Distinction Between Kushta And Visarpa

By Dr Raghuram Y.S. MD (Ay) & Dr Manasa, B.A.M.S
Kushta and Visarpa are the ailments often encountered in scientific follow. Each are completely different ailments. Kushta is a gaggle of pores and skin problems and 18 differing kinds have been defined. They manifest in 11 minor and seven main types. Kushta is in comparison with pores and skin ailments typically and leprosy to be particular. However going by way of its varieties we will see that completely different sorts of pores and skin problems have been enumerated below this subject.
Learn – Charak Samhita Kushta Chikitsa – seventh Chapter

Visarpa is manifested in 7 alternative ways, which types 7 kinds of visarpa. It has an exterior and inside manifestation. The kinds brought on by mixture of two doshas and all three doshas have been highlighted within the treatises. These are troublesome to deal with clinically as per Ayurveda. Visarpa is in comparison with herpes. However despite each these ailments being completely different entities why are we discussing the variations between them on this article? It’s because they’ve a similarity in the best way they manifest. The weather involving within the pathogenesis of each these ailments are the identical. Regardless of having the identical pathological components resulting in their causation why one illness is known as as Kushta and the opposite known as as Visarpa? This can be a level of dialogue right here. We have to know this to grasp the character of ailments which manifest in several methods despite having the identical causative components in widespread. This may assist in diagnosing these circumstances correctly and treating them comprehensively.
Learn – Visarpa: Causes, Sorts, Therapy, Medicines

Kushta and Visarpa from elements of pathogenesis factors of view

1. Pathological elements of Kushta
The Sapta Dravya Samgraha 7 elements essentially take part within the manifestation of kushta –

• Vata
• Pitta
• Kapha
• Twak – pores and skin
• Rakta – blood
• Mamsa – muscle
• Ambu / Lasika – serum / lymph / fluid element of the physique

These 7 elements are thought-about as sapta dravyas of the pathogenesis of kushta. It’s necessary that each one these elements are concerned in causation of the illness. Because of permutation and mixture of those elements 7 (maha kushta – main pores and skin ailments) or 11 (kshudra kushta – minor pores and skin ailments) kushtas are fashioned. No pores and skin illness is manifested from single dosha. This implies to inform that each one kinds of kushtas are fashioned by the involvement of all three morbid doshas.

Grasp Charaka has quoted the identical within the 5^th chapter of Nidana Sthana coping with etio-pathogenesis of Kushta. The beneath talked about 7 elements are the causes of kushta when they’re in a state of vitiation. They’re –

• the three doshas – vata, pita and kapha
• the 4 tissues – pores and skin, blood, muscle groups and lymph / fluid element of the physique – that are vitiated by the aggravated doshas

These elements get aggravated collectively and trigger many kinds of kushta. The pores and skin ailments produced by these elements would unfold all around the physique and hassle the affected person.

It is very important notice that Grasp Charaka has used the time period ‘lasika’ in Nidana Sthana and ‘ambu’ in Chikitsa Sthana. Therefore each must be taken as the identical element – synonymous of one another.
Learn – Dhatu – 7 Physique Tissues As Defined In Ayurveda

2. Pathological elements of Visarpa
The pathological elements which ends up in the causation of visarpa are –

• Rakta – blood
• Lasika – lymph / plasma
• Twak – pores and skin
• Mamsa – muscle groups
• Vata
• Pitta
• Kapha

The primary 4 are dushyas i.e. tissues that are contaminated. The final three are doshas. The aggravated doshas vitiate these tissues. All these 7 elements collectively, result in the manifestation of visarpa.

Sanskrit verses

Comparability between the pathological elements of Kushta and Visarpa

If we evaluate the elements talked about in Kusta and Visarpa, it’s the similar 7 elements which trigger each kushta and visarpa. Grasp Charaka has simply modified the chronology of mentioning these elements. In case of Visarpa he has talked about the tissues concerned within the pathogenesis of visarpa first and later the doshas. Then again he has first talked about the doshas and later the tissues. However this doesn’t make any distinction. The elements are the identical.

Grasp Chakrapani provides the clarification for a similar in his commentary (Cha.Chi.21/15) taken from the chapter coping with therapy of Visarpa.

Although the blood and so forth elements are additionally concerned within the causation of Kushta illness (similar to visarpa), the distinction is that in visarpa the doshas are continually in circulation. In kushta the illness is brought on by the identical elements however they accumulate within the physique for an extended time frame earlier than inflicting the illness. Placing it in different method –

• Kushta is brought on by 7 elements after they get amassed within the physique for an extended time frame (stagnant doshas) i.e. the doshas afflict the tissues, get lodged in them and this vicious mixture would trigger kushta in the end of time as and when the pathogenesis completes. On this case, the doshas / elements should not in circulation.
• Visarpa is brought on by the identical 7 elements which trigger kushta however right here the doshas should not stagnant. They afflict the doshas and kind vicious mixtures, they afflict the identical tissues, all three doshas are concerned however the distinction is that the doshas are in a state of circulation. Seeing it the opposite method, the severely aggravated doshas that are in circulation mix with the talked about tissues and trigger visarpa.
  Learn – Rasa Dhatu: Definition, Formation, Circulation, Imbalance Illnesses, Therapy

Simply after briefing these, Chakrapani provides a cross reference of an earlier context of the identical part (kushta chikitsa – chapter coping with therapy of kushta) and tells that pathogenesis and elements concerned and the formation of the illness shall be understood as defined in Kushta chapter.

In Kushta Grasp Chakrapani provides the cross reference of Visarpa and the reason given therein. This justifies the point out of pathogenic elements of kushta in visarpa and vice versa in order to make clear the similarity of the elements concerned in causation of each these ailments but the range of their manifestation and therefore each being named with completely different phrases. Right here, within the context of Kushta, Grasp Chakrapani tells – ‘The identical seven elements concerned within the causation of kushta are additionally concerned within the causation of visarpa. However kushta is brought on by sthira doshas i.e. localized doshas and develops steadily in lengthy time frame. Then again, visarpa is brought on by visarpanashila doshas i.e. the doshas in circulation’.

Allow us to return to the reference in Visarpa. Grasp Charaka tells that blood, serum, pores and skin and muscle groups are the tissues concerned within the causation of visarpa. Other than these, the three doshas concerned within the causation of the illness are the malas. Doshas and malas are completely different elements. However Charaka has talked about the phrase ‘mala’ to explain the doshas concerned within the causation of visarpa. We are able to not often discover these two phrases i.e. dosha and mala getting used collectively.
Learn – Tri Malas – The Three Main Waste Issues Of Physique

Then why did Charaka use the time period mala on this context?
Chakrapani feedback on this and tells – ‘The time period mala used to explain the doshas on this context is to point extreme aggravation of doshas which in flip contaminate the complete physique in a extreme method’. Even within the context of kushta it’s mentioned that Kushta contaminates the physique however in visarpa the contamination is extra extreme and aggressive compared to that which occurs in kushta. This occurs as a result of the aggravation of doshas is extreme and these severely aggravated doshas are in a state of circulation.

Why ought to one know this?
It’s important for the doctor to know these variants. The elements taking part within the pathogenesis often is the similar, however the vicious mixture, the best way wherein these elements combine up and behave thereafter, the route which they take and the completely different varieties they manifest provides these ailments completely different nomenclature. The data of this helps the doctor to diagnose a given illness as kushta or visarpa. This additionally will allow the doctor to differentially diagnose these two circumstances and likewise present complete treatment for each these circumstances. Many remedies, medicines and restrictions for each these ailments are comparable. Even in scientific follow we will see that sure medicines and formulations talked about in kushta are useful in treatment of visarpa and vice versa. Understanding it will assist the doctor in short-listing the widespread remedies and medicines which can be utilized in each circumstances. The doctor may also know the place to make use of comparable and the place to make use of illness particular remedies in order to deal with these circumstances successfully.
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