E-ISSN:2456-3110

Case Report

Non-Healing Ulcer

Journal of Ayurveda and Integrated Medical Sciences

2025 Volume 10 Number 9 September
Publisherwww.maharshicharaka.in

Ayurvedic management of Vrana (Non-Healing Ulcer) - A Case Report

Malviya K1*, Mishra S2, Mittal S3
DOI:10.21760/jaims.10.9.36

1* Kavita Malviya, Post Graduate Scholar, Department of Dravyaguna, Govt Dhanwantari Ayurveda College, Ujjain, Madhya Pradesh, India.

2 Shiromani Mishra, Associated Professor, Department of Dravyaguna, Govt Dhanwantari Ayurveda College, Ujjain, Madhya Pradesh, India.

3 Shivangi Mittal, Post Graduate Scholar, Department of Dravyaguna, Govt Dhanwantari Ayurveda College, Ujjain, Madhya Pradesh, India.

Ayurveda described Vranas as pathological condition which is categorizes as Nija and Agantuja Vrana. Nija Vrana occurs due to intrinsic factors while Agantuja Vrana may arise due to external factors such as burn, accidents, injury, animal bites etc. In this case study a female of age 40yrs come with complaint of pain, swelling, redness and wound lesion in right sole region from 6month. The condition gradually increases; she took symptomatic allopathic pain killers and anti-biotics but doesn’t get relief. She came for Ayurvedic medication in hospital. After 3 months of treatment patient get significant result in wound healing, pain, swelling. The traditional approach acquire for the management of Vrana involving Shodhana by Panchvalkal Kwath, Avchurnan by Panchvalkal Churna, Picchu Vrana Bandhana by Karanja Tail and Triphala Guggul orally. This article presents the effectiveness of herbal treatment in wound healing.

Keywords: Vrana, Panchvalkal Kwath, Panchvalkal Churna, Karanja Tail, Triphala Guggul

Corresponding Author How to Cite this Article To Browse
Kavita Malviya, Post Graduate Scholar, Department of Dravyaguna, Govt Dhanwantari Ayurveda College, Ujjain, Madhya Pradesh, India.
Email: 		Malviya K, Mishra S, Mittal S, Ayurvedic management of Vrana (Non-Healing Ulcer) - A Case Report. J Ayu Int Med Sci. 2025;10(9):246-249.
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https://jaims.in/jaims/article/view/4428/

Manuscript Received Review Round 1 Review Round 2 Review Round 3 Accepted
2025-07-18 2025-07-28 2025-08-08 2025-08-18 2025-08-27
Conflict of Interest Funding Ethical Approval Plagiarism X-checker Note
None Nil Not required 12.36

© 2025 by Malviya K, Mishra S, Mittal S and 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 2025;10(9)246
Download PDFBack To ArticleIntroductionCase ReportObservations and ResultsDiscussionConclusionReferences
Kavita M et al. Ayurvedic management of Vrana (Non-Healing Ulcer)

Introduction

The destruction and breakdown of body is called Vrana (Ulcer). In Ayurveda, various types of Vrana and their management has been mentioned. In recent past, brilliant progress has immensely reduced the incidence of wound infection and enhance the healing process.

Wound infection is one of the most important factors which delays healing and is also responsible for the formation of Dusta Vrana. In the wound management, all efforts have been made to keep the wound clean during the various stages of healing. Such cleansing process is called Vrana Shodhana. After Shodhana, Avachurnan, Lepana and Vrana Bandhana are one among the Shasti Upakrama.

In the above case study Shodhana was done by Panchavalkal Kwath and Avchurnan was done by Panchvalkal Churna. Rest oral medications was provided for 3 months. After treatment patient get relief in pain, swelling and wound healing.

Case Report

Patient information:

A female of age 40yrs, housewife, who has no history of comorbidities came to outpatient department of Rachna Sharir on 12-5-2023.

Primary Concerns and symptoms:

Severe itching, redness and pain, swelling in skin lesions, localized at right sole region 6months. Transient white, brown, or red macular lesions of size >5cm. Bleeding occurs after scratching lesion. She had associated complaint of loss of appetite, headache, dizziness, disturbed sleep and irregular bowel evacuation since 6months.

History of Present Illness:

Patient was asymptomatic 6months ago, then suddenly she had intense itching and reaction. She had disturbed lifestyle which aggravates the skin problem. Gradually skin lesions spread around fingers of right leg and bleeding, pain, swelling, cracking of skin occurs.

History of Past Illness:

Patient had no history of hypertension, diabetes mellitus, thyroid disorder.

Clinical Findings:

General Examination

Patient was average built but with weight 55kg, height 5’3” and BMI 23.0kg/㎡. Blood pressure (B.P.) 120/70mmHg, Pulse Rate 78/min. On general examination, no clubbing, cyanosis, icterus, pallor, pigmentation seen.

Treatment Plan

Diagnostic Protocol:

On the basis of symptoms like Shyavatu Kandu, Shula, Daha, Raag, Vrana associated with Aruchi, Mukhvairasya, Gauravta, Vibandha, Rukshamlana Sphutitha Twak indicates Rasa, Rakta, Mamsa Dhatu Dusti reflects through Twaka Dusti which is clinically assessed by Ashtavidha Pariksha (Eight-Fold Examination).

Nadi ParikshaVataj-Kaphaj
MalaVikrit (hard, non-sticky, yellowish in color).
MutraPrakrit
JivhaMalavrit (white coated)
ShabdaPrakrit
SparshaRuksha
DrishtiPrakrit
AkritiKrisha

Drug Intervention

Time FrameDrug InterventionDoseFrequencyAnupana
17/4/2024Panchvalkal Kwath for Shodhana + Panchvalkal Churna Avachurnan + Triphala Guggul + Karanja Tail2TDSBefore meal, in morning, noon and at bed timeLukewarm water
12/5/2024Triphala Guggul +
Karanja Tail		1TDS
L/A		Before meal, in morning, noon and at bed timeLukewarm water
24/5/2024Triphala Guggul +
Karanja Tail		2BD
L/A		Before meal, in morning
At bed time		Lukewarm water
5/6/20241st follow upNo intervention given

Therapeutic Interventions:

After complete screening of patient and consent taken, on the basis of above findings patient was provisionally diagnose with Agantuja Vrana. The patient was treated on the line of management of Vrana Chikitsa.


J Ayu Int Med Sci 2025;10(9)247
Kavita M et al. Ayurvedic management of Vrana (Non-Healing Ulcer)

The drugs selected for treatment was Panchvalkal Kwath, Panchvalkal Churna and Karanja Tail & Triphala Guggul indicated as drug of choice in Vrana Chikitsa. In next visit (after 15 days from drug intervention) diet and life style advised to patient to improve quality of life.

Pathya Apathya

PathyaApathya
  • Sadrutta Palana
  • Junk Food
  • Vyayama, Yoga
  • Consuming Sour, Salty, Meat & Alcohol
  • Satvika Ahara
  • Ati Maituna
  • Meditation
  • Excessive Sleep
  • Healthy Food Habits
  • Avoid Stress

Observations and Results

jaime_4428_01.JPG
Before Treatment  After Treatment

Discussion

Effect on Vrana Vedana

Pain and tenderness were gradually reduced by the end of 3rd week of treatment. Vedana is a cardinal feature of Vata Dosha. Contents of Kwath and Tail such as Panchvalakal Dravya and Karanja effectively reduces the vitiated Dosha because of Ushna Virya and Vedna Sthapana property.

Effect on Vrana Shotha

Vrana Shotha is significantly reduced within 2nd week of treatment. Tripahala Guggul is effective as Shothahara and indicated as drug of choice in Shotha and Vrana.

Effect on Akriti

After treatment of 8 weeks, Vrana was completely healed, this may due to Shodhana and Vrana Ropan properties of Panchvalkal Dravya and Karanja. Simultaneously Picchu of Karanja Tail enhance the healing.

Conclusion

In Vrana Chikitsa, Shodhana, Avchurna and Lepana is effectively worked and enhance the process of healing of wound. It helps to avoid pain, swelling, itching and reduce the further bacterial growth. In the above case study, patient get significant relief in wound healing, swelling, pain in her right sole region after Ayurvedic management but there is further need in the research of the Shashti Upakramas in order to validate the effectiveness of treatment and enlighten the path of herbal treatment in wound management.

References

1. Rao RB, Shivani AC, Rao PN. A case study of Dusta Vrana Lepa with special reference to Sahastrayoga. J Ayurveda Integr Med Sci. 2025 May. [Crossref][PubMed][Google Scholar]

2. Giri RV. Shashti Upakrama in the management of Vrana (wound): a review. J Res Tradit Med. 2017 Jul-Aug;3(4). [Crossref][PubMed][Google Scholar]

3. Padavi SB, Sharma R, Shah HS. Essential Ayurvedic diagnostic approach of Vrana: a conceptual study. J Ayurveda Integr Med Sci. 2024;9(3):178–80. [Crossref][PubMed][Google Scholar]

4. Gopikakrishna S, Krishnaja KT, Indu PV. Ayurvedic management of Dust Vrana. Int J Ayurveda Pharma Res. 2023;11(11):97–102. [Crossref][PubMed][Google Scholar]

5. Chauhan S, Thakur R, Sonali, Indu. Importance of Pathya Apathya in Ayurveda: a literary review. J Ayurveda Integr Med Sci. 2024 Jan 31. [Crossref][PubMed][Google Scholar]


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Kavita M et al. Ayurvedic management of Vrana (Non-Healing Ulcer)

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