BuIUnd.lnst.Hist.Med. Vol. XXVII. 1997. pp. 119 to 125

HISTORICAL REVIEW OF VICHARCHIKA AS PERAYURVEDIC CLASSICS

R.KUMARASWAMY* P.K.J.P. SUBHAKTA**

ABSTRACTVicharchika which is one of the common skin diseases, is most prevalent

among masses whether rural or Urban. A critical peep with regard to this into thevarious Ayurvedic Classics reveals that, the various kushtha rogas (includingVicharchika) were known to ancients of remote antiquity. Though all Ayurvedicclassics have described eighteen varieties of Kushthas dividing into two maingroups viz. Mahakushthas and Kshudra Kushthas, but they differ in nomenclature,order, description, doshas involved and prognosis etc.

In Ayurveda all skin disorders havebeen classified mainly into two groupsviz. Mahakushthas and KshudraKushthas, Vicharchika has been de-scribed under Kshudra Kushthas(Cha.Nid.Chap.5.shloka.4),1 Vicharchika,which is one of the common skin dis-eases is most prevalent among massesboth rural and urban. It is most baneful,obstinate and highly troublesome dis-ease. A critical peep with regard to thisinto the Ayurvedic classics is sufficientenough to denote that the variousKushtharogas (including Vicharchika)were known to ancients of remote antiq-uity.

In Ayurveda "Kushtha" is defined as"Kushnateeti Kushtham" the diseasewhich destroys the effected part of thebody (skin) is called Kushtha(Cha.Chi.Chap.7, Shloka.S).' Being avariety of Kushtha, Vicharchika also de-stroysaffected partoftheskin. The wordKushtha is derived from the root Kushameans that which comes out from theinner part of the body to the outer part.(Ayu, Vya.Vig. 2nd part, P.No. 249,Chap. 13)5. When the three vitiated

doshas provoke the four body elements(viz. Twak, Mamsa, Rakta & Ambu) andif this derangement of the seven dravyasnot cured a disease is formed inside thebody manifests itself on the skin and ,which is called "Kushtham"(Mad.Nid.Chap.as)".

According to Sushruta. uncuredKushtha raga is the most painful andmost troublesome of all diseases be-cause it causes constant trouble.(Sus.Nid.Chap. V Shlokas 23-44).2Kushtharogas are said to be infectiousexcept the Shvitra (Leukoderma) that iswhy Shvitra has not been included in thevarieties of Kushtharoga (Cha.Chi. P .No.248).1Classification:

"Ayurvedic classics have given thenumber of Kushthas as eighteen out ofwhich, seven are called Mahakushthasand tile remaining eleven asKshudrakushthas. All the Kushtharogasare described elaborately in Ayurveda.There seems some differences of opin-ion among different authorities ofAyurveda with regard to nomenclatureand order in each group as shown in thetable No. I & II.

• Research Officer (Ay), Indian Institute of History of Medicine, OMC Building, Putlibowli, Hyderabad, 500195 .•• Asst. Research Officer (Ay), Indian Institute of HistoryofMedicine OMC Building Putlibowli, Hyderabad,(lndia)

120 Historical Review of Vicharchika - Swamy & Subhakta

TABLE NO. IMAHA KUSHTHAS ACCORDING TO BRIHATTRAYEE

CHARAKA SAMHITA SUSHRUTA SAMHITA ASHTANGA HRIDAYA

S.No. Name S.No. Name S.No. Name

1. Kapala Kushtha 4. Kapala Kushtha 1. Kapala Kushtha2. Udumbar Kushtha 2. Udumbara Kushtha 2. Udumbara Kushtha3. Mandala Kushtha 3. Mandala Kushtha4. Rishya Jihwa Kushtha 3. Rishya Jihwa Kushtha 7. Rishya Jihwa Kushth5. Pundarika Kushtha 6. Pundarika Kushtha 5. Pundarika Kushtha6. Sidhma Kushtha7. Kakanaka Kushtha 5. Kakanaka Kushtha 6. Kakanaka Kushtha

1. Aruna Kushtha7. Oadru Kushtha 4. Oadru Kushtha

TABLE NO. IIKSHUDRA KUSHTHAS ACCORDING TO BRIHATTRAYEE

CHARAKA SAMHITA SUSHRUTA SAMHITA ASHTANGA HRIDAYA

S.No. Name S.No. Name

3. Eka Kushtha1 Eka Kushtha2. Charma Kushtha3. Kitibha Kushtha4. Vipadika Kushtha5. Alasaka Kushtha6. Oadru Kushtha7. Charrnadala Kushtha8. Pama Kushtna9. Visphotaka Kushtha10. ShCltaru Kushtha11. Vicharchika Kushtha

9. Kitibha Kushtha

4. Charmadala Kushtha10 Pama Kushtha

8. Vicharchika Kushtha1. Sthularushka Kushtha2. Mahakushtha5. Visarpa Kushtha6. Parisarpa Kushtha7. Sidhma Kushtha11. Rakasa Kushtha

S.No. Name

3. Eka Kushtha2. Charma Kushtha4. Kitibha Kushtha7. Vipadika Kushtha6. Alasaka Kushtha

11.Charmadala Kushtha10. Parna Kushtha9. Visphotaka Kushtha8. Silataru Kushtha1. Vicharchika Kushtha

5. Sidhma Kushtha

Bu/l.lnd./nst.Hist.Med. Vol. XXV/I. 1997

Coming to the order of diseasesCharaka mentioned Vicharchika in lastnumber of Kshudra Kusthas (Cha-Chi.Chap.7, Shloka.13)' and it wasfollowed by Madhavakara (Mad.Nid.Chap. -49 Shloka 17).4 But in Sushruta itis mentioned at 8th number (Sus.Nid.Chap.49, shtokas 4-6)2, whereasVagbhata mentioned, Vicharchika firstin order of Kshudra kushtha group(Ash.Hri. Nid.Chap.14, Shloka 7)3.

According to Ayurvedic classicsVicharchika can be classified into twovarieties.1. Shushka (Dry) Vicharchika.2. Ardra (Wet) Vicharchika.Signs And Symptoms:

According to Charaka the skin in

121

Vicharchika is profusely weeping withdark eruptions, and itching (Cha.Chi.Chap.7, Shloka 25).' But Sushrutaexplains that when in the hands and feetetc. linear rough lessions with intenseitching and pain starts, the malady isnamed Vicharchika. But when the sameitching burning and pain experienced inthe feet alone it is termed as Vipadika(Sus.Nid.Chap.5. Shlokas 9-11).2 Thereis no antagonism regarding signs and -symptoms. But there are somedifferences of opinion among Brihattra-yee regarding ascribed doshas to theMaha Kushthas and Kshudra Kushthasrespectively, as shown in the followingtwo tables.

TABLE NO. IIIASCRIBED DOSHAS TO THE MAHAKUSHTHAS ACCORDING

TO BRIHATTRAYEE

S.No. NAME OF THE KUSHTHAS CHARAKA SUSHRUTA ASHTANGASAMHITA SAMHITA HRIDAYA

1. Kapala Kushtha Vat a Pitta Vat a2. Audumbara Kushtha Pitta Pitta Pitta3. Mandala Kushtha Kapha Kapha4. Rishyajihwa Kushtha Vatapitta Pitta Vatapitta5. Pundarika Kushtha Kapha Pitta Kapha Kaphapitta6. Sidhma Kushtha Vatakapha7. Kakanaka Kushtha Tridosha Pitta Tridosha8. Aruna Kushtha Vat a9. Dadru Kushtha Kapha Kaphapitta.

122' Historical Review of Vicharchika - Swamy & Subhakta

TABLE IVASCRIBED DOS HAS TO THE KSHUDRA KUSHTHAS ACCORDING

TO BRIHATTRAYEE

S.No. NAME OF THE KUSHTHAS CHARAKA SUSHRUT ASAMHITA SAMHITA

ASHTANGAHRIDAYA

1.2.3.4.5.6.7.8.9.10.11.12.13.14.15.16.17.

Eka KushthaCharma KushthaKitibha KushthaVipadika KushthaAlasaka KushthaDadru KushthaCharmadala KushthaPama KushthaVisphotaka KushthaShataru KushthaVicharchika KushthaSthularushka KushthaMaha KushthaVisarpa KushthaParisarpa KushthaSidhma KushthaRasaka Kushtha

Vat a KaphaVata KaphaVat a KaphaVata KaphaVata KaphaPitta KaphaPitta KaphaPitta KaphaPitta KaphaPitta KaphaKapha

Vat a KaphaVat a KaphaVat a KaphaVata KaphaVat a Kapha

Kapha

Pitta

PittaPitta

Kapha PittaKapha PittaKapha PittaKapha PittaKaphaPitta

KaphaKaphaPittaVataKaphaKapha

Vat a Kapha

Aetiology and Pathogenesis:In Ayurveda there is no specific

aetiology for Vicharchika but given as awhole for all the Kushtharogas, caus-ative factors of Kushtha according toCharaka and Sushruta in brief are asfollows:

Sudden changes from cold to heat orheat to cold without observinq the rulesof gradual change, similarly suddenchange from samtarpana (rich dieting) toApatarpana (less dieting Dr fasting),continuous and excessive use of honey,treacle, fish etc. or grief beyond the lim-its, excessive taking of shali ricehorsegram, black gram etc, are the fac-tors of Kushtha which tend to derange

and aggravate the fundamental princi-ple ofVayu in a person. The aggravatedVayu in combination with the agitatedPitta and Kapha, enters into siras (thevessels orducts), which are transverselyspread over the surface of the body.Thus the aggravated morbific Vayu de-posits the pitta and kapha on the skinthrough the medium of their channelsand then vitiates the four body elementsand spreads them over the entire sur-face of the body. So the Kushtha or skindisease is produced (Cha.ChLChap.7,Shloka 10).'

Thus the causative factors of theKushtha consists of seven dravyas i.e.(three doshas and skin, muscle, blood

BuIUnd.lnst.Hist.Med. Vol. XXVII. 1997

and body-fluid), these seven dravyasbeing the cause eventually culminateinto the pathological entity o~ Kushtha.This is corroborated in Charaka Samhita(Cha.Nid.Chap.S, Shloka.3).' InCharakaSamhita emphasis is laid on explaininggeneral pathology in which derangementof the four dhatus is mentioned. ButSushruta has given detailed pathology inthe following manner. According toSushruta causative factors of the Kush-tha which tend to derange and aggravatethe fundamental principle of Vayu in aperson. The enraged or aggravated Vayu,in combination with the agitated Pitta andKapha, enters into the vessels or ducts(sira), which transversely spread overthesurface of the body. Thus the enragedVayu deposits the Pitta and Kapha onthe skin through the medium of theirchannels and spreads them over theentire surface of the body. The regions ofthe skin in which the aforesaid morbificdiatheses are deposited ,become markedwith circularringsorpatches. The morbificdiatheses (doshas), thus lodged in theskin, continue to aggravate, and havingbeen neglected at the outset, tend toenter into the deeper tissues and thuscontaminate the fundamental principles(Dhatus) of the body (Sus.Nid. Chap.5.Shloka 42)2.

On the same line as Charaka andSushruta have enunciated causation pa-thology and presentation of Kushtharogas, Vagbhata has described it con-cisely but clearly inthe following manner:defective food, misconduct, incompat-iblediet, killing the virtuous, use of moneyor material acquired through theft thesinful acts of this life or of past life causeprovocation of dosha which get vitiated.The vitiated doshas reach Tiryaggatsiras

123

and hence pass to the skin, the body-fluid, the blood and the muscular tissueand make them deranged and weak-ened, they pass on to the external sur-face of the patients body causing discol-oration of the skin and produce Kushtha.If it is neglected at this stage after someperiod it tears the body, reaches all thedhatus and spreads there and gets themcausing Atisveda (perspiration),Adhikasrava (discharges), Dushtavrana(gangrene) and penetration of minuteparasites of terrible nature which eat upthe hair, the skin, the ligaments the arter-ies and the cartilages etc. one by one(Ash.Nid. Chap.S -Shloka 1-3).3Prognostic Consideration ofKushthas:

A tender plant can be cut down bysmall efforts but requires big efforts whengrown big. Similarly a disease in its earlystage is easily cured. When it gets inadvanced stage requires great effortsfor, and if not, it can even take the fonn ofan incurable one.

According to Charaka the weak pa-tient of Kushtharoga having all the symp-toms along with complications of thirst,burning, absence of food digesting agni,infected with parasites is to be avoidedby awise physician. If the patient suffersfrom Kushtha roga with deranged Vataand Kapha orfrom one of the doshas hewill be easily cured. But Kushtha withderanged Kapha Pitta and Vatapitta aredifficult to cure. (Cha.Nid, Chap.S.,.Shloka 11y

According to Sushruta the patient,nQhas full control over his sense or-

.ians and the disease touches only skin,

.,icod or flesh it is curable. If the disease,,::aches Medodhatu (adipose tissue) itbecomes yapya (symptomatic relief so

124 Historical Review of Vicharchika - Swamy & Subhakta

long as treatment continues), other vari-eties are incurable (Sus.Nid, Chap., 5,Shloka 22-29).2

According to Madhavakara the cur-able Kushthas are those which are lo-cated in the skin, blood or flesh and inwhich Vata and Kapha are derangedtogether. Yapya are those located inMedodhatu or dual doshas (Vatakaphaor Kaphapitta etc.) and those located inthe bone or bone-marrow are incurablediseases to be avoided by the physicians(Mad.Nid.Chap., 49, Shloka 31 & 32).4

Finally, Vagbhata has summarised

the facts about prognosis ofKushtharogamore clearlythatthe physician should nottreat the cases of Kushtharoga where allthe three doshas are provoked or havingArishta symptoms and where infectionhas penetrated to the Bone, Bone - mar-row and the Shukradhatu where infectionhas reached medas is yapya and whereone of the provoked dual doshas containpitta they are all difficult to treat. Curableskin diseases are those in which only onedosha or Kapha and Vata are provokedand cause kushta. (Ash.Hri. Nid.Chap.,14, Shloka 30-34).3.

REFERENCES1. Yadavji TrikamjiChaukham-

2. Kunjalal Kaviraj

3. Kunte A.M. & Navre, K.R.S.

4. Shastry, s. & Upadhyaya, Y.

5. Yadavji Trikamji Acharya.

1941 "Charaka Samhita" Pub. byba Sanskrit Series Office, Varanasi.

1911 "Sushruta Samhita" of Sushruta VoL II,PUb. by the author Calcutta, P.Nos.22-29, 35, 42.

1982 "Ashtanga Hridaya" of Vagbhata ed-ited. Paradkar, Pub. by. Chowkha-mba Sanskrit series office, Varanasi- p.no. s 524 35, 524.

1975 Madhava Nidana, 4th Edn, PUb. by.Chowkhamba Sanskrit SamsthanVaranasi. P. Nos. 31& 32,154,158,163.

1956 "Ayurvediya Vyadhi Vigyan" Uttarar-dha, II part, Pub.by. Baidyanath-Ayurved Shawano

Bull.lnd. Inst. Hist. Med. Vol. XXVII. 1997 125

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