Changes

The incurable disease never give up its incurability (never become curable). The curable disease may sometimes become incurable due to misconduct (not following the diet and lifestyle regulations properly). The six (types of) ''kushtha'' are curable except ''kakanaka''. However if not treated properly, they may become incurable due to lack of timely management, improper management and constantly excess aggravation of ''doshas''. [9]

The incurable disease never give up its incurability (never become curable). The curable disease may sometimes become incurable due to misconduct (not following the diet and lifestyle regulations properly). The six (types of) ''kushtha'' are curable except ''kakanaka''. However if not treated properly, they may become incurable due to lack of timely management, improper management and constantly excess aggravation of ''doshas''. [9]

==== Complications of kushtha ====

==== Complications of ''kushtha'' ====

साध्यानामपि ह्युपेक्ष्यमाणानां त्वङ्मांसशोणितलसीकाकोथक्लेदसंस्वेदजाः क्रिमयोऽभिमूर्च्छन्ति; ते भक्षयन्तस्त्वगादीन् दोषाः  पुनर्दूषयन्त इमानुपद्रवान् पृथक् पृथगुत्पादयन्ति- तत्र वातः श्यावारुणवर्णंपरुषतामपि च रौक्ष्यशूलशोषतोदवेपथुहर्षसङ्कोचायासस्तम्भसुप्तिभेदभङ्गान्, पित्तं दाहस्वेदक्लेदकोथस्रावपाकरागान्, श्लेष्मा त्वस्य श्वैत्यशैत्यकण्डूस्थैर्यगौरवोत्सेधोपस्नेहोपलेपान्, क्रिमयस्तु त्वगादींश्चतुरःसिराः स्नायूश्चास्थीन्यपि च तरुणान्याददते  ||१०||  

साध्यानामपि ह्युपेक्ष्यमाणानां त्वङ्मांसशोणितलसीकाकोथक्लेदसंस्वेदजाः क्रिमयोऽभिमूर्च्छन्ति; ते भक्षयन्तस्त्वगादीन् दोषाः  पुनर्दूषयन्त इमानुपद्रवान् पृथक् पृथगुत्पादयन्ति- तत्र वातः श्यावारुणवर्णंपरुषतामपि च रौक्ष्यशूलशोषतोदवेपथुहर्षसङ्कोचायासस्तम्भसुप्तिभेदभङ्गान्, पित्तं दाहस्वेदक्लेदकोथस्रावपाकरागान्, श्लेष्मा त्वस्य श्वैत्यशैत्यकण्डूस्थैर्यगौरवोत्सेधोपस्नेहोपलेपान्, क्रिमयस्तु त्वगादींश्चतुरःसिराः स्नायूश्चास्थीन्यपि च तरुणान्याददते  ||१०||

sādhyānāmapi hyupēkṣyamāṇānāṁ tvaṅmāṁsaśōṇitalasīkākōthaklēdasaṁsvēdajāḥkrimayō'bhimūrcchanti; tē bhakṣayantastvagādīn dōṣāḥ [1] punardūṣayanta imānupadravān pr̥thakpr̥thagutpādayanti- tatra vātaḥ śyāvāruṇavarṇaṁ paruṣatāmapi caraukṣyaśūlaśōṣatōdavēpathuharṣasaṅkōcāyāsastambhasuptibhēdabhaṅgān, pittaṁdāhasvēdaklēdakōthasrāvapākarāgān, ślēṣmā tvasyaśvaityaśaityakaṇḍūsthairyagauravōtsēdhōpasnēhōpalēpān, krimayastu tvagādīṁścaturaḥ sirāḥsnāyūścāsthīnyapi ca taruṇānyādadatē [2] ||10||  

sādhyānāmapi hyupēkṣyamāṇānāṁ tvaṅmāṁsaśōṇitalasīkākōthaklēdasaṁsvēdajāḥkrimayō'bhimūrcchanti; tē bhakṣayantastvagādīn dōṣāḥ [1] punardūṣayanta imānupadravān pr̥thakpr̥thagutpādayanti- tatra vātaḥ śyāvāruṇavarṇaṁ paruṣatāmapi caraukṣyaśūlaśōṣatōdavēpathuharṣasaṅkōcāyāsastambhasuptibhēdabhaṅgān, pittaṁdāhasvēdaklēdakōthasrāvapākarāgān, ślēṣmā tvasyaśvaityaśaityakaṇḍūsthairyagauravōtsēdhōpasnēhōpalēpān, krimayastu tvagādīṁścaturaḥ sirāḥsnāyūścāsthīnyapi ca taruṇānyādadatē [2] ||10||  

sAdhyAnAmapihyupekShyamANAnAMtva~gmAMsashoNitalasIkAkothakledasaMsvedajAHkrimayo~abhimUrcchanti; tebhakShayantastvagAdIndoShAHpunardUShayantaimAnupadravAnpRuthakpRuthagutpAdayanti- tatravAtaHshyAvAruNavarNaMparuShatAmapica raukShyashUlashoShatodavepathuharShasa~gkocAyAsastambhasuptibhedabha~ggAn, pittaMdAhasvedakledakothasrAvapAkarAgAn, shleShmAtvasyashvaityashaityakaNDUsthairyagauravotsedhopasnehopalepAn, krimayastutvagAdIMshcaturaHsirAHsnAyUshcAsthInyapicataruNAnyAdadate ||10||  

sAdhyAnAmapihyupekShyamANAnAMtva~gmAMsashoNitalasIkAkothakledasaMsvedajAHkrimayo~abhimUrcchanti; tebhakShayantastvagAdIndoShAHpunardUShayantaimAnupadravAnpRuthakpRuthagutpAdayanti- tatravAtaHshyAvAruNavarNaMparuShatAmapica raukShyashUlashoShatodavepathuharShasa~gkocAyAsastambhasuptibhedabha~ggAn, pittaMdAhasvedakledakothasrAvapAkarAgAn, shleShmAtvasyashvaityashaityakaNDUsthairyagauravotsedhopasnehopalepAn, krimayastutvagAdIMshcaturaHsirAHsnAyUshcAsthInyapicataruNAnyAdadate ||10||  

If the curable diseases are neglected (not treated), then they are also afflicted with putrefaction of skin, muscle tissue, blood, lymph and swedaja krimi (maggots or micro-organisms). The krimi get nourishment from the decayed skin etc. and further vitiate doshas leading to variety of complications corresponding to individual doshas as follows:   

If the curable diseases are neglected (not treated), then they are also afflicted with putrefaction of skin, muscle tissue, blood, lymph and ''swedaja krimi'' (maggots or micro-organisms). The ''krimi'' get nourishment from the decayed skin etc. and further vitiate ''doshas'' leading to variety of complications corresponding to individual ''doshas'' as follows:  

Thus  due to vata, blackish and downy red discoloration appears, roughness, dryness, piercing  pain, emaciation (atrophy), pricking  pain, tremors, horripilation, constriction, exhaustion, stiffness, numbness, ulceration and fissures;   

   

Pitta causes burning sensation, sweating, moistening, putrefaction, discharge, suppuration and redness;  

*Due to ''vata'', blackish and downy red discoloration appears, roughness, dryness, piercing  pain, emaciation (atrophy), pricking  pain, tremors, horripilation, constriction, exhaustion, stiffness, numbness, ulceration and fissures;   

Kapha causes whiteness, coldness, itching, immobility, heaviness, protuberance, unctuousness and coating, maggots eat up the skin etc. (skin, flesh, blood, lymph) vessels, ligaments  and cartilages. [10]

*''Pitta'' causes burning sensation, sweating, moistening, putrefaction, discharge, suppuration and redness;  

*''Kapha'' causes whiteness, coldness, itching, immobility, heaviness, protuberance, unctuousness and coating, maggots eat up the skin etc. (skin, flesh, blood, lymph) vessels, ligaments  and cartilages. [10]

 

अस्यां चैवावस्थायामुपद्रवाः कुष्ठिनं स्पृशन्ति; तद्यथा- प्रस्रवणमङ्गभेदः पतनान्यङ्गावयवानां तृष्णाज्वरातीसारदाहदौर्बल्यारोचकाविपाकाश्च, तथाविधमसाध्यं विद्यादिति||११||  

अस्यां चैवावस्थायामुपद्रवाः कुष्ठिनं स्पृशन्ति; तद्यथा- प्रस्रवणमङ्गभेदः पतनान्यङ्गावयवानां तृष्णाज्वरातीसारदाहदौर्बल्यारोचकाविपाकाश्च, तथाविधमसाध्यं विद्यादिति||११||  

asyāṁ caivāvasthāyāmupadravāḥ kuṣṭhinaṁ spr̥śanti; tadyathā- prasravaṇamaṅgabhēdaḥpatanānyaṅgāvayavānāṁ tr̥ṣṇājvarātīsāradāhadaurbalyārōcakāvipākāśca, tathāvidhamasādhyaṁvidyāditi||11||

asyāṁ caivāvasthāyāmupadravāḥ kuṣṭhinaṁ spr̥śanti; tadyathā- prasravaṇamaṅgabhēdaḥpatanānyaṅgāvayavānāṁ tr̥ṣṇājvarātīsāradāhadaurbalyārōcakāvipākāśca, tathāvidhamasādhyaṁvidyāditi||11||

asyAMcaivAvasthAyAmupadravAHkuShThinaMspRushanti; tadyathA- prasravaNama~ggabhedaHpatanAnya~ggAvayavAnAMtRuShNAjvarAtIsAradAhadaurbalyArocakAvipAkAshca, tathAvidhamasAdhyaMvidyAditi||11||  

asyAMcaivAvasthAyAmupadravAHkuShThinaMspRushanti; tadyathA- prasravaNama~ggabhedaHpatanAnya~ggAvayavAnAMtRuShNAjvarAtIsAradAhadaurbalyArocakAvipAkAshca, tathAvidhamasAdhyaMvidyAditi||11||  

During this stage, a patient of kushtha afflicts with complications such as- excessive discharge, ulceration of body parts, sequestration of body  parts (necrosis of phallenges), thirst, fever, diarrhea, burning sensation, debility, anorexia , indigestion. Such types of kushtha should be known as incurable. [11]

During this stage, a patient of ''kushtha'' afflicts with complications such as- excessive discharge, ulceration of body parts, sequestration of body  parts (necrosis of phallenges), thirst, fever, diarrhea, burning sensation, debility, anorexia, indigestion. Such types of ''kushtha'' should be known as incurable. [11]

Summary

 

==== Summary ====

 

भवन्ति चात्र-  

भवन्ति चात्र-  

साध्योऽयमिति यः पूर्वं नरो रोगमुपेक्षते|  

साध्योऽयमिति यः पूर्वं नरो रोगमुपेक्षते|  

स किञ्चित्कालमासाद्य मृत एवावबुध्यते||१२||  

स किञ्चित्कालमासाद्य मृत एवावबुध्यते||१२||  

यस्तु प्रागेव रोगेभ्यो रोगेषु तरुणेषु वा|  

यस्तु प्रागेव रोगेभ्यो रोगेषु तरुणेषु वा|  

भेषजं कुरुते सम्यक् स चिरं सुखमश्नुते||१३||  

भेषजं कुरुते सम्यक् स चिरं सुखमश्नुते||१३||  

यथा ह्यल्पेन यत्नेन छिद्यते तरुणस्तरुः|  

यथा ह्यल्पेन यत्नेन छिद्यते तरुणस्तरुः|  

स एवातिप्रवृद्धस्तु छिद्यतेऽतिप्रयत्नतः||१४||  

स एवातिप्रवृद्धस्तु छिद्यतेऽतिप्रयत्नतः||१४||  

एवमेव विकारोऽपि तरुणः साध्यते सुखम्|  

एवमेव विकारोऽपि तरुणः साध्यते सुखम्|  

विवृद्धः साध्यते कृच्छ्रादसाध्यो वाऽपि जायते||१५||  

विवृद्धः साध्यते कृच्छ्रादसाध्यो वाऽपि जायते||१५||  

तत्र श्लोकः-  

तत्र श्लोकः-  

सङ्ख्या द्रव्याणि दोषाश्च हेतवः पूर्वलक्षणम्|  

सङ्ख्या द्रव्याणि दोषाश्च हेतवः पूर्वलक्षणम्|  

रूपाण्युपद्रवाश्चोक्ताः कुष्ठानां कौष्ठिके पृथक्||१६||  

रूपाण्युपद्रवाश्चोक्ताः कुष्ठानां कौष्ठिके पृथक्||१६||  

bhavanti cātra- sādhyō'yamiti yaḥ pūrvaṁ narō rōgamupēkṣatē|  

bhavanti cātra- sādhyō'yamiti yaḥ pūrvaṁ narō rōgamupēkṣatē|  

sa kiñcitkālamāsādya mr̥ta ēvāvabudhyatē||12||  

sa kiñcitkālamāsādya mr̥ta ēvāvabudhyatē||12||  

yastu prāgēva rōgēbhyō rōgēṣu taruṇēṣu vā|  

yastu prāgēva rōgēbhyō rōgēṣu taruṇēṣu vā|  

bhēṣajaṁ kurutē samyak sa ciraṁ sukhamaśnutē||13||  

bhēṣajaṁ kurutē samyak sa ciraṁ sukhamaśnutē||13||  

yathā hyalpēna yatnēna chidyatē taruṇastaruḥ|  

yathā hyalpēna yatnēna chidyatē taruṇastaruḥ|  

sa ēvātipravr̥ddhastu chidyatē'tiprayatnataḥ||14||  

sa ēvātipravr̥ddhastu chidyatē'tiprayatnataḥ||14||  

ēvamēva vikārō'pi taruṇaḥ sādhyatē sukham|  

ēvamēva vikārō'pi taruṇaḥ sādhyatē sukham|  

vivr̥ddhaḥ sādhyatē kr̥cchrādasādhyō vā'pi jāyatē||15||  

vivr̥ddhaḥ sādhyatē kr̥cchrādasādhyō vā'pi jāyatē||15||  

tatra ślōkaḥ- saṅkhyā dravyāṇi dōṣāśca hētavaḥ pūrvalakṣaṇam|  

tatra ślōkaḥ- saṅkhyā dravyāṇi dōṣāśca hētavaḥ pūrvalakṣaṇam|  

rūpāṇyupadravāścōktāḥ kuṣṭhānāṁ kauṣṭhikē pr̥thak||16||  

rūpāṇyupadravāścōktāḥ kuṣṭhānāṁ kauṣṭhikē pr̥thak||16||  

bhavanticAtra-  

bhavanticAtra-  

sAdhyo~ayamitiyaHpUrvaMnarorogamupekShate| saki~jcitkAlamAsAdyamRutaevAvabudhyate||12||  

sAdhyo~ayamitiyaHpUrvaMnarorogamupekShate| saki~jcitkAlamAsAdyamRutaevAvabudhyate||12||  

yastuprAgevarogebhyorogeShutaruNeShuvA| bheShajaMkurutesamyaksaciraMsukhamashnute||13|| yathAhyalpenayatnenachidyatetaruNastaruH| saevAtipravRuddhastuchidyate~atiprayatnataH||14||  

 

yastuprAgevarogebhyorogeShutaruNeShuvA| bheShajaMkurutesamyaksaciraMsukhamashnute||13||  

 

yathAhyalpenayatnenachidyatetaruNastaruH| saevAtipravRuddhastuchidyate~atiprayatnataH||14||

evamevavikAro~apitaruNaHsAdhyatesukham| vivRuddhaHsAdhyatekRucchrAdasAdhyovA~apijAyate||15||  

evamevavikAro~apitaruNaHsAdhyatesukham| vivRuddhaHsAdhyatekRucchrAdasAdhyovA~apijAyate||15||  

tatrashlokaH-  

tatrashlokaH-  

sa~gkhyAdravyANidoShAshcahetavaHpUrvalakShaNam| rUpANyupadravAshcoktAHkuShThanAMkauShThikepRuthak||16||

sa~gkhyAdravyANidoShAshcahetavaHpUrvalakShaNam| rUpANyupadravAshcoktAHkuShThanAMkauShThikepRuthak||16||

The individual, who neglects the disease in early stage by assuming it as curable,( doesn’t take treatment at early stage) can be regarded as dead after a lapse of time( due to complications). The individual who took treatment properly prior to full manifestation of disease or in its early stage attains happiness for long time. Just as a tender plant is easy to cut down with a little effort, but the same require great effort when fully grown.

The individual, who neglects the disease in early stage by assuming it as curable,( does not take treatment at early stage) can be regarded as dead after a lapse of time(due to complications). The individual who took treatment properly prior to full manifestation of disease or in its early stage attains happiness for long time. Just as a tender plant is easy to cut down with a little effort, but the same require great effort when fully grown.

 

Likewise, a disease is easily curable in the early stage; it becomes incurable or difficulty to cure as it reaches the advanced stage.[12-15]

Likewise, a disease is easily curable in the early stage; it becomes incurable or difficulty to cure as it reaches the advanced stage.[12-15]

इत्यग्निवेशकृते तन्त्रे चरकप्रतिसंस्कृते निदानस्थाने कुष्ठनिदानं नाम पञ्चमोऽध्यायः||५||  

इत्यग्निवेशकृते तन्त्रे चरकप्रतिसंस्कृते निदानस्थाने कुष्ठनिदानं नाम पञ्चमोऽध्यायः||५||  

ityagniveshakRutetantrecarakapratisaMskRutenidAnasthAnekuShThanidAnaMnAmapa~jcamo~adhyAyaH||5||

ityagniveshakRutetantrecarakapratisaMskRutenidAnasthAnekuShThanidAnaMnAmapa~jcamo~adhyAyaH||5||

Tattva Vimarsha:

 

=== ''Tattva Vimarsha'' ===

 

• Kushtha disease is the result of combined and simultaneous involvement of all the three dosha and subsequently vitiation of the four body constituents i.e. rasa (twak-skin), mamsa(muscle tissue), rakta(blood), and lasika(lymph).

• Kushtha disease is the result of combined and simultaneous involvement of all the three dosha and subsequently vitiation of the four body constituents i.e. rasa (twak-skin), mamsa(muscle tissue), rakta(blood), and lasika(lymph).

• There can be infinite clinical presentations of kushtha [skin diseases] depending upon severity of combination of abovementioned vitiating factors.

• There can be infinite clinical presentations of kushtha [skin diseases] depending upon severity of combination of abovementioned vitiating factors.

• If the curable Kushtha are not timely treated, it leads to favorable environment to growth of micro-organisms. The micro-organisms grow on the vitiated Twak, Rakta, Mamsa, and Lasika leading to various severe skin lesions.  

• If the curable Kushtha are not timely treated, it leads to favorable environment to growth of micro-organisms. The micro-organisms grow on the vitiated Twak, Rakta, Mamsa, and Lasika leading to various severe skin lesions.  

• The curable disease can become incurable due to improper management, exposure to causative factors and aggravation of dosha. However, the incurable diseases are never curable.  

• The curable disease can become incurable due to improper management, exposure to causative factors and aggravation of dosha. However, the incurable diseases are never curable.  

Vidhi Vimasha:

 

=== ''Vidhi Vimarsha'' ===

 

Three chapters are devoted to dermatological disorders, present chapter and Cikitsa Sthana chapter 7 (kushtha chikitsa) and 21(visarpa chikitsa). Present chapter deals with  seven types of Kushtha, while in Chi. 7 all eighteen types have been described and have been given the name of Mahakushtha (major) and Kshudra kushtha (Minor). After reviewing the symptoms of seven major types it is clear that it covers a progressive disorder of skin leading to loss of organs and impaired sensation (sensory neuropathy).  According to some commentators Kshudra kushtha is a  group of mild and localized skin diseases, which runs a chronic course.

Three chapters are devoted to dermatological disorders, present chapter and Cikitsa Sthana chapter 7 (kushtha chikitsa) and 21(visarpa chikitsa). Present chapter deals with  seven types of Kushtha, while in Chi. 7 all eighteen types have been described and have been given the name of Mahakushtha (major) and Kshudra kushtha (Minor). After reviewing the symptoms of seven major types it is clear that it covers a progressive disorder of skin leading to loss of organs and impaired sensation (sensory neuropathy).  According to some commentators Kshudra kushtha is a  group of mild and localized skin diseases, which runs a chronic course.

Most of the diseases are classified on the basis of dosha predominance. There is variable interplay of three dosha and four dushya in Kushtha, which can present as seven types, eighteen types and innumerable types on the basis of symptoms, color, location, prognosis and treatment. (see chart).

Most of the diseases are classified on the basis of dosha predominance. There is variable interplay of three dosha and four dushya in Kushtha, which can present as seven types, eighteen types and innumerable types on the basis of symptoms, color, location, prognosis and treatment. (see chart).