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LUTA VISHA
Aswani Vaishak
2nd year PG Scholar
Department of Agad Tantra
VPSV Ayurveda college, Kottakkal
1
CONTENTS
Introduction
Origin
Classification
2
Lakshana
Treatment
Case report
INTRODUCTION
• Luta – lunati lun chedane.
• Derived from the root word lun – means chedane.
• Synoyms :
• Tantuvayah
• Urnanabhah
• Markatakah
3
Contd…
• More than 40,000 species.
• In India: 600 different spiders.
• Most of them : venomous.
• In India : Fringed-Ornamental Tarantula.
4
TAXONOMICAL CLASSIFICATION
• Kingdom : Animalia
• Phylum : Arthropoda
• Class : Arachnida
• Order : Araneae
5
MYTHOLOGICAL ORIGIN
• A/c to Su. S : Sweat on the forehead of vasista.
• A/c to A . S :
• Spark of fire that came out of the bodies of asura
• Vesicles develop on the body due to ingestion of contaminated or
poisonous food - Luta
6
CLASSIFICATION
• Su.S: 16
• Vagbhata : 16 / 28/ 1000 or innumerable
• Prayoga samuchaya
• Jyotsnika 24
• Kriyakoumudi
7
Contd…
• Based on Vishaprabhava (action of poison)
• Tikshna Visha : Occurrence of death within 7 days.
• Madhyama Visha: Occurrence of death within 7 to 10 days.
• Manda Visha: Occurrence of death within 15 days
8
Contd…
• According to the effect of poisoning.
1)Charaka
a) Dooshivisha type (slow poisoning)
b) Pranahara type (causing death)
2) Kriyakoumudi
a) Luta visha which affects rakta (blood)
b) Luta visha which affects Nadi (Nerve)
9
POISONOUS SPIDER
THE BLACK WIDOW SPIDER THE BROWN RECLUSE
THE FUNNEL WEB SPIDER
THE WOLF SPIDER
10
THE BLACK WIDOW SPIDER
11
• Have a black hairless body.
• Red marking on its abdomen similar to an hourglass.
• Not aggressive under normal circumstances.
• Attacks if disturbed.
THE BROWN RECLUSE SPIDER
12
• Recognized by the violin-shaped marking on its back .
• Takes rest during the day.
• Not aggressive.
• Usually bitten by wearing clothes and shoes with spiders in them
THE FUNNEL WEB SPIDER
13
• Most dangerous spider in the world.
• Aggressive in the absence of provocation.
• Spider’s web is funnel-shaped, hence the name.
• Venom - neurotoxin
THE WOLF SPIDER
14
• Most wolf spiders are dark brown.
• The hairy body is long and broad, with stout, long legs.
COMMON SOUTH INDIAN SPIDER
Tiger spiders – Theraphosidae.
15
Velvet spider – Eresidae
16
Sac spider – Clubionidae Jumping spiders – salticidae
VISHADHISHTANAS
• 8 – A.S
• 7 – Su. S
• No swasa – A/c to Su . S
17
ass
Swasa
Damstra
Sakrit
Mutra
Sukra
Lala
Nakha
Artava
MORPHOLOGY OF SPIDER
18
• The body is divided into two regions,
• Cephalothorax
• Abdomen
• Attached by a narrow pedicel.
19
Contd …
• The ventral surfaces of the abdomen possesses the external openings
of
• Reproductive
• Respiratory
• Digestive system.
20
SPIDER VENOM GLANDS
• Glands absent – Uloboridae & Holarchaeidae family.
• Glands
• Basal segment of chelicerae ( Mygalomorph)
• Anterior prosoma (Araneomorph).
21
VENOM DELIVERY METHODS
• Fangs
• Envenomated apparatus acts like a
pressurized hypodermic needle
delivering venom
22
SPIDER VENOM
• Venom : mixture of neurotoxic compounds
• Spider venom components – 4 groups.
23
Small molecular mass compounds (SMMSs)
Antimicrobial peptides
Peptide neurotoxins
Proteins and enzymes
Contd…
• Small molecular mass compounds:
Include ions, organic acids, nucleotides, nucleosides, amino acids,
amines, and polyamines.
• Peptide neurotoxins : Mu – Agatoxins, Delta Atracotoxin & Latrotoxin.
24
SPIDER ENVENOMATION
• Two fundamental principles :
25
• Neurotoxic venom
• Necrotic or cytotoxic venom
NEUROTOXIC VENOM
• Majority possess neurotoxic venom.
• The nervous system is attacked varies from spider to spider.
26
NECROTIC VENOM
• Family – sicariidae.
• Includes both the recluse spider & the six eyed sand spider.
• Possess a known dermonecrotic agent sphingomyelinase D.
27
LAKSHANAS
Dosha Signs & symptoms
Vataja {ɯþ¹É& ¶ªÉÉ´É& ,{É´ÉǦÉän ,
V´É®.
Pithaja nüɽý, iÉÞ]Âü ,º¡úÉä],ü V´É®,
¨ÉÉä½ý. ®Hú{ÉÒiÉɦÉ, KäúnüÒ ,
püÉIÉÉ¡ú™üÉä{ɨÉ,
Kaphaja ÊxÉpüÉÆ, ¶ÉÒiÉV´É®Æ, EúɺÉ,Æ
EúhbÚÆü ¦ÉÞ¶ÉÉ乨ÉÉ, EúÊ`üxÉ,
{ÉÉhbÖü, {É°ÿ¹ÉEú¡ú™üÉEÞúÊiÉ.
Sannipathika ¾ýx¨ÉÉä½ý, ·ÉɺÉ, ʽýv¨ÉÉ,
ʶɮÉäOɽýÉ,
28
SAMANYA LAKSHANA
• nüpÖü¨Éhbü™üºÉÊzɦÉ&
• ʺÉiÉÉä%ʺÉiÉÉä%¯þhÉ&
{ÉÒiÉ& ¶ªÉÉ´ÉÉä
• ¨ÉÞnÖü¯þzÉiÉ&
• ¨ÉvªÉä EÞú¹hÉÉä%lÉ´ÉÉ
¶ªÉÉ´É& {ɪÉÇxiÉä
29
• ¤É½Öý´ÉänüxÉ&
• V´É®
• {ÉÉEúÊ´ÉKäúnüEúÉ
älÉÉ´Énü®hÉÉÎx´É
iÉ&
• KäúnäüxÉ
LAKSHANAS A/C TO DAY BY DAY PROGRESSION
Vegas
½ day xÉè´É nÆü¶ÉÉä
™ÚüiÉÉʴɹÉÉä‘ü´É& (A.H)
1st day ºÉÚSÉÒ´ªÉvÉ´ÉnüɦÉÉÊiÉ
,+´ªÉHú´ÉhÉÇ& |ÉSÉ™ü&
ÊEúʈÉiEúhbÚü¯þVÉÉÎx´ÉiÉ& (A.H)
<ǹÉiºÉEúhbÖü, |ÉSÉ™Æü ,
EúÉä`ü¨É´ªÉHú´ÉhÉÈ (Su.S)
nd
30
3rd day V´É®Éä
®Éä¨É½ý¹ÉÇEÞúpüHú¨Éhbü™ü&,
¶É®É´É°ÿ{É, iÉÉänüÉf¬Éä
®Éä¨ÉEÚú{Éä¹ÉÖ ºÉɻɴÉ& (A.H)
iÉqü¶ÉǪÉiÉÒ½ý °ÿ{ÉÆ Ê´É¹ÉÆ (Su.S)
4th day ¨É½ýɷɪÉlÉÖ, iÉÉ{É,
·ÉɺÉ,§É¨É|Énü& (A.H)
SÉiÉÖlÉæ%½ýÊxÉ EúÉä{ɨÉäÊiÉ
(Su.S)
Contd…
31
Contd…
6th day ´ªÉÉ{ÉîÉäÊiÉ ¨É¨ÉÉÇÊhÉ (A.H)
Ê´É|ɺÉÞiÉÆ iÉÖ ºÉ´ÉÉÇxÉ ,
¨É¨ÉÇ|Énäü¶ÉÉxÉ ,
¦É޶ɨÉÉ´ÉÞhÉÉäÊiÉ
7th day ½ýÎxiÉ VÉÒÊ´ÉiɨÉ (A.H)
iÉiÉÂ
ºÉ”ɨÉä%iªÉlÉÇ{É®ÒiÉMÉÉjÉÆ
´ªÉÉ{ÉÉnüªÉä¨ÉiªÉǨÉÊiÉ|É´ÉÞr
ü¨É 32
VISHAVEGA LAKSHANA
Vitiated dhatu Symptoms
Tvak Angasada, karsya, kandu
Rakta Kampa, romaharsa
Mamsa Pidaka, sopha, trisna
According to kriya koumadi
33
Contd…
Medas Sphota, mandala, jwara
Asthi Gatrasada, jihvasosa
Majja Sirotaluruja, moha, jwara
Sukra Trsna, moha, indriyasada
34
CLINICAL FEATURES
• Most bites produce sharp pin prick pain at the site of bite, with
erythema and edema.
• Painful and pruritic with central induration .
• In severe - the erythema spreads, centre of lesion becomes
hemorrhagic and necrotic with an overlying bulla.
• Later - sloughing of the necrotic tissue with ulcer formation and a
depressed scar. 35
CLINICAL SYNDROMES RESULTING
FROM SPIDER BITE
36
• Latrodectism (caused by latrodectus spp.)
• Loxoscelism (caused by loxosceles spp.).
• Funnel web spider syndrome.
LATRODECTISM
• Envenomation by bite of latrodectus spiders.
• Toxin – latrotoxin
• Release - neurotransmitters acetylcholine, norepinephrine & GABA
• Acts on presynaptic nerve membranes & through the cell's signalling
protein.
• Initial pain is followed by severe muscle cramps.
37
LOXOSCELISM SYNDROME
• Caused by the bite of the brown recluse spider.
• Usually painless but it later becomes an inflammatory, hemorrhagic
and painful lesion.
• The area becomes dusky and a shallow open sore forms as the skin
around the necrosis.
38
DIAGNOSIS
• Based on the history and clinical presentation.
• Spider bites - typically single lesions.
• No commercially available laboratory tests.
39
DIFFERENTIAL DIAGNOSIS
Infections
• Community-acquired methicillin-resistant staphylococcus aureus (CA-
MRSA) skin infections
• The skin lesion of early lyme disease
• Herpes zoster and herpes simplex infections
40
CONTD…
41
Skin lesion of early lyme disease Herpes zoster
Contd…
 Other bites and stings.
 Other common dermatoses — Poison ivy, poison oak, and other
plants in the Anacardiaceae family
42
Contd..
43
Scorpion bite
Bhallathaka visha
ASADYA LAKSHANA
• ¾ýx¨ÉÉä½ ý
• ·ÉɺÉ
• ʽýv¨ÉÉ
• ʶɮÉäOɽýÉ&
• ·ÉäiÉ{ÉÒiÉÉʺ
ÉiÉÉ®HúÉ&
Ê{ÉÊ]üEúÉ&
• ·ÉªÉlÉÚ‘ü´É&
• ´Éä{ÉlÉÖ
• ´ÉǨÉlÉÖ
• nüÉǽý
• त्रिट्
• आन्ध्यम ्
• ´ÉGúxÉɺÉiÉÉ
• ¶ªÉÉ´ÉÉ袴ÉCjÉnüxi
Éi´ÉÆ
• {ÉÞ¢OÉÒ´ÉɴɦɉÉxÉ
¨ÉÂ
• {ÉFúVɨ¤ÉںɴÉhÉÈ
SÉ nÆü¶ÉÉi»É´ÉÊiÉ
44
TREATMENT
xɺªÉɉÉxÉɦªÉ‰ÉxÉ{ÉÉxÉvÉÚ¨ÉÆ
iÉlÉÉ%´É{ÉÒbÆü Eú´É™üOɽÆý SÉ **
ºÉƶÉÉävÉxÉÆ SÉÉä¦ÉªÉiÉ:
|ÉMÉÉfÆ EÖúªÉÉÇÎiºÉ®É¨ÉÉäIÉhɨÉä´É
SÉÉjÉ **134**
Su. Kal. 8/134
45
Contd…
1. Uddharana - sastra
2. Dahana – except paithika damsa
3. Lepa – agada + honey & saindava
4. Seka – ksheerivriksha twak kwatha
5. Rakthamoksha – sringa, sira vyada
6. Parisheka – bodhi, sleshmathaka, akshaka vriksha
46
Contd…
7. Vamana
8. Virechena
9. Vasthi
10. Nasya
11. Anjana
12. Karnika patana
47
DAY WISE TREATMENT
• A/c to Prayoga sammuchaya
Day Treatment
1 Raktamokshana, lepana – haridra + thulasi
2 Pana of thulasi moola along with milk internally
3 Pana & lepana of yashtimadhu + chanadana + usira
48
Contd…
Day Treatment
4 Lepana with sirishamula + nilimula grinded in sirisasvarasa
5 Pana of tanduliyaka + kshira
6 Pana of equal quantities of grinded paste of asana, usira,
nilimula
7 Nasya, anjana done with luthavisha hara drugs.
49
VISHAVEGA LAKSHANA TREATMENT
Dhatu Treatment
Tvak After raktamoksha, lepana with haridra + thulasidala
Rakta Pana of tulasi moola kalka with milk
Mamsa Pana, nasya, lepa with usira, yasti, candana.
50
Contd…
Dhatu Treatment
Medas Pana, nasya, lepana with nilitwak, sirisatvak in sirisha
swarasa
Asthi Pana of tanduliyaka kalka in milk.
Majja Pana of nilini, usira, candana & asana in milk.
Sukla Pana of sariba, Amari and tanduliyakamulakalka with milk,
nasya & anjana with suitable medicines.
51
IMPORTANT AGADAS
• Lodrasevyadi agadam
• Dasanga agada
• Vilwadi gulika
52
• Campakam agada
• Padmaka agada
• Mandara agada
• Sarvakarmikagada
YOGAS MENTIONED IN MALAYALAM
BOOKS
• Nilitulasyadi yoga
• Nalpamara kashaya dhara.
• Aswatha vibitakadi yoga – lepa & dhara
• Panchaka agada
• Hingu kalka - pralepa
• Karavellaka patradi yoga
53
PATHYA
• Sastika Sali
• Bitter gourd
• Snake gourd
• Green gram
• Dry ginger
54
• Pepper
• Onion
• Rock salt
• Asafetida
APATHYA
Ahara
• Salt
• Curds
• Amla rasa
• Matsya
• Mamsa
• Thila thailam
55
Vihara
• Bath
• Sleep during day time.
• Anger
• Physical exercise
• Exposure to sun, fire, wind
THE PALLIYARA SREE BHAGAVATHY
TEMPLE
56
DOOSHI VISHA & SPIDER POISONING
• Victim ignored spider bites and neglected treatment
• Not completed the course of treatment
• Misdiagnosed by physician
57
CONCLUSION
• Luta is darunatara among keeta visha.
• Skin eruptions – one of the surest diagnostic measures of luta visha.
• Misdaignosing the case will make the prognosis poor.
58
REFERENCES
• Golay V, Desai A, Hossain A, Roychowdhary A, Pandey R. Acute kidney injury with pigment
nephropathy following spider bite: a rarely reported entity in India. Renal Failure. 2013 May
1;35(4):538-40.
• Shackleford R, Veillon D, Maxwell N, LaChance L, Jusino T, Cotelingam J, Carrington P. The
black widow spider bite: differential diagnosis, clinical manifestations, and treatment options. J La
State Med Soc. 2015 Mar-Apr;167(2):74-8. Epub 2015 Apr 15. PMID: 25978056.
• Angad.Ramesh.Shripat et al : Conceptual Study on Luta-Vis
• Jegaraj K, Saurabh R S, Rakesh P S. Spider bite from South India. J Postgrad Med 2014;60:216-7
• Patel KD, Modur V, Zimmerman GA, Prescott SM, McIntyre TM. The necrotic venom of the
brown recluse spider induces dysregulated endothelial cell-dependent neutrophil activation.
Differential induction of GM-CSF, IL-8, and E-selectin expression. J Clin Invest. 1994
Aug;94(2):631-42. doi: 10.1172/JCI117379. PMID: 7518841; PMCID: PMC296140.
59
Contd…
• :Adarsh, C.K. & P.O. Nameer(2015). Spiders of Kerala Agricultural University Campus, Thrissur,
Kerala, India. Journal of Threatened Taxa 7(15): 8288–
8295;http://dx.doi.org/10.11609/jott.2468.7.15.8288-8295.
• Sushruta Samhita Vol.1 by Dr. Ambikadutta Shastri, Chaukhamba Sanskrit Sansthan, Kalpasthana
Adhaya no.8
• Asthang Sangraha by Dr K.R.Srikantha Murthy, Chaukhambha Orientala, published-1999,
Uttartantra Adhaya no.44
60
61

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LUTHA VISHA

  • 1. LUTA VISHA Aswani Vaishak 2nd year PG Scholar Department of Agad Tantra VPSV Ayurveda college, Kottakkal 1
  • 3. INTRODUCTION • Luta – lunati lun chedane. • Derived from the root word lun – means chedane. • Synoyms : • Tantuvayah • Urnanabhah • Markatakah 3
  • 4. Contd… • More than 40,000 species. • In India: 600 different spiders. • Most of them : venomous. • In India : Fringed-Ornamental Tarantula. 4
  • 5. TAXONOMICAL CLASSIFICATION • Kingdom : Animalia • Phylum : Arthropoda • Class : Arachnida • Order : Araneae 5
  • 6. MYTHOLOGICAL ORIGIN • A/c to Su. S : Sweat on the forehead of vasista. • A/c to A . S : • Spark of fire that came out of the bodies of asura • Vesicles develop on the body due to ingestion of contaminated or poisonous food - Luta 6
  • 7. CLASSIFICATION • Su.S: 16 • Vagbhata : 16 / 28/ 1000 or innumerable • Prayoga samuchaya • Jyotsnika 24 • Kriyakoumudi 7
  • 8. Contd… • Based on Vishaprabhava (action of poison) • Tikshna Visha : Occurrence of death within 7 days. • Madhyama Visha: Occurrence of death within 7 to 10 days. • Manda Visha: Occurrence of death within 15 days 8
  • 9. Contd… • According to the effect of poisoning. 1)Charaka a) Dooshivisha type (slow poisoning) b) Pranahara type (causing death) 2) Kriyakoumudi a) Luta visha which affects rakta (blood) b) Luta visha which affects Nadi (Nerve) 9
  • 10. POISONOUS SPIDER THE BLACK WIDOW SPIDER THE BROWN RECLUSE THE FUNNEL WEB SPIDER THE WOLF SPIDER 10
  • 11. THE BLACK WIDOW SPIDER 11 • Have a black hairless body. • Red marking on its abdomen similar to an hourglass. • Not aggressive under normal circumstances. • Attacks if disturbed.
  • 12. THE BROWN RECLUSE SPIDER 12 • Recognized by the violin-shaped marking on its back . • Takes rest during the day. • Not aggressive. • Usually bitten by wearing clothes and shoes with spiders in them
  • 13. THE FUNNEL WEB SPIDER 13 • Most dangerous spider in the world. • Aggressive in the absence of provocation. • Spider’s web is funnel-shaped, hence the name. • Venom - neurotoxin
  • 14. THE WOLF SPIDER 14 • Most wolf spiders are dark brown. • The hairy body is long and broad, with stout, long legs.
  • 15. COMMON SOUTH INDIAN SPIDER Tiger spiders – Theraphosidae. 15 Velvet spider – Eresidae
  • 16. 16 Sac spider – Clubionidae Jumping spiders – salticidae
  • 17. VISHADHISHTANAS • 8 – A.S • 7 – Su. S • No swasa – A/c to Su . S 17 ass Swasa Damstra Sakrit Mutra Sukra Lala Nakha Artava
  • 18. MORPHOLOGY OF SPIDER 18 • The body is divided into two regions, • Cephalothorax • Abdomen • Attached by a narrow pedicel.
  • 19. 19
  • 20. Contd … • The ventral surfaces of the abdomen possesses the external openings of • Reproductive • Respiratory • Digestive system. 20
  • 21. SPIDER VENOM GLANDS • Glands absent – Uloboridae & Holarchaeidae family. • Glands • Basal segment of chelicerae ( Mygalomorph) • Anterior prosoma (Araneomorph). 21
  • 22. VENOM DELIVERY METHODS • Fangs • Envenomated apparatus acts like a pressurized hypodermic needle delivering venom 22
  • 23. SPIDER VENOM • Venom : mixture of neurotoxic compounds • Spider venom components – 4 groups. 23 Small molecular mass compounds (SMMSs) Antimicrobial peptides Peptide neurotoxins Proteins and enzymes
  • 24. Contd… • Small molecular mass compounds: Include ions, organic acids, nucleotides, nucleosides, amino acids, amines, and polyamines. • Peptide neurotoxins : Mu – Agatoxins, Delta Atracotoxin & Latrotoxin. 24
  • 25. SPIDER ENVENOMATION • Two fundamental principles : 25 • Neurotoxic venom • Necrotic or cytotoxic venom
  • 26. NEUROTOXIC VENOM • Majority possess neurotoxic venom. • The nervous system is attacked varies from spider to spider. 26
  • 27. NECROTIC VENOM • Family – sicariidae. • Includes both the recluse spider & the six eyed sand spider. • Possess a known dermonecrotic agent sphingomyelinase D. 27
  • 28. LAKSHANAS Dosha Signs & symptoms Vataja {ɯþ¹É& ¶ªÉÉ´É& ,{É´ÉǦÉän , V´É®. Pithaja nüɽý, iÉÞ]Âü ,º¡úÉä],ü V´É®, ¨ÉÉä½ý. ®Hú{ÉÒiÉɦÉ, KäúnüÒ , püÉIÉÉ¡ú™üÉä{ɨÉ, Kaphaja ÊxÉpüÉÆ, ¶ÉÒiÉV´É®Æ, EúɺÉ,Æ EúhbÚÆü ¦ÉÞ¶ÉÉ乨ÉÉ, EúÊ`üxÉ, {ÉÉhbÖü, {É°ÿ¹ÉEú¡ú™üÉEÞúÊiÉ. Sannipathika ¾ýx¨ÉÉä½ý, ·ÉɺÉ, ʽýv¨ÉÉ, ʶɮÉäOɽýÉ, 28
  • 29. SAMANYA LAKSHANA • nüpÖü¨Éhbü™üºÉÊzɦÉ& • ʺÉiÉÉä%ʺÉiÉÉä%¯þhÉ& {ÉÒiÉ& ¶ªÉÉ´ÉÉä • ¨ÉÞnÖü¯þzÉiÉ& • ¨ÉvªÉä EÞú¹hÉÉä%lÉ´ÉÉ ¶ªÉÉ´É& {ɪÉÇxiÉä 29 • ¤É½Öý´ÉänüxÉ& • V´É® • {ÉÉEúÊ´ÉKäúnüEúÉ älÉÉ´Énü®hÉÉÎx´É iÉ& • KäúnäüxÉ
  • 30. LAKSHANAS A/C TO DAY BY DAY PROGRESSION Vegas ½ day xÉè´É nÆü¶ÉÉä ™ÚüiÉÉʴɹÉÉä‘ü´É& (A.H) 1st day ºÉÚSÉÒ´ªÉvÉ´ÉnüɦÉÉÊiÉ ,+´ªÉHú´ÉhÉÇ& |ÉSÉ™ü& ÊEúʈÉiEúhbÚü¯þVÉÉÎx´ÉiÉ& (A.H) <ǹÉiºÉEúhbÖü, |ÉSÉ™Æü , EúÉä`ü¨É´ªÉHú´ÉhÉÈ (Su.S) nd 30
  • 31. 3rd day V´É®Éä ®Éä¨É½ý¹ÉÇEÞúpüHú¨Éhbü™ü&, ¶É®É´É°ÿ{É, iÉÉänüÉf¬Éä ®Éä¨ÉEÚú{Éä¹ÉÖ ºÉɻɴÉ& (A.H) iÉqü¶ÉǪÉiÉÒ½ý °ÿ{ÉÆ Ê´É¹ÉÆ (Su.S) 4th day ¨É½ýɷɪÉlÉÖ, iÉÉ{É, ·ÉɺÉ,§É¨É|Énü& (A.H) SÉiÉÖlÉæ%½ýÊxÉ EúÉä{ɨÉäÊiÉ (Su.S) Contd… 31
  • 32. Contd… 6th day ´ªÉÉ{ÉîÉäÊiÉ ¨É¨ÉÉÇÊhÉ (A.H) Ê´É|ɺÉÞiÉÆ iÉÖ ºÉ´ÉÉÇxÉ , ¨É¨ÉÇ|Énäü¶ÉÉxÉ , ¦É޶ɨÉÉ´ÉÞhÉÉäÊiÉ 7th day ½ýÎxiÉ VÉÒÊ´ÉiɨÉ (A.H) iÉiÉ ºÉ”ɨÉä%iªÉlÉÇ{É®ÒiÉMÉÉjÉÆ ´ªÉÉ{ÉÉnüªÉä¨ÉiªÉǨÉÊiÉ|É´ÉÞr ü¨É 32
  • 33. VISHAVEGA LAKSHANA Vitiated dhatu Symptoms Tvak Angasada, karsya, kandu Rakta Kampa, romaharsa Mamsa Pidaka, sopha, trisna According to kriya koumadi 33
  • 34. Contd… Medas Sphota, mandala, jwara Asthi Gatrasada, jihvasosa Majja Sirotaluruja, moha, jwara Sukra Trsna, moha, indriyasada 34
  • 35. CLINICAL FEATURES • Most bites produce sharp pin prick pain at the site of bite, with erythema and edema. • Painful and pruritic with central induration . • In severe - the erythema spreads, centre of lesion becomes hemorrhagic and necrotic with an overlying bulla. • Later - sloughing of the necrotic tissue with ulcer formation and a depressed scar. 35
  • 36. CLINICAL SYNDROMES RESULTING FROM SPIDER BITE 36 • Latrodectism (caused by latrodectus spp.) • Loxoscelism (caused by loxosceles spp.). • Funnel web spider syndrome.
  • 37. LATRODECTISM • Envenomation by bite of latrodectus spiders. • Toxin – latrotoxin • Release - neurotransmitters acetylcholine, norepinephrine & GABA • Acts on presynaptic nerve membranes & through the cell's signalling protein. • Initial pain is followed by severe muscle cramps. 37
  • 38. LOXOSCELISM SYNDROME • Caused by the bite of the brown recluse spider. • Usually painless but it later becomes an inflammatory, hemorrhagic and painful lesion. • The area becomes dusky and a shallow open sore forms as the skin around the necrosis. 38
  • 39. DIAGNOSIS • Based on the history and clinical presentation. • Spider bites - typically single lesions. • No commercially available laboratory tests. 39
  • 40. DIFFERENTIAL DIAGNOSIS Infections • Community-acquired methicillin-resistant staphylococcus aureus (CA- MRSA) skin infections • The skin lesion of early lyme disease • Herpes zoster and herpes simplex infections 40
  • 41. CONTD… 41 Skin lesion of early lyme disease Herpes zoster
  • 42. Contd…  Other bites and stings.  Other common dermatoses — Poison ivy, poison oak, and other plants in the Anacardiaceae family 42
  • 44. ASADYA LAKSHANA • ¾ýx¨ÉÉä½ ý • ·ÉÉºÉ • ʽýv¨ÉÉ • ʶɮÉäOɽýÉ& • ·ÉäiÉ{ÉÒiÉÉʺ ÉiÉÉ®HúÉ& Ê{ÉÊ]üEúÉ& • ·ÉªÉlÉÚ‘ü´É& • ´Éä{ÉlÉÖ • ´ÉǨÉlÉÖ • nüÉǽý • त्रिट् • आन्ध्यम ् • ´ÉGúxÉɺÉiÉÉ • ¶ªÉÉ´ÉÉ袴ÉCjÉnüxi Éi´ÉÆ • {ÉÞ¢OÉÒ´ÉɴɦɉÉxÉ ¨É • {ÉFúVɨ¤ÉںɴÉhÉÈ SÉ nÆü¶ÉÉi»É´ÉÊiÉ 44
  • 45. TREATMENT xɺªÉɉÉxÉɦªÉ‰ÉxÉ{ÉÉxÉvÉÚ¨ÉÆ iÉlÉÉ%´É{ÉÒbÆü Eú´É™üOɽÆý SÉ ** ºÉƶÉÉävÉxÉÆ SÉÉä¦ÉªÉiÉ: |ÉMÉÉfÆ EÖúªÉÉÇÎiºÉ®É¨ÉÉäIÉhɨÉä´É SÉÉjÉ **134** Su. Kal. 8/134 45
  • 46. Contd… 1. Uddharana - sastra 2. Dahana – except paithika damsa 3. Lepa – agada + honey & saindava 4. Seka – ksheerivriksha twak kwatha 5. Rakthamoksha – sringa, sira vyada 6. Parisheka – bodhi, sleshmathaka, akshaka vriksha 46
  • 47. Contd… 7. Vamana 8. Virechena 9. Vasthi 10. Nasya 11. Anjana 12. Karnika patana 47
  • 48. DAY WISE TREATMENT • A/c to Prayoga sammuchaya Day Treatment 1 Raktamokshana, lepana – haridra + thulasi 2 Pana of thulasi moola along with milk internally 3 Pana & lepana of yashtimadhu + chanadana + usira 48
  • 49. Contd… Day Treatment 4 Lepana with sirishamula + nilimula grinded in sirisasvarasa 5 Pana of tanduliyaka + kshira 6 Pana of equal quantities of grinded paste of asana, usira, nilimula 7 Nasya, anjana done with luthavisha hara drugs. 49
  • 50. VISHAVEGA LAKSHANA TREATMENT Dhatu Treatment Tvak After raktamoksha, lepana with haridra + thulasidala Rakta Pana of tulasi moola kalka with milk Mamsa Pana, nasya, lepa with usira, yasti, candana. 50
  • 51. Contd… Dhatu Treatment Medas Pana, nasya, lepana with nilitwak, sirisatvak in sirisha swarasa Asthi Pana of tanduliyaka kalka in milk. Majja Pana of nilini, usira, candana & asana in milk. Sukla Pana of sariba, Amari and tanduliyakamulakalka with milk, nasya & anjana with suitable medicines. 51
  • 52. IMPORTANT AGADAS • Lodrasevyadi agadam • Dasanga agada • Vilwadi gulika 52 • Campakam agada • Padmaka agada • Mandara agada • Sarvakarmikagada
  • 53. YOGAS MENTIONED IN MALAYALAM BOOKS • Nilitulasyadi yoga • Nalpamara kashaya dhara. • Aswatha vibitakadi yoga – lepa & dhara • Panchaka agada • Hingu kalka - pralepa • Karavellaka patradi yoga 53
  • 54. PATHYA • Sastika Sali • Bitter gourd • Snake gourd • Green gram • Dry ginger 54 • Pepper • Onion • Rock salt • Asafetida
  • 55. APATHYA Ahara • Salt • Curds • Amla rasa • Matsya • Mamsa • Thila thailam 55 Vihara • Bath • Sleep during day time. • Anger • Physical exercise • Exposure to sun, fire, wind
  • 56. THE PALLIYARA SREE BHAGAVATHY TEMPLE 56
  • 57. DOOSHI VISHA & SPIDER POISONING • Victim ignored spider bites and neglected treatment • Not completed the course of treatment • Misdiagnosed by physician 57
  • 58. CONCLUSION • Luta is darunatara among keeta visha. • Skin eruptions – one of the surest diagnostic measures of luta visha. • Misdaignosing the case will make the prognosis poor. 58
  • 59. REFERENCES • Golay V, Desai A, Hossain A, Roychowdhary A, Pandey R. Acute kidney injury with pigment nephropathy following spider bite: a rarely reported entity in India. Renal Failure. 2013 May 1;35(4):538-40. • Shackleford R, Veillon D, Maxwell N, LaChance L, Jusino T, Cotelingam J, Carrington P. The black widow spider bite: differential diagnosis, clinical manifestations, and treatment options. J La State Med Soc. 2015 Mar-Apr;167(2):74-8. Epub 2015 Apr 15. PMID: 25978056. • Angad.Ramesh.Shripat et al : Conceptual Study on Luta-Vis • Jegaraj K, Saurabh R S, Rakesh P S. Spider bite from South India. J Postgrad Med 2014;60:216-7 • Patel KD, Modur V, Zimmerman GA, Prescott SM, McIntyre TM. The necrotic venom of the brown recluse spider induces dysregulated endothelial cell-dependent neutrophil activation. Differential induction of GM-CSF, IL-8, and E-selectin expression. J Clin Invest. 1994 Aug;94(2):631-42. doi: 10.1172/JCI117379. PMID: 7518841; PMCID: PMC296140. 59
  • 60. Contd… • :Adarsh, C.K. & P.O. Nameer(2015). Spiders of Kerala Agricultural University Campus, Thrissur, Kerala, India. Journal of Threatened Taxa 7(15): 8288– 8295;http://dx.doi.org/10.11609/jott.2468.7.15.8288-8295. • Sushruta Samhita Vol.1 by Dr. Ambikadutta Shastri, Chaukhamba Sanskrit Sansthan, Kalpasthana Adhaya no.8 • Asthang Sangraha by Dr K.R.Srikantha Murthy, Chaukhambha Orientala, published-1999, Uttartantra Adhaya no.44 60
  • 61. 61

Editor's Notes

  1. Lutha are one among keeta. The word luta is derived from the root word lun, which means chedane – to severe, to cut etc. Tantuvayah – which means to produce thread Urnanabhah – one which has the threat resembling the wool of sheep, originated from its umbilical region. Markatakah: means one which is able to produce threads for entrapping the insects.
  2. More than 40,000 species of spiders have been identified in the world. In India /approximately 59 different Family /of spiders are found, which include more than approximately /600 different spiders. The most venomous spider/ found in India is the/ Fringed Ornamental Tarantula /which can cause excruciating pain, muscle cramps and leads to coma.
  3. Coming to the taxonomical classification . Spider belongs to the
  4. There are different opinions & concepts about origin of luta. a/c to susruthacharya the drops of sweat on the forehead of vasista angered by visamitra fell on cut grass. This holly sweat transformed into dreadful and highly poisonous spiders of different size and shapes. a/c to ashtanga sangraha the spark of fire that came out of the bodies of asura during the burning of khandava forest became luta. Another opininon about origin of lutha is that vesicles develop on the body due to ingestion of contaminated or poisonous food are known as lutas.
  5. Regarding the total number of Luta Acharyas have different opinions Vaghbata again explains vata, pitta, kapha and sannipatika on the basis of dosha predominance and Vata, pitta, kapha, are Krichra sadhya and sannipatika is Asadhya. Vaghbata in AH, in the context of enumeration of Luta quotes various schools of thoughts as 16,28,1000 or innumerable
  6. Spiders are classified as poisonous and non poisonous spider. The most poisonous spider are black widow spider, the brown recluse, the funnel web spider and the wolf spider .
  7. Black widow spiders have a black hairless body. Its major characteristic is a red marking on its abdomen similar to an hourglass . It is not aggressive under normal circumstances but attacks if disturbed, especially while protecting its egg sacs. .
  8. The brown recluse spider is recognized by the violin-shaped marking on its back . This spider takes rest during the day and is not aggressive but it will attack in the case of provocation. Patients are usually bitten by wearing clothes and shoes with spiders in them 
  9. Funnel-web spider, the most dangerous spider in the world, is aggressive in the absence of provocation. The structure of this spider’s web is funnel-shaped, hence the name .
  10. Most wolf spiders are dark brown. The hairy body is long and broad, with stout, long legs. Wolf spiders are noted for their running speed.
  11. According to susrutha : no swasa is mentioned and indriya is mentioned instead of sukra.
  12. The body of a spider is divided into two regions, cephalothorax and abdomen, attached by a narrow pedicel.
  13. The two sections of the spider body are called the Prosoma or Cephalothorax, which is the head region, and the Opisthosoma or Abdomen which is the rest of the body. They are connected by the thin pedicel. The cephalothorax is sclerotized with dorsal and ventral plates, and bears the eyes, mouthparts, legs, pedipalps, and stomach. The abdomen is usually soft and unsclerotized, and contains the primary reproductive organs, respiratory system, heart, intestine, anus, silk glands, and spinnerets.
  14. Near the anterior margin of the ventral side, there are one or two pairs of slits that correspond to the external openings of the book lungs, respiratory organs of spider. These external openings of reproductive , respiratory and digestive system may be considered as visha adhisthana like sukra, swasa, mutra, sakrit
  15. Venom glands are present in most spiders, /but they are absent in the family Uloboridae. In mygalomorphs, the venom glands are located in the upper part of the chelicare . In aranemorphs, the venom glands are located inside narrow duct and opens near the tip of the fangs. The glands are located either in the chelicerae /or under the carapace. The venom gland is surrounded by/ muscular layers controlling venom release /by squeezing the venom gland .
  16. The spider venom flows through a narrow duct and opens fangs. The fang, the organic functional equivalent to a hypodermic needle, & which is penetrates the skin.
  17. Spider venom components are typically divided into four groups. (1) Small molecular mass compounds (SMMSs), (2) antimicrobial peptides (only a few spider families), (3) peptide neurotoxins, and (4) proteins and enzymes.
  18. Small molecular mass compounds (SMMCs) are thought to be present in most spider venoms. They include ions, organic acids, nucleotides, nucleosides, amino acids, amines, and polyamines Antimicrobial peptides (AMPs) are also termed cytolytic or cationic peptides. They are widely distributed as major components of animal immune systems and are also present in various arthropod venoms, such as ant, scorpion, bee, and wasp venoms
  19. Spider venoms work on one of two fundamental priciples; they are ethier neurotoxic (attacking the nervous system) or necrotic (attacking tissues surrounding the bite and sometimes attacking vital organs and systems).
  20. The majority of spiders with serious bites possess neurotoxic venom. The specific manner in which the nervous system is attacked varies from spider to spider. Widow spider venom contains latrotoxins, which cause the release of the neurotransmitter acetylcholine, stimulating muscle contractions. This can affect the body & causing painful abdominal cramps, as well as interfering with respiration and causing other systemic effects
  21. Spider having necrotic venom occur most notoriously in the family sicariidae. The family sicariidae includes both the recluse spiders and the six eyed sand spiders. Spiders in this family possess a known dermonecrotic agent sphingomyelinase D.
  22. Site of vathika spider bite turns rough & brownish in colour; there will be joint pain and fever. A bite by a spider having pitha dosha is characterized by burning sensation of the body, excessive thirst, eruption of pustules associated with fever & fainting and resembles fruit of dates. Kaphaja spider bites give rise to sedation, fever, cough, bite site turns solid, pale and resembles fruit of parushaka. A thridoshaja spider bite is characterized by faintaing, dyspnoea, hiccough, dizziness, shivering, vomiting, burning sensation, thrist, blindness, bending of nose and severe pain on sacral and cervical region. Lips, mouth and teeth becomes brownish, bite site resembles ripe jambu fruit, edematous, and there will be bleeding. Dermatological manifestation includes multicolored pustules. IT IS ASADHYA
  23. Lesion looks like dadrumandalam White, black, blue, yellow color It is soft and raised up The centre is either black or blue and resembling a net at its edges. Spreading overall , swelling, severe pain and burning sensation will also be seen If the putrified matter of the site is transferred to any place, there arises vranas.
  24. 1st day: It appears as though /pricked by a needle, with no colour manifestations , moveable slightly, having itching sensation and pain. (V) Mild itching sensation as well as shifting and indistinctly coloured urticarial patches appear.(S} 2nd day: The edges are raised, surrounded by eruptions, with well manifested colour, depressed in the center, is itchy and resembles a grandi. (V) The bite site becomes swollen at the periphery with depression in the center and the clinical features become more manifested. (S)
  25. 3rd day: There is a red patch /in the shape of a sarava, associated with fever, horripilations, severe pricking pain and bleeding from the hair follicles (V) On the third day,the actual symptoms of poisoning sets in. (S) 4th day: Profound swelling, temperature, dyspnoea and giddiness (V) On the fourth day the poison gets aggravated. .(S) Day 5 : It gives rise to symptoms of poisoning related to the dosas. (V) Various disorders of the aggravated poison are produced .(S)
  26. Day 6 : It spreads to the vital spots(V) The poison, widely spreading, completely envelops all the vital regions including the marmas. (S) Day 7:It destroys life(V) The poison, diffused throughout the whole organism and being highly aggravated, kills the victim. (S)
  27. most bites produce sharp pin prick pain at the site of bite, with erythema and edema. • The site becomes painful and pruritic with central induration • The lesion resolves in few days • In severe cases the erythema spreads, centre of lesion becomes hemorrhagic and necrotic with an overlying bulla. • Later there is sloughing of the necrotic tissue with ulcer formation and a depressed scar.
  28. Three important syndromes caused by spider bites are loxoscelism, latrodectism and funnel web spider syndrome.
  29. LATRODECTISM IS THE illness caused by the bite of Latrodectus spiders (the black widow spider and related species).  latrodectism is very rarely fatal for humans,. spider venoms are a complex collection of toxic agents latrotoxin. Pain, muscle rigidity, vomiting, and sweating are the symptoms of latrodectism. The venom acts on nerves causing the massive release of the neurotransmitters acetylcholine, norepinephrine, and GABA. The release of these neurotransmitters leads to pain, cramps, sweating and fast pulse.  
  30. Loxosceles venom has several toxins; the most important for necrotic arachnidism is the enzyme sphingomyelinase D. Necrotic cutaneous loxoscelism - most common in loxoscelism. It is characterized by a localized necrotic wound at the site of bite. The majority of Loxosceles bites result in minor skin irritation that heals in one week.[1] Such lesions often heal within 6 to 8 weeks, and can leave lasting scars. Viscerocutaneous loxoscelism refers to the combination of local and systemic manifestations that occur infrequently after Loxosceles bites. Symptoms include low energy, nausea and vomiting, and fever. Destruction of blood cells (hemolytic anemia) may require transfusion and injure the kidney.[
  31. A presumptive diagnosis of a spider bite is most often based on the history and clinical presentation Multiple lesions or more than one lesion on widely-separated parts of the body suggest another etiology. Spider bites are typically single lesions. Laboratory data — There are no commercially available laboratory tests for identifying the presence of spider venom. Thus, the diagnosis is made clinically.
  32. Infections — Papules and pustules should be /carefully unroofed and cultured /to identify infectious causes. Common infections that could be /mistaken for spider bites include /staphylococcus and streptococcal infections, the skin lesion of early Lyme disease, and atypical presentations of herpes zoster or herpes simplex. Community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) skin infections can begin with singular papules or pustules that may evolve to necrotic lesions [13]. CA-MRSA is far more prevalent than spider bites. Lyme disease is caused by a bite from a black-legged tick. In the first stage of Lyme disease, a quick-spreading rash often develops at or near the site of the bite. a distinctive bull’s-eye rash with a central clear ring that slowly expands — this is the “classic” type Herpes zoster and herpes simplex infections may occasionally present with singular lesions . Acute onset is associated with vesicles, vesicopustules, severe edema, erythema, or pain. Tzanck staining of vesicles will demonstrate multinucleated giant cells and viral culture will grow HSV.
  33. Other bites and stings — A wide variety of insects sting or bite , including ants, bedbugs, blister beetles, ticks, mites, mosquitoes, and biting flies . Spiders are less likely to do so/ than many others Scorpion stings are more common than spider envenomations worldwide, Stings are instantaneously painful, and so patients usually capture/ or at least clearly witness the scorpion inflicting the sting . Local pain is the most common presenting symptom. Systemic symptoms include hypertension, tachycardia, diaphoresis, and salivation Other common dermatoses — Poison ivy, poison oak, and other plants in the Anacardiaceae family may occasionally cause dermatitis that presents as a single lesion, although linear lesions are more typical . These lesions tend to be pruritic, rather than painful.
  34. Scorpion bite : A macule or papule appears initially at the sting site, occurring within the first hour of the sting. The diameter of the lesion is dependent on the quantity of venom injected.The lesion progresses to a purpuric plague that will necrose and ulcerate.
  35. Spider bite of incurable variety shows the following symptoms like - Hrinmoha: pain in heart Pidaka: the eruptions which will be either white, black,yellow, red. Syava oshta: bluish discoloration of lips, mouth and teeth Vakranasa: distoriation of nose. Pristaavabanjanam: bending of back and neck. Sonitha sravathi: the blood of the colour of ripe jambu phala flows out from the site of bite.
  36. Acharya susrutha mentioned 10 upakramas for lutha . They are Nasya, anjana, abyanjan, pana, dhuma, avapeeda, kabalagraha, vamana, virechana, siramokshana
  37. First aid management mentioned in luta visha are Udhharana with vridhi pathra sastra (su) and mandalagra (va). The bite site should be incised & teeth should be removed. Dahana: bite site should be cauterized by heated stone except for paithika damsa & having lakshana such as roughness, having damaged hairs, located in marmas. Lepana : after dahana the site must be applied with a paste of agada added with honey and saindhava lavana. Seka: bite site is bathed with ksheerivrishka twak kwatha Raktha mokshana should be done with sringa or by sira vyadha Parisekha: then parisheka with bhodi, sleshmathaka, akshaka vriksha and applying their paste in cold condition. Bhodi sleshmathaka, akshaka are used for all karmas in lutha visha
  38. Vamana: The poison should be removed by administrating Vamana using Koshataki, Lodhra, Indrayava ,Saindhava, Patola patra , Maricha and Priyangu Virechana: should be done by using triphala, nilini. Vasthi: when the person is suffering from admana, hikka etc of vata origin, vasti is administered. Gritha manda prepared with the kashaya of eranda, bilwa, sarala, chirabilwa, arka patola, sigru, patha etc is used for vasti. Navana should be administrated with sarpimanda when there is feeling of heaviness of head , swelling , lalasrava, hanugraha etc. Anjana: if disorders of vision, swelling and itching in the eyes are present, anjana is administered with vachadi, surasadi and sireeshadi yoga. Karnika patina: kusumba pusha godantha swarnakshiri kapothavitt/ trivrit saindavam danti karnika patanam tada//
  39. Nili tulasyadi kashaya is tridoshahara especially KV samana. Kalka of Hingu made by mixing with tambula swarasa in kamsya patra can be used as pralepa. It is effective in healing the pastular dermatological lesions cause by luta visha. Equal quantity of karavellaka and tulasi patra can be used as nasya and anjana and is effective in detoxifying luta visha. After chewing the kalaka of this yoga for a short time period and then spitting this is also effective in detoxifying luta visha.
  40. This Temple, renowned to the devotees as the Chilanthi Ambalam . It is the only temple of worship for those who are suffering from spider poison in world . Located at kodumon near Pathanamthitta.
  41. If victim ignored spider bites and neglected treatment otherwise not completed the course of treatment or misdiagnosed by physician , visha in the body if not properly eliminated visha itself turn less virulent or keep dominant it drain into the blood & deeper dhathus and gets lodged , the venom has turned to the dooshi visha. In favourable condition, the latent visha gets vitiated & emerges out of the deepest dhathus & produce lesion specific of lootha visha.