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edema
Edema (Shotha)
Description

Edema (Shotha in Sanskrit) is the accumulation of excess fluid in the cells (cellular edema) or in the intercellular spaces within tissues (interstitial edema), resulting in raised skin.

In modern medicine, edema refers to massive swelling and swelling (shota in Sanskrit) refers to localized swelling (utseda in Sanskrit). If the skin of the entire body is raised as a result of excess fluid, it is samhatam edema. In samhatam edema, the skin becomes stretched like a balloon, where there is bulging and stretching of the skin.

Edema is the result of failure of normal lymph drainage. Normally, the lymph nodes (Kapha and rasa dhatu) filter fluid as it flows through them, trapping bacteria, viruses, and other foreign substances (called ama in Sanskrit), which are then destroyed by special white blood cells called lymphocytes. When normal lymph drainage fails to occur, the fluid can build up in the affected arm or leg, resulting in lymphedema, which is a collection of fluid in the arms and legs that causes swelling. Lymphedema can also be caused by the medication tamoxifen (Nolvadex), radiation therapy, and injury to the lymph nodes. This is called secondary lymphedema.

Edema is stagnation of fluid, local or generalized. Edema as a separate disease is quite rare. Usually associated as a symptom of some other condition.

Preliminary signs (Purva rupa) of edema are: the veins become popped, local organ feels heavy, person may have anemia, hypo-protein condition, and previous history of bruise.

Other signs of edema include:

 * heaviness
 * increase of body weight due to [[water]] retention
 * Intratendital spaces of [[hand]] are obliterated
 * Goosebumps.  Because of swelling, hairs stand-up and looks like goosebumps.
 * Stretched [[skin]]
 * [[veins]] become invisible
 * skin is swollen
 * skin looks [[cold]]
 * ascites
 * Pallor. color changes due to [[doshic]] changes

Edema is a disorder of vyana vayu (circulating Vata).

Types of Edema

Edema is the result of excess Vata, Pitta, or Kapha.

**Vata Edema**

Vata edema is generally due to exposure to cold weather. Swelling is at the periphery, especially to doshal part of hand and feet. Capillaries constrict. It is common in the winter season. The skin swells like a balloon, but there is no pitting when the skin is pressed. As well, the skin is dry and cold; pulse is fast and feeble.

Vata edema is non-pitting edema (Nonnamati prapidata) and includes subcutaneous edema and gaseous edema.

Use warm sesame oil

**Pitta Edema**

When edema is the result of excess pitta, the skin swells with hives, rash, etc. and the swelling is red and sensitive when pressed. The skin is hot, flushed, and inflamed. The person gets nausea, vomiting, and fever. It can create drowsiness and unconsciousness. Pitta edema can be localized or generalized.

Pitta edema is sparsha sahata prapidata and includes hematoma, celulities, allergic swelling, and abcess.

Note: Karposi’s sarcoma is a Pitta-Kapha Shotha.

**Kapha Edema**

When edema is the result of excess kapha, the liquid component of plasma, protein and lymphatics and the liquid component of Kapha is pushed from the blood vessel, resulting in increased permeability. It is like osmotic pressure. It will go from high concentration to low concentration, ghana to drava within the cell membrane. Because Vata is aggravated by increased ghana quality, it will create pressure on blood vessel, increasing capillary permeability. skin, subcutaneous fat, muscle, will create localized swelling or lack of tone of skin so skin is stretched. The skin is cold and damp.

Kapha swelling includes:

 * pitting on pressure
 * gradual swelling
 * puffiness of [[eyes]] due to [[kidney]] dysfunction 
 * [[Nephrotic syndrome]] 
 * [[ascites]]
 * [[congestive heart failure]]
 * paleness in the [[face]], [[genital organs]] (female), [[tongue]], and [[gums]]
 * whiteness of the eyes

Kapha edema includes solid edema such as elephant leg, ghana, and lymphatic swelling. Solid edema could be lymphatic or due to an organism in the person’s body. It also includes chronic anemia, edema kidney disorders, nephrotic syndrome, hypertension edema and increased blood urea.

Edema can be present in anemia or lymphatic obstruction.

Etiology (Causes)

Edema can be due to:

 * consumption of [[excess]] [[salt]], [[sugar]], and Kapha type of food. 
 * Pitta person eating sour fruit, drinking alcohol, sleeping during the daytime. heavy meals.  
 * [[hemorrhoids]], person loses [[blood]], creating anemia.  
 * Insufficient [[exercise]].  
 * wrong kind of [[Pancha Karma]], when [[ama]] is present. 
 * [[trauma]] to marma can create localized swelling.  
 * pregnancy can create swelling on feet.  Eclampsia, toxemia. 
 * wrong treatment, creating allergy leading to swelling. 
 * edema to trachea or brain. 
 * Also due to allergic manifestation, such as hay fever or drug allergy or sting bite.  
 * Sting bite can create nephrotis because]] of toxicity of sting, pitta type.

Samprapti

There is a change in concentration of interstitital and intervascular fluids. As fluid moves from high to low concentration, creates swelling. cardiac edema, because of congestive heart failure, congestion in veins. cardiac edema becomes worse in evening because of gravity, is Vata type. renal edema is worse in morning Kapha.

Samprapti may be generalized or localized or topical. glaucoma is localized swelling within the eyeball. hydrocele is localized swelling within the scratal skin. Hydrocephalis is swelling in brain, cerebral edema. pericardial edema creates pressure on the heart. lung edema. The approach of modern medicine is to treat these conditions as localized. Ayurveda deals with whole picture.

Treatments

chikitsa - Detect and then treat the cause of the edema. The cause can be Vata, Pitta or Kapha; traumatic or symptom of some other disease.

**cardiac edema**

cardiac edema (kapha)

Arjuna 500

Punarnava 400

pushkarmula (Elecampane) 300 regulates capillary permiability

1/2 t tid

Punarnava lepan, paste on feet to relieve swelling

Gold Water

Triphala 1 t tid

pillow under feet for sleep

**renal edema**

worse in morning. May be nephritis or nephrotic syndrome. May be diabetic renopathy or hypertension. Check blood pressure.

Punarnava 500 diuretic

Gokshura 400 urinary antiseptic

Shilajit 300

__If infection add:__

Motibhasma 200

Neem 300

1/2 t tid with CCF [[tea]]

rakta Punarnava 1/2 t HS

purgative and [[diuretic]]

__If hypertension add:__

passion flower

Hawthorn berry

**pregnancy edema**

May go with anemia or folic acid deficiency or lack of protein.

Shatavari 500 OK to use after first 2 months

Punarnava 400

Gokshura 300

1/2 t tid with CCF

milk 1 cup with Castor oil one teaspoon (milk laxative)

Helps [[relieve]] constipation and [[pressure]] from ileac [[pain]]

Punarnava paste

Give folic acid, iron, protein. Gentle walking and swimming.

Give same treatment to pregnancy edema with eclampsia. Can create spasm, albuminuria, high blood pressure. Add passion flower and hawthorn if hypertension present. Sarpagandha contains Sarpina. If too high a dose can create depression. Sarpina is one active ingredient that creates depression. However, other active ingredients counteract. So Sarpagandha should be taken as a whole.

**elephantitis**

legs look like elephant’s foot. Dr. Lad saw one man whose penis looked like that, also nose. Severe lymphatic obstruction. skin becomes hard and rough like elephant’s skin. Difficult or impossible to treat. However one herb effective for Ghana Shotha.

Punarnava 700

Gokshura 500

Paribhadra 400 – not available here. Looks like Neem. Neem also effective.

Suvarna Raj Vangeshwha 200 – gold and Vangabhasma

**Vata Shotha**

PunarnavaVati Guggulu 200

ashwaghandha 500

**Pitta Shotha**

Sutshekhara 200 – contains Mercury. Use black pepper

gulwel sattva 500

Cumin 400

1/2 t tid with [[ghee]]
Or [[black]] [[pepper]] with [[ghee]] orally as well as topically

treat sting bite as Pitta

**Kapha Shotha**

Punarnava 500

Gokshura 500

Shilajit 200

1/2 t tid

glaucoma treat as Kapha

If person is on dialysis, add Abrak bhasma to renal formula and restrict CCF tea to 2 ounces.

**rasa vriddhi**

rasa vriddhi increase when RD > 9 anjali

RD increase→ waste product increase → kapha disorders creates lymphatic congestion, swelling, edema, pallor, excess salivation, nausea, vomiting, ovarian cyst, leukharia, fibro cystic breasts (enlarged), repeated fungal infection, yeast infection, obesity (DurveA:1:36)

**rasa GATA **

rasa GATA when Kapha goes into rasa dhatu heavy, thick, cold, clammy, wet skin, pallor prone to fungal infections, lymphatic congestion sticky eyes, cloudy sclera edema, salivation (DurveA:1:37)

**mamsa GATA **

mamsa GATA (Kapha)

Kapha enters muscle tissue lack of tone, flaccidity, makes muscles sluggish, chubby, slight edema, myomas, fibro cystic lumps, cystic swelling, muscular tumors, dental tartar (DurveA:1:41)

SrotaMSI function mula marga MUKHA AVAYana

ambu vaha Srotas body temperature lubrication, gives energy, elimination of wastes, electrolyte balance soft palate (talu) 3rd ventricle of brain, pancreas (kloman), lungs (phupphusam) GI mucus membrane kidney (vrkka), tongue (jihva), pores of skin (Tvak)

palate (talu), pancreas(kloman), tongue (jihva)

causes

examination ASSOCIATED emotions Marmas LakshanaM

signs and symptoms

excess consumption of salt, sweet, sour, sun; profuse sweating, excess ama (clogs Srotas), fear, over-exercise, over-hunger, eating dry food

ask about urinary habits, examine the urine, ask about thirst, Water consumption, look for any edema, sunken eyes, check conjunctiva, tongue, skin for dryness fear, grief, mobility, flexibility, good taste intelligence gulpha, pad madhya, vrikka, dry lips, tongue, palate; excess thirst, dehydration, sunken eyes, sunken fontanel, pinched skin (tents when pinched), extreme debility, edema, dropsy,

drinking Water - depends on Prakruti and agni Vata - 4 cups Water vishema agni Pitta - 6 cups Water tikshna agni Kapha - 5 cups Water manda agni too much Water leads to edema (DurveA:1:69)

**DREAMS**

Vata - falling dreams, being attacked, pursued, doing something frozen with fright, death of loved one, being locked up, snakes, autumn, fulfillment, falling deep down into valley, flying dreams - gases in colon and colon flying

Pitta - schooling, teaching, studying, being late, overeating, house on Fire, failing exam, killing someone, inappropriately dressed, nude in public, summer, problem solving, angry, violence, shouting

Kapha - swimming, finding money, eating, romantic, doing same thing over and over slowly, arriving late, seeing self as dead, spring, winter, edema patient - dream of drowning (DurveA:1:89)

anupan’s for 7 dhatus

- s[[ama]] and nir[[ama]] of 3 [[dosha]]s

dhatu dosha Role of ama anupan rasa Kapha Sama Ginger tea, lymphatic congestion, flu, cold, sinus congestion

[[Kapha]]	Nir[[ama]]		[[tendency]] to retain [[Water]], [[edema]], [[swelling]]
			1 tsp. [[honey]] + [[hot]] [[Water]], CCF [[tea]]

s[[hot]]ha - [[edema]]	[[cardiac]] [[edema]] - worse in [[evening]],  [[renal]] [[edema]] - worse in morning
cardiac edema - shringa bhasmarenal edema - Punarnavapulmonary edema - Kantakari[[cerebral edema - jatamamsi • hypoproteinic edema - Gokshuraedema due to anemia - Loha bhasma

glaucoma is like intra opthalmic edema - tx with Punarnava • generalized anasarca - nephritic syndrome - tx with Shilajith

2. nasal administration - nasya

[[nose]] = doorway to [[conscious]]ness, [[brain]]
acts on [[prana]], [[udan]]a]], [[tar[[pak]]a, [[sadhak]]a, and [[direct]]ly on [[majja]] [[dhatu]] and mano[[vaha]] [[Srota]]s]]
helps [[decrease]] remnant [[toxin]]s and impurities during PK
specific for [[disease]]s of supraclavicular areas
acts on entire [[body]] through [[whole]] [[majja]] [[dhatu]]

 bruhana nasya - medicate]]d, calms V  shamana nasya - sedative, calms P  virechana nasya - calms K  pradhaman nasya - dry powder, for instantaneous action ex. epilepsy - vaccha powderGinger jaggery nasya - for renal edema, increase renal threshold, clears sinuses

pratimarsha - daily for lubrication

			[[Kapha]] AVRTA [[apana]]		 	5/16/00
			     [[Kapha]] [[block]]ing [[apana]] [[vayu]] 				

Adhah kaye gurutvam ca shitata ca Kaphavrte from Madhava nidan

adhah - [[lower]]		[[shita]]ta - [[cold]], [[clammy]] [[sensation]]
kaye - [[body]]		[[Kapha]]vrte - [[block]]ed by [[Kapha]]
[[guru]]tva - [[heavy]]		

apana vayu - sympathetic and parasympathetic impulses originating form lumbosacral plexus

Sx: heaviness in lower extremities, edema, cold clammy skin, cold feet

[[chronic]] [[condition]] - ankle [[swelling]], [[edema]]

Sx in Srotamsi artavaSrotas]]: repeated vaginal infections, trichomonis yeast infection, cystic changes in ovary, endometriosis - undue thickening of endometrium into fallopian tube and pelvic cavity, delayed menstruation, K type PMS: Water retention, depression, drowsiness, swelling mutravaha Srotas]] - albuminurea, kidney ureter or bladder stones shukravaha Srotas]] - prostatic calculi, benign prostatic hypertrophy purishavaha Srotas]] - repeated amoebic dysentery= amoebiasis, amoebuma - huge benign encapsulated tumor

TX • abhyanga of lower extremity= adha kayobhyanga • adha kaya avagaha - tubbath with Ginger baking soda - muscle relaxant, helps capillary action, decreases painanu[[Vasan]]a basti - sticky quality of K sticks to intestines mucus in stools

1 [[cup]] [[sesame]] [[oil]] to lubricate [[colon]], [[pacify]] V, [[will]] [[increase]] K so slides out and doesn’t stick
[[oil]] douche also good for [[white]] [[sticky]] [[discharge]],  or [[Licorice]] douche with [[sesame]] [[oil]]

Yoga basti - 7 in a row, do anu[[Vasan]]a 7 times in a row, tx 50% prostatic hypertrophy

	[[massage]]s pro[[static]] [[wp>[[gland]]

after couple of days of anu[[Vasan]]a basti - person feels great, warmth in lower extremities apana vayu - becomes anuloma, foot swelling decreases, sesame oil acts as diureticKutaja (200) - if K type diarrhea, mucus in stools • straining and tenesmus, but no loose stools

straining can loosen liga[[men]]ts of [[rectum]] rectal [[prolapse]]  grad[[ash]]ramsha
tx with [[Chukra]]tailam - 1 [[cup]] [[sesame]] [[oil]] + 1 tsp [[vine]]gar, do [[basti]]
	[[Chukra]] - like [[vine]]gar, very [[sour]]
	or apply on [[rectum]] and [[pus]]h inside, then apply kambarband

• rectal prolapse - internally Bala (400) + vidhari (400) + Ashwagandha (400) -  tsp TID

[[will]] [[strength]]en liga[[men]]t, only after [[Chukra]]tailam [[basti]] tx to [[decrease]] K first

no prolapse, but persistent tenesmus, passing blood or pus in stools panchamrut parati Kalpa compound - helps maintain muscular tone of rectum, contains mercury

can substitute with san[[Jiva]]ni (200) TID

Kutaja arista - 1 gallon + yeast + jaggery, 700 temperature with electric blanket allows it to ferment take 4 tsp before food will act on apana vayuvirechana - works on entire GI track • sat isabgol - silium husk, boil 1 tsp silium seed] in 1 cup Watertea, drink whole cup - removes K from GI track • kidney stones - flush out with beer, or beer + c[[handra]]prabha (200 mg) TID • Ghritavarti - suppository, dip cotton in tiktaGhrita and make finger size tampon, introduce into rectum, dissolves by rectal temperature and stimulates mass [[peristalsisganesh dhauti - dip middle finger into Castor oil, rub around anal orifice a couple of times, enter in to rectum up to linea alba - switch that activates muLadhara]] chakra

[[ear]]lier stage of rectal [[prolapse]] - [[patient]] can do [[Ghrita]]varti and [[gan]]esh dhauti
do after good [[bowel]] [[movement]], [[wash]] [[anal]] [[orifice]] [[proper]]lly
= [[self]] induced [[basti]], awakens [[kundalini]] shakiti
[[gan]]esh - [[deity]] of mu[[Lad]]hara]] [[chakra]],  dhauti - to [[wash]] or clean

fecal matter stuck above linea alba - creates hemmorhoids, fissures, etc…

so must keep linea alba well lubricated

tenesmus - caused by K mucus stuck to mucus lining creates sensation to pass stools

Yoga asanas: inverted poses will help anuloma of vayu

[[shoulder]] s[[tan]]d, leg lifting, [[Plow pose]], [[sound]] [[sleep]] at [[night]] - [[burn]]s 200 calories
squatting [[pose]] - for 5 mins [[will]] [[burn]] 11 calories, everts [[pressure]] on [[liver]] and [[Spleen]]

Punarnava - Boerhaavia diffusaspreading hog Weed Sanskrit name: Punarnava

Common name: Spreading [[hogweed]]

botanical name: Boerhaavia diffusa Linn;

Parts Used: root, whole herb

constituents: phlobaphene, potassium, tannin, KNO3, K, Cl therefor it does not create potassium loss; N = potassium nitrate, punarnavine alkaloid, sulphates, chlorides, chlorates traces

affect on Vata, Pitta, Kapha: - + -

guna / attributes: none listed

rasa / tastes: M T; sweet, bitter

virya / energy: UÃna; heating

Vipaka / Post-digestive effect: katu; pungent

Pharmacological Actions: cardiac, diuretic, cough suppressant [[cerebral diuretic (white), diuretic, antirheumatic, vasodilator, laxative, antiepileptic, anticonvulgent, bronchodilator, expectorant; Kapoorbitter, stomachic, laxative, expectorant, diaphoretic, emetic, purgative, anthelMintic, febrifuge, snake venom antidote;

Indications: convulgence, ascites, edema, asthma, pericardial effusion, pleurisy with effusion, renal calculi, pulmonary congestion, adrenal stress, Spleen, liver, enlargement;

Contraindications: – dehydration

Affinity: rakta, meda; mutra vs, heart, respiratory tract

(DickherbalH:19:20)

(spreading hog weed) Punarnava - means does rejuvenation of tissue/ punar= again, nava= new Rasa: sweet, bitter Virya: heating Vipak: pungent action on doshas: V v P ^ K v 500 mg dose can increase P

properties: • active principle - punarnavine • contains boerhavic acid - has diuretic action • contains tannin - stimulates adrenals • has potassium nitrate - anti-flatulent, (K+ loss creates abdominal distention) • does rejuvenation of renal function, acts as urinary anti-bacterial, affinity to kidney • breaks down KD stones • improves glomerular threshold, tx acute glomerular nephritis • helps decrease serum cholesterol, tx lipideia • decreases blood sugardecreases BP because of diuretic action, but doesn’t create K+ loss like most diuretics • tx edema - extravasation of vessels into interstitial tissues, changes osmotic pressuremovement of fluid/ Punarnava maintains osmotic pressure - that’s why decreases swelling and no K+ loss • tx nephritic syndromeanti-rheumatic factor tx rheumatoid arthritis, goutaffects pulmonary immune function

abhraka - mica [[ash]], maintains [[pulmonary]] [[immune]] [[function]]

• mild laxative • good cardiac tonic

Tx: • tx CCF, ascites, pleurisy, asthma, anemia, cystitis, prostatitis, acute glomerular nephritis, pulmonary edema, cardiac edema, renal edema, pitting on pressure edema • best herb for polycystic kidneyglaucoma = increased intra[[ocular pressure, wash eyes with distilled Water of Punarnava or 1 tsp. Punarnava boiled with 1 cup Water for 3 mins, cool, strain • tx asthma, lung edema, bron[[chiectesis - dilation of bron[[chi and increased secretion of Kaphacystic fibrosis - Vata pusHing Kapha in pranavaha Srotas]] Kapha molecules responsible for fibrocystic changes Punarnava (500 mg), Pippali (250 mg), abhrak (250 mg), Kantakari (300 mg) -  tsp. TID • congestive heart failure - Punarnava (500 mg) + Arjuna (400 mg) + shringa bhasma (200 mg) • kidney stones - Punarnava does de-crystallization

[[Punarnava]] (500 mg) + [[Gokshura]] (400 mg) + [[c[[hand]]ra]]prabha ([[200 mg]]) + [[beer]] as 	[[anu]]pan - does [[renal]] flus[[Hing]], [[will]] pass [[small]] crystals 

uterine fibroids - kutki (300 mg), Chitrak (200 mg), Punarnava (500 mg) • low KD energy - corresponds to decreased glomerular threshold in Western medicine, use Punarnava with Gokshura or Shilajitdiabetes - Punarnava used with tikta to decrease blood sugarswelling - Punarnava tea basti

CI: hypoglycemia (DurveHrb:51)

Punarnava Boerhaavia diffusa/ Nyctaginaceae (S) Punarnava (what renews us) part used—-plant Energetics—–bitter, sweet/ heating/ pungent

KV - P+		

tissues——-plasma, blood systems——urinary, circulatory actions——- alterative, blood tonic, diuretic, rejuvenative Indications — - anemia, edema, difficult or burning urination, kidney stones, heart disease, alcoholism, hepatitis, hemorrhoids Precautions —–dehydration preparation —- - powder (250 to 500 mg), decoction

Punarnava literally means the plant that makes one new again and has a special power to renew our health and vitality. It rebuilds the blood and strengthens the kidney, improving its function and through revitalizing this key organ, aids in our oVerall health and vitality. Punamava is particularly good for conditions of weak kidney function leading to Water retention and edema. As a tonifying diuretic it is often combined with Gokshura. (LadYoga]]Hrb)

drink Punarava tea daily PG 200 mg BID pc heart problem with edema: Punarnava 500, Shringha bhasma 100, Abhrak 100, Arjun 300, Hawthorne berry 200, YG 200

Ajwain – Apium graveolens – wild celery seed] family name - umbelliferae part used - seed], root Rasa: katu-pungent Virya: ushna - hot Vipak: katu-pungent action on doshas: V v P ^ K v long-term increase Vata because drying, light, nerve stimulant

properties: • mainly used as diuretic because stimulates absorption from kidney, so release more fluids • stimulates GI track • antispasmodic, nerve stimulant, burns ama in GI track • carminative - herb that releases gasseed] - also aphrodisiac, antispasmodic

more c[[arm]]i[[native]] than the [[root]]

root - a little stronger for dieresis because lower in body

Tx: edema, UTI, colic, flatulence used with Gokshura, Punarnava - associated with kidney

(SpelmanHrb0699)
edema= shotha, 1 tsp. bhringaraj + 1 tsp. Punarnava make tea and boil with 1 cup of Water, BID - morning and evening, will act as diuretic (beauty of this diuretic is no potassium loss which usually leads to fatigue) • edema–, Punarnava, goksura 1/3 each 1/4t TID Jyotishmati - obesity/cholesterol/edema: steep O/N 1/2t 1 sip before and after meal = 6/dayedema–1/3 each of Kutaja, Punarnava, goksura (swelling ankle and face esp.)

Acu points: Sp 3, 6, 9 Traditional [[Chinese medicine Patent medicine Prescription: Wu Ling San and xiang]] Sha Liu Jun Zi wan

Wu Ling San powder of five herbs with Poria Aka Wu Ling San teapills (Wu Ling San wan) Ingredients Alisma plantago aquatica rhizome,Poria cocos fungus,Atractylodes macrocephala rhizome, polyporus umbellatus fungus, Cinnamomum cassia twig Ze xie, Fu ling, Bai Zhu, zhu ling, Gui zhi

xiang]] Sha Liu Jun Zi tang Saussurea and Amomi Combination, aka six Gentlemen Plus teapills xiang]] Sha Liu Jun Zi wan Ingredients: Atractylodes macrocephala rhizome, Poria cocos fungus, Codonopsis pilosula root, pinellia ternata rhizome, citrus reticulata peel, Amomum villosum fruit, Aucklandia lappa root, Glycyrrhiza uralensis root, Ziziphus jujuba fruit, Zingiber officinale rhizome-fresh,/br>Bai Zhu, Fu ling, Dang Shen Ban xia, Chen pi, Sha Ren, Mu xiang]], Gan Cao, Da Zao, sheng]] jiang


edema.txt · Last modified: 2018/02/26 18:11 (external edit)