2. INTRODUCTION
Shotha is a well known disease since ancient
days. It is an identified symptom of vast many
disorder encountered in almost every specialised
branch of Ayurveda. Age and sex are no
exceptions. It may manifest itself in a cell or in
the whole organ or in the whole body. Ancient
Ayurvedic texts have explained different types of
shotha covering both non-inflamatory and
inflamatory swelling .
3. Paryaya
Shopha and Shvayathu are indicated as
the synonyms of Shotha in various classics.
Though there is a view that Shotha refers to
generalised oedema and Shopha signifies
local oedematous condition or
inflammation, sufficient references to
support this view are not present.
4. samprapthi
All doshas get vitiated ,they vitiate raktha and
localize in blood vessels. This couses obstraction
in the vessels and doshas get diverted and start
accumulating under the skin and muscle and rasa
raktha and udaka get vitiated with kidney .
7. Pittaja shotha
Edema is soft
Reddish and yellow in colour
Unpleasent odour
Red eye, vertigo, sweating and burning
Fever
Tenderness
Pus formation
8. Kaphaja shotha
Edema is heavy stable
Loss appetite
Salivation
Sleep
Non pitting edema
increases in night
9. CHIKITSA
Chikitsa is the breaking up of pathogenesis going on
in the body with appropriate measures to attain the
equilibrium of doshas, dhatus and malas which is
responsible for health.
The pathogenesis of Shotha leads to the abnormal
collection of drava pradhana doshas inbetween
Twacha and Mamsa. So breaking up of this
samprapti can be achieved by elimination of this
sanchita Ap. dosha by various procedures.
10. What ever the cause of the disease may be
the final resultant will be the Jala sanchaya
and machanism of fluid collection remains
the same. So aiming at Jala nirharana
makes the half of the correction of the total
treatment, other half includes the affected
organ which is done by prakruthi vighata
chikitsa.
11. Samanya Chikitsa
• It is estimated considering the following points
• a) Avastha
• In Amavastha - If doshas are in minimum
quantity then langhana
and pachana is advocated. In Bahudoshavastha
Doshavasechana makes
the line of management.
• In Niramavastha- Shodhana procedures like
vamana, virechana, nasya
are adopted according to dosha involvement
12. b) Vyaktha sthana - Treatment is adopted
according to the part of the body affected.
In Shira Shotha -- Shirovirechana
In Adha Shareera shotha -- Virechana
In urdhwa Shareeragata shotha -- Vamana
c) Based on Hetu
If Shotha is caused due to the factor santarpana
factor then rookshana should be adopted. If it is
due to Apatarpana Hetus then brimhana in the
form of snehana is advocated.
13. d) Doshanusara
Nirooha basthi is indicated in vataja Shotha where
vibandha vit is present.
Tikthaka Gritha is indicated in pitta vataja shotha
Ksheera is adviced in conditions of Moorcha, Arati,
Daha, Trishna and also in vatapithaja Shotha.
14. Acharya Sushrutha opines that according to the
condition of the patient and disease, shodhana karma,
snehana, swedana, upanaha and siramokshana can be
carried out in Shotharoga.
Acharya Vagbhata stress on vishodhana, laghu bhojana
and pachana chikitsa in Shotha.
Acharya Bhela has referred Kalyanaka Gritha,
Mahatikthaka Gritha and Panchagavya Gritha in the
management of shotha.
15. • Langhana
Doshavridhi, Apyamsha vridhi, Bahyasira sanga
are the responsible factors in the manifestation of
the disease. Langhana has been explained as the
first line of management in all types of Shotha
especially in Kaphaja Shotha.
Acharya Vagbhata uses the word vishoshana for
langhana and Arunadatta clarifies the type of
langhana as upavasa. (Vishoshanam Atra
Upavasa)
16. • Pachana
Pachana procedure helps in digesting the ama, and thus
helps in samprapti vighatana similar to langhana. Since
langhana and pachana normalises jataragni, no doubt they
also rectifies Dhatwagni and this action may be at the
cellular level.
Vamana
Though Acharya Charaka advocates vamana in shotha, but
never explained about vamana yogas in this context. Even
Acharya Vagbhata and Acharya Kashyapa have not
touched this topic. In Jalodara (which is a type of shotha)
also vamana is contraindicated and Nithyavirechana is
indicated.
17. • Shodhana
This procedure is mainly indicated at the
stage of Bahudoshas. In Urdhwaga shotha
i.e. shotha produced by the uraha sthita
dosha (Kapha). Vamana is indicated. In
Adhoga shotha which is produced due to
adhosthita dosha (vata) virechana is
indicated.
18. • Shothagna Dravya Prayoga
That which annihilates Shotha is termed as
shothagna which includes punernava, dashamoola,
guggulu etc. Kshara Prayoga
All the Ayurvedic authors have mentioned the use
of kshara in all types of shothas and specifically in
Kaphaja Shotha. Yavakshara which is used in
many yogas is laghu, sookshma, agnideepaka,
pandu and hridrogahara. Sarja kshara is deepaka
and pachaka. These ksharas acts as mootrala and
thus helps in elimation of accumulated fluids.
19. • Shothagna Dravya Prayoga
That which annihilates Shotha is termed as shothagna
which includes punernava, dashamoola, guggulu etc.
Kshara Prayoga
All the Ayurvedic authors have mentioned the use of
kshara in all types of shothas and specifically in Kaphaja
Shotha. Yavakshara which is used in many yogas is laghu,
sookshma, agnideepaka, pandu and hridrogahara. Sarja
kshara is deepaka and pachaka. These ksharas acts as
mootrala and thus helps in elimation of accumulated fluids.
20. • Gomutra Prayoga
Gomutra is extensively used in all varieties of
shotha. It is advised alongwith other dravyas like
Hareetaki, Ksheera etc. both for shodhana and
shamana. Due to its properties it purifies the
srotas and thus removes srotosanga. So doshas are
driven into kosta and then by shodhana it is
expelled out.
The kshara property helps in dragging a large
amount of water to koshta and thus acts as
Mutrala.
21. • Katu Ushna Dravya Prayoga
Along with kshara, katu ushna dravyas are
indicated in Kaphaja Shotha to palliate kapha and
to produce shoshana of sanchita drava. For this
pippali, shunti etc. dravyas have been used.
• Asava Arishta Madhya Prayoga
All the authors emphasis the use of these dravyas
in all varieties of shotha where there is
srothorodha, agni and ruchinasha, owing to their
rooksha, teekshna, deepana and rochana
properties. Amla madhya is contraindicated in
shotha where sa anamla madhya is advised.
22. • Loha, Mandoora and Tamra Kalpas
Many preparations of Loha, Tamra and Mandoora
have been advocated in kaphaja shotha. These
preparations may help in oedema due to
hypoproteinemia and also may cure anaemia in
various oedemas.
• Bahya Prayoga
Bahiparimarjana chikitsa is mainly helpfull in
vataja and pittaja type of shotha. Where as in
Kaphaja Shotha these are having very little role to
play.
23. • Snehana
Though Sushruta has mentioned it as a samanya
chikitsa, Charaka and Vagbhata specifies it to
vataja shotha, which is more appropriate, since the
main symptoms of vataja shotha like khara,
paroosha, bhinnatwak needs proper oleation.
• Swedana
Similar to snehana the use of swedana is
mentioned particularly for vataja shotha. But as a
poorvakarma it can be used in all shothas where in
shodhana is indicated.
24. • Lepa
Two groups of drugs mentioned for lepa. Among
which with the first group consists of sheetala
dravyas such as Mrinala, Manjista, etc. which are
pittashamaka and thus produces dahaprashamana
action. These may be useful in pittajashotha to
prevent paka.
The other group consists of rooksha and shushka
dravyas such as vibheetaki, pippali, siktha etc. which
when applied as a shushka lepa helps in absorbing
theliquids from the skin surface and then reduces
Kaphaja Shotha.
25. • Seka and Snana
Snana and seka with water prepared out of that particular
doshahara dravya are mentioned for the individual variety of
shotha such as kakolyadi gana kwatha in pittaja, kulattha
shunti sadita jala in kaphaja shotha etc. Here the effect of
ushnajala snana or seka is similar to that of swedana.
• Upanaha
Even though Sushruta has mentioned this under samanya
chikitsa it is more useful in vataja shotha where in toda,
bheda, katinata, twachasrutana, etc. are common.
• Cheda and Daha Karma
