The document discusses Vrischika Visha (scorpion poison) in Ayurvedic classics. It describes three varieties of scorpions based on toxicity - mild, moderate and severe. Symptoms and treatment are detailed for each variety. Local and systemic symptoms of scorpion sting are provided. Treatment focuses on alleviating vata and includes measures like sweating, oil application and anti-venom herbal formulations. A case study is presented of a patient experiencing blistering after a scorpion bite who was treated with herbal formulations and poultices.

1. VRISCHIKA VISHA
Dr Anu Mariam Varghese
1st MD Scholar
Dept of Agadatantra
Govt Ayurveda College, TVM
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2. CONTENTS
• Introduction
• Classification
• Poisonous features
• Prognosis
• Treatment
• Scorpion –poison ,features ,treatment
• References
• Case report
• Research articles
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3. INTRODUCTION
• In our classics Vrischika is categorized under the keeta visha.
• Vrischika (scorpion) is said to oldest poisonous creature on the
earth.
• In our classics Vrischika visha is explained detailed in Brhatrayees,
Keraleeya visha granthas etc….
3

4. IN CLASSICS
BRHATRAYEES OTHER TEXTS KEERALEEYA VISHA
GRANTHAS
1.Caraka Samhitha
2.Susrutha Samhitha
3.Ashtanga sangraha
4.Ashtanga Hrdayam
1.Bhaishajyaratnavali
2.Yogaratnakara
1.Kriyakoumudi
2.Prayogasamuchayam
3.Vishajyotsnika
4.Lakshanamritham
4

5. • According to their origin and nature of poison-AS, AH, Su
1. Mandha Visha Vrischika – 12
2. Madhyama Visha Vrischika – 3
3. Theekshna / Maha Visha Vrischika – 15
• According to dosha
Vatikam,Paithikam, Kaphajam, Sannipathikam
CLASSIFICATION
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6. Based on Toxicity
• Kriyakoumudhi –Vishaveeryam kuranjittum, Athyugra vishamullavayum
• 67 varieties -Vatika -18, Paithika-24, Kaphajam-13, Sannipathikam -12
• Two more varieties mentioned are Itching scorpion(Chorithel), Seetavrischika
Origin (Su.k.8/57) (AH.U.37/7)
• Mandhavisha – from putrified cow dung or from any rotten substances.
• Madhyamavisha – from decayed wood or decayed bricks, cadaver of animals
killed by poisoned arrow
• Teekshana visha – from decomposed carcass of a snake or from any other
poisonous putrid organic matter.
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7. POISONOUS FEATURES
• SAMANYA VISHA LAKSHANA(General poisonous features)
• VISHISHTA VISHA LAKSHANA(Specific poisonous features)
7

8. SAMANYA VISHA LAKSHANA
Vrischikasya visham thikshanamadow dhahati vahnivat|
Urdhvamaarohathi kshipram damsham paschatthu thishtathi |
Damshaha sadhyoathiruk shayavasthudyathe sphutatheeva cha||
[A.S.U.43/27]
• Poison is teekshna in nature.
• It causes burning sensation like fire in the beginning ( local spread) and there after it
spreads upwards (general spread) at the end it localizes at the site of sting.
• It produces severe pain , blackish discoloration , pricking pain and throbbing type of
pain at site of sting.
8

9. VISHISHTA VISHA LAKSHANAS
MANDHA VRISCHIKA
mandhaha peethaha sitha shyavam rushaha karburamechaka romashaa bahuparvaano lohithaha
pandurodharaha|
[A.S.U43/30]
• Yellow , white or brown in colour .
• Dry and rough hairs on their body.
• Having many joints in the tail.
• Their belly being either reddish or white.
9

10. SYMPTOMS
Ebhirdashtae vedhana vepathushcha gaathrasthampaha krishnarakthaagamascha |
shakhadashtaevedhana cha urdhamethi dhaaha swedhaw dhamsa shophow jwarascha||
[Su.K.8/60]
• Pain in the site bite.
• Tremor.
• Stiffness of the body.
• Flow of blackish discoloured blood.
• In the case of a bite at any of the extremities the pain radiates upwards accompanied
by a burning sensation, perspiration, swelling of the bitten part and fever.
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11. MADHYAMA VRISCHIKA
Dhoomrodaraasthriparvano madhyasthu kapilaarunaha|
[A.S.U.43/31]
Have smoke coloured belly. Have three joints . Either reddish or brown in
colour.
SYMPTOMS
Jihwashopho bhojanasyaavarodhomurchaa chogra madhyaveeryaabhidhastae|
[Su.K.8/63]
Swelling of the tounge. Obstruction to food . Deep fainting.
11

12. TEEKSHNA VRISCHIKA
pishangaha shabalaschithraha shonithabha mahavisha a agnyabha ekaparvano
rakthaasithasithodharaha|
[A.S.U.43/32-33]
• Reddish brown, Spotted, of variegated colours and resemble blood or fire.
• Have only one joint, belly is either reddish black or white in colour.
12

13. SYMPTOMS:
Ebirdashtae sarpa vega pravirthihi Sphotolpathir bhranthidhahow jwarascha|
Khebyaha krishnam shonitham yaathi theevram thasmath praanasthejyathe sheekrameva||
[Su.K.8/66]
• Produces poisonous impulses similar to snake poison.
• Gives rise to pustular eruptions along with vertigo , burning sensation , fever.
• Excessive discharge of blackish discoloured blood from the passages due to
which the person dies soon
13

14. Vatika
Hrthpeedordwanilastamba sirayamo asthiparvaruk /
Dhoornanodweshtanam gatrasyavatha vatike vishe // (AH.U.37.17)
Pithikam Samja nasho ushnanishwasou hrdaha katukasyatha /
Mamsavadaranam shopho raktapeetashcha pithikae // (AH.U.37.18)
Kaphajam Chardi arochaka hrllasa praseka utklesha peenasai /
Sashaithyamughamaduryai vidyath sleshmadikam visham // (AH.U.37.19)
14

15. Jyotsnika and
Lakshanamritham
Kampam, chardi, budhibramam, shoolam, swedam, jwaram, romabedam, trishna,
daham
kriyakoumudi Karnikani vrane raktadourgandam brama murchakal /
Jwaram kithapparuchiyum samanya vishalakshanam//
Prayoga samuchayam Similar to sarpavegam
oedema
Bad smell of blood, heaviness of head and eyes, palpitation, sweating
Severe pain , blackish discolouration
Sara sangraham Kampam, chardi, vibranti, swedam, jwaram, romabedam, daham, raktavamanam,
trishna, shulam
15

16. DHATU VYAPTHI
• According to Kriyakoumudi; in highly venomous cases
1.Twak - pricking pain
2.Raktam – vomiting, kampam, vibranti, soola, daham
3.Mamsam – hikka, granti
4. Medas –galashushkam
5. Asthi – Teevra jwaram
6. Majja – Manasthapam
7. Shuklam – Rakta netram, Mrityu
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17. UCCHITINGA
Vrischikasthu deergho anya ucchitinga ithi smritham (Manjari)
• Vagbhata described another variety of scorpion called as ucchitinga-bites by
its mouth which produces ,
very severe pain, Stiffness of the penis, horripilations ,feeling as though the body
is sprinkled with cold water.
• Because of having the color like the camel , this scorpion is known as
USHTRADHOOMAKA.
• RAATHRIKA-since it moves out at night times.
17

18. PROGNOSIS
Dhasto asadyasthu drik ghrana rasanopahatho nara Athyartham vedhanaartho
jahanthyashun||
[Ch.Chi.23/15]
In case of asadhya damsa sensory preceptions of eyes , nose and tongue will
impaired, skin and muscle tissue peeled off from the bitten area and excessive
pain and lastly kills the patient.
18

19. TREATMENT
19

20. Prayo vatolbana visha Vrischika soushtradoomika (AH.U.37/15)
• So Rx should aim at vatasamana.
• Seetakriya should be avoided .
Samanya chikitsa:
Vrischikae swedhamabhyangam grithena lavanena cha
Sekaamschoshnan prayunjitha bhojiyam panam cha sarpishaha|
[Ch.Chi.23/136]
Swedanam , Abhyangam ,Seka with warm ghee mixed with salt, Gritha for food
and drink
20

21. Teekshana- Madhyama vishavrischikas:
• Should be treated as a case of snake bite to all intents and purposes. Around the
site of bite fomentation should be done followed with
• Prathisaaranam
with powders of haridra, saindhava , thrikatu and the fruits and flowers of sirisha.
• Lepam
Surasa + juice of mathulunga+ gomuthra
• Panam
Ghee + honey or milk added with plenty of sugar.
Sarvatra chograanilavishe payayeth dadhisarpishi…… (AH.U37/39)
21

22. Mandha vishavrischikas
• Chakra taila sechanam or warm oil cooked with the drugs of vidaryadi gana.
• Swedanam with the application of poultices in the utkarika form prepared with
anti venomous drugs(sirisha etc).
• Panam cooled jaggery-water mixed with chathurjatha or Cooled milk mixed
with jaggery.
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23. OTHER YOGAS
• Vilwadhi gulika.
• Dasanga agada- good for all types of vrischika visha.
• Maricha + kaalashaka triturated in takra should be applied
• Pancha sirishaagadha + ghee(Ch.Chi.23)
• According to kashyapa,dhoopana of human hairs,peetha sarshapa and jeerna
guda. –Nrkeeshadi dhooma
• Visha vajra paaka rasa(rasendra saara sangraha)
• Applying kalka of nishaadala and harithala(bhaishajya rathnavali)
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24. • Heat small quantity of gavya ghritham and add saindhava in to it .apply the
preparation on the spot.(B.R).
• Hinguvadi gulika.
• Paravata sakrit+pathya+tagara+nagara+beejapura juice.
• Sirishaarishtam.
• Sirishabeejadi gulika.
• Shikari ghritham.
• Muktha lepam.
• Thanduleeyaka ghritham.
• Karanja pushpadi lepanam.
• Mrithyupaashachedhi ghritham.
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25. • Some of the anti poisonous therapeutics from the yogaretnakara:
• Mantra vidhi
• Jeerakathi lepa
• Ajaksheerathi yogam
• Kaarpaasa pathradi yogam
• Manashiladi gulika
• Usage of punarnava yoga
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26. SCORPIONS • Scorpions belongs to class Arachnidae-a
class of Arthropode(comprising 8 legged
creatures).
• 8 legged arthropods having a hallow sting
in the last joint of their tail , which
communicates by means of a duct with
the poisonous glands , which secretes
poison on stinging
• Abomen-Pre abdomen and narrow taillike
post abdomen terminating in telson or
sting.
26

27. • Telson is vesicular in shape and at the tip possess a sharp hollow stinger with
tiny pores which serves as oulet for venom, secreted by two poison glands
contained in the telson.
• In India there are 6 families comprising about 89 species scorpion are found.
• Its venom is a clear , colourless, slightly acidic in nature toxalbumen and can
be classified as either hemolytic(same as viperine venom )or neurotoxic (same
as strychnine poisioning), coagulant ,cardiotoxic
• Its toxicity is more than that of snakes , but only a small quantity is injected.
27

28. 28

29. GRADING OF SYSTEMIC FEATURES OF SCORPION STING
Grade 1 – severe excruciating local pain at the site of sting which radiates along
with corresponding dermatomes.
Grade 2 – local signs associated with profuse sweating , salivation , hyper or
hypotension , cold extremities and bradycardia.
Grade 3 – pulmonary oedema with hyper or hypotension and cold extremities.
Grade 4 – warm extremities , tachycardia , hypotension , pulmonary oedema and
shock.
Grade 5 – death.
29

30. CLINICAL FEATURES
• Local burning pain, swelling, paraesthesia.
• Sweating , salivation , vomiting , abdominal cramps.
• Mydriasis.
• Hypotension followed by hypertension , bradycardia followed by tachycardia
, cardiac arrythmias , myocarditis.
• Convulsion.
• Oliguria.
• Pulmonary oedema.
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31. DIFFERENTIAL DIAGNOSIS
• Alcohol withdrawal
• Botulism
• Hysteria
• Meningitis
• Opium poisoning
• Tetanus
MLI
Accidental
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32. TREATMENT
• Immobilize the sting limb by application of tourniquet above the bite .
• Local ice application , incise and use suction , and wash with a weak solution
of ammonia , borax etc.
• A local anesthetic is injected at the site to lessen the pain.
• IV fluids and oxygen according to need.
• A specific anti venom is available for most species.
• Diazepam for convulsions.
• Metoclopramide for vomiting.
• Atropine is valuable in preventing pulmonary edema.
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33. DISCUSSION
• Three varieties of vrischika , their symptoms and treatments are mentioned .
• In all poisons mostly the cold measures are adopted except incase of vrischika
and ucchidinga .
• Saamanya treatment includes – ,swedhanam,abhyangam,seka and ghritha pana.
• In modern aspect red variety scorpion is the most dangerous one(Buthidae
family) .It is not seen in our country hence the sting by this type of scorpion is
minimal
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34. CONCLUSSION
• The scorpions that found in India are less dangerous. So the complications
occurs due to its sting can be minimised
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35. REFERENCEs
• Ashtanga sangraham-Utharasthanam
• Ashtanga hridayam-Utharasthanam.
• Charakasamhitha-Chikitsasthanam.
• Susruthasamhitha-Kalpasthanam.
• Baishajyaratnavali.
• Yogaratnakaram.
• Kriyakoumudi
• Prayogasamuchayam
• Vishajyotsnika
• The Essentials of Forensic Medicine and Toxicology; 34th edition-Dr.K.S.Narayan Reddy and Dr.
O.P.Murty
• Comprehensive Medical Toxicology- VV Pillay,3rd edition
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36. CASE
• A 27 years old female came to our OPD with complaints of Blisters on the
anterior aspect of left thigh with pain ,swelling and difficulty in walking
followed by a scorpion bite one week ago
Rx given
1.Padoladi gana kashayam
2.Vilwadi Gulika –with Ks
3.Sigrupunarnavadi+Vishavilwadi+Akashatarshyam –e/a
After one week blisters became ulcer,pain persists, swelling reduces
36

37. Rx,
1.Vara choornam –Kshalanam
2.WH5 oinment
3.Azithral(antibiotic)
On the next follow-up after one week pain and swelling completely subsides.
37

38. 38

39. RESEARCH ARTICLES
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4397632/
Scorpion bite :a sting to heart - Case Report
• Effect of Arkapatra ghritha and patoldi gana kashaya in Vrischika visha;
Dr Parvathy V; Govt Ayurveda College, Trivandrum.
• Effect of Hinguadi gulika lepana and kulakadi Kashaya in Vrischika visha
;Dr Deepthi M.K ; Govt Ayurveda College, Trivandrum.
39

40. • An open clinical trial to evaluate the efficacy of Shunti tagara lepa along with
Dasangam gulika sevana in Vrischika visha; Dr Jayadev Vijayan; Alva’s Ayurveda
college,Moodbidri
• A comparative clinical study of Hingwadi lepa against jeerakadi lepa along with
vilwadi gulika pana in Mandavrishchika damsa ; Dr Sanath Kumar T; Alva’s
Ayurveda College,Moodbidri.
• A comparative study on the efficacy of Sakshara aranala dhara against ghrita
saindhava dhara in Vrischika damsha ; Dr Smitha ;2008;VPSE Ayurveda college
Kottakal
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41. • A randomized controlled trial on Arkapatra sweda against Sakshara lavana
aranala dharain Vrischika damsa; Dr Binoy;2010; VPSE Ayurveda College,
Kottakkal.
• A comparative clinical evaluation of Vilwadi gulika against Dasanga agada
along with ghrita saindhava dhara in management of Vrischika damsa; Dr
Sandep 2007; VPSE Ayurveda college Kottakkal .
• A RCT on jeerakadi lepa against Arkapatra sweda in Vrischika damsa; Dr
Nazem Ahmed 2016; VPSE Ayurveda college Kottakkal .
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42. • A RCT on Darvi hingu dhupa against Arka patra sweda along with Dasanga
agada in Vrischika damsa; Dr Sreedevi; 2014; VPSE Ayurveda college
Kottakkal .
• A clinical study to evaluate the efficacy of jeerakadi lepa along with dasanda
gulika in Vrischika damsha ; Dr Anagha V.N; KVG Ayurveda college Sullia
• A clinical study to evaluate the efficacy of kaidaryayukta takra lepa as
Sadhyochikitsa in vrishchika damsa ;Dr Jayadeep.K ; KVG AVC Sullia
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