Article by Dr Raghuram Y.S. MD (Ay) & Dr Manasa, B.A.M.S
Kotha is one of the three skin manifestations which is explained in the same context, same chapter. The other two conditions are shitapitta and udarda. This is because all three conditions are almost alike with some differences in the etiological factors, few symptoms, nature of manifestation and dosha predominance.
The manifestation of these conditions may be on the skin but not limited to the skin. They also spread to the inner tissues.
Related Reading – Shitapitta
Related Reading – Udarda
Kotha also has its variant and has been named as Utkotha.
Like Shitapitta and Udarda, Kotha is also caused by aggravation of tridoshas and tends to contaminate the skin i.e. manifests as a skin disease, just like kushta (leprosy, skin diseases).
Etiological Factors of Kotha
Like Shitapitta and Udarda, ‘excessive and repeated exposure to cold breeze’ is a single main and common etiological factor causing kotha too. Apart from this we also can find specific etiological factors for kotha being explained in the texts.
असम्यग्वमनोदीर्णपित्तश्लेष्मान्ननिग्रहैः।॥मा.नि.५०/६॥
Asamyak Vamana Udirna Pitta Shleshma Anna Nigrahai – This needs to be understood in two different ways (according to Madhukosha commentary of the verse).
- Ayoga (inadequate administration) or Mithya Yoga (erroneous / improper administration) of Vamana (emesis therapy) will exacerbate (provoke) pitta and kapha doshas. When these doshas which are tending to go out of the body are withheld by choice or by the impact of inadequate or improper administration or when the bouts of emesis are forcibly withheld or otherwise the doshas would cause a disease called as Kotha. Apart from this forcibly withholding the anna vega i.e. the urge for stagnant food to get expelled from the body (stomach) i.e. vomiting urge will also cause kotha.
- Inadequate or improper (erroneous) administration of emesis therapy would cause kotha. Also forcibly withholding the urges of pitta, kapha and anna (food) i.e. preventing them from getting expelled even when they are ready to get expelled would cause kotha.
Here we need to see that improper or inadequate expulsion of pitta, kapha and anna in their excited / provoked state (ready to be expelled) and improper or inadequately administered emesis therapy are the main causes of Kotha. But we should also consider the exposure of cold breeze in these persons amongst the etiological factors (because it is the common cause of all three conditions).
Premonitory Symptoms of Kotha
Premonitory symptoms of Kotha are similar to those of Shitapitta and Udarda (premonitory symptoms of all these three conditions are the same). They are as enlisted below –
- excessive thirst,
- loss of taste (tastelessness),
- nausea,
- weakness in the body parts,
- heaviness of the body, and
- redness of the eyes
Dosha predominance
In spite of being caused by aggravation of all the three doshas, kotha would have kapha and pitta predominance.
Symptoms of Kotha
मण्डलानि सकण्डूनि रागवन्ति बहूनि च।
उत्कोठः सानुबन्धश्च कोठ इत्यभिधीयते॥मा.नि.५०/६॥
The disease marked by many circular red colored patches associated with itching is known as Kotha.
Utkotha – A variant of Kotha is known as Utkotha.
Difference between Kotha and Utkotha
सानुबन्ध उत्कोठोऽभिधीयते। सानुबन्धता च पुनः पुनर्भवनेन॥ मा.नि.५०/६, मधुकोश।
Utkothah Sanubandhah Cha – That (kotha) which has anubandha is known as Utkotha. Anubandha means ‘that which occurs repeatedly, again and again’.
This shows that Utkotha runs a longer course and tends to recur again and again.
कोठो निरनुबन्धः। तथा चोक्तं – ’क्षणिकोत्पादविनाशः कोठ इति निगध्यते तज्ञैः’ इति। मा.नि.५०/६, मधुकोश।
Kotho Niranubandhah – On the other hand Kotha is defined as that which does not have anubandha. Niranubandha means opposite of anubandha (characteristic of utkotha) i.e. ‘that which does not occur repeatedly’. Further, the commentary explains – ‘experts opine that kotha is a disease which manifests in a second and vanishes in another second’. This shows that kotha is a temporary situation which comes and goes in quick time, stays for shorter time period and doesn’t trouble the person a lot.
So, the difference between kotha and utkotha is that kotha is short lived and less troublesome, a temporary situation, while utkotha tends to occur repeatedly, runs a longer course and is more troublesome.
The symptoms of utkotha are the same as those of kotha, but run a longer course.
Kotha v/s Udarda & Shitapitta
These three conditions i.e. shitapitta, udarda and kotha have small differences in spite of being explained in the similar context (chapter).
Related Reading – Similarities and differences between shitapitta, udarda and kotha
Treatment of Kotha
All three conditions i.e. shitapitta, udarda and kotha share similar line of treatment.
Related Reading – ‘Treatment of Shitapitta, Udarda, Kotha’
