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Shvayathu Chikitsa (view source)

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Now we shall expound ~~upon~~ the ~~management~~ of swelling. Thus said Lord Atreya [1-2]

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

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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]

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==== Causative factors of ''nija'' (endogenous) swelling/edema ====

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=== Causative factors of ''nija'' (endogenous) swelling/edema ===

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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]

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==== Causative factors of ''agantuka'' (exogenous) swelling ====

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=== Causative factors of ''agantuka'' (exogenous) swelling ===

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

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==== Pathogenesis of swelling ====

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=== Pathogenesis of swelling ===

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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]

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==== Prodromal symptoms of edema ====

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=== Prodromal symptoms of edema ===

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

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==== ''Tridoshaja'' nature of all swellings ====

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=== ''Tridoshaja'' nature of all swellings ===

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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]

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==== General symptoms of swelling ====

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=== General symptoms of swelling ===

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

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==== Symptoms of ''vataja'' dominant edema/swelling ====

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=== Symptoms of ''vataja'' dominant edema/swelling ===

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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]

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==== Symptoms of ''pitta'' dominant swelling (inflammation) ====

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=== Symptoms of ''pitta'' dominant swelling (inflammation) ===

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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]

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==== Symptoms of ''kapha''-dominant edema ====

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=== Symptoms of ''kapha''-dominant edema ===

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''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]

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==== Symptoms of bad prognostic of edema ====

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=== Symptoms of bad prognostic of edema ===

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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]

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==== Symptoms of easily curable swelling ====

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=== Symptoms of easily curable swelling ===

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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]

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==== Principles of treatment of edema/swelling ====

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=== Principles of treatment of edema/swelling ===

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*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]

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==== ''Apathya'' (unwholesome) for swelling/edema ====

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=== ''Apathya'' (unwholesome) for swelling/edema ===

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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]

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==== ''Vyoshadi churna'' for ''kapha'' swelling/edema ====

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=== ''Vyoshadi churna'' for ''kapha'' swelling/edema ===

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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]

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==== Remedy for ''tridoshaja'' edema ====

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=== Remedy for ''tridoshaja'' edema ===

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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]

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==== Remedy for ''vata'' edema/swelling ====

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=== Remedy for ''vata'' edema/swelling ===

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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]

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==== Remedy for ''vata-pitta'' swelling/edema ====

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=== Remedy for ''vata-pitta'' swelling/edema ===

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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]

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==== General remedies for edema ====

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=== General remedies for edema ===

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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]

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==== ''Gandeeradyarishta'' ====

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=== ''Gandeeradyarishta'' ===

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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]

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==== ''Ashtashato arishta'' ====

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=== ''Ashtashato arishta'' ===

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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]

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==== ''Punarnavadi arishta'' ====

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=== ''Punarnavadi arishta'' ===

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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]

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==== ''Triphaladyarishta'' ====

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=== ''Triphaladyarishta'' ===

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

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==== Powder preparations for edema ====

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=== Powder preparations for edema ===

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''bhasma'' of iron, ''trikatu'' and ''yavakshara'' taken with decoction of ''triphala'' [41-42]

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==== ''Ksharagudika'' ====

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=== ''Ksharagudika'' ===

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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]

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==== Course of ''gud-adraka'' ====

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=== Course of ''gud-adraka'' ===

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

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==== Course of ''shilajatu'' ====

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=== Course of ''shilajatu'' ===

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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]

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==== ''Kamsa haritaki'' ====

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=== ''Kamsa haritaki'' ===

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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]

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==== ''Patolādi kaṣāya'' ====

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=== ''Patolādi kaṣāya'' ===

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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]

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==== ''Chitraka ghrita'' ====

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=== ''Chitraka ghrita'' ===

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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]

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==== ''Yavāgu'' preparations ====

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=== ''Yavāgu'' preparations ===

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

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==== ''Pathya'' (wholesome food) for ''shotha'' ====

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=== ''Pathya'' (wholesome food) for ''shotha'' ===

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*Old ''shali rice'' and old barley [62-63]

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==== External applications ====

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=== External applications ===

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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]

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==== ''Shaileyadi taila'' ====

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=== ''Shaileyadi taila'' ===

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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]

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==== Medicated water for bath ====

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=== Medicated water for bath ===

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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]

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==== External application in ''pitta'' dominance ====

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=== External application in ''pitta'' dominance ===

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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]

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==== External application in ''kapha'' dominance ====

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=== External application in ''kapha'' dominance ===

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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).

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==== External application in burning sensation ====

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=== External application in burning sensation ===

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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]

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==== Various types of local swellings ====

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=== Various types of local swellings ===

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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]

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

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

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When it affects inside of the throat, it produces sālūka, which is accompanied with stertorous breathing and obstruction to expiration [75]

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==== ''~~Biḍālikā~~'' (Ludwig’s angina) ====

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=== ''Bidalika'' (Ludwig’s angina) ===

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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]

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==== ''~~Tālu~~-vidradhi'' (palatal abscess), ''~~upajihvikā~~'' (superficial glossitis) and ''adhijihvikā'' (sub-lingual glossitis) ====

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

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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]

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

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

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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]

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==== ''~~Galagaṇḍa~~'' (goiter),''~~gaṇḍamālā~~'' (cervical adenitis) and its management ====

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

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

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==== ''Granthi'' (nodule) and its management ====

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=== ''Granthi'' (nodule) and its management ===

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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]

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==== Surgical management of ''granthi'' ====

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=== Surgical management of ''granthi'' ===

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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]

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==== Differential diagnosis of ''arbuda'' (tumor) ====

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=== Differential diagnosis of ''arbuda'' (tumor) ===

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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]

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==== ''~~Alajī~~'' and ''akshata'' (whitlow)====

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=== ''Alaji'' and ''akshata'' (whitlow)===

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The severe inflammation occurring by vitiating flesh and blood in the skin adjoining nail which suppurates quickly is known as akṣata [88]

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==== ''~~Vidārikā~~'' (lymphadenitis) and its management ====

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=== ''Vidarika'' (lymphadenitis) and its management ===

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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]

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==== ''~~Visphōṭaka~~'' (eruption) ====

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=== ''Visphotaka'' (eruption) ===

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

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==== ''~~Kakṣā~~'' (herpes zoster) ====

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=== ''Kaksha'' (herpes zoster) ===

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

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==== ''~~Romāntikā~~'' (measles) ====

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=== ''Romantika'' (measles) ===

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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]

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===~~= Masurikā~~ (chickenpox) and its management ====

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=== Masurika (chickenpox) and its management ===

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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]

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==== ''Bradhna'' (hernia) and its management ====

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=== ''Bradhna'' (hernia) and its management ===

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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]

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==== Bhagandara (fistula-in-ano) and its management ====

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=== Bhagandara (fistula-in-ano) and its management ===

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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]

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==== ''Shlipada'' (elephantiasis) and its management ====

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=== ''Shlipada'' (elephantiasis) and its management ===

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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]

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==== ''Jalakagardabha'' and its management ====

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=== ''Jalakagardabha'' and its management ===

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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]

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==== General guidelines of management ====

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=== General guidelines of management ===

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

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==== Summary ====

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=== Summary ===

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== Vidhi Vimarsha (Applied Inferences ) ==

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==== Derivation of term ====

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=== 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).

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==== Pathogenesis ====

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=== 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''.

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==== Types of ''shotha'' ====

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=== 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.

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''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).

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==== Complications ====

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=== Complications ===

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)

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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).

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==== ''Shat-kriya-kala'' of ''shotha'' ====

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=== ''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.

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#''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).

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==== Differential Diagnosis of ''shotha'' ====

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=== 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.

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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.

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==== ''Chikitsa Sutra'' (Principles of treatment) ====

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=== ''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.

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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.

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==== Clinical practices ====

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=== Clinical practices ===

{| class="wikitable"

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|}

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~~=== Glossary ===~~

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*Āgantuja (आगन्तु) exogenous

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*Arbuda (अर्बुद) tumor

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*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~~ ===

+

=== Further reading ===

#Ashtanga Hridaya by Vagbhata with Sarvanga-Sundra commentry by Arunadatta, published by Chaukhamba Samskrit series office, Varanasi,

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