Shitapitta: Meaning, causes, symptoms, dosha relation; differential diagnosis, prognosis

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

Shitapitta is one of the three conditions presenting with skin manifestations, in a single chapter. Udarda and Kotha are the other two conditions.

Table of Contents

Shitapitta – meaning?

Though the meaning of Shitapitta has not been explained anywhere in the texts, we can infer that from the explanation of the disease.

The word shitapitta is made up of two terms –

Shita = means cold
Pitta = the dosha

Does it mean Pitta which is cold?

No, this does not make any sense because we know that one of the qualities of pitta is ushna i.e. hot or being hot. Pitta in its normalcy bestows heat / warmth in the body. All the heat process including digestion of food is due to the hot quality / property of pitta. So, pitta being cold is abnormal.

Does it mean Pitta influenced by cold?

This appears to be the appropriate meaning. When we go through the etiology and pathogenesis of Shitapitta (and other two conditions) we learn that these conditions are caused due to excessive exposure to cold air / wind. This leads to aggravation of kapha and vata. In later time kapha and vata would get associated with pitta also since these are tridosha conditions. This pitta has undergone aggravation independently due to its own etiological factors. Here we can see that Shitapitta is mainly caused by kapha and vata aggravated by cold breeze and later pitta gets associated in the disease. Kapha and Vata being cold predominant doshas would fall heavy on the hot pitta, like too much coldness of two doshas influencing and dominating a single hot dosha. The pitta is still aggravated in this condition but its aggravation is masked by coldness of kapha and vata. Therefore this condition is probably called as shitapitta, shita representing kapha and vata and pitta representing itself, coldness prevailing over heat. The pitta aggravation in this condition is dormant and hence we do not find predominant pitta symptoms. Most symptoms are contributory to kapha and vata. Fever and burning sensation which are caused by pitta may be a part of escape phenomenon, pitta trying to express itself being subdued by kapha and vata. Even from treatment perspective shitapitta is benefitted by warm and hot comforts and medicines.

Etiological Factors of Shitapitta

Shitapitta shares its common etiological factors with Udarda and Kotha. Excessive and repeated exposure to cold is the main causative factor for the causationof shitapitta.

Premonitory Symptoms of Shitapitta

Premonitory symptoms of Shitapitta (udarda and kotha) are – 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, shitapitta would have vata predominance.

Symptoms of Shitapitta

Actually the symptoms of Shitapitta have not been enumerated in the texts.

After enlisting the symptoms of Udarda, the author tells ‘The disease having these symptoms is called as Udarda, some people also call it as Shitapitta’.

This gives us a clarification that many experts consider Udarda and Shitapitta as one and the same. Some have considered these terms to be synonymous. The only difference between these conditions is that vata is predominant dosha in shitapitta while kapha predominance causes udarda, both being tridosha (caused by aggravation of all three doshas) conditions.

The symptoms of Shitapitta include –

Varati Dashta Samsthana Shothah Sanjayate Bahih – swelling or elevated patches (rashes) as if stung by a wasp manifesting on the exterior (skin)
Kandu – itching
Toda bahula – excessive pricking pain
Chardi – vomiting
Jwara – fever
Vidaha – burning sensation