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Nirukti

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Shoola is formed by the combination of

vÉÔsÉ ÂeÉÉrÉÉqÉç (kÉÉiÉÑ )+ Mü(mÉëirÉrÉ)

Generally shoola refers to any type of pain like karna soola, sirasoola, netra soola etcShoola can appear as roopa or upadrava of a

disease.Shoola and roga both have same meaning ie, pain giving.

Shoola is classified as swatantra shoola &paratantrashoola

Paratantra shoola is considered as updrava of a disease.

Swatantra soola is defined as a vyadhi itself.

Caraka and Vagbhata did not mention shoola as a swatantra vyadhi

Susruta has explained shoola as “abdominal pain”in his uttara tantra (ch.42).He has also explained shoola as the upadrava of gulma in the same chapter.

Madhava kara has explained about shoola in his Madhava nidanam.

We will also get references of shoola in kasyapasamhita khila stana ( ch 18 )

TYPES OF SHOOLA

Madhavakara has described 8 types of shoola rogaVataja , pittaja, kaphaja,vatapittaja, vatakapha,

pittakapha, sannipathaja, amaja.

[ Later each of these were described as: vatajaparinama soola, pitajaparinama soola; kaphajaparinama soola; vatapittaja parinamasoola; vatakaphajaparinama soola; pittaja kaphaja parinama soola ; sannipathaja parinamasoola; annadrava soola.]

In all types, vata is the predominant causative factor.

Later he described 7 types of shoola i.e.parsva shoola,

kukshi shoola, hrit shoola,vasti shoola, mootra shoola,vit shoola, avipaka/anna dosajashoola

Susruta has described4 types of shoolaaccording to dosainvolved i.e.vataja,

pittaja

Kaphaja

Sannipataja

o Madavakara has described 8 types of shoola

o Susruta has explained another 11 types of shoola

VATAJA SOOLA

“Vyayama yana atimaidhuna…………”(M.N.26/2-5)

Over indulgence in physical exercise, riding ,keeping awake at night, sexual inter course ,intake of incompatible foods, suppression of urges of urine semen and feces, grief ,starvation or fasting , excessive laughing and speaking etc, all will increase vata in the body which produces shoola;which is found in the region of heart, flanks, back, waist and urinary bladder , get exacerbated during or after the digestion of food, in the evenings, during cloudy and cold weather -

pain increases or decreases of its own accord frequently, of pricking or tearing in nature, there is obstruction to the movement of feces and flatus, pain gets reduced by use of hot fomentation, oil massage, fatty and warm foods and drinks.

• Thirst, delusion, burning sensation near the umbilicus, perspiration, fainting, giddiness, localized burning sensation ;•Pain exacerbates during midday or mid night, during digestion of food and in any rainy weather ;gets reduced by cold comforts and cold sweet foods and drinks.

“ ksara ati tikshna ……….” (M.N.26.6)

• Over-indulgence of food which are alkaline, heat producing, very hot, causing burning sensation during digestion, oil cakes etc anger, exposure to fire, fatigue, prolonged exposure to hot sun, sexual intercourse and irritatingfood, make increase of pitta and in turn produce colic

•-

PITTAJA SHOOLA

KAPHAJA SHOOLA

“Aanupa varija kilata………………”(M.N.26.9-10)

Over indulgence in foods that are prepared out of flesh of marshy animals and those living in water, milk and milk products etc such other foods and habit that increases kapha,produces kaphaja shoola.

Oppression in chest , cough, debility, anorexia, salivation, pain near the stomach, fullness and loss of movement in the abdomen ,heaviness of the head, pain is severe soon after taking food, in the mornings at sunrise, in sisira and vasanta ritus

In vata kaphaja shoola there will be pain in heart and flanks

In kapha pittaja shoola there will be pain in kukshi, hridaya and nabhi

In vata pittaja shoola there will be severe pain in nabhi and vasti.

SANNIPATAJA SHOOLA

“Sarveshu dosheshu cha……”(M.N.26.11)

The colic produced by the combination of all the three dosas together will have all the symptoms in severe form, during all the times, powerful and hard to treat like poison or fit to be refused treatment.

PROGNOSIS OF SHOOLA

“Ekadoshothida saadhyaha…….”(M.N.26.14)

• Shoola produced by the increase of any one of the dosa is easily curable,• That produced by the combination of any two dosas is curable with difficulty, • That produced by the combination of all the three dosas, that which is very severe and associated with many complications is impossible to cure.

AMAJA SHOOLA

“Aatopa hrillasa …………”(M.N.26.12)

Gurgling in the intestine, oppression in the chest, vomiting, feeling of heaviness, loss of movement and distention of the abdomen, salivation and shoola having the symptoms similar to those of kaphaja type are also found in Amaja shoola.

PARINAMA SHOOLA

•“Svanidhanir prakupito vayu…………” (M.N.26.16-17)

•The consumption of food items which have similar properties to that of vata leads to its vitiation in its seat.

•It gets strengthened at the end of digestion (pachyamanavastha) and causes aavarana of kapha & pitta; leading to colic pain.

•Since this pain occurs at the end of digestion it is called parinama shoola.

PARINAMA SHOOLA DUE TO VATA

Abdominal distension, gurgling noise in the intestine, obstruction to the movement of feces and urine, restlessness, severe suffering of pain gets reduced by fatty and warm foods

PITTAJA PARINAMA SHOOLA

Thirst, burning sensation, restlessness, perspiration, pain increases by use of pungent, sour and salty foods ; but reduced by cold foods and comforts.

KAPHAJA PARINAMA SHOOLA

Vomiting , nausea, delusion, long continued mild pain get reduced by pungent and bitter foods.

. PROGNOSIS OF PARINAMA SHOOLA

•Appearance of symptoms of two or three dosas together are seen in conditions of increase of two or three dosasrespectively. •The tridosaja type associated with emaciation, loss of strength and digestion is considered as impossible to cure

ANNADRAVA SHOOLAo Pain occurs at the time of digestion, after digestion

or before digestiono Do not subside on keeping the stomach empty or

by taking foodo There will be continuous pain, & subsides on

vomiting

PARSVA SHOOLAo By the over indulgence of incompatible foods, the

vitiated kapha places itself in kukshi & parsva and blocks the vata.

o This vata will in turn produce abdominal distention with sound& pricking pain in the flank region. Th ill i b thi diffi lt l f

KUKSHI SHOOLA

o When the aggravated vata invades and vitiates the digestive fire, then the ingested food stays there long without digestion.

o The patient breaths with difficulty, eliminates amamala, suffers from pain often and does not find comfort in either sitting, sleeping or standing.

o Kukshi shoola is caused by vata and ama.

HRITH SHOOLA

Vata getting obstructed by kapha and pitta present in the chest, on combining with rasa present in the heart ,give rise to pain which causes obstruction to breathing This shoola is caused by rasa and vata

VASTI SHOOLAVata getting aggravated by suppression of urges (of urine, faces and flatus ) and get placed in vasti give rise to pain in the vasti, vamshana and nabhi; which obstruct the elimination of faces, urine and flatus.This shoola is caused by vata.

MOOTRA SHOOLA

o Aggravated vata getting localized in the areas of umbilicus, groin, flanks, intestine and penis, obstruct the elimination of urine and produces pain

o Mootra shoola is caused by vata

VIT SHOOLA

o In the person who indulges dry foods, vata obstruct the feces in the alimentary tract

o Cause weakness of the digestive power

o Gives rise to severe pain either in the right or left portion of the abdomen; spreads to all other parts moving about accompanied with noise ,

o increased thirst, giddiness, fainting appears.

o It does not subside even after elimination of feces or urine.oThis shouldbe understood as vit shoola by the physician ,which is dreadful.

ANNA DOSAJA SHOOLA.

The digestive fire become weak due to ingestion of large quantity of food. This food staying long inside, give rise to aggravation of vata and with the undigested food produces severe pain accompanied with fainting, flatulence ,heart burn, more purgation, vomiting, shaking and unconsciousness.

Anna dosaja shoola is caused by improper digestion

UPDRAVA OF SHOOLA

Pain ,thirst, fainting, abdominal distention, heaviness of body, anorexia, cough etc are its complications

BIBLIOGRAPHY

Madhava NidhanamSusruta SamhitaText book of KayachikitsaKasyapa SamhitaCaraka Samhita