Visarpa (erysipelas) according to Caraka

In Western language, Visarpa is called Erysipelas. It spreads rapidly throughout the body, sometimes in one place or suddenly in different places. The name of the disease is Visarpa. The term has two parts, i.e., ‘Vi’ and ‘Sarpa’. ‘Vi’ stands for ‘Vividha’ meaning different, and ‘Sarpa’ Stands for ‘Sarpaṇa’ meaning spreading. Since the roga spreads either upwards or downwards or sidewards or in all these directions, it is called Visarpa. This roga is also called Pari-sarpa. The prefix ‘Pari’ stands for ‘Paritaḥ’ and ‘Sarpa’ stands for ‘Sarvataḥ’ meaning all over. Maharṣi Caraka discusses disease of Visarpa and treatment of Erysipelas and Herpes or Visarpa-cikitsā. The causes of Visarpa are -excessive intake of saline, sour, and pungent tastes; intake of sour, curd, mastu, surā, śukta, Sauvīra; excessive intake of Madya, intake of polluted Madya, condiments, pickles, haritas, vidāhis, kūrcikā, kilāṭa, mandaka, śāṇḍāki, other fermented drinks, tila, masa, Kulattha, different types of oil and pastries, Ānūpa meat, Audaka meat, garlic; intake of food large quantity, sleeping during day time etc.; affliction by phthisis, injury, bandha and falls; excessive exposure to hot sun and excessive physical work etc. The seven dhatus are involved in the pathogenesis of Visarpa, namely, Rakta, Lasikā, Tvak, Māṃsa, and three doṣas. Visarpa is seven types, viz., Vātika, Paittika, Kaphaja, Sānnipātika, Vātapittaka, Kaphavātaja and Pittaśleṣmika. The location of Visarpa is of three types, namely, Internal (difficult to cure), External (curable), and the both (incurable).

The general treatment of visarpa is Virecana followed by bloodletting is adopted. The general treatment of visarpa includes: Virecana followed by bloodletting is adopted; if the dosas causing Visarpa are of āma nature and if these dosas are located in the abode of kapha, then fasting and emetic therapies and bitter drugs, application of dry and cool drugs are useful; If doṣa in the sites of pitta, then lightening measure, purgation, emesis, bloodletting, and bitter drugs are useful; if doṣa in the sites of vāta, then medicines and ununctuous nature are useful, and if doṣa in the periphery, then the patient should be treated with bloodletting with horns, leeches, etc. To cure of Visarpa the patient should be advised the following diet, namely, rice-paste, old śāli, green gram, bengal gram, Āmalaki, barley and wheat. Use of formulations to cures of this disease, namely, Muktā paste, Dantyādi lepa, Kampillakādi oil, and Ghṛta etc. Blood-letting is most effective therapy for visarpa^[1].