Introduction
In shvayathu (shotha) chikitsa, Charaka described granthi (tumor),
galaganda, apachi (scrofula) etc. while Sushruta as well as Madhava both
described arbuda and mentioned similarity in the symptoms of their
respective granthis and stated that granthi and arbuda are similar in site,
etiology, characters, doshas and dushya.Following are the six types of
arbuda:
- Vataja
- Pittaja
- Kaphaja
- Raktaja
- Mamsaja
- Medaja
Sushruta mentioned one more type of arbuda in kshudraroga called as
'sharkararbuda' (S.N. 13/25-27) and while describing prognosis (sadhyata) of
arbuda, Sushruta mentioned two more states of this as -
According to Samprapti- (S. N. 11/ 13): Increasing doshas,
invade the muscles and blood and produce round (vrittam), immovable
(sthiram), slightly painful (manda ruja), big (mahan), deep-seated (unalpa
moolam), slowly increasing (chira vruddhi), non-suppurating (apakam) tumors
of muscular tissue are called arbuda.
Roopa (Signs and Symptoms)
- Vataja arbuda
Mass is black in color, soft, resembles a bladder (bas (basti), and
when pricked exudes thin and pure blood. Patient feels different types
of pain, such as - expanding, tearing, pricking, pulling, churning and
cutting.
- Pittaja arbuda
Mass is red or yellowish - red in color and exudes large amount of warm
blood if pricked.
Patient feels severe burning sensation (dhoopyate), sucking pain
(chushyate), excessive suppurating (papachyate) is there and feels as if
burning with fire (prajwalativ).
- Kaphaja arbuda
Mass is cold in touch, not having any discoloration, very hard like
stone, slow growth rate, and when pricked exudes thick white puss
Patient feels mild pain with severe itching.
- Medaja arbuda
Mass will have increase or decrease in size in accordance to that of
body, unctuous (snigdha). If pricked exudes thick fatty material
resembling paste of sesame seeds or ghee.
Patient feels severe itching with no pain or mild pain.
- Raktaja arbuda
Increased dosha invades the blood, compresses and constricts the blood
vessels (sirastu sampidya- sankochya) gets suppurate and produces big
sized muscular tumor; studded all over with sprouts developing quickly
and discharging large quantity of blood constantly.
This makes the patient to suffer from pandu (anemia) and complications
of loss of blood.
- Mamsaja arbuda
This is said to be more common in those who are fond of eating
non-vegetarian food. Body assault, by the fist etc makes derangement in
mansa and gives rise to shotha (swelling), which is painless, smooth,
and same in color as of skin, non-supportive, hard like stone, and
immovable.
- Adhyarbuda
One more arbuda developing after, the course of the earlier on, is
known as adhyarbuda.
- Dvirarbuda
Another arbuda developing concurrently with the first one is known as
Dvirarbuda.
- Sharkararbuda
Vata and kapha both make site in mansa, sira, snayu and meda and
develops mass or tumor. When this mass bursts, it exudes like honey,
ghrita and vasa; then vitiated vata of that place dries up mansa and
produces crystals like sugar (sharkara).
Treatment
- Upanaha should be applied mainly to those arbuda, which are made up
of mansa (meat) and vesawar.
- Fomentation (nadi sweda) and blood letting by shringa (horn) should
be done periodically.
- Milk and kanji is to be processed first with the decoction of
vata-shamak drugs (drugs which alleviates vata, such as - devadaru).
Then oil is processed from the milk-kanji-decoction, which is called
shatpaki oil. The patient should drink this oil.
- Ghrita (ghee), oil and fat (vasa) processed with the above said
vata-shamak dravya (drugs) decoction, milk and kanji should be drank ·
Pittaj arbuda -
- In this type of arbuda mild fomentation and upanaha (poultice) is
preferred such as drava sweda.
- Poultice (upanaha) of drugs mentioned in kakolyadi gana triturate in
milk and kanji should be applied in lukewarm state (not so hot).
- Same drugs are applied on (bandhana), kakolyadi gana, kshirakakoli,
jivak, rushabhak, mudgaparni, mash-parni, meda, mahameda, amruta,
karkatshrungi, tugashiri, padmak, prapaundarik, ruddhi, vruddhi,
mridvika, jivanti and yashtimadhu.
- Mild purgatives should be used.
- Arbuda should be rubbed with the leaves of udumbara and gojivha,
priyangu, rakta chandan, lodhra, anjan and yashtimadhu mixed with honey
should be applied on it frequently.
- After blood letting local application of aragwadha, gojivha, kataphal
and krishna nishoth should be done.
- Processed ghee made up of krishna nishoth, girivha, anjan, draksha
rasa/ yavatikta juice, together with yashtimadhu kalka (paste) should be
given to the patient to drink.
Kaphaj arbuda
- To this kind of patients, after emesis and bloodletting (rakta
mokshan), local application of kalka is done. Kalka is made-up of
enematic and purgative drugs, such as - jimutak, koshataki, danti,
dravanti, nishoth etc.
- Kansya neel, shuka, langali, root of kakadani and faeces of pigeon
and paravat powdered and mixed with gomutra or ksharodak should be
applied over arbuda.
- Paste of nishpav, pinyak, and kulatha mixed with mansa (meat), curd,
and mastu should be applied on arbuda.
As flies approaches over this lepa they generate ova and maggots over
it. When partial mass is remained after eating by maggots, it should be
scrubbed (lekhan) and cauterized.
An arbuda, which is not deeply seated should be treated by kshara (alkali),
agnikarma and surgically.
- Decoction of jatipatra, karavir, and asphot should be used for
dressing the wound.
- After wound, dressing oil used is prepared by bharangi, vidanga,
patha, trifala etc.
Medorbuda
- After fomentation, excision should be made for blood letting, when
the blood stops suture the wound.
- Powder of haridra, grihadhum, lodhra, chandana, manashil and haratal
mixed with honey should be rubbed over this wound for cleaning
(shodhana).After clean up this wound karanja oil should be applied over
it.
- One should excise the mass completely because if doshas, if exist in
less quantity also are likely to develop new masses further.
Few lepas (local applications) that are used usually applied in all
types of arbudas.
- Yavakshara, vidanga, gandhak (sulphur) powdered in saratasya raktam
(blood of sarata i.e. girgit or chameleon) is used as local application,
cures arbuda without fail.
- Juice of poi shaka (upodika) is applied over arbuda and the leaves of
the same plant are used for dressing purpose over arbudajata pidika.
- Poi mixed with kanji and buttermilk added with saindhava subsides
arbuda.
- Gandhak, manashil, nagar, vidanga and naga bhasma added with krikalas
rakta (girgit or chameleon) and applied over mass subsides arbuda
quickly.
- Fmentation of snuhi and gandirika.
- Powder of haridra, lodhra, patanga, jaggery, griha dhum and manashil
mixed with honey and applied over sharkararbuda pacifies it.
Pathya-apathya (dos and don'ts)
- Pathya
- Puran ghrita (old ghee), shali rice, yava (barley), mudga (green
gram), patol, rakta shigroo, karavellak, shalishak vetagra, dry and
bitter dravya, all deepan (which improves digestion) dravyas,
guggulu and shilajatu.
- Apathya
- Milk, Ikshu and dugdha vikrutis (products made up of sugarcane
and milk e.g. curd, jaggery etc), meat of aquatic animals, sweet,
sour, heavy (guru) and products, which block channels (abhishyandi).
