Changes

=== Types of ''shotha'' and their location/site ===

=== Types of ''shotha'' and their location/site ===

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

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

The appearance of ''vātaja shotha'' can be correlated with the increased hydrostatic pressure mechanism of edema. The features are similar to edema caused by cardiac diseases where congestion is a major cause of increased hydrostatic pressure in vessels<ref>  Manual of practical medicine by R. Alagappan; chapter-3(page-159), 3rd edition.</ref>. Through the day, due to gravity, water goes down the body and gets retained in lower limbs causing edema in the evening hours. During night (i.e., at rest), the retained water redistributes and the edema subsides. Edema of cardiac origin is pitting in type, similar to vataja shotha.  

The appearance of [[vata]]ja shotha can be correlated with the increased hydrostatic pressure mechanism of edema. The features are similar to edema caused by cardiac diseases where congestion is a major cause of increased hydrostatic pressure in vessels<ref>  Manual of practical medicine by R. Alagappan; chapter-3(page-159), 3rd edition.</ref>. Through the day, due to gravity, water goes down the body and gets retained in lower limbs causing edema in the evening hours. During night (i.e., at rest), the retained water redistributes and the edema subsides. Edema of cardiac origin is pitting in type, similar to [[vata]]ja shotha.  

Kaphaja shotha, on the other hand, could be due to hypoproteinaemia in liver diseases or due to proteinuria in renal diseases<ref>  Manual of practical medicine by R. Alagappan, chapter-7 page-369-371, 3rd edition.</ref>. In renal edema, swelling is typically facial and manifests early in the morning.  Sometimes these swellings are too hard, as found in cases of malignancies or tumors. The swellings of paittika/pittaja type are mostly inflammatory in nature.  [9-15]

[[Kapha]]ja shotha, on the other hand, could be due to hypoproteinaemia in liver diseases or due to proteinuria in renal diseases<ref>  Manual of practical medicine by R. Alagappan, chapter-7 page-369-371, 3rd edition.</ref>. In renal edema, swelling is typically facial and manifests early in the morning.  Sometimes these swellings are too hard, as found in cases of malignancies or tumors. The swellings of paittika/[[pitta]]ja type are mostly inflammatory in nature.  [9-15]

=== Distribution of ''shotha'' and prognosis ===

=== Distribution of ''shotha'' and prognosis ===