E-ISSN:2456-3110

Review Article

Shotha

Journal of Ayurveda and Integrated Medical Sciences

2023 Volume 8 Number 5 May
Publisherwww.maharshicharaka.in

A review on analysis of Dosha predominance in patient of Shotha (oedema) with the help of Rupa (symptoms)

Madhukarrao Maske V.1, Narayanrao Manwatkar M.2*
DOI: http://dx.doi.org/10.21760/jaims.8.5.21

1 Vijay Madhukarrao Maske, Assistant Professor, Department of Kayachikitsa, SSVP Ayurved College and Research Institute, Hatta, Hingoli, Maharashtra, India.

2* Mayuri Narayanrao Manwatkar, Assistant Professor, Department of Kayachikitsa, SSVP Ayurved College and Research Institute, Hatta, Hingoli, Maharashtra, India.

Principles of Ayurveda emphasise firstly on diagnosis of disease and then on the treatment. Nidanpanchaka helps for the diagnosis of disease. Rupa is one of the Nidanpanchaka which reflects the present status of disease along with the Dosha predominance and state of Dosha like Ama (unripe), Pakwa (ripe), etc. which helps in diagnosis and treatment as well. Shotha is explained in all the classical texts of Ayurveda which depicts its importance. It is one of the most common presentations seen in patients. With the analysis of symptoms present in patient of Shotha, we can ascertain the Dosha predominance and can plan the treatment accordingly. So, the present article focuses on to study the symptoms of Shotha to analyse the Dosha predominance in it.

Keywords: Shotha, Rupa, Oedema, Symptoms, Dosha predominance

Corresponding Author How to Cite this Article To Browse
Mayuri Narayanrao Manwatkar, Assistant Professor, Department of Kayachikitsa, SSVP Ayurved College and Research Institute, Hatta, Hingoli, Maharashtra, India.
Email: 		Vijay Madhukarrao Maske, Mayuri Narayanrao Manwatkar, A review on analysis of Dosha predominance in patient of Shotha (oedema) with the help of Rupa (symptoms). J Ayu Int Med Sci. 2023;8(5):135-139.
Available From
https://jaims.in/jaims/article/view/2418

Manuscript Received Review Round 1 Review Round 2 Review Round 3 Accepted
2023-03-25 2023-03-27 2023-04-03 2023-04-10 2023-04-17
Conflict of Interest Funding Ethical Approval Plagiarism X-checker Note
Nil Nil Yes 18%

© 2023by Vijay Madhukarrao Maske, Mayuri Narayanrao Manwatkarand Published by Maharshi Charaka Ayurveda Organization. This is an Open Access article licensed under a Creative Commons Attribution 4.0 International License https://creativecommons.org/licenses/by/4.0/ unported [CC BY 4.0].

Journal of Ayurveda and Integrated Medical Sciences 2023;8(5)135
Maske V et al: Dosha predominance in patient of Shotha (oedema) with the help of Rupa

Introduction

Ayurveda has stated that a physician should first diagnose a disease and then select the proper medicine and thereafter should administer the therapy by applying knowledge of science of medicine.[1] Any disease can be diagnosed with the help of 5 entities called as Nidanpanchak which includes Nidan, Purvarupa, Rupa, Upashay, Samprapti.[2,3,4] Rupa is one of the important tool for understanding the nature of disease. It is supposed to be the outcome of specific combination of Dosha and Dushya.[5] The presentation of manifested disease along with peculiar Dosha predominance, state of Dosha like Ama (unripe) or Pakwa (ripe) can be understood with the help of Rupa.[6]

In Nidan Sthan of Charak Samhita, compendium of symptomatology has been provided as reckoner for the Ayurveda practitioners to gain adequate knowledge of some of major class of disease and diagnose them effectively.[7] The diseases which are not described in classical texts due to their various nature and classical presentation shall also be treated with the help of various factors out of which predominance of Dosha is the prime one.[8] So, the Rupa guides us for finding the nature of disease, Dosha predominance and indirectly helps for treatment as it is supposed to be opposite of Dosha, Dushya and Nidanam.[9]

All the classical texts of Ayurveda have explained the disease Shotha. Acharya Charaka has quoted it to be a major disease i.e., Mahagada.[10] It is a very common manifestation perhaps every individual come across once or more in their lifetime.[11] All Shotha are supposed to be due to Rakta and Tridosha vitiation.[12] But, from treatment point of view they are classified into 3 types i.e., Vataj, Pittaj and Kaphaj.[13] In patients presenting with Shotha, the particular symptoms helps us to find the Dosha predominance and guide us for treatment further.[14] So, the present article focusses on particular symptoms of Shotha for analysis of Dosha predominance.

Materials and Methods

All the classical texts of Ayurveda i.e., Charak Samhita, Sushrut Samhita, Ashtang Hriday, Madhav Nidanam along with their commentaries were studied. Apart from this research articles, books and websites were referred for the same topic.

Observations and Results

The symptoms of Vataj, Pittaja and Kaphaja Shotha according to all classical texts are described in table below[15-20]

Table 1: Symptoms of Shotha types.

SN Type of Shotha Symptoms
1. Vataj Shotha Shotha increases as well as subsides quickly, Shyam (blackish) or Aruna (reddish) in colour, fleeting, pulsating, horripilation with thin, dry, coarse skin, rough and broken hair, the person feels different types of pain sensation like excision, incision, pricking, crawling of ants, irritation and a feeling of contraction or expansion, numbness and discomfort, swelling rebounds immediately after releasing pressure, increases during day time and subsides during night, by application of unctuous and hot massage and beating. Swelling is movable and often subsides without appreciable reason.
2. Pittaj Shotha Hot & soft with brown and copper hair, painful to touch, with specific odour, blackish, yellow, red or bluish copper tinged skin and has tendency of turning into abscess, accompanied with excessive burning sensation, fever, perspiration, giddiness, thirst, redness in eyes & intoxication, loose motion, craves for cold, increases and subsides quickly. Hot, sweaty, moist, sensitive to heat. Initiates in middle of body.
3. Kaphaj Shotha Grows slowly and subsides with difficulty. Affected part becomes pale, whitish, heavy, unctuous, sticky, smooth, stable thick with white hair, tolerant of touch and heat. Swelling is heavy and firm, immovable, unctuous, cold, associated with anaemia, anorexia, lowered digestion, water brash, vomiting and sleepiness. On pressing it takes long time to attain its normal position, increases at night time. If incised with the help of Kusha grass or Shastra then there is no letting out of blood and Piccha oozes lately, craves for hot touch.

Discussion

Acharya Chakrapani stated that treatment can’t be initiated without proper knowledge of disease.[21] The Nidanpanchak helps for the proper knowledge of disease hence known as Pancha Dnyana Upaya or Vyadhibodhak.[22] The symptoms which manifest after Purvarupa and clarify the Dosha predominance in Vyadhi e.g. Vataj Jwara, Pittaj Jwara, Kaphaj Jwara, etc., are known as Rupa.[23] Acharya Charaka has included Shotha under the category of Mahagada.[24] It is one of the most common presentation seen now a days. The understanding of Dosha predominance and guidance about treatment can be obtained with the help of Rupa. In patients of Shotha following points should be considered for analysis of Dosha predominance –


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Maske V et al: Dosha predominance in patient of Shotha (oedema) with the help of Rupa

1. Characteristics of Shotha underlying skin - The morbid Vata obstructed by vitiated Kapha, Pitta and Rakta aggravated at the site of peripheral superficial vessels reside at Twak and Mamsa leads to an elevation called Shotha.[25] So, the underlying skin gets the properties of respective vitiated Dosha.[26]g., in Vataj Shotha the underlying skin acquires the properties of vitiated Vata i.e., skin becomes thin, dry, coarse, rough with broken hair, blackish or red coloured. In Pittaj Shotha skin is blackish, yellow or red coloured, with brown and copper hair, hot, sweaty, moist, sensitive to touch and heat, with specific odour, craves for cold. In Kaphaja Shotha, the skin is pale, whitish, unctuous, smooth, thick with white hair, tolerant of heat and touch, craves for hot touch.

2. Characteristics of Shotha - The properties of vitiated Dosha reflect in Shotha E.g., in Vataj Shotha, due to Chala Guna of Vayu the Shotha is mobile, appears and subsides quickly, is fleeting or pulsating, rebounds immediately after release of pressure, often subsides without appreciable reason.[27] In Pittaj Shotha, due to soft, hot, liquid property and Vistra Gandha of Pitta the Shotha is hot, soft in touch, with specific odour, increases and subsides quickly. In Kaphaja Shotha, due to heavy, steady property of Kapha the Shotha is heavy, firm or immobile, unctuous, grows slowly and subsides with difficulty and on pressing it takes long time to regain. If incised with the help of Kusha grass or Shastra, there is no letting of blood and Lasika oozes out lately.

3. Diurnal variation - The symptoms of disease vary as per different season, time of day and night, age, stage of digestion of food known as Kal Samprapti.[28-30] As there is dominance of Vayu, Pitta and Kapha at morning, mid-day and night respectively naturally. So, the symptoms of Shotha appear at that time of day particularly.[31] Acharya Chakrapani has stated that as the body channels are open, and the body is fully functioning. Hence, the Vayu dominates and not the Kapha. So, the Vataj Shotha appears at daytime and at the night time the body channels are obstructed by Kleda and body is not active functionally. So, the Kapha increases and hence, Kaphaja Shotha appears at night-time.[32]

4. Upashaya and Anupshaya - The medicine, diet and regimen that bring about relief either by acting directly on the cause of disease or the disease

itself or by producing such effects indirectly are termed as Upashaya.[33-35] Vataj Shotha pacifies with the use of hot and unctuous substance and Mardana as they are opposite to the qualities of Vata.[17] Similarly, Pittaj and Kaphajshotha gets pacified by medicine, diet and regimen opposite of their qualities.

5. Site of appearance - The Vata, Pitta and Kapha dwell specially below umbilicus, between heart and umbilicus and above heart respectively.[36] So, the Pittaj Shotha appears firstly in mid body.[16] The Vataj and Kaphaj Shotha might appear firstly in lower and upper body respectively.

6. Associated symptoms - As the obstruction of morbid Vata by vitiated Kapha, Rakta and Pitta occur at the site of peripheral superficial vessels.[37] So, it may be stated that Dosha travels the whole body through blood vessels which in turn lead to other systemic Dosha vitiation symptoms. So, the Vataj Shotha has various type of pain, numbness, horripilation. Pittaj Shotha has associated symptoms like burning sensation, fever, perspiration, giddiness, thirst, redness in eyes, intoxication, loose motion. Kaphaj Shotha is associated with anaemia, anorexia, reduced appetite, water brash, vomiting and sleepiness.[15-20]

Conclusion

Shotha has been given immense importance by all the classical texts of Ayurveda. It is one of the most common presentations seen in patients. Rupa plays an important role in deciding Dosha predominance and thus guides for further treatment. In patients presenting with Shotha, characteristics of Shotha and underlying skin, diurnal variation, site of first appearance, aggravating and relieving factors and associated symptoms helps us to precisely reach upto particular Dosha vitiation and eases the treatment further.

Reference

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2. Yadavji T., editor. Charak Samhita of Agnivesha, Nidan sthana. Ch – 1, Ver. 6, 3rd edition, Varanasi: Choukhamba Surbharati Prakashana; 2017. p.194.


Journal of Ayurveda and Integrated Medical Sciences 2023;8(5)137
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18. Kaviraj Ambikadatta Shastri.,Editor. Sushrut Samhita of Sushrut,Sutra sthana. Chapter 17, Verse no. 4, 2014 reprint edition, Varanasi, Choukhamba publication, 2014:p.92.

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37. Garde G., Sartha Vagbhata, Sutra sthana. Ch – 1, Ver. 7, reprint 2012 edition, Varanasi: Choukhamba Surbharati Prakashana; 2017. p.2 .

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