Shoshan and Sanshaman in Managing Mandal Kushtha (Psoriasis)
Journal name: Ayushdhara
Original article title: Approach of Shoshan and Sanshaman Chikitsa in Management of Mandal Kushtha w.s.r. to Psoriasis
AYUSHDHARA is an international peer-reviewed journal. It focuses on research in Ayurveda, Yoga, Unani, Siddha, Homeopathy, Allopathy, and Pharmaceutical Sciences.
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Sheetal Katariya
PG Scholar, Department of Kaya Chikitsha, MMM. Government Ayurved College, Udaipur, Rajasthan, India.
Ravi Sharma
Professor and HOD., Department of Kaya Chikitsha, MMM. Government Ayurved College, Udaipur, Rajasthan, India.
Ayushdhara:
(A peer-reviewed, bi-monthly open-access journal)
Full text available for: Approach of Shoshan and Sanshaman Chikitsa in Management of Mandal Kushtha w.s.r. to Psoriasis
Year: 2024 | Doi: 10.47070/ayushdhara.v11i3.1553
Copyright (license): CC BY-NC-SA 4.0
Summary of article contents:
Introduction
Psoriasis, referred to in Ayurveda as "Mandal Kushtha," is a chronic inflammatory skin condition characterized by scaly, erythematous plaques primarily on extensor surfaces, the scalp, and nails. It affects 1.5% to 3% of populations, with a higher prevalence in European ancestry than in Asian, South American, or African populations. Ayurvedic treatment principles emphasize a holistic approach to health, aiming for both prevention and cure. This study focuses on evaluating the effects of Ayurvedic medicines and detoxification therapies (Shodhana Chikitsa) specifically in managing Mandal Kushtha, with a case study illustrating treatment interventions.
Shodhana Chikitsa: Ayurvedic Detoxification Therapy
Shodhana Chikitsa, a detoxification process in Ayurveda, includes procedures like Vamana (therapeutic emesis) and Virechana (therapeutic purgation) to purify the body of toxins termed 'ama.' In the described case study, a 53-year-old male patient suffering from psoriasis underwent these detoxification therapies after failing to find relief through modern medicine. The treatment protocol commenced with Deepana and Pachana for digestive enhancement, followed by Snehapana (oil intake) using Panchatikta Ghrita. After a thorough patient assessment, Vamana was performed, resulting in significant elimination of symptoms such as itching and scaling, demonstrating the efficacy of this Ayurvedic detoxification approach.
Management and Effectiveness of Ayurvedic Treatments
The second key component of the treatment regimen was Shamana Aushadhi, or palliative therapy, aimed at maintaining the balance of the body’s doshas. Following detoxification, the patient received various herbal preparations known for their blood-purifying, anti-inflammatory, and skin-soothing properties. This included local applications like Mahatikta Ghrit and oral medications such as Arogyavardhini Vati and Manjishtha, each selected for their specific therapeutic actions against skin conditions and to restore imbalances in doshas. Clinical assessments indicated a remarkable improvement in the PASI score, indicative of a significant reduction in psoriasis severity and associated symptoms, validating the effectiveness of the Ayurvedic treatment modalities applied.
Conclusion
In conclusion, the case study illustrates that Ayurvedic approaches, combining detoxification therapies like Vamana and Virechana with supportive herbal treatments, are effective in managing psoriasis (Mandal Kushtha). These strategies focus on purifying the body from accumulated toxins and restoring the balance of doshas, leading to symptomatic relief and improved skin health. The findings emphasize the potential of Ayurveda as a viable alternative or complement to conventional dermatological treatments, advocating further research to explore the broader applicability of these traditional practices in modern medicine.
FAQ section (important questions/answers):
What is the Ayurvedic perspective on managing psoriasis?
In Ayurveda, psoriasis is treated as a condition resulting from Dosha vitiation. The management includes therapies like Vamana and Virechana to detoxify the body, along with specific herbal medicines that help restore balance and improve skin health.
What were the treatment methods used for the patient?
The patient underwent Shodhana therapy, including Vamana (therapeutic emesis) and Virechana (therapeutic purgation). Preceding these treatments, procedures like Deepan, Pachan, and Snehapana helped prepare the body for effective treatment.
What results were observed after the Ayurvedic treatment?
After treatment, significant improvement was noticed in the patient's symptoms, including reduced scaling, itching, and skin lesions. The PASI score improved considerably, indicating effective management of Mandal Kushtha, or psoriasis.
Glossary definitions and references:
Scientific and Ayurvedic Glossary list for “Shoshan and Sanshaman in Managing Mandal Kushtha (Psoriasis)�. This list explains important keywords that occur in this article and links it to the glossary for a better understanding of that concept in the context of Ayurveda and other topics.
1) Karma (Karman):
Karma in this context refers to the treatment procedures used in Ayurveda, particularly Vamana Karma and Virechana Karma, which are therapeutic emesis and purgation techniques, respectively. These karmas are utilized to manage various conditions, including Mandal Kushtha, a type of psoriasis [see source text or glossary: Karma].
2) Vamana:
Vamana is a therapeutic emesis procedure used in the Ayurvedic treatment of diseases like Mandal Kushtha (psoriasis). It involves inducing vomiting to cleanse and detoxify the body, particularly to remove Kapha dosha. This treatment was part of the management regimen described for the patient in the text.
3) Kushtha (Kustha):
Kustha denotes skin diseases in Ayurveda, with Mandal Kushtha being a specific type. Mandal Kushtha shows symptoms like chronic inflammation, disfigurement, and increased skin proliferation and has been correlated with psoriasis in the article [see source text or glossary: Kustha].
4) Mandal:
Mandal Kushtha is a specific type of Kushtha, characterized by round, elevated patches that are reddish and itchy. The patient's symptoms, such as silvery scales and severe itching, align with the description of Mandal Kushtha in Ayurvedic texts.
5) Abhyanga (Abhyamga):
Abhyanga is the procedure of massaging the entire body with oil. In the treatment described, Sarvanga Abhyanga (full-body oil massage) was performed before Vamana and Virechana Karma to facilitate the detoxification process.
6) Medicine:
In the context of the article, medicine refers to the various Ayurvedic formulations and treatments employed, such as Panchatikta Ghrita, Arogyavardhini Vati, and Mahatikta Ghrita. These medicines are integral to both the Shodhana (purification) and Shamana (palliative) therapies described.
7) Vega:
Vega refers to the urges or episodes of therapeutic emesis or purgation. In the text, the patient experienced seven Vamana Vega (episodes of vomiting) and sixteen Virechana Vega (episodes of purgation) during their respective treatments.
8) Ayurveda (Ayus-veda):
Ayurveda is an ancient system of medicine that focuses on holistic health, integrating physical, mental, and spiritual well-being. The article discusses Ayurvedic treatments and concepts such as Vamana Karma, Virechana Karma, and the management of Mandal Kushtha.
9) Disease:
In this context, disease refers to Mandal Kushtha, which is compared to psoriasis. Psoriasis is described as chronic, inflammatory, and characterized by red, scaly plaques. The Ayurvedic approach to managing this disease involves Shodhana (purification) and Shamana (palliative) treatments.
10) Dosha (Dosa):
Dosha denotes the three fundamental bodily bio-elements in Ayurveda: Vata, Pitta, and Kapha. The imbalance among these Doshas leads to health issues such as Mandal Kushtha. The treatments described aim to balance these Doshas, particularly focusing on Kapha and Pitta.
11) Kapha:
Kapha is one of the three Doshas in Ayurveda, associated with the elements of water and earth. In the context of Mandal Kushtha, there is a dominance of Kapha Dosha, which leads to the symptoms described. Treatments like Vamana Karma target the excess Kapha to restore balance.
12) Sneha:
Sneha refers to the process of internal and external oleation used in Ayurvedic treatments. Sneha Paan (internal oleation) with Panchatikta Ghrita was administered to the patient before undergoing Vamana and Virechana Karma to prepare the body for detoxification.
13) Ghrita (Ghrta):
Ghrita denotes clarified butter or ghee used in many Ayurvedic treatments. Panchatikta Ghrita and Mahatikta Ghrita were used for Snehapaan (internal oleation) and local applications to aid in the treatment of Mandal Kushtha.
14) Agni:
Agni refers to the digestive and metabolic fire in Ayurveda. Proper functioning Agni is essential for health, and its imbalance can cause diseases like Mandal Kushtha. Thus, Deepana (digestive stimulants) and Pachana (digestive aids) were administered to normalize Agni before treatment.
15) Drug:
In this study, drugs refer to specific Ayurvedic formulations like Panchatikta Ghrita, Mahatikta Ghrita, Arogyavardhini Vati, and others used in the treatment of Mandal Kushtha. These drugs were chosen for their properties to balance Doshas and alleviate symptoms.
16) Vitiation (Vitiated):
Vitiation refers to the disturbance or imbalance of Doshas. Mandal Kushtha involves the vitiation of Tridosha, particularly Kapha and Pitta. The treatments of Vamana and Virechana aim to correct this Dosha vitiation and restore balance [see source text or glossary: Vitiation].
17) Tridosha (Tridosa, Tri-dosha):
Tridosha is the theory of the three fundamental bio-elements (Vata, Pitta, Kapha) in Ayurveda. Mandal Kushtha is considered a Tridoshaja disease, meaning it involves the vitiation of all three Doshas, especially Kapha. The article employs treatments to balance these Doshas.
18) Pariksha (Pariksa):
Pariksha means examination or assessment in Ayurveda. The patient underwent Ashtavidha Dashvidha Pariksha, which are eight and ten-fold examinations, respectively, to understand his bodily conditions like Dosha dominance and physical and mental strength [see source text or glossary: Pariksha].
19) Sheetal:
Sheetal Katariya is one of the authors of the research article, which investigates the Ayurvedic treatment approach for Mandal Kushtha with a focus on Vamana and Virechana Karma [see source text or glossary: Sheetal].
20) Vilepi:
Vilepi refers to a type of rice gruel used in Ayurvedic post-treatment care known as Samsarjana Krama. It was part of the diet given to the patient after undergoing Shodhana therapies like Vamana and Virechana Karma to aid in recovery [see source text or glossary: Vilepi].
21) Sharman (Sarma, Sharma, Sarman):
Ravi Sharma is a co-author of the article and holds the position of Professor and HOD in the Department of Kaya Chikitsha, MMM Government Ayurved College, Udaipur, Rajasthan, India [see source text or glossary: Sharma].
22) Pitta:
Pitta is one of the three Doshas, associated with fire and water elements. It governs digestion and metabolism. In the treatment for Mandal Kushtha, Virechana Karma is used specifically to balance the Pitta Dosha, which is prominent in the condition.
23) Satva (Shatva):
Satva refers to mental strength or temperament in Ayurvedic parlance. The patient's Satva was assessed as part of the Dashvidha Pariksha. It represents the mental resilience which also plays a role in the overall treatment approach [see source text or glossary: Satva].
24) Blood:
Blood, or Rakta in Ayurvedic terms, is an important bodily tissue. Many skin diseases, including Mandal Kushtha, involve Rakta vitiation. Treatments like Panchatikta Ghrita help in Raktaprasadan and Raktashodhaka, which means blood purification.
25) Roga:
Roga means disease or ailment. In this context, Mandal Kushtha (psoriasis) is the Roga being treated. The Ayurvedic approach includes both Shodhana and Shamana therapies to manage the symptoms and root causes of this chronic skin condition [see source text or glossary: Roga].
26) Ravi (Ravin):
Ravi Sharma, a co-author of the article, is notable for his position as Professor and HOD in the Department of Kaya Chikitsha at MMM Government Ayurved College, Udaipur, Rajasthan, India [see source text or glossary: Ravi].
27) Peya:
Peya is a type of rice water or thin gruel used during the recuperative diet period (Samsarjana Krama) after detoxification treatments like Vamana Karma. It helps to gradually reintroduce solid foods into the patient's diet [see source text or glossary: Peya].
28) Milk:
Milk was part of the preparatory steps before Vamana Karma. The patient was given milk continuously up to a certain point to induce therapeutic emesis, which is a significant part of the Ayurvedic detoxification process [see source text or glossary: Milk].
29) Purification:
Purification in Ayurveda refers to Shodhana Chikitsa procedures like Vamana and Virechana Karma, aimed at cleansing the body of toxins and restoring Dosha balance. This is essential in the management of diseases like Mandal Kushtha.
30) Manjishtha (Manjistha, Mamjishtha):
Manjishtha is an Ayurvedic herb known for its Raktashodhaka (blood purifying) and Pitta balancing properties. It is used to reduce skin damage caused by free radicals and to purify the blood, making it effective in treating conditions like Mandal Kushtha.
31) Ashtavidha (Astavidha, Ashtan-vidha):
Ashtavidha refers to the eight types of Pariksha (examinations) in Ayurveda used to assess a patient’s health. The article mentions Ashtavidha Pariksha for evaluating the patient's condition, including Nadi (pulse), Mutra (urine), and Jihwa (tongue) [see source text or glossary: Ashtavidha].
32) Discussion:
The Discussion section in the article elaborates on the causative factors and Ayurvedic treatment modalities for Mandal Kushtha. It underscores the importance of procedures like Shodhana Karma (Vamana and Virechana) and outlines the outcomes observed in the patient [see source text or glossary: Discussion].
33) Mahatikta (Maha-tikta):
Mahatikta Ghrita is an Ayurvedic formulation used for its potent therapeutic properties in treating chronic skin diseases like Mandal Kushtha. It contains numerous herbs that aid in blood purification, inflammation reduction, and overall skin health improvement.
34) Shodhana (Sodhana):
Shodhana refers to purification therapies in Ayurveda, such as Vamana Karma and Virechana Karma. These treatments aim to cleanse the body of toxins and balance the Doshas, especially vital for managing chronic conditions like Mandal Kushtha (psoriasis).
35) Triphala (Tri-phala):
Triphala is a well-known Ayurvedic formulation made from three fruits: Haritaki, Bibhitaki, and Amalaki. It was used as part of the Virechana Karma treatment to enhance digestive health and aid in the purgation process [see source text or glossary: Triphala].
36) Udaipur (Udaypur):
Udaipur is the location of MMM Government Ayurved College, where the case study was conducted. The institution is situated in the Rajasthan state of India and is a center for Ayurvedic education and research [see source text or glossary: Udaipur].
37) Coconut (Cocoanut):
Coconut oil was used in the Sarvanga Abhyanga procedure as part of the preparatory steps for Vamana and Virechana Karma. The oil aids in the oleation of the skin and helps to detoxify the body externally [see source text or glossary: Coconut].
38) Patola:
Patola is a medicinal herb included in Panchatikta Ghrita, used for its Ushna (heating) and Tikta (bitter) properties. It helps in Deepana (enhancing digestion) and Pachan (aiding digestion) and is effective in treating skin disorders like Mandal Kushtha [see source text or glossary: Patola].
39) Yavagu:
Yavagu is a type of gruel given before Vamana Karma to help induce vomiting. The patient consumed Yavagu containing a small amount of Ghrita (ghee) as part of the preparatory steps for the therapeutic emesis procedure [see source text or glossary: Yavagu].
40) Dushya (Dusya):
Dushya refers to bodily tissues that become affected or vitiated by Doshas. In the context of Mandal Kushtha, Dushya includes muscles, skin (Twak), and blood (Rakta). The treatment aims to purify these affected tissues through procedures like Vamana and Virechana Karma [see source text or glossary: Dushya].
41) Ushna (Usna):
Ushna refers to the heating quality. Many of the herbs and treatments used in the described therapy process, like Patola and Panchatikta Ghrita, possess Ushna properties, which help in reducing Kapha and balancing the body's overall metabolism [see source text or glossary: Ushna].
42) Fever:
Fever is not directly mentioned, but can be correlated to the Ayurvedic concept of Agni disturbances. Various treatments and herbs mentioned in the article, such as Giloy Satva, have antipyretic properties and are used in managing conditions that involve fever [see source text or glossary: Fever].
43) Vaca:
Vacha is an Ayurvedic herb used in the Vamanopag Yoga for its therapeutic emesis properties. Together with other ingredients like Madanphala and Saindhavalavan, Vacha helps to induce cleansing vomiting during Vamana Karma [see source text or glossary: Vacha].
44) Kaya:
Kaya Chikitsha is the department of internal medicine in Ayurveda. The case study was carried out in the Department of Kaya Chikitsha at MMM Government Ayurved College, focusing on the Ayurvedic treatment of Mandal Kushtha [see source text or glossary: Kaya].
45) Bala:
Bala refers to physical strength or bodily endurance. The patient's Bala was assessed before initiating the Vamana and Virechana Karma treatments to ensure that the patient could withstand the rigorous detoxification procedures [see source text or glossary: Bala].
46) Yoga:
In this context, Yoga refers to a specific formulation or combination of Ayurvedic herbs used for a particular treatment. The Vamanopag Yoga mentioned includes Madanphala, Vacha, and Saindhavalavan as key ingredients for inducing therapeutic emesis [see source text or glossary: Yoga].
47) Vati:
Vati denotes a form of Ayurvedic medicine prepared in tablet form. Examples mentioned include Arogyavardhini Vati, known for balancing Pitta and Kapha Doshas, and helping in blood purification and detoxification [see source text or glossary: Vati].
48) Sara (Shara):
Sara indicates the quality or purity of body tissues in Ayurveda. The patient was noted to have Mansa Sara, meaning well-developed muscle tissue, which was part of the Dasvidha Pariksha or ten-fold examination [see source text or glossary: Sara].
49) Food:
Food or dietary guidelines are crucial in Ayurvedic treatment. Post-treatment, the patient was given a prescribed diet during the Samsarjana Krama, starting with Peya (thin gruel) and progressing to Vilepi (thicker gruel) and other light, easily digestible foods [see source text or glossary: Food].
50) Pan (Panne):
Paan generally means the act of drinking or ingestion in Ayurveda. In the context of the article, it refers to Sneha Paan (internal oleation) where the patient ingests specific Ayurvedic ghee preparations like Panchatikta Ghrita [see source text or glossary: Paan].
51) Sthanasamshraya (Sthanasamsraya, Sthana-samshraya):
Sthana-samshraya refers to the localization of vitiated Doshas to specific tissues or organs, leading to disease. In Mandal Kushtha, vitiated Tridoshas find their Sthanas in the skin (Twak), blood (Rakta), and muscles (Masha) [see source text or glossary: Sthana-samshraya].
52) Tiktakaghrita (Tiktakaghrta, Tiktaka-ghrita):
Tiktaka Ghrita is a type of Ayurvedic ghee formulation containing bitter herbs. Pancha Tiktaka Ghrita, used in the treatment, is known for its ability to pacify Pitta Dosha and to purify the blood, making it effective for skin disorders like Mandal Kushtha [see source text or glossary: Tiktaka-ghrita].
53) Paschat-karma:
Paschat-karma refers to post-treatment care protocols in Ayurveda. After procedures like Vamana and Virechana Karma, Paschat Karma includes dietary regulations and activities to help the patient recover and stabilize their metabolism [see source text or glossary: Paschat-karma].
54) Disfigurement:
Disfigurement is a characteristic of Mandal Kushtha, where chronic inflammation and increased skin proliferation result in noticeable changes to the skin's appearance. The article highlights the disfigurement caused by psoriasis and its Ayurvedic management [see source text or glossary: Disfigurement].
55) Amalakiphala (Amalaki-phala):
Amalakiphala refers to Indian gooseberry or Amla, an ingredient in several Ayurvedic formulations. It is mentioned in the composition of Mahatikta Ghrita, used for its antioxidant and anti-inflammatory properties in treating chronic skin diseases [see source text or glossary: Amalakiphala].
56) Inflammation:
Inflammation is a key symptom of Mandal Kushtha (psoriasis) treated in the article. Ayurvedic treatments like Mahatikta Ghrita and Vamana and Virechana Karma aim to reduce this chronic inflammation by balancing the Doshas and detoxifying the body [see source text or glossary: Inflammation].
57) Kiratatikta (Kirata-tikta):
Kiratatikta is an anti-inflammatory and antipyretic herb used in Ayurvedic formulations such as Panchatikta Ghrita. It helps in treating skin disorders like Mandal Kushtha by decreasing inflammation and purifying the blood [see source text or glossary: Kiratatikta].
58) Tiktarohini:
Tiktarohini, also known as Katuka, is a bitter herb included in Panchatikta Ghrita. It has detoxifying, anti-inflammatory, and skin-healing properties, making it effective in the Ayurvedic treatment of conditions like Mandal Kushtha [see source text or glossary: Tiktarohini].
59) Daruharidra (Daru-haridra):
Daruharidra, or Indian barberry, is a herbal component in Panchatikta Ghrita. Known for its anti-inflammatory and blood-purifying properties, it helps in managing skin disorders like Mandal Kushtha by reducing inflammation and improving skin health [see source text or glossary: Daruharidra].
[Note: The above list is limited to 75. Total glossary definitions available: 117]
Other Science Concepts:
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Tridosha, Ritucharya, Snehapana, Kaphadosha, Ayurvedic medicine, Modern medicine, Vamana Karma, Shodhana Karma, Virechana Karma, Therapeutic Emesis, Therapeutic Purgation, Samsarjan Krama, Psoriasis management, Skin lesion, Shodhanchikitsa, Chronic inflammatory, Mandal Kushtha, Dhincharya.