Swelling and oedema (shotha)

Shopha (swelling) is described as a disease distinct from granthi, vidradhi and the many other diseases that have the shape of a swelling; it has its own features, arises in connection with skin and flesh, and may be uneven or even, large or small, or compact.

Swelling in people is of two kinds: one confined to a particular part and one arising in the whole body.

A very large, pot-shaped swelling is called vidradhi, swellings without an opening are granthi and those with an opening are pidaka; all are treated at the proper time with suitable drugs, poultices and other measures.

Swelling is of two kinds, unripe (ama) and ripe (pakva).

It is said to arise from vata, pitta, kapha, sannipata, blood and external (agantuka) causes, and so to be of six kinds.

A swelling that is particularly hard is unripe; one with fever, much burning heat and warmth is ripening (vidagdha), which the commentary places between unripe and ripe; one whose fever, pain and other severe troubles have gone and whose colour has changed is ripe (vipakva).

Swellings from vata, pitta and kapha show the signs and qualities of their own dosha and the sannipata swelling those of all three; the swelling from blood shows signs like the pitta swelling and is very black; the external (agantuja) swelling shows signs like the pitta and blood swellings and is red.

The unripe (ama) swelling is hard, slightly painful, firm (unchanged), of the same colour as healthy skin, only slightly warm, small and cold.

The burning (vidagdha) swelling has many kinds of severe pain and great heat, is badly discoloured and stretched like an inflated leather bag, hurts when standing, walking, sitting or lying, gives pain like a scorpion sting, and comes with much thirst and aversion to food.

The ripe (pakva) swelling has its pain calmed and is soft, not red but white, and reduced; it itches, the skin begins to break, there is pricking pain and wrinkling, it looks sunken, the pus inside moves about under finger pressure like water in a full leather bag, it is cold to touch and free of complications, and desire for food returns.

When the aggravated doshas in a swelling are very strong, when the treatment used to calm it is contrary, or when no external or internal treatment is given, the swelling does not subside but turns towards ripening; the commentary adds in brackets that such a swelling has three stages, unripe (ama), burning (vidagdha) and ripe (pakva).

The text says, citing the excellent Ayurveda samhita, that in all diseases medicines are to be applied according to the unripe (ama), burning (vidagdha) and ripe (pakva) stages; with this it introduces a brief account of swelling (shopha, vranashotha) and its treatment.

Swelling spread through the whole body, or in the middle of the body or half of it, with the other limbs dried up, is described as hard to cure.

Note: The verse has अर्धदेहे (half the body); the commentary prints गर्म शरीर.

Swelling that arises in a man's face and gradually moves to the feet, or in a woman arises in the feet and comes up to the face, is said to be fatal; swelling in the genital region, and swelling that settles in half the body and dries that half, are said to be fatal for both.