Changes

=== ''Tattva Vimarsha'' ===

=== ''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.  

*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 (especially towards venerable people).  

*These factors vitiate water component of skin, blood, muscular layer and other layers of skin and localize three dosha in the skin to cause kushtha, layer by layer.

*These factors vitiate water component of skin, blood, muscular layer and other layers of skin and localize three ''dosha'' in the skin to cause ''kushtha'', layer by layer.

*Variable skin manifestations of kushtha depend upon degree of involvement of three vitiated dosha and their effect on four dhatus i.e. rasa, rakta, mansa and lasika.

*Variable skin manifestations of ''kushtha'' depend upon degree of involvement of three vitiated ''dosha'' and their effect on four ''dhatus'' i.e. ''rasa, rakta, mansa'' and ''lasika''.

*With involvement of first and second layer, prodromal symptoms appear. Third and fourth layer involvement results in minor kushtha.  Fifth and sixth layer involvement causes mahakushtha.

*With involvement of first and second layer, prodromal symptoms appear. Third and fourth layer involvement results in minor ''kushtha''.  Fifth and sixth layer involvement causes ''mahakushtha''.

*Dryness, atrophy, pricking pain / paraesthesia, pain, constriction or loss of elasticity, hardness, roughness, horripilation, blackish, brownish, slight reddish in colour are manifestation of vata dosha. Burning sensation, redness, exudation, suppuration, offensive smell, stickiness / moist and sloughing of body parts are the symptoms caused by predominancy of pitta dosha. Kapha dosha is responsible for symptoms like whitish discolouration, cold in touch, pruritus, non-progressive / slow progression of disease, elevated; heaviness and oiliness are presented alongwith maggot’s formation and stickiness like symptoms.

*Dryness, atrophy, pricking pain / paraesthesia, pain, constriction or loss of elasticity, hardness, roughness, horripilation, blackish, brownish, slight reddish in colour are manifestation of ''vata dosha''. Burning sensation, redness, exudation, suppuration, offensive smell, stickiness / moist and sloughing of body parts are the symptoms caused by predominance of ''pitta'' ''dosha''. ''Kapha dosha'' is responsible for symptoms like whitish discoloration, cold in touch, pruritus, non-progressive / slow progression of disease, elevated; heaviness and oiliness are presented along with maggot’s formation and stickiness like symptoms.

*Different degree of doshic involvement determines the color, shape, size, symptoms and discharge from the lesions. The treatment differs as per dominance of dosha.

*Different degree of ''doshic'' involvement determines the color, shape, size, symptoms and discharge from the lesions. The treatment differs as per dominance of ''dosha''.

{| class="wikitable" style="text-align: center;

{| class="wikitable" style="text-align: center;

| ''Pitta''

| ''Pitta''

| Burning sensation, redness, exudation, suppuration, offensive smell, stickiness / moist and sloughing of body parts  

| Burning sensation, redness, exudation, suppuration, offensive smell, stickiness / moist and sloughing of body parts  

| Virechana (therapeutic purgation) raktamokshana (bloodletting)

| ''Virechana'' (therapeutic purgation), ''raktamokshana'' (bloodletting)

|-

|-

| 3

| 3

| ''Kapha''

| ''Kapha''

| Whitish discolouration, cold in touch, pruritus, non-progressive/ slow progression of disease, elevated; heaviness and oiliness, stickiness, maggot infestation   

| Whitish discolouration, cold in touch, pruritus, non-progressive/ slow progression of disease, elevated; heaviness and oiliness, stickiness, maggot infestation   

| Vamana (therapeutic emesis)

| ''Vamana'' (therapeutic emesis)

|}

|}

*If all symptoms appear simultaneously, then the kushtha is untreatable. Similarly, immune-compromised patients and those suffering from morbid thirst, burning sensation, loss of digestive power and lesions have maggots then the prognosis is bad. Vata kapha dominant and single dosha predominated kushtha are easily curable. Whereas kapha pitta and vata pitta dominated kushtha are kricchra sadhya i.e. curable with difficulty.   

*If all symptoms appear simultaneously, then the ''kushtha'' is untreatable. Similarly, immune-compromised patients and those suffering from morbid thirst, burning sensation, loss of digestive power and lesions have maggots then the prognosis is bad. ''Vata kapha'' dominant and single ''dosha'' predominated ''kushtha'' are easily curable. Whereas ''kapha pitta'' and ''vata pitta'' dominated ''kushtha'' are ''kricchra sadhya'' i.e. curable with difficulty.   

*If the skin lesion is small, then prachchanna [bloodletting by rubbing with coarse device] should be done. If the skin lesions are large and spread all over body, siravyadha [ venesection] should be done for bloodletting.

*If the skin lesion is small, then ''prachchanna'' (bloodletting by rubbing with coarse device) should be done. If the skin lesions are large and spread all over body, ''siravyadha'' (venesection) should be done for bloodletting.

*Frequent body purification procedures are needed in treatment of skin diseases. The treatment includes internal purification in the form of therapeutic emesis, purgation etc and external purification in the form of local applications of lepa of purifying herbs.  

*Frequent body purification procedures are needed in treatment of skin diseases. The treatment includes internal purification in the form of therapeutic emesis, purgation etc. and external purification in the form of local applications of ''lepa'' of purifying herbs.  

*Shwitra may be caused by meta-physical causes like sinful deeds and those in previous life.   

*''Shwitra'' may be caused by meta-physical causes like sinful deeds and those in previous life.   

*Therapeutic purgation is main principle of management in shwitra (vitiligo).  

*Therapeutic purgation is main principle of management in ''shwitra'' (vitiligo).  

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

*Exposure to sunlight is one of the treatments of ''shwitra''.

=== Vidhi Vimarsha ===

=== Vidhi Vimarsha ===