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 premise of predominant dosha concerned within the pathogenesis of a selected 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 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 a variety of time to manifest and on the similar time takes a variety of time to go away. b. Nipidito Na Cha Unnamed – when pressed the pitting stays for a very long time and it takes a variety 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 may be precipitated both by aggravated doshas – Ninja Shotha or attributable to 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 vitally essential to establish the reason for swelling or predominant dosha which is inflicting the shotha. Solely then, trigger particular and dosha particular remedy may be deliberate. On this article we’ll look in direction of diagnosing shotha on the premise of their dosha predominance.

Word – Shotha can also 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 sorts of Shotha, they come up attributable to 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.

Major classification of Shotha / Shwayathu from Classical Texts

A lot of the main Ayurveda texts, primarily Brihat Trayis have labeled Shotha into three predominant varieties based mostly 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 sort of odor – Sagandho

–        Has blackish, crimson or yellow tint

–        Speedy 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 colour

–        Clean

–        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 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

Word 

Other than these predominant doshic sorts of Shotha, the illness can also be manifested attributable to

–        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 combined proportions.

Different kinds of Shotha are 

–        Ekanga Shotha – localized swelling and

–        Sarvanga Shotha – generalized swelling

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

Samhita References and Spotlight Factors relating to Shotha – Doshic varieties

1. Charaka Samhita

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

Vital factors –

–        All shothas contain tridoshas however the naming of every shotha has been carried out 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 get well / Pittaja Shotha – is scorching and is burning or has burning sensation / Kaphaja Shotha – is chilly, heavy and steady

–        Prognosis – Shotha brought on by one dosha involvement, of current origin and manifesting in sturdy 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

Vital factors –

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

–        Sushruta has additionally labeled shotha on dosha predominance with deal with surgical points, 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 typically correlates agantuja shotha i.e. exogenous swellings with abhighataja i.e. these precipitated attributable to harm

3. Ashtanga Hrdaya

Vital factors –

–        Follows technique of rationalization of Acharya Charaka and Sushruta, has combined 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

–        Further 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 Fashionable Interpretations and Correlations

Vataja Shotha – typically correlates with non-pitting edema. It might be precipitated attributable to 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 – may 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

General, Shotha may be grossly seen as being brought on by fluid imbalance attributable to dosha vitiation affecting rasa dhatu and channels of circulation (srotas). From the trendy viewpoint the doshic sorts of shotha may 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 method for customized identification and administration of shotha emphasizing correction of root-causes over symptomatic aid. This may 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.