Changes

ityagnivēśakr̥tē tantrē carakapratisaṁskr̥tē ślōkasthānē āragvadhīyō nāma tr̥tīyō'dhyāyaḥ||3||

ityagnivēśakr̥tē tantrē carakapratisaṁskr̥tē ślōkasthānē āragvadhīyō nāma tr̥tīyō'dhyāyaḥ||3||

Thus ends the third chapter titled [[Aragvadhiya]] in [[Sutras Sthana]] in the treaties composed by Agnivesha and redacted by Charaka. [3]

Thus ends the third chapter titled [[Aragvadhiya]] in [[Sutra Sthana]] in the treaties composed by Agnivesha and redacted by Charaka. [3]

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

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

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

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

The drugs mentioned in verse 3-7 are found effective as kushthaghna (effective in skin diseases), kandughna (effective in pruritus) and arshoghna (effective in hemorrhoids) mahakashaya33. Kuṭaja is indicated in bleeding hemorrhoids while bhallataka is indicated in non-bleeding ones. By adding these two drugs of opposing action, their spectrum of action is enhanced considerably. Their ability to penetrate the affected areas is enhanced further when admixed with gopitta and mustard oil. This combination is particularly effective in treating rectal fistula and hemorrhoids. Sulfur is effective in treating most of the skin diseases and neem is a rich source of sulfur. Minerals like manahshila, kasisa and praval are used commonly for treating skin diseases because of their richness in sulfur. In psoriasis there is a deficiency of fatty acids, sulfur and immunoglobulins in the skin. Oil, ghrita, milk, neem (Azadirachta Indica) and amrita (Tenospora cordifolia) preparations help in correcting those deficiencies. The use of atasi (flax) poultice has anti-inflammatory and analgesic effect in vata vyadhi. amrita (Tinospora cordifolia) and yashtimadhu (liquorice) have anti-inflammatory and analgesic properties and are used for vatarakta. Vesavara and dashamoola are used as analgesics. Dashamoola has analgesic, anti-inflammatory and antiplatelet properties. Shirisha (Albizia lebbeck) is indicated as the best drug for treating dermal toxicity.

The drugs mentioned in verse 3-7 are found effective as ''kushthaghna'' (effective in skin diseases), ''kandughna'' (effective in pruritus) and ''arshoghna'' (effective in hemorrhoids) ''mahakashaya''33. ''Kuṭaja'' is indicated in bleeding hemorrhoids while ''bhallataka'' is indicated in non-bleeding ones. By adding these two drugs of opposing action, their spectrum of action is enhanced considerably. Their ability to penetrate the affected areas is enhanced further when admixed with ''gopitta'' and mustard oil. This combination is particularly effective in treating rectal fistula and hemorrhoids. Sulfur is effective in treating most of the skin diseases and ''neem'' is a rich source of sulfur. Minerals like ''manahshila, kasisa'' and ''praval'' are used commonly for treating skin diseases because of their richness in sulfur. In psoriasis there is a deficiency of fatty acids, sulfur and immunoglobulins in the skin. Oil, ghrita, milk, ''neem'' (Azadirachta Indica) and ''amrita'' (Tenospora cordifolia) preparations help in correcting those deficiencies. The use of ''atasi'' (flax) poultice has anti-inflammatory and analgesic effect in ''vata vyadhi''. ''Amrita'' (Tinospora cordifolia) and ''yashtimadhu'' (liquorice) have anti-inflammatory and analgesic properties and are used for ''vatarakta''. ''Vesavara'' and ''dashamoola'' are used as analgesics. ''Dashamoola'' has analgesic, anti-inflammatory and antiplatelet properties. ''Shirisha'' (Albizia lebbeck) is indicated as the best drug for treating dermal toxicity.

Powdered drug is used most effectively in the form of udvartana (smearing or massaging powdered drugs) on body parts smeared in oil. [8-9]

Powdered drug is used most effectively in the form of ''udvartana'' (smearing or massaging powdered drugs) on body parts smeared in oil. [8-9]

The utility of applying oil before administering powdered medication is to provide passage for lipid-soluble substances. [10-11]

The utility of applying oil before administering powdered medication is to provide passage for lipid-soluble substances. [10-11]

There are various forms of external therapies (churnapradeha, pradeha, lepa, pralepa, udvartana, avachurnana, alepana and pragharsha). Apart from kushtha, other conditions covered under the 32 types of churnapradeha are as follows:

There are various forms of external therapies (''churnapradeha, pradeha, lepa, pralepa, udvartana, avachurnana, alepana'' and ''pragharsha''). Apart from ''kushtha'', other conditions covered under the 32 types of ''churnapradeha'' are as follows:

Table 1: Showing indications of 32 types of churnapradeha  

Table 1: Showing indications of 32 types of churnapradeha  

Total: 32

Total: 32

Alepa has been given due importance as an initial treatment for all types of sopha (swelling). Among the remedies applied internally and externally, it is superior to others because it alleviates pain instantaneously 18  

''Alepa'' has been given due importance as an initial treatment for all types of ''sopha'' (swelling). Among the remedies applied internally and externally, it is superior to others because it alleviates pain instantaneously 18  

Types of lepa (external application): 19  

Types of ''lepa'' (external application): 19  

According to character and therapeutic use, alepa can be divided into three types viz., pralepa, pradeha and alepa. It could be shown as tabulated below-

According to character and therapeutic use, ''alepa'' can be divided into three types viz., ''pralepa, pradeha'' and ''alepa''. It could be shown as tabulated below-

Table 2: Showing character and indications of different types of alepa

Table 2: Showing character and indications of different types of alepa

Pralepa Pradeha Alepa

Pralepa Pradeha Alepa

Indications - Pacifies vata-kapha, cleanses, heals and alleviates inflammatory swelling and pain Normalizes rakta and pitta

Indications - Pacifies vata-kapha, cleanses, heals and alleviates inflammatory swelling and pain Normalizes rakta and pitta

Lepa is of four types, viz. avachurnana (dusting), udvartana (anointing), jalapishtalepana (paste made by mixing with water), and rasakriyalepana (by mixing with semisolids) 22.

''Lepa'' is of four types, viz. ''avachurnana'' (dusting), ''udvartana'' (anointing), ''jalapishtalepana'' (paste made by mixing with water), and ''rasakriyalepana'' (by mixing with semisolids) 22.

   

   

==== Method of application ====

==== Method of application ====

The method of use, quantity, time of application and other pharmacotherapeutic aspects are not in scope of this chapter. However, it is to be noted that an alepa is generally advised for application against the direction of the hair growth (pratiloma) to enhance its penetration (swedavahi shira) 23.

The method of use, quantity, time of application and other pharmacotherapeutic aspects are not in scope of this chapter. However, it is to be noted that an ''alepa'' is generally advised for application against the direction of the hair growth (pratiloma) to enhance its penetration (''swedavahi shira'') 23.

Measurement

==== Measurement ====

The quantity, or dosage, of medication in the case of topical medicines is measured by the thickness of the layer of paste. Typically, it should be equivalent to the thickness of fresh skin of a buffalo 24. Thickness of a layer of pralepa should be equivalent to the thickness of a typical chandana (sandal paste) application. Pradeha is typically applied as a thick paste or bolus (pinda)25. Thus, it is thin and thick pastes for application of pralepa/anulepana and pradeha respectively 26,27.

The quantity, or dosage, of medication in the case of topical medicines is measured by the thickness of the layer of paste. Typically, it should be equivalent to the thickness of fresh skin of a buffalo 24. Thickness of a layer of ''pralepa'' should be equivalent to the thickness of a typical chandana (sandal paste) application. Pradeha is typically applied as a thick paste or bolus (pinda)25. Thus, it is thin and thick pastes for application of pralepa/anulepana and pradeha respectively 26,27.

==== Indication and contraindications ====

==== Indication and contraindications ====