Classification of Kushtha

Classification of Kushtha (Kashyapa Samhita):
SADHYA: Sidhma, Vicharchika, Pama, Dadru, Kitibha, Kapala, Sthularushka, Mandala, Vishaja.
ASADHYA: Pundarika, Shvitra, Rushyajihva, Shataru, Audumbara, Kankana, Charmadala, Ekakustha, Vipadika.

Classification on the basis of Doshik Predominance (Charaka & Vagbhata)

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Doshik Predominance Name of Kustha

Vata Kapala
Pitta Audumbara
Kapha Mandala, Vicharchika
Vata-Kapha Sidhma, Ekakustha, Alasaka, Charmakhya, Kitibha, Vipadika
Vata-Pitta Rushyajihva
Kapha-Pitta Pundarika, Dadru, Charmadala, Pama, Visphotaka, Shataru
Tridosha Kakanaka

Classification on the basis of Doshik Predominance (Sushruta)
Doshik Predominance Name of Kushtha
Vata Aruna, Parisarpa.
Pitta Rushyajihva, Audumbara, Charmadala, Visarpa, Kapala, Vicharchika, Kitibha, Kankana, Pama.
Kapha Pundarika, Dadru, Sthularushka, Mahakustha, Ekakustha, Sidhma, Raksha.

Doshik Dominance in Vicharchika:
Charaka – Kapha,
Vagbhata – Kapha,
Sushruta – Pitta
Charaka also described symptoms of predominant Dosha in Kustha. It is useful in the diagnosis and management of the disease.

Predominant Dosha-
Vata – Rukshata, Shosa, Toda, Shula, Samkocha, Ayama, Parushya, Kharata, Harsha, Shyava-Arunata
Pitta – Daha, Raga, Parishrava, Paka, Visragandha, Kleda, Angapatana
Kapha – Shwetata, Shaitya, Kandu, Sthairya, Utsedha, Gaurava, Sneha, Kleda
On the basis of foregone discussion it may be said that generally Alpa Dosha are involved in Kshudrakushtha, which do not involve succeeding Dhatu. Hence may not require major medicament i.e. intense Shodhana. Vicharchika is also categorized under Kshudrakustha, so it can be said that in the disease the involved Dosha may be of less (Alpa) intensity, which may localize without involving Gambhira Dhatus and thus may be of slow progression in nature. Sushruta has also included Vicharchika in Kshudra Roga. It indicates towards its chronic and recurrant nature.

VICHARCHIKA – Etymological Consideration:

Vicharchika word is derived from “Charcha” dhatu, Vee- prefix and “Navul?- suffix. It means that a type of Svalpa (Minor type) Kustha
Vicharchika is formed by “Charcha Tarjane” Dhatu by adding „Navul’ to it. Means a type of disease.
“Vichar” means to move in different directions, spread, and expand to differ. Whereas Vicharchika means coating, cover, a form of cutaneous eruption, itching, scab. So, it can be concluded that, it is cutaneous eruption, itching, scab which spread in different directions.

Thus, Vicharchika is derived from “Charcha Adhyane” by adding prefix „Vee; to it. The word Adhyane has two syllables viz. Adhi and Ayne. Adhi means above and Ayne means spread out. Thus it reads as “Visheshate Charchate Adhi Eyate Anaya Sakandu Kshudrapidika Swarupena Charmani Upariti Vicharchika”, which means Kshudrapidika spreads with Kandu elevated on the surface of the skin is termed as Vicharchika.

Vicharchika is one of the skin disease which has been described in Ayurveda under the heading of kushdra kushta. The majority of skin diseases in Ayurveda were mentioned under the braod term kushta. The kushta has been described as follows
“The disease which spoils the skin and makes it ugly is called as kushta”. The description along with their signs symptoms and treatment of all skin diseases prevailing at that period was mentioned by Acharyas of Brihatrayi.

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Means the skin lesion with itching boil (eruption), darkness and profuse oozing21. Vagbhata further mentioned Lasikadhya instead of Bahusrava22

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Means that marked lining, excessive itching and pain and dry lesion on the body called Vicharchika. If this condition occurs in feet with pain then it called as Vipadika. 23
Blackish brown eruption with intense itching and pain is proposed by Kashyapa 24.
Multiple pin head sized eruptions with ulceration and itching is described by Harita
Dark red colored routed lesion with moisture or oozing is opined by Bhela 25.

Nidana Panchaka of Vicharchika

One of the fundamental principles of Ayurveda is the Karya – Karana Siddhaanta. The Kaarya – the production of the disease is not possible without the Karana – Nidana or Hetu. Ultimately the aim of the physician is to cure as well as to prevent the disease. Moreover, the knowledge of Nidana is useful to provide proper guidance for therapy as well as in the prevention of the disease.
Though, there is no specific description about etiological factors of the disease Vicharchika but it being a variety of Kshudra Kustha, the etiological factors of the Kustha are to be accepted as the etiological factors of the Vicharchika.

NIDANA (Etiological factor):-
The knowledge of Nidana plays a great role in the management of the disease. Nidana means the factors responcible for Dosha prakopa by which the disease is produced.
Nidana Parivarjana is the major part of the full treatment. Both in the preventive and treatment aspect, the Nidana holds the key role. In Ayurvedic classics specific etiology for Vicharchika has been not described. So the etiology of Vicharchika has been constructed on the basis of general etiology of Kustha.
Ayurvedic texts has been described Samanya Nidana for all types of Kustha instead of specific Nidanas for particular type of Kustha. In order to present them in an orderly manner Nidanas were categorized in following stages.

1. Aharaja – Diet and dietetic pattern
2. Viharaja – Faulty lifestyle
3. Infections (Sankramika factors)
4. Psychological factors (Manasika karanas)

They have been described by Charaka, Sushruta and Vagbhata:

1) AHARAJA NIDANA (Factors related to food pattern)
Ahara plays more important role than the medicine. Food is able to build up or repair tissue, protects against disease as supply material for the production of health and energy.
1. Sudden change of diet habits from santarpana to apatarpana.
2. Taking of excess spicy, oily food, bakery products, fish, meat in the diet.
3. The adyasana (taking meals before the first meal is digested).
4. By not following the principles of eating food as described by acharyas.
5. Consuming kaphaj ahara and sleeping during the day time inspite of having kaphaja vikara will causes the kushta (Bhel samhita).
6. Taking incompatible foods such as fish with milk, milk and lemon.
7. Excessive use of oils, sweets, fats, bone marrows etc, which provoks the thr twak doshas and vitiated the dushyas (twak, mamsa rakta and lasika).

Aharaja Nidana can be divides as follows:
i) Types of food
ii) Quantity of food
iii) Quality of food
iv) Food incompatibility
v) Faulty dietetic habit

2) VIHARAJA NIDANA – Factors related to behavioural pattern
1. Sudden changes of environment from cold to heat and heat to cold or for staying in the air conditioned rooms and sudden entry into atmosphere (it may be occupational).
2. Excessive sexual act and exercise.
3. Drinking water immediately after getting fatigue.
Mithya vihara is improper physical, vocal and mental activities. Dalhana
divided the Viharaja hetu in to physical, verbal and psychological.
After taking sunbath or any exercise in summer heat the skin temperature rise. After this phenomena sweat gland dilated and perspiration come out and then the person take cold bath this suddenly changes in body temperature disruption and produce histamine.
3) INFECTIONS (Sankramika factors) –
Some types of kushta are said to be of infective origine. They are contagious and spreads from the patients by many ways such as:
1. Conversation with the patient of kushta at close distance.