4b. Leprosy (Kuṣṭha) in the Caraka-saṃhitā

On the other hand, as Caraka-Saṃhitā described, the chemical imbalance of the elements like Vāta, Pitta, and Kapha are the prime causes of Leprosy. Moreover, abnormality in skin, muscle, blood, and lymph causes this disease. In the Sūtrasthāna, Caraka refers to the three varieties of Kilāsa and enumerates them in the Cikitsāsthāna.

The three varieties mentioned by Caraka can be identified with the three given by Atharvaveda–

1. Asthija is Dāruṇa;
2. Tanuja is Aruṇa, and
3. Śvitra is Yat-tvachi^[1].

However, the treatment of Leprosy depends on the variation of the diseases. There are eighteen types of Leprosy as described in Caraka-Saṃhitā.

Kuṣṭha makes the body ugly that is why this is called leprosy. According to Ācārya Caraka, one which produces deformity of the body is called Kuṣṭha or skin diseases. Kuṣṭha also produces a loss of sensation of the affected skin. Mādhavanidāna has said one who consumes incompatible food items is also affected by the Kuṣṭha roga^[2]. In herpes (visarpa) the same body entities are involved, but the difference is that in Kuṣṭha the disease occurs gradually, while it is fast spreading in visarpa^[3]. Ācārya Caraka says that seven causative factors responsible for the manifestation of leprosy are the three doṣas such as Vāta, Pitta, and Kapha which get vitiated by the causative factors, and four minerals such as skin, flesh, blood, lymph which get vitiated by the morbid doṣas. These seven perverted morbid dhātus have produced seven types of leprosy. The Kuṣṭha so caused spreads to the entire body after its manifestation^[4]. It has been said to the Bhāvaprakāśa, that the seven doṣa-dūṣyas are the causes of the proximity of leprosy, namely, air bile, skin, phlegm, blood, flesh, and lymph^[5]. Similarly, in Aṣṭāṅga Saṃgraha described the causes of Kuṣṭha to be tamasikā food and activity, committing murder, abusing the sages, etc. When getting deep inside, the Kuṣṭha invades all the dhātus and becomes harmful. The disease is of seven kinds arising from doṣas. The symptoms include smooth or rough skin, itching, discolouration, etc.^[6] In modern medicine leprosy is regarded as a chronic infectious disease of the skin and peripheral nerves. This disease caused by a bacterium is called mycobacterium leprae. This disease is affecting mainly the peripheral nerves, skin, and muscles^[7].

The Premonitory symptoms of leprosies are lack of perspiration or excessive perspiration, the roughness of excessive smoothness, discolouration, itching, pricking pain, numbness, burning sensation, tingling sensation, horripilation, coarseness, production of heat, heaviness, the frequent occurrence of oedema and acute spreading, sticking of excreta in the body especially in the orifices, excessive pain in case of suppuration, burn, bite, fracture and dislocation, purification and non–healing of even small wounds^[8]. Diagnosis of all types of leprosy has been mentioned. All the three doṣas get simultaneously vitiated by the following: unwholesome diet and drinks which are liquid, unctuous, and heavy; suppression of the urge for vomiting and other natural urges; excessive physical activity and excessive rest after taking a very heavy meal; unnecessarily of cold, warm, fasting and intake of food; Use of cold water immediately after exposure to the scorching Sun, exertion to frightening situation; Intake of uncooked food and, intake of food before the previous meal is digested; Transgression of the procedure of Pañcakarma; always excessive consumption of honey, phāṇita, fish, Mūlaka and kākamācī; not eating properly, eating cilicima fish with milk; frequent consumption of Hāyaṇaka, Yavaka, Cīnaka, Koddālaka and Koradūṣa grains; overconsumption of Kṣīra, Curd, Takra, Kula, Kulattha, Māṣakalāya, Atasīyūṣa and Kusumbha and unctuous substance; Excessive indulgence in cohabitation, physical exercise and exposure to heat after taking the above mentioned food to one’s satisfaction; Entering into cold water immediately after one is afflicted with fear, exhaustion and grief; intake of such food as would cause burning sensation without vomiting out the undigested food; suppression of the urge for emesis; Excessive oleation; excessive intake of masa, pastry, Tila, milk and jaggery; inter courses with the wife in the indigestion of food; daydream; insults to Brāhmaṇa and elders and sinful deeds; and overeating of affections, etc.^[9] The above reasons also loosen the four dhātus, the aggravated doṣas localized in this dhatus vitiate the latter due to their looseness and so produce Kuṣṭhas^[10]. They produce eighteen types of Kuṣṭha. Among these eighteen, seven are regarded as Mahākuṣṭha (Major leprosy) and eleven others are Kṣudrakuṣṭha (Small leprosy). The seven types of Mahākuṣṭha are Kapāla, Udumvara, Maṇḍala, Ṛṣyajihva, Puṇḍarīka, Sidhma, and Kākaṇaka. And the eleven types of Kṣudrakuṣṭha are Ekakuṣṭha, Carmākhya, Kiṭima, Vipādikā, Alasaka, Dadra, Carmadala, Pāmā, Visphoṭaka, Śatāru, Vicarcikā^[11]. Bāgbhaṭṭa and Suśruta, call dadru as Mahākuṣṭha and

Sidhma as Kṣudrakuṣṭha. According to Bāgbhaṭṭa, Sidhma Kuṣṭha and Śvitra are distinct. Bāgbhaṭṭa does not include Śvitra in the eighteen leprosies but mentions it separately. Why did Suśruta call Sidhma leprosy as Kṣudrakuṣṭha and Caraka Sidhma as Mahākuṣṭha? In response, Bhāvamiśra says that Sidhma soon penetrates deep into the dhātus in the body. It is sheltered from ulvaṇa-doṣa and is subject to many treatments. Again, Suśruta called Dadru as Mahākuṣṭha. Why did Caraka call it Kṣudrakuṣṭha? In reply, Bhāvamiśra said, Dadru is not as deep as leprosy, nor is its colours are like leprosy. Among these eighteen, seven are regarded as Mahākuṣṭha and eleven others are Kṣudrakuṣṭha. The Mahākuṣṭha described in Caraka-Saṃhitā is called leprosy in modern medical science and the eleventh small leprosy is called skin disease^[12]. The following table gives a clear idea about the names of different types of Leprosy as described in Caraka-Saṃhitā, Suśruta-Saṃhitā, Kāśyapasaṃhitā, Aṣṭāṅga Hṛdaya, and Aṣṭāṅga-Saṃgraha.

Table 8: Classification of Eighteen types of Leprosy^[13]

Sl. No.	Caraka- Saṃhitā	Suśruta- Saṃhitā	Kāśyapasaṃhitā	Aṣṭāṅga Hṛdaya	Aṣṭāṅga- Saṃgraha
1	Kapāla	Aruṇa	Sidhma	Kapāla	Kapāla
2	Udumbara	Udumbara	Vicarcikā	Udumbara	Udumbara
3	Maṇḍala	Ṛṣyajihva	Pāmā	Maṇḍala	Maṇḍala
4	Ṛṣyajihva	Kapāla	Dadru	Vicarcikā	Vicarcikā
5	Puṇḍarīka	Kākaṇaka	Kiṭima	Ṛṣyajihva	Ṛṣyajihva
6	Sidhma	Puṇḍarīka	Kapāla	Carmakuṣṭha	Carmakuṣṭha
7	Kākaṇaka	Dadru	Mahāruṣka	Ekakuṣṭha	Ekakuṣṭha
8	Ekakuṣṭha	Sthūlāruṣka	Maṇḍala	Kiṭima	Kiṭima
9	Carmakuṣṭha	Mahākuṣṭha	Viṣaja	Sidhma	Sidhma
10	Kiṭima	Ekakuṣṭha	Pauṇḍarīka	Alasaka	Alasaka
11	Vipādikā	Carmadala	Kṣipta	Vipādikā	Vipādikā
12	Alasaka	Visarpa	Ṛṣyajihva	Dadru	Dadru
13	Dadru	Parisarpa	Śatāruṣka	Śatāru	Śatāru
14	Carmadala	Sidhma	Udumbara	Puṇḍarīka	Puṇḍarīka
15	Pāmā	Vicarcikā	Kākaṇa	Visphoṭa	Visphoṭa
16	Visphoṭaka	Kiṭima	Carmadala	Pāmā	Pāmā
17	Śatāru	Pāmā	Ekakuṣṭha	Carmadala	Carmadala
18	Vicarcikā	Rakasā	Vipādikā	Kākaṇaka	Kākaṇaka

(Source: Caraka-Samhita–Vol. II)

According to the Modern medical sciences skin diseases are twenty-two types–Eczema, Urticaria, Psoriasis, impetigo, Acne Vulgaris, Herpes-Zoster, Scabies, Seborrhoea, Alopecia, Leucoderma, Tinea, Lichen planus, Pruritus, Lupus erythematosus, Chilblains, Pemphigus Vulgaris, Boils, Pityriasis Versicolor, Fissures, Warts, Corns, Leprosy^[14]. In Śāraṅgadhara-Saṃhitā the eighteen types of Kuṣṭha are described in details Kapālikā from Vāta, Adumbara from Pitta, Maṇḍala and Vicarcikā from Kapha, Ṛṣyajihva from Vātapitta, Vipādikā from Kaphavāta, so also Sidhma, Ekakuṣṭha, Kiṭibha, and Alaska; Dadru, Pāmā, Visphoṭaka from Kaphapitta: Mahākuṣṭha, Carmadala, Puṇḍarīka, Śatāru and Kākaṇa from all the three together^[15].

Excessive imbalance in Vāta causes Kapālakuṣṭha, excessive imbalance in pitta causes Udumbara Kuṣṭha, excessive śleṣmā causes Maṇḍala Kuṣṭha, excessive vāta, and pitta cause Ṛṣyajihva, excessive pitta and śleṣmā cause Puṇḍarīka, and excessive vāta and śleṣmā cause Kākaṇaka type of leprosy. Less or excessive perspiration, paleness, irritation, temperature, irritation in pores of body hair, etc., are some of the symptoms. The symptoms of Kapāla Kuṣṭha include kṛṣṇa, aruṇa, and kapāla varṇa. The symptoms of Udumbara Kuṣṭha are colour like Udumbara fruit. The symptoms of Maṇḍala Kuṣṭha include red in colour, warmth, and shape of maṇḍala, etc. It the shape of the tongue of a bear then it is called Ṛṣyajihva leprosy. The symptoms of Puṇḍarīka Kuṣṭha include lymph with puss and blood, warmth and shape of Puṇḍarīka leaves, etc. Sidhma Kuṣṭha looks like the shape of the leaf of the flower of the bottle gourd. The symptom of Kākaṇaka Kuṣṭha is the colour of guñja fruit and it includes all the other symptoms of leprosy^[16]. This disease attacks only sinners. It left untreated skin, flesh; blood, and limb get rotten for the worms start eating the affected area which further turns the disease fatal. If the cause of leprosy is vāyu then the colour of the affected area becomes dark or bright and irritation, pain, numbness, etc., are felt. If the cause of leprosy is pitta then the patient suffers irritation pain, swelling, and the affected area. Leprosy caused by śleṣmā has tenderness, swelling, numbness, and worms start eating the affected part of the body. The symptoms of The Eighteenth type of leprosy described in the Caraka Saṃhitā are discussed below.

Table 9: Eighteenth type of leprosy^[17]

[Mahākuṣṭha]

Kuṣṭha	Doṣa	Features
Kapāla	Vāta	Painful blackish or reddish lesions, rough, resembling the colour of an earthen pot.
Udumbara	Pitta	Burning sensation, redness, brownish patches resembling colour of a ripe Udumbara fruit.
Maṇḍala	Kapha	Whitish-red, unctuous, elevated, circular lesions.
Ṛṣyajihva	Vāta-pitta	Painful blackish lesions with red border, resembling the tongue of ṛṣya (a variety of deer).
Puṇḍarīka	Kapha-pitta	White lesions with reddish periphery & centre, with burning sensation.
Sidhma	Vāta-kapha	White or coppery lesions, appearance of powder like sub-stance on rubbing; more seen in the chest.
Kākaṇa	All three doṣa	Painful lesions which are like guñja black in the centre & red in the periphery, is incurable.

[Ksudrakuṣṭha]

Kuṣṭha	Doṣa	Features
Ekakuṣṭha	Vāta, Kapha	Scaly skin like fish scales, with no sweating.
Carmākhya	Vāta, Kapha	Thick skin like elephant skin.
Kiṭima	Vāta, Kapha	Rough, blackish lesions.
Vipādikā	Vāta, Kapha	Painful fissures in the palms & soles.
Alasaka	Vāta, Kapha	Reddish pustules, with itching.
Dadru	Pitta, Kapha	Reddish lesions, with itching.
Carmadala	Pitta, Kapha	Reddish eruptive lesions, with itching, severe pain.
Pāmā	Pitta, Kapha	White/red/bluish pimples.
Visphoṭa	Pitta, Kapha	White/red, thin-walled eruptions.
Śatāru	Pitta, Kapha	Red/black ulcers with pain & burning sensation.
Vicarcikā	Kapha	Blackish eruptions with itching and excess discharge.

(Source: Synopsis on Caraka Saṃhitā)

First of all, the doctor needs to determine the cause of leprosy; whether it is for Vāta, Pitta, or Kapha. Leprosy in which there is an excess of doṣa, leprosy should be treated mainly for the tri-doṣa. Leprosy is known by the doṣa, and vice versa. Leprosy is characterized by roughness, Śoṣa, toda, colic, constipation, āyāsa, pāruṣya, dryness and lomahorṣa, and its body colour is śyāmā or aruṇa in leprosy, it is called Vāta symptoms^[18]. If there is burning, redness, discharge, digestion, bad smell, kleda, and limb collapse in leprosy, it is called bile symptoms^[19]. If leprosy has whiteness, coldness, kaṇḍū (itching), elevation, heaviness, magot formation, and stickiness, it is called mucus symptoms^[20]. The symptoms of untreatable leprosy have been mentioned -if you are overwhelmed by thirst and burning if the patient is symptomatic of the aforesaid tridoṣa, and when the patient becomes weak; and suffers from indigestion and becomes insect-eaten this patient should be discarded^[21]. Rheumatoid arthritis and phlegm biliary or rheumatic biliary leprosy are difficult. When leprosy is ignored, worms are produced due to skin, flesh, blood, and lymph digestion, kleda, and sweat. When the worms start eating in all the leprosy areas, they are re-contaminated with individual faults and produce the following infestations. Diseases such as excessive exudation, ulceration of organs, thirst, fever, burning sensation, diarrhoea, heartburn, weakness, anorexia, and indigestion occur. A patient having such complications is incurable^[22]. The following treatment methods are mentioned for the line of treatment of leprosy. For example, Leprosy patients suffering from an imbalance of vāta should drink clarified butter. Leprosy patients suffering from an imbalance of Kapha should be vomited. Leprosy caused by the imbalance of Pitta should be treated with the purification of blood and purgation^[23].

The following treatment methods have been suggested for the treating of leprosy. For example, the treatment for leprosy is to use vomiting and purgation. Pracchana used for Kṣudrakuṣṭha, and venesection used for Mahākuṣṭha^[24]. Many defective leprosy patients have to be used purification therapy over and over. But the patients should not be hurmed through purification therapy^[25]. Leprosy patients have to drink after emetic and purgation therapies and blood-letting therapy^[26] because Vāyu gets aggravated and the patients become weak soon after the elimination therapies. If the patient is suffering from leprosy in the upper part of the body, and the dosas are located in the heart, emetic therapy should be done with the juice of Indrayava, Madanaphala, Licorice, Paltā, and Nimba leaves. In the case of used emetic therapy in leprosy, śitarasa and pakvarasa should be applied with different types of honey and Yaṣṭimadhu powder. And if you want to give purgation therapy, Trivṛt, Dantī, and Triphalā should be given together. The recipe making of purgation products can be prepared by adding Sauvīraka, Tuṣodaka, etc., Āsava, and different types of śīdhu mixed. The leprosy patient should be given Āsthāpana therapy, with the decoctions of Dāruharidrā, Bṛhatī, Sevya, Paṭola, Picumarda, Madanaphala, Kṛtamāla, Kaliṅga, Indrayava, and Mustā, by adding Sneha (oil, ghee, etc.) In Vātaja leprosy, the medicated oil boiled with Mayanāphala, Madhuka, Nimba, Kuṭaja, and Paṭola, the patient should be given Anuvāsana therapy. These drugs should be used for Inhalation therapy, namely-Dantī, Marica, rock-salt, Phaṇijjhaka basil, pippalī, the fruit of Ḍaharakarañja and Viḍaṅga. These drugs cured worm, leprosy, and phlegm. Smoking destroys worms, leprosy, and Kilāsa^[27].

Intake of Kanakabindvariṣṭa every morning in an appropriate dosage for a month certainly cures Mahākuṣṭha and fifteen days’ use of these drugs cures Kṣudrakuṣṭha. This drug is prepared by one droṇa of the decoction of Khadira should be kept in a ghee-smeared jar. To this, six palas of the powder of Triphalā, Trikaṭu, Viḍaṅga, Rajanī, Musta, Āṭarūṣka, Indrayava, bark of Sauvarṇī and Chinnaruhā should be added. The jar containing the recipe should be kept inside a heap of grains for a month^[28].

Madhvāsava is used to cure Kuṣṭha. This medicine is made by heart-wood of Khadira and Devadāru, taken eight palas each, should be boiled with water. To this decoction, one prastha of honey should be added in the place of water. To this, eight palas of the powder, of iron and one karṣa of each of Triphalā, Ela, Tvak, Marica, Patra and Kanaka, one prastha of sugar should be added. This mixture should be kept in an iron jar for one month^[29].

Blood-letting therapy has been mentioned for the treatment of purification for leprosy patients. The patches of Kuṣṭha which are stable, hard and rounded, should be fomented with nāḍī types of Svedana or fomentation therapy and rubbed with Kūrca. The blood oozing out through this process should thereafter be eliminated. The elevated patches of Kuṣṭha should be fomented with luke-warm Paṭola containing the meat of semiaquatic and aquatic animals. Afterwards, blood should be eliminated by incising with a sharp-edged scalpel. In Kapha-Kuṣṭha, blood should be eliminated by scratching the patch and by applying śṛṅga, Alābu, and Jalaukā. It is only after the elimination of impurities in the blood and elimination of doṣas from the Gastrointestinal tract, that the ointments given for Kuṣṭha become promptly efficacious^[30]. In leprosy, the application of alkalis and other therapies has to be useful. In leprosy where arms do not work and in leprosy where only tactile energy is lost, the application of alkali relieves bleeding and doṣas. Hard as a stone, touch with straw, dormant, stable, and old leprosy patient should be given medicines of poison and after coated with poison. Besides, if there is the nonappearance of perspiration and itching, then they should be rubbed with the Kūrca made of the stems of Dantī, Triphalā, Karavīra, Karañja, Nimba and Kuṭaja or with the leaves of Jāti, Arka and Nimba or with the sharp weapons, or with Samudra phena, or with cow dung. Afterwards, ointments should be applied^[31]. The following treatments should be used cures for the Pitta-Kuṣṭha. Namely -emesis, purgation, bloodletting therapies, bitter and astringent drugs, medicated ghee, and other externally and internally treatments^[32]. The general treatment of leprosy has been mentioned such as Dāruharidrā or Rasāñjana or Harītakī is applied with cow urine to cure leprosy. During such application applied, meat, trikaṭu, molasses, and oil are to be abandoned.

There are various herbs used in the treatment of leprosy. The root of paltā, the root of shepherd cucumber, eight tolā of each separately; Harītakī, Āmalakī, Baheḍā, and Teuḍī, four tolā of each separately; Four tolā of Balādumuralatā, four tolā of Kaṭakī, and two tolā of Śuṭha should be crushed. One pala of this powder is to be boiled in water. Intake of this decoction alleviates doṣas of the patient. After this potion is digested, the patient should be given an old śāli type of rice along with the meat soup, of animals and birds in the habiting arid land. This recipe when administered for six nights cure Kuṣṭha. Mustā, trikaṭu, triphalā, Mañjiṣṭhā, Devadāru, Daśamūla, the bark of Chātima, the bark of Neem, the root of Rākhālaśasā, Citā, and Mūrvā–these drugs, should be made of a powder, this powder should be mixed with nine times of saktu and be taken by the patient mixed with honey and ghee every day. This drug cures leprosy. It also cures Śotha, Grahaṇī doṣa, and Śvitra, etc. To cured of subtle or numbness applied to be two palas of each of triphalā, Ativiṣa, Nimba, Kaliṅgaka, Vacā, Paṭola, Pippalī, Haridrā, Dāruharidrā, Padmaka, Mūrvā, Viśāla, Bhūnimba, Palāśa, and sixtyeight palas of Trivṛt, and one hundred thirty-six palas of Brāhmī should be made to a powder. Application of lelītaka with the juice of Jāti together with honey is the cure of seventeen types of leprosy^[33].

The patients suffering from Kuṣṭha should take the following types of diet -Light food, bitter vegetables, cooked food and ghee with Bhallātaka, triphalā, neem and old grains, jungle meat, Mudga, and Paṭola, etc., are beneficial. The products are rich food, acid, milk, curd, the meat of animals inhabiting marshy land, fish, molasses, and sesame^[34]. To cure leprosy, small cardamom, Kuḍa, Dāruharidrā, Śulphā, Citā, Viḍaṅga, and Abhayā should be crushed and applied. The medicine for leprosy is cow urine, mixed with Palāśa alkali, after with sieved then mixed with powder of Citā, small cardamom, Bimbi, Bāsaka, Teuḍī, Arka and Śuṭha should be boiled for eight days. Application of this paste followed by exposure to the heat of the sun soon leads to the bursting as well as dissolution of maṇḍala type of Kuṣṭha. Famous commentator Cakrapāṇi has interpreted the term Arka as kuruvinda or copper^[35].

Leprosy is cured by the use of various medicines, Namely-Jaṭāmāṃsī, Marica, sea-salt, Haridrā, Tagarapādikā, Manasā, gṛha-dhūma (soot), cow urine, alkali of bile and Palāśa alkali are combined apply by coated together. Also, ointment applied mixed with trapu, lead, iron powder, Yajñaḍumura, Citā, and Bṛhatī. Further, the use of ointment should be mixed with Godhārasa, sea-salt, devadāru, and cow urine. Besides, the meat should be cooked in the pure alkaline water of Kadalī, Palāśa, Pārula, and Hijjala; and the rice powder and the Surākiṇva should be dissolved in the alkaline water. After that, the above-mentioned meat extract and Surākiṇva will be medaka in a day or two. When this is well fermented, ‘Kiṇva’ is to be taken out and exposed to the heat of the Sun. This paste cured Mandala-Kuṣṭha^[36].

The decoction of the following mentioned drugs is also useful in emetic and purgation therapies and paste of these drugs is useful for unction which promotes the colour of the skin^[37]. The water boiled with Mustā, Madana, Triphalā, Karañja, Āragvadha, Indrayava, Dārvī, and Saptaparṇa should be used for bath.

The following used ointments to cure Kuṣṭha. Such as Kuḍa, the seeds of Karañja and Cākunda should be made to a paste adding water^[38]. Also, the paste of the seeds of Prapunnāḍa, Saindhava, Rasāñjana, Kapittha, Lodha, Karavīramūla, Kuḍacī, the seeds of Ḍaharakarañja, Indrayava, the bark of Dāruharidrā and the leaves of Jāti should be applied for curing Kuṣṭha. In the addition, the paste of Lodha, Dhaiphul, Indrayava, Ḍaharakarañja, and Mālatī Kalka should be Used externally as unction and ointment. The bark and flower of Śirīṣa, the bark of corpus, leaves of Sodālura, kākamācī Kalka, etc., paste should be used as ointment cured for leprosy.

Leprosy is also cured by bathing, drinking, and Udvartana. The decoction of the following mentioned recipes is used in the bath, as a drink, as Ālepana for rubbing, and for dusting. These decoctions may also be used in the preparation of medicated oil and medicated ghee^[39]. The decoctions of eight recipes are Dāruharidrā and Rasāñjana, the bark of neem and Paltā, heart-wood of Khadira, Āragvadha and Vṛkṣaka, Triphalā, Saptaparṇa, tiniśa, and Aśvamāra. Used to intake of different kaṣāyas are -Triphalā, Neem, Paltā, Mañjiṣṭhā, Kaṭakī, Vacā, and Haridrā cures Kuṣṭha caused by Kapha and Pitta. Vātika type of Kuṣṭha is cure by applying medicated ghee prepared by boiling with the decoction of the above-mentioned drugs.

The patient should use Medicated oil to be cured of leprosy^[40]. Medicated oil made of Kuḍa, Ākanda, Tuttha, Kaṭphala, Mūlaka, Kaṭakī, Indrayava, Nīlotpala, Musta, Bṛhatī, Karavīra, Kāśiśa, Cākunda, Nimba, Pāṭhā, Durālabhā, Citā, Viḍaṅga, seeds of Tiktālābu, Kamalāguri, Sarṣapa, Vacā, and Dāruharidrā. Also, Medicated oil prepared of the juice of White-Karavīra, Cow urine, Citā, and Viḍaṅga^[41]. Medicated oil should be prepared of the following recipes -one part of oil; four parts of cow-urine; paste of the leaf and root-back of the white-Karavīra, Vatsaka, Viḍaṅga, Kuḍa, the root of Ākanda, Sarṣapa, the bark of Sajinā, Rohiṇī and Kaṭukā (all taken in equal quantities and 1/4th part of them in quantity).

Mustard oil should be boiled with the paste of Seeds of Bitter Ikṣvāku, both the varieties of Tuttha, Gorocanā, Haridrā, Kalka prepared by -Dāruharidrā, the fruit of Bṛhatī, the root of Eraṇḍa, the root of Rākhālaśasā, Citā, Mūrvā, Kāśiśa, Hiṅgu, Śigru, Trikaṭu, Devadāru, Tumburu, Viḍaṅga, Biṣalāṅgulī, Kuḍacī bark, Kaṭakī by adding cow-urine, four times in quantity of the oil. Massage of this medicated oil cures itches, Kuṣṭha, and diseases caused by Vayu as well as Kapha^[42].

Massage of Kanakakṣīrītaila immediately helps in the bursting of the Mandala type of Kuṣṭha, cures worm infection, and itches^[43]. Mustard oil should be adding the decoction of the roots and leaves of Karavīraka, the paste of Kanakakṣīrī, Śaila, Bhārgī, fruits, and roots of Dantī, tender leaves of Jāti, Sarṣapa, Garlic, Viḍaṅga, Ḍaharakarañja bark, Chātima bark, Ākanda leaves, Nimba, Citā, Āsphotā, Guñja, Eraṇḍa, Bṛhatī, Mūlaka,

seeds of Surasā, seeds of Ārjjaka-tulasī, Kuṣṭha, Pāṭhā, Ākanādi, Musta, Tumburu, Mūrvā, Vacā, Cākunda, Kuḍacī, Sajinā, Bhelā, Kṣavaka-tulsī, Haritāla, Abākpuṣpī, Tulva, Kamalāguḍi, Amṛtāsaṅga, Saurāṣṭra-mṛtikā, Lead, the bark of Dāruharidrā, Sarjjikākṣāra and cow-urine, four-time in the quantity of the oil. And will be placed that oil in the shell of the Titalāu; the paste of Kuḍa, Tamālapatra, Marica, Manaḥśila and Kāśiśa should be mixed with oil and kept in a copper pot for a week; if you apply that oil in the sun, Maṇḍala type of leprosy is cured within seven days. And without bathing, this oil is applied to the cleansed body for a month, but leprosy called Kilāsa is cured^[44]. Also, the oil extracted from the seeds of Sarṣapa, Ḍaharakarañja, Koṣātakī, Iṅgudī and the boiled with the heart-wood of Khadira is useful in the treatment of Kuṣṭha^[45]. Massage with Vapādikāhara ghṛta and oil is useful in the treatment of Kuṣṭha. Medicated ghee and oil should be prepared by boiling ghee and oil with the paste of Jīvantī, Mañjiṣṭhā, Dāruharidrā, Kampillaka, milk, and Tuttha. When cooking of this is over, sarjarasa and Madhūcchiṣṭa should be added.

To eradicate maṇḍala leprosy, rheumatic leprosy, bile-phlegm leprosy used medicine with various ointments, baths, drinks, decoctions, ghee, etc, namely-the paste of Surābīja, Barāharakta, Kṛṣṇajīrā, and Saindhava; or the paste of Kustumburu; The paste of Nāṭākarañja, Devadāru, Jaṭāmāṃsī, Pakvasurā, Madhu, Mudagaparṇī, and Kākanāsā^[46]. The paste of the following six recipes prepared by adding thin butter-milk cures Kuṣṭha caused by Vāta, Pitta, and Kapha, namely Citā and Sajinā; Gulañca, Apāmārga, and Devadāru; Khadira; Dhava; Śyāmā, Dantī, and Dravantī; and Lākṣā, Rasāñjana, Elā, and Punarṇavā.

The use of the paste of Vāsā and triphalā, Bṛhatī, Sevya, Paṭola, Sārivā, and Rohini should be used in drinks, baths, Udvartana and it provides relief from leprosy^[47]. Similarly, the paste of Khadirasāra, Avaghāta, Kakubha Rohītaka, Lodhra, Kuṭaja, Dhava, Nimba, Saptacchada and Karavīra is useful for bath and drink by a patient suffering from Kuṣṭha.

According to Rasendrasāra Saṃgraha treating Kuṣṭha disease is regarded as a highly spiritual activity deserving the boon of God. The herb and medicines associated with the disease are śuddhapārada, Citraka, Marica, śuddhagandhaka, etc.^[48] Similarly, the nature of treatment in various processes is described as Pāribhadra rasa, Kuṣṭhari Rasa, Śvitra Dadrupātāla Lepa, etc.^[49]

The decoction of Yaṣṭimadhu, Lodha, Padmakāṣṭha, Paltā, Neem, and Raktachandana is extremely chilling and it is suitable for bath and drink of patients suffering from Paittika type Kuṣṭha. Also, the paste of Priyaṅgu, Reṇukā, Indrayava, Ativiṣa, Sevya, Raktachandana, and Kaṭurohinī is the anti-leprosy; Oil should be cooked with Rakta Chandan, Yaṣṭimadhu, Puṇḍariyā Kāṣṭha, Nīlotpala, and ghee, is used to massage to cure for burning sensation over the patches of leprosy; Besides, if leprosy is controlled by blood and bile, then for its treatment, Khadiraghṛta, Dārvīghṛta, and Paṭolaghṛta should be used. Half pala of each of Triphalā and Paṭola, one karṣa of each of Kaṭurohinī, Nimba, Yaṣṭi, and Trāyamāṇā, and two palas of seeds of Masūra should be boiled in one ādhaka of water and reduce to 1/8th. The decoction should then be collected by filtration. In this decoction, four palas of ghee should be added and cooked till 1/4th remnants. It cures leprosy caused by Vāyu and Pitta, Visarpa, serious types of gout, fever, burning sensation, gulma, abscess, giddiness, and Visphoṭaka.

Besides, half palas of Nimba, Paṭola, Dāruharidrā, Durālabhā, Tiktarohiṇī, Triphalā, Parpaṭaka, and Trāyamāṇā should be boiled with two ādhakas of water till 1/8th remains. The decoction should then be strained out, and to this, the paste of half Kṣāra of each Candana, Kirātatikta, Pippalī, Musta and seeds of Vatsaka, and six palas of freshly collected ghee is useful in the treatment of Kuṣṭha, fever, gulma, Arśas, Grahaṇī, Pāṇḍu, Oedema, Pāmā, Visarpa, Piḍakā, Kaṇḍū, Mada or Unmāda, and Gaṇḍamālā^[50].

Also, Chātima bark, Ātaica, Śampāka, Kaṭurohinī, Ākanādi, Musta, Uśīra, Triphalā, Paṭola, Picumarda, Kṣetapābaḍā, Durālabhā, Raktachandana, Upakulyā, Padmakāṣṭha, Haridrā, Dāruharidrā, Ṣaḍgranthā, Rākhālaśasā, Śatāvarī, Anantamūla, Śyāmālatā, Indrayava, Bāsaka, Mūrvā, Amṛta, Ciretā, Yaṣṭimadhu, and Trāyamāṇā -the paste of all his drugs should be taken in the quantity of 1/4th part of ghee. To, this ghee (one part), water (eight parts), and the juice of Āmalaki (two parts) should be and cooked. This medicated ghee is called Mahātiktaka Ghṛta. Applied of this medicated ghee cures leprosy, Raktapitta, Serious types of piles with bleeding, Visarpa, Amlapitta, Vātarakta, vitiligo, Pustular eruption, Pāmā, insanity, jaundice, fever, constipation, heart disease, fever, itching, phantom tumour (Gulma), pimples, menorrhagia, and scrofula (Gaṇḍamālā)^[51]. According to Nārada-Smṛti, Mahāvikāra is as follows insanity, tvagadoṣa, tuberculosis, shortness of breath, diabetes, fistula, stomach disease, and stone disease. According to Bāgbhaṭṭa, Mahāvikāra is as follows Vātavyādhi, stone, leprosy, diarrhoea, fistula, piles, Grahaṇī, etc.^[52]

Apart from this, Pañca-tulās of Khadira wood, one tulā of Śiṃśapā, one tulā of Aśana and half tulā of each of Karanja, Arista, Vetasa, Parpaṭa, Kuṭaja, Vṛṣa, Viḍaṅga, Haridrā, Dāruharidrā, Kṛtamāla, Gulañca, Triphalā, Teuḍī, and Chātima should be made to a coarse powder and boiled by adding ten droṇas of water till 1/8th remains. After that, to this decoction, the juice of one ādhaka of Dhātrī, one ādhaka of ghee and the aforesaid Mahātiktaka Ghṛtokta Kalka separately of one pala should be added and cooked. This medicated ghee, known as Mahākhadirādighṛta. It is said to be the greatest medicine in the treatment of leprosy^[53].

In the case of leprosy, burning, and lymphatic discharge and worm-eaten, should be given cow-urine, Nimba, and Viḍaṅga for bath, pāna, and pradeha. To destroy worms of leprosy, the decoction should be made of bāsaka, Kuḍacī, Chātima, Karavīra, Karañja, and neem bark and Khadira wood and mixed with cow-urine and boiled, then used of preparation of food, drinks, sprinkling, fumigation, and ointment. Applying Viḍaṅga to drinks, food, etc., destroys worms in a special way or leprosy destroyed especially by applying Khadira^[54].

Śvitra (Leucoderma) is not included in the eighteen types of leprosy. It is not a contagious disease. The treatment of leucoderma is described after Kuṣṭha. In respect of other diseases, first of all, their diagnosis and thereafter, their treatment is described. But in the present case, the order in changed since the treatment of the diseases is described first, and thereafter, its diagnosis. Śvitra is three types -Dāruṇa, Aruṇa, and Kilāsa. all of them are generally caused by the simultaneous vitiation of all the three dosas. For example, if located in the blood, it is red, if in muscle tissue, it is of copper colour, and if located in fat, it is white^[55]. Ācārya Bhāvamiśra says–if Śvitra is the colour of Aruṇa then called Kilāsa; Vāta type Śvitra is rough and the colour of Aruṇa, Pitta type Śvitra is copper colour and white like a lotus and finally red, burning and hairy. Kapha type Śvitra is white, thick, and guru, etc.^[56] Ācārya Bāgbhaṭṭa said that, unlike other leprosies, Śvitra discharge does not occur. This is the difference between leprosy and Śvitra. In Śāraṅgadhara-Saṃhitā, Śvitra (leucoderma) is three types–Vātaja, Pittaja, and Kaphaja^[57].

However, it is difficult to cure Śvitra patients should be cleaned by first the used of elimination therapies, and thereafter, the following therapy should be applied -The juice of Kākoḍumbabikā along with jaggery is excellent for causing Sraṃsana for a patient suffering from leucoderma^[58]. The patient should first oleation therapy, thereafter, this recipe should be according to the strength of the patient. In Śvitra, all the explosions in the body have to be pierced with thorns. And if all the explosives are to be emitted, after the exudation of the fluid the patient should take every morning, continuously for fifteen days, the decoction of Kākoḍumura, Aśana, Priyaṅgu, and Śulphāra prepared by boiling with water^[59].

Besides, the disease is alleviated by drinking the alkali of Palāśa mixed with Fāṇita. Drinking Khadira water or mixed with the decoction of Khadira is an excellent remedy for Śvitra disease. Different types of recipes should also be used for external application in the treatment of leucoderma, namely, Manaḥśila, Viḍaṅga, Hirākasa, Gorocanā, Kaṇakapuṣpī, Saindhava should be used. The ashes of the bone of ass mixed with the Kṣāra of Kadalī by adding the blood of cattle; Alkali preparation of the bud of Mālatī flowers is mixed with the rut of the elephant; the paste should be made of Nīlotpala, Kuḍa, and Saindhava by adding urine of elephant or crushing seeds of Mūlaka and Somarājī adding urine of cow; Kākoḍumbabikā, Bāsaka, Somarājī, and Citā made to a paste by adding cow-urine; or Manaḥśila made to a paste by adding Peacock-bile; then apply the paste for the cure of Śvitra disease. Also, root of Somarājī, Lākṣā, cow-bile, Sauvīrāñjana, Rasāñjana, Pippalī, and Cūrṇa of Kāntalauha were mixed and applied and the Kilāsa types Śvitra was cured^[60].

Also, some peoples of leucoderma, who are free from the belonging of their sinful acts get cured by the use of elimination therapies, blood-letting, and intake of ununctuous food like saktu^[61]. Symptoms of curable Śvitra disease are -the small hair over the patches is not red if the skin is not thin and long-lasting Pāṇḍu. Symptoms of incurable Śvitra disease are -the small hair over the patches is red and the patient is suffering from this disease for several years^[62]. Lying, ingratitude, blasphemy, an insult to the guru, sinful deeds, premeditated misdeeds, or unhealthy eating are the causes of Kilāsa disease^[63]. Also, Śvitra disease is caused by dog bites^[64].

Footnotes and references:

[1]:

C. Sū. –XIX.3; & C. Ci. –VIII.173—
dāruṇaṃ cāruṇaṃ śvitraṃ kilāsaṃ nāmabhistribhiḥ |
vijñeyaṃ trividhaṃ tatra tridoṣaṃ prāyaśaśca tat ||
& also, Suśruta -Nidāna 5.17—
kilāsamapi kuṣṭhavikalpaḥ | tattrividhaṃ vātena pittena śleṣmaṇā ceti | kuṣṭhakilāsayoraṃ ntaram | tvaggatameva kilāsamaparistrāvi ca |

[2]:

Mā. Ni. –II /Kuṣṭha Nidānam/1-6); Mādhava-Nidāna of Mādhavakara with the Commentary Madhukoṣa by Vijayarakṣita & Śrīkaṇṭhadatta, Brahmanand Tripathi(ed.), trans. Kanjiv Lochan, Varanasi, Chaukhamba Surbharati Prakashan, 2018, p. 719.

[3]:

Mādhava-Nidāna of Mādhavakara with the Commentary Madhukoṣa by Vijayarakṣita & Śrīkaṇṭhadatta, Brahmanand Tripathi(ed.), trans. Kanjiv Lochan, Varanasi, Chaukhamba Surbharati Prakashan, 2018, pp. 720-721.

[4]:

sapta dravyāṇi kuṣṭhānāṃ prakru tirvikṛ timāpannāni bhavanti | tadyathā-trayo doṣā vātapittaśleṣmāṇaḥ prakopaṇavikṛ tāḥ, dūṣyāśca śarīradhātavastvaṅmāṃsaśoṇitalasīkāścaturdhā doṣopaghātavikṛ tā iti | etat saptānāṃ saptadhātukamevaṅgatamājananaṃ kuṣṭhānām ataḥ prabhavāṇyabhinirvartamānāni ke valaṃ śarīramupatapanti || CS. Nidānasthāna–V.3); R. K. Sharma & Bhagwan Dash (eds.), Caraka Saṃhitā–Vol. II, Varanasi, Chowkhamba Sanskrit Series Office, 2017, p. 67.

[5]:

vātādayastrayo doṣāstvagraktaṃ māṃsamamvu ca |
dūṣayanti sakūṣṭhānāṃ saptako dravyasaṃgrahaḥ || (Bhāvaprakāśa–Kuṣṭhādhikāra -5/6) Bhāvaprakāśa by Bhāvamiśra Vol. IV, trans. Kalishachandra Sengupta, Vaidyacarya Kalikinkara Senasharma & Ayurvedacharya Satya Shekhara Bhattyacharya (eds.), Kolkata, Deepayan, 2000, p. 25.

[6]:

kṛ ṣṇāruṇakapālābhaṃ rūkṣaṃ suptaṃ kharaṃ tanu |
vistṛtāsamaparyantaṃ hṛṣitairlomabhiścitam |
todāḍhyamalpakaṇḍū kaṃ kāpālaṃ śīghrasarpi ca || (Aṣṭā. S. –Nidānasthāna-14/15); Aṣṭāṅga Saṃgraha of Vāgbhaṭṭa Vol. II, trans. K. R. Srikantha Murthy, Varanasi, Chaukhambha Orientalia, 2018, p. 236.

[7]:

Mādhava-Nidāna of Mādhavakara with the Commentary Madhukoṣa by Vijayarakṣita & Śrīkaṇṭhadatta, Brahmanand Tripathi(ed.), trans. Kanjiv Lochan, Varanasi, Chaukhamba Surbharati Prakashan, 2018, pp. 738-741.

[8]:

asvedanamatisvedanaṃ pāruṣyamatiślakṣṇatā vaivarṇyaṃ kaṇḍū rnistodaḥ suptatā paridāhaḥ pariharṣo lomaharṣaḥ kharatvamūṣmāyaṇaṃ gauravaṃ śvayathurvīsarpāgamanamabhīkṣṇaṃ ca kāye kāyacchidreṣūpadehaḥ pakvadagdhadaṣṭabhagnakṣatopaskhaliteṣvatimātraṃ vedanā svalpānāmapi ca vraṇānāṃ duṣṭirasaṃrohaṇaṃ ceti || (CS. Nidānasthāna–V.7); R. K. Sharma & Bhagwan Dash (eds.), Caraka Saṃhitā–Vol. II, Varanasi, Chowkhamba Sanskrit Series Office, 2017, p. 71.

[9]:

virodhīnyannapānāni dravasnigdhagurūṇi ca |
bhajatāmāgatāṃ chardiṃ vegāṃścānyānprati?[?]knatām |
vyāyāmamatisaṃtāpamatibhuktvopasevinām |
śitoṣṇalaṅghanāhārān karmaṃ muktvāniṣeviṇām ||
gharmaśrabhamayārtānāṃ drutaṃ śītāmbusevinām |
ajīrṇādhyaśiṇāṃ caiva pañcakarmāpacāriṇām ||
navānnadadhimatsyātilavaṇāmlaniṣeviṇām |
māśamūlakapiṣṭānnatilakṣāraguḍāśinām ||
vyavāyaṃ cāpyajīrṇe'nne nidrāṃ ca bhajanāṃ divā | viprān gurūn gharṣayatāṃ pāpaṃ karma ca kurvatām || (CS. Cikitsāsthāna–VII.4-8); Caraka Saṃhitā Vol. II with elaborated Vidyotini Hindi Commentary, trans. Kasinatha Pandey & Gorakha Natha Chaturvedi, Varanasi, Chaukhambha Bharati Academy, 2015, p. 248.

[10]:

trayo doṣāḥ yugapat prakopamāpadyante; tvagādayaścatvāraḥ śaithilyamāpadyante; teṣu śithileṣu doṣāḥ prakupitāḥ sthanamadhigamya saṃtiṣṭhamānāstāneva tvagādīn dū ṣayantaḥ kuṣṭhānyabhinirvartayanti || (CS. Nidānasthāna–V.6); R. K. Sharma & Bhagwan Dash (eds.), Caraka Saṃhitā–Vol. II, Varanasi, Chowkhamba Sanskrit Series Office, 2017, p. 70.

[11]:

ata urdhvamaṣṭādaśānāṃ kuṣṭhānāṃ kapālodumbaramaṇḍalarṣyajihvapuṇḍarīkasidhmakākaṇakai kakuṣṭhacarmākhyakitima—vipādikālasakadadrucarmadalapāmāvisphoṭakaśatārurvicarcikānāṃ lakṣaṇānyapadekṣyāmaḥ || (CS. Cikitsāsthāna–VII.13); R. K. Sharma & Bhagwan Dash (eds.), Caraka Saṃhitā–Vol. III, Varanasi, Chowkhamba Sanskrit Series Office, 2017, p. 328.

[12]:

Baidyacharya Kalikinkar Sensarma & Ayurbedacharya Satyasekhar Bhattacharya (eds.), Caraka- Samhita–Vol. II, trans. Kabiraj Jasodanandan Sirkar, Kolkata, Deepayan Publication, 2013, pp. 308.

[13]:

Baidyacharya Kalikinkar Sensarma & Ayurbedacharya Satyasekhar Bhattacharya (eds.), Caraka- Samhita–Vol. II, trans. Kabiraj Jasodanandan Sirkar, Kolkata, Deepayan Publication, 2013, pp. 308- 309.

[14]:

Baidyacharya Kalikinkar Sensarma & Ayurbedacharya Satyasekhar Bhattacharya (eds.), Caraka- Samhita–Vol. II, trans. Kabiraj Jasodanandan Sirkar, Kolkata, Deepayan Publication, 2013, p. 311.

[15]:

kuṣṭhānyaṣṭadaśoktāni vātātkāpālikaṃ bhavet |
pittenodumbaraṃ proktaṃ kaphānmaṇḍalacarcike ||
marutpittādṛṣyajihvaṃ śleṣmavātādvipādikā |
tathā sidhmaikakuṣṭhaṃ ca kiṭibhaṃ cālasaṃ tathā ||
kaphapittātpunardadrūḥ pāmā visphoṭakaṃ tathā ||
mahākuṣṭhaṃ carmadalaṃ puṇḍarīkaṃ śatārukam ||
tridoṣaiḥ kākaṇaṃjñeyaṃ tathānyacchvitrasaṃjñitam | (Śāraṅg. S. –I/7/87-90); Śāraṅgadhara-Saṃhitā: A Treatise on Ayurveda by Śāraṅgadhara, trans. K. R. Srikantha Murthy, Varanasi, Chaukhambha Orientalia, 2017, pp. 39.

[16]:

kṛ ṣṇāruṇakapālābhaṃ yadrū kṣaṃ paruṣaṃ tanu |
kāpālaṃ todabahulaṃ tatkuṣṭhaṃ viṣamaṃ smṛtam ||
dāhakaṇḍurujārāgaparītaṃ......................................
tridoṣaliṅgaṃ tat kuṣṭhaṃ kākaṇaṃ naiva sidhyati || (CS. Cikitsāsthāna–VII.14-20); R. K. Sharma & Bhagwan Dash (eds.), Caraka Saṃhitā–Vol. III, Varanasi, Chowkhamba Sanskrit Series Office, 2017, p. 328.

[17]:

Rajneesh V. Giri & Smitha Rajneesh, Synopsis on Caraka Saṃhitā, Varanasi, Chaukhambha Orientalia, 2019, pp. 131-132.

[18]:

raukṣyaṃ śoṣastodaḥ śūlaṃ saṃkocanaṃ tathā''yāmaḥ |
pāruṣyaṃ kharabhāvo harṣaḥ śyāvāruṇatvaṃ ca || (CS. Cikitsāsthāna–VII.34); R. K. Sharma & Bhagwan Dash (eds.), Caraka Saṃhitā–Vol. III, Varanasi, Chowkhamba Sanskrit Series Office, 2017, p. 328.

[19]:

kuṣṭheṣu vātaliṅgaṃ, dāho rāgaḥ parisravaḥ pākaḥ |
vistro gandhaḥ kledastathā'ṅgapatanaṃ ca pittakṛ tam || (CS. Cikitsāsthāna–VII.35); Caraka Saṃhitā Vol. II with elaborated Vidyotini Hindi Commentary, trans. Kasinatha Pandey & Gorakha Natha Chaturvedi, Varanasi, Chaukhambha Bharati Academy, 2015, p. 254.

[20]:

śvaitaṃ śaityaṃ kaṇḍuḥ sthairyaṃ cotsedhagauravasnehāḥ ||
kuṣṭheṣu tu kaphaliṅgaṃ jantubhirabhibhakṣaṇaṃ kledaḥ || (CS. Cikitsāsthāna–VII.36); R. K. Sharma & Bhagwan Dash (eds.), Caraka Saṃhitā–Vol. III, Varanasi, Chowkhamba Sanskrit Series Office, 2017, p. 328.

[21]:

sarvailirṅgai ryuktaṃ matimān vivarjayedabalam |
tṛṣṇādāhaparītaṃ śāntāgniṃ jantubhirjagdham || (CS. Cikitsāsthāna–VII.37); Caraka Saṃhitā Vol. II with elaborated Vidyotini Hindi Commentary, trans. Kasinatha Pandey & Gorakha Natha Chaturvedi, Varanasi, Chaukhambha Bharati Academy, 2015, p. 254.

[22]:

asyāṃ caivāvasthayāmupadravāḥ kuṣṭhinaṃ spṛśanti; tadyathā -prasravaṇmaṅgabhedaḥ patanānyaṅgāvayavānāṃ tṛṣṇājvarātīsāra—dāhdaurbalyā-rocakāvipākāśca, tathāvidhamasādhyaṃ vidyāditi || (CS. Nidānasthāna–V.11); R. K. Sharma & Bhagwan Dash (eds.), Caraka Saṃhitā–Vol. II, Varanasi, Chowkhamba Sanskrit Series Office, 2017, p. 75.

[23]:

vātorakteṣu sarpirvamanaṃ śleṣmottare ṣu kuṣṭheṣu |
pittottareṣu mokṣo raktasya virecanaṃ cāgre || (CS. Cikitsāsthāna–VII.39); R. K. Sharma & Bhagwan Dash (eds.), Caraka Saṃhitā–Vol. III, Varanasi, Chowkhamba Sanskrit Series Office, 2017, p. 329.

[24]:

prapracchanamalpe kuṣṭhe mahati ca śastaṃ sirāvyadhanam || (CS. Cikitsāsthāna–VII.40); Caraka Saṃhitā Vol. II with elaborated Vidyotini Hindi Commentary, trans. Kasinatha Pandey & Gorakha Natha Chaturvedi, Varanasi, Chaukhambha Bharati Academy, 2015, p. 255.

[25]:

bahudoṣaḥ saṃśodhyaḥ kuṣṭhī bahuśo'nurakṣatā prāṇān |
doṣe hyatimātrahṛte vāyurhanyādabalamāśu || (CS. Cikitsāsthāna–VII.41); R. K. Sharma & Bhagwan Dash (eds.), Caraka Saṃhitā–Vol. III, Varanasi, Chowkhamba Sanskrit Series Office, 2017, p. 329.

[26]:

snehasya pānamiṣṭaṃ śuddhe koṣṭhe pravāhite rakte |
vāyurhi śuddhakoṣṭhaṃ kuṣṭhinamabalaṃ viśati śīghram || (CS. Cikitsāsthāna–VII.42); Caraka Saṃhitā Vol. II with elaborated Vidyotini Hindi Commentary, trans. Kasinatha Pandey & Gorakha Natha Chaturvedi, Varanasi, Chaukhambha Bharati Academy, 2015, p. 255.

[27]:

śvetā jyotiṣmatī caiva haritālaṃ manaḥśilā ||
gandhāścāgurupatrādyā dhūmaṃ mūrdhaviracane ||
gauravaṃ śirasaḥ śūlaṃ pīnasārdhāvabhedakau ||
karṇākṣiśūlaṃ kāsaśca hikkāśvāsau galagrahaḥ || (CS. Sūtrasthāna–V.26-27); R. K. Sharma & Bhagwan Dash (eds.), Caraka Saṃhitā–Vol. I, Varanasi, Chowkhamba Sanskrit Series Office, 2017, p. 114.

[28]:

nidadhīta dhānyamadhye prātaḥ prātaḥ pibettato yuktyā |
māsena mahākuṣṭhaṃ hantyevālpaṃ tu pakṣeṇa ||
arśaḥśvāsabhagandarakāsakilāsapramehaśoṣāṃśca |
nā bhavati kanakavarṇaḥ pītvā'riṣṭaṃ kanakabindum || (CS. Cikitsāsthāna–VII.78-79); Caraka Saṃhitā Vol. II with elaborated Vidyotini Hindi Commentary, trans. Kasinatha Pandey & Gorakha Natha Chaturvedi, Varanasi, Chaukhambha Bharati Academy, 2015, p. 261.

[29]:

matsyaṇḍikāmadhusamā tanmāsaṃ jātamāyase bhāṇḍe |
madhvāsavamācarataḥ kuṣṭhakilāse śamaṃ yātaḥ || (CS. Cikitsāsthāna–VII.75); R. K. Sharma & Bhagwan Dash (eds.), Caraka Saṃhitā–Vol. III, Varanasi, Chowkhamba Sanskrit Series Office, 2017, p. 339.

[30]:

rudhirāgamārthamathavā śṛṅgālābūni yojayet kuṣṭhe |
pracchitamalpaṃ kuṣṭhaṃ virecayedvā jalokobhiḥ ||
ye lepāḥ kuṣṭhānāṃ yujyante nirhṛtāsradoṣāṇām |
saṃśodhitāśayānāṃ sadyaḥ siddhirbhavetteṣām || (CS. Cikitsāsthāna–VII.49-50); Caraka Saṃhitā Vol. II with elaborated Vidyotini Hindi Commentary, trans. Kasinatha Pandey & Gorakha Natha Chaturvedi, Varanasi, Chaukhambha Bharati Academy, 2015, p. 257.

[31]:

stabdhāni suptasuptānyasvedanakaṇḍu lāni kuṣṭhāni |
kūrcairdantītrivṛtākaravīrakarañjakuṭajānām ||
jātyarka nimbajairvā patraiḥ śastraiḥ samudraphe nairvā |
ghṛṣṭāni gaumayairvā tataḥ pradehaiḥ pradehyāni || (CS. Cikitsāsthāna–VII.56-57); R. K. Sharma & Bhagwan Dash (eds.), Caraka Saṃhitā–Vol. III, Varanasi, Chowkhamba Sanskrit Series Office, 2017, p. 343.

[32]:

mārutakaphakuṣṭhaghnaṃ karmoktaṃ pittakuṣṭhināṃ kāryam |
kaphapittaraktaharaṇaṃ tiktakaṣāyaiḥ praśamanaṃ ca ||
sarṣāpi tiktakāni ca yaccānyadraktapittanut karma |
bāhyābhyantaramagryaṃ tat kāryaṃ pittakuṣṭheṣu || (CS. Cikitsāsthāna–VII.58-59); Caraka Saṃhitā Vol. II with elaborated Vidyotini Hindi Commentary, trans. Kasinatha Pandey & Gorakha Natha Chaturvedi, Varanasi, Chaukhambha Bharati Academy, 2015, p. 258.

[33]:

lelītakaprayogo rasena jātyaḥ samākṣikaḥ paramaḥ |
saptadaśakuṣṭhaghātī mākṣikadhātuśca mūtreṇa || (CS. Cikitsāsthāna–VII.70); R. K. Sharma & Bhagwan Dash (eds.), Caraka Saṃhitā–Vol. III, Varanasi, Chowkhamba Sanskrit Series Office, 2017, p. 343.

[34]:

laghuni cānnāni hitāni vidyāt kuṣṭheṣu śākāni ca tiktakāni |
bhallātakai ḥ satriphalaiḥ sanimbairyuktāni cānnāni ghṛtāni caiva ||
purāṇadhānyānyatha jāṅgalāni māṃsāni mudgaśca paṭolayuktāḥ |
śastā, na gurvamlapayodadhīni nānupamatsyā na guḍastilāśca || (CS. Cikitsāsthāna–VII.82-83); Caraka Saṃhitā Vol. II with elaborated Vidyotini Hindi Commentary, trans. Kasinatha Pandey & Gorakha Natha Chaturvedi, Varanasi, Chaukhambha Bharati Academy, 2015, p. 262.

[35]:

CS. Cikitsāsthāna–VII.84; R. K. Sharma & Bhagwan Dash (eds.), Caraka Saṃhitā–Vol. III, Varanasi, Chowkhamba Sanskrit Series Office, 2017, p. 342.

[36]:

kiṇvairjanitaṃ pralepanaṃ śastam |
maṇḍalakuṣṭhavināśanamātapasaṃsthaṃ kṛ mighnaṃ ca || (CS. Cikitsāsthāna–VII.90); Caraka Saṃhitā Vol. II with elaborated Vidyotini Hindi Commentary, trans. Kasinatha Pandey & Gorakha Natha Chaturvedi, Varanasi, Chaukhambha Bharati Academy, 2015, p. 263.

[37]:

eṣa kaṣāyo vamanaṃ virecanaṃ varṇakastayodvarṣaḥ |
tvagdoṣakūṣṭhaśophaprabādhanaḥ pāṇḍu rogaghnaḥ || (CS. Cikitsāsthāna–VII.92); R. K. Sharma & Bhagwan Dash (eds.), Caraka Saṃhitā–Vol. III, Varanasi, Chowkhamba Sanskrit Series Office, 2017, p. 343.

[38]:

kuṣṭhaṃ karañjabījānyeḍagajaḥ kuṣṭhasūdano lepaḥ || (CS. Cikitsāsthāna–VII.93); Caraka Saṃhitā Vol. II with elaborated Vidyotini Hindi Commentary, trans. Kasinatha Pandey & Gorakha Natha Chaturvedi, Varanasi, Chaukhambha Bharati Academy, 2015, p. 264.

[39]:

iti ṣaṭ kaṣāyayogāḥ kuṣṭhaghnāḥ saptamaśca tiniśasya |
snāne pāne ca hitāstathā'ṣṭamaścāśvamārasya ||
ālepanaṃ pragharṣaṇamavacūrṇanameta eva ca kaṣāyāḥ |
tailaghṛtapākayoge ceṣyante kuṣṭhaśāntyartham || (CS. Cikitsāsthāna–VII.96-99); R. K. Sharma & Bhagwan Dash (eds.), Caraka Saṃhitā–Vol. III, Varanasi, Chowkhamba Sanskrit Series Office, 2017, p. 345.

[40]:

etaistailaṃ siddhaṃ kuṣṭhaghnaṃ yoga eṣa cālepaḥ |
udvartanaṃ pragharṣaṇamavacūrṇanameṣa eveṣṭaḥ || (CS. Cikitsāsthāna–VII.104); Caraka Saṃhitā Vol. II with elaborated Vidyotini Hindi Commentary, trans. Kasinatha Pandey & Gorakha Natha Chaturvedi, Varanasi, Chaukhambha Bharati Academy, 2015, p. 265.

[41]:

śvetakaravīrakaraso gomūtraṃ citrakoviḍaṅgaśca |
kuṣṭheṣu tailayogaḥ siddho'yaṃ saṃmato bhiṣajām || (CS. Cikitsāsthāna–VII.105); R. K. Sharma & Bhagwan Dash (eds.), Caraka Saṃhitā–Vol. III, Varanasi, Chowkhamba Sanskrit Series Office, 2017, p. 347.

[42]:

tiktālābukabījaṃ dve tutthe rocanā haridre dve |
bṛhatīphalameraṇḍaḥ.............................
sarṣapatailaṃ kalkai retairmūtre caturguṇe sādhyam |
kaṇḍū kuṣṭhavināśanamabhyaṅgānmārutakaphahantṛ || (CS. Cikitsāsthāna–VII.108-110); Caraka Saṃhitā Vol. II with elaborated Vidyotini Hindi Commentary, trans. Kasinatha Pandey & Gorakha Natha Chaturvedi, Varanasi, Chaukhambha Bharati Academy, 2015, p. 265.

[43]:

sthapyaṃ kaṭukālābuni tatsiddhaṃ tena maṇḍalānyāśu |
bhindyādbhiṣagabhyaṅgātkṛmīścaṃ kaṇḍūṃ ca vinihanyāt || (CS. Cikitsāsthāna–VII.116); R. K. Sharma & Bhagwan Dash (eds.), Caraka Saṃhitā–Vol. III, Varanasi, Chowkhamba Sanskrit Series Office, 2017, p. 348.

[44]:

tenāliptaṃ sidhmaṃ saptāhā?[?]ti tiṣṭhato gharme |
māsānnavaṃ kilāsaṃ snānaṃ muktvā viśuddhatanoḥ || (CS. Cikitsāsthāna–VII.118); Caraka Saṃhitā Vol. II with elaborated Vidyotini Hindi Commentary, trans. Kasinatha Pandey & Gorakha Natha Chaturvedi, Varanasi, Chaukhambha Bharati Academy, 2015, p. 266.

[45]:

sarṣapakarañjakoṣātakīnāṃ tailānyatheṅ gudīnāṃ ca |
kuṣṭhetuhitanyāhustailaṃ yaccāpi khadirasārasya || (CS. Cikitsāsthāna–VII.119); R. K. Sharma & Bhagwan Das (eds.), Caraka Saṃhitā–Vol. III, Varanasi, Chowkhamba Sanskrit Series Office, 2017, p. 349.

[46]:

citrakaśobhāñjanakoguḍū cyapāmārgadevadārūṇi |
khadiro dhavaśca lepaḥ śyāmā dantī dravantī ca ||
lākṣārasāñjanailāḥ punarnavā ceti kuṣṭhino lepāḥ |
dadhimaṇḍayutāḥ sarve deyāḥ ṣaṇmārutakaphakuṣṭhaghnāḥ || (CS. Cikitsāsthāna–VII.124-125); Caraka Saṃhitā Vol. II with elaborated Vidyotini Hindi Commentary, trans. Kasinatha Pandey & Gorakha Natha Chaturvedi Varanasi, Chaukhambha Bharati Academy, 2015, p. 267.

[47]:

vāsā triphalā pāne snāne codvartane pralepe ca |
bṛhatīsevyapaṭolāḥ sasārivā rohiṇī caiva || (CS. Cikitsāsthāna–VII.128); R. K. Sharma & Bhagwan Dash (eds.), Caraka Saṃhitā–Vol. III, Varanasi, Chowkhamba Sanskrit Series Office, 2017, p. 352.

[48]:

śuddhasūtāgnimaricaṃ sūtād dviguṇagandhakam |
kākoḍumbarikākṣīrairdinaṃ mardyaṃ prayatnataḥ ||
varāvyoṣakaṣāyena vaṭīñcāsya samācaret |
lihyāt vajravaṭī hyeṣāṃ pāmārogavināśinī || (Ras. S. –III/Kuṣṭha Cikitsā/16-17); Ashok D. Satpute, Rasendra Sāra Saṅgraha of Sri. Gopal Krishna, Varanasi, Chowkhamba Krishnadas Academy, 2009, p. 587.

[49]:

Ras. S. –III/Kuṣṭha Cikitsā; Ashok D. Satpute, Rasendra Sāra Saṅgraha of Sri. Gopal Krishna, Varanasi, Chowkhamba Krishnadas Academy, 2009, pp. 596, 602, 603.

[50]:

navasarpiṣaśca ṣaṭpalametatsiddhaṃ ghṛtaṃ peyam ||
kuṣṭhajvaragulmarśograhaṇīpāṇḍvāmayaścathuhāri |
vāmāvisarpapiḍakākaṇḍū madagaṇḍanutsiddham || (CS. Cikitsāsthāna–VII.142-143); Caraka Saṃhitā Vol. II with elaborated Vidyotini Hindi Commentary, trans. Kasinatha Pandey & Gorakha Natha Chaturvedi, Varanasi, Chaukhambha Bharati Academy, 2015, p. 270.

[51]:

kuṣṭhāni raktapittaprabalānyarśāṃsi raktavāhīni |
visarpamamlapittaṃ vātāsṛk pāṇḍurogaṃ ca ||
visphoṭakānsapāmānunmādaṃ kāmalāṃ jvaraṃ kaṇḍūm |
hṛdrogagulmapiḍakā asṛgdaraṃ gaṇḍamālāṃ ca ||
hanyādetata sarpiḥ pītaṃ kāle yathābalaṃ sadyaḥ |
yogaśatairapyajitānmahāvikāranmahātiktam || (CS. Cikitsāsthāna–VII.148-150); R. K. Sharma & Bhagwan Dash(eds.), Caraka Saṃhitā–Vol. III, Varanasi, Chowkhamba Sanskrit Series Office, 2017, p. 361.

[52]:

Baidyacharya Kalikinkar Sensarma & Ayurbedacharya Satyasekhar Bhattacharya (eds.), Caraka- Samhita–Vol. II, trans. Kabiraj Jasodanandan Sirkar, Kolkata, Deepayan Publication, 2013, p. 325.

[53]:

nihanti sarvakuṣṭhāni pānābhyaṅganiṣevaṇāt |
mahākhadiramityetat paraṃ kuṣṭhavikāranut || (CS. Cikitsāsthāna–VII.156); R. K. Sharma & Bhagwan Dash(eds.), Caraka Saṃhitā–Vol. III, Varanasi, Chowkhamba Sanskrit Series Office, 2017, p. 357.

[54]:

pānāhāravidhāne prasacane dhūpane pradehe ca |
kṛ mināśanaṃ viḍaṅgaṃ viśiṣyate kuṣṭhahā khadiraḥ || (CS. Cikitsāsthāna–VII.159); Caraka Saṃhitā Vol. II with elaborated Vidyotini Hindi Commentary, trans. Kasinatha Pandey & Gorakha Natha Chaturvedi, Varanasi, Chaukhambha Bharati Academy, 2015, p. 272.

[55]:

dāruṇaṃ cāruṇaṃ śvitraṃ kilāsaṃ nāmabhistribhiḥ |
vijñeyaṃ trividhaṃ tacca tridoṣaṃ prāyaśaśca tat ||
doṣe raktāśrite raktaṃ tāmraṃ māṃsasamāśrite |
śvetaṃ medaḥ śrite śvitraṃ guru taccottarottaram || (CS. Cikitsāsthāna–VII.173-174); R. K. Sharma & Bhagwan Dash(eds.), Caraka Saṃhitā–Vol. III, Varanasi, Chowkhamba Sanskrit Series Office, 2017, p. 361.

[56]:

vātādrū kṣāruṇa pittāt tāmraṃ kamalapatravat |
sadāhaṃ romavidhvaṃsi kaphāt śvetaṃ ghanaṃ guru ||
sakaṇḍū kaṃ kramādraktamāṃsamedaḥsu cādiśet |
varṇenaivadṛgubhayaṃ kuṣṭhaṃ taccottarottaram || (Bhāvaprakāśa–Kuṣṭhādhikāra) Bhāvaprakāśa by Bhāvamiśra Vol. IV, trans. Kalishachandra Sengupta, Vaidyacarya Kalikinkara Senasharma & Ayurvedacharya Satya Shekhara Bhattyacharya (eds.), Kolkata, Deepayan, 2000, p. 33.

[57]:

tathātena pittena śleṣmaṇā ca tridhā bhavet | (Śāraṅg. S. –I/7/90); Śāraṅgadhara-Saṃhitā: A Treatise on Ayurveda by Śāraṅgadhara, trans. K. R. Srikantha Murthy, Varanasi, Chaukhambha Orientalia, 2017, pp. 39.

[58]:

śvitrāṇāṃ saviśeṣaṃ yoktavyaṃ sarvato viśuddhānām |
śvitre sraṃsanamagryaṃ malapūyūrasa iṣyate saguḍaḥ || (CS. Cikitsāsthāna–VII.162); R. K. Sharma & Bhagwan Dash (eds.), Caraka Saṃhitā–Vol. III, Varanasi, Chowkhamba Sanskrit Series Office, 2017, p. 359.

[59]:

śvitre'ṅge ye sphoṭā jāyante kaṇṭake na tānmindyāt |
sphoṭeṣu visruteṣu prātaḥ prātaḥ pibet pakṣam ||
malayūpūmasanaṃ priyaṅ guṃ śatapuṣpāṃ cāmbhasā samutkvāthya |
pālāśaṃ vā kṣāraṃ yathābalaṃ phāṇitopetam || (CS. Cikitsāsthāna–VII.164-165); Caraka Saṃhitā Vol. II with elaborated Vidyotini Hindi Commentary, trans. Kasinatha Pandey & Gorakha Natha Chaturvedi, Varanasi, Chaukhambha Bharati Academy, 2015, p. 273.

[60]:

kadalīkṣārayutaṃ vā kharāsthi dagdhaṃ gavāṃ rudhirayuktam |
hastimadādhyuṣitaṃ vā mālatyaḥ korakakṣāram ||
nīlotpalaṃ sakuṣṭhaṃ.............................. || (CS. Cikitsāsthāna–VII.168-171); R. K. Sharma & Bhagwan Dash (eds.), Caraka Saṃhitā–Vol. III, Varanasi, Chowkhamba Sanskrit Series Office, 2017, p. 360.

[61]:

doṣe raktāśrite raktaṃ tāmraṃ māṃsasamāśrite |
śvetaṃ medaḥ śrite śvitraṃ guru taccottarottaram || (CS. Cikitsāsthāna–VII.174); Caraka Saṃhitā Vol. II with elaborated Vidyotini Hindi Commentary, trans. Kasinatha Pandey & Gorakha Natha Chaturvedi, Varanasi, Chaukhambha Bharati Academy, 2015, p. 274.

[62]:

yat parasparato'bhinnaṃ bahu yadraktalomavat |
yacca varṣagaṇotpannaṃ tacchvitraṃ naiva sidhyati ||
araktaloma tanu yat pāṇḍu nāticirotthitam |
madhyāvakāśe cocchū naṃ śvitraṃ tatsādhyamucyate || (CS. Cikitsāsthāna–VII.175-176); R. K. Sharma & Bhagwan Dash (eds.), Caraka Saṃhitā–Vol. III, Varanasi, Chowkhamba Sanskrit Series Office, 2017, p. 376.

[63]:

vacāṃsyatathyāni kṛ taghnabhāvo nindā surāṇāṃ gurudharṣaṇaṃ ca |
pāpakriyā pūrvakṛ taṃ ca karma hetuḥ kilāsasya virodhi cānnam || (CS. Cikitsāsthāna–VII.177); Caraka Saṃhitā Vol. II with elaborated Vidyotini Hindi Commentary, trans. Kasinatha Pandey & Gorakha Natha Chaturvedi, Varanasi, Chaukhambha Bharati Academy, 2015, p. 275.

[64]:

Baidyacharya Kalikinkar Sensarma & Ayurbedacharya Satyasekhar Bhattacharya (eds.), Caraka- Samhita–Vol. II, trans. Kabiraj Jasodanandan Sirkar, Kolkata, Deepayan Publication, 2013, p. 329.