E-ISSN:2456-3110

Review Article

Kushta (Skin Disease)

Journal of Ayurveda and Integrated Medical Sciences

2024 Volume 09 Number 06 JUNE
Publisherwww.maharshicharaka.in

Role of Kleda in Kushta (Skin Diseases) - A Review Article

Shetty S1*, Kaur P2, Kamath S3, Bairwa R4, Sharma SK5
DOI:10.21760/jaims.9.6.21

1* Srinidhi Shetty, Post Graduate Scholar, Department of Roganidan Evam Vikriti Vijnana, National Institute of Ayurveda, Jaipur, Rajasthan, India.

2 Prabhjot Kaur, Post Graduate Scholar, Department of Roganidan Evam Vikriti Vijnana, National Institute of Ayurveda, Jaipur, Rajasthan, India.

3 Surekha Kamath, Post Graduate Scholar, Department of Roganidan Evam Vikriti Vijnana, National Institute of Ayurveda, Jaipur, Rajasthan, India.

4 Rashmi Bairwa, Post Graduate Scholar, Department of Roganidan Evam Vikriti Vijnana, National Institute of Ayurveda, Jaipur, Rajasthan, India.

5 Surendra K Sharma, Professor and Head, Department of Roganidan Evam Vikriti Vijnana, National Institute of Ayurveda, Jaipur, Rajasthan, India.

The human body's outermost layer skin, shields interior organs and tissues. Skin disorders account for 1.79% of the world's total illness burden.[1] The majority of the time, skin disorders are the external manifestations of underlying systemic disorders. Modern dermatological treatment strives to relieve symptoms and achieve a long-lasting remission, but Ayurveda seeks to cure patients completely by identifying and treating the underlying causes of their skin disorders. In Ayurveda, skin conditions fall mostly under the category of Kushta. The seven important components that Ayurveda believes are involved in the pathophysiology of Kushta are referred to as Saptako Dravyasangraha. It consists of Tridosha, Tvak, Mamsa, Rakta and Ambu/Lasika (body fluids).[2] The Ambu described here is likewise a Kleda, signifying Ap Mahabhuta in the body.[3] The goal of the current work is to emphasize Kleda's function in Kushta and how treating Kleda can aid in the treatment of skin conditions.

Keywords: Kleda, Kushta, Skin-diseases, Leprosy, Body fluids

Corresponding Author How to Cite this Article To Browse
Srinidhi Shetty, Post Graduate Scholar, Department of Roganidan Evam Vikriti Vijnana, National Institute of Ayurveda, Jaipur, Rajasthan, India.
Email: 		Shetty S, Kaur P, Kamath S, Bairwa R, Sharma SK, Role of Kleda in Kushta (Skin Diseases) - A Review Article. J Ayu Int Med Sci. 2024;09(06):144-149.
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https://jaims.in/jaims/article/view/3244

Manuscript Received Review Round 1 Review Round 2 Review Round 3 Accepted
2024-04-09 2024-04-16 2024-04-27 2024-05-07 2024-05-17
Conflict of Interest Funding Ethical Approval Plagiarism X-checker Note
Authors state no conflict of interest. Non Funded. The conducted research is not related to either human or animals use. 13.12 All authors have accepted responsibility for the entire content of this manuscript and approved its submission.

© 2024by Shetty S, Kaur P, Kamath S, Bairwa R, Sharma SKand 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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Introduction

Skin is a window into the inner workings of the body. This proverb is accurate and has great significance. Every day, skin conditions are growing more prevalent. Most skin conditions don't pose a serious threat to life, but they can have a negative impact on mental and overall well-being. Skin conditions are primarily classified as Kushta in Ayurveda. The term Kushta refers to Kushnati Tadvapu, or the condition that causes abnormal skin tone.[4]

The word Kushta's origin comes from the root word Kush, which signifies something that emerges from inside. Pathogenesis of Kushta has seven important elements. They are Lasika/Ambu, Mamsa, Shonita, Tvak, and Tridosha. Ap is one of the Five Elements of Nature, according to the Panchamahabhuta doctrine of Ayurveda.[5] In the pathophysiology of Kushta, Lasika/Ambu is mentioned as a representation of the Ap Mahabhoota in the body, or Kleda. The root word Klid, which meaning to wet, is where Kleda gets its name. The typical function of Kledana is performed by Udaka (water), and because of its Drava Mridu Snigdha qualities, it causes compact materials to soften and loosen.[6]

Thus, terms that are synonymous with Kleda include Udaka, Ambu, Lasika, and Soumyadhatu. In a healthy person, Kleda is found in all seven Sharira Dhatus[7] and is essential for maintaining bodily elements in the proper consistency and hydration to support daily activities. In our scriptures, the term Kleda is discussed in relation to Dosha, Dhatu, Mala, and the pathophysiology of several ailments, including Prameha and Kushta. Therefore, an attempt is made in the present work to both understand and defend Kleda's role in the Kushta manifestation and treatment as it is described in our classical writings.

Aim and Objectives

To establish the fact about role of Kleda in pathogenesis of Kushta (Skin diseases).

Materials and Methods

Information about Kleda and Kushta (skin illnesses) is gathered from websites, Ayurvedic text books, contemporary text books, and index medical journals.

Discussion

Kleda in relation with mythological origin of Kushta

The author of Charaka Samhita, in Nidana Sthana, identified a single causative factor for each disease while recounting the mythical beginnings of illnesses during Daksha Yajna.

This suggests that the causative factor's characteristics are crucial for the disease's manifestation. Prameha and Kushta are thought to have resulted from people taking Havis after Daksha Yajna ended.[8]

Havis is the oblation for the gods made of rice, milk, ghee, jaggery, etc. Ishvara Samhita describes Havis as an offering to the gods made of rice, milk, ghee, jaggery, etc.[9]

All of these ingredients are naturally occurring forms of Kledakaraka and Santarpaka food.[10] This implies that diet and lifestyle choices that raise Kleda are crucial to the manifestation of Kushta.

Kleda in relation with etiological factors of Kushta

Ayurvedic scriptures typically list Kledakaraka variables as etiological factors for disease Kushta, either because of their direct vitiating effect on Kleda or because of their vitiating effects on Rasa and Rakta, as explained in the Vidhishoniteeya Adhyaya of the Charaka Samhita.

Kleda have a tight relationship with Rasa and Rakta. Because Tvak is Rasa's reflector and expresses the quality of Rasa within, Rasa Sara Purusha is evaluated by looking at a person's skin. When Pitta is vitiated, the body produces Kleda, and Kleda is said to be the primary cause of ailments brought on by Rakta.[11]

In Ashraya Ashrayee Bhava with Rakta, Pitta exists.[12] Kushta refers to Raktadhatupradoshaja Vikara,[13] which are blood-related disorders. Kleda is described by Vriddha Vagbhata as the low viscosity (Tanu), the foul-smelling (Durgandha), and the discolored (Krishna) parts of Rakta.[14]

Thus, in order to reach other Dhatus, Kleda travels through Rasa and Rakta, and Kleda's vitiation always has a significant effect on Rasa and Rakta Dhatus, as well as the other way around.


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Table 1: Relation of Kleda with etiological factors of Kushta

NidanaRelation with Kleda [15]
Atilavana (excess salt)Increases Kleda, Vishyandana (oozing) vitiates Rakta
Ati Amla (excess sour)Vitiates Rakta, Shithileekarana of body (loosening of body)
Viruddhahara (incompatible food)Vitiates Rakta.
Guru Anna Pana (heavy food)Vitiates Raktavaha Srotas
Snighda Anna Pana (unctuous food)Vitiates Rasa and Raktavaha Srotas
Drava Anna Pana (fluids)Increases Kleda, Vitiates Raktavaha Srotas, Vitiates Udakavaha Srotas, Vitiates Rakta
Excess intake of Sneha (excess fats)Increases Kleda
Nava Anna (Newly harvested grains)Increases Kleda
Mithyahara, Ahitashana (improper intake of food)Vitiation of Rakta
Asathmya Ahara (unwholesome food)Vitiates Rasa and Raktavaha Srotas
Ajeernashana, Adhyashana (especially intake of honey, Phanita, Fish, Radish when previous food is not digested)Vitiates Rasa and Rakta
Sheethoshna Vyathyasa without proper Krama (sudden transition from hot and cold environment)Vitiates Swedavaha Srotas and Vitiates Rakta
Gramya Audaka Anupa Mamsa (meat of aquatic and marshy land)Vitiates Rakta
Curd/Yogurt, Fish, Milk, JaggeryIncreases Kleda
Raddish, Blackgram, Pishtanna (grained food), Sesame seedsVitiates Rakta
Holding on urge of VomitingVitiates Rakta
Day sleepingVitiates Rasa and Rakta
Panchakarma Apachara (Improper cleansing through Panchakarma)Deposit vitiated Doshas in Rasa Rakta Dhatu.

Kleda in relation with Kushta Adhishtana

Table 2: Kleda in relation with Tridosha

DoshaProperties of Dosha [19]Relation with KledaSymptoms seen in Kushta [20]
VataRuksha, Laghu, VishadaVata has property of drying up of excess Kleda.Dry, rough lesions with minimal or no secretions.
PittaDrava, Sara, Snigdha Function of Kledasruti
(secretion and flow of Kleda)		Inflammatory changes and signs of suppuration and secretions are seen.
KaphaShita, Snigdha, PicchilaKapha and Kleda shares similar properties as both Kapha and Kleda has predominance of Jala Mahabhuta.Excessive Kleda, thick secretions are seen externally with severe itching. May also be associated with maggots

The Adhishtana for the disease Kushta is Tvak, or skin. Tvak is Rasa's seat and embodies the essence of Rasa.[16]

Therefore, in situations such as Ashtasara Lakshana, Dhatugata Kushta, etc. the term Rasa is typically substituted with Tvak.[17]

The Ap Mahabhuta entities are transported by Rasa within the body.[18] Thus, the quality of Kleda in relation to Rasa quality is crucial for maintaining skin health.

Kleda in relation with Tridosha

Because it participates in the Kledana function, a particular kind of Kapha is called Kledaka Kapha in honor of Kleda.[21]Therefore, Pitta and Kapha Doshas are more likely to vitiate Kleda than Vata.

Kleda in relation with different types of Kushta

18 types of Kushta are classified into 7 Mahakushta and 11 Kshudrakushta.

Table 3: Kleda in relation with different types of Mahakushta

SymptomMahakushta [22]
Bahalasika, Bahalasrava (Excessive secretions)Udumbara, Mandala, Pundarika
Kleda/ Bahukleda (Excessive Kleda)Udumbara, Mandala
Picchila Srava (Thick discharge)Mandala
Paka (Inflammation and suppuration)Udumbara, Pundarika
Bahukrimi, Sakrimi (infection / maggot formation)Mandala,Udumbara, Pundarika
Bahupuya (Pus formation)Udumbara, Pundarika

Table 4: Kleda in relation with different types of Kshudrakushta

SymptomKshudrakushta [23]
Kledadhya (Excess Kleda)Shataru
Kleda Pama
Bahusrava, LasikadhyaVicharchika

Kleda in relation with Dhatugata Kushta

When discussing the meaning and etiopathology of Kushta, Acharya Vagbhata states that Dhatu is vitiated by Kleda one after the other, as time passes.[25]

There is fluid in every live cell in the body. Kleda/Udaka is an integral, flowing component of all Dhatus, according to Acharya Charaka.[26]


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Table 5: Kleda in relation with Dhatugata Kushta

DhatuSymptoms seen in Dhatugata Kushta[24]
RasaHere, excessive Kledavastha is causing Sweda, or excessive sweating. Sweda disposes of extra Kleda since it is part of its responsibility to retain the proper amount of Kleda.
Raktaexcess Sweda, Vipuyaka (pus formation)
Mamsaexcessive Kleda in joints
MedaDourgandhya (foul odour), Puya (pus), Krimi (formation of maggots) and loosing of body parts
Asthi Krimi and Nasabhanga (depressed nasal bridge)
MajjaAsthi and Majja shows same symptoms.
ShukraAnganam Sambhedha(break down of body parts) are seen due to excess Kleda.

Kleda in relation with Sweda in Kushta

Sweda is the most involved with Kushta among the three Mala. It aids in maintaining fluid homeostasis by assisting the body in retaining the necessary quantity of Kleda and excreting the excess as sweat.[27] Both prodromal symptoms of Kushta and Swedavaha Sroto Dushti indicate similar symptoms.[28] This suggests a close relationship between the body's Kleda imbalance and Kushta Vyadhi.

Table 6: Common symptoms of Swedavaha Sroto Dushti and Purvarupa of Kushta

SymptomsSwedavaha Sroto DushtiPurvarupa of Kushta
Asweda (no sweating)üü
Atisweda (excessive sweatingüü
Parushya (dryness)üü
Paridaha (burning sensationüü
Lomaharsha (horripilation)üü
Atishlakshna (Excess smooth skin)üü

Stages of Kleda in Kushta

When vitiated, Kleda often exhibits an unexpected rise in amount. Kleda and Vishyandi (the Srotas coating and blocking property) are complementary.[29]

Unless there is no exposure to Vishyandi variables, there is no growth in Kleda. Many Vishyandi Ahara are considered as cause of Kushta.
Depending on how severe the Kleda is engaged, we can divide the Kleda Avastha into three stages.

1. Mild Kleda / Anabhishyandi Avastha
2. Moderate Kleda / Alpa Abhishyandi Avastha
3. Severe Kleda / Maha Abhishyandi Avastha

Table 7: Stages of Kleda in Kushta

Stages of Kleda in KushtaSampraptiSymptoms
Mild Kleda / Anabhishyandi AvasthaAccording to Dalhana, the phrase Anabhishyandi in this context refers to very little Kleda rather than Kleda's absence.[30]Dry lesions are signs of conditions here. Or the patient may not have any outward lesions yet still be experiencing symptoms like Supti (numbness) and Kandu (itching).
Moderate Kleda / Alpa Abhishyandi AvasthaDosha Dhatu Mala and Srotas are affected by moderately vitiated KledaWhere there are external skin lesions like Vicharchika, Vipadika, Dadru with or without secretions.
Severe Kleda / Maha Abhishyandi AvasthaHere all Dosha Dhatu Mala and Srotas are affected by highly vitiated KledaHere symptoms like severe oozing, necrosis, gangrene, maggots are seen due to excess Kleda.

Kleda in relation with complications of Kushta

Patients with Kushta get persistent wounds or lesions as a result of having an excess of Kleda in their bodies.[31] Therefore, in order to avoid Kushta Upadrava, Kleda should be treated.

Kleda in management of Kushta

The therapeutic process known as Shodhana involves thoroughly cleaning Kleda, or bodily fluids, in order to prepare them for expulsion.[32] The primary course of treatment for Kushta is repeated Shodhana.[33] This is meant to purge Kleda since it is the source and the means by which Kushta originates and spreads. Shamanoushadis (palliative medicines) are also crucial to the management of Kushta. Most Shamanoushadis contain Tikta (bitter) herbs, such as Nimba, Patola, Katuki, and others. Medicinal preparations such as Panchatikta Ghrita, Mahatikta Ghrita, and Tiktaka Ghrita are recommended in Kushta. This is due to the fact that Tikta Rasa is Kushtahara (alleviates Kushta) since it purges and purifies polluted Kleda.[34] Certain medicinal herbs such as Nimba, Patola, Haridra, Khadira, are primarily Kapha-Pittahara in nature. The primary function of Kapha-Pittahara medicines is to cleanse Kleda. Light foods like Puranadhanya (aged grains), Mudhga (green gram), Jangala Mamsa (flesh of animals that live in dry land), and Tikta Shakas (bitter vegetables) are part of a Pathya (advisable diet) in patient's of Kushta because they aid to repair Kleda.[35]


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Conclusion

Kleda is a crucial but little-known Ayurvedic principle. In addition to hydrating bodily components and supporting regular physiological functions, Prakruta Kleda aids in the proper operation of Dosha, Dhatu, Mala, Agni, and other bodily systems. When it crosses its threshold and becomes vitiated, it disrupts normal physiology and produces disorders like Prameha and Kushta. Every component of the illness, from Utpatti to the Chikitsa stage, mentions Kleda's association with Kushta. In order to properly treat Kushta by correcting Kleda, it is necessary to evaluate the degree of body fluid involvement, the stages of Kleda involvement, and the degree to which Dhatus is impacted by Kleda, during the diagnosis process.

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