E-ISSN:2456-3110

Review Article

Kushtha

Journal of Ayurveda and Integrated Medical Sciences

2024 Volume 9 Number 10 OCTOBER
Publisherwww.maharshicharaka.in

Kushtha in Ayurveda a comprehensive study

Bishnoi N1*, Sharma MM2, Prakash V3, Meena S4
DOI:10.21760/jaims.9.10.30

1* Neha Bishnoi, Post Graduate Scholar, PG Department of Rog Nidan Evum Vikriti Vigyan, Madan Mohan Malviya Government Ayurvedic College and Hospital, Udaipur, Rajasthan, India.

2 Man Mohan Sharma, Professor, PG Department of Rog Nidan Evum Vikriti Vigyan, Madan Mohan Malviya Government Ayurvedic College and Hospital, Udaipur, Rajasthan, India.

3 Ved Prakash, Lecturer, PG Department of Rog Nidan Evum Vikriti Vigyan, Madan Mohan Malviya Government Ayurvedic College and Hospital, Udaipur, Rajasthan, India.

4 Suman Meena, Ayurved Medical Officer, Rajkiya Ayurved Chikitshalya Ayad, Udaipur, Rajasthan, India.

The skin is the most visible and presentable part of the body, playing a significant role in one’s personality. It acts as a mirror, reflecting internal health conditions. As the largest organ of the body, the skin covers a surface area of about 1.8 square meters and accounts for approximately 18% of total body weight. Skin diseases, while manifesting physically, often lead to significant psychological distress, causing discomfort, disfigurement, disability, and in some cases, even death. Changes in skin color are frequently indicative of homeostatic imbalances within the body. The health of the skin is influenced by a variety of interrelated factors, including nutrition, hygiene, circulation, age, immunity, genetic predispositions, psychological state, and medication use. In modern society, the prevalence of fast food consumption and irregular sleep patterns has contributed to the emergence of "Viruddha Aahara Janya Vyadhi," or diseases caused by incompatible dietary habits. As a result, a significant portion of the population experiences skin problems. The skin is considered a combination of the five great elements (Pancha Mahabhutas), with Vayu (air) being the most significant. Sparsh Pareeksha (examination by touch) is also included as one of the eight diagnostic tools in Ashtavidha Pareeksha. Common skin conditions like eczema, acne, blisters, melanoma, age spots, and pemphigus are discussed under the broader category of Kushtha in Ayurvedic literature. All forms of Kushtha are classified into two categories: Maha Kushthas (major skin diseases) and Kshudra Kushthas (minor skin diseases).

Keywords: Viruddha Aahara Janya Vyadhi, Maha Kushtha, Kshudra Kushtha

Corresponding Author How to Cite this Article To Browse
Neha Bishnoi, Post Graduate Scholar, PG Department of Rog Nidan Evum Vikriti Vigyan, Madan Mohan Malviya Government Ayurvedic College and Hospital, Udaipur, Rajasthan, India.
Email: 		Bishnoi N, Sharma MM, Prakash V, Meena S, Kushtha in Ayurveda a comprehensive study. J Ayu Int Med Sci. 2024;9(10):187-192.
Available From
https://jaims.in/jaims/article/view/3541

Manuscript Received Review Round 1 Review Round 2 Review Round 3 Accepted
2024-09-12 2024-09-23 2024-10-02 2024-10-12 2024-10-21
Conflict of Interest Funding Ethical Approval Plagiarism X-checker Note
None Nil Yes 12.32

© 2024by Bishnoi N, Sharma MM, Prakash V, Meena Sand 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

The word Kushtha is derived from the word "Kus Nishkarshane" by adding the suffix ″Tka ″to it.[1]

The meaning of "Kush" is to tear, extract, pull or draw out. Thus, the word Kushtha means that which destroys with certainity & also which comes out from the inner part to the outer part.

Definition

1. कुष्णात्यङ्गम् ।

One which causes despise or despicable situations.

2. कुष्णाति निशेषेण विलेखनं कान्तिऽड्रङ्गप्रत्यांनि धातूपधात्वनीति कुष्ठम्।

Discolouration is produced over Twacha after Doshik vitiation, hence called Kushtha. From these definitions one can conclude as: When the derangement is not cared, then a disease is formed inside the body which manifests itself on the skin & makes it Kutsit or contemptible by vitiating Rasadi Sapta Dhatus. The whole body becomes despised & hence called as Kushtha.

3. कुष्णाति शरीरस्थ शोणितं विकृते।

Vitiated Rakta leads to the destruction of body; hence it is called as Kushtha.

4. त्वचः कुर्वन्ति वैवर्ण्य दुष्टाः कुष्ठमुशन्ति तत् ।
5. कालेनोपेक्षितं यस्मात्सर्व कुष्णाति तद्वपुः॥ [2]

One which produces discolouration over skin region is said to be Kushtha. During the lapse of time, it makes the entire body look ugly.

Kushtha Nidan/ Hetu

As per Ayurveda, Acharaya have not explained separate Nidana Kushtha. But some common causes of Kushtha is well explained in Ayurveda. Kushtha (skin diseases) is caused by the vitiation of doshas etc., in persons indulging in unwholesome regimens as follows:-

Aharaja Nidana[3-5]

1. Virodhi Anna Pana and Snigdha Guru Pana: Intake of incompatible combinations such as milk with fish, such bad food combinations. Drinks which are unctuous and heavy to digest.
2. Haphazard intake of foods with hot and cold properties and fasting.

3. Intake of excess food, uncooked food and intake of food before the previous meal is digested.
4. Excessive intake of foods of freshly harvested grains, curd, fish, salt and sour substances.
5. Excessive intake of Masha (black gram), Mulaka (radish), pastry, Tila (sesame seeds) and Jaggery.

Viharaj Nidana

1. Suppression of the urge for vomiting and other natural urges.
2. Doing physical exercise in excessive heat and after a heavy meal.
3. Use of cold water immediately after exposure to scorching sun, heat, exertion or exposure to frightening situation.
4. Improper administration of Panchakarma
5. Performance of sexual act while suffering with indigestion.
6. Sleep during day time.

Kushtha Samprapti (Pathogenesis)[6]

The three vitiated Doshas viz Vata, Pitta and Kapha in turn vitiate the Twak (Skin or Rasa Dhatu) Rakta (Blood), Mamsa (Muscle tissue) and Ambu (Lymph or plasma part of blood tissue). These taken together, constitute the seven fold pathogenic substance of Kushtha. These are together called Kushtha Dravya Sangraha.

All the 18 types of Kushtha (skin diseases) are caused by the above seven factors. Kushtha is never caused by the vitiation of only one of the above-mentioned pathogenic substances. All of them are necessarily involved in the causation of the disease. The process beginning with the vitiation of Doshas, due to specific Nidana and which lead to the full-fledged manifestation of the disease after the Dosha Dushya Sammurchana is called Samprapti. The knowledge of Samprapti helps the physician to understand the specific features of a disease, like the involvement of particular Dosha. According to Acharya Charaka Nidana Sevana leads to Prakopa of Tridosha and thus the vitiated Doshas will get Ashraya in Twak, Rakta, Mamsa and Ambu causing the Shaithalyatha in these Dhatus leading to the Manifestation of Kushtha Roga further in Chikitsha sthana he has explained that the Vatadi Doshas get Prakopa and does Dushana of Twak, Rakta, Mamsa and Ambu leading to seven or eleven types of Mahakushtha and Kshudrakushtha respectively.

दोषाणां सञ्चितानां तु त्वड्मांसास्रचारिणाम् ।


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तु प्रदूषणं हि सर्वेषां कुष्ठमित्यभिधीयते ॥[7]

After the vitiation, all the Doshas accumulates and wander in Twacha, Mamsa, Lasika and Rakta and produce a condition known as Kushtha.

Kushtha classification

Almost all the skin disorders come under the broad term "Kushtha. In Charaka Samhita, Kushtha is divided into two categories viz. Mahakushtha and Kshudrakushtha. There is no clearcut explanation for this division but commentators have tried to solve this query. Chakrapani explained that Kshudrakushtha has Alpa (less) Dosha and Lakshanas in comparison to Mahakushtha. So, it is known as Kshudrakushtha.[8] Gayadas mentioned that there is Alpa Dosha in Kshudrakushtha in comparison to Mahakushtha. Kanthadatta has added that the quick (Shighra) involvement of Dosha to succeeding Dhatu results in Mahakushtha which may not be the feature in Kshudrakushtha.[9] While Maha Kushtha starts with major involvement of Doshas, penetrate the Gambhira (deeper) Dhatus[10] resulting in excessive symptoms and involvement of major body area, so require urgent and major medicaments.

The difference between Maha Kushtha and Kshudra Kushtha

SNMaha KushthaKshudra Kustha
1.Bahu Dosha ArambhavataAlpa Dosha Arambhavata
2.Bahu Lakshana Alpa Lakshana
3.Excessive discomfortLess discomfort
4.Excess tendency to penetrate deeper Dhatus rapidlyLess tendency to penetrate in deeper Dhatus
5.Maha chikitsa Alpa Chikitsa
6.ChronicLess chronic
7.Loss of skin functions like Sparshagnata.Less functional deformities of skin.

Classification of Kushtha according to differentAcharyas.

Maha Kushtha

SNTypes of KushthaCHSUAHASKSBHMNBP
1.Kapala++++++++
2.Audumbara++++++++
3.Mandala+-++++++
4.Rishyajihva++++++++
5.Pundarika++++++++
6.Sidhma+--+++++
7.Kakanaka++++-+++
8.Dadru-+++----
9.Aruna-++-----

Kshudra Kushtha

SNTypes of KushthaCHSUAHASKSBHMNBP
1.Ekakushtha++++++++
2.Kitibha++++++++
3.Charmadala++++++-+
4.Pama++++++++
5.Vicharchika++++++++
6.Charmakhya+-++-+++
7.Vipadika+-+++-++
8.Alasaka+-+++-++
9.Dadru+---++++
10.Visphotaka+-+-++++
11.Shataru+-++++++
12.Sidhma-++-----
13.Sthularushka-+------
14.Mahakustha-+------
15.Visarpa-+------
16.Parisarpa-+------
17.Raksha-+------
18.Shvitra-----+--
19.Vishaja----++--

Acharya Kashyapa[11] has mentioned classification of Kushtha on the basisofprognosis

PrognosisType of Kushtha
SadhyaSidhma, Vicharchika, Pama, Dadru, Kitibha, Kapala, Sthularushka, Mandala, Vishaja.
AsadhyaPundarika, Shvitra, Rishyajihva, Shataru, Audumbaru, Kakanaka, Charmadala, Ekakushtha, Vipadika

On the basis of prognosis Acharya Charaka has mentioned Kakanaka Kushtha as Asadhya while Sushruth Acharya has mentioned Kakanaka and Pundarika as Asadhya.

Classification of Kushtha according to Harita Samhita:-

In 42nd chapter of Trutiya Sthana of Harita Samhita, counting types of Kushtha, Harita has mentioned 18 types of Kushtha but described only 16 types of Kushtha as follows: Kapalika, Visarpaka, Lohitamandala, Bahuvrana, Audumbara, Hastibala, Vaipadika, Khasa Dadru, Kina, Charmadala, Vicharchika, Mandalaka, Gojihvaka, Vishphotak, Sidhma Classification on the basis of Doshajapredominance

DoshaName of Kushtha (Charaka and Vagbhatta)
VataKapala
PittaAudumbara
KaphaMandala,Vicharchika
Vata-KaphaSidhma, Ekakushtha, Alasaka, Charmakhya, Kitibha, Vipadika
Vata-PittaRishyajihva
Kapha-PittaPundarika,Charmadal, Dadru, Pama, Visphotaka,Shataru
TridoshaKakana

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Classification on the basis of Doshic predominance (Sushrutha)[12]

DoshaName of Kushtha
VataAruna, Parisarpa
PittaRishyajihva, Audumbara, Charmadala, Visarpa, Kapala Vicharchika, Kitibha, Kakana, Pama
KaphaPundarika, Dadru, Sthularushka, Ekakushtha, Sidhma, Raksha Mahakustha

Premonitory sign and symptoms (Poorva Roopa)

  • Sparsagyatva is a loss of touch sensitivity in the vicinity of a skin lesion
  • Ati Sweda or Nava - Excessive perspiration or a lack of feeling
  • Loma Harsha, Kandu, Todo, Shrama and Klam - stinging pain, physical tiredness, and mental and emotional lethargy.
  • Skin patches (Kotha) that are elevated and discolored.
  • Shoolam - excessive discomfort in the areas with ulcers.
  • Vrana Adhikam these ulcers appeared instantly and persisted over time.
  • Daha, Suptangato - a burning feeling, and numbness.

According to Acharya Charaka and Sushruta

Predominant DoshaSymptoms (Charaka)Symptoms (Sushruta)
VataRaukshya, Sosha, Toda. P Shula, Samkochana, Ayama, S Parushya. Kharabhava, Harsha, Syava-ArunatvaTvaka Samkocha, Svap. Sweda, Shopha, Bheda, Kaunya, Svaropghata
PittaDaha, Raga, Parisrava, Paka, Visragandha, Kleda AngapatanaPaka, Avadarana, Anguli Patana, Karna Bhanga, Nasa Akshiraga, Satvotpattaya
KaphaShvaitya, Shaitya Kandu, Sthairya, Utsedha, Gaurava, Sneha Kleda,Kandu Varnabheda, Shopha, Strava, Gaurava

According to Kashyapa (Kushtha Chikitsadhyaya)

Predominant DoshaSymptoms
VataSyava, Aruna, Kandu, Chimachimayana, Kharatva, Parushya, Sanstambh, Ayam.
PittaDaha, Vedana, Jvara, Vidbheda, Ushayana, Paka, Strava, Kotha, Kshiprotthana, Sheeta Madhura Kashaya Sarpiranushaya
KaphaShveta, Pandu, Ghanotsedha, Guru, Staimitya, Stambha, Mahaparigraha, Sheetaditaranushaya Agnisada,

Symptoms according to Dosha Bahulya

Acharyas have also mentioned symptoms according to the predominance Dosha in Kushtha. It is also useful in the diagnosis and management of the disease.

According to Harita (Trutiya sthana, 42ndchapter)

Predominant DoshaSymptoms
VataToda, Vepathu
PittaShosha, Bhruma, Daha, Trushna
KaphaKathina, Sheetala, Netra 1-Nakheshu-Vapush

Discussion

Kushtha, traditionally recognized as one of the most chronic disorders, is notoriously difficult to treat. It was classified as one of the Asthamahagadas the eight most severe diseases by ancient Ayurvedic scholars. This classification holds true even today, as Kushtha continues to be a significant health challenge despite advancements in modern medicine.

Charaka, one of the principal contributors to Ayurveda, emphasized the profound connection between the skin and the mind (Mann). This link suggests that psychological stress, whether direct or indirect, can negatively impact an individual's health. Such stress can either trigger the onset of skin conditions or exacerbate existing ones.

In addition to psychological factors, environmental influences, dietary habits, and lifestyle choices are also critical in the development and persistence of skin disorders like Kushtha. The holistic approach of Ayurveda, which includes dietary management, herbal remedies, and stress-relief practices, aims to address both the physical and psychological aspects of these conditions. This approach remains relevant as we continue to understand the complex interplay between the mind, body, and environment in the manifestation of chronic skin diseases.

Conclusion

Ayurveda is undoubtedly a science of life. The principles outlined in Ayurvedic classics for leading a healthy and fulfilling life are not only easy to understand but also highly beneficial for people in all aspects of daily living. Maintaining awareness of skin health is crucial.


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Avoiding unhealthy habits is essential for preserving skin health, while following a proper seasonal regimen and balanced diet can significantly enhance overall well-being. When the body's Doshas become imbalanced and manifest externally, it can lead to skin disorders such as Kushtha, highlighting the importance of internal harmony for maintaining healthy skin.

References

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9. Madhavakar, Madhava Nidan, "Madunha hindi commentary by Narendra Nath Shastri published by Motilal Banarasidas Edition sh. 49/10-22 pg no.623-425
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