BY DR.SANTHOSH KUMAR S,BAMS.DNHE.DHHM
INTRODUCTION
Shopha,Shotha, shvayathu are synonyms that denote an unnatural elevation in a part orwhole of the body. Shotha as a clinical entity was very well known from the period of samhita. Detailed description of shotha along with classification,symptomatology,complication and management is explained in all most all Ayurvedic classics. The surgical aspects
of shopha and vrana is explained in Sushruta samhita.
of shopha and vrana is explained in Sushruta samhita.
Sushruta a surgical man defined shopha as localized swelling
involving the skin and the underlying flesh which may be
involving the skin and the underlying flesh which may be
even or uneven. Again he differentiated the vrana from other clinical entities as glandular enlargements, abscesses etc.Above mentioned conditions which are also associated with swellings. Shopha is that which exists before vrana. According to Charaka when vitiated vata comes in contact with vitiated rakta, pitta and kapha, it brings them to
the periphery then the srotas get obstructed to develop shotha around the skin and it is not limited to a part of body.
Classification & Aetiopathogenesis of shopha
According to clinical entity sushruta has classified vranashopha into 6 types :Vatika,Pittika, Kaphaja,Shonita,Sannipattaja & Agantuja.
It is well known that the imbalanced state of doshas lead to pathogenesis of diseases.
It is well known that the imbalanced state of doshas lead to pathogenesis of diseases.
Aetiopathogenesis of shopha is much resembled to inflammation.It is defined as local response of tissue to any kind of injury.
Sushruta mentioned that shopha occurs in sequential pattern,
in six different stages called shatkriya kala. They are respectively
as:
Sushruta mentioned that shopha occurs in sequential pattern,
in six different stages called shatkriya kala. They are respectively
as:
i. Chaya : Accumulation of physiologically active doshas
ii. Prakopa : Excitation of previously accumulated and imbalanced doshas
iii. Prasara : Overflowing i,e. excited dosha leave their original site.
iv. Sthana : localisation of wandering imbalanced dosha in a particular site.
v. Vyakta : Manifestation doshas in the form of disease with signs & symptoms
vi. Bheda : Definite termination of pathological lession.
Stages of vranashopha
Three stages of vranashopha
1) Amawastha: Stage of unripe abscess (early inflammation) :
This stage results due to vitiated doshas and the defending dushyas,in this stage kapha dosha may be prominent due to which a swelling is produced.
Feeling of cold / hot ,induration,dull pain , mild inflammation etc.
2) Pachyamanawastha : stage of ripening abscess (inflammatory stage ) :
If the vitiated doshas are further allowed to produced more exaggerated phase in which the prakupit pitta will act upon the dushya to produce disintegration.
This stage produced symptoms like as Pricking and other types of pain,Discolouration of skin,burning sensation ,
Pyrexia etc.
3) Pakwawastha: Stage of riped abscess (suppuration) :
Further in related to dosha dushya sammurcha-na the dhatus are affected and burnt. There is an attempt for absorption (shoshana by vayu) due to which following sign and symptoms are produced reduced in pain , appearance of pallor, Appearance of Wrinkles and cracking of skin.
Management of vranashopha
The vranashopha should be managed in early stages to avoid further suppuration. There are different kind of management is required in different stages of shopha like in amawastha only vimlapana, oleation,alepa,upanaha are needed for treatment while in
pakwawastha ,bhedana etc. are needed for treatment. Acharya Sushruta has mentioned 7 sthambas for treatment of vranashopha :
i. Vimlapana :Light massage or rubbing ( to improve circulation )
ii. Avasechana : Elimination therapy including bloodletting ( for removal of toxins )
iii. Upahana : Poultice (Application of Medicated paste )
iv. Patana : Operative procedure ( I & D )
v. Shodhana : Antispetic measures ( detoxification )
vi. Ropana : Healing measures
vii. Vaikritapaha : To restore normalcy of scar .
Conclusions: Vranashopha is widely explained by different Acharyas but Sushruta’s
concept is appropriate for diagnosis and treatment. Diagnosis according to three progressive stages is very beneficial for treating the vranashopha. Sushruta explained “if
the doshas are eliminated in stage of accumulation itself, they do not progress to
the further stages of pathogenesis, otherwise in the later stages they would
become more and more harmful.
No comments:
Post a Comment