Reference:
C.Ni.5, S.Ni.6, A.H.Ni.14, M.Ni.49
Introduction:
Vitiated Dosha cause discoloration of skin, this is कुष्ठ. 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 कुष्ठ:
During the destruction of Dakshaas sacrifice due to Havih Praas`hana, प्रमेह and कुष्ठ manifested itself after गुल्म. 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) प्रमेह being one of them.
Svaroopa
कुष्ठ means skin disorders; as कुष्ठ manifests on skin with various symptoms according to Dosha. कुष्ठ is a disease in which skin gets affected. Tvak is Spars`hanendriya. Hence, कुष्ठ 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 कुष्ठ as Tvag Dosha.
Dosha
There are 7 factors involved in the disease कुष्ठ. 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 कुष्ठ, it does not manifest but if they vitiated from some other causative factors some other disease will be manifested like विसर्प.
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 कुष्ठ. कुष्ठ may affect other Dhaatu also with due course of time. Ultimately, कुष्ठ spreads all over the body. (Chakrapaan`i)
Vitiation of all the three Dosha is a necessary factor in manifestation of कुष्ठ. No कुष्ठ 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 कुष्ठ 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 कुष्ठ are possible.
The types of कुष्ठ may be 7 or 18 or numerous (countless). Dosha bring various combinations in this disease related to Saadhya Vyaadhi only. For incurable type of कुष्ठ various types are not to be considered. As all the types of कुष्ठ are impossible to describe only seven types of कुष्ठ are explained in Charaka.
Types of कुष्ठ:
Though कुष्ठ 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 कुष्ठ.
- When Dosha get stability in the tissues then only they are capable to manifest कुष्ठ. Dosha which are moving in the tissues are not able to manifest कुष्ठ.
Types:
कुष्ठ 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 कुष्ठ 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
कुष्ठ and विसर्प
In विसर्प and Kusht`ha, the Dooshya are same which get vitiated due to the already vitiated Dosha. But the difference is that in विसर्प, all the Dooshya do not get affected, whereas in कुष्ठ 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 कुष्ठ may turn to incurable status due to negligence or wrong treatment.
In the incurable types of कुष्ठ there may be the exudation due to Dosha (Abhishyanda).
Also, in curable types of कुष्ठ due to negligence maggots may happen as effect of putrefaction of skin, muscular tissue, blood, and body fluid (Kleda).
These maggots (कृमि) are the cause of complications in कुष्ठ.
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 | विसर्प | – | 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 | अलसक | 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 कुष्ठ are manifested due to Tridosha. कृमि is another factor which is also responsible for कुष्ठ according to Sus`hruta,but the type of कुष्ठ 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 |
| अलसक | – | Alasa | अलसक |
| Dadru | – | – | – |
| Charmadala | Charmadala | Charmadala | Charmadala |
| Paamaa | – | Paamaa | Paamaa |
| Visphot`aka | – | विस्फोट | विस्फोट |
| S`hataaru | – | S`hataaru | S`hataaru |
| Vicharchikaa | Vicarchikaa | Vicarchikaa | Vicarchikaa |
| – | Mahaa Kusht`ha | – | – |
| – | Sthoolaarushka | – | – |
| – | विसर्प | – | – |
| – | Parisarpa | – | – |
| – | Sidhma | Sidhma | – |
| – | Paamaa | – | – |
| – | Rakasaa | – | – |
| – | – | – | Dadruman`d`ala |
| – | – | – | Kachchhoo |
Last updated on February 10th, 2021 at 11:22 am