnibalapradaM [15] ca|  
+
arsho~atisArAnilagulmamehAMshcaitannihantyagnibalapradaM [15] ca| <br />
takreNa cAdyAt saghRutena tena bhojyAni siddhAmathavA yavAgUm||59||  
+
takreNa cAdyAt saghRutena tena bhojyAni siddhAmathavA yavAgUm||59|| <br />
  
iti citrakaghRutam
+
iti citrakaghRutam <br />
 +
</div></div>
  
Put milk in a pot coated with paste of ''chitraka'' and curdle it. Churn this curd well to get butter which is heated to ghee. Add to the ghee all the buttermilk (which contains mixed ''chitraka'' also) from the pot and prepare the medicated ''ghrita''. It is best to cure edema. It also provides relief in piles, diarrhea, ''vāta-gulma'', polyuria and stimulates digestion and metabolism (''agni'').  
+
Put milk in a pot coated with paste of ''chitraka'' and curdle it. Churn this curd well to get butter which is heated to ghee. Add to the ghee all the buttermilk (which contains mixed ''chitraka'' also) from the pot and prepare the medicated ''ghrita''. It is best to cure edema. It also provides relief in piles, diarrhea, ''[[vata]]-gulma'', polyuria and stimulates digestion and metabolism (''agni'').  
  
 
During the treatment the diet should be taken with buttermilk prepared as above with ''chitraka'' along with ghee prepared from the above butter or gruels prepared with this butter milk and ghee. Thus ''chitraka ghrita'' is described [58-59]
 
During the treatment the diet should be taken with buttermilk prepared as above with ''chitraka'' along with ghee prepared from the above butter or gruels prepared with this butter milk and ghee. Thus ''chitraka ghrita'' is described [58-59]
  
==== ''Yavāgu'' preparations ====
+
=== Yavagu preparations ===
 +
<div class="mw-collapsible mw-collapsed">
  
जीवन्त्यजाजीशटिपुष्कराह्वैः सकारवीचित्रकबिल्वमध्यैः|  
+
जीवन्त्यजाजीशटिपुष्कराह्वैः सकारवीचित्रकबिल्वमध्यैः| <br />
सयावशूकैर्बदरप्रमाणैर्वृक्षाम्लयुक्ता घृततैलभृष्टा||६०||  
+
सयावशूकैर्बदरप्रमाणैर्वृक्षाम्लयुक्ता घृततैलभृष्टा||६०|| <br />
  
अर्शोऽतिसारानिलगुल्मशोफहृद्रोगमन्दाग्निहिता यवागूः|  
+
अर्शोऽतिसारानिलगुल्मशोफहृद्रोगमन्दाग्निहिता यवागूः| <br />
या पञ्चकोलैर्विधिनैव [१६] तेन सिद्धा भवेत् सा च समा तयैव||६१||  
+
या पञ्चकोलैर्विधिनैव [१६] तेन सिद्धा भवेत् सा च समा तयैव||६१|| <br />
 +
<div class="mw-collapsible-content">
  
jīvantyajājīśaṭipuṣkarāhvaiḥ sakāravīcitrakabilvamadhyaiḥ|  
+
jīvantyajājīśaṭipuṣkarāhvaiḥ sakāravīcitrakabilvamadhyaiḥ| <br />
sayāvaśūkairbadarapramāṇairvr̥kṣāmlayuktā ghr̥tatailabhr̥ṣṭā||60||  
+
sayāvaśūkairbadarapramāṇairvr̥kṣāmlayuktā ghr̥tatailabhr̥ṣṭā||60|| <br />
  
arśō'tisārānilagulmaśōphahr̥drōgamandāgnihitā yavāgūḥ|  
+
arśō'tisārānilagulmaśōphahr̥drōgamandāgnihitā yavāgūḥ| <br />
yā pañcakōlairvidhinaiva [16] tēna siddhā bhavēt sā ca samā tayaiva||61||  
+
yā pañcakōlairvidhinaiva [16] tēna siddhā bhavēt sā ca samā tayaiva||61|| <br />
 
   
 
   
jIvantyajAjIshaTipuShkarAhvaiH sakAravIcitrakabilvamadhyaiH|  
+
jIvantyajAjIshaTipuShkarAhvaiH sakAravIcitrakabilvamadhyaiH| <br />
sayAvashUkairbadarapramANairvRukShAmlayuktA ghRutatailabhRuShTA||60||  
+
sayAvashUkairbadarapramANairvRukShAmlayuktA ghRutatailabhRuShTA||60|| <br />
  
arsho~atisArAnilagulmashophahRudrogamandAgnihitA yavAgUH|  
+
arsho~atisArAnilagulmashophahRudrogamandAgnihitA yavAgUH| <br />
yA pa~jcakolairvidhinaiva [16] tena siddhA bhavet sA ca samA tayaiva||61||  
+
yA pa~jcakolairvidhinaiva [16] tena siddhA bhavet sA ca samA tayaiva||61|| <br />
 +
</div></div>
  
Take 5 gm each of ''jivanti,'' cumin, ''saṭi, pushkarmula, karvi'' (celery), ''chitraka, bilva'' and  ''yavakashara,'' make a medicated gruel (''yavāgu'') and then fry it in ghee and oil. This gruel taken by adding ''vrikshamla'' cures piles, diarrhea, ''vāta gulma'', edema, heart disease and low digestion.  
+
Take 5 gm each of ''jivanti,'' cumin, ''saṭi, pushkarmula, karvi'' (celery), ''chitraka, bilva'' and  ''yavakashara,'' make a medicated gruel (''yavāgu'') and then fry it in ghee and oil. This gruel taken by adding ''vrikshamla'' cures piles, diarrhea, ''[[vata]] gulma'', edema, heart disease and low digestion.  
  
 
The medicated ''yavāgu'' (gruel) similarly prepared with ''panchakola'' also gives the same relief as mentioned above (60-61).
 
The medicated ''yavāgu'' (gruel) similarly prepared with ''panchakola'' also gives the same relief as mentioned above (60-61).
  
==== ''Pathya'' for ''shotha'' ====
+
=== ''Pathya'' (wholesome food) for ''shotha'' ===
 +
<div class="mw-collapsible mw-collapsed">
  
कुलत्थयूषश्च सपिप्पलीको मौद्गश्च सत्र्यूषणयावशूकः|  
+
कुलत्थयूषश्च सपिप्पलीको मौद्गश्च सत्र्यूषणयावशूकः| <br />
रसस्तथा विष्किरजाङ्गलानां सकूर्मगोधाशिखिशल्लकानाम्||६२||  
+
रसस्तथा विष्किरजाङ्गलानां सकूर्मगोधाशिखिशल्लकानाम्||६२|| <br />
  
सुवर्चला गृञ्जनकं पटोलं सवायसीमूलकवेत्रनिम्बम्|  
+
सुवर्चला गृञ्जनकं पटोलं सवायसीमूलकवेत्रनिम्बम्| <br />
शाकार्थिनां शाकमिति प्रशस्तं भोज्ये पुराणश्च यवः सशालिः||६३||  
+
शाकार्थिनां शाकमिति प्रशस्तं भोज्ये पुराणश्च यवः सशालिः||६३|| <br />
 +
<div class="mw-collapsible-content">
  
kulatthayūṣaśca sapippalīkō maudgaśca satryūṣaṇayāvaśūkaḥ|  
+
kulatthayūṣaśca sapippalīkō maudgaśca satryūṣaṇayāvaśūkaḥ| <br />
rasastathā viṣkirajāṅgalānāṁ sakūrmagōdhāśikhiśallakānām||62||  
+
rasastathā viṣkirajāṅgalānāṁ sakūrmagōdhāśikhiśallakānām||62|| <br />
  
suvarcalā gr̥ñjanakaṁ paṭōlaṁ savāyasīmūlakavētranimbam|  
+
suvarcalā gr̥ñjanakaṁ paṭōlaṁ savāyasīmūlakavētranimbam| <br />
śākārthināṁ śākamiti praśastaṁ bhōjyē purāṇaśca yavaḥ saśāliḥ||63||
+
śākārthināṁ śākamiti praśastaṁ bhōjyē purāṇaśca yavaḥ saśāliḥ||63||<br />
  
kulatthayUShashca sapippalIko maudgashca satryUShaNayAvashUkaH|  
+
kulatthayUShashca sapippalIko maudgashca satryUShaNayAvashUkaH| <br />
rasastathA viShkirajA~ggalAnAM sakUrmagodhAshikhishallakAnAm||62||  
+
rasastathA viShkirajA~ggalAnAM sakUrmagodhAshikhishallakAnAm||62|| <br />
  
suvarcalA gRu~jjanakaM paTolaM savAyasImUlakavetranimbam|  
+
suvarcalA gRu~jjanakaM paTolaM savAyasImUlakavetranimbam| <br />
shAkArthinAM shAkamiti prashastaM bhojye purANashca yavaH sashAliH||63||
+
shAkArthinAM shAkamiti prashastaM bhojye purANashca yavaH sashAliH||63||<br />
 +
</div></div>
  
 
Followings diet articles are wholesome for the patient of edema/swelling:
 
Followings diet articles are wholesome for the patient of edema/swelling:
Line 851: Line 983:
 
*Old ''shali rice'' and old barley [62-63]
 
*Old ''shali rice'' and old barley [62-63]
  
==== External applications ====
+
=== External applications ===
 +
<div class="mw-collapsible mw-collapsed">
  
आभ्यन्तरं भेषजमुक्तमेतद्बर्हिर्हितं यच्छृणु तद्यथावत्|  
+
आभ्यन्तरं भेषजमुक्तमेतद्बर्हिर्हितं यच्छृणु तद्यथावत्| <br />
स्नेहान् प्रदेहान् परिषेचनानि स्वेदांश्च वातप्रबलस्य कुर्यात्||६४||  
+
स्नेहान् प्रदेहान् परिषेचनानि स्वेदांश्च वातप्रबलस्य कुर्यात्||६४|| <br />
 +
<div class="mw-collapsible-content">
  
ābhyantaraṁ bhēṣajamuktamētadbarhirhitaṁ yacchr̥ṇu tadyathāvat|  
+
ābhyantaraṁ bhēṣajamuktamētadbarhirhitaṁ yacchr̥ṇu tadyathāvat| <br />
snēhān pradēhān pariṣēcanāni svēdāṁśca vātaprabalasya kuryāt||64||  
+
snēhān pradēhān pariṣēcanāni svēdāṁśca vātaprabalasya kuryāt||64|| <br />
  
AbhyantaraM bheShajamuktametadbarhirhitaM yacchRuNu tadyathAvat|  
+
AbhyantaraM bheShajamuktametadbarhirhitaM yacchRuNu tadyathAvat| <br />
snehAn pradehAn pariShecanAni svedAMshca vAtaprabalasya kuryAt||64||  
+
snehAn pradehAn pariShecanAni svedAMshca vAtaprabalasya kuryAt||64|| <br />
 +
</div></div>
  
Thus internal preparations have been described. Now external preparations beneficial for the patient of swelling will be described. ''Snehana, swedana,'' smearing with pastes and effusions should be done in a patient having dominance of ''vata'' swelling [64]
+
Thus internal preparations have been described. Now external preparations beneficial for the patient of swelling will be described. ''[[Snehana]], [[swedana]],'' smearing with pastes and effusions should be done in a patient having dominance of ''[[vata]]'' swelling [64]
  
==== ''Shaileyadi taila'' ====
+
=== ''Shaileyadi taila'' ===
 +
<div class="mw-collapsible mw-collapsed">
  
शैलेयकुष्ठागुरुदारुकौन्तीत्वक्पद्मकैलाम्बुपलाशमुस्तैः|  
+
शैलेयकुष्ठागुरुदारुकौन्तीत्वक्पद्मकैलाम्बुपलाशमुस्तैः| <br />
प्रियङ्गुथौणेयकहेममांसीतालीशपत्रप्लवपत्रधान्यैः||६५||  
+
प्रियङ्गुथौणेयकहेममांसीतालीशपत्रप्लवपत्रधान्यैः||६५|| <br />
  
श्रीवेष्टकध्यामकपिप्पलीभिः स्पृक्कानखैश्चैव यथोपलाभम्|  
+
श्रीवेष्टकध्यामकपिप्पलीभिः स्पृक्कानखैश्चैव यथोपलाभम्| <br />
वातान्वितेऽभ्यङ्गमुशन्ति तैलं सिद्धं सुपिष्टैरपि च प्रदेहम्||६६||  
+
वातान्वितेऽभ्यङ्गमुशन्ति तैलं सिद्धं सुपिष्टैरपि च प्रदेहम्||६६|| <br />
 +
<div class="mw-collapsible-content">
  
śailēyakuṣṭhāgurudārukauntītvakpadmakailāmbupalāśamustaiḥ|  
+
śailēyakuṣṭhāgurudārukauntītvakpadmakailāmbupalāśamustaiḥ| <br />
priyaṅguthauṇēyakahēmamāṁsītālīśapatraplavapatradhānyaiḥ||65||  
+
priyaṅguthauṇēyakahēmamāṁsītālīśapatraplavapatradhānyaiḥ||65|| <br />
  
śrīvēṣṭakadhyāmakapippalībhiḥ spr̥kkānakhaiścaiva yathōpalābham|  
+
śrīvēṣṭakadhyāmakapippalībhiḥ spr̥kkānakhaiścaiva yathōpalābham| <br />
vātānvitē'bhyaṅgamuśanti tailaṁ siddhaṁ supiṣṭairapi ca pradēham||66||  
+
vātānvitē'bhyaṅgamuśanti tailaṁ siddhaṁ supiṣṭairapi ca pradēham||66|| <br />
  
shaileyakuShThAgurudArukauntItvakpadmakailAmbupalAshamustaiH|  
+
shaileyakuShThAgurudArukauntItvakpadmakailAmbupalAshamustaiH| <br />
priya~gguthauNeyakahemamAMsItAlIshapatraplavapatradhAnyaiH||65||  
+
priya~gguthauNeyakahemamAMsItAlIshapatraplavapatradhAnyaiH||65|| <br />
  
shrIveShTakadhyAmakapippalIbhiH spRukkAnakhaishcaiva yathopalAbham|  
+
shrIveShTakadhyAmakapippalIbhiH spRukkAnakhaishcaiva yathopalAbham| <br />
vAtAnvite~abhya~ggamushanti tailaM siddhaM supiShTairapi ca pradeham||66||
+
vAtAnvite~abhya~ggamushanti tailaM siddhaM supiShTairapi ca pradeham||66||<br />
 +
</div></div>
  
Take ''kuṣṭha, aguru, devadāru, kaunti,'' cinnamon, ''padmaka,'' cardamom, ''sugandhabālā, palāśa, mustaka, priyangu, thauneyaka, nāgakeśara, jatāmāmsi, tālisapatra, plava, tejapatra,'' coriander, ''sriveshtaka, dhyāmaka,'' piper longum, ''sprikkā'' and ''nakha''. Make paste of all or as much as drugs available and prepare medicated oil from it. In ''vāta'' edema, do massage with this oil. Alternatively make paste of the entire drugs and apply on the body of the patient as smear [65-66]   
+
Take ''kuṣṭha, aguru, devadāru, kaunti,'' cinnamon, ''padmaka,'' cardamom, ''sugandhabālā, palāśa, mustaka, priyangu, thauneyaka, nāgakeśara, jatāmāmsi, tālisapatra, plava, tejapatra,'' coriander, ''sriveshtaka, dhyāmaka,'' piper longum, ''sprikkā'' and ''nakha''. Make paste of all or as much as drugs available and prepare medicated oil from it. In ''[[vata]]'' edema, do massage with this oil. Alternatively make paste of the entire drugs and apply on the body of the patient as smear [65-66]   
 
   
 
   
==== Medicated water for bath ====
+
=== Medicated water for bath ===
 +
<div class="mw-collapsible mw-collapsed">
  
जलैश्च वासार्ककरञ्जशिग्रुकाश्मर्यपत्रार्जकजैश्च  सिद्धैः|  
+
जलैश्च वासार्ककरञ्जशिग्रुकाश्मर्यपत्रार्जकजैश्च  सिद्धैः| <br />
स्विन्नो मृदूष्णै  रवितप्ततोयैः स्नातश्च गन्धैरनुलेपनीयः||६७||  
+
स्विन्नो मृदूष्णै  रवितप्ततोयैः स्नातश्च गन्धैरनुलेपनीयः||६७|| <br />
 +
<div class="mw-collapsible-content">
  
jalaiśca vāsārkakarañjaśigrukāśmaryapatrārjakajaiśca  siddhaiḥ|  
+
jalaiśca vāsārkakarañjaśigrukāśmaryapatrārjakajaiśca  siddhaiḥ| <br />
svinnō mr̥dūṣṇai  ravitaptatōyaiḥ snātaśca gandhairanulēpanīyaḥ||67||
+
svinnō mr̥dūṣṇai  ravitaptatōyaiḥ snātaśca gandhairanulēpanīyaḥ||67||<br />
  
jalaishca vAsArkakara~jjashigrukAshmaryapatrArjakajaishca [17] siddhaiH|  
+
jalaishca vAsArkakara~jjashigrukAshmaryapatrArjakajaishca [17] siddhaiH| <br />
svinno mRudUShNai [18] ravitaptatoyaiH snAtashca gandhairanulepanIyaH||67||
+
svinno mRudUShNai [18] ravitaptatoyaiH snAtashca gandhairanulepanIyaH||67||<br />
 +
</div></div>
  
 
Add leaves of ''vāsā, arka, karanja, sigru, kashmarya'' and holy basil in hot water and take sudation with this tolerably hot water. Then the patient should take bath with water heated in sun and apply aromatics on the body [67]
 
Add leaves of ''vāsā, arka, karanja, sigru, kashmarya'' and holy basil in hot water and take sudation with this tolerably hot water. Then the patient should take bath with water heated in sun and apply aromatics on the body [67]
 
      
 
      
==== External application in ''pitta'' dominance ====
+
=== External application in ''[[pitta]]'' dominance ===
 +
<div class="mw-collapsible mw-collapsed">
  
सवेतसाः क्षीरवतां द्रुमाणां त्वचः समञ्जिष्ठलतामृणालाः|  
+
सवेतसाः क्षीरवतां द्रुमाणां त्वचः समञ्जिष्ठलतामृणालाः| <br />
सचन्दनाः पद्मकवालकौ च पैत्ते प्रदेहस्तु सतैलपाकः||६८||  
+
सचन्दनाः पद्मकवालकौ च पैत्ते प्रदेहस्तु सतैलपाकः||६८|| <br />
  
आक्तस्य तेनाम्बु रविप्रतप्तं सचन्दनं साभयपद्मकं च|  
+
आक्तस्य तेनाम्बु रविप्रतप्तं सचन्दनं साभयपद्मकं च| <br />
स्नाने हितं क्षीरवतां कषायः क्षीरोदकं चन्दनलेपनं च||६९||   
+
स्नाने हितं क्षीरवतां कषायः क्षीरोदकं चन्दनलेपनं च||६९||  <br />
 +
<div class="mw-collapsible-content">
  
savētasāḥ kṣīravatāṁ drumāṇāṁ tvacaḥ samañjiṣṭhalatāmr̥ṇālāḥ|   
+
savētasāḥ kṣīravatāṁ drumāṇāṁ tvacaḥ samañjiṣṭhalatāmr̥ṇālāḥ|  <br />
sacandanāḥ padmakavālakau ca paittē pradēhastu satailapākaḥ||68||  
+
sacandanāḥ padmakavālakau ca paittē pradēhastu satailapākaḥ||68|| <br />
  
āktasya tēnāmbu raviprataptaṁ sacandanaṁ sābhayapadmakaṁ ca|  
+
āktasya tēnāmbu raviprataptaṁ sacandanaṁ sābhayapadmakaṁ ca| <br />
snānē hitaṁ kṣīravatāṁ kaṣāyaḥ kṣīrōdakaṁ candanalēpanaṁ ca||69||
+
snānē hitaṁ kṣīravatāṁ kaṣāyaḥ kṣīrōdakaṁ candanalēpanaṁ ca||69||<br />
 
   
 
   
savetasAH kShIravatAM drumANAM tvacaH sama~jjiShThalatAmRuNAlAH|  
+
savetasAH kShIravatAM drumANAM tvacaH sama~jjiShThalatAmRuNAlAH| <br />
sacandanAH padmakavAlakau ca paitte pradehastu satailapAkaH||68||  
+
sacandanAH padmakavAlakau ca paitte pradehastu satailapAkaH||68|| <br />
  
Aktasya tenAmbu raviprataptaM sacandanaM sAbhayapadmakaM ca|  
+
Aktasya tenAmbu raviprataptaM sacandanaM sAbhayapadmakaM ca| <br />
snAne hitaM kShIravatAM kaShAyaH kShIrodakaM candanalepanaM ca||69||
+
snAne hitaM kShIravatAM kaShAyaH kShIrodakaM candanalepanaM ca||69||<br />
 +
</div></div>
  
Prepare medicated oil from ''vetasa, manjiṣhthā, mrināla,'' sandal, ''padmaka'' and ''khasha'' and bark of latex-exuding plants. Apply this oil on the body to relieve ''pitta'' swelling. Thereafter, bathing with medicated water prepared with sandal, ''khaśa'' and ''padmaka'' and heated by sun rays or with water prepared with latex-exuding plants or water mixed with milk is beneficial. Smearing with paste of sandalwood is also beneficial [68-69]   
+
Prepare medicated oil from ''vetasa, manjiṣhthā, mrināla,'' sandal, ''padmaka'' and ''khasha'' and bark of latex-exuding plants. Apply this oil on the body to relieve ''[[pitta]]'' swelling. Thereafter, bathing with medicated water prepared with sandal, ''khaśa'' and ''padmaka'' and heated by sun rays or with water prepared with latex-exuding plants or water mixed with milk is beneficial. Smearing with paste of sandalwood is also beneficial [68-69]   
 
   
 
   
==== External application in ''kapha'' dominance ====
+
=== External application in ''[[kapha]]'' dominance ===
 +
<div class="mw-collapsible mw-collapsed">
  
कफे तु कृष्णासिकतापुराणपिण्याकशिग्रुत्वगुमाप्रलेपः|  
+
कफे तु कृष्णासिकतापुराणपिण्याकशिग्रुत्वगुमाप्रलेपः| <br />
कुलत्थशुण्ठीजलमूत्रसेकश्चण्डागुरुभ्यामनुलेपनं च||७०||  
+
कुलत्थशुण्ठीजलमूत्रसेकश्चण्डागुरुभ्यामनुलेपनं च||७०|| <br />
 +
<div class="mw-collapsible-content">
  
kaphē tu kr̥ṣṇāsikatāpurāṇapiṇyākaśigrutvagumāpralēpaḥ|  
+
kaphē tu kr̥ṣṇāsikatāpurāṇapiṇyākaśigrutvagumāpralēpaḥ| <br />
kulatthaśuṇṭhījalamūtrasēkaścaṇḍāgurubhyāmanulēpanaṁ ca||70||  
+
kulatthaśuṇṭhījalamūtrasēkaścaṇḍāgurubhyāmanulēpanaṁ ca||70|| <br />
  
kaphe tu kRuShNAsikatApurANapiNyAkashigrutvagumApralepaH|  
+
kaphe tu kRuShNAsikatApurANapiNyAkashigrutvagumApralepaH| <br />
kulatthashuNThIjalamUtrasekashcaNDAgurubhyAmanulepanaM ca||70||  
+
kulatthashuNThIjalamUtrasekashcaNDAgurubhyAmanulepanaM ca||70|| <br />
 +
</div></div>
  
In ''kapha'' dominant edema, application of paste of long pepper, sand, old oil-cake, bark of drum-stick and linseed is advised.  
+
In ''[[kapha]]'' dominant edema, application of paste of long pepper, sand, old oil-cake, bark of drum-stick and linseed is advised.  
 
Effusion with decoction of ''kulattha'' (hoarse gram), dry ginger and cow’s urine followed by anointing of the body with paste of sandal and ''aguru'' is also beneficial (70).   
 
Effusion with decoction of ''kulattha'' (hoarse gram), dry ginger and cow’s urine followed by anointing of the body with paste of sandal and ''aguru'' is also beneficial (70).   
  
==== External application in burning sensation ====
+
=== External application in burning sensation ===
 +
<div class="mw-collapsible mw-collapsed">
  
बिभीतकानां फलमध्यलेपः सर्वेषु दाहार्तिहरः प्रदिष्टः|  
+
बिभीतकानां फलमध्यलेपः सर्वेषु दाहार्तिहरः प्रदिष्टः| <br />
यष्ट्याह्वमुस्तैः सकपित्थपत्रैः सचन्दनैस्तत्पिडकासु लेपः||७१||  
+
यष्ट्याह्वमुस्तैः सकपित्थपत्रैः सचन्दनैस्तत्पिडकासु लेपः||७१|| <br />
 +
<div class="mw-collapsible-content">
  
bibhītakānāṁ phalamadhyalēpaḥ sarvēṣu dāhārtiharaḥ pradiṣṭaḥ|  
+
bibhītakānāṁ phalamadhyalēpaḥ sarvēṣu dāhārtiharaḥ pradiṣṭaḥ| <br />
yaṣṭyāhvamustaiḥ sakapitthapatraiḥ sacandanaistatpiḍakāsu lēpaḥ||71||  
+
yaṣṭyāhvamustaiḥ sakapitthapatraiḥ sacandanaistatpiḍakāsu lēpaḥ||71|| <br />
  
bibhItakAnAM phalamadhyalepaH sarveShu dAhArtiharaH pradiShTaH|  
+
bibhItakAnAM phalamadhyalepaH sarveShu dAhArtiharaH pradiShTaH| <br />
yaShTyAhvamustaiH sakapitthapatraiH sacandanaistatpiDakAsu lepaH||71||  
+
yaShTyAhvamustaiH sakapitthapatraiH sacandanaistatpiDakAsu lepaH||71|| <br />
 +
</div></div>
  
 
In all types of swelling, smearing with paste of fruit of ''vibhitaka'' is recommended to cure burning sensation and discomfort.  
 
In all types of swelling, smearing with paste of fruit of ''vibhitaka'' is recommended to cure burning sensation and discomfort.  
 
The topical application of paste of leaves of ''kapittha'' (wood apple), sandal, liquorices and ''mustaka'' provides relief in papules [71]  
 
The topical application of paste of leaves of ''kapittha'' (wood apple), sandal, liquorices and ''mustaka'' provides relief in papules [71]  
 +
<div class="mw-collapsible mw-collapsed">
 
   
 
   
रास्नावृषार्कत्रिफलाविडङ्गं शिग्रुत्वचो मूषिकपर्णिका च|   
+
रास्नावृषार्कत्रिफलाविडङ्गं शिग्रुत्वचो मूषिकपर्णिका च|  <br />
निम्बार्जकौ व्याघ्रनखः सदूर्वा सुवर्चला तिक्तकरोहिणी च||७२||  
+
निम्बार्जकौ व्याघ्रनखः सदूर्वा सुवर्चला तिक्तकरोहिणी च||७२|| <br />
  
सकाकमाची बृहती सकुष्ठा पुनर्नवा चित्रकनागरे च|  
+
सकाकमाची बृहती सकुष्ठा पुनर्नवा चित्रकनागरे च| <br />
उन्मर्दनं शोफिषु मूत्रपिष्टं शस्तस्तथा मूलकतोयसेकः||७३||  
+
उन्मर्दनं शोफिषु मूत्रपिष्टं शस्तस्तथा मूलकतोयसेकः||७३|| <br />
 +
<div class="mw-collapsible-content">
  
rāsnāvr̥ṣārkatriphalāviḍaṅgaṁ śigrutvacō mūṣikaparṇikā ca|  
+
rāsnāvr̥ṣārkatriphalāviḍaṅgaṁ śigrutvacō mūṣikaparṇikā ca| <br />
nimbārjakau vyāghranakhaḥ sadūrvā suvarcalā tiktakarōhiṇī ca||72||  
+
nimbārjakau vyāghranakhaḥ sadūrvā suvarcalā tiktakarōhiṇī ca||72|| <br />
  
sakākamācī br̥hatī sakuṣṭhā punarnavā citrakanāgarē ca|  
+
sakākamācī br̥hatī sakuṣṭhā punarnavā citrakanāgarē ca| <br />
unmardanaṁ śōphiṣu mūtrapiṣṭaṁ śastastathā mūlakatōyasēkaḥ||73||
+
unmardanaṁ śōphiṣu mūtrapiṣṭaṁ śastastathā mūlakatōyasēkaḥ||73||<br />
  
rAsnAvRuShArkatriphalAviDa~ggaM shigrutvaco mUShikaparNikA ca|  
+
rAsnAvRuShArkatriphalAviDa~ggaM shigrutvaco mUShikaparNikA ca| <br />
nimbArjakau vyAghranakhaH sadUrvA suvarcalA tiktakarohiNI ca||72||  
+
nimbArjakau vyAghranakhaH sadUrvA suvarcalA tiktakarohiNI ca||72|| <br />
  
sakAkamAcI bRuhatI sakuShThA punarnavA citrakanAgare ca|  
+
sakAkamAcI bRuhatI sakuShThA punarnavA citrakanAgare ca| <br />
unmardanaM shophiShu mUtrapiShTaM shastastathA mUlakatoyasekaH||73||
+
unmardanaM shophiShu mUtrapiShTaM shastastathA mUlakatoyasekaH||73||<br />
 +
</div></div>
  
 
Take ''rāsnā, vāsā, arka, triphalā, vidanga,'' bark of ''sigru, mushakaparni, neem,'' holy basin, nails of ''vyāghra'' (shell), ''durvā'', sunflower, ''katukā, kākamāchi, brihati, kuṣtha, punarnavā, chitraka'' and dry ginger and make paste with cow’s urine. ''Unmardana'' type of massage with it is beneficial for swelling. Also effusion done with water boiled with above drugs is beneficial [72-73]
 
Take ''rāsnā, vāsā, arka, triphalā, vidanga,'' bark of ''sigru, mushakaparni, neem,'' holy basin, nails of ''vyāghra'' (shell), ''durvā'', sunflower, ''katukā, kākamāchi, brihati, kuṣtha, punarnavā, chitraka'' and dry ginger and make paste with cow’s urine. ''Unmardana'' type of massage with it is beneficial for swelling. Also effusion done with water boiled with above drugs is beneficial [72-73]
  
==== Various types of local swellings ====
+
=== Various types of local swellings ===
 +
<div class="mw-collapsible mw-collapsed">
  
शोफास्तु गात्रावयवाश्रिता ये ते स्थानदूष्याकृतिनामभेदात्|  
+
शोफास्तु गात्रावयवाश्रिता ये ते स्थानदूष्याकृतिनामभेदात्| <br />
अनेकसङ्ख्याः  कतिचिच्च तेषां निदर्शनार्थं गदतो निबोध||७४||  
+
अनेकसङ्ख्याः  कतिचिच्च तेषां निदर्शनार्थं गदतो निबोध||७४|| <br />
 +
<div class="mw-collapsible-content">
  
śōphāstu gātrāvayavāśritā yē tē sthānadūṣyākr̥tināmabhēdāt|  
+
śōphāstu gātrāvayavāśritā yē tē sthānadūṣyākr̥tināmabhēdāt| <br />
anēkasaṅkhyāḥ  katicicca tēṣāṁ nidarśanārthaṁ gadatō nibōdha||74||
+
anēkasaṅkhyāḥ  katicicca tēṣāṁ nidarśanārthaṁ gadatō nibōdha||74||<br />
  
shophAstu gAtrAvayavAshritA ye te sthAnadUShyAkRutinAmabhedAt|  
+
shophAstu gAtrAvayavAshritA ye te sthAnadUShyAkRutinAmabhedAt| <br />
anekasa~gkhyAH [19] katicicca teShAM nidarshanArthaM gadato nibodha||74||
+
anekasa~gkhyAH [19] katicicca teShAM nidarshanArthaM gadato nibodha||74||<br />
 +
</div></div>
  
The swelling occurring in one limb or organ is of many types owing to their different classifications based on involved site, ''duṣhya,'' shape and name. Listen to the descriptions of some of them being given as illustration [74]   
+
The swelling occurring in one limb or organ is of many types owing to their different classifications based on involved site, ''[[duṣhya]],'' shape and name. Listen to the descriptions of some of them being given as illustration [74]   
  
==== ''Shira Sopha'' (cellulitis of head) and ''Salūka'' (quinsy) ====
+
=== ''Shira Shopha'' (cellulitis of head) and ''Salūka'' (quinsy) ===
 +
<div class="mw-collapsible mw-collapsed">
  
दोषास्त्रयः स्वैः कुपिता निदानैः कुर्वन्ति शोफं शिरसः सुघोरम्|
+
दोषास्त्रयः स्वैः कुपिता निदानैः कुर्वन्ति शोफं शिरसः सुघोरम्|<br />
अन्तर्गले घुर्घुरिकान्वितं च शालूकमुच्छ्वासनिरोधकारि||७५||  
+
अन्तर्गले घुर्घुरिकान्वितं च शालूकमुच्छ्वासनिरोधकारि||७५|| <br />
 +
<div class="mw-collapsible-content">
  
dōṣāstrayaḥ svaiḥ kupitā nidānaiḥ kurvanti śōphaṁ śirasaḥ sughōram|
+
dōṣāstrayaḥ svaiḥ kupitā nidānaiḥ kurvanti śōphaṁ śirasaḥ sughōram|<br />
antargalē ghurghurikānvitaṁ ca śālūkamucchvāsanirōdhakāri||75||
+
antargalē ghurghurikānvitaṁ ca śālūkamucchvāsanirōdhakāri||75||<br />
  
doShAstrayaH svaiH kupitA nidAnaiH kurvanti shophaM shirasaH sughoram|
+
doShAstrayaH svaiH kupitA nidAnaiH kurvanti shophaM shirasaH sughoram|<br />
antargale ghurghurikAnvitaM ca shAlUkamucchvAsanirodhakAri||75||
+
antargale ghurghurikAnvitaM ca shAlUkamucchvAsanirodhakAri||75||<br />
 +
</div></div>
  
All the three dosha, provoked by indulging in their etiological factors produce severe inflammation of head.  
+
All the three [[dosha]], provoked by indulging in their etiological factors produce severe inflammation of head.  
When it affects inside of the throat, it produces sālūka, which is accompanied with stertorous breathing and obstruction to expiration [75]  
+
When it affects inside of the throat, it produces sālūka, which is accompanied with stertorous breathing and obstruction to expiration [75]
  
==== ''Biḍālikā'' (Ludwig’s angina) ====
+
=== ''Bidalika'' (Ludwig’s angina) ===
 +
<div class="mw-collapsible mw-collapsed">
  
गलस्य सन्धौ चिबुके गले च सदाहरागः श्वसनासु  चोग्रः|  
+
गलस्य सन्धौ चिबुके गले च सदाहरागः श्वसनासु  चोग्रः| <br />
शोफो भृशार्तिस्तु बिडालिका  स्याद्धन्याद्गले चेद्वलयीकृता सा||७६||  
+
शोफो भृशार्तिस्तु बिडालिका  स्याद्धन्याद्गले चेद्वलयीकृता सा||७६|| <br />
 +
<div class="mw-collapsible-content">
  
galasya sandhau cibukē galē ca sadāharāgaḥ śvasanāsu  cōgraḥ|  
+
galasya sandhau cibukē galē ca sadāharāgaḥ śvasanāsu  cōgraḥ| <br />
śōphō bhr̥śārtistu biḍālikā  syāddhanyādgalē cēdvalayīkr̥tā sā||76||
+
śōphō bhr̥śārtistu biḍālikā  syāddhanyādgalē cēdvalayīkr̥tā sā||76||<br />
  
galasya sandhau cibuke gale ca sadAharAgaH shvasanAsu [20] cograH|  
+
galasya sandhau cibuke gale ca sadAharAgaH shvasanAsu [20] cograH| <br />
shopho bhRushArtistu biDAlikA [21] syAddhanyAdgale cedvalayIkRutA sA||76||
+
shopho bhRushArtistu biDAlikA [21] syAddhanyAdgale cedvalayIkRutA sA||76||<br />
 +
</div></div>
  
 
Acute swelling at the junction of throat behind the chin i.e. in trachea with redness and burning sensation in throat and causes obstruction to breathing with very much discomfort is known as ''biḍālikā''. It kills the patient if folds are formed in throat [76]
 
Acute swelling at the junction of throat behind the chin i.e. in trachea with redness and burning sensation in throat and causes obstruction to breathing with very much discomfort is known as ''biḍālikā''. It kills the patient if folds are formed in throat [76]
  
==== ''Tālu-vidradhi'' (palatal abscess), ''upajihvikā'' (superficial glossitis) and ''adhijihvikā'' (sub-lingual glossitis) ====
+
=== ''Talu-vidradhi'' (palatal abscess), ''upajihvika'' (superficial glossitis) and ''adhijihvikā'' (sub-lingual glossitis) ===
 +
<div class="mw-collapsible mw-collapsed">
  
स्यात्तालुविद्रध्यपि दाहरागपाकान्वितस्तालुनि सा त्रिदोषात्|  
+
स्यात्तालुविद्रध्यपि दाहरागपाकान्वितस्तालुनि सा त्रिदोषात्| <br />
जिह्वोपरिष्टादुपजिह्विका स्यात् कफादधस्तादधिजिह्विका च||७७||  
+
जिह्वोपरिष्टादुपजिह्विका स्यात् कफादधस्तादधिजिह्विका च||७७|| <br />
 +
<div class="mw-collapsible-content">
  
syāttāluvidradhyapi dāharāgapākānvitastāluni sā tridōṣāt|  
+
syāttāluvidradhyapi dāharāgapākānvitastāluni sā tridōṣāt| <br />
jihvōpariṣṭādupajihvikā syāt kaphādadhastādadhijihvikā ca||77||  
+
jihvōpariṣṭādupajihvikā syāt kaphādadhastādadhijihvikā ca||77|| <br />
  
syAttAluvidradhyapi dAharAgapAkAnvitastAluni sA tridoShAt|  
+
syAttAluvidradhyapi dAharAgapAkAnvitastAluni sA tridoShAt| <br />
jihvopariShTAdupajihvikA syAt kaphAdadhastAdadhijihvikA ca||77||  
+
jihvopariShTAdupajihvikA syAt kaphAdadhastAdadhijihvikA ca||77|| <br />
 +
</div></div>
  
 
Abscess in palate caused by ''tridosha'' with burning sensation, redness and pus formation is known as ''tālu-vidradhi''.  
 
Abscess in palate caused by ''tridosha'' with burning sensation, redness and pus formation is known as ''tālu-vidradhi''.  
  
Swelling due to ''kapha'' occurring on the upper part of tongue is called ''upajihvikā'' (acute superficial glossitis) and which occurs sublingual part is called a''dhijihvikā'' (sub lingual glossitis) [77]  
+
Swelling due to ''[[kapha]]'' occurring on the upper part of tongue is called ''upajihvikā'' (acute superficial glossitis) and which occurs sublingual part is called a''dhijihvikā'' (sub lingual glossitis) [77]  
  
==== ''Upakusha'' (gingivitis) and ''danta-vidradhi'' (dental abscess) ====
+
=== ''Upakusha'' (gingivitis) and ''danta-vidradhi'' (dental abscess) ===
 +
<div class="mw-collapsible mw-collapsed">
  
यो दन्तमांसेषु तु रक्तपित्तात् पाको भवेत् सोपकुशः प्रदिष्टः|  
+
यो दन्तमांसेषु तु रक्तपित्तात् पाको भवेत् सोपकुशः प्रदिष्टः| <br />
स्याद्दन्तविद्रध्यपि दन्तमांसे शोफः कफाच्छोणितसञ्चयोत्थः||७८||  
+
स्याद्दन्तविद्रध्यपि दन्तमांसे शोफः कफाच्छोणितसञ्चयोत्थः||७८|| <br />
 +
<div class="mw-collapsible-content">
  
yō dantamāṁsēṣu tu raktapittāt pākō bhavēt sōpakuśaḥ pradiṣṭaḥ|  
+
yō dantamāṁsēṣu tu raktapittāt pākō bhavēt sōpakuśaḥ pradiṣṭaḥ| <br />
syāddantavidradhyapi dantamāṁsē śōphaḥ kaphācchōṇitasañcayōtthaḥ||78||
+
syāddantavidradhyapi dantamāṁsē śōphaḥ kaphācchōṇitasañcayōtthaḥ||78||<br />
  
yo dantamAMseShu tu raktapittAt pAko bhavet sopakushaH pradiShTaH|  
+
yo dantamAMseShu tu raktapittAt pAko bhavet sopakushaH pradiShTaH| <br />
syAddantavidradhyapi dantamAMse shophaH kaphAcchoNitasa~jcayotthaH||78||
+
syAddantavidradhyapi dantamAMse shophaH kaphAcchoNitasa~jcayotthaH||78||<br />
 +
</div></div>
  
Provoked ''rakta'' and ''pitta'' causes suppuration of the gums and it is called ''upakusha''. Accumulation of ''kapha'' and ''rakta'' produces elevated swelling in gums and it is known as ''danta-vidradhi'' [78]
+
Provoked ''[[rakta]]'' and ''[[pitta]]'' causes suppuration of the gums and it is called ''upakusha''. Accumulation of ''[[kapha]]'' and ''[[rakta]]'' produces elevated swelling in gums and it is known as ''danta-vidradhi'' [78]
  
==== ''Galagaṇḍa'' (goiter),''gaṇḍamālā'' (cervical adenitis) and its management ====
+
=== ''Galaganḍa'' (goiter),''gandamala'' (cervical adenitis) and its management ===
 +
<div class="mw-collapsible mw-collapsed">
  
गलस्य पार्श्वे गलगण्ड एकः स्याद्गण्डमाला बहुभिस्तु गण्डैः|  
+
गलस्य पार्श्वे गलगण्ड एकः स्याद्गण्डमाला बहुभिस्तु गण्डैः| <br />
साध्याः स्मृताः पीनसपार्श्वशूलकासज्वरच्छर्दियुतास्त्वसाध्याः||७९||  
+
साध्याः स्मृताः पीनसपार्श्वशूलकासज्वरच्छर्दियुतास्त्वसाध्याः||७९|| <br />
 +
<div class="mw-collapsible-content">
  
galasya pārśvē galagaṇḍa ēkaḥ syādgaṇḍamālā bahubhistu gaṇḍaiḥ|  
+
galasya pārśvē galagaṇḍa ēkaḥ syādgaṇḍamālā bahubhistu gaṇḍaiḥ| <br />
sādhyāḥ smr̥tāḥ pīnasapārśvaśūlakāsajvaracchardiyutāstvasādhyāḥ||79||  
+
sādhyāḥ smr̥tāḥ pīnasapārśvaśūlakāsajvaracchardiyutāstvasādhyāḥ||79|| <br />
  
galasya pArshve galagaNDa ekaH syAdgaNDamAlA bahubhistu gaNDaiH|  
+
galasya pArshve galagaNDa ekaH syAdgaNDamAlA bahubhistu gaNDaiH| <br />
sAdhyAH smRutAH pInasapArshvashUlakAsajvaracchardiyutAstvasAdhyAH||79||  
+
sAdhyAH smRutAH pInasapArshvashUlakAsajvaracchardiyutAstvasAdhyAH||79|| <br />
 +
</div></div>
  
 
Single glandular swelling on the (middle) of neck is called ''galagaṇḍa'' (goiter) but if there are many nodular swellings making a chain like appearance, is known as ''gandamālā''. Generally they are curable but if accompanied with coryza, pain in side of the chest, cough, fever and vomiting then they are incurable [79]  
 
Single glandular swelling on the (middle) of neck is called ''galagaṇḍa'' (goiter) but if there are many nodular swellings making a chain like appearance, is known as ''gandamālā''. Generally they are curable but if accompanied with coryza, pain in side of the chest, cough, fever and vomiting then they are incurable [79]  
 +
<div class="mw-collapsible mw-collapsed">
  
तेषां सिराकायशिरोविरेका धूमः पुराणस्य घृतस्य पानम्|  
+
तेषां सिराकायशिरोविरेका धूमः पुराणस्य घृतस्य पानम्| <br />
स्याल्लङ्घनं वक्त्रभवेषु चापि प्रघर्षणं स्यात् कवलग्रहश्च||८०||  
+
स्याल्लङ्घनं वक्त्रभवेषु चापि प्रघर्षणं स्यात् कवलग्रहश्च||८०|| <br />
 +
<div class="mw-collapsible-content">
  
tēṣāṁ sirākāyaśirōvirēkā dhūmaḥ purāṇasya ghr̥tasya pānam|  
+
tēṣāṁ sirākāyaśirōvirēkā dhūmaḥ purāṇasya ghr̥tasya pānam| <br />
syāllaṅghanaṁ vaktrabhavēṣu cāpi pragharṣaṇaṁ syāt kavalagrahaśca||80||
+
syāllaṅghanaṁ vaktrabhavēṣu cāpi pragharṣaṇaṁ syāt kavalagrahaśca||80||<br />
  
teShAM sirAkAyashirovirekA dhUmaH purANasya ghRutasya pAnam|  
+
teShAM sirAkAyashirovirekA dhUmaH purANasya ghRutasya pAnam| <br />
syAlla~gghanaM vaktrabhaveShu cApi pragharShaNaM syAt kavalagrahashca||80||
+
syAlla~gghanaM vaktrabhaveShu cApi pragharShaNaM syAt kavalagrahashca||80||<br />
 +
</div></div>
  
In all the above mentioned conditions blood-letting, purgation, ''nasya, dhuma'' (medicated smoking therapy) and intake of old ghee is beneficial.  
+
In all the above mentioned conditions blood-letting, purgation, ''[[nasya]], dhuma'' (medicated smoking therapy) and intake of old ghee is beneficial.  
  
For the conditions specially affecting mouth, the line of treatment is ''langhana'' and rubbing with medicated powders and mouth washes (''kavala'') are beneficial [80]
+
For the conditions specially affecting mouth, the line of treatment is ''[[langhana]]'' and rubbing with medicated powders and mouth washes (''kavala'') are beneficial [80]
  
==== ''Granthi'' (nodule) and its management ====
+
=== ''Granthi'' (nodule) and its management ===
 +
<div class="mw-collapsible mw-collapsed">
  
अङ्गैकदेशेष्वनिलादिभिः स्यात् स्वरूपधारी स्फुरणः सिराभिः|  
+
अङ्गैकदेशेष्वनिलादिभिः स्यात् स्वरूपधारी स्फुरणः सिराभिः| <br />
ग्रन्थिर्महान्मांसभवस्त्वनर्तिर्मेदोभवः स्निग्धतमश्चलश्च||८१||  
+
ग्रन्थिर्महान्मांसभवस्त्वनर्तिर्मेदोभवः स्निग्धतमश्चलश्च||८१|| <br />
 +
<div class="mw-collapsible-content">
  
aṅgaikadēśēṣvanilādibhiḥ syāt svarūpadhārī sphuraṇaḥ sirābhiḥ|  
+
aṅgaikadēśēṣvanilādibhiḥ syāt svarūpadhārī sphuraṇaḥ sirābhiḥ| <br />
granthirmahānmāṁsabhavastvanartirmēdōbhavaḥ snigdhatamaścalaśca||81||  
+
granthirmahānmāṁsabhavastvanartirmēdōbhavaḥ snigdhatamaścalaśca||81|| <br />
  
a~ggaikadesheShvanilAdibhiH syAt svarUpadhArI sphuraNaH sirAbhiH|  
+
a~ggaikadesheShvanilAdibhiH syAt svarUpadhArI sphuraNaH sirAbhiH| <br />
granthirmahAnmAMsabhavastvanartirmedobhavaH snigdhatamashcalashca||81||  
+
granthirmahAnmAMsabhavastvanartirmedobhavaH snigdhatamashcalashca||81|| <br />
 +
</div></div>
  
Swelling occurring in one organ or region due to ''vata'' or other ''dosha'' may be diagnosed on the basis of their characteristic symptoms. The swelling occurring in vessels are pulsating in nature. The nodular swelling occurring in muscles is large in size. Swelling of the adipose tissues is excessively unctuous and movable [81]
+
Swelling occurring in one organ or region due to ''[[vata]]'' or other ''[[dosha]]'' may be diagnosed on the basis of their characteristic symptoms. The swelling occurring in vessels are pulsating in nature. The nodular swelling occurring in muscles is large in size. Swelling of the adipose tissues is excessively unctuous and movable [81]
 
    
 
    
==== Surgical management of ''granthi'' ====
+
=== Surgical management of ''granthi'' ===
 +
<div class="mw-collapsible mw-collapsed">
  
संशोधिते स्वेदितमश्मकाष्ठैः साङ्गुष्ठदण्डैर्विलयेदपक्वम्|  
+
संशोधिते स्वेदितमश्मकाष्ठैः साङ्गुष्ठदण्डैर्विलयेदपक्वम्| <br />
विपाट्य चोद्धृत्य भिषक् सकोशं शस्त्रेण दग्ध्वा व्रणवच्चिकित्सेत्||८२||  
+
विपाट्य चोद्धृत्य भिषक् सकोशं शस्त्रेण दग्ध्वा व्रणवच्चिकित्सेत्||८२|| <br />
 +
<div class="mw-collapsible-content">
  
saṁśōdhitē svēditamaśmakāṣṭhaiḥ sāṅguṣṭhadaṇḍairvilayēdapakvam|  
+
saṁśōdhitē svēditamaśmakāṣṭhaiḥ sāṅguṣṭhadaṇḍairvilayēdapakvam| <br />
vipāṭya cōddhr̥tya bhiṣak sakōśaṁ śastrēṇa dagdhvā vraṇavaccikitsēt||82||
+
vipāṭya cōddhr̥tya bhiṣak sakōśaṁ śastrēṇa dagdhvā vraṇavaccikitsēt||82||<br />
 
   
 
   
saMshodhite sveditamashmakAShThaiH sA~gguShThadaNDairvilayedapakvam|  
+
saMshodhite sveditamashmakAShThaiH sA~gguShThadaNDairvilayedapakvam| <br />
vipATya coddhRutya bhiShak sakoshaM shastreNa dagdhvA vraNavaccikitset||82||  
+
vipATya coddhRutya bhiShak sakoshaM shastreNa dagdhvA vraNavaccikitset||82|| <br />
 +
</div></div>
  
 
If the tumor is non-suppurative then after purification therapy, local sudation of the swelling should be done. Then the physician should try to dissolve the swelling by rubbing with stone or wooden apparatus or with manipulation of thumb or of a rod. Then it should be cut open and take out the tumor with its capsule. Then it should be cauterized and treatment of regular wound should be adopted [82]  
 
If the tumor is non-suppurative then after purification therapy, local sudation of the swelling should be done. Then the physician should try to dissolve the swelling by rubbing with stone or wooden apparatus or with manipulation of thumb or of a rod. Then it should be cut open and take out the tumor with its capsule. Then it should be cauterized and treatment of regular wound should be adopted [82]  
 +
<div class="mw-collapsible mw-collapsed">
 
   
 
   
अदग्ध ईषत् परिशेषितश्च प्रयाति भूयोऽपि शनैर्विवृद्धिम्|  
+
अदग्ध ईषत् परिशेषितश्च प्रयाति भूयोऽपि शनैर्विवृद्धिम्| <br />
तस्मादशेषः कुशलैः समन्ताच्छेद्यो भवेद्वीक्ष्य शरीरदेशान्||८३||  
+
तस्मादशेषः कुशलैः समन्ताच्छेद्यो भवेद्वीक्ष्य शरीरदेशान्||८३|| <br />
  
शेषे कृते पाकवशेन शीर्यात्ततः क्षतोत्थः प्रसरेद्विसर्पः|  
+
शेषे कृते पाकवशेन शीर्यात्ततः क्षतोत्थः प्रसरेद्विसर्पः| <br />
उपद्रवं तं प्रविचार्य तज्ज्ञस्तैर्भेषजैः  पूर्वतरैर्यथोक्तैः||८४||  
+
उपद्रवं तं प्रविचार्य तज्ज्ञस्तैर्भेषजैः  पूर्वतरैर्यथोक्तैः||८४|| <br />
  
निवारयेदादित  एव यत्नाद्विधानवित् स्वस्वविधिं विधाय|  
+
निवारयेदादित  एव यत्नाद्विधानवित् स्वस्वविधिं विधाय| <br />
ततः क्रमेणास्य यथाविधानं व्रणं व्रणज्ञस्त्वरया चिकित्सेत्||८५||  
+
ततः क्रमेणास्य यथाविधानं व्रणं व्रणज्ञस्त्वरया चिकित्सेत्||८५|| <br />
 +
<div class="mw-collapsible-content">
  
adagdha īṣat pariśēṣitaśca prayāti bhūyō'pi śanairvivr̥ddhim|  
+
adagdha īṣat pariśēṣitaśca prayāti bhūyō'pi śanairvivr̥ddhim| <br />
tasmādaśēṣaḥ kuśalaiḥ samantācchēdyō bhavēdvīkṣya śarīradēśān||83||  
+
tasmādaśēṣaḥ kuśalaiḥ samantācchēdyō bhavēdvīkṣya śarīradēśān||83|| <br />
  
śēṣē kr̥tē pākavaśēna śīryāttataḥ kṣatōtthaḥ prasarēdvisarpaḥ|  
+
śēṣē kr̥tē pākavaśēna śīryāttataḥ kṣatōtthaḥ prasarēdvisarpaḥ| <br />
upadravaṁ taṁ pravicārya tajjñastairbhēṣajaiḥ [22] pūrVātarairyathōktaiḥ||84||  
+
upadravaṁ taṁ pravicārya tajjñastairbhēṣajaiḥ [22] pūrVātarairyathōktaiḥ||84|| <br />
  
nivārayēdādita [23] ēva yatnādvidhānavit svasvavidhiṁ vidhāya|  
+
nivārayēdādita [23] ēva yatnādvidhānavit svasvavidhiṁ vidhāya| <br />
tataḥ kramēṇāsya yathāvidhānaṁ vraṇaṁ vraṇajñastvarayā cikitsēt||85||  
+
tataḥ kramēṇāsya yathāvidhānaṁ vraṇaṁ vraṇajñastvarayā cikitsēt||85|| <br />
  
adagdha IShat parisheShitashca prayAti bhUyo~api shanairvivRuddhim|  
+
adagdha IShat parisheShitashca prayAti bhUyo~api shanairvivRuddhim| <br />
tasmAdasheShaH kushalaiH samantAcchedyo bhavedvIkShya sharIradeshAn||83||  
+
tasmAdasheShaH kushalaiH samantAcchedyo bhavedvIkShya sharIradeshAn||83|| <br />
  
sheShe kRute pAkavashena shIryAttataH kShatotthaH prasaredvisarpaH|  
+
sheShe kRute pAkavashena shIryAttataH kShatotthaH prasaredvisarpaH| <br />
upadravaM taM pravicArya tajj~jastairbheShajaiH [22] pUrvatarairyathoktaiH||84||  
+
upadravaM taM pravicArya tajj~jastairbheShajaiH [22] pUrvatarairyathoktaiH||84|| <br />
  
nivArayedAdita [23] eva yatnAdvidhAnavit svasvavidhiM vidhAya|  
+
nivArayedAdita [23] eva yatnAdvidhAnavit svasvavidhiM vidhAya| <br />
tataH krameNAsya yathAvidhAnaM vraNaM vraNaj~jastvarayA cikitset||85||  
+
tataH krameNAsya yathAvidhAnaM vraNaM vraNaj~jastvarayA cikitset||85|| <br />
 +
</div></div>
  
 
If the tumor is not properly cauterized or if some of its part is left out then it starts gradually increasing again. In that case it should be removed completely by opening from all sides by the skillful surgeon keeping in view the regional anatomy. If some portion is still left then it may suppurate and slough and may lead to complication of ''visarpa'' (erysipelas). The surgeon considering it as the severe complication first should try to treat it with great care by appropriate remedies described earlier. Therefore the wound specialist should quickly treat it in the prescribed manner following the appropriate line of treatment [83-85]   
 
If the tumor is not properly cauterized or if some of its part is left out then it starts gradually increasing again. In that case it should be removed completely by opening from all sides by the skillful surgeon keeping in view the regional anatomy. If some portion is still left then it may suppurate and slough and may lead to complication of ''visarpa'' (erysipelas). The surgeon considering it as the severe complication first should try to treat it with great care by appropriate remedies described earlier. Therefore the wound specialist should quickly treat it in the prescribed manner following the appropriate line of treatment [83-85]   
 +
<div class="mw-collapsible mw-collapsed">
  
विवर्जयेत् कुक्ष्युदराश्रितं च तथा गले मर्मणि संश्रितं च|  
+
विवर्जयेत् कुक्ष्युदराश्रितं च तथा गले मर्मणि संश्रितं च| <br />
स्थूलः खरश्चापि भवेद्विवर्ज्यो यश्चापि बालस्थविराबलानाम्||८६||  
+
स्थूलः खरश्चापि भवेद्विवर्ज्यो यश्चापि बालस्थविराबलानाम्||८६|| <br />
 +
<div class="mw-collapsible-content">
  
vivarjayēt kukṣyudarāśritaṁ ca tathā galē marmaṇi saṁśritaṁ ca|  
+
vivarjayēt kukṣyudarāśritaṁ ca tathā galē marmaṇi saṁśritaṁ ca| <br />
sthūlaḥ kharaścāpi bhavēdvivarjyō yaścāpi bālasthavirābalānām||86||
+
sthūlaḥ kharaścāpi bhavēdvivarjyō yaścāpi bālasthavirābalānām||86||<br />
  
vivarjayet kukShyudarAshritaM ca tathA gale marmaNi saMshritaM ca|  
+
vivarjayet kukShyudarAshritaM ca tathA gale marmaNi saMshritaM ca| <br />
sthUlaH kharashcApi bhavedvivarjyo yashcApi bAlasthavirAbalAnAm||86||
+
sthUlaH kharashcApi bhavedvivarjyo yashcApi bAlasthavirAbalAnAm||86||<br />
 +
</div></div>
  
 
The tumors occurring in flanks, abdomen, in the throat and in vital organs are incurable. Similarly tumors of big size and indurated which occurs in children, aged and weak are also incurable [86]
 
The tumors occurring in flanks, abdomen, in the throat and in vital organs are incurable. Similarly tumors of big size and indurated which occurs in children, aged and weak are also incurable [86]
 
    
 
    
==== Differential diagnosis of ''arbuda'' (tumor) ====
+
=== Differential diagnosis of ''arbuda'' (tumor) ===
 +
<div class="mw-collapsible mw-collapsed">
  
ग्रन्थ्यर्बुदानां च यतोऽविशेषः प्रदेशहेत्वाकृतिदोषदूष्यैः|  
+
ग्रन्थ्यर्बुदानां च यतोऽविशेषः प्रदेशहेत्वाकृतिदोषदूष्यैः| <br />
ततश्चिकित्सेद्भिषगर्बुदानि विधानविद्ग्रन्थिचिकित्सितेन||८७||  
+
ततश्चिकित्सेद्भिषगर्बुदानि विधानविद्ग्रन्थिचिकित्सितेन||८७|| <br />
 +
<div class="mw-collapsible-content">
  
granthyarbudānāṁ ca yatō'viśēṣaḥ pradēśahētvākr̥tidōṣadūṣyaiḥ|  
+
granthyarbudānāṁ ca yatō'viśēṣaḥ pradēśahētvākr̥tidōṣadūṣyaiḥ| <br />
tataścikitsēdbhiṣagarbudāni vidhānavidgranthicikitsitēna||87||
+
tataścikitsēdbhiṣagarbudāni vidhānavidgranthicikitsitēna||87||<br />
  
granthyarbudAnAM ca yato~avisheShaH pradeshahetvAkRutidoShadUShyaiH|  
+
granthyarbudAnAM ca yato~avisheShaH pradeshahetvAkRutidoShadUShyaiH| <br />
tatashcikitsedbhiShagarbudAni vidhAnavidgranthicikitsitena||87||
+
tatashcikitsedbhiShagarbudAni vidhAnavidgranthicikitsitena||87||<br />
 +
</div></div>
  
There is no much difference in nodules and tumors with regards to site, causative factors, shape, ''dosha'' morbidity and ''dushya'' (susceptible tissues). Therefore, tumor specialist should treat the tumor on the line of nodules described above [87]
+
There is no much difference in nodules and tumors with regards to site, causative factors, shape, ''[[dosha]]'' morbidity and ''[[dushya]]'' (susceptible tissues). Therefore, tumor specialist should treat the tumor on the line of nodules described above [87]
 
    
 
    
==== ''Alajī'' and ''akshata'' (whitlow)====
+
=== ''Alaji'' and ''akshata'' (whitlow)===
 +
<div class="mw-collapsible mw-collapsed">
  
ताम्रा सशूला  पिडका भवेद्या सा चालजी नाम परिस्रुताग्रा|  
+
ताम्रा सशूला  पिडका भवेद्या सा चालजी नाम परिस्रुताग्रा| <br />
शोफोऽक्षतश्चर्मनखान्तरे  स्यान्मांसास्रदूषी भृशशीघ्रपाकः||८८||  
+
शोफोऽक्षतश्चर्मनखान्तरे  स्यान्मांसास्रदूषी भृशशीघ्रपाकः||८८|| <br />
 +
<div class="mw-collapsible-content">
  
tāmrā saśūlā  piḍakā bhavēdyā sā cālajī nāma parisrutāgrā|  
+
tāmrā saśūlā  piḍakā bhavēdyā sā cālajī nāma parisrutāgrā| <br />
śōphō'kṣataścarmanakhāntarē  syānmāṁsāsradūṣī bhr̥śaśīghrapākaḥ||88||
+
śōphō'kṣataścarmanakhāntarē  syānmāṁsāsradūṣī bhr̥śaśīghrapākaḥ||88||<br />
 
   
 
   
tAmrA sashUlA [25] piDakA bhavedyA sA cAlajI nAma parisrutAgrA|  
+
tAmrA sashUlA [25] piDakA bhavedyA sA cAlajI nAma parisrutAgrA| <br />
shopho~akShatashcarmanakhAntare [26] syAnmAMsAsradUShI bhRushashIghrapAkaH||88||  
+
shopho~akShatashcarmanakhAntare [26] syAnmAMsAsradUShI bhRushashIghrapAkaH||88|| <br />
 +
</div></div>
  
 
Appearing of copper colored papules with acute pain from which pus oozes out is known as alajī.
 
Appearing of copper colored papules with acute pain from which pus oozes out is known as alajī.
 
The severe inflammation occurring by vitiating flesh and blood in the skin adjoining nail which suppurates quickly is known as akṣata [88]
 
The severe inflammation occurring by vitiating flesh and blood in the skin adjoining nail which suppurates quickly is known as akṣata [88]
 
   
 
   
==== ''Vidārikā'' (lymphadenitis) and its management ====
+
=== ''Vidarika'' (lymphadenitis) and its management ===
 +
<div class="mw-collapsible mw-collapsed">
  
ज्वरान्विता वङ्क्षणकक्षजा या वर्तिर्निरर्तिः कठिनायता च|  
+
ज्वरान्विता वङ्क्षणकक्षजा या वर्तिर्निरर्तिः कठिनायता च| <br />
विदारिका सा कफमारुताभ्यां तेषां यथादोषमुपक्रमः स्यात्||८९||  
+
विदारिका सा कफमारुताभ्यां तेषां यथादोषमुपक्रमः स्यात्||८९|| <br />
  
विस्रावणं पिण्डिकयोपनाहः पक्वेषु चैव व्रणवच्चिकित्सा|  
+
विस्रावणं पिण्डिकयोपनाहः पक्वेषु चैव व्रणवच्चिकित्सा| <br />
 +
<div class="mw-collapsible-content">
  
jvarānvitā vaṅkṣaṇakakṣajā yā vartirnirartiḥ kaṭhināyatā ca|  
+
jvarānvitā vaṅkṣaṇakakṣajā yā vartirnirartiḥ kaṭhināyatā ca| <br />
vidārikā sā kaphamārutābhyāṁ tēṣāṁ yathādōṣamupakramaḥ syāt||89||  
+
vidārikā sā kaphamārutābhyāṁ tēṣāṁ yathādōṣamupakramaḥ syāt||89|| <br />
  
visrāvaṇaṁ piṇḍikayōpanāhaḥ pakvēṣu caiva vraṇavaccikitsā|
+
visrāvaṇaṁ piṇḍikayōpanāhaḥ pakvēṣu caiva vraṇavaccikitsā|<br />
  
jvarAnvitA va~gkShaNakakShajA yA vartirnirartiH kaThinAyatA ca|  
+
jvarAnvitA va~gkShaNakakShajA yA vartirnirartiH kaThinAyatA ca| <br />
vidArikA sA kaphamArutAbhyAM teShAM yathAdoShamupakramaH syAt||89||  
+
vidArikA sA kaphamArutAbhyAM teShAM yathAdoShamupakramaH syAt||89|| <br />
  
visrAvaNaM piNDikayopanAhaH pakveShu caiva vraNavaccikitsA|
+
visrAvaNaM piNDikayopanAhaH pakveShu caiva vraNavaccikitsA|<br />
 +
</div></div>
  
Painless cylindrical and hard swelling in the groin or axillary region accompanied with fever is known as ''vidārikā''. It occurs due to vitiation of ''kapha'' and ''vāta'' and should be managed according to the treatment of these ''dosha'', which include bloodletting, ''pinda sweda, upanāha'' and on suppuration it should be treated on the line of abscess [89]
+
Painless cylindrical and hard swelling in the groin or axillary region accompanied with fever is known as ''vidārikā''. It occurs due to vitiation of ''[[kapha]]'' and ''[[vata]]'' and should be managed according to the treatment of these ''[[dosha]]'', which include bloodletting, ''pinda sweda, upanāha'' and on suppuration it should be treated on the line of abscess [89]
 
   
 
   
==== ''Visphōṭaka'' (eruption) ====
+
=== ''Visphotaka'' (eruption) ===
 +
<div class="mw-collapsible mw-collapsed">
  
 
विस्फोटकाः सर्वशरीरगास्तु स्फोटाः [२७] सरागज्वरतर्षयुक्ताः||९०||  
 
विस्फोटकाः सर्वशरीरगास्तु स्फोटाः [२७] सरागज्वरतर्षयुक्ताः||९०||  
 +
<div class="mw-collapsible-content">
  
 
visphōṭakāḥ sarvaśarīragāstu sphōṭāḥ [27] sarāgajvaratarṣayuktāḥ||90||  
 
visphōṭakāḥ sarvaśarīragāstu sphōṭāḥ [27] sarāgajvaratarṣayuktāḥ||90||  
  
 
visphoTakAH sarvasharIragAstu sphoTAH [27] sarAgajvaratarShayuktAH||90||  
 
visphoTakAH sarvasharIragAstu sphoTAH [27] sarAgajvaratarShayuktAH||90||  
 +
</div></div>
  
 
Red colored eruptions occurring all over the body along with fever and thirst are known as ''visphōṭaka'' (90).
 
Red colored eruptions occurring all over the body along with fever and thirst are known as ''visphōṭaka'' (90).
 
   
 
   
==== ''Kakṣā'' (herpes zoster) ====
+
=== ''Kaksha'' (herpes zoster) ===
 +
<div class="mw-collapsible mw-collapsed">
  
 
यज्ञोपवीतप्रतिमाः प्रभूताः पित्तानिलाभ्यां जनितास्तु कक्षाः [२८] |
 
यज्ञोपवीतप्रतिमाः प्रभूताः पित्तानिलाभ्यां जनितास्तु कक्षाः [२८] |
 
   
 
   
 
याश्चापराः स्युः पिडकाः प्रकीर्णाः स्थूलाणुमध्या अपि पित्तजास्ताः||९१||
 
याश्चापराः स्युः पिडकाः प्रकीर्णाः स्थूलाणुमध्या अपि पित्तजास्ताः||९१||
 +
<div class="mw-collapsible-content">
 
   
 
   
 
yajñōpavītapratimāḥ prabhūtāḥ pittānilābhyāṁ janitāstu kakṣāḥ [28] |  
 
yajñōpavītapratimāḥ prabhūtāḥ pittānilābhyāṁ janitāstu kakṣāḥ [28] |  
Line 1,198: Line 1,398:
  
 
yAshcAparAH syuH piDakAH prakIrNAH sthUlANumadhyA api pittajAstAH||91||  
 
yAshcAparAH syuH piDakAH prakIrNAH sthUlANumadhyA api pittajAstAH||91||  
 +
</div></div>
  
Multiple eruptions occurring on the trunk due to ''pitta'' and ''vata'' where usually Hindu holy thread is worn, is known as ''kakṣā''.  
+
Multiple eruptions occurring on the trunk due to ''[[pitta]]'' and ''[[vata]]'' where usually Hindu holy thread is worn, is known as ''kakṣā''.  
  
Other such types of eruptions (''pidikā'') whether big, medium or small are also due to ''pitta'' [91]  
+
Other such types of eruptions (''pidikā'') whether big, medium or small are also due to ''[[pitta]]'' [91]  
  
==== Romāntikā (measles) ====
+
=== ''Romantika'' (measles) ===
 +
<div class="mw-collapsible mw-collapsed">
  
क्षुद्रप्रमाणाः पिडकाः शरीरे सर्वाङ्गगाः सज्वरदाहतृष्णाः|  
+
क्षुद्रप्रमाणाः पिडकाः शरीरे सर्वाङ्गगाः सज्वरदाहतृष्णाः| <br />
कण्डूयुताः सारुचिसप्रसेका रोमान्तिकाः पित्तकफात् प्रदिष्टाः||९२||  
+
कण्डूयुताः सारुचिसप्रसेका रोमान्तिकाः पित्तकफात् प्रदिष्टाः||९२|| <br />
 +
<div class="mw-collapsible-content">
  
kṣudrapramāṇāḥ piḍakāḥ śarīrē sarvāṅgagāḥ sajvaradāhatr̥ṣṇāḥ|  
+
kṣudrapramāṇāḥ piḍakāḥ śarīrē sarvāṅgagāḥ sajvaradāhatr̥ṣṇāḥ| <br />
kaṇḍūyutāḥ sārucisaprasēkā rōmāntikāḥ pittakaphāt pradiṣṭāḥ||92||  
+
kaṇḍūyutāḥ sārucisaprasēkā rōmāntikāḥ pittakaphāt pradiṣṭāḥ||92|| <br />
  
kShudrapramANAH piDakAH sharIre sarvA~ggagAH sajvaradAhatRuShNAH|  
+
kShudrapramANAH piDakAH sharIre sarvA~ggagAH sajvaradAhatRuShNAH| <br />
kaNDUyutAH sArucisaprasekA romAntikAH pittakaphAt pradiShTAH||92||  
+
kaNDUyutAH sArucisaprasekA romAntikAH pittakaphAt pradiShTAH||92|| <br />
 +
</div></div>
  
Small sized eruption all over the body due to pitta and kapha along with fever, burning sensation, thirst, itching, anorexia and salivation are known as romāntikā (measles) [92]  
+
Small sized eruption all over the body due to pitta and kapha along with fever, burning sensation, thirst, itching, anorexia and salivation are known as romāntikā (measles) [92]
  
==== Masurikā (chickenpox) and its management ====
+
=== Masurika (chickenpox) and its management ===
 +
<div class="mw-collapsible mw-collapsed">
  
याः सर्वगात्रेषु मसूरमात्रा मसूरिकाः पित्तकफात् प्रदिष्टाः|  
+
याः सर्वगात्रेषु मसूरमात्रा मसूरिकाः पित्तकफात् प्रदिष्टाः| <br />
वीसर्पशान्त्यै विहिता क्रिया या तां तेषु  कुष्ठे च हितां विदध्यात्||९३||  
+
वीसर्पशान्त्यै विहिता क्रिया या तां तेषु  कुष्ठे च हितां विदध्यात्||९३|| <br />
 +
<div class="mw-collapsible-content">
  
yāḥ sarvagātrēṣu masūramātrā masūrikāḥ pittakaphāt pradiṣṭāḥ|  
+
yāḥ sarvagātrēṣu masūramātrā masūrikāḥ pittakaphāt pradiṣṭāḥ| <br />
vīsarpaśāntyai vihitā kriyā yā tāṁ tēṣu  kuṣṭhē ca hitāṁ vidadhyāt||93||
+
vīsarpaśāntyai vihitā kriyā yā tāṁ tēṣu  kuṣṭhē ca hitāṁ vidadhyāt||93||<br />
  
yAH sarvagAtreShu masUramAtrA masUrikAH pittakaphAt pradiShTAH|  
+
yAH sarvagAtreShu masUramAtrA masUrikAH pittakaphAt pradiShTAH| <br />
vIsarpashAntyai vihitA kriyA yA tAM teShu [29] kuShThe ca hitAM vidadhyAt||93||
+
vIsarpashAntyai vihitA kriyA yA tAM teShu [29] kuShThe ca hitAM vidadhyAt||93||<br />
 +
</div></div>
  
Eruptions similar to size and shape of lentil (''masura'') occurring all over the body due to ''pitta'' and ''kapha'' is known as ''masurikā''; the treatment described for ''visarpa'' should is also adopted for it. For ''visphotaka'' etc., treatment described for ''kuṣtha'' should be adopted [93]
+
Eruptions similar to size and shape of lentil (''masura'') occurring all over the body due to ''[[pitta]]'' and ''[[kapha]]'' is known as ''masurikā''; the treatment described for ''visarpa'' should is also adopted for it. For ''visphotaka'' etc., treatment described for ''kuṣtha'' should be adopted [93]
  
==== ''Bradhna'' (hernia) and its management ====
+
=== ''Bradhna'' (hernia) and its management ===
 +
<div class="mw-collapsible mw-collapsed">
  
ब्रध्नोऽनिलाद्यैर्वृषणे  स्वलिङ्गैरन्त्रं निरेति प्रविशेन्मुहुश्च|  
+
ब्रध्नोऽनिलाद्यैर्वृषणे  स्वलिङ्गैरन्त्रं निरेति प्रविशेन्मुहुश्च| <br />
मूत्रेण पूर्णं मृदु मेदसा चेत् स्निग्धं च विद्यात् कठिनं च शोथम्||९४||  
+
मूत्रेण पूर्णं मृदु मेदसा चेत् स्निग्धं च विद्यात् कठिनं च शोथम्||९४|| <br />
  
विरेचनाभ्यङ्गनिरूहलेपाः पक्वेषु चैव व्रणवच्चिकित्सा|  
+
विरेचनाभ्यङ्गनिरूहलेपाः पक्वेषु चैव व्रणवच्चिकित्सा| <br />
स्यान्मूत्रसेकः  कफजं विपाट्य विशोध्य सीव्येद्व्रणवच्च पक्वम्||९५||   
+
स्यान्मूत्रसेकः  कफजं विपाट्य विशोध्य सीव्येद्व्रणवच्च पक्वम्||९५||  <br />
 +
<div class="mw-collapsible-content">
  
bradhnō'nilādyairvr̥ṣaṇē  svaliṅgairantraṁ nirēti praviśēnmuhuśca|  
+
bradhnō'nilādyairvr̥ṣaṇē  svaliṅgairantraṁ nirēti praviśēnmuhuśca| <br />
mūtrēṇa pūrṇaṁ mr̥du mēdasā cēt snigdhaṁ ca vidyāt kaṭhinaṁ ca śōtham||94||   
+
mūtrēṇa pūrṇaṁ mr̥du mēdasā cēt snigdhaṁ ca vidyāt kaṭhinaṁ ca śōtham||94||  <br />
  
virēcanābhyaṅganirūhalēpāḥ pakvēṣu caiva vraṇavaccikitsā|   
+
virēcanābhyaṅganirūhalēpāḥ pakvēṣu caiva vraṇavaccikitsā|  <br />
syānmūtrasēkaḥ  kaphajaṁ vipāṭya viśōdhya sīvyēdvraṇavacca pakvam||95||
+
syānmūtrasēkaḥ  kaphajaṁ vipāṭya viśōdhya sīvyēdvraṇavacca pakvam||95||<br />
  
bradhno~anilAdyairvRuShaNe [30] svali~ggairantraM nireti pravishenmuhushca|  
+
bradhno~anilAdyairvRuShaNe [30] svali~ggairantraM nireti pravishenmuhushca| <br />
mUtreNa pUrNaM mRudu medasA cet snigdhaM ca vidyAt kaThinaM ca shotham||94||  
+
mUtreNa pUrNaM mRudu medasA cet snigdhaM ca vidyAt kaThinaM ca shotham||94|| <br />
  
virecanAbhya~gganirUhalepAH pakveShu caiva vraNavaccikitsA| syAnmUtrasekaH [31]  
+
virecanAbhya~gganirUhalepAH pakveShu caiva vraNavaccikitsA| <br />
kaphajaM vipATya vishodhya sIvyedvraNavacca pakvam||95||
+
syAnmUtrasekaH [31] kaphajaM vipATya vishodhya sIvyedvraNavacca pakvam||95|| <br />
 +
</div></div>
  
Due to ''vata'' or other ''dosha'', the intestine frequently enters into scrotum and comes out and this condition is known as bradhna (hernia).  
+
Due to ''[[vata]]'' or other ''[[dosha]]'', the intestine frequently enters into scrotum and comes out and this condition is known as bradhna (hernia).  
  
 
If liquid (''mutra'') accumulates in scrotum then the swelling is soft (hydrocele).
 
If liquid (''mutra'') accumulates in scrotum then the swelling is soft (hydrocele).
Line 1,255: Line 1,465:
 
If fat accumulates in scrotum it is hard and unctuous.  
 
If fat accumulates in scrotum it is hard and unctuous.  
  
Its treatment is ''virechana karma'', oil massage, ''niruha basti'' and smearing of paste. If it suppurates then treatment of ulcer (''vrana'') should be adopted.  
+
Its treatment is ''[[virechana]] karma'', oil massage, ''niruha [[basti]]'' and smearing of paste. If it suppurates then treatment of ulcer (''vrana'') should be adopted.  
  
If there is oozing of liquid (''mutra'') and the swelling is due to ''kapha,'' then it should be open up, cleaned and sutured as per line of treatment of ulcer [94-95]
+
If there is oozing of liquid (''[[mutra]]'') and the swelling is due to ''[[kapha]],'' then it should be open up, cleaned and sutured as per line of treatment of ulcer [94-95]
  
==== Bhagandara (fistula-in-ano) and its management ====
+
=== Bhagandara (fistula-in-ano) and its management ===
 +
<div class="mw-collapsible mw-collapsed">
  
क्रिम्यस्थिसूक्ष्मक्षणनव्यवायप्रवाहणान्युत्कटकाश्वपृष्ठैः  |  
+
क्रिम्यस्थिसूक्ष्मक्षणनव्यवायप्रवाहणान्युत्कटकाश्वपृष्ठैः  | <br />
गुदस्य पार्श्वे पिडका भृशार्तिः पक्वप्रभिन्ना तु भगन्दरः स्यात्||९६||  
+
गुदस्य पार्श्वे पिडका भृशार्तिः पक्वप्रभिन्ना तु भगन्दरः स्यात्||९६|| <br />
  
विरेचनं चैषणपाटनं च विशुद्धमार्गस्य च तैलदाहः|  
+
विरेचनं चैषणपाटनं च विशुद्धमार्गस्य च तैलदाहः| <br />
स्यात् क्षारसूत्रेण सुपाचितेन  छिन्नस्य चास्य व्रणवच्चिकित्सा||९७||   
+
स्यात् क्षारसूत्रेण सुपाचितेन  छिन्नस्य चास्य व्रणवच्चिकित्सा||९७||  <br />
 +
<div class="mw-collapsible-content">
  
krimyasthisūkṣmakṣaṇanavyavāyapravāhaṇānyutkaṭakāśvapr̥ṣṭhaiḥ  |  
+
krimyasthisūkṣmakṣaṇanavyavāyapravāhaṇānyutkaṭakāśvapr̥ṣṭhaiḥ  | <br />
gudasya pārśvē piḍakā bhr̥śārtiḥ pakvaprabhinnā tu bhagandaraḥ syāt||96||
+
gudasya pārśvē piḍakā bhr̥śārtiḥ pakvaprabhinnā tu bhagandaraḥ syāt||96|| <br />
  
virēcanaṁ caiṣaṇapāṭanaṁ ca viśuddhamārgasya ca tailadāhaḥ|  
+
virēcanaṁ caiṣaṇapāṭanaṁ ca viśuddhamārgasya ca tailadāhaḥ| <br />
syāt kṣārasūtrēṇa supācitēna  chinnasya cāsya vraṇavaccikitsā||97||
+
syāt kṣārasūtrēṇa supācitēna  chinnasya cāsya vraṇavaccikitsā||97||<br />
  
krimyasthisUkShmakShaNanavyavAyapravAhaNAnyutkaTakAshvapRuShThaiH [33] |  
+
krimyasthisUkShmakShaNanavyavAyapravAhaNAnyutkaTakAshvapRuShThaiH [33] | <br />
gudasya pArshve piDakA bhRushArtiH pakvaprabhinnA tu bhagandaraH syAt||96||  
+
gudasya pArshve piDakA bhRushArtiH pakvaprabhinnA tu bhagandaraH syAt||96|| <br />
  
virecanaM caiShaNapATanaM ca vishuddhamArgasya ca tailadAhaH|  
+
virecanaM caiShaNapATanaM ca vishuddhamArgasya ca tailadAhaH| <br />
syAt kShArasUtreNa supAcitena [34] chinnasya cAsya vraNavaccikitsA||97||
+
syAt kShArasUtreNa supAcitena [34] chinnasya cAsya vraNavaccikitsA||97||<br />
 +
</div></div>
  
 
On the lateral side of anus, a very painful pustule (''pidika'') occurs which suppurates and opens up; it is known as ''bhagandara'' (fistula-in-ano). It is caused by infection (''krimi''), injury with pointed object like bone leading to minute erosion, excessive sex, straining at defecation and friction due to sitting on hard seat of a horse or moving object.  
 
On the lateral side of anus, a very painful pustule (''pidika'') occurs which suppurates and opens up; it is known as ''bhagandara'' (fistula-in-ano). It is caused by infection (''krimi''), injury with pointed object like bone leading to minute erosion, excessive sex, straining at defecation and friction due to sitting on hard seat of a horse or moving object.  
 
   
 
   
Its treatment is ''virechana'', probing, cutting and after cleansing cauterization with hot oil. If surgery is contraindicated then ''kshara-sutra'' should be applied and during and after cutting the track, routine line of management of ulcer is adopted [96-97]
+
Its treatment is ''[[virechana]]'', probing, cutting and after cleansing cauterization with hot oil. If surgery is contraindicated then ''kshara-sutra'' should be applied and during and after cutting the track, routine line of management of ulcer is adopted [96-97]
 
    
 
    
==== ''Shlipada'' (elephantiasis) and its management ====
+
=== ''Shlipada'' (elephantiasis) and its management ===
 +
<div class="mw-collapsible mw-collapsed">
  
जङ्घासु पिण्डीप्रपदोपरिष्टात् [३५] स्याच्छ्लीपदं मांसकफास्रदोषात्|  
+
जङ्घासु पिण्डीप्रपदोपरिष्टात् [३५] स्याच्छ्लीपदं मांसकफास्रदोषात्| <br />
सिराकफघ्नश्च विधिः समग्रस्तत्रेष्यते सर्षपलेपनं च||९८||  
+
सिराकफघ्नश्च विधिः समग्रस्तत्रेष्यते सर्षपलेपनं च||९८|| <br />
 +
<div class="mw-collapsible-content">
  
jaṅghāsu piṇḍīprapadōpariṣṭāt [35] syācchlīpadaṁ māṁsakaphāsradōṣāt|  
+
jaṅghāsu piṇḍīprapadōpariṣṭāt [35] syācchlīpadaṁ māṁsakaphāsradōṣāt| <br />
sirākaphaghnaśca vidhiḥ samagrastatrēṣyatē sarṣapalēpanaṁ ca||98||
+
sirākaphaghnaśca vidhiḥ samagrastatrēṣyatē sarṣapalēpanaṁ ca||98||<br />
  
ja~gghAsu piNDIprapadopariShTAt [35] syAcchlIpadaM mAMsakaphAsradoShAt|  
+
ja~gghAsu piNDIprapadopariShTAt [35] syAcchlIpadaM mAMsakaphAsradoShAt| <br />
sirAkaphaghnashca vidhiH samagrastatreShyate sarShapalepanaM ca||98||
+
sirAkaphaghnashca vidhiH samagrastatreShyate sarShapalepanaM ca||98||<br />
 +
</div></div>
  
The provoked ''kapha'' and ''rakta'' by involving flesh causes edema which begins from the upper part of the foot and spreads up to calf-muscle or shank; it is known as ''shlipada'' (elephantiasis). Its treatment is vene-section and local application of paste of mustard-seed as well as all other anti-''kapha'' treatment [98]
+
The provoked ''[[kapha]]'' and ''[[rakta]]'' by involving flesh causes edema which begins from the upper part of the foot and spreads up to calf-muscle or shank; it is known as ''shlipada'' (elephantiasis). Its treatment is vene-section and local application of paste of mustard-seed as well as all other anti-''[[kapha]]'' treatment [98]
  
==== ''Jalakagardabha'' and its management ====
+
=== ''Jalakagardabha'' and its management ===
 +
<div class="mw-collapsible mw-collapsed">
  
मन्दास्तु पित्तप्रबलाः प्रदुष्टा दोषाः सुतीव्रं तनुरक्तपाकम्|  
+
मन्दास्तु पित्तप्रबलाः प्रदुष्टा दोषाः सुतीव्रं तनुरक्तपाकम्| <br />
कुर्वन्ति शोथं ज्वरतर्षयुक्तं विसर्पणं जालकगर्दभाख्यम्||९९||                
+
कुर्वन्ति शोथं ज्वरतर्षयुक्तं विसर्पणं जालकगर्दभाख्यम्||९९||   <br />             
  
विलङ्घनं रक्तविमोक्षणं च विरूक्षणं कायविशोधनं च|  
+
विलङ्घनं रक्तविमोक्षणं च विरूक्षणं कायविशोधनं च| <br />
धात्रीप्रयोगाञ् शिशिरान् प्रदेहान् कुर्यात् सदा जालकगर्दभस्य||१००||   
+
धात्रीप्रयोगाञ् शिशिरान् प्रदेहान् कुर्यात् सदा जालकगर्दभस्य||१००||  <br />
 +
<div class="mw-collapsible-content">
  
mandāstu pittaprabalāḥ praduṣṭā dōṣāḥ sutīvraṁ tanuraktapākam|  
+
mandāstu pittaprabalāḥ praduṣṭā dōṣāḥ sutīvraṁ tanuraktapākam| <br />
kurvanti śōthaṁ jvaratarṣayuktaṁ visarpaṇaṁ jālakagardabhākhyam||99||  
+
kurvanti śōthaṁ jvaratarṣayuktaṁ visarpaṇaṁ jālakagardabhākhyam||99|| <br />
  
vilaṅghanaṁ raktavimōkṣaṇaṁ ca virūkṣaṇaṁ kāyaviśōdhanaṁ ca|  
+
vilaṅghanaṁ raktavimōkṣaṇaṁ ca virūkṣaṇaṁ kāyaviśōdhanaṁ ca| <br />
dhātrīprayōgāñ śiśirān pradēhān kuryāt sadā jālakagardabhasya||100||
+
dhātrīprayōgāñ śiśirān pradēhān kuryāt sadā jālakagardabhasya||100||<br />
  
mandAstu pittaprabalAH praduShTA doShAH sutIvraM tanuraktapAkam|  
+
mandAstu pittaprabalAH praduShTA doShAH sutIvraM tanuraktapAkam| <br />
kurvanti shothaM jvaratarShayuktaM visarpaNaM jAlakagardabhAkhyam||99||  
+
kurvanti shothaM jvaratarShayuktaM visarpaNaM jAlakagardabhAkhyam||99|| <br />
  
vila~gghanaM raktavimokShaNaM ca virUkShaNaM kAyavishodhanaM ca|  
+
vila~gghanaM raktavimokShaNaM ca virUkShaNaM kAyavishodhanaM ca| <br />
dhAtrIprayogA~j shishirAn pradehAn kuryAt sadA jAlakagardabhasya||100||
+
dhAtrIprayogA~j shishirAn pradehAn kuryAt sadA jAlakagardabhasya||100||<br />
 +
</div></div>
  
Mildly provoked ''dosha'' with dominance of ''pitta'' causes very acute inflammation which slightly bleeds and suppurates, has a tendency of quick spreading and is accompanied by fever and thirst is known as ''jalakagardabha''.   
+
Mildly provoked ''[[dosha]]'' with dominance of ''[[pitta]]'' causes very acute inflammation which slightly bleeds and suppurates, has a tendency of quick spreading and is accompanied by fever and thirst is known as ''jalakagardabha''.   
  
Its treatment is ''langhana'' (lightening therapy), blood-letting, un-unctuous therapy, ''virechana'', use of ''amalaki'' and application of paste of drugs having cold potency [99-100]
+
Its treatment is ''[[langhana]]'' (lightening therapy), blood-letting, un-unctuous therapy, ''[[virechana]]'', use of ''amalaki'' and application of paste of drugs having cold potency [99-100]
 +
<div class="mw-collapsible mw-collapsed">
  
एवंविधांश्चाप्यपरान् परीक्ष्य शोथप्रकाराननिलादिलिङ्गैः|  
+
एवंविधांश्चाप्यपरान् परीक्ष्य शोथप्रकाराननिलादिलिङ्गैः| <br />
शान्तिं नयेद्दोषहरैर्यथास्वमालेपनच्छेदनभेददाहैः||१०१||  
+
शान्तिं नयेद्दोषहरैर्यथास्वमालेपनच्छेदनभेददाहैः||१०१|| <br />
 +
<div class="mw-collapsible-content">
  
ēvaṁvidhāṁścāpyaparān parīkṣya śōthaprakārānanilādiliṅgaiḥ|  
+
ēvaṁvidhāṁścāpyaparān parīkṣya śōthaprakārānanilādiliṅgaiḥ| <br />
śāntiṁ nayēddōṣaharairyathāsvamālēpanacchēdanabhēdadāhaiḥ||101||
+
śāntiṁ nayēddōṣaharairyathāsvamālēpanacchēdanabhēdadāhaiḥ||101||<br />
  
evaMvidhAMshcApyaparAn parIkShya shothaprakArAnanilAdili~ggaiH|  
+
evaMvidhAMshcApyaparAn parIkShya shothaprakArAnanilAdili~ggaiH| <br />
shAntiM nayeddoShaharairyathAsvamAlepanacchedanabhedadAhaiH||101||
+
shAntiM nayeddoShaharairyathAsvamAlepanacchedanabhedadAhaiH||101||<br />
 +
</div></div>
  
Other types of inflammatory swellings may be diagnosed on the basis of the characteristic symptoms of the involved ''vata'' and other ''dosha''. It may also be managed by prescribing the treatment of involved ''dosha'' as well as by application of paste, incision and excision [101]
+
Other types of inflammatory swellings may be diagnosed on the basis of the characteristic symptoms of the involved ''[[vata]]'' and other ''[[dosha]]''. It may also be managed by prescribing the treatment of involved ''[[dosha]]'' as well as by application of paste, incision and excision [101]
  
==== General guidelines of management ====
+
=== General guidelines of management ===
 +
<div class="mw-collapsible mw-collapsed">
  
प्रायोऽभिघातादनिलः सरक्तः शोथं सरागं प्रकरोति तत्र|  
+
प्रायोऽभिघातादनिलः सरक्तः शोथं सरागं प्रकरोति तत्र| <br />
वीसर्पनुन्मारुतरक्तनुच्च कार्यं विषघ्नं विषजे च कर्म||१०२||  
+
वीसर्पनुन्मारुतरक्तनुच्च कार्यं विषघ्नं विषजे च कर्म||१०२|| <br />
 +
<div class="mw-collapsible-content">
  
prāyō'bhighātādanilaḥ saraktaḥ śōthaṁ sarāgaṁ prakarōti tatra|   
+
prāyō'bhighātādanilaḥ saraktaḥ śōthaṁ sarāgaṁ prakarōti tatra|  <br />
vīsarpanunmārutaraktanucca kāryaṁ viṣaghnaṁ viṣajē ca karma||102||
+
vīsarpanunmārutaraktanucca kāryaṁ viṣaghnaṁ viṣajē ca karma||102||<br />
  
prAyo~abhighAtAdanilaH saraktaH shothaM sarAgaM prakaroti tatra|  
+
prAyo~abhighAtAdanilaH saraktaH shothaM sarAgaM prakaroti tatra| <br />
vIsarpanunmArutaraktanucca kAryaM viShaghnaM viShaje ca karma||102||
+
vIsarpanunmArutaraktanucca kAryaM viShaghnaM viShaje ca karma||102||<br />
 +
</div></div>
  
Generally external trauma causes reddish swelling due to provocation of ''vata'' and ''rakta''. It should be treated with drugs used for the treatment of ''visarpa'' and provoked ''vata'' and ''rakta''.   
+
Generally external trauma causes reddish swelling due to provocation of ''[[vata]]'' and ''[[rakta]]''. It should be treated with drugs used for the treatment of ''visarpa'' and provoked ''[[vata]]'' and ''[[rakta]]''.   
  
 
If the swelling is caused by poisonous substances then it should be treated with anti-poison measures [102]
 
If the swelling is caused by poisonous substances then it should be treated with anti-poison measures [102]
  
==== Summary ====
+
=== Summary ===
 +
<div class="mw-collapsible mw-collapsed">
  
 
तत्र श्लोकः-  
 
तत्र श्लोकः-  
  
त्रिविधस्य दोषभेदात् सर्वार्धावयवगात्रभेदाच्च|  
+
त्रिविधस्य दोषभेदात् सर्वार्धावयवगात्रभेदाच्च| <br />
श्वयथोर्द्विविधस्य  तथा लिङ्गानि चिकित्सितं चोक्तम्||१०३||  
+
श्वयथोर्द्विविधस्य  तथा लिङ्गानि चिकित्सितं चोक्तम्||१०३|| <br />
 +
<div class="mw-collapsible-content">
 
                  
 
                  
 
tatra ślōkaḥ-  
 
tatra ślōkaḥ-  
  
trividhasya dōṣabhēdāt sarvārdhāvayavagātrabhēdācca|  
+
trividhasya dōṣabhēdāt sarvārdhāvayavagātrabhēdācca| <br />
śvayathōrdvividhasya  tathā liṅgāni cikitsitaṁ cōktam||103||
+
śvayathōrdvividhasya  tathā liṅgāni cikitsitaṁ cōktam||103|| <br />
  
 
tatra shlokaH-  
 
tatra shlokaH-  
  
trividhasya doShabhedAt sarvArdhAvayavagAtrabhedAcca|  
+
trividhasya doShabhedAt sarvArdhAvayavagAtrabhedAcca| <br />
shvayathordvividhasya [36] tathA li~ggAni cikitsitaM coktam||103||
+
shvayathordvividhasya [36] tathA li~ggAni cikitsitaM coktam||103|| <br />
 +
</div></div>
  
 
Re-capitulatory verses-
 
Re-capitulatory verses-
  
Three types of swelling as per involvement of dosha; classification of swelling according to involvement whole or half body or one part; exogenous and endogenous swelling; their symptoms and treatment have been described [103]
+
Three types of swelling as per involvement of [[dosha]]; classification of swelling according to involvement whole or half body or one part; exogenous and endogenous swelling; their symptoms and treatment have been described [103]
 +
<div class="mw-collapsible mw-collapsed">
 
   
 
   
 
इत्यग्निवेशकृते तन्त्रेऽप्राप्ते दृढबलसम्पूरिते चिकित्सास्थाने  
 
इत्यग्निवेशकृते तन्त्रेऽप्राप्ते दृढबलसम्पूरिते चिकित्सास्थाने  
 
श्वयथुचिकित्सितं नाम द्वादशोऽध्यायः||१२||  
 
श्वयथुचिकित्सितं नाम द्वादशोऽध्यायः||१२||  
 +
<div class="mw-collapsible-content">
  
 
ityagnivēśakr̥tē tantrē'prāptē dr̥ḍhabalasampūritē cikitsāsthānē  
 
ityagnivēśakr̥tē tantrē'prāptē dr̥ḍhabalasampūritē cikitsāsthānē  
Line 1,375: Line 1,605:
 
ityagniveshakRute tantre~aprApte dRuDhabalasampUrite cikitsAsthAne  
 
ityagniveshakRute tantre~aprApte dRuDhabalasampUrite cikitsAsthAne  
 
shvayathucikitsitaM nAma dvAdasho~adhyAyaH||12||
 
shvayathucikitsitaM nAma dvAdasho~adhyAyaH||12||
 +
</div></div>
  
 
Thus 12th chapter named [[Shvayathu Chikitsa]] in [[Chikitsa Sthana]] of treatise compiled by Agnivesha, revised by Charaka and unavailable part restored by Dridhabala is completed (12).   
 
Thus 12th chapter named [[Shvayathu Chikitsa]] in [[Chikitsa Sthana]] of treatise compiled by Agnivesha, revised by Charaka and unavailable part restored by Dridhabala is completed (12).   
  
=== ''Tattva Vimarsha'' ===
+
== Tattva Vimarsha (Fundamental Principles) ==
  
*''Shotha'' is caused by dietary causes like excessive use of ''kshara'' (alkali) or food articles having sour, sharply acting, hot and heavy properties by an emaciated or weak person due to excessive ''shodhana'', fasting or disease; excessive intake of curd, raw food articles, soil, leafy vegetables, mutually contradictory food articles (''virodhi''), spoiled or mixed with toxic substance (such as pesticide), or a person suffering from piles, having sedentary life style, nonperforming of ''shodhana'' therapy even if indicated, injury to vital organs (''marma''), abnormal delivery, due to improper treatment and as complication of improper purification treatment.
+
*''Shotha'' is caused by dietary causes like excessive use of ''kshara'' (alkali) or food articles having sour, sharply acting, hot and heavy properties by an emaciated or weak person due to excessive ''[[shodhana]]'', fasting or disease; excessive intake of curd, raw food articles, soil, leafy vegetables, mutually contradictory food articles (''virodhi''), spoiled or mixed with toxic substance (such as pesticide), or a person suffering from piles, having sedentary life style, nonperforming of ''[[shodhana]]'' therapy even if indicated, injury to vital organs (''marma''), abnormal delivery, due to improper treatment and as complication of improper purification treatment.
 
*Exogenous causes include trauma or injuries of various types and have acute pathogenesis.  
 
*Exogenous causes include trauma or injuries of various types and have acute pathogenesis.  
*The pathogenesis of ''nija shotha'' includes obstruction of morbid vāta by vitiated ''kapha, rakta'' and ''pitta'' at the site of peripheral superficial vessels. This vitiated ''vata'' (due to obstruction) spreads to the various places causing swelling as its cardinal symptom.
+
*The pathogenesis of ''nija shotha'' includes obstruction of morbid vāta by vitiated ''[[kapha]], [[rakta]]'' and ''[[pitta]]'' at the site of peripheral superficial vessels. This vitiated ''[[vata]]'' (due to obstruction) spreads to the various places causing swelling as its cardinal symptom.
 
*Rise in temperature, burning sensation as if burnt by fire and dilation of the vessels are the prodromal symptoms of swelling.
 
*Rise in temperature, burning sensation as if burnt by fire and dilation of the vessels are the prodromal symptoms of swelling.
*All types of swelling are produced by involvement of all the three ''dosha'' but they are named based on the predominance of that particular ''dosha''. The line of treatment is also according to the dominant ''dosha''.
+
*All types of swelling are produced by involvement of all the three ''[[dosha]]'' but they are named based on the predominance of that particular ''[[dosha]]''. The line of treatment is also according to the dominant ''[[dosha]]''.
*The swelling in a patient who is neither emaciated nor weak; that involved single ''dosha'' or is of recent origin is easily curable.
+
*The swelling in a patient who is neither emaciated nor weak; that involved single ''[[dosha]]'' or is of recent origin is easily curable.
*If swelling is associated with ''ama'' it should be managed first by prescribing lightening therapy (''langhana'') and digestive drugs. Only after that ''shodhana'' therapy should be undertaken according to dominant ''dosha''. General lines of treatment of ''doshaja'' swelling are as follows:
+
*If swelling is associated with ''ama'' it should be managed first by prescribing lightening therapy (''[[langhana]]'') and digestive drugs. Only after that ''[[shodhana]]'' therapy should be undertaken according to dominant ''[[dosha]]''. General lines of treatment of ''[[dosha]]ja'' swelling are as follows:
 
**If it involves head then ''shiro-virechana'' is prescribed;  
 
**If it involves head then ''shiro-virechana'' is prescribed;  
**If it involves lower parts of the body then ''virechana'' (therapeutic purgation) is prescribed;  
+
**If it involves lower parts of the body then ''[[virechana]]'' (therapeutic purgation) is prescribed;  
**If it involves upper parts of the body then ''vamana'' (therapeutic emesis)is prescribed;
+
**If it involves upper parts of the body then ''[[vamana]]'' (therapeutic emesis)is prescribed;
**If it is caused by unctuous then ''rukshana'' (drying) therapy is done;
+
**If it is caused by unctuous then ''[[rukshana]]'' (drying) therapy is done;
**If it is caused by un-unctuous (''ruksha'') then unctuous (''snehana'') therapy is done;
+
**If it is caused by un-unctuous (''ruksha'') then unctuous (''[[snehana]]'') therapy is done;
**If ''vata'' swelling is associated with constipation then it should be treated with ''niruha basti'';
+
**If ''[[vata]]'' swelling is associated with constipation then it should be treated with ''niruha [[basti]]'';
**If it is caused by ''vata-pitta'' then it should be treated with ghee prepared with bitter drugs;
+
**If it is caused by ''[[vata]]-[[pitta]]'' then it should be treated with ghee prepared with bitter drugs;
 
**If the patient is suffering from associated symptoms such as fainting, pain, burning sensation and thirst then it should be treated with intake of milk;  
 
**If the patient is suffering from associated symptoms such as fainting, pain, burning sensation and thirst then it should be treated with intake of milk;  
**If the patient is suffering from swelling where ''shodhana'' is required then milk mixed with cow’s urine should be given;  
+
**If the patient is suffering from swelling where ''[[shodhana]]'' is required then milk mixed with cow’s urine should be given;  
**If the patient is suffering from ''kapha'' swelling then ''kshara'' or pungent and hot articles mixed in cow’s urine or buttermilk or ''asava'' are given.
+
**If the patient is suffering from ''[[kapha]]'' swelling then ''kshara'' or pungent and hot articles mixed in cow’s urine or buttermilk or ''asava'' are given.
**Generally external trauma causes reddish swelling due to provocation of ''vata'' and ''rakta''. It should be treated with drugs used for the treatment of ''visarpa'' and provoked ''vata'' and ''rakta''. If the swelling is caused by poisonous substances then it should be treated with anti-poison measures (102).
+
**Generally external trauma causes reddish swelling due to provocation of ''[[vata]]'' and ''[[rakta]]''. It should be treated with drugs used for the treatment of ''visarpa'' and provoked ''[[vata]]'' and ''[[rakta]]''. If the swelling is caused by poisonous substances then it should be treated with anti-poison measures (102).
  
=== ''Vidhi Vimarsha'' ===
+
== Vidhi Vimarsha (Applied Inferences ) ==
  
==== Derivation of term ====
+
=== Derivation of term ===
  
 
The word ''Shvayathu'' is derived from root ''Tuoshchi-Gati-Vriddhyoh''. ''Tuo'' is converted to ''Shvi'' indicating to increase (''Vriddhi'') and by adding ''Athuc Pratyaya'' the word ''Shvayathu'' is derived which literally means increased (3).
 
The word ''Shvayathu'' is derived from root ''Tuoshchi-Gati-Vriddhyoh''. ''Tuo'' is converted to ''Shvi'' indicating to increase (''Vriddhi'') and by adding ''Athuc Pratyaya'' the word ''Shvayathu'' is derived which literally means increased (3).
  
==== Pathogenesis ====
+
=== Pathogenesis ===
  
 
In pathogenesis of ''shotha'' there is involvement of superficial veins (''Bahya shira''). Involvement of circulatory or lymphatic system is must in producing the ''shotha''.
 
In pathogenesis of ''shotha'' there is involvement of superficial veins (''Bahya shira''). Involvement of circulatory or lymphatic system is must in producing the ''shotha''.
  
==== Types of ''shotha'' ====
+
=== Types of ''shotha'' ===
  
''Vata shotha'' is shifting in nature, pitting on pressure and increases in the day time and may vanish without visible cause. Further ''vata'' causes edema of the lower part of the body i. e feet and legs. All these characteristics of ''vata shotha'' are indicative cardiac edema.  
+
''[[Vata]] shotha'' is shifting in nature, pitting on pressure and increases in the day time and may vanish without visible cause. Further ''[[vata]]'' causes edema of the lower part of the body i. e feet and legs. All these characteristics of ''[[vata]] shotha'' are indicative cardiac edema.  
  
In day time due to various activities and fatigue ''vata'' gets increased leading to increase in the edema. From modern point of view, cardiac edema increases in the evening which is ''vata kala'' due to the day activities. ''Vata shotha'' is pitting on pressure but on removing the pressure it immediately takes its original shape.
+
In day time due to various activities and fatigue ''[[vata]]'' gets increased leading to increase in the edema. From modern point of view, cardiac edema increases in the evening which is ''[[vata]] kala'' due to the day activities. ''[[Vata]] shotha'' is pitting on pressure but on removing the pressure it immediately takes its original shape.
  
''Pitta sopha'' begins from middle parts of the body and then spreads to the other parts and has yellow-reddish color (Ashtangahridaya Nidana 13/33). Yellowish coloration indicates involvement of liver. Inflammatory swelling is related to ''pittaja shotha'' .  
+
''[[Pitta]] sopha'' begins from middle parts of the body and then spreads to the other parts and has yellow-reddish color<ref>Vagbhata. Nidana Sthana, Cha.13 Pandurogasophavisarpa Nidana Adhyaya verse 33. In: Harishastri Paradkar Vaidya, Editors. Ashtanga Hridayam. 1st ed. Varanasi: Krishnadas Academy;2000.p.4. </ref>. Yellowish coloration indicates involvement of liver. Inflammatory swelling is related to ''[[pitta]]ja shotha'' .  
 
    
 
    
''Kapha Shotha'' slightly pits on pressure but takes long time to attain its original position after removing the pressure and increases at night. It develops slowly and also takes long time to subside. ''Kapha shotha'' occurs in upper part of the body and the treatment of edema occurring on the upper part is ''vamana'' i.e. of ''kapha''. On this basis it can be said that which mainly includes face. Renal edema occurs on the face in the morning (noticed on awakening though increased in the night). Other important sign is it is hard and the serous discharge comes out on scratching the skin (Ashtangahridaya Nidana 13/35-36). This indicates that hard non-pitting edema of elephantiasis may also be included under it. Other symptom mentioned for ''kaphaja shotha'' that the patient like warm touch indicates towards edema found in hypothyroidism (14).
+
''[[Kapha]] Shotha'' slightly pits on pressure but takes long time to attain its original position after removing the pressure and increases at night. It develops slowly and also takes long time to subside. ''[[Kapha]] shotha'' occurs in upper part of the body and the treatment of edema occurring on the upper part is ''[[vamana]]'' i.e. of ''[[kapha]]''. On this basis it can be said that which mainly includes face. Renal edema occurs on the face in the morning (noticed on awakening though increased in the night). Other important sign is it is hard and the serous discharge comes out on scratching the skin <ref>Vagbhata. Nidana Sthana, Cha.13 Pandurogasophavisarpa Nidana Adhyaya verse 35-36. In: Harishastri Paradkar Vaidya, Editors. Ashtanga Hridayam. 1st ed. Varanasi: Krishnadas Academy;2000.p.4.</ref>. This indicates that hard non-pitting edema of elephantiasis may also be included under it. Other symptom mentioned for ''[[kapha]]ja shotha'' that the patient like warm touch indicates towards edema found in hypothyroidism (14).
 +
 
 +
=== Complications ===
  
==== Complications ====
+
Complications of ''shotha'' are vomiting, dyspnea, anorexia, thirst, fever, loose motions and weakness (Cha. Sa. [[Sutra Sthana]] chapter 18/18]. Sushruta mentions two additional complications viz. cough and hiccups.<ref>Sushruta. Chikitsa Sthana, Cha.23 Sopha Chikisitam  Adhyaya verse 8-9. In: Jadavaji Trikamji Aacharya, Editors. Sushruta Samhita. 8th ed. Varanasi: Chaukhambha Orientalia;2005. p.1.</ref>(15)
  
Complications of ''shotha'' are vomiting, dyspnea, anorexia, thirst, fever, loose motions and weakness ([[Sutra Sthana]] chapter 18/18). Sushruta mentions two additional complications viz. cough and hiccups (Sushruta Chikitsa 23/8-9)(15)
+
Sushruta classify general edema in five types viz., ''[[vata]], [[pitta]], [[kapha]], sannipata'' and ''vishaja''<ref>Sushruta. Chikitsa Sthana, Cha.23 Sopha Chikisitam  Adhyaya verse 3. In: Jadavaji Trikamji Aacharya, Editors. Sushruta Samhita. 8th ed. Varanasi: Chaukhambha Orientalia;2005. p.1.</ref>  but does not consider local swelling as the part of ''shopha'' because while defining swelling it is clearly mentioned that which occurs in the large part under the skin and flesh etc but is other than nodules (''granthi''), abscess (''vidradhi''), ''alaji'' etc is known as ''shopha'' <ref>Sushruta. Sutra Sthana, Cha.17 Amapkweshaneeya Adhyaya verse 3 In: Jadavaji Trikamji Aacharya, Editors. Sushruta Samhita. 8th ed. Varanasi: Chaukhambha Orientalia;2005. p.1.</ref>
Sushruta classify general edema in five types viz., ''vata, pitta, kapha, sannipata'' and ''vishaja'' (Sushruta Chikitsa 23/3) but does not consider local swelling as the part of ''shopha'' because while defining swelling it is clearly mentioned that which occurs in the large part under the skin and flesh etc but is other than nodules (''granthi''), abscess (''vidradhi''), ''alaji'' etc is known as ''shopha'' (Sushruta Sutra 17:3).
 
  
Ashtangahridaya describes ''shopha'' in the chapter on ''panduroga'' (anemia) because it is a main complication of anemia. Nine types of ''shopha'' described therein are three single ''dosha'' type, three ''samsarga'' types, one ''tridoshaja'' and one each due to trauma and poison. In addition three new types of ''shopha'' viz. ''prithu'' (extensive), ''unnata'' (elevated) and ''grathita'' (compact) are also mentioned (Ashtangahridaya Nidana 13/21-42).   
+
Ashtangahridaya describes ''shopha'' in the chapter on ''panduroga'' (anemia) because it is a main complication of anemia. Nine types of ''shopha'' described therein are three single ''[[dosha]]'' type, three ''samsarga'' types, one ''tridoshaja'' and one each due to trauma and poison. In addition three new types of ''shopha'' viz. ''prithu'' (extensive), ''unnata'' (elevated) and ''grathita'' (compact) are also mentioned.<ref>Vagbhata. Nidana Sthana, Cha.13 Pandurogasophavisarpa Nidana Adhyaya verse 21-42. In: Harishastri Paradkar Vaidya, Editors. Ashtanga Hridayam. 1st ed. Varanasi: Krishnadas Academy;2000.p.4. </ref>.   
 
    
 
    
Madhava Nidana followed Ashtangahridaya and describes nine types of ''shotha'' and does not describe localized ''shotha'' in this chapter on ''shotha'' (Madhava Nidana ''shothadhikara'').
+
Madhava Nidana followed Ashtangahridaya and describes nine types of ''shotha'' and does not describe localized ''shotha'' in this chapter on ''shotha'' <ref>Madhavakara. Madhava Nidanam (Roga vinischaya). Translated from Sanskrit by K. R. Srikantha Murthy. 8th ed. Varanasi: Chaukhambha orientalia;2007.pp--</ref>.
 
    
 
    
 
''Charaka'' considers bulging (''utsedha'') from the skin as ''shvayathu'' therefore local swellings such as ''pidika'' (papules and pustules), nodules (including ''gandhamala''), ''galagandha'' (goiter), tumor etc are also described in this chapter. The probable modern equivalents are given in the bracket while describing these conditions in the text (74-100).   
 
''Charaka'' considers bulging (''utsedha'') from the skin as ''shvayathu'' therefore local swellings such as ''pidika'' (papules and pustules), nodules (including ''gandhamala''), ''galagandha'' (goiter), tumor etc are also described in this chapter. The probable modern equivalents are given in the bracket while describing these conditions in the text (74-100).   
  
Sushruta defines ''arbuda'' as a round and immovable growth produced by vitiated ''dosha'' by afflicting ''mamsa'' with mild pain but having deep roots and located in extensive area at the expense of tissue and causes swelling of the ''mamsa'' extensively. This ''arbuda'' (tumor) grows slowly and does not suppurate (Sushruta Nidana 11/13-14). But Charaka being a clinician does not consider much difference in the management of ''arbuda'' and ''granthi'' as their site, causative factors, shape, ''dosha'' morbidity and ''dushya'' (susceptible tissues) are about the same. However, it is clearly mentioned that ''arbuda'' should be managed by the expert surgeon only (87).   
+
Sushruta defines ''arbuda'' as a round and immovable growth produced by vitiated ''[[dosha]]'' by afflicting ''[[mamsa]]'' with mild pain but having deep roots and located in extensive area at the expense of tissue and causes swelling of the ''[[mamsa]]'' extensively. This ''arbuda'' (tumor) grows slowly and does not suppurate <ref>Sushruta. Nidana Sthana, Cha.11 Grandhiapachiarbudagalaganda Nidana Adhyaya verse 13-14 In: Jadavaji Trikamji Aacharya, Editors. Sushruta Samhita. 8th ed. Varanasi: Chaukhambha Orientalia;2005. p.1.</ref>. But Charaka being a clinician does not consider much difference in the management of ''arbuda'' and ''granthi'' as their site, causative factors, shape, ''[[dosha]]'' morbidity and ''[[dushya]]'' (susceptible tissues) are about the same. However, it is clearly mentioned that ''arbuda'' should be managed by the expert surgeon only (87).   
  
 
Line of treatment, various procedures and preparations mentioned in this chapter for the management of various types of swellings are easy to administer and practical so should be practiced (16-73).
 
Line of treatment, various procedures and preparations mentioned in this chapter for the management of various types of swellings are easy to administer and practical so should be practiced (16-73).
  
==== ''Shat-kriya-kala'' of ''shotha'' ====
+
=== ''Shat-kriya-kala'' of ''shotha'' ===
  
#''Sanchaya'' (Accumulation): This is the first stage of the disease where due to indulgence into the causative factors accumulation of concerned ''dosha'' occurs. During this stage increase in the normal functions of the ''dosha'' is noticed.  
+
#''Sanchaya'' (Accumulation): This is the first stage of the disease where due to indulgence into the causative factors accumulation of concerned ''[[dosha]]'' occurs. During this stage increase in the normal functions of the ''[[dosha]]'' is noticed.  
#''Prakopa'' (Provocation): If the accumulated ''dosha'' are not properly taken care then they may go to the next stage of provocation. During this stage the ''prakopa'' symptoms of the involved ''dosha'' appear.   
+
#''Prakopa'' (Provocation): If the accumulated ''[[dosha]]'' are not properly taken care then they may go to the next stage of provocation. During this stage the ''prakopa'' symptoms of the involved ''[[dosha]]'' appear.   
#''Prasara'' (Spreading): In the stage of ''prasara'' the ''dosha'' leaves their normal site and starts circulating all over the body.  
+
#''Prasara'' (Spreading): In the stage of ''prasara'' the ''[[dosha]]'' leaves their normal site and starts circulating all over the body.  
#''Sthana-Smashrya'' (Localization): The circulating ''dosha'' interacts with such tissues which have some problem in their channels which may be anatomical, physiological or pathological. This phenomenon is ''dosha-dushya-samurchchana''. This localization of ''dosha'' leads to beginning of the pathogenesis of the disease and during this stage prodromal symptoms (''purva-rupa'') of the disease are produced. The prodromal symptoms of edema are heat, burning sensation and dilation of the vessels.
+
#''Sthana-Smashrya'' (Localization): The circulating ''[[dosha]]'' interacts with such tissues which have some problem in their channels which may be anatomical, physiological or pathological. This phenomenon is ''[[dosha]]-[[dushya]]-samurchchana''. This localization of ''[[dosha]]'' leads to beginning of the pathogenesis of the disease and during this stage prodromal symptoms (''purva-rupa'') of the disease are produced. The prodromal symptoms of edema are heat, burning sensation and dilation of the vessels.
 
#''Vyakti'' (Manifestation): If the disease is not managed at the stage of localization then the disease manifest with its specific symptoms. The symptoms of various types of edema are mentioned in the verses from 11 to 16 of this chapter. All or few symptoms mentioned for the disease may appear but if all the symptoms appear then the disease may become incurable and if few then it is easily curable. Moderate appearance of the symptom indicates its moderate prognosis.  
 
#''Vyakti'' (Manifestation): If the disease is not managed at the stage of localization then the disease manifest with its specific symptoms. The symptoms of various types of edema are mentioned in the verses from 11 to 16 of this chapter. All or few symptoms mentioned for the disease may appear but if all the symptoms appear then the disease may become incurable and if few then it is easily curable. Moderate appearance of the symptom indicates its moderate prognosis.  
#''Bheda'' (Complications): If the disease is not properly treated even after it is fully manifestation then the complications may appear and the disease becomes difficult to cure or incurable. The seven complications of edema are vomiting, thirst, anorexia, dyspnea, fever, diarrhea and weakness ([[Sutra Sthana]] 18:18).
+
#''Bheda'' (Complications): If the disease is not properly treated even after it is fully manifestation then the complications may appear and the disease becomes difficult to cure or incurable. The seven complications of edema are vomiting, thirst, anorexia, dyspnea, fever, diarrhea and weakness [ Cha. Sa. [[Sutra Sthana]] 18/18].
  
==== Differential Diagnosis of ''shotha'' ====
+
=== Differential Diagnosis of ''shotha'' ===
  
Ayurveda is a clinical science, therefore the classifications are also planned so that the disease can systematically be diagnosed on the basis of the symptoms. ''Shotha'' is a good example for it.
+
[[Ayurveda]] is a clinical science, therefore the classifications are also planned so that the disease can systematically be diagnosed on the basis of the symptoms. ''Shotha'' is a good example for it.
  
 
''Shotha'' has been defined as any abnormal elevation from the skin. First question to be asked to the patient whether there is any history of trauma, biting etc and if yes, then it is an ''agantuja shotha''. If there is a history of contact or taking poisonous substance then it is ''vishaja''.
 
''Shotha'' has been defined as any abnormal elevation from the skin. First question to be asked to the patient whether there is any history of trauma, biting etc and if yes, then it is an ''agantuja shotha''. If there is a history of contact or taking poisonous substance then it is ''vishaja''.
Line 1,451: Line 1,683:
 
Hereafter it is to be confirmed that whether the  swelling is localized or all over the body. If ''shotha'' is localized in single organ or site then it can be diagnosed on the basis of nature of the lesion such as papules, pustules, nodules, tumor etc. It is further diagnosed on the basis of shape, site etc. For example ''gandhamala'' is garland like and ''galagandha'' is scrotum like swelling in neck. ''Romantika'' has minute papules while ''masurika'' has lentil like papules and so on. Associated general features such as fever, thirst etc also helps in differential diagnosis.  
 
Hereafter it is to be confirmed that whether the  swelling is localized or all over the body. If ''shotha'' is localized in single organ or site then it can be diagnosed on the basis of nature of the lesion such as papules, pustules, nodules, tumor etc. It is further diagnosed on the basis of shape, site etc. For example ''gandhamala'' is garland like and ''galagandha'' is scrotum like swelling in neck. ''Romantika'' has minute papules while ''masurika'' has lentil like papules and so on. Associated general features such as fever, thirst etc also helps in differential diagnosis.  
  
If ''shotha'' is generalized swelling then the point of its beginning is important e.g. ''pitta shopha'' starts from middle part of the abdomen, ''vata'' from the lower parts and ''kapha'' from upper parts of the body. The consideration of other characteristic features mentioned above will help in reaching the final diagnosis.
+
If ''shotha'' is generalized swelling then the point of its beginning is important e.g. ''[[pitta]] shopha'' starts from middle part of the abdomen, ''[[vata]]'' from the lower parts and ''[[kapha]]'' from upper parts of the body. The consideration of other characteristic features mentioned above will help in reaching the final diagnosis.
  
For example moving, pitting on pressure, increasing in the day time and sometime subsides without appreciable cause etc help in reaching the diagnosis for ''vata shopha''.
+
For example moving, pitting on pressure, increasing in the day time and sometime subsides without appreciable cause etc help in reaching the diagnosis for ''[[vata]] shopha''.
  
Swelling which is firm, slight pitting on pressure, increases in the night, takes long time to subside and is associated with low digestion, vomiting, anemia indicates towards ''kapha shotha''.
+
Swelling which is firm, slight pitting on pressure, increases in the night, takes long time to subside and is associated with low digestion, vomiting, anemia indicates towards ''[[kapha]] shotha''.
  
Swelling which is soft, tender on touch, associated with change to yellow color, fever etc is ''pitta shotha''.
+
Swelling which is soft, tender on touch, associated with change to yellow color, fever etc is ''[[pitta]] shotha''.
  
Similarly causative factors can also be sorted out by asking whether it relates to food articles (curd, unripe fruits, spoiled, leafy vegetables) or its properties (excessive use of ''kshara'', sour, sharp, hot and heavy food articles), diet habit (fasting), sedentary life style, emaciation or weakness due to a disease or excessive ''shodhana'', contact to poisonous substances etc.
+
Similarly causative factors can also be sorted out by asking whether it relates to food articles (curd, unripe fruits, spoiled, leafy vegetables) or its properties (excessive use of ''kshara'', sour, sharp, hot and heavy food articles), diet habit (fasting), sedentary life style, emaciation or weakness due to a disease or excessive ''[[shodhana]]'', contact to poisonous substances etc.
  
==== ''Chikitsa Sutra'' (Line of treatment) ====
+
=== ''Chikitsa Sutra'' (Principles of treatment) ===
  
Ayurveda gives very importance to ''ama''. Therefore, if ''ama'' is associated with swelling then first it should be managed by prescribing lightening therapy (''langhana'') and digestive drugs. After getting the ''nirama'' symptoms, ''shodhana'' therapy can be done according to dominant ''dosha''. It is the general rule for all types of swellings.  
+
[[Ayurveda]] gives very importance to ''ama''. Therefore, if ''ama'' is associated with swelling then first it should be managed by prescribing lightening therapy (''[[langhana]]'') and digestive drugs. After getting the ''nirama'' symptoms, ''[[shodhana]]'' therapy can be done according to dominant ''[[dosha]]''. It is the general rule for all types of swellings.  
  
''Shiro-virechana'' is the choice of therapy for ''dosha'' situated in head. Therefore if the swelling involves the head then first ''nasya'' should be done.  
+
''Shiro-virechana'' is the choice of therapy for ''[[dosha]]'' situated in head. Therefore if the swelling involves the head then first ''[[nasya]]'' should be done.  
  
Chest and the upper parts are the main sites of ''kapha'' and for its removal, ''vamana'' therapy is best. Therefore if swelling is situated in upper parts or begins from upper parts and then spreads to other parts or it is ''kapha'' type then first of all ''vamana'' (emesis) therapy is prescribed. ''Kshara'' or pungent and hot articles mixed in cow’s urine or buttermilk or ''asava'' are indicated after ''vamana'' therapy. If ''vamana'' therapy is not possible in the patient suffering from ''kapha'' swelling then these drugs may be given directly.
+
Chest and the upper parts are the main sites of ''[[kapha]]'' and for its removal, ''[[vamana]]'' therapy is best. Therefore if swelling is situated in upper parts or begins from upper parts and then spreads to other parts or it is ''[[kapha]]'' type then first of all ''[[vamana]]'' (emesis) therapy is prescribed. ''Kshara'' or pungent and hot articles mixed in cow’s urine or buttermilk or ''asava'' are indicated after ''[[vamana]]'' therapy. If ''[[vamana]]'' therapy is not possible in the patient suffering from ''[[kapha]]'' swelling then these drugs may be given directly.
  
Generally ''basti'' is not preferred for the treatment of swelling, but if ''vata'' swelling is associated with constipation then it should be treated with ''niruha basti''. Otherwise ''virechana'' is indicated for the swelling of lower part as well as of ''vata''.
+
Generally ''[[basti]]'' is not preferred for the treatment of swelling, but if ''[[vata]]'' swelling is associated with constipation then it should be treated with ''niruha [[basti]]''. Otherwise ''[[virechana]]'' is indicated for the swelling of lower part as well as of ''[[vata]]''.
 
The local swellings with symptom of inflammation may be treated by following the general line of treatment as mentioned above and other measures mentioned while describing their treatment in this chapter. If it belongs to ''shalya'' or ''shalakya'' type specialties, then let it be treated by the experts of the specialty.
 
The local swellings with symptom of inflammation may be treated by following the general line of treatment as mentioned above and other measures mentioned while describing their treatment in this chapter. If it belongs to ''shalya'' or ''shalakya'' type specialties, then let it be treated by the experts of the specialty.
  
==== Clinical practices ====
+
=== Clinical practices ===
  
Type Formulation Dose Time Anupana
+
{| class="wikitable"
Vata dominant Harina shringa mixture 60-120 mg In between two meals Honey+ Dashamularishta + Punarnavasa
+
|-
Pitta dominant Aarogya mixture 120-250 mg In between two meals Milk+ saravadyasava + punarnavasava+
+
! scope="col"| Type
vasakasava
+
! scope="col"| Formulations
Kapha dominant Gomutra haritaki 1-3 gram In between two meals Cow’s urine, honey  
+
! scope="col"| Dosage
Punarnava mandura 250-500 mg In between two meals Punarnavasava
+
! scope="col"| Time
Gudadraka yoga 120-250 mg In between two meals Honey
+
! scope="col"| ''Anupana''
 +
|-
 +
| ''[[Vata]]'' dominant
 +
| ''Harina shringa'' mixture
 +
| 60-120 mg
 +
| In between two meals
 +
| Honey + ''Dashamularishta'' + ''Punarnavasa''
 +
|-
 +
| ''[[Pitta]]'' dominant
 +
| ''Aarogya'' Mixture
 +
| 120-250 mg
 +
| In between two meals
 +
| Milk + ''saravadyasava'' + ''punarnavasava'' + ''vasakasava'
 +
|-
 +
| rowspan = "3"|''[[Kapha]]'' dominant
 +
| ''Gomutra Haritaki''
 +
| 1-3 grams
 +
| In between two meals
 +
| Cow urine, honey
 +
|-
 +
| ''Punarnava mandura''
 +
| 250-500 mg
 +
| In between two meals
 +
| ''Punarnavasava''
 +
|-
 +
| ''Gudadraka Yoga''
 +
| 120-250 mg
 +
| In between two meals
 +
| Honey
 +
|}
  
=== Glossary ===
+
=== Related Chapter ===
  
*Āgantuja (आगन्तु) exogenous
+
* [[Trishothiya Adhyaya]]
*Arbuda (अर्बुद) tumor
 
*Bhagandara (भगन्दरः) fistula-in-ano
 
*Bradhna (ब्रध्न) hydrocele
 
*Dushya (दूष्य) which got vitiated by Dosa i.e. Dhatu and Mala
 
*Ekānga (एकाङ्ग) local, one part/organ
 
*Galaganda (गलगण्ड) goiter
 
*Granthi (ग्रन्थि) nodule
 
*Kṣāra-Sutra ( क्षारसूत्र) A thread specially prepared with specific alkaline matter 
 
*Kuṣtha (कुष्ठ) dermatosis
 
*Masurikā (मसूरिकाः) chikenpox 
 
*Nija (निज) endogenous
 
*Romāntikā (रोमान्तिकाः) measles
 
*Sarvānga (सर्वाङ्ग) all over the body
 
*Ślipada (शलीपद) elephantiasis, filariasis
 
*Śodhana (शोधन) purification, detoxification
 
*Śopha (शोफ) swelling
 
*Śōtha (शोथ) swelling
 
*Śvayathu (श्वयथु) swelling 
 
*Utsedha (उत्सेध) bulging 
 
*Vrana-Śotha (व्रण शोथ) inflammatory swelling
 
  
=== Bibliography ===
+
<big>'''[[Special:ContactMe|Send us your suggestions and feedback on this page.]]'''</big>
  
#Ashtanga Hridaya by Vagbhata with Sarvanga-Sundra commentry by Arunadatta, published by Chaukhamba Samskrit series office, Varanasi,
+
==References==
#Charaka: Charaka Samhita, Sutra Sthana chapter 18 and Ciktsa sthana chpter 12. Edited by Yadavaji T. Acharya. Niranaya sagar Press, Bombay.
+
</div>
#Madhava: Madhava Nidana; Śothadhikara. Published by Chaukhamba Samskrit series office, Varanasi,
 
#Sushruta:  Sushruta Samhita. Sutra Sthana chapter 17 and Cikitsa sthana chapter 23. Edited by Yadavaji T. Acharya. Niranaya sagar Press, Bombay.
 
#Vagbhata: Ashtanga Hridaya with Sarvanga-Sundra commentry by Arunadatta, published by Chaukhamba Samskrit series office, Varanasi.
 
 
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Latest revision as of 10:16, 23 February 2024

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Chikitsa Sthana Chapter 12. Management of Shvayathu (Various types of Swellings)

Shvayathu Chikitsa
Section/Chapter Chikitsa Sthana Chapter 12
Preceding Chapter Kshatakshina Chikitsa
Succeeding Chapter Udara Chikitsa
Other Sections Sutra Sthana, Nidana Sthana, Vimana Sthana, Sharira Sthana, Indriya Sthana, Kalpa Sthana, Siddhi Sthana
Translator and commentator Goyal M.
Reviewer Singh G.
Editors Singh G., Goyal M., Deole Y.S., Basisht G.
Year of publication 2020
Publisher Charak Samhita Research, Training and Skill Development Centre
DOI 10.47468/CSNE.2020.e01.s06.013

Abstract

This chapter deals with the treatment of various types of swellings like generalized edema and local eruptions including pustules, nodules and tumors. The etiological factors for these swellings can be endogenous (nija) or exogenous (agantuja). In all types of swellings, three doshas are involved but it is named according to the dominance of the dosha. After describing general symptoms and signs of the swelling, specific symptoms and signs of vata, pitta and kapha as well as of incurable and curable swellings are explained.
Line of treatment depends upon type of swelling as well as involved parts of the body; wholesome and unwholesome diet and lifestyle for the benefit of the patient is explained. Detailed treatments along with drug preparations, internal and external therapeutic measures are discussed according to vata, pitta and kapha types of swelling.
Local swellings occurring in the various parts of the body in the form of papules, pustules, nodules, tumors etc are described in the last part of the chapter. It includes shaluka (quinsy), Bidalika (Ludwig’s angina), Taluvidradhi (palatal abscess), Upajihivika (superficial glossitis), Upakusha (gingivitis) and Danta-Vidradhi (dental abscess) which occurs in buccal cavity and generally included in Śālākya specialty. Galaganda is goiter and gandamala and granthi are mainly related with various types of swellings of lymph nodes. Arbuda (tumor), alaji (inflammation of eye), akshata (whitlow), vidarika (lymphadenitis), visphotaka (eruption), kaksha (herpes zoster), romantika (measles), masurika (chickenpox), bradhna (hernia), bhagandara (fistula-in-ano), shleepada (elephantiasis), jalakagardabha (acute sprading inflammation), abhighataja (traumatic) and vishaja (poisonous) swellings along with their medical treatment and wherever necessary surgical measures are also described. Difference and similarity between granthi and arbuda are also mentioned.
Keywords: Shvayathu, shotha, shopha, edema, swelling, langhana, amapachana, shodhana.

Introduction

This chapter on Shvayathu Chikitsa (treatment of swelling) follows the chapter on kshata-kshina because in both the diseases vital organs are involved. Charaka defines shvayathu as bulging (utsedha) from the skin and this chapter mainly deals with the management of various types of general swellings and local swellings such as pidika (papules and pustules), nodules (including gandhamala), large swellings like galaganda (goiter), tumor etc are also described.

Chapter 18th of Sutra Sthana deals with diagnostic aspects of swelling under the name of trishothiya. Therein the word shopha is frequently used for shotha. Thus, the words shvayathu, shotha and shopha are used as synonyms and all denote edema or swelling. For inflammatory swelling Sushruta has used the word vrana-shotha.

In the Sutra Sthana, Charaka classified shotha in many ways but in this chapter which is mainly on the treatment, only those classifications are given which are important from treatment point of view, such as three types according to dosha viz, vata, pitta and kapha; two types viz. nija (endogenous) and agantuja (exogenous) as well as ekanga (local) and sarvanga (generalized ) types.

Sanskrit text, Transliteration and English Translation

अथातः श्वयथुचिकित्सितं व्याख्यास्यामः||१||

इति ह स्माह भगवानात्रेयः||२||

athātaḥ śvayathucikitsitaṁ vyākhyāsyāmaḥ||1||

iti ha smāha bhagavānātrēyaḥ||2||

athAtaH shvayathucikitsitaM vyAkhyAsyAmaH||1||

iti ha smAha bhagavAnAtreyaH||2||

Now we shall expound the chapter "Shvayathu chikitsa" (Management of different types of swelling). Thus said Lord Atreya. [1-2]

भिषग्वरिष्ठं सुरसिद्धजुष्टं मुनीन्द्रमत्र्यात्मजमग्निवेशः|
महागदस्य श्वयथोर्यथावत् प्रकोपरूपप्रशमानपृच्छत्||३||

bhiṣagvariṣṭhaṁ surasiddhajuṣṭaṁ munīndramatryātmajamagnivēśaḥ|
mahāgadasya śvayathōryathāvat prakōparūpapraśamānapr̥cchat||3||

bhiShagvariShThaM surasiddhajuShTaM munIndramatryAtmajamagniveshaH|
mahAgadasya shvayathoryathAvat prakoparUpaprashamAnapRucchat||3||

Agnivesha approached the best physician and great sage, the son of Atri sitting midst of gods and saints and requested him to elaborate on the etiology, signs and symptoms and treatment of the major disease- shvayathu [3]

तस्मै जगादागदवेदसिन्धुप्रवर्तनाद्रिप्रवरोऽत्रिजस्तान्|
वातादिभेदात्त्रिविधस्य सम्यङ्निजानिजैकाङ्गजसर्वजस्य||४||

tasmai jagādāgadavēdasindhupravartanādripravarō'trijastān|
vātādibhēdāttrividhasya samyaṅnijānijaikāṅgajasarvajasya||4||

tasmai jagAdAgadavedasindhupravartanAdripravaro~atrijastAn|
vAtAdibhedAttrividhasya samya~gnijAnijaikA~ggajasarvajasya||4||

Sage Atreya who is like Himalaya from which flows out the Indus of the science of healing, fully expounded the subject of swellings of three types based on tridosha, nija and agantuja based on etiology and ekanga and sarvanga type according to location [4]

Causative factors of nija (endogenous) swelling/edema

शुद्ध्यामयाभक्तकृशाबलानां क्षाराम्लतीक्ष्णोष्णगुरूपसेवा|
दध्याममृच्छाकविरोधिदुष्टगरोपसृष्टान्ननिषेवणं च||५||

अर्शांस्यचेष्टा न च देहशुद्धिर्मर्मोपघातो विषमा प्रसूतिः|
मिथ्योपचारः प्रतिकर्मणां च निजस्य हेतुः श्वयथोः प्रदिष्टः||६||

śuddhyāmayābhaktakr̥śābalānāṁ kṣārāmlatīkṣṇōṣṇagurūpasēvā|
dadhyāmamr̥cchākavirōdhiduṣṭagarōpasr̥ṣṭānnaniṣēvaṇaṁ ca||5||

arśāṁsyacēṣṭā na ca dēhaśuddhirmarmōpaghātō viṣamā prasūtiḥ|
mithyōpacāraḥ pratikarmaṇāṁ ca nijasya hētuḥ śvayathōḥ pradiṣṭaḥ||6||

shuddhyAmayAbhaktakRushAbalAnAM kShArAmlatIkShNoShNagurUpasevA|
dadhyAmamRucchAkavirodhiduShTagaropasRuShTAnnaniShevaNaM ca||5||

arshAMsyaceShTA na ca dehashuddhirmarmopaghAto viShamA prasUtiH|
mithyopacAraH pratikarmaNAM ca nijasya hetuH shvayathoH pradiShTaH||6||

Excessive use of kshara (alkali) or food articles having sour, sharply acting, hot and heavy properties by an emaciated or weak person due to excessive shodhana, fasting or disease.

Excessive intake of curd, raw food articles, soil, leafy vegetables, mutually contradictory food articles (virodhi), spoiled or mixed with toxic substance (such as pesticide), or a person suffering from piles, having sedentary life style, nonperforming of shodhana therapy even if indicated, injury to vital organs (marma), abnormal delivery, due to improper treatment and as complication of improper purification treatment [5-6]

Causative factors of agantuka (exogenous) swelling

बाह्यास्त्वचो दूषयिताऽभिघातः काष्ठाश्मशस्त्राग्निविषायसाद्यैः [१] |

आगन्तुहेतुःत्रिविधो निजश्च सर्वार्धगात्रावयवाश्रितत्वात्||७||

bāhyāstvacō dūṣayitā'bhighātaḥ kāṣṭhāśmaśastrāgniviṣāyasādyaiḥ [1] |

āgantuhētuḥ trividhō nijaśca sarvārdhagātrāvayavāśritatvāt||7||

bAhyAstvaco dUShayitA~abhighAtaH kAShThAshmashastrAgniviShAyasAdyaiH |

AgantuhetuH trividho nijashca sarvArdhagAtrAvayavAshritatvAt||7||

External causative factors of swelling are trauma to skin with wood, stone, weapon, fire, poison etc.

Endogenous swelling is of three types i.e. of whole body, half body or limited to one part or organ [7]

Pathogenesis of swelling

बाह्याः सिराः प्राप्य यदा कफासृक्पित्तानि सन्दूषयतीह वायुः|
तैर्बद्धमार्गः स तदा विसर्पन्नुत्सेधलिङ्गं श्वयथुं करोति||८||

उरःस्थितैरूर्ध्वमधस्तु [१] वायोः स्थानस्थितैर्मध्यगतैस्तु मध्ये|
सर्वाङ्गगः सर्वगतैः क्वचित्स्थैर्दोषैः क्वचित् स्याच्छ्वयथुस्तदाख्यः||९||

bāhyāḥ sirāḥ prāpya yadā kaphāsr̥kpittāni sandūṣayatīha vāyuḥ|
tairbaddhamārgaḥ sa tadā visarpannutsēdhaliṅgaṁ śvayathuṁ karōti||8||

uraḥsthitairūrdhvamadhastu [1] vāyōḥ sthānasthitairmadhyagataistu madhyē|
sarvāṅgagaḥ sarvagataiḥ kvacitsthairdōṣaiḥ kvacit syācchvayathustadākhyaḥ||9||

bAhyAH sirAH prApya yadA kaphAsRukpittAni sandUShayatIha vAyuH|
tairbaddhamArgaH sa tadA visarpannutsedhali~ggaM shvayathuM karoti||8||

uraHsthitairUrdhvamadhastu [1] vAyoH sthAnasthitairmadhyagataistu madhye|
sarvA~ggagaH sarvagataiH kvacitsthairdoShaiH kvacit syAcchvayathustadAkhyaH||9||

Morbid vata is obstructed by vitiated kapha, rakta and pitta aggravated at the site of peripheral superficial vessels. This vitiated vata (due to obstruction) spreads to the various places causing swelling as its cardinal symptom.

If the vata lodges in the chest, then it causes edema of upper parts of the body; if it lodges in its own place i.e. lower parts then it causes edema of lower parts and if it lodges in middle then it causes edema of middle parts.

If vata spreads in the entire body then it causes edema all over the body but if it lodges in one place then it causes local swelling of that part or organ. These swellings are named after the particular region that it affects [8-9]

Prodromal symptoms of edema

ऊष्मा तथा स्याद्दवथुः सिराणामायाम इत्येव च पूर्वरूपम्|

ūṣmā tathā syāddavathuḥ sirāṇāmāyāma ityēva ca pūrvarūpam|

UShmA tathA syAddavathuH sirANAmAyAma ityeva ca pUrvarUpam|

Rise in temperature, burning sensation as if burnt by fire and dilation of the vessels are the prodromal symptoms of swelling [9½]

Tridoshaja nature of all swellings

सर्वस्त्रिदोषोऽधिकदोषलिङ्गैस्तच्छब्दमभ्येति भिषग्जितं च||१०||

sarvastridōṣō'dhikadōṣaliṅgaistacchabdamabhyēti bhiṣagjitaṁ ca||10||

sarvastridoSho~adhikadoShali~ggaistacchabdamabhyeti bhiShagjitaM ca||10||

All types of swelling are produced by involvement of all the three dosha but they are named based on the predominance of that particular dosha. The line of treatment is also according to the dominant dosha [10]

General symptoms of swelling

सगौरवं स्यादनवस्थितत्वं सोत्सेधमुष्माऽथ सिरातनुत्वम्|
सलोमहर्षाऽङ्गविवर्णता च सामान्यलिङ्गं श्वयथोः प्रदिष्टम्||११||

sagauravaṁ syādanavasthitatvaṁ sōtsēdhamuṣmā'tha sirātanutvam|
salōmaharṣā'ṅgavivarṇatā ca sāmānyaliṅgaṁ śvayathōḥ pradiṣṭam||11||

sagauravaM syAdanavasthitatvaM sotsedhamuShmA~atha sirAtanutvam|
salomaharShA~a~ggavivarNatA ca sAmAnyali~ggaM shvayathoH pradiShTam||11||

Heaviness, movability, bulging, heat, thinning of the vessels, horripilation and discoloration of the affected skin are the general signs and symptoms of edema [11]

Symptoms of vataja dominant edema/swelling

चलस्तनुत्वक्परुषोऽरुणोऽसितः प्रसुप्तिहर्षार्तियुतोऽनिमित्ततः|
प्रशाम्यति प्रोन्नमति प्रपीडितो दिवाबली च श्वयथुः समीरणात्||१२||

calastanutvakparuṣō'ruṇō'sitaḥ prasuptiharṣārtiyutō'nimittataḥ|
praśāmyati prōnnamati prapīḍitō divābalī ca śvayathuḥ samīraṇāt||12||

calastanutvakparuSho~aruNo~asitaH prasuptiharShArtiyuto~animittataH|
prashAmyati pronnamati prapIDito divAbalI ca shvayathuH samIraNAt||12||

Skin of the effected part in vata dominant swelling becomes thin and rough and dry (parusha), dusky-brown colored with horripilation and feeling of numbness and discomfort. The swelling is moveable and pitting on pressure but it attains normal position immediately, increases during the day time and often subsides without appreciable reason [12]

Symptoms of pitta dominant swelling (inflammation)

मृदुः सगन्धोऽसितपीतरागवान् भ्रमज्वरस्वेदतृषामदान्वितः|
य उष्यते स्पर्शरुगक्षिरागकृत् [१] स पित्तशोथो भृशदाहपाकवान्||१३||

mr̥duḥ sagandhō'sitapītarāgavān bhramajvarasvēdatr̥ṣāmadānvitaḥ|
ya uṣyatē sparśarugakṣirāgakr̥t [1] sa pittaśōthō bhr̥śadāhapākavān||13||

mRuduH sagandho~asitapItarAgavAn bhramajvarasvedatRuShAmadAnvitaH|
ya uShyate sparsharugakShirAgakRut [1] sa pittashotho bhRushadAhapAkavAn||13||

The pitta-dominant swelling is soft, painful to touch, with specific odor and blackish, yellow or red colored skin and has tendency of turning to abscess. It is accompanied with excessive burning sensation, fever, perspiration, giddiness, thirst, redness in eyes and intoxication [13]

Symptoms of kapha-dominant edema

गुरुः स्थिरः पाण्डुररोचकान्वितः प्रसेकनिद्रावमिवह्निमान्द्यकृत्|
स कृच्छ्रजन्मप्रशमो निपीडितो न चोन्नमेद्रात्रिबली कफात्मकः||१४||

guruḥ sthiraḥ pāṇḍurarōcakānvitaḥ prasēkanidrāvamivahnimāndyakr̥t|
sa kr̥cchrajanmapraśamō nipīḍitō na cōnnamēdrātribalī kaphātmakaḥ||14||

guruH sthiraH pANDurarocakAnvitaH prasekanidrAvamivahnimAndyakRut|
sa kRucchrajanmaprashamo nipIDito na connamedrAtribalI kaphAtmakaH||14||

Kapha-dominant swelling is heavy and firm/immovable. It is associated with anemia, anorexia, low digestion, water-brash, vomiting and sleepiness. It appears and disappears very slowly and on pressing it takes long time to attain its normal position and increases at the night time [14]

Symptoms of bad prognostic of edema

कृशस्य रोगैरबलस्य यो भवेदुपद्रवैर्वा वमिपूर्वकैर्युतः|
स हन्ति मर्मानुगतोऽथ राजिमान् परिस्रवेद्धीनबलस्य सर्वगः||१५||

kr̥śasya rōgairabalasya yō bhavēdupadravairvā vamipūrvakairyutaḥ|
sa hanti marmānugatō'tha rājimān parisravēddhīnabalasya sarvagaḥ||15||

kRushasya rogairabalasya yo bhavedupadravairvA vamipUrvakairyutaH|
sa hanti marmAnugato~atha rAjimAn parisraveddhInabalasya sarvagaH||15||

The edema/swelling of the patient, whose body is emaciated and weakened by a disease or is debilitated, or having complications or associated with vomiting, involving vital organs or whole body or spread with prominent vessels or in which profuse discharge oozes out, leads to death [15]

Symptoms of easily curable swelling

अहीनमांसस्य य एकदोषजो नवो बलस्थस्य सुखः स साधने|
निदानदोषर्तुविपर्ययक्रमैरुपाचरेत्तं बलदोषकालवित्||१६||

ahīnamāṁsasya ya ēkadōṣajō navō balasthasya sukhaḥ sa sādhanē|
nidānadōṣartuviparyayakramairupācarēttaṁ baladōṣakālavit||16||

ahInamAMsasya ya ekadoShajo navo balasthasya sukhaH sa sAdhane|
nidAnadoShartuviparyayakramairupAcarettaM baladoShakAlavit||16||

The swelling of a patient who is neither emaciated nor weak; that involved single dosha or is of recent origin is easily curable. The physician expert in the knowledge of strength, dosha and proper time of treatment should treat the curable patients by prescribing such measures which are opposite to cause, dosha and season [16]

Principles of treatment of edema/swelling

अथामजं लङ्घनपाचनक्रमैर्विशोधनैरुल्बणदोषमादितः|
शिरोगतं शीर्षविरेचनैरधो [४] विरेचनैरूर्ध्वहरैस्तथोर्ध्वजम्||१७||

उपाचरेत् स्नेहभवं विरूक्षणैः प्रकल्पयेत् स्नेहविधिं च रूक्षजे|
विबद्धविट्केऽनिलजे निरूहणं घृतं तु पित्तानिलजे सतिक्तकम्||१८||

पयश्च मूर्च्छारतिदाहतर्षिते विशोधनीये तु समूत्रमिष्यते|
कफोत्थितं क्षारकटूष्णसंयुतैः समूत्रतक्रासवयुक्तिभिर्जयेत्||१९||

athāmajaṁ laṅghanapācanakramairviśōdhanairulbaṇadōṣamāditaḥ|
śirōgataṁ śīrṣavirēcanairadhō [4] virēcanairūrdhvaharaistathōrdhvajam||17||

upācarēt snēhabhavaṁ virūkṣaṇaiḥ prakalpayēt snēhavidhiṁ ca rūkṣajē|
vibaddhaviṭkē'nilajē nirūhaṇaṁ ghr̥taṁ tu pittānilajē satiktakam||18||

payaśca mūrcchāratidāhatarṣitē viśōdhanīyē tu samūtramiṣyatē|
kaphōtthitaṁ kṣārakaṭūṣṇasaṁyutaiḥ samūtratakrāsavayuktibhirjayēt||19||

athAmajaM la~gghanapAcanakramairvishodhanairulbaNadoShamAditaH|
shirogataM shIrShavirecanairadho [4] virecanairUrdhvaharaistathordhvajam||17||

upAcaret snehabhavaM virUkShaNaiH prakalpayet snehavidhiM ca rUkShaje|
vibaddhaviTke~anilaje nirUhaNaM ghRutaM tu pittAnilaje satiktakam||18||

payashca mUrcchAratidAhatarShite vishodhanIye tu samUtramiShyate|
kaphotthitaM kShArakaTUShNasaMyutaiH samUtratakrAsavayuktibhirjayet||19||

If swelling is associated with ama it should be managed first by prescribing lightening therapy (langhana) and digestive drugs and only then shodhana therapy should be undertaken according to dominant dosha. General lines of treatment of doshaja swelling are as follows:

  • If it involves head then shiro-virechana is prescribed;
  • If it involves lower parts of the body then virechana (therapeutic purgation) is prescribed;
  • If it involves upper parts of the body then vamana (therapeutic emesis)is prescribed;
  • If it is caused by unctuous then rukshana (drying) therapy is done;
  • If it is caused by un-unctuous (ruksha) then unctuous (snehana) therapy is done;
  • If vata swelling is associated with constipation then it should be treated with niruha basti;
  • If it is caused by vata-pitta then it should be treated with ghee prepared with bitter drugs;
  • If the patient is suffering from associated symptoms such as fainting, pain, burning sensation and thirst then it should be treated with intake of milk;
  • If the patient is suffering from swelling where shodhana is required then milk mixed with cow’s urine should be given.
  • If the patient is suffering from kapha swelling then kshara or pungent and hot articles mixed in cow’s urine or buttermilk or asava are given [17-19]

Apathya (unwholesome) for swelling/edema

ग्राम्याब्जानूपं पिशितमबलं शुष्कशाकं नवान्नं
गौडं पिष्टान्नं दधि तिलकृतं [५] विज्जलं [६] मद्यमम्लम्|
धाना वल्लूरं समशनमथो गुर्वसात्म्यं विदाहि
स्वप्नं चारात्रौ श्वयथुगदवान् वर्जयेन्मैथुनं च||२०||

grāmyābjānūpaṁ piśitamabalaṁ śuṣkaśākaṁ navānnaṁ
gauḍaṁ piṣṭānnaṁ dadhi tilakr̥taṁ [5] vijjalaṁ [6] madyamamlam|
dhānā vallūraṁ samaśanamathō gurvasātmyaṁ vidāhi
svapnaṁ cārātrau śvayathugadavān varjayēnmaithunaṁ ca||20||

grAmyAbjAnUpaM pishitamabalaM shuShkashAkaM navAnnaM
gauDaM piShTAnnaM dadhi tilakRutaM [5] vijjalaM [6] madyamamlam|
dhAnA vallUraM samashanamatho gurvasAtmyaM vidAhi
svapnaM cArAtrau shvayathugadavAn varjayenmaithunaM ca||20||

Meat of domestic, aquatic and wet-land animals or weak animals; dry vegetables, fresh grains, molasses, fine flour products, curd, products of sesame, slimy and sour food articles, wine, roasted barley, dried meat, samashana (taking of mixture of wholesome and unwholesome food), taking of unwholesome, heavy and irritant diet articles, day sleep and sexual acts should be avoided by the patient of edema/swelling [20]

Vyoshadi churna for kapha swelling/edema

व्योषं त्रिवृत्तिक्तकरोहिणी च सायोरजस्का त्रिफलारसेन|
पीतं कफोत्थं शमयेत्तु शोफं गव्येन मूत्रेण हरीतकी च||२१||

vyōṣaṁ trivr̥ttiktakarōhiṇī ca sāyōrajaskā triphalārasēna|
pītaṁ kaphōtthaṁ śamayēttu śōphaṁ gavyēna mūtrēṇa harītakī ca||21||

vyoShaM trivRuttiktakarohiNI ca sAyorajaskA triphalArasena|
pItaM kaphotthaM shamayettu shophaM gavyena mUtreNa harItakI ca||21||

Mixture of powders of trikatu, trivrit, katuka and lauha-bhasma taken with juice of triphala; or haritaki powder taken by mixing with cow’s urine relieves kapha edema/swelling [21]

Remedy for tridoshaja edema

हरीतकीनागरदेवदारु सुखाम्बुयुक्तं सपुनर्नवं वा|
सर्वं पिबेत्त्रिष्वपि मूत्रयुक्तं स्नातश्च जीर्णे पयसाऽन्नमद्यात्||२२||

harītakīnāgaradēvadāru sukhāmbuyuktaṁ sapunarnavaṁ vā|
sarvaṁ pibēttriṣvapi mūtrayuktaṁ snātaśca jīrṇē payasā'nnamadyāt||22||

harItakInAgaradevadAru sukhAmbuyuktaM sapunarnavaM vA|
sarvaM pibettriShvapi mUtrayuktaM snAtashca jIrNe payasA~annamadyAt||22||

Mixture of haritaki, dried ginger and devadaru taken with lukewarm water, or punarnava mixed with all the above drugs taken with cow‘s urine relieves swelling produced by all the three dosha. On digestion of the drug and after taking bath, the patient should take food with milk [22]

Remedy for vata edema/swelling

पुनर्नवानागरमुस्तकल्कान् प्रस्थेन धीरः पयसाऽक्षमात्रान्|
मयूरकं मागधिकां समूलां सनागरां वा प्रपिबेत् सवाते||२३||

punarnavānāgaramustakalkān prasthēna dhīraḥ payasā'kṣamātrān|
mayūrakaṁ māgadhikāṁ samūlāṁ sanāgarāṁ vā prapibēt savātē||23||

punarnavAnAgaramustakalkAn prasthena dhIraH payasA~akShamAtrAn|
mayUrakaM mAgadhikAM samUlAM sanAgarAM vA prapibet savAte||23||

The 500 ml of milk prepared with paste of 10 gm each punarnava, dried ginger and mustaka; or milk prepared with mayuraka, pippalimula and dried ginger taken orally relieves swelling due to vata [23]

Remedy for vata-pitta swelling/edema

दन्तीत्रिवृत्त्र्यूषणचित्रकैर्वा पयः शृतं दोषहरं पिबेन्ना|
द्विप्रस्थमात्रं तु पलार्धिकैस्तैरर्धावशिष्टं पवने सपित्ते||२४||

dantītrivr̥ttryūṣaṇacitrakairvā payaḥ śr̥taṁ dōṣaharaṁ pibēnnā|
dviprasthamātraṁ tu palārdhikaistairardhāvaśiṣṭaṁ pavanē sapittē||24||

dantItrivRuttryUShaNacitrakairvA payaH shRutaM doShaharaM pibennA|
dviprasthamAtraM tu palArdhikaistairardhAvashiShTaM pavane sapitte||24||

One liter of milk prepared with 20 gm each of danti, trivrit, trikatu and chitraka added with one liter of water reduced to half, taken orally relieves edema caused by combination of vata and pitta [24]

General remedies for edema

सशुण्ठिपीतद्रुरसं प्रयोज्यं श्यामोरुबूकोषणसाधितं वा|
त्वग्दारुवर्षाभुमहौषधैर्वा गुडूचिकानागरदन्तिभिर्वा||२५||

saśuṇṭhipītadrurasaṁ prayōjyaṁ śyāmōrubūkōṣaṇasādhitaṁ vā|
tvagdāruvarṣābhumahauṣadhairvā guḍūcikānāgaradantibhirvā||25||

sashuNThipItadrurasaM prayojyaM shyAmorubUkoShaNasAdhitaM vA|
tvagdAruvarShAbhumahauShadhairvA guDUcikAnAgaradantibhirvA||25||

Milk prepared with dry ginger and daruharidra or prepared with shyama, castor root and black pepper, or prepared with cinnamon, devadaru, punarnava and dry ginger; or prepared with guduchi, dry ginger and danti; taken orally relieves edema [25]

सप्ताहमौष्ट्रं त्वथवाऽपि मासं पयः पिबेद्भोजनवारिवर्जी|
गव्यं समूत्रं महिषीपयो वा क्षीराशनो मूत्रमथो गवां वा||२६||

saptāhamauṣṭraṁ tvathavā'pi māsaṁ payaḥ pibēdbhōjanavārivarjī|
gavyaṁ samūtraṁ mahiṣīpayō vā kṣīrāśanō mūtramathō gavāṁ vā||26||

saptAhamauShTraM tvathavA~api mAsaM payaH pibedbhojanavArivarjI|
gavyaM samUtraM mahiShIpayo vA kShIrAshano mUtramatho gavAM vA||26||

The patient by avoiding all other food and drinks if remains only on camel’s milk for a week or month or similarly remains on cow’s milk mixed with equal quantity of cow’s urine or on buffalo’s milk mixed with an equal quantity of cow’s urine or other milk with cow’s urine, then edema is cured [26]

तक्रं पिबेद्वा गुरुभिन्नवर्चाः सव्योषसौवर्चलमाक्षिकं च|
गुडाभयां वा गुडनागरं वा सदोषभिन्नामविबद्धवर्चाः||२७||

takraṁ pibēdvā gurubhinnavarcāḥ savyōṣasauvarcalamākṣikaṁ ca|
guḍābhayāṁ vā guḍanāgaraṁ vā sadōṣabhinnāmavibaddhavarcāḥ||27||

takraM pibedvA gurubhinnavarcAH savyoShasauvarcalamAkShikaM ca|
guDAbhayAM vA guDanAgaraM vA sadoShabhinnAmavibaddhavarcAH||27||

Patient of edema if passes heavy (with mucous) and loose stools may drink butter milk mixed with trikatu, sauvarchala-salt and honey; or if the stool is morbid, loose, with ama or hard stool, then jaggery and haritaki or jaggery with dry ginger are given [27]

विड्वातसङ्गे पयसा रसैर्वा प्राग्भक्तमद्यादुरुबूकतैलम् [७] |

स्रोतोविबन्धेऽग्निरुचिप्रणाशे मद्यान्यरिष्टांश्च पिबेत् सुजातान्||२८||

viḍvātasaṅgē payasā rasairvā prāgbhaktamadyādurubūkatailam [7] |

srōtōvibandhē'gnirucipraṇāśē madyānyariṣṭāṁśca pibēt sujātān||28||

viDvAtasa~gge payasA rasairvA prAgbhaktamadyAdurubUkatailam [7] |

srotovibandhe~agnirucipraNAshe madyAnyariShTAMshca pibet sujAtAn||28||

If there is retention of feces and flatus, the patient may be given castor oil with milk or with meat-soup before meal; and if there is occlusion of channels or loss of digestion power and appetite, then the patient may be given simple or medicated wines [28]

Gandeeradyarishta

गण्डीरभल्लातकचित्रकांश्च व्योषं विडङ्गं बृहतीद्वयं च|
द्विप्रस्थिकं गोमयपावकेन द्रोणे पचेत् कूर्चिकमस्तुनस्तु [८] ||२९||

त्रिभागशेषं च सुपूतशीतं द्रोणेन तत् प्राकृतमस्तुना च|
सितोपलायाश्च शतेन युक्तं लिप्ते घटे चित्रकपिप्पलीनाम्||३०||

वैहायसे स्थापितमादशाहात् प्रयोजयंस्तद्विनिहन्ति शोफान्|
भगन्दरार्शःक्रिमिकुष्ठमेहान् वैवर्ण्यकार्श्यानिलहिक्कनं च||३१||

इति गण्डीराद्यरिष्टः

gaṇḍīrabhallātakacitrakāṁśca vyōṣaṁ viḍaṅgaṁ br̥hatīdvayaṁ ca|
dviprasthikaṁ gōmayapāvakēna drōṇē pacēt kūrcikamastunastu [8] ||29||

tribhāgaśēṣaṁ ca supūtaśītaṁ drōṇēna tat prākr̥tamastunā ca|
sitōpalāyāśca śatēna yuktaṁ liptē ghaṭē citrakapippalīnām||30||

vaihāyasē sthāpitamādaśāhāt prayōjayaṁstadvinihanti śōphān|
bhagandarārśaḥkrimikuṣṭhamēhān vaivarṇyakārśyānilahikkanaṁ ca||31||

iti gaṇḍīrādyariṣṭaḥ

gaNDIrabhallAtakacitrakAMshca vyoShaM viDa~ggaM bRuhatIdvayaM ca|
dviprasthikaM gomayapAvakena droNe pacet kUrcikamastunastu [8] ||29||

tribhAgasheShaM ca supUtashItaM droNena tat prAkRutamastunA ca|
sitopalAyAshca shatena yuktaM lipte ghaTe citrakapippalInAm||30||

vaihAyase sthApitamAdashAhAt prayojayaMstadvinihanti shophAn|
bhagandarArshaHkrimikuShThamehAn vaivarNyakArshyAnilahikkanaM ca||31||

iti gaNDIrAdyariShTaH

Take 1.280 Kg of gandeera, bhallataka, chitraka, trikatu, vidnaga, kantakari and brihati and add 1.024 Kg of kurchika-mastu (prepared by adding hot water in curd) and boil on cow-dung fire till one-third remains and then filter. On cooling add to it 1.024 Kg natural-mastu (prepared by adding water in curd), 4 kg of sugar-candy and put in a pitcher lined with paste of chitraka and pippali and leave this pot at a high-open place for 10 days for fermentation to prepare arishta.

Oral administration of gandeeradyarishtha cures edema, fistula-in-ano, piles, helminthiasis, kushtha(obstinate skin diseases), polyuria, discoloration, emaciation and hiccup due to vata. Thus gandeeradyarishtha is described [29-31]

Ashtashato arishta

काश्मर्यधात्रीमरिचाभयाक्षद्राक्षाफलानां [९] च सपिप्पलीनाम्|
शतं शतं जीर्णगुडात्तुलां [१०] च सङ्क्षुद्य कुम्भे मधुना प्रलिप्ते||३२||

सप्ताहमुष्णे द्विगुणं तु शीते स्थितं जलद्रोणयुतं पिबेन्ना|
शोफान् विबन्धान् कफवातजांश्च निहन्त्यरिष्टोऽष्टशतोऽग्निकृच्च||३३||

इत्यष्टशतोऽरिष्टः

kāśmaryadhātrīmaricābhayākṣadrākṣāphalānāṁ [9] ca sapippalīnām|
śataṁ śataṁ jīrṇaguḍāttulāṁ [10] ca saṅkṣudya kumbhē madhunā praliptē||32||

saptāhamuṣṇē dviguṇaṁ tu śītē sthitaṁ jaladrōṇayutaṁ pibēnnā|
śōphān vibandhān kaphavātajāṁśca nihantyariṣṭō'ṣṭaśatō'gnikr̥cca||33||

ityaṣṭaśatō'riṣṭaḥ

kAshmaryadhAtrImaricAbhayAkShadrAkShAphalAnAM [9] ca sapippalInAm|
shataM shataM jIrNaguDAttulAM [10] ca sa~gkShudya kumbhe madhunA pralipte||32||

saptAhamuShNe dviguNaM tu shIte sthitaM jaladroNayutaM pibennA|
shophAn vibandhAn kaphavAtajAMshca nihantyariShTo~aShTashato~agnikRucca||33||

ityaShTashato~ariShTaH

Take 100 pala each of kashmarya, amalaki, black pepper, haritaki, vibhitaki, pippali and grapes, add to it 100 pala of old jaggery and two drona of water, then put the mixture in a vessel lined with honey for 7 days in summer or for 14 days in winter for fermentation. Thus fermented asava is known as ashtashato-arishtha. Its oral administration cures edema and constipation due to kapha and vata and stimulates digestion and metabolism (agni). Thus ashthato-arishta is described [32-33]

Punarnavadi arishta

पुनर्नवे द्वे च बले सपाठे दन्तीं [११] गुडूचीमथ चित्रकं च|
निदिग्धिकां च त्रिपलानि पक्त्वा द्रोणावशेषे सलिले ततस्तम्||३४||

पूत्वा रसं द्वे च गुडात् पुराणात्तुले मधुप्रस्थयुतं सुशीतम्|
मासं निदध्याद्घृतभाजनस्थं पल्ले यवानां परतस्तु मासात्||३५||

चूर्णीकृतैरर्धपलांशिकैस्तं पत्रत्वगेलामरिचाम्बुलोहैः [१२] |
गन्धान्वितं क्षौद्रघृतप्रदिग्धे जीर्णे पिबेद् व्याधिबलं समीक्ष्य||३६||

हृत्पाण्डुरोगं श्वयथुं प्रवृद्धं प्लीहज्वरारोचकमेहगुल्मान्|
भगन्दरं षड्जठराणि कासं श्वासं ग्रहण्यामयकुष्ठकण्डूः||३७||

शाखानिलं बद्धपुरीषतां च हिक्कां किलासं च हलीमकं च|
क्षिप्रं जयेद्वर्णबलायुरोजस्तेजोन्वितो मांसरसान्नभोजी||३८||

इति पुनर्नवाद्यरिष्टः

punarnavē dvē ca balē sapāṭhē dantīṁ [11] guḍūcīmatha citrakaṁ ca|
nidigdhikāṁ ca tripalāni paktvā drōṇāvaśēṣē salilē tatastam||34||

pūtvā rasaṁ dvē ca guḍāt purāṇāttulē madhuprasthayutaṁ suśītam|
māsaṁ nidadhyādghr̥tabhājanasthaṁ pallē yavānāṁ paratastu māsāt||35||

cūrṇīkr̥tairardhapalāṁśikaistaṁ patratvagēlāmaricāmbulōhaiḥ [12] |
gandhānvitaṁ kṣaudraghr̥tapradigdhē jīrṇē pibēd vyādhibalaṁ samīkṣya||36||

hr̥tpāṇḍurōgaṁ śvayathuṁ pravr̥ddhaṁ plīhajvarārōcakamēhagulmān|
bhagandaraṁ ṣaḍjaṭharāṇi kāsaṁ śvāsaṁ grahaṇyāmayakuṣṭhakaṇḍūḥ||37||

śākhānilaṁ baddhapurīṣatāṁ ca hikkāṁ kilāsaṁ ca halīmakaṁ ca|
kṣipraṁ jayēdvarṇabalāyurōjastējōnvitō māṁsarasānnabhōjī||38||

iti punarnavādyariṣṭaḥ

punarnave dve ca bale sapAThe dantIM [11] guDUcImatha citrakaM ca|
nidigdhikAM ca tripalAni paktvA droNAvasheShe salile tatastam||34||

pUtvA rasaM dve ca guDAt purANAttule madhuprasthayutaM sushItam|
mAsaM nidadhyAdghRutabhAjanasthaM palle yavAnAM paratastu mAsAt||35||

cUrNIkRutairardhapalAMshikaistaM patratvagelAmaricAmbulohaiH [12] |
gandhAnvitaM kShaudraghRutapradigdhe jIrNe pibed vyAdhibalaM samIkShya ||36||

hRutpANDurogaM shvayathuM pravRuddhaM plIhajvarArocakamehagulmAn|
bhagandaraM ShaDjaTharANi kAsaM shvAsaM grahaNyAmayakuShThakaNDUH ||37||

shAkhAnilaM baddhapurIShatAM ca hikkAM kilAsaM ca halImakaM ca|
kShipraM jayedvarNabalAyurojastejonvito mAMsarasAnnabhojI||38||

iti punarnavAdyariShTaH

Make a decoction of 120 gm each of two types of punarnavā, balā, pāṭhā, dantī, guḍūchī, chitraka, kantakāri and triphalā by adding water (about 4.1 liters) and reducing it to 1.024 liter. Add to this decoction 8 kg of jaggery and 640 gm of honey and keep it in a vessel lined with ghee and place it in a heap of barley for a month. Thereafter to make it fragrant, add 20 gm powders each of tejapatra, cinnamon, cardamom, black pepper, couscous and iron bhasma and store in a pot lined with honey and ghee. It is to be taken after the digestion of the meal in a dose according to the strength of the disease. In diet, food with meat soup may be given.

It provides quick cure in heart disease, anemia, severe edema, splenic disorders, fever, anorexia, polyuria, gulma, fistula-in-ano, six types of udararoga, cough, dyspnea, assimilation disorders (grahani), dermatosis (kushtha), pruritis, vata disorders of limbs, constipation, hiccup, leukoderma and halimaka (greenish coloration of skin). It also improves complexion, strength, ojas and vitality. Thus punarnavadi arishta is described [34-38]

Triphaladyarishta

फलत्रिकं दीप्यकचित्रकौ च सपिप्पलीलोहरजो विडङ्गम्|
चूर्णीकृतं कौडविकं द्विरंशं क्षौद्रं पुराणस्य तुलां गुडस्य||३९||

मासं निदध्याद्घृतभाजनस्थं यवेषु तानेव निहन्ति रोगान्|
ये चार्शसां पाण्डुविकारिणां च प्रोक्ता हिताः शोफिषु तेऽप्यरिष्टाः||४०||

इति त्रिफलाद्यरिष्टः

phalatrikaṁ dīpyakacitrakau ca sapippalīlōharajō viḍaṅgam|
cūrṇīkr̥taṁ kauḍavikaṁ dviraṁśaṁ kṣaudraṁ purāṇasya tulāṁ guḍasya||39||

māsaṁ nidadhyādghr̥tabhājanasthaṁ yavēṣu tānēva nihanti rōgān|
yē cārśasāṁ pāṇḍuvikāriṇāṁ ca prōktā hitāḥ śōphiṣu tē'pyariṣṭāḥ||40||

iti triphalādyariṣṭaḥ

phalatrikaM dIpyakacitrakau ca sapippalIloharajo viDa~ggam|
cUrNIkRutaM kauDavikaM dviraMshaM kShaudraM purANasya tulAM guDasya||39||

mAsaM nidadhyAdghRutabhAjanasthaM yaveShu tAneva nihanti rogAn|
ye cArshasAM pANDuvikAriNAM ca proktA hitAH shophiShu te~apyariShTAH||40||

iti triphalAdyariShTaH

Make decoction from the coarse powder of 160 gm each of triphala, ajawan, chitraka, pippali, iron bhasma and vidanga. To this decoction add 320 ml of honey and 4 kg of jaggery and put it in a vessel lined with ghee and place in a heap of barley for a month. Its oral administration cures all the diseases mentioned above. Thus triphaladyarishtha is described.

The asava and arishtha mentioned for the treatment of piles and anemia are also beneficial for relieving the edema [39-40]

Powder preparations for edema

कृष्णा सपाठा गजपिप्पली च निदिग्धिका चित्रकनागरे च|
सपिप्पलीमूलरजन्यजाजीमुस्तं च चूर्णं सुखतोयपीतम्||४१||

हन्यात्त्रिदोषं चिरजं च शोफं कल्कश्च भूनिम्बमहौषधस्य|
अयोरजस्त्र्यूषणयावशूकचूर्णं च पीतं त्रिफलारसेन||४२||

kr̥ṣṇā sapāṭhā gajapippalī ca nidigdhikā citrakanāgarē ca|
sapippalīmūlarajanyajājīmustaṁ ca cūrṇaṁ sukhatōyapītam||41||

hanyāttridōṣaṁ cirajaṁ ca śōphaṁ kalkaśca bhūnimbamahauṣadhasya|
ayōrajastryūṣaṇayāvaśūkacūrṇaṁ ca pītaṁ triphalārasēna||42||

kRuShNA sapAThA gajapippalI ca nidigdhikA citrakanAgare ca|
sapippalImUlarajanyajAjImustaM ca cUrNaM sukhatoyapItam||41||

hanyAttridoShaM cirajaM ca shophaM kalkashca bhUnimbamahauShadhasya|
ayorajastryUShaNayAvashUkacUrNaM ca pItaM triphalArasena||42||

Use of any one of the following powder preparations cures chronic edema caused by all the three dosha:

The mixture of the powders of pippali, pippalimula, pāthā, gajapippali, cumin, kantakāri, chitraka, dried ginger, turmeric, cumin and mustaka taken with lukewarm water, or paste of bhumyāmalaki and dried ginger taken with lukewarm water or bhasma of iron, trikatu and yavakshara taken with decoction of triphala [41-42]

Ksharagudika

क्षारद्वयं स्याल्लवणानि चत्वार्ययोरजो व्योषफलत्रिके च|
सपिप्पलीमूलविडङ्गसारं मुस्ताजमोदामरदारुबिल्वम्||४३||

कलिङ्गकाश्चित्रकमूलपाठे यष्ट्याह्वयं सातिविषं पलांशम्|
सहिङ्गुकर्षं त्वणुशुष्कचूर्णं द्रोणं तथा मूलकशुण्ठकानाम्||४४||

स्याद्भस्मनस्तत् सलिलेन साध्यमालोड्य यावद्घनमप्रदग्धम्|
स्त्यानं ततः कोलसमां तु मात्रां कृत्वा सुशुष्कां विधिनोपयुञ्ज्यात्||४५||

प्लीहोदरश्वित्रहलीमकार्शःपाण्ड्वामयारोचकशोषशोफान्|
विसूचिकागुल्मगराश्मरीश्च सश्वासकासाः प्रणुदेत् सकुष्ठाः||४६||

इति क्षारगुडिका

kṣāradvayaṁ syāllavaṇāni catvāryayōrajō vyōṣaphalatrikē ca|
sapippalīmūlaviḍaṅgasāraṁ mustājamōdāmaradārubilvam||43||

kaliṅgakāścitrakamūlapāṭhē yaṣṭyāhvayaṁ sātiviṣaṁ palāṁśam|
sahiṅgukarṣaṁ tvaṇuśuṣkacūrṇaṁ drōṇaṁ tathā mūlakaśuṇṭhakānām||44||

syādbhasmanastat salilēna sādhyamālōḍya yāvadghanamapradagdham|
styānaṁ tataḥ kōlasamāṁ tu mātrāṁ kr̥tvā suśuṣkāṁ vidhinōpayuñjyāt||45||

plīhōdaraśvitrahalīmakārśaḥpāṇḍvāmayārōcakaśōṣaśōphān|
visūcikāgulmagarāśmarīśca saśvāsakāsāḥ praṇudēt sakuṣṭhāḥ||46||

iti kṣāraguḍikā ||

kShAradvayaM syAllavaNAni catvAryayorajo vyoShaphalatrike ca|
sapippalImUlaviDa~ggasAraM mustAjamodAmaradArubilvam||43||

kali~ggakAshcitrakamUlapAThe yaShTyAhvayaM sAtiviShaM palAMsham|
sahi~ggukarShaM tvaNushuShkacUrNaM droNaM tathA mUlakashuNThakAnAm||44||

syAdbhasmanastat salilena sAdhyamAloDya yAvadghanamapradagdham|
styAnaM tataH kolasamAM tu mAtrAM kRutvA sushuShkAM vidhinopayu~jjyAt||45||

plIhodarashvitrahalImakArshaHpANDvAmayArocakashoShashophAn|
visUcikAgulmagarAshmarIshca sashvAsakAsAH praNudet sakuShThAH||46||

iti kShAraguDikA

Take 40 gm fine powder each of svarajjikā and yava-kshara, four varieties of salt, iron bhasma, trikatu, triphala, pippalimula, pealed seeds of vidanga, mustaka, ajamodā, devadāru, bilva, indrayava, root of chitraka, pāthā, ativishā and liquorice; 10 gm of asafetida and 1.024 Kg of dried radish and dried ginger. Add water to it and heat the mixture till it becomes thick taking care that it should not seared and from it make pills of 5 gm each and dry them.

Properly administered pills cure splenomegaly, leukoderma, halimaka (greenish coloration of the skin), piles, anemia, anorexia, emaciation, edema, gastroenteritis, gulma, synthetic poisoning, lithiasis, dyspnea, cough and dermatosis. Thus ksharagudika is described [43-46]

Course of gud-adraka

प्रयोजयेदार्द्रकनागरं वा तुल्यं गुडेनार्धपलाभिवृद्ध्या|
मात्रा परं पञ्चपलानि मासं जीर्णे पयो यूषरसाश्च भक्तम्||४७||

गुल्मोदरार्शःश्वयथुप्रमेहाञ् श्वासप्रतिश्यालसकाविपाकान्|
सकामलाशोषमनोविकारान् कासं कफं चैव जयेत् प्रयोगः||४८||

prayōjayēdārdrakanāgaraṁ vā tulyaṁ guḍēnārdhapalābhivr̥ddhyā|
mātrā paraṁ pañcapalāni māsaṁ jīrṇē payō yūṣarasāśca bhaktam||47||

gulmōdarārśaḥśvayathupramēhāñ śvāsapratiśyālasakāvipākān|
sakāmalāśōṣamanōvikārān kāsaṁ kaphaṁ caiva jayēt prayōgaḥ||48||

prayojayedArdrakanAgaraM vA tulyaM guDenArdhapalAbhivRuddhyA|
mAtrA paraM pa~jcapalAni mAsaM jIrNe payo yUSharasAshca bhaktam||47||

gulmodarArshaHshvayathupramehA~j shvAsapratishyAlasakAvipAkAn|
sakAmalAshoShamanovikArAn kAsaM kaphaM caiva jayet prayogaH||48||

Mix equal quantity of jaggery and ginger and take it in 20 gm dose initially and then increase its dose by 20 gm daily till the dose becomes 200 gm per day. Then this dose is to be continued for the remaining days of the month. During this treatment, on digestion of the drug, rice gruel and milk or meat soup should be given to eat.

The one month course cures gulma, udararoga, piles, edema, polyuria, dyspnea, coryza, cough, alasaka, indigestion, jaundice, consumption, mental disorders and kapha disorders [47-48]

Course of shilajatu

रसस्तथैवार्द्रकनागरस्य पेयोऽथ जीर्णे पयसाऽन्नमद्यात्|
जत्वश्मजं [१३] च त्रिफलारसेन हन्यात्त्रिदोषं श्वयथुं प्रसह्य||४९||

इति शिलाजतुप्रयोगः

rasastathaivārdrakanāgarasya pēyō'tha jīrṇē payasā'nnamadyāt|
jatvaśmajaṁ [13] ca triphalārasēna hanyāttridōṣaṁ śvayathuṁ prasahya||49||

iti śilājatuprayōgaḥ

rasastathaivArdrakanAgarasya peyo~atha jIrNe payasA~annamadyAt|
jatvashmajaM [13] ca triphalArasena hanyAttridoShaM shvayathuM prasahya||49||

iti shilAjatuprayogaH

Similarly juice of ginger may be taken with shilajatu for one month in the doses and manner mentioned above. On getting the hunger food should be taken with milk.

A month’s course of shilājatu with juice of triphalā will completely cure the edema/swelling caused by all the three dosha. Thus course of shilājatu is described [49]

Kamsa haritaki

द्विपञ्चमूलस्य पचेत् कषाये कंसेऽभयानां च शतं गुडस्य|
लेहे सुसिद्धेऽथ विनीय चूर्णं व्योषं त्रिसौगन्ध्यमुषास्थिते च||५०||

प्रस्थार्धमात्रं मधुनः सुशीते किञ्चिच्च चूर्णादपि यावशूकात्|
एकाभयां प्राश्य ततश्च लेहाच्छुक्तिं निहन्ति श्वयथुं प्रवृद्धम्||५१||

श्वासज्वरारोचकमेहगुल्मप्लीहत्रिदोषोदरपाण्डुरोगान्|
कार्श्यामवातावसृगम्लपित्तवैवर्ण्यमूत्रानिलशुक्रदोषान्||५२||

इति कंसहरीतकी

dvipañcamūlasya pacēt kaṣāyē kaṁsē'bhayānāṁ ca śataṁ guḍasya|
lēhē susiddhē'tha vinīya cūrṇaṁ vyōṣaṁ trisaugandhyamuṣāsthitē ca||50||

prasthārdhamātraṁ madhunaḥ suśītē kiñcicca cūrṇādapi yāvaśūkāt|
ēkābhayāṁ prāśya tataśca lēhācchuktiṁ nihanti śvayathuṁ pravr̥ddham||51||

śvāsajvarārōcakamēhagulmaplīhatridōṣōdarapāṇḍurōgān|
kārśyāmavātāvasr̥gamlapittavaivarṇyamūtrānilaśukradōṣān||52||

iti kaṁsaharītakī

dvipa~jcamUlasya pacet kaShAye kaMse~abhayAnAM ca shataM guDasya|
lehe susiddhe~atha vinIya cUrNaM vyoShaM trisaugandhyamuShAsthite ca||50||

prasthArdhamAtraM madhunaH sushIte ki~jcicca cUrNAdapi yAvashUkAt|
ekAbhayAM prAshya tatashca lehAcchuktiM nihanti shvayathuM pravRuddham||51||

shvAsajvarArocakamehagulmaplIhatridoShodarapANDurogAn|
kArshyAmavAtAvasRugamlapittavaivarNyamUtrAnilashukradoShAn||52||

iti kaMsaharItakI

Make 2.56 liter decoction of dashamula and add to it haritaki 100 in number and 4.0 kg of jaggery and powder of trikatu and trijata (three aromatics- leaves and bark of cinnamon and cardamom). Leave it overnight and next morning on cooling adds 320 gm of honey and little quantity of yavakshara.

Take it in the dose of 10 gm along with one haritaki. It will cure severe edema and also dyspnea, fever, anorexia, polyuria, gulma, splenic-disorders, sannipātika-udararoga, anemia, emaciation, rheumatoid arthritis, bleeding disorders, hyperchlorhydria, discoloration of skin and vata disorders of urine and semen. Thus kaṁsaharītakī is described [50-52]

Patoladi kashaya

पटोलमूलामरदारुदन्तीत्रायन्तिपिप्पल्यभयाविशालाः|
यष्ट्याह्वयं तिक्तकरोहिणी च सचन्दना स्यान्निचुलानि दार्वी||५३||

कर्षोन्मितैस्तैः क्वथितः कषायो घृतेन पेयः कुडवेन युक्तः|
वीसर्पदाहज्वरसन्निपाततृष्णाविषाणि श्वयथुं च हन्ति||५४||

paṭōlamūlāmaradārudantītrāyantipippalyabhayāviśālāḥ|
yaṣṭyāhvayaṁ tiktakarōhiṇī ca sacandanā syānniculāni dārvī||53||

karṣōnmitaistaiḥ kvathitaḥ kaṣāyō ghr̥tēna pēyaḥ kuḍavēna yuktaḥ|
vīsarpadāhajvarasannipātatr̥ṣṇāviṣāṇi śvayathuṁ ca hanti||54||

paTolamUlAmaradArudantItrAyantipippalyabhayAvishAlAH|
yaShTyAhvayaM tiktakarohiNI ca sacandanA syAnniculAni dArvI||53||

karShonmitaistaiH kvathitaH kaShAyo ghRutena peyaH kuDavena yuktaH|
vIsarpadAhajvarasannipAtatRuShNAviShANi shvayathuM ca hanti||54||

Make decoction of 10 gm each of roots of patola, devadāru, danti, trāyamānā, pippali, haritaki, indrāyana, liquorices, sandal wood, katukā, dāruhridrā and samudraphala. This decoction should be taken with 160 gm of ghee. It cures visarpa (erysipelas), burning sensation, fever, sannipāta thirst, poisoning and edema [53-54]

Chitraka ghrita

सचित्रकं [१४] धान्ययवान्यजाजीसौवर्चलं त्र्यूषणवेतसाम्लम्|
बिल्वात् फलं दाडिमयावशूकौ सपिप्पलीमूलमथापि चव्यम्||५५||

पिष्ट्वाऽक्षमात्राणि जलाढकेन पक्त्वा घृतप्रस्थमथ प्रयुञ्ज्यात्|
अर्शांसि गुल्मं श्वयथुं कृच्छ्रं निहन्ति वह्निं च करोति दीप्तम्||५६||

sacitrakaṁ [14] dhānyayavānyajājīsauvarcalaṁ tryūṣaṇavētasāmlam|
b0ilvāt phalaṁ dāḍimayāvaśūkau sapippalīmūlamathāpi cavyam||55||

piṣṭvā'kṣamātrāṇi jalāḍhakēna paktvā ghr̥taprasthamatha prayuñjyāt|
arśāṁsi gulmaṁ śvayathuṁ ca kr̥cchraṁ nihanti vahniṁ ca karōti dīptam||56||

sacitrakaM [14] dhAnyayavAnyajAjIsauvarcalaM tryUShaNavetasAmlam|
bilvAt phalaM dADimayAvashUkau sapippalImUlamathApi cavyam||55||

piShTvA~akShamAtrANi jalADhakena paktvA ghRutaprasthamatha prayu~jjyAt|
arshAMsi gulmaM shvayathuM ca kRucchraM nihanti vahniM ca karoti dIptam||56||

Make paste of 10 gm each of chitraka, coriander, ajawan, cumin, sauvarchala-salt, trikatu, amlavetasa, bilva, pomegranate, yavakṣāra, pippalimula and chavya; add to it 640 gm of ghee and 2.56 liter of water. Prepare ghrita as per sneha pāka method.

Oral administration of chitraka ghee cures edema/swelling even if it is difficult to cure as well as piles and gulma and stimulate the digestion and metabolism (agni). [55-56]

पिबेद्घृतं वाऽष्टगुणाम्बुसिद्धं सचित्रकक्षारमुदारवीर्यम्|
कल्याणकं वाऽपि सपञ्चगव्यं तिक्तं महद्वाऽप्यथ तिक्तकं वा||५७||

pibēdghr̥taṁ vā'ṣṭaguṇāmbusiddhaṁ sacitrakakṣāramudāravīryam|
kalyāṇakaṁ vā'pi sapañcagavyaṁ tiktaṁ mahadvā'pyatha tiktakaṁ vā||57||

pibedghRutaM vA~aShTaguNAmbusiddhaM sacitrakakShAramudAravIryam|
kalyANakaM vA~api sapa~jcagavyaM tiktaM mahadvA~apyatha tiktakaM vA||57||

Prepare a ghrita with eight times of water with paste of chitraka and yavakshara. It has great potency. The patient may also take the kalyānaka ghrita or panchagavya ghrita or mahātikta ghrita or tikta ghrita [57]

क्षीरं घटे चित्रककल्कलिप्ते दध्यागतं साधु विमथ्य तेन|
तज्जं घृतं चित्रकमूलगर्भं तक्रेण सिद्धं श्वयथुघ्नमग्र्यम्||५८||

अर्शोऽतिसारानिलगुल्ममेहांश्चैतन्निहन्त्यग्निबलप्रदं [१५] च|
तक्रेण चाद्यात् सघृतेन तेन भोज्यानि सिद्धामथवा यवागूम्||५९||

इति चित्रकघृतम्

kṣīraṁ ghaṭē citrakakalkaliptē dadhyāgataṁ sādhu vimathya tēna|
tajjaṁ ghr̥taṁ citrakamūlagarbhaṁ takrēṇa siddhaṁ śvayathughnamagryam||58||

arśō'tisārānilagulmamēhāṁścaitannihantyagnibalapradaṁ [15] ca|
takrēṇa cādyāt saghr̥tēna tēna bhōjyāni siddhāmathavā yavāgūm||59||

iti citrakaghr̥tam

kShIraM ghaTe citrakakalkalipte dadhyAgataM sAdhu vimathya tena|
tajjaM ghRutaM citrakamUlagarbhaM takreNa siddhaM shvayathughnamagryam||58||

arsho~atisArAnilagulmamehAMshcaitannihantyagnibalapradaM [15] ca|
takreNa cAdyAt saghRutena tena bhojyAni siddhAmathavA yavAgUm||59||

iti citrakaghRutam

Put milk in a pot coated with paste of chitraka and curdle it. Churn this curd well to get butter which is heated to ghee. Add to the ghee all the buttermilk (which contains mixed chitraka also) from the pot and prepare the medicated ghrita. It is best to cure edema. It also provides relief in piles, diarrhea, vata-gulma, polyuria and stimulates digestion and metabolism (agni).

During the treatment the diet should be taken with buttermilk prepared as above with chitraka along with ghee prepared from the above butter or gruels prepared with this butter milk and ghee. Thus chitraka ghrita is described [58-59]

Yavagu preparations

जीवन्त्यजाजीशटिपुष्कराह्वैः सकारवीचित्रकबिल्वमध्यैः|
सयावशूकैर्बदरप्रमाणैर्वृक्षाम्लयुक्ता घृततैलभृष्टा||६०||

अर्शोऽतिसारानिलगुल्मशोफहृद्रोगमन्दाग्निहिता यवागूः|
या पञ्चकोलैर्विधिनैव [१६] तेन सिद्धा भवेत् सा च समा तयैव||६१||

jīvantyajājīśaṭipuṣkarāhvaiḥ sakāravīcitrakabilvamadhyaiḥ|
sayāvaśūkairbadarapramāṇairvr̥kṣāmlayuktā ghr̥tatailabhr̥ṣṭā||60||

arśō'tisārānilagulmaśōphahr̥drōgamandāgnihitā yavāgūḥ|
yā pañcakōlairvidhinaiva [16] tēna siddhā bhavēt sā ca samā tayaiva||61||

jIvantyajAjIshaTipuShkarAhvaiH sakAravIcitrakabilvamadhyaiH|
sayAvashUkairbadarapramANairvRukShAmlayuktA ghRutatailabhRuShTA||60||

arsho~atisArAnilagulmashophahRudrogamandAgnihitA yavAgUH|
yA pa~jcakolairvidhinaiva [16] tena siddhA bhavet sA ca samA tayaiva||61||

Take 5 gm each of jivanti, cumin, saṭi, pushkarmula, karvi (celery), chitraka, bilva and yavakashara, make a medicated gruel (yavāgu) and then fry it in ghee and oil. This gruel taken by adding vrikshamla cures piles, diarrhea, vata gulma, edema, heart disease and low digestion.

The medicated yavāgu (gruel) similarly prepared with panchakola also gives the same relief as mentioned above (60-61).

Pathya (wholesome food) for shotha

कुलत्थयूषश्च सपिप्पलीको मौद्गश्च सत्र्यूषणयावशूकः|
रसस्तथा विष्किरजाङ्गलानां सकूर्मगोधाशिखिशल्लकानाम्||६२||

सुवर्चला गृञ्जनकं पटोलं सवायसीमूलकवेत्रनिम्बम्|
शाकार्थिनां शाकमिति प्रशस्तं भोज्ये पुराणश्च यवः सशालिः||६३||

kulatthayūṣaśca sapippalīkō maudgaśca satryūṣaṇayāvaśūkaḥ|
rasastathā viṣkirajāṅgalānāṁ sakūrmagōdhāśikhiśallakānām||62||

suvarcalā gr̥ñjanakaṁ paṭōlaṁ savāyasīmūlakavētranimbam|
śākārthināṁ śākamiti praśastaṁ bhōjyē purāṇaśca yavaḥ saśāliḥ||63||

kulatthayUShashca sapippalIko maudgashca satryUShaNayAvashUkaH|
rasastathA viShkirajA~ggalAnAM sakUrmagodhAshikhishallakAnAm||62||

suvarcalA gRu~jjanakaM paTolaM savAyasImUlakavetranimbam|
shAkArthinAM shAkamiti prashastaM bhojye purANashca yavaH sashAliH||63||

Followings diet articles are wholesome for the patient of edema/swelling:

  • Soup of kulattha mixed with long piper
  • Soup of munga mixed with trikatu and yavakshara
  • Meat soup of gallinaceous and wild creatures,
  • Meat soup of tortoise, iguana, peacock and pangolin,
  • Vegetables such as heliotrope, turnip, makoya (wild snake gourd), radish, vetra, neem and patola
  • Old shali rice and old barley [62-63]

External applications

आभ्यन्तरं भेषजमुक्तमेतद्बर्हिर्हितं यच्छृणु तद्यथावत्|
स्नेहान् प्रदेहान् परिषेचनानि स्वेदांश्च वातप्रबलस्य कुर्यात्||६४||

ābhyantaraṁ bhēṣajamuktamētadbarhirhitaṁ yacchr̥ṇu tadyathāvat|
snēhān pradēhān pariṣēcanāni svēdāṁśca vātaprabalasya kuryāt||64||

AbhyantaraM bheShajamuktametadbarhirhitaM yacchRuNu tadyathAvat|
snehAn pradehAn pariShecanAni svedAMshca vAtaprabalasya kuryAt||64||

Thus internal preparations have been described. Now external preparations beneficial for the patient of swelling will be described. Snehana, swedana, smearing with pastes and effusions should be done in a patient having dominance of vata swelling [64]

Shaileyadi taila

शैलेयकुष्ठागुरुदारुकौन्तीत्वक्पद्मकैलाम्बुपलाशमुस्तैः|
प्रियङ्गुथौणेयकहेममांसीतालीशपत्रप्लवपत्रधान्यैः||६५||

श्रीवेष्टकध्यामकपिप्पलीभिः स्पृक्कानखैश्चैव यथोपलाभम्|
वातान्वितेऽभ्यङ्गमुशन्ति तैलं सिद्धं सुपिष्टैरपि च प्रदेहम्||६६||

śailēyakuṣṭhāgurudārukauntītvakpadmakailāmbupalāśamustaiḥ|
priyaṅguthauṇēyakahēmamāṁsītālīśapatraplavapatradhānyaiḥ||65||

śrīvēṣṭakadhyāmakapippalībhiḥ spr̥kkānakhaiścaiva yathōpalābham|
vātānvitē'bhyaṅgamuśanti tailaṁ siddhaṁ supiṣṭairapi ca pradēham||66||

shaileyakuShThAgurudArukauntItvakpadmakailAmbupalAshamustaiH|
priya~gguthauNeyakahemamAMsItAlIshapatraplavapatradhAnyaiH||65||

shrIveShTakadhyAmakapippalIbhiH spRukkAnakhaishcaiva yathopalAbham|
vAtAnvite~abhya~ggamushanti tailaM siddhaM supiShTairapi ca pradeham||66||

Take kuṣṭha, aguru, devadāru, kaunti, cinnamon, padmaka, cardamom, sugandhabālā, palāśa, mustaka, priyangu, thauneyaka, nāgakeśara, jatāmāmsi, tālisapatra, plava, tejapatra, coriander, sriveshtaka, dhyāmaka, piper longum, sprikkā and nakha. Make paste of all or as much as drugs available and prepare medicated oil from it. In vata edema, do massage with this oil. Alternatively make paste of the entire drugs and apply on the body of the patient as smear [65-66]

Medicated water for bath

जलैश्च वासार्ककरञ्जशिग्रुकाश्मर्यपत्रार्जकजैश्च सिद्धैः|
स्विन्नो मृदूष्णै रवितप्ततोयैः स्नातश्च गन्धैरनुलेपनीयः||६७||

jalaiśca vāsārkakarañjaśigrukāśmaryapatrārjakajaiśca siddhaiḥ|
svinnō mr̥dūṣṇai ravitaptatōyaiḥ snātaśca gandhairanulēpanīyaḥ||67||

jalaishca vAsArkakara~jjashigrukAshmaryapatrArjakajaishca [17] siddhaiH|
svinno mRudUShNai [18] ravitaptatoyaiH snAtashca gandhairanulepanIyaH||67||

Add leaves of vāsā, arka, karanja, sigru, kashmarya and holy basil in hot water and take sudation with this tolerably hot water. Then the patient should take bath with water heated in sun and apply aromatics on the body [67]

External application in pitta dominance

सवेतसाः क्षीरवतां द्रुमाणां त्वचः समञ्जिष्ठलतामृणालाः|
सचन्दनाः पद्मकवालकौ च पैत्ते प्रदेहस्तु सतैलपाकः||६८||

आक्तस्य तेनाम्बु रविप्रतप्तं सचन्दनं साभयपद्मकं च|
स्नाने हितं क्षीरवतां कषायः क्षीरोदकं चन्दनलेपनं च||६९||

savētasāḥ kṣīravatāṁ drumāṇāṁ tvacaḥ samañjiṣṭhalatāmr̥ṇālāḥ|
sacandanāḥ padmakavālakau ca paittē pradēhastu satailapākaḥ||68||

āktasya tēnāmbu raviprataptaṁ sacandanaṁ sābhayapadmakaṁ ca|
snānē hitaṁ kṣīravatāṁ kaṣāyaḥ kṣīrōdakaṁ candanalēpanaṁ ca||69||

savetasAH kShIravatAM drumANAM tvacaH sama~jjiShThalatAmRuNAlAH|
sacandanAH padmakavAlakau ca paitte pradehastu satailapAkaH||68||

Aktasya tenAmbu raviprataptaM sacandanaM sAbhayapadmakaM ca|
snAne hitaM kShIravatAM kaShAyaH kShIrodakaM candanalepanaM ca||69||

Prepare medicated oil from vetasa, manjiṣhthā, mrināla, sandal, padmaka and khasha and bark of latex-exuding plants. Apply this oil on the body to relieve pitta swelling. Thereafter, bathing with medicated water prepared with sandal, khaśa and padmaka and heated by sun rays or with water prepared with latex-exuding plants or water mixed with milk is beneficial. Smearing with paste of sandalwood is also beneficial [68-69]

External application in kapha dominance

कफे तु कृष्णासिकतापुराणपिण्याकशिग्रुत्वगुमाप्रलेपः|
कुलत्थशुण्ठीजलमूत्रसेकश्चण्डागुरुभ्यामनुलेपनं च||७०||

kaphē tu kr̥ṣṇāsikatāpurāṇapiṇyākaśigrutvagumāpralēpaḥ|
kulatthaśuṇṭhījalamūtrasēkaścaṇḍāgurubhyāmanulēpanaṁ ca||70||

kaphe tu kRuShNAsikatApurANapiNyAkashigrutvagumApralepaH|
kulatthashuNThIjalamUtrasekashcaNDAgurubhyAmanulepanaM ca||70||

In kapha dominant edema, application of paste of long pepper, sand, old oil-cake, bark of drum-stick and linseed is advised. Effusion with decoction of kulattha (hoarse gram), dry ginger and cow’s urine followed by anointing of the body with paste of sandal and aguru is also beneficial (70).

External application in burning sensation

बिभीतकानां फलमध्यलेपः सर्वेषु दाहार्तिहरः प्रदिष्टः|
यष्ट्याह्वमुस्तैः सकपित्थपत्रैः सचन्दनैस्तत्पिडकासु लेपः||७१||

bibhītakānāṁ phalamadhyalēpaḥ sarvēṣu dāhārtiharaḥ pradiṣṭaḥ|
yaṣṭyāhvamustaiḥ sakapitthapatraiḥ sacandanaistatpiḍakāsu lēpaḥ||71||

bibhItakAnAM phalamadhyalepaH sarveShu dAhArtiharaH pradiShTaH|
yaShTyAhvamustaiH sakapitthapatraiH sacandanaistatpiDakAsu lepaH||71||

In all types of swelling, smearing with paste of fruit of vibhitaka is recommended to cure burning sensation and discomfort. The topical application of paste of leaves of kapittha (wood apple), sandal, liquorices and mustaka provides relief in papules [71]

रास्नावृषार्कत्रिफलाविडङ्गं शिग्रुत्वचो मूषिकपर्णिका च|
निम्बार्जकौ व्याघ्रनखः सदूर्वा सुवर्चला तिक्तकरोहिणी च||७२||

सकाकमाची बृहती सकुष्ठा पुनर्नवा चित्रकनागरे च|
उन्मर्दनं शोफिषु मूत्रपिष्टं शस्तस्तथा मूलकतोयसेकः||७३||

rāsnāvr̥ṣārkatriphalāviḍaṅgaṁ śigrutvacō mūṣikaparṇikā ca|
nimbārjakau vyāghranakhaḥ sadūrvā suvarcalā tiktakarōhiṇī ca||72||

sakākamācī br̥hatī sakuṣṭhā punarnavā citrakanāgarē ca|
unmardanaṁ śōphiṣu mūtrapiṣṭaṁ śastastathā mūlakatōyasēkaḥ||73||

rAsnAvRuShArkatriphalAviDa~ggaM shigrutvaco mUShikaparNikA ca|
nimbArjakau vyAghranakhaH sadUrvA suvarcalA tiktakarohiNI ca||72||

sakAkamAcI bRuhatI sakuShThA punarnavA citrakanAgare ca|
unmardanaM shophiShu mUtrapiShTaM shastastathA mUlakatoyasekaH||73||

Take rāsnā, vāsā, arka, triphalā, vidanga, bark of sigru, mushakaparni, neem, holy basin, nails of vyāghra (shell), durvā, sunflower, katukā, kākamāchi, brihati, kuṣtha, punarnavā, chitraka and dry ginger and make paste with cow’s urine. Unmardana type of massage with it is beneficial for swelling. Also effusion done with water boiled with above drugs is beneficial [72-73]

Various types of local swellings

शोफास्तु गात्रावयवाश्रिता ये ते स्थानदूष्याकृतिनामभेदात्|
अनेकसङ्ख्याः कतिचिच्च तेषां निदर्शनार्थं गदतो निबोध||७४||

śōphāstu gātrāvayavāśritā yē tē sthānadūṣyākr̥tināmabhēdāt|
anēkasaṅkhyāḥ katicicca tēṣāṁ nidarśanārthaṁ gadatō nibōdha||74||

shophAstu gAtrAvayavAshritA ye te sthAnadUShyAkRutinAmabhedAt|
anekasa~gkhyAH [19] katicicca teShAM nidarshanArthaM gadato nibodha||74||

The swelling occurring in one limb or organ is of many types owing to their different classifications based on involved site, duṣhya, shape and name. Listen to the descriptions of some of them being given as illustration [74]

Shira Shopha (cellulitis of head) and Salūka (quinsy)

दोषास्त्रयः स्वैः कुपिता निदानैः कुर्वन्ति शोफं शिरसः सुघोरम्|
अन्तर्गले घुर्घुरिकान्वितं च शालूकमुच्छ्वासनिरोधकारि||७५||

dōṣāstrayaḥ svaiḥ kupitā nidānaiḥ kurvanti śōphaṁ śirasaḥ sughōram|
antargalē ghurghurikānvitaṁ ca śālūkamucchvāsanirōdhakāri||75||

doShAstrayaH svaiH kupitA nidAnaiH kurvanti shophaM shirasaH sughoram|
antargale ghurghurikAnvitaM ca shAlUkamucchvAsanirodhakAri||75||

All the three dosha, provoked by indulging in their etiological factors produce severe inflammation of head. When it affects inside of the throat, it produces sālūka, which is accompanied with stertorous breathing and obstruction to expiration [75]

Bidalika (Ludwig’s angina)

गलस्य सन्धौ चिबुके गले च सदाहरागः श्वसनासु चोग्रः|
शोफो भृशार्तिस्तु बिडालिका स्याद्धन्याद्गले चेद्वलयीकृता सा||७६||

galasya sandhau cibukē galē ca sadāharāgaḥ śvasanāsu cōgraḥ|
śōphō bhr̥śārtistu biḍālikā syāddhanyādgalē cēdvalayīkr̥tā sā||76||

galasya sandhau cibuke gale ca sadAharAgaH shvasanAsu [20] cograH|
shopho bhRushArtistu biDAlikA [21] syAddhanyAdgale cedvalayIkRutA sA||76||

Acute swelling at the junction of throat behind the chin i.e. in trachea with redness and burning sensation in throat and causes obstruction to breathing with very much discomfort is known as biḍālikā. It kills the patient if folds are formed in throat [76]

Talu-vidradhi (palatal abscess), upajihvika (superficial glossitis) and adhijihvikā (sub-lingual glossitis)

स्यात्तालुविद्रध्यपि दाहरागपाकान्वितस्तालुनि सा त्रिदोषात्|
जिह्वोपरिष्टादुपजिह्विका स्यात् कफादधस्तादधिजिह्विका च||७७||

syāttāluvidradhyapi dāharāgapākānvitastāluni sā tridōṣāt|
jihvōpariṣṭādupajihvikā syāt kaphādadhastādadhijihvikā ca||77||

syAttAluvidradhyapi dAharAgapAkAnvitastAluni sA tridoShAt|
jihvopariShTAdupajihvikA syAt kaphAdadhastAdadhijihvikA ca||77||

Abscess in palate caused by tridosha with burning sensation, redness and pus formation is known as tālu-vidradhi.

Swelling due to kapha occurring on the upper part of tongue is called upajihvikā (acute superficial glossitis) and which occurs sublingual part is called adhijihvikā (sub lingual glossitis) [77]

Upakusha (gingivitis) and danta-vidradhi (dental abscess)

यो दन्तमांसेषु तु रक्तपित्तात् पाको भवेत् सोपकुशः प्रदिष्टः|
स्याद्दन्तविद्रध्यपि दन्तमांसे शोफः कफाच्छोणितसञ्चयोत्थः||७८||

yō dantamāṁsēṣu tu raktapittāt pākō bhavēt sōpakuśaḥ pradiṣṭaḥ|
syāddantavidradhyapi dantamāṁsē śōphaḥ kaphācchōṇitasañcayōtthaḥ||78||

yo dantamAMseShu tu raktapittAt pAko bhavet sopakushaH pradiShTaH|
syAddantavidradhyapi dantamAMse shophaH kaphAcchoNitasa~jcayotthaH||78||

Provoked rakta and pitta causes suppuration of the gums and it is called upakusha. Accumulation of kapha and rakta produces elevated swelling in gums and it is known as danta-vidradhi [78]

Galaganḍa (goiter),gandamala (cervical adenitis) and its management

गलस्य पार्श्वे गलगण्ड एकः स्याद्गण्डमाला बहुभिस्तु गण्डैः|
साध्याः स्मृताः पीनसपार्श्वशूलकासज्वरच्छर्दियुतास्त्वसाध्याः||७९||

galasya pārśvē galagaṇḍa ēkaḥ syādgaṇḍamālā bahubhistu gaṇḍaiḥ|
sādhyāḥ smr̥tāḥ pīnasapārśvaśūlakāsajvaracchardiyutāstvasādhyāḥ||79||

galasya pArshve galagaNDa ekaH syAdgaNDamAlA bahubhistu gaNDaiH|
sAdhyAH smRutAH pInasapArshvashUlakAsajvaracchardiyutAstvasAdhyAH||79||

Single glandular swelling on the (middle) of neck is called galagaṇḍa (goiter) but if there are many nodular swellings making a chain like appearance, is known as gandamālā. Generally they are curable but if accompanied with coryza, pain in side of the chest, cough, fever and vomiting then they are incurable [79]

तेषां सिराकायशिरोविरेका धूमः पुराणस्य घृतस्य पानम्|
स्याल्लङ्घनं वक्त्रभवेषु चापि प्रघर्षणं स्यात् कवलग्रहश्च||८०||

tēṣāṁ sirākāyaśirōvirēkā dhūmaḥ purāṇasya ghr̥tasya pānam|
syāllaṅghanaṁ vaktrabhavēṣu cāpi pragharṣaṇaṁ syāt kavalagrahaśca||80||

teShAM sirAkAyashirovirekA dhUmaH purANasya ghRutasya pAnam|
syAlla~gghanaM vaktrabhaveShu cApi pragharShaNaM syAt kavalagrahashca||80||

In all the above mentioned conditions blood-letting, purgation, nasya, dhuma (medicated smoking therapy) and intake of old ghee is beneficial.

For the conditions specially affecting mouth, the line of treatment is langhana and rubbing with medicated powders and mouth washes (kavala) are beneficial [80]

Granthi (nodule) and its management

अङ्गैकदेशेष्वनिलादिभिः स्यात् स्वरूपधारी स्फुरणः सिराभिः|
ग्रन्थिर्महान्मांसभवस्त्वनर्तिर्मेदोभवः स्निग्धतमश्चलश्च||८१||

aṅgaikadēśēṣvanilādibhiḥ syāt svarūpadhārī sphuraṇaḥ sirābhiḥ|
granthirmahānmāṁsabhavastvanartirmēdōbhavaḥ snigdhatamaścalaśca||81||

a~ggaikadesheShvanilAdibhiH syAt svarUpadhArI sphuraNaH sirAbhiH|
granthirmahAnmAMsabhavastvanartirmedobhavaH snigdhatamashcalashca||81||

Swelling occurring in one organ or region due to vata or other dosha may be diagnosed on the basis of their characteristic symptoms. The swelling occurring in vessels are pulsating in nature. The nodular swelling occurring in muscles is large in size. Swelling of the adipose tissues is excessively unctuous and movable [81]

Surgical management of granthi

संशोधिते स्वेदितमश्मकाष्ठैः साङ्गुष्ठदण्डैर्विलयेदपक्वम्|
विपाट्य चोद्धृत्य भिषक् सकोशं शस्त्रेण दग्ध्वा व्रणवच्चिकित्सेत्||८२||

saṁśōdhitē svēditamaśmakāṣṭhaiḥ sāṅguṣṭhadaṇḍairvilayēdapakvam|
vipāṭya cōddhr̥tya bhiṣak sakōśaṁ śastrēṇa dagdhvā vraṇavaccikitsēt||82||

saMshodhite sveditamashmakAShThaiH sA~gguShThadaNDairvilayedapakvam|
vipATya coddhRutya bhiShak sakoshaM shastreNa dagdhvA vraNavaccikitset||82||

If the tumor is non-suppurative then after purification therapy, local sudation of the swelling should be done. Then the physician should try to dissolve the swelling by rubbing with stone or wooden apparatus or with manipulation of thumb or of a rod. Then it should be cut open and take out the tumor with its capsule. Then it should be cauterized and treatment of regular wound should be adopted [82]

अदग्ध ईषत् परिशेषितश्च प्रयाति भूयोऽपि शनैर्विवृद्धिम्|
तस्मादशेषः कुशलैः समन्ताच्छेद्यो भवेद्वीक्ष्य शरीरदेशान्||८३||

शेषे कृते पाकवशेन शीर्यात्ततः क्षतोत्थः प्रसरेद्विसर्पः|
उपद्रवं तं प्रविचार्य तज्ज्ञस्तैर्भेषजैः पूर्वतरैर्यथोक्तैः||८४||

निवारयेदादित एव यत्नाद्विधानवित् स्वस्वविधिं विधाय|
ततः क्रमेणास्य यथाविधानं व्रणं व्रणज्ञस्त्वरया चिकित्सेत्||८५||

adagdha īṣat pariśēṣitaśca prayāti bhūyō'pi śanairvivr̥ddhim|
tasmādaśēṣaḥ kuśalaiḥ samantācchēdyō bhavēdvīkṣya śarīradēśān||83||

śēṣē kr̥tē pākavaśēna śīryāttataḥ kṣatōtthaḥ prasarēdvisarpaḥ|
upadravaṁ taṁ pravicārya tajjñastairbhēṣajaiḥ [22] pūrVātarairyathōktaiḥ||84||

nivārayēdādita [23] ēva yatnādvidhānavit svasvavidhiṁ vidhāya|
tataḥ kramēṇāsya yathāvidhānaṁ vraṇaṁ vraṇajñastvarayā cikitsēt||85||

adagdha IShat parisheShitashca prayAti bhUyo~api shanairvivRuddhim|
tasmAdasheShaH kushalaiH samantAcchedyo bhavedvIkShya sharIradeshAn||83||

sheShe kRute pAkavashena shIryAttataH kShatotthaH prasaredvisarpaH|
upadravaM taM pravicArya tajj~jastairbheShajaiH [22] pUrvatarairyathoktaiH||84||

nivArayedAdita [23] eva yatnAdvidhAnavit svasvavidhiM vidhAya|
tataH krameNAsya yathAvidhAnaM vraNaM vraNaj~jastvarayA cikitset||85||

If the tumor is not properly cauterized or if some of its part is left out then it starts gradually increasing again. In that case it should be removed completely by opening from all sides by the skillful surgeon keeping in view the regional anatomy. If some portion is still left then it may suppurate and slough and may lead to complication of visarpa (erysipelas). The surgeon considering it as the severe complication first should try to treat it with great care by appropriate remedies described earlier. Therefore the wound specialist should quickly treat it in the prescribed manner following the appropriate line of treatment [83-85]

विवर्जयेत् कुक्ष्युदराश्रितं च तथा गले मर्मणि संश्रितं च|
स्थूलः खरश्चापि भवेद्विवर्ज्यो यश्चापि बालस्थविराबलानाम्||८६||

vivarjayēt kukṣyudarāśritaṁ ca tathā galē marmaṇi saṁśritaṁ ca|
sthūlaḥ kharaścāpi bhavēdvivarjyō yaścāpi bālasthavirābalānām||86||

vivarjayet kukShyudarAshritaM ca tathA gale marmaNi saMshritaM ca|
sthUlaH kharashcApi bhavedvivarjyo yashcApi bAlasthavirAbalAnAm||86||

The tumors occurring in flanks, abdomen, in the throat and in vital organs are incurable. Similarly tumors of big size and indurated which occurs in children, aged and weak are also incurable [86]

Differential diagnosis of arbuda (tumor)

ग्रन्थ्यर्बुदानां च यतोऽविशेषः प्रदेशहेत्वाकृतिदोषदूष्यैः|
ततश्चिकित्सेद्भिषगर्बुदानि विधानविद्ग्रन्थिचिकित्सितेन||८७||

granthyarbudānāṁ ca yatō'viśēṣaḥ pradēśahētvākr̥tidōṣadūṣyaiḥ|
tataścikitsēdbhiṣagarbudāni vidhānavidgranthicikitsitēna||87||

granthyarbudAnAM ca yato~avisheShaH pradeshahetvAkRutidoShadUShyaiH|
tatashcikitsedbhiShagarbudAni vidhAnavidgranthicikitsitena||87||

There is no much difference in nodules and tumors with regards to site, causative factors, shape, dosha morbidity and dushya (susceptible tissues). Therefore, tumor specialist should treat the tumor on the line of nodules described above [87]

Alaji and akshata (whitlow)

ताम्रा सशूला पिडका भवेद्या सा चालजी नाम परिस्रुताग्रा|
शोफोऽक्षतश्चर्मनखान्तरे स्यान्मांसास्रदूषी भृशशीघ्रपाकः||८८||

tāmrā saśūlā piḍakā bhavēdyā sā cālajī nāma parisrutāgrā|
śōphō'kṣataścarmanakhāntarē syānmāṁsāsradūṣī bhr̥śaśīghrapākaḥ||88||

tAmrA sashUlA [25] piDakA bhavedyA sA cAlajI nAma parisrutAgrA|
shopho~akShatashcarmanakhAntare [26] syAnmAMsAsradUShI bhRushashIghrapAkaH||88||

Appearing of copper colored papules with acute pain from which pus oozes out is known as alajī. The severe inflammation occurring by vitiating flesh and blood in the skin adjoining nail which suppurates quickly is known as akṣata [88]

Vidarika (lymphadenitis) and its management

ज्वरान्विता वङ्क्षणकक्षजा या वर्तिर्निरर्तिः कठिनायता च|
विदारिका सा कफमारुताभ्यां तेषां यथादोषमुपक्रमः स्यात्||८९||

विस्रावणं पिण्डिकयोपनाहः पक्वेषु चैव व्रणवच्चिकित्सा|

jvarānvitā vaṅkṣaṇakakṣajā yā vartirnirartiḥ kaṭhināyatā ca|
vidārikā sā kaphamārutābhyāṁ tēṣāṁ yathādōṣamupakramaḥ syāt||89||

visrāvaṇaṁ piṇḍikayōpanāhaḥ pakvēṣu caiva vraṇavaccikitsā|

jvarAnvitA va~gkShaNakakShajA yA vartirnirartiH kaThinAyatA ca|
vidArikA sA kaphamArutAbhyAM teShAM yathAdoShamupakramaH syAt||89||

visrAvaNaM piNDikayopanAhaH pakveShu caiva vraNavaccikitsA|

Painless cylindrical and hard swelling in the groin or axillary region accompanied with fever is known as vidārikā. It occurs due to vitiation of kapha and vata and should be managed according to the treatment of these dosha, which include bloodletting, pinda sweda, upanāha and on suppuration it should be treated on the line of abscess [89]

Visphotaka (eruption)

विस्फोटकाः सर्वशरीरगास्तु स्फोटाः [२७] सरागज्वरतर्षयुक्ताः||९०||

visphōṭakāḥ sarvaśarīragāstu sphōṭāḥ [27] sarāgajvaratarṣayuktāḥ||90||

visphoTakAH sarvasharIragAstu sphoTAH [27] sarAgajvaratarShayuktAH||90||

Red colored eruptions occurring all over the body along with fever and thirst are known as visphōṭaka (90).

Kaksha (herpes zoster)

यज्ञोपवीतप्रतिमाः प्रभूताः पित्तानिलाभ्यां जनितास्तु कक्षाः [२८] |

याश्चापराः स्युः पिडकाः प्रकीर्णाः स्थूलाणुमध्या अपि पित्तजास्ताः||९१||

yajñōpavītapratimāḥ prabhūtāḥ pittānilābhyāṁ janitāstu kakṣāḥ [28] |

yāścāparāḥ syuḥ piḍakāḥ prakīrṇāḥ sthūlāṇumadhyā api pittajāstāḥ||91||

yaj~jopavItapratimAH prabhUtAH pittAnilAbhyAM janitAstu kakShAH [28] |

yAshcAparAH syuH piDakAH prakIrNAH sthUlANumadhyA api pittajAstAH||91||

Multiple eruptions occurring on the trunk due to pitta and vata where usually Hindu holy thread is worn, is known as kakṣā.

Other such types of eruptions (pidikā) whether big, medium or small are also due to pitta [91]

Romantika (measles)

क्षुद्रप्रमाणाः पिडकाः शरीरे सर्वाङ्गगाः सज्वरदाहतृष्णाः|
कण्डूयुताः सारुचिसप्रसेका रोमान्तिकाः पित्तकफात् प्रदिष्टाः||९२||

kṣudrapramāṇāḥ piḍakāḥ śarīrē sarvāṅgagāḥ sajvaradāhatr̥ṣṇāḥ|
kaṇḍūyutāḥ sārucisaprasēkā rōmāntikāḥ pittakaphāt pradiṣṭāḥ||92||

kShudrapramANAH piDakAH sharIre sarvA~ggagAH sajvaradAhatRuShNAH|
kaNDUyutAH sArucisaprasekA romAntikAH pittakaphAt pradiShTAH||92||

Small sized eruption all over the body due to pitta and kapha along with fever, burning sensation, thirst, itching, anorexia and salivation are known as romāntikā (measles) [92]

Masurika (chickenpox) and its management

याः सर्वगात्रेषु मसूरमात्रा मसूरिकाः पित्तकफात् प्रदिष्टाः|
वीसर्पशान्त्यै विहिता क्रिया या तां तेषु कुष्ठे च हितां विदध्यात्||९३||

yāḥ sarvagātrēṣu masūramātrā masūrikāḥ pittakaphāt pradiṣṭāḥ|
vīsarpaśāntyai vihitā kriyā yā tāṁ tēṣu kuṣṭhē ca hitāṁ vidadhyāt||93||

yAH sarvagAtreShu masUramAtrA masUrikAH pittakaphAt pradiShTAH|
vIsarpashAntyai vihitA kriyA yA tAM teShu [29] kuShThe ca hitAM vidadhyAt||93||

Eruptions similar to size and shape of lentil (masura) occurring all over the body due to pitta and kapha is known as masurikā; the treatment described for visarpa should is also adopted for it. For visphotaka etc., treatment described for kuṣtha should be adopted [93]

Bradhna (hernia) and its management

ब्रध्नोऽनिलाद्यैर्वृषणे स्वलिङ्गैरन्त्रं निरेति प्रविशेन्मुहुश्च|
मूत्रेण पूर्णं मृदु मेदसा चेत् स्निग्धं च विद्यात् कठिनं च शोथम्||९४||

विरेचनाभ्यङ्गनिरूहलेपाः पक्वेषु चैव व्रणवच्चिकित्सा|
स्यान्मूत्रसेकः कफजं विपाट्य विशोध्य सीव्येद्व्रणवच्च पक्वम्||९५||

bradhnō'nilādyairvr̥ṣaṇē svaliṅgairantraṁ nirēti praviśēnmuhuśca|
mūtrēṇa pūrṇaṁ mr̥du mēdasā cēt snigdhaṁ ca vidyāt kaṭhinaṁ ca śōtham||94||

virēcanābhyaṅganirūhalēpāḥ pakvēṣu caiva vraṇavaccikitsā|
syānmūtrasēkaḥ kaphajaṁ vipāṭya viśōdhya sīvyēdvraṇavacca pakvam||95||

bradhno~anilAdyairvRuShaNe [30] svali~ggairantraM nireti pravishenmuhushca|
mUtreNa pUrNaM mRudu medasA cet snigdhaM ca vidyAt kaThinaM ca shotham||94||

virecanAbhya~gganirUhalepAH pakveShu caiva vraNavaccikitsA|
syAnmUtrasekaH [31] kaphajaM vipATya vishodhya sIvyedvraNavacca pakvam||95||

Due to vata or other dosha, the intestine frequently enters into scrotum and comes out and this condition is known as bradhna (hernia).

If liquid (mutra) accumulates in scrotum then the swelling is soft (hydrocele).

If fat accumulates in scrotum it is hard and unctuous.

Its treatment is virechana karma, oil massage, niruha basti and smearing of paste. If it suppurates then treatment of ulcer (vrana) should be adopted.

If there is oozing of liquid (mutra) and the swelling is due to kapha, then it should be open up, cleaned and sutured as per line of treatment of ulcer [94-95]

Bhagandara (fistula-in-ano) and its management

क्रिम्यस्थिसूक्ष्मक्षणनव्यवायप्रवाहणान्युत्कटकाश्वपृष्ठैः |
गुदस्य पार्श्वे पिडका भृशार्तिः पक्वप्रभिन्ना तु भगन्दरः स्यात्||९६||

विरेचनं चैषणपाटनं च विशुद्धमार्गस्य च तैलदाहः|
स्यात् क्षारसूत्रेण सुपाचितेन छिन्नस्य चास्य व्रणवच्चिकित्सा||९७||

krimyasthisūkṣmakṣaṇanavyavāyapravāhaṇānyutkaṭakāśvapr̥ṣṭhaiḥ |
gudasya pārśvē piḍakā bhr̥śārtiḥ pakvaprabhinnā tu bhagandaraḥ syāt||96||

virēcanaṁ caiṣaṇapāṭanaṁ ca viśuddhamārgasya ca tailadāhaḥ|
syāt kṣārasūtrēṇa supācitēna chinnasya cāsya vraṇavaccikitsā||97||

krimyasthisUkShmakShaNanavyavAyapravAhaNAnyutkaTakAshvapRuShThaiH [33] |
gudasya pArshve piDakA bhRushArtiH pakvaprabhinnA tu bhagandaraH syAt||96||

virecanaM caiShaNapATanaM ca vishuddhamArgasya ca tailadAhaH|
syAt kShArasUtreNa supAcitena [34] chinnasya cAsya vraNavaccikitsA||97||

On the lateral side of anus, a very painful pustule (pidika) occurs which suppurates and opens up; it is known as bhagandara (fistula-in-ano). It is caused by infection (krimi), injury with pointed object like bone leading to minute erosion, excessive sex, straining at defecation and friction due to sitting on hard seat of a horse or moving object.

Its treatment is virechana, probing, cutting and after cleansing cauterization with hot oil. If surgery is contraindicated then kshara-sutra should be applied and during and after cutting the track, routine line of management of ulcer is adopted [96-97]

Shlipada (elephantiasis) and its management

जङ्घासु पिण्डीप्रपदोपरिष्टात् [३५] स्याच्छ्लीपदं मांसकफास्रदोषात्|
सिराकफघ्नश्च विधिः समग्रस्तत्रेष्यते सर्षपलेपनं च||९८||

jaṅghāsu piṇḍīprapadōpariṣṭāt [35] syācchlīpadaṁ māṁsakaphāsradōṣāt|
sirākaphaghnaśca vidhiḥ samagrastatrēṣyatē sarṣapalēpanaṁ ca||98||

ja~gghAsu piNDIprapadopariShTAt [35] syAcchlIpadaM mAMsakaphAsradoShAt|
sirAkaphaghnashca vidhiH samagrastatreShyate sarShapalepanaM ca||98||

The provoked kapha and rakta by involving flesh causes edema which begins from the upper part of the foot and spreads up to calf-muscle or shank; it is known as shlipada (elephantiasis). Its treatment is vene-section and local application of paste of mustard-seed as well as all other anti-kapha treatment [98]

Jalakagardabha and its management

मन्दास्तु पित्तप्रबलाः प्रदुष्टा दोषाः सुतीव्रं तनुरक्तपाकम्|
कुर्वन्ति शोथं ज्वरतर्षयुक्तं विसर्पणं जालकगर्दभाख्यम्||९९||

विलङ्घनं रक्तविमोक्षणं च विरूक्षणं कायविशोधनं च|
धात्रीप्रयोगाञ् शिशिरान् प्रदेहान् कुर्यात् सदा जालकगर्दभस्य||१००||

mandāstu pittaprabalāḥ praduṣṭā dōṣāḥ sutīvraṁ tanuraktapākam|
kurvanti śōthaṁ jvaratarṣayuktaṁ visarpaṇaṁ jālakagardabhākhyam||99||

vilaṅghanaṁ raktavimōkṣaṇaṁ ca virūkṣaṇaṁ kāyaviśōdhanaṁ ca|
dhātrīprayōgāñ śiśirān pradēhān kuryāt sadā jālakagardabhasya||100||

mandAstu pittaprabalAH praduShTA doShAH sutIvraM tanuraktapAkam|
kurvanti shothaM jvaratarShayuktaM visarpaNaM jAlakagardabhAkhyam||99||

vila~gghanaM raktavimokShaNaM ca virUkShaNaM kAyavishodhanaM ca|
dhAtrIprayogA~j shishirAn pradehAn kuryAt sadA jAlakagardabhasya||100||

Mildly provoked dosha with dominance of pitta causes very acute inflammation which slightly bleeds and suppurates, has a tendency of quick spreading and is accompanied by fever and thirst is known as jalakagardabha.

Its treatment is langhana (lightening therapy), blood-letting, un-unctuous therapy, virechana, use of amalaki and application of paste of drugs having cold potency [99-100]

एवंविधांश्चाप्यपरान् परीक्ष्य शोथप्रकाराननिलादिलिङ्गैः|
शान्तिं नयेद्दोषहरैर्यथास्वमालेपनच्छेदनभेददाहैः||१०१||

ēvaṁvidhāṁścāpyaparān parīkṣya śōthaprakārānanilādiliṅgaiḥ|
śāntiṁ nayēddōṣaharairyathāsvamālēpanacchēdanabhēdadāhaiḥ||101||

evaMvidhAMshcApyaparAn parIkShya shothaprakArAnanilAdili~ggaiH|
shAntiM nayeddoShaharairyathAsvamAlepanacchedanabhedadAhaiH||101||

Other types of inflammatory swellings may be diagnosed on the basis of the characteristic symptoms of the involved vata and other dosha. It may also be managed by prescribing the treatment of involved dosha as well as by application of paste, incision and excision [101]

General guidelines of management

प्रायोऽभिघातादनिलः सरक्तः शोथं सरागं प्रकरोति तत्र|
वीसर्पनुन्मारुतरक्तनुच्च कार्यं विषघ्नं विषजे च कर्म||१०२||

prāyō'bhighātādanilaḥ saraktaḥ śōthaṁ sarāgaṁ prakarōti tatra|
vīsarpanunmārutaraktanucca kāryaṁ viṣaghnaṁ viṣajē ca karma||102||

prAyo~abhighAtAdanilaH saraktaH shothaM sarAgaM prakaroti tatra|
vIsarpanunmArutaraktanucca kAryaM viShaghnaM viShaje ca karma||102||

Generally external trauma causes reddish swelling due to provocation of vata and rakta. It should be treated with drugs used for the treatment of visarpa and provoked vata and rakta.

If the swelling is caused by poisonous substances then it should be treated with anti-poison measures [102]

Summary

तत्र श्लोकः-

त्रिविधस्य दोषभेदात् सर्वार्धावयवगात्रभेदाच्च|
श्वयथोर्द्विविधस्य तथा लिङ्गानि चिकित्सितं चोक्तम्||१०३||

tatra ślōkaḥ-

trividhasya dōṣabhēdāt sarvārdhāvayavagātrabhēdācca|
śvayathōrdvividhasya tathā liṅgāni cikitsitaṁ cōktam||103||

tatra shlokaH-

trividhasya doShabhedAt sarvArdhAvayavagAtrabhedAcca|
shvayathordvividhasya [36] tathA li~ggAni cikitsitaM coktam||103||

Re-capitulatory verses-

Three types of swelling as per involvement of dosha; classification of swelling according to involvement whole or half body or one part; exogenous and endogenous swelling; their symptoms and treatment have been described [103]

इत्यग्निवेशकृते तन्त्रेऽप्राप्ते दृढबलसम्पूरिते चिकित्सास्थाने श्वयथुचिकित्सितं नाम द्वादशोऽध्यायः||१२||

ityagnivēśakr̥tē tantrē'prāptē dr̥ḍhabalasampūritē cikitsāsthānē śvayathucikitsitaṁ nāma dvādaśō'dhyāyaḥ||12||

ityagniveshakRute tantre~aprApte dRuDhabalasampUrite cikitsAsthAne shvayathucikitsitaM nAma dvAdasho~adhyAyaH||12||

Thus 12th chapter named Shvayathu Chikitsa in Chikitsa Sthana of treatise compiled by Agnivesha, revised by Charaka and unavailable part restored by Dridhabala is completed (12).

Tattva Vimarsha (Fundamental Principles)

  • Shotha is caused by dietary causes like excessive use of kshara (alkali) or food articles having sour, sharply acting, hot and heavy properties by an emaciated or weak person due to excessive shodhana, fasting or disease; excessive intake of curd, raw food articles, soil, leafy vegetables, mutually contradictory food articles (virodhi), spoiled or mixed with toxic substance (such as pesticide), or a person suffering from piles, having sedentary life style, nonperforming of shodhana therapy even if indicated, injury to vital organs (marma), abnormal delivery, due to improper treatment and as complication of improper purification treatment.
  • Exogenous causes include trauma or injuries of various types and have acute pathogenesis.
  • The pathogenesis of nija shotha includes obstruction of morbid vāta by vitiated kapha, rakta and pitta at the site of peripheral superficial vessels. This vitiated vata (due to obstruction) spreads to the various places causing swelling as its cardinal symptom.
  • Rise in temperature, burning sensation as if burnt by fire and dilation of the vessels are the prodromal symptoms of swelling.
  • All types of swelling are produced by involvement of all the three dosha but they are named based on the predominance of that particular dosha. The line of treatment is also according to the dominant dosha.
  • The swelling in a patient who is neither emaciated nor weak; that involved single dosha or is of recent origin is easily curable.
  • If swelling is associated with ama it should be managed first by prescribing lightening therapy (langhana) and digestive drugs. Only after that shodhana therapy should be undertaken according to dominant dosha. General lines of treatment of doshaja swelling are as follows:
    • If it involves head then shiro-virechana is prescribed;
    • If it involves lower parts of the body then virechana (therapeutic purgation) is prescribed;
    • If it involves upper parts of the body then vamana (therapeutic emesis)is prescribed;
    • If it is caused by unctuous then rukshana (drying) therapy is done;
    • If it is caused by un-unctuous (ruksha) then unctuous (snehana) therapy is done;
    • If vata swelling is associated with constipation then it should be treated with niruha basti;
    • If it is caused by vata-pitta then it should be treated with ghee prepared with bitter drugs;
    • If the patient is suffering from associated symptoms such as fainting, pain, burning sensation and thirst then it should be treated with intake of milk;
    • If the patient is suffering from swelling where shodhana is required then milk mixed with cow’s urine should be given;
    • If the patient is suffering from kapha swelling then kshara or pungent and hot articles mixed in cow’s urine or buttermilk or asava are given.
    • Generally external trauma causes reddish swelling due to provocation of vata and rakta. It should be treated with drugs used for the treatment of visarpa and provoked vata and rakta. If the swelling is caused by poisonous substances then it should be treated with anti-poison measures (102).

Vidhi Vimarsha (Applied Inferences )

Derivation of term

The word Shvayathu is derived from root Tuoshchi-Gati-Vriddhyoh. Tuo is converted to Shvi indicating to increase (Vriddhi) and by adding Athuc Pratyaya the word Shvayathu is derived which literally means increased (3).

Pathogenesis

In pathogenesis of shotha there is involvement of superficial veins (Bahya shira). Involvement of circulatory or lymphatic system is must in producing the shotha.

Types of shotha

Vata shotha is shifting in nature, pitting on pressure and increases in the day time and may vanish without visible cause. Further vata causes edema of the lower part of the body i. e feet and legs. All these characteristics of vata shotha are indicative cardiac edema.

In day time due to various activities and fatigue vata gets increased leading to increase in the edema. From modern point of view, cardiac edema increases in the evening which is vata kala due to the day activities. Vata shotha is pitting on pressure but on removing the pressure it immediately takes its original shape.

Pitta sopha begins from middle parts of the body and then spreads to the other parts and has yellow-reddish color[1]. Yellowish coloration indicates involvement of liver. Inflammatory swelling is related to pittaja shotha .

Kapha Shotha slightly pits on pressure but takes long time to attain its original position after removing the pressure and increases at night. It develops slowly and also takes long time to subside. Kapha shotha occurs in upper part of the body and the treatment of edema occurring on the upper part is vamana i.e. of kapha. On this basis it can be said that which mainly includes face. Renal edema occurs on the face in the morning (noticed on awakening though increased in the night). Other important sign is it is hard and the serous discharge comes out on scratching the skin [2]. This indicates that hard non-pitting edema of elephantiasis may also be included under it. Other symptom mentioned for kaphaja shotha that the patient like warm touch indicates towards edema found in hypothyroidism (14).

Complications

Complications of shotha are vomiting, dyspnea, anorexia, thirst, fever, loose motions and weakness (Cha. Sa. Sutra Sthana chapter 18/18]. Sushruta mentions two additional complications viz. cough and hiccups.[3](15)

Sushruta classify general edema in five types viz., vata, pitta, kapha, sannipata and vishaja[4] but does not consider local swelling as the part of shopha because while defining swelling it is clearly mentioned that which occurs in the large part under the skin and flesh etc but is other than nodules (granthi), abscess (vidradhi), alaji etc is known as shopha [5]

Ashtangahridaya describes shopha in the chapter on panduroga (anemia) because it is a main complication of anemia. Nine types of shopha described therein are three single dosha type, three samsarga types, one tridoshaja and one each due to trauma and poison. In addition three new types of shopha viz. prithu (extensive), unnata (elevated) and grathita (compact) are also mentioned.[6].

Madhava Nidana followed Ashtangahridaya and describes nine types of shotha and does not describe localized shotha in this chapter on shotha [7].

Charaka considers bulging (utsedha) from the skin as shvayathu therefore local swellings such as pidika (papules and pustules), nodules (including gandhamala), galagandha (goiter), tumor etc are also described in this chapter. The probable modern equivalents are given in the bracket while describing these conditions in the text (74-100).

Sushruta defines arbuda as a round and immovable growth produced by vitiated dosha by afflicting mamsa with mild pain but having deep roots and located in extensive area at the expense of tissue and causes swelling of the mamsa extensively. This arbuda (tumor) grows slowly and does not suppurate [8]. But Charaka being a clinician does not consider much difference in the management of arbuda and granthi as their site, causative factors, shape, dosha morbidity and dushya (susceptible tissues) are about the same. However, it is clearly mentioned that arbuda should be managed by the expert surgeon only (87).

Line of treatment, various procedures and preparations mentioned in this chapter for the management of various types of swellings are easy to administer and practical so should be practiced (16-73).

Shat-kriya-kala of shotha

  1. Sanchaya (Accumulation): This is the first stage of the disease where due to indulgence into the causative factors accumulation of concerned dosha occurs. During this stage increase in the normal functions of the dosha is noticed.
  2. Prakopa (Provocation): If the accumulated dosha are not properly taken care then they may go to the next stage of provocation. During this stage the prakopa symptoms of the involved dosha appear.
  3. Prasara (Spreading): In the stage of prasara the dosha leaves their normal site and starts circulating all over the body.
  4. Sthana-Smashrya (Localization): The circulating dosha interacts with such tissues which have some problem in their channels which may be anatomical, physiological or pathological. This phenomenon is dosha-dushya-samurchchana. This localization of dosha leads to beginning of the pathogenesis of the disease and during this stage prodromal symptoms (purva-rupa) of the disease are produced. The prodromal symptoms of edema are heat, burning sensation and dilation of the vessels.
  5. Vyakti (Manifestation): If the disease is not managed at the stage of localization then the disease manifest with its specific symptoms. The symptoms of various types of edema are mentioned in the verses from 11 to 16 of this chapter. All or few symptoms mentioned for the disease may appear but if all the symptoms appear then the disease may become incurable and if few then it is easily curable. Moderate appearance of the symptom indicates its moderate prognosis.
  6. Bheda (Complications): If the disease is not properly treated even after it is fully manifestation then the complications may appear and the disease becomes difficult to cure or incurable. The seven complications of edema are vomiting, thirst, anorexia, dyspnea, fever, diarrhea and weakness [ Cha. Sa. Sutra Sthana 18/18].

Differential Diagnosis of shotha

Ayurveda is a clinical science, therefore the classifications are also planned so that the disease can systematically be diagnosed on the basis of the symptoms. Shotha is a good example for it.

Shotha has been defined as any abnormal elevation from the skin. First question to be asked to the patient whether there is any history of trauma, biting etc and if yes, then it is an agantuja shotha. If there is a history of contact or taking poisonous substance then it is vishaja.

Hereafter it is to be confirmed that whether the swelling is localized or all over the body. If shotha is localized in single organ or site then it can be diagnosed on the basis of nature of the lesion such as papules, pustules, nodules, tumor etc. It is further diagnosed on the basis of shape, site etc. For example gandhamala is garland like and galagandha is scrotum like swelling in neck. Romantika has minute papules while masurika has lentil like papules and so on. Associated general features such as fever, thirst etc also helps in differential diagnosis.

If shotha is generalized swelling then the point of its beginning is important e.g. pitta shopha starts from middle part of the abdomen, vata from the lower parts and kapha from upper parts of the body. The consideration of other characteristic features mentioned above will help in reaching the final diagnosis.

For example moving, pitting on pressure, increasing in the day time and sometime subsides without appreciable cause etc help in reaching the diagnosis for vata shopha.

Swelling which is firm, slight pitting on pressure, increases in the night, takes long time to subside and is associated with low digestion, vomiting, anemia indicates towards kapha shotha.

Swelling which is soft, tender on touch, associated with change to yellow color, fever etc is pitta shotha.

Similarly causative factors can also be sorted out by asking whether it relates to food articles (curd, unripe fruits, spoiled, leafy vegetables) or its properties (excessive use of kshara, sour, sharp, hot and heavy food articles), diet habit (fasting), sedentary life style, emaciation or weakness due to a disease or excessive shodhana, contact to poisonous substances etc.

Chikitsa Sutra (Principles of treatment)

Ayurveda gives very importance to ama. Therefore, if ama is associated with swelling then first it should be managed by prescribing lightening therapy (langhana) and digestive drugs. After getting the nirama symptoms, shodhana therapy can be done according to dominant dosha. It is the general rule for all types of swellings.

Shiro-virechana is the choice of therapy for dosha situated in head. Therefore if the swelling involves the head then first nasya should be done.

Chest and the upper parts are the main sites of kapha and for its removal, vamana therapy is best. Therefore if swelling is situated in upper parts or begins from upper parts and then spreads to other parts or it is kapha type then first of all vamana (emesis) therapy is prescribed. Kshara or pungent and hot articles mixed in cow’s urine or buttermilk or asava are indicated after vamana therapy. If vamana therapy is not possible in the patient suffering from kapha swelling then these drugs may be given directly.

Generally basti is not preferred for the treatment of swelling, but if vata swelling is associated with constipation then it should be treated with niruha basti. Otherwise virechana is indicated for the swelling of lower part as well as of vata. The local swellings with symptom of inflammation may be treated by following the general line of treatment as mentioned above and other measures mentioned while describing their treatment in this chapter. If it belongs to shalya or shalakya type specialties, then let it be treated by the experts of the specialty.

Clinical practices

Type Formulations Dosage Time Anupana
Vata dominant Harina shringa mixture 60-120 mg In between two meals Honey + Dashamularishta + Punarnavasa
Pitta dominant Aarogya Mixture 120-250 mg In between two meals Milk + saravadyasava + punarnavasava + vasakasava'
Kapha dominant Gomutra Haritaki 1-3 grams In between two meals Cow urine, honey
Punarnava mandura 250-500 mg In between two meals Punarnavasava
Gudadraka Yoga 120-250 mg In between two meals Honey

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References

  1. Vagbhata. Nidana Sthana, Cha.13 Pandurogasophavisarpa Nidana Adhyaya verse 33. In: Harishastri Paradkar Vaidya, Editors. Ashtanga Hridayam. 1st ed. Varanasi: Krishnadas Academy;2000.p.4.
  2. Vagbhata. Nidana Sthana, Cha.13 Pandurogasophavisarpa Nidana Adhyaya verse 35-36. In: Harishastri Paradkar Vaidya, Editors. Ashtanga Hridayam. 1st ed. Varanasi: Krishnadas Academy;2000.p.4.
  3. Sushruta. Chikitsa Sthana, Cha.23 Sopha Chikisitam Adhyaya verse 8-9. In: Jadavaji Trikamji Aacharya, Editors. Sushruta Samhita. 8th ed. Varanasi: Chaukhambha Orientalia;2005. p.1.
  4. Sushruta. Chikitsa Sthana, Cha.23 Sopha Chikisitam Adhyaya verse 3. In: Jadavaji Trikamji Aacharya, Editors. Sushruta Samhita. 8th ed. Varanasi: Chaukhambha Orientalia;2005. p.1.
  5. Sushruta. Sutra Sthana, Cha.17 Amapkweshaneeya Adhyaya verse 3 In: Jadavaji Trikamji Aacharya, Editors. Sushruta Samhita. 8th ed. Varanasi: Chaukhambha Orientalia;2005. p.1.
  6. Vagbhata. Nidana Sthana, Cha.13 Pandurogasophavisarpa Nidana Adhyaya verse 21-42. In: Harishastri Paradkar Vaidya, Editors. Ashtanga Hridayam. 1st ed. Varanasi: Krishnadas Academy;2000.p.4.
  7. Madhavakara. Madhava Nidanam (Roga vinischaya). Translated from Sanskrit by K. R. Srikantha Murthy. 8th ed. Varanasi: Chaukhambha orientalia;2007.pp--
  8. Sushruta. Nidana Sthana, Cha.11 Grandhiapachiarbudagalaganda Nidana Adhyaya verse 13-14 In: Jadavaji Trikamji Aacharya, Editors. Sushruta Samhita. 8th ed. Varanasi: Chaukhambha Orientalia;2005. p.1.