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# ''Manashila, gr̥uhadhuma, ela kasisa, lodhra, arjuna, musta,'' and ''sarja;''

# ''Manashila, gr̥uhadhuma, ela kasisa, lodhra, arjuna, musta,'' and ''sarja;''

These six formulations, when mixed with ''pita-gopitta'' (ox-bile) and ground, and then mixed again with ''sarshapa-taila'' (mustard oil) before their administration by a wise physician in the form of a ''churnapradeha'' (paste), cure ''kushtha''  diseases (which are difficult to treat otherwise), ''kilasa'' (leucoderma) in the early stages, ''sureshalupta'' (alopecia), ''kitibha, dadru'' (ringworm), ''bhagandara'' (fistula), ''arsha'' (piles), ''apachi'' (cervical and axillary lymphadenitis), and ''pama'' (papular eruptions) quickly.[3-7]

These six formulations, when mixed with ''pita-gopitta'' (ox-bile) and ground, and then mixed again with ''sarshapa-taila'' (mustard oil) before their administration by a wise physician in the form of a ''churnapradeha'' (paste), cure ''kushtha''  diseases (which are difficult to treat otherwise), ''kilasa'' (leucoderma) in the early stages, ''sureshalupta'' (alopecia), ''kitibha'' (resembling psoriasis), ''dadru'' (ringworm), ''bhagandara'' (fistula), ''arsha'' (piles), ''apachi'' (cervical and axillary lymphadenitis), and ''pama'' (papular eruptions) quickly.[3-7]

=== Kushthadi formulation-I ===

=== Kushthadi formulation-I ===

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''Kushtha, amritasanga (tuttha), katankateri (daruharidra), kasisa, kampillaka, mustaka, lodhra, saugandhika'' (''gandhatruna'' or sulphur), ''sarjarasa (rala), vidanga, manahshila, ala (haratala),'' and the bark of ''karaviraka'' - mixed and ground into a powder - is used for the purpose of dusting (''avachurnana'') on the body already smeared with oil. This medication helps cure ''dadru'', along with ''kandu'' (itching), as well as all kinds of ''kiṭibha, pama'' and ''vicharchika'' (eczema). [10-11]

''Kushtha, amritasanga (tuttha), katankateri (daruharidra), kasisa, kampillaka, mustaka, lodhra, saugandhika'' (''gandhatruna'' or sulphur), ''sarjarasa (rala), vidanga, manahshila, ala (haratala),'' and the bark of ''karaviraka'' - mixed and ground into a powder - is used for the purpose of dusting (''avachurnana'') on the body already smeared with oil. This medication helps cure ''dadru''(ring worms), ''kandu'' (itching), as well as all kinds of ''kiṭibha'' (resembling psoriasis), ''pama''(papular eruptions) and ''vicharchika'' (eczema). [10-11]

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Both types of ''haridra'', seeds of ''kutaja'', seeds of ''karanja'', tender leaves of ''sumana (jati),'' bark and pith of ''hayamaraka'' ''(karaviraka)'' - mixed with ''kshara'' of ''tila'' (stems of sessamum) - make a good ''lepa'' (for ''kushtha''). [14]

Both types of ''haridra'', seeds of ''kutaja'', seeds of ''karanja'', tender leaves of ''sumana (jati),'' bark and pith of ''hayamaraka'' ''(karaviraka)'' - mixed with ''kshara'' of ''tila'' (alkali preparation of sesame) - make a good ''lepa'' (for ''kushtha''). [14]

===Manahshiladi formulation-II ===

===Manahshiladi formulation-II ===

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''Kola, kulattha, suradaru, rasna, masha, atasi, tailaphalani, kushtha, vachaa, shatahva, yavachurna'' (all in equal quantity), ground with ''amla (kanji),'' is used as a hot ''(ushna) pradeha'' for patients suffering from ''vatika'' disorders. [18]

''Kola, kulattha, suradaru, rasna, masha, atasi, tailaphalani, kushtha, vachaa, shatahva, yavachurna'' (all in equal quantity), ground with ''amla (kanji or a fermented sour beverage),'' is used as a hot ''(ushna) pradeha'' for patients suffering from ''vatika'' disorders. [18]

=== Anup matsyadi ''pradeha'' formulation ===

=== Anup matsyadi ''pradeha'' formulation ===

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A ''pradeha'' prepared by mixing ''prapaundarika, suradaru, kushtha, yashtyahva, ela, kamala, utpala, loha (agaru), eraka, padmaka'' and ''choraka'' with ''ghrita'' is useful in treating ''shiroruja''. [24]

A ''pradeha'' prepared by mixing ''prapaundarika, suradaru, kushtha, yashtyahva, ela, kamala, utpala, loha (agaru), eraka, padmaka'' and ''choraka'' with ''ghrita'' is useful in treating headache ( ''shiroruja'') . [24]

=== Rasna-Haridradi formulation ===

=== Rasna-Haridradi formulation ===

== Vidhi Vimarsha (Applied Inferences) ==

== Vidhi Vimarsha (Applied Inferences) ==

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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''. ''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''. ''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'' (Tinospora 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 anti-platelet 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]

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''Lepa'' is of four types, viz. ''avachurnana'' (dusting), ''udvartana'' (anointing), ''jalapishtalepana'' (paste made by mixing with water), and ''rasakriyalepana'' (by mixing with semisolids) <ref>Ibidem Chakrapānidatta (2), CikitsaSthāna 7/84-96.</ref>

''Lepa'' is of four types, viz. ''avachurnana'' (dusting), ''udvartana'' (anointing), ''jalapishtalepana'' (paste made by mixing with water), and ''rasakriyalepana'' (by mixing with semisolids) <ref>Ibidem Chakrapanidatta (2), Chikitsa Sthana 7/84-96.</ref>

==== 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'') <ref> Ibidem Sushruta Samhitā (9), Su.18/4.</ref>

The method of use, quantity, time of application and other pharmaco-therapeutic 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'') <ref> Ibidem Sushruta Samhitā (9), Su.18/4.</ref>

==== Measurement ====  

==== Quantity and thickness of application ====  

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 <ref>Ibidem Sushruta Samhitā (9), Su.18/10.</ref>. 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'')<ref>Ibidem Dalhana, commentator (18), Su 18/6. </ref>. Thus, it is thin and thick pastes for application of ''pralepa/anulepana'' and ''pradeha'' respectively <ref>Ibidem Sushruta Samhitā (9), Su.18/6.</ref>

 

<ref>YogindraNathSen, commentator, Charak Samhita,Ni.1/36.</ref>

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 moist skin of a buffalo <ref>Ibidem Sushruta Samhita (9), Su.18/10.</ref>. In current times, the thickness measures around 4-5 millimetre. <ref name="Patil lepa"> Patil S, Chaudhary AK. Topical dosages forms (Lepa Kalpana) of Ayurveda: An unexplored treasure. Int J Green Pharm. 2015;9(4):12. Accessed June 1, 2020. https://www.greenpharmacy.info/index.php/ijgp/article/viewFile/579/492</ref>

 

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'')<ref>Ibidem Dalhana, commentator (18), Su 18/6. </ref>. Thus, it is thin and thick pastes for application of ''pralepa/anulepana'' and ''pradeha'' respectively <ref>Ibidem Sushruta Samhitā (9), Su.18/6.</ref>, <ref>YogindraNathSen, commentator, Charak Samhita,Ni.1/36.</ref>

 

It can be stated that the thickness of applications as pradeha(thick paste) is more than or equal to 4 to 5 mm. Pralepa (thin paste)  applications include thickness less than 4 to 5 mm. <ref name="Patil lepa"/>  

==== Indication and contraindications ====

==== Indication and contraindications ====