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<div style="text-align:justify;">This chapter deals with diagnosis of skin disease termed as Kushtha. The disease has variable manifestations on skin depending upon degree of involvement of three vitiated dosha and their effect on four vitiated factors i.e. rasa, rakta, mamsa and lasika (lymphatic system). On the basis of clinical manifestations and severity, kushtha is classified into seven major types, eleven minor types or innumerable types due to the permutation and combination of dosha predominance and involvement of particular quality of a dhatu and accretion of dosha at different sites. The etiopathology, prodromal symptoms (purvarupa), symptomatology of seven major types of kushtha (maha-kushtha), their dosha predominance, prognosis, complications and significance of early treatment are described in this chapter. </div>

<div style="text-align:justify;">This chapter deals with diagnosis of skin disease termed as Kushtha. The disease has variable manifestations on skin depending upon degree of involvement of three vitiated dosha and their effect on four vitiated factors i.e. rasa, rakta, mamsa and lasika (lymphatic system). On the basis of clinical manifestations and severity, kushtha is classified into seven major types, eleven minor types or innumerable types due to the permutation and combination of dosha predominance and involvement of particular quality of a dhatu and accretion of dosha at different sites. The etiopathology, prodromal symptoms (purvarupa), symptomatology of seven major types of kushtha (maha-kushtha), their dosha predominance, prognosis, complications and significance of early treatment are described in this chapter. </div>

'''Keywords''': ''Kushtha, Mandal, Kapala, Kakanak, Audambar, Rishyajihva, Pundareeka, Sidhma, causes of skin diseases, discoloration of skin.  

'''Keywords''': ''Kushtha, Mandal, Kapala, Kakanak, Audambar, Rishyajihva, Pundareeka, Sidhma'', causes of skin diseases, discoloration of skin.  

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Thus ends the fifth chapter on [[Kushtha Nidana]] in [[Nidana Sthana]] in the treatise composed by Agnivesha and as redacted by Charak.

Thus ends the fifth chapter on [[Kushtha Nidana]] in [[Nidana Sthana]] in the treatise composed by Agnivesha and as redacted by Charak.

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

=== ''Tattva Vimarsha'' / Fundamental Principles===

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*''Kushtha'' is the result of combined and simultaneous involvement of all the three ''dosha'' and subsequently vitiation of the four body constituents i.e. ''rasa'' (''twak'', or skin), ''mamsa''(muscle tissue), ''rakta''(blood), and ''lasika''(lymph).

*''Kushtha'' is the result of combined and simultaneous involvement of all the three ''dosha'' and subsequently vitiation of the four body constituents i.e. ''rasa'' (''twak'', or skin), ''mamsa''(muscle tissue), ''rakta''(blood), and ''lasika''(lymph).

*There can be infinite clinical presentations of ''kushtha'' (skin diseases) depending upon severity of combination of abovementioned vitiating factors.

*There can be infinite clinical presentations of ''kushtha'' (skin diseases) depending upon severity of combination of above mentioned vitiating factors.

*While diagnosing the severity of ''kushtha'', the depth of lesion can be assessed according to involvement of skin, muscle, blood and lymph respectively. The treatment should be planned accordingly targeting these constitutes and based upon predominantly vitiated ''dosha''.  

*While diagnosing the severity of ''kushtha'', the depth of lesion can be assessed according to involvement of skin, muscle, blood and lymph respectively. The treatment should be planned accordingly, targeting these constituents and should be based upon predominantly vitiated ''dosha''.  

*The varieties in vitiated qualities of ''doshas'' (like ''ruksha'' etc.) depend upon dietary and lifestyle causative factors. ''Kushtha'' can be classified based upon the criteria like specific sensation in skin, change in color of skin (pigmentation), site of lesion, spread of lesion, clinical features.

*The varieties in vitiated qualities of ''doshas'' (like ''ruksha'' etc.) depend upon dietary and lifestyle causative factors. ''Kushtha'' can be classified based upon the criteria like specific sensation in skin, change in color of skin (pigmentation), site of lesion, spread of lesion, clinical features.

*Continuous exposure to change in temperature (thermal sensitivity), change in fluid volume and muscle mass inside body, incompatible dietary and lifestyle factors are main causative factors of ''kushtha''. Similarly sudden changes in above factors may lead to acute condition of skin disease.  

*Continuous exposure to change in temperature (thermal sensitivity), change in fluid volume and muscle mass inside body, incompatible dietary and lifestyle factors are main causative factors of ''kushtha''. Similarly sudden changes in above factors may lead to acute condition of skin disease.  

*If the curable ''kushtha'' are not timely treated, it leads to favorable environment to growth of micro-organisms. The micro-organisms grow on the vitiated ''twak, rakta, mamsa,'' and ''lasika'' leading to various severe skin lesions.  

*If the curable ''kushtha'' are not timely treated, it leads to favorable environment to growth of micro-organisms. The micro-organisms grow on the vitiated ''twak, rakta, mamsa,'' and ''lasika'' leading to various severe skin lesions.  

*The curable disease can become incurable due to improper management, exposure to causative factors and aggravation of ''dosha''. However, the incurable diseases are never curable.

*The curable disease can become incurable due to improper management, exposure to causative factors and aggravation of ''dosha''.

=== ''Vidhi Vimarsha'' ===

=== ''Vidhi Vimarsha'' / Applied Inferences ===

Three chapters are devoted to dermatological disorders, present chapter and [[Chikitsa Sthana]] chapter 7 ([[Kushtha Chikitsa]]) and 21([[Visarpa Chikitsa]]). The present chapter deals with seven types of ''kushtha'', while in [[Kushtha Chikitsa]], all eighteen types have been described and have been given the name of ''Mahakushtha'' (major) and ''Kshudra kushtha'' (Minor). After reviewing the symptoms of seven major types it is clear that it covers a progressive disorder of skin leading to loss of organs and impaired sensation (sensory neuropathy). According to some commentators ''Kshudra kushtha'' is a  group of mild and localized skin diseases, which runs a chronic course.

Three chapters are devoted to dermatological disorders, present chapter and [[Chikitsa Sthana]] chapter 7 ([[Kushtha Chikitsa]]) and 21([[Visarpa Chikitsa]]). The present chapter deals with seven types of ''kushtha'', while in [[Kushtha Chikitsa]], all eighteen types have been described and have been given the name of ''Mahakushtha'' (major) and ''Kshudra kushtha'' (Minor). After reviewing the symptoms of seven major types it is clear that it covers a progressive disorder of skin leading to loss of organs and impaired sensation (sensory neuropathy). According to some commentators ''Kshudra kushtha'' is a  group of mild and localized skin diseases, which runs a chronic course.

*we have correlated the relative terms in modern dermatology that are selected by considering the origin of the disease and thickness of layer explained in Ayurveda.

*we have correlated the relative terms in modern dermatology that are selected by considering the origin of the disease and thickness of layer explained in [[Ayurveda]].

Various Vedic texts on the subject have tried to classify all signs and symptoms on the basis of ''tridosha'' thus this serves a good tool to diagnose the lesions as per three ''doshas'' seen in the following table:

Various Vedic texts on the subject have tried to classify all signs and symptoms on the basis of ''tridosha'' thus this serves a good tool to diagnose the lesions as per three ''doshas'' seen in the following table:

! rowspan="1"| Subject and Institute

! rowspan="1"| Subject and Institute

|-

|-

| Sharma R. K. - A study of Leprosy according to Ayurveda and its management with M. G. Capsule. L-1118 || 1982 || Kayachikitsa ||  IPGT&RA, Jamnagar

| Sharma R. K. - A study of Leprosy according to [[Ayurveda]] and its management with M. G. Capsule. L-1118 || 1982 || Kayachikitsa ||  IPGT&RA, Jamnagar

|-

|-

| Singh B P - A conceptual, clinical and experimental study of leprosy with its treatment by some indigenous drugs.  || 1973 || Kayachikitsa || Faculty of Ayurveda BHU, Vaaranasi  

| Singh B P - A conceptual, clinical and experimental study of leprosy with its treatment by some indigenous drugs.  || 1973 || Kayachikitsa || Faculty of [[Ayurveda]] BHU, Vaaranasi  

|-

|-

| Awadhwal V K - Studies on treatment of leprosy with some indigenous compounds || 1986 || Kayachikitsa ||  Faculty of Ayurveda BHU, Vaaranasi

| Awadhwal V K - Studies on treatment of leprosy with some indigenous compounds || 1986 || Kayachikitsa ||  Faculty of [[Ayurveda]] BHU, Vaaranasi

|-

|-

|  Rane S B – To prepare GandhakaDruti and study of the effect of an Ayurvedic preparation GandhakaDruti on leprosy and lepromatous leprosy patients. ||1997 || Ph.D. theses || University of Pune  

|  Rane S B – To prepare GandhakaDruti and study of the effect of an Ayurvedic preparation GandhakaDruti on leprosy and lepromatous leprosy patients. ||1997 || Ph.D. theses || University of Pune