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Kushtha Chikitsa (view source)

Revision as of 12:17, 10 February 2018

372 bytes added , 12:17, 10 February 2018

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If dosha are utkliṣṭa and located in hridaya or kuṣṭha is manifested in the upperpart of body, then vaman should be administered with help of fruit of kuṭaja, madanaphala and madhuka alongwith juice of paṭōla and nimba. Śīta rasa (cold effusion), pakva rasa(decoction), honey and madhuka should be used for vamana.(43)

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कुष्ठेषु त्रिवृता दन्ती त्रिफला च विरेचने शस्ता||४४||

सौवीरकं तुषोदकमालोडनमासवाश्च सीधूनि|

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Trivr̥tā, dantī and triphala are to be used for virechan in kuṣṭha. Sauvīraka, tuṣōdaka, ālōḍana, āsava, sīdhu are types of aushadi kalpana to be used in virechan. Further sansarjan karma should be followed as per order. (44-45)

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दार्वीबृहतीसेव्यैः पटोलपिचुमर्दमदनकृतमालैः|

सस्नेहैरास्थाप्यः कुष्ठी सकलिङ्गयवमुस्तैः||४६||

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Dārvi, br̥hatī, paṭōla, pichumarda, madanphala, kr̥tamāla, kaliṅga, yava and musta should be used along with sneha for āsthāpana. After virechan and āsthāpana basti still if there is excess of vāta than give anuvāsana basti should be given. In such condition sneha fortified with madanaphala, madhuka, nimba, kuṭaja, and paṭōla should be used. (46-47)

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सैन्धवदन्तीमरिचं फणिज्झकः पिप्पली करञ्जफलम्|

नस्यं स्यात्सविडङ्गं क्रिमिकुष्ठकफप्रकोपघ्नम् [१] ||४८||

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vairecanikairdhUmaiH shlokasthAneritaiH prashAmyanti|

kRumayaH kuShThakilAsAH prayojitairuttamA~ggasthAH||49||

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Saindhava, dantī, maricha, phaṇijjhaka, pippali, fruit of karañja and viḍaṅga should be used for nasya especially in case of kr̥mi and kapha pradhan kuṣṭha.

Drugs mentioned in sutrasthan for vairēcanika dhuma should be used in kr̥mija kuṣṭha and kilāsa and also disease affecting the upperpart of the body. (48-49)

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स्थिरकठिनमण्डलानां स्विन्नानां प्रस्तरप्रणाडीभिः|

कूर्चैर्विघट्टितानां रक्तोत्क्लेशोऽपनेतव्यः||५०||

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kUrcairvighaTTitAnAM raktotklesho~apanetavyaH||50||

If the patches are stable and hard, then give foementation by prastara sweda or nadi sweda method and later on with the help of kūrcha (a surgical instrument) scrub the patches so that there is increased flow of rakta in that specific area alongwith blood letting.(50)

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Local treatments:

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==== Local treatments ====

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आनूपवारिजानां मांसानां पोट्टलैः सुखोष्णैश्च|

स्विन्नोत्सन्नं [१] विलिखेत् कुष्ठं तीक्ष्णेन शस्त्रेण||५१||

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If the patches are elevated then swedan with lukewarm poultice of meat of acquatic animals should be followed by scrubbing with sharp edge surgical instrument for blood letting. For blood letting śr̥ṅgā (horn), alābu (gourd) may be used. Especially in alpa kuṣṭha, prachan, virechan and/or use of jaluka should be done.

Lepa explained in kuṣṭha become efficient if applied after raktamokshana and other shodhan procedures. (51-53)

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येषु न शस्त्रं क्रमते स्पर्शेन्द्रियनाशनानि यानि स्युः|

तेषु निपात्यः क्षारो रक्तं दोषं च विस्राव्य||५४||

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If kuṣṭha is hard like stone with numbness, it is stable (not spreading) and chronic in such cases antidotes should be given internally prior to the application of poison in the form of lepa followed by application of antidote.

If there is numbness around the patch of kuṣṭha associated with complete loss of sensation alongwith anhidrosis, and pruritus then for scrubbing in such condition brush (kūrca) prepared from dantī, trivr̥tā, karavīra, karañja, kuṭaja or leaves of jāti, arka, nimba or surgical instruments, samudra phena, dried cowdung should be used followed by application of lepa. (54-57)

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मारुतकफकुष्ठघ्नं कर्मोक्तं पित्तकुष्ठिनां कार्यम्|

कफपित्तरक्तहरणं तिक्तकषायैः प्रशमनं च||५८||

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bAhyAbhyantaramagryaM tat kAryaM pittakuShTheShu||59||

In Pittaja kuṣṭha line of treatment followed in vāta kaphaj kuṣṭha should be followed alongwith kapha, pitta and rakta should be elimated and tikta (bitter), kaṣāya (astringent) drugs are to be used for pacifying the dosha. Ghee fortified with tikta (bitter) drugs and line of treatment of raktapitta should be followed internally and externally for treatment of pittaj kuṣṭha. (58-59)

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दोषाधिक्यविभागादित्येतत् कर्म कुष्ठनुत् प्रोक्तम्|

वक्ष्यामि कुष्ठशमनं प्रायस्त्वग्दोषसामान्यात्||६०||

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Dārvi or rasāñjan alongwith cow’s urine helps in treatment of kuṣṭha. Similarly haritaki alongwith trikatu or guda and taila for period of one month is helpful. (61)

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मूलं पटोलस्य तथा गवाक्ष्याः पृथक् पलांशं त्रिफलात्वचश्च [१] |

स्यात्त्रायमाणा कटुरोहिणी च भागार्धिका नागरपादयुक्ता||६२||

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kuShThAni shophaM grahaNIpradoShamarshAMsi kRucchrANi halImakaM ca|

ShaDrAtrayogena nihanti caiSha hRudbastishUlaM viShamajvaraM ca||64||

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One pala of root of paṭōla and gavākṣi, contents of triphala (haritaki, bibhataki and amalaki) taken separately in one pala quantity each. Trāyamāṇ and katuki in quantity of 6 sanas and 4 sana of sunthi, should be taken together. One pala of this combination should be boiled in water and administered for elimination of dosha. After the combination has been digested by jatharagni of patient, soup of animal and birds residing in arid land alongwith old shali type of rice should be given. The preparation when administered for 6 days cures kuṣṭha, shoth, grahani, arsha, mutrakricha, halimaka, chest pain and pain in bladder region along with viṣama jwara. (62-64)

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Mustadi churna:

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==== Mustadi churna ====

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मुस्तं व्योषं त्रिफला मञ्जिष्ठा दारु पञ्चमूल्यौ द्वे|

सप्तच्छदनिम्बत्वक् सविशालश्चित्रको मूर्वा||६५||

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ब्रघ्नभगन्दरपिडकाकण्डूकोठांश्च विनिहन्ति||६७||

इति मुस्तादिचूर्ण

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mustaṁ vyōṣaṁ triphalā mañjiṣṭhā dāru pañcamūlyau dvē|

saptacchadanimbatvak saviśālaścitrakō mūrvā||65||

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braghnabhagandarapiḍakākaṇḍūkōṭhāṁśca vinihanti||67||

iti mustādicūrṇam

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mustaM vyoShaM triphalA ma~jjiShThA dAru pa~jcamUlyau dve|

saptacchadanimbatvak savishAlashcitrako mUrvA||65||

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braghnabhagandarapiDakAkaNDUkoThAMshca vinihanti||67||

iti mustAdicUrNam

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Musta, trikatu, triphala, mañjiṣṭhā, dāruharidra, two pañcamūla (brihat and laghu) saptacchada, bark of nimba, viśāla, citraka, mūrvā are taken in equal quantity and powdered together. This powder should be mixed with nine times of saktu and should be prescribed with honey and ghr̥ita. It is among the best treatment for kuṣṭha which should be given everyday. The combination is also useful in shoth, pāṇḍu, śvitra, grahaṇīdoṣa, arśa, braghna, bhagandar, piḍakā, kaṇḍū, kōṭhā. This ends the explanation of mustādicūrṇam.(65-67)

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त्रिफलाफलातिविषाकटुकानिम्बकलिङ्गकवचापटोलानाम्|

मागधिकारजनीद्वयपद्मकमूर्वाविशालानाम्||६८||

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bhUnimbapalAshAnAM dadyAdvipalaM tatastrivRuddviguNA|

tasyAshca punarbrAhmI taccUrNaM suptinut paramam||69||

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Triphala, ativiṣā, kaṭuki, nimba, kaliṅgaka, vacā, paṭōla, pippali, haridra, dāruharidra, padmaka, mūrvā, viśālā, bhūnimba and palāśa, all are taken in 2 pala quantity each (i.e. total 34 pala), double the total quantity of above churna (68 pala) trivr̥t is taken and double of trivr̥tā (136 pala) brahmi churna should be taken. It is a best combination for numbness.(68-69)

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Benefits of lelitaka (sulphur):

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==== Benefits of lelitaka (sulphur) ====

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लेलीतकप्रयोगो [१] रसेन जात्याः समाक्षिकः परमः|

सप्तदशकुष्ठघाती माक्षिकधातुश्च मूत्रेण||७०||

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saptadashakuShThaghAtI mAkShikadhAtushca mUtreNa||70||

Lelitaka (Sulphur) when administered with juice of jāti (āmalaki) alongwith honey is beneficial in 17 types of kuṣṭha. Similarly use of makshika (copper pyrite) with cows’ urine too is very beneficial. (70)

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श्रेष्ठं [२] गन्धकयोगात् सुवर्णमाक्षिकप्रयोगाद्वा|

सर्वव्याधिनिबर्हणमद्यात् कुष्ठी रसं च निगृहीतम्||७१||

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Gandhaka (Sulphur) and/or suvarṇamākṣika when used for processing of rasa (mercury) acts as the best medicine in treatment of all disease especially kuṣṭha.

Similarly kuṣṭha patient should regularly consume parada (mercury) with vajra śilājatu or yogaraj which helps in curing of all diseases. (71-72)

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Madhvasava:

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==== Madhvasava ====

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खदिरसुरदारुसारं श्रपयित्वा तद्रसेन तोयार्थः|

क्षौद्रप्रस्थे कार्यः कार्ये ते चाष्टपलिके च||७३||

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मध्वासवमाचरतः कुष्ठकिलासे शमं यातः||७५||

इति मध्वासवः

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khadirasuradārusāraṁ śrapayitvā tadrasēna tōyārthaḥ|

kṣaudraprasthē kāryaḥ kāryē tē cāṣṭapalikē ca||73||

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madhvāsavamācarataḥ kuṣṭhakilāsē śamaṁ yātaḥ||75||

iti madhvāsavaḥ

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khadirasuradArusAraM shrapayitvA tadrasena toyArthaH|

kShaudraprasthe kAryaH kArye te cAShTapalike ca||73||

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madhvAsavamAcarataH kuShThakilAse shamaM yAtaH||75||

iti madhvAsavaH

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Decoction should be prepared from 8 pala each of water extract of khadira and devadāru to this one prastha of honey should be added. To this powder (bhasma / mandur) of iron in 8 pala quantity should be added alongwith triphala, ela, tvak, marica, patra and kanaka (nagkeshar) in one karsa quantity. Matsyaṇḍikā (sugar) should be added in quantity equal to honey (one prastha). This preparation should be kept in an iron jar for one month. This is called as Madhvāsava and it is administered in kuṣṭha and kilāsa.(73-75)

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Kanaka bindu arishta:

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==== Kanaka bindu arishta ====

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खदिरकषायद्रोणं कुम्भे घृतभाविते समावाप्य|

द्रव्याणि चूर्णितानि च षट्पलिकान्यत्र देयानि||७६||

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kRutamAlakvAthashcApyeSha visheShAt kaphakRuteShu||80||

In ghee smeared jar one drōṇa of decoction of khadira should be added. To these 6 palas each of powdered triphala, trikatu, viḍaṅga, haridra, musta, vāsā, indrayava, bark of sauvarni (dāruharidra), and guduchi should be added. The jar should be kept for one month inside a heap of grains. Every morning if this preparation is taken then in one month mahakuṣṭha gets cured and within 15 days ksudrakuṣṭha is cured. It is also useful arśa, śvāsa, bhagandar, kasa, kilasa, prameha and shosha. Skin achieves golden complexion after having kanakabindu. This ends explanation of kanakabindvariṣṭa. It is useful in all vātaj, pittaj and kaphaj kuṣṭha. Especially in kaphaja kuṣṭha, kritmalaka decoction should be used in place of khadira.(76-80)

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त्रिफलासवश्च गौडः सचित्रकः कुष्ठरोगविनिहन्ता|

क्रमुकदशमूलदन्तीवराङ्गमधुयोगसंयुक्तः||८१||

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kramukadashamUladantIvarA~ggamadhuyogasaMyuktaH||81||

Triphalāsava prepared from jaggery alongwith citraka, kramuka, daśamūla, dantī, varā (triphala) and honey helps in treating various kuṣṭha.(81)

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Diet in kushtha:

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==== Diet in kushtha ====

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लघूनि चान्नानि हितानि विद्यात् कुष्ठेषु शाकनि च तिक्तकानि|

भल्लातकैः सत्रिफलैः सनिम्बैर्युक्तानि चान्नानि घृतानि चैव||८२||

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Easily digestible and wholesome food, green leafy vegetables bitter in taste, food and ghee prepared by fortifying with bhallataka, triphala and nimba, one year old cereals, meat of animals inhabiting from arid area, preparations of mudga and paṭōla.

Avoid heavy to digest, sour food, milk, curd, meat of animals residing in marshy area, fish, jaggery and sesame. (82-83)

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एला कुष्ठं दार्वी शतपुष्पा चित्रको विडङ्गश्च|

कुष्ठालेपनमिष्टं रसाञ्जनं चाभया चैव||८४||

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Ela, kuṣṭha, dārvi, śatapuṣpā, chitraka, viḍaṅga, rasāñjan and abhaya taken together and their paste when applied has a very efficacious role in kuṣṭha.(84)

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चित्रकमेलां बिम्बीं [१] वृषकं त्रिवृदर्कनागरकम्|

चूर्णीकृतमष्टाहं भावयितव्यं पलाशस्य||८५||

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bhidyante vilayanti ca liptAnyarkAbhitaptAni||86||

Chitraka, ela, bimbi, vr̥ṣaka, trivr̥tā, arka and shunthi should be powdered together and trichurate with palāśa kshara and fortify it with cows urine for eight days. Application of this paste followed by sun exposure leads to bursting and dissolution of maṇḍala. (85-86)

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मांसी मरिचं लवणं रजनी तगरं सुधा गृहाद्धूमः|

मूत्रं पित्तं [२] क्षारः पालाशः कुष्ठहा लेपः||८७||

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Māṁsī, marica, lavana, haridra, tagara, sudhā and gr̥hāddhūma paste should be prepared along with cow urine, cow’s bile and palasha kshara should be applied.(87)

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त्रपु सीसमयश्चूर्णं मण्डलनुत् फल्गुचित्रकौ बृहती|

गोधारसः सलवणो दारु च मूत्रं च मण्डलनुत्||८८||

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Trapu (tin), sīsa (lead) and ayaś (iron) powders when applied treats maṇḍala kuṣṭha. Similarly application of phalgu, citraka, br̥hatī, gōdhārasa (meat soup of iguana) lavana, devdāru and cow’s urine is also helpful in maṇḍala. (88)

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कदलीपलाशपाटलिनिचुलक्षाराम्भसा प्रसन्नेन|

मांसेषु तोयकार्यं कार्यं पिष्टे च किण्वे [३] च||८९||

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tairmedakaH sujAtaH kiNvairjanitaM pralepanaM shastam|

maNDalakuShThavinAshanamAtapasaMsthaM kRumighnaM ca||90||

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From kshara of kadalī, palāśa, pātalā and nicula kshara jala (alkaline water) should be prepared which should be well filtered. The same should be added to meat of animals for cleaning of meat, for making paste and for fermentation process. A self fermented (medaka) alcoholic formulation should be prepared. After well fermented medaka prepared the kinva (fermented paste of drug) should be removed and applied as paste. It is useful in maṇḍala kuṣṭha and other kr̥imi infestations.(89-90)

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Siddharthaka snana( medicinal bath):

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==== Siddharthaka snana( medicinal bath) ====

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मुस्तं मदनं त्रिफला करञ्ज आरग्वधकलिङ्गयवाः|

दार्वी ससप्तपर्णा स्नानं सिद्धार्थकं नाम||९१||

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Powder of musta, madanphala, triphala, karañja, āragvadha, kaliṅgaka, yava, dārvi, saptaparna are boiled in water and used for bath. This preparation is called as siddhārthaka snana.

Decoction of above combination is useful for vamana and virechana procedures. It helps in promotion of colour and complexion. It is also useful in tvagdōṣa, kuṣṭha, śōpha and panduroga.(91-92)

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External applications:

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==== External applications ====

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कुष्ठं करञ्जबीजान्येडगजः कुष्ठसूदनो लेपः|

प्रपुन्नाडबीजसैन्धवरसाञ्जनकपित्थलोध्राश्च||९३||

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sumanaHpravAlayukto lepaH kuShThApahaH siddhaH||94||

Lepa of kuṣṭha (herb), seeds of karañja and ēḍagaja is useful in kuṣṭha roga. Similarly, paste of seeds prapunnāḍa, saindhava, rasāñjan, kapittha, lōdhra, root of white variety of karavīra, fruits of kuṭaja and karañja, bark of dāruharidra along with tender leaves of jati is useful in kuṣṭha. (93-94)

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लोध्रस्य धातकीनां वत्सकबीजस्य नक्तमालस्य|

कल्कश्च मालतीनां कुष्ठेषून्मर्दनालेपौ||९५||

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kalkashca mAlatInAM kuShTheShUnmardanAlepau||95||

Paste of lōdhra, dhātakī, seeds of vatsaka (kuṭaja), naktamāla and malati is to be used externally for udvartan and lepa.(95)

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शैरीषी त्वक् पुष्पं कार्पास्या राजवृक्षपत्राणि|

पिष्टा च काकमाची चतुर्विधः कुष्ठनुल्लेपः||९६||

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iti lepAH

Paste of bark of shirīṣa or flowers of kārpās, leaves of rājavr̥kksha or paste of kākamācī are 4 different types of lepa useful in kuṣṭha. (96)

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दार्व्या रसाञ्जनस्य च निम्बपटोलस्य खदिरसारस्य|

आरग्वधवृक्षकयोस्त्रिफलायाः सप्तपर्णस्य||९७||

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Seventh decoction is of tiniśa and decoction of āśvamāra.

All of the above decoctions should be used for bathing, drinking, in the form of lepa, for scrubbing and for dusting. The same decoctions can be used for fortifying of medicated ghee and oil.(97-99)

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त्रिफला निम्बपटोलं मञ्जिष्ठा रोहिणी वचा रजनी|

एष कषायोऽभ्यस्तो निहन्ति कफपित्तजं कुष्ठम्||१००||

Line 1,008: Line 1,054:

In kaphaj-pittaj kuṣṭha, triphala, nimba, paṭōla, mañjiṣṭhā, rōhiṇī, vacā, rajani should be regularly taken in the form of decoction. The same medicine, when used to fortify ghr̥ita helps in curing vātaj kuṣṭha.

Khadira, asana, devadāru and nimba together when used like above has similar benefits.(100-101)

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कुष्ठार्कतुत्थकट्फलमूलकबीजानि रोहिणी कटुका|

कुटजफलोत्पलमुस्तं बृहतीकरवीरकासीसम्||१०२||

Line 1,027: Line 1,074:

udvartanaM pragharShaNamavacUrNanameSha eveShTaH||104||

Kuṣṭha, arka, tuttha, katphala, seeds of mūlaka, katukarōhiṇī, fruits of kuṭaja, utpala, musta, br̥hatī, karavīra, kāsīsa, ēḍagaja, nimba, pāṭhā, durālabhā, citraka, viḍaṅga, seeds of alābū which is bitter in taste, kampillaka, sarṣapa, vacā and dārvī when used for preparation of medicated oil helps in reducing kuṣṭha. The same contents may be used for lepa, udvartan, scrubbing and dusting. (102-104)

−

Shweta-karaviradya taila:

+

==== Shweta-karaviradya taila ====

+

श्वेतकरवीरकरसो गोमूत्रं चित्रको विडङ्गश्च|

कुष्ठेषु तैलयोगः सिद्धोऽयं सम्मतो भिषजाम्||१०५||

Line 1,038: Line 1,087:

iti shvetakaravIrAdyaM tailam

Physicians recommend that, medicated oil prepared with the help of juice of white variety of karavīra, cows’ urine, citraka and viḍaṅga cures all type of kuṣṭha. This ends the explanation of śvēta karavīrādya taila.(105)

−

Shweta karavira palladi tailam:

+

==== Shweta karavira palladi tailam ====

+

श्वेतकरवीरपल्लवमूलत्वग्वत्सको विडङ्गश्च|

कुष्ठार्कमूलसर्षपशिग्रुत्वग्रोहिणी कटुका||१०६||

Line 1,055: Line 1,106:

iti shvetakaravIrapallavAdyaM tailam

Paste of tender leaves of śvēta karavīra, root and bark of vatsaka, viḍaṅga, kuṣṭha, root of arka, sarṣapa, bark of śigru, rōhiṇī, 1/4th quantity of oil and cows urine in quantity four times that of oil and then tail siddhi is done then it helps in treating kuṣṭha and itching. The preparation is known as śvēta karavīrapallavādya tailam.(106-107)

−

Tikta-ikshwakwadi tailam:

+

==== Tikta-ikshwakwadi tailam ====

+

तिक्तालाबुकबीजं द्वे तुत्थे रोचना हरिद्रे द्वे|

बृहतीफलमेरण्डः सविशालश्चित्रको मूर्वा||१०८||

Line 1,079: Line 1,132:

Seeds of bitter variety of alābu, both varieties of tuttha (mayura and kharparika tuttha) gorōcanā, haridra, dāruharidra, fruit of br̥hatī, ēraṇḍa, viśāla, citraka, murva, kāsīsa, hiṅgu, śigru, trikatu suradāru, tumburu, viḍaṅga, lāṅgāli, bark of kuṭaja, katukarōhiṇī are pasted together and mustard oil is fortified with above medicines and cow’s urine taken in quantity four times of oil.

Application of tikta ekṣvākvādi tailam is useful in itching, kuṣṭha and vāta kapha dominated diseases. (108-110)

−

Kanakaksheeri tailam:

+

==== Kanakaksheeri tailam ====

+

कनकक्षीरी शैला भार्गी दन्त्याः फलानि मूलं च|

जातीप्रवालसर्षपलशुनविडङ्गं करञ्जत्वक्||१११||

Line 1,120: Line 1,175:

iti kanakakShIrItailam

Kanakakṣīrī (Kankuṣṭha), śailā (manashila), bhārangi, fruits, root and tender leaves of dantī, sarṣapa, laśuna, viḍaṅga, bark, of karañja, saptacchadā, tender leaves, root and bark of arka, nimba, chitraka, āsphōtāḥ, guñja, eraṇḍa, root of br̥hatī, seeds of surasā and fruits of arjaka kuṣṭha, pāṭhā, musta, tumburu, vacā, murva, ṣaḍgranthā, ēḍagaja, kuṭaja, śigru, trikatu, bhallataka, kṣavaka, haritāla, avākpuṣpī (apāmārga), tuttha, kampillaka, amr̥tāsañjña (kharparika tuttha), saurāṣṭrī, kāsīsa, bark of dārvi, sarjikālavaṇa. All the above medicines should be pasted and oil should be added (either sesame or mustard oil) alongwith decoction of root and tender leaves of karavira and four times of oil, cows urine should be added and the same should be stored in container of kaṭukālābu. It immediately cures maṇḍala kuṣṭha by bhedan of mandala also cures kr̥imi and itching. This preparation is known as kanakakṣīrī taila .(111-116)

−

Sidhmahara lepa:

+

==== Sidhmahara lepa ====

+

कुष्ठं तमालपत्रं मरिचं समनःशिलं सकासीसम्|

तैलेन युक्तमुषितं सप्ताहं भाजने ताम्रे||११७||

Line 1,144: Line 1,201:

kuShTheShu hitAnyAhustailaM yaccApi khadirasArasya||119||

Oil extracted from sarṣapa, karañja, kōṣātakī, and ingudi when fortified with heartwood of khadira is useful in kuṣṭha.(119)

−

Vipadikahara ghee and taila:

+

==== Vipadikahara ghee and taila ====

+

जीवन्ती मञ्जिष्ठा दार्वी कम्पिल्लकः पयस्तुत्थम्|

एष घृततैलपाकः सिद्धः सिद्धे च सर्जरसः||१२०||

Line 1,160: Line 1,219:

carmaikakuShThakiTimaM kuShThaM shAmyatyalasakaM ca||121||

iti vipAdikAharaghRutataile|

+

With jīvantī, mañjiṣṭhā, dārvi, kampillaka, payas (milk) and tuttha should be used to prepare ghee and/or fortify oil. Once sneha siddhi lakshana are seen sarjarasa and madhūcchiṣṭa should be added. Application of the oil cures, carmakuṣṭha, ekakuṣṭha, kiṭibha and alasaka type of kuṣṭha. This preparation is called as vipādikāhara ghr̥it and taila.(120-121)

+

किण्वं [१] वराहरुधिरं पृथ्वीका सैन्धवं च लेपः स्यात्|

लेपो योज्यः कुस्तुम्बुरूणि कुष्ठं च मण्डलनुत्||१२२||

Line 1,167: Line 1,228:

kiNvaM [1] varAharudhiraM pRuthvIkA saindhavaM ca lepaH syAt|

lepo yojyaH kustumburUNi kuShThaM ca maNDalanut||122||

+

Application of paste of kiṇva (enzyme used for fermentation), blood of boar, pr̥thvīkā and saindhava or lepa of kustumburūṇi cures maṇḍala type of kuṣṭha.(122)

+

पूतीकदारुजटिलाः पक्वसुरा क्षौद्रमुद्गपर्ण्यौ च|

लेपः सकाकनासो मण्डलकुष्ठापहः सिद्धः||१२३||

Line 1,176: Line 1,239:

Application of lepa of pūtīka, devadāru, jaṭi, pakvasurā, ksaudravalli (guduchi) mudgaparṇi and kākanāsa cures maṇḍala kuṣṭha.(123)

+

चित्रकशोभाञ्जनकौ गुडूच्यपामार्गदेवदारूणि|

खदिरो धवश्च लेपः श्यामा दन्ती द्रवन्ती च||१२४||

Line 1,196: Line 1,260:

6) lākṣā, rasāñjana , ela, punarnava

The above six combinations when mixed separately with dadhimaṇḍa and applied in the form of lepa cures kuṣṭha having predominancy of vāta and kapha doṣa.(124-125)

+

एडगजकुष्ठसैन्धवसौवीरकसर्षपैः कृमिघ्नैश्च|

कृमिकुष्ठमण्डलाख्यं दद्रूकुष्ठं च शममुपैति||१२६||

Line 1,204: Line 1,269:

Application of ēḍagaja, kuṣṭha, saindhava, sauviraka, sarṣapa and kr̥mighna (viḍaṅga) cures kr̥mi, maṇḍala and dadru kuṣṭha. (126)

+

एडगजः सर्जरसो मूलकबीजं च सिध्मकुष्ठानाम्|

काञ्जिकयुक्तं तु पृथङ्मतमिदमुद्वर्तनं लेपाः||१२७||

Line 1,212: Line 1,278:

Application of ēḍagaja or sarjarasa or seeds of mūlaka prepared by adding kāñji should be used as udvartana or in the form of lepa it cures sidhma.(127)

−

Management of pitta-kapha dominant kushtha:

+

==== Management of pitta-kapha dominant kushtha ====

+

वासा त्रिफला पाने स्नाने चोद्वर्तने प्रलेपे च|

बृहतीसेव्यपटोलाः ससारिवा रोहिणी चैव||१२८||

Line 1,229: Line 1,297:

Vāsā and triphalā may be used internally, for bathing, udvartana and lepa alongwith br̥hatī, sēvya, paṭōla, sārivā, rōhiṇī.

Similarly khadira, avaghāta (karnikākāra), kakubha, rōhītaka, lōdhra, kuṭaja, dhava, nimba, saptacchada and karavira combination is useful for external use, for bathing and internal use. (128-129)

+

जलवाप्यलोहकेशरपत्रप्लवचन्दनं मृणालानि|

भागोत्तराणि सिद्धं प्रलेपनं पित्तकफकुष्ठे||१३०||

Line 1,236: Line 1,305:

bhAgottarANi siddhaM pralepanaM pittakaphakuShThe||130||

Application of water (one part), vāpya (kuṣṭha herb) (2 part), lōha (agaru) (3 part) kēśara (4 part), patra (5 part), plava or kaivartamusta (6 part), cāndana, mr̥ṇāla (8 part) is useful in pitta-kapha type of kuṣṭha.(130)

−

Management of pitta dominant kushtha:

+

==== Management of pitta dominant kushtha ====

+

यष्ट्याह्वलोध्रपद्मकपटोलपिचुमर्दचन्दनरसाश्च|

स्नाने पाने च हिताः सुशीतलाः पित्तकुष्ठिभ्यः||१३१||

Line 1,245: Line 1,316:

Decoction of yaṣṭyāhva, lōdhra, padmaka, paṭōla, picumarda and candana may be used externally for bathing and internal use. It has cooling effect and is beneficial in pittaj kuṣṭha.(131)

+

आलेपनं प्रियङ्गुर्हरेणुका वत्सकस्य च फलानि|

सातिविषा च ससेव्या सचन्दना रोहिणी कटुका||१३२||

Line 1,253: Line 1,325:

Application of priyaṅgu, harēṇuka, fruits of vatsaka, ativiṣā, sēvyā, candana and katu rōhiṇī is also useful in paittika kuṣṭha. (132)

+

तिक्तघृतैर्धौतघृतैरभ्यङ्गो दह्यमानकुष्ठेषु|

तैलैश्चन्दनमधुकप्रपौण्डरीकोत्पलयुतैश्च||१३३||

Line 1,261: Line 1,334:

Massaging with tiktaghr̥ta and dhautaghr̥ta helps in reducing burning sensation in kuṣṭha. Similarly medicated oil prepared from chandana, madhuka, prapauṇḍarīka and utpala also has similar effect. (133)

+

क्लेदे प्रपतति चाङ्गे दाहे विस्फोटके सचर्मदले|

शीताः प्रदेहसेका व्यधो विरेको घृतं तिक्तम्||१३४||

Line 1,267: Line 1,341:

klede prapatati cA~gge dAhe visphoTake sacarmadale|

shItAH pradehasekA vyadho vireko ghRutaM tiktam||134||

+

If there is excessive secretions from skin lesion, sloughing of body parts, burning sensation, eruptions and exfoliation of skin then shitā pradēha (application of lepa with shitā dravya), sēkā, virēchan and use of tikta ghr̥ita should be done.(134)

+

खदिरघृतं निम्बघृतं दार्वीघृतमुत्तमं पटोलघृतम्|

कुष्ठेषु रक्तपित्तप्रबलेषु भिषग्जितं सिद्धम्||१३५||

Line 1,275: Line 1,351:

kuShTheShu raktapittaprabaleShu bhiShagjitaM siddham||135||

Khandiraghr̥ta, nimbaghr̥ta, dārvighr̥ta and paṭōlaghr̥ta are among the best to be used in rakta and pitta pradhan kuṣṭha.(135)

+

त्रिफलात्वचोऽर्धपलिकाः पटोलपत्रं च कार्षिकाः शेषाः|

कटुरोहिणी सनिम्बा यष्ट्याह्वा त्रायमाणा च||१३६||

Line 1,283: Line 1,360:

तद्वातपित्तकुष्ठं वीसर्पं वातशोणितं प्रबलम्|

ज्वरदाहगुल्मविद्रधिविभ्रमविस्फोटकान् हन्ति||१३९||

+

triphalātvacō'rdhapalikāḥ paṭōlapatraṁ ca kārṣikāḥ śēṣāḥ|

kaṭurōhiṇī sanimbā yaṣṭyāhvā trāyamāṇā ca||136||

Line 1,299: Line 1,377:

tadvAtapittakuShThaM vIsarpaM vAtashoNitaM prabalam|

jvaradAhagulmavidradhivibhramavisphoTakAn hanti||139||

+

Triphala fruit pulp in quantity of ½ pala each, paṭōla patra ½ pala quantity, one karsa each of katurōhiṇī, nimba, yaṣṭyāhva and trāyamāṇa and two pala of dehusked seeds of masūra which should be boiled in one āḍhaka of water and reduced to 1/8th. The decoction should be filtered and to this eight pala of decoction, four pala of ghee should be added and cooked till 8 palas remain and this medicated ghee should be administered lukewarm. It is useful in vāta pitta kuṣṭha, visarpa, vātarakta, jwara, daha, gulma, vidradhi, giddiness and visphōṭaka. (136-139)

−

Tikta shatpala ghee:

+

==== Tikta shatpala ghee ====

+

निम्बपटोलं दार्वीं दुरालभां तिक्तरोहिणीं त्रिफलाम्|

कुर्यादर्धदलांशं पर्पटकं त्रायमाणां च||१४०||

Line 1,310: Line 1,391:

पामाविसर्पपिडकाकण्डूमदगण्डनुत्सिद्धम्||१४३||

इति तिक्तषट्पलकं घृतम्

+

nimbapaṭōlaṁ dārvīṁ durālabhāṁ tiktarōhiṇīṁ triphalām|

kuryādardhadalāṁśaṁ parpaṭakaṁ trāyamāṇāṁ ca||140||

Line 1,328: Line 1,410:

pAmAvisarpapiDakAkaNDUmadagaNDanutsiddham||143||

iti tiktaShaTpalakaM ghRutam

+

Nimba, paṭōla, dārvi, duralabha, tiktarōhiṇī, triphala, parpaṭaka and trāyamāṇa are taken in half pala quantity and boiled with water in quantity of one āḍhaka and reduced to 1/8th. The decoction should be filtered and to it paste of candana, kirātatiktaka, pippali, trāyamāṇa, musta, seeds of vatsaka in quantity of half karsa should be added alongwith 6 palas of ghr̥it and sneha siddhi should be carried out. This tiktaṣaṭpala ghr̥it is useful in kuṣṭha, jwara, gulma, arśa, grahani, pāṇḍu, śvayathu, pāmā, visarpa, piḍakā, kaṇḍū, mada and galagaṇḍa. (140-143)

−

Mahatiktaka ghee:

+

==== Mahatiktaka ghee ====

+

सप्तच्छदं प्रतिविषां शम्पाकं तिक्तरोहिणीं पाठाम्|

मुस्तमुशीरं त्रिफलां पटोलपिचुमर्दपर्पटकम्||१४४||

Line 1,377: Line 1,462:

Saptacchada, prativiṣā, śampāka (āragvada), tiktarōhiṇī, pāṭhā, musta, uśīra, triphala, paṭōla, picumarda, parpaṭaka, dhanvayavās, candana, upakulyā (pippali), padmaka haridra, dāruharidra, ṣaḍgrantha, viśālā, śatāvarī, both the type of sāriva (Krsna and sveta), seeds of vatsaka, yāsa, mūrvā, amr̥tā, kirātatikta, yastimadhu and trayamana are taken together and paste is prepared in quantity of one fourth of ghr̥ita. To this water should be added in quantity of 8 times of ghee alongwith juice of amr̥taphala (amalaki) in quantity of twice of ghr̥ita and siddha ghr̥ita should be prepared. It is beneficial in kuṣṭha, raktapitta, serious type of bleeding piles, vīsarpa, amlapitta, vātarakta, pāṇḍurōga, visphōṭakaka, pāmā, unmāda, kāmalā, jwara, kaṇḍū, hr̥drōga, gulma, piḍakā, raktapradar, gaṇdamālā. This ghee should be administered at recommended time and dose according to the strength of patient. This Mahātiktakaghr̥it is useful in above mentioned disease conditions where hundred of other preparations do not cure above diseases. (144-150)

+

दोषे हृतेऽपनीते रक्ते बाह्यान्तरे कृते शमने [७] |

स्नेहे च कालयुक्ते न कुष्ठमनुवर्तते [८] साध्यम्||१५१||

Line 1,384: Line 1,470:

snehe ca kAlayukte na kuShThamanuvartate [8] sAdhyam||151||

After shodhan of dosha, blood letting, external and internal shaman therapies and administration of ghee at appropriate time helps in curing skin diseases and also prevents recurrence. (151)

−

Maha khadita ghee:

+

==== Maha khadita ghee ====

+

खदिरस्य तुलाः पञ्च शिंशपासनयोस्तुले|

तुलार्धाः सर्व एवैते करञ्जारिष्टवेतसाः||१५२||

Line 1,396: Line 1,484:

महाखदिरमित्येतत् परं कुष्ठविकारनुत्||१५६||

इति महाखदिरं घृतम्

+

khadirasya tulāḥ pañca śiṁśapāsanayōstulē|

tulārdhāḥ sarva ēvaitē karañjāriṣṭavētasāḥ||152||

Line 1,407: Line 1,496:

mahākhadiramityētat paraṁ kuṣṭhavikāranut||156||

iti mahākhadiraṁ ghr̥tam

+

khadirasya tulAH pa~jca shiMshapAsanayostule|

tulArdhAH sarva evaite kara~jjAriShTavetasAH||152||

Line 1,418: Line 1,508:

mahAkhadiramityetat paraM kuShThavikAranut||156||

iti mahAkhadiraM ghRutam

+

Five tulā of khadira, one tulā each of śiṁśapa and āsana, half tulā each of karañja, ariṣṭa, vētasa, parpata, kuṭaja, vrsa, kr̥mi hara (viḍaṅga), haridra, kr̥tamāla, guḍūcī, triphala, trivr̥t, saptaparṇa should be cut into small parts and boiled in 10 drōṇa of water and reduced to 1/8th . To this add one ādhaka each of ghrit and juice of āmalaki alongwith one pala of mahātiktaka kalka content. Sneha siddhi should be done; this mahākhadira ghr̥ita when used internally and for application cures all type of kuṣṭha.(152-156)

−

Treatment of maggots/micro-organisms in kushtha:

+

==== Treatment of maggots/micro-organisms in kushtha ====

+

प्रपतत्सु लसीकाप्रस्रुतेषु गात्रेषु जन्तुजग्धेषु|

मूत्रं निम्बविडङ्गे स्नानं पानं प्रदेहश्च||१५७||

Line 1,428: Line 1,521:

If there is sloughing of phalanges, exudation, maggots than such kuṣṭha patient should use gomūtra, nimba and viḍaṅga in appropriated quantity for bath (dressing), internally and for lepa. (157)

+

वृषकुटजसप्तपर्णाः करवीरकरञ्जनिम्बखदिराश्च|

स्नाने पाने लेपे क्रिमिकुष्ठनुदः सगोमूत्राः||१५८||

Line 1,436: Line 1,530:

Vr̥ṣa, kuṭaja, saptaparna, karavira, karañja, nimba, khadira, along with gomūtra is useful in kr̥imi and kuṣṭha in the form of lepa, internal and external use.(158)

+

पानाहारविधाने प्रसेचने धूपने प्रदेहे च|

कृमिनाशनं विडङ्गं विशिष्यते कुष्ठहा खदिरः||१५९||

Line 1,444: Line 1,539:

For internal use in the form of medicine and diet along with external use in the form of prasēcana, dhupan, lepa viḍaṅga which is effective in kr̥imi and khadira which is special drug for kuṣṭha should be used.(159)

+

एडगजः सविडङ्गो मूलान्यारग्वधस्य कुष्ठानाम्|

उद्दालनं श्वदन्ता गोश्ववराहोष्ट्रदन्ताश्च||१६०||

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Ēḍagaja, viḍaṅga, root of āragvadha and tooth of dog, cow, horse, boar and camel are useful in kuṣṭha.(160)

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एडगजः सविडङ्गो द्वे च निशे राजवृक्षमूलं च|

कुष्ठोद्दालनमग्र्यं सपिप्पलीपाकलं योज्यम्||१६१||

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kuShThoddAlanamagryaM sapippalIpAkalaM yojyam||161||

Ēḍagaja, viḍaṅga, haridra, dāruharidra, root of rājavr̥kṣa, pippali, pākala (kuṣṭha herb) are useful in kuṣṭha.(161)

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Management of shwitra(vitiligo):

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==== Management of shwitra(vitiligo) ====

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श्वित्राणां सविशेषं [१] योक्तव्यं सर्वतो विशुद्धानाम्|

श्वित्रे स्रंसनमग्र्यं मलपूरस इष्यते सगुडः||१६२||

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saMseveta viriktastryahaM pipAsuH pibet peyAm||163||

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In case of śvitrā, shodhan is the specific treatment especially purgation with malapūrasa along with jaggery is the best treatment for leucoderma. The patient must be firstly oleated and should take the above mentioned combination as per his bala and disease bala and later on expose to sunlight. Purgation will be started and whenever patient feels thirsty pēyā should be given for next three days. (162-163)

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In case of śvitrā, shodhan is the specific treatment especially purgation with malapūrasa along with jaggery is the best treatment for leucoderma. The patient must be firstly oleated and should take the above mentioned combination as per his bala and disease bala and later on expose to sunlight. Purgation will be started and whenever patient feels thirsty pēyā should be given for next three days. (162-163)

श्वित्रेऽङ्गे ये स्फोटा जायन्ते कण्टकेन तान्भिन्द्यात्|

स्फोटेषु विस्रुतेषु प्रातः प्रातः पिबेत् पक्षम्||१६४||

मलपूमसनं प्रियङ्गुं शतपुष्पां चाम्भसा समुत्क्वाथ्य|

पालाशं वा क्षारं यथाबलं फाणितोपेतम्||१६५||

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śvitrē'ṅgē yē sphōṭā jāyantē kaṇṭakēna tānbhindyāt|

sphōṭēṣu visrutēṣu prātaḥ prātaḥ pibēt pakṣam||164||

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malapUmasanaM priya~gguM shatapuShpAM cAmbhasA samutkvAthya|

pAlAshaM vA kShAraM yathAbalaM phANitopetam||165||

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Eruptions that occur over the hypopigmented patches should be punctured with thorn so that the exudation within the eruptions is removed. Later on for 15 days malapū, asana, priyaṅgu, śatapuṣpā should be boiled in water and should be administered as per strength with pālāśa kṣāra and/or with phāṇita.(164-165)

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यच्चान्यत् कुष्ठघ्नं श्वित्राणां सर्वमेव तच्छस्तम्|

खदिरोदकसंयुक्तं खदिरोदकपानग्र्यं वा||१६६||

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khadirodakasaMyuktaM khadirodakapAnagryaM vA||166||

All the treatment which is kuṣṭhaghna is also useful in śvitrā especially drinks of khadira or mixed with decoctions of khadira.(166)

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समनःशिलं विडङ्गं कासीसं रोचनां कनकपुष्पीम्|

श्वित्राणां प्रशमार्थं ससैन्धवं लेपनं दद्यात्||१६७||

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shvitrANAM prashamArthaM sasaindhavaM lepanaM dadyAt||167||

Manaḥśila, viḍaṅga, kāsīsa, gorōcana, kanakapuṣpī (svarnakshri) and saindhava when applied externally is useful in leucoderma.(167)

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कदलीक्षारयुतं वा खरास्थि दग्धं गवां रुधिरयुक्तम्|

हस्तिमदाध्युषितं वा मालत्याः कोरकक्षारम्||१६८||

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5) Kākōdumbar along with bakuchi, citraka and cows urine.

6) Manaḥśilā with peacocks’ bile.

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7) Seeds of avalguja, lākṣā, cow bile, both type of añjana (rasāñjana and sauvirāñjan)

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7) Seeds of avalguja, lākṣā, cow bile, both type of añjana (rasāñjana and sauvirāñjan) pippali and powder of kalaloha.

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pippali and powder of kalaloha.

The above 7 combination of lepa is useful in leucoderma.(168-171)

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शुद्ध्या शोणितमोक्षैर्विरूक्षणैर्भक्षणैश्च सक्तूनाम्|

श्वित्रं कस्यचिदेव प्रणश्यति क्षीणपापस्य||१७२||

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shvitraM kasyacideva praNashyati kShINapApasya||172||

After shodhan therapy raktamōkṣana and also intake of ununctuous food like saktū (roasted corn flour) leucoderma is cured only in few who are free from effects of sinful deeds. (172)

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Various stages of shwitra:

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==== Various stages of shwitra ====

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दारुणं चारुणं [१] श्वित्रं किलासं नामभिस्त्रिभिः|

विज्ञेयं त्रिविधं तच्च [२] त्रिदोषं प्रायशश्च तत्||१७३||

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shvetaM medaHshrite shvitraM guru taccottarottaram||174||

Dāruṇa, Cāruṇa, and Kilāsa are the various synonyms for śvitrā. It is of 3 types and generally all the tridosha are involved. If the dosha responsible for śvitrā are seated in the rakta dhatu then the colour of hypopigmentation is red. It is coppery coloured if dosha are seated in māṁsa dhatu and whitish in colour if located in meda dhatu. The subsequent ones are more difficult to treat than earlier ones.(173-174)

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Prognosis of vitiligo:

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==== Prognosis of vitiligo ====

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यत् परस्परतोऽभिन्नं बहु यद्रक्तलोमवत्|

यच्च वर्षगणोत्पन्नं तच्छ्वित्रं नैव सिध्यति||१७५||

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If the patches are conjoined together and are more in number, if the body hair above the patches are red in colour and if the disease is more than one year old. Such śvitrā never gets cured. If body hair over the patches is not red if skin is thin and pale in colour. The disease, if is not old, space between patches is elevated then such śvitrā is sādhya (curable). ( 175-176)

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Meta-physical causes of kilasa:

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==== Meta-physical causes of kilasa ====

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वचांस्यतथ्यानि कृतघ्नभावो निन्दा सुराणां [१] गुरुधर्षणं च|

पापक्रिया पूर्वकृतं च कर्म हेतुः किलासस्य विरोधि चान्नम्||१७७||

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pApakriyA pUrvakRutaM ca karma hetuH kilAsasya virodhi cAnnam||177||

Untruthfulness, ungratefulness, no respect for the gods, disrespect for the peers (guru), sinful acts, and misdeeds of past life and intake of mutually contradictory food are the causes for śvitrā.(177)

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Summary:

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==== Summary ====

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तत्र श्लोकाः-

हेतुर्द्रव्यं लिङ्गं विविधं ये येषु चाधिका दोषाः|

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इति सङ्ग्रहः प्रणीतो महर्षिणा कुष्ठनाशनेऽध्याये|

स्मृतिबुद्धिवर्घनार्थं शिष्याय हुताशवेशाय||१८०||

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tatra ślōkāḥ-

hēturdravyaṁ liṅgaṁ vividhaṁ yē yēṣu cādhikā dōṣāḥ|

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iti saṅgrahaḥ praṇītō maharṣiṇā kuṣṭhanāśanē'dhyāyē|

smr̥tibuddhivarghanārthaṁ śiṣyāya hutāśavēśāya||180||

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tatra shlokAH-

heturdravyaM li~ggaM vividhaM ye yeShu cAdhikA doShAH|

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iti sa~ggrahaH praNIto maharShiNA kuShThanAshane~adhyAye|

smRutibuddhivarghanArthaM shiShyAya hutAshaveshAya||180||

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Etiology, dravya (Tridosha, rasa, rakta, māṁsa, ambu), various signs and symptoms, predominancy of dosha in various kuṣṭha and \symptoms as per type of vitiated dosha, curable and difficult to cure types of kuṣṭha, preparation useful in kuṣṭha. Similarly etiology, symptoms, curable and incurable symptoms and treatment of śvitrā have been explained.

The above detailed description has been given by Acharya Lord Punarvasu with a view of sharpening the memory and intellect of disciple Agnivēśā.

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Tattva Vimarsha:

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=== Tattva Vimarsha ===

• Important etiological factors for skin diseases include: Diet and beverages with antagonistic properties, excess intake of liquid, unctuous, heavy to digest food, suppression of natural urges specially that of emesis, excess exercise, exposure to excess heat, excessive eating, quick change in environmental temperature, inappropriate follow up of purification procedures, eating new grains, curd, fish, sesame, excessive salty and sour food, black gram, radish, milk, sugar products, following daytime sleep, and bad thoughts and deeds towards worshipful persons.

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• Exposure to sunlight is one of the treatments of shwitra.

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Vidhi Vimarsha

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=== Vidhi Vimarsha ===

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Six layers of skin:

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==== Six layers of skin ====

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In the context of Kushtha, four aspects of skin are important. First is that it consists of six layers, and each layer is seat of specific type of gradually progressing kushtha.

Following highlighted part should be in vidhi

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(5) Fifth layer of skin is seat of makushtha and severe dermal pathologies. 5th layer may be correlated with Papillary layer.

(6) Sixth layer is the seat of most severe mahakushtha, which are incurable. 6th layer may be compared with Reticular layer. (Ch. Sharir 7/ 4)

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Patho-physiology of kushtha:

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==== Patho-physiology of kushtha ====

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1. Kapāla Kuṣṭha:

It is rūkṣa, paruṣa, khara in nature which signifies the increase of rūkṣa, khara guna at the level of skin. Roughness, dryness increases when there is destruction of sweat glands (dusti of ambu dhatu), decrease in essential fatty acids (reduce snigdhata of meda inturn kapha), proliferation of keratinocytes. Primary lesion manifest in the form of dry, rough and blackish brownish colour. Secondary lesion includes loss of sensation (due to degeneration of nerve endings or less nutrition to the nerve tissue due to atherosclerosis or reduce blood supply) severe pricking pain (nistōda) itching, burning sensation and pustular presentation. Thus conditions of non erythematous eczema, keratosis, atrophic actinic keratosis, non hypertrophic keratosis, seborrhic conditions can be understood in Kapāla Kuṣṭha.

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