It is a condition of painless swelling due to water accumulation. It is the disorder affecting water- carrying system in which all three doshas are vitiated. In Ayurveda it is known as ‘Shotha.” However Kapha vitiation produces solid or nonpitting edema mostly due to lymph stasis while Vata vitiation produces pitting edema of venous origin with pain, and that of Pitta is responsible for inflammatory type of edema. In all types ama and obstruction in channels is common factor.
Edema of venous origin is due to excess intake of salts or steroids. Other causes are Vitamin B12 deficiency, pregnancy, anemia, and portal obstruction. It can be due to cardiac and renal origin. Lymphoedema is due to filariasis, allergic, post thromboflebitic, post traumatic or due to idiopathic origin.
Kapha type- In long standing edema of lymphatic origin, medicated emesis is advised. Herbs indicated are punarnava, plant alkalies like punarnava kahara, apamarga kshara ginger, triphala and shilajatu. Decoction of punarnva or triphala with shilajatu rasayana, dashamoola haritaki.
Tab. Chandraprabha 250 mgm, 3 times day with punarnavasava 15 ml. 3 times day or kumari asava 15 ml. 3 times day for 1 month are best. Tab. Dugdha bati (shotha) (BR) 250 mgm, 3 times a day for 1 month is indicated.
For external application, use paste of dashanga.
Western diuretics of heating type should be used. They are cubebs, juniper berries, Mormon tea, parsley and wild carrot.
To reduce the tendency of after retention , herbs for regulating kidney function and diuretics should be given like punarnava or gokshura in dose of 1 to 2 gms twice a day for 15 days, along with anti-Kapha diet. Tab. Punarnava guggulu or tab. Yogaraj guggulu in dose of 500 milligram 3 times day can be given. Dry massage with calamus should be done with sauna at least 3 times a week.
Western diuretics like parsley, wild can be given. Reduce sugars and salt intake. Avoid all dairy products and meat. Sleeping during the day should also be avoided.
Pitta type- for allergic or inflammatory condition use ipomoea turpethum, amalaki, cassia fistula, cyndon dactylon, curcuma and berberis aristata. Western cooling type of diuretics like asparagus, coriander, cornsilk, dandelion, fennel ad gravel root are useful. Guduchi Ghana 250 mgm, twice a day with decoction of patola or punarnava 30 ml. 3 times a day for 1 month is useful.Similarly, punarnavadi mandura, 125 mgm, twice a day for 15 days is also useful. Externally application of red sandalwood or curcuma is ideal. Avoid red meat and fried substances. Take plenty of green vegetables preferably bitter in nature. Herbs of choice are aloe, barberry, and turmeric.
Vata type- Avoid complex carbohydrates. Spices like cayenne and trikatu 125 mgm, twice a day for 15 day should e given with triphala gugulu 250 mgm, twice a day with warm water if given for 3 weeks is also useful. Or tab. Mahayogaraj guggulu 125 mgm, twice a day for 15 days is also useful. Light massage with fomentation should be given.
Give mixture of jaggery with fresh ginger in 1 to ¼ ratios, before meals twice every day. Start with 5 grams of jaggery and when increase the dose until 10 grams. This simple remedy is effective in many cases. Western warming diuretics like cinnamon and parsley should e given. Ayurvedic herbs like punarnava or gokshur 1gm. A day can be supplemented with this therapy.
Avoid curds, sour foods, excess salt, cheese, fermented foods and drinks, foods with preservatives.