E-ISSN:2456-3110

Review Article

Visha Chikitsa

Journal of Ayurveda and Integrated Medical Sciences

2022 Volume 7 Number 2 March
Publisherwww.maharshicharaka.in

Waghmare T et al: Utility of Lepa Kalpana with special reference to Visha Chikitsa

Waghmare T.1*, Chavhan K.2
DOI:

1* Tushar S. Waghmare, Post Graduate Scholar, Department of Agad Tantra, Government Ayurved College, Nagpur, Maharashtra, India.

2 Kalpana R. Chavhan, Associate Professor, Department of Agad Tantra, Government Ayurved College, Nagpur, Maharashtra, India.

Agadtantra is the one of the branches of Ashtang Ayurveda, which deals with the signs and symptoms and also with management of poisoning resulting from various sources. Poison or Visha is mainly classified as Sthavar, Jangam and Krutrim Visha. Signs and symptoms of any poisoning is seen externally, internally or both. The external signs and symptoms appear on the skin in the form of local pain, Raga (Redness), Shotha (inflammation), Sphota (blisters/vesication), Kandu (Itching), Srava (oozing) etc. Treating these external signs and symptoms is important in the management of poisoning. Lepa is an important treatment modality told by Acharya Charaka in Chaturvimshati Upakram. Its importance is also described by other Acharyas. Agada plays very important role in the Visha Chikitsa and is well described in Agadtantra. Vishaghana Lepa is used in the treatment of various poisonous conditions arising due to Sthavar Visha, Jangam Visha, Gara Visha and Dooshi Visha. Lepa has important role in local treatment and prevention of further spread of poison. In this article Lepa treatment which is used for the treatment of poisoning is well explained along with importance of Lepa, mode of application, mode of action and list of various Vishaghna Lepas and Agada’s.

Keywords: Lepa, Visha, Visha Chikitsa, Vishaghna Lepa, Agada, Ayurveda

Corresponding Author How to Cite this Article To Browse
Tushar S. Waghmare, Post Graduate Scholar, Department of Agad Tantra, Government Ayurved College, Nagpur, Maharashtra, India.
Email: 		Tushar S. Waghmare, Kalpana R. Chavhan, Waghmare T et al: Utility of Lepa Kalpana with special reference to Visha Chikitsa. J Ayu Int Med Sci. 2022;7(2):83-89.
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https://jaims.in/jaims/article/view/1707

Manuscript Received Review Round 1 Review Round 2 Review Round 3 Accepted
2022-01-22 2022-01-24 2022-01-31 2022-02-07 2022-02-13
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© 2022by Tushar S. Waghmare, Kalpana R. Chavhanand Published by Maharshi Charaka Ayurveda Organization. This is an Open Access article licensed under a Creative Commons Attribution 4.0 International License https://creativecommons.org/licenses/by/4.0/ unported [CC BY 4.0].

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Utility of Lepa Kalpana with special reference to Visha Chikitsa - A Review

Introduction

Agadatantra is one of the branches of Ashtang Ayurveda, which deals with the signs and symptoms and also with management of poisoning resulting from various sources.[1] Poison or Visha is mainly classified as Sthavar, Jangam and Krutrim Visha.[2] Sthavar Visha can again be classified as Visha and Upvisha.[3] Manifestation of these poisoning is seen on human body in the form of systemic and local signs and symptoms. In systemic manifestation pathology takes place inside the body and in local manifestation pathology takes place at the locally or at site of contact of the poison. Majorly local effect of poison is seen on the skin and some of the systemic effects also affect skin.

Skin is the largest organ in the body it works as a protective barrier. Skin prevents entry of microorganisms, toxins and foreign substances in the body. The external signs and symptoms appear on the skin are in the form of local pain, swelling, rashes, itching and various skin lesions. Treating these external signs and symptoms is important in the management of poisoning.

In modern medical science these skin lesions are treated with the topical application of analgesic, antibiotic, anti-allergic and steroidal ointments. In Ayurveda Lepa treatment is very useful for treatment of skin lesions.

Antahaparimarjan & Bahiparimarjana are two types of Chikitisa i.e., mode of treatment. Bahiparimarjana Chikitsa is mainly applied on Twak i.e., Skin and the treatments like Abhyanga, Swedana, Parisheka, Unmardana are included in Bahirparimarjan Chikitsa.

Lepa treatment is one of the important Bahiparimarjana Chikitsa.[4]

In the treatment of poisoning the various Lepas are used. In Visha Chikitsa, Lepas are considered as the basic & important treatment and it is well described in Samhitas. They neutralize the poison and prevent further spread of poison and eliminate the harmful effect of the poison locally. After that the poison doesn’t enter in the body.

In the various poisonous case the local area (site of contact or site of bite) shows various changes such as Raga (Redness), Shotha (inflammation), Sphota (blisters/vesication), Kandu (Itching), Srava

(oozing) etc. which can be treated by Vishaghna Lepa. Lepa also absorbs the remaining amount of poison from the local site. It is used in the treatment of Sthavarvisha, Jangamvisha and Krutrimvisha.

Aim

To evaluate importance of Lepa Kalpana in treatment of poisoning.

Objectives

1. To study Lepa Kalpana in detail.

2. To study need and scope Lepa Kalpana from Agadtantra perspective.

Materials and Methods

1. Various Ayurvedic Samhitas were critically studied along with their commentaries.

2. Different reference books regarding Agad Tantra were studied.

Observations

Definition of Lepa: Drugs in the form of paste used for topical (External) application is known as Lepas.

The Lepa should not produce irritation or sensitization of the skin, nor should it retard wound healing; it should be smooth, inert, odourless, physically and chemically stable and compatible with the skin and with incorporated medicaments. The proportions of the ingredients should be such that the Lepa is not too soft or too hard for convenient use. The consistency should be such that the Lepa spreads and softens when stress is applied.[5]

Definition of Lepa: Drugs in the form of paste used for topical (External) application is known as Lepas.

Method of Preparation of Lepa: Lepa can be prepared with Ardra Dravyas (wet ingredients) and also with Shushka Dravyas (dried ingredients). Pharmaceutically Lepa Kalpana is basic Kalpana of Kalka. In both the cases the Kalka (paste) should be prepared first by utilising the liquid media like Swarasa, Kwatha, Ghrita, Taila, Godugdha, Gomutra, Jala according to condition of particular disease.[6]


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Utility of Lepa Kalpana with special reference to Visha Chikitsa - A Review

Types of Lepa

A. According to Acharya Sushruta:[7]

1.       Pralepa 2.       Pradeha 3.       ALepa

B. According to Acharya Vagbhata:[8]

1.       Snaihika 2.       Nirvapana 3.       Prasadana
4.       Stambhana 5.       Vilayana 6.       Pachana
7.       Pidana 8.       Shodhana 9.       Shoshana
10.   Savarnikara    

C. According to Acharya Sharandhara:[9]

1.       Doshaghna 2.       Vishaghna 3.       Varnya

1. Doshaghna Lepa

This Lepa is prepared by finely powdering Punarnava, Daru Haridra, Sunthi, Sarshap and Shigru Bija separately, then it is mixed together and preserve. While using this, mix the Churna with Aranala/Kanji and apply. This Lepa is indicated in Shotha.

2. Vishaghna Lepa

This Lepa is prepared by pounding the ingredients Shirish Twak, Yastimoola, Tagara Kanda, Chandana, Ela, Jatamansi, Haridra, Daru Haridra, Bala Mula, Kustha Mula all in equal parts into fine powder and preserved. While using, mix it with Ghrita and Hot water, make the paste and apply in Pratiloma Gati. This Lepa is indicated in Jwara, Shotha, Visarpa and Kustha.

3. Varnya Lepa

This Lepa is prepared by pounding the ingredients Rakta Chandana, Manjistha, Lodhra, Kustha, Priyangu, Vatankura and Masura Dal.

For using add lemon juice/milk/egg-albumin, prepare the paste and apply it to the face. This Lepa is indicated in Vyanga, improves colour and complexion of the skin.

Vishaghna Lepa

Definition

  • The Lepa which destroys the effect of poison is known as Vishaghna Lepa.
  • Lepa is the one of the Chikitsaupakram among Chatur Vimshati Upakrama according to Charaka Samhita.[10] Importance of Lepa Chikitsa in Visha Badha is also explained by various Acharyas.
  • Visha vitiates Doshas and these Doshas are treated with Vishaghna Lepa having Shital Guna.
  • In the treatment of Kushtha Roga importance of Agad Yogas (Vishaghna Yogas) been described in Charak Samhita, when skin lesion is stony hard, rough, stable and old then one can use Agad Yogas (Vishaghana Yogas) in the form of Lepa, Paana, Anjana, and Nasya.[11]

Rules for application of Lepa

  • Lepa should always be applied in Pratiloma direction i.e., the opposite direction of the hair follicles as the drugs get quickly absorbed through hair roots, sweat glands and capillaries. [12]
  • The Lepa should not be applied at night time[13]
  • Lepa should not be left in situ after drying. It must be removed as soon as it dries up.[14]
  • Lepa in wet state help to cure the diseases and on drying, they lose their potency and cause the irritation of the skin.
  • Only freshly prepared Lepa should be used.[15]
  • Lepa should be applied only once and should not be applied over the previous one.[15]
  • All these rules are addressed for proper absorption and avoiding any ill effects of Lepa.

Pramana of Sneha in Lepa: According to Sushruta Samhita, when Lepa is used for Doshaj Vikara, Sneha Dravya should be added. The addition of Sneha is depending on the Dosha involved.

The Sneha pramana is as follows:

  1. Vataj Shotha : 1/4th part of Lepa.
  2. Pittaj Shotha : 1/6th part of Lepa.
  3. Kaphaj Shotha : 1/8th part of Lepa.[16]

Thickness of Lepa

  • Acharya Sushruta instructed that the Thickness of Lepa should be equivalent to Ardra Mahisha Charma (moist buffalo’s skin.) [17] It is 4-5 mm approximately. Hence, a Lepa having thickness <4-5 mm should be considered as “Thin Lepa” and greater should be considered as “Thick Lepa.”
  • Whereas Acharya Charaka clarifies that when a rubefacient action of a drug is expected, it should be applied uniformly

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  • thick over the skin. However, when softening and soothing action is to be elicited, the drug should be applied uniformly thin over the skin. In fact, this statement interprets the mode of application of a drug as per the requirement and not the properties of the mentioned drugs.[18]
  • Acharya Sharangdhar has told the size of Lepa according to the purpose of usage of Lepa as
  • Doshaghna Lepa : ¼ Angula Utsedha. (= 0.325 inch)
  • Vishaghna Lepa : 1/3 Angula Utsedha. (= 0.205 inch)
  • Varnya Lepa : ½ Angula Utsedha. (= 0.175 inch) [19]

Mechanism of Action of Lepa

  • Network of Siras is formed underneath the skin and their openings are attached to hair follicles which carry sweat and replenish rasa inside and outside through them only the Veerya of Abhyanga, Snana and Lepa Dravyas enter the body after being transformed in skin. “Swedam Abhivahanti Rasamch Abhitarpayanthi Antharbahischa…..” [20]
  • Because of rubbing during exfoliation of Lepa, the skin temperature increases which might be hastening the pilosebaceous uptake and skin permeation of the drug in the topical formulation. [21]
  • To be absorbed through the skin, a chemical must pass through the epidermis, glands, or hair follicles. Sweat glands and hair follicles make up about 0.1 to 1.0 percent of the total skin surface.
  • Though small amounts of chemicals may enter the body rapidly through the glands or hair follicles, they are primarily absorbed through the epidermis.
  • Chemicals must pass through the cell layers of epidermis before entering the dermis where they can enter the blood stream or lymph and circulate to other areas of the body.
  • The stratum corneum is the outermost layer of the epidermis and the rate-limiting barrier in absorption of an agent. After penetrating through the stratum conium and into viable epidermis and dermis the molecules
  • of the formulation produce its characteristic pharmacological response through receptors even before the blood and lymph circulations remove it. Thus, helps to remove or neutralize the toxins in initial stage only.[22]

Precaution for using Vishaghna/Agada Lepa[23]


  • Vishaghna Lepa should be used very cautiously. After confirmation that the person is poisoned then only these Agad Lepas should be used.
  • If Vishaghna Lepa are used in poison fewer people, then it may cause ill effects to the patient and may be harmful for the patient. So, all precautions should be strictly followed when Agada has to be used.

Agad/Vishaghna Kalpas


  • There are various Agada’s used for treatment of poison.
  • Agada are administered as Pana, Anjana, Nasya, Lepa and Abhyanga.
  • Some agada which are used as Lepa for treating poison are listed as follows:

According to Charak Samhita

SN Name of Agada/Lepa Indication Reference
1. Kakandadi Agad Sarva Keeta Visha Ch. Chi 23/53
2. Mrutasanjeeevana Agada Sarva Vishaghna Ch. Chi 23/58
3. Gandhahastinama Agada Savisha Vrana Vishajanya Damstra Buta Graha, Visuchika, Unmada, Apasmara Ch. Chi 23/75-76
4. Mahagandhahasti Agada Sarva Vishaghna Ch. Chi 23/77-84
5. Kshar Agada Shotha, Gulma, Arsha, Bhagandhar  
6. Khandasharkara Lepa Vatapradana Vishajantu Damstra. Pittapradhana Vishajantu Damstra Ch. Chi 23/170-171
7. Chandanadi Agada Sarvavishahara Ch. Chi 23/191-192
8. Madukadi Lepa Luta Visha Ch. Chi 23/200-202
9. Kapotavitaadi Lepa Vruschika Visha, Manduka Visha Ch. Chi 23/208-209
10. Vishaghna Lepa (Shirisha + Nirgundi) Sarva Visha Hara Ch. Su 3/28


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Utility of Lepa Kalpana with special reference to Visha Chikitsa - A Review

According to Sushruta Samhita

SN Name of Agada/Lepa Indication Reference
1. Shirishadi Agada Hrut Peeda due to Visha Su. Ka 1/36
2. Shyamadi Agada Hasta and Nakha Visha Su. Ka 1/37
3. Chandanadi Lepa Abhyangaja Visha Su. Ka 1/53
4. Chandan-Agrutadi Lepa Cosmetic induced Twakavikara Su. Ka 1/60-61
5. Mahasugandhi Agada Lepa Aabharana Janya Visha Paaduka Visha Su. Ka 1/77
6. Vamshadi Agada Lepa Loota Visha, Mushika Visha, Sarpa Visha, Keeta Visha Su. Ka 5/78-79
7. Shirisha-Rajanyadi Agada Mushikavisha Su. Ka 7/33
8. Kustadi Agada Lepa Keetavisha Su. Ka 8/47
9. Meshasrungyadi Agada Mandukavisha Su. Ka 8/50
10. Krushna Mrutrika Lepa Pippalika Damstra Visha Su. Ka 8/55
11. Padmakadi Agada Lepa Luta visha Su. Ka 8/104

According to Ashtang Sangraha

SN Name of Agada/Lepa Indication Reference
1. Sanjeevini Agada Lepa Sarva Visha Hara A.S.U 40/46
2. Pippalyadi Lepa Vruschika Visha A.S.U 43/50
3. Harenyavadi Lepa Gara Visha Upahata Twacha A.S.U 40/69
4. Gruta Lepa Sarvavishahara A.S.U 40/88
5. Chadana-Shirisha Lepa Sarpavisha A.S.U 42/9
6. Kashmaryadi Agada Lepa Mandalisarpavisha A.S.U 42/20
7. Dashanga Lepa All type of Keetavisha A.S.U 43/31
8. Sheerisha Beeja Lepa Mandukavisha A.S.U 43/34
9. Vachadi Lepa Keetavisha A.S.U 43/35
10. Hingu-Haritaladi Lepa Vrushcikavisha A.S.U 43/48
11. Matulungadi Lepa Alarka Visha A.S.U 46/48

Discussion

  • Lepa is one of the important treatments in Agadtantra. Lepa acts locally as well as systemically. It neutralizes the poison and prevents its further spread. It acts as Vishaghana on vitiated Doshas from Twacha and
  • For local application Vishaghana Lepa is mixed with Ghrita or lukewarm water or Kwath (decoction) or Tandulaodak. These are the best media for all Vishaghana Lepa. These media increases efficacy and penetration of the drug.
  • Action of the treatment is completely depending upon the type and thickness of In Sushruta Samhita the thickness is compared with buffalo’s skin and In Sharangdhar Samhita it is said to be 1/3rd Angula.
  • In Lepa Chikitsa the drugs enter into the body from Romkupa then into the Swed Vaha Strotas and further acts on the body.
  • Lepa Chikitsa is not only effective in Vishabadha (Poisoning) but it is also effective in the Twak Vikar, Kushtha, Unmmada, Apasmar, Gulma, Arsha like disorders.

Conclusion

In the Visha Chikitsa, Lepa plays very important role. Vishaghana Lepa is applicable in all types of Visha Badha. Lepa is effective in treatment of local as well as systemic signs and symptoms of Visha and prevention of its further spread. Lepa are also effective in neutralizing the locally present Visha. Vishaghana Lepa is indicated only in confirmed and fully diagnosed poisoning case. There are many Vishaghana Lepa and Agada being used as Lepa in Visha Chikitsa. Effects of Vishaghana Lepas are well described in the Various Samhitas.

Reference

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