“Rogamadou Parikshet Tatoanataram Aushadham” Physician should first of all diagnose the disease then he should select proper medicine. Diagnosis is not complete without elucidation of all factors related to disease. For the diagnosis of the disease Nidaan Panchaka is very useful entity. Except Chikitsa, Nidaan Panchaka includes all the necessary information related to disease. Here we consider the Nidaan Panchaka of Shotha according to Brihat Trayi and its management with Rasa Sindoor one of the unique preparation in Rasashastra

Dr. Girish Ashok Kulkarni

English

Journal of Ayurveda and Integrated Medical Sciences (JAIMS)

                                                      REVIEW ARTICLE July-Aug 2020  Journal of Ayurveda and Integrated Medical Sciences | July - Aug  2020 | Vol. 5 | Issue 4 221  Conceptual study of Rasa Sindoora in management of Shotha Roga w.s.r. to Brihat-Trayi Dr. Girish Ashok Kulkarni Assistant Professor, Department of Rasa Shastra and Bhaishajya Kalpana, Acharya Deshbhushan Ayurvedic Medical College, Bedakihal, Karnataka, INDIA.               INTRODUCTION Shotha even though explained as Lakshana in many disease it can be studied as a separate disease not considering as a Lakshana. “Shavatiti Shugatou + Bahulakatyen” by adding Athuchpratyayato Shwi Dhatu the word Shotha is formed.[1] In Ayurvedic classics we get the reference of three different words Shotha, Shopha & Shwaythu which are used as synonyms of Shotha.[2] Classification of Shotha[3-5] Shotha can be classified as follows according to Brihat Trayis. Address for correspondence:  Dr. Girish Ashok Kulkarni Assistant Professor, Department of Rasa Shastra and Bhaishajya Kalpana, Acharya Deshbhushan Ayurvedic Medical College, Bedakihal, Karnataka, INDIA.  E-mail: drgk29@gmail.com  Submission Date: 09/07/2020 Accepted Date: 12/08/2020 Access this article online Quick Response Code Website: www.jaims.in  Published by Maharshi Charaka Ayurveda Organization, Vijayapur, Karnataka (Regd) under the license CC-by-NC-SA Table 1: Classification of Shotha  Type of Shotha C.S S.S A.H Ekavidha + - - Dwividha + - + Trividha + - + Chaturvidha + - - Panchavidha - + - Shadvidha - + - Saptavidha + - - Ashtavidha + - - Navavidha - - + Shotha Nidaan[6-8] The word Nidaan is used in 2 different meanings i.e  1st as a etiological factor and 2nd is as a diagnosis of disease. “Nidaantwadaadikaranm” i.e. It initiates disease formation. “Hetulakshannirdeshat Nidaanani” that which  gives Nirdesh about Hetu and Lakshan is Nidan. These  are the  Nidaans of Shotha according to Brihat Trayis. A B S T R A C T  “Rogamadou Parikshet Tatoanataram Aushadham” Physician should first of all diagnose the disease then he should select proper medicine. Diagnosis is not complete without elucidation of all factors related to disease. For the diagnosis of the disease Nidaan Panchaka is very useful entity. Except Chikitsa, Nidaan Panchaka includes all the necessary information related to disease. Here we consider the Nidaan Panchaka of Shotha according to Brihat Trayi and its management with Rasa Sindoor one of the unique preparation in Rasashastra. Key words: Chikitsa, Nidaan Panchaka, Rasashastra, Rasa Sindoora, Shotha Roga. Dr. Girish Ashok Kulkarni. Conceptual study of Rasa Sindoora in management of Shotha Roga ISSN: 2456-3110                                                      REVIEW ARTICLE July-Aug 2020  Journal of Ayurveda and Integrated Medical Sciences | July - Aug  2020 | Vol. 5 | Issue 4 222  Table 2: Nija Shotha Nidaanas Nidana CS SS AH Mithyayoga of Vamanadi Karma + + + Apathyaprayoga after Panchakarma + + + Ati Krusha with Alasaka, Jwara, Shwasa atisara, bhagandara + + + Kushta & Kandupeedita + + - Udgara, Mala, Mutra, Apanavayu Vegadharana + + + Amla , Lavanaati Sevana + + + Pishtannaati Sevana + + - Phala, Shaakaati Sevana + + + Dadhi, Madhya, Mandakaati Sevana + + + Shooka, Shamidhanyaati Sevana + + + Atisevana of Aanupa and Audakamamsa + + + Garbhasampeedana + + - Garbhaprapatana + + - Prajatanaammithyopachara + + - Atiupavaasa + + + Ratrijagarana - - + Mrudbhakshana + + + Atimaithuna - + + Atichankramana - + + Atiyaana - + + Table 3: Aagantuja Shotha Nidaanas Nidana CS SS AH Chedana + + + Bhedana + + + Kshanana + + + Bhanjana + + + Utpeshana + + - Prahara + + + Bhandana + + - Veshtana + + - Vyadhana + + + Peedana + + - Bhallatakapushpa, Phala, Rasa Samsparsha + + + Shooka, Krimishookahita + + + Vishapatra, Lata, Gulmasamsparsha + + + Savishapranidamshtra + + + Garbhasampeedana + + - Garbhaprapatana + + - Poorvaroopa of Shotha[9-11] Poorvaroopa are prior indications of forthcoming diseases. They occur prior to complete manifestation of disease. The signs and symptoms which develop before the manifestation of the cardinal features are considered as Poorvaroopa. When the Dusta Dosha localizes at the Dhatu and brings about morbidity in the Dhatu. The normal functioning of that particular Dhatu is altered and hence some abnormal features are developed. The initial response of the Dhatu, when Dusta Dosha affects the normal functioning is considered as Poorvaroopa. These are the Poorvaroopas of Shotha according to Brihattrayis. Table 4: Poorvaroopa of Shotha Poorvaroopa CS SS AH Ushma + - - Davathu + - + Sirayama + + + Dr. Girish Ashok Kulkarni. Conceptual study of Rasa Sindoora in management of Shotha Roga ISSN: 2456-3110                                                      REVIEW ARTICLE July-Aug 2020  Journal of Ayurveda and Integrated Medical Sciences | July - Aug  2020 | Vol. 5 | Issue 4 223  Angagaurava - + + Samprapti of Shotha[12] The sequential process of Dosha vitaiation, their spread in the body to manifest disease is called as Samprapti. It includes various stages as disease progression i.e. Nidaana Sevana leads to Dosha Dushti which further leads to Vyadhi Utpatti. The term Shotha refers to Swayathu where ‘Utsedha’ is the Pratyatma Lakshana. Uthseda refers to swelling. Shotha is primarily because of Kapha Prakopa in the Shareera.Kapha is responsible for kKedanain Shareera. ‘Aapah Kledah’ - Generally the term Kleda refers to Jaleeya Dhatu. Accumulation of Jaleeya Dhatu results in Uthseda in the Shareera. From the etiological factors it is learnt that different diseases are the Pradhanika or Utpadaka or Vyadhi Hetu of Shotha. All the Aharaja and Viharaja Nidana are either Vyanjaka or Dosha or Vyabhicari Hetu. A person suffering from the Vyadhi if he is indulging in the Aharaja and Viharaja Nidana there will be further Dusti of the Dosha in the Shareera. Dusta Tridosha obstructs Vyanavata in the Shareera especially Ambuvaha, Moortavaha and Swedavaha Srotus.  Tridosha are moving in all the Srotas with the help of Vyanavata along with the rasa Rakta Adi Dravadhatu to maintain the respective functions of the Shareera Dhatu and Avayava. Once the Dusta Dosha obstructs the Vyanavata at Ambuvaha, Mootravaha and Swedavaha Srotas Vata gets Prakupita and brings the other Dosha along with Rasa Raktadi Drava Dhatu to the Bahya Sira. Bahya Sira refers to Agambheera Sira i.e., Sira related with Twak Mamasa Pradesha. In this way Dusta Dosha and the Shareeraja Kledadi Drava Dhatu reaches the Twak Mamsantara Pradesha and vitiates the Sthanika Dosha, results in Uthseda i.e., Shotha Vyadhi. Roopa of Shotha[13] “Pradurbhuta Lakashanam Punarlinagam”. The Lakshanas which are seen after complete manifestation of disease is Roopa. According to Charaka the following are the Samanya Lakshanas of Shotha. 1. Utsedha - Utsedha is the Pratyatma Lakshanas of the Shotha and it is formed due  to the accumulation of the vitiated Doshas in between the Twacha and Mamsa. 2. Gaurava - Gauravata is seen due to the Guru Guna in the Kapha Dosha. It is seen because of the accumulation of the Kapha Dosha in between the layers of  Twacha and Mamsa. 3. Anavasthitatva - Anavasthitatva means the increase and decrease in the Shotha.  As the Vataja Shotha is Divabali in nature, i.e. it increases in the day time  whereas the Kaphaja Shotha is Ratribali in nature, i.e. it increases in the night  time. 4. Ushma - the Ushmata is due to the involvement of the pitta and the Raktadoshas which are accumulated in between the Twacha and Mamsa. 5. Siratanutwa - Siratanutwa will be there due to the accumulation of the Kleda in  the Siras. 6. Lomaharsha - the Lomaharsha can be taken as horripilation. 7. Vivarnata - there will be the Vivarnata on the site of the Shotha and the  Vivarnata will be seen depending on the Dosha involved.  ▪ Vata Shotha - Shyava, Arunavarna. ▪ Pitta Shotha - Peeta, Tamravarna ▪ Kapha Shotha - Pandu, Shwetavarna ▪ Sannipataja Shotha - Mishra Varna VISHESH LAKSHANAS OF SHOTHA Vataja Shotha Lakshanas Varna - Shyava, Aruna, Krishna Varna Dr. Girish Ashok Kulkarni. Conceptual study of Rasa Sindoora in management of Shotha Roga ISSN: 2456-3110                                                      REVIEW ARTICLE July-Aug 2020  Journal of Ayurveda and Integrated Medical Sciences | July - Aug  2020 | Vol. 5 | Issue 4 224  Swaroopa - Sheeghraunnata, Sheeghrashamana,   Khara,   Parusha,   Bhinnatwak, Romaharsha, Twacha Shunyata, Chala, Mrudu, Anavasthita, Tanutwak, Divabali, Ruksha, Vedana-Todavat, Chedanavat, Bhedanavat, Peedanavat, Pipeelikasarpannavat. Pittaja Shotha Lakshanas Varna - Peeta, Tamravarna, Raktavarna, Krishna, Neela.  Swaroopa - Kshipronnataprashamo, Ushna, Mrudu, Sagandho, Kledayukta, Vedana - Jwara, Trushna, Daaha, Klinnata. Kaphaj Shotha Lakshanas Varna - Pandu, Shwetavarna Swaroopa - Kruchroothanaprashamobhavati, Guru, Sthira, Shlakshna, Sheetala, Nipeeditona cha unnamati, Ratribali, Ghana  Vedana - Kandu. Dwandwaja Shotha Lakshanas In Dwandwaja Shotha the mixed Lakshanas of the involved Doshas are seen. Sannipataja Shotha Lakshanas In Sannipataja Shotha the Lakshanas of the Tridoshas are seen. Upadravas[14] The Upadrava is stage which develops by the factors whichare responsible for the manifestation of the main disease. The Upadrava of Shotha according to different Acharyas are, Table 5: Upadravas of Shotha ▪ Chardi ▪ Durbalata ▪ Shwasa ▪ Hikka ▪ Aruchi ▪ Kasa ▪ Trushna ▪ Avipaka ▪ Jwara ▪ Parikartika ▪ Atisaara ▪ Agnimandya ▪ Karshya ▪ Tamogunadhikya ▪ Bhrama ▪ Vrana Sadhyasadhyata[15,16] ▪ If the Shotha is present in the Madhya Shareera or Sarva Shareeragata Shotha is present, it is cured with difficulty. ▪ When the Shotha is present in the lower half of the body which spreads upwards is curable. ▪ The Shotha is incurable if it is associated with the symptoms like Shwasa, Pipasa, Chardi, Jwara, Daurbalya and Aruchi. ▪ The Shotha appeared in the feet which spreads to the whole body in males, is difficult to cure. ▪ If the Shotha in females starts from the face and spreads to the whole body then it is difficultly curable. ▪ Both in males and females if the Shotha starts from the genital organs and spreads to the whole body then the Upadravas are seen and this type of Shotha is incurable. ▪ Shotha in the regions like Kukshi, Udara, Gala and Marma Sthana is also incurable. ▪ Shotha in children and in old aged people is fatal. ▪ Shotha which is of recent onset having no complications is curable. Chikitsa of Shotha Rasaaushadhis used in little quantity , don’t have any taste, smell due to its all all qualities it gives favourable and ultimate results.[17] According to Bhaishajya Ratnavali “Langhanam Paachanam Shothe Shirkaya Virechanam Vamanam Cha Yathasatvam Yathadosham Pralapyet”[18] i.e. in Shotha Roga according to Dosha & Rogi Bala treatment should be done. Mainly it consists of Langhana, Pachana, Shirovirechana and Vamanadi Karma  can be adopted along with Shamana.  Dr. Girish Ashok Kulkarni. Conceptual study of Rasa Sindoora in management of Shotha Roga ISSN: 2456-3110                                                      REVIEW ARTICLE July-Aug 2020  Journal of Ayurveda and Integrated Medical Sciences | July - Aug  2020 | Vol. 5 | Issue 4 225  In Shotha, Shamana treatment adopted in the form of Rasaaushadhis especially the Parada preparation are used for Shotharoga, to see the efficacy of the treatment. In Rasashastra mainly like Kupipakwa Rasa, Potalli Rasa, Kharaliya Rasa etc. are majorly used. In Shotharoga Adhyaya the Kupipakwa Rasayana taken for study Rasa Sindura a unique formulation of Kupipakwa Rasayana which is used in all types diseases with different Anupanas. In this study Rasa Sindura along with Mandoor Bhasma and Punarnavasava as Anupana used for treatment of Shotha.[19] Rasa Sindura is prepared by Shuddha Parada 8 parts, Shuddha Gandhak 8 parts, Shuddha Navasadar 2 parts according to procedure of Kupipakwa Rasayan. Dose is Rasasindura - 1 Ratti, Mandoor Bhasma 2 Ratti mixed in Madhu and Lehana Karma should be done and Punarnavasava 2 and half Tola is taken as Anupana.[20] Mandoor Bhasma is Vrishya, Sheeta, Ruchikaraka, Agni Deepaka, Sreshta Roganashaka, Raktavardhaka and Shothghna in nature.[21] Rasasindura is very Laghu in nature due to preparation technique. i.e. during its preparation intense heat is used. Hence it penetrates fast into the tissues and enhances Jatharagni and Dhatwagni. Punarnavasam according to Bhaishajya Ratnavali helpful in all diseases which are considered to be Asadhya. CONCLUSION References of Shotha are obtained from BrihatTrayis. Rasashastra is one of the beautiful branch of Ayurveda which gives ultimate results in less dosages. Use of Rasaaushdis should be done very carefully otherwise it can act as a Visha also. The physician can study it from other literary work for also for treating Shotha effectively. REFERENCES 1. Shabdakalpadruma, Raja Radhkant Dev, Shabdakalpadruma  volume 5, published by Nag Sharan Singh, Nag Publishers, 11-A/ U.A, Jawaharnagar, Delhi – 7, 1987 , Page number 139 2. Amarkosha, Amarkosha with Ramasrami Commentry, by Bhanuji Dikshit, edited by Haragovinda Shastri, 3rd edition, Chaukhamba Sanskrit Samsthan Varanasi, 1992, Page Number -282 3. Vd. Yadavji Trikamaji Acharya, Agnivesha, Charaka Samhita, with Ayurveda Dipika Commentary by Chakrapani, Chiktsa sthana, 12th chapter, verse 7, Chaukhamba Publication New Delhi.Reprint 2018, Page Number -483. 4. Sushrut, Sushruta Samhita, with Nibandha sangraha of Dalhanachrya & Nyachandrika Panjika of Gayadasachrya edited by Vaidya Yadavji Trikamji Acharya. Chikitsa sthan, 23rd chapter, Chaukhamba Surbharati Prakashan, Varanasi, Page Number - 485 5. Dr. Anna Moreshwar Kunte & Krsna Ramachandra Sastri Navre, edited by Pt. Hari Sastri, Astanga hrdaya of Vagbhata, with the commentaries: Sarvanga sundara of Arunadatta & Ayurvedarasyana of Hemadri, nidaan sthana, 13th chapter, Chaukhambha Sanskrit Sansthan, Varanasi, Reprint 2018, verse- 21, Page number - 521 6. Vd. Yadavji Trikamaji Acharya, Agnivesha, Charaka Samhita, with Ayurveda Dipika Commentary by Chakrapani, Chiktsasthana, 12th chapter, verse 5-6, Chaukhamba Publication, New Delhi. Reprint 2018, Page Number -483. 7. Sushrut, Sushruta Samhita, with Nibandha sangraha of Dalhanachrya & Nyachandrika Panjika of Gayadasachrya edited by Vaidya Yadavji Trikamji Acharya. Chikitsasthan, 23rd chapter, Chaukhamba Surbharati Prakashan, Varanasi, Page Number - 485 8. Dr. Anna Moreshwar Kunte & Krsna Ramachandra Sastri Navre, edited by Pt. Hari Sastri, Astanga hrdaya of Vagbhata, with the commentaries: Sarvanga sundara of Arunadatta & Ayurveda rasyana of Hemadri, nidaansthana, 13th chapter, Chaukhambha Sanskrit Sansthan, Varanasi, Reprint 2018, verse- 21, Page number - 521 9. Vd. Yadavji Trikamaji Acharya, Agnivesha, Charaka Samhita, with Ayurveda Dipika Commentary by Chakrapani, Chiktsasthana, 12th chapter, verse 10, Chaukhamba Publication New Delhi. Reprint 2018, Page Number -483. Dr. Girish Ashok Kulkarni. Conceptual study of Rasa Sindoora in management of Shotha Roga ISSN: 2456-3110                                                      REVIEW ARTICLE July-Aug 2020  Journal of Ayurveda and Integrated Medical Sciences | July - Aug  2020 | Vol. 5 | Issue 4 226  10. Sushrut, Sushruta Samhita, with Nibandha sangraha of Dalhanachrya & Nyachandrika Panjika of Gayadasachrya edited by Vaidya Yadavji Trikamji Acharya. Chikitsasthan, 23rd chapter, Chaukhamba Surbharati Prakashan, Varanasi, Page Number - 485 11. Dr. Anna Moreshwar Kunte & Krsna Ramachandra Sastri Navre, edited by Pt. Hari Sastri, Astanga hrdaya of Vagbhata, with the commentaries: Sarvanga sundara of Arunadatta & Ayurveda rasyana of Hemadri, chikitsasthana, 17th chapter, Chaukhambha Sanskrit Sansthan, Varanasi, Reprint 2018. Page number - 705 12. VdYadavji Trikamaji Acharya, Agnivesha, Charaka Samhita, with Ayurveda Dipika Commentary by Chakrapani, Chiktsasthana, 12th chapter, verse 8, Chaukhamba Publication, New Delhi. 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Vagbhatachrya, Rasaratnasamucchaya, translated by Indradev Tripathi, Chaukhamba Publication, New Delhi, 28thAdhyaya, verse 1, Page Number -371 18. Govindadas Bhashajya Ratnavali, Ambika Datta Shastri edition by Chaukhamba Prakashana Varanasi 2010, 42ndAdhyaya, verse 1, Page Number -790 19. Sadanand Sharma, Rasa Tarangini, by Kashinath Shastri, Motilal Banarasidas Publication, New Delhi, edition 2000, 6thAdhyaya, verse 183-185, Page Number – 139 20. Sadanand Sharma, Rasa Tarangini, by Kashinath Shastri, Motilal Banarasidas Publication, New Delhi, edition 2000, 6thAdhyaya, verse 203-206, Page Number – 143 21. Sadanand Sharma, Rasa Tarangini, by Kashinath Shastri, Motilal Banarasidas Publication, New Delhi, edition 2000, 20thAdhyaya, verse 136-140, Page Number – 790     *******************************  How to cite this article: Dr. Girish Ashok Kulkarni. Conceptual study of Rasa Sindoora in management of Shotha Roga w.s.r. to Brihat-Trayi. J Ayurveda Integr Med Sci 2020;4:221-226.  Source of Support: Nil, Conflict of Interest: None declared. Copyright © 2020 The Author(s); Published by Maharshi Charaka Ayurveda Organization, Vijayapur (Regd). This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.  

Conceptual study of Rasa Sindoora in management of Shotha Roga w.s.r. to Brihat-Trayi

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Conceptual study of Rasa Sindoora in management of Shotha Roga w.s.r. to Brihat-Trayi

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