Aragvadhiya Adhyaya

Sutra Sthana Chapter 3. Aragvadha(cassia) and other medicines

Aragvadhiya Adhyaya

Section/Chapter	Sutra Sthana Chapter 3
Tetrad/Sub-section	Bheshaja Chatushka
Preceding Chapter	Apamarga Tanduliya Adhyaya
Succeeding Chapter	Shadvirechanashatashritiya Adhyaya
Other Sections	Nidana Sthana, Vimana Sthana, Sharira Sthana, Indriya Sthana, Chikitsa Sthana, Kalpa Sthana, Siddhi Sthana
Translator and commentator	Dubey S.D., Sen B., Deole Y. S.
Reviewer	Jani D., Sirdeshpande M.
Editors	Jani D., Deole Y.S., Basisht G.
Year of publication	2020
Publisher	Charak Samhita Research, Training and Skill Development Centre
DOI	10.47468/CSNE.2020.e01.s01.005

Abstract

While the preceding chapter (Apamarga Tanduliya) dealt with internal application of therapies in the form of Panchakarma, this chapter deals with the external application of medications. Thirty two types of external applications are enlisted in this chapter. The important indication is Kushtha (Skin diseases). These are systemic disorders considered as major disease (maharoga). They require internal cleansing and purification treatments prior to external treatments – and hence, the sequence of the chapters. Without prior internal treatment, local treatments have limited efficacy.

Keywords: Aragvadha, churnapradeha, pradeha, lepa, pralepa, kushtha, skin diseases, external applications, external cleansing.

Introduction

This chapter includes thirty-two types of formulations in the form of powder or paste (churna/pradeha). The paste is prepared by mixing the powder with oil, ghrita (ghee, or clarified butter), milk, butter milk or cow urine etc. Occasionally, oil smearing in the affected part is a pre-requisite for such application of powder (avachurnana and udvartana), so that the drug used gets in contact with the oily surface and enhances the rate of penetration. Different kinds of skin diseases and conditions like shopha (swelling), pain in the abdomen, head and flanks, vatarakta (painful inflammation of joints), etc. are discussed here for external cleansing treatments.

The three types of external applications viz. pralepa, pradeha and alepa are mentioned in this chapter. Pralepa is a form which is applied cold, in a thin layer irrespective of its absorbability. It is indicated in vitiation of pitta and rakta dosha.Pradeha is thick and it is generally applied in the form of bolus. It is applied in cold in case of pitta-rakta vitiation and hot in cases of vata-kapha vitiation. Alepa is the medium form which is neither too thin nor too thick. Thus the thickness or thinness of paste application determines its specific effect. Temperature of paste also plays role in determining effect of application. The underlying mechanism may be due to absorption through sweat pores.

Sanskrit text, Transliteration and English translation

अथात आरग्वधीयमध्यायं व्याख्यास्यामः||१||

इति ह स्माह भगवानात्रेयः||२||

athāta āragvadhīyamadhyāyaṁ vyākhyāsyāmaḥ||1||

iti ha smāha bhagavānātrēyaḥ||2||

athAta AragvadhIyamadhyAyaM vyAkhyAsyAmaH||1||

iti ha smAha bhagavAnAtreyaH||2||

Now we shall expound the chapter "Aragvadhiya" (Cassia and other medicines). Thus said Lord Atreya. [1-2]

Six formulations used for local application

आरग्वधः सैडगजः करञ्जो वासा गुडूची मदनं हरिद्रे|
श्र्याह्वः सुराह्वः खदिरो धवश्च निम्बो विडङ्गं करवीरकत्वक्||३||

ग्रन्थिश्च भौर्जो लशुनः शिरीषः सलोमशो गुग्गुलुकृष्णगन्धे|
फणिज्झको वत्सकसप्तपर्णौ पीलूनि कुष्ठं सुमनःप्रवालाः||४||

वचा हरेणुस्त्रिवृता निकुम्भो भल्लातकं गैरिकमञ्जनं च|
मनःशिलाले गृहधूम एला काशीसलोध्रार्जुनमुस्तसर्जाः||५||

इत्यर्धरूपैर्विहिताः षडेते गोपित्तपीताः पुनरेव पिष्टाः|
सिद्धाः परं सर्षपतैलयुक्ताश्चूर्णप्रदेहा भिषजा प्रयोज्याः||६||

कुष्ठानि कृच्छ्राणि नवं किलासं सुरेशलुप्तं किटिभं सदद्रु|
भगन्दरार्शांस्यपचीं सपामां हन्युः प्रयुक्तास्त्वचिरान्नराणाम्||७||

āragvadhaḥ saiḍagajaḥ karañjō vāsā guḍūcī madanaṁ haridrē|
śryāhvaḥ surāhvaḥ khadirō dhavaśca nimbō viḍaṅgaṁ karavīrakatvak||3||

granthiśca bhaurjō laśunaḥ śirīṣaḥ salōmaśō guggulukr̥ṣṇagandhē|
phaṇijjhakō vatsakasaptaparṇau pīlūni kuṣṭhaṁ sumanaḥpravālāḥ||4||

vacā harēṇustrivr̥tā nikumbhō bhallātakaṁ gairikamañjanaṁ ca|
manaḥśilālē gr̥hadhūma ēlā kāśīsalōdhrārjunamustasarjāḥ||5||

ityardharūpairvihitāḥ ṣaḍētē gōpittapītāḥ punarēva piṣṭāḥ|
siddhāḥ paraṁ sarṣapatailayuktāścūrṇapradēhā bhiṣajā prayōjyāḥ||6||

kuṣṭhāni kr̥cchrāṇi navaṁ kilāsaṁ surēśaluptaṁ kiṭibhaṁ sadadru|
bhagandarārśāṁsyapacīṁ sapāmāṁ hanyuḥ prayuktāstvacirānnarāṇām||7||

AragvadhaH saiDagajaH kara~jjo vAsA guDUcI madanaM haridre|
shryAhvaH surAhvaH khadiro dhavashca nimbo viDa~ggaM karavIrakatvak||3||

granthishca bhaurjo lashunaH shirIShaH salomasho guggulukRuShNagandhe|
phaNijjhako vatsakasaptaparNau pIlUni kuShThaM sumanaHpravAlAH||4||

vacA hareNustrivRutA nikumbho bhallAtakaM gairikama~jjanaM ca|
manaHshilAle gRuhadhUma elA kAshIsalodhrArjunamustasarjAH||5||

ityardharUpairvihitAH ShaDete gopittapItAH punareva piShTAH|
siddhAH paraM sarShapatailayuktAshcUrNapradehA bhiShajA prayojyAH||6||

kuShThAni kRucchrANi navaM kilAsaM sureshaluptaM kiTibhaM sadadru|
bhagandarArshAMsyapacIM sapAmAM hanyuH prayuktAstvacirAnnarANAm||7||

1. Aragvadha, aidagaja (chakramarda), karanja, vasa, guduchi, madana, haridra and daruharidra;
2. Shryahvah(sarala), surahvah (devadaru), khadira, dhava, nimba, vidanga, bark of karaviraka;
3. Granthi (nodes) of bhorja, lashuna, shirisha, lomasha (kasisa), guggulu, and krishnagandha (shigru);
4. Phanizzaka, vatsaka (kutaja), saptaparna, pilu, kushtha, and sumana pravala (tender leaves of Jati);
5. Vacha, harenu, trivruta, nikumbha (danti), bhallataka, gairika and anjana;
6. Manashila, gr̥uhadhuma, ela kasisa, lodhra, arjuna, musta, and sarja;

These six formulations, when mixed with pita-gopitta (ox-bile) and ground, and then mixed again with sarshapa-taila (mustard oil) before their administration by a wise physician in the form of a churnapradeha (paste), cure kushtha diseases (which are difficult to treat otherwise), kilasa (leucoderma) in the early stages, sureshalupta (alopecia), kitibha (resembling psoriasis), dadru (ringworm), bhagandara (fistula), arsha (piles), apachi (cervical and axillary lymphadenitis), and pama (papular eruptions) quickly.[3-7]

Kushthadi formulation-I

कुष्ठं हरिद्रे सुरसं पटोलं निम्बाश्वगन्धे सुरदारुशिग्रू|
ससर्षपं तुम्बुरुधान्यवन्यं चण्डां च चूर्णानि समानि कुर्यात्||८||

तैस्तक्रपिष्टैः प्रथमं शरीरं तैलाक्तमुद्वर्तयितुं यतेत|
तेनास्यकण्डूः पिडकाः सकोठाः कुष्ठानि शोफाश्च शमं व्रजन्ति||९||

kuṣṭhaṁ haridrē surasaṁ paṭōlaṁ nimbāśvagandhē suradāruśigrū|
sasarṣapaṁ tumburudhānyavanyaṁ caṇḍāṁ ca cūrṇāni samāni kuryāt||8||

taistakrapiṣṭaiḥ prathamaṁ śarīraṁ tailāktamudvartayituṁ yatēta|
tēnāsyakaṇḍūḥ piḍakāḥ sakōṭhāḥ kuṣṭhāni śōphāśca śamaṁ vrajanti||9||

kuShThaM haridre surasaM paTolaM nimbAshvagandhe suradArushigrU|
sasarShapaM tumburudhAnyavanyaM caNDAM ca cUrNAni samAni kuryAt||8||

taistakrapiShTaiH prathamaM sharIraM tailAktamudvartayituM yateta|
tenAsyakaNDUH piDakAH sakoThAH kuShThAni shophAshca shamaM vrajanti||9||

Kushtha, (both types of) haridra, surasa (tulasi), patola, nimba, ashvagandha, suradaru, shigru, sarshapa, tumburudhanya (seeds of tumburu), vanya (kaivarta mustaka), and chanda- powdered in equal quantities, admixed with takra (buttermilk) and grounded well - make for an effective formulation that alleviates diseases like kandu, pidaka, kotha, all types of kushtha and shopha. Before anointing this formulation, the body or an affected part of the body is smeared with oil. [8-9]

Kushthadi formulation-II

कुष्ठामृतासङ्गकटङ्कटेरीकासीसकम्पिल्लकमुस्तलोध्राः|
सौगन्धिकं सर्जरसो विडङ्गं मनःशिलाले करवीरकत्वक्||१०||

तैलाक्तगात्रस्य कृतानि चूर्णान्येतानि दद्यादवचूर्णनार्थम्|
दद्रूः सकण्डूः किटिभानि पामा विचर्चिका चैव तथैति शान्तिम्||११||

kuṣṭhāmr̥tāsaṅgakaṭaṅkaṭērīkāsīsakampillakamustalōdhrāḥ|
saugandhikaṁ sarjarasō viḍaṅgaṁ manaḥśilālē karavīrakatvak||10||

tailāktagātrasya kr̥tāni cūrṇānyētāni dadyādavacūrṇanārtham|
dadrūḥ sakaṇḍūḥ kiṭibhāni pāmā vicarcikā caiva tathaiti śāntim||11||

kuShThAmRutAsa~ggakaTa~gkaTerIkAsIsakampillakamustalodhrAH|
saugandhikaM sarjaraso viDa~ggaM manaHshilAle karavIrakatvak||10||

tailAktagAtrasya kRutAni cUrNAnyetAni dadyAdavacUrNanArtham|
dadrUH sakaNDUH kiTibhAni pAmA vicarcikA caiva tathaiti shAntim||11||

Kushtha, amritasanga (tuttha), katankateri (daruharidra), kasisa, kampillaka, mustaka, lodhra, saugandhika (gandhatruna or sulphur), sarjarasa (rala), vidanga, manahshila, ala (haratala), and the bark of karaviraka - mixed and ground into a powder - is used for the purpose of dusting (avachurnana) on the body already smeared with oil. This medication helps cure dadru(ring worms), kandu (itching), as well as all kinds of kiṭibha (resembling psoriasis), pama(papular eruptions) and vicharchika (eczema). [10-11]

Manahshiladi formulation-I

मनःशिलाले मरिचानि तैलमार्कं पयः कुष्ठहरः प्रदेहः|
तुत्थं विडङ्गं मरिचानि कुष्ठं लोध्रं च तद्वत् समनःशिलं स्यात्||१२||

manaḥśilālē maricāni tailamārkaṁ payaḥ kuṣṭhaharaḥ pradēhaḥ|
tutthaṁ viḍaṅgaṁ maricāni kuṣṭhaṁ lōdhraṁ ca tadvat samanaḥśilaṁ syāt||12||

manaHshilAle maricAni tailamArkaM payaH kuShThaharaH pradehaH|
tutthaM viDa~ggaM maricAni kuShThaM lodhraM ca tadvat samanaHshilaM syAt||12||

Manahshila, ala, maricha (seeds of maricha), taila (mustard oil), and arka-paya (latex of arka) , ground and made into a paste (pradeha) , alleviates kushtha . Tuttha, vidanga, maricha, kushtha, and lodhra, along with manahshila can also be used in the preparation. [12]

Rasanjanadi formulation

रसाञ्जनं सप्रपुन्नाडबीजं युक्तं कपित्थस्य रसेन लेपः|
करञ्जबीजैडगजं सकुष्ठं गोमूत्रपिष्टं च परः प्रदेहः||१३||

rasāñjanaṁ saprapunnāḍabījaṁ yuktaṁ kapitthasya rasēna lēpaḥ|
karañjabījaiḍagajaṁ sakuṣṭhaṁ gōmūtrapiṣṭaṁ ca paraḥ pradēhaḥ||13||

rasA~jjanaM saprapunnADabIjaM yuktaM kapitthasya rasena lepaH|
kara~jjabIjaiDagajaM sakuShThaM gomUtrapiShTaM ca paraH pradehaH||13||

Rasanjana and prapunnadabija, mixed with the juice of kapittha makes a good lepa for kushtha. Similarly, karanjabija, aidagaja, and kushtha -ground with gomutra - makes an effective pradeha (for kushtha). [13]

Haridradi formulation

उभे हरिद्रे कुटजस्य बीजं करञ्जबीजं सुमनःप्रवालान्|
त्वचं समध्यां हयमारकस्य लेपं तिलक्षारयुतं विदध्यात्||१४||

ubhē haridrē kuṭajasya bījaṁ karañjabījaṁ sumanaḥpravālān|
tvacaṁ samadhyāṁ hayamārakasya lēpaṁ tilakṣārayutaṁ vidadhyāt||14||

ubhe haridre kuTajasya bIjaM kara~jjabIjaM sumanaHpravAlAn|
tvacaM samadhyAM hayamArakasya lepaM tilakShArayutaM vidadhyAt||14||

Both types of haridra, seeds of kutaja, seeds of karanja, tender leaves of sumana (jati), bark and pith of hayamaraka (karaviraka) - mixed with kshara of tila (alkali preparation of sesame) - make a good lepa (for kushtha). [14]

Manahshiladi formulation-II

मनःशिला त्वक् कुटजात् सकुष्ठात् सलोमशः सैडगजः करञ्जः|
ग्रन्थिश्च भौर्जः करवीरमूलं चूर्णानि साध्यानि तुषोदकेन||१५||

पलाशनिर्दाहरसेन चापि कर्षोद्धृतान्याढकसम्मितेन|
दर्वीप्रलेपं प्रवदन्ति लेपमेतं परं कुष्ठनिसूदनाय||१६||

manaḥśilā tvak kuṭajāt sakuṣṭhāt salōmaśaḥ saiḍagajaḥ karañjaḥ|
granthiśca bhaurjaḥ karavīramūlaṁ cūrṇāni sādhyāni tuṣōdakēna||15||

palāśanirdāharasēna cāpi karṣōddhr̥tānyāḍhakasammitēna|
darvīpralēpaṁ pravadanti lēpamētaṁ paraṁ kuṣṭhanisūdanāya||16||

manaHshilA tvak kuTajAt sakuShThAt salomashaH saiDagajaH kara~jjaH|
granthishca bhaurjaH karavIramUlaM cUrNAni sAdhyAni tuShodakena||15||

palAshanirdAharasena cApi karShoddhRutAnyADhakasammitena|
darvIpralepaM pravadanti lepametaM paraM kuShThanisUdanAya||16||

Powder of manashila, bark of kuṭaja, kushtha, lomasha, aidagaja, karanja, bhurja granthi, and roots of karavira, - each of these taken one karsha (10 g) and cooked with adhaka (2.56 liters) quantity of tushodaka and palashanirdaharasa (juice of palasha that is obtained from burning the roots), when reduced to a semi-solid state (darvipralepa), makes the best lepa for kushtha. [15-16]

Chaturanguladi formulation

पर्णानि पिष्ट्वा चतुरङ्गुलस्य तक्रेण पर्णान्यथ काकमाच्याः|
तैलाक्तगात्रस्य नरस्य कुष्ठान्युद्वर्तयेदश्वहनच्छदैश्च||१७||

parṇāni piṣṭvā caturaṅgulasya takrēṇa parṇānyatha kākamācyāḥ|
tailāktagātrasya narasya kuṣṭhānyudvartayēdaśvahanacchadaiśca||17||

parNAni piShTvA catura~ggulasya takreNa parNAnyatha kAkamAcyAH|
tailAktagAtrasya narasya kuShThAnyudvartayedashvahanacchadaishca||17||

A lepa prepared by grinding the leaves of chaturangula (aragvadha), the leaves of kakamachi, and the leaves of ashvahana (karaviraka) with takra, should be anointed on the (oil-smeared) body of a person affected with kushtha. [17]

Kola-kulatthadi formulation in Vata disorders

कोलं कुलत्थाः सुरदारुरास्नामाषातसीतैलफलानि कुष्ठम्|
वचा शताह्वा यवचूर्णमम्लमुष्णानि वातामयिनां प्रदेहः||१८||

kōlaṁ kulatthāḥ suradārurāsnāmāṣātasītailaphalāni kuṣṭham|
vacā śatāhvā yavacūrṇamamlamuṣṇāni vātāmayināṁ pradēhaḥ||18||

kolaM kulatthAH suradArurAsnAmAShAtasItailaphalAni kuShTham|
vacA shatAhvA yavacUrNamamlamuShNAni vAtAmayinAM pradehaH||18||

Kola, kulattha, suradaru, rasna, masha, atasi, tailaphalani, kushtha, vachaa, shatahva, yavachurna (all in equal quantity), ground with amla (kanji or a fermented sour beverage), is used as a hot (ushna) pradeha for patients suffering from vatika disorders. [18]

Anup matsyadi pradeha formulation

आनूपमत्स्यामिषवेसवारैरुष्णैः प्रदेहः पवनापहः स्यात्|
स्नेहैश्चतुर्भिर्दशमूलमिश्रैर्गन्धौषधैश्चानिलहः प्रदेहः||१९||

ānūpamatsyāmiṣavēsavārairuṣṇaiḥ pradēhaḥ pavanāpahaḥ syāt|
snēhaiścaturbhirdaśamūlamiśrairgandhauṣadhaiścānilahaḥ pradēhaḥ||19||

AnUpamatsyAmiShavesavArairuShNaiH pradehaH pavanApahaH syAt|
snehaishcaturbhirdashamUlamishrairgandhauShadhaishcAnilahaH pradehaH||19||

Pradeha made of hot veshavara (a preparation of meat) prepared with anupamatsyamisha (meat of marshy fish) subsides vata. Similarly, four types of sneha, dashamula and gandhaushadha, when mixed together, make a vata alleviating pradeha. [19]

Yavadi formulation

तक्रेण युक्तं यवचूर्णमुष्णं सक्षारमर्तिं जठरे निहन्यात्|
कुष्ठं शताह्वां सवचां यवानां चूर्णं सतैलाम्लमुशन्ति वाते||२०||

takrēṇa yuktaṁ yavacūrṇamuṣṇaṁ sakṣāramartiṁ jaṭharē nihanyāt|
kuṣṭhaṁ śatāhvāṁ savacāṁ yavānāṁ cūrṇaṁ satailāmlamuśanti vātē||20||

takreNa yuktaM yavacUrNamuShNaM sakShAramartiM jaThare nihanyAt|
kuShThaM shatAhvAM savacAM yavAnAM cUrNaM satailAmlamushanti vAte||20||

Yavachurṇa mixed with takra, heated and added with kshara serves as an abdominal pain relieving drug. Kushtha, shatahva, vacha, and yavachurna - mixed with taila and amla - is indicated in vata related disorders. [20]

Shatavhadi formulation

उभे शताह्वे मधुकं मधूकं बलां प्रियालं च कशेरुकं च|
घृतं विदारीं च सितोपलां च कुर्यात् प्रदेहं पवने सरक्ते||२१||

ubhē śatāhvē madhukaṁ madhūkaṁ balāṁ priyālaṁ ca kaśērukaṁ ca|
ghr̥taṁ vidārīṁ ca sitōpalāṁ ca kuryāt pradēhaṁ pavanē saraktē||21||

ubhe shatAhve madhukaM madhUkaM balAM priyAlaM ca kasherukaM ca|
ghRutaM vidArIM ca sitopalAM ca kuryAt pradehaM pavane sarakte||21||

Both types of shatahva, madhuka, bala, priyala, kasheruka, and vidari - ground and mixed with ghrita and sitopala - makes a pradeha in vatarakta disorders. [21]

Rasnadi formulation

रास्ना गुडूची मधुकं बले द्वे सजीवकं सर्षभकं पयश्च|
घृतं च सिद्धं मधुशेषयुक्तं रक्तानिलार्तिं प्रणुदेत् प्रदेहः||२२||

rāsnā guḍūcī madhukaṁ balē dvē sajīvakaṁ sarṣabhakaṁ payaśca|
ghr̥taṁ ca siddhaṁ madhuśēṣayuktaṁ raktānilārtiṁ praṇudēt pradēhaḥ||22||

rAsnA guDUcI madhukaM bale dve sajIvakaM sarShabhakaM payashca|
ghRutaM ca siddhaM madhusheShayuktaM raktAnilArtiM praNudet pradehaH||22||

Ghrita prepared with rasna, guduchi, madhuka, two types of bala (bala and atibala), jivaka, rishabhaka, mixed with milk and added with honey-wax (madhushesha) is used to prepare a pradeha for alleviating discomfort due to vatarakta. [22]

Godhumadi formulation

वाते सरक्ते सघृतं प्रदेहो गोधूमचूर्णं छगलीपयश्च|
नतोत्पलं चन्दनकुष्ठयुक्तं शिरोरुजायां सघृतं प्रदेहः||२३||

vātē saraktē saghr̥taṁ pradēhō gōdhūmacūrṇaṁ chagalīpayaśca|
natōtpalaṁ candanakuṣṭhayuktaṁ śirōrujāyāṁ saghr̥taṁ pradēhaḥ||23||

vAte sarakte saghRutaM pradeho godhUmacUrNaM chagalIpayashca|23|
natotpalaM candanakuShThayuktaM shirorujAyAM saghRutaM pradehaH||23||

In vatarakta, the pradeha is prepared using godhumachurna mixed with ghrita and chagalipaya (goat’s milk). In the case of shiroruja, the pradeha is prepared by mixing nata, utpala, chandana, kushtha with ghrita. [23]

Prapaudarikadi formulation

प्रपौण्डरीकं सुरदारु कुष्ठं यष्ट्याह्वमेला कमलोत्पले च|
शिरोरुजायां सघृतः प्रदेहो लोहैरकापद्मकचोरकैश्च||२४||

prapauṇḍarīkaṁ suradāru kuṣṭhaṁ yaṣṭyāhvamēlā kamalōtpalē ca|
śirōrujāyāṁ saghr̥taḥ pradēhō lōhairakāpadmakacōrakaiśca||24||

prapauNDarIkaM suradAru kuShThaM yaShTyAhvamelA kamalotpale ca|
shirorujAyAM saghRutaH pradeho lohairakApadmakacorakaishca||24||

A pradeha prepared by mixing prapaundarika, suradaru, kushtha, yashtyahva, ela, kamala, utpala, loha (agaru), eraka, padmaka and choraka with ghrita is useful in treating headache ( shiroruja) . [24]

Rasna-Haridradi formulation

रास्ना हरिद्रे नलदं शताह्वे द्वे देवदारूणि सितोपला च|
जीवन्तिमूलं सघृतं सतैलमालेपनं पार्श्वरुजासु कोष्णम्||२५||

rāsnā haridrē naladaṁ śatāhvē dvē dēvadārūṇi sitōpalā ca|
jīvantimūlaṁ saghr̥taṁ satailamālēpanaṁ pārśvarujāsu kōṣṇam||25||

rAsnA haridre naladaM shatAhve dve devadArUNi sitopalA ca|
jIvantimUlaM saghRutaM satailamAlepanaM pArshvarujAsu koShNam||25||

Rasna, two types of haridra, nalada (jatamamsi), two types of shatavha, devadaru (seeds of devadaru), sitopala and roots of jivanti, mixed with ghrita and taila, is used to prepare a luke warm alepana that serves as an effective medication to treat parshvaruja (pain in flanks). [25]

Shaivaladi formulation

शैवालपद्मोत्पलवेत्रतुङ्गप्रपौण्डरीकाण्यमृणाललोध्रम्|
प्रियङ्गुकालेयकचन्दनानि निर्वापणः स्यात् सघृतः प्रदेहः||२६||

śaivālapadmōtpalavētratuṅgaprapauṇḍarīkāṇyamr̥ṇālalōdhram|
priyaṅgukālēyakacandanāni nirvāpaṇaḥ syāt saghr̥taḥ pradēhaḥ||26||

shaivAlapadmotpalavetratu~ggaprapauNDarIkANyamRuNAlalodhram|
priya~ggukAleyakacandanAni nirvApaNaH syAt saghRutaH pradehaH||26||

Shaivala, padma, utpala, vetra, tunga (punnaga), prapaunḍarika, amranala (uhira), lodhra, priyangu, kaleyaka, and chandana mixed with ghrita makes an effective nirvapaṇa (heat alleviating) pradeha. [26]

Sita-latadi formulation

सितालतावेतसपद्मकानि यष्ट्याह्वमैन्द्री नलिनानि दूर्वा|
यवासमूलं कुशकाशयोश्च निर्वापणः स्याज्जलमेरका च||२७||

sitālatāvētasapadmakāni yaṣṭyāhvamaindrī nalināni dūrvā|
yavāsamūlaṁ kuśakāśayōśca nirvāpaṇaḥ syājjalamērakā ca||27||

sitAlatAvetasapadmakAni yaShTyAhvamaindrI nalinAni dUrvA|
yavAsamUlaM kushakAshayoshca nirvApaNaH syAjjalamerakA ca||27||

Sita (shweta durva), lata (manjishtha), vetasa, padmaka, yashtyavha, aindri (gorakshakarkati), nalina (kamala), durva, roots of yavasa, kusha and kasha, jala (hribera) and eraka are used to make a nirvapana (pradeha) for alleviating heat. [27]

Shaileyadi formulation

शैलेयमेलागुरुणी सकुष्ठे चण्डा नतं त्वक् सुरदारु रास्ना|
शीतं निहन्यादचिरात् प्रदेहो विषं शिरीषस्तु ससिन्धुवारः||२८||

śailēyamēlāguruṇī sakuṣṭhē caṇḍā nataṁ tvak suradāru rāsnā|
śītaṁ nihanyādacirāt pradēhō viṣaṁ śirīṣastu sasindhuvāraḥ||28||

shaileyamelAguruNI sakuShThe caNDA nataM tvak suradAru rAsnA|
shItaM nihanyAdacirAt pradeho viShaM shirIShastu sasindhuvAraH||28||

Shaileya, ela, aguru, kushtha, chanda, nata (tagara), tvak (dalachini), suradaru and rasna are key ingredients needed for preparing a quick, cold alleviating pradeha. A pradeha made of shirisha mixed with sindhuvara neutralizes poisons quickly. [28]

Shirishadi formulation

शिरीषलामज्जकहेमलोध्रैस्त्वग्दोषसंस्वेदहरः प्रघर्षः|
पत्राम्बुलोध्राभयचन्दनानि शरीरदौर्गन्ध्यहरः प्रदेहः||२९||

śirīṣalāmajjakahēmalōdhraistvagdōṣasaṁsvēdaharaḥ pragharṣaḥ|
patrāmbulōdhrābhayacandanāni śarīradaurgandhyaharaḥ pradēhaḥ||29||

shirIShalAmajjakahemalodhraistvagdoShasaMsvedaharaH pragharShaH|
patrAmbulodhrAbhayacandanAni sharIradaurgandhyaharaH pradehaH||29||

Shirisha, lamajjaka (ushira), hema (nagakeshara) and lodhra help prepare balms for pragharsha (rubbing) that help alleviate skin diseases and excessive perspiration. A pradeha made of patra (tejapatra), ambu (hribera), lodhra, abhaya (ushira) and chandana alleviates foul smell of the body. [29]

Summary

तत्र श्लोकः-
इहात्रिजः सिद्धतमानुवाच द्वात्रिंशतं सिद्धमहर्षिपूज्यः|
चूर्णप्रदेहान् विविधामयघ्नानारग्वधीये जगतो हितार्थम्||३०||

tatra ślōkaḥ-
ihātrijaḥ siddhatamānuvāca dvātriṁśataṁ siddhamaharṣipūjyaḥ|
cūrṇapradēhān vividhāmayaghnānāragvadhīyē jagatō hitārtham||30||

tatra shlokaH-
ihAtrijaH siddhatamAnuvAca dvAtriMshataM siddhamaharShipUjyaH|
cUrNapradehAn vividhAmayaghnAnAragvadhIye jagato hitArtham||30||

Now (the concluding) verses:

Here, Atri’s son (i.e., Lord Atreya), worshipped by accomplished and great sages, mentioned 32 successful (disease alleviating) churnapradeha, destroyers of various disorders (described in the chapter of aragvadhiya) for the welfare of the world. [30]

इत्यग्निवेशकृते तन्त्रे चरकप्रतिसंस्कृते श्लोकस्थाने आरग्वधीयो नाम तृतीयोऽध्यायः||३||

ityagnivēśakr̥tē tantrē carakapratisaṁskr̥tē ślōkasthānē āragvadhīyō nāma tr̥tīyō'dhyāyaḥ||3||

Thus ends the third chapter titled Aragvadhiya in Sutra Sthana in the treaties composed by Agnivesha and redacted by Charak. [3]

Tattva Vimarsha (Fundamental Principles)

• The skin diseases have multiple pathologies based upon etiological factors like microbial infection, allergy, injury, poisons, chemical contacts etc. and require multipronged treatment. They can be managed with internal administration and external applications of medicines. The Ayurvedic drugs are known to have multiple effects. Their combination with other herbs and processing method of preparation increases their spectrum of action. Argavadha is a medicinal herb considered one of the best for making such preparations.
• Drugs mentioned in the chapter have antibacterial, anti-parasitic, anti-inflammatory, antihistaminic, deodorant, analgesic, poison neutralizing, cauterizing, cleansing, moisturizing, normalizing pigmentation, hair regrowth and wound healing properties.
• Various solvents are used to extract a specific active component for the desired effect.

Vidhi Vimarsha (Applied Inferences)

The drugs mentioned in verse 3-7 are found effective as kushthaghna (effective in skin diseases), kandughna (effective in pruritus) and arshoghna (effective in hemorrhoids) mahakashaya. Kuṭaja is indicated in bleeding hemorrhoids while bhallataka is indicated in non-bleeding ones. By adding these two drugs of opposing action, their spectrum of action is enhanced considerably. Their ability to penetrate the affected areas is enhanced further when admixed with gopitta and mustard oil. This combination is particularly effective in treating rectal fistula and hemorrhoids. Sulfur is effective in treating most of the skin diseases and neem is a rich source of sulfur. Minerals like manahshila, kasisa and praval are used commonly for treating skin diseases because of their richness in sulfur. In psoriasis there is a deficiency of fatty acids, sulfur and immunoglobulins in the skin. Oil, ghrita, milk, neem (Azadirachta Indica) and amrita (Tinospora cordifolia) preparations help in correcting those deficiencies. The use of atasi (flax) poultice has anti-inflammatory and analgesic effect in vatavyadhi. Amrita (Tinospora cordifolia) and yashtimadhu (liquorice) have anti-inflammatory and analgesic properties and are used for vatarakta. Vesavara and dashamoola are used as analgesics. Dashamoola has analgesic, anti-inflammatory and anti-platelet properties. Shirisha (Albizia lebbeck) is indicated as the best drug for treating dermal toxicity.

Powdered drug is used most effectively in the form of udvartana (smearing or massaging powdered drugs) on body parts smeared in oil. [8-9] The utility of applying oil before administering powdered medication is to provide passage for lipid-soluble substances. [10-11] There are various forms of external therapies (churnapradeha, pradeha, lepa, pralepa, udvartana, avachurnana, alepana and pragharsha). Apart from kushtha, other conditions covered under the 32 types of churnapradeha are as follows:

Table 1: Showing indications of 32 types of churnapradeha

Indication/Actions	Translation	Numbers
Kushtha hara	Alleviates skin diseases	15
Vatahara	Pacifies vitiated vata	05
Vataraktahara	Alleviates gout	03
Shirorujahara	Subsides headache	02
Parshwarujahara	Subsides pain in the sides of the chest	01
Nirvapana	Relieves burning and heat	02
Shitahara	Relieves cold	01
Vishahara	Counteracts poisons	01
Twagdosasamswedahara	Cures skin diseases and perspiration	01
Shariradaurgandhyahara	Destroys foul smell in the body	01
Total:		32

Alepa has been given due importance as an initial treatment for all types of shopha (swelling). Among the remedies applied internally and externally, it is superior to others because it alleviates pain instantaneously. [Dalhana on Su.Sa.Sutra Sthana 18/3] Types of lepa (external application):[Su.Sa.Sutra Sthana 18/6]

According to character and therapeutic use, alepa can be divided into three types viz., pralepa, pradeha and alepa. It could be shown as tabulated below-

Table 2: Showing character and indications of different types of alepa

Type	Pralepa	Pradeha	Alepa
Characteristics	Cold, thin, non-drying or drying	Hot or cold, thick, little or non-drying	Medium character
Indications	--	Pacifies vata-kapha, cleanses, heals and alleviates inflammatory swelling and pain	Normalizes rakta and pitta

Lepa is of four types, viz. avachurnana (dusting), udvartana (anointing), jalapishtalepana (paste made by mixing with water), and rasakriyalepana (by mixing with semisolids). [Chakrapanidatta Chikitsa Sthana 7/84-96]

Method of application

The method of use, quantity, time of application and other pharmaco-therapeutic aspects are not in scope of this chapter. However, it is to be noted that an alepa is generally advised for application against the direction of the hair growth (pratiloma) to enhance its penetration (swedavahi shira). [Su.Sa.Sutra Sthana 18/4]

Quantity and thickness of application

The quantity, or dosage, of medication in the case of topical medicines is measured by the thickness of the layer of paste. Typically, it should be equivalent to the thickness of moist skin of a buffalo. [Su.Sa.Sutra Sthana 18/11] In current times, the thickness measures around 4-5 millimetre.

Thickness of a layer of pralepa should be equivalent to the thickness of a typical chandana (sandal paste) application. Pradeha is typically applied as a thick paste or bolus (pinda).[Dalhana on Su.Sa.Sutra Sthana 18/6] Thus, it is thin and thick pastes for application of pralepa/anulepana and pradeha respectively. [Dalhana on Su.Sa.Sutra Sthana 18/6]

It can be stated that the thickness of applications as pradeha(thick paste) is more than or equal to 4 to 5 mm. Pralepa (thin paste) applications include thickness less than 4 to 5 mm.

Indication and contraindications

Hot pradeha is indicated in vata and kapha ailments while cold pradeha in conditions due to pittaja and raktaja disorders. [Dalhana on Su.Sa.Sutra Sthana 18/6] It is also stated that alepa is indicated in non-suppurative, inflammatory swellings (avidagdha sopha) whereas pradeha/upnah (poultice) is used for suppurative swellings. [Dalhana on Su.Sa.Sutra Sthana 18/6-9] Pradeha could also be applied at night in case of swellings caused by vata and kapha.[Dalhana on Su.Sa.Sutra Sthana 18/12-14] Pastes should not be used at night. Stale paste, pastes applied on top of an existing layer, or repeating of used pastes are prohibited. [Su.Sa.Sutra Sthana 18/12-14]

Cross references of external medications in Kushtha Chikitsa

Forms	References	Remarks
Avachurṇana	CS.Ci.7/99, 104
Alepa	CS.Ci.7/95, 104
Alepana	CS.Ci.7/95, 104
Ghrishṭa	CS.Ci.7/57
Lepa	CS.Ci.7/53, 87, 93, 94, 96, 118, 127, 158, 167, 169 and 171
Pragharshana	CS.Ci.7/99, 104
Pralepa	CS.Ci.7/128
Pralepana	CS.Ci.7/90, 130
Pradeha	CS.Ci.7/55, 57, 134, 157, 159
Udvartana	CS.Ci.7/104, 127, 128
Unmardana	CS.Ci.7/95	Udvartana, Chakrapani
Udgharsha	CS.Ci.7/92	Avachurṇana, Chakrapani

Regarding taila, sarshapa taila (mustard oil) is most commonly used in kushtha. A specific procedure for obtaining pharmacologically active extract from palasha (Butea monosperma), an anti-parasitic, has been mentioned in the text as palashanirdaharasa. It is obtained by uprooting and then cutting the tree off the main root, burning off the segment above the root and collecting the resulting juices in an earthen pot [Chakrapanidatta Sutra Sthana 3/3-17] [15-16] Vesavara is defined as mashed boneless flesh cooked with jaggery and ghrita, mixed with black pepper [Chakrapanidatta Sutra Sthana 3/19]

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References