Article by Dr Raghuram Y.S. MD (Ay) & Dr Manasa S, B.A.M.S
Meaning of Kroshtuka shirsha
Kroshtuka – jackal
shirsha – head
Kroshtuka shirsha is a type of Vata Vyadhi – a special diseased condition caused by aggravation of ‘only vata’. It has also been explained in the context / chapter of ‘vata vyadhi’.
The disease manifests with a big swelling in the centre of the knee joint with severe pain as caused by combined aggravation of vata and rakta. The shape of the swelling resembles that of the head of a jackal and hence the name kroshtuka shirsha.
Ref – Sushruta Nidana Sthana, Chapter 1, verse 76
Kroshtuka Shirsa
वातशोणितजः शोफो जानुमध्ये महारुजः ।।
शिरः क्रोष्टकपूर्वं तु स्थूलः क्रोष्टकमूर्धवत् ।।७६ ।।
Kroshtuka shirsha is caused by simultaneous aggravation of vata and sonita – blood.
Aggravated vata associated with blood get lodged in the knee joint and produces swelling therein. The swelling occurs at the centre of the knee joint. The swelling is associated with severe pain.
Appearance of swelling – The swelling is stout and resembles the head of kroshtuka i.e. jackal in shape and hence the name ‘Kroshtuka shirsha’.
Causes –
– Vata aggravating factors including foods and lifestyle practices and seasonal changes
– Factors responsible for aggravation of rakta
Symptoms –
– Shotha – swelling at the centre of knee joint which resembles the head of jackal in shape
– Maharaja – severe pain in the region of swelling over the knee joint
Difference from other joint disorders
Many kinds of joint related disorders may occur due to aggravated vata in different joints of the body. But in Kroshtuka shirsha, the knee joint has been specifically mentioned to be involved. There is also an association of rakta in pathogenesis.
Is Kroshtuka shirsha a variant of Vatarakta?
Due to the involvement of rakta along with vata, it might appear to be similar to vatarakta but in vatarakta multiple joints are involved whereas in Kroshhtuka shirsha, only the knee joint is involved. Also, the swelling is big and pain is severe in this condition and Kroshtuka shirsha is also mentioned amongst vata vyadhis and not as a variant of vatarakta. So, Kroshtuka shirsha is a vata vyadhi occurring in ‘only knee joint’ with association of aggravated rakta.
On the other hand, Kroshtuka shirsha may also be considered as a variant of Vatarakta because Acharya Sushruta has explained Vatarakta in the context of / chapter of Vata Vyadhi itself.
So, Kroshtuka shirsha is a Vata Vyadhi, Vatarakta according to Acharya Sushruta is also a Vata Vyadhi. Rakta is involved in both cases. So, they may be variants of each other. Kroshtuka shirsha is considered as Vata Vyadhi because it does not have its origin from pada i.e. foot, as in Vatarakta, and is confined to the knee joint itself i.e. the disease origin is in the knee itself. In Kroshtuka shirsha, only one joint is involved whereas many joints are involved in Vatarakta.
Treatment
Treatment for Kroshtuka shirsha has not been explained in Ayurveda texts.
So, it needs to be treated on the lines of Vata Vyadhi Chikitsa.
Other treatment principles include –
– Vatarakta Chikitsa – treatment on the lines of treating vatarakta
– Shotha Chikitsa – treatment on the lines of treating swelling / inflammatory swelling
Research
Management of Pseudogout (Kroshtuksheersha) through herbal medicine – a case report – In this study conducted by Department of Panchakarma, Vijayashree Ayurvedic Medical College and Hospital, Jabalpur, Madhya Pradesh, India, Pseudogout was treated effectively using Kaishora Guggulu, Punarnavasavam and Punarnavadi Guggulu – correlating the condition to Pseudogout.
Modern Correlation
Kroshtuka shirsha has been correlated to Pseudogout due to similarity of presentation of both conditions.
Some experts have also correlated it with
– Inflamed knee joint
– Sino-arthritis of knee joint
– Gonorrhoeal arthritis
