This document presents a case study of a 37-year-old female patient named Mrs. Shashikala suffering from a skin condition for 3 years. She experiences burning and itching on her palms and all over her body. On examination, she has lesions on her hands and healed marks from previous lesions. The proposed treatment includes snehana, swedana, virechana, herbal medicines both internal and external, and a pathya-apathya diet. The differential diagnosis is determined to be kustha with vipadika or psoriasis with irritant contact dermatitis.

1. 1
CASE PRESENTATION
VINAY TIWARI
FINAL P.G. SCHOLAR
DEPARTMENT OF P.G. STUDIES IN
KAYACHIKITSA
SKAMCH&RC
BANGALORE

2. PREMILINARY DATA OF PATIENT
 Name : Mrs. Shashikala
 Age : 37 Years
 Sex : Female
 Religion : Hindu
 Socio economic status : Middle class
 Marital status : Married
 Education status : 9th Standard
 Occupation : Peon (Aaya) in school.
 Date of admission : 02/07/17
 Date of discharge : 09/07/17 2

3.  Ward : Female General Ward
 Source of history : Patient
 Case taken on : 07/07/17
 Consultant doctor : Dr. Nayan
 O.P No : E-20851
 I.P. No : 2624/17
 Address : # Nelamangala
3

4. PRADHAN VEDANA
 C/O Sputhna in both hasta pradesha associated with
sotha, daha, srava yukta pidakas and kandu since 3
years.
4

5. ANUBANDHA VEDANA
 Stabhdhata in hasta pradesha when srava dries up
5

6. VEDANA VRUTTANTA
 Patient is suffering from pidakas, all over the body
associated with kandu on and off since 3 years and
subside on medication. The pidakas develop any where
in the body and subsides on medication. 3 months
back when she resumed her work after which rashes
appeared with sputhana in both hasta pradesha
associated with shotha, and srava yukta pidakas with
kandu since 3 years . 6

7.  Presently the patient has severe lesions in her both
hand and itching all over the body with healed marks
of previous lesions. Rashes appeared extensor surface
of b/l hand and left palm with severe itching and it
spreads to right palm and b/l foot region due to severe
itching all fingers became oedematous and multiple
fluid filled lesions appeared on the palms which burst
open, oozing clear fluid which was foul smelling
because of the swelling of the fingers patient is unable
to do closing and opening of the fist.
7

8.  After the lesion bursted it was associated with
burning sensation and pricking type of pain .
 For the above complaints she got admitted to
SKAMCH & RC
8

9. POORVA VYADHI VRUTTANTA
 Nothing contributory.
 Patient is not a k/c/o Diabetes Mellitus,
Hypertension, Tuberculosis, Asthma
9

10. TREATMENT HISTORY
IN SAPTHAGIRI HOSPITAL (12/12/16 to 24/12/16 )
1) Inj. Avil 0-0-1 (IM)
2) Inj. Betnisol 1-0-1 (IV)
3) Clonate lotion (E/A) @ night
Advice on discharge
1) Tab Teczine 0-0-1
2) Sper lotion (morning)
3) Clonate lotion (night)
10

11. FATHER MOTHER
HUSBANDPATIENT
SON
KAUTAMBIKA VRUTTANTA
All family members are said to be healthy.
No one is suffering from similar set of complains.

12. VYAKTIKA VRUTTANTA
 Diet : Mixed (non veg 2 to 3 times in a month)
 Appetite : Moderate
 Bowel : once per day (constipated)
 Bladder : 4 to 5 times/day (Occasionally burning
1 to 2 times/night. Micturation)
 Sleep : Disturbed
 Habit : Tea / coffee 3-4 times/day
Rajo vruttanta
 Menarche - @ 15 years of age
 Cycle – Irregular till age of 26, later said to be regular 12

13.  Present M.C. 3-5 days
28-30 days
 L.M.P. – 27/6/17
 Presentely no history of dysmennhorea
 Old History 8-10 days of bleeding
 Married @ the age of 26
PRASAVA VRUTTANTA
 G2 P1 L1 A1 D0
 P1 - FTND (Son) 13 year age
 Underwent tubectomy after 3 years i.e., @ 29 years
of age due to restraint relationship with her husband. 13

14. GENERAL PHYSICAL EXAMINATION
 General Condition : Fair.
 Built : Moderately built.
 Nourishment : Moderately Nourished.
 Pallor : Absent.
 Oedema : Present over both hands
 Nails : Pitting
 Cyanosis : Absent.
 Icterus : Absent.
 Lymphadenopathy : Absent.
 Pulse :78 bpm. 14

15.  BP :120/80 mmHg.
 R/R :18/minute.
 Tongue :Coated.
 Height : 1.55 m
 Weight : 57.5 Kgs
 BMI : 23.95
15

16. PER ABDOMEN EXAMINATION
 Inspection – Shape of abdomen – Scaphoid
Umbilicus – Normal, Inverted
Hyperpigmentation scars over abdomen
Stria marks present
Palpation – Soft , no tenderness, No organomegaly
 Percussion – Tympanic sounds heard except the area of
Liver dullness.
 Auscultation – Peristaltic sounds heard. 16

17. RESPIRATORY SYSTEM
 INSPECTION
 Shape of chest - Bilaterally symmetrical
 PALPATION
 Trachea - Centrally placed
 Tactile Vocal Fremitus -Normal
 PERCUSSION
 Resonant sounds heard except the cardiac dullness.
 AUSCULTATION
 Normal Vesicular Breath Sounds heard
17

18. CARDIO VASCULAR SYSTEM
 INSPECTION - No scar, No swelling .
 PALPATION - Non tender, Apex Beat felt at 5th
intercostal space 9 cm from the mid sternal line.
 PERCUSSION - Defined Area of cardiac dullness.
 AUSCULTATION - S1 and S2 heard.
No added sounds heard.
No murmurs heard.
18

19. CENTRAL NERVOUS SYSTEM
 Patient is conscious, well oriented to time, place
and person.
 NAD
19

20. INTEGUMENTARY EXAMINATION
Skin
Colour – Normal skin colour
Lesio - Secondary
Character – Size -: Small
Colour -: Dark black
Shape -: Asymmetrical
Individual Lesion
Extensor surface – Papule
Palm, Soles – Flake
Scales present
Nature – Dry Flake
20

21. Itching – Present
Discharge – Absent (present when new lesion occur)
Distribution of lesion – Symmetrical
extensor surface
On exposed body parts
Superficial sensation of lesion – Normal
Candle grease sign – Positive
Auspitz sign – Positive
Koebner phenomenon - Positive
21

22. 22

23. 23

24. 24

25. 25

26. DASHAVIDHA PARIKSHA
1) प्रकृ ति: –: Vata Pittaja.
2) सारतः –: Madhyama.
3) संहनि –: Madhyama.
4) प्रमाणतः –: Height - 1.55 m
- : Weight – 57.5 kgs.
5) सात्म्यि –: Madhyama.
26

27. 6) सत्मवि –: Madhyama
7) आहर शक्ति -: अभ्यवहरण शक्ति – Avara
-: जरण शक्ति – Avara
8) व्यायाम शक्ति –: Avara
9) वयः –: Madhyama
10) ववकृ ति –: Pravara
27

28. NIDANA PANCHAKA
NIDANA : Viruddhahara, mandagni, ati vyayama after
snigdha bhojana, snana after bhojana in the
night everyday, chinta, shoka, uses of acidic solution
for cleaning in school
SAMPRAPTI GHATAKA:
 Dosha : Tridosha
 Dushya : Twak, Mamsa, Rakta, Lasika.
 Srotas : Rasa, Rakta, Annavaha
28

29.  Sroto dusti : Sanga
 Agni : Jathragni
 Ama : Jathragni
 Udbhava sthana : Twak, Mamsa, Rakta, Lashika
 Sanchara sthana : Sarvasarira
 Vyakta sthana : Twak, Mamsa
 Roga marga : Bahya
 Vyadhi Svabhava : Chirakari.
 Sadhya asadhyata : Krichra sadhya.
29

30. SAMPRAPTI
Nidana sevana Tridosha prakopa
Spreaded in triyak gata shiras
Twak, Rakta, Mamsa, Lasika
Dosha-Dushyas takes sthanshanshraya in Twak
Leads to mandaloutpatti
Kustha cont…
30

31. Kustha
Viruddhopkrama or Nidana sevana
Causes Flaring up of lesions
Resulting to Vaipadika
31

32. POORVAROOPA
ROOPA
Sputhna in both hasta pradesha associated with sotha,
daha, srava yukta pidakas and kandu.
 UPASAYA : Aushadha sevana.
 ANUPSAYA: Nidana sevana.
32

33. VYAVECHADAKA NIDANA
inclusion exclusion
Vaipadika pani, pada, sputhana, tevra
vedana, kandu, raga, red
colour pidakas
Vicharchika kandu, srava in pidikas,
krushna shyava varna,)
Eka kustha Krushna varna,
aswedana
Vruna vastu
Pama Rakta varna pidakas,
kleda yukta srava, ati
vedana, hastha , kurpara
sandhi pradesha
Sweta, shyama varna
pidakas, nitamba
pradesha,
Charma dala Kandu yukta, toda Rakta varna
33

34. DIFFERENTIAL DIAGNOSIS
Inclusion Exclusion
Pustular psoriasis
Nail beds, palms, soles
Fever, trunk, extrimities,
Echzema Primary lesions are
erythematous macules,
papules and vesicles
than patches and
plaques.
Atopic dermatitis with
Hand dermatitis
Aggravated by repeated
wetting and by washing
of the hands with harsh
shoaps, detergents, and
disinfectants, dryness,
pruritis, Nails pitting
Psoriasis (plaque) Palms Well defined
erythematous plaques
with silvery scale, with
predilection for the
scalp, extensor surface,
sub mammary or axillary
34

35. 35
Palmoplantar psoriasis Scaly plaques, thickening
and scaling of the entire
surface of palms without
redness
soles
Allergic dermititis Pruritic, eczematous
dermatitisinitially localized
to the primary site of
allergen exposure,during
acute phase edema,
erythema and vesicle
formations as the vesicles
rupture oozing papules
plaques appears
Irritant contact dermititis Burning sensation more
with above symptoms

36. 36
Lepromatous leprosy Rash – numerous small
symmetrical
hypopigmented macules
with normal sensation and
indefinite edeges
Face, extensor surface of
limb and upper trunk,
sparing the midline of
back, axillae, groins,
scalps

37. VYADHI VINASCHAYA
 Kustha with Vipadika
 Psoriasis with Irritant contact dermatitis
37

38. CHIKITSA VRUTTANTA
DATE LAKSHANA CHIKITSA OBSERVATION
02/07/17 Burning sensation in the palm
region with itiching all over the
body
Snehapana with
aragwadadhi mahatikta
ghrita 30 ml
03/07/17 Burning sensation in the palm
region with itiching all over the
body
Snehapana with
aragwadadhi mahatikta
ghrita 60 ml
38

39. DATE LAKSHANAS CHIKITSA OUTCOME
04/07/1
7
Burning sensation in the
palm region with itiching
All over the body
Snehapana with aragwadadhi
mahatikta ghrita 90 ml
Itiching Increased
slightly
05/07/1
7
Burning sensation in the
palm region with itiching
all over the body
Snehapana with aragwadadhi
mahatikta ghrita 120 ml
•Itiching reduced
slightly
39

40. DATE LAKSHANA CHIKITSA OUTCOME
06/07/17 Burning sensation
in the palm region
with itiching all
over the body
Sarvanga abhyanga with
suryapaki talia f/b baspa sweda
day 1
07/07/17 Burning sensation
in the palm region
with itiching all
over the body
Sarvanga abhyanga with
suryapaki talia f/b baspa sweda
day 2
Burning sensation
increased
40

41. DATE LAKSHANA CHIKITSA OUTCOME
08/07/17 Burning sensation in the palm
region with itiching all over
the body
Sarvanga abhyanga
with suryapaki talia f/b
baspa sweda day 3
Burning sensation
reduced
09/07/17 Burning sensation in the palm
region with itiching all over
the body
Virechana karma with
Trivrut avaleha 50 gm
with 100 ml triphala
kashaya
No of vegas 16
She had 2
episodes of
vomiting(reduced
after taking nimbu
water)
41

42. PROPOSED LINE OF TREATMENT
 Snehapana with mahatiktaka ghrita
 Sarvanga abhyanga with Marichadi taila
 Virechana with Trivrut, Danti & Triphala with souveeraka
 Manjisthadi kwatha
 Tandula lepa
 Unmatta taila for external application
 Dhattura beeja kalka lepa
 Kanaka bindu arista with krutmala kwatha
 Tab – Arogya vardhini
 Tab – Gandhak rasayana
 Mustadi churna for Shotha
 Bhallataka rasayan
 Tuvarak rasayan (Ah.Chi.19/53)
 Tuvaraka taila 10 ml for internal purpose kostha suddhi
42

43. PATHYA & APATHYA
43
 Laghu aahara, tikta rasa
pradhana, ghruta,
bhallatak, triphala, nimba,
purana dhanya, jangala
mamsa, mudga, patola,
 Laghu vyayama,
Siddhartha snana,
abhyanga
 Viruddhara (amla, payo,
dadhi, anupa mamsa, matsya,
guda, tila)
 Divaswapna, mala-mutra
vega dharana.

44. THANK
YOU
44

45.  Su su 9/6
 Ubhaya gata shodhana
 Twak gata – alepa chikitsa by shodhana
 Shonita gata – Samshodhana, kashaya pana,
shonitavsechana
 Mamsa gata – Shodhana, aalepana, kashayapana,
rakta mokshana, arista prayoga, mantha prayoga,
prasha prayoga
 Medo gata – Bhallataka, shilajita, swarna makshika,
guggulu, agaru, tuvaraka, khadira, asana, ayaskriti,
 Later dhatus it become asadhya so no chikitsa 45

46. 46
Kapala Kustha
Vata dosha pradhanata
Krushna-aruna varna
Ruksha
Parusha
Tanu
Toda vahula
Alpa kandu
Alpa daha
Alpa puya
Audambara Kustha Daha
Kandu
Ruja
Redness
Kapila varna
Pakva phala sannibham
Mandala kustha Sweta and rakta varna
Sthira
Styana
Snigdha
Mandala akriti (coin
shaped)
Kruchrounnata
Hrushyajihwa kustha Karkasha
Shyava
Vedana yukta
Rakta varna over edeges
Hrushya jihva sannibham

47. Pundarika kustha Sweta varna yukta
Red
47

48. VEDANA VRUTTANTA
Patient was apparently healthy 3 years back suddenly she
developed rashes over the face associated with itching
sensation. She also noticed blackish discolouration of
upper lip and there was thickening of skin along with
itching for this she consulted Adarsh clinic and was
prescribed with some oral medication and topical
applications (details are not known) After 3-4 days of
taking them she developed severe itching in both eyes
and ears and also rashes spread to whole body.
48

49. She also developed ulcers in the mouth and cracking of the
angle of the mouth bilaterally which was very painful.
For this she consulted another clinic there they suggested
some investigation all was in normal. Than prescribed
some medication and ointments for 3 months. Initially
symptoms relieved after taking medication for 1 month
later suddenly developed a fluid filled lesion over her
right arm in flexor aspect which spread to forearm within
20 days associated with severe itching, pricking type of
pain and foul smell and clear liquid oozing from it.
49

50. Meanwhile she got loose stools on and off with a gap of
about 8-10 days three times. No of episodes of watery
loose stools was 10 – 20 times. She used to take tab
Eldopar everytime it occurred and get relief. Pt felt that
she is getting loose stools because of the oral medications
which was given for the rashes so she discontinued after
few days her symptoms like itching sensation all over the
body and in eyes, ears, buttocks got aggravated. Thus for
the above she got admitted in Saptagiri hospital for 10
days.
50

51. They did some blood investigations and injectable were given. She
found moderate relief as the ulcer over the right forearm
completely healed, itching in the eyes and ears reduced. But itching
sensation all over the body still persisted (on itching she used to get
rashes) after 4 months , (rashes appeared extensor surface of b/l
hand and left palm on severe itching. And it spreads to right palm
and b/l foot region due to severe itching all fingers became
oedematous and multiple fluid filled lesions appeared on the palms
which burst open , oozing clear fluid which was foul smelling
because of the swelling of the fingers pt is unable to do closing and
opening of the fist.)
51

52.  After the lesion bursted it was associated with burning
sensation and pricking type of pain . For the above
complaints she got admitted to skamc h&rc
52

53.  Tiktashatpalak ghruta (ch.chi.7/140-143)
 Mahatiktaka ghruta (ch.chi.7/144-150)
 Mahakhadira ghruta (ch.chi.7/152-156)
 Khadira, nimba, darvi ghruta (ch.chi.7/135)
 Sarvakushta- By bhallataka taila, tuvaraka taila etc.
(Su.Chi.9/7)
 Kusthaghna hitakar taila (ch.chi.7/119)
 Vipadika hara ghruta-taila (ch.chi.7/120,121)
 Swetakarveradh taila
 Swetakarverapallavadh taila
 Tiktekshvakadi taila
 Kanakakshiri taila
 Vipadikaya dhatturbija taila
 Aarogyavardhini vati (R.RS.)
 Saptasama gutika
 Triphala gutika
 Gandhaka rasayana
 Panchatiktaghrita guggulu
Marichaditailam,
Somarajitaila,
 Chitraka rasayan
 Bhallataka rasayan
 Tuvarak rasayan (Ah.Chi.19/53)
 Bhallatakavaleha, 53

54. CONTENTS Introduction
 Shodhana
 Shamana
 Rasayana
 Kustha
 Kustha bheda
 Mahakustha
 Kshudrakustha
 Vamana
 Virechana
 Basti
 Nasya
 Raktamokshana
 Samanya chikitsa
 Rasayana chikitsa
 Conclusion
54

55. INTRODUCTION
 Skin that covers the major part of the body when it
is diseased causes social stigma. It is important to
maintain the health of skin in order to ward off
various skin diseases explained under the heading of
‘Kushta’.
 Any disease in Ayurveda is managed with Shodhana,
Shamana & Rasayana chikitsa.
 The same is true for Kushta.
 It is important to understand the concept, indication
and appropriate use of these to get optimum results
55

56. SHODHANA
 यदीययदहहदोषान ्पन्चधा शोधनं च िि ्।
तनरुहो वमन ्ं कायशशरोरेकोस्त्रववस्त्रुति: ॥
 Shodhana is the process by which vitiated doshas are eliminated
from the body through the nearest orifice.
(अ.ह्.सू 14/5)
 स्त्थानाद् बहहनेयेदूर्धवयमर्धयो वा मलसंचयम ।
देह्ंंस्त्ंशोधनं ित्मस्त्याद् ॥(शा. स.पू.4/9)
 Drugs which dislodge the body wastes from their places and
expel them forcibly either in upward or downward direction are
deha samshodhana.
56

57. TYPES
1. तनरुह्
2. वमन
3. ववरेचन
4. शशरोववरेचन्
5. रतत्ममोक्षण्
57

58. SODHANA -INDICATION
 अववपाक
 अरुचच
 स्त्थौल्य
 पाण्डुिा
 गुरुिा
 तलम
 वपडका
 कोठ कण्डू
 अतिय
 आलस्त्य
 श्रम
 दौबयल्य
 अतिदुगन्ध
 अवसाद्
 कफवपत्त उत्मतलेशो
 अतनद्रा
 अतितनद्रा
 िन्द्रा
 तलैब्य
 अबुचधत्मव
 अप्रशस्त्ि स्त्वप्न दयशनम्
 बलवणयप्रणाशश्र्च िृप्यिो
बृंहणैरवप

59.  BENEFITS :-
 एवं ववशुर्धद् कोष्ठस्त्य कायक्ननराशिवधयिे ।
.............िस्त्माि् स्त्ंशोधन्ं काले युक्तियुति ्ं वपवेन्नरे ॥(च.सु16/17-
19)
 Charaka while elaborating the effects of Samshodhana says
that it enhances Kayagni, Upashamana of vyadhi & health
returns to normal.
 Indriya, Manas, Buddhi, Varnas become clear & acquires
bala, pusthi, apatya, vrishata. His aging is retarded & he lives
a long life free of diseasea. Hence he emphasized to take
Samshodhana at a proper time & skillfully administered.
59

60.  IMPORTANCE :-
 दोषा कदचचि कु प्यक्न्ि क्जिा लंघनं पाचने ।
क्जिा स्त्ंशोधनेयय िु न िेषां पुनरुर्धव ॥ (च.सू.16/20)
 Charaka has said that the doshas controlled by
Samshamana are having the possibility of reprovocation
while there is no such probability in case of the control of
the doshas by Samshodhana.
60

61. SHAMANA
 न शोधयति यदोषान् समान्नोदीरयत्मयवप । समीकरोति ववषमान् शमन्ं िच्च
सप्त्मधा ॥ पाचनं दीपन्ं क्षुत्तड्वव्यायामािपमारुिा । ब्रंह्ंण्ं शमन्ं त्मवेव्ं वायो
वपत्ततनलस्त्य च ॥ (अ.ह्.सू.14/6,7)
 The process by which vitiated doshas are pacified or nullified is
called Shamana.
 न शोधयति न द्वेक्ष्ि समान्दोषांस्त्िथोर्धदिान्।
समीकरोति ववषमाव्यशमन्ं िधथास्त्रुिा ॥ (शा.पू. 4)
Drugs which bring down the increased dosha to normal without
expelling them out and not interfering with the dosha which are
normal are called shamana (palliatives) . 61

62. RASAYANA
 लािोपायो हह शस्त्िानां रसदीनां रसायनम ्। (च.चच.1/1/8)
 यज्जरा व्याचध ववक्र्धव्ंस िेषज्ं िद रसायनम ॥(शा.pu 4/14)
 Benefit
 दीघाययु स्त्रतिय मेधामारोनय्ं िरुण्ं वय् ।
 प्रिावणयस्त्वरौदयं देहेक्न्द्रयबल्ं परम्॥
 वाक्तसक्र्धद प्रणतिं काक्न्िं लििे ना रसायनाि्। (च.चच.1/1/7,8)
62

63. Types
 कु हिप्रावेशशक चरक (च.चच. 1/1/16)
 वािािवपका वानिट् (अ.ह्.उ.39/5)
 का्य (बल-बुक्र्धद-व्रक्र्धद)
 नेमेवत्तक् (व्यचध नष्ट्) (dalhana सु.चच27/3)
 आजाक्स्त्रक (दुनध-घ्रुि सेवन्ओज व्रुक्र्धद)
 स्त्ंशोधन्
 स्त्ंशमन्
63

64.  वय् स्त्थेययकराणांमयन्ं लािोपायो रसायनम्; वधयक्ं
स्त्थापकमप्राप्िमापक्ं वेत्मयथय (ड्वल्हण्)
 Before administring any rasayan first do kostha suddhi
with Haritakyadi choorna along with ushna jala.
(च.चच.1/1/25-28)
 Rasayana should be used in युवा & मर्धयमवस्त्था as the
colour not look good on malina vastra so as the
rasayana can not be beneficial in the asudha sarira
(सु.चच.27/3,4), (अ.ह्.उ.39/11)
64

65. RASAYANA SEVANAAYOGYA
PURUSHA
 Anatmavaan
 Aalaso
 Daridra
 Pramadi
 Vyasani
 Papakrud
 Bheshajaapmanani (सु.चि.30/4)
65

66. KUSTHA
 कुष्णाचत च ःशेषेण् चवलेख ््ं करोचत अ्ंग् प्रत्यङ्च इचत कुष्ठम् ॥ (चसद्धान्त्
कौचमचि)
 कुष्ठ is a condition in which different body organs , dhatus, updhatus,
are destroyed & contempted.
 त्मवच कु वयक्न्ि वेवण्य्ंय दुष्िां कु ष्ठमुशाक्न्ि िि ।
One which produces discolouration over skin region is said to
be kustha.
कालेनोपेक्षक्षि्ं यस्त्मात्मसवं कु ष्णाति िद् वपु ॥
During the lapse of time, it makes the entire body look ugly.
(अ.ह्.तन.14/3)
66

67. कु ष्ठ िेद
 कु ष्ठातन सप्िववधान्यष्िादशववधान्यपररसंख्येयववधातन च ।
(च.तन.5/4 )
67
सप्िववधा
अष्टादशविधा
अपररसंख्ये
महाकु ष्ठ
7
क्षुद्र
कु ष्ठ
11
अष्िादश
कु ष्ठ

68. महाकु ष्ठ
महाकुष्ठ लक्षण िोष प्रधान्यत
कापाला कृष्ण, अरुण, कपालाभ, रुक्ष, परुष, त ु, अचततोि, चवषम्ं स्मृतम. वातज
औदुम्बर िाह, राग, कण्डुयुक्त,रुक, परीत, रोमचपञ्जरम, उिुम्बरफलाभास. चपत्तज
मण्डल श्व्वेत, रक्तवणण, चस्िर, स्त्या , चस् ग्ध, उत्सन् मण्डलम, कृच्छ्र् साध्य. कफज
ऋष्यजिह्व वेि युक्त, रक्तपयणन्तमन्त:श्वयाव, यदृष्यचजह्व स्ंस्िा ्ं. वतचपत्तज
पुजण्िक श्वेताभ , रक्तपयणन्त like पुचण्िकिल, उन् त ,
िाह युक्त.
चपत्तकफज
जिध्म श्वेत, ताम्र, त ु lesions, usually situated on the उरु from which
scales like अलाबूपुष्पवणं fall off on rubbing
वातकफज
काकण गुञ्ज वणण, सपाक, चतव्र वेि , असाध्य. चििोषज 68

69. क्षुद्र कु ष्ठ
क्षुद्र कु ष्ठ लक्षण िोष प्रधान्यत
एककु ष्ठ
चमायख्यं
स्त्वेदरहहि, मस्त्यशकलोपमम, महावास्त्िु .
बहलं , हक्स्त्िचमयवि .
वाि-कफ
वाि-कफ
ककहिि श्यावं, ककण्खरस्त्पशय, परुषं, ककहििं स्त्मृिम ्.
वाि-कफ
वैपहदकं पाणणपादस्त्फु िनं, तिव्रवेदना. वाि-कफ
अलसक कण्डुयुति, सरागैश्र्च, गण्डैरलसक्ं वाि-कफ
दद्रुमण्डलं कण्डु, राग, मुदगावि वपडडका वपत्त-कफ 69

70. क्षुद्र कु ष्ठ लक्षण िोष प्रधान्यत
चमयदल कण्डु, स्त्फोि, रतिवणय, सशूल, असहहष्णुिा, रुग. वपत्त-कफ
पामा श्वेि, अरुण शयाव वणय , कण्डुयुति वपडका वपत्त-कफ
ववस्त्फोि िनु, त्मवकयुति, श्याव अरुण वणायत्ममक वपडका
वपत्त-कफ
शिारु रतिश्याव वणायत्ममक, दाहयुति, बहुव्रणी कु ष्ठ . वपत्त-कफ
ववचचचयका सकण्डु, श्याव वणय वपडक, बहुस्राव कफ
70

71. कु ष्ठगि दोष लक्षण
 वातज : रौक्ष्य्ं,शोष, तोि, शूल, स्ंकोि ्ं, पारुष्य्ं,
खरा भाव, हषण, श्वयाव अरुण्ं .
 चपत्तज : िाह, राग, पररस्राव,पाक, चवस्रगचन्ध, क्लेि, अ्ंगपत ्ं.
 कफज : श्र्वेत्य, शैत्य,कण्डु, स्िैय, उत्सेध, गौरव, स् ेह, क्लेि,
जन्तुचभरचभक्षण्ं
(ि.चि. ७/३४-३६)
71

72. कु ष्ठोत्मपवत्तकर दोष - दूष्या
1) वाि
2) वपत्त त्ररदोष
3) कफ
4) त्मवक
5) रति दूष्य
6) मांस
7) लशसका
When these seven dravyas are got affected than
they will cause for कु ष्ठोक्त्मप्त्त.
72

73. सप्िधात्मवश्र्य कु ष्ठ लक्षणा
 त्मवक्: - Toda, Vaivarnyam, Rukshatwa
 रति: - Rakta: Sweda, Swapa, Swayathu.
 मांस्: - Sphota in pani & pada, kledatwa in joints.
 मेदस: - Kounyam & gatikshaya for angas, dalana of
angas.
 अक्स्त्थ & मज्जा:- Nasa bhanga, netra raga,
swarakshaya, krimis in kshatas.
 शुक्र:- Swadara paktya badhanam.
(A.H.Ni.14)
73

74. धािुगि लक्षणा
 स्त्पशयहातन स्त्वेदनत्मवमीषत्मकण्डुस्त्च ्जायिे ।
 वेवण्य ्ंय रुक्षिावस्त्च ्कु ष्ठे त्मवचच समचश्रिे ॥
 त्मवतस्त्वापो रोमहषयस्त्च ्स्त्वेदस्त्याशिप्रवत्मनयम्।
 कण्डूववयपूयकस्त्चेव ्कु ष्ठे शोणणिसंचश्रिे॥
 बाहुल्यं वतरशोषस्त्च ्काकय स्त्य ्ं वपड्वकोद्गम् ।
 िोद स्त्फोि क्स्त्थरत्मवं च कु ष्ठे मांससमाचश्रिे ॥
74

75.  दौगयन्र्धयमुपदेहस्त्च्पूयोथ कक्र्यस्त्था ।
 गारणां िेदनं चावप कु ष्ठे मेद समचश्रिे ॥
 नासािंडोक्षक्षरागस्त्च्क्षिे च कक्रशमस्िव ।
 िवेि्स्त्वरोपघािस्त्च्हक्स्त्थमज्जसमचश्रिे ॥
 कौण्यं गतिक्षयोन्डानां स्िेद् क्षिसपयणम ्।
 शुक्रस्त्थान्गिे शलन्डे प्रागुतिातन िथेव च ॥
(सु.तन.5/21-26)
75

76. सामान्य चचककत्मसा
 सवं त्ररदोषजं कु ष्ठं दोषाणां िु बलाबलम ्।
यथास्त्वेलयक्षणेबुयर्धद्वा कु ष्ठानां कक्रयिे कक्रया ॥
दोषस्त्य यस्त्य पश्येि ्कु ष्ठेषु ववशेक्ष्लन्नरुद्ववति ्ं ।
िस्त्येव ्शमं कु यायत्मत्त ् पर्ं चानुबन्र्धस्त्य ॥ (च.चच.7/31,32)
All kustha are tridosaja so they should be treated by
knowing there doshobala abala & lakshnas.
First do samana in those kusthas who are having
there increased doshas than treat apradhan doshas.
76

77. धािुगिानुसार् चचककत्मसा
 त्मवक् प्राप्िे- Shodhanam, Alepanam.
 शोणणि्प्राप्िे- Shodhanam, Alepanam, Kashayapanam,
Shonitavasechanam.
 मांसप्राप्िे- Shodhanam, Alepanam, Kashayapanam,
Shonithavasechanam, Arishtapana, Manthaprayoga,
Prasaprayoga.
 मेदसप्राप्िे- Shodhanam, Shonithavasechanam, Bhallathaka,
Shilajatu, Dhatumakshikam, Guggulu, Agaru, Tuvaraka, Ayaskriti.
 From अक्स्त्थ onwards- असार्धय.
 Rest of all dhatugata condition of kustha should be considered
incurable and left untreated. (सु.चच.9/6)
77

78. CHIKITSA SUTRA
 वािोत्तरेषु सवपयवयमनं श्लेष्मोत्तरेषु कु ष्ठेषु ।
वपत्तोत्तरेषु मोक्षो रतिस्त्य ववरेचनं चाग्रे ।
वमनववरेचनयोगा: कल्पोतिा: कु क्ष्ठनां प्रयोतिव्या ।
प्रच्छनमल्पे कु ष्ठे महति च शस्त्िं शसराव्यधम ् ।
बहुदोष: संशोर्धय: कु ष्ठी बहुशो अनुरक्षिा प्राणान ्।
दोषे ह्ंयतिमारहृिे वायुहयन्यादबलमाशु ।
स्त्नेहस्त्य पानशमष्िं शुद्धे कोष्ठे प्रवाहहिे रतिे ।
वायुहहय शुद्धकोष्ठं कु क्ष्ठनमबलं ववशति शीग्रम ्। (च.चच. 7/39-
42) 78

79.  Vata - Sarpi
 Kapha - Vamana
 Pitta - Raktamokshana, Virechana
Chakrapani Commentary
 अग्रे इति सवपयराहदषु योज्यं; िेन वािोत्तराहदषु सवपयराहद प्रथमं
कियव्यं
अग्र means it is the foremost and the best to be done.
After that only any other treatment should be adopted
79

80. SHODHANA IN KUSTHA
 पक्षाि्पक्षाच्छदयनान्यभ्युपेयाद् मासान्मासाि्
स्त्रसनं चावप देयम्।
 स्त्राव्यं रतिं वत्मसरे हह द्ववरल्प्ं नस्त्यं दधाच्च त्ररराराक्त्मरराराि्॥
(सु.चच.9/43),(अ.ह्.चच.19/96)
 Vamana- Pakshatpakshat. (15 – 15)days
 Virechana- Masanmasan.(1 – 1)month
 Rakta mokshanam- Shashte shashte masya.
(6 – 6)months
 Nasya- Triratrat triratrat. (3 – 3)days
 Basti
80

81. VAMANA
 िरदोषहरण्. उर्धवय िाग्ं वमन्स्त्ंञक्ं ॥ (च.क.1/4)
 अपतववपत्त्शश्लेष्मणौ बलार्धव्ंय नयेिु यि वमन्ं िचध ववननेय्ं ॥
(शा.पू.ख्.4)
 INDICATION
 कफे ववद्र्धयाद्व्मन्ं स्त्ंयोगे वा कफाल्बणे ।
 नवज्वरातिसाराध् वपत्तास्रगा जयक्षक्षमण् ॥
 कु ष्ठमेहापचीग्रक्न्थश्ली पदोन्मादकाशसन् ।
 श्वासहल्लासवी सपयस्त्त्मन्यदोषोर्धवयरोचगण ॥ (अ.ह्.सू.18/1-3)
81

82.  Contraindication
 Garbhini, sukumar, rooksha, kshudita, shokarta, krusha,
durbala.
 Diseased condition
 Vataprakopaja – Udavarta, Gulma, Vatavyadhi
 Marmaja vyadhi – Hridroga, Mutragata, Timira
 Maharoga – Arsas, Udara (अ.ह्.सू.18/3-5),
Kala
 In vasant rutu
(च.शस 8)
82

83.  दोषोक्त्मतलष्िे ह्रदये वा्य् कु ष्ठेषु चोर्धवयिागेषु ।
कु िजफलमदनमधुके सपिोलेतनय्बरसयुतिे ॥
शीिरस पतकरसो मधूतन मधुकं च वमनातन । (च.चच.7/43,44)
Vamana in श्लेष्मोत्तरेषु कु ष्ठेषु .
Vamana Yogas
 Kutajaphala,Madhanaphala,Yastimadhu churna + Patola
and Nimba rasa yukta
 Sheetha rasa(शीिरस: शीि कषाय:) with madhu +
yastimadhu churna.
83

84. VIRECHANA
िर दोषहरण ्ं अधोिाग ्ं ववरेचन संझा |
उिय ्ं वा शरीरमल ववरेचनाि ्ववरेचन स्त्ंझा ॥
(च ्.क.1/4)
INDICATION
Kustha, jvara,...........................pitta vyadhi
vishesed rogadhayayoktasch
(ch.si.2/13)
Virechana is best for pitta & rakta pradosaja 84

85.  CONTRAINDICATION
 Avirechyastu
 Subhag kshata
 Durbalendriya
 Durbalendriya
 Alpagni
 Kamadivyagra
 Ajirna
 Navajvara
 Madatya
 Aadhmana
 Salyardita
 Garbhini
 Kshatkshen
 Atisthoola
 Atikrusha
 Bala
 Vruddha
 Durbala
 Upavasa
 Maithun
 Chinta
 Vyayama
(च.शस.2/11)
85

86.  कु ष्ठेषु त्ररव्रिा दन्िी त्ररफला च ववरेचने शस्त्िा ।
 सौववरक्ं िुषोदकमालोडनमासवास्त्च ्सीधूतन ॥
 श्ंसन्त्मयधोहराणां यथाववरेक्ं क्रमस्त्ष्चेष्ि ।
(च.चच.7/44,45)
 VIRECHANA YOGAS Trivrut, Danti & Triphala
with souveeraka, tushodaka, alodana & sidhu
86

87. BASTI
 बक्स्त्िना दीयिे इति बक्स्त्ि ॥(अ.ह्.सू.19/1)
 बक्स्त्िशिदीयिे यस्त्माि्िस्त्माि्बक्स्त्िररति स्त्रि ॥
(शा.उ.ख्5/1)
 Acc. To Vruhattrayi Niruha & Anuvasana basti is
contraindicated in kustha. (च.शस.२/14), (सु.चच. 35/21), (अ.ह्.सु
19/4-6)
 दाववयब्रहिीसेव्ये पिोलवपचुमदयमदनक्रिमाले ।
 सस्त्नेहेरास्त्थाप्य कु क्ष्ठ सकशलंडेयवमुस्त्िे ॥
 वािोल्बण्ं ववररति्ं तनरुढ्मनुवासनाहयमालक्ष्य्।
 फलमधुकतन्बकु िजे सपिोले साधयेत्मस्त्नेहम ॥(च.चच.7/46,47) 87

88.  If there is excess of vata even after shodhana – asthapana &
anuvasana
 Sneha – madanaphala, madhuka, nimba, kutaja, patola
 नास्त्थाप्या: कु क्ष्ठन: (च.शस.२)
Cakrapani Commentary
िथास्त्थापनानुवासनैक सार्धयायां अवस्त्थायां कियव्ये एव:
In excessive vitiation of vata – no alternative - basti
 प्रवृवत्ततनवृवत्त लक्षण सयोगे िु गुरुलाघवं संप्रधायय स्यगर्धयवस्त्येि्
(च.वव.८/१३४)
If there is lakshana which is simultaneously responsive and
irresponsive to
a given chikitsa – vaidya can decide the chikitsa – lakshana –
guru or laghu
88

89. NASYA
 उर्धवय जरुववकारेषु ववशेषस्त्य शमष्यिे ।
 नासाहह शशरसो द्वार्ं िेन्िदव्याप्य क्ह्ंंि िाि्॥
(अ.ह्.सु 20/1)
 औषधम्औषध्शसर्धद्ं स्त्नेहो वा नाशसकाभ्यां दीयिे इति नस्त्यम्
॥ (सु.चच.40/21)
89

90.  INDICATION
 Manyastambha
 Galagraha
 Hanugraha
 Pinasa
 Vyanga
 Apatanaka etc
(च्.शस.2/22)
 CONTRAINDICATION
 Ajirna
 Bhuktavata sneha,
madhya, jala
 Snata sirasa
 Snanachisirasa
 Navajvara
 Garbhini etc
(च्.शस.2/21)
90

91.  सेन्धवदन्िीमररचं फणणञझक वपक्प्पली करन्ज्फलम्।
 नस्त्यं स्त्यात्मसववडंग कक्रशमकु ष्ठकफप्रकोपघ्नम्॥
 वेरेचतनके धूयमे श्लोकस्त्थानेररिे प्रशा्यक्न्ि ।
 क्रमय कु ष्ठककलासा प्रयोक्जिेरुत्त्शमांड्वस्त्था ॥
(च.चच.7/48,49) Saindhava, Danti, Maricha,
Phanijjhaka, Pippali, Karanjaphala, Vidanga – Kapha
pradhana kushta with krimi anubandha
91

92.  च.सू ५/२६-२७
 Vairechanika dhumapana
 श्वेिा ज्योतिष्मति चैव हररिालं मन:शशला ।
गन्धाश्च अगरुपरार्धया धूमं मूधयववरेचने ।
92

93. RAKTAMOKSHANA
Raktamokshana is mainly two types
 1)SASTRA
 A) Pracchana
 B) Siravyadha (venesection)
 2) ASASTRA
 A) jaloukavacarana – application of leeches (pitta dosha)
 B) Sringavacharana – application of cow’s horn (vata
dosha)
 C) Alabu avacharana – aplication of gourd (kapha dosha) 93

94. INDICATION (SU.SU.25/12-15)
(A.H.SU.27/3-5)
 Apachi
 Asyapaka
 Arsa
 Daha
 Dantapupputa
 Dantavesta
 Dustartava
 Granthi
 Sopha
 Galasula
 Karnapali roga
 Putigraha
 Raktadimantha
 Raktapitta
 Sitada
 Raktarsha
 SoushiraJihva kantaka
 Krimi dantaka
 Kshudra roga
 Kustha
 Ostaroga
 Pidaka etc.
94

95.  CONTRAINDICATION
 अववस्त्राव्या सवांग्शोफ क्षीणस्त्य चा्लिोजने तनशमत्ता ।
 पांडु रोनयश्य सोदरर शोवष गशियणीणां च श्वयथव्
(सु.सू 14/24)
KALA
 व्यिे वषायषु ववर्धयेत्तु ग्रीष्मकाले िु शीिले ।
 हेमन्ि्काले मर्धयान्हे शस्त्रकालास्त्रय् स्त्रिा ॥
(सु. शा.8/10)
95

96.  RAKTAMOKSHANA IN KUSTHA
 क्स्त्थरकहठनमण्ड्वलानां क्स्त्वन्नानां प्रस्त्िरप्रणाडीशि ।
 कू चेववघट्हििानां रतिौत्मतलेशोपनेिव्य् ॥
 आनूपवाररजानां मांसानां पोट्ट्ले सुखोष्णेस्त्च्।
 क्स्त्वन्नौत्मसन्नं ववशलखेि्कु ष्ठं िीक्ष्णेन्शस्त्रेण्॥
 रुचधरगमाथयमथवा स्रुन्गालाबूतन योज्येि्कु ष्ठे ।
 प्रक्च्छिमल्पं कु ष्ठं ववरेचयेद्वा जलौकोशि ॥ (च.चच.7/50-52)
 Kushta – Sthira, Katina and Mandala – Nadi & Prastara sweda
 Rub with Kurcha
 Rakta nirharana with Srunga / Alabu / Jalouka
96

97. SHAMANA YOGAS
 There are innumerable shamana yogas
mentioned for kushta in the form of churna,
vati, lehya, kashaya, asavarista,
rasoushadha, lepa, taila, gritha. It is
important to know when to use what to get
good results.
97

98. CHIKITSA YOGAS
Darvi kalka or chorna with gomutra
 Rasanjana with gomuta
 Abhaya, vyosha, guda, tila taila for one month.
 Patoladi kwatha
 Lelitaka (sulphur) with jati (amalaki) swarasa
mixed with honey internally intake.
 Vajrashilajatu with jati swarasa
 Yogaraj with jati swarasa
 Kusthakuthara rasa
98

99. GHRUTA
Vatakushta- Ghrita prepared of meshasringi,
guduchi, swadamshtra, sarngeshta, dwipanchamuli.
 Pittakushta- By ghrita prepared of Dhava,
aswakarna, kakubha, palasa, pichumarda,
parpataka, madhuka, lodhra, samanga
 Kaphajakushta- By ghrita prepared of priyalasala,
aragwadha, nimba, saptaparna, chitraka, maricha,
vacha, kushta, bhallataka, abhaya, vidanga
99

100.  In pitta & Rakta- Tikta Ghritas externally &
internally.
Eg:
 Tiktashatpalak ghruta (ch.chi.7/140-143)
 Mahatiktaka ghruta (ch.chi.7/144-150)
 Mahakhadira ghruta (ch.chi.7/152-156)
 Khadira, nimba, darvi ghruta (ch.chi.7/135)
10
0

101. TAILAS
 Vatakushta- Taila prepared of meshasringi, guduchi, swadamshtra,
sarngeshta, dwipanchamuli.
 Kaphajakushta- By taila of priyalasala,aragwadha, nimba, saptaparna,
chitraka, maricha, vacha, kushta, bhallataka, abhaya, vidanga.
 Sarvakushta- By bhallataka taila, tuvaraka taila etc.
(Su.Chi.9/7)
 Kusthaghna hitakar taila (ch.chi.7/119)
 Vipadika hara ghruta-taila (ch.chi.7/120,121)
 Swetakarveradh taila
 Swetakarverapallavadh taila
 Tiktekshvakadi taila
 Kanakakshiri taila
 Vipadikaya dhatturbija taila
10
1

102. KASHAYA
 Sonitha prapta & Mamsa prapta.
 Tikta kashayas; For kaphaja, pithaja & Raktaja
kushtas.
Eg: Laghu Manjishtadi, Madhyama
Manjishtadi, Brihat Manjishtadi Kashayas,
Patolamuladikwatha
10
2

103. CHURNA
 Mustadi churna(ch.chi7/65-67)
 Triphaladi churna (in numbness of skin)
(ch.chi.7/68,69)
 Swarnamakshika churna with gomutra
(ch.chi.7/70-72)
 Gandhapashana churna
 Somraji chorna
 Vaguji chorna
10
3

104. ARISTHA, ASAVA, MANTHA,PRASA
 Mamsa prapta kushta.
Eg: Khadirarishta,Madhwasava,
Kanakabindwarishta, Triphalasava
 Madvaasava in kustha & kilasa
 Kanakavinduristha
 Triphalasava
 Kashayas made of rasanjan, aragbadha patra,
kutaja, patola mula, nimba bark, khadirsara,
triphala
 We can use of above said drugs in the form of
ghruta and taila in kustha samanartha
10
4

105. ALEPANA
 Nirhrita asradosha
 Samsodhitasayanam (Cha.Chi.7/53)
 Twak prapta
 Shonita prapta
 Mamsa prapta (Su.Chi.9/6)
Eg: Eladilepa, Kushtadilepa,
Lodhrabijadilepa, Mamsyadilepa.
10
5

106. LEPAS
 Sidhma nasak lepa (ch.chi.7/117,118)
 Mandala kustha nashak taila (ch.chi.7/122-127)
 Pittakusthan nashak lepa (ch.chi.7/130,131)
 Vidangadi lepa
 Dadrurvaadou durvadi lepa (chakradatta)
 Manashiladi lepa
 Dadrugajendra pralepa
 Chakramardobijadi pralepa
 Tranak pradeha
 Kaasmarda pralepa
 Molakabeej pralepa
 Gandhapashad pralepa
10
6

107.  Karanjabijadi patra pralepa
 Amaltaaspatra pralepa
 Sidhma kustha gandhapashan pralepa
 Sidhma kasmarda pralepa
 Sidhma sarjasaadi praleepa
 Siddh kusthadi lepa
 Chatrahadi lepa
 Edgajadi lepa
 Vicharchikaya bhrustasarsapaka kalka
 Vicharchika grah dhoom lepa
 Tandula pralepa
 Sarjasaadi lepa
 Avalgujadi lepa
 Sinduradi lepa
 Bhallatakadi lepa 10
7

108. VATI
 Aarogyavardhini vati (R.RS.)
 Saptasama gutika
 Triphala gutika
 Gandhaka rasayana
10
8

109. GUGGULU PREPARATIONS
Amrita guggulu
Ekavimsatika guggulu
Panchatiktaghrita guggulu
10
9

110. UDVARTANA
 Kusthadh udvartanam churna
 Nishadyaudvartanam
11
0

111. RASALEPA:
Pashana churna + Yavakshara+ Mustard oil/
Gandhapashana+ Katu taila exposed the mixture to
sunrays.
11
1

112. KSHARA PRAYOGA
 येषु न शस्त्रं क्रमेि ्स्त्पशेक्न्द्रयनाशनातन यातन स्त्यु ।
िेषु तनपात्मय ् क्षारो रतिं दोष ्ं च ववस्त्राव्य ॥
(च.चच.7/54)
1) Kushtas where sastra karma is
contraindicated.
2) In Sparsanendriyanasa
3) Nipatya
4) After visravana
11
2

113. AGADA PRAYOGA
 पाषाणकहठनपरुषे सुप्िे कु ष्ठे क्स्त्थरे पुराणे च ।
 पीिागदस्त्य कायो ववषे प्रदेहोगदेस्त्चानु ॥
 स्त्िब्धातन सुप्िसुप्िान्यस्त्वेदनकण्डुलातन कु ष्ठातन।
 कू चेदयक्न्ित्ररव्रिाकरवीरकरन्जकु िजानाम्॥
 जात्मयकय तन्ब्जेवाय परे शस्त्रे समुद्रफे नेवो ।
 घ्रष्िातन गोमयेवाय िि् प्रदेहे प्रदेहातन ॥ (च.चच.7/55-57)
11
3

114. SNANOPYOGI DRAVYAS
 Ch.chi7/129,130
 Siddharthaka snana churna
 Darvi kwatha
 Patola
 Nimba
 Khadirasara
 Karanja
 Aragwadha
11
4

115. ABHYANGA:
Vajrakatailam,
Mahavajrakatailam,
Adityapaka tailam (B.P,mad.),
Marichaditailam,
Somarajitaila,
Swetakaranjaditaila
11
5

116. दाहयुतिकु क्ष्ठ स्त्नान प्रयोगा
 रोध्राररष्िं पद्मकं रतिसार् सप्िाहाक्षौ व्रक्षको बीजकस्त्च्।
 योज्या स्त्नाने दहमानस्त्य जन्िो पेया वा स्त्याि्क्षौद्रयुतिा
त्ररिण्डी ॥ (सु.चच.9/50)
11
6

117. RASAYAN YOGAS
 Navayasa rasayana (chakradatta)
 Brahmiaadi rasayan
 Chitraka rasayan
 Bhallataka rasayan
 Tuvarak rasayan (Ah.Chi.19/53)
 Medo prapta kushta
 Yapya kushta
 All kushtas
Eg:Tuvarasthi, Bhallataka, Bakuchi,
Chitrakamulam, Silajatu (Ah.Chi.19/53
11
7

118. GUDA
 Manibhadra guda (A.H.chi.19/31,32)
Modaka
 Triphala modaka
AVALEHA
Bhallatakavaleha,
Sashangavaleha,
Dhatryadyavaleha
11
8

119. CONCLUSION
 Selection of chikitsa for kushta depends on
predominant of doshas
 Repeated shodhana is essential for bahu doshavastha
other than trying to eliminate it all at once since it
weakens the patient
 In excessive vata aggravated condition, basti chikitsa
can be adopted
 Nasya is indicated in kapha pradhana kushta and
dhumapana in kushta affecting jatrurdwa
 If doshas are in alpavastha we can treat with shaman
line of treatment.
11
9

120. 120
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