Journal of Ayurveda and Integrated Medical Sciences

Introduction

Acharya Charaka has illustrated various skin pathologies under Kushta and Visarpa Chikitsa Adhyaya. Skin diseases vary greatly in signs, symptoms and severity; they can be infectious or not; can be painless or painful; can have only situational cause or the genetic or autoimmune one; they can be a temporary or permanent one.

With all these diversities, the major issues of concern in patient are the disfigurement, disability and symptoms such as intense itch, burning, discharge, non- healing wounds, and recurrence of symptoms and chronicity of certain conditions. They may be either solitary one or shows the systemic involvement.

Majority of the skin diseases are mentioned and classified under Kushta and Visarpa Chikitsa in Charaka Samhita on the basis of the involvement of Dosha, Dushya and Adhishthana. Treatment of certain skin diseases become laborious because of involvement of Saptadhatu Sangraha (Twak, Rakta, Mansa, Lasika and all three Doshas i.e., Vaat, Pitta, Kapha.)

It involves both Shodhana and Shamana Chikitsa. With this Chikitsa Sutra, certain local application also gives excellent results in minor skin conditions and also relives the symptoms in severe skin pathologies and restores the disfigurement (Varnyaprasadan Karma) and helps in wound healing (Vranaropan Karma).

While assigning the treatment of various skin diseases, most of time Lepa preparations are taken into consideration In classics, the Chikitsa is classified into Antaparimarjan and Bahiparimarjan Chikitsa. The later one is the local application of medicines in various forms. Lepa is one of them. Application of drugs in the paste form over the concerned body part is widely acceptable method of Lepa preparation.

Acharya Charaka has mentioned different combinations at the starting of text in Bheshaj Chatushka. He gave different kinds of Lepa preparations in various conditions e.g. Kustha. Vaatvyadhi, Shirashool in Argwadhiya Adhyaya of Sutra Sthana. These number of combinations in Kushta and Visarpa Chikitsa Adhyaya of Chikitsasthan, increased up to fifty eight.

Probable mode of action

Ayurveda therapy suggests that Lepa, that is, the topical formulations should be gently rubbed in an upward or reverse direction of the hairs over the skin to make the action of application quick and more effective.^[3] Due to this, the drug enters into the pores at the root of the hair through which the drug gets absorbed in the capillary network to minor veins and then further into systemic blood circulation. This ultimately results in the absorption of medicament and desired effects. This method of rubbing increases the skin temperature,

Discussion

Topical applications are more effective only after Shodhana Chikitsa. Acharya Charaka used number of combinations of Kushtahar, Krumihar, Vranya, Varnya Dravyas for above formulations of Lepa. Acharya mostly used Katu,Tikta, Kashaya Raspradhan Dravya for these skin diseases. Twak-Sar is Ras-Sar. Overall health of Twak is depend of Vishudhha Rakta.

Godhuma is Snigdha and has Sandhaniya property and can be used according to Dosh Pradhanya.^[8] Acharya also used Rasdravya like Hartal, Mansheela, Gairik, Kasis, Sarja, Morchuda, Kampillak, Rasanjan, Trapu (Vang), Sisak, Ayas and used is in particular skin pathology. Hartal is Katu,Snigdha Ushna and can be used in Vaat-Kapha Pradhan Kushta. Mansheela is also Kapha-Vaatghna in nature. Suvarna Gairika is Shita, Raktapittahar. Kasis Bhasma is mild Kashaya, Ushna and Amlaguna Yukta and is effective in Rakta-Mansagat Vrana. It has effect on Ras Rakta and is Vaat-Kaphaghna in nature. Sarja is Kushta -Pama-Krumihar due to its Kashaya, Tikta Guna. Morchuda has Lekhana, Bhedana, Kandunashan property and acts on Raktagat Vikar. Kampillak is Vrana Nashak, Krumighna. Rasanjan is Ushna and has Kaphaghna and Vran Nashak property. Trapu is Varnakarak, Krumighna and has Krumighna property. It shows deep action on Ras, Rakta, Mansa and Asthi Dhatu. Ayas (Lauha) is used in Pitta Pradhan Kushta Roga.^[9] All these properties of Ras Kalpa are considered by acharya Charaka in above formulations. While some preparations have animal products such as as Ajadugdha, Goghrut, Varah Rudhir, Hastimutra, Gopitta, Gorochana. Ajadugdha is used in Rakta-Pitta Vikar.Ghruta is Pitta Anilahar and also Varnaprasadan.^[10] Hastimutra Is Ruksha, Lavana in nature and is indicated in Krimi and Kushta Vikar.^[11] Also Vaajimutra can be used in Kushta and Krimi Chiktsa due to its Tikta Guna.^[12] These additional properties of binding agents or Bhawana Dravya enhance the effect of given combination. Charaka has found all above amalgamations to get the best results in particular skin conditions keeping the view of dosha dhatu Awastha of Vyadhi.

Conclusion

Drugs used in above preparations can be now used in advanced forms of topical preparations. These numbers of combinations increase the scope of managing multiple skin pathologies at the same time. Premixing of these preparations can show the Vatghna, Pittaghna, Kaphaghna, Krimighna, Kandughna, Varnaprasadan properties. Also, the use of Ras kalpa majorly shows Krimighna and Vranahar property and can be further thought for topical antimicrobial properties. Efforts should be made in direction to explore each element of composition for further use.

11. Agnivesha, Charaka Samhita, Ayurveda Deepika Commentary of Chakrapani, edited by; Vaidya Yadavji Trikamji Acharya, Krishnadas Academy, Varanasi, reprint- 2000, Charaka Sutra Sthana 1^st Chapter, shloka 102. Page no.21
12. Agnivesha, Charaka Samhita, AyurvedaDeepika Commentary of Chakrapani, edited by; Vaidya Yadavji Trikamji Acharya, Krishnadas Academy, Varanasi, reprint- 2000, Charaka Sutra Sthana 1^st Chapter, shloka 104. Page no.21.