Prognosis of Shotha on the Foundation of Dosha Predominance

Article by Dr Raghuram Y.S. MD (Ay) & Dr Manasa S, B.A.M.S

AIAPGET Factors

1. सर्वस्त्रिदोषोऽधिकदोषलिङ्गैस्तच्छब्दमभ्येति भिषग्जितं च||Cha.Chi.12. All Shothas are brought on by Tridoshas however they’re named on the idea of predominant dosha concerned within the pathogenesis of a selected kind of shotha.
2. Shvayathu and Shopha are synonyms of Shotha.
3. The colour of Vataja Shotha is Aruna-Asita. The color of Pittaja Shotha is Asita-Pita-Raga. The color of Kaphaja Shotha is Pandu varna. 
4.   Particular options of Vataja Shotha – a. Prashamyati Pronnamati Prapidito – Pits on stress nevertheless it rapidly rises to the floor  & b. Divabali – will increase and is distinguished throughout day time
5.   Particular options of Pittaja Shotha – a. Ushyate – Has extreme burning sensation, b. Spashta Ruk – clearcut ache & c. Pakavan – tends to suppurate
6.   Particular options of Kaphaja Shotha – a. Krichra Janma Prashamo – this swelling happens slowly i.e. takes lots of time to manifest and on the similar time takes lots of time to go away. b. Nipidito Na Cha Unnamed – when pressed the pitting stays for a very long time and it takes lots of time for the pit to vanish and the swelling to return again to the floor – persistent swelling & c. Ratribali – will increase and is distinguished throughout evening time

Shotha which implies swelling or edema, which may both be inflammatory or non-inflammatory in origin has been defined intimately in Ayurveda together with detailed remedy protocol. Shotha could be precipitated both by aggravated doshas – Ninja Shotha or as a consequence of exterior elements like harm, publicity to toxins or allergens and so on – Agantuja Shotha. Ayurveda has defined every of the various kinds of shotha with their pathogenesis, signs and administration. However it is extremely necessary to determine the reason for swelling or predominant dosha which is inflicting the shotha. Solely then, trigger particular and dosha particular remedy could be deliberate. On this article we are going to look in direction of diagnosing shotha on the idea of their dosha predominance.

Notice – Shotha can also be known as SHVAYATHU or SHOPHA.

Identification and Prognosis of Shotha primarily based on predominant dosha / doshas concerned

Shvayathu or Shotha is marked by swelling or edema which seems within the type of utsedha – irregular elevation of the pores and skin or tissues. Whereas talking about Nija forms of Shotha, they come up as a consequence of vitiation of three doshas i.e. vata, pitta and / or kapha. There may be typically involvement of rakta – blood and sira avarodha i.e. obstruction in circulatory channels / blood vessels of the physique. Shotha is undoubtedly brought on by the involvement of all of the three doshas i.e. vata, pitta and kapha however they’re primarily recognized and named after the predominant dosha which determines particular group of signs within the shvayathu. This classification is the hallmark function of Ayurveda’s description of ailments and aids in analysis and remedy of ailments.

Main classification of Shotha / Shwayathu from Classical Texts

A lot of the main Ayurveda texts, primarily Brihat Trayis have categorized Shotha into three most important sorts primarily based on dosha predominance. They’re –

Vataja Shotha 

That is brought on by predominantly aggravated vata.

Signs –

–        Chala – swelling is movable

–        Tough, dry and skinny pores and skin,

–        Aruna Asita – Golden brown / Dusky-brown or blackish in color

–        Swelling is movable

–        The swelling pits on stress however rapidly regains form (surfaces again)

–        Divabali – swelling will increase primarily throughout day time

–        Swelling subsides spontaneously

Traits of the swelling –

–        Swelling is movable

–        Prashamyati Pronnamati Prapidito – Pits on stress nevertheless it rapidly rises to the floor 

–        Divabali – will increase and is distinguished throughout day time

Related elements –

–        Horripilation / goosebumps

–        Numbness

–        Discomfort,

–        Completely different sorts of ache,

Pittaja Shotha

That is brought on by predominantly aggravated pitta.

 Indicators and Signs –

–        Swelling is clean on contact,

–        Has peculiar kind of scent – Sagandho

–        Has blackish, crimson or yellow tint

–        Fast onset of swelling 

Traits of Swelling –

–        Sizzling on contact,

–        Ushyate – Has extreme burning sensation

–        Spashta Ruk – clearcut ache

–        Pakavan – tends to suppurate

–        Spreads rapidly

–        Non-pitting or barely pitting in nature

Related options –

–        Burning sensation

–        Raised warmth

–        Thirst, fever, sweating,

–        Giddiness,

–        Intoxication

–        Akshi Ragakrut – redness of the eyes

 Kaphaja Shotha

That is brought on by predominantly aggravated kapha.

Indicators and Signs –

–        Swelling is chilly,

–        Pale or whitish in coloration

–        Clean

–        Pores and skin over swelling is oily

–        Presence of heaviness, itching

–        Onset of swelling is gradual and secure

–        Has stiffness

Traits of swelling –

–        Krichra Janma Prashamo – this swelling happens slowly i.e. takes lot of time to manifest and on the similar time takes lot of time to go away

–        Nipidito Na Cha Unnamed – when pressed the pitting stays for very long time and it takes lot of time for the pit to vanish and the swelling to return again to the floor – persistent swelling

–        Ratribali – will increase and is distinguished throughout evening time

–        Is agency

–        Persistent

–        Heavy

–        Steady 

Related options –

–        Extreme salivation,

–        Extreme sleep

–        Sluggish digestion

Notice 

Aside from these most important doshic forms of Shotha, the illness can also be manifested as a consequence of

–        the mix of two doshas – dvidoshaja or samsargaja shotha (instance – vata-pittaja shotha, pitta-kaphaja shotha and so on) and

–        the mix of all three doshas – tridoshaja shotha, which is a extreme type of shotha

The signs of two or three doshas concerned within the pathogenesis of such shothas might be discovered manifested in blended proportions.

Other forms of Shotha are 

–        Ekanga Shotha – localized swelling and

–        Sarvanga Shotha – generalized swelling

As already talked about, Agantuja Shotha is precipitated as a consequence of exterior elements like harm, bites of animals and so on.

Samhita References and Spotlight Factors relating to Shotha – Doshic sorts

1. Charaka Samhita

Ref – Chikitsa Sthana Chapter 12 – Shvayathu Chikitsa Adhyaya & Charaka Sutra Sthana Chapter 18

Necessary factors –

–        All shothas contain tridoshas however the naming of every shotha has been carried out on the idea of predominant dosha concerned in causation of shotha

–        Detailed signs are enumerated in Chapter 12, verse 12 of Chikitsa Sthana

–        Vataja Shotha – is tough, dry, dusky, pitting however will rapidly get well / Pittaja Shotha – is sizzling and is burning or has burning sensation / Kaphaja Shotha – is chilly, heavy and secure

–        Prognosis – Shotha brought on by one dosha involvement, of latest origin and manifesting in robust affected person is curable

–        Remedy ideas – The energy of the affected person and illness, dosha and season must be assessed. Langhana, Pachana and Shodhana are the principle ideas of remedy.

2. Sushruta Samhita

Necessary factors –

–        Sushruta Samhita emphasizes on discussing Vrana Shotha – inflammatory swellings and Agantuja Shotha – traumatic sorts

–        Sushruta has additionally categorized shotha on dosha predominance with concentrate on surgical points, examples – abscesses and tumours

–        The dosha signs in doshic shotha align with clarification of Acharya Charaka – Vataja kind is tough and movable, Pittaja kind is sizzling and spreading and Kaphaja kind is agency and heavy

–        The treatise typically correlates agantuja shotha i.e. exogenous swellings with abhighataja i.e. these precipitated as a consequence of harm

3. Ashtanga Hrdaya

Necessary factors –

–        Follows methodology of clarification of Acharya Charaka and Sushruta, has blended excerpts from these texts

–        Classification of Shotha has been carried out as Vataja, Pittaja, Kaphaja and so on. with signs just like these defined in Charaka Samhita

–        Extra emphasis has been given on the subtypes and mixtures of doshas. Remedy of shotha mirrors dosha pacification and dosha-specific strategy.

Different texts like Madhava Nidana have adopted related patterns of explaining Shotha as these of Brihat Trayis.

Possible Trendy Interpretations and Correlations

Vataja Shotha – typically correlates with non-pitting edema. It could be precipitated as a consequence of neurological or cardiac causes like coronary heart failure or peripheral neuropathy. The swelling is fluctuating and has dry pores and skin over and round it.

Pittaja Shotha – could be correlated with inflammatory edema as present in acute infections, liver ailments like hepatitis inflicting ascites and so on.

Kaphaja Shotha – correlates with pitting edema typically ensuing from renal points like nephrotic syndrome, hypothyroidism, lymphatic obstruction and so on. It presents with fluid retention and heaviness.

 Simply earlier than ending

Total, Shotha could be grossly seen as being brought on by fluid imbalance as a consequence of dosha vitiation affecting rasa dhatu and channels of circulation (srotas). From the fashionable viewpoint the doshic forms of shotha could be correlated with situations like congestive coronary heart failure (vata dominant), cirrhosis (pitta dominant) or persistent kidney illness (kapha dominant).

This dosha-based strategy in direction of analysis of various sorts of Shotha makes manner for personalised identification and administration of shotha emphasizing correction of root-causes over symptomatic reduction. It will assist Ayurveda physicians to correctly diagnose and categorize the shothas below the brackets of dosha or doshas concerned which is the inspiration for complete dosha-specific remedy approaches together with choice and administration of herbs, formulations, therapies and dietetic protocols.