Introduction:
- Vidradhi is an elevation on the surface of the skin which manifests with Oedema. It is S`hastrakarmasaadhyaVyaadhi.
- Charakaachaarya has explained Vidradhi as one of the types of the PramehaPid`akaa. But he has also stated that without suffering form Prameha, thesePramehaPid`akaa including Vidradhi can get manifested.
Nirukti:
- Dusht`aRaktaatimaatratvaat Sa VaiS`heeghramVidahyate |
TatahS`heeghravidaahitvaatVidradhiItiAbhidheeyate | (Cha. Su. 17/95)
- S`heeghravidaahaadVidradhih | (Su. Ni. 9/1 Gayadaasa)
Sampraapti:
- Dosha vitiate skin, Rakta, Maamsa and Medas. They are harboured on Asthi. Gradually, these Dosha create serious Oedema. This Oedema (S`hopha) has large base. There is pain. It is circular or rectangular. This S`hopha is called as Vidradhi.
Types:
- Baahya :
- It originates from skin, Snaayu and Maamsa. It resembles to tendons and is extremely painful.
- Aabhyantara :
- Dosha when enter interior of the body affecting Maamsa and Rakta (Asra), thereby causes deep seated abscess (Granthi), which is very painful.
- This Aabhyantaar (internal) Vidradhi may happen at heart (Hridaya), Kloma, Yakrit (Liver), Pleehaa (Spleen), Kukshi (Flanks), Vrikka (kidneys), Naabhi(Umbilicus), Vamkshan`a or Basti (Urinary Bladder).
- Due to vitiation of Blood (Rakta), the Vidradhi get suppurated quickly, due to this quick suppuration only, it is called as Vidradhi. (TatahS`heeghraVidaahitvaatVidradhiItiAbhidheeyate | (Ch. Su. 17/95)
- AabhyantaVidradhi manifests same as of Gulma (GulmaRoopin`am)
- Vidradhi again can be classified as:
- Vaatika
- Paittika
- S`hlaishmika
- Saannipaatika
- Types:
It is of 6 types:-
- Vaataja
- Pittaja
- Kaphaja
- Saannipaatika
- Kshataja
- Asrija
General guidelines to know:
- When Vidradhi suppurates completely and ruptures, then if Vidradhi is situated at upper side of the body (above the chest), it discharges out through mouth. If Vidradhi is situated at lower side of the body (below the umbilicus), it discharges out through the anus. When the Vidradhi is at umbilicus, after ripening it discharges through both mouth and anus.
- Completely ripened Vidradhi at Hridaya, Naabhi and Basti and SaannipaatikaVidradhi are incurable. They lead to death. So as soon as a person affects from Vidradhi, one should immediately get treated by Snehana, Virechana therapy.
- The general rule to treat Vidradhi is like Gulma.
- It is necessary that Vidradhi should be treated before the complications are manifested.
- Actually, Pid`akaa related to Prameha and those which are manifesting without Prameha have same line of treatment, as Dosha and Dooshya both are same in these types. D`alhan`a.
- It has been described that Pid`akaa are manifested due to negligence to treat Prameha. But it is also possible that without Prameha, Pid`akaa can be manifested. Unless and until these Pid`akaa get substantial root in the Dhaatu they are not manifested.
- S`haraavikaa, Kachchaapikaa and Jaalinee are difficult to tolerate and very serious in nature. They occur in such patients where Medas and Kapha are in excess.
- Sarshapee, Alajee, Vinataa and Vidradhi are due to dominance of Pitta and are possible in a person having moderately vitiated Medas and Kapha. These are curable.
Incurable condition for Vidradhi:
If Pid`akaa are manifested in a patient suffering from Prameha, at MarmaSthaana, Amsa, Guda (Anal region), Stana (Breasts), Sandhi (Joints), Paada (feet), then this patient does not survive.
Vaataja:
This Vidradhi is black in colour. It is Parusha. There is severe pain. This S`hotha manifests with different ways. This is VaatajaVidradhi. The secretions are thin (Tanu).
Pittaja:
This resembles to ripened fruit of Udumbara. It may be of S`hyaava (gray) color. There is Jvara and Daaha. It manifests quickly. It ripens / suppurates quickly. The secretions are yellow coloured (Peeta).
Kaphaja:
It resembles to an earthen vessel. It is whitish and cold to touch. It is stable. There is mild pain. It manifests with longer duration. It suppurates too lately. There is Kan`d`oo also. The secretions are white colored (Sita).
Saannipaatika:
There are different colored secretions, pain. The Ghaat`aala (The upper part) of the Vidradhi is large in size. It is irregular in size (Vishama). It is Asaadhya.
Kshataja / Abhighaataja:
Due to the trauma there is formation of wound. The heat at the wound gets spread due to Vaayu which provokes Pitta with Rakta. There is Jvara, Trishn`aa,Daaha. This is AagantuVidradhi which manifests same as Pitta Vidradhi.
RaktaVidradhi
- The Vidradhi is covered with multiple black colored blisters. It is grey colored (S`hyaava). There is severe burning sensation, pain and Jvara. It manifests with the symptoms of Pitta Vidradhi. This is RaktaVidradhi.
- RaktajaVidradhi manifests in the females only. If there is improper delivery of fetus or if Aparaa (Placenta) is not evacuated properly, then there isRaktajavidradhi which is also called as Makkalla. If this is not pacified within 7 days, then it gets suppurated within seven days.
According to the site of the manifestation, Vidradhi is of 9 types
- Gudaja
- Naabhigata
- Kukshigata
- Vamkshan`agata
- Vrikkagata
- Pleehaagata
- Hridayagata
- Yakritagata
- Klomagata
- When Pleehaagata, Yakritgata, Klomagata, Vamkshan`agataVidradhi_s burst out, they are drained in the upward direction.
- Other Vidradhi_s like Gudagata, Bastigata, Vrikkagata, Vamkshan`agata drain in the downward direction.
- Vidradhi may it be Apakva, Pakva, may it be large or small in size; if it is manifested on the Marma; then it is Krichchhrasaadhya.
Difference between Gulma and Vidradhi:-
- There is no root of the Gulma (Nibandhah NaAsti); where as Vidradhi has its root (Sanibandha)
- Doshathemselves are turned in to Gulma; in GulmaDosha doe not get harbor in to some other Dooshya; whereas in VidradhiDosha get harboured in to the Maamsa and S`hon`ita.
- Gulma is like a bubblein the water which manifest in the Srotas, it resembles to VaataGranthi, therefore it does not get suppurate (as there is no involvement of Rakta and Maamsa in the pathogenesis of Gulma); whereas Vidradhi is having Maamsa and Rakta as Dooshya, it gets suppurated.
AsthigataVidradhi:
Vidradhi manifested on the Asthi causes suppuration of Majjaa. When these suppurated MajjaaDhaatu can not drain out then it causes severe burning pain. Due to this heat produced in the Majjaa, there is severe pain. When this gets drained out, there is unctuous (Snigdha), white colored secretions which is cold to touch.
StanaVidradhi:
In the lactating or non lactating breasts, Dosha cause S`hotha residing in to the StanaSiraa. This manifests in to Prasootaa or Garbhin`ee. The S`hotha isGhana. This manifests as BaahyaVidradhi.
It does not manifests in the girls as the StanaNaad`ee are small in them.
Vidradhi: SampraaptiGhat`aka and Saadhyaasaadhyataa
Vidradhi | Baahya | Aabhyantara | Vaataja | Pittaja | Kaphaja | Saannipaatika | Kshatja /Aagantuja | Asrija/ RaktaVidradhi |
Rogamaarga | ||||||||
Vyaadhi_class | Streevis`Hisht`aVyaadhi | |||||||
Avayava | Tvak
Snaayu Maamsa Hridaya Kloma Yakrit Pleehaa Kukshi Vrikka Naabhi Vamkshan`a Basti |
Guda
BastiMukha Naabhi Kukshi Vamkshan`a Vrikka Yakrit Pleehaa Hridaya Kloma |
||||||
Saadhya | AdhonihsritaVidradhi | Saadhya | Saadhya | Saadhya | Saadhya | Saadhya | ||
Krichchhra | Marmagata
AntarvidradhishuBaahyatahBhinnamVidradhi Su. Ni. 9.25 D`alhan`a |
|||||||
Asaadhya | HridayasthaParipakvaVidradhi
NaabhijaParipakvaVidradhi BastijaParipakvaVidradhi Saannipaatika UrdhvanihsritaVidradhi Tridoshaja |
Asaadhya | ||||||
Dosha | Tridosha | VaataPrakopa | Pitta Prakopa | KaphaPrakopa | Tridoshaja | Pitta Prakopa | Pitta Prakopa | |
Dhaatu | RaktaDusht`iMaamsaDusht`i
AsthiAas`HrayaSu. Ni. 9.4, 34 D`alhan`a |
VidradhiChikitsaa
Reference:
A.H.Chi. 13, S.Chi. 16, C.Su.17, N.R. Vidradhi
SaamanyaChikitsaa:
- Vidradhi in primordial stage should be treated as ApakvaVran`aS`hotha and RaktaMokshan`a should be done frequently.
- Vidradhi in stage of suppuration should be treated as Vran`a (Bhinna)
- In all types of Vidradhi in Pakva /Apakva stage VidradhiNaas`hakaKashaaya (decoction) should be given combined with S`hilaajitu or Guggulu.
- Vidradhi should be treated in Apakvavasthaa (initial stage) and Pakvavasthaa/Paaka should be avoided as it becomes suppurative faster than Vran`ahence, it is termed as Vidradhi.
Treatment of VaatajaVidradhi: – (Aamavasthaa)
- Sechana with BrihatpanchamoolaKvaatha
- Lepa of VaatghnaGan`aSneha
- Upanaaha(Poultice) of Audaka / AnoopaMaamsa, AmlaLavan`a Siddha Sneha,Ves`havaara, Kris`haraa.
- Rakatamoks`han`a
- Siraavedha should be done at KoorparaSandhi (at Elbow Joint).
- Svedana with Dugdha and Paayasa.
- Vran`aRopan`a with BhadradaarvaadiGan`a
- S`hodhana with TrivritadiGan`aSneha
- Vran`a Ropan`a with Vidaryaadi Trivritta Gan`a Sneha (After Vidradhi Bhedana)
VaatajaVidradhi: – (Pakvavasthaa)
- Bhedana followed by Vran`aS`hodhana and Sechana with BrihatpanchamoolaKvaatha
- Vran`aRopan`a with BhadradaarvaadiGan`a, Saalavan`aTaila.
Treatment of PittajaVidradhi: –
- Sechana with KsheeriVriksha Siddha Jala / Kvaatha
- Lepa with Yasht`yaadi Kalka, Saarivaadi Kalka
- Vran`aRopan`a with NyagrodhaadiGan`a Siddha Ghrita and Manjist`haadi Kalka(After VidradhiBhedana)
- Seka with JeevaneeyaGhrita with S`harkaraa, Ikshu Rasa, Dugdha
- Raktamokshan`a
- Siraavedha should be done at KoorparaSandhi (at Elbow Joint).
- To pacify Daaha and Vedanaa (pain and burning sensation) purgation with TrivritaadiChoorn`a should be administered
- Parisheka with KsheeriVrikshaKashaaya and AudakaDravyaKashaaya
Treatment of KaphajaVidradhi: –
- RookshaSvedana with Isht`ikaa, Sikataa, Losht`a, S`hakrit, Tusha, Paamshu and Gomootra.
- Kashaayapaana
- Vamana
- Aalepa
- Raktamokshan`a with (Alaabu) (Refer: – Alaabu Karma)
- Siraavedha in mid axillary line (VaamaPaarshvaKakshaaStanantarashrayaAdhahDes`ha) between Axilla and Mammary gland.
- Sechana / Dhaavana with AaragvadhaadiGan`a Siddha Jala
- Lepa with Saktvaadilepa
- Vran`aRopan`a with KulaatthaadiTaila (After VidradhiBhedana)
Treatment of RaktajaVidradhi: –
- Same as PittajaVidradhi
- Siraavedhaa should be done at KoorparaSandhi (at Elbow Joint).
Treatment of AagantujaVidradhi:
- Same as PittajaVidradhi
Treatment of KshatajaVidradhi: –
- Same as PittajaVidradhi
Treatment of Aabhyantara / Antarvidradhi: –
- General treatment: –
o Snehana
o Svedana
o GulmaChikitsaa
- Aamaavasthaa:
o Vaarun`aadiGan`aKvaatha with OoshakaadiGan`a Kalka Prakshepa
o Ghrita made of Vaarun`aadiGan`a, OoshakaadiGan`a and VairechanikaDravya_s in morning.
o Vaarun`aadiGan`a, OoshakaadiGan`aVairechanikaDravya_s Siddha Taila should be used for Aasthaapana /AnuvaasanaBasti.
o MadhuS`higru Kalka + YathaaDosha Kalka Avaapa (to pacify the specific Dosha_s)
o YathaaDosha Kalka Kvaatha added with S`hilaajatu (to pacify the specific Dosha_s)
o GuuguluPradhaanaDevadaaruKvaatha (for Vaatapraadhaanya) or S`hunt`hee Siddha Kvaatha (for Kaphapraadhaanya)
o Snehana
o Upanaaha
o Anulomana
o Siraavedha should be in mid axillary line (VaamaPaarshvaKakshaaStanantara) if Vidradhi is in left side. (S.Sha 8)
o Siraavedha should be in mid axillary line (Dakshin`aParshvaKakshaaStanantara) if Vidradhi is in right side. (S.Sha 8)
Treatment for AabhyaantraVidradhi with Raktadusht`i and Gambheeranugatatva: –(Deep situated internal abscess with Vitiated blood)
Siraavedha should be done in mid axillary line (KakshaaStanaantaraAdhah Desha) between Axilla and Mammary gland in lower side (S. Sha. 8)
VidradhiChikitsaa:
In Vidradhi bloodletting is done with the help of S`hringa etc. adjacent to the region of abscess (Vidradhi) from Siraa.
Treatment of Antarvidradhi:
In internal abscess treatment should be same as Gulma considering Dosha_s.
- Pachyamaanaavasthaa:
o Vidradhi situated in Kost`ha when attains Pachyamaanavasthaa protrudes externally, indicating this protuberance as the site of affliction.
o Upanaaha should be applied locally to attain Pakva / BhinnaAvasthaa.
Examination of Pakva / Bhinna or Pakvaavasthaa:
- Regression of tenderness locally.
- Regression of symptoms like burning sensation.
- Oozing of the vitiatedDosha_s from the Vran`a.
- Treatment of VidradhiPakvaavasthaa:
o Similar to Vran`aChikitsaa
o Allow Pus discharge through (Oordhva /Adhah) upper / lower parts of body to flow off.
Vaarun`aadiGan`aKvaathaMadhuS`higru Kalka/Yavaagoo.
o Management of complications. o After 10- 12 days S`hodhana with Trayamaan`a / TailvakaGhrita o TiktakaGhritaPaana.
Treatment in Raktaja Pittaja VaatajaVidradhi: – Siraavedha should be done at Baahu (at Elbow Joint).
o Bhedana o Vran`a vat Upachaara
o Vaarun`aadiGana or MadhuS`higruChoorn`a added in Maireeya, Dhaanyaamla, Suraa, Aasava o S`higru Moola Jaala Siddha Sidhharthaka Odana o Yava Kola KulatthaYoosha. o TilvakaGhrita (of Vaatvyadhi) in a low dose. o TrivritaadiGan`aKvaatha
Treatment of AsthimajjaGataVidradhi (Osteomyelitis)
Treatment of VidradhiVran`a –Devoid of Pus and foreign body
Treatment of MajjagataVidradhi (SraaviAvasthaa) Sams`hodhanaDravya_sKvaatha
Treatment of StanaVidradhi
Special precaution: Avoid Upanaaha.
Pathya:
Apakvaavasthaa
Pakvaavasthaa
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