Changes

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

''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).  

#'''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, ''pidika'' (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.  

Dietary factors: Excess intake of too heavy diet, sour, salty, preparations of rice flour/maida/pastry, fruits, vegetables, raga preparations or pickles, curd, green salads, wine,   unfermented curd, sprouted and new corn and cereals, consumption of meat of animals in marshy places or of acquatic animals such as certain types of fish, eating clay or pieces of earthen pots or bricks, or eating excessive salt (resulting in swelling).  

#'''Dietary factors''': Excess intake of too heavy diet, sour, salty, preparations of rice flour/maida/pastry, fruits, vegetables, ''raga'' preparations or pickles, curd, green salads, wine, unfermented curd, sprouted and new corn and cereals, consumption of meat of animals in marshy places or of acquatic animals such as certain types of fish, eating clay or pieces of earthen pots or bricks, or eating excessive salt (resulting in swelling).  

Ante-natal and post-natal factors: Due to excessive pressure of gravid uterus, abortion, pre mature delivery and improper follow up of puerperal regimen, doshas get aggravated and produce shotha. [6]  

#'''Ante-natal and post-natal factors''': Due to excessive pressure of gravid uterus, abortion, pre mature delivery and improper follow up of puerperal regimen, doshas get aggravated and produce ''shotha''. [6]  

Specific causes of swelling due to dosha dominance:

 

Swelling due to vata dominance:

==== Specific causes of swelling due to ''dosha'' dominance ====

 

===== Swelling due to ''vata'' dominance =====

 

अयं त्वत्र विशेषः- शीतरूक्षलघुविशदश्रमोपवासातिकर्शनक्षपणादिभिर्वायुः [१] प्रकुपितस्त्वङ्मांसशोणितादीन्यभिभूय शोफंजनयति; स क्षिप्रोत्थानप्रशमो भवति, तथा श्यामारुणवर्णः प्रकृतिवर्णो वा, चलः स्पन्दनः खरपरुषभिन्नत्वग्रोमा छिद्यत इवभिद्यत इव पीड्यत इव सूचीभिरिव तुद्यते पिपीलिकाभिरिव संसृप्यते सर्षपकल्कावलिप्त इव चिमिचिमायते सङ्कुच्यतआयम्यत इवेति वातशोथः (१);  

अयं त्वत्र विशेषः- शीतरूक्षलघुविशदश्रमोपवासातिकर्शनक्षपणादिभिर्वायुः [१] प्रकुपितस्त्वङ्मांसशोणितादीन्यभिभूय शोफंजनयति; स क्षिप्रोत्थानप्रशमो भवति, तथा श्यामारुणवर्णः प्रकृतिवर्णो वा, चलः स्पन्दनः खरपरुषभिन्नत्वग्रोमा छिद्यत इवभिद्यत इव पीड्यत इव सूचीभिरिव तुद्यते पिपीलिकाभिरिव संसृप्यते सर्षपकल्कावलिप्त इव चिमिचिमायते सङ्कुच्यतआयम्यत इवेति वातशोथः (१);  

ayaṁ tvatra viśēṣaḥ- śītarūkṣalaghuviśadaśramōpavāsātikarśanakṣapaṇādibhirvāyuḥ [1]prakupitastvaṅmāṁsaśōṇitādīnyabhibhūya śōphaṁ janayati; sa kṣiprōtthānapraśamō bhavati, tathāśyāmāruṇavarṇaḥ prakr̥tivarṇō vā, calaḥ spandanaḥ kharaparuṣabhinnatvagrōmā chidyata iva bhidyata ivapīḍyata iva sūcībhiriva tudyatē pipīlikābhiriva saṁsr̥pyatē sarṣapakalkāvalipta iva cimicimāyatē saṅkucyataāyamyata ivēti vātaśōthaḥ (1);  

 

ayaṁ tvatra viśēṣaḥ- śītarūkṣalaghuviśadaśramōpavāsātikarśanakṣapaṇādibhirvāyuḥ [1]prakupitastvaṅmāṁsaśōṇitādīnyabhibhūya śōphaṁ janayati; sa kṣiprōtthānapraśamō bhavati, tathāśyāmāruṇavarṇaḥ prakr̥tivarṇō vā, calaḥ spandanaḥ kharaparuṣabhinnatvagrōmā chidyata iva bhidyata ivapīḍyata iva sūcībhiriva tudyatē pipīlikābhiriva saṁsr̥pyatē sarṣapakalkāvalipta iva cimicimāyatē saṅkucyataāyamyata ivēti vātaśōthaḥ (1);

ayaM tvatra visheShaH- shItarUkShalaghuvishadashramopavAsAtikarshanakShapaNAdibhirvAyuH [1] prakupitastva~gmAMsashoNitAdInyabhibhUya shophaMjanayati; sa kShiprotthAnaprashamo bhavati, tathA shyAmAruNavarNaH prakRutivarNo vA, calaH spandanaH kharaparuShabhinnatvagromA chidyata iva bhidyata ivapIDyata iva sUcIbhiriva tudyate pipIlikAbhiriva saMsRupyate sarShapakalkAvalipta iva cimicimAyate sa~gkucyata Ayamyata iveti vAtashothaH (1);  

ayaM tvatra visheShaH- shItarUkShalaghuvishadashramopavAsAtikarshanakShapaNAdibhirvAyuH [1] prakupitastva~gmAMsashoNitAdInyabhibhUya shophaMjanayati; sa kShiprotthAnaprashamo bhavati, tathA shyAmAruNavarNaH prakRutivarNo vA, calaH spandanaH kharaparuShabhinnatvagromA chidyata iva bhidyata ivapIDyata iva sUcIbhiriva tudyate pipIlikAbhiriva saMsRupyate sarShapakalkAvalipta iva cimicimAyate sa~gkucyata Ayamyata iveti vAtashothaH (1);  

vata gets vitiated due to excess intake of sheeta (cold things), ruksha (rough or low calorie), laghu (very light), vishada (non-slimy substance) diets, shrama (excessive exertion), upavasa (excessive fasting), ati-karshan (emaciation), and kshapana (wasting). This vitiated vata gets into and stays within twak (skin), mamsa (muscle tissue), along with rakta (blood) and produces shotha, i.e., swelling. This swelling increases as well as subsides quickly, black or reddish in color, fleeting, pulsating, with coarse skin, rough and broken hair. The person feels different types of pain sensation like chhidyati (excision), bhidyati (incision), suchibhiriva (piercing by needles/pricking), crawling of ants, irritation (as if pasted with mustard) and a feeling of contraction or expansion. These are some of the traits of swelling caused by vata. [1]

''Vata'' gets vitiated due to excess intake of ''sheeta'' (cold things), ''ruksha'' (rough or low calorie), ''laghu'' (very light), ''vishada'' (non-slimy substance) diets, ''shrama'' (excessive exertion), ''upavasa'' (excessive fasting), ''ati-karshan'' (emaciation), and ''kshapana'' (wasting). This vitiated ''vata'' gets into and stays within ''twak'' (skin), ''mamsa'' (muscle tissue), along with ''rakta'' (blood) and produces ''shotha'', i.e., swelling. This swelling increases as well as subsides quickly, black or reddish in color, fleeting, pulsating, with coarse skin, rough and broken hair. The person feels different types of pain sensation like ''chhidyati'' (excision), ''bhidyati'' (incision), ''suchibhiriva'' (piercing by needles/pricking), crawling of ants, irritation (as if pasted with mustard) and a feeling of contraction or expansion. These are some of the traits of swelling caused by ''vata''. [1]

 

उष्णतीक्ष्णकटुकक्षारलवणाम्लाजीर्णभोजनैरग्न्यातपप्रतापैश्च पित्तं प्रकुपितं त्वङ्मांसशोणितान्यभिभूय शोथं जनयति; सक्षिप्रोत्थानप्रशमो भवति, कृष्णपीतनीलताम्रावभास उष्णो मृदुः कपिलताम्ररोमा  उष्यते दूयते धूप्यते ऊष्मायते स्विद्यतेक्लिद्यते न च स्पर्शमुष्णं च सुषूयत  इति पित्तशोथः (२);  

उष्णतीक्ष्णकटुकक्षारलवणाम्लाजीर्णभोजनैरग्न्यातपप्रतापैश्च पित्तं प्रकुपितं त्वङ्मांसशोणितान्यभिभूय शोथं जनयति; सक्षिप्रोत्थानप्रशमो भवति, कृष्णपीतनीलताम्रावभास उष्णो मृदुः कपिलताम्ररोमा  उष्यते दूयते धूप्यते ऊष्मायते स्विद्यतेक्लिद्यते न च स्पर्शमुष्णं च सुषूयत  इति पित्तशोथः (२);  

uṣṇatīkṣṇakaṭukakṣāralavaṇāmlājīrṇabhōjanairagnyātapapratāpaiśca pittaṁ prakupitaṁtvaṅmāṁsaśōṇitānyabhibhūya śōthaṁ janayati; sa kṣiprōtthānapraśamō bhavati,kr̥ṣṇapītanīlatāmrāvabhāsa uṣṇō mr̥duḥ kapilatāmrarōmā  uṣyatē dūyatē dhūpyatē ūṣmāyatē svidyatēklidyatē na ca sparśamuṣṇaṁ ca suṣūyata  iti pittaśōthaḥ (2);  

uṣṇatīkṣṇakaṭukakṣāralavaṇāmlājīrṇabhōjanairagnyātapapratāpaiśca pittaṁ prakupitaṁtvaṅmāṁsaśōṇitānyabhibhūya śōthaṁ janayati; sa kṣiprōtthānapraśamō bhavati,kr̥ṣṇapītanīlatāmrāvabhāsa uṣṇō mr̥duḥ kapilatāmrarōmā  uṣyatē dūyatē dhūpyatē ūṣmāyatē svidyatēklidyatē na ca sparśamuṣṇaṁ ca suṣūyata  iti pittaśōthaḥ (2);  

uShNatIkShNakaTukakShAralavaNAmlAjIrNabhojanairagnyAtapapratApaishca pittaM prakupitaM tva~gmAMsashoNitAnyabhibhUya shothaM janayati; sakShiprotthAnaprashamo bhavati, kRuShNapItanIlatAmrAvabhAsa uShNo mRuduH kapilatAmraromA [2] uShyate dUyate dhUpyate UShmAyate svidyate klidyate na casparshamuShNaM ca suShUyata [3] iti pittashothaH (2);  

uShNatIkShNakaTukakShAralavaNAmlAjIrNabhojanairagnyAtapapratApaishca pittaM prakupitaM tva~gmAMsashoNitAnyabhibhUya shothaM janayati; sakShiprotthAnaprashamo bhavati, kRuShNapItanIlatAmrAvabhAsa uShNo mRuduH kapilatAmraromA [2] uShyate dUyate dhUpyate UShmAyate svidyate klidyate na casparshamuShNaM ca suShUyata [3] iti pittashothaH (2);  

pitta is vitiated due to excessive intake of hot, irritant, pungent, alkaline, salt, sour food, taking food when ailing from indigestion, or due to excessive exposure to heat and sunlight. This gets into the skin, muscle tissue, or blood and produces swelling. It also increases and subsides quickly. The affected part becomes blackish, yellow, bluish, copper-tinged, hot, or soft with brown and coppery hair. It gives a burning sensation of various forms and could be hot, sweaty, and moist. The affected region could be tender to touch and very sensitive to heat. These are the traits of swelling due to pitta dosha. [2]

''Pitta'' is vitiated due to excessive intake of hot, irritant, pungent, alkaline, salt, sour food, taking food when ailing from indigestion, or due to excessive exposure to heat and sunlight. This gets into the skin, muscle tissue, or blood and produces swelling. It also increases and subsides quickly. The affected part becomes blackish, yellow, bluish, copper-tinged, hot, or soft with brown and coppery hair. It gives a burning sensation of various forms and could be hot, sweaty, and moist. The affected region could be tender to touch and very sensitive to heat. These are the traits of swelling due to ''pitta dosha''. [2]

Swelling due to kapha dominance:

 

===== Swelling due to ''kapha'' dominance =====

 

गुरुमधुरशीतस्निग्धैरतिस्वप्नाव्यायामादिभिश्च श्लेष्मा प्रकुपितस्त्वङ्मांसशोणितादीन्यभिभूय शोथं जनयति; सकृच्छ्रोत्थानप्रशमो भवति, पाण्डुश्वेतावभासो गुरुः स्निग्धः श्लक्ष्णः स्थिरः स्त्यानः शुक्लाग्ररोमा स्पर्शोष्णसहश्चेतिश्लेष्मशोथः (३);  

गुरुमधुरशीतस्निग्धैरतिस्वप्नाव्यायामादिभिश्च श्लेष्मा प्रकुपितस्त्वङ्मांसशोणितादीन्यभिभूय शोथं जनयति; सकृच्छ्रोत्थानप्रशमो भवति, पाण्डुश्वेतावभासो गुरुः स्निग्धः श्लक्ष्णः स्थिरः स्त्यानः शुक्लाग्ररोमा स्पर्शोष्णसहश्चेतिश्लेष्मशोथः (३);  

gurumadhuraśītasnigdhairatisvapnāvyāyāmādibhiśca ślēṣmā prakupitastvaṅmāṁsaśōṇitādīnyabhibhūyaśōthaṁ janayati; sa kr̥cchrōtthānapraśamō bhavati, pāṇḍuśvētāvabhāsō guruḥ snigdhaḥ ślakṣṇaḥ sthiraḥstyānaḥ śuklāgrarōmā sparśōṣṇasahaścēti ślēṣmaśōthaḥ (3);  

gurumadhuraśītasnigdhairatisvapnāvyāyāmādibhiśca ślēṣmā prakupitastvaṅmāṁsaśōṇitādīnyabhibhūyaśōthaṁ janayati; sa kr̥cchrōtthānapraśamō bhavati, pāṇḍuśvētāvabhāsō guruḥ snigdhaḥ ślakṣṇaḥ sthiraḥstyānaḥ śuklāgrarōmā sparśōṣṇasahaścēti ślēṣmaśōthaḥ (3);  

gurumadhurashItasnigdhairatisvapnAvyAyAmAdibhishca shleShmA prakupitastva~gmAMsashoNitAdInyabhibhUya shothaM janayati; sa kRucchrotthAnaprashamobhavati, pANDushvetAvabhAso guruH snigdhaH shlakShNaH sthiraH styAnaH shuklAgraromA sparshoShNasahashceti shleShmashothaH (3);  

gurumadhurashItasnigdhairatisvapnAvyAyAmAdibhishca shleShmA prakupitastva~gmAMsashoNitAdInyabhibhUya shothaM janayati; sa kRucchrotthAnaprashamobhavati, pANDushvetAvabhAso guruH snigdhaH shlakShNaH sthiraH styAnaH shuklAgraromA sparshoShNasahashceti shleShmashothaH (3);  

kapha is vitiated due to excessive use of heavy to digest, sweet, cold and unctuous food, excessive sleep, sedentary life, etc. Vitiated kapha inhabits the skin, muscle tissues, and blood, causing swelling. A kapha-induced swelling grows slowly and subsides with difficulty. Affected part becomes pale, whitish, heavy, unctuous, smooth, stable, thick, with white hair, tolerant of touch and heat  This is the swelling caused due to kapha.

''Kapha'' is vitiated due to excessive use of heavy to digest, sweet, cold and unctuous food, excessive sleep, sedentary life, etc. Vitiated ''kapha'' inhabits the skin, muscle tissues, and blood, causing swelling. A ''kapha''-induced swelling grows slowly and subsides with difficulty. Affected part becomes pale, whitish, heavy, unctuous, smooth, stable, thick, with white hair, tolerant of touch and heat  This is the swelling caused due to ''kapha''.

 

Different types due to involvement of more than one dosha:

Different types due to involvement of more than one dosha:

यथास्वकारणाकृतिसंसर्गाद्द्विदोषजास्त्रयः शोथा भवन्ति; यथास्वकारणाकृतिसन्निपातात् सान्निपातिक एकः; एवं [४]सप्तविधो भेदः||७||  

यथास्वकारणाकृतिसंसर्गाद्द्विदोषजास्त्रयः शोथा भवन्ति; यथास्वकारणाकृतिसन्निपातात् सान्निपातिक एकः; एवं [४]सप्तविधो भेदः||७||