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A 30-year male who worked as a plumber in Goa came to the OPD clinic with swelling of the left foot with severe pain with watery discharge for 5 days. The pain was a throbbing type with a severe burning sensation. He complained of inability to move the toes of the same leg.
Other vitals were normal. After local examination, all signs of inflammation (redness, calor, dolor, inability to move toes) were present. In addition, all clinical features of pittaja vrana shotha were present.
पित्तशोफ़ः पीतो मृदुः सरक्तो वा शीघ्रनुसार्योषादयश्र्चात्र वेदनाविशेषा भवन्ति / (सु. सू. 17/4)
ओषादयश्र्चेति आदिशब्दाच्चोषपरिदाहधूमायनानि / (Dalhana commentary)
The swelling in the Pittaja Vrana Shotha is slightly yellowish and reddish discoloration of the skin, with the skin being soft.
Nature of pain is चोष: Burning/Sucking/Heat/Burning type with a severe burning sensation like hot fumes coming out.
I decided to do leech therapy treatment- Jalauka Vicharana (leech application) followed by Vishaghna Lepa and Dashanga Lepa.
Internal Medication: Panchatikta Kashayam 40ml before meals
Sukshma triphala 2-2-2
Gandhak rasayan 2-2-2 vyanodan(after meals)
Combination of Sariva+ Manjista + Nimba churna 200 mg each + Rasamanikya 125mg in 3 divided doses with Panchatikta Kwatha.
Result: Immediately after Jalauka Vacharan, his pain was reduced substantially.
On the second day, the swelling subsided.
At present, he is on Vrana Chikitsa (dressing), with wound cleaning with Panchavalkala kashaya and then application with Jatyadi Taila. I continued with the same internal medicines as described above for 2 weeks.
Diet Suggestions: Avoid food which is too pungent (chilly), sour and salty. Avoid curd, mustard oil, fish and meat until the wound heals completely. We checked the blood and urine samples and found to be normal and non-diabetic. Cause of the swelling may be pulling off the hair follicle over the dorsum of the leg accidentally after friction with slippers.