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 attributable to Tridoshas however they’re named on the premise of predominant dosha concerned within the pathogenesis of a specific sort 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 strain 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 a whole lot of time to manifest and on the identical time takes a whole lot of time to go away. b. Nipidito Na Cha Unnamed – when pressed the pitting stays for a very long time and it takes a whole lot 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 night time time

Shotha which suggests 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 might be precipitated both by aggravated doshas – Ninja Shotha or as a consequence of exterior elements like damage, publicity to toxins or allergens and so forth – Agantuja Shotha. Ayurveda has defined every of the several types of shotha with their pathogenesis, signs and administration. However it is extremely essential to establish the reason for swelling or predominant dosha which is inflicting the shotha. Solely then, trigger particular and dosha particular remedy might be deliberate. On this article we’ll look in direction of diagnosing shotha on the premise of their dosha predominance.

Observe – Shotha can be known as SHVAYATHU or SHOPHA.

Identification and Prognosis of Shotha based mostly 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 varieties of Shotha, they come up as a consequence of vitiation of three doshas i.e. vata, pitta and / or kapha. There may be usually involvement of rakta – blood and sira avarodha i.e. obstruction in circulatory channels / blood vessels of the physique. Shotha is undoubtedly attributable to 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 illnesses and aids in analysis and remedy of illnesses.

Main classification of Shotha / Shwayathu from Classical Texts

Many of the main Ayurveda texts, primarily Brihat Trayis have labeled Shotha into three important sorts based mostly on dosha predominance. They’re –

Vataja Shotha 

That is attributable to 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 strain 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 strain 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 attributable to predominantly aggravated pitta.

 Indicators and Signs –

–        Swelling is easy on contact,

–        Has peculiar sort of scent – Sagandho

–        Has blackish, purple 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 attributable to predominantly aggravated kapha.

Indicators and Signs –

–        Swelling is chilly,

–        Pale or whitish in colour

–        Easy

–        Pores and skin over swelling is oily

–        Presence of heaviness, itching

–        Onset of swelling is sluggish and steady

–        Has stiffness

Traits of swelling –

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

–        Is agency

–        Persistent

–        Heavy

–        Steady 

Related options –

–        Extreme salivation,

–        Extreme sleep

–        Sluggish digestion

Observe 

Other than these important doshic varieties of Shotha, the illness can be manifested as a consequence of

–        the mix of two doshas – dvidoshaja or samsargaja shotha (instance – vata-pittaja shotha, pitta-kaphaja shotha and so forth) 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 will probably be discovered manifested in blended proportions.

Different kinds 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 damage, bites of animals and so forth.

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

Essential factors –

–        All shothas contain tridoshas however the naming of every shotha has been executed on the premise 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 recuperate / Pittaja Shotha – is scorching and is burning or has burning sensation / Kaphaja Shotha – is chilly, heavy and steady

–        Prognosis – Shotha attributable to one dosha involvement, of current origin and manifesting in robust affected person is curable

–        Remedy rules – The power of the affected person and illness, dosha and season needs to be assessed. Langhana, Pachana and Shodhana are the primary rules of remedy.

2. Sushruta Samhita

Essential factors –

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

–        Sushruta has additionally labeled shotha on dosha predominance with give attention to surgical facets, examples – abscesses and tumours

–        The dosha signs in doshic shotha align with rationalization of Acharya Charaka – Vataja sort is tough and movable, Pittaja sort is scorching and spreading and Kaphaja sort is agency and heavy

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

3. Ashtanga Hrdaya

Essential factors –

–        Follows technique of rationalization of Acharya Charaka and Sushruta, has blended excerpts from these texts

–        Classification of Shotha has been executed as Vataja, Pittaja, Kaphaja and so forth. with signs much 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 method.

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

Possible Fashionable Interpretations and Correlations

Vataja Shotha – usually 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 – might be correlated with inflammatory edema as present in acute infections, liver illnesses like hepatitis inflicting ascites and so forth.

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

 Simply earlier than ending

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

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