E-ISSN:2456-3110

Case Report

Shataru Kushta

Journal of Ayurveda and Integrated Medical Sciences

2024 Volume 9 Number 10 OCTOBER
Publisherwww.maharshicharaka.in

A clinical case study of successful management of Shataru Kushta through Daivavyapashraya and Yuktivyapashraya Chikitsa

Bharadwaj BA T1*, Ranjitha2
DOI:10.21760/jaims.9.10.53

1* Tejas Bharadwaj BA, Post Graduate Scholar, Dept of Roga Nidana Evam Vikriti Vijnana, Government Ayurveda Medical College, Bengaluru, Karnataka, India.

2 Ranjitha, Associate Professor, Dept of Roga Nidana Evam Vikriti Vijnana, Government Ayurveda Medical College, Bengaluru, Karnataka, India.

Ayurveda classifies Chikitsa into Daivavyapashraya Chikitsa and Yuktivyapashraya Chikitsa.[1] Shataru is one among the eighteen types of Kshudra Kushta and is characterized by reddish-black discoloration, burning sensation, pain, and multiple wounds.[2] Khadira (Acacia catechu) is the best Dravya /drug for the pacification of Kushta.[3] By using Khadira (Acacia catechu) in the form of Pralepa (external application of Khadira in the form of paste.), Udvartana (dusting and rubbing of Khadira Churna on the lesion), Snana (for bathing), Paana (drinking), and Bhojana (eating) all types of Kushta/ Twak Roga’s get pacified.[4] As a part of Daivavyapashraya Chikitsa for Kushta, Bhaskara Aradhana (Worship of Surya Bhagavan) and worship of Shivasuta namely Bhagavan Kumara is mentioned by Acharya Vagbhata.[5] Thus, in the present case study, Shataru Kushta was successfully treated through Bhaskara and Kumara Aradhana, which constituted the Daivavyapashraya Chikitsa and Khadira Dravya was administered in various modes as a part of Yuktivyapashraya Chikitsa.

Keywords: Bhaskara and Kumara Aradhana (Japa), Daivavyapashraya Chikitsa, Khadira, Shataru Kushta

Corresponding Author How to Cite this Article To Browse
Tejas Bharadwaj BA, Post Graduate Scholar, Dept of Roga Nidana Evam Vikriti Vijnana, Government Ayurveda Medical College, Bengaluru, Karnataka, India.
Email: 		Bharadwaj BA T, Ranjitha, A clinical case study of successful management of Shataru Kushta through Daivavyapashraya and Yuktivyapashraya Chikitsa. J Ayu Int Med Sci. 2024;9(10):319-323.
Available From
https://jaims.in/jaims/article/view/3658

Manuscript Received Review Round 1 Review Round 2 Review Round 3 Accepted
2024-09-08 2024-09-18 2024-09-28 2024-10-08 2024-10-20
Conflict of Interest Funding Ethical Approval Plagiarism X-checker Note
None Nil Yes 13.19

© 2024by Bharadwaj BA T, Ranjithaand 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].

J Ayu Int Med Sci 2024;9(10)319
Tejas BBA et al. A clinical case study of successful management of Shataru Kushta

Introduction

Shataru is one among the eighteen types of Kshudra Kushta. It is predominant in Pitta and Kapha Doshas.[6] Thus, it is characterized by Rakta-Shyava Varna (Reddish-black discoloration), Daha (Burning sensation.), Bahuvrana (Multiple wounds), and Arti (pain). Apart from other signs and symptoms, Acharya Vaghbhata says Shataru is also characterised with Kleda, Jantvaadya (excessive secretions, worms) and Praayasha Parvajanma (lesions originating in joints).[7] Ayurveda treatment approach is of two ways namely: Daivavyapashraya and Yuktivyapashraya. For Kushta, Daivavyapashraya is Bhaskara, Kumara Aradhana, and Yuktivyapashraya is usage of Khadira Dravya in various modes such as Pralepa, Udvartana, Snana, Pana and Bhojana.

Objective of the study

To determine the efficacy of Daivavyapashraya Chikitsa, namely Bhaskara and Kumara Japa as Yuktivyapashraya Chikitsa vis-a-vis Khadira Dravya in the treatment of Shataru Kushta as mentioned in Ayurveda Samhita’s.

Brief history of the patient

The present case report is of 52 years old female; not a known case of HTN / DM / other systemic illness; came with complaints of reddish black discolouration of skin at right ankle joint associated with burning sensation; pain and multiple small wounds since 1 week. Subject initially neglected these symptoms and did not take any medicines but just removed the anklet which she was wearing. As the small sized wounds and other symptoms mentioned above started to aggravate, she approached SJIIM for the treatment.

Past History

  • No history of above skin complaints before.
  • No history of trauma.
  • No history of HTN/DM/Thyroid/other systemic disorders.

Family History

Nothing significant, all other family members are said to be healthy.

Personal History

  • Occupation - Home maker
  • Marital status - Married
  • Religion - Hindu
  • Diet - Pure vegetarian
  • Appetite - Normal
  • Bowel - 2 to 3 times / day
  • Micturition - 3 to 4 times/ day; 1 time/ night.
  • Sleep - sound
  • Allergies to any medication / food - no
  • Addictions - coffee, 8 to 9 times / day

Table 1: Nidanas

AharajaVishamashana : fasting/ Upavasa at day time, not taking solid food but used to drink coffee 200ml 5-6 times a dayDadhi Sevana at night
Viharaja Shrama: working continuously without rest by cooking, cleaning, washing about 10 hours.
ManasikaBhaya: fear from elders if work is not completed.

Clinical findings = Integumentary system

O/E of skin

Site of lesion - on right ankle region

  • Lesion - epidermal
  • Distribution - asymmetrical
  • Character of lesion - maculo-papular
  • Colour - reddish-black
  • Itching - present
  • Discharge - present
  • Burning sensation - present
  • Swelling - present
  • Pain - present

Aggravating factors: coffee, spicy food, fear, hot sunny day.

Table 2: Samprapti

Nidana
↓
Aharaja-Viharaja-Manasika
↓
Tridosha Prakopa
↓
Dushti of Twak, Rakta, Mamsa and Lasika
↓
At Gulpha Sandhi Pradesha
↓


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Tejas BBA et al. A clinical case study of successful management of Shataru Kushta

Causing Rakta-Shyava Varna of Twak, Arti (pain), Bahuvrana (multiple wounds), Daha (burning sensation)
↓
Shataru Kushta

Table 5: Samprapti Ghatakas

DoshaPitta-Shleshma Adhika, Tridosha
DushyaTwak, Rakta, Mamsa, Lasika
AmaJatharagni Janya
AgniVishama
SrotasRasavaha, Raktavaha and Mamsavaha
Srotodushti PrakaraSanga
Rogamarga Bahya
Udbhava SthanaAmashaya
Vyakta SthanaTwak
Roga SwabhavaChirakari
SadhyasadhyataKricchrasadhya

Materials and Methods

Assessment criteria
Based on subjective criteria: Patient was observed for improvement in discoloured lesions, itching, pain, burning sensation with respect to small wounds.

Treatment plan

  • Jalaukavacharana
  • Daivavyapashraya Chikitsa
  • Yuktivyapashraya Chikitsa

Table 6: Treatment schedule

CourseShodhanaDaivavyapashraya Chikitsa and ShamanaObservation
12/04/24JalaukavacharanaSri Kumaraya Namah Japa 108 timesBurning sensation and pain reduced.
13/04/24 - 25/04/24Khadira Churna was administered in different forms such as Pralepa, Udvartana, Snana, Paana and Bhojana;
Sri Kumaraya Namah and Sri Bhaskaraya Namah 108 Japa each		Reddish black discolouration, burning sensation, pain and small wounds got cured gradually.

Results

jaims_3658_01.JPG
Figure 1: Before treatment

jaims_3658_02.JPG

jaims_3658_03.JPG

jaims_3658_04.JPG
Figure 2: Jalaukavacharana

jaims_3658_05.JPG
Figure 3: After 12 day’s course of Daivavyapashraya and Yuktivyapashraya Chikitsa


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Tejas BBA et al. A clinical case study of successful management of Shataru Kushta

Discussion

Shataru Kushta is one among the eighteen types of Kushta which is a Rakta Pradoshaja Vyadhi.[8] Hence, Raktamokshana is the standard line of treatment in Kushta. As, in the present case study, the lesion was localised and deep; the best way of Raktamokshana, to be adopted is Jalaukavacharana.[9]

Shataru is Pitta-Kapha Pradhana Kushta and Jalauka is indicated when Rakta is vitiated along with Pitta and hence in this case as there is involvement of Pitta Dushita Rakta, Jalauka was done and immediately after Jalaukavacharana, Daha (burning sensation) and Arti (pain) was reduced. Khadira is considered as the best Dravya to cure Kushta. By using Khadira Churna for Snana (bathing), Paana (drinking) and Bhojana (food), Pralepa (paste), Udvartana (rubbing), Kushta is pacified. In this present case Khadira Churna was applied with water in the form of paste (Pralepa) twice a day morning and evening. During Snaana (bathing), the bucket of water used for bathing was added with Khadira Churna of approximately 25g and mixed well. This water mixed with Khadira Churna was used for bathing and rubbing (Udvartana) of the lesion was done with Khadira Churna only instead of a soap during bathing. Throughout the whole day, whenever the patient felt thirst, she was advised to drink water mixed with Khadira Churna. The dose was: for 1 glass of water, 1tsp(6g) of Khadira Churna was added, stirred well and was advised to drink. During food time; initial 2-3 bolus of food mixed with Khadira Churna and 1tsp ghee was advised for the patient.In this manner, Khadira Churna was given both internally (Abhyantara Prayoga) and externally (Bahya Prayoga).

A patient of Kushta should worship Shiva-Suta (Kumara/Subrahmanya) and Bhaskara (Surya Deva) which act as Daivavyapashraya Chikitsa and hence, Japa

  • Sri Kumaraya NamaH
  • Sri Bhskaraya NamaH

was advised for 108 times at morning time after Snana, facing east direction.

The Nirukti (etymological derivation) of Kumara is Kutsnaati Maarayati Iti Kumaarah i.e., one who destroys Ku such as Kushta, Kubuddhi etc.

is Kumara and Nirukti of Bhaskara is Bhaasam Karoti Iti Bhaskarah, i.e., one who induces glow is Bhaskara. So, by the Japa of Kumara Nama, Kushta gets pacified and by the Japa of Bhaskara Nama, glow will be induced in the skin and thus, the result is seen in the patient.

Conclusion

Ayurveda’s mode of treatment, namely, Daivavyapashraya and Yuktivyapashraya Chikitsa, when adopted collectively results in complete and quick curation of a disease. In that regard, Shivasuta, Bhaskara Aradhana (worship) and Khadira Dravya usage in different forms by a Kushta patient does pacification of Kushta. In the present case study, both the methods of Chikitsa mentioned for Shataru Kushta were adopted, as a result of which improvement was seen in the patient.

References

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