Which of the following is listed as a cause of shotha?

• A. Mandagni
• B. Viral infection
• C. High altitude exposure
• D. Excessive light exercise

Answer: (A)

Shotha arises when there is an accumulation of ama due to impaired digestion, leading to blockage of channels (srotas) and swelling. When the digestive fire is weak—Mandagni—the jatharagni does not properly break down food. This incomplete digestion promotes ama formation, and as ama accumulates, it vitiates kapha and causes edema and swelling in tissues. That link between weak digestion and ama-driven obstruction is why Mandagni is listed as a cause of shotha.

Viral infection, high altitude exposure, and excessive light exercise can influence inflammation or fluid balance in the body, but they are not the classical etiological factors for shotha in traditional Ayurvedic texts.