Imaging modalities have been suggested as useful adjuncts to the ISL staging to clarify the diagnosis. The lymphedema expert Dr. Ming-Huei Cheng developed a Chengs Lymphedema Grading tool to assess the severity of extremity lymphedema based on objective limb measurements and providing appropriate options for management. I. Grading
Grade 1: Spontaneously reversible on elevation. Mostly pitting edema. Grade 2: Non-spontaneously reversible on elevation. Mostly non-pitting edema. Grade 3: Gross increase in volume and circumference of Grade 2 lymphedema, with eight stages of severity given below based on clinical assessments. II. Staging
As described by the Fifth WHO Expert Committee on Filariasis, and endorsed by the American Society of Lymphology., the staging system helps to identify the severity of lymphedema. With the assistance of medical imaging apparatus, such as MRI or CT, staging can be established by the physician, and therapeutic or medical interventions may be applied:
Stage 0: The lymphatic vessels have sustained some damage that is not yet apparent. Transport capacity is sufficient for the amount of lymph being removed. Lymphedema is not present. Stage 1 : Swelling increases during the day and disappears overnight as the patient lies flat in bed. Tissue is still at the pitting stage: when pressed by the fingertips, the affected area indents and reverses with elevation. Usually, upon waking in the morning, the limb or affected area is normal or almost normal in size. Treatment is not necessarily required at this point. Stage 2: Swelling is not reversible overnight, and does not disappear without proper management.
This may happen accidentally or intentionally as a consequence of either recreational or entheogenic drug use, though many users find the side effects to be exceedingly unpleasant and not worth the recreational effects they experience. In the context of recreational use, anticholinergics are often called deliriants. Plant sources
The most common plants containing anticholinergic alkaloids (including atropine, scopolamine, and hyoscyamine among others) are:

Atropa belladonna (deadly nightshade)
Brugmansia species
Datura species
Garrya species
Hyoscyamus niger (henbane)
Mandragora officinarum (mandrake)

Use as a deterrent
Several narcotic and opiate-containing drug preparations, such as those containing  hydrocodone and codeine are combined with an anticholinergic agent to deter intentional misuse. Examples include Hydromet/Hycodan (hydrocodone/homatropine), Lomotil (diphenoxylate/atropine) and Tussionex (hydrocodone polistirex/chlorpheniramine). However, it is noted that opioid/antihistamine combinations are used clinically for their synergistic effect in the management of pain and maintenance of dissociative anesthesia (sedation) in such preparations as Meprozine (meperidine/promethazine) and Diconal (dipipanone/cyclizine), which act as strong anticholinergic agents. == References ==