Importance of Shodana in Kushta chikitsa-An ayurvedic view
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Jul 09, 2024
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About This Presentation
Shodhana in Kushta about Nirukti of Kushta, nidana, poorvaroopa,Bheda,
Lakshana,Samprapti,upadrava, Chikitsa of Kushta, and importance of shodhana in Kushta like Pakshat Pakshat vamana, Masat masat virechana, Shashte Shashte Raktamokshana, trirat trirat nasya according to different acharyas with ind...
Slide Content
1
IMPORTANCE OF SHODHANA IN
KUSHTA CHIKITSA- AN AYURVEDIC
VIEW
Presented by
Dr. Kavya B Laxmeshwar
Final year PG
Department of Kayachikitsa
Under the guidance of
Dr. Rajeshwari Kadkol H.O.D and Professor
Dr. Sanmati Kurundwade Professor
Dr. Sangangowda Melashankar Reader
Dr. Kamala .H Assistant Professor
Department of Kayachikitsa
Dr. B.N.M Rural Ayurvedic Medical College, Hospital, PG and research Centre,
Vijayapura
2
KUSHTA CHIKITSA- AN AYURVEDIC
VIEW
Presented by
Dr. Kavya B Laxmeshwar
Final year PG
Department of Kayachikitsa
Under the guidance of
Dr. Rajeshwari Kadkol H.O.D and Professor
Dr. Sanmati Kurundwade Professor
Dr. Sangangowda Melashankar Reader
Dr. Kamala .H Assistant Professor
Department of Kayachikitsa
Dr. B.N.M Rural Ayurvedic Medical College, Hospital, PG and research Centre,
Vijayapura
2
INTRODUCTION
• Skin is the largest organ of the body Which act as Barriers between the internal tissue
and the external environment. Skin is the Sthana for Sparshanedriya. There is an
inseparable relation between skin and Manas due to their Sarva Indriya Vyapakatva,
So any problem to the Sparshanendriya it also effects the Manas.
•The word Kushta is a broad term used for almost all skin disorders. Acharya Sushruta
given the term Twakāmaya as synonyms of Kushta. Kushta is one among the
Deergakalina Vyadhi and also one of the Ashta Mahagada, Santarpanajanya and
Raktapradoshaja vikara. Kushta is difficult to cure, so it is called Dushchikitsa.
Acharya Sushruta considered Kushta as the Aupasargika roga (contagious disease)
which may spread by contact.
3
• Skin is the largest organ of the body Which act as Barriers between the internal tissue
and the external environment. Skin is the Sthana for Sparshanedriya. There is an
inseparable relation between skin and Manas due to their Sarva Indriya Vyapakatva,
So any problem to the Sparshanendriya it also effects the Manas.
•The word Kushta is a broad term used for almost all skin disorders. Acharya Sushruta
given the term Twakāmaya as synonyms of Kushta. Kushta is one among the
Deergakalina Vyadhi and also one of the Ashta Mahagada, Santarpanajanya and
Raktapradoshaja vikara. Kushta is difficult to cure, so it is called Dushchikitsa.
Acharya Sushruta considered Kushta as the Aupasargika roga (contagious disease)
which may spread by contact.
3
•Shodhana karma helps in removal of Bahudosha, Raktapradoshaja vikara and Also
there is mentioned lots of Shamana aushadhi for Kushta but Shodhana has great
importance as it evacuate the Prakupita Doshas from the body.
•शोधनं यत् कुपितान् दोषान् पनिःसाययबप िः रोगप्रशमनं करोपत। (इन्दु.अ.सं.सू. 1/38)
•The word Shodhana is derived from the Dhatus Sudh - It means Cleansing (शब्दकल्िद्रुम)
•The Procedure for evacuation of Prakupita doshas from the body for the purification of
Roga Upashamana is known as Shodhana.
•Hence this study was undertaken with an aim to understand the effectiveness of Shodhana
karma in Kushta Chikitsa.
4
there is mentioned lots of Shamana aushadhi for Kushta but Shodhana has great
importance as it evacuate the Prakupita Doshas from the body.
•शोधनं यत् कुपितान् दोषान् पनिःसाययबप िः रोगप्रशमनं करोपत। (इन्दु.अ.सं.सू. 1/38)
•The word Shodhana is derived from the Dhatus Sudh - It means Cleansing (शब्दकल्िद्रुम)
•The Procedure for evacuation of Prakupita doshas from the body for the purification of
Roga Upashamana is known as Shodhana.
•Hence this study was undertaken with an aim to understand the effectiveness of Shodhana
karma in Kushta Chikitsa.
4
VYUTPATTI
•कुष् + पन कुषीपत। इपत क्थन्। कुष्ठं। (शब्दकल्िद्रुम)
कुष् पनष्कषे + पन कुषीपत। इपत क्थन्। कुष्ठं। (शब्दकल्िद्रुम)
The word ‘Kushta’ is derived from ‘Kuş nişkarşane’ dhātu by adding ‘Kthan’ pratyaya. The
word ‘Kus’ means to extract or to destroy or to tear or to draw out or to deform and the word
‘Kthan’ means certainty. Hence, the word ‘Kushta’ means that which destroys with certainty.
NIRUKTI AND PARIBHASHA
•कुष्ठं-कुष्णापत शरीरस्य शोपणतं पिकु�ते इपत। (शब्दकल्िद्रुम)
The vitiated Rakta leads to destruction of body, so it is called Kushta.
5
•कुष् + पन कुषीपत। इपत क्थन्। कुष्ठं। (शब्दकल्िद्रुम)
कुष् पनष्कषे + पन कुषीपत। इपत क्थन्। कुष्ठं। (शब्दकल्िद्रुम)
The word ‘Kushta’ is derived from ‘Kuş nişkarşane’ dhātu by adding ‘Kthan’ pratyaya. The
word ‘Kus’ means to extract or to destroy or to tear or to draw out or to deform and the word
‘Kthan’ means certainty. Hence, the word ‘Kushta’ means that which destroys with certainty.
NIRUKTI AND PARIBHASHA
•कुष्ठं-कुष्णापत शरीरस्य शोपणतं पिकु�ते इपत। (शब्दकल्िद्रुम)
The vitiated Rakta leads to destruction of body, so it is called Kushta.
5
•कालेनोिेपितं यस्मात्सिं कुष्णापत तद्विुिः। (अ.हृ.पन. 14/4)
• That which disfigures the body in the course of time is called Kuşhta.
•त्िचिः कुियपन्त िैिर्णयय दुष्ािः कुष्ठमुशपन्त तत्। (अ.हृ.पन. 14/3)
•That which produces discoloration of the Tvak (skin) is known as Kuşhta.
•कुष्णापत तस्मात्तत् कुष्ठपमत्युच्यते। (अ�.अ.हृ.पन. 14/4)
•That which destroys the body is called Kushta
•त्िचागिः सियपत रोगदोषिः कुष्ठेपत संज्ञा प्रिदपन्त धीरािः ।। ( ा.सं.तृ. 39/2)
•The aggravated Doşha gets located in the skin and spreads throughout the body, which is called
Kuşhta by an intelligent physician.
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• That which disfigures the body in the course of time is called Kuşhta.
•त्िचिः कुियपन्त िैिर्णयय दुष्ािः कुष्ठमुशपन्त तत्। (अ.हृ.पन. 14/3)
•That which produces discoloration of the Tvak (skin) is known as Kuşhta.
•कुष्णापत तस्मात्तत् कुष्ठपमत्युच्यते। (अ�.अ.हृ.पन. 14/4)
•That which destroys the body is called Kushta
•त्िचागिः सियपत रोगदोषिः कुष्ठेपत संज्ञा प्रिदपन्त धीरािः ।। ( ा.सं.तृ. 39/2)
•The aggravated Doşha gets located in the skin and spreads throughout the body, which is called
Kuşhta by an intelligent physician.
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NIDANA
•विरोधीन्यन्नपानानन द्रिस्ननग्धगुरुस्न्ि च। भजताभागताां छर्दि िेगाांश्चान्यान् प्रनतष्नताम् ॥
व्यायाममनतसन्तापमनत भुक्तिोसेविनाम्। शीतोष्िलङ्घनाहारान् क्रमि मुक््िा ननेेवििाम्॥
धमिश्रमभयातािनाां द्रुतां शीताम्बुसेविनाम्। अजीिािध्यशशनाां चैि पञ्िकर्मािपचाणरिाम्॥
निान्नदधधम्नयानतल लििाम्लननेेवििाम्। माेमूलकर्वपष्टान्ननतलक्षीरगुडाशशनाम् ॥
व्यिायां चाप्यजीिेऽन्ने ननद्राां च भजताां र्दिा। विप्रान् गुरुन् धमियताां पापां कर्मि च कर्ुििताम् ॥
(च.धच. 7/4-8)
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•विरोधीन्यन्नपानानन द्रिस्ननग्धगुरुस्न्ि च। भजताभागताां छर्दि िेगाांश्चान्यान् प्रनतष्नताम् ॥
व्यायाममनतसन्तापमनत भुक्तिोसेविनाम्। शीतोष्िलङ्घनाहारान् क्रमि मुक््िा ननेेवििाम्॥
धमिश्रमभयातािनाां द्रुतां शीताम्बुसेविनाम्। अजीिािध्यशशनाां चैि पञ्िकर्मािपचाणरिाम्॥
निान्नदधधम्नयानतल लििाम्लननेेवििाम्। माेमूलकर्वपष्टान्ननतलक्षीरगुडाशशनाम् ॥
व्यिायां चाप्यजीिेऽन्ने ननद्राां च भजताां र्दिा। विप्रान् गुरुन् धमियताां पापां कर्मि च कर्ुििताम् ॥
(च.धच. 7/4-8)
7
NIDANA
NIDANA C.S Su.S A.H Bh. S Ha.S
Aharaja nidana
Viruddha Annapana + + + + +
Sheeta- Ushna akrama sevana + - + - -
Santarpana- Apatarpana vyatyasa+ - - - -
Ajeerna bhojana + + - - -
Adhyashana + - + - -
Asatmya ahara - + - - -
Mithya ahara - + + + -
Vidagda ahara + - - - -
Vidahi ahara + - - + -
Drava, Snigda, Guru bhojana + + - + -
Dushita jala sevana - - - - +
Navanna sevana + - - -
Anupa, Audaka, Mama, Ksheera - + - - -
Matsya + - - + - 8
NIDANA C.S Su.S A.H Bh. S Ha.S
Aharaja nidana
Viruddha Annapana + + + + +
Sheeta- Ushna akrama sevana + - + - -
Santarpana- Apatarpana vyatyasa+ - - - -
Ajeerna bhojana + + - - -
Adhyashana + - + - -
Asatmya ahara - + - - -
Mithya ahara - + + + -
Vidagda ahara + - - - -
Vidahi ahara + - - + -
Drava, Snigda, Guru bhojana + + - + -
Dushita jala sevana - - - - +
Navanna sevana + - - -
Anupa, Audaka, Mama, Ksheera - + - - -
Matsya + - - + - 8
Kshera, dadhi + + - + -
Masha, Pistanna, Atasi, Kusumba sneha + - - - -
Guda + - - + -
Tila, kola, Kulatta + - - - -
Amla rasa + - - - +
Kakamachi, Mulaka, Matsya with Ksheera + - - + -
Pippali, Ghruta, Lakucha - - - + -
Phanita, Madhu, Yavaka, Uddalaka + - - - -
Viharaja ahara
Ativyayama,Vyavaya, Exposure to Sheetala jala after santapa+ + - - -
Adhwa after jalapana - - - + -
Mithya vihara - + + - -
Diwaswapna, Ratrijagarana + - - - +
Ati santapa, Bhaya, Shrama + - - -
Other nidana
Papakarma, Purva janma karma + + + - -
Sadu nindana + - + - -
9
Masha, Pistanna, Atasi, Kusumba sneha + - - - -
Guda + - - + -
Tila, kola, Kulatta + - - - -
Amla rasa + - - - +
Kakamachi, Mulaka, Matsya with Ksheera + - - + -
Pippali, Ghruta, Lakucha - - - + -
Phanita, Madhu, Yavaka, Uddalaka + - - - -
Viharaja ahara
Ativyayama,Vyavaya, Exposure to Sheetala jala after santapa+ + - - -
Adhwa after jalapana - - - + -
Mithya vihara - + + - -
Diwaswapna, Ratrijagarana + - - - +
Ati santapa, Bhaya, Shrama + - - -
Other nidana
Papakarma, Purva janma karma + + + - -
Sadu nindana + - + - -
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PURVAROOPA
•स्िशायज्ञत्िमपतस्िेदो न िा िैिर्णययमुन्नपतिः । कोठानां लोम षयश्च कर्णडूस्तोदिः श्रमिः क्लमिः ॥११॥
व्रणानामपधकं शूलं शीघ्रोत्िपत्तपश्चरपस्थपतिः । दा िः सुप्ताङ्गता चेपत कुष्ठलिणमग्रजम् ।। १२ ॥
( Cha. Chi 7/ 11-12)
•तस्य िूिय�िापण-त्िक्िा�ष्यमकस्माद्रोम षयिः कर्णडूिः स्िेदबा ुल्यमस्िेदनं िाऽङ्गप्रदेशानां
स्िािं ितपिसियणमसृजिः कृष्णता चेपत ॥” (सु.पन. 5/4)
•अपतश्लक्ष्णसरस्िशयस्िेदास्िेदपििणयतािः । दा िः कर्णडूस्त्िपचस्िािस्तोदिः कोठोन्नपतिः श्रमिः ।।११।।
व्रणानामपधकं शूलं शीनोत्िपत्तपश्चरपस्थपतिः। �ढानामपि �ित्िं पनपमत्तेऽल्िेऽपि कोिनम् ।।१२।।
रोम षोऽ सृजिः काष्य कुष्ठलिणमग्रजम् | (A.H.Ni 14/11-12)
10
•स्िशायज्ञत्िमपतस्िेदो न िा िैिर्णययमुन्नपतिः । कोठानां लोम षयश्च कर्णडूस्तोदिः श्रमिः क्लमिः ॥११॥
व्रणानामपधकं शूलं शीघ्रोत्िपत्तपश्चरपस्थपतिः । दा िः सुप्ताङ्गता चेपत कुष्ठलिणमग्रजम् ।। १२ ॥
( Cha. Chi 7/ 11-12)
•तस्य िूिय�िापण-त्िक्िा�ष्यमकस्माद्रोम षयिः कर्णडूिः स्िेदबा ुल्यमस्िेदनं िाऽङ्गप्रदेशानां
स्िािं ितपिसियणमसृजिः कृष्णता चेपत ॥” (सु.पन. 5/4)
•अपतश्लक्ष्णसरस्िशयस्िेदास्िेदपििणयतािः । दा िः कर्णडूस्त्िपचस्िािस्तोदिः कोठोन्नपतिः श्रमिः ।।११।।
व्रणानामपधकं शूलं शीनोत्िपत्तपश्चरपस्थपतिः। �ढानामपि �ित्िं पनपमत्तेऽल्िेऽपि कोिनम् ।।१२।।
रोम षोऽ सृजिः काष्य कुष्ठलिणमग्रजम् | (A.H.Ni 14/11-12)
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BHEDA
•न च पकपचचदपस्त कुष्ठमेकदोषप्रकोिपनपमत्तम्, अपस्त तु खलु समानप्रकृतीनामपि कुष्ठनां सप्तपिधोऽष्ा-
दोषांशांशपिकल्िानुबन्धस्थानपिभागेनिेदनािणयसंस्थानप्रभािनामपचपकपत्सतपिशेषिः । स दशपिधोऽिररसङ््येयपिधोिाभिपत। दोषा प
पिकल्िनैपियकल््यमानापिकल्ियपन्तपिकारान्, अन्यत्रा- साध्यभािात् …… (च. पन. 5/4)
•No Kushta manifests due to vitiation of only one Dosha. Though all the Kushta same causative
factors, there is much difference in Vedana (pain). Varta Samsthana (site), Prabhāva (effect).
Nama (name) and Chikitsa (treatment) due to variation in Doshamshāmšha (degree or stage of
doshas). Anubandha doshas (their association) Sthana (location). Hence, it is said to be of
Saptavidha (seven types). Ashtadasha (eighteen types) or Aparisankhya (innumerable) types of
Kushta. Depending upon the permutation and combination of Doshas, variation in types of
diseases occurs except incurable conditions.
11
•न च पकपचचदपस्त कुष्ठमेकदोषप्रकोिपनपमत्तम्, अपस्त तु खलु समानप्रकृतीनामपि कुष्ठनां सप्तपिधोऽष्ा-
दोषांशांशपिकल्िानुबन्धस्थानपिभागेनिेदनािणयसंस्थानप्रभािनामपचपकपत्सतपिशेषिः । स दशपिधोऽिररसङ््येयपिधोिाभिपत। दोषा प
पिकल्िनैपियकल््यमानापिकल्ियपन्तपिकारान्, अन्यत्रा- साध्यभािात् …… (च. पन. 5/4)
•No Kushta manifests due to vitiation of only one Dosha. Though all the Kushta same causative
factors, there is much difference in Vedana (pain). Varta Samsthana (site), Prabhāva (effect).
Nama (name) and Chikitsa (treatment) due to variation in Doshamshāmšha (degree or stage of
doshas). Anubandha doshas (their association) Sthana (location). Hence, it is said to be of
Saptavidha (seven types). Ashtadasha (eighteen types) or Aparisankhya (innumerable) types of
Kushta. Depending upon the permutation and combination of Doshas, variation in types of
diseases occurs except incurable conditions.
11
•Two types- 1. Mahakushta-7
2. Kshudra Kushta-11
•Seven types- Mahakushta Eleven types- Kshudra kushta
1. Kapala- Vataja 1. Ekakushta: Vata-Kapha
2. Udumbara- Pittaja 2. Charmakushta: Vata-Kapha
3. Mandala- Kaphaja 3. Kitiba: Vata-Kapha
4. Rishyajiwha- Vatapittaja 4. Vipadika: Vata-Kapha
5. Pundarika- Pittakaphaja 5. Alasaka: Vata- Kapha
6. Sidhma- Vatakaphaja 6. Dadru- Pitta- Kapha
7. Kakanaka- Sannipataja 7. Charmadala: Pitta-Kapha
8. Pama: Pitta-Kapha
9. Visphota: Pitta-Kapha
10. Shataru: Pitta-Kapha
11. Vicharchika: Kapha
12
2. Kshudra Kushta-11
•Seven types- Mahakushta Eleven types- Kshudra kushta
1. Kapala- Vataja 1. Ekakushta: Vata-Kapha
2. Udumbara- Pittaja 2. Charmakushta: Vata-Kapha
3. Mandala- Kaphaja 3. Kitiba: Vata-Kapha
4. Rishyajiwha- Vatapittaja 4. Vipadika: Vata-Kapha
5. Pundarika- Pittakaphaja 5. Alasaka: Vata- Kapha
6. Sidhma- Vatakaphaja 6. Dadru- Pitta- Kapha
7. Kakanaka- Sannipataja 7. Charmadala: Pitta-Kapha
8. Pama: Pitta-Kapha
9. Visphota: Pitta-Kapha
10. Shataru: Pitta-Kapha
11. Vicharchika: Kapha
12
चरक सुश्रुत वाग्भट
महाकुष्ठ किाल किाल किाल
औदुम्बर उदुम्बर औदुम्बर
मर्णडल अ�ण मर्णडल
ऋष्यपजह्न ऋष्यपजह्न ऋष्यपजह्न
िुर्णडरीक िुर्णडरीक िुर्णडरीक
पसध्म दद्रु दद्रु
काकण काकण काकण
13
महाकुष्ठ किाल किाल किाल
औदुम्बर उदुम्बर औदुम्बर
मर्णडल अ�ण मर्णडल
ऋष्यपजह्न ऋष्यपजह्न ऋष्यपजह्न
िुर्णडरीक िुर्णडरीक िुर्णडरीक
पसध्म दद्रु दद्रु
काकण काकण काकण
13
चरक सुश्रुत वाग्भट
क्षुद्रकुष्ठ एकर्कर्ुष्ठ एकर्कर्ुष्ठ एकर्कर्ुष्ठ
चमिकर्ुष्ठ नथूलारुष्कर् चमिकर्ुष्ठ
ककर्र्टभ ककर्र्टभ ककर्र्टभ
विपार्दकर्ा महाकर्ुष्ठ विपार्दकर्ा
अलसकर् विसपि अलसकर्
दद्रु पणरसपि शसध्म
चमिदल चमिदल चमिदल
पामा पामा पामा
विनफोट शसध्म विनफोट
शतारु रकर्सा शतारु
विचधचिकर्ा विचधचिकर्ा विचधचिकर्ा
14
क्षुद्रकुष्ठ एकर्कर्ुष्ठ एकर्कर्ुष्ठ एकर्कर्ुष्ठ
चमिकर्ुष्ठ नथूलारुष्कर् चमिकर्ुष्ठ
ककर्र्टभ ककर्र्टभ ककर्र्टभ
विपार्दकर्ा महाकर्ुष्ठ विपार्दकर्ा
अलसकर् विसपि अलसकर्
दद्रु पणरसपि शसध्म
चमिदल चमिदल चमिदल
पामा पामा पामा
विनफोट शसध्म विनफोट
शतारु रकर्सा शतारु
विचधचिकर्ा विचधचिकर्ा विचधचिकर्ा
14
1. कपाल कुष्ठ
•कर्ृष्िारुिकर्पालाभां यद्रूक्षां परुेां तनु। कर्ापालां तोदबहुलां त्कर्ुष्ठां विेमां नमृतम् ॥ Cha.Chi 7/14
Dosha pradhanya- Vataja
Colour- Krshna, Aruna varna
Nature- Kapala ( Similar to broken piece of earthen pot)
Touch- Ruksha, Parusha, Tanu
Associated symptoms- Severe pain
2. औदुम्बर कुष्ठ
•दाहकर्ण्डूरुजारागपरीतां लोमवपञ्जरम्। उदुम्बरफलाभासां कर्ुष्ठमौदुम्बरां विदुुः ॥ Cha.Chi 7/15
•Dosha predominancy- Pittaja
•Colour- Coppery coloured skin lesion
( similar to Udumbara fruit)
•Nature- रागपरीत ( Redness),
लोमवपञ्जर (Hair on patch becomes brown)
•Associated symptoms- दाह, कर्ण्डू, रुजा
15
•कर्ृष्िारुिकर्पालाभां यद्रूक्षां परुेां तनु। कर्ापालां तोदबहुलां त्कर्ुष्ठां विेमां नमृतम् ॥ Cha.Chi 7/14
Dosha pradhanya- Vataja
Colour- Krshna, Aruna varna
Nature- Kapala ( Similar to broken piece of earthen pot)
Touch- Ruksha, Parusha, Tanu
Associated symptoms- Severe pain
2. औदुम्बर कुष्ठ
•दाहकर्ण्डूरुजारागपरीतां लोमवपञ्जरम्। उदुम्बरफलाभासां कर्ुष्ठमौदुम्बरां विदुुः ॥ Cha.Chi 7/15
•Dosha predominancy- Pittaja
•Colour- Coppery coloured skin lesion
( similar to Udumbara fruit)
•Nature- रागपरीत ( Redness),
लोमवपञ्जर (Hair on patch becomes brown)
•Associated symptoms- दाह, कर्ण्डू, रुजा
15
3. मण्डल कुष्ठ
•श्िेतां रक्तां स्नथरां न्यानां स्ननग्धमु्सन्नमण्डलम्।कर्ृच्छ्रमन्योन्यसांसक्तां कर्ुष्ठां मण्डलमुच्छ्यते।।
Cha.Chi 7/16
•Dosha predominancy- Kaphaja
•Colour- श्िेत,रक्त
•Nature- स्नथर (Slow),न्यान (Compact),स्ननग्ध and elevated round patches
•Associated symptoms- patches are mutually coalescing
4. ऋष्यजिह्न कुष्ठ
कर्कर्िशां रक्तपयिन्तमन्तुःश्यािां सिेदनम्। यद् ऋष्यस्जह्िासांनथानमृष्यस्जहां तदुच्छ्यते ।। Cha.Chi7/17
• Dosha predominancy- Vata Pittaja
•Colour- रक्तपयिन्तमन्तुःश्याि (Red in edges and brown inside)
•Nature- कर्कर्िश (Rough), It resembles the tongue of Rsya
(A type of deer)
•Associated symptoms- pain
16
•श्िेतां रक्तां स्नथरां न्यानां स्ननग्धमु्सन्नमण्डलम्।कर्ृच्छ्रमन्योन्यसांसक्तां कर्ुष्ठां मण्डलमुच्छ्यते।।
Cha.Chi 7/16
•Dosha predominancy- Kaphaja
•Colour- श्िेत,रक्त
•Nature- स्नथर (Slow),न्यान (Compact),स्ननग्ध and elevated round patches
•Associated symptoms- patches are mutually coalescing
4. ऋष्यजिह्न कुष्ठ
कर्कर्िशां रक्तपयिन्तमन्तुःश्यािां सिेदनम्। यद् ऋष्यस्जह्िासांनथानमृष्यस्जहां तदुच्छ्यते ।। Cha.Chi7/17
• Dosha predominancy- Vata Pittaja
•Colour- रक्तपयिन्तमन्तुःश्याि (Red in edges and brown inside)
•Nature- कर्कर्िश (Rough), It resembles the tongue of Rsya
(A type of deer)
•Associated symptoms- pain
16
5. पुण्डरीक कुष्ठ
•सश्िेतां रक्तपयिन्तां पुण्डरीकर्दलोपमम् ।
सो्सेधां च सदाहां च पुण्डरीकर्ां तदुच्छ्यते ॥ Cha.Chi 7/18
•Dosha predominancy- Pitta Kaphaja
•Colour- श्िेतां रक्तपयिन्त ( white with red edges)
•Nature- पुण्डरीकर्दलोपमम ( Resembles lotus petals, elevated patches)
•Associated symptoms- दाह
6. जसध्मकुष्ठ
श्िेतां ताम्र तनु च यद् रजो घृष्टां विमुञ्चनत।
अलाबुपुष्पििि तत् शसध्मां प्रायेि चोरशस ।।Cha.Chi7/19
•Dosha predominancy- Vata Kaphaja
•Colour- श्िेत,ताम्र, अलाबुपुष्पििि
(White coppery, Colour resembles the flower of Alabu)
•Nature- तनु
•Associated symptoms- Particles resembling dust are observed
17
•सश्िेतां रक्तपयिन्तां पुण्डरीकर्दलोपमम् ।
सो्सेधां च सदाहां च पुण्डरीकर्ां तदुच्छ्यते ॥ Cha.Chi 7/18
•Dosha predominancy- Pitta Kaphaja
•Colour- श्िेतां रक्तपयिन्त ( white with red edges)
•Nature- पुण्डरीकर्दलोपमम ( Resembles lotus petals, elevated patches)
•Associated symptoms- दाह
6. जसध्मकुष्ठ
श्िेतां ताम्र तनु च यद् रजो घृष्टां विमुञ्चनत।
अलाबुपुष्पििि तत् शसध्मां प्रायेि चोरशस ।।Cha.Chi7/19
•Dosha predominancy- Vata Kaphaja
•Colour- श्िेत,ताम्र, अलाबुपुष्पििि
(White coppery, Colour resembles the flower of Alabu)
•Nature- तनु
•Associated symptoms- Particles resembling dust are observed
17
6. काकण कुष्ठ
•यत् कर्ाकर्िस्न्तकर्ािििमपाकर्ां तीव्रिेदनम् । त्रिदोेशलङ्ग तत् कर्ुष्ठां कर्ाकर्िां नैि शसध्यनत ।।
Cha.Chi7/20
•Dosha predominancy- Sannipataja
•Colour- Resembles Gunja (Abrus precatorius) i,e red in colour
•Nature- Does not get suppurated
•Associated symptoms- Pain and incurable, all the three doshas are present
18
•यत् कर्ाकर्िस्न्तकर्ािििमपाकर्ां तीव्रिेदनम् । त्रिदोेशलङ्ग तत् कर्ुष्ठां कर्ाकर्िां नैि शसध्यनत ।।
Cha.Chi7/20
•Dosha predominancy- Sannipataja
•Colour- Resembles Gunja (Abrus precatorius) i,e red in colour
•Nature- Does not get suppurated
•Associated symptoms- Pain and incurable, all the three doshas are present
18
1.एककुष्ठ
अनिेदनां महािानतु यन्म्नयशकर्लोपमम् । तदेकर्कर्ुष्ठां- Cha. Chi 7/21
•Dosha predominancy- Vata Kapha
•Nature- Looks like scales of fish, Aswedana
Absence of sweating around the lesion,
महािानतु- The lesion is spread over an extended area of the skin.
•Touch- Rough and coarse on touch, extensive in size
2. चर्मकुष्ठ
चमािख्यां बहलां हस्नतचमिित्।। Cha. Chi 7/21
Dosha dominancy- Vata Kaphaja
Nature- Skin of the affected area is looks like elephants skin,
Spreading in vast area
19
अनिेदनां महािानतु यन्म्नयशकर्लोपमम् । तदेकर्कर्ुष्ठां- Cha. Chi 7/21
•Dosha predominancy- Vata Kapha
•Nature- Looks like scales of fish, Aswedana
Absence of sweating around the lesion,
महािानतु- The lesion is spread over an extended area of the skin.
•Touch- Rough and coarse on touch, extensive in size
2. चर्मकुष्ठ
चमािख्यां बहलां हस्नतचमिित्।। Cha. Chi 7/21
Dosha dominancy- Vata Kaphaja
Nature- Skin of the affected area is looks like elephants skin,
Spreading in vast area
19
3. ककटिभ
श्यािां ककर्िखरनपशि परुेां ककर्र्टभां मतम् ।
Dosha dominancy- Vata Kaphaja
Colour- श्याि
Touch- ककर्िखरनपशि, परुे ( Feeling rough on touch like a scar,
hard)
4. विपाटिका
•िैपार्दकर्ां पाणिपादनफुटनां तीव्रिेदनम् ।। २२ ।।
•Dosha dominancy-Vata Kaphaja
•Nature- पाणिपादनफुटन ( Cracking of palms and souls)
•Symptom- तीव्रिेदन
20
श्यािां ककर्िखरनपशि परुेां ककर्र्टभां मतम् ।
Dosha dominancy- Vata Kaphaja
Colour- श्याि
Touch- ककर्िखरनपशि, परुे ( Feeling rough on touch like a scar,
hard)
4. विपाटिका
•िैपार्दकर्ां पाणिपादनफुटनां तीव्रिेदनम् ।। २२ ।।
•Dosha dominancy-Vata Kaphaja
•Nature- पाणिपादनफुटन ( Cracking of palms and souls)
•Symptom- तीव्रिेदन
20
5. अलसक
कर्ण्डूमद्शभुः सरागैश्च गण्डैरलसकर्ां धचतम्। Cha. Chi 7/22
Dosha dominancy- Vata Kaphaja
Nature- गण्डै (boils)
Symptoms- कर्ण्डू, राग
6. दद्रु
•सकर्ण्डूरागवपडकर्ां दद्रुमण्डलमुद्गतम् ।। Cha. Chi 7/23
•Dosha dominancy- Pitta kapha
•Nature- It is circular in shape and elevated on the border
•Symptom- कर्ण्डूरागवपडकर्ां- It is accompanied with itching, redness and eruptions or boils
21
कर्ण्डूमद्शभुः सरागैश्च गण्डैरलसकर्ां धचतम्। Cha. Chi 7/22
Dosha dominancy- Vata Kaphaja
Nature- गण्डै (boils)
Symptoms- कर्ण्डू, राग
6. दद्रु
•सकर्ण्डूरागवपडकर्ां दद्रुमण्डलमुद्गतम् ।। Cha. Chi 7/23
•Dosha dominancy- Pitta kapha
•Nature- It is circular in shape and elevated on the border
•Symptom- कर्ण्डूरागवपडकर्ां- It is accompanied with itching, redness and eruptions or boils
21
7. चर्मिल
रक्तां सकर्ण्डु सनफोटां सरुग्दलनत चावप यत्। तच्छ्चमिदलमाख्यातां सांनपशािसहमुच्छ्यते ।। Cha. Chi 7/23
Dosha dominancy- Pitta Kapha
Colour- Rakta – redness around the boils
Nature- सांनपशािसह – Tenderness, the person does not allow
the afflicted part of the skin to be touched
Symptom- Itching, pain, erosion or cracks in the skin
8. पार्ा
पामा श्िेतारुिश्यािाुः कर्ण्डूलाुः वपडकर्ा भृशम्। Cha. Chi 7/24
Dosha predominancy- Pitta Kapha
Colour- श्िेतारुिश्यािा- Whitish, reddish, blackish
eruption or boils on the affected skin area
Symptom- कर्ण्डू
22
रक्तां सकर्ण्डु सनफोटां सरुग्दलनत चावप यत्। तच्छ्चमिदलमाख्यातां सांनपशािसहमुच्छ्यते ।। Cha. Chi 7/23
Dosha dominancy- Pitta Kapha
Colour- Rakta – redness around the boils
Nature- सांनपशािसह – Tenderness, the person does not allow
the afflicted part of the skin to be touched
Symptom- Itching, pain, erosion or cracks in the skin
8. पार्ा
पामा श्िेतारुिश्यािाुः कर्ण्डूलाुः वपडकर्ा भृशम्। Cha. Chi 7/24
Dosha predominancy- Pitta Kapha
Colour- श्िेतारुिश्यािा- Whitish, reddish, blackish
eruption or boils on the affected skin area
Symptom- कर्ण्डू
22
9.विस्कोि
•नफोटा। श्िेतारुिाभासा विनकर्ोटाुः नयुनतनु्िचुः॥ Cha. Chi 7/25
•Dosha predominancy- Pitta Kapha
•Colour- श्िेतारुिाभासा – Whitish, Golden yellow or red colour
lesion
•Symptom- नफोटा- boils or eruptions,
नतनु्िच – Skin over the lesion will be thin.
10. शतारु
रक्तां श्यायां सदाहानति शतारुुः नयाद् बहुव्रिम्।
Dosha dominancy- Pitta Kaphaja
Colour- रक्त,श्याय – Red or Blackish lesion
Symptom- दाहानति , बहुव्रिम –Burning sensation and severe pain and multiple lesion.
23
•नफोटा। श्िेतारुिाभासा विनकर्ोटाुः नयुनतनु्िचुः॥ Cha. Chi 7/25
•Dosha predominancy- Pitta Kapha
•Colour- श्िेतारुिाभासा – Whitish, Golden yellow or red colour
lesion
•Symptom- नफोटा- boils or eruptions,
नतनु्िच – Skin over the lesion will be thin.
10. शतारु
रक्तां श्यायां सदाहानति शतारुुः नयाद् बहुव्रिम्।
Dosha dominancy- Pitta Kaphaja
Colour- रक्त,श्याय – Red or Blackish lesion
Symptom- दाहानति , बहुव्रिम –Burning sensation and severe pain and multiple lesion.
23
11. विचर्चमका
•श्यािा बहुस्रािा विचधचिकर्ा ।। Cha. Chi 7/26
•Dosha dominancy- Kaphaja
•Colour- श्यािा - Blackish lesion
•Symptom- बहुस्रािा
According to Acharya Sushruta
❖स्थूलारुष्क
•नथूलानन सस्न्धष्िनतदारुिानन नथूलारुवे नयुुः
कर्र्ठनान्यरांवे। (सु.नन. 5/9)
•Sthūlaruşka Kuştha is characterized by Kathinānyarumşi
(hard eruptions) occurring especially in Sandhi (joint) and Atidāruṇāni (in a severe form).
24
•श्यािा बहुस्रािा विचधचिकर्ा ।। Cha. Chi 7/26
•Dosha dominancy- Kaphaja
•Colour- श्यािा - Blackish lesion
•Symptom- बहुस्रािा
According to Acharya Sushruta
❖स्थूलारुष्क
•नथूलानन सस्न्धष्िनतदारुिानन नथूलारुवे नयुुः
कर्र्ठनान्यरांवे। (सु.नन. 5/9)
•Sthūlaruşka Kuştha is characterized by Kathinānyarumşi
(hard eruptions) occurring especially in Sandhi (joint) and Atidāruṇāni (in a severe form).
24
र्हाकुष्ठ
•्िकर्् कर्ोचभेदनिपनाांगसादाुः कर्ुष्ठे मह्पूिियुते भिस्न्त। (सु.नन. 5/9)
•Mahakushta is characterized by Tvak kocabhedasvapan
(appearance of wrinkles. Cracks and numbness in the skin) associated with Anga sada (lethargy).
विसपम
•विसपिित् सपिनत सिितो यन्िग्रक्तोमाांसान्यशभभूय शीघ्रम्।
मूच्छ्छािविदाहारनततोदपाकर्ान् कर्ृ्िा विसपिुः स भिेद्विकर्ारुः।।
(सु.नन. 5/11)
•Visarpa, it quickly spreads all over the body by affecting the skin, blood and muscles like erysipelas) and it is
associated with Murcha (unconsciousness), Vidaha (burning sensation), Arati (restlessness), Toda (pricking
pain) and Paka (suppuration).
25
•्िकर्् कर्ोचभेदनिपनाांगसादाुः कर्ुष्ठे मह्पूिियुते भिस्न्त। (सु.नन. 5/9)
•Mahakushta is characterized by Tvak kocabhedasvapan
(appearance of wrinkles. Cracks and numbness in the skin) associated with Anga sada (lethargy).
विसपम
•विसपिित् सपिनत सिितो यन्िग्रक्तोमाांसान्यशभभूय शीघ्रम्।
मूच्छ्छािविदाहारनततोदपाकर्ान् कर्ृ्िा विसपिुः स भिेद्विकर्ारुः।।
(सु.नन. 5/11)
•Visarpa, it quickly spreads all over the body by affecting the skin, blood and muscles like erysipelas) and it is
associated with Murcha (unconsciousness), Vidaha (burning sensation), Arati (restlessness), Toda (pricking
pain) and Paka (suppuration).
25
•परिसपम
शनैुः शरीरे वपडकर्ाुः स्रिन््युः सपिस्न्त यानतां पणरसपिमाहुुः। (सु.नन. 5/12)
•Parisarpa Kuştha is characterized by discharging eruptions gradually spreading all over the body.
•िकसा
कर्ण््िस्न्िता या वपडकर्ा शरीरे सांनिािहीना रकर्सोच्छ्यते सा। (सु.नन. 5/15)
•Rakasā Kuştha is characterized by Kandu (itching sensation) associated with Pidaka samsrāvahīna
(blisters without discharge) in the body.
26
शनैुः शरीरे वपडकर्ाुः स्रिन््युः सपिस्न्त यानतां पणरसपिमाहुुः। (सु.नन. 5/12)
•Parisarpa Kuştha is characterized by discharging eruptions gradually spreading all over the body.
•िकसा
कर्ण््िस्न्िता या वपडकर्ा शरीरे सांनिािहीना रकर्सोच्छ्यते सा। (सु.नन. 5/15)
•Rakasā Kuştha is characterized by Kandu (itching sensation) associated with Pidaka samsrāvahīna
(blisters without discharge) in the body.
26
•त्रििोष अनुसाि लक्षण
िाततक लक्षण पैविक लक्षण कफज लक्षण
रक्षता दाह श्िेततता
शोे राग शीतलता
तोद पणरस्राि कर्ण्डू
शूल पाकर् स्नथरता
सांकर्ोच विनि गन्ध उ्सेध युक्त
आयाम क्लेद गौरि
पारुष्य अांगपतन स्ननग्ध
खरता क्लेदाधधक्य
श्यािता या अरुिता
27
िाततक लक्षण पैविक लक्षण कफज लक्षण
रक्षता दाह श्िेततता
शोे राग शीतलता
तोद पणरस्राि कर्ण्डू
शूल पाकर् स्नथरता
सांकर्ोच विनि गन्ध उ्सेध युक्त
आयाम क्लेद गौरि
पारुष्य अांगपतन स्ननग्ध
खरता क्लेदाधधक्य
श्यािता या अरुिता
27
सप्त धातु लक्षण
त्िक (िसगत’) िक्तगत र्ाांसगत र्ेिगत असस्था-र्ज्जागत शुक्रगत
नपशिहानन नपशिनाश बहुलता दौगिन्ध - अांगो में
विकर्लता
वििििता रोमहेि नथूलता उपदेह नासाभांग गनतक्षय
कर्ण्डू निेदा-धधक्य मुख शोे पूय-कर्ृशम अक्षक्ष रोग
अल्पनिेद कर्ण्डू वपड़कर्ा-उ्पवि क्षत-व्रि में कर्ृशम-
उ्पवि
रक्षता पूयो्पवि तोद
नफोट
स्नथर्ि
28
त्िक (िसगत’) िक्तगत र्ाांसगत र्ेिगत असस्था-र्ज्जागत शुक्रगत
नपशिहानन नपशिनाश बहुलता दौगिन्ध - अांगो में
विकर्लता
वििििता रोमहेि नथूलता उपदेह नासाभांग गनतक्षय
कर्ण्डू निेदा-धधक्य मुख शोे पूय-कर्ृशम अक्षक्ष रोग
अल्पनिेद कर्ण्डू वपड़कर्ा-उ्पवि क्षत-व्रि में कर्ृशम-
उ्पवि
रक्षता पूयो्पवि तोद
नफोट
स्नथर्ि
28
SAMPRAPTI
•“िातादयनियो दुष्टान्िग्रक्तां माांसमम्बु च। दूेयस्न्त स कर्ुष्ठानाां सप्तकर्ो द्रव्यसांग्रहुः ॥“ (च.धच. 7/9)
Nidana sevana
Tridosha prakopa
Spread in Tiryak gata siras
Vitiate Twak, Rakta, Mamsa, Lasika
Dosha- Dushya takes stanasamshraya in Twak
Leads to Mandaloutpatti Kushta
29
•“िातादयनियो दुष्टान्िग्रक्तां माांसमम्बु च। दूेयस्न्त स कर्ुष्ठानाां सप्तकर्ो द्रव्यसांग्रहुः ॥“ (च.धच. 7/9)
Nidana sevana
Tridosha prakopa
Spread in Tiryak gata siras
Vitiate Twak, Rakta, Mamsa, Lasika
Dosha- Dushya takes stanasamshraya in Twak
Leads to Mandaloutpatti Kushta
29
SADHYASADHYATA
•Based on Doshas Based on Dhatus
Charaka Vagbhata
SadhyaEka doshaja
Vata Kaphaja
Eka doshaja
Vata Kaphaja
Krichra
Sadhya
Kapha Pittaja
Vata Pittaja
Kapha Pittaja
Vata Pittaja
AsadhyaTridoshaja Tridoshaja
Sushruta Vagbhata
Sadhya Twakgata
Raktagata
Mamsagata
Twakgata
Krichra sadhya- Raktagata
Mamsagata
Yapya Medogata Medogata
Asadhya Asthi, Majja,
Shukra
dhatugata
Asthi, Majja,
Shukra
dhatugata
30
•Based on Doshas Based on Dhatus
Charaka Vagbhata
SadhyaEka doshaja
Vata Kaphaja
Eka doshaja
Vata Kaphaja
Krichra
Sadhya
Kapha Pittaja
Vata Pittaja
Kapha Pittaja
Vata Pittaja
AsadhyaTridoshaja Tridoshaja
Sushruta Vagbhata
Sadhya Twakgata
Raktagata
Mamsagata
Twakgata
Krichra sadhya- Raktagata
Mamsagata
Yapya Medogata Medogata
Asadhya Asthi, Majja,
Shukra
dhatugata
Asthi, Majja,
Shukra
dhatugata
30
•Based on Laxanas
Charaka Sushruta
Asadhya
Balarahita rogi
Prasravana
Angabheda
Angapatana
Trushna
Jwara
Atisara
Daha
Dourbalya
Arochaka
Apipaka
Raktanetra
Hataswara
Panchakarma
gunaaititam
Prabhinnam
31
Charaka Sushruta
Asadhya
Balarahita rogi
Prasravana
Angabheda
Angapatana
Trushna
Jwara
Atisara
Daha
Dourbalya
Arochaka
Apipaka
Raktanetra
Hataswara
Panchakarma
gunaaititam
Prabhinnam
31
UPADRAVA –
•अनयाां चैिािनथायामुपद्रिाुः कर्ुस्ष्ठनां नपृशस्न्त, तद्यथा-प्रस्रििमङ्गभेदुः पतनान्यङ्गाियिानाां तृष्िा
ज्िरातीसारदाहदौबिल्यारोचकर्ाविपाकर्ाश्च, तथाविधमसाध्यां विद्यार्दनत॥“(च.नन. 5/11)
CHIKITSA SUTRA
•ति पूििरपेेूभयतुः सांशोधनमासेिेत। (सु.धच. 9/6)
During Purvarupa avastha of Kuştha, Urdhva and Adhah should be done.
• कर्ुष्ठीनां ननेहपानेन पूिि सििमुपाचरेत्। (अ.हृ.धच. 19/1)
Vagbhata opines that, Snehapana (intake of ghee) should be given in the Purvarupa avastha of
Kuştha.
32
•अनयाां चैिािनथायामुपद्रिाुः कर्ुस्ष्ठनां नपृशस्न्त, तद्यथा-प्रस्रििमङ्गभेदुः पतनान्यङ्गाियिानाां तृष्िा
ज्िरातीसारदाहदौबिल्यारोचकर्ाविपाकर्ाश्च, तथाविधमसाध्यां विद्यार्दनत॥“(च.नन. 5/11)
CHIKITSA SUTRA
•ति पूििरपेेूभयतुः सांशोधनमासेिेत। (सु.धच. 9/6)
During Purvarupa avastha of Kuştha, Urdhva and Adhah should be done.
• कर्ुष्ठीनां ननेहपानेन पूिि सििमुपाचरेत्। (अ.हृ.धच. 19/1)
Vagbhata opines that, Snehapana (intake of ghee) should be given in the Purvarupa avastha of
Kuştha.
32
सिि त्रिदोेजां कर्ुष्ठां दोेािाां तु बलाबलम्। यथानिैलिक्षिैबुिद्िा कर्ुष्ठानाां कक्रयते कक्रया ॥
दोेनय यनय पश्येत् कर्ुष्ठेेु विशेेशलङ्गमुर्द्रक्तम्। तनयैि शमां कर्ुयािितुः परां चानुबन्धनय॥”
(च.धच.7/31-32)
All Kushta are Tridoshaja so they should be treated by knowing there doshabala and lakshanas.
hamana in those Kushtas who are having there increased doshas than treat anubanda doshas.
िातोिरेेु सवपिििमनां श्लेष्मोिरेेु कर्ुष्ठेेु । वपिोिरेेु मोक्षोरक्तनय विरेचनां चाये ।।३९।।
िमनविरेचनयोगाुः कर्ल्पोक्ताुः कर्ुस्ष्ठनाां प्रयोक्तव्याुः । प्रव्छनम्ये कर्ुष्ठे महनत च शनतां शसराव्यधनम्II
बहुदोेुः सांशोध्युः कर्ुष्ठी बहुशोऽनुरक्षता प्रािान्। दोेे ह्यनतमािहुते िायुहिन्यादबलमाशु ।।
ननेहनय पानशमष्टां शुद्धे कर्ोष्ठे प्रिार्हते रक्ते। िायुर्हि शुद्धकर्ोष्ठां कर्ुस्ष्ठनमबलां विशनत शीघ्रम्॥
Cha.Chi 7/39-42
33
दोेनय यनय पश्येत् कर्ुष्ठेेु विशेेशलङ्गमुर्द्रक्तम्। तनयैि शमां कर्ुयािितुः परां चानुबन्धनय॥”
(च.धच.7/31-32)
All Kushta are Tridoshaja so they should be treated by knowing there doshabala and lakshanas.
hamana in those Kushtas who are having there increased doshas than treat anubanda doshas.
िातोिरेेु सवपिििमनां श्लेष्मोिरेेु कर्ुष्ठेेु । वपिोिरेेु मोक्षोरक्तनय विरेचनां चाये ।।३९।।
िमनविरेचनयोगाुः कर्ल्पोक्ताुः कर्ुस्ष्ठनाां प्रयोक्तव्याुः । प्रव्छनम्ये कर्ुष्ठे महनत च शनतां शसराव्यधनम्II
बहुदोेुः सांशोध्युः कर्ुष्ठी बहुशोऽनुरक्षता प्रािान्। दोेे ह्यनतमािहुते िायुहिन्यादबलमाशु ।।
ननेहनय पानशमष्टां शुद्धे कर्ोष्ठे प्रिार्हते रक्ते। िायुर्हि शुद्धकर्ोष्ठां कर्ुस्ष्ठनमबलां विशनत शीघ्रम्॥
Cha.Chi 7/39-42
33
• In Vata predominant Kushta- Snehapana
• In kapha predominant Kushta- Vamana
• In Pitta predominant Kushta- Virechana, Raktamokshana
•In कर्ल्पनथान, िमन and विरेचन योगों प्रयोग is done in कर्ुष्ठ रोगी, Pracchanna is done in Alpa
kushta and Siravyadha is done in Bahu kushta. In Bahudosha Avastha Samshodana is done
repeatedly by doing the Prana rakshana of Kushta rogi.
•Due to repeated Shamshodana there is increase of Vata dosha which leads to destruction of health in
Durbala person. So After Raktamokshana and After Koshta Shuddi, Grutha pana is done, because of
Samshodana there is Sheghra utpatti of Vata in Koshta.
34
• In kapha predominant Kushta- Vamana
• In Pitta predominant Kushta- Virechana, Raktamokshana
•In कर्ल्पनथान, िमन and विरेचन योगों प्रयोग is done in कर्ुष्ठ रोगी, Pracchanna is done in Alpa
kushta and Siravyadha is done in Bahu kushta. In Bahudosha Avastha Samshodana is done
repeatedly by doing the Prana rakshana of Kushta rogi.
•Due to repeated Shamshodana there is increase of Vata dosha which leads to destruction of health in
Durbala person. So After Raktamokshana and After Koshta Shuddi, Grutha pana is done, because of
Samshodana there is Sheghra utpatti of Vata in Koshta.
34
Shodhana in Kushta
•पक्षात् पक्षाच्छ्छदिनान्यभ्युपेयान्मासान्मासात् निांसनां चावप देयम्। निाव्यां रक्तां ि्सरे र्ह द्विरल्पां ननयां
दद्याच्छ्च त्रिरािास््िरािात् ।। (सु.धच. 9/43)
•पक्षा्पक्षाच्छ्छेदनान्यभ्युपेयान्मासान्मासाच्छ्छोधनान्यप्यधनतात्
शुद्धधमूिधधनि नयास््िरािास््िरािात् ेष्ठे ेष्ठे मानयसृ मोक्षिांच।। (A.H 19/96)
Vamana- Pakshatpakshat (15-15) days
Virechana- masan masan (1-1) month
Raktamokshana- Shashte Shashte Masya (6-6) month
Nasya- Triratrat Triratrat (3-3)days
•ेष्ठे मासे शशरामोक्षां प्रनतमासां विरेचनम् । प्रनतपक्षां च िमनां कर्ुष्ठे लेपां त्र्यहाच्छ्चरेत् ॥(Yogaratnakara 55/54)
•In case of Kushta, Raktamokshana done in every 6 months, Virechana done in once a month, Vamana done
in 15 days, Lepa application in 3 days should be administered.
35
•पक्षात् पक्षाच्छ्छदिनान्यभ्युपेयान्मासान्मासात् निांसनां चावप देयम्। निाव्यां रक्तां ि्सरे र्ह द्विरल्पां ननयां
दद्याच्छ्च त्रिरािास््िरािात् ।। (सु.धच. 9/43)
•पक्षा्पक्षाच्छ्छेदनान्यभ्युपेयान्मासान्मासाच्छ्छोधनान्यप्यधनतात्
शुद्धधमूिधधनि नयास््िरािास््िरािात् ेष्ठे ेष्ठे मानयसृ मोक्षिांच।। (A.H 19/96)
Vamana- Pakshatpakshat (15-15) days
Virechana- masan masan (1-1) month
Raktamokshana- Shashte Shashte Masya (6-6) month
Nasya- Triratrat Triratrat (3-3)days
•ेष्ठे मासे शशरामोक्षां प्रनतमासां विरेचनम् । प्रनतपक्षां च िमनां कर्ुष्ठे लेपां त्र्यहाच्छ्चरेत् ॥(Yogaratnakara 55/54)
•In case of Kushta, Raktamokshana done in every 6 months, Virechana done in once a month, Vamana done
in 15 days, Lepa application in 3 days should be administered.
35
•SNEHANA IN KUSHTA:
•Types : Internally – Snehapana
Externally – Abhyanga, Utsadana, Pradeha
❑Indication of Snehana:
Vataja Kushta, as in Poorva karma, paschat karma, shodhana anthare
❑Yogas:
•Vatika- Dashamoolasidda taila/Ghrita
NishottamadiGhrita
•Pittika- Tiktaka(P)/ Mahatiktaka Ghrita ( VP), Khadiradi Ghrita (P), Darvi Ghrita ( P),
Nimba Ghrita (P), Patola Ghrita (P)
•Shleshmika- Nimbadi Ghrita( K), Khadiradi Ghrita (K), Guggulu thiktaka Ghrita(KV)
❑Abhyanga:
•Shwetakaraveeradi pallava taila( K), Kanakaksheeri taila(K), Nimba taila(KV), Tuvaraka
taila( K), Jeevantyadi yamakam(PV)
36
•Types : Internally – Snehapana
Externally – Abhyanga, Utsadana, Pradeha
❑Indication of Snehana:
Vataja Kushta, as in Poorva karma, paschat karma, shodhana anthare
❑Yogas:
•Vatika- Dashamoolasidda taila/Ghrita
NishottamadiGhrita
•Pittika- Tiktaka(P)/ Mahatiktaka Ghrita ( VP), Khadiradi Ghrita (P), Darvi Ghrita ( P),
Nimba Ghrita (P), Patola Ghrita (P)
•Shleshmika- Nimbadi Ghrita( K), Khadiradi Ghrita (K), Guggulu thiktaka Ghrita(KV)
❑Abhyanga:
•Shwetakaraveeradi pallava taila( K), Kanakaksheeri taila(K), Nimba taila(KV), Tuvaraka
taila( K), Jeevantyadi yamakam(PV)
36
•SWEDANA-
•स्नथरकर्र्ठनमण्डलानाां स्निन्नानाां प्रनतरप्रिाडीशभुः । कर्ूचेवििघट्र्टतानाां रक्तो्क्लेशोऽपनेतव्युः।।
आनूपिाणरजानाां माांसाना पोट्टलैुः सुखोष्िैश्च । स्निन्नो्सन्नां विशलखेत् कर्ुष्ठां ती्िेन शखेि।।
Cha.Chi7/50-51
•Indication – Twakgata, Vataja kushta, Sthira kathina mandala, utsanna, poorvakarma- mild
•Types of swedana – Sthira katina mandala- Nadi sweda and with Kurcha shastra raktanirharana is
done.
•Utsanna- potali sweda using Anupavarija mamsa, Avagaha, Parisheka, Bhashpa sweda
37
•स्नथरकर्र्ठनमण्डलानाां स्निन्नानाां प्रनतरप्रिाडीशभुः । कर्ूचेवििघट्र्टतानाां रक्तो्क्लेशोऽपनेतव्युः।।
आनूपिाणरजानाां माांसाना पोट्टलैुः सुखोष्िैश्च । स्निन्नो्सन्नां विशलखेत् कर्ुष्ठां ती्िेन शखेि।।
Cha.Chi7/50-51
•Indication – Twakgata, Vataja kushta, Sthira kathina mandala, utsanna, poorvakarma- mild
•Types of swedana – Sthira katina mandala- Nadi sweda and with Kurcha shastra raktanirharana is
done.
•Utsanna- potali sweda using Anupavarija mamsa, Avagaha, Parisheka, Bhashpa sweda
37
•VAMANA
▪ तिदोेहरि, उध्िि भाग् िमन् नत्र्कर्् ॥ (च.कर्.1/4)
▪Indication:
o श्लेष्मोत्तर कुष्ठ
o उपत्क्लष् दोष in हृदय
o ऊध्ियभागेषु कुष्ठेषु
दोषोपत्क्लष्े हृदये िाम्यिः कुष्ठेषु चोध्ियभागेषु । कुटजफलमदनमधुकेिः सिटोलेपनयम्बरसयुक्ेिः ॥ शीतरसिः िक्करसो मधूपन मधुकं च िमनापन। (च.पच.7/43,44)
•Vamana in श्लेष्मोतरेषु कुष्ठेषु.
•Kutajaphala, Madhanaphala, Yastimadhu churna + Patola and Nimba rasa yukta
Sheeta rasa (शीतरसिः शीत कषायिः) with madhu + yastimadhu churna.
•Vamana is must and first line of treatment in kushta ( snigdaguna- kleda karaka kapha)
38
▪ तिदोेहरि, उध्िि भाग् िमन् नत्र्कर्् ॥ (च.कर्.1/4)
▪Indication:
o श्लेष्मोत्तर कुष्ठ
o उपत्क्लष् दोष in हृदय
o ऊध्ियभागेषु कुष्ठेषु
दोषोपत्क्लष्े हृदये िाम्यिः कुष्ठेषु चोध्ियभागेषु । कुटजफलमदनमधुकेिः सिटोलेपनयम्बरसयुक्ेिः ॥ शीतरसिः िक्करसो मधूपन मधुकं च िमनापन। (च.पच.7/43,44)
•Vamana in श्लेष्मोतरेषु कुष्ठेषु.
•Kutajaphala, Madhanaphala, Yastimadhu churna + Patola and Nimba rasa yukta
Sheeta rasa (शीतरसिः शीत कषायिः) with madhu + yastimadhu churna.
•Vamana is must and first line of treatment in kushta ( snigdaguna- kleda karaka kapha)
38
VIRECHANA
•तत्र दोष रणं अधोभागं पिरेचन संझा ।
•उभयं िा शरीरमल पिरेचनात् पिरेचन स्झा ॥(च्.क.1/4)
Indication: Pittottareshu kushteshu, Amashayasthita dosha.
•Virechana is best for pitta & rakta pradosaja vyadhis.
•कुष्ठेषु पत्रव्रता दन्ती पत्रफला च पिरेचने शस्ता ।
सौपिरं तुषोदकमालोडनमासिास्च् सीधूपन ॥
श्सन्त्यधो राणां यथापिरें क्रमस्ष्चेष्िः । (च.पच.7/44,45)
•Virechana yogas Trivrut, Danti & Triphala with souveeraka, Tushodaka & Sidhu
39
•तत्र दोष रणं अधोभागं पिरेचन संझा ।
•उभयं िा शरीरमल पिरेचनात् पिरेचन स्झा ॥(च्.क.1/4)
Indication: Pittottareshu kushteshu, Amashayasthita dosha.
•Virechana is best for pitta & rakta pradosaja vyadhis.
•कुष्ठेषु पत्रव्रता दन्ती पत्रफला च पिरेचने शस्ता ।
सौपिरं तुषोदकमालोडनमासिास्च् सीधूपन ॥
श्सन्त्यधो राणां यथापिरें क्रमस्ष्चेष्िः । (च.पच.7/44,45)
•Virechana yogas Trivrut, Danti & Triphala with souveeraka, Tushodaka & Sidhu
39
•RAKTAMOKSHANA:
•Indications:
Pittotaram, Raktodbhava, Sannipadotbhava, Sthira kathina mandala Kushta, Utsanna Kushta
(Cha.chi 7/40-41)
•Types:
▪Siraveda- Bahu Kushta
▪Pracchanna- Alpa Kushta
▪Jalouka, Alabu, Shringa- Alp Kushta, Twak sthita
Pracchanna Raktamokshana ( scrapping type of blood letting) is done in case of Kushta with Sthira,
Kathina and Mandala with Kurcha ( surgical brush with hard bristles) after Nadi and Prastara Sweda
and in Utsanna Kushta with Tikshna shastra after Sukoshna pottali Sweda containing Jangala and
Anupa mamsa.
•Vagbhata stated that Siravyadha should be done in the veins of Lalata, Hasta, Pada, according to the
Bala of Kushta rogi. (A.H 19/16)
40
•Indications:
Pittotaram, Raktodbhava, Sannipadotbhava, Sthira kathina mandala Kushta, Utsanna Kushta
(Cha.chi 7/40-41)
•Types:
▪Siraveda- Bahu Kushta
▪Pracchanna- Alpa Kushta
▪Jalouka, Alabu, Shringa- Alp Kushta, Twak sthita
Pracchanna Raktamokshana ( scrapping type of blood letting) is done in case of Kushta with Sthira,
Kathina and Mandala with Kurcha ( surgical brush with hard bristles) after Nadi and Prastara Sweda
and in Utsanna Kushta with Tikshna shastra after Sukoshna pottali Sweda containing Jangala and
Anupa mamsa.
•Vagbhata stated that Siravyadha should be done in the veins of Lalata, Hasta, Pada, according to the
Bala of Kushta rogi. (A.H 19/16)
40
❖ NASYA:
•उर्ध्वजत्रुव्कारेषुव्शेषस्यमिष्यते।
नासाविशशरसोद्वार्तेन्तदव्याप्यविततत्॥ (अ.ि्.सु20/1)
•औषधि्औषधशसर्धदंस्नेिो्ानाशसकाभयांदीयतेइवतनस्यि्॥(सु.शि.40/21)
Indication:
▪ Urdhwabhagastita Kushta, Kapha Pradhana Kushta, Kandu, Dadru, Swarabheda, Kota
▪ Virechana Nasya- Kushta ( Bha. Pr, Vangasena, Shar. Sa)
•Yogas- Saindhava, Danti, Maricha, Pippali, Karanjaphala, Vidanga- Kapha Pradhana Kushta with Krimi
anubandha ( Cha. Chi 7/48-49)
❖ DHUMAPANA- Vairechanika dhumapana
•श्िेता ज्योनतष्मनत चैि हणरतालां मनुःशशला । गन्धाश्च अगरुपिाध्या धूमां मूधिविरेचने ।(Cha. Su 5/26-27)
41
•उर्ध्वजत्रुव्कारेषुव्शेषस्यमिष्यते।
नासाविशशरसोद्वार्तेन्तदव्याप्यविततत्॥ (अ.ि्.सु20/1)
•औषधि्औषधशसर्धदंस्नेिो्ानाशसकाभयांदीयतेइवतनस्यि्॥(सु.शि.40/21)
Indication:
▪ Urdhwabhagastita Kushta, Kapha Pradhana Kushta, Kandu, Dadru, Swarabheda, Kota
▪ Virechana Nasya- Kushta ( Bha. Pr, Vangasena, Shar. Sa)
•Yogas- Saindhava, Danti, Maricha, Pippali, Karanjaphala, Vidanga- Kapha Pradhana Kushta with Krimi
anubandha ( Cha. Chi 7/48-49)
❖ DHUMAPANA- Vairechanika dhumapana
•श्िेता ज्योनतष्मनत चैि हणरतालां मनुःशशला । गन्धाश्च अगरुपिाध्या धूमां मूधिविरेचने ।(Cha. Su 5/26-27)
41
BASTI
•बस्स्तनादीयतेइवतबस्स्तिः॥(अ.ि.सू. 19/1)
•बस्स्तभिदीयतेयस्िात्तस्िात्बस्स्तररवतस्ितिः॥ (शा.उ.खू5/1)
•Acc. To Bruhattrayi, Niruha & Anuvasana basti is contraindicated in kustha. (ि.शस.२/14),
(सु.शि. 35/21), (अ.ि.सु19/4-6)
•If there is excess of vata even after shodhana – asthapana with anuvasana basti is given.
•Asthapana basti is given with Daruharidra, Bruhati, Patolamula, Nimba, Madanaphala,
Amlatasa from these Kwatha is prepared, and added with Indrayava and Musta kalka and
Sneha is added and basti is given. (Cha.Chi 7/47)
•After Virechana and Niruha basti, if Vata dosha vruddhi is seen then Sneha basti prepared
with – Madanaphala, Madhuka, Nimba, Kutaja, Patola kwath and with kalka sadhika
Sneha, anuvasana basti is given.
42
•बस्स्तनादीयतेइवतबस्स्तिः॥(अ.ि.सू. 19/1)
•बस्स्तभिदीयतेयस्िात्तस्िात्बस्स्तररवतस्ितिः॥ (शा.उ.खू5/1)
•Acc. To Bruhattrayi, Niruha & Anuvasana basti is contraindicated in kustha. (ि.शस.२/14),
(सु.शि. 35/21), (अ.ि.सु19/4-6)
•If there is excess of vata even after shodhana – asthapana with anuvasana basti is given.
•Asthapana basti is given with Daruharidra, Bruhati, Patolamula, Nimba, Madanaphala,
Amlatasa from these Kwatha is prepared, and added with Indrayava and Musta kalka and
Sneha is added and basti is given. (Cha.Chi 7/47)
•After Virechana and Niruha basti, if Vata dosha vruddhi is seen then Sneha basti prepared
with – Madanaphala, Madhuka, Nimba, Kutaja, Patola kwath and with kalka sadhika
Sneha, anuvasana basti is given.
42
•Dhatugata anusara chikitsa –Acharya Charaka not mentioned about Dhatugata
Chikitsa, Acharya Sushruta mentioned about Dhatugata anusara chikitsa and Acharya
Vagbhata followed the same.
Dhatu Sushruta Samhita Harita Samhita
Twak Shodhana Sweda, Lepa
Rakta Shodana, Lepana, Kashaya pana, Shonita
avasechana
Raktamokshana
Mamsa Shodana, Lepana, Kashaya pana, Shonita
avasechana,
Arishta, Mantha pana
Virechana
Meda Samshodana, Shonita avasechana, Use of
Bhallataka, Shilajatu, Dhatu Makshika,
Guggulu, Avalaguja, Tuvaraka, Khadira,
Asana, Ayaskriti
Kwata, Pachana
Asthi Asadhya Kwata, Pachana
Majja Asadhya Kwata, Pachana
Shukra Asadhya Asadhya 43
Chikitsa, Acharya Sushruta mentioned about Dhatugata anusara chikitsa and Acharya
Vagbhata followed the same.
Dhatu Sushruta Samhita Harita Samhita
Twak Shodhana Sweda, Lepa
Rakta Shodana, Lepana, Kashaya pana, Shonita
avasechana
Raktamokshana
Mamsa Shodana, Lepana, Kashaya pana, Shonita
avasechana,
Arishta, Mantha pana
Virechana
Meda Samshodana, Shonita avasechana, Use of
Bhallataka, Shilajatu, Dhatu Makshika,
Guggulu, Avalaguja, Tuvaraka, Khadira,
Asana, Ayaskriti
Kwata, Pachana
Asthi Asadhya Kwata, Pachana
Majja Asadhya Kwata, Pachana
Shukra Asadhya Asadhya 43
•Kshara karma- should be administered after the Rakmokshana if the Shastra karma is not possible or
contraindicated and has Sparshanendriya nasha.
•Alepa- It is more beneficial only after Rakmokshana and Shamshodana like paste is prepared with Kushta,
Karanja bija and Edagaja it alleviates Kushta etc
•Agada prayoga- In Katina, Parusha, Sthira, Sparshanaghana, Chirakari kushta, in this Visha oushadi is given
and then Visha nashaka lepa is applied.
दोष हृतेऽपनीते रक्ते बाह्यान्तरे कर्ृते शमने । ननेहे च कर्ालयुक्ते न कर्ुष्ठमनुितित साध्यम् ।। Cha. Chi 7/151
•After Dosha nirharana through Vamana and Raktamokshana, Bahya and Abhyantara shamana chikitsa is done,
If Mahatiktaka ghruta etc is taken on Uchita kala then their will be no reoccurrence of the Sadhya kushta.
•Siddharthaka snana:
•मुनतां मदनां त्रिफला कर्रांज आरग्िधकर्शलांगयिाुः। दािी सनप्तपिाि ननानां शसद्धाथिकर्ां नाम ।।
एे कर्ेायो िमनां विरेचनां िििनतथोद्धेिुः। ्िग्दोेकर्ुष्ठशोफप्रबाधनुः पाण्डुरोगघ्नुः ।। (च.धच 7/91-92
Decoction prepared with Musta, Madana, Triphala, Karanja, Aragvada, Kalingayava, Darvi and Saptaparna are
used for snana known as Siddhartaka. And this can also be used for Vamana, Virechana, Varna, Udgarshana. It
eliminates Twak doşha and Kushta.
44
contraindicated and has Sparshanendriya nasha.
•Alepa- It is more beneficial only after Rakmokshana and Shamshodana like paste is prepared with Kushta,
Karanja bija and Edagaja it alleviates Kushta etc
•Agada prayoga- In Katina, Parusha, Sthira, Sparshanaghana, Chirakari kushta, in this Visha oushadi is given
and then Visha nashaka lepa is applied.
दोष हृतेऽपनीते रक्ते बाह्यान्तरे कर्ृते शमने । ननेहे च कर्ालयुक्ते न कर्ुष्ठमनुितित साध्यम् ।। Cha. Chi 7/151
•After Dosha nirharana through Vamana and Raktamokshana, Bahya and Abhyantara shamana chikitsa is done,
If Mahatiktaka ghruta etc is taken on Uchita kala then their will be no reoccurrence of the Sadhya kushta.
•Siddharthaka snana:
•मुनतां मदनां त्रिफला कर्रांज आरग्िधकर्शलांगयिाुः। दािी सनप्तपिाि ननानां शसद्धाथिकर्ां नाम ।।
एे कर्ेायो िमनां विरेचनां िििनतथोद्धेिुः। ्िग्दोेकर्ुष्ठशोफप्रबाधनुः पाण्डुरोगघ्नुः ।। (च.धच 7/91-92
Decoction prepared with Musta, Madana, Triphala, Karanja, Aragvada, Kalingayava, Darvi and Saptaparna are
used for snana known as Siddhartaka. And this can also be used for Vamana, Virechana, Varna, Udgarshana. It
eliminates Twak doşha and Kushta.
44
Ghruta Kashaya Churna Rasa Guggulu Asava/Arish
ta
Lehya Taila Lepa
Tiktashatpala
di ghruta
Nimbadi
Kashaya
Mustadi
churna
Gandaka
rasayana
Panchatikta
ghruta
guggulu
MadwasavaAmruta
Bhallataka
lehya
Shweta
karaveera
taila
Aragwada
patra lepa
Tiktaka
ghruta
Patoladi
Kashaya
Triphaladi
churna
Rasa
manikya rasa
Arogyavardi
ni vati
Khadirarisht
a
Bhallataka
lehya
Shweta
karaveera
pallavadhya
taila
Karanjadi
lepa
Mahatiktaka
ghruta
Patola
muladi kwata
Bhunimbadi
churna
Talakeshwar
a rasa
Amruta
guggulu
Kanaka
bindu arishta
Dhatrya lehaNalpamaradi
taila
Karaveeradi
lepa
Maha
Khadira
ghruta
Patola
katurohinyad
i kashaya
Panchanimba
churna
Kusta kutara
rasa
Somaraji
taila
Gandaka
malahara
Panchatiktak
a ghruta
Guggulu
tiktakam
kashaya
Kanaka
ksheeri taila
Shatadouta
ghrita
Gugglu
tiktaka
ghruta
Aragwadadi
kwatha
Marichayadi
taila
Sindooradi
lepa
Kalyanaka
ghruta
Manjishtadk
ashaya
Edajadi lepa
45
ta
Lehya Taila Lepa
Tiktashatpala
di ghruta
Nimbadi
Kashaya
Mustadi
churna
Gandaka
rasayana
Panchatikta
ghruta
guggulu
MadwasavaAmruta
Bhallataka
lehya
Shweta
karaveera
taila
Aragwada
patra lepa
Tiktaka
ghruta
Patoladi
Kashaya
Triphaladi
churna
Rasa
manikya rasa
Arogyavardi
ni vati
Khadirarisht
a
Bhallataka
lehya
Shweta
karaveera
pallavadhya
taila
Karanjadi
lepa
Mahatiktaka
ghruta
Patola
muladi kwata
Bhunimbadi
churna
Talakeshwar
a rasa
Amruta
guggulu
Kanaka
bindu arishta
Dhatrya lehaNalpamaradi
taila
Karaveeradi
lepa
Maha
Khadira
ghruta
Patola
katurohinyad
i kashaya
Panchanimba
churna
Kusta kutara
rasa
Somaraji
taila
Gandaka
malahara
Panchatiktak
a ghruta
Guggulu
tiktakam
kashaya
Kanaka
ksheeri taila
Shatadouta
ghrita
Gugglu
tiktaka
ghruta
Aragwadadi
kwatha
Marichayadi
taila
Sindooradi
lepa
Kalyanaka
ghruta
Manjishtadk
ashaya
Edajadi lepa
45
PATHYAPATHYA
•Pathya
•लघुनन चानानन र्हतानन विद्यात् कर्ुष्ठेेु शाकर्ानन च नतक्तकर्ानन।
भल्लातकर्ैुः सत्रिफलैुः सननम्बैयुिक्तानन चान्नानन घृतानन चैि ।।
पुरािधान्यान्यथ जाांगलानन माांसानन मुद्गश्च पटोलयुक्ताुः। (च.धच. 7/82-83)
Laghu anna, Tikta shakani and Ghrita prepared by mixing with Bhallataka, Triphala and Nimba,
Purana dhanya, Jangala mamsa, Mudga and Patola are Pathya.
•Apathya
•शनता, न गुििम्लपयोदधीनन नानूपम्नय न गुडस्नतलाच ।। (च.धच. 7/83)
Guru, Amla,Paya, Dadhi, Anupa mamsa, Matsya, Guda and Tila are Apathya
46
•Pathya
•लघुनन चानानन र्हतानन विद्यात् कर्ुष्ठेेु शाकर्ानन च नतक्तकर्ानन।
भल्लातकर्ैुः सत्रिफलैुः सननम्बैयुिक्तानन चान्नानन घृतानन चैि ।।
पुरािधान्यान्यथ जाांगलानन माांसानन मुद्गश्च पटोलयुक्ताुः। (च.धच. 7/82-83)
Laghu anna, Tikta shakani and Ghrita prepared by mixing with Bhallataka, Triphala and Nimba,
Purana dhanya, Jangala mamsa, Mudga and Patola are Pathya.
•Apathya
•शनता, न गुििम्लपयोदधीनन नानूपम्नय न गुडस्नतलाच ।। (च.धच. 7/83)
Guru, Amla,Paya, Dadhi, Anupa mamsa, Matsya, Guda and Tila are Apathya
46
DISCUSSION
•Kushta is a condition in which the vitiated doshas combine with Sapta dushyas of the body to
produce the symptoms. All acharyas have emphasized on Shodhana therapy in the management of
Kushta.
•The therapy which expels out the morbid doshas from the body is known as Shodhana, By nature,
Kushta is difficult to cure disease, so it is called ‘Dushchikitsya’ but by the application of
shodhana therapy, cure of the diseases becomes easier due to removal of the root cause, hence
shodhana has great importance in treating Kushta (Bahudosha avastha).
•Acharya Charaka mentioned as Saptakodravya sangraha which is responsible for development
of Kushta – Vata, Pitta, Kapha, Twak, Rakta, Mamsa, Lasika. When these factors gets vitiated
then they cause Kushta.
•Acharya Sushruta mentioned Kushta as Kulaja, Aupasargika, Krimija
Kulaja- Acharya Sushruta mentioned it as Adibala pravrutta vyadhi
Aupasargika- Mentioned Kushta as Aupasargika vyadhi
Krimija- Mentioned Krimi as a nidana for Kushta.
47
•Kushta is a condition in which the vitiated doshas combine with Sapta dushyas of the body to
produce the symptoms. All acharyas have emphasized on Shodhana therapy in the management of
Kushta.
•The therapy which expels out the morbid doshas from the body is known as Shodhana, By nature,
Kushta is difficult to cure disease, so it is called ‘Dushchikitsya’ but by the application of
shodhana therapy, cure of the diseases becomes easier due to removal of the root cause, hence
shodhana has great importance in treating Kushta (Bahudosha avastha).
•Acharya Charaka mentioned as Saptakodravya sangraha which is responsible for development
of Kushta – Vata, Pitta, Kapha, Twak, Rakta, Mamsa, Lasika. When these factors gets vitiated
then they cause Kushta.
•Acharya Sushruta mentioned Kushta as Kulaja, Aupasargika, Krimija
Kulaja- Acharya Sushruta mentioned it as Adibala pravrutta vyadhi
Aupasargika- Mentioned Kushta as Aupasargika vyadhi
Krimija- Mentioned Krimi as a nidana for Kushta.
47
•Discussion on Nidana
Nidanas are divided into Aaharaja, Viharaja, Manasika and Papakarma is the specific
cause.
•Poorvaroopa.
•Sparshagnatwa, Aswedana, Atiswedana, Vaivarnya, Kota, Kandu, Toda, Daha, Shota,
Srava etc are prime lakshanas.
•For example- Aswedana is found is Ekakushta,
•Sparshagnatwa is found in Charmadala kushta
•Bahusrava is found in Vicharchika
•Tivra vedhana in Kapala, Vipadika, Kakana
•Parusha in Kapala, Kitibha kushta
•Kandu in Dadru
48
Nidanas are divided into Aaharaja, Viharaja, Manasika and Papakarma is the specific
cause.
•Poorvaroopa.
•Sparshagnatwa, Aswedana, Atiswedana, Vaivarnya, Kota, Kandu, Toda, Daha, Shota,
Srava etc are prime lakshanas.
•For example- Aswedana is found is Ekakushta,
•Sparshagnatwa is found in Charmadala kushta
•Bahusrava is found in Vicharchika
•Tivra vedhana in Kapala, Vipadika, Kakana
•Parusha in Kapala, Kitibha kushta
•Kandu in Dadru
48
SAMPRAPTI GHATAKA
•Dosha – Tridosha
•Dushya- Dhatu: Rasa, Rakta, Mamsa, Lasika
Upadhatu: Sira, Twacha, Snayu
Mala: Sweda, Loma
•Agni- Jataragni Mandata, Dhatwagni Mandata
•Srotas- Rasavaha, Raktavaha, Mamsavaha, Swedavaha
•Srotodushti- Sanga, Vimargagamana
•Sancharasthana-Sarvasharira
•Udbhavasthana- Amashaya
•Vyaktasthana- Twacha
•Adhisthana-Sharira, Manas
•Swabhava- Chirakari
49
•Dosha – Tridosha
•Dushya- Dhatu: Rasa, Rakta, Mamsa, Lasika
Upadhatu: Sira, Twacha, Snayu
Mala: Sweda, Loma
•Agni- Jataragni Mandata, Dhatwagni Mandata
•Srotas- Rasavaha, Raktavaha, Mamsavaha, Swedavaha
•Srotodushti- Sanga, Vimargagamana
•Sancharasthana-Sarvasharira
•Udbhavasthana- Amashaya
•Vyaktasthana- Twacha
•Adhisthana-Sharira, Manas
•Swabhava- Chirakari
49
•Sapeksha nidana:
50
Kushta Visarpa
Avisarpanashila Visarpanashila
It is Tridoshaja vyadhi It can occurs with Vatadi
Ekadoshaja also
Karana- Guru, Devataadi
tiraskara, Papa karma
It not occurs due to Papa karma
karana
Sapta dushyas are the reason for
causing Kushta
Sapta dushyas are not necessary
for causing visarpa
Chirakari Shigrakari
50
Kushta Visarpa
Avisarpanashila Visarpanashila
It is Tridoshaja vyadhi It can occurs with Vatadi
Ekadoshaja also
Karana- Guru, Devataadi
tiraskara, Papa karma
It not occurs due to Papa karma
karana
Sapta dushyas are the reason for
causing Kushta
Sapta dushyas are not necessary
for causing visarpa
Chirakari Shigrakari
Importance of Shodhana
oएिां विशुद्ध कर्ोष्ठनय कर्ायास्ग्नणरशभिधिते। व्याध्योश्चोपशाम्यांनत प्रकर्ृनतश्चानुितिते ॥
इस्न्द्रयाणि मनोबुद्धध िििश्चानयप्रसीदनत। बलां पुस्ष्टरप्यश्च िृेताचानय जायते ॥
जराां कर्ृष्रेि लभते धचरांजीि्यनामयुः ॥ (च.सू. 16/17-19)
oCharaka while elaborating the effects of Samshodhana says that it enhances Kayagni,
Upashamana of vyadhi & health returns to normal.
oIndriya, Manas, Buddhi, Varnas become clear & acquires bala, pusthi, vrishata, aging is retarded
& lives a long life.
•दोेाुः कर्दधचत कर्ुप्यस्न्त स्जता लांघनां पाचनेुः । स्जता सांशोधनैयि तु न तेेाां पुनरुध्िुः ॥
दोेािाां च द्रुमािाां च मूलेऽनुपहते सनत। रोगािाां प्रसिानाां च गतानामागनतभुििा।। (च.सू.16/20-21
The doshas which have been mitigated by Langhana and Pachana are likely to aggravate once
again. But those doshas treated by Shodhana therapy will never increase again.
51
oएिां विशुद्ध कर्ोष्ठनय कर्ायास्ग्नणरशभिधिते। व्याध्योश्चोपशाम्यांनत प्रकर्ृनतश्चानुितिते ॥
इस्न्द्रयाणि मनोबुद्धध िििश्चानयप्रसीदनत। बलां पुस्ष्टरप्यश्च िृेताचानय जायते ॥
जराां कर्ृष्रेि लभते धचरांजीि्यनामयुः ॥ (च.सू. 16/17-19)
oCharaka while elaborating the effects of Samshodhana says that it enhances Kayagni,
Upashamana of vyadhi & health returns to normal.
oIndriya, Manas, Buddhi, Varnas become clear & acquires bala, pusthi, vrishata, aging is retarded
& lives a long life.
•दोेाुः कर्दधचत कर्ुप्यस्न्त स्जता लांघनां पाचनेुः । स्जता सांशोधनैयि तु न तेेाां पुनरुध्िुः ॥
दोेािाां च द्रुमािाां च मूलेऽनुपहते सनत। रोगािाां प्रसिानाां च गतानामागनतभुििा।। (च.सू.16/20-21
The doshas which have been mitigated by Langhana and Pachana are likely to aggravate once
again. But those doshas treated by Shodhana therapy will never increase again.
51
•All the three types of treatment viz, Daivavyapashraya chikitsa, Yuktivyapashraya chikitsa and
Satwavajaya chikitsa are to be followed while treating Kushta. While applying Yukti
vyapashraya chikitsa preferably start with any form of Apatarpana chikitsa (ex- Rukshana)
because Kushta is Santharpanottaha vikara. This should be followed by Vyadhi pratyanika
chikitsa where in-
•Ghritapana is indicated in Vata pradhana Kushta, Virechana and Raktamokshana indicated in
Pitta pradhana kushta, Vamana is indicated in Kapha pradhana kushta.
•Daivavyapashraya chikitsa
•व्रतदमयमसेिा ्यागशीलाशभयोगो द्विजसुरगुरुपूजा सििसत्त्िेेु मैिी।
शशिशशिसुतताराभानकर्राराधनानन प्रकर्र्टतमलपापां कर्ुष्ठमुन्मूलयस्न्त।। (अ.हृ.धच. 19/98)
52
Satwavajaya chikitsa are to be followed while treating Kushta. While applying Yukti
vyapashraya chikitsa preferably start with any form of Apatarpana chikitsa (ex- Rukshana)
because Kushta is Santharpanottaha vikara. This should be followed by Vyadhi pratyanika
chikitsa where in-
•Ghritapana is indicated in Vata pradhana Kushta, Virechana and Raktamokshana indicated in
Pitta pradhana kushta, Vamana is indicated in Kapha pradhana kushta.
•Daivavyapashraya chikitsa
•व्रतदमयमसेिा ्यागशीलाशभयोगो द्विजसुरगुरुपूजा सििसत्त्िेेु मैिी।
शशिशशिसुतताराभानकर्राराधनानन प्रकर्र्टतमलपापां कर्ुष्ठमुन्मूलयस्न्त।। (अ.हृ.धच. 19/98)
52
•Shodhana in kushta
•All types of kushta are caused due to aggrevation of all Tridosha. In this there is one or the
other dosha will be predominant.
•The disease has a tendency to reoccur because the disease tends to spread deep into the
Dhatus and contaminate them and may cause complications.
•If the Person is suffering from Kushta who has excessive vitiation of dosha should be given
eliminative therapies repeatedly since there will be chance of recurrence, While
administering these eliminative therapies, excessive elimination of morbid factors may
weaken the patients and Vayu which become aggravated might cause danger to the life. So
wise physician should eliminate morbid dosha in small quantities repeatedly by accessing
the strength of the person each time.
53
•All types of kushta are caused due to aggrevation of all Tridosha. In this there is one or the
other dosha will be predominant.
•The disease has a tendency to reoccur because the disease tends to spread deep into the
Dhatus and contaminate them and may cause complications.
•If the Person is suffering from Kushta who has excessive vitiation of dosha should be given
eliminative therapies repeatedly since there will be chance of recurrence, While
administering these eliminative therapies, excessive elimination of morbid factors may
weaken the patients and Vayu which become aggravated might cause danger to the life. So
wise physician should eliminate morbid dosha in small quantities repeatedly by accessing
the strength of the person each time.
53
•Acharya Sushruta and Acharya Vagbhata has mentioned importance of Samshodana in
Kushta by mentioning Vamana once in 15 day, Virechana once a month, Raktamokshana
once in 6 month & Nasya after 3 days in chikitsa.
•The reason behind Pakshat pakshat vamana and masat masat virechana may be based on the
formation of Kleda. If Kleda is formed due to kapha, its accumulation is faster because of
Snigdha, Picchila and Sandra guna. Thus it has to be removed frequently, so vamana is
advised once in 15 days.
•Whereas the Kleda accumulating on the account of Pitta due to its upasneha, drava and
visraguna is relatively a slow process, so virechana is prescribed once a month.
•Rakta is the Ashraya for pitta, when dushita rakta is removed the skin gets nourished by the
shudda rakta and it helps in treatment of kushta.
54
Kushta by mentioning Vamana once in 15 day, Virechana once a month, Raktamokshana
once in 6 month & Nasya after 3 days in chikitsa.
•The reason behind Pakshat pakshat vamana and masat masat virechana may be based on the
formation of Kleda. If Kleda is formed due to kapha, its accumulation is faster because of
Snigdha, Picchila and Sandra guna. Thus it has to be removed frequently, so vamana is
advised once in 15 days.
•Whereas the Kleda accumulating on the account of Pitta due to its upasneha, drava and
visraguna is relatively a slow process, so virechana is prescribed once a month.
•Rakta is the Ashraya for pitta, when dushita rakta is removed the skin gets nourished by the
shudda rakta and it helps in treatment of kushta.
54
❖Vamana karma-in Kapha pradhana:
If doshas located in the upper part of the body then Vamana should be given.
Ex- Mandala and Vicharchika kushta ( Mainly Kapha pradhana kushta)
❖Virechana karma- in Pittapradhana:
• Most of the Kushta comes under the heading of Raktapradoshaja vyadhi.
•Pitta is the mala of Rakta. So there is avinabhava sambandha between rakta and pitta. When
excessive amount of pitta is expelled out from the body it helps to purify the rakta also, and
cures the Raktapradoshaja vikara like Kushta.
55
If doshas located in the upper part of the body then Vamana should be given.
Ex- Mandala and Vicharchika kushta ( Mainly Kapha pradhana kushta)
❖Virechana karma- in Pittapradhana:
• Most of the Kushta comes under the heading of Raktapradoshaja vyadhi.
•Pitta is the mala of Rakta. So there is avinabhava sambandha between rakta and pitta. When
excessive amount of pitta is expelled out from the body it helps to purify the rakta also, and
cures the Raktapradoshaja vikara like Kushta.
55
•Virechana karma has got specific action on sapthadravyas (rasa, rakta, lasika, udaka, kapha,
pitta etc) and on vata also, which are prime factors in causation of skin disorders. Hence
virechana is the best shodhana karma in pitta pradhana kushta and to prevent reoccurrences.
•Virechana helps in regulating sodium and potassium exchange. This indirectly regulates agni
and there will be no ama production. In ama where agni is in manda condition, malabhaga is
more than saarabhaga. Similarly in raktadushti conditions malaroopa pitta gets increased in
the body, which is located in liver and gallbladder. To eliminate such malaroopa pitta,
virechana karma is the only best line of treatment. Ex- Udumbara kushta
56
pitta etc) and on vata also, which are prime factors in causation of skin disorders. Hence
virechana is the best shodhana karma in pitta pradhana kushta and to prevent reoccurrences.
•Virechana helps in regulating sodium and potassium exchange. This indirectly regulates agni
and there will be no ama production. In ama where agni is in manda condition, malabhaga is
more than saarabhaga. Similarly in raktadushti conditions malaroopa pitta gets increased in
the body, which is located in liver and gallbladder. To eliminate such malaroopa pitta,
virechana karma is the only best line of treatment. Ex- Udumbara kushta
56
❖Basti-
•According to Acharya Charaka and Acharya Sushruta Basti karma is directly contraindicated
because it aggravates Kushta roga. If there is excess of vata after the administration of
Virechana and Asthapana Basti and if the patient is suitable, Anuvasana Basti can be given.
❖Raktamokshana-
In pitta pradhana kushta, Raktamokshana should be done whereas, in less acute stage
pracchan should be done and in more acute stage of kushta Siravyadha should be done.
57
•According to Acharya Charaka and Acharya Sushruta Basti karma is directly contraindicated
because it aggravates Kushta roga. If there is excess of vata after the administration of
Virechana and Asthapana Basti and if the patient is suitable, Anuvasana Basti can be given.
❖Raktamokshana-
In pitta pradhana kushta, Raktamokshana should be done whereas, in less acute stage
pracchan should be done and in more acute stage of kushta Siravyadha should be done.
57
SAMPRAPTI VIGHATANA BY PANCHAKARMA
Drava doshas by Vamana and Virechana
Repeated shodhana
Shodhana and Raktamokshana ( Varna Prasadana)
Shamana and Rasayana prayoga
Tridosha prakopa
Tiryak Dhamani
Twak rakta mamsa
ambu dushti
Twak
Vaivarnyam
58
Drava doshas by Vamana and Virechana
Repeated shodhana
Shodhana and Raktamokshana ( Varna Prasadana)
Shamana and Rasayana prayoga
Tridosha prakopa
Tiryak Dhamani
Twak rakta mamsa
ambu dushti
Twak
Vaivarnyam
58
CONCLUSION
•Shodhana is essential for Bahu doshavastha other than trying to eliminate it all at once
since it weakens the patients.
•Selection of Chikitsa for kushta depends upon the predominant of doshas and on
Yuktivyapashraya chikitsa.
•If Doshas are in Alpa Avastha we can treat it with Shamana line of treatment and along
with Pathyapathya palana.
59
•Shodhana is essential for Bahu doshavastha other than trying to eliminate it all at once
since it weakens the patients.
•Selection of Chikitsa for kushta depends upon the predominant of doshas and on
Yuktivyapashraya chikitsa.
•If Doshas are in Alpa Avastha we can treat it with Shamana line of treatment and along
with Pathyapathya palana.
59
60
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