Virechana, Lepa and Fish Pedicure in Vipadika - A Case Study

INTRODUCTION

The word ‘Kushta’ is a broad term, which covers almost all the skin diseases. Kushtha is produced invariably by the vitiation of the seven factors i.e. 3 Doshas and 4 Dushyas¹ ]. But different types of pain, color, shape, specific manifestation etc. are found in Kushtha because of Anshanshakalpana of the Doshas. Charaka explained Kushthas are in fact of innumerable types² ], but for systemic study they are classified into two major groups 7 Maha Kushtha & 11 Kshudra Kushtha³ ]. Sushruta explained that if person dies due to Kushthathen that person suffer with same disease in rebirth⁴ ]. It gives an idea how hazardous disease it is. Sushruta explained that Vicharchika when appear on sole it is considered as Vipadika⁵ . Vipadika is one of the KshudraKushtha,Kashyapa mention it as Asadhya Vyadhi⁶ (Incurable disease); hence it is very difficult to treat.

AIMS AND OBJECTIVES:

1) To assess the efficacy of Virechana in Vipadika.

2) To assess the efficacy of Lepa in Vipadika.

3) To assess the efficacy of fish pedicurein Vipadika.

4) To assess the efficacy of above modalities in Vipadika.

MATERIALS AND METHODS:

The patient having classical signs & symptoms of Vipadika was selected from the O.P.D. of Dr. D. Y. Patil College of Ayurveda, Nerul, Navi Mumbai. A special Proforma including all the etiological factors ofkushtha with dushtilakshanas of dosha, dushya, &srotas etc. were made for assessing the patient. The patient was thoroughly questioned and examined on the basis of proforma to confirm the diagnosis.

Brief History of Patient: Male social worker belonging to Hindu koli community. He is married and having mixed diet. Age is 47yrs. Complained of- Torn skin of both the sole, Pain, Itching, Black & Red edges, Blackish discoloration, Dryness of skin at lower extremity since 1 yr. No history of diabetes, hypertension or allergies was elicited.

Intervention:

Deepana and Pachana (Increase Appetite & Digestion): Tab. Chitrakadi vati, 2 tabs bid, after food, for 3 days.

Snehana (Internal drinking of medicated ghrita): Arohana Krama (Ascending order) snehapana with Panchatikthaghritha, starting from 30 ml and was continued till samyak sneha lakshanas (Proper oleation symptoms) are seen. In this patient snehapana was done for 5 days, upto 170 ml was administered. Samyak lakshanas were seen and then for 3 days Abhyanga(Body Massage) and swedan (Sudation) was done, Nimbataila was used for abhyanga.

Virechana: Abhyadimodaka, 4 tab and Gandharvahastyadi tail 50 ml was given, followed by shunthijala (Ginger water) as anupana.

Fish pedicure: Fish pedicure was carried out after Virechana it was done in 3 sitting, 7 days gap given between each sitting.

Lepa-(External application): JeevantyadiYamak7is applied throughout the whole duration of treatment twice in a day.

OBSERVATIONS AND RESULT

General observations: He shows Madhyamakoshtha, disturbed sleep. The aggravation season is winter season. Pravarashudhi (Proper purification) was noticed in Virechana karma without any complication Patient was relieved from padasphutana, kandu, varna also became prakruta after the completion of intervention.

DISCUSSION AND CONCLUSION

Kushtha whether it is Mahakushtha or Kshudrakushtha it is very difficult to treat; even then ayurvedic modality shows very good effect in this condition. Almost all symptoms are vatakaphapredominant & even tri doshic involvement and located at lower extremity for this Virechana is main line of treatment. This disease requires repeated shodhana(Purification/Detoxification) as explained in treaties⁸ . Highly significant result was found after Virechana(Medicated Purgation) Fish pedicureand Lepa(External application).