Reference:
C.Ni.5, S.Ni.6, A.H.Ni.14, M.Ni.49
Introduction:
Vitiated Dosha cause discoloration of skin, this is Kusht`ha. Hence, this term covers all skin disorders.
Nirukti:
- Doshaah Dusht`aah Tvachah Vaivarn`yam Kurvanti,Tat Kusht`ham |
A.H.Ni. 14/3 - Yasmaat Sarvam Vapuh Kaalena Upekshitam Kushn`aati,Tat Kusht`ham |
A.H.Ni. 14/4
Mythological Origin of Kusht`ha:
During the destruction of Dakshaas sacrifice due to Havih Praas`hana, Prameha and Kusht`ha manifested itself after Gulma. Havih is the sacred offering meant for the deity and the Agni, if a person consumes it then his Jaat`haraagni is affected adversely and manifests as various diseases of low gastric fire activity (Mandaagni) Prameha being one of them.
Svaroopa
Kusht`ha means skin disorders; as Kusht`ha manifests on skin with various symptoms according to Dosha. Kusht`ha is a disease in which skin gets affected. Tvak is Spars`hanendriya. Hence, Kusht`ha is named upon any skin disorder which changes the natural luster and glow of skin. It gives tattered appearance to the skin. Sus`hruta has named Kusht`ha as Tvag Dosha.
Dosha
There are 7 factors involved in the disease Kusht`ha. Out of them the three are Dosha viz., Vaata, Pitta and Kapha. It is necessary that these Dosha should get vitiated first due to the causative factors of Kusht`ha. Unless and until the Dosha vitiate by causative factors of Kusht`ha, it does not manifest but if they vitiated from some other causative factors some other disease will be manifested like Visarpa.
Dooshya
Four Dooshya are:
Tvak (skin)
Maamsa (muscular tissue)
Rakta
Laseekaa (body fluid between skin and muscular tissue) / Ambu
It means that in any type of Kusht`ha, Tvak (skin) is the factor which gets affected at the onset of disease. Then as time passes the other factors get affected. This affection of Maamsa, Rakta, Laseekaa and Tvak is general factor in all the types of Kusht`ha. Kusht`ha may affect other Dhaatu also with due course of time. Ultimately, Kusht`ha spreads all over the body. (Chakrapaan`i)
Vitiation of all the three Dosha is a necessary factor in manifestation of Kusht`ha. No Kusht`ha manifests itself due to the aggravation of only one Dosha. Depending upon combinations of Dosha and Dooshya, depending upon the different types of pain, colour, shape, specific symptomatic manifestations (Prabhaava), name of the Kusht`ha and treatment of various types; though they are produced by same types of causative factors (Three Dosha, Tvak, Maamsa, Laseekaa and Rakta), number of types of Kusht`ha are possible.
The types of Kusht`ha may be 7 or 18 or numerous (countless). Dosha bring various combinations in this disease related to Saadhya Vyaadhi only. For incurable type of Kusht`ha various types are not to be considered. As all the types of Kusht`ha are impossible to describe only seven types of Kusht`ha are explained in Charaka.
Types of Kusht`ha:
Though Kusht`ha is a disease due to all the three Dosha, its types are mentioned according to the dominance of the Dosha in a specific type, as explained in the table.
Mahaa Kusht`ha:
| No. | Name | Dosha Dominance |
| 1 | Kapaala | Vaataja |
| 2 | Audumbara | Pittaja |
| 3 | Man`d`ala | Kaphaja |
| 4 | Rishyajihva | VaataPittaja |
| 5 | Sidhma | VaataKaphaja |
| 6 | Pun`d`areeka | PittaKaphaja |
| 7 | Kaakan`aka | Saannipaatika |
Sampraapti:
- Due to the indulgence in causative factors all the three Dosha simultaneously aggravate.
- All the four Dooshya viz., Laseekaa, Maamsa, Rakta and Tvak become flaccid (S`haithila)
- Dosha harboring in the Dhaatu, affecting all the 4 Dooshya produce Kusht`ha.
- When Dosha get stability in the tissues then only they are capable to manifest Kusht`ha. Dosha which are moving in the tissues are not able to manifest Kusht`ha.
Types:
Kusht`ha is of 7 types according to the dominance of the Dosha.
- Vaataja
- Pittaja
- Kaphaja
- VaataPittaja
- VaataKaphaja
- PittaKaphaja
- Saannipaatika
Dhaatugata Kusht`ha:
Maadhava nidaana has given the types of Kusht`ha according to the Dhaatugatatva.
- Tvakstha Kusht`ha
- Rakta Sams`hrita Kusht`ha
- Maamsa Samaas`hrita Kusht`ha
- Meda Sthaanagata Kusht`ha
- Asthi Majja Samaas`hrita Kusht`ha
- S`hukta S`hin`itagata Kusht`ha
Kusht`ha and Visarpa
In Visarpa and Kusht`ha, the Dooshya are same which get vitiated due to the already vitiated Dosha. But the difference is that in Visarpa, all the Dooshya do not get affected, whereas in Kusht`ha invariably all the Dooshya get affected. In Visarpa Rakta Dusht`i is a major part hence there is acute pain.
Asaadhyatva:
Kaakan`ka Kusht`ha is incurable.
Except Kaakan`aka Kusht`ha all the types of Kusht`ha may turn to incurable status due to negligence or wrong treatment.
In the incurable types of Kusht`ha there may be the exudation due to Dosha (Abhishyanda).
Also, in curable types of Kusht`ha due to negligence maggots may happen as effect of putrefaction of skin, muscular tissue, blood, and body fluid (Kleda).
These maggots (Krimi) are the cause of complications in Kusht`ha.
Mahaakusht`ha and Dosha dominance
| Mahaa Kusht`ha | Charaka | Sus`hruta | Vaagbhat`a | |
| 1 | Arun`a | – | Vaata | – |
| 2 | Udumbara | Pitta | Pitta | Pitta |
| 3 | Rishyajihva | Vaata Pitta | Pitta | Vaata Pitta |
| 4 | Kapaala | Vaata | Pitta | Vaata |
| 5 | Kaakan`aka | Tridosha | Pitta | Tridosha |
| 6 | Pun`d`areeka | Pitta Kapha | Kapha | Pitta Kapha |
| 7 | Dadru | – | Kapha | Pitta Kapha |
| 8 | Man`d`ala | Kapha | – | Kapha |
| 9 | Sidhma | Kapha Vaata | – | Vaata Kapha |
Kshudra Kusht`ha and Dosha dominance
| Kshudra Kusht`ha | Charaka | Sus`hruta | Vaagbhat`a | |
| 1 | Sthoolaarushka | – | Kapha | – |
| 2 | MahaaKusht`ha | – | Kapha(Vaata Gayadaasa) | – |
| 3 | Ekakusht`ha | Vaata Kapha | Kapha(Vaata Gayadaasa) | Vaata Kapha |
| 4 | Charmadala | Pitta Kapha | Pitta | Pitta Kapha |
| 5 | Visarpa | – | Pitta | – |
| 6 | Parisarpa | – | Vaata(Vaata Pitta– Gayadaasa) | – |
| 7 | Sidhma | – | Kapha(VaataanubandhaKapha Gayadaasa) | Vaata Kapha |
| 8 | Vicarcikaa | Kapha | Pitta | Kapha |
| 9 | Kit`ibha | Vaata Kapha | Pitta | Vaata Kapha |
| 10 | Paamaa | Pitta Kapha | Pitta | Pitta Kapha |
| 11 | Rakasaa | Kapha | ||
| 12 | Vipaadikaa | Vaata Kapha | Pitta | Vaata Kapha |
| 13 | Kachchhoo | Pitta | ||
| 14 | Alasaka | Vaata Kapha | – | Vaata Kapha |
| 15 | Dadru | Pitta Kapha | – | |
| 16 | Charma Kusht`ha(Charma) | Vaata Kapha | – | Vaata Kapha |
| 17 | Visphot`aka | Pitta Kapha | – | Pitta Kapha |
| 18 | S`hataaru | Pitta Kapha | – | Pitta Kapha |
According to Sus`hruta,all the types of Kusht`ha are manifested due to Tridosha. Krimi is another factor which is also responsible for Kusht`ha according to Sus`hruta,but the type of Kusht`ha is named as per the dominance of the Dosha.
Mahaa Kusht`ha: Comparative Study
| Charaka & Madhava Nidaana | Sus`hruta | Vaagbhat`a |
| Kapaala | Kapaala | Kapaala |
| Audumbara | Udumbara | Udumbara |
| Man`d`ala | – | Man`d`ala |
| Rishyajihva | Rishyajihva | Rishyajihva |
| Pun`d`areeka | Pun`d`reeka | Pun`d`reeka |
| Sidhma | – | – |
| Kaakan`aka | Kaakan`aka | Kaakan`aka |
| – | Arun`a | – |
| – | Dadru | Dadru |
Kshudra Kusht`ha: Comparative Study
| Charaka | Sus`hruta | Vaagbhat`a | Maadhava Nidaana |
| Eka Kusht`ha | Eka Kusht`ha | Eka Kusht`ha | Ekakusht`ha |
| Charma Kusht`ha | – | Charma Kusht`ha | Charma Kusht`ha |
| Kit`ibha | Kit`ibha | Kit`ibha | Kit`ibha |
| Vipaadikaa | – | Vipaadikaa | Vipaadikaa |
| Alasaka | – | Alasa | Alasaka |
| Dadru | – | – | – |
| Charmadala | Charmadala | Charmadala | Charmadala |
| Paamaa | – | Paamaa | Paamaa |
| Visphot`aka | – | Visphot`a | Visphot`a |
| S`hataaru | – | S`hataaru | S`hataaru |
| Vicharchikaa | Vicarchikaa | Vicarchikaa | Vicarchikaa |
| – | Mahaa Kusht`ha | – | – |
| – | Sthoolaarushka | – | – |
| – | Visarpa | – | – |
| – | Parisarpa | – | – |
| – | Sidhma | Sidhma | – |
| – | Paamaa | – | – |
| – | Rakasaa | – | – |
| – | – | – | Dadruman`d`ala |
| – | – | – | Kachchhoo |
Last updated on February 10th, 2021 at 11:22 am