Visarpa Chikitsa: Difference between revisions

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{{#seo:

|title=Visarpa Chikitsa

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<big>'''[[Chikitsa Sthana]] Chapter 21. Management of Visarpa (acute spreading erysepalas)</big>'''

{{Infobox

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|data7 = Ojha S.N.

|label8 = Editors

|data8 = Ojha S.N.,Deole Y.S., Basisht G.

|data8 = Ojha S.N., [[Yogesh Deole|Deole Y.S.]], [[Gopal Basisht|Basisht G.]]

|label9 = Year of publication

|data9 = 2020

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<big>'''Abstract </big>'''

<~~div~~ style="text-align:justify;">

<p style="text-align:justify;">This chapter deals with detailed description of etiopathogenesis, classification and management principles of ''visarpa''. This is acute disease with a quick spread involving mainly skin, blood, lymph and muscle tissue due to vitiation of all three [[dosha]]. Disease is clinically presented in three pathways viz. external, internal and both. Based on the involvement of dominant [[dosha]], it is classified into seven types. Prognosis and treatment duration of disease is proportionate to degree of involvement of [[dosha]] and affected internal organs. As the basic nature of disease is [[rakta]] and [[pitta]] dominant, management is focused on body purification treatments especially therapeutic purgation, blood letting, fasting therapy, medicated ghee, use of bitter drugs and various external applications having soothing and cooling effect. Guidelines for external application in the form of ''pralepa, pradeha'' and ''alepa'' are enlisted in the chapter. Blood letting is emphasized as most important treatment in ''visarpa''.

This chapter deals with detailed description of etiopathogenesis, classification and management principles of ''visarpa''. This is acute disease with a quick spread involving mainly skin, blood, lymph and muscle tissue due to vitiation of all three [[dosha]]. Disease is clinically presented in three pathways viz. external, internal and both. Based on the involvement of dominant [[dosha]], it is classified into seven types. Prognosis and treatment duration of disease is proportionate to degree of involvement of [[dosha]] and affected internal organs. As the basic nature of disease is [[rakta]] and [[pitta]] dominant, management is focused on body purification treatments especially therapeutic purgation, blood letting, fasting therapy, medicated ghee, use of bitter drugs and various external applications having soothing and cooling effect. Guidelines for external application in the form of ''pralepa, pradeha'' and ''alepa'' are enlisted in the chapter. Blood letting is emphasized as most important treatment in ''visarpa''.

<br/>

'''Keywords''': ''Visarpa, Parisarpa,'' Erysepalas, Gangrene, Septicaemia, Sepsis, Fulminant spreading skin infections.

</~~div~~>

</p>

== Introduction ==

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The twenty first chapter is named [[Visarpa Chikitsa]]. The term ''visarpa'' has two parts viz., ''vi'' and ''sarpa''- ''vi'' stands for ''vividha'' meaning ‘various’ (ways) and ''sarpa'' stands for ''sarpan'' means ‘spreading’. Erythematous, pustular, glandular etc. lesions which spread rapidly in localized or generalized pattern are known as ''visarpa'' [ Cha.Sa. [[Chikitsa Sthana]] 21/11, Chakrapani]. This aliment is also called ''parisarpa''. The prefix ''pari'' stands for ''paritah'' or ''sarvatah'' meaning all over. The disease which spreads all over the body is called ''visarpa''. [Cha. Sa.[[ Chikitsa Sthana]] 21/11, Chakrapani]. This indicates that ''visarpa'' is an umbrella term used for acute spreading disorders caused due to vitiation of [[rakta]].

In this chapter Atreya answers the queries about ''visarpa'' derivation, synonyms, classification, [[dosha]], dushya,'' etiology, habitat, gradation, symptoms, complications, prognosis and treatment of curable ones. The chapter follows that of[ Cha. Sa. [[Chhardi Chikitsa]] ] because suppression of ''chhardi'' (vomiting) causes [[rakta]] dushti(vitiation of blood) leading to ''visarpa'' indicating that [[rakta]] (blood) vitiating factors and vitiation of [[rakta]] is an important basic underlying phenomenon prior to the ''visarpa''.

In this chapter Atreya answers the queries about ''visarpa'' derivation, synonyms, classification, [[dosha]], dushya,etiology, habitat, gradation, symptoms, complications, prognosis and treatment of curable ones. The chapter follows that of [Cha. Sa. [[Chhardi Chikitsa|Chhardi]] Chikitsa ] because suppression of chhardi (vomiting) causes [[Rakta dhatu|rakta]] dushti(vitiation of blood) leading to visarpa indicating that [[Rakta dhatu|rakta]] (blood) vitiating factors and vitiation of rakta is an important basic underlying phenomenon prior to the visarpa.

''Visarpa'' is acute, spreading and fatal in nature leading to death if not treated promptly. On location basis this is classified into ''bahih-shrita'' (externally situated), ''antah-shrita'' (internally situated) and ''ubhayasam shrita'' (all over situated). ''Bahih-shrita visarpa'' is fulminant, spreading skin and flesh infection with symptoms and signs of inflammatory edema, blisters, ulcers, fever, pain etc. and is curable. ''Antah-shrita visarpa'' involves internal vital organs with mild septicaemia and is curable before complications. ''Ubhayasamshrita visarpa'' has advanced manifestations of both types spreading all over body with severe septicaemia and is fatal.

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Various etiological factors of ''visarpa'' are diet, life style, injury, poison, toxin, burn etc. vitiates [[rakta]] as well as [[dosha]] ([[vata]], [[pitta]] and [[kapha]]) and other [[dhatu]] (body elements) leading to fulminant disease requiring urgent medical care.

Seven components are involved in the pathogenesis of ''visarpa'' viz., [[rakta]] (blood), ''lasika'' (lymph), ''tvak'' (skin), [[mamsa dhatu]] (flesh), [[vata]], [[pitta'' and ''kapha''. Same components are associated with ''kushtha'' (various skin disorders) but clinical presentation of both the diseases is different because etiological factors act different. As ''kushtha'' is chronic in nature and ''visarpa'' is acute in nature[Cha. Sa. [[Chikitsa Sthana]] 21/15,Chakrapani] therefore spreading ''kushtha'' should not be interpreted as ''visarpa''.

Seven components are involved in the pathogenesis of ''visarpa'' viz., [[rakta]] (blood), ''lasika'' (lymph), ''tvak'' (skin), [[mamsa dhatu]] (flesh), [[vata]], [[pitta]]<nowiki/>and [[Kapha dosha|kapha]]. Same components are associated with [[Kushtha Chikitsa|kushtha]] (various skin disorders) but clinical presentation of both the diseases is different because etiological factors act different. As kushtha is chronic in nature and visarpa is acute in nature[Cha. Sa. Chikitsa Sthana 21/15,Chakrapani] therefore spreading kushtha should not be interpreted as visarpa.

It is also classified into ''vatika, paittika, slaishmika, agni visarpa, kardam visarpa, granthi visarpa'' and ''sannipatik'' on [[dosha]] basis. ''Bahih-shrita visarpa'' involves exterior part i.e. Skin, flesh, etc. of the body having symptoms like inflammatory oedema, blisters, ulcers, fever, pain etc. and is curable. ''Agni visarpa'' and ''kardam visarpa'' may be cured with appropriate timely management otherwise negligence leads to death of the patient. ''Granthi visarpa'' should be treated before complications otherwise it becomes incurable. ''Sannipatika visarpa'' is a severe manifestation of the disease leading to death.[Cha. Sa. [[Chikitsa Sthana]] 21/42]

@@ Line 1: / Line 1: @@
+{{CiteButton}}
 {{#seo:
 |title=Visarpa Chikitsa
@@ Line 8: / Line 9: @@
 |type=article
 }}
 <big>'''[[Chikitsa Sthana]] Chapter 21. Management of Visarpa (acute spreading erysepalas)</big>'''
 {{Infobox
@@ Line 26: / Line 26: @@
 |data7  = Ojha S.N.
 |label8 = Editors
-|data8  = Ojha S.N.,Deole Y.S., Basisht G.
+|data8  = Ojha S.N., [[Yogesh Deole|Deole Y.S.]], [[Gopal Basisht|Basisht G.]]
 |label9 = Year of publication
 |data9 = 2020
@@ Line 35: / Line 35: @@
 }}
 <big>'''Abstract </big>'''
-<div style="text-align:justify;">
+<p style="text-align:justify;">This chapter deals with detailed description of etiopathogenesis, classification and management principles of ''visarpa''. This is acute disease with a quick spread involving mainly skin, blood, lymph and muscle tissue due to vitiation of all three [[dosha]]. Disease is clinically presented in three pathways viz. external, internal and both. Based on the involvement of dominant [[dosha]], it is classified into seven types. Prognosis and treatment duration of disease is proportionate to degree of involvement of [[dosha]] and affected internal organs. As the basic nature of disease is [[rakta]] and [[pitta]] dominant, management is focused on body purification treatments especially therapeutic purgation, blood letting, fasting therapy, medicated ghee, use of bitter drugs and various external applications having soothing and cooling effect. Guidelines for external application in the form of ''pralepa, pradeha'' and ''alepa'' are enlisted in the chapter. Blood letting is emphasized as most important treatment in ''visarpa''.
-This chapter deals with detailed description of etiopathogenesis, classification and management principles of ''visarpa''. This is acute disease with a quick spread involving mainly skin, blood, lymph and muscle tissue due to vitiation of all three [[dosha]]. Disease is clinically presented in three pathways viz. external, internal and both. Based on the involvement of dominant [[dosha]], it is classified into seven types. Prognosis and treatment duration of disease is proportionate to degree of involvement of [[dosha]] and affected internal organs. As the basic nature of disease is [[rakta]] and [[pitta]] dominant, management is focused on body purification treatments especially therapeutic purgation, blood letting, fasting therapy, medicated ghee, use of bitter drugs and various external applications having soothing and cooling effect. Guidelines for external application in the form of ''pralepa, pradeha'' and ''alepa'' are enlisted in the chapter. Blood letting is emphasized as most important treatment in ''visarpa''.
+  <br/>
 '''Keywords''': ''Visarpa, Parisarpa,'' Erysepalas, Gangrene, Septicaemia, Sepsis, Fulminant spreading skin infections.
-</div>
+</p>
 == Introduction ==
@@ Line 46: / Line 44: @@
 The twenty first chapter is named [[Visarpa Chikitsa]]. The term ''visarpa'' has two parts viz., ''vi'' and ''sarpa''- ''vi'' stands for ''vividha'' meaning ‘various’ (ways) and ''sarpa'' stands for ''sarpan'' means ‘spreading’.  Erythematous, pustular, glandular etc. lesions which spread rapidly in localized or generalized pattern are known as ''visarpa'' [ Cha.Sa. [[Chikitsa Sthana]]  21/11, Chakrapani]. This aliment is also called ''parisarpa''. The prefix ''pari'' stands for ''paritah'' or ''sarvatah'' meaning all over. The disease which spreads all over the body is called ''visarpa''. [Cha. Sa.[[ Chikitsa Sthana]] 21/11, Chakrapani]. This indicates that ''visarpa'' is an umbrella term used for acute spreading disorders caused due to vitiation of [[rakta]].
-In this chapter Atreya answers the queries about ''visarpa'' derivation, synonyms, classification, [[dosha]], dushya,'' etiology, habitat, gradation, symptoms, complications, prognosis and treatment of curable ones. The chapter follows that of[ Cha. Sa. [[Chhardi Chikitsa]] ] because suppression of ''chhardi'' (vomiting) causes [[rakta]] dushti(vitiation of blood) leading to ''visarpa'' indicating that [[rakta]] (blood) vitiating factors and vitiation of [[rakta]] is an important basic underlying phenomenon prior to the ''visarpa''.
+In this chapter Atreya answers the queries about ''visarpa'' derivation, synonyms, classification, [[dosha]], dushya,etiology, habitat, gradation, symptoms, complications, prognosis and treatment of curable ones. The chapter follows that of [Cha. Sa. [[Chhardi Chikitsa|Chhardi]] Chikitsa ] because suppression of chhardi (vomiting) causes [[Rakta dhatu|rakta]] dushti(vitiation of blood) leading to visarpa indicating that [[Rakta dhatu|rakta]] (blood) vitiating factors and vitiation of rakta is an important basic underlying phenomenon prior to the visarpa.
 ''Visarpa'' is acute, spreading and fatal in nature leading to death if not treated promptly. On location basis this is classified into ''bahih-shrita'' (externally situated), ''antah-shrita'' (internally situated) and ''ubhayasam shrita'' (all over situated). ''Bahih-shrita visarpa'' is fulminant, spreading skin and flesh infection with symptoms and signs of inflammatory edema, blisters, ulcers, fever, pain etc. and is curable. ''Antah-shrita visarpa'' involves internal vital organs with mild septicaemia and is curable before complications. ''Ubhayasamshrita visarpa'' has advanced manifestations of both types spreading all over body with severe septicaemia and is fatal.
@@ Line 53: / Line 51: @@
 Various etiological factors of ''visarpa'' are diet, life style, injury, poison, toxin, burn etc. vitiates [[rakta]] as well as [[dosha]] ([[vata]], [[pitta]] and [[kapha]]) and other [[dhatu]] (body elements) leading to fulminant disease requiring urgent medical care.
-Seven components are involved in the pathogenesis of ''visarpa'' viz., [[rakta]] (blood), ''lasika'' (lymph), ''tvak'' (skin), [[mamsa dhatu]] (flesh), [[vata]], [[pitta'' and ''kapha''. Same components are associated with ''kushtha'' (various skin disorders) but clinical presentation of both the diseases is different because etiological factors act different. As ''kushtha'' is chronic in nature and ''visarpa'' is acute in nature[Cha. Sa. [[Chikitsa Sthana]] 21/15,Chakrapani] therefore spreading ''kushtha'' should not be interpreted as ''visarpa''.
+Seven components are involved in the pathogenesis of ''visarpa'' viz., [[rakta]] (blood), ''lasika'' (lymph), ''tvak'' (skin), [[mamsa dhatu]] (flesh), [[vata]], [[pitta]]<nowiki/>and [[Kapha dosha|kapha]]. Same components are associated with [[Kushtha Chikitsa|kushtha]] (various skin disorders) but clinical presentation of both the diseases is different because etiological factors act different. As kushtha is chronic in nature and visarpa is acute in nature[Cha. Sa. Chikitsa Sthana 21/15,Chakrapani] therefore spreading kushtha should not be interpreted as visarpa.
 It is also classified into ''vatika, paittika, slaishmika, agni visarpa, kardam visarpa, granthi visarpa'' and ''sannipatik'' on [[dosha]] basis. ''Bahih-shrita visarpa'' involves exterior part i.e. Skin, flesh, etc. of the body having symptoms like inflammatory oedema, blisters, ulcers, fever, pain etc. and is curable.  ''Agni visarpa'' and ''kardam visarpa'' may be cured with appropriate timely management otherwise negligence leads to death of the patient. ''Granthi visarpa'' should be treated before complications otherwise it becomes incurable. ''Sannipatika visarpa'' is a severe manifestation of the disease leading to death.[Cha. Sa. [[Chikitsa Sthana]] 21/42]