Efficacy of Ayurvedic Therapies in Treating Vicharchika

[Full title: Efficacy of Ayurvedic Therapies in Treating Vicharchika: A Case  Report on Holistic Skin Health Management]

© 2024 Kusum Dixit, et al . This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International License (CC BY 4.0). ( https://creativecommons.org/licenses/by/4.0/ ) CASE REPORT Efficacy of Ayurvedic Therapies in Treating Vicharchika: A Case Report on Holistic Skin Health Management Kusum Dixit 1 , Fatemeh Moazzamipeiro 1 , Avvinish Narine 2 , Nisha Gupta 3 1 PG Scholar, Department of Samhita and Maulik Siddhanta, National Institute of Ayurveda, (Deemed University), Jaipur, India 2 Ph.D Scholar, Department of Panchkarma, National Institute of Ayurveda, (Deemed University), Jaipur, India 3 Professor & HOD, Department of Samhita and Maulik Siddhanta, National Institute of Ayurveda, (Deemed University), Jaipur, India ABSTRACT Introduction: This case study presents a unique instance of a 50-year-old female diagnosed with Vicharchika , an Ayurvedic skin disorder analogous to eczema. The patient experienced severe pruritus, extensive rashes, and serous discharge, leading to significant distress, including burning sensations and thickened, discolored skin. Despite receiving allopathic treatments for over a decade, her condition remained chronic and resistant Methods: The therapeutic intervention consisted of a comprehensive 38-day Ayurvedic regimen that included both Shodhana (~purification) and Shamana (~palliative) therapies. The treatment began with a structured preparatory phase involving Deepana (~digestive enhancement) and Snehapana (~oleation), followed by the administration of Vamana (~emesis) and Virechana (~purgation). The regimen was complemented with supportive herbal medications and dietary modifications tailored to the patient’s needs Results: Following the Ayurvedic intervention, the patient reported substantial relief from itching and a notable reduction in skin lesions. In addition, her overall well-being improved, including enhanced sleep quality, marking a significant change from her previous state of distress Discussion and Conclusion: This case highlights the effectiveness of traditional Ayurvedic treatment modalities in managing chronic skin disorders like Vicharchika . The successful application of Vamana and Virechana in this instance contributes valuable insights to the scientific literature, suggesting that integrative approaches combining traditional practices can offer significant relief where conventional treatments have failed. Further research is encouraged to explore the efficacy of such therapies across broader populations, underscoring Ayurveda’s potential role in contemporary healthcare 1. INTRODUCTION This case is unique because it demonstrates the effective use of traditional Ayurvedic therapies, specifically Vamana (~ therapeutic emesis) and Virechana (~ therapeutic purgation), in the management of Vicharchika , a chronic skin disorder that resembles eczema. The patient, who had struggled with severe symptoms for over a decade without success from allopathic treatments, experienced significant relief, and improved quality of life following this Ayurvedic intervention. This highlights the potential of holistic approaches to Corresponding Author: Kusum Dixit PG Scholar, Department of Samhita and Maulik Siddhanta, National Institute of Ayurveda, (Deemed University), Jaipur. Email: kusumdixit 2206@gmail.com treat chronic conditions that are often deemed difficult to manage in conventional medicine [1,2] In addition, this case adds to the growing body of literature advocating for integrative healthcare practices, suggesting that traditional therapies can complement modern medicine, particularly in managing chronic diseases. The findings align with the previous studies that indicate the efficacy of Ayurvedic treatments in dermatological conditions, thus warranting further exploration and validation within the scientific community [3,4] 2. PATIENT INFORMATION A 50-year-old female from Jaipur, India, presented with severe skin rashes affecting large areas of her body, characterized by redness, International Research Journal of Ayurveda & Yoga Vol. 7(10), pp. 30-39, October, 2024 Available online at http://irjay.com ISSN: 2581-785 X DOI: 10.48165/IRJAY.2024.71006 ARTICLE INFO Article history: Received on: 01-09-2024 Accepted on: 07-10-2024 Published on: 31-10-2024 Key words : Ayurveda, Shamana, Shodhana, Vamana, Vicharchika, Virechana

Dixit, et al .: Efficacy of Ayurvedic Therapies in Treating Vicharchika 2024; 7(10):30-39 31 Kandu (~intense itching), Daah (~burning sensations), and profuse Srava (~serous discharge). These symptoms had escalated over the past ten days, significantly impacting her quality of life. She reported a 10-year history of chronic skin issues diagnosed as Vicharchika . Despite seeking allopathic treatments, including topical corticosteroids and antihistamines, she experienced only temporary relief, leading to frustration and increased anxiety regarding her condition. In terms of her medical history, the patient had no known allergies and no significant family history of dermatological conditions or chronic diseases. Psychosocially, she expressed concerns about her skin’s appearance affecting her social interactions and reported difficulties sleeping due to intense itching. The Ayurvedic assessment included Dashavidha Pariksha , which consists of ten diagnostic parameters to evaluate the patient’s overall health and Doshic balance: • Prakriti (~constitution): Vata-Pitta predominant with some Kapha characteristics • Vikriti (~current state): Kapha Dosha was vitiated, leading to symptoms of excess moisture and discharge • Saar (~essence): Compromised due to chronic symptoms • Sanhanan (~body status): Normal body proportion but affected by skin condition • Praman (~measurement): Stable physical measurements with significant skin observations • Satmya (~compatible): Compatibility issues with foods and treatments due to Doshic imbalances • Satva (~mental capacity): Reduced mental resilience and increased anxiety • Ahar Shakti (~appetite): Diminished appetite linked to discomfort • Vyayam Shakti (~exercise): Impaired exercise capacity due to symptoms • Vaya (~age): Age-related factors influencing healing processes 2.1. Before Assessment Criteria Symptoms: Severe skin rashes with extensive erythema, intense itching ( Kandu ), burning sensations ( Daah ), profuse serous discharge ( Srava ), and foul odor from the lesions. Quality of Life: Significant negative impact on daily activities and sleep, anxiety regarding social interactions due to skin appearance, emotional distress related to chronicity of condition. Medical History: 10-year history of chronic skin disorder diagnosed as Vicharchika , previous treatments included topical corticosteroids and antihistamines with only temporary relief, constipation indicating vitiated Vata Dosha . Clinical Findings: Extensive erythematous rashes observed on arms, trunk, and legs, thickening and lichenification in some areas, signs of mild malnutrition, and digestion issues 2.2. After Assessment Criteria Symptoms: Significant reduction or resolution of skin rashes, decreased itching ( Kandu ), alleviation of burning sensations ( Daah ), reduction or absence of serous discharge ( Srava ), and improvement in foul odor from the lesions. Quality of Life: Improved daily activities and sleep quality, reduced anxiety regarding social interactions and improved self-esteem, and enhanced emotional well-being related to improvement in skin condition. Clinical Findings: Significantly improved skin appearance across all affected areas, resolution of thickening and lichenification, and improved nutritional status and digestive health. Specifically, the following symptoms were considered for confirming the diagnosis: Severe skin rashes, intense itching ( Kandu ), burning sensations ( Daah ), profuse serous discharge ( Srava ), foul odor, skin texture abnormalities, and coated tongue. These symptoms helped to provide a comprehensive understanding of the patient’s condition and ultimately confirmed the diagnosis of Vicharchika 2.3. Clinical Findings On examination, the patient presented several notable physical signs indicative of Vicharchika like moist appearance with serous discharge, extensive erythematous rashes, intense pruritus, burning sensations, and blackish discoloration. The extensive erythematous rashes were observed across multiple areas of her body, including the arms, trunk, and legs, characterized by a moist appearance and clear serous discharge. The patient also reported severe pruritus, which significantly affected her sleep and daily activities, along with burning sensations that added to her discomfort. The affected skin exhibited thickening and lichenification in some areas, indicating chronicity, while blackish discoloration surrounding certain lesions suggested a prolonged inflammatory process. In addition, a foul odor emanated from the lesions, contributing to the patient’s distress and anxiety about social interactions. The general appearance of the patient was anxious and distressed, likely due to her chronic skin condition and its impact on her quality of life. Signs of mild malnutrition were also noted, particularly a coated tongue, which may indicate issues with digestion and absorption. On inquiry about her bowel habits, the patient reported constipation, further supporting the notion of vitiated Vata Dosha , a contributing factor to her skin issues according to Ayurvedic principles. Vital signs were stable, with no significant deviations from normal ranges. These clinical findings, assessed alongside Ayurvedic diagnostic parameters, provided a comprehensive understanding of the patient’s condition, guiding the development of an appropriate treatment plan aimed at restoring Doshic balance and alleviating her symptoms 2.4. Timeline of Events The patient’s timeline of care begins 10 years ago when she, previously healthy, experienced the initial onset of mild and localized itching and skin rashes. About eight years ago, she sought treatment from an allopathic practitioner, receiving topical corticosteroids that provided temporary relief. However, symptoms re-emerged with increased intensity and spread 5 years ago, prompting her to return for further treatment, which included systemic medications alongside topical applications. Three years ago, despite various allopathic treatments, including antihistamines, the patient’s condition became chronic with recurrent flare-ups, and the lesions continued to worsen. One year ago, she faced a significant decline in her condition, characterized by frequent exacerbations, skin thickening, oozing, and a foul-smelling discharge, severely impacting her quality of life and limiting her social interactions. Ten days before her admission on February 19, 2024, the patient experienced an acute exacerbation, with widespread rashes accompanied by intense itching, burning sensations, and serous discharge, prompting her to seek alternative treatment options. On presentation at the Ayurveda Hospital, she was diagnosed with Vicharchika . A comprehensive assessment through Dashavidha Pariksha confirmed Doshic imbalances, leading to the initiation of a treatment plan that included both Shodhana (~purification) and Shamana (~symptomatic management) therapies.

Dixit, et al .: Efficacy of Ayurvedic Therapies in Treating Vicharchika 2024; 7(10):30-39 32 Throughout her treatment from February 19 to March 4, 2024, the patient underwent Vamana and Virechana procedures, along with internal medications and dietary modifications. Symptoms were closely monitored, resulting in significant improvement. In the followup assessment, 38 days post-treatment, the patient reported substantial relief from itching, reduced skin lesions, and an overall improvement in her quality of life. Continued follow-up medications were prescribed to maintain her health and prevent recurrence 2.5. Diagnostic Testing The patient underwent a comprehensive evaluation that included both physical examination (PE) and laboratory testing. The physical examination revealed extensive erythematous rashes with associated symptoms of itching, burning, and serous discharge. Laboratory tests included complete blood count and basic metabolic panel, which showed no significant abnormalities, confirming the absence of systemic infections. In addition, skin scrapings were performed to rule out secondary infections or fungal elements 2.6. Diagnostic Challenges Several diagnostic challenges were encountered during the evaluation process. Access to specialized Ayurvedic diagnostic tools was limited in her previous allopathic treatment settings, which primarily focused on symptomatic management rather than a holistic approach. Financial constraints also posed a barrier, as the patient had incurred significant costs from multiple unsuccessful allopathic treatments, leading to hesitance in seeking further care. Cultural beliefs regarding skin diseases added complexity, as there is a common perception that herbal treatments are entirely safe, potentially overlooking the need for thorough evaluation of adverse reactions 2.7. Diagnosis The primary diagnosis was Vicharchika , which aligns with the Ayurvedic classification of skin diseases characterized by excessive exudation. Other differential diagnoses considered included atopic dermatitis and contact dermatitis, given the similarity in presentation. However, the chronicity of more than 10 years, specific symptoms such as skin rashes, intense itching ( Kandu ), burning sensations ( Daah ), profuse serous discharge ( Srava ), foul odor, skin texture abnormalities, coated tongue, and Ayurvedic assessment ultimately supported the diagnosis of Vicharchika , confirming a vitiation of Kapha Dosha with a secondary impact on Pitta 2.8. Prognosis Prognosis for the patient was cautiously optimistic. Given the chronic nature of her condition, the potential for recurrence was acknowledged. However, the integration of Ayurvedic treatment modalities, including Shodhana (~purification) and Shamana (~symptomatic management), indicated a favorable response. The patient’s follow-up assessments revealed significant symptom relief, suggesting that with ongoing management and lifestyle modifications, a positive outcome could be sustained. Continued monitoring and adjustments in therapy were recommended to ensure long-term management of her condition 2.9. Types of Therapeutic Interventions The therapeutic interventions for the patient with Vicharchika involved a comprehensive approach, incorporating various modalities aligned with Ayurvedic principles: 1. Pharmacologic Interventions: • Internal Medications: These included formulations such as Jvarahara Kashaya , Pashanbhedadi Kwath , and Punarnava Mandoora . These herbal preparations were aimed at detoxifying the body and managing symptoms. In addition, Arogyavardhini Vati and Manjishtadi Kwath were prescribed to support blood purification and alleviate skin symptoms • Topical Treatments: Although not extensively detailed in the original treatment plan, external applications such as medicated oils or ghee may have been utilized to soothe the skin and promote healing 2. Purification Therapies ( Shodhana ): • Vamana (~therapeutic emesis): This procedure aimed to expel excess Kapha from the body, helping to address the root cause of the condition • Virechana (~ therapeutic purgation): This was administered to cleanse the gastrointestinal tract and eliminate accumulated toxins, further balancing the Doshas 3. Preventive Measures: • Dietary Modifications: The patient was advised to avoid incompatible foods and adhere to a diet that promotes balance among the Doshas . This included avoiding spicy, oily, and processed foods while focusing on easily digestible meals • Lifestyle Adjustments: Recommendations included stress management techniques and adequate hydration to support overall health 4. Self-Care: • The patient was encouraged to practice regular self-care measures, including maintaining skin hygiene and applying soothing herbal pastes or oils to alleviate symptoms 2.10. Administration of Therapeutic Interventions Internal Medications: Jvarahara Kashaya was administered at 20 mL twice daily before meals. Pashanbhedadi Kwath and Manjishtadi Kwath followed the same dosing regimen. Punarnava Mandoora was prescribed at two tablets twice daily after food. Arogyavarghini Vati was prescribed two tablets thrice daily after food. Shatyadi Churana and Arjun Twak Churana were prescribed 3 g twice daily after food. All the medications and dosages were administered for a period of 15 days from February 19, 2024, to March 04, 2024, and are mentioned in Table 1 below 2.11. Purification Therapies Vamana : It is divided into three phases: Purvakarma , Pradhankarma, and Pashchatkarma First, Deepana–Pachana Chikitsa was administered for 5 Days as in Table 2 below. After Pachana Chikitsa , routine blood investigation, chest X-Ray, and ECG of patient was done. Consent of patient for Vamana Karma was taken Purvakarma:-After routine investigation and consent, the patient was prepared for Snehapana with Panchatikta Guggulu Ghrita . Samyaka Snigdha Lakshanas were obtained in 7 days as patient was Krurakoshthi . Snehapana Lakshanas were as follows. Snehapana was administered for 7 days as in Table 3 below. During the Snehapana phase, the diet included was administered as indicated in Table 4 below.

Dixit, et al .: Efficacy of Ayurvedic Therapies in Treating Vicharchika 2024; 7(10):30-39 33 2.12. Pradhanakarma – Vamana Day The patient was instructed to attend to morning natural urges (urination and defecation). After confirmation, Sarvang Bahya Sneha (~external application of coconut oil) and Sarvang Bashpa Peti Swedana (~steam therapy) were performed. Following this, Yavagu (~a type of gruel) was administered for Aakanthapana (~preparing for emesis). After 15 min, the Vamaka Yoga was provided, which included: • Madanaphala Pippali Churna : 12 gm • Vacha Churna : 2 gm • Saindhava (rock salt): 3 gm • Honey: 15–20 gm The Vamanopagadravya administered was Yashtimadhu Kwatha . After 30 min of consuming the Vamaka Yoga , the patient experienced nausea, sweating, and abdominal bloating. To facilitate the emesis procedure, Yashtimadhu Kwatha was given to the patient. Vitals, including pulse, respiratory rate (RR), and blood pressure (BP), were monitored throughout the Vamana procedure. The summary of the procedure is mentioned in Table 5 2.13. Paschatkarma On completion of the Vamana procedure, the patient was instructed to rinse their mouth, clean their face, hands, and feet with warm water, and rest for 48 minutes. Following this, Dhoomapana (~herbal smoke inhalation) was performed. The patient was then advised on the Samsarjana Krama (~post-cleansing dietary regimen) for 5 days and given guidance on Pariharyavishaya (~lifestyle recommendations) to gradually reintroduce regular food, as shown in Table 6 2.14. Virechana Karma Virechana Karma is divided into three phases: Purvakarma, Pradhankarma , and Pashchatkarma Purvakarma : Following investigation and patient consent, the preparation for Snehapana was initiated using Panchatikta Guggulu Ghrita, as shown in Table 7. The patient exhibited Samyaka Snigdha Lakshanas within 7 days, indicating an appropriate response, as the patient had a Krura Koshthi (~firm digestion). The specific Snehapana Lakshanas were as follows: Diet in Snehapana Kala : The patient was advised a diet consisting of Daliya , Khichadi , and lukewarm water Snehavishrama (2 days): Management during Snehavishrama included S arvang Bahya Snehana with coconut oil and Sarvang Bashpa Pati Swedana . The diet for this period comprised Taridarsabji (e.g., Alooki Tari ), roti with Sabji, Daliya, and Khichadi Pradhanakarma – Virechana day: On the day of Virechana , the patient was instructed to attend to morning natural urges (urine and stool). Following confirmation, Sarvang Bahya Snehana with coconut oil and Sarvang Bashpa Pati Swedana were performed. Virechana Yoga was then administered. Vitals, including pulse, blood pressure, SpO 2 level, temperature, and respiration rate, were recorded at regular intervals during the Virechana procedure. Approximately 250 mL of a decoction containing Triphala, Kutki , Erandbharishtah, Haritaki, Panchskara , and Nisotha was given, along with 25 mL of Eranda Taila at 11 am. A total of 21 Vega were noted after the completion of the process Paschat Karma : Following the Virechana procedure, the patient was placed on Sansarjana Karma for 5 days, with a focus on achieving Madhya Shuddhi . The patient was advised to take proper rest and was given Peya on the day of the procedure, followed by a special diet from the next day. After the Sansarjana Karma , (as in Table 5) oral medications (as per Table 1) were prescribed for 30 days 3. CHANGES IN THERAPEUTIC INTERVENTIONS During the treatment course, adjustments were made based on the patient’s response. Initially, the patient experienced significant discomfort during the emesis procedure, necessitating the administration of Yashtimadhu Kwatha to ease the process. This adjustment was made to ensure patient comfort while still achieving the therapeutic goals. Following the initial phases of treatment, the dosages of certain medications were modified based on the patient’s progress. When symptoms of itching and discharge showed marked improvement, the strength of some herbal formulations might be decreased to prevent excessive detoxification. As the patient’s symptoms improved, her dietary restrictions were gradually relaxed, allowing for a more balanced intake of nutrients while still avoiding known irritants These changes were implemented to ensure that the therapeutic interventions remained effective while prioritizing the patient’s comfort and overall well-being. Continuous assessment and adjustments based on the patient’s response exemplified the individualized approach inherent in Ayurvedic treatment 4. DISCUSSION This case report highlights several strengths and limitations that contribute to the understanding of Vicharchika (~eczema) management through Ayurvedic interventions A notable strength of this case is the comprehensive approach that integrates traditional Ayurvedic therapies with a patient-centered care model. The combination of Shodhana (~purification therapies) and Shamana (~symptomatic treatment) exemplifies the holistic philosophy of Ayurveda, which aims to address root causes rather than merely alleviating symptoms. The treatment protocol included oral medicines such as Jvarahara Kashaya , Punarnava Mandoora , and Arogyavardhini Vati , each of which has demonstrated efficacy in managing inflammatory and immune-related conditions. For instance, Punarnava Mandoora is known for its diuretic and antiinflammatory properties, supporting the body’s natural detoxification processes and enhancing tissue healing [5,6] Jvarahara Kashaya has been reported to reduce fever and inflammation, making it beneficial for inflammatory skin conditions [7] Arogyavardhini Vati , with its ingredients rich in antioxidants, further aids in reducing oxidative stress associated with skin disorders [8] The detailed documentation of treatment methods and patient responses enhances the reproducibility of the findings, while the commitment to dietary modifications and lifestyle changes reinforces the multifaceted nature of the treatment However, this case report has limitations. The focus on a single patient restricts the generalizability of the findings to a wider population. The subjective nature of symptom reporting may introduce bias, as patient-reported outcomes can be influenced by psychological factors and personal expectations. Moreover, the lack of a control group or comparison with allopathic treatments limits the ability to draw definitive conclusions about the efficacy of Ayurvedic methods relative to other therapeutic options.

Dixit, et al .: Efficacy of Ayurvedic Therapies in Treating Vicharchika 2024; 7(10):30-39 34 Relevant literature supports the efficacy of Ayurvedic treatments for skin disorders. A study done previously, demonstrated the positive effects of herbal formulations on eczema-like symptoms, emphasizing their anti-inflammatory properties [9] Another, similarly highlighted the benefits of Panchakarma therapies in dermatological conditions, correlating with the findings of this case [10] Additional studies have indicated that Virechana is effective in alleviating symptoms of chronic skin conditions, leading to improved patient outcomes [11,12] The oral medications used in this case, particularly Jvarahara Kashaya , contain ingredients such as Ginger and Long Pepper, known to reduce inflammation and promote healing [13,14] Furthermore, Punarnava’s role in enhancing renal function and detoxification may facilitate the clearance of metabolic toxins, further benefiting skin health [15] The outcomes observed can be attributed to the balanced approach of Dosha management, particularly targeting the Kapha predominance in Vicharchika . Vamana and Virechana likely facilitated detoxification and restoration of Doshic equilibrium, leading to symptom relief. The improvements in skin condition and reduced inflammation are plausible results of effective detoxification and dietary modifications 5. CONCLUSION The primary takeaway from this case report is that a holistic Ayurvedic approach can effectively manage Vicharchika , offering significant symptom relief and improved quality of life for patients suffering from chronic skin conditions. By combining purification therapies with lifestyle and dietary changes, this case underscores the importance of individualized treatment plans that focus on both physical and psychological well-being in managing complex health issues 6. ACKNOWLEDGEMENT Nil 7. AUTHORS’ CONTRIBUTIONS All the authors contributed equally to the design and execution of the article 8. FUNDING Nil 9. ETHICAL APPROVALS This manuscript does not required ethical approval as it is a case study 10. CONFLICTS OF INTEREST Nil 11. DATA AVAILABILITY This is an original manuscript and all data are available for only review purposes from principal investigators 12. PUBLISHERS NOTE This journal remains neutral with regard to jurisdictional claims in published institutional affiliation REFERENCES 1. Saha S, Ghosh R, Mukherjee A. A review on the role of Ayurveda in dermatological disorders. Ayurveda J Health Sci. 2020;6:153-9 2. Sharma S, Singh M, Kumar V. Efficacy of Ayurvedic treatments in chronic skin diseases: A review. J Altern Complement Med. 2021;27:393-400 3. Pandey R, Bhattacharya S, Dey S. Role of Panchakarma in managing skin disorders: An overview. J Ayurveda Integr Med 2019;10:190-5 4. Choudhary S, Yadav S, Gupta S. Efficacy of ayurvedic therapies in eczema: A systematic review. Indian J Dermatol Venereol Leprol 2022;88:459-65 5. Kumar R, Singh P, Kumar N, Haque V, Diwakar R. Pharmacological properties of Boerhavia diffusa : A review. Int J Chem Stud 2018;SP 4:72-80 6. Pandya M, Dave A. A clinical study of Punarnava Mandura in the management of Pandu Roga in old age (geriatric anemia). Ayu 2014;35:252-60 7. Shastri R. Charaka Samhita: Sutrasthana. Varanasi: Chowkhamba Sanskrit Series; 2001 8. Kumar G, Srivastava A, Sharma SK, Gupta YK. Safety evaluation of an Ayurvedic medicine, Arogyavardhini vati on brain, liver and kidney in rats. J Ethnopharmacol 2012;140:151-60 9. Kwon CY, Lee B, Kim S, Lee J, Park M, Kim N. Effectiveness and safety of herbal medicine for atopic dermatitis: An overview of systematic reviews. Evid Based Complement Alternat Med 2020;2020:4140692 10. Kumar V, Singh A, Srivastava S. Panchakarma therapies for skin disorders: A review. Ayurvedic Sci J 2020;10:145-50 11. Thakur K, Singh SP. A review on the role of virechana in various skin diseases. Int Ayu Med J 2021;9:2835-9 12. Mukherjee A, Khuje SM. Virechana karma towards the management of various diseases; An ayurveda review. Int J Med Health Prof Res 2020;7:13-6 13. Nair HJ, Sa S, Monisha M, Joseph SG, Vijaya R, Aiswarya P, et al . A critical review of Jwarahara Yogas of ayurvedic classics: A paradigm to reverse pharmacology. Int J Res Ayurveda Pharm 2021;12:85-95 14. Mashhadi NS, Ghiasvand R, Askari G, Hariri M, Darvishi L, Mofid MR. Anti-oxidative and anti-inflammatory effects of ginger in health and physical activity: Review of current evidence. Int J Prev Med 2013;4 Suppl 1:S 36-42 15. Tewari V, Tewari D, Tewari V. A study of microbial contamination in punarnava mandura. Int Ayurvedic Med J 2024;8:210-7 How to cite this article: Dixit K, Moazzamipeiro F, Narine A, Gupta N. Efficacy of Ayurvedic Therapies in Treating Vicharchika : A Case Report on Holistic Skin Health Management. IRJAY. [online] 2024;7(10);30-39 Available from : https://irjay.com DOI link- https://doi.org/10.48165/IRJAY.2024.71006

Dixit, et al .: Efficacy of Ayurvedic Therapies in Treating Vicharchika 2024; 7(10):30-39 35 Table 4: Diet Plan during Snehapana Diet in Snehapana Kala Daliya, Khichadi, and Lukewarm Water Snehavishrama 1 day Management in Snehavishrama day Sarvang Bahya Sneha (~external application of coconut oil) and Sarvang Bashpa Peti Swedana (~steam therapy) Diet in Snehavishrama day Kaphavruddhikara Aahara, including Khichadi made with Tila (~sesame), Urad Dal (~black gram), rice, Dahee (~yogurt), Urad Dal Kheer (~rice pudding), and Malaeekophta (~a type of preparation) Table 2: Deepana-Pachana Chikitsa Avipathikar Churna 5 gm BD After food Luke Warm Water Dadimastak Churna 5 gm BD Before food Luke Warm Water Panchkola Churna 5 gm BD After food Luke Warm Water Shankh Vati 500 mg BD After food Luke Warm Water Chitrakadi Vati 500 mg BD after food Luke Warm Water Table 3: Ghrita Administration Panchatikta Guggulu Ghrita Ghrita was administered for 7 days, beginning with a dosage of 50 mL and increasing daily until reaching 120 ml, with each dose taken every morning at 7 am. Lukewarm water was administered after ingesting the Ghrita Table 1: Medications and Dosages Medicine Dosage Jvarahara Kashaya 20 mL BD Before food Pashanbhedadi Kwath 20 mL BD Before food Punarnava Mandoora 2-0-2 After food with lukewarm water Arogyavarghini Vati 2-2-2 After food with lukewarm water Manjishtadi Kwath 20 mL BD Before food Shtyadi Churana 3 gm BD After food with lukewarm water Arjun Twak Churana 3 gm BD After food with lukewarm water Table 5: Vamana procedure summary Vega 6 Vega Aantikishuddhi Pittanta Laingikishuddhi Shareeralaghavata Indreeyaprasannata Type of Shuddhi Madhyama Table 6: Samsarjana Krama Chart Day Annakala Aahara 1 st Morning - Evening Peya 2 nd Morning Peya Evening Vilepi 3 rd Morning Vilepi Evening Akrita Yusha 4 th Morning Krita Yusha Evening Akrita Krushara 5 th Morning Krita Krushara Evening Normal Diet Table 7: Ghrita Administration Panchatikta Guggulu Ghrita Ghrita was administered for 7 days, beginning with a dosage of 50 mL and increasing daily until reaching 120 mL, with each dose taken every morning at 7 am. Lukewarm water was administered after ingesting the Ghrita Snehapana day Dose Time of Snehapana Time of Kshudha 1 500 mL 6.45 am 6.30 pm 2 70 mL 7.00 am 6.50 pm 3 90 mL 7.00 am 6.50 pm 4 100 mL 7.00 am 7.00 pm 5 110 mL 7.00 am 7.00 pm 6 120 mL 7.00 am 7.00 pm 7 120 mL 7.00 am 7.00 pm

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