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Journal of Natural & Ayurvedic Medicine Research Article 7 min read

Vicharchika and its Ayurvedic Management

Rawat S*, Pravesh K and Nitesh A
* Corresponding author
ISSN: 2578-4986  10.23880/jonam-16000350  Received: May 19, 2022  Published: June 28, 2022
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Keywords
Vicharchika Kshudra Kushtha Eczema Shodhan Chikitsa
Abstract

Healthy skin is the mirror image of the good health. It performs vital function like act as protective barrier between the body and the external environment. Skin diseases are common manifestation in present era and Eczema is one of them, it not only ruins the quality of life but also has substantial psychological and social impact on patient’s life, particularly because of its visibility. In Ayurveda “Kushnateeti Kushtham” the disease which destroys the affected part of the body (skin) is known as Kushtha. Vicharchika is classified under Kshudra Kushtha characterized by Kandu, Srava and Pidika. The involvement of Vata Dosha is responsible for dry, blackish lesion of eczema, Kapha Dosha is responsible for itching in those affected areas and oozing is due to pitta Dosha.In modern dermatology, the clinical presentation of Vicharchika is analogue to eczema.In eczema patches of skin become inflamed, itchy, red, cracked and rough. Acute phase of eczema includes vesicular and oozing whereas in chronic phase hyper pigmented and thickened scratch marks are seen.

Introduction

Etymology of the Word Vicharchika

The word Vicharchika is derived from Sanskrit origin “charch adhyane” by using the prefix ‘Vee’ to it. The word adhyane has two syllables ‘adhi’ which means ‘above’ and ‘ayane’ means to spread out.

Classical Definition of Vicharchika

• According to Charaka Samhita सकण्डूः पिडका श्यावा बहुस्रावा विचर्चिका | (च.चि. 7/26) Acharya Charaka has defined as blackish eruption with itching and profuse discharge known as Vicharchika [1].

• According to Sushruta Samhita राज्योऽतिकण्ड्वर्तिरुजः सरूक्षा भवन्ति गात्रेषु विचर्चिकायाम् । (सु.नि. 05/12) Acharya Sushruta has described Vicharchika as a condition in which the skin has linear rough lesions with intense itching and pain but when the same symptoms appear at the feet alone, it is termed as Vipadika.[2].

• According to Asthanga Hridya सकण्डूपिटिका श्यावा लसीकाठ्या विचर्चिका | (अ.ह.नि. 14/6) Acharya Vagbhata has mentioned symptom Lasikadhya instead of Bahusrava rest of symptoms of Vicharchika same as that of Acharya Charaka [3].

• According to Bhela Samhita श्यावा रक्ता समुत्पन्ना प्रक्लिन्ना स्राविणी तथा। मांसेनोपचिता युक्ता विज्ञेया सा विचर्चिका ॥ (भेल. चि.6/25) Acharya Bhela has mentioned exact site of lesion (Dhatugatva) i.e., Mamsenopachita [4].

• According to Kashyapa Samhita श्यामलोहित व्रणवेदनास्रावपाकवती विचर्चिका। (का .चि .9/2) Acharya Kashyapa has described special symptoms like Vrana and Paka which indicates pustular eruption [5].

Nidana of Vicharchika [6]

Etiological factors of Kusththa are to be accepted as the etiological factors of Kushtha. Its Nidana can be classified as: Aaharaj Nidana

  • Intake of Chilchim fish with milk
  • Intake of Mulaka and Lasuna with milk
  • Use of Mulaka with Guda
  • Excessive use of alcohol with milk
  • Intake of food mostly containing Yavaka,Uddalaka along with Ksheera, Dadhi and Takra,Kola,Kulatha, Masha,Atasi,Kusumbha and Sneha
  • Continuous intake of Gramya, Audaka and Anupa Mamsa with milk
  • Use of fish, citrus and milk together
  • Excessive use of Navanna, Dadhi, Matsya, Amla, Lavana, Tila,Milk,Guda.
  • Intake of food during indigestion
  • Asatmaya Ahara
  • Intake of polluted water

Rupa of Vicharchika (Table 1)

Viharaja Nidana

  • Physical exercise, sunbath after intake of heavy meal.
  • Sexual intercourse after indigestion, after Snehapaan and Vaman.
  • Sudden changes from cold to heat or heat to cold without judiciously following the rules of gradual changes.
  • Suppression of the urges of emesis.
  • Adharniya Vega Vidharan.
  • Panchakarma Apcharana like improper administration of Snehapan therapy.

Achara Nidana

  • Acts insulting Brahmans, teachers and other respectable persons
  • Indulgence in sinful activities
  • Use of money or material acquired by unfaired means.

Purvarupa of Vicharchika

There are no specific Purvarupa of Vicharchika are mentioned in the text.

As it is classified as one of the Kshudra Kushtha so Purvarupa of Kushtha can be taken as Purvarupa of Vicharchika [6]. स्पर्शाज्ञत्वमतिस्वेदो न वा वैवर्ण्यमुन्नतिः। कोठानां लोमहर्षश्च कण्डूस्तोदः श्रमः क्लमःll व्रणानामधिकं शूलं शीघ्रोत्पत्तिश्चिरस्थितिः। दाहः सुप्ताङ्गता चेति कुष्ठलक्षणमग्रजम् ॥ (Ch. chi 7/ 11-12)

CharakaSushrutaVagbhatBhelaKashyap
KanduRajiKanduShyavaSrava
PidikaAtikanduPidikaSravaRuja
SravaRujaSravaRaktaRukshata
ShyavtaRukshtaShyavtaPraklinnaVrana ,Paka

Table 1: Rupa of Vicharchika.

Samprapti

In classics there is no separate description regarding the Samprapti of Vicharchika so, common Samprapti of Kushtha can be considered. By the various causative factors, all the three doshas are simultaneously provoked, the four Dushyas (Twak, Mansa, Rakta, Lasika) thin out or lose their tone. In these dearanged four Dushyas, the provoked doshas get located. This causes them to become vitiated and so the Kushtha or the skin disease is produced [7].

Samprapti Ghatakas

  • Doshas: Tridosha
  • Dushya: Twak, Rakta,Mansa,Lasika(Ambu)
  • Srotas: Rasa, Rakta,Mansa,Udakavaha
  • Agni: Jatharagini & Dhatwagnimandya
  • Srotodushti: Sang and Vimargagamana
  • Sanchara: Tiryanga Sira
  • Adhisthana: Twaka
  • Roga Marga: Bahya
  • Swabhva: Chirkari

Pathya- Apathya (Table 2)

PATHYAAPATHYA
Laghu annaGuru anna
Tikta shakaDugdha
Purana dhanyaDadhi
Jangala mansaAmla rasa guda
GhritaTila
MudgaAnupa mansa
TriphalaMatsya
BhallatakMansa and vasa
Nimba
Patola

Table 2: Pathya- Apathya.

Sadhya-Asadhyata of Vicharchika

Regarding prognosis of Kushtha it has been stated if it is confined to Twacha, Rakta, Mansa Dhatu of the body involving Vata and Kapha Doshas should be regarded as Sadhya Kushtha whereas if it is confined to Meda Dhatu then it is regarded as Yapya Kushtha and if it is confined to Asthi and Shukra Dhatu and all the three Doshas are involved, having complication then it is considered as Asadhya Kushtha [8]. As Twaka, Rakta Mansa Dhatu are vitiated in the disease Vicharchika, so it may be counted under Sadhya Kushtha.

Updrava [9]

In Charak Nidan 5/11 following complications of Kushtha have been described:

  • Puyasravam
  • Angabheda
  • Trishna
  • Jwara
  • Atisara
  • Daha
  • Daurablya
  • Arochaka
  • Avipaka
  • Angapatan

Chikitsa of Vicharchika

  • There is no special description available in Samhitas regarding the Chikitsa Sutra of Vicharchika. As Vicharchika always involve more than one Dosha, the Chikitsa will vary based on the presence of particular symptoms. The most aggravated symptom should be treated first. The Charaka Samhita offers detailed treatment for each Dosha, although none specifically for Vicharchika.
  • In Bhela Samhita Vicharchika has been mentioned as one of the Virechaya group. It reveals that acharya have favored to conduct the Virechana Karma in Vicharchika.
  • In Vidhishonitya Adhyaya of Sutrasthan, Acharya Charak has mentioned kushtha as one of the diseases of Shonitashraya Roga and Virechana has mean stated as one of the measures for it.
  • General line of treatment stated that all the kushtha are caused by Tridosha, so the treatment is to be carried out according to the predominance of doshas. वातोत्तरेषु सर्पिर्वमनं श्लेष्मोत्तरेषु कुष्ठेषु। पित्तोत्तरेषु मोक्षो रक्तस्य विरेचनं चाग्रे॥ (च.चि७/३९) The treatment of kushtha can broadly be classified into 3 main methods of management:
  • Shodhana -Bahi Parimarjan, Antaha Parimarjan, Shastra Pranidhana
  • Shamana
  • Nidana Parivarjana

Shodhana Chikitsa

Kustha is Tridoshaja Vyadhi. Therefore, first prominent dosha should be treated then anubandha should be treated. When Dosha is potent, then Shodhan Karma advised. वातोत्तरेषु सर्पिर्वमनं श्लेष्मोत्तरेषु कुष्ठेषु। पित्तोत्तरेषु मोक्षो रक्तस्य विरेचनं चाग्रे॥ (च.चि.७/३९) In case of Vata dominant Kushtha Ghrita is indicated & in Kapha dominant Kushtha Vamana is indicated whereas in dominance of Pitta Virechana Karma and Raktamokshan should be done.

Raktamokshan is to be done once in 6 months. Virechana is to be given once in a month. Vamana is to be given once in 15 days.

  • Snehana Acharya Vagbhata says that Kushtha Rogi should be given Snehapan in the stage of Purvarupa. Dose of Snehapan is explained on the basis of capacity of an individual to digest the Sneha in the specific time. Charaka advice Madhyama Matra.
  • Swedana Swedana is given by Nadi Sweda or Vaspa Sweda for very short period before Shodhana. This liquefies the Doshas.
  • Basti Both the types Basti are contraindicated in the general indications but depending upon the situations it can be done.
  • Raktamokshana Acharya Sushruta has categorized Vicharchika (dry eczema) as Pitta Pradhana Kshudra Kushtha. For Pitta Pradhana Kushtha Jalaukavacharana is the ideal treatment.
  • Virechana Karma Best for skin disease where Pitta and Rakta are involved Acharya Charaka stated that Virechana should be done by the utilization of safed Nishoth, Danti root, Triphala. the utilization of Kostha Shuddhi decreased the reoccurrence of the diseases.
  • Vamana Karma Effective treatment for both Pitta and Kapha excess. Acharya Charaka stated that if Kushtha affected the upper part of the body, the patient should be subjected to the procedure of Vamana by the utilization of Madanphala, Mulathi,Parora leaf mixed with the juice of Neem.
  • Nasya Nasya is indicated with the drugs like Saindhava, Danti, Maricha, Pippali etc which are effective against Krimi,Kushtha and Kapha Prakopaja Vikara.
  • Dhoompana Virechanika Dhumpana is indicated in Kushtha, Krimi and Kilasa.
  • Lepa Lepa are topical treatment of anti Kushtha drug will be effective in diseases. Commonly used for the treatment of Vicharchika are Guduchi,Turmeric,Amla,Shatavari,Nimba is that the herb described as kushthaghana by Bhavprakash and its medicated oil is one amongst the simplest healing and disinfectant agents for skin diseases.

Shamana Chikitsa

  • Single drugs: Haridra, Nimba, Amalki, Khadir, Nimb, Patola, Daruharidra, Kasisa, Musta, Lodhra, Sarjrasa, Vidanga, Manahshila, Hartala, Karaveera etc.
  • Specific Preparation for Vicharchika Pathya Churna, Visha Tailam, Durvadh Tailam, Ekvinshati Guguglu, Panchnimb Churna, Edagajadi Lepa, Grihdhumadi Lepa, Aragwadhadi Kwatha, Udaybhaskar Ras, Ras Manikya, Amritankur Loha, Marichadi Taila, Vicharchikari Taila, Neeli Ghrita, Khadir Kwatha,Haridradi Taila, Arka Taila,Lghu And Maha Marichyadi Taila , Ras Manikya, Shadbindu Taila, Vicharchikahar Lepa, Vidangadi Churna, Karanja Taila And Kashmaryadi Lepa etc are specific preparations mentioned in ayurvedic texts.

Nidana Parivarjana

Nidana Parivarjana means to avoid etiologicators factors. This stops further progression of disease, by restricting vitiation of Doshas. Viruddha Ahara and Mithya Ahara Vihara are stated as main etiological factors of Kushtha so they should be avoided.

Conclusion

Vicharchika is Tridoshaja Kapha Pradhana Vyadhi so humid, cold, watery contact may aggravates symptoms of Vicharchika. Excessive intake of Lavana, Katu, Madhura Rasa are most common causative factor for disease like Vicharchika. Viharaja Nidana like Diwaswapana, industrial pollution is also considered as main causative factors for Vicharchika. Most affected site for Vicharchika flexural surfaces like lower legs, axilla and neck. In the contemporary view of Vicharchika it can be correlated to eczema.

Modern science has no satisfactory treatments. It consists of antihistamine pills, oral and topical corticosteroids, topical immunomodulators and Phototherapy by UV and UVB rays. These drugs can give only symptomatic relief and cannot completely cure the disease. So now a day, whole world is gradually turning towards Ayurveda for safe and complete cure of disease.

References

  1. Sharma RK (1998) 1st (Edn.), Vol-III, Charaka Samhita. Chikitsa sthana, Kushta Chikitsadhyaya (Ch-7/26), Varanasi: Chaukhambha Sanskrit series.
  2. Sri Dalhanacharya (2004) Nidana sthana, Kustha nidanam, Sushruta Samhita. Edited by Jadavji Trikamji Acharya, Chaukhambha krisnadas academy, Varansai (Ch-5/13): 285.
  3. Murthy Srikantha KR (1992) Vol-II, 1st (Edn.), Nidana sthana, Kusthasvitra krimi nidanam, Vagbhata-Astanga Hrudaya. Krishnadas Academy, Varanasi (Ch-14/2- 3):136.
  4. Sharma Priya () Bhela Samhita. Reprint edition, Varanasi: Chaukhambha Orientalia Ch -6/25.
  5. Satypala () Shri Kashyap Samhita. Revised by Vatsya, Reprint edition, Varanasi: Chaukhambha Ch 9/2.
  6. Vaidya Harishchandra singh Kushwaha (2012) Vol- 2, Chikitsa Sthana, 7th Chapter, Charak Samhita of Agnivesha. In: Ayurveda Dipaka’s Ayusi (Edn.), Chaukhambha Orientalia,Varanasi.
  7. Shridhar (2014) A Comparative clinical study on vaman and virechana karma in management of vicharchika (eczema). pp: 122.
  8. Sri Dalhanacharya (2004) Sushruta Samhita, Nidana sthana, Kustha nidanam Nibandha sangraha. In: Jadavji Trikamji Acharya (Edn.), Chaukhambha krisnadas academy, Varanasi.
  9. Sharma RK, Bhagwan Dash (1998) Charaka Samhita, Nidana sthana, Kushta Nidanaadhyaya. Chaukhambha Sanskrit series office, Varanasi (Ch-5/11).
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@article{rawat2022,
  title   = {Vicharchika and its Ayurvedic Management},
  author  = {Rawat S, Pravesh K and Nitesh A},
  journal = {Journal of Natural & Ayurvedic Medicine},
  year    = {2022},
  volume  = {6},
  number  = {2},
  doi     = {10.23880/jonam-16000350}
}
Rawat S, Pravesh K and Nitesh A (2022). Vicharchika and its Ayurvedic Management. Journal of Natural & Ayurvedic Medicine, 6(2). https://doi.org/10.23880/jonam-16000350
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TI  - Vicharchika and its Ayurvedic Management
AU  - Rawat S, Pravesh K and Nitesh A
JO  - Journal of Natural & Ayurvedic Medicine
PY  - 2022
VL  - 6
IS  - 2
DO  - 10.23880/jonam-16000350
ER  -