Changes

{{Infobox

{{Infobox

|title =  Trishothiya Adhyaya

|title =  Trishothiya Adhyaya

}}

}}

=== Introduction ===

=== Introduction ===

shanaiH paritudan [7] pArshvaM plIhA tasyAbhivardhate||28||  

shanaiH paritudan [7] pArshvaM plIhA tasyAbhivardhate||28||  

When the vitiated ''vata'' inhabits and elevates the spleen, it causes a gradual prickly pain in the sides, causing ''vliha vriddhi'' i.e. splenomegaly. [28]

When the vitiated ''vata'' inhabits and elevates the spleen, it causes a gradual prickly pain in the sides, causing ''pliha vriddhi'' i.e. splenomegaly. [28]

===== ''Gulma'' (abdominal lumps) =====

===== ''Gulma'' (abdominal lumps) =====

Types, causes, symptoms and prognoses of swelling, of various diseases, types of diseases, definitions of the three doshas, normal functions and symptoms of decrease and aggravation of doshas - all these have been explained in this chapter on three types of swellings by Punarvasu , who is free from tamas  and rajas qualities, doshas, greed, conceit, pride and ambition.[54-56]

Types, causes, symptoms and prognoses of swelling, of various diseases, types of diseases, definitions of the three doshas, normal functions and symptoms of decrease and aggravation of doshas - all these have been explained in this chapter on three types of swellings by Punarvasu , who is free from tamas  and rajas qualities, doshas, greed, conceit, pride and ambition.[54-56]

=== ''Tattva Vimarsha'' ===

=== ''Tattva Vimarsha'' /Fundamental Principles ===

<div style="text-align:justify;">

<div style="text-align:justify;">

*''Shotha'' (swelling) is associated with ''tridosha'' and occurs due to endogenous and exogenous factors.  

*''Shotha'' (swelling) is associated with ''tridosha'' and occurs due to endogenous and exogenous factors.  

*For knowing and treating a new disease that has not been described in the text, the underlying ''dosha'', its location, etiological factors, and the movement of ''dosha'' should be well identified. Then pathogenesis should become evident and rational treatment can be started. [45-47]  

*For knowing and treating a new disease that has not been described in the text, the underlying ''dosha'', its location, etiological factors, and the movement of ''dosha'' should be well identified. Then pathogenesis should become evident and rational treatment can be started. [45-47]  

*Three ''doshas'' - ''vata, pitta'' and ''kapha'' - are always present in the body of living beings. The learned should know about their normal and vitiated states. [48]

*Three ''doshas'' - ''vata, pitta'' and ''kapha'' - are always present in the body of living beings. The learned should know about their normal and vitiated states. [48]

*Enthusiasm, inspiration, expiration, movements, processing of ''dhatu'' (body tissues) and elimination of excreta are natural functions of of a normal ''vata''.[49]   

*Enthusiasm, inspiration, expiration, movements, processing of ''dhatu'' (body tissues) and elimination of excreta are natural functions of normal ''vata''.[49]   

*Vision, digestion, heat production, hunger, thirst, softness in body, luster, serenity and intelligence are the natural functions of a normal ''pitta''. [50]

*Vision, digestion, heat production, hunger, thirst, softness in body, luster, serenity and intelligence are the natural functions of normal ''pitta''. [50]

*Unctuousness, binding, firmness/stability, heaviness (maintaining volume/mass), virility, strength, forbearance, restraint and absence of greed are the natural functions of of a normal ''kapha''. [51]

*Unctuousness, binding, firmness/stability, heaviness (maintaining volume/mass), virility, strength, forbearance, restraint and absence of greed are the natural functions of normal ''kapha''. [51]

*The decrease (or increase) of these ''doshas'' in a body can be best diagnosed by a decrease (or increase) in the functions mentioned above. The alternate method to examine the status is to check functions of other (opposite) ''dosha''. Thus the status of ''dosha'' can be investigated based on their representative functions only.[52]

*The decrease (or increase) of these ''doshas'' in a body can be best diagnosed by a decrease (or increase) in the functions mentioned above. The alternate method to examine the status is to check functions of other (opposite) ''dosha''. Thus the status of ''dosha'' can be investigated based on their representative functions only.[52]

</div>

</div>

=== ''Vidhi Vimarsha'' ===

=== ''Vidhi Vimarsha'' / Applied Inferences ===

==== Classification of ''shotha'' (swelling/ distension) ====

==== Classification of ''shotha'' (swelling/ distension) ====

==== Various locations of ''shotha'' ====

==== Various locations of ''shotha'' ====

Sushruta described ''galashundi'' as ''kanthashundi'', a condition indicated by breathlessness, coughing and thirst. He mentioned the role of ''rakta'' along with ''kapha'' in causing the condition. (Su.ni.-16/41). ''Visarpa'' is a kind of inflammatory swelling mostly caused due to infection. In the context of ''kshudra rogas'' (curable diseases), ''tilaka'' (mole) is black in color, similar to size of sesame seed, painless and is flat (Su.ni.-13/43). Similarly ''vyanga'' (pigmentation) as painless, fine, black color circles (Su.ni.-13/45,46). Same manifestation over the face or other body parts is called ''nilika'' (Su.ni.-13/46). In addition to ''pitta'', Sushruta has mentioned involvement of ''vata, kapha'' and ''rakta'' in the affliction of ''shankhaka roga'' (saggital sinus thrombosis/intracranial growth/temporal arteritis) (Su.ut.-25/16-18). In Madhava Nidanam it is described as a very severe and fatal condition that, by causing blockages in the head and throat, can kill the patient in three days [Ma.ni.-60/15].''Karnamoola shotha'' (swelling at base of ear/parotitis) has been described as a complication of ''sannipataja jwara'' (Ca.chi.-3/287). ''Pliha vriddhi'' (splenomegaly) has been described as ''plīhodara'' (Ca.chi.-13/35-38). Sushruta has described ''plihodara'', due to intake of irritant and slimy food items, as a cause for aggravation of ''rakta'' and ''kapha''. ''Gulma'' is a very special disease class described in Ayurveda, because it is neither mentioned independently in modern medicine nor it can be correlated with any disease. The problems or symptoms described in reference to ''gulma'' are practically found in clinical practice therefore it should be considered exclusively(Ca.chi.-5 & ch.ni.-3). In ''Aanaha'' (distension of abdomen), not only is the movement of ''vata'' hampered but the vitiated ''vata'' also dries the stool. Therefore, the patient of ''aanaha'' complains of constipation along with flatulence.  

Sushruta described ''galashundi'' as ''kanthashundi'', a condition indicated by breathlessness, coughing and thirst. He mentioned the role of ''rakta'' along with ''kapha'' in causing the condition. (Su.ni.-16/41). ''Visarpa'' is a kind of inflammatory swelling mostly caused due to infection. In the context of ''kshudra rogas'' (curable diseases), ''tilaka'' (mole) is black in color, similar to size of sesame seed, painless and is flat (Su.ni.-13/43). Similarly ''vyanga'' (pigmentation) as painless, fine, black color circles (Su.ni.-13/45,46). Same manifestation over the face or other body parts is called ''nilika'' (Su.ni.-13/46). In addition to ''pitta'', Sushruta has mentioned involvement of ''vata, kapha'' and ''rakta'' in the affliction of ''shankhaka roga'' (saggital sinus thrombosis/intracranial growth/temporal arteritis) (Su.ut.-25/16-18). In Madhava Nidanam it is described as a very severe and fatal condition that, by causing blockages in the head and throat, can kill the patient in three days [Ma.ni.-60/15].''Karnamoola shotha'' (swelling at base of ear/parotitis) has been described as a complication of ''sannipataja jwara'' (Ca.chi.-3/287). ''Pliha vriddhi'' (splenomegaly) has been described as ''plīhodara'' (Ca.chi.-13/35-38). Sushruta has described ''plihodara'', due to intake of irritant and slimy food items, as a cause for aggravation of ''rakta'' and ''kapha''. ''Gulma'' is a very special disease class described in [[Ayurveda]], because it is neither mentioned independently in modern medicine nor it can be correlated with any disease. The problems or symptoms described in reference to ''gulma'' are practically found in clinical practice therefore it should be considered exclusively(Ca.chi.-5 & ch.ni.-3). In ''Aanaha'' (distension of abdomen), not only is the movement of ''vata'' hampered but the vitiated ''vata'' also dries the stool. Therefore, the patient of ''aanaha'' complains of constipation along with flatulence.  

Two causes of ''aanaha'' are: impaired peristalsis of the stomach and that of the large bowel (Su.utt.-57/20-22). ''Vriddhi roga'' (hydrocele and hernia) has been described to be of seven types i.e. ''vataja, pittaja, kaphaja, raktaja, medoja, mutraja'' and ''antraja''. (A.H.Ni.-11/21-31). The ''antraja vriddhi'' may be correlated with swelling of the hernia and is said to be incurable. Sushruta has described five types of ''rohini'' (diptheria) i.e. ''vataja, pittaja, kaphaja, raktaja'' and ''sannipataja''  (Su.ni.-16/47-50).

Two causes of ''aanaha'' are: impaired peristalsis of the stomach and that of the large bowel (Su.utt.-57/20-22). ''Vriddhi roga'' (hydrocele and hernia) has been described to be of seven types i.e. ''vataja, pittaja, kaphaja, raktaja, medoja, mutraja'' and ''antraja''. (A.H.Ni.-11/21-31). The ''antraja vriddhi'' may be correlated with swelling of the hernia and is said to be incurable. Sushruta has described five types of ''rohini'' (diptheria) i.e. ''vataja, pittaja, kaphaja, raktaja'' and ''sannipataja''  (Su.ni.-16/47-50).

''Upajihvika, galashundika, galagraha, rohini'' are basically infectious disorders affecting the mouth and throat area. ''Galaganda'' closely resembles goitre which is caused due to thyroid disorders. ''Visarpa'' and ''pidika'' are caused due to skin infections, whereas ''tilaka, piplu, vyanga'' and ''nilika'' are the problems present in skin due melanin pigment disorders. ''Pliha vridhi'' or spleenomegaly is condition where spleen gets enlarged due to many reasons such as infections, hematological disorders, malignancies etc. ''Gulma, udara roga, aanaha'' are diseases mainly located and related to gastrointestinal tract, having main features of fullness or protuberance. Eight ''udara rogas'' described in Ayurveda are actually diseases present as protuberances in abdomen. But all ''udara rogas'' are not directly related to the gastrointestinal tract e.g. ''plihodara'' (splenomegaly), ''yakradaludara'' (hepatomegaly), and ''jalodara'' (ascites). Still their manifestation is similar to ''shotha'' i.e. swellings. Swelling at the roots of ears, commonly known as ''Karnamoola shotha'' (Parotitis), is mostly due to viral infections. ''Vriddhi roga'' is a kind of hernia, i.e., inguinal, femoral, umbilical or incision hernia with visible swelling. ''Adhimansa'' (increased muscles bulk) and ''arbuda''(tumor) are swellings associated with extra or new growth that could be benign or malignant. ''Rohini'' can be closely correlated with diphtheria which is caused by a bacterial infection i.e. Corynibacterium diphtheriae <ref>Textbook of microbiology – Orient Longman, chapter-26 page-23, 4th edition. </ref>. It can affect many sites in the body but most commonly the throat where if not treated properly may cause death due to suffocation or asphyxia. [19-36]

''Upajihvika, galashundika, galagraha, rohini'' are basically infectious disorders affecting the mouth and throat area. ''Galaganda'' closely resembles goitre which is caused due to thyroid disorders. ''Visarpa'' and ''pidika'' are caused due to skin infections, whereas ''tilaka, piplu, vyanga'' and ''nilika'' are the problems present in skin due melanin pigment disorders. ''Pliha vridhi'' or spleenomegaly is condition where spleen gets enlarged due to many reasons such as infections, hematological disorders, malignancies etc. ''Gulma, udara roga, aanaha'' are diseases mainly located and related to gastrointestinal tract, having main features of fullness or protuberance. Eight ''udara rogas'' described in [[Ayurveda]] are actually diseases present as protuberances in abdomen. But all ''udara rogas'' are not directly related to the gastrointestinal tract e.g. ''plihodara'' (splenomegaly), ''yakradaludara'' (hepatomegaly), and ''jalodara'' (ascites). Still their manifestation is similar to ''shotha'' i.e. swellings. Swelling at the roots of ears, commonly known as ''Karnamoola shotha'' (Parotitis), is mostly due to viral infections. ''Vriddhi roga'' is a kind of hernia, i.e., inguinal, femoral, umbilical or incision hernia with visible swelling. ''Adhimansa'' (increased muscles bulk) and ''arbuda''(tumor) are swellings associated with extra or new growth that could be benign or malignant. ''Rohini'' can be closely correlated with diphtheria which is caused by a bacterial infection i.e. Corynibacterium diphtheriae <ref>Textbook of microbiology – Orient Longman, chapter-26 page-23, 4th edition. </ref>. It can affect many sites in the body but most commonly the throat where if not treated properly may cause death due to suffocation or asphyxia. [19-36]

==== ''Dosha'' and disease ====

==== ''Dosha'' and disease ====