Changes

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.Chi. Chakrapani 21/11). 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.Chi. Chakrapani 21/11) This indicates that ''visarpa'' is an umbrella term used for acute spreading disorders caused due to vitiation of ''rakta''.  

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.Chi. Chakrapani 21/11). 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.Chi. Chakrapani 21/11) 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 [[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 [[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''.

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

 

Visarpa never occurs without association of rakta and pitta, hence general treatment of visarpa is described by considering rakta and pitta vitiation. Specific treatments are described by considering particular dosha involvement.  

''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.

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

 

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

''Visarpa'' never occurs without association of ''rakta'' and ''pitta'', hence general treatment of ''visarpa'' is described by considering ''rakta'' and ''pitta'' vitiation. Specific treatments are described by considering particular ''dosha'' involvement.  

It is also classified into vatik, paittik, slaismik, agni visarpa, kardam visarpa, granthi visarpa and sannipatik on dosha basis. Bahih-śrita 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. Sannipatik visarpa is a severe manifestation of the disease leading to death.(Cha.Chikitsa 21/42)  

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.

In visarpa, shodhan therapy has given prime importance because rakta kleda (putrificatory ingredient) and dosha vitiation is at higher level hence samana (pacification) therapy is not very effective. Visarpa never occurs without association of rakta and pitta. Hence general treatment of visarpa is described by considering rakta and pitta vitiation. Specific treatments are described as per the involvement of dosha. Single raktamokshana (blood letting) treatment is equal to all of other treatments described for visarpa. (Cha.Chikitsa 21/141-143)  

 

Kshataja visarpa is another variety mentioned additionally in Sushruta Samhita. The later texts followed the same description with addition of some medications.   

Seven components are involved in the pathogenesis of ''visarpa'' viz., ''rakta'' (blood), ''lasika'' (lymph), ''tvak'' (skin), ''mamsa'' (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.Chi. Chakrapani 21/15) therefore spreading ''kushtha'' should not be interpreted as ''visarpa''.  

 

It is also classified into ''vatik, paittik, slaishmik, 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. ''Sannipatik visarpa'' is a severe manifestation of the disease leading to death.(Cha.Chikitsa 21/42)  

 

In ''visarpa, shodhana'' therapy has given prime importance because ''rakta kleda'' (putrificatory ingredient) and ''dosha'' vitiation is at higher level hence ''samana'' (pacification) therapy is not very effective. ''Visarpa'' never occurs without association of ''rakta'' and ''pitta''. Hence general treatment of ''visarpa'' is described by considering ''rakta'' and ''pitta'' vitiation. Specific treatments are described as per the involvement of ''dosha''. Single ''raktamokshana'' (blood letting) treatment is equal to all of other treatments described for ''visarpa''. (Cha.Chikitsa 21/141-143)  

 

''Kshataja visarpa'' is another variety mentioned additionally in Sushruta Samhita. The later texts followed the same description with addition of some medications.   

 

Translitration and Translation of Sanskrit text

Translitration and Translation of Sanskrit text

अथातो विसर्पचिकित्सितं व्याख्यास्यामः ||१||

अथातो विसर्पचिकित्सितं व्याख्यास्यामः ||१||