Changes

Inflammation is an important pathology that includes tumor (swelling) as a cardinal sign. Further, classifications of ''shotha'' (swelling/distension) based on cause, predominance of ''dosha'', and prognosis as per site of swelling are explained. Principles of identification of new diseases are also elucidated. The normal functions of ''dosha'' and their importance in disease conditions is emphasized. Thus, the chapter is fundamental in knowing disease.

Inflammation is an important pathology that includes tumor (swelling) as a cardinal sign. Further, classifications of ''shotha'' (swelling/distension) based on cause, predominance of ''dosha'', and prognosis as per site of swelling are explained. Principles of identification of new diseases are also elucidated. The normal functions of ''dosha'' and their importance in disease conditions is emphasized. Thus, the chapter is fundamental in knowing disease.

===Sanskrit text, transliteration and english translation===

=== Sanskrit text, Transliteration and English Translation ===

अथातस्त्रिशोथीयमध्यायं व्याख्यास्यामः||१||  

अथातस्त्रिशोथीयमध्यायं व्याख्यास्यामः||१||  

इति ह स्माह भगवानात्रेयः||२||  

इति ह स्माह भगवानात्रेयः||२||  

athātastriśōthīyamadhyāyaṁ vyākhyāsyāmaḥ||1||  

athātastriśōthīyamadhyāyaṁ vyākhyāsyāmaḥ||1||  

iti ha smāha bhagavānātrēyaḥ||2||  

iti ha smāha bhagavānātrēyaḥ||2||  

athAtastrishothIyamadhyAyaM vyAkhyAsyAmaH||1||  

athAtastrishothIyamadhyAyaM vyAkhyAsyAmaH||1||  

iti ha smAha bhagavAnAtreyaH||2||

iti ha smAha bhagavAnAtreyaH||2||

Now we will discuss the chapter on three types of shotha i.e. swellings. Thus, said Lord Atreya. [1-2]

 

Three types of shotha:

Now we will discuss the chapter on three types of ''shotha'' i.e. swellings. Thus, said Lord Atreya. [1-2]

 

==== Three types of ''shotha'' ====

 

त्रयः शोथा भवन्ति वातपित्तश्लेष्मनिमित्ताः, ते पुनर्द्विविधा निजागन्तुभेदेन||३||  

त्रयः शोथा भवन्ति वातपित्तश्लेष्मनिमित्ताः, ते पुनर्द्विविधा निजागन्तुभेदेन||३||  

trayaḥ śōthā bhavanti vātapittaślēṣmanimittāḥ, tē punardvividhā nijāgantubhēdēna||3||

trayaḥ śōthā bhavanti vātapittaślēṣmanimittāḥ, tē punardvividhā nijāgantubhēdēna||3||

trayaH shothA bhavanti vAtapittashleShmanimittAH, te punardvividhA nijAgantubhedena||3||

trayaH shothA bhavanti vAtapittashleShmanimittAH, te punardvividhA nijAgantubhedena||3||

tatrāgantavaśchēdanabhēdanakṣaṇanabhañjanapicchanōtpēṣaṇaprahāravadhabandhanavēṣṭanavyadhanapīḍanādibhirvābhallātakapuṣpaphalarasātmaguptāśūkakrimiśūkāhitapatralatāgulmasaṁsparśanairvā svēdanaparisarpaṇāvamūtraṇairvāviṣiṇāṁ saviṣaprāṇidaṁṣṭrādantaviṣāṇanakhanipātairvā sāgaraviṣavātahimadahanasaṁsparśanairvā śōthāḥsamupajāyantē||4||

tatrAgantavashchedanabhedanakShaNanabha~jjanapicchanotpeShaNaprahAravadhabandhanaveShTanavyadhanapIDanAdibhirvAbhallAtakapuShpaphalarasAtmaguptAshUkakrimishUkAhitapatralatAgulmasaMsparshanairvA svedanaparisarpaNAvamUtraNairvA viShiNAMsaviShaprANidaMShTrAdantaviShANanakhanipAtairvA sAgaraviShavAtahimadahanasaMsparshanairvA shothAH samupajAyante||4||

 

Causes of agantuja shotha (exogenous swelling): Common etiological factors of agantuja shotha include chhedana (excision), bhedana (incision), kshanana (churning of bones), bhanjana (breaking), pichhana (excess squeezing), utprashana (grinding), prahaara (hitting), vadha (stroking), bandhan (binding), veshtana (twisting), vyadhana (piercing), peedana (pressing) etc. In addition to these traumas some other factors such as coming in contact with the juice of flowers or fruits of some plants such as bhallātaka (Semicarpus anacardium), atmagupta (Mucuna pruriens) or getting bitten or stung by certain insects or touching irritant leaves, climbers, shrubs, sweat or urine of poisonous animals or even coming in physical contact with them, or getting injured by their teeth, horns and nails, or exposure to marine or poisonous air, or exposure to excess cold or burns may also result in agantuja shotha. [4]

Diagnosis and treatment of exogenous swelling:

 

 

rasātmaguptāśūkakrimiśūkāhitapatralatāgulmasaṁsparśanairvā svēdanaparisarpaṇāvamūtraṇairvāviṣiṇāṁ saviṣaprāṇidaṁṣṭrādantaviṣāṇanakhanipātairvā sāgaraviṣavātahimadahanasaṁsparśanairvā śōthāḥsamupajāyantē||4||

 

tatrAgantavashchedanabhedanakShaNanabha~jjanapicchanotpeShaNa prahAravadhabandhanaveShTanavyadhana pIDanAdibhirvAbhallAtakapuShpaphala rasAtmaguptAshUkakrimishUkAhitapatralatAgulmasaMsparshanairvA svedanaparisarpaNAvamUtraNairvAviShiNAM saviShaprANidaMShTrAdantaviShANanakhanipAtairvA sAgaraviShavAtahimadahanasaMsparshanairvA shothAH samupajAyante||4||

 

Causes of ''agantuja shotha'' (exogenous swelling): Common etiological factors of ''agantuja shotha'' include ''chhedana'' (excision), ''bhedana'' (incision), ''kshanana'' (churning of bones), ''bhanjana'' (breaking), ''pichhana'' (excess squeezing), ''utprashana'' (grinding), ''prahaara'' (hitting), ''vadha'' (stroking), ''bandhana'' (binding), ''veshtana'' (twisting), ''vyadhana'' (piercing), ''peedana'' (pressing) etc. In addition to these traumas some other factors such as coming in contact with the juice of flowers or fruits of some plants such as ''bhallātaka'' (Semicarpus anacardium), ''atmagupta'' (Mucuna pruriens) or getting bitten or stung by certain insects or touching irritant leaves, climbers, shrubs, sweat or urine of poisonous animals or even coming in physical contact with them, or getting injured by their teeth, horns and nails, or exposure to marine or poisonous air, or exposure to excess cold or burns may also result in ''agantuja shotha''. [4]

 

==== Diagnosis and treatment of exogenous swelling ====

 

ते पुनर्यथास्वं हेतुव्यञ्जनैरादावुपलभ्यन्ते निजव्यञ्जनैकदेशविपरीतैः;बन्धमन्त्रागदप्रलेपप्रतापनिर्वापणादिभिश्चोपक्रमैरुपक्रम्यमाणाः प्रशान्तिमापद्यन्ते||५||  

ते पुनर्यथास्वं हेतुव्यञ्जनैरादावुपलभ्यन्ते निजव्यञ्जनैकदेशविपरीतैः;बन्धमन्त्रागदप्रलेपप्रतापनिर्वापणादिभिश्चोपक्रमैरुपक्रम्यमाणाः प्रशान्तिमापद्यन्ते||५||  

tē punaryathāsvaṁ hētuvyañjanairādāvupalabhyantē nijavyañjanaikadēśaviparītaiḥ;bandhamantrāgadapralēpapratāpanirvāpaṇādibhiścōpakramairupakramyamāṇāḥpraśāntimāpadyantē||5||  

tē punaryathāsvaṁ hētuvyañjanairādāvupalabhyantē nijavyañjanaikadēśaviparītaiḥ;bandhamantrāgadapralēpapratāpanirvāpaṇādibhiścōpakramairupakramyamāṇāḥpraśāntimāpadyantē||5||  

te punaryathAsvaM hetuvya~jjanairAdAvupalabhyante nijavya~jjanaikadeshaviparItaiH;bandhamantrAgadapralepapratApanirvApaNAdibhishcopakramairupakramyamANAH prashAntimApadyante||5||

te punaryathAsvaM hetuvya~jjanairAdAvupalabhyante nijavya~jjanaikadeshaviparItaiH;bandhamantrAgadapralepapratApanirvApaNAdibhishcopakramairupakramyamANAH prashAntimApadyante||5||

Exogenous swellings can be primarily identified by characteristic signs of injury and localization. After some time, they become similar to endogenous swellings [due to vitiation of dosha]. They are treated by bandage, mantra (holy chants), antidotes, local application of medicines, fomentation, cooling measures etc. [5]

 

General causes of endogenous swellings:

Exogenous swellings can be primarily identified by characteristic signs of injury and localization. After some time, they become similar to endogenous swellings (due to vitiation of ''dosha''). They are treated by bandage, ''mantra'' (holy chants), antidotes, local application of medicines, fomentation, cooling measures etc. [5]

 

==== General causes of endogenous swellings ====

 

निजाः पुनः स्नेहस्वेदवमनविरेचनास्थापनानुवासनशिरोविरेचनानामयथावत्प्रयोगान्मिथ्यासंसर्जनाद्वाछर्द्यलसकविसूचिकाश्वासकासातिसारशोषपाण्डुरोगोदरज्वरप्रदरभगन्दरार्शोविकारातिकर्शनैर्वा कुष्ठकण्डूपिडकादिभिर्वाछर्दिक्षवथूद्गारशुक्रवातमूत्रपुरीषवेगधारणैर्वा कर्मरोगोपवासाध्वकर्शितस्य वासहसाऽतिगुर्वम्ललवणपिष्टान्नफलशाकरागदधिहरितकमद्यमन्दकविरूढनवशूकशमीधान्यानूपौदक-पिशितोपयोगान्मृत्पङ्कलोष्टभक्षणाल्लवणातिभक्षणाद्गर्भसम्पीडनादामगर्भप्रपतनात् प्रजातानां चमिथ्योपचारादुदीर्णदोषत्वाच्च शोफाः प्रादुर्भवन्ति; इत्युक्तः सामान्यो हेतुः||६||  

निजाः पुनः स्नेहस्वेदवमनविरेचनास्थापनानुवासनशिरोविरेचनानामयथावत्प्रयोगान्मिथ्यासंसर्जनाद्वाछर्द्यलसकविसूचिकाश्वासकासातिसारशोषपाण्डुरोगोदरज्वरप्रदरभगन्दरार्शोविकारातिकर्शनैर्वा कुष्ठकण्डूपिडकादिभिर्वाछर्दिक्षवथूद्गारशुक्रवातमूत्रपुरीषवेगधारणैर्वा कर्मरोगोपवासाध्वकर्शितस्य वासहसाऽतिगुर्वम्ललवणपिष्टान्नफलशाकरागदधिहरितकमद्यमन्दकविरूढनवशूकशमीधान्यानूपौदक-पिशितोपयोगान्मृत्पङ्कलोष्टभक्षणाल्लवणातिभक्षणाद्गर्भसम्पीडनादामगर्भप्रपतनात् प्रजातानां चमिथ्योपचारादुदीर्णदोषत्वाच्च शोफाः प्रादुर्भवन्ति; इत्युक्तः सामान्यो हेतुः||६||  

nijāḥ punaḥ snēhasvēdavamanavirēcanāsthāpanānuvāsanaśirōvirēcanānāmayathāvatprayōgānmithyāsaṁsarjanādvāchardyalasakavisūcikāśvāsakāsātisāraśōṣapāṇḍurōgōdarajvarapradarabhagandarārśōvikārātikarśanairvākuṣṭhakaṇḍūpiḍakādibhirvā chardikṣavathūdgāraśukravātamūtrapurīṣavēgadhāraṇairvākarmarōgōpavāsādhvakarśitasya vāsahasā'tigurvamlalavaṇapiṣṭānnaphalaśākarāgadadhiharitakamadyamandakavirūḍhanavaśūkaśamīdhānyānūpaudaka-piśitōpayōgānmr̥tpaṅkalōṣṭabhakṣaṇāllavaṇātibhakṣaṇādgarbhasampīḍanādāmagarbhaprapatanāt prajātānāṁ camithyōpacārādudīrṇadōṣatvācca śōphāḥ prādurbhavanti; ityuktaḥ sāmānyō hētuḥ||6||  

nijāḥ punaḥ snēhasvēdavamanavirēcanāsthāpanānuvāsanaśirōvirēcanānāmayathāvatprayōgānmithyāsaṁsarjanādvāchardyalasakavisūcikāśvāsakāsātisāraśōṣapāṇḍurōgōdarajvarapradarabhagandarārśōvikārātikarśanairvākuṣṭhakaṇḍūpiḍakādibhirvā chardikṣavathūdgāraśukravātamūtrapurīṣavēgadhāraṇairvākarmarōgōpavāsādhvakarśitasya vāsahasā'tigurvamlalavaṇapiṣṭānnaphalaśākarāgadadhiharitakamadyamandakavirūḍhanavaśūkaśamīdhānyānūpaudaka-piśitōpayōgānmr̥tpaṅkalōṣṭabhakṣaṇāllavaṇātibhakṣaṇādgarbhasampīḍanādāmagarbhaprapatanāt prajātānāṁ camithyōpacārādudīrṇadōṣatvācca śōphāḥ prādurbhavanti; ityuktaḥ sāmānyō hētuḥ||6||  

nijAH punaH snehasvedavamanavirecanAsthApanAnuvAsanashirovirecanAnAmayathAvatprayogAnmithyAsaMsarjanAdvAchardyalasakavisUcikAshvAsakAsAtisArashoShapANDurogodarajvarapradarabhagandarArshovikArAtikarshanairvA kuShThakaNDUpiDakAdibhirvAchardikShavathUdgArashukravAtamUtrapurIShavegadhAraNairvA karmarogopavAsAdhvakarshitasya vAsahasA~atigurvamlalavaNapiShTAnnaphalashAkarAgadadhiharitakamadyamandakavirUDhanavashUkashamIdhAnyAnUpaudaka-pishitopayogAnmRutpa~gkaloShTabhakShaNAllavaNAtibhakShaNAdgarbhasampIDanAdAmagarbhaprapatanAt prajAtAnAM ca mithyopacArAdudIrNadoShatvAccashophAH prAdurbhavanti; ityuktaH sAmAnyo hetuH||6||

nijAH punaH snehasvedavamanavirecanAsthApanAnuvAsanashirovirecanAnAmayathAvatprayogAnmithyAsaMsarjanAdvAchardyalasakavisUcikAshvAsakAsAtisArashoShapANDurogodarajvarapradarabhagandarArshovikArAtikarshanairvA kuShThakaNDUpiDakAdibhirvAchardikShavathUdgArashukravAtamUtrapurIShavegadhAraNairvA karmarogopavAsAdhvakarshitasya vAsahasA~atigurvamlalavaNapiShTAnnaphalashAkarAgadadhiharitakamadyamandakavirUDhanavashUkashamIdhAnyAnUpaudaka-pishitopayogAnmRutpa~gkaloShTabhakShaNAllavaNAtibhakShaNAdgarbhasampIDanAdAmagarbhaprapatanAt prajAtAnAM ca mithyopacArAdudIrNadoShatvAccashophAH prAdurbhavanti; ityuktaH sAmAnyo hetuH||6||

Nija shotha i.e. endogenous swelling could be caused due to any of the following factors:

 

Iatrogenic factors: Improper administration of snehana (oleation), swedana (sudation), vamana (therapeutic emesis), virechana (therapeutic purgation), asthapana basti (non-unctuous enema), anuvasana basti (unctuous enema), shirovirechana (nasal errhines) and/or samsarjana krama (dietetic regimen after purification therapy).  

''Nija shotha'' i.e. endogenous swelling could be caused due to any of the following factors:

 

'''''Iatrogenic factors''''': Improper administration of ''snehana'' (oleation), swedana (sudation), vamana (therapeutic emesis), virechana (therapeutic purgation), asthapana basti (non-unctuous enema), anuvasana basti (unctuous enema), shirovirechana (nasal errhines) and/or samsarjana krama (dietetic regimen after purification therapy).  

Complication of other diseases: It can also result as complication of chhardi (vomiting), alasaka (delayed and obstructive digestive process), visuchika (cholera), shwasa (dyspnoea), kasa (cough), atisara (diarrhea), shosha (tuberculosis or pthysis ), pandu roga (anemia), udara roga (abdominal diseases including ascitis), jwara (pyrexia), pradara (excessive vaginal discharge), bhagandara (fistula-in-ano), arsha (piles) excessive emaciation, skin disorders, worm infestation, peedika (boils) etc..  

Complication of other diseases: It can also result as complication of chhardi (vomiting), alasaka (delayed and obstructive digestive process), visuchika (cholera), shwasa (dyspnoea), kasa (cough), atisara (diarrhea), shosha (tuberculosis or pthysis ), pandu roga (anemia), udara roga (abdominal diseases including ascitis), jwara (pyrexia), pradara (excessive vaginal discharge), bhagandara (fistula-in-ano), arsha (piles) excessive emaciation, skin disorders, worm infestation, peedika (boils) etc..  

Lifestyle: It may be due to suppression of natural urges like vomiting, sneezing, belching, ejaculation, flatus, micturition, defecation, excessive weakness caused by therapeutic purification procedures, chronic diseases, fasting, and excessive walking.  

Lifestyle: It may be due to suppression of natural urges like vomiting, sneezing, belching, ejaculation, flatus, micturition, defecation, excessive weakness caused by therapeutic purification procedures, chronic diseases, fasting, and excessive walking.