A Successful Clinical Case Study on Management of Visarpa
Journal name: Ayushdhara
Original article title: A Successful Clinical Case Study on Management of Visarpa
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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Prabhu.K.bhairaji
Final year PG Scholar,Department of Kayachikitsa, SVM AMC, Ilkal, Bagalakot, Karnataka.
Venkatesh Polampalli
Assistant Professor, Department of Kayachikitsa, SVM AMC, Ilkal, Bagalakot, Karnataka.
Ayushdhara:
(A peer-reviewed, bi-monthly open-access journal)
Full text available for: A Successful Clinical Case Study on Management of Visarpa
Year: 2023 | Doi: 10.47070/ayushdhara.v10i4.1290
Copyright (license): CC BY-NC-SA 4.0
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Summary of article contents:
Introduction
Visarpa is a common skin disorder outlined in Ayurvedic literature, characterized by painful skin rashes and acute blister-like outbreaks due to a predominance of Pitta dosha. It is often associated with the viral organism varicella zoster, leading to a condition frequently referred to in modern contexts as shingles. This condition is particularly prevalent among immunosuppressed patients, especially those between the ages of 18 to 40. The treatment modalities within Ayurveda emphasize Raktamokshana, particularly through the method known as Jaloukavacharana, which aims to alleviate the symptoms effectively.
Raktamokshana and Its Efficacy
Raktamokshana, or therapeutic bloodletting, is a key treatment strategy for managing Visarpa. This procedure is integral to Ayurvedic Panchakarma and is implemented to purify the vitiated blood, alleviating acute symptoms associated with the condition. In the discussed clinical case study, a 75-year-old male patient presented with symptoms of Sukshma pidaka and Kandu over the abdomen and back. Raktamokshana was performed successfully, letting down more than 50 ml of vitiated blood. Immediate positive changes were noted post-procedure, with a significant reduction in discomfort.
Shamana Chikitsa: Supplementing the Treatment
After Raktamokshana, Shamana Chikitsa was initiated to further manage the symptoms of Visarpa. This treatment included various Ayurvedic formulations such as Reviral, Nimbadi Guggulu, and Manibhadra Guda, as well as topical applications and decoctions meant to soothe the skin. The combination of these treatments contributed to the alleviation of symptoms like itching, burning, and the formation of rashes over the subsequent days. This multifaceted approach exemplifies the comprehensive nature of Ayurvedic medicine, where a combination of bloodletting and herbal formulations work synergistically to restore balance.
Conclusion
The clinical case study highlights the effective management of Visarpa through a combination of Raktamokshana and Shamana Chikitsa, showcasing the strengths of Ayurvedic practices in resolving acute skin disorders. The successful resolution of symptoms in the patient underscores the importance of addressing underlying dosha imbalances, particularly Pitta dosha and Rakta dosha disturbances, in treating conditions like Visarpa. This case reinforces the relevance of traditional Ayurvedic approaches, especially in contemporary health care settings, for managing viral-induced skin manifestations effectively.
FAQ section (important questions/answers):
What is Visarpa and its cause?
Visarpa is a common Ayurvedic skin disorder characterized by painful rashes and blisters. It is primarily caused by vitiation of Pitta dosha due to factors like the viral organism varicella zoster, leading to symptoms like itching and burning.
How was the patient with Visarpa treated in the case study?
The patient underwent Raktamokshana (therapeutic bloodletting) through Jaloukavacharana, followed by oral medications including Reviral and Nimbadi Guggulu. This treatment resulted in significant symptom relief and marked improvement within a week.
What are the symptoms of Visarpa?
Visarpa presents with symptoms such as intense itching (Kandu), burning sensation (Daha), and red clusters of rashes (Pidaka) that spread across the body. These symptoms are indicative of Pitta dosha imbalance and require immediate treatment.
Glossary definitions and references:
Scientific and Ayurvedic Glossary list for “A Successful Clinical Case Study on Management of Visarpa”. 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) Visarpa:
Visarpa is a viral disease characterized by a painful skin rash and the appearance of acute onset blisters. In Ayurveda, it is considered predominantly a Pitta-dosha disorder due to its rapid spread and severity, affecting mainly younger people.
2) Rakta:
Rakta refers to the blood, which is vitiated in various skin diseases according to Ayurveda. In Visarpa, Rakta is one of the main dushya or tissues affected, necessitating treatments like Raktamokshana to purify the blood.
3) Dosha (Dosa):
Dosha in Ayurveda refers to the three fundamental bodily bio-elements: Vata, Pitta, and Kapha. Visarpa is considered primarily a Pitta-dosha disorder but also involves Vata and Kapha in its pathology.
4) Pitta:
Pitta is one of the three doshas in Ayurveda, characterized by heat and metabolism. Visarpa is primarily a Pitta-dosha disorder, evident from symptoms like burning sensation, redness, and acute inflammation on the skin.
5) Daha:
Daha means burning sensation, a symptom commonly associated with Pitta-dosha disorders like Visarpa. In this clinical case of Visarpa, management aimed to reduce Daha as a primary symptom.
6) Pidaka:
Pidaka refers to small, raised skin lesions or blisters. In the context of Visarpa, Pidaka appear on the skin, causing discomfort and necessitating treatments like Raktamokshana.
7) Raktamokshana (Raktamoksana, Rakta-mokshana):
Rakta-mokshana is a bloodletting procedure used in Ayurveda to purify vitiated blood. This was a primary therapy used to manage the symptoms of Visarpa in this case.
8) Disease:
In Ayurveda, disease such as Visarpa is understood as an imbalance of doshas affecting the body. Management focuses on restoring balance through treatments and medicinal formulations.
9) Vyadhin (Vyadhi):
Vyadhi means disease in Sanskrit. Visarpa is considered a vyadhi associated with skin disorders, predominantly involving the Pitta dosha.
10) Nimba:
Nimba refers to the Neem tree, known for its medicinal properties. In this case study, Nimba was used in formulations to treat Visarpa due to its purifying and anti-inflammatory properties.
11) Roga:
Roga means disease in Sanskrit. In this case, Twacha roga refers to skin diseases caused by dosha imbalances, like the Visarpa predominantly involving Pitta dosha.
12) Rasa (Rasha):
Rasa is the essence or juice, often referring to the body's plasma or nutrients. In the case of Visarpa, one's rasa is affected by vitiation of doshas, requiring treatments like Raktamokshana for purification.
13) Parisheka (Pariseka):
Parisheka refers to the act of sprinkling or pouring medicinal decoctions over affected areas. In this case study, Parisheka with Triphala and Nimba churna was performed to manage Visarpa.
14) Vitiation (Vitiated):
Vitiation means the disturbance or corruption of bodily elements. In the case of Visarpa, the vitiation of Rakta and Pitta dosha is a key factor in its pathology.
15) Triphala (Tri-phala):
Triphala is an Ayurvedic herbal blend consisting of three fruits: Haritaki, Bibhitaki, and Amalaki. It was used for Parisheka in this case to treat Visarpa due to its healing and purifying properties.
16) Guggulu:
Guggulu is a resin used in Ayurvedic medicine for its anti-inflammatory and detoxifying properties. Nimbadi Guggulu was administered in this case to manage the symptoms of Visarpa.
17) Kashaya (Kasaya):
Kashaya is an astringent taste, often used in Ayurvedic treatments. Medicines with Kashaya rasa, like the formulations mentioned, were used to treat symptoms of Visarpa.
18) Prabhu:
Prabhu K. Bhairaji is one of the authors of the clinical case study on the management of Visarpa.
19) Kandu (Kamdu):
Kandu means itching. It is one of the symptoms of Visarpa observed in the patient, though it was absent initially but monitored during the management process.
20) Burning sensation:
Burning sensation, or Daha, is a key symptom of Pitta dosha disorders like Visarpa. The treatment aimed to alleviate this symptom through various Ayurvedic therapies.
21) Pittadosha (Pittadosa, Pitta-dosha):
Pitta-dosha is one of the three bodily bio-elements in Ayurveda responsible for heat and metabolism. Visarpa is primarily characterized as a Pitta-dosha disorder.
22) Karnataka:
Karnataka is the Indian state where the studied case of Visarpa was managed. The patient was residing in Ilkal, Bagalkot district of Karnataka.
23) Ayurveda (Ayus-veda):
Ayurveda is the ancient Indian medical system that involves holistic healing methods. This case study details an Ayurvedic treatment of Visarpa through procedures like Raktamokshana.
24) Haritaki:
Haritaki is one of the three fruits in Triphala, and it was used as part of Nimbadi Guggulu in this case study to treat Visarpa.
25) Shodhana (Sodhana):
Shodhana is a purification therapy in Ayurveda. In the management of Visarpa, Raktamokshana is a Shodhana therapy used to cleanse vitiated blood.
26) Ashraya (Asraya):
Ashraya means the abode or seat. In the context of Visarpa, Rakta is the ashraya of Pitta, playing a crucial role in the disease's pathology.
27) Nimbadi:
Nimbadi Guggulu is an Ayurvedic formulation containing Nimba among other ingredients. It was used in this case to manage Visarpa due to its detoxifying properties.
28) Pittaja (Pitta-ja):
Pittaja refers to conditions caused by vitiation of Pitta dosha. Symptoms like Daha and Pidaka in Visarpa are indicative of a Pittaja vyadhi.
29) Samana (Shamana):
Shamana refers to palliative treatment in Ayurveda. After Shodhana therapy like Raktamokshana, Shamana chikitsa was administered to control Visarpa symptoms.
30) Patola:
Patola is an herb used in Ayurvedic medicine, present in formulations like Nimbadi Guggulu, which was used for treating Visarpa.
31) Family:
Family history was checked in the case study to see if any members had similar complaints. No relevant family history was found in this Visarpa case.
32) Drava:
Drava refers to liquidity, a quality attributed to Pitta dosha which contributes to the rapid spread of Visarpa in the body.
33) Tikta:
Tikta means bitter taste, often used in Ayurvedic medicine for its purifying properties. Herbs with Tikta rasa were used in Visarpa treatment.
34) Blood:
Blood, or Rakta, is integral to the pathology of Visarpa. Raktamokshana was performed to cleanse vitiated blood, key to managing Visarpa.
35) Agni:
Agni refers to digestive fire in Ayurveda. Agnimandya, or weak digestive fire, was observed in the patient, affecting the management of Visarpa.
36) Guda:
Guda refers to jaggery, often used in Ayurvedic formulations like Manibhadra Guda, which was administered to treat Visarpa.
37) Sara (Shara):
Sara refers to flow or quality. In the context of Visarpa, Pitta's sara guna contributes to its rapid spread across the body.
38) Guna:
Guna means quality. The qualities (drava, sara) of Pitta play a significant role in the pathology of Visarpa, necessitating targeted Ayurvedic treatments.
39) Sama (Shama):
Sama means balanced or equal. In the context of assessing doshas during Visarpa management, the Jihva was found to be Sama.
40) Ras (Rash):
Rash appears in Visarpa as painful skin blisters and redness, necessitating treatments like Raktamokshana and Ayurvedic formulations.
41) Agnimandya (Agni-mandya, Agnimamdya):
Agnimandya means weak digestive fire in Ayurveda. It was noted as part of the patient's condition, requiring attention in the management of Visarpa.
42) Discussion:
The discussion in this article covers the Ayurvedic approach to managing Visarpa, emphasizing the effectiveness of Raktamokshana and herbal formulations.
43) Samprapti:
Samprapti refers to the pathogenesis of a disease. For Visarpa, it includes the involvement of dosha, dushya, and srotas, outlining the complete disease mechanism.
44) Ashtavidha (Astavidha, Ashtan-vidha):
Astavidha means eightfold examination. It includes various diagnostic methods like Naadi, Mala, Mutra, etc., used to assess the condition in the Visarpa case.
45) Tridosha (Tridosa, Tri-dosha):
Tridosha refers to the three doshas: Vata, Pitta, and Kapha. An imbalance in these doshas leads to various diseases, including Visarpa.
46) Madhyama:
Madhyama means middle or moderate. In this case, Akruti (body constitution) was assessed as Madhyama for the patient with Visarpa.
47) Pradhana:
Pradhana means primary or chief. In this context, Kashaya-tikta rasa pradhana was used in Shamana aoushadi to manage the Visarpa symptoms.
48) Mokshana (Moksana):
Mokshana refers to the liberation or relief of symptoms. Raktamokshana, as part of Panchakarma, provided significant relief from Visarpa symptoms.
49) Pariksha (Pariksa):
Pariksha means examination. Astavidha pariksha is a comprehensive examination process used to assess the condition of a patient with Visarpa.
50) Pradesha (Pradesa):
Pradesha means region or area. In the Visarpa case, the affected pradesha was the abdomen and back, areas of concentrated symptoms.
51) Sukshma (Suksma, Shukshma):
Sukshma means subtle or small. Sukshma pidaka refers to small blisters, one of the primary symptoms of Visarpa examined in the patient.
52) Vidanga (Vidamga):
Vidanga is an Ayurvedic herb utilized for its anthelmintic and detoxifying properties, a component in Manibhadra Guda used in this Visarpa case.
53) Trivrit (Tri-vrit, Trivrt):
Trivrit is an herb used in Ayurveda, often in detoxifying formulations. It is one of the ingredients in Manibhadra Guda, used to manage Visarpa.
54) Sparsha (Sparsa):
Sparsha means touch. During the examination, the patient's skin was noted as usna (warm) and ruksha (dry) due to the Pitta dosha's involvement in Visarpa.
55) Ghataka:
Samprapti ghataka refers to the factors involved in the pathogenesis of a disease. For Visarpa, it includes Dosha (Vata-kapha), Dushya (Rasa, Rakta, Mamsa), and others.
56) Haridra:
Haridra, or turmeric, has anti-inflammatory properties. It was included in ointments used for the external treatment of Visarpa lesions.
57) Pradhan:
Pradhan means predominant. Kashaya-tikta rasa pradhana indicates the predominant use of astringent-bitter substances in the Shamana aoushadi for Visarpa.
58) Dravya:
Dravya means substance. In this case, Dravya like Nimba and Haridra were used for both internal and external therapies to manage Visarpa.
59) Shabda (Sabda):
Shabda means sound. The patient's Shabda was noted as Prakruta (normal) during the systemic examination in assessing Visarpa symptoms.
60) Ropana:
Ropana means healing. The ointment used for Visarpa lesions contained ingredients like Nimba and Haridra, which have Ropana properties.
61) Ruksha (Ruksa):
Ruksha means dry. During examination, the patient’s skin was noted as Ruksha, a characteristic often associated with Pitta dosha disorders like Visarpa.
62) Dushya (Dusya):
Dushya refers to the tissues targeted in a disease. In Visarpa, the primary dushya include Rasa, Rakta, and Mamsa, requiring targeted treatments.
63) Katuki:
Katuki is an herb with detoxifying properties, used in Ayurvedic formulations like Reviral, which was administered in the treatment of Visarpa.
64) Srotas (Shrotas):
Srotas are channels in Ayurvedic physiology. In Visarpa, the affected srotas include Rasavaha, Raktavaha, and Mamsavaha, influencing treatment strategies.
65) Shyava (Syava):
Shyava means dark or dusky. Shyava varna rakta indicates the appearance of vitiated blood seen during Raktamokshana performed for Visarpa.
66) Kapha:
Kapha is one of the three doshas in Ayurveda, responsible for structure and cohesion. In Visarpa, it is one of the doshas involved along with Pitta and Vata.
67) Karma (Karman):
Karma means action or deed. In this context, Ropana karma refers to the healing action, particularly in the use of ointments for Visarpa lesions.
68) Udara:
Udara means abdomen. The patient suffering from Visarpa displayed symptoms like Pidaka over the abdomen and back, which were the primary areas treated.
69) Mamsa (Mamsha):
Mamsa refers to the muscle tissue. Mamsa is one of the dushya involved in the pathology of Visarpa, affecting treatment approaches.
70) Patra:
Patra refers to leaves. In this context, Panchanimba choorna includes Patra (leaves) as one of the parts used to treat Visarpa through Rakta shodana.
71) Jihva:
Jihva means tongue. During examination, the patient’s Jihva was found to be Sama (balanced), signifying a specific state in the Ayurvedic diagnostic process.
72) Ushna (Usna):
Ushna means warm or hot. The patient’s body was noted to have Ushna sparsha, indicating a Pitta-dosha predominance in the case of Visarpa.
73) Mutra:
Mutra means urine. Mutra pariksha or examination of urine was part of the diagnosis, showing Prakrut (normal) in the Visarpa case patient.
74) Ahara:
Ahara means food or diet. The patient was noted to have a pure vegetarian diet, which could influence the management and prognosis of Visarpa.
75) Sukha:
Sukha means comfort or ease. The treatment aimed to bring sukha by alleviating symptoms like itching and burning in the patient suffering from Visarpa.
[Note: The above list is limited to 75. Total glossary definitions available: 93]
Other Science Concepts:
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