Vrana Sotha, Shakya Tantra

Vrana or an ulcer is formed secondary to inflammation (paka) of a swelling.

Since this swelling is for the causation of a vrana or leads to the formation of an ulcer, it is called vrana shotha.

Vrana sotha is that condition, which is characterised by the following features:-

• Like in granthi, vidradhi, Alaji etc there is a swelling
• It is hard (granthita)
• It is regular or irregular (Sama/visama)
• Located in the plane of skin and muscles (twak Mansa sthayi)
• It is localised lesion.
• Though it is also a swelling, it is different from granthi, vidradhi or Alaji.

Thus here vrana sotha indicates the inflammatory stage, which leads to the causation of a localised collection of pus, which once suppurated or improperly treated causes ulcer (vrana).

Thus Vrana sotha --> Vidradhi --> Vrana

The causes may be either intrinsic (due to vitiated dosa) or extrensic (agantuja).

Note-  
When trauma, chemicals, heat or any other causes, produces injury to the tissue, a number of substances are released by the injured tissues which produce lot of changes in the local tissue all this tissue changes are totally Defined by a single technical term inflammation.

Inflammation is characterised by:
increased blood flow to the injured area secondary to the dilation of local blood vessels.

• Leakage of Plasma from the vessels due to increased permeability of the capillary walls.
• Large number of granulocytes and monocytes migrate into the injured area.
• Localised swelling or oedema.

These reactions are brought about by various tissue products like histamine bradykinin etc, which basically activates the macrophages.
These macrophages play an important role in cleaning of the dead, injured tissues.

Another important consequence of inflammation is that the tissue spaces, lymphaties extra around the injured area are blocked. Thus halting or delaying in the spread of bacteria or toxins to other areas from the injured area.

The degree of inflammation largely depends upon the severity of tissue destruction.

with the initiation of inflammation the local macrophages get activated which internal phagocytose the foreign matter.

Apart from this the increased blood flow to the area brings in a large number of neutrophils which are capable of cleaning the area of any bacteria or toxins excetra.

later on gradually monocytes take over the scavenging action which requires several hours to day after the initial inflammatory reactions.

Samprapti-

The various intrinsic and extrinsic etiological factors cause the abbreviation of all three dosa, which in turn vitiate the Rakta dosha. These travel in the rasayani, localise in the area of trauma or where ever there is low immunity or in a weakened structure (kha vaigunya), resulting in the causation of a vrana sotha.


8 Sites of a vrana sotha-

For a vrana or for a vrana sotha to occur, certain tissues or structures (vrana vastu) need to be vitiated. Thus for the manifestation of a vrana, 8 tissues are required and they are;
Skin (twak), muscles (mamsa), vessels (Sira), ligaments (snayu), bones(asthi), joints (Sandhi), abdomen (Kosta) and vital structure (mamsa).
Charaka has considered twak, Sira, mamsa, media, asthi, snayu, marmalade and antarsraya (Kosta) as the 8 vrana vastu.

Classification of vrana sotha-

6 varieties

1. Vataja vrana sotha
2. Pittaja vrana sotha
3. Kaphaja vrana sotha
4. Raktaja vrana sotha
5. Sannipataja vrana sotha
6. Agantuja vrana sotha

Features of Vataja vrana sotha-

• The area of vrana sotha appears blackish or reddish black
• Rough (parusa)
• Soft (mrudu)
• Mobile (anavasthita)
• it is associated with varieties of pain ( pricking, cutting type etc)

Features of Pittaja vrana sotha-

• Yellowish or yellowish with red tinge (pita, sarakta)
• Soft (mrudu)
• Spreads fast (sighranusarya)
• With different pains like burning (osa), sucking type of pain(cosa), or scorching pain (daha) etc.