E-ISSN:2456-3110

Review Article

Vicharchika

Journal of Ayurveda and Integrated Medical Sciences

2024 Volume 9 Number 9 SEPTEMBER
Publisherwww.maharshicharaka.in

An insight on Vicharchika and its management

Agarwal P1*, HML Meena2, Mutha R3, Shinsha4, Annu5
DOI:10.21760/jaims.9.9.9

1* Puja Agarwal, Post Graduate Scholar, Dept of Kayachikitsa, National Institute of Ayurved, Jaipur, Rajasthan, India.

2 HML Meena, Professor and Head, Dept of Kayachikitsa, National Institute of Ayurved, Jaipur, Rajasthan, India.

3 Rashmi Mutha, Assistant Professor, Dept of Kayachikitsa, National Institute of Ayurved, Jaipur, Rajasthan, India.

4 Shinsha, PhD Scholar, Dept of Kayachikitsa, National Institute of Ayurved, Jaipur, Rajasthan, India.

5 Annu, Post Graduate Scholar, Dept of Kayachikitsa, National Institute of Ayurved, Jaipur, Rajasthan, India.

The skin serves as the body's interface with the external environment, constantly interacting with physical, chemical, and biological agents. These interactions can lead to specific reaction patterns, resulting in characteristic skin lesions across various body parts. Environmental stimuli vary, and the body's innate resilience determines the occurrence of spontaneous remissions and relapses. In Ayurveda, skin diseases are categorized under Kustha, further divided into Mahakustha and Kshudra Kustha. Vicharchika falls under the latter category. It is characterized by symptoms such as itching (Kandu), eruptions (Pidaka), dark discoloration (Shyva Varna), and excessive discharge (Bahusrava). Charaka Samhita describes Vicharchika with predominance of Kapha, while Sushruta Samhita highlights symptoms indicating Pitta dominance. Vicharchika is regarded as a challenging condition to treat, categorized as a minor skin disorder (Kshudra-Kustha) yet considered a significant health issue. Ayurvedic texts outline various Sodhana (purification) and Shamana (palliative) treatments to balance the Doshas involved in Kustha. Shamana therapies include applications of medicated pastes (Lepa), internal medications (Pradeha), and herbal oils (Taila). Overall, addressing Vicharchika requires a comprehensive approach that integrates Ayurvedic principles with lifestyle modifications aimed at restoring balance and promoting skin health.

Keywords: Vicharchika, Kshudra Kustha, Mahakustha, Eczema

Corresponding Author How to Cite this Article To Browse
Puja Agarwal, Post Graduate Scholar, Dept of Kayachikitsa, National Institute of Ayurved, Jaipur, Rajasthan, India.
Email: 		Agarwal P, HML Meena, Mutha R, Shinsha, Annu, An insight on Vicharchika and its management. J Ayu Int Med Sci. 2024;9(9):68-74.
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https://jaims.in/jaims/article/view/3826

Manuscript Received Review Round 1 Review Round 2 Review Round 3 Accepted
2024-08-15 2024-08-26 2024-09-05 2024-09-15 2024-09-28
Conflict of Interest Funding Ethical Approval Plagiarism X-checker Note
None Nil Yes 12.87

© 2024by Agarwal P, HML Meena, Mutha R, Shinsha, Annuand 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

Ayurveda, a traditional Indian medicine, focuses on preventive health and holistic well-being. Increasing global recognition stems from its natural, safe methods and potential to address diverse health needs. However, modern challenges include identifying at-risk individuals,


assessing disease severity, and tailoring treatments. Skin, the body's largest organ, reflects internal and external health. Ayurveda categorizes skin diseases under Kustha, with Vicharchika, characterized by itching, discharge, and vesicles, among them. Charaka attributes Vicharchika to Kapha dominance, while Sushruta emphasizes Pitta imbalance.

SNNidanaCSSSASBSHS
A.Aharaja Hetu+++++
1.  Viruddha Ahara - Intake of chilchim fish & milk
2.  Intake of food mostly containing Hayanaka, Yavaka, Chinaka, Uddalaka & Koradusa along with Ksheera, Dadhi, Takra, Kola, Kulattha, Masha, Atasi, Kusumbha & Sneha.
3.  Intake of Mulaka & Lashuna with Ksheera+
4.  Continuous intake of Gramya, Audaka & Anupa Mamsa with Ksheera++
5.  Use of Pippali, Kakmachi, Lakucha with Dadhi & Sarpisha+
6.  Use of meat of dear with milk+
7.  Use of Mulaka with Guda+
8.  Excessive use of alcohol & milk+
9.  Intake of articles having sour taste with milk+
10.  Excessive use of green vegetables with milk+
11.  Intake of honey & meat after taking hot diet & vice-versa+
12.Use of fish, citrus & milk together+
1.Mithya Ahara
Excessive use of Navanna, Dadhi, Matsya, Amla & Lavana		+++
2.Excessive use of Tila, Ksheera & Guda+++
3.Drava, Snigdha, Guru Aharanam Atyartha Sevanam+++
4.Excessive oleation+
5.Continuous & excessive use of Madhu & Phanita+
6.Intake of food that would cause burning sensation++
7.Intake of food during indigestion++++
8.Adhyasana++++
9.Asatmyahara++
10.Intake of polluted water
B.
(a)
1.		Vihara Hetu
Mithya Hetu
To do physical exercise & to take sunbath after heavy meals		+++
2.To perform sexual act during indigestion++++
3.To do exercise/sexual act after Snehapana & Vamana+
4.Sudden change from cold to heat or heat to cold without following the rules of gradual change++++
5.Sudden change from Santarpana to Apatarpana & vice-versa++
6.Entering into cold water immediately after one is affected with fear, exhaustion & sunlight+++
7.Mithya Sansarga Sevana+
(b)
1.		Vega Vidharana
Withholding of the natural urges i.e. Mutra & Purisha Vega, etc.		+
2.Suppression of the urge of emesis++++
(c)
1.		Panchakarma Apacharaj
Panchakarma Kriyamane Nisshidha Sevana		+
2.Improper administration of Snehapana
C.
1.		Achara Hetu
Insulting acts to Brahmins, Teachers & other respectable persons		++++
2.Indulgence in sinful activities in present or past life+++++
3.Use of money or material acquired by unfair means++
4.Censuring or killing virtuous persons+++

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Treatment involves Shamana (palliative) and Shodhana (purification) therapies. Skin diseases, while not life-threatening, disrupt routine and appearance, causing discomfort and distress. Eczema, correlated with Vicharchika, manifests as inflammatory skin eruptions, particularly affecting children. Overall, Ayurveda's approach to skin ailments underscores the importance of holistic care and personalized treatment for optimal health and well-being.

Etymology of Vicharchika

Vicharchika’ stems from the Sanskrit origin ‘Charch Adhyane,’ with the prefix ‘Vee’ added. ‘Adhyane’ consists of ‘Adhi’ and ‘Ayane,’ where ‘Adhi’ denotes ‘above,’ and ‘Ayane’ refers to ‘to spread out.’ Thus, it can be concluded that Vicharchika refers to a distinct skin condition, characterized by its tendency to coat, cover, or injure the skin, particularly leading to cracking of the skin on the hands and feet. This definition is derived from the text Shabdakalpadrum.

Vicharchika As Eczema
Definition

Vicharchika is defined as, ‘Rajyo Atikandu Atiruja Sa Ruksha Bhavanti Gatreshu Vicharchikayam’. (Su.Ni.5/13) Accordingly, condition in which skin is dry with severe itching & marked linings present in Vicharchika. Furthermore, he added that if the same condition appears at the feet with pain, then it is known as ‘Vipadika’

Etiopathology of Vicharchika and eczema

Nidana, or the causative factors, play a crucial role in the development of diseases in Ayurveda. The etiological factors of Kustha, categorized under three headings, namely

  • Aharaja Nidan (dietary factors),
  • Viharaja Nidan (lifestyle factors), and
  • Acharaja Nidan (environmental factors), serve as the basis for understanding Vicharchika’s causes

Purvarupa

There is no classical description regarding the Purvarupa of Vicharchika, but being a variety of Kshudra Kustha, the Purvarupa of Kustha should be considered as its Purvarupa. This can be summarized in the following table.

SNPurvarupaCSSSAH/ASBSKS
1.Aswedanam (anhidrosis)+++++
2.Atiswedanam+++++
3.Parushyam++
4.Atishlakshnata++++
5.Vaivarnyam++++
6.Kandu+++
7.Nistoda++++
8.Suptata+++
9.Paridaha+++
10.Pariharsha+
11.Lomaharsha+++++
12.Kharatvam+++
13.Ushmayanam+++
14.Gauravam+
15.Shwayathu+
16.Visarpagamanam Abhikshanam+
17.Bahya Chhidreshupadeha+
18.Pakva-Dagdha-Danshta-Bhagna-Kshata Upashkhaliteshu Ati Matram Vedna+
19.Svalpanam Api Vrananam Dusti+
20.Kothonnati++
21.Swalpanam Api Vrananam Asamrohnam+
22.Shrama++
23.Klama++

Rupa

Rupa of Vicharchika, according to different Ayurvedic classics are summarized in the following table -

RupaCSSSAH/ASBSKS
Subjective symptoms
Kandu+++++
Vedana ----+
Ati-ruja +-+--
Daha -+---
Colour of Pidika (lesion)
Shyava -+-+-
Shweta+-+--
Rakta +--++
Srava (nature of discharge)
Bahusrava --+++
Ruksha-+---
Lasikadhya--+--
Praklinna (Mamsenopachita)---+-
Raji -+---
Pakavati ----+

Pathogenesis of Vicharchika

According to Charaka: The vitiation of the Tridosha occurs due to improper lifestyle choices (Nidana Sevana), leading to the contamination of the Dushya. This imbalance causes the Shaithilya (loosening) of the skin (Twak), blood (Rakta), muscles (Mamsa), and lymph (Lasika). The disturbance in the Tridosha,


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along with the involvement of the four Dhatus and the Saptako Dravya Samgraha, contributes to the manifestation of Kushtha (skin disorders) (Ch.Ni. 5/6, Ch.Chi. 7/9-10).

According to Sushruta: Due to the influence of Doshaja and Karmaja Nidana Sevana, the aggravation of Pitta and Kapha leads to an obstruction (Avarana) in the movement of Vata. This aggravated Vata becomes vitiated and, along with Pitta and Kapha, enters the Tiryaga Sira (lateral channels), where it further spreads and contaminates. As a result, these Doshas reach the external pathways of the body (Bahya Rogamarga), including the skin (Twaka), blood (Rakta), muscles (Mamsa), and lymph (Lasika), and spread throughout the body. Wherever these Doshas accumulate, they form Mandala (lesions). If left untreated, they can penetrate deeper into the tissues (Dhatu) of the body (Su.Ni. 5/3).

Samprapti Ghataka of Vicharchika

Saptako Dravya Sangraha

Dosha : Tridosha, Kapha Pradhana (Ch.) , Pitta Pradhana (Su.)

  • Vata: Vyana, Samana, Udana
  • Pitta: Pachaka, Bhrajaka
  • Kapha: Avalambaka, Kledaka

Dushya: Twak, Rakta, Mamsa, Lasika

Agni: Jatharagnimandya, Dhatvagnimandya and Amavisha

Srotasa: Rasavaha, Raktavaha, Mamsavaha, Swedavha, Udakavaha

Srotodushti: Sanga, Vimargagamana

Udbhava : Amashaya

Adhisthana : Twak

Rogamarga : Bahya

Prabhava : Chirakari (Chronic)

Chikitsa of Vicharchika

All the varieties of the Kustha are caused by the simultaneous vitiation of Tridosha, hence depending upon the signs and symptoms one should decide the line of treatment. Initially the predominantly vitiated Dosha should be alleviated; later the remaining secondarily vitiated Dosha should be alleviated.

Dosha-AvasthaChikitsa Upkrama
Vata Pradhana KusthaSarpipana
Pitta Pradhana KusthaVirechana and Raktamokshana
Shleshma Pradhan Kustha Vamana
PrachchhanaAlpa Dosha Yukta Kustha
SiravyadhaMahat Dosha
Bahudosha AvasthaSamshodhana therapies

According to Sushruta, the treatment should be started in the Purvarupa stage itself. He says during Purvarupa stage, Ubhaya Bhaga Shodhana i.e., Vamana and Virechana should be done (Su.Chi.9/6).

  • In Su.Chi.9/6, Chikitsa is described for Twagadi Dhatugata Kustha.
  • Initially Snehapana should be done for Vamanadi Shodhana purpose (Dalhana on Su.Chi.9/6). Snehapana Should be done with the specific sneha mentioned according to Avastha of Doshadi. In Vataja Kustha, Swedana is said to be Pathya (Ha.S.3/39/20).
  • Tuvaraka and Bhallataka Sneha are useful in all types of Kustha (Su.Chi.9/7).
  • Snehamatra in Kushtha: Madhyama Matra Sneha is advised in Kustha (Ch.Su.13/34)
  • Swedana: according to Charaka, if the lesion is Sthira, Kathina and Mandala, then Swedana can be done with Prastara and Pranadi (Ch.Chi.7/50).

Shodhana Chikitsa:

Vamana Karma:

In Ch.Chi.7/43, says that when the Dosha are located in Hridaya or the centre of the body, Dosha are in a state of Utklesha, and then the patient having Kustha in the upper parts should be given Vamana with Kutaja, Madana Phala, Madhuka mixed with decoction of Patola and Nimba.

Virechana Karma:

  • Drugs like Trivruta, Danti and Triphala are useful for Virechana. The recipe can be prepared by adding Souviraka, Tushodaka, Alodana, Asava and different types of
  • If Vata and Kapha make their seat in Pitta Sthana, then Vamana and Virechana Karma and if Pitta and Kapha are localised in Vatasthana, then Virechana should be conducted, depending upon the nature of the therapy, Samsarjana Krama should be followed (Ch.Chi.7/45).

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Asthapana Basti:

If there is excess of Vayu then Asthapana Basti should be given with the drugs like Darvi, Bruhati etc. (Ch.Chi.7/46).

Anuvasana Basti:

When there is excess of Vayu even after Virechana and Asthapana and if the patient is suitable for the administration of Anuvasana and then he should be administered with Madanaphala, Madhukayukta Anuvasana Basti (Ch.Chi.7/47). But in the general indications both types of Basti are contraindicated, but depending upon the situations it can be done (Ch.Vi.8/138)

Nasya:

Nasya is indicated with the drugs like Saindhava, Danti, Maricha etc. which are effective against Krumi and Kustha and diseases caused by Kapha Prakopa (Ch.Chi.7/48).

Dhumapana:

Virechanika Dhuma cures Krumi, Kustha and Kilasa affecting the Shira (Ch.Chi.7/49).

Raktamokshana:

  • If the patches of Kustha are Sthira, Kathina and Mandala, Prastara and Nadi Sweda should be done and rubbed with The blood oozing out through this process should there after be eliminated (Ch.Chi.7/50).
  • Bhela in Chikitsa 6/40 mentions that the Raktajanya and Sannipataja Kustha are initially treated with Siravyadha. In Alpa Kustha Pracchanna is indicated, either with the help of Jalauka, Alabu or Shrunga (Bh.Chi.6/40).
  • Site for Raktamokshana is mentioned in a.h.chi.19/15. Siravyadha can be done At Lalata, Hasta and Pada Siravyadha can be done 2 Angula above the Kshipra Marma (Su.Sa.8/16).
  • Snehapana is necessary after Raktamokshana and Virechana to control the aggravation of Vata (A.H.Chi.19/16-17).
  • Even though Bahu Doshavastha is found in Kustha, only little quantity of Dosha should be eliminated repeatedly otherwise aggravated Vata destroys the Bala (Ch.Chi.7/41, A.H.Chi.19/15).
  • repeated administrations of Vamanadi procedures are mentioned: Vamana once in 15 days, Virechana once in 30 days, Rakta Mokshana once in 6 months and Nasya for once in 3 days (Su.Chi.9/43).
  • Bhela has mentioned Avapeedana Nasya for once in 3 days

Shamana Chikitsa:

Some of the Yoga early in the morning like Guduchi Swarasa, Kwatha or Siddha Ghruta for one month helps to nullify all types of Kustha (Su.Chi.10/14). Kwatha of Darvi, Khadira and Nimba is said to be Kushtahara (A.H.Chi.19/37). Tuvaraka, Bhallataka, Bakuchi, Chitrakamula and Shilajatu are indicated for Rasayana Prayoga.

Specific treatments for Vicharchika are:

Arka Taila, Marichyadi Taila, Visha Taila, Shadbindu Taila, Aragwadhadi Kwatha, Rasamanikya etc.

Kshara Prayoga:

  • In case of anaesthetic patches, Shastra is contraindicated and Kshara should be applied after elimination of blood and Dosha (Ch.Chi.7.54).
  • The Lepa prescribed for Kustha becomes instantaneously efficacious only after the elimination of impurities in the blood and in Koshtha (Ch.Chi.7/53).
  • The drugs like Kustha, Amrutasanga, Daruharidra, Kasisa, Kampillaka, Musta, Lodhra, Sougandhika, Sarja Rasa, Vidanga, Manashila, Haratala, Karaveera Twak are indicated for Avachrnana in Vicharchika (Ch.Su.3/11).

Daivavyapashraya Chikitsa:

Vrata, Dama, Yama, Guruseva, Tyaga, Shilabhiyoga, Dwija-Sura-Guru Puja, Maitri to all living creature, Aradhana of Shiva, Kartikeya, Tara and Bhaskara will subside all types of Kustha. Tapopasevana (Su.Ni.5/31) and Karmakshya (Ch.Sha.1/117) will subside the disease. Harita has mentioned Dana of Go, Bhumi, Swarna or Anna for Papakarmottapanna Kustha (Ha.Dwi.1).

Conclusion

In conclusion, the Ayurvedic perspective on skin diseases like Vicharchika (eczema) offers valuable insights into their aetiology, progression, and management.


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Through the lens of Ayurveda, it becomes evident that Kshudrakustha, including Vicharchika, primarily involves Alpa Dosha, indicating a localized and slow progression nature of the condition. Furthermore, the holistic approach of Ayurveda, encompassing Ahar, Vihar, Nidan Parivarjan, and Panchakarma purification methods, not only treats the symptoms but also prevents recurrence and promotes overall well-being.

Unlike medications used in modern medical science, which may carry lifelong side effects, embracing ayurvedic principles and practices provides individuals suffering from Vicharchika with a comprehensive and sustainable approach to managing their condition, improving their quality of life, and preventing future episodes. By fostering awareness and adherence to ayurvedic principles, we can empower individuals to lead healthier, happier lives free from the burdens of Vicharchika and other skin ailments.

References

1. Charaka Samhita - Charaka Chandrika Hindi Comm. By Bramhanand Tripathi,
2. Dalhana – Nibandha Sangraha Comm. on Sushruta Samhita. By YT. Acharya, Chaukhambha Orientalia, Varanasi.
3. Harita Samhita - Ed. By. Ravidatta Shastri., Shri Krishnadas Academy, Mumbai.
4. Madhava Nidana - Madhukosha Comm. with Hindi Vidyotini Comm. By S. Shastri. Vol. I & II, Chaukhambha Sanskrit Sansthana, Varanasi.
5. Sushruta Samhita - Hindi Comm. By Ambikadatta Shastri, Chaukhambha Sanskrit Series, Varanasi.
6. Ashtanga Hridaya - Nirmala Hindi Commentary By. Bramhanand Tripathi, Chaukhambha Sanskrit Pratisthan, Delhi.
7. Ashtanga Samgraha - Hindi Commentary by. Pd. Lalchandra Shastri, Baidyanath Ayu. Bhavan. Ltd., Nagpur


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