Vruddhi Causes, Types, Symptoms, Prognosis, Ayurvedic treatment

Article by Dr Raghuram Y.S. MD (Ay) and Dr Manasa, B.A.M.S
Vruddhi means to increase. This term has been used at many instances in Ayurveda and has to be understood according to the context and situation. 

Example, Vata Vriddhi indicates pathological increase in Vata which may lead to many neurological, neuromuscular and degenerative diseases, Rakta Vriddhi indicates pathological increase of blood tissue which leads to many infections, skin diseases, gout, bleeding disorders, etc, Medo vriddhi indicates pathological increase of fat tissue which leads to the manifestation of obesity and weight related health issues etc.

But when the term ‘Vriddhi’ is not used with any suffix or prefix, it indicates only one condition – ‘Vrushana or Mushka or Andakosha Vriddhi’ i.e. swelling in the scrotum (small bag like structure which holds the testes in men), i.e. variants of orchitis.

Causes

The causes of Vriddhi have not been explained in the treatises. Charaka has included Vriddhi in the context of ‘Shotha’, the chapter which deals with ‘Swelling’ and its types. Thus according to Charaka, Vriddhi is a type of Shotha, therefore all the causes (etiological factors) which cause Shotha should be considered as nidana (causative factors) of Vriddhi also.

Below mentioned are the causative factors of Shotha and Vriddhi –
Charaka Chikitsa Sthana 12th chapter

Kshara amla teekshna ushna guru bhojana – Excessive intake of foods which are alkaline, sour in taste, intense, sharp and corrosive, very hot in nature and heavy for digestion by those people who have been already debilitated and emaciated due to excessive administration of shuddhi (cleansing treatment procedures in the form of Panchakarma treatments), due to long standing (chronic) diseases) and due to lack of proper food and nutrition (or due to non-availability of good quality and quantity food)

Excessive consumption of –

• Dadhi – curds
• Ama – unprocessed foods
• Mrut – mud
• Shaka – green vegetables
• Virodhi – mutually incompatible foods
• Dushta – contaminated foods
• Garaopasrushta – food contaminated or poisoned by artificial poisoning, food poisoning

Arsha – as an effect of piles or hemorrhoids

Acheshta – lack of physical activities and exercises, sedentary life

Na cha deha-shuddhihi – Not administering shodhana or body cleansing treatments (Panchakarma – including Vamana or Therapeutic emesis, Virechana or therapeutic purgation, Vasti – medicated enemas, Nasya – nasal medication and Raktamokshana – bloodletting) in spite of their requirements

Marma upaghata – injury to the marmas (vital points in the body formed by convergence of muscles, blood vessels, ligaments and nerves, bones and joints, which on injury cause damage, disorders, deformity and or death)

Vishama prasuta – miscarriage or abortion (artificial or untimely or induced)

Mithya upachara – Improper administration of Vamana etc panchakarma procedures (shotha occurs as a complication of improperly managed Panchakarma)

vAta pitta zleSma zoNita medo mUtra Antra nimittAH sapta vRddhayaH|
tAsAM mUtra Antra nimitte vRddho vAta samutthe kevalam utpatti hetuH anya tamaH||(su.ni.12/3)

According to Sushruta – Vriddhi is of 7 types, they are:

• Vata Vriddhi – caused due to vitiation of Vata
• Pittaja Vriddhi – caused due to vitiation of Pitta
• Kaphaja Vriddhi – caused due to vitiation of Kapha
• Shonita Vriddhi – caused due to vitiation of rakta or blood
• Medo vriddhi – caused due to excessive deposition or vitiation of fat tissue
• Mutra Vriddhi – caused by vitiation of Vayu and by accumulation of excessive mutra (urine, water, fluids)
• Aantra Vriddhi – caused by vitiation of Vata and by displacement of intestine from its place and heading into the groin and scrotum hence causing a bulge (vriddhi) in those places (hernia)

Pathogenesis

Pathogenesis (Samprapti) of Vriddhi
vRddho anUrdhva gatiH vAyuH zotha zUla karaH caran|
muSkau vaMkSaNatah prApya phala koSa abhivAhinIH||
prapIDya dhamanI vRddhiM karoti phalakoSayoH|(vA.ni.11)
adhaH pratihato anyatamo hi doSaH phalakoSa vAhinIH abhiprapadhya dhamanIH phalakoSayoH vRddhiM janayati, tAM vRddhim iti AcakSate||(su.ni.12/4)
yasya vAyuH prakupitaH zopha zUla karan caran|
vaMkSaNAd vRSaNau yAti vRddhiH tasya upajAyate||(ca.sU.18/15)

The Vayu which generally tends to move downwards, (normal course of movement of vayu) on getting vitiated moves upwards. Causing swelling (shotha) and pain (shula), the vitiated Vayu reaches the mushka (scrotum, testes) and vankshana (groin).

On reaching and getting localized in these places, the vitiated vayu contaminates the dhamanees (blood vessels) therein and causes vruddhi (engorgement, enlargement, and swelling) of the phalakosha (scrotum). This condition wherein the scrotum and groin get engorged and swollen up due to vitiated Vayu is called Vruddhi.

Sushruta giving a similar sequence of Pathogenesis explains the samprapti as ‘The doshas (Vata and also pitta, kapha) which are obstructed in the lower portion of the body i.e. in the kati (pelvic cavity) travel into the dhamanis (blood vessels) of the phalakosha (scrotum). On contaminating the dhamanis of phalakosha they cause swelling of the phalakosha. This condition is called Vruddhi.

Charaka also gives a similar opinion and tells – ‘The vitiated vayu on causing pain and swelling when enters the vankshana (groin) and vrushana (testes, scrotum) causes swelling of these structures leading to Vruddhi’.

Purvarupa

Purvarupa of Vruddhi (premonitory symptoms)
tAsAM bhaviSyatInAM pUrvarUpANi vasti kaTI muSka meDhreSu vedanA mAruta nigrahaH phala koSa zophaH ca iti||(su.ni.12/5)

• Vasti vedana – pain in the urinary bladder
• Kati vedana – pain in the pelvis
• Mushka vedana – pain in scrotum, testes
• Medhra vedana – pain in the penis
• Maruta nigrahaha – obstruction of vayu
• Phalakosha shopha – swelling of the scrotum

Types of Vruddhi

As mentioned above, Vriddhi is of 7 types. They are:

• Vataja vruddhi
• Pittaja vruddhi
• Kaphaja vruddhi
• Raktaja vruddhi
• Medaja vruddhi
• Mutraja vruddhi
• Aantra vruddhi

Note: Mutraja and Antraja Vruddhi are mainly caused by vitiated Vayu. Therefore they basically are Vataja Vruddhis with specific causes i.e. Mutraja Vruddhi caused by excessive accumulation of mutra and Aantra Vruddhi caused by displacement of aantra.

To make things clear, if vata vitiation causes vriddhi it is called Vataja Vruddhi. If in Vataja Vruddhi excessive accumulation of mutra (urine, water, fluids) take place in the scrotum, it will be called Mutra Vridhi. If in Vataja Vruddhi the aantra (intestine) gets displaced from its normal position and drips down into the scrotum causing the enlargement of the groin and scrotum, it will be called as Aantra Vruddhi. Therefore Mutra Vruddhi and Aantra Vriddhi are variants of Vataja vriddhi.

Signs and symptoms

Signs and Symptoms of Vriddhi (Lakshana)
vAtapUrNa dhruti sparzo rUkSo vAtAt ahetu ruk||
pakva uduMbara saMkAzaH pittAd dAha USma pAkavAn|
kaphAt zIto guruH snigdhaH kaNDUmAn kaThino alpa ruk||
kRSNa sphoTa AvRtaH pitta vRddhi liGgaH ca raktajaH|
kaphavat medasA vRddhiH mRduH tAlaphala upamAH||
mUtra dhAraNa zIlasya mUtrajaH sa tu gacchataH|
ambhobhiH pUrNa dhrutivat kSobhaM yAti sa ruk mRduH||
mUtra kRcchram adhaH syAt ca cAlayan phalakoSayoH|(vA.ni.11)

Vataja Vriddhi

– Vata purna dhruti sparsha – the scrotum looks like an air filled sac or bag (or balloon)
– Ruksha – scrotum looks dry
– Ahetu ruk – pain without any reason

Pittaja Vriddhi

– Pakwa udumbara sadrusha – appears like a ripe fruit of Ficus racemosa
– Daha – burning sensation in scrotum (whole body too)
– Ushma – raised heat in scrotum (in whole body too)
– Paka – suppuration, tends to form pus in scrotum

Kaphaja Vriddhi

– Sheeta – coldness in scrotum (cold on touch)
– Guru – feeling of heaviness in the scrotum
– Snigdha – scrotum looks unctuous, shiny and oily (on touch also)
– Kanduman – itching
– Katina – hard to touch (hard swelling, lot of fluid)
– Alpa ruk – feeble or negligible pain

Raktaja Vriddhi

Raktaja Vruddhi –
– Krushna Sphota Avruta – scrotum surrounded (enveloped) by black colored blisters (eruptions)
– Pakwa udumbara sadrusha – appears like a ripe fruit of Ficus racemosa
– Daha – burning sensation in scrotum (whole body too)
– Ushma – raised heat in scrotum (in whole body too)
– Paka – suppuration, tends to form pus in scrotum
(Pakwa udumbara to Paka are same as in Pittaja Vruddhi)

Medaja Vriddhi

Medaja Vruddhi –
– Mrudu – scrotum is soft and smooth on touch
– Tala phala upamam – scrotum looks like a fruit of Borassus flabellifer or Asian Palymyra palm
– Sheeta – coldness in scrotum (cold on touch)
– Guru – feeling of heaviness in the scrotum
– Snigdha – scrotum looks unctuous, shiny and oily (on touch also)
– Kanduman – itching
– Katina – hard to touch (hard swelling, lot of fluid)
– Alpa ruk – feeble or negligible pain
(From Sheeta to Alpa Ruk, it is almost similar to Kaphaja Vruddhi)

Mutraja Vriddhi

Mutraja Vruddhi –
Mutraja vruddhi occurs in people who are habituated to hold on to their urge (reflex) for urination (mutra vega dharana). The symptoms of Mutraja Vruddhi are as below mentioned –

• Ambhu poorna dhrutivat kshobha – the scrotum feels like a bag filled with fluid
• Kshobha – fluctuates
• Mrudu – Soft in touch
• Sa ruk – associated with pain
• Mutra kruchchra – dysuria, difficulty in passing urine or painful urination
• Chalayana phala kosha – oscillating scrotum

Aantra Vriddhi

Aantra Vruddhi –
vAta kopibhiH AhAraiH zIta toya avagAhanaiH||
dhAraNeraNa bhAra adhva viSamAnna pravartanaiH|
kSobhaNaiH kSobhito anyaiH ca kSudrAntra avayavaM yadA||
pavano viguNIkRtya sva nidezAt adho nayet|
kuryAt vaMkSaNa sandhistho granthyAbhaM zvayathuM tadA||
upekSamANasya ca muSka vRddhim AdhmAna ruk stambhavatIM sa vAyuH|(a.hR.ni.11)
prapIDito antaH svanavAn prayAti pradhmApayanneti punaH ca muktaH||
antra vRddhiH asAdhyo ayaM vAta vRddhi samAkRtiH|

Specific causes

Vata prakopaka ahara – foods which cause vitiation of Vata
Sheeta toya avagaahana – excessive bathing by keeping the body dipped in a tub of cold water (cold tub water bath), swimming

Dhaarana eerana – withholding the naturally impending body urges or reflexes like those of defecation, urination, passing the flatus etc or forcibly trying to expel those urges (creating artificial reflexes or urges) when they have not manifested

Bhaara – excessive weight lifting
Adhwa – excessive walking
Vishama anna – incompatible or unwholesome foods
Pravartanaihi – excessive physical activities (violent physical activities or activities which involve excessive moving or throwing of limbs)
Kshobhana – irritating or provoking activities (brisk activities)

The Vayu getting aggravated due to the consumption and exposure to the above said causes narrowing (shrinks) of a part of intestine and displaces it from its normal site. After displacing the intestine from its normal site, the vitiated vayu further pushes the part of the intestine into the groin (inguinal region, folds between thigh and scrotum) and causes a swelling which resembles a granthi (cyst, a cavity filled with fluid). If neglected, the vitiated vayu further pushes the intestinal part downwards. At the same time, the vitiated vayu also moves further down into the scrotum and causes swelling of the scrotum. This condition is called Aantra vruddhi.

(Aantra=intestine, Vruddhi=enlargement, swelling, protrusion).

Symptoms

– Vankshana shotha – swelling in the groin
– Vrushana (mushka) vruddhi – swelling in the scrotum
– Aadhmana – distension of the scrotum
– Ruk – pain
– Stambhana – stiffness or rigidity of the scrotum

– Prapeedayanto antaha swanavaan prayaati pradhmaapayanneti punaha cha muktaha – if the scrotum is pressed, the intestinal part moves back into the abdomen (inguinal canal) and when the pressure is released the intestine once again bulges and protrudes into the scrotum causing the swelling of scrotum

– Vata purna dhruti sparsha – the scrotum looks like an air filled sac or bag (or balloon)

– Ruksha – scrotum looks dry
– Ahetu ruk – pain without any reason

Note: The last 3 symptoms from Vata purna to Ahetu Ruk are same as Vataja Vruddhi, we can recollect that Aantra Vruddhi is a variant of Vataja Vruddhi.

Aantra vriddhi is said to be asaadhya (difficult to cure).

Sadhya Asadhyata

Prognosis of Vriddhi (sadhya asadhyata) –
The Vruddhi in which the vitiated vayu fills up both the mushka (scrotum) along with coils of intestines dipping down into both sides of scrotum and getting matted with it is said to be asadhya or incurable.

Similarly, the antra vruddhi which looks and resembles like Vataja Vriddhi is said to be asadhya or incurable.
Among all the types fo vriddhi, Aantra Vruddhi is said to be asaadhya or incurable.

Treatment

Treatment of Vruddhi (Chikitsa)

Vata Vruddhi Chikitsa

In Vata Vruddhi, snigdha virechana (purgation with medicated oils or ghee) should be administered as and when it is possible.

For this milk mixed with Eranda Taila (castor oil) should be consumed daily for at least 1 month.

Eranda taila (castor oil) mixed with Guggulu (Commiphora mukul) and go mutra (urine of cow) is also beneficial in Vataja Vriddhi.

According to Sushruta:

• Traivrut sneha – Initially the patient of Vataja Vruddhi should be administered with Traivrut or Trivrut sneha mentioned in the context of Vata Vyadhi. Later he should be subjected to Swedana (sudation, fomentation). On the 15^th day (keeping the first day of snehana as first day) Virechana or therapeutic purgation should be administered.
• Koshamradi taila – Alternatively, the oil processed with Koshamra (Schleichera oleosa), Lodhra (Symplocos racemosa) and eranda phalas (fruits of castor plant) should be given for oral consumption
• Eranda taila – Castor oil should be given mixed with hot milk for 1 month
• Niruha Vasti – After the Virechana and after a gap of 8 days, Niruha Vasti (herbal decoction enemas) prepared with kwatha (decoction) and kalka (paste) of Vatahara dravyas (herbs which are anti-vata or antagonistic to morbid vata) should be administered.
• Bhojana – After Niruha proper diet comprising predominantly of mamsarasa (meat soup) and shali (rice) should be given.
• Anuvasana Vasti – After Niruha vasti and recommended diet, Anuvasana Vasti (enemas using medicated oils) is administered with Yashtimadhu taila (oil)
• Pralepa – Later anointments using sneha (medicated oils), upanaha (poultices) and Vatahara pralepa (paste prepared from herbs having anti-vata properties) is done over the afflicted area
• Pachana – the vruddhi which has not matured should be allowed to ripen
• Bhedhana – After the unripe vruddhi has been ripened, bhedhana or incision should be done done on the scrotum below and to the side of the raphe (the fold or line which divides the scrotum into left and right halves), meanwhile protecting it.

Pittaja Vruddhi Chikitsa

Raktamokshana with Jalauka – In Pittaja Vriddhi raktamokshana (bloodletting) should be done by using jalaukas (leech application).

Chandanadi Kalka – The paste made by mixing Chandana (sandal wood), Madhuka (Liquorice), Kamala (lotus), Usheera (Vetiveria ziznioides) and Neela kamala (blue variety of lotus) should be applied over the Pittaja Vruddhi. This will relieve burning sensation, swelling and pain associated with pittaja vriddhi.

The treatments and medicines advised in Pittaja SHotha (swelling caused by pitta) should also be administered in pittaja vriddhi.

According to Sushruta:
In apakwa pittaja vruddhi (immature or unripe pittaja vruddhi), treatment should be done on the lines of pittaja granthi (cystic swelling caused due to morbid pitta)

In pakwa vruddhi (ripe vruddhi), bhedana (incision) should be done and its shodhana (cleansing) should be done by applying madhu (honey) and ghrita (ghee)

After cleansing the vruddhi, ropana taila and ropana kalka (oils and paste of medicines which have wound healing properties) should be applied

Kaphaja Vruddhi Chikitsa

Shuntyadi Kwatha – The decoction prepared with Shunti (ginger), Maricha (black pepper), Pippali (Long pepper), Haritaki (Terminalia chebula), Bibhitaki (Terminalia bellirica) and Amalaki (Emblica officinalis) mixed with Yava kshara (alkali prepared by burning the whole plant of barley) and Saindhava Lavana (rock salt) is very useful in curing Kaphaja Vridhi. It is also a good purgative.

Below said are also beneficial:

• Katu-Teekshna-Ushna lepa – anointments of pastes made up of medicinal herbs which are pungent in taste, intense acting and hot in nature
• Ruksha – dry comforts, drying treatments
• Sweda – fomentation, sudation, steaming, sweating treatment
• Parisheka – sprinkling of scrotum with warm medicinal liquids
• Upanaha – warm poultices over the scrotum
• Sarva ushna upachara – all type of warm comforts

According to Sushruta:
Ushna veerya dravya lepa – Pastes of medicines of herbs having ushna veerya (hot potency) of the likes of Pippalyadi gana group of medicines or Vachadi gana group of medicines or Mushkakaadi group of medicines grinded or rubbed with gomutra (urine of cow) should be applied.

Daruharidra kwatha – Decoction of Daruharidra (Berberis aristata) mixed with Gomutra (urine of cow) should be given for oral consumption.

Jatyadi Taila – After the vruddhi gets ripe and opens up, it should be applied with Jatyadi taila oil for healing purpose

Raktaja Vruddhi Chikitsa

Muhurmuhu jalaukabhihi shonitam haret – repeated bloodletting using leeches
Virechanam – purgation therapy (therapeutic purgation) with the medicines mixed with sugar and honey
Sheeta pralepa – cold application of pastes prepared with the herbs having cold potency (quality) over the scrotum

Sarva pittaha kriya – all the treatments and medicines which are antagonistic to pitta

Pitta Vruddhi haram chikitsa – all measures which have been mentioned in the Pittaja vruddhi shall be administered in raktaja vriddhi also

Medoja Vruddhi Chikitsa

Swedana and Pralepa – Medoja Vruddhi should be given swedana (fomentation) followed by application of paste of medicines belonging to Surasadi Gana group of herbs.

According to Sushruta:

• Swedana – initially fomentation should be given
• Lepa – After swedana, the paste prepared with Surasaadi gana group of medicines or shirovirechana dravyas should be applied lukewarm.
• Pattika – bandage should be applied
• Darana – excision should be done with the help of vruddhipatra shastra (scalpel), a specific instrument used for cutting open the vruddhi.
• Medo nirharana – After excising the Vruddhi, the deposited meda should be scraped and removed from the scrotum
• Bandhana – After removing the fat, Kasisa (Green vitriol) and Saindhava Lavana (rock salt) should be applied and Gophana or Sthagika bandhana (Sling or stump bandage) should be done.
• Ropana – After the vranas (wounds) gets cleansed after the bandaging, Manashiladi taila oil should be applied for further healing

Mutra Vruddhi Chikitsa

Swedana – Fomentation should be given with decoction prepared from Shirovirechana dravyas (herbs used for nasal medication and head cleansing) mixed with Gomutra (urine of cow). After swedana, the scrotum should be tied (bandaged) with a sterile cloth.

Vedhana karma – The vruddhi should be punctured little below and to the side of the raphae (suture or fold running at the centre of the scrotum, looking like a dividing line seen to divide the scrotum into left and right parts). Vedhana or puncture of the Mutraja Vruddhi should be done using Vrihimukha shastra (an instrument similar to trocar and cannula used for draining the fluid from the hydrocele vis-à-vis mutraja Vruddhi or Jalodara vis-à-vis ascites). This allows draining of the fluid which has collected in the mushka (scrotum) and gives relief from the symptoms of mutraja vruddhi.

Bandhana (bandaging) – After removal of the instrument Sthagika bandhana (stump bandage) should be done. The bandage should be regularly changed and recurrent bandaging for the stump should be done.

Ropana – After the wounds get cleansed after the bandaging, Ropana dravyas (wound healing medicines) should be used.

Aantra Vruddhi Chikitsa

Vata Vriddhi chikitsa – Vata Vruddhi Chikitsa should be done in the Aantra Vruddhi which is devoid of discharges or in aantra Vruddhi which hasn’t reached the scrotum

Agni karma – Swedana (fomentation) should be given to the scrotum with agni (fire), i.e. fire cauterization in cases of aantra vruddhi which has not reached the scrotum.

Vankshana daha – According to Sushruta, agni karma should be done over the vankshana (inguinal region) to prevent the descent of the intestine into the scrotum. This should be strictly done in cases of vruddhi wherein the intestine has not yet reached the scrotum but is causing a bulge in the groin (about to enter the scrotum). Agni karma or cauterization with fire should be done using ardhendu shalaka (cauterization instrument which is having the shape of ardha indu or half moon). The aantra vruddhi which has descended into the scrotum should be discarded. (According to Sushruta, the hernia which has descended into the scrotum is difficult to treat).

Padangushta daha – Daha karma (fire cauterization) should be done on the Big toe (angushta) in viparyaya method. To do this, the skin over the Angushta Madhya (middle of the toe) is cut open and cauterization is done. If it is right sided hernia, daha karma should be done over the left toe. If it is left sided hernia, daha karma should be done over the right toe. This method is called vyatyasa krama.

Sira vedha – To prevent the progression of the aantra vruddhi into the scrotum, siravedha – vein-section should be done. This siravedha should be done over the vein located above the Shanka sthana (temple) and near to the ear. Care should be taken to protect the suture therein. The sira vedha should be done in vyatyasa krama i.e. sira vedha should be done on the right side in left sided hernia and on the left side in right sided hernia.

Formulations for Aantra Vruddhi

Bala-Eranda – Eranda Taila (castor oil) prepared and processed with the decoction of Bala (Sida cordifolia) is highly effective to relieve Aadhmana (distension and flatulence) and cure Antravruddhi associated with pain.

Radnadi Kwatha – The decoction prepared from the below mentioned ingredients should be taken mixed with eranda taila (castor oil) to get relieved from aantra vruddhi.

• Rasna – Pluchea lanceolata
• Yashtimadhu – Liquorice
• Guduchi – Tinospora cordifolia
• Erandamula – Roots of Castor plant
• Bala – Sida cordifolia
• Aragwadha – Cassia fistula
• Gokshura – Tribulus terrestris
• Patola – Pointed gourd
• Vasa – Adhatoda vasica

Vishala kashaya – Decoction prepared with Vishala mula churna (powder of the roots of Citrullus colocynthis) mixed with Eranda Taila (castor oil) and milk is beneficial in aantra vruddhi

Pippalyadi Lepa – Paste of Pippali (long pepper), Jeeraka,  Kushta (Saussurea lappa), Badara (jujube), Shushka gomaya (dried cow dung) made in Kanji (fermented herbal liquid)

Devadarvadi Pralepa – Paste of Devadaru (Cedrus deodara), Mishi (fennel seeds), Vasa (Adhatoda vasica), Takali mula (roots of Clerodendrum multiforum) and Saindhava Lavana (Rock salt) mixed in honey should be applied on the scrotum swelling to relieve aantra vruddhi

Classical formulations for Vruddhi

Vachadi Kalka – Paste of Vacha (Acorus calamus) and Sarshapa (mustard seeds) should be applied over the scrotum (useful in any type of swelling formed over the scrotum)

Shigru-sarshapa kalka – Paste of Shigru (drumstick) and Sarshapa (mustard seeds) when applied destroys shotha (swelling), kapha (morbid kapha) and vayu (vitiated vayu)

Narayana Taila – Medicated oil in the name of Narayana Taila should be used in the form of pana (internal, oral consumption), abhyanga (massage) and vasti (enema) helps in Anda vruddhi (inguino-scrotal swelling)

Gomutra-Eranda – Gomutra mixed with castor oil admixed with shuddha parada and shuddha gandhaka or Kajjali is beneficial in Anda kosha vruddhi (scrotal swelling)

Phalatrikadi kwatha – Decoction of Haritaki (Terminalia chebula), Bibhitaki (Terminalia bellirica) and Amalaki (Emblica officinalis) mixed with gomutra (urine of cow) is extremely helpful in combating Vata-Kaphaja shotha i.e. scrotal swelling caused by morbid vata and kapha

Plakshadi Pinda – Bolus prepared from the paste of Plaksha (Ficus lacor), Bibhitaki beeja (seeds of Teminalia bellirica), Shunti (ginger) and Nirgundi (Vitex negundo) mixed in honey and ghee should be used for rubbing against the swollen scrotum. This can also be used for oral consumption.

Daruharidra – Powder of Daruharidra (Berberis aristata) mixed in cow urine
Ardraka swarasa – Fresh ginger juice mixed with honey

Haritaki-Erandadi yoga – Powder of Haritaki (Terminalis chebula) fried in Eranda taila (castor oil) should be taken mixed with powders of pippali (long pepper) and saindhava lavana (rock salt)

Swadamstradi Yoga – Powder of Swadamshtra (Tribulus terrestris), Saindhava lavana (rock salt), shunti (ginger), musta (Cyperus rotundus), devadaru (Cedrus deodara), Vidanga (Embelia ribes), Pashanabheda (Bergenia ligulata) and Lodhra (Symplocus racemosa) should be given mixed with ghee

Pathya Apathya (Beneficial and non-beneficial things in Vruddhi)

Pathya

Pathya (beneficial and wholesome things)

• Samshodhana – cleansing treatments in the form of panchakarma methods of treatments, mainly Virechana (therapeutic purgation) and Vasti (therapeutic enemas)
• Vasti karma – therapeutic enemas
• Raktamokshana – bloodletting
• Sweda karma – fomentation, sweating therapy
• Lepa – anointments of medicinal pastes
• Vankshana daha – giving heat or cauterization using heated ardhachandrakara loha (iron instrument in half moon shape) over inguinal region
• Bahu sira vyadha – bloodletting should be done through vein-section i.e. cutting the veins in the shoulder in vyatyasa krama i.e. if the right part of scrotum is swollen, the sira in the left shoulder should be cut and if the left scrotum is swollen, the sira in the right shoulder should be cut
• Shastra vidhi – surgical process according to the condition of the disease should be done
• Rakta shali – red variety of rice
• Eranda taila – castor oil
• Vamana – therapeutic emesis
• Dhanwa amisha – flesh of animals living in desert areas
• Ushna jala – hot water
• Takra – buttermilk

Single herbs

Single herbs useful in Vriddhi, which are also mentioned under pathya

• Eranda – Ricinus communis, castor plant
• Surabhi jala or go mutra – cow urine
• Shigru phala – drumstick
• Patolam – pointed gourd
• Punarnava – Boerhavia diffusa
• Gokshura – Tribulus terrestris
• Agnimantha – Premna integrifolia
• Tambula – betel leaves
• Haritaki – Terminalia chebula
• Rasna – Pluchea lanceolata
• Rasona – garlic
• Priyangu – Callicarpa macrophylla
• Grunjanaka – carrot
• Madhu – honey
• Kaumbha ghrita – 100 years old ghee

Apathya

Apathya (unwholesome, non-beneficial thins)

• Aanupa mamsa – flesh of animals living in marshy areas
• Dadhi – curds, preparations made in large quantities of curds
• Masha – black gram
• Pishta – flour, flour preparations
• Dushta anna – contaminated food
• Upodika – Basella alba
• Guru dravya – food which is heavy to digest
• Shukra vega dharana – forcibly controlling the ejaculation reflex during sex or urge (reflex) to ejaculate semen or sexual desire
• Vega dharana – forcibly controlling the natural body urges or reflexes Example, the urge for defecation, urination, hunger etc
• Prushta yana – travelling on animal backs
• Vyayama – excessive exercises
• Maithuna – excessive indulgence in sex
• Ati ashana – excessive consumption of foods (over-eating)
• Adhwa – excessive walking
• Upavasa – fasting in excess

Ayurvedic medicines

Useful Classical formulations for Vruddhi

• Punarnavadi Kashayam, Dashamulam Kashayam
• Gandharvahastadi Kashayam, Dashamulapanchakoladi Kashayam
• Punarnavadi Mandura, Kanchanara Guggulu
• Punarnavadi Guggulu, Shilajatu
• Vanga Bhasma, Trivanga Bhasma
• Punarnavasavam, Triphala Churna
• Haritaki Churna, Shotari Mandura
• Vruddhivadhika Vati, Arogyavardhini Vati
• Chandraprabha vati, Dashanga Lepa (external)

Effective decoctions (Vriddhihara Kashayam) from Sahasrayogam

Ref – Sahasrayogam, Kashaya Prakaranam, 42

a. Lashunadi Kashayam

b. Lashuna Erandadi Kashayam

2. Maha Rasnadi Kwatha

Other effective formulations for Hernia (Sahasrayogam)

Sukumara Ghritam
Dhanwantaram Ghritam
Varanadi Ghrita
Dhanwantaram Tailam
Hinguvachadi Choornam
Anthrakutharam Rasa / Gulika
Vriddhihara kashaya
Parpanadi Ghrita
Trikatvadi choorna
Vidanga Rasnadi choornam
Kukkuda Rasayana
Rasna Yashtyadi Kashaya

Modern correlation

Vriddhi and its modern counterparts (comparative study) –
Vriddhi is a term generally used for swelling of scrotum. Therefore all forms of orchitis (swelling of tests, inflammation of testes and or scrotum) can be clubbed under the term Vriddhi. Therefore according to modern day medicine Vriddhi can be equated to Orchitis or Epididymo-orchitis (inflammation of epididymis and testes, scrotum).

Vataja Vruddhi can be compared to – Chronic or sub-acute orchitis
Pittaja Vruddhi can be compared to – Acute orchitis
Kaphaja Vriddhi can be compared to – Chronic or Tubercular orchitis
Medoja Vriddhi can be compared to – Scrotal Elephantiasis or simple tumour
Raktaja Vruddhi can be compared to – Haematocele (filling of blood in the scrotum)

Mutraja Vruddhi can be compared to – Hydrocele (collection of fluid or water in the scrotum), here hydrocele has nothing to do with mutra or urine, and probably the term is given because the part of the body in which the swelling occurs (scrotum and testes) is seen close to the part of the body which voids urine (penis, urethra?)

Aantra Vriddhi can be compared to – Hernia, inguinal hernia

Anda vrudhi, Mushka Vriddhi, Andakosha Vriddhi (Swelling of scrotum and testis) –
Depending on the nature of swelling and the part involved, the Anda Vriddhi or Vriddhi can be viewed in the below mentioned perspective:

Swelling in the scrotum may be caused due to:

• Cellulitis
• Sebaceous cyst
• Tumor
• Elephantiasis

Swelling of spermatic cord and tunica vaginalis may be due to:

• Hydrocele
• Haematocele
• Varicocele

Swelling of Testes may be due to:

• Orchitis
• Tumor
• Epididymitis
• Cyst of epididymitis (spermatocele)

Swelling in the scrotum from a non-scrotal or non-testicular origin is generally caused by hernia.

Just before finishing –
Vruddhi is a condition which includes many deformities or diseases occurring in the vankshana (groin) and mushka or phala kosha (scrotum). These areas are delicate organs and are related to the fertility of an individual. The term Vruddhi encapsulates conditions like hernia, hydrocele, hematocele etc which demand urgent attention. This article is to explain the basic concept of Vruddhi and the options of treatment available for the same according to Ayurvedic references.
Click to Consult Dr Raghuram Y.S. MD (Ayu)