Sheetapitta, udarda and kotha

Correlated with Urticaria, Angioedema, Nicolau Syndrome.

1. Sheetapitta , udarda and kotha Dr. Bikash Maharjan, MD( Kayachikitsa )

2. INTRODUCTION Sheetpitta is not described in Brihatrayies , but explanation about Udarda , Koth are mentioned as Vyadhi or Purvarupa and Lakshana b y Acharyas . Vata and Kapha Doshaja are primarily disturbed. Charaka – Udarda – Kapha nanatmaja vikara Kotha – Raktapradoshaja vikara

3. Nidana 1. Aharaja Hetu Santarpana , Atilavana , atiamla , katu kshara , tikshana , madya , viruddha ahara sevena , Adhyasana , Guru dravyas sevana , Snigdha bhojana , Dadhi sevena , Visha-yukta annapanasevana 2. Viharaja Hetu Sheeta maruta sparsha , vishayuktajala snana , abhyanga , udvartana , vastra , abhusana , keeta damsha , bahya krimi , chardi nigraha , atidiwaswapna , shishir ritu , varshakala . 3. Nidanaarthakara Roga Sannipatika , Pittaja and Kaphaja Jwara , Unmada , Adhoga Amlapitta 4. Chikitsa Mithya yoga- Vamana Virechana Ayoga .

4. Purvarupa Atitrishna Aruchi Hrillasa Dehasada Gouravata raktalochanata

5. Lakshana Sheetapitta – Varati Damsta samsthana Sotha , Kandu , Toda, Chardi , Jwara , Daha Udarda - Utsanga yukta sotha utpatti Utpatti in Shishir ritu Rakta varna with kandu and sotha Kotha Rag Yukta mandala Kandu

6. Samprapti NIDANA SEVANA VAYU( Ruksha Sheeta ) AND KAPHA(Snigdha Sheeta ) PRAKOPA COMBINES WITH PITTA( Usma mandata ) PRASARA IN TWACHA AND RAKTADI DHATU STHANSAMSRAYA IN TWAK STHANSAMSRAYA IN RAKTADI DHATU SOTHA MANDALOTPATTI SHEETAPITTA, UDARDA AND KOTHA UTPATTI

7. SAMPRAPTI GHATAKA Dosha : Tridosha Agni : Manda Doshagati : Vriddhi , Tiryak , Shakha Vyadhimarga : Bahya Dushya : Rasa, Rakta Srotas : Rasavaha , Raktavaha Srotodushti prakara : Vimarga Gamana Udbhava Sthana : Aamashaya Vyakti Sthana : Tvak Svabhava : Ashukari

8. Sapeksha Nidana Sheetapitta Udarda Kotha Vata pradhana Kapha pradhana Kapha rakta pradhana Toda Kandu and Vamana Excessive Kandu Kinchit mandalotpatti Awasthika mandolatpatti Awasthika rakta mandolatpatti Intake of sheeta and ushna alongside Aggravates in Shishir ritu Vamana ayoga , chardi vegadharana Asukari Subacute Chronic

9. Chikitsa sutra Similar Treatment in Sheetapitta , Udarda and kotha First of all, Krimi and Dadru nashaka chikitsa should be done followed by Purvakarma and Samsodhana karma Then, Kusthanasaka chikitsa should be done Pariseka with warm water and Sarshapa taila abhyanga Amlapitta , Kustha and udarda treatment should be done for Kotha .

10. Chikitsa Shodhana Chikitsa Vamana : Emesis should be given with decoction of Patola and Arishtaka . Virechana : Purgation should be given with decoction of Triphala,pippali . Charak - Udarda Prashamana Mahakashaya , Katu Taila , Mustadi Churna . Sushrut - Eladi Gana Chakradutta : Shodhan Chikitsa: Vaman and Virechana Shaman Chikitsa: Amrutadi Gan Kwath pan, Saguddipkyaprayog , Sthanik Chikitsa: Sidharthak Udavarthanam , Durvadi Lep , Agnimanth , Nimbapatradi Lep

11. 6. Bhavaprakash has described Shodhana , Shamana and Bahi Parimarjana Chikitsa. Navakarshika Guggulu , Trikatu + Sharkara , Yavani + Vyosha + Yavakshara , Aardraka Rasa + Purana Guda , Yavani + Guda , Guda + Amalaki, Nimba Patra + Ghrita +Amalaki, Ardraka Khanda 7 . Bhaishajya Ratnavali : Yashtyadi Kwatha , Goghrita + Maricha As Vardhamana Prayoga , HaridraKhanda , BrihatHaridraKhanda , Shleshmapittantaka Rasa, Veereshvaro Rasa, Shitapittaprabhanjana Rasa, Durva + Nisha- Lepa , Siddhartha + Rajani + Kustha + Prapunnada + Tila + Katu Taila-Udvartana , Katu Taila - Abhyanga , Kshara + Rocksalt + Oil- Abhyanga 8. Yogaratnaka r : Vardhamana Pippali , Vardhamana Lasuna Prayoga , Agnimantha yog , Nimbapatra Yoga, Amrutadi Yoga, Sidharthak Yoga, Kushtadi Churna

12. Udarda Prashamana Mahakashaya 1. Tinduka 2. Priyala 3. Badara 4. Khadira 5. Kadara 6. Saptaparna 7. Aswakarna 8. Arjuna 9. Asana 10. Arimeda

13. Samsamana Chikitsa Rasa/ Bhasma / Satva – Sarvatobhadra Rasa(VP) Kamdudha (P) Swarnamakshik (KP) SwarnaGairika (P) Sutasekhara (P) Yavakshara (KV) Amrita satva Chandrakala Pravala bhasma Shitapittabhanjana Sleshmapittantaka Pittantaka yoga Vati/Guggulu Arogyavardhini Navakarshika Guggulu Kaisore Sparshavataghni vati Kwath Amritadi Yastyadi yoga Churna Triphala Panchasirisha Trikatu Yavanyadi Ghrita Mahatiktaka ghrita Paka / Khanda / Avaleha Haridrakhanda Adraka Khanda Nimbapatradi leha Asava /Arista Amritarishta Manjistharista Pralepa / udvartana Durvadi lepa Saindhavadi yoga Siddharthadi yoga

14. Pathyapathya Ahara Vihara Pathya Purana shali rice, Jangala mamsha rasa, munga , karela , sigru , dadima , madhu , sarshapa taila Langhana , abhyanga Apathya Ikshu vikara , Anupa mamsa rasa, Naveena madya , viruddha bhojana , amla rasaa Chardi , Vegavarodha , Vayusevana , diwaswapna , snanan , atapasevana maithuna