Bull. tnd. Inst. Hist. Moo. Vol.

XXV 38 to 45

FILARIASIS (SHLIPADA)

P.K. WARRIER*

ABSTRACT

Filariasis is known to medical science over many centuries. It

is a disease of tropical countries due to the presence of micro-

filaria. The effected areas are large and elephantoid in appearance,

so it is called' Elephantiasis '. A non- parasitic form of Elephantiasis

occurs when the lymphatics are blocked. In Ayurveda this disease

is termed as Shlipada.

Filariasis, a disease known to the lymphatics. Because of that the

the medical science over many cen- lymph nodes enlarge particularly of
turies, still defies a cure and hence the legs and the external genitalia.
it calls for extensive discussions. It The affected areas are large and
is the disease due to the presence of elephantoid in appearance. So it is
filaria in blood and lymphatic sys- called elephantiasis. The skin turns
tem. Filaria is a parascitic thread thick and covered with scabs. The
like organism. Filarial elephantiasis condition is not painful, but it is
is described as a disease of tropical extremely disfiguring and it limits
countries due to the presence of movement and the ability to work
micro - filaria - as the worm is called which causes frustation and un-
because of its microscopic size. It happiness. A non-parasitic form of
is introduced by the Culex mosquito. elephantiasis occurs when the lym-
Three months after the infection of phatics are blocked, in intractable
filaria the changes which occur in cases of varicose veins and certain
the tissues give rise to blockage of types of carcinoma and as a sequel

* Managing Trustee & Chief Physician, Arya Vaidyashala, Kottakkal - 676 503, Kerala.
Filariasis (Shlipada) - Warrier 39

to any chronic septic local condi- appearance". By Pittadosa it is

tions. coloured yellow with burning sensa-
tion and tever>. By Kaphadosa the
In filariasis, according to the
shlipada is heavy, big, unctuous and
modern medicine, the only effective
without pain and surrounded by nodes
drug is diethyl carbamazine cit-rate.
of flesh", Shlipada with a duration
Tight bandaging of the legs may be
of more than a year and of very big
helpful. Surgical treatment does not
size', and with excessive discharges
ensure cure. In Ayurvedic literature
are to be abandoned i.e. "not de-
it is termed as Shlipada. In the
penda ble for successfu I treatrnent'".
thirtieth chapter in the UUarasthana
of Ashtangahridaya of Vagbhata, it Some say that shlipada appears
is presented along with the descrip- on palm, nose, lips and ears as on
tion and treatments of other dis- the legs. Because of the nature of
eases as Granthi, Arbuda, Apachi the disease its incidence is more in
and Nadivrana clubbed together, as 'Anupa' places. (Anupa is one vari-
all of these are related to Sopha ety of localities described in Ayur-
(inflammation) and being cornptlcateo, veda which are classified according
treatment also is very difficult. to the nature of places)". Treatment
of Shlipada is described in the ~Oth
Regarding the aetiology of Shli-
chapter as follows:
pada Vagbhata says, The bodily humors
(doshas) all together with the pre- In all Shlipedas, venesection is
dominance of Kapha through flesh prescribed. In Vatika type vein two
and blood move to the lower part of finger-girth above the ankle is to be
the body as the inguinal region and cut. But before doing Siravedha
thigh in course of time having made (venesection) one must be subje-
the feet as the base create thick cted to proper lubrication, sudation
swelling (Sopham) which is termed and the part is also treated with
as Shlipada.' Shlipada when Upanaha as purvakarma (prepara-
occurs by Vatadosa, it is with small tory steps). Then the patient is to
eruptions, dark in colour, paining take castor oil with cow's urine. When
without cause, rough and dry in the medicine is properly digested,
1 to 6 to be reffered at page no. 44
40 Bu//. Ind. Ins!. His!. Med. Va/.XXV

the patient is to be fed with the have shown good results even in old
cooked rice of one year old grain cases, although filariasis is consid-
with milk boiled with dry ginger or ered beyond our control even after
turpith. Even then if it is not in one year. Below, we indicate one
control, cauterisation is suggested. such technique practised by an old
In the case of a.Paittika Shlipada the physician and which in our own ex-
vein under the ankle is to be cut and perience also has proved its claim.
then medicines and food, good for
In the treatment of filariasis, the
curing Pitta in general, are to be
first and most important step is cau-
followed. In a Kapha predominating
tion to prevent the attack. In this,
Shlipada, the vein on the big toe is
protection from mosquitos, removal
to be cut. The patient is to take food
of stagnant water pools and restraint
with Indian barley as main. Decoc-
from using impure water are impor-
tions with honey, Haritaki (Chebulic
tant. People who live in these places
myrobalan) in Increasing doses, are
or others who are forced to live there
to be taken in. Mustard, brinjal or
because of occupational exigencies
coriander are to be used for apply-
have to be very careful in taking
ing as Lepas. The above are the
food articles by using protective safe-
general directions to treat Shlipada.
guards. Fever and chill are the
Now coming to practical expe- preliminary symptoms of most at-
rience, physicians of Kerala can- tacks and so dietetic articles and
not lag behind, since most parts of decoctions ac-ting against such
Kerala are Anupa and filariasis is conditions are always advisable. Black
endemic in these places. Areas like pepper is a very good dietitic ar-
Cherthala, Cochin, Ponnani and other ticle, to be used by the inhabitants of
coastal regions with backwater such areas. It is said that the
hinter-lands, are the localities where particular medicine for an endemic
filariasis had been endemic in all its disease also will be available as
forms. So physicians of Kerala natural supply at the same locality.
were forced to cope up with curing Black pepper is an example here.
the troubles and some techniques Kerala is the land of heavy rain due
Filariasis (Shlipada) - Warrier 41

to monsoons and it is also the home- and the tender leaves of 'Manhapa-
land of black pepper. vitta' ( Morinda pubescens) and
Sakhotaka (Strebulus asper) is to
Daily use of black pepper in our
be applied on the head.
food or drinks helps in prevention of
filariasis. With the appearance of The sesamum oil cooked with the
the symptoms one must be careful to betel leaves if taken with the well-
control and cure them as early as churned butter milk and cow's urine
possible. Kerala physicians have and Haritaki (Chebulic mvroba/an)
many simple remedies at this stage. pacifies the Shlipada.
We have experience of a cure in
In the juice of Nonganampullu
such an aggravated case by the use
sesarnum oil or castor oil is pre-
ofThumba (Leucasaspera) and pepper
pared with the root of Parakam
taken together. It is a very drying
(Strebulus asper) being pounded
medicine and so the patient advise
and mixed. By using this, the shlipada
to take milk irnrnedtatety and copi-
not later than of eighteen months'
ously. Our physicians prescribe
duration is cured.
internal medicine and external Lepas
on the affected parts. Oil taken from the juice of
Nonganampullu is good for internal
In Keralite practice, we usually
use.
follow the instructions of
'Chikitsamanjari', 'Yogamritam' and Forexternal Lepa, well-powderea

other keralite works. The medicines Nonganampullu and turmeric and a

suggested by these texts are usually handful of raw rice cooked in the

available in the market. Of course, water leaving of rice washes with

in "the early stages they are fully moderate heat is used to apply the

reliable. The first instruction is to affected part covered with the leaf of

administer purgatives repeatedly. Clerodendrum viscosum~ It paci-

fies the Shlipadas.
Sesamum oil boiled and prepared
with the mixture of the juices of Apply the oil prepared with the

'Nonganampullu' (Hedvotis herbacea) juice of the leaves of Strebulus asper

 42 Bull. /nd./nst. Hist. Med. Va/.XXV

and Hedyotis herbacea adding the this verdict and took pains to heal
pounded paste of the tubers of Yam. old cases also, provided the patients
Apply this oil all over the body. It willing to undergo the strenuous tre-
prevents fever. atment strictly. Following the report
of an old physician, Vaidyan K.Kesava
720 grams of Haritaki (Chebu/ic
Pillai from Aroor, who worked as a
myroba/an) is boiled in 18 litres of
self appointed mission treated 104
cow's urine and reduced to one
cases of elephantiasis with a spe-
sixth and one litre of oil is prepared
cial technique successfully,wh-ich
in it with the juice of the leaves of
was published in 'Dhanwanthary',
Sakhotaka and the pounded paste of
the Malayalam medical journal in th :
. triphala and punarnava. Take this
year 1909. Going through that ar-
oil for 21 days. In this way castor oil
ticle we can understand that having
with 1/3 ghee can be taken in.
thought the limitations of the thera-
The fore-going matter points peutic abilities of the then existing
out the limited possibilities of treat- medical systems. Vaidyan K-esava
ing filariasis under present condi- Pillai evolved a line of treatment
tions and common practice as reali- from his own observation. Inspired
sed now. Cases of elephantiasis by the information detailed in the
which have transgressed the ac- article, we too tried the same regi-
cepted period of 18 months are taken men in a few established cases of
as incurable. But it is doubtful whether filariasis. The results are found
the old Keralite physicians had com- encouraging. The regimen that we
pletely agreed with this verdict. Our tried here is as follows.
drive to find out more effective thera-
A.Administration of purgative
peutic measures shall be guided by
the observation and findings recorded
Avipathi Churnam (10-15 grams,
by our predecessors who engaged
according to the requirements) mix-
their -minds in pursuit of well-being
ed with warm water is given early in
of the ailing humanity. We have
the morning on empty stomach for
evidence from these records to prove
these consecutive alternate days.
that old practitioners often challenged
(That is to say on Sunday - Tuesday
Filariasis (Shlipada) - Werner 43

& Thursday). Aquilaria aga//ocha, Ec/ipta

prostrate, Gossypium herbaceum
B.Post purgative Drug
and Myristica malabarica.)
schedule
2) Bandage with appropriate cotton
On the last day of adrninlstration
clothes smeared with the pow-
of Avipathi Churnam, Marichadi
der of black pepper, being mixed
Kashayam 15 ml. (diluted with 60
with the juice of Narumpa-nal on
rnl. of warm water) is given after
the affected leg/legs daily at night.
dinner. Additives to be mixed with
(This is to be removed next day
Mari~hadi Kashayam are (1)
morning).
Gorochanadi Pill one (Powdered)
3) Liberal application of Nonganadi
(2) Powder of the root bark of thailam on the affected parts be-
Narumpanal (Uvarianarum) 500 mg. fore tying the above bandage.
Next day onwards Marichadi Kasha-
4) Wearing a chain made of ripe
yam, Narumpanal root bark powder
dry pepper (just like rosary of
and Gorochanadi Pill are given in
beads) or Wearing suitably made
the above dosage on empty stomach
cloth bag filled with dry pepper
in the morning and after dinner in
powder.
the night. Marichadi Kashayam contains
5) Wearing a belt made of cloth,
Maricham (black pepper) and Shunthi
filled with pepper powder around
(dried Ginger) in 3:1 proportion.
the waist.
C. Medicines administered ex-
Duration of treatment
ternally

1) Twice in a week application of Patients are instructed to continue

Kupilwadi thailam on the head the medication without break until'
and body before bath. (It con- satisfactory improvement is obtained.
tains Uvaria narum, Yam tuber, There is no fixed time-frame for

Piper nigrum, Hordeum vulgare, treatment.

strebulus asper, Tinospora

cordifolia, Aristolochia indica,
44 Bull. Ind. Inst. Hist. Med. Vol. XXV

Results observed affected leg to a certain extent with

a fair degree of improvement.
Fairly good response is seen
in the cases treated on the above Guide for further study

line. Recurrent attacks offever and

Shlipada (Filariasis) and its
lymphadenitis were reduced re-
treatment, written byVaidyan K.Kesavan
markably and the ulceration of the
Pillai - reproduced in "Aryavaidyan",
affected area was healed. Thick-
a quarterly journal of the Arya Vaidya
ness of the subcutaneous tissue was
Sala, Kottakkal (Vo1.8 No.2 issue -
Jessened. The treatment helped to
Nov./94) (English translation).
restore normal appearance of the

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