E-ISSN:2456-3110

Case Report

Sheetapitta

Journal of Ayurveda and Integrated Medical Sciences

2015 Volume 9 Number 7 JULY
Publisherwww.maharshicharaka.in

Ayurvedic management of Sheetapitta - A Case Study

Thakur D1*, Gupta P2, Tiwari D3
DOI:10.21760/jaims.9.7.51

1* Deekshant Thakur, Post Graduate, Department of Kayachikitsa, Jammu Institute of Ayurveda and Research, Jammu, India.

2 Poonam Gupta, Associate professor, Department of Kayachikitsa, Jammu Institute of Ayurveda and Research, Jammu, India.

3 Deepu Tiwari, Research Scholar, Department of Statistics, University of Jammu, Jammu, India.

Ayurveda is the science of life which described the Hita and Ahita to Ayu. Means, it described the favorable and unfavorable to life. If man doesn’t follow the rules described in Ayurveda, it leads to several pathogeneses, which ultimately produces different disorders. Sheetapitta (Urticaria) is one of such disorder, which caused by Asatmya Sevana means the Exposure to allergens and antibody. In present busy and fast life, one can’t follow the rules of Dinacharya and Ritucharya described in Ayurveda. Due to heavy industrialization and heavy traffic one constantly comes into contact with various pollutants. The spicy and fast food eaten now a days, which have very less nutritional values and also having similar properties to Viruddhahara. These all ultimately resulted into Dhatudurbalya (lower immunity). Which causes sensitization towards allergens as well as antibodies and produces various types of allergic reactions, one of them is Urticaria, which is very common. Urticaria is a disease characterized by itchy red rashes on skin on almost all over the body. Sheetapitta is characterized by Varati Damshta Samsthana Shotha, Kandu Bahula, Toda Bahula, Chhardi, Jvara, Vidaha. Based on sign and symptoms Sheetapitta can be correlated with Urticaria.

Keywords: Sheetapitta, Urticaria, Ayurveda

Corresponding Author How to Cite this Article To Browse
Deekshant Thakur, Post Graduate, Department of Kayachikitsa, Jammu Institute of Ayurveda and Research, Jammu, , India.
Email:
Thakur D, Gupta P, Tiwari D, Ayurvedic management of Sheetapitta - A Case Study. J Ayu Int Med Sci. 2015;9(7):322-327.
Available From
https://jaims.in/jaims/article/view/3613

Manuscript Received Review Round 1 Review Round 2 Review Round 3 Accepted
2024-05-06 2024-05-14 2024-05-24 2024-06-04 2024-06-14
Conflict of Interest Funding Ethical Approval Plagiarism X-checker Note
None Nil Yes 13.24

© 2015by Thakur D, Gupta P, Tiwari Dand 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].

Introduction

According to Ayurveda, Sheetpitta is described as Tridoshaj Vyadhi, but Vata and Pitta Dosha are predominant and Ras and Rakta are main Dushya. Sheetapitta is one among the Twak Vikara that have related Hetu of Kotha and Udarda. Vata and Kapha are two Doshas, which are primarily bothered which in turn is associated through Pitta resulting in Tridosha Prakopa causing to redness, swelling itching on the skin etc. Anjana Nidana explained Udarda as, the appearance of skin patches look like those caused by the sting of wasp along with Itching, Vomiting, Fever and is caused by Sheeta and Pitta.[1]

Madhukosa explained that, though the features of Sheetapitta and Udarda are similar to each other, there is a predominance of Vata in Sheetapitta while Udarda is dominated by Kapha[2] Acharaya Madhava and Bhavprakash have defined Sheetpitta as Shotha caused by Sarti-Dansh along with Kandu, Toda, Jvara, Chhardi and Vidaah.[3] Urticaria is a common problem affecting up to 25% of the population at some point in their lifetime.[4]

Chief symptoms of Sheetpitta are reddish spots, inflammation on skin with moderate to severe itching at site. It is compared with urticaria in modern science and termed as primary cutaneous disorder. An episode of it may start with pruritis. Episodes of urticaria may continue to revert for days, weeks, months or year if not cured properly. Urticaria is calculated as allergic reaction due to certain food and has only symptomatic treatment and anti-allergic drug.

Though the disease, Urticaria is not a life threatening, it makes worried the patient due to its appearance, severe itching disturbing routine and its nature susceptible to be chronic. Urticaria affects 20% of people at some point in their lifetime. In some cases, the disorder is relatively mild, recurrent and frustrating for both the patient and physician.

In other cases, it manifests as part of a spectrum of systemic anaphylaxis, which may be life threatening. The disability and distress caused by Urticaria can lead to serious impairment of quality of life, almost comparable to that experienced by patients with cardiovascular disease. To further complicate the issue, a fairly extensive list of diseases can cause Urticaria.

Patients often seek medical attention with the hope that a reversible cause can be identified. Therefore, the challenge for the clinician is to try to identify a cause that could lead to a specific treatment or avoidance strategy.

A carefully taken history, blood tests, cutaneous punch biopsy, and allergy skin testing may provide the clues to specific mechanisms in some cases. Often, however, it is impossible to pinpoint the exact cause.

Modern medicine not having any remedy for permanent cure but remission of the disease can be achieved administering the medicine. Patients have to take those medicines for lifetime, which are having some unwanted side effects. Ayurveda can provide better and permanent management for Sheetapitta.

Nidana

(1) Aaharaja Hetus

1. Abhishyandi and Kaphaprakopakara nidana
2. Pittaprakopakara and Raktadushtikara nidana
3. Visha Janana Nidana

(2) Viharaja Hetus

1. Vata Prakopaka and Tvak Vaigunyakara
2. Pitta Prakopaka and Rakta Dushtikara nidana

(3) Nidarthakara Roga

1. Sannipatika Jvara and other Jvara.
2. Unmada
3. Adhoga Amlapitta

(4) Chikitsa Mithya Yoga

1. Vamana Ayoga and Virechana Ayoga
2. Svedatiyoga
3. Raktarshe Dushita Rakta Nigraha

Poorvarupa[5,6]

Pipasa (Thirst), Aruchi (loss of appetite), Hrillasa (Nausea), Deha Saad (Feeling of tiredness) Anga Gaurava (Feeling of heaviness), Rakta Lochanata (Redness of eyes).

Rupa: (Madhavnidana 50/3)

Vartidasht Sansthan Shotha (Inflammation like insect bite), Kandu (itching), Todda Bahulya (excessive pain like pricking), Chhardi (nausea or vomiting). Jvara (fever), Vidaah (burning sensation).


Samprapti:

Nidana Sevan + Agni Mandhya

Formation of Aam along with dosha Prakopa

Prasara of Dosha

Dosha Dushya Sammurchna in Amashya

Sthana Samsraya in Twak

Case Report

A 34 year old female patient came to OPD of Jammu institute of Ayurveda and Research Jammu on 13 Feburary 2024.

  • Patient name: XYZ
  • Age/ Sex: 34/F
  • Religion: Hindu
  • Occupation: Teacher
  • Address: Satwari, Jammu.

Pradhana Vedana

  • Reddish slightly elevated papules or erythematous wheals on bilateral Upper and lower limbs since 1 month
  • Itching since 1 month
  • Burning sensation since 1 month

Vedana Vruttanta

Patient was apparently alright 1 month ago, then patient having complained of frequent eruption of smooth, reddish slightly elevated papules or erythematous wheals on bilateral Upper and lower limbs for 1 month which gradually increased.

It is associated with localized and generalized itching, burning sensation. The complaints got aggravated during evening and night time, or on exposure to cold climate and wind.

The patient took allopathic medication and found relief. But the condition relapsed on discontinuing the medications. Hence patient came to OPD of JIAR Jammu.

Poorva Vyadhi Vruttanta

NO H/O Hypertension, T2DM, Hypo / Hyperthyroidism

Kutumbh Vritanta

No significant history was found.

Vyaktika Vruttanta

Appetite: Reduced Bowel habit: Constipation

Micturition: 7-9 times/day

Sleep: Sound sleep

Socio economic status: Middle class

General Examination

General condition: Fair

Pallor: Absent

Oedema: Absent

Cyanosis: Absent

Icterus: Absent

Clubbing: Absent.

Lymphadenopathy: Absent

Weight: 58 Kg

Height: 5.6 feet

BMI: 20.5.

BP: 126/88 mm of Hg.

Pulse: 70/min

Respiratory rate: 17/min

Temp: 98.6° F

Systemic Examination

Reddish slightly elevated papules or erythematous wheals on bilateral Upper and lower limbs

Gastro intestinal system: Abdomen soft, non-tender and no Organomegaly was found.

Respiratory system: Symmetrical chest, no added sound, bilateral normal air entry. Normal vesicular sound heard.

Cardio vascular examination: S1, S2 heard, no murmur was found.

CNS examination: Conscious, Oriented.


Before Treatment
jaims_3613_01.JPGjaims_3613_02.JPG

After Treatment
jaims_3613_03.JPG
jaims_3613_04.JPG

Asthasthana Pariksha

NadiVataj
MalaNiram
MutraSamanya
JihwaSaam
DrikSamanya
ShabdaKsheena
SparshaKhara
AkrithiKrish

Dashavidha Pariksha

प्रकृतिवात – कफ
विकृति दोषवात, कफ
सारमध्यम
संहननमध्यम
प्रमाणमध्यम
सात्म्यमध्यम
सत्वमध्यम
आहार शक्तिअभ्यवहरण शक्ति: अवर जरणशक्ति: अवर
व्यायाम शक्तिअवर
वयःमध्यम
  • Varati Damsha Sansthana Shotha: +++
  • Kandu: +++
  • Toda: +++
  • Vidaha: +++
  • Jwara: +++ (occasional)
  • Chardi: +++ (occasional)

(+ : Mild; ++ : Moderate; Severe : +++)

  • Agni - Mandagni
  • Koshtha - Asamyak
  • Prakruti - Pitta Pradhan Kapha Anubandhi

Management

Shaman Chikitsa

1. Use of Sarshap, Haridra, Kustha, Prapunnag and Tila with Katu Taila[7] for 21 days .
2. Yashtimadhvaadi Kwatha[8] for 21 days.
3. Tab. Laghusutshekhar Rasa - 1 tab. bd (with lukewarm water) for 21 days.
4. Kamdudha Ras - 250mg od for 21 days.

Shodhan Chikitsa

Nitya Virechan with Gandharvahastadi Erenda Taila for 14 days.


Result

Patient was instructed for follow up every 7 days.

SymptomsDay 0Day 7Day 14Day 21
Kandu+ + ++ + ++ +Absent
Toda+ ++ABSENTAbsent
Vidaha+ + ++ ++Absent
Vartidasht Sansthan Shotha++++++++Absent

(+- Mild; ++ - Moderate; +++ - Severe)

All sign and symptoms after treatment is diminished after Shodhan by Virechan and rest of Doshas are pacified by Shaman Chikitsa. At last follow up after 21 days all symptoms Kandu, Toda, Vidaha, Vartidasht Sansthan Shotha were diminished.

Discussion

Use of Sarshap, Haridra, Kustha, Prapunnag and Tilla with Katu Taila is beneficial in Sheetpitta.

SNContentRasaGunaVeeryaVipaka
1.Sarshap[9]Katu, TiktaSanigdhaUshnaKatu
2.Haridra[10]Katu, TiktaRuksha, LaghuUshnaKatu
3.Kustha[11]Tikta, Madhur, KatuLaghu Ruksha, TikshnaUshnaKatu
4.Prapunnaga[12]KatuLaghu, RukshaUshnaKatu
5.Tilla[13]MadurGuru, SanigdhaUshnaMadhur

All contents here possess Ushna Veerya. Sarshap and Tilla have Sanigdha Guna, which helps in Shaman of Vata Dosha which is predominant in Sheetpitta

Contents of Yashtimadhvaadi Kwatha

SNContentRasaGunaVeeryaVipaka
1.Yashtimadhu[14]MadhurGuru, SnigdhaSheetaMadhur
2.Madhuk[15]MadhurLaghu, SnigdhaPichhilSheetaMadhur
3.Rasna[16]KatuLaghu, TikshnaRukshaUshnaKatu
4.Chandan[17]Tikta, MadhurLaghu, RukshaSheetaKatu
5.Raktchandan[18]Tikta, MadhurGuru, RukshaSheetaKatu
6.Nirgundi[19]Katu, TiktaLaghu, RukshaUshnaKatu
7.Pippali[20]KatuLaghu, Snigdha TikshnaAnushna SheetaMadhur

In Sheetpitta there was vitiation of Kapha and Vaat due to Sheeta-Amla Ahara and Shita Vihara. Kapha was dominant and Pitta was Anubandhi. In such condition Strotavarodha created by vitiated Kapha should be broken first.

Pitta achieved normal state after removal of Avarodha and in this Laghusutshekhar Ras was helpful to give relief in symptoms Virechan is said to be best for vitiated Pitta dosha. Nitya Virechan with Gandharvahastadi Erenda Taila was done.

Conclusion

According to Ayurveda, Sheetpitta is described as Tridoshaj Vyadhi, but Vata and Pitta Dosha are predominant. Use of Sarshap, Haridra, Kustha, Prapunnag and Tila with Katu Taila is beneficial in Sheetpitta. Use of Yashtimadhvaadi Kwath, Tab. Laghusutshekhar Rasa, Kamdudha Ras was found effective in Sheetapitta. Nitya Virechan with Gandharvahastadi Erenda Taila was very useful.

References

1. Anjana Nidana by Dr.S.Suresh Babu, Chowkhambha Sanskrit Series, Varanasi, edition, 2004; 206.

2. Madhava nidana 50/4 (Madhukosa commentary) Part 2 by Dr P.Himasagara Chandra Murthy, Chowkhambha Sanskrit Series office, Varanasi, edition, 2012.

3. Shastri B. Sheetpitta, Udarda and Kotha Nidanam, Chapter 50, Verse 4-6. Madhavnidanam. Chaukhamba Sanskrit Sansthan, Varanasi. 2012, p.284.

4. Siddique N, Pereira BN, Hasan Arshad S. Hepatitis C and urticaria: cause and effect? Allergy, 2004; 59: 668.

5. Sri Vijayarakshita and Srikanttadatta with Vidyotinihindi commentary By-Sudarshana Shastry, Madhavanidana of Srimadhavakara with Madhukosha Sanskrit commentary by Part –II, 50th chapter 1st -6th verse 26th edition. Chaukhamba Sanskrit Sansthana, Varanasi, 1996; 168-170.

6. Yogaratnakara Vidyotini Hinditeeka by Vaidya Sri Lakshmipathi Shastry Sheetapitta Udardakotha nidana and Chikitsa, 1-15 verse, 8th edition. Chauwkambha Samskrita samsthana, Varanasi, 2004; 234-237

7. Sharma P. Deepanadi Varga, Chapter 5, Dravyaguna Vigyan, Part 2. Chaukhamba Bharti Academy, Varanasi. 2018, p494-495.


8. Chunekar K. Haritkyadi Varga, Chapter 86, verse 241, Bhavprakash Nighantu. Chaukhamba Bharti Acaedmy, Varanasi. 2018, 149-152.

9. Sharma P. Udarda, Kotha and Sheetpitta Chikitsa Adhyaya, Chapter 51, Verse 5. Cakradutta. Chaukhamba orientalia, Varanasi. 2013, p410.

10. Sharma P. Chakshusyadi Varga, Chapter 2, Dravyaguna Vigyan, Part 2. Chaukhamba Bharti Academy, Varanasi. 2018, p152-153.

11. Sharma P. Chakshusyadi Varga, Chapter 2, Dravyaguna Vigyan, Part 2. Chaukhamba Bharti Academy, Varanasi. 2018, p163.

12. Sharma P. Vrishyadi Varga, Chapter 7, Dravyaguna Vigyan, Part 2. Chaukhamba Bharti Academy, Varanasi. 2018, p573.

13. Sharma P. Chakshusyadi Varga, Chapter 2, Dravyaguna Vigyan, Part 2. Chaukhamba Bharti Academy, Varanasi. 2018, p187.

14. Shastri L. Sheetpitta, Udarda and Kotha Nidanam Adhyaya, Yogratnakar Uttrardh, In: Shastri B, editor. Chaukhamba Prakashan, Varanasi. 2020, p234-236.

15. Sharma P. Chedanadi Varga, Chapter 4, Dravyaguna Vigyan, Part 2. Chaukhamba Bharti Academy, Varanasi. 2018, p254.

16. Sharma P. Jvarghanadi Varga, Chapter 9, Dravyaguna Vigyan, Part 2. Chaukhamba Bharti Academy, Varanasi. 2018, p813.

17. Sharma P. Medhyadi Varga, Chapter 1, Dravyaguna Vigyan, Part 2. Chaukhamba Bharti Academy, Varanasi. 2018, p39.

18. Sharma P. Jvarghanadi Varga, Chapter 9, Dravyaguna Vigyan, Part 2. Chaukhamba Bharti Academy, Varanasi. 2018, p715.

19. Sharma P. Jvarghanadi Varga, Chapter 9, Dravyaguna Vigyan, Part 2. Chaukhamba Bharti Academy, Varanasi. 2018, p718.

20. Sharma P. Medhyadi Varga, Chapter 1, Dravyaguna Vigyan, Part 2. Chaukhamba Bharti Academy, Varanasi. 2018, p67.