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''Alepa'' has been given due importance as an initial treatment for all types of ''shopha'' (swelling). Among the remedies applied internally and externally, it is superior to others because it alleviates pain instantaneously <ref>Dalhana, commentator, Sushruta Samhitā, edited by Acharya J T & N R, Reprint edition, Chaukhamba Surbharati Prakashan, Varanasi, 2003, Sutra Sthana 18/3 </ref>

''Alepa'' has been given due importance as an initial treatment for all types of ''shopha'' (swelling). Among the remedies applied internally and externally, it is superior to others because it alleviates pain instantaneously. [Dalhana on Su.Sa.Sutra Sthana 18/3]

Types of ''lepa'' (external application):<ref>Ibidem Sushruta Samhita (9), Su.18/6. </ref>

Types of ''lepa'' (external application):[Su.Sa.Sutra Sthana 18/6]

According to character and therapeutic use, ''alepa'' can be divided into three types viz., ''pralepa, pradeha'' and ''alepa''. It could be shown as tabulated below-

According to character and therapeutic use, ''alepa'' can be divided into three types viz., ''pralepa, pradeha'' and ''alepa''. It could be shown as tabulated below-

==== Method of application ====

==== Method of application ====

The method of use, quantity, time of application and other pharmaco-therapeutic aspects are not in scope of this chapter. However, it is to be noted that an ''alepa'' is generally advised for application against the direction of the hair growth (pratiloma) to enhance its penetration (''swedavahi shira'') <ref> Ibidem Sushruta Samhitā (9), Su.18/4.</ref>

The method of use, quantity, time of application and other pharmaco-therapeutic aspects are not in scope of this chapter. However, it is to be noted that an ''alepa'' is generally advised for application against the direction of the hair growth (pratiloma) to enhance its penetration (''swedavahi shira''). [Su.Sa.Sutra Sthana 18/4]

==== Quantity and thickness of application ====  

==== Quantity and thickness of application ====  

The quantity, or dosage, of medication in the case of topical medicines is measured by the thickness of the layer of paste. Typically, it should be equivalent to the thickness of moist skin of a buffalo <ref>Ibidem Sushruta Samhita (9), Su.18/10.</ref>. In current times, the thickness measures around 4-5 millimetre. <ref name="Patil lepa"> Patil S, Chaudhary AK. Topical dosages forms (Lepa Kalpana) of Ayurveda: An unexplored treasure. Int J Green Pharm. 2015;9(4):12. Accessed on June 1,2020.Available from https://www.greenpharmacy.info/index.php/ijgp/article/viewFile/579/492 </ref>

The quantity, or dosage, of medication in the case of topical medicines is measured by the thickness of the layer of paste. Typically, it should be equivalent to the thickness of moist skin of a buffalo. [Su.Sa.Sutra Sthana 18/11]  In current times, the thickness measures around 4-5 millimetre. <ref name="Patil lepa"> Patil S, Chaudhary AK. Topical dosages forms (Lepa Kalpana) of Ayurveda: An unexplored treasure. Int J Green Pharm. 2015;9(4):12. Accessed on June 1,2020.Available from https://www.greenpharmacy.info/index.php/ijgp/article/viewFile/579/492 </ref>

Thickness of a layer of ''pralepa'' should be equivalent to the thickness of a typical ''chandana'' (sandal paste) application. ''Pradeha'' is typically applied as a thick paste or bolus (''pinda'')<ref>Ibidem Dalhana, commentator (18), Su 18/6. </ref>. Thus, it is thin and thick pastes for application of ''pralepa/anulepana'' and ''pradeha'' respectively <ref>Ibidem Sushruta Samhitā (9), Su.18/6.</ref>, <ref>YogindraNathSen, commentator, Charak Samhita,Ni.1/36.</ref>

Thickness of a layer of ''pralepa'' should be equivalent to the thickness of a typical ''chandana'' (sandal paste) application. ''Pradeha'' is typically applied as a thick paste or bolus (''pinda'').[Dalhana on Su.Sa.Sutra Sthana 18/6] Thus, it is thin and thick pastes for application of ''pralepa/anulepana'' and ''pradeha'' respectively. [Dalhana on Su.Sa.Sutra Sthana 18/6]<ref>YogindraNathSen, Charak. Nidana Sthana, Cha.1 Jwara Nidana ver.36. In: YogindraNathSen, Editor. Charakopaskara Charak Samhita.1st ed. ???;?</ref>

It can be stated that the thickness of applications as pradeha(thick paste) is more than or equal to 4 to 5 mm. Pralepa (thin paste)  applications include thickness less than 4 to 5 mm. <ref name="Patil lepa"/>

It can be stated that the thickness of applications as pradeha(thick paste) is more than or equal to 4 to 5 mm. Pralepa (thin paste)  applications include thickness less than 4 to 5 mm. <ref name="Patil lepa"/>

==== Indication and contraindications ====

==== Indication and contraindications ====

Hot ''pradeha'' is indicated in ''vata'' and ''kapha'' ailments while cold ''pradeha'' in conditions due to ''pittaja'' and ''raktaja'' disorders <ref>Ibidem Dalhana, commentator (18), Su 18/6. </ref> It is also stated that ''alepa'' is indicated in non-suppurative, inflammatory swellings (''avidagdha sopha'') whereas ''pradeha/upnah'' (poultice) is used for suppurative swellings<ref>Ibidem Dalhana, commentator (18), Su.18/6-9.</ref> ''Pradeha'' could also be applied at night in case of swellings caused by ''vata'' and ''kapha''<ref>Ibidem Dalhana, commentator (18), Su.18/12-14. </ref>

Hot ''pradeha'' is indicated in ''vata'' and ''kapha'' ailments while cold ''pradeha'' in conditions due to ''pittaja'' and ''raktaja'' disorders. [Dalhana on Su.Sa.Sutra Sthana 18/6] It is also stated that ''alepa'' is indicated in non-suppurative, inflammatory swellings (''avidagdha sopha'') whereas ''pradeha/upnah'' (poultice) is used for suppurative swellings. [Dalhana on Su.Sa.Sutra Sthana 18/6-9] ''Pradeha'' could also be applied at night in case of swellings caused by ''vata'' and ''kapha''.[Dalhana on Su.Sa.Sutra Sthana 18/12-14]

Pastes should not be used at night. Stale paste, pastes applied on top of an existing layer, or repeating of used pastes are prohibited<ref>Ibidem Sushruta Samhitā (9), Su.18/12-14. </ref>

Pastes should not be used at night. Stale paste, pastes applied on top of an existing layer, or repeating of used pastes are prohibited. [Su.Sa.Sutra Sthana 18/12-14]

===== Cross references of external medications in [[Kushtha Chikitsa]] =====

===== Cross references of external medications in [[Kushtha Chikitsa]] =====