Role of virechana in psoriasis (kitibha kushta) – a case study
Journal name: Ayushdhara
Original article title: Role of virechana in psoriasis (kitibha kushta) – a case study
AYUSHDHARA is an international peer-reviewed journal. It focuses on research in Ayurveda, Yoga, Unani, Siddha, Homeopathy, Allopathy, and Pharmaceutical Sciences.
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Athira C*
PG Scholar, Department of Kayachikitsa, Karnataka Ayurveda Medical College, Karnataka
Ajay Bhat U
Associate Professor, Department of Kayachikitsa, Karnataka Ayurveda Medical College, Karnataka
Ayushdhara:
(A peer-reviewed, bi-monthly open-access journal)
Full text available for: Role of virechana in psoriasis (kitibha kushta) – a case study
Year: 2019
Copyright (license): CC BY-NC-SA 4.0
Download the PDF file of the original publication
Summary of article contents:
Introduction
Psoriasis, a chronic autoimmune condition affecting the skin and joints, significantly impacts the quality of life for many individuals. Its prevalence varies globally, commonly emerging between the second and fourth decades of life and affecting both genders equally. Ayurvedic medicine classifies psoriasis as "Kitibhakushta," predominantly characterized by Vata and Kapha dosha imbalances. This case study details the management of a 49-year-old male patient suffering from long-standing erythrodermic psoriasis, which had persisted despite various allopathic treatments. The study emphasizes the Ayurvedic approach of detoxification (Shodhana) followed by palliative treatments (Shamana) to address the root cause of the condition.
Virechana: The Detoxification Process
A key aspect of treatment in Ayurveda for conditions such as psoriasis is Virechana, which involves medicated purgation to cleanse the body of toxins. The case study details the administration of classical Virechana in conjunction with Deepanapachana, Snehapana, and various herbal treatments. In this instance, the patient underwent a structured schedule that included deep nourishing treatments and followed by Virechana. Improvements in the patient’s condition, particularly in the reduction of skin lesions, itching, and dryness, were noted after this detoxification approach, highlighting the efficacy of Virechana in managing psoriasis.
Importance of Shamana Treatment
Following the cleansing procedures, the patient was placed on Shamana treatments designed to balance the doshas and provide symptomatic relief. These included the use of various Ayurvedic formulations such as Gandhakarasayana and Panchatiktaghritaguggulu, which are known for their soothing effects on the skin and overall health. The results indicated significant improvement in the patient's symptoms, including reduced skin scaling and itching. This component of treatment reinforces Ayurveda’s holistic approach, which not only focuses on detoxification but also aims to restore balance within the body to prevent the recurrence of psoriasis.
Conclusion
This case study serves as evidence of the effectiveness of Ayurvedic treatment for psoriasis, particularly through the strategic use of Shodhana and Shamana therapies. While psoriasis is notoriously difficult to treat, the combination of Virechana and supportive medications not only provided substantial relief for the patient but also demonstrated the potential for holistic therapies to manage chronic skin conditions. The study suggests that continued Ayurvedic treatment can be beneficial for long-term management, underscoring the importance of periodic detoxification to prevent recurrence and promote complete recovery.
FAQ section (important questions/answers):
What is psoriasis and how does it affect patients?
Psoriasis is a chronic autoimmune disease that causes scaly skin lesions. It can significantly impact the physical, emotional, and psychosocial well-being of patients, affecting their quality of life.
What is Virechana and its role in treating psoriasis?
Virechana is a traditional Ayurvedic cleansing therapy aimed at eliminating toxins. In treating psoriasis, it helps balance the body's doshas, primarily Vata and Kapha, thus alleviating skin symptoms and promoting overall health.
What were the treatment outcomes in this case study?
The case study showed significant improvement in symptoms like dryness, itching, and scaling of the skin. After Virechana therapy, the patient experienced reduced lesions and was discharged in an improved condition.
Glossary definitions and references:
Scientific and Ayurvedic Glossary list for “Role of virechana in psoriasis (kitibha kushta) – a case study”. This list explains important keywords that occur in this article and links it to the glossary for a better understanding of that concept in the context of Ayurveda and other topics.
1) Madhyama:
In Ayurveda, 'Madhyama' denotes a medium or balanced state. In the provided text, 'Madhyama' is used to describe aspects such as Pramana (measurements), Ahara Shakti (food intake power), Vyayama Shakti (exercise power), and other parameters of the patient's state. It indicates an average or moderate level in these aspects.
2) Shodhana (Sodhana):
'Shodhana' refers to the Ayurvedic process of purification or detoxification. In the case study, it involves procedures like Virechana (therapeutic purgation) to cleanse the body of accumulated toxins or Doshas. Shodhana is pivotal for treating chronic diseases like Kitibha Kushta (Psoriasis).
3) Kitibha:
'Kitibha' is an Ayurvedic term for a type of skin disease characterized by symptoms such as rough, dry, and discolored skin. It is identified in the text as a Vata-Kapha dominant Kushta, which corresponds to certain types of psoriasis.
4) Karnataka:
'Karnataka' refers to the Karnataka Ayurveda Medical College in Karnataka, India. It's the medical institution where the case study was conducted, highlighting the role of Virechana in treating psoriasis.
5) Medicine:
'Medicine' in the text refers to both modern allopathic treatments and classical Ayurvedic treatments. Modern medicine includes topical steroids, while Ayurvedic Medicine includes Shodhana and Shamana therapies with specific herbal formulations.
6) Disease:
'Disease' in the context of this case study is primarily 'Psoriasis,' a skin condition characterized by scaly papules and plaques. It is also referred to as Kitibha Kushta in Ayurveda, which involves the vitiation of Vata and Kapha Doshas.
7) Kapha:
'Kapha' is one of the three Doshas in Ayurveda, associated with earth and water elements. It contributes to the physical constitution and governs structure and fluid balance. In the case study, psoriasis is linked to Vata-Kapha dominance.
8) Rasa (Rasha):
'Rasa' in Ayurveda refers to the primary essence or sap that nourishes the body. The text mentions rasa as one of the Dhatus (tissues) that can become vitiated in skin diseases like Kitibha Kushta.
9) Samshamana (Samsamana):
'Samshamana' in Ayurveda involves palliative treatments that balance the Doshas without expelling toxins. After the initial Shodhana (purification), the patient in the case study received Samshamana drugs for further management of psoriasis symptoms.
10) Ayurveda (Ayus-veda):
'Ayurveda' is the traditional system of medicine native to India, emphasizing natural treatments and holistic health. The study uses Ayurvedic principles like Shodhana (cleansing) and Samshamana (pacification) to treat psoriasis, denoted as Kitibha Kushta.
11) Mamsa (Mamsha):
'Mamsa' refers to muscle tissue in Ayurveda. The text mentions Mamsa Dhatus when discussing the vitiation of bodily tissues in psoriasis, indicating its involvement in the pathology of the disease.
12) Rakta:
'Rakta' is another essential tissue in Ayurveda, correlating to blood. In the case study, vitiation of Rakta Dhatu is noted as part of the pathology of Kitibha Kushta (Psoriasis), requiring purificatory treatments.
13) Vata:
'Vata' is one of the three Doshas in Ayurveda, associated with air and ether elements. It governs movement and activity in the body. The text identifies Kitibha Kushta as a Vata-Kapha dominant condition, implying that Vata is imbalanced.
14) Drug:
'Drug' or 'Oushadhi' in Ayurveda refers to various herbal formulations used for treatment. In the case study, specific drugs like Laghusutashekhara rasa and Guggulutiktakaghrita are administered for purificatory and palliative treatments.
15) Samshodhana (Samsodhana):
[see source text or glossary: Samshodhana]
16) Sweating (Sweat):
'Sweating' is mentioned in the context of symptoms and conditions like excessive sweating as an aspect of Poorva Roopa (preliminary symptoms) and its reduction after treatment in the patient with psoriasis.
17) Milk:
'Milk' is used as an adjunct in taking specific Ayurvedic medications. For instance, Gandhakarasayana and Panchatiktaghritaguggulu are administered with milk as part of the Shamana therapy in the case study.
18) Abhyanga (Abhyamga):
'Abhyanga' is the Ayurvedic practice of oil massage. In the case study, the patient underwent Sarvanga Abhyanga (full-body massage) with Nalpamaraditaila as part of the preparatory steps leading to Virechana (therapeutic purgation).
19) Samana (Shamana):
'Shamana' refers to treatments aimed at pacifying or balancing the Doshas. After the Shodhana (purification), the patient is given Shamana drugs to manage psoriasis symptoms and restore harmony in the body.
20) Shakti (Sakti):
[see source text or glossary: Shakti]
21) Nidana:
'Nidana' refers to the etiological factors or causes of a disease. In the case study, excessive intake of certain food types and lifestyle factors are identified as Nidana for the vitiation of Doshas leading to psoriasis.
22) Lasika:
'Lasika' in Ayurveda refers to lymph or plasma, involved in the body's nutritional and immune functions. The study mentions Lasika as one of the bodily tissues that get vitiated in Kitibha Kushta (Psoriasis).
23) Shyava (Syava):
'Shyava' describes a dusky or bluish-black discoloration of the skin. It is one of the symptoms observed in Kitibha Kushta (Psoriasis) as indicated in the text. The treatment aims to reduce this discoloration.
24) Family:
[see source text or glossary: Family]
25) Dosha (Dosa):
'Dosha' refers to the three fundamental bio-energies (Vata, Pitta, Kapha) in Ayurveda that regulate physiological and pathological processes. The vitiation of Doshas is central to the pathology of Kitibha Kushta (Psoriasis) discussed in the case study.
26) Varna:
'Varna' denotes the color or complexion of the skin in Ayurvedic diagnosis. The symptom 'Shyava Varna,' referring to dusky discoloration, is a characteristic of Kitibha Kushta (Psoriasis) as described in the text.
27) India:
'India' is the country where the research was conducted, specifically in Karnataka at the Karnataka Ayurveda Medical College, highlighting the regional practice and study of Ayurveda in managing diseases like Psoriasis.
28) Rupa:
'Roopa' in Ayurveda refers to the clinical features or symptoms of a disease. In the provided text, Roopa includes the dry, scaly, and discolored lesions characteristic of Kitibha Kushta (Psoriasis).
29) Food:
[see source text or glossary: Food]
30) Diet:
'Diet' in the case study includes details about the patient's intake, preferences, and its impact on their health. The patient’s mixed diet, preference for spicy and dry fried foods, is cited as a factor affecting their condition.
31) Vyayamashakti (Vyayamasakti, Vyayama-shakti):
[see source text or glossary: Vyayama-shakti]
32) Aharashakti (Aharasakti, Ahara-shakti):
[see source text or glossary: Ahara-shakti]
33) Mamsadhatu (Mamsha-dhatu):
[see source text or glossary: Mamsa-dhatu]
34) Kaphapitta (Kapha-pitta):
'Kapha-pitta' refers to a combination of the two Doshas, Kapha and Pitta. These Doshas are assessed in the patient's constitution (Prakruti) and disease state (Vikruti) to guide treatment in Ayurvedic practice.
35) Mamsagni (Mamsa-agni):
[see source text or glossary: Mamsa-agni]
36) Jatharagni (Jathara-agni):
'Jatharagni' is the digestive fire that governs the digestion and assimilation of food. Impairment in Jatharagni is one of the factors leading to the formation of 'Ama' or toxins, influencing the pathology of Kitibha Kushta (Psoriasis).
37) Anupashaya (Anupasaya):
'Anupashaya' refers to factors that cause aggravation of disease symptoms. In this case study, psoriasis symptoms worsen during winter, which is noted as Anupashaya, guiding the seasonal adaptations in treatment.
38) Anupadesha (Anupadesa, Anupa-desha):
[see source text or glossary: Anupadesha]
39) Icchabhedi (Iccha-bhedi):
'Icchabhedi' is a specific Ayurvedic purgative used in the Virechana procedure. In the case study, it was combined with Trivrutlehya to induce bowel movements and cleanse the Doshas, leading to improved psoriasis symptoms.
40) Adhishthana (Adhisthana):
[see source text or glossary: Adhishtana]
41) Discussion:
'Discussion' in the text examines the results of the treatment, providing an analysis of the efficacy of Virechana and subsequent Shamana therapy in reducing the symptoms of Kitibha Kushta (Psoriasis).
42) Samprapti:
'Samprapti' in Ayurveda is the pathogenesis or the process of disease development. The text details how Nidana (causative factors) lead to the vitiation of Doshas, affecting tissues like Rasa, Rakta, and Mamsa, contributing to Kitibha Kushta (Psoriasis).
43) Siddhanta (Siddha-anta, Siddhamta):
'Siddhanta' refers to the established principles or doctrines in Ayurveda. Chikitsa Siddhanta in the case study guides the use of Shodhana (Virechana) followed by Shamana therapy to treat psoriasis effectively.
44) Samhanana:
[see source text or glossary: Samhanana]
45) Vitiation (Vitiated):
[see source text or glossary: Vitiation]
46) Pramana:
[see source text or glossary: Pramana]
47) Vyayama:
[see source text or glossary: Vyayama]
48) Mandala (Mamdala):
[see source text or glossary: Mandala]
49) Utpatti:
[see source text or glossary: Utpatti]
50) Sparsha (Sparsa):
[see source text or glossary: Sparsha]
51) Snigdha:
'Snigdha' denotes the unctuous property that balances Vata's dry nature. In the context, Snigdha Virechana (oily purgation) was administered to help alleviate dryness and roughness of the skin in Kitibha Kushta (Psoriasis).
52) Pravara:
[see source text or glossary: Pravara]
53) Haridra:
'Haridra' is another name for turmeric, used medicinally in Ayurveda. Haridra Khanda mentioned in the text is an ayurvedic formulation used for its anti-inflammatory and skin-healing properties, administered to the patient with psoriasis.
54) Shabda (Sabda):
[see source text or glossary: Shabda]
55) Sadhya:
[see source text or glossary: Sadhya]
56) Satmya:
[see source text or glossary: Satmya]
57) Srotas (Shrotas):
'Srotas' in Ayurveda are the bodily channels that transport various substances like nutrients and wastes. The text identifies Srotodushti (channel obstruction) in Rasavaha, Raktavaha, and Mamsavaha Srotas contributing to psoriasis pathology.
58) Vyadhin (Vyadhi):
'Vyadhi' is the term for disease in Ayurveda. The specific Vyadhi discussed in the case study is Kitibha Kushta, a chronic skin condition correlated with psoriasis in modern medicine.
59) Nature:
[see source text or glossary: Nature]
60) Khanda (Khamda):
'Khanda' refers to a semi-solid confectionery form of Ayurvedic medicine. In this study, 'Haridra Khanda' is used as Shamana therapy for its beneficial effects on skin conditions.
61) Khara:
'Khara' means rough or coarse. The text describes psoriasis lesions as having Khara Sparsha (coarse touch), indicating the rough nature of the patient's skin affected by Kitibha Kushta.
62) Pitta:
'Pitta' is one of the three Doshas in Ayurveda, associated with fire and water elements. It governs transformation processes, including digestion and metabolism. Pitta-Kapha states are noted in the patient's constitution.
63) Sutra:
'Sutra' refers to a concise aphorism or guideline in Ayurvedic texts. The study follows specific Chikitsa Sutras (treatment guidelines) like the ones for Kushta Chikitsa (treatment of skin diseases) to manage psoriasis.
64) Karma (Karman):
'Karma' here refers to specific therapeutic actions or procedures. The case study describes Virechana Karma (purgation therapy) and Peyadi Samsarjana Karma (dietary regimen post-purgation) as part of the treatment.
65) Kleda:
'Kleda' in Ayurveda refers to accumulated moisture or fluid, which can cause imbalances when in excess. In the case study, the loss of Kleda contributed to Vata aggravation and skin dryness in the patient with psoriasis.
66) Tikta:
'Tikta' refers to the bitter taste, which has detoxifying and purifying properties. Tikta drugs with Snigdha Guna (unctuous nature) were administered to the patient post-Virechana to pacify the remaining Doshas.
67) Ushna (Usna):
'Ushna' refers to heat or warmth. In the case study, Snigdha and Ushna Gunas (warm and unctuous qualities) were enhanced in the treatment to balance the Rooksha (dry) and Khara (rough) qualities in the patient's condition.
68) Ahara:
[see source text or glossary: Ahara]
69) Kandu (Kamdu):
'Kandu' means itching. Severe itching is one of the primary symptoms experienced by the patient in the case study. Effective treatments aimed to reduce Kandu as part of managing Kitibha Kushta (Psoriasis).
70) Bahya:
[see source text or glossary: Bahya]
71) Dhatu:
'Dhatu' refers to the fundamental tissues in Ayurveda. In the case study, the vitiation of Dhatus like Rasa, Rakta, and Mamsa is critical in understanding the pathology and treatment of Kitibha Kushta (Psoriasis).
72) Ayus (Ayush):
'Ayush' in this context likely relates to AYUSHDHARA, the international journal where the case study is published. AYUSH stands for Ayurveda, Yoga, Unani, Siddha, and Homeopathy, systems of traditional medicine practiced in India.
73) Sanga (Samga, Shanga, Shamga):
'Sanga' refers to obstruction or blockage in Ayurvedic terminology. The case study identifies Sanga in Rasavaha, Raktavaha, and Mamsavaha Srotas, contributing to the pathogenesis of psoriasis.
74) Edema (Oedema):
Edema refers to swelling caused by fluid accumulation. In the case study's general examination, the absence of edema is noted, indicating it is not a contributing symptom for the patient.
75) Birth:
[see source text or glossary: Birth]
[Note: The above list is limited to 75. Total glossary definitions available: 82]
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