Kukshi Shula Causes, Signs, Pathogenesis, Therapy

By Dr Raghuram Y.S. MD (Ay) & Dr Manasa, B.A.M.S

The phrase kukshi usually encompasses ‘hole cavity’ contained in the physique. However on this context kukshi is take into account as stomach. Kukshi shula explains ‘diffuse ache within the stomach’.
Kukshi – stomach, stomach cavity
Shula – colic, ache.
Additionally it is referred to as Kukshishoola.
Learn – Shoola Varieties, Signs, Therapy, Medicines, Cures

Causes

Extreme consumption of vata aggravating meals and publicity to actions and seasons resulting in aggravation of vata will result in pathological vitiation of vata within the physique.
Learn – Completely different Causes For Vata Dosha Imbalance, Improve

Pathogenesis

• As a result of consumption of extra meals and getting uncovered to the actions and seasons which trigger vitiation of vata, the vata will get aggravated.
• This aggravated vata strikes to the seat of agni i.e. digestive system (abdomen and small gut) and causes diminution of digestive fireplace.
• This vata will get additional aggravated within the stomach cavity and causes stagnation of meals resulting in its indigestion.
• Consequentially there may be construct up of ama and mala (excreta) within the intestine.
• The stagnated meals, indigestion, and extreme accumulation of ama and excreta repeatedly trigger ache within the stomach.
• This illness brought on by vitiated vata together with ama and excreta is named kukshishula.

Signs

• Bhojana upastambham – consumed meals would get stagnated
• Bhojanam na pachyate – meals doesn’t get digested correctly
• Muhuh shulah – ache within the stomach happens repeatedly
• Krichchra shwasa – respiratory issue
• Na asane labhate sukham – doesn’t discover consolation sitting
• Na shayane labhate sukham – doesn’t discover consolation sleeping
• Na tishtane labhate sukham – doesn’t discover consolation standing
  Learn – Parinama Shoola : Definition, Varieties, Therapy, Medicines

Sanskrit Verses

Therapy of KukshiShoola

Rules

Vamana or Langhana – Therapeutic emesis or lightening therapies are the therapies of selection in treating ache or colic within the stomach. These therapies needs to be applied after having thought of the power of the doshas and their depth of vitiation.

Dipana Pachana – Powder of medicines which kindle digestion and digest ama like asafetida, rock salt and Panchakola needs to be blended in buttermilk or recent juice of pomegranate and given to drink together with samsarga pachana i.e. gruels.
Learn – Deepaneeya Gana Herbs Of Charaka: Evaluate, Advantages, Formulations

Virechana – Therapeutic purgation is without doubt one of the greatest therapies to cope with stomach ache. A particular formulation defined by Grasp Sushruta will function purgative in addition to illness particular treatment by way of assuaging ache within the stomach. The formulation is named Vachadi Churna. It’s ready with the beneath talked about elements.

Vacha – Acorus calamus
Sauvarchala – Sauchal salt
Hingu – Asafetida
Kushta – Saussurea lappa
Ativisha – Aconitum heterophyllum
Abhaya – Terminalia chebula
Kutaja Bija – seeds of Holarrhena antidysenterica

This formulation needs to be administered after contemplating the power of the doshas.

Vasti – enema with natural oils and decoctions needs to be given to alleviate ache stomach. The doshas which have gathered needs to be flushed out of the intestine. This is not going to solely assist in relieving ache but additionally will stop recurrences. For this objective Erandadi Taila or Higvadi Ghrta needs to be used for unctuous enema. Decoction enemas ready with the identical herbs may be administered.

Nagaradi Kwatha

Decoction needs to be ready with the beneath talked about elements –

Ginger – Zingiber officinale
Dipyaka – Trachyspermum ammi
Chavya – Piper retrofractum
Hingu – asafetida
Sauvarchala – sauchal salt
Vida – vid salt
Matulunga bija – seeds of Citrus medica
Shyama bija – seeds of Operculina turpethum
Urubuka bija – seeds of Ricinus communis (castor plant)
Brhati – Solanum indicum
Kantakari – Solanum xanthocarpum

The decotion needs to be ready and powder of asafetida, sauchal salt and vid salt needs to be sprinkled or blended on the finish and the decoction needs to be served recent for ingesting. This could relieve stomach ache or colic.

Different efficient measures

The beneath talked about measures could also be included within the remedy of stomach ache –Upanaha – natural poultices needs to be administered over the painful a part of the stomach.
Sneha – oleation / exterior and inner lubrication will assist in relieving ache.
Seka – showering or stream pouring of medicinal liquids on the stomach.
Dhanyamla parishechana – showering of bitter fermented medicinal liquid over the stomach
Avagaha – sitting in a bathtub full of decoctions ready with vata assuaging herbs
Anyad hitam – another measure which alleviates stomach ache shall be used as treatment.

Different efficient formulations

Indukantham Kashayam
Gandharvahastadi Kashayam
Chitrakagrandhikadi Kashayam
Sukumaram Kashayam
Abhayarishtam
Jeerakarishtam
Putikaranjasavam
Putikasavam
Dwirutharam Churnam
Hinguvachadi Churnam
Induppukanam Churnam
Panchakola churna
Chitrakadi Vati
Kankayana Vati (Gulma)
Dashamula Haritaki
Sukumara Rasayanam
Vilwadi Leham

Different remedy inclusions

KukshiShoola can be handled on the traces of treating
Shula – colic
Gulma – stomach tumors related to ache in flanks, coronary heart, navel and urinary bladder
Learn – Understanding Digestion Course of From An Ayurveda View

Fashionable Correlation

In kukshi shoola we see that the situation is manifested on the backdrop of imbalance of digestive energy. This results in formation of ama i.e. intermediate merchandise of improper digestion, indigestion of vata origin and constipation. The particular person will be unable to clear the faeces and there may even be accumulation of undigested meals within the intestine. The occasions are occurring within the abdomen, small gut and enormous gut. Sluggish digestive fireplace and weak digestion and formation of ama and stagnation of undigested meals are the occasions happening within the abdomen and small gut. On the similar time constipation takes place as a result of faeces not being cleared simply within the colon. It will result in stress within the intestines and extreme ache. From the attitude of contemporary drugs all these occasions may be put collectively and referred to as ‘intestinal colic’ since ache within the stomach is an important symptom of this illness. We will make it extra exact and name it ‘intestinal colic brought on on account of weak digestion, stagnation of undigested meals and constipation’. It will rule out different circumstances which might trigger ache within the stomach.

Intestinal colic

It’s a cramp like ache. It originates within the small or massive gut. It’s brought on by a blockage within the gut. This in flip retains meals and liquids stagnated and prevents them from passing by the physique to the surface.
The blockage can happen on account of completely different causes which embrace –

• Impacted faeces / constipation
• Inflammatory ailments of the gut like Crohn’s illness
• Formation of scar tissue within the intestines (from earlier surgical procedures associated to stomach and pelvis)
• Irritation or an infection of diverticula
• Cancerous tumours

Signs

Stomach ache
Lack of urge for food
Vomiting
Lack of or lessened bowel motion
Incapability to fart (move out the gases)
Distension of stomach

Parshva Shoola and Kukshi Shoola

Parsva Shula is a kind of colic or ache manifested within the flanks – sides of the physique (chest and stomach). This situation is defined by Grasp Sushruta amongst several types of ache or colic.

The time period ‘parsva’ is most frequently taken as ‘urah parshva’ i.e. ‘sides of the chest wall’ in scientific observe. So parsva shula confined to the ache within the sides of the chest cavity. However the sides of the stomach are additionally thought of within the sides of the physique or trunk. Until specified parsva means each – sides of the chest and sides of the stomach. Sides of the stomach may be thought of as udara parsva, udara stands for stomach.
Learn – Shoola Varieties, Signs, Therapy, Medicines, Cures

So there’s a confusion as to what we must always take into account by ‘parsva shula’ – ache within the sides of the chest or ‘ache within the sides of the chest in addition to sides of the stomach’?
Learn associated: Parsva Shula Causes, Signs, Pathogenesis, Therapy, Fashionable View

Why this doubt?
We get this doubt as a result of within the description of pathogenesis of parsva shula, Grasp Sushruta has additionally talked about the obstruction of vata by kapha in kukshi i.e. stomach and parsva i.e. sides of the chest and stomach. Right here using each phrases ‘kukshi’ and ‘parsva’ results in confusion.

1. Is the ache within the stomach and sides of each chest and stomach?
2. Is the ache within the stomach and sides of the chest?
3. Is the ache within the kukshi-parsva (if each phrases are taken collectively) i.e. sides of the stomach?

If case 3 is taken into account then what was the necessity of explaining one other painful situation referred to as ‘kukshi shula’ which suggests stomach ache or ‘intestinal colic’ by Grasp Sushruta instantly after explaining parsva shula?
Why would Sushruta clarify ‘ache within the sides of the stomach’ earlier than ‘ache within the stomach’?
Learn – Parinama Shoola : Definition, Varieties, Therapy, Medicines

Ought to we take into account Parsva Shula defined by Sushruta as ache in sides of chest or ache within the sides of stomach?

The pathogenesis and signs of parsva shula as defined by Grasp Sushruta directs us to know that this situation is brought on each within the sides of the chest in addition to stomach. There are some signs associated to the involvement of stomach like distension, gurgling sounds in stomach, and anorexia. On the similar time we get to see the signs pointing in direction of the involvement of sides of the chest like issue in respiratory. Pricking ache has not been particularly talked about in order to the place it happens. We will infer that this ache happens each within the sides of the chest in addition to stomach. Sleeplessness could also be brought on on account of ache in either side of the chest and stomach.

Ache could also be predominant in stomach or chest or in each locations. However the separate clarification of ‘kukshi shula’ drives us to restrict the that means of parsva shula as ‘ache within the sides of the chest’.
Learn – Fullness Of Stomach – Ayurvedic Method And Therapy

Variations between Parsva Shula and Kukshi Shula

Grasp Sushruta has additionally defined Kukshi Shula in the identical chapter. Kukshi means stomach. We could get a doubt in order to why Grasp Sushruta has as soon as once more defined stomach ache or colic individually after contemplating stomach ache within the context of parsva shula a couple of paragraphs earlier than kukshi shula. We will infer that –

Parsva shula is ache within the sides of the stomach and in addition related to ache within the sides of the chest. Parsva Shula is brought on by vitiated kapha and vata.
Kukshi shula is ache within the stomach, i.e. complete stomach and isn’t restricted to the edges of the stomach. Kukshi shula is brought on by vitiated vata. This situation has its personal pathogenesis and signs completely different from that of parsva shula.

Briefly –

• Parsva shula is predominantly a situation presenting with ache within the sides of the chest and consists of stomach signs
• Kukshi shula is predominantly a situation presenting with ache within the stomach together with its websites and consists of chest circumstances / signs

We will see breathlessness in each circumstances. In parsva shula it’s as a result of involvement of the lungs and in kukshi shula it’s as a result of ache referred from the intestines to the edges of the chest wall.
Learn – Completely different Causes For Vata Dosha Imbalance, Improve

Subdivisions of Parsva Shula

Relying on the place of manifestation of ache / colic, parsva shula may be categorized as –

Udara Parsva Shula – Ache within the sides of the stomach
Urah Parsva Shula – Ache within the sides of the chest

2^nd perspective of understanding parsva shula by understanding the time period kukshi

The time period ‘kukshi’ most frequently refers to stomach or stomach cavity. Kukshi can also be thought of to have the beneath talked about meanings –
Womb
Cavity

If kukshi is taken into account a cavity it additionally consists of the area contained in the chest or thoracic cavity. On this sense the kukshi parsva talked about within the pathogenesis of the illness by Grasp Sushruta may be thought of as ‘sides of the chest cavity’.

• Adhmana may be thought of as enlargement of the chest cavity brought on by vitiated kapha and vata.
• Gudagudayana may be thought of as irregular chest sounds brought on on account of friction.
• Suchibhiriva nistoda refers to pricking ache within the sides of the chest.

The stomach complaints and sleeplessness may be as a result of impact of lengthy standing ache within the sides of the chest and in addition as a result of stress imparted by the expanded chest over the stomach organs and organs of digestion.

Within the ‘kukshi shula’ defined by Grasp Sushruta ‘issue in respiratory’ has been talked about among the many signs. This can be on account of lengthy standing stomach ache and imparting stress over the chest and inflicting respiratory hassle. In kukshi shula if there may be ache within the stomach brought on on account of pathology of intestines the ache might not be restricted to central ache but additionally could embrace sides of the stomach. On this means udara parsva shula i.e. ‘ache within the sides of the stomach’ can also be a symptom of kukshi shula.

In parsva shula ache might be first manifested within the chest sides and later would come with sides of the stomach. In kukshi shula ache will first manifest within the stomach together with its sides and later will embrace sides of the chest.

Contemplating all these factors we are able to take into account that parsva shula is an evidence of ‘ache within the sides of the chest cavity’ together with stomach complaints or referred stomach ache. On this context we’ll take into account parsva shula as ache within the sides of the chest.
Learn – Vedanasthapana Gana – Ache Relieving Group Of Herbs Evaluate, Advantages

Different fascinating factors about Parsva Shula

Parsva Shula and Rajayakshma – Parsva shula is without doubt one of the signs of Rajayakshma (tuberculosis, phthisis) illness talked about by each Grasp Charaka and Sushruta. This point out clearly factors in direction of ache within the sides of the chest relatively than ache within the sides of the stomach.

Defining Parsva shula pathogenesis in Rajayakshma illness Grasp Charaka tells that this situation is characterised by sankocha i.e. constriction and ayama i.e. distension or stress manifested in an unsure / irregular means. In parsva shula generally there may be constriction and generally there may be enlargement. Constriction is because of predominance of vata and enlargement is because of predominance of kapha within the pathogenesis. Subsequently the character of ache might be unpredictable and unsure.

Parsva Shula in Gulma – Ache in Gulma – Gulma is a illness whereby ache manifests in 5 completely different areas as a result of presence of an stomach tumor or an enlargement therein. Ache is current in –

• Parsva – sides of the physique / flanks / sides of chest and stomach
• Hridaya – central chest (area of coronary heart)
• Nabhi – central a part of the stomach across the navel
• Vasti – decrease a part of the stomach / area of the urinary bladder

Even in Gulma there may be ache in flanks which embrace ache within the sides of chest in addition to stomach. It is because the central chest has been included in ‘hridaya’ and central stomach within the time period ‘nabhi’ and decrease stomach within the time period ‘vasti’. However this ache is as a result of presence of a tumor like swelling or cystic swelling in between the center and navel i.e. within the stomach. Right here parsva shula is a symptom of gulma. In parsva shula and kukshi shula there isn’t a tumor or mass within the stomach or chest cavities.
Learn – Gulma- Stomach Tumor- A Distinctive Illness In Ayurveda

Parsva shula as ‘ache within the sides of the chest’

As a result of beneath talked about causes parsva shula ought to strictly be thought of as ‘ache within the sides of the thorax – chest wall’.

Sushruta has defined kukshi shula instantly after parsva shula. Kukshi shula is ‘ache in tummy – intestinal colic’ whereby the ache is situated not solely within the central a part of the stomach but additionally in its sides.

Parsva Shula talked about by grasp Charaka within the context of ‘signs of Rajayakshma illness’ signs and remedy of parsva shula therein explains ‘ache within the sides of the edges of the chest wall’.

Stomach signs of parsva shula could also be manifested as a result of impact of the ‘ache within the sides of the chest wall’ over the stomach. Sleeplessness too could also be as a result of impact of fixed and ongoing chest wall ache.

The phrases which denote signs of stomach illness i.e. adhmana, gudagudayanam, suchibhiriva nistodam talked about as signs of parsva shula needs to be thought of as associated to the chest and never in relation to the stomach.
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