त्वक् विकार

Manual of Twak vikara in
ayurveda
Kushta, visarpa, kshudra roga
Page | 1
Kushta is a tridoshaja vyadhi mentioned in Ayurveda that undergoes manifestation in the
bahya rogamarga. Kushta is considered a mahagada due to its durvijneya, sudustara and
daruna swabhava. The samprapthi of kushta begins with the multitude of interactions of
tridosa with twak, rakta, mamsa and lasika and gradually may afflict other dhathus,
depending upon the strength of samprapti ghataka. Majority of the dermatological
disorders have been described under the umbrella of Kushtha.
Nirukti: The word “Kushtha‟ is derived from – „Kusnishkarshane‟ + „Kta‟ which implies
„to destroy‟, „to deform‟ or „to scrap out‟, by adding the suffix „kta‟ which stands for
„certainty‟ or „firmness‟. Thus, the word Kushtha means that which destroys with
certainty.
Vyakhya: Kushnativapuetikushtam i.e. that which disfigures the body is known as

Kushtha.
Skin is an organ of complex physiology and any manifestation in skin should be explored
in terms of general physical and mental health and also on the basis of the status of rasa
and raktha dhatus, the physical and functional state of which is more often reflected
through the skin.
Depending on the amsamsavikalpa of dosha- dushya, kushta has been classified into 7
maha kushta and 11 kshudra kushta. It also can be classified on the basis of the
following:
 Vedana- nature of pain – “काऩारं तोदफहुरं”

 Varna- based on colour-“मत ् काकणन्ततकावणं”
 Samsthana- appearance -“मदृष्मन्जह्वासंस्थानं”
 Prabhava- prognosis- साध्मतासाध्मतादद
 Nama – name-काऩार इत्मादद
 Chikitsa visesha –treatment
NIDANA (ETIOLOGICAL FACTORS)
Nidana or the etiological factors closely linked with the manifestation, transmission and
progression of the disease are broadly classified in the classical Ayurveda texts in the
following categories:
1. AHARAJA NIDANA- food related etiological factors

2. VIHARAJA NIDANA- regimen related etiological factors
3. MANASIKA NIDANA- psychological etiological factors.
4. VISESHA NIDANA- an etiology that is not common in all diseases, but specifically
act as hetu in this disease.
5. SAHAJA NIDANA – those factors which causes disease due to beeja bhaga avayava
dushti.
aharaja
sahaja visesha nidana viharaja
manasi
ka
In kushta roga, following nidans could be identified according to samhitas.
 Sannikrishta nidana –sannikrishta nidana is the chief components of roga

samprapthi janana. “saptako dravya sangraha”. The Sapta Dravya includes three
Doshas viz. Vata, Pitta and Kapha and four Dushyas viz. Tvaka (Rasa), Rakta,
Mansa and Ambu or Lasika.
 Viprakrishta nidana – the factors that support the dosha-dusya sammurchana are
included under this classification.
Kushta is also considered as an adibala pravrtta vyadhi (hereditary )
Purvajanmakrta karma is considered as a nidana for kushta. (म्रिमते मदद कुद्षेन
ऩन
ु जाातेऽपऩ गच्छतत | नात् कद्शतयो योगो मथा कुद्षं प्रकीततातभ ्) su ni 5/31-32
Kushta is also considered as an upasaragaja vyadhi
प्रसङ्गाद्गात्रसंस्ऩर्ाान्तनद्वासात ् सहबोजनात ् |
सहर्य्मासनाच्चापऩ वस्त्रभाल्मानुरेऩनात ् ||३३||
कुद्षं ज्वयद्ळ र्ोषद्ळ नेत्राम्रबष्मतद एव च |
औऩसर्गाकयोगाद्ळ सङ्राभन्तत नयातनयभ ्(su ni 5/34)
AHARAJA NIDANA
TYPE OF NIDANA DOSHA
/CATEGORY DUSHTI
PARTICULAR RASA SEVANA
अततरवण: Salt predominant Pitta vridhi Visyandana
foods like pickles, Kapha Kleda
bhelpuri, papad, visyandana vridhi
chips, namkeen Raktadusht
i
कुष्णातत
भांसातन
प्रगारमतत
कुद्षातन
अततअम्र: Fermented products, Pitta Raktadusht
pickles, bhelpuri, sour abhivridhi i
fruit juices, sauces Kapha Mamsa –
like tomato sauce, vilapayati vidahati
excess intake of Shithileeka
preserved foods, curd, rana -kaya
buttermilk, pickles,
lemon juice, vinegar,
alcohol, sauce,
squashes, cold drinks,
SPECIAL HABITS RELATED WITH FOOD INTAKE
पवरुद्धाहाय: Sprouted Tridosha Rakta dushti
vegetables/grains with dushti
meat, milk with meat,
honey with meat,
black gram with meat,
lotus stem with meat,
muli with meat,
jaggery with meat,
milk or honey with
leafy vegetables, curd
with chicken, honey
heated in any form or
taken with hot water,
alcohol with kheer,
fish with jaggery or
sugar, muli with
honey or milk, pork
with jaggery, banana
with milk, buttermilk
or curd. Drinking
milk after eating
garlic or any species
of tulsi, any sour taste
substances such as
unripe mango, badara,
jambu, akshoda,
jackfruit, cocunut,
dadima, amla with
milk, safflower with
alcohol, sweet
porridge with process:
ghee kept in copper
vessel, amount: honey
and water inequal
quantity, honey and
ghee in equal quantity
गव
ु त
ा नऩानभ ् Pizza, cheese mixed Kapha Agni
foods, bakery prakopa vaigunya
products, kidney (annavaha
beans, paneer etc, srotodushti)
food items prepared Raktavaha
mainly from black srotodushti
gram such as dosa, Mamsa vaha
idli, vada; beef, pork; srotodushti
food prepared from
flour.
Regular intake of
meat products
Intake of milk shakes,
kheer etc.
न्स्नग्धातनऩानभ ् Excessively oily Kapha Rasavaha
foods such as prakopa srotodushti
biriyani, fried oily Raktadushti
foods, meatsoups, Raktavaha
sweets made of srotodushti
excess ghee, milk etc Agni
such as kheer vaisamya
Food prepared with
cheese& ghee, sweets
etc
द्रवातनऩानभ ् Drinking excess Kapha Agni
quantity of prakopa mandya
water/juices/madya/ Kleda
soft drinks/ milk / janana
liquid foods like Raktavaha
rasam/sambhar more srotodushti
than needed for the Udakavaha
body srotodushti
Rakta dushti
स्नेहाततसेवनभ ् Excessive intake of Kapha Agni
ghee for medical prakopa, vaisamya,
purposes or as part of Doshotkles Kleda
diet. ha janaka
नवातन: Newly harvested Kapha Kleda

grains prakopa janaka
म्रभत््माहाय: Intake of food Tridosha Rakta

foregoing ahara
visesha vidhi ayatana
असात्म्माहाय: Foods which are not Tridosha Rasa and
native to the place rakta dushti
such as fruits of (such food
foreign origin, eating may remain
food which is not indigested
native to the area such and may
as chinese food, pasta produce
or pizza, soyabean, vidaha)
olive oil,
अजीणााहाय: Intake of food before Tridosha Agni
the previous food is dushti dourbalya
properly digested. Rasadushti
Rakta dushti
अजीणााध्मर्नभ ् eating food before Tridosha Rasa rakta
digestion of previous dushti dushti
meal or when there is Agni
no appetite vaisamya
अदहताम्रर्न: Fast food/junk Tridosha Agni
food/excessive spicy dushti vaisamya
food/excessive oily Rakta dushti
food (such ahara
Food taken when the might
individual does not remain in
mentally prefer to koshta
partake. without
proper
absorption
and
assimilation
to tissues)
र्चम्ररर्चभ ्ं च ऩमसा Intake of Prawns in Tridosha Rakta dushti
combination with dushti karaka
milk . because of
its virudha
swabhava
(seeta-ushna
etc)
ग्राम्यानूपौदकमाांसानन पयसा अशनम् Non vegetarian food Tridosha Rakta dushti
with lassi, ice cream (specific
along with non type of
vegetarian food, milk virudha,
products with meat guna
eg. Dishes like butter virudha,
chicken veerya
virudha )
रभं भुक्तत्वा र्ीतोष्णाहाय सेवनभ ् Intake of cold and hot Tridosha Agni
food together or dushti vaisamya
intake of cold food Rakta dushti
soon after intake of Swedavaha
hot food or vice versa. sroto dushti
Using cold water with (guna
hot lunch/dinner. virudha
Using dessert along swabhava)
with hot food.
Using cold milk with
hot samosae etc.
रभं भुक्तत्वा रङ्घनाहाय सेवनभ ् Taking food which Tridosha Raktadushti,
are ill nourishing and vaisamya ruksha
in improper order especially janana
neglecting the rules vata (ati Agni
mentioned for food langhana) vaisamya
intake. Kapha(ati
Intake of ill- brimhana)
nourishing food when
body requires
nourishing food etc
सततं अततभात्रं अजीणे
सभद्लत: Habit of taking Tridosha Raktadushti
honey/jiggery/fish/art dushti (specific
भधपु ाणणतभत्स्म रकुच भरू क ocarpus lakucha/ type of
काकभाची radish/solanum virudha
nigrum etc in which might
excessive quantity act as cause
and especially when for kushta)
previous food has not
been properly
digested.
ऺीयदर्धतरकोरकुरत्थभाषातसीकुसु Tridosha rakatdushti
dushti
म्बस्नेहवन्तत हामनक मवक
चीनकोद्दद्दारक कोयदष
ू प्रामाणी
चातनातन
अहायजातं पवदग्धं
अनन्ु ल्रख्म Taking food such as Pitta- Raktadushti
Spicy and pungent predomina (prabala)
पवदाहीतमभ्मवहायत: foods with more of nt dushti
red chilli, pepper, with kapha
kulatha, shukta, vata
aaranaala, madya, involveme
sprouts, fried foods nt
while previously
taken food is in
vidagdavastha(semidi
gested and
acidic/chyme) and has
not been eliminated
by induced emesis.
SPECIFIC FOOD ITEMS
दर्ध: Curd in different Kapha – Abhisyandi
forms such as raita, pitta dushti Kleda
lassi, dahivada, mixed janaka
in curry etc especially Agni
after heating and in vaisamya
autumn, summer and karaka
spring seasons Rakta dushti
karaka
(ushna,
amla)
भत्स्म Excessive intake of Kapha- Rakta dushti
fish, regular intake of Pitta dushti (virudhas
fish, various with matsya
preparations is specific
involving fish. causative
Combination of fish factor for
with milk is a kushta)
causative factor for
kushta
भाष: Use of urad dal and Kapha pitta Raktadushti
preparations such as dushti
vada, idli, dosa etc
भूरक: Regular usage of Ama Specific
radish.(radish is mulaka- hetu for
considered prakrsta pitta-kapha rakta dushti
apathya) dushti
*(snigdha
swabhava)
Suska
mulaka
(vatakapha
gna)
पऩद्शातन ्: Food prepared after Kapha – Raktadushti

grinding rice, gram pitta dushti hetu
etc and preparations
such as Dosha, idli,
vada, dhokla etc
ततर: Regular intake of Kapha – Rakta dushti
Sesame especially in pitta krt
the form of ladoo,
chikki, gajak or as
sesame itself.
ऺीय Milk and milk Kapha Snigda guna
products, ice creams Kleda
गुड: Use of Jaggery and Kapha – Rakta-

products made with pitta-vata mamsa-
jaggery regularly medo dushti
karaka
Krimikaraka
VIHARAJA NIDANA
अननऩ
ु र्वू मा सततऩाणाऩतऩाणाभ्मवहामा Habit of using Tridosha Rasarakta
santarpana and dushti dushti
र्वमत्मासोऩसेवा apatarpana ahara-
vihara simultaneously
or one after other
such as
Heavy work out in
gym soon after heavy
food intake.
Heavy and highly
nutritive food intake
soon after fasting etc
अननुऩूर्वमा र्ीतोष्णर्वमत्मासोऩसेवा Indulging in hot or Tridosha Swedavaha
cold things together (type of srotodushti
or one after other. virudha Rakta
Eating hot and cold vihara) dushtikaraka
food items together,
frequent going in and
out of ac room in
summer, bathing in
cold water just after
exercise or coming
from hot exterior,
working or travelling
in airconditioned
atmosphere and then
sudden exposure to
hot climate outside.
उष्णाम्रबतद्ऱस्म अप्सु भज्जनभ ् bathing in cold water Virudha Swedavaha

just after coming from vihara srotodushti
hot exterior, Tridosha Raktadushti
swimming in cold dushti
water just after
exercise or work
आततभात्रा सौदहत्मानततयं र्वमवाम Indulgence in coitus Tridosha Sakha gati
after excessive or dushti of doshas
सेवनं heavy food intake Rasa rakta
dushti
आततभात्रा सौदहत्मानततयं र्वमामाभ/ Indulgence in Tridosha Sakha gati
exercise when dushti of doshas
अतत बक्त
ु त्वा र्वमामाभोऩसेवनभ ् stomach is full or Rasa rakta
after heavy food. dushti
आततभात्रा सौदहत्मानततयं संताऩ Excessive sun Tridosa Raktadushti
exposure after heavy dushti
सेवनं/अततबुक्तत्वा food or when stomach
is full.
अततसतताऩोऩसेवनभ ्
बमोऩहतस्म सहसा र्ीतोदक सेवनभ ् Drinking cold water Tridosha Raktadushti
when mind is agitated dushti (karma
with fear virudha)
श्रभोऩहतस्म सहसा र्ीतोदक सेवनभ ् Drinking cold water Tridosha Raktadushti
when body is tired dushti (karma
with exertion. virudha)
सतताऩोऩहतस्म सहसा र्ीतोदक Drinking cold water Tridosha Raktadushti
when mind is afflicted dushti (karma
सेवनभ ् with grief or stress virudha)
छददा वेगधायण: Taking anti emetics, Tridosha Raktadushti
habit of suppressing dushti Specific
vomiting predomina hetu for
ntly kapha kushta
–pitta
utklesha
and vata
pratilomata
वाततस्म र्वमामाभग्राम्मधभासेपवन:  Indulging inTridosha Rasa rakta
vyayama after (sakha dushti
vomiting gamana of
 Indulging inutklishta
coitus afterdosha )
vomiting
ददवा तनद्रा Habit of indulging in Kapha pitta Rasa rakta
day sleep. predomina dushti
nt dosha
dushti
स्नेहपीतस्य व्यायामग्राम्यधममसेनिन: Exercise, exertion, Utklishta Rasa rakta
sexual activity after dosha dushti
eating unctuous food Sakha
such as ghee, butter, gamana
cheese, biriyani Tridosha
dushti
PANCHAKARMA APACHARAJA HETU
ऩञ्चकभााऩचाय  Refraining Tridosha Dhatu dushti
from doing vitiation In this case,
panchakarma improper
 Not following virechana or
pathya-apathya raktamoksha
or peyadi / donot
karma during undergo
and after virechana or
panchakarma raktamoksha
 Doing : there is
panchakarma possibility
without of
guidance of raktadushti
physician and hence
kushta
VISESHA HETU
पवप्र धषाणभ ् Offending Brahmins Karma Kushta hetu
itself act as
hetu for
kushta
गुरु धषाणभ ् Offending teachers Karmaja Karmaja
and elders hetu for kushta hetu
kushta
ऩाऩ कभा Indulging in sin – Karmaja Karmaja
murder, rape, bribery, hetu for kushta hetu
thievery, looting, any kushta
crime that may harm
others
साधु तनतदा Offending or abusing Karmaja Karmaja
saintly people hetu for kushta hetu
kushta
साधु वध Murder of saintly Karmaja Karmaja
people hetu for kushta hetu
kushta
अतमस्वहयण Looting or snatching Karmaja Karmaja
things from others for hetu for kushta hetu
personal benefit kushta
SYMPTOMATOLOGY OF KUSHTA
Ayurveda acharyas has classified kushta into mahakushta and ksudra kushta .
ICD code -ED-4-kushta
Purvarupa : कुद्ष-ऩव
ू रू
ा ऩभ ्- ED-4.1
स्ऩर्ााऻत्वभ ् Inability to perceive touch sensation

अततस्वेद् Excessive sweating
अस्वेद् Anhidrosis/lack of sweating
वैवर्णमाभ ्/पववणाता Discolouration of skin
कोठानाभ ् उतनतत् Raised reddish patches.
रोभहषा् Horripilation
कर्णडू् Itching
तोद् Pricking pain
श्रभ् Exhaustion/fatigue
क्तरभ् Exhaustion without exertion
व्रणानाभर्धकं र्ूरभ ् Excessive pain in the wounds
र्ीघ्रोत्ऩपत् Sudden onset of skin lesions without any
apparent reason
र्चयन्स्थतत् Lesions and wounds remain unhealed for
long time.
दाह् Burning sensation
सुद्ऱाङ्गता Loss of sensation of body parts/affected
area
अततद्ऴक्ष्णस्ऩर्ा् Excessive smoothness of skin
अततखयस्ऩर्ा् Excessive roughness of skin
रूढानाभपऩ रूऺत्वभ ् Improper healing of wounds
तनम्रभते अल्ऩे अपऩ कोऩनभ ् Aggravation of skin lesions/healed wounds
by minor causative factors
असज
ृ ् काष्र्णमाभ ् Blackish colour of blood
भहाकुद्ष्- ED-4.2
ED-4.2.1: कऩार्/अरुण-कुद्ष्/वाततककुद्ष्-कुद्ष ( skin affliction) with lesions resembling

black clay pot fragments/अरुण (reddish) patches
रूऺ Dryness of skin lesion and/ surrounding

area
अरुण् reddish colour of skin over the lesion
ऩरुष् rough/dry appearing lesion
पवषभपवसत
ृ ् uneven spreading lesion
खयऩमातत् rough margins of the lesion
तनू Thin skin over lesion/atrophied skin/thin
lesion
उद्धृतफदहस्तनु raised outer margins of the lesions
सद्ऱ
ु वत्सद्ऱ
ु ् loss of touch sensation/numbness over the
lesion
रृपषतरोभार्चत् Lesion covered with raised hairs
तनस्तोदफहुर् Excessive pricking pain over lesion.
अल्ऩकर्णडू With minimal or absent itching compared
with other skin conditions
अल्ऩदाह् Less/minimal burning sensation
अल्ऩऩम
ू ् Minimal/less/absent pus discharge
अल्ऩरसीका Absent /Minimal/less watery discharge
आर्ग
ु तत् Rapid spreading lesion
आर्ुसभुत्थान् Rapid onset of lesion.
आर्ुबेदद sudden onset of complications/rupture of
lesion
कृष्णवणा blackish discoloration of overlying and
surrounding skin
अरुणवणा् slightly reddish discoloration of overlying
skin
कऩारवणा्/कऩाराबभ ् Discoloration/hue or appearance similar to
that of earthen vessel
पवसपऩाणण्/र्ीघ्रसपऩा् rapid spreading nature
ED4.2.2 : काऩारककुद्षभ ्
कृष्णकऩाम्ररकाप्रकार्् -resembling black earthen vessel

ED-4.2.3: उदम्
ु फय-कुद्ष्/ऩैपतक-कुद्ष्
ताि् coppery coloured lesion

तािनख् copper coloured nails
ताियोभयाजीम्रबयनवद्ध् Lesion covered with copper coloured hairs
फहरातन copious discharge
फहुऩम
ू ् excessive pus discharge
फहुयक्त् excessive bloody discharge
फहुरसीका excessive watery discharge
फहरऩूम् thick pus discharge

फहरयक्त् thick bloody discharge
फहररसीका thick watery discharge
क्तरेद् moistening /saddening of lesion
कोथ् Putrefaction of skin and muscle
दाह् burning sensation
ऩाक् inflammation/suppuration
आर्ुगतत् rapid spreading lesions
आर्स
ु भत्ु थान् rapid onset of skin lesions
आर्ुबेदद् sudden onset of complications/rapid suppuration
and rupture
ससंताऩ् associated with elevated temperature over the
lesion
सकृम्रभ् associated with worms
ऩक्तवौदम्
ु फयपरवणा्/उदम्
ु फयपराबासभ ् resembling the ripe fruit of उदम्
ु फय्
गौयम्रसयार्चतभ ् with whitish veins over the lesion
रुजाकयभ ् Painful lesions
आर्ु अवदयणभ ् sudden onset of putrefaction/cracking
यागभ ् redness/congestion of lesion and surrounding area
रोभपऩञ्जयभ ् tawny brownish coloured hairs
ED-4.2.4-भर्णडरकुद्ष्/कपजकुद्ष्-कुद्ष ( skin affliction) with lesions resembling maNDala
(circular skin) lesions
न्स्नग्ध् smooth/unctuous /oily appearing skin ldesions

गुरु Heaviness over the lesion or surrounding skin
उत्सेध् Raised lesion (papule/patch)
द्ऴक्ष्णऩमातत् glossy margins of lesion
न्स्थयऩमातत् Hard/rigid margins
ऩीतऩमातत् yellowish margins
र्ुक्तरावबासी whitish appearance or hue
यक्तावबासी reddish appearance or hue
र्ुक्तरयोभयाजीसततत् Lesion covered with whitish hairs
फहुस्राव् excessive/copious discharge
फहरस्राव् profuse discharge
पऩन्च्छरस्राव् slimy discharge
फहुक्तरेद् excessive moistness/saddening
फहुकर्णडू excessive itching
फहुकृम्रभ् excess worms

सक्तगतत् slow spread
सक्तसभत्ु थान् slow onset
सक्तबेदी slow onset of complications/rupture
ED-4.2.5: ऋष्मन्जह्वक् - कुद्ष ( skin affliction) with lesions resembling tongue of RuShya
type of deer
ऋष्मन्जह्वाकृतीतन/ऋष्मन्जह्वाप्रकार्् Lesion looks like a tongue of a antelope
ऩरुष् rough/dry lesion
अरुणवणा् slightly reddish coloured appearence
फदहयतत्श्माव् Blackish appearance- internal and external
नीराबास् bluish tinge to lesion
ऩीतावबास् yellowish tinge to lesion
तािावबास् coppery hue to the lesion
आर्ुगतत् rapid spreading lesion
आर्ुसभुत्थान् rapid onset
अल्ऩकर्णडु Less/mild itching
अल्ऩक्तरेद् less /mild soddening only
अल्ऩकृम्रभ Less possibility of worm infestation
दाहफहुर् excessive burning sensation
बेदफहुर् severe splitting type of pain
तनस्तोदफहुर् excessive pricking pain
र्ूकोऩहतोऩभवेदना Lesion having pain as if pierced with bristles
उत्सतनभध्म् raised middle part of lesion
तनुऩमातत् thin margins
ककार्पऩडकार्चत् covered with rough eruptions
दीघाऩरयभर्णडर् large circular patch
खय् Rough
ED-4.2.6: ऩुर्णडयीक्कुद्ष (skin affliction) with lesions resembling a white lotus
ऩुर्णडयीकसङ्कार््/ऩुर्णडयीकऩत्रप्रकार्् Lesion resembling the petals of a ऩुर्णडयीक (lotus)

ऩरार्सङ्कार्् Lesion resembling ऩरार् flower
र्ुक्तरावबास् whitish appearance of lesion
यक्तावबास् reddish appearance
यक्तऩमातत् reddish margins
यक्तयाजीसततत् full of red streaks
यक्तम्रसयासततत् associated with reddish veins
उत्सेधवन्तत Raised lesion
फहुऩम
ू ् excessive pus discharge
फहुयक्त् excess bloody discharge
फहुरसीका excessive watery discharge
फहरऩूम् thick pus discharge
फहरयक्त् thick bloody discharge
फहररसीका thick watery discharge
कर्णडू् itching
कृम्रभ् Worm infestation
ऩाक् inflammation/suppuration
आर्ुगतत् rapid spread
आर्स
ु भत्ु थन् rapid onset
आर्ुबेदद् sudden onset of complications
ED-4.2.7: म्रसध्भ्-कुद्ष (skin affliction) with lesions resembling alAbu (bottle gourd) flower
अराफुऩुष्ऩसङ्कार्भ ् resembling flowers of a gourd

ऩरुष् rough/dry skin lesions
अरुण् reddish in colour
पवर्ीणा broken, shattered appearance of overlying skin
फदहस्तनतू न Thin appearing skin outside
अतत्न्स्नग्धातन unctuous inside
र्क्त
ु रयक्तावबास् whitish and reddish tinged lesions
फहूतन Numerous lesions

अल्ऩवेदना mild pain
अल्ऩकर्णडू less itching
अल्ऩदाह् less burning sensation
अल्ऩऩम
ू ् less pus discharge
अल्ऩरसीका less watery discharge
रघुसभुत्थान् light onset
अल्ऩबेद् less complications

अल्ऩकृम्रभ less worms
घद्श
ृ ं यज् ककये त ् dust on itching
दौन्ग्धकऩुष्ऩवत ् resembles दौन्ग्धक flower
प्रामेण ऊध्वाकामे स्मात ् usually affects upper part of the body
ED-4.2.8: काकणक्- कुद्ष ( skin affliction) with lesions resembling gu~jja (Abrus
precatorius) seed
काकणान्ततकावणा् /काकणान्ततकापरसदृर्् Lesion resembling colour of काकणान्ततका

सवाकुद्षम्ररङ्गसभन्तवत् with symptoms of all the कुद्ष
अतीवयक्त् dark red in colour
अतीवकृष्ण् dark black in colour
तीव्रदाह् severe burning sensation

तीव्ररुक् severe pain
ED-4.3: ऺुद्रकुद्षभ ्:
ED-4.3.1: एककुद्ष् कुद्ष (skin affliction) with lesions resembling fish scales
अस्वेदनभ ् anhidrosis/lack of sweating

भहावस्त/ु भहाश्रमभ ् broad based
भत्स्मर्करोऩभभ ् looks like the scales of a fish
ED-4.3.2: चभाकुद्ष् - कुद्ष (skin affliction) with lesions resembling elephant’s skin
फहरभ ् large in size

हन्स्तचभावत ् resembling the skin of elephant
खयस्ऩर्ाभ ् rough on touch
ED-4.3.3-ककदिब् - कुद्ष ( skin affliction) with lesions with rough surface and scar like
appearance
श्मावं bluish black colour
ककणखयस्ऩर्ाभ ् rough on touch

ऩरुषभ ् rough/dry
रूऺभ ् dry
कर्णडूभत ् itching sensation
अम्रसतभ ् blackish discoloration
ED-4.3.4: पवऩाददका: cracks in palms and soles
ऩाणणस्पुिनभ ् Cracks/fissuring in the hands

ऩादस्पुिनभ ् Cracks/fissuring in the feet
तीव्रवेदनभ ्/तीव्रातता् severe pain on the lesion
भतदकर्णडू mild itching only
याग् redness/congestion
पऩिकार्चत् associated with eruptions
ED-4.3.5: अरसककुद्ष्/अरसकुद्ष्- कुद्ष (skin affliction) with nodular skin lesions

ED-4.3.6: दद्र-ु कुद्ष्-कुद्ष (skin affliction) with lesions elevated pimple like skin lesions
कर्णडू् associated with itching sensation

याग् reddish nodules
पऩडका papule/eruptions
उद्गत भर्णडरभ ्/उत्सतनभर्णडरा elevated ring shaped plaque
दीघाप्रताना् spreading out
दव
ू ाावत ् resembling दवू ाा, in its character
of spread
अतसीकुसुभच्छपव् resembling the flower of अतसी
अनुषङ्र्गणी chronic (associated over a long
period)
ED-4.3.7-चभादर-कुद्ष्
यक्तभ ् Redness of over lying /surrounding skin.

स्पोि् Blister/vesicle formation.
रुजा Pain
दरनभ ् Peeling of skin
स्ऩर्ाासहत्वभ ्/अस्ऩर्ासहभ ् tenderness/inability to tolerate touch
ऊषा burning sensation with sweating and
restlessness
ED-4.3.8: ऩाभा ( कच्छू): कुद्ष ( skin affliction) with lesions with white, reddish, blackish-
brown eruptions
द्वेत् whitish discoloration of lesion

अरुण् reddish discoloration of lesion
श्माव् bluish black colour of lesion
कर्णडू् Itching over the lesion
पऩडका papule/eruptions
क्तरेद् moistening /saddening of skin
रुजा With pain
सूक्ष्भ् Minute papular eruptions

प्राम् न्स्पक्तऩाणणकूऩाये especially in the buttocks, hands and elbow
O-46: पवस्पोिक-कुद्ष् कुद्ष (skin affliction) with pustules covered with thin skin
द्वेताबास् whitish hue of lesion

अरुणाबास् slightly reddish hue of lesion
स्पोिा् blisters
तनुत्वच् thin skin
ED-4.3.9: र्तारु-कुद्ष्- कुद्ष ( skin affliction) with several ulcerated reddish/ blackish/
brown coloured patches
यक्तभ ् reddish ulcerative lesion

श्मावभ ् bluish black colour
दाह् lesion associated with burning
sensation
अतता् pain
फहुव्रण् multiple ulcerative lesion

स्थूरभूरभ ् broad based
क्तरेदाढ्मभ ् excessively moist/wet/discharge
जतत्वाढ्मभ ् full of worms
प्रामर्् ऩवाजतभ च usually appears on joints
ED-4.3.10: पवचर्चाका- कुद्ष (skin affliction) with excessive exudation
पऩडका Papular eruptions
श्मावा blackish discoloration
फहुस्रावा excessive/copious discharge
रसीकाढ्मा excessive watery discharge
ED-4.3.11: स्थूरारुष्क: कुद्ष (skin affliction) with hard and thick ulcers on joints
स्थूरातन (अरूंपष्) broad based
सन्तधषु (अरूंपष्) at the joints
अततदारुण (अरूंपष्) severe form
कदठन् (अरूंपष्) hard eruptions
O-38: यकसा: skin affliction with non- oozing boils
पऩडका र्यीये papule/eruptions in
body
संस्रावहीना् devoid of discharge
ED-4.4: धातुगतकुद्ष्कुद्ष (skin affliction) affecting dhAtu (bodily tissues)
ED-4.4.1-त्वग्गतकुद्ष्--कुद्ष (skin affliction) localized in यसधातु (skin)
स्ऩषाहातन् loss of tactile sensation

स्वेदनत्वभ ् sweating
ईर्त ् कर्णडू minimal itching

वैवर्णमाभ ्/अङ्ग-वैवणाभ ् Discolouration of skin
रूऺबाव्/रूऺता dryness
तोद् pricking pain
ED-4.4.2: यक्तगतकुद्ष्कुद्ष (skin affliction) localized in यक्तधातु (blood)
त्वक् -स्वाऩ् numbness at the site

योभहषा् horripilation
स्वेदाम्रबप्रवतानभ ्/स्वेदाततप्रवतानभ ्/स्वेद् excessive sweating
पवऩूमक् putrid suppuration
द्वमथु् oedema
ED-4.4.3: भांसगतकुद्ष्-कुद्ष (skin affliction) localized in भांसधातु (muscle)
फाहुल्मभ ् large circular patches

वक्तत्रर्ोष् dryness of mouth
काकाश्मभ ् roughness
पऩडकोद्गभ् appearance of eruptions
तोद् pricking pain
स्पोिा् blisters
न्स्थयत्वभ ् fixity
ऩार्णमार्श्रतस्पोिा् blisters on palms
ऩादार्श्रतस्पोिा् blisters on sole
सन्तधषु अर्धकं क्तरेद् discharge, secretion at joint

places
ED-4.4.4: भेदगतकुद्ष्कुद्ष (skin affliction) localized in भेदोधातु (adipose tissue)
दौगातध्मभ ् bad odour

उऩदे ह् rheum
ऩूम् pus formation
करम्रभसंबव् production of maggots
गात्राणां बेदनभ ् breaking pain in body
कौर्णमभ ् falling off of the fingers and
toes
गततऺम् restricted movements of the
limbs
अङ्गानां दरनभ ् putrifaction
संबेद् tearing sensation
ऺतसऩाणभ ् spreading of the lesions
ED-4.4.5: अन्स्थगतकुद्ष् कुद्ष (skin affliction) localized in अन्स्थधातु (osseus tissue)

नासाबङ्ग् depression of nasal bridge
अक्षऺयाग्/नेत्रयाग् redness in the eyes
करम्रभसंबव् (ऺतेषु ) production of maggots in the
lesion
स्वयोऩघात् loss of speech
स्वयऺम् diminution of voice/loss of voice
ED-4.4.6: भज्जागतकुद्ष्कुद्ष (skin affliction) localized in भज्जाधातु (bone marrow)
नासाबङ्ग् depression of nasal bridge

अक्षऺयाग् redness in the eyes
करम्रभसंबव् (ऺतेषु ) production of maggots in the
lesion
स्वयोऩघात् loss of speech
स्वयऺम् diminution of voice/loss of voice
ED-4.4.7: र्ुरगतकुद्ष्कुद्ष (skin affliction) localized in र्ुरधातु (seminal tissue)
कौर्णमभ ् falling off of the fingers and toes

गततऺम् restricted movements of the limbs
अङ्गानां सम्बेद् tearing sensation of the limbs
ऺतसऩाणभ ् spreading of the lesions
प्रागुक्तरऺणातन clinical features mentioned as
above/earlier
दायाफाधनभ ् affliction to spouse
अऩत्मफाधनभ ्/अऩत्मं बवतत affliction to progeny
कुपद्षतभ ्
ED-4.5: असाध्मकुद्ष्irremediable कुद्ष (skin affliction)
सवाम्ररंगैमत
ुा त्वभ ् clinical features of all types
of दोष
अफरत्वभ ् lack of strength
तष्ृ णा thirst
र्ाततान्ग्न् loss of digestive power
जततुजग्धभ ् affected with worms
सवादोषोल्फणता predominance of all three दोष
रयद्शोक्तरऺणमुक्तभ ् associated with fatal signs
अन्स्थसभाश्रमभ ् involving अन्स्थ धातु
भज्जासभाश्रमभ ् involving भज्जा धातु
र्ुरसभाश्रमभ ् involving र्ुर धातु
ED-4.6: कुद्ष-उऩद्रव्complications of कुद्ष (skin affliction)
प्रस्रवणभ ् discharge
अंगबेद् cracking of skin/body parts
अंगावमवानां ऩतनभ ् suppuration, falling of body parts
ज्वय् fever
अततसाय् diarrhoea
दौफाल्मभ ् weakness
अयोचक् tastelessness
अपवऩाक् indigestion
ED-4.7: कुद्ष-अरयद्श् fatal signs of कुद्ष (skin affliction)
ED-5 न्द्वत्र्/ककरास् कुद्ष ( skin affliction) with morbid white patches on skin (i.e.
vitiligo)
अऩरयस्रावी not having discharge

केवरत्वग्गतत्वभ affecting only the skin
ED-5.1: वाततक-न्द्वत्र्/ककरास् न्द्वत्र (leucoderma) due to vitiated वात
भर्णडरभ ् circular patches

अरुणभ ् slightly reddish coloured
ऩरुषभ ् rough/dry
ऩरयध्वंम्रस ruining
रूऺभ ् dry
ED-5.2: ऩैपतक-न्द्वत्र्/ककरास् न्द्वत्र (leucoderma) due to vitiated पऩत
ऩद्मऩत्रप्रतीकार्भ ्/कभरऩत्रवत ् like the petals of a

lotus
सऩरयदाह् burning sensation
ताि् copper coloured
योभपवध्वंसनभ ् loss of hairs
ED-5.3: कपजन्द्वत्र्/ककरास् न्द्वत्र (leucoderma) due to vitiated कप
द्वेत् whitish discoloration

न्स्नग्ध् smooth/unctuous /oily
फहर् large in size
घन् thick and dense lesion
गुरु् heaviness
ED-5.4: यक्तजन्द्वत्र्-दरुण् न्द्वत्र (leucoderma) due to vitiated यक्त
यक्तवणा् red colour
ED-5.5: भांसजन्द्वत्र्-चारुण् न्द्वत्र (leucoderma) due to vitiated भांसधातु
तािवणा् coppery colour lesions

ED-5.6: भेदोजन्द्वत्र्-ककरास् न्द्वत्र (leucoderma) due to vitiated भेदोधातु
द्वेतवणा् white colour lesions
ED-5.7: असाध्मककरास Incurable न्द्वत्र (leucoderma)
सम्फद्धभर्णडरभ ् non overlapping lesions

अततेजातभ ् lesions developing on extremities,
lips etc.
यक्तयोभ् in which the terminal hairs are red
अन्ग्नदग्धजतमन्ववत्रभ ् those which developed after burns
VISARPA
Skin is the largest organ of the body and act as the first barrier of body against all
external factors. Skin is affected by external factors as well as internal factors and by
innate and adaptive immune responses. Visarpa is a group of potentially life-threatening
diseases characterized by cutaneous and mucosal involvement.
Lesions maybe in the form of bullae, vesicles or swelling that rapidly spreads across body
tissues and is characterized by often rather acute onset of skin lesions with often severe
presentation and rather speedy progression and may often be life threatening. The site,
severity, rapidity of onset and spread, extend of dhatu involvement etc decides the
prognosis and progression of the disease.
According to Ayurveda the term visarpa has two parts „vi‟ and „sarpa‟
vi stands for vividha
sarpa stands for sarpana meaning spreading.
Nidana –
 Aharaja
 Viharaja
 Agantuja
Samprapthi
 Indulgence in the nidanas leads to vitiation of 3 dosa and rakta, mamsa, twak and
lasika with pitta/vata predominance
 Rakta plays an important role in this disease as a dhatu and also as a medium of
circulating vitiated dosha in the body
 Prasara(rapid) occurs with help of rasa and rakta
 Dosha- dusya sammurchana leads to sthanasamsraya in bahya or abhyantara
rogamarga and produces symptoms as per amshamsa samprapthi.
NIDANA OF VISARPA
Type Examples Dosa dushti Others
Aharaja nidana
RASA
रवण- अततसेवन intake of mutra, namkeens, salted nuts, पऩतं दोषसञ्चमा
sauces, noodles , chips, dried fish,
pappads.. कोऩमतत, यक्तं नफु तधं
वधामतत Rakta
dushti
pitta and
kapha(proka कुष्णातत
pana, भांसातन,
visyandana)
Specific प्रगारमतत
hetu for कुद्षातन, पवषं
visarpa.
वधामतत,
र्ोपान ्
स्पोिमतत
आम्र अततसेवन Fermented products, pickles, bhelpuri, Pitta Raktadush

sour fruit juices, sauces like tomato abhivridhiti
sauce, excess intake of preserved foods, Kapha Mamsa –
curd, buttermilk, pickles, lemon juice, vilapayatividahati
vinegar, alcohol, sauce, squashes, cold Shithileek
drinks arana -
kaya
किु अततसेवन excessive pungent food Pitta- vata rakta
spicy food, ginger, garlic, asafoetida, prakopa dushti
mustard,chutney, momom sauce, chilli badha- vit
sauce, Chinese foods, spicy packeted mutra
foods , biriyani, grilled non-vegetarian (indirectly
foods prepared after marinating in causes
spices, further
rakta
dushti)
GUNA sevana
उष्णअततसेवन drinking hot water, tea, coffee etc , Pitta Rakta
eating food that is excessively hot, use prakopa dushti
of salty, pungent , spicy food, using, Prachalita
madya, visha, fish rakta
prachalata
(may
reduce the
sanghata of
rakta and
increases
the flow of
flowing
blood, may
increase
bleeding.)
SPECIFIC ITEMS
दर्ध Curd in different forms such as raita, Kapha – Abhisyandi
lassi, dahivada, mixed in curry etc pitta(if Kleda
especially after heating and in autumn, atyamla) janaka
summer and spring seasons dushti Agni
vaisamya
Special karaka
nidana for Rakta
kushta & dushti
visarpa karaka
(ushna,
amla)
अम्र भस्तु watery part of curd (abhisyandi rakta
& amla)
kapha
dushti,pitta
prakopa ..
alcoholic preparations Teekshna, Rata dushti

ushna-laghu Raktapitta
Kaphaghna karam
Pitta
र्ुक्त prakopi
Alcoholic preparation. Beer etc Vata kara Rakta
Pitta dushti
prakopi Medo
dushti
karaka
Ushna -
सुय amla
alcoholic preparation from yava Pittakaraka Amla-
ushna
सौवीयक Raktadusht
i
madya which is spoiled..prepared with Pittadi Raktadusht
ingredients that are not good for health tridosha i
र्वमाऩतन भद्य dushti
Excessive alcohol consumption Pittadi Rakta
Alcohol intake in excessive quantity tridosha prakopaka
without heeding prakrti, rtu and physical dushti
फहु भद्य health regularly
याग सेवन Sour preparation made with unripe Kapha-pitta Katu-amla-
mango with guda swadu-
lavana
Rakta
dushti ?
हरयत र्ाक Regular use of Greenleafy vegetables Ruksha
Palak, methi, amaranthus, dhanyaka Raktadusht
patra, sigru patra… i karaka
Salads prepared from this
पवदादह tridosha raktadushti
ककराि Cream Kapha kara Guru
Vata
samana
Ill formed curd Pittakrt Rakta
भतदक दर्ध dushti
An alcoholic preparation Pitta Rakta
र्ार्णडाकक)सतधानं( dushtikara dushti
ततर Gingelly Pitta vata Rakta
भाष Black gram Kapha pitta Rakta
कुरत्थ Horse gram Pitta vata
तैर सेवन Intake of oils Kapha vata Agni
dushti vaisamya
Food prepared from grinded rice, black Kapha, pitta Rakta
gram etc like dosha, idli, vada dushtikarak dushti
पऩद्शाहाय a
Flesh of domesticated animals like
ग्राम्म भांस chicken, duck
आनूऩ भांस Flesh of animals living in anupa region
औदक भांस Flesh of water living animals
garlic Vata pitta Rakta
रर्ून dushti
Intake of heavy to digest food soon after 3 dosha Agni
recovery from disease dushti vaisamya.
Rasa rakta
dhatu
र्वमार्धऺीणे गव
ु त
ा न dushti
Intake of amla food(with curd, juices Pitta kapha Rakta
र्वमार्धऺीणे अम्र etc) while tired with disease dushti dushti
Intake of unctuous food while person is 3 dosha Rasa dhatu
र्वमार्धऺीणे न्स्नग्ध recovering or still fatigued with disease dushti dushti
र्वमार्धऺीणेर्ीतरा Intake of cold food while fatigued by Kapha vata Agni
disease dushti vaisamya
हाय
Heavy food after exertion Vata, pitta Agni
कभाऺीणस्म गुवत
ा न dushti vaisamya
Amla rasa food after heavy exertion Pitta vata Agni
कभाऺीणस्म अम्र dushti vaisamya
कभाऺीणस्म Intake of unctuous food after exertion Vata di Agni
dosha dushti vaisamya
न्स्नग्धाहाय
कभाऺीणस्म Intake of cold food after exertion Kapha pitta Agni
prakopa vaisamya
र्ीतराहाय
Intake of heavy food after fasting 3 Agni
doshotklesh vaisamya
उऩवासऺीणे गुवत
ा न a
उऩवासऺीणेाम्राहा Intake of amla rasa ahara after fasting Doshotklesh Agni
a karaka vaisamya
य
Intake of unctuous food after fasting Ama janaka, Agni
उऩवासऺीणेन्स्न
3 dosha vaisamya
ग्धाहाय dushti karaka
उऩवासऺीणे Intake of cold food after fasting Vata – Agni
kapha dushti mandyakar
र्ीतराहाय a
Vata pitta Rakta
dushti dushti
तीक्ष्णाहाय karaka
Intake of excess quantity of water when Vata kapha Agni
the person is tired/after exercise/ after dushti vaisamya
अम्फु अततभात्र fasting Pitta dushti
Mud, stones etc, pica (roughens the 3 dosha Agni
srotases and obstructs the srotases and dushti vaisamya
भत
ृ ् impairs digestion.
वल्रूय Dried mamsa intake Vata dushti
Intake of excessive hot food or food Pitta dushti Rakta
which is having ushna virya like karaka dushti
उष्णाहाय maricha, red chilly, ginger
Intake of rough food such as oats, Vata Agni
रूऺ आहाय biscuits, namkeen etc dushti
Pittja visarpa, kaphaja visarpa Pitta Rakta
prakopa, dushti
kapha
अम्रार्न utklesha
Cause only for kaphaja visarpa Kapha Rasa
dushti, agni
स्वाद ु vaisamya
Cause only for kaphaja visarpa Kapha Rasa
dushti, agni
न्स्नग्ध vaisamya
Cause only for kaphaja visarpa Kapha Rasa dushti
agni
गुरु vaisamya
असम्मक आहाय पवर्ध

Food which has started decaying (with Vatadi Agni
excessive kleda) tridosha vaisamya
Food kept overnight dushti karaka
Rakta rasa
प्रन्क्तरतन बोजन dushti
Food that is not conducive to the prakrti, Vatadi Rasa rakta
desha or kala of the person tridosha dushti
असात्म्म बोजन dushti
पवरुद्ध बोजन
Intake of food while previous food has Doshotklesa Rasa, rakta
अजीणा बोजन not been properly digested (3 dosha)
Excessive intake of food without due Tridosha Rasa, rakta
अध्मर्न consideration to agni dushti
र्वमार्धऺीणे Excessive food intake while fatigued Tridosha Rasa rakta
with disease dushti agni
अततभात्राहाय vaisamya
कभाऺीनस्म Excessive food intake while fatigued Tridosha Rasa rakta
after exertion dushti agni
अततभत्राहाय vaisamya
Excessive food intake after fasting Tridosha Rasa rakta
उऩवासऺीणे dushti agni
अततभात्राहाय vaisamya
Day sleep Kapha – Rasa dushti

ददवास्वप्न pitta dushti
Excessive sun Pitta vata rakta
घभााततसेवन dushti dushti
Excessive exertion Vata
कभाततसेवन prakopa
Excessive indulgence in coitus Vata
अततभैथन
ु prakopa
Excessive walking Vata
ऩदे अततगभन prakopa
Excessive jolting due to travelling in Vata
मान ऺोब vehicles prakopa
Skipping sleep at night Vata
जागयण prakopa
Abhyantara visarpa Vatadi Rakta
tridosha dushti
वेगानं पवषभप्रवतानं kopa
In pittaja visarpa Pitta kopa Rakta
उष्णोऩचाय dushti
AGANTU
ऺत Injury Pitta vata Rakta
ऺतफतध Bandaging over injury Pitta vata Rakta
प्रऩतन Fall Pitta , vata Rakta
पवष Poisons 3 doshas Rakta
वात दोष Wind and exposure to winds Vata
Abhyantara visarpa 3 dosha Raktadi
dusti dhatu
भभााघात vitiation
अमनानां पवघट्टन Abhyantara visarpa
Abhigataja visarpa Vp (3 dosha Rakta
अम्रबघात is possible)
र्स्त्रच्छे द Abhigataja visarpa 3 doshas rakta
र्स्त्र बेद Abhigataja visarpa 3 doshas rakta
र्स्त्र ऺत Abhigataja visarpa 3 doshas rakta
दहभातनर Abhigataja visarpa Vata kapha
उदध्मतनर Abhigataja visarpa Vata pitta
बल्रातक यस Abhigataja visarpa 3 dosha Rakta
Abhigataja visarpa Pitta vata Rakta
कपऩकच्छु र्क
ु kapha
NIDANARTHAKARA ROGA
त्रत्रष्णाततमोग Vata pitta Rasa rakta
ED-10: पवसऩा् disease charactarized by quick spreading akin to erysipelas/spreading

cellulitis
Classified into 3 major types based on the rogamarga and site of sthanasamsraya
ED-10.1 फाह्याश्रम पवसऩा पवसऩा (erysipelas/spreading cellulitis) affecting र्ाखा:
ED-10.2 आभ्मततय पवसऩा : पवसऩा ( erysipelas/spreading cellulitis) affecting आततया
(internal organs)
ED-10.3 उबमाश्रम-पवसऩा् पवसऩा ( erysipelas/spreading cellulitis) affecting र्ाखा
and अततया (internal organs)
ED-10.4: वातजपवसऩा् पवसऩा (erysipelas/spreading cellulitis) due to vitiated वात
भ्रभ् giddiness or dizziness
दवथु् burning sensation of eye

पऩऩासा thirst
तनस्तोद् pricking type of pain
र्ूर् severe pain
अङ्गभदा ् generalised bodyache
उद्रे द्शनभ ् cramps
कम्ऩ् tremors
तभक् black outs
कास् cough
अन्स्थबेद् breaking/splitting type of pain in the bones
सन्तधबेद् breaking/splitting pain in joints
अन्स्थपवद्ऴेषणभ ् feel of loosening in bones
सन्तधपवद्ऴेषणभ ् loosening /dislocation of joints
वेऩनभ ् shivering/tremors
अयोचकभ ् tastelessness
चऺुषो् आकुरत्वभ ् querulous eyes
अस्रागभनभ ् bleeding
अङ्गेषु पऩऩीम्ररका इव सञ्चाय् tingling sensation
श्मावाबासर्ोथ् geyish coloured oedema
अरुणाबासर्ोथ् slightly reddish coloured oedema
अततभात्रं बेद् excessive tearing sensation
अततभात्रं आमाभ् excessive stretching
अततभात्रं सङ्कोच् excessive contracture
अततभात्रं हषा् horripilation
अततभात्रं स्पुयणभ ् excessive twitching
वातज्वयसभर्वमथा- constitutional features as in वातज fever
ऩक्तवम्रबतने वातव्रणोत्ऩपत् wound/ulcer formation after rupture of ripened (absess)
ED-10.5 : पऩतजपवसऩा् पवसऩा (erysipelas/spreading cellulitis) due to vitiated पऩत
भूछाा syncope/attacks of swooning
भोह् confusion/delirium
छददा ् vomiting/emesis
अङ्गबेद् breaking pain in body
अततभात्रं स्वेद् excessive perspiration
अततदााह् burning sensation inside the body
प्रराऩ् excess talking/irrelevant speech/incoherent speech
म्रर्योरुक् headache
चऺुषोयाकुरत्वभ ् querulous eyes
अस्वप्नभ ् insomnia/sleeplessness
अयतत् distress/dicontent/restlessness
र्ीतवारयतषा् अततभात्रभ ् excessive desire for cold water
र्ीतवाततषा् अततभात्रभ ् excessive desire for cold air
हरयतनेत्रत्वभ ् greenish tint in eyes/excessive icterus
हरयतभूत्रत्वभ ् green coloured urine
हरयतवचास्त्वभ ् greenish tint in stool
हरयतरूऩदर्ानभ ् greenish vision (of patient)
हारयद्रनेत्रत्वभ ् yellow coloured eyes

हारयद्रभूत्रत्वभ ् yellowish discoluration of urine
हारयद्रवचास्त्वभ ् excess yellow tint to stool
हारयद्ररूऩदर्ानभ ् yellowish vision (of patient)
पवसऩामुक्तावकार्स्म ताित्वभ ् pinkish colouration of पवसऩा affected area
पवसऩामुक्तावकार्स्म हरयतत्वभ ् greenish colouration of पवसऩा affected area
पवसऩामुक्तावकार्स्म हारयद्रत्वभ ् yellowish colouration of पवसऩा affected area
पवसऩामक्त
ु ावकार्स्म नीरत्वभ ् bluish colouration of पवसऩा affected area
पवसऩामुक्तावकार्स्म कृष्णत्वभ ् blackish colouration of पवसऩा affected area
पवसऩामुक्तावकार्स्म यक्तत्वभ ् redness of पवसऩा affected area
उत्सेद् local swelling
अततभात्रं दाह् severe burning sensation
अततभात्रबेदनभ ् excessive breaking pain
तािस्रावमुक्तस्पोि् eruption with pinkish discharge
हरयतस्रावमुक्तस्पोि् eruption with greenish discharge
हारयद्रस्रावमुक्तस्पोि् eruption with yellowish discharge
नीरस्रावमुक्तस्पोि् eruption with blueish discharge
कृष्णस्रावमक्त
ु स्पोि् eruption with blackish discharge
यक्तस्रावमुक्तस्पोि् eruptions with bloody discharge/with bleeding
द्रत
ु गतत् speedy/quick/swift gait
अततरोदहत्(ऩीडका) furuncle with deep red colour
पऩतज्वयम्ररङ्ग् constitutional features of पऩतज fever

ऩक्तवम्रबतने पऩतव्रणोत्ऩपत् पऩत dominant wound formation in ripened and
ruptured (abscess)
ED-10.6: कपजपवसऩा् पवसऩा (erysipelas/spreading cellulitis) due to vitiated कप
र्ीतक् chills
र्ीतज्वय् fever with chills
गौयवभ ् heaviness
तनद्रा sleep
ततद्रा drowsiness/lassitude
अयोचकभ ् tastelessness
भधुयास्मत्वभ ् sweet taste in mouth
आस्मोऩरेऩ् sticky feel in mouth
तनद्षीपवका sputum/expectoration
छददा ् vomiting
आरस्मभ ् lethargy
स्तैम्रभत्मभ ् a sensation of being covered with wet clothes
अन्ग्ननार्् loss of अन्ग्न(digestive power)

द्वमथुभान ् अवकार्् affected area of body with swelling over it
ऩार्णडु-अवकार्् affected area of body with pallor over it
नाततयक्तावकार्् affected area of body without much redness on it
स्नेहान्तवतावकार्् area of body with unctuousness
सुप्त्मन्तवतावकार्् affected area of body with numbness
स्तम्बान्तवतावकार्् affected area of body with stiffness
गौयवान्तवतावकार्् area of body with heaviness

अल्ऩवेदनावकार्् affected area of body with mild pain
कृच्रऩाकीस्पोि् eruption which is difficult to ripen
र्चयकायीस्पोि्/अर्ीघ्रऩाक् eruption which is late to ripen
फहरत्वगुऩरेऩमुक्तस्पोि् eruption covered with thick skin
द्वेतस्पोि् whitish colored eruption
ऩार्णडुस्पोि् blisters with pallor
प्रम्रबतने द्वेतभास्राव् whitish discharge after burst (abscess/eruption)

प्रम्रबतने पऩन्च्छरभास्राव् sticky discharge after burst (abscess/eruption)
प्रम्रबतने तततुभदाश्राव् fibrous discharge after burst (abscess/eruption)
प्रम्रबतने घनभाश्राव् thick discharge after burst (abscess/eruption)
प्रम्रबतने अनुफद्धभाश्राव् clotted discharge after burst (abscess/eruption)
प्रम्रबतने न्स्नग्धभाश्राव् unctuousdischarge after burst (abscess/eruption)
ऊध्वाकामे गुरुन्स्थयजारावतत् covered with thick and heavy netted appearance in
upper body ..(ref needed for proper context)
न्स्नग्ध-फहुरत्वक् उऩरेऩ् covering of thick and unctuous skin
अनष
ु ंगी chronic (associated over a long period)
द्वेतनखभ ् white nails
द्वेतनमनभ ् white eyes

द्वेतवदनभ ् whitish face
द्वेतत्वक् whitish skin
द्वेतभूत्रभ ् whitish urine
द्वेतवचा् whitish stool
भतद्सयणभ ् slow (forward) movement
अल्ऩरुक् mild pain
उग्रकर्णडू excessive itching
कर्णडूमुत् associated with itching

न्स्नग्ध् smooth/unctuous /oily
कपज्वय-सभानरुक् constitutional features (or pain )as in a case
of कपज fever
ऩक्तवम्रबतने कपव्रणोत्ऩपत् कप dominant wound formation in rippened and
ruptured (abscess)
ED-10.7 अन्ग्नपवसऩा् / वातपऩतजपवसऩा् / अन्ग्नदाहज: पवसऩा ( erysipelas/spreading
cellulitis) due to vitiated वात and पऩत
भच्
ू छाा syncope/attacks of swooning
तभक् respiratory distress
अन्स्थबेद् breaking/splitting type of pain in the bones

सन्तधबेद् breaking/splitting pain in joints
अंगायै रयवाकीमाभानभ ् feels as if burnt with heated charcoal
तट्
ृ thirst
र्ाततांगायप्रकार्भ ् अततयक्तभ ् area becomes as cool down coal as black or red
अन्ग्नदग्ध इव स्पोि् blisters as after a thermal burn
र्ीघ्रगतत-मत
ु ् with quick speed
भभाानुसायी associated with or progressing towards vital
points(भभा)
ED-10.8 भभागत-अन्ग्नपवसऩाभ ्
भभाानुसायी associated with or progressing towards vital
points(भभा)
म्रबनपत अङ्गातन breaks down the organs/tissues
संऻा प्रभोहमतत takes away the conciosness or alertness
दहक्तकाद्वासौ जनमतत generates hiccups and dyspnoea
तनद्रानार्् insomnia
प्रभढ
ू संऻा (तनद्रानार्े सतत) disoriented with insomnia
र्वमर्थतचेत् (तनद्रानार्े सतत) disturbed mind with insomnia
न सुखं उऩरबते ( तनद्रानार्े unhappy and having insomnia
सतत)
अयततऩयीत् (तनद्रानार्े सतत) severe distress/dicontent/restlessness
स्थानादासनं आसनात ् र्य्मां changes positions due to restlessness
राततुम्रभच्छतत
न्क्तरद्शबतू मद्ष् आर्ु तनद्रां बजतत falls asleep while caught in complex condition
दीद्ऱांगायावकीणावत ् like burning coal
र्ाततांगायाम्रसत् white like burnt coal
नीर् bluish
यक्त् red/blood
आर्ु चीमते accumulates/grows quickly
ED-10.9 ग्रन्तथपवसऩा्/वातकपजपवसऩा् 
पवसऩा (erysipelas/spreading cellulitis) due to vitiated वात and कप
कपार्मे कृच्रऩाकी ग्रन्तथभारा a series of slow ripening nodules in कप dominant
region
म्रसयास्नामुभांसत्वगार्श्रतग्रतथीनां a series of nodules associated in region with vessels,
muscles,skin
भारा
तीव्ररुजा severe pain
स्थर
ू /अणु ग्रन्तथ large/small neolasm/growth
दीघा /वत
ृ ग्रन्तथ elongated/round growth/neoplasm
यक्तवणाग्रन्तथ red colored neoplasm/growth
कास् cough
दहक्तका hiccup
द्वास् breathlessness/difficult breathing
र्ोष् dryness/wasting/emaciation
वैवर्णमाभ ् discolouration
प्रसेक् excessive salivation
भूच्छाा syncope/attacks of swooning
अंगबंग् breaking type of pain in body

अन्ग्नसदनभ ् diminution of अन्ग्न( digestive power)
खयग्रन्तथ् rough nodules
ED-10.10 कदा भपवसऩा्/पऩतकपजपवसऩा पवसऩा (erysipelas/spreading cellulitis) due to
vitiated पऩत and कप
र्ीतज्वय् fever with chills

म्रर्योगरु
ु त्वभ ् heavyness of head
स्तैम्रभत्मभ ् a sensation of being covered with wet clothes
अङ्गावसाद् fatigue
ततद्रा drowsiness/lassitude
अतनद्रे ष् aversion to food
प्रराऩ् excess talking/irrelevant speech/incoherent speech
अन्ग्ननार््अन्ग्नहातन् loss of अन्ग्न(digestive power)
अन्स्थबेद्- breaking/splitting type of pain in the bones
भच्
ू छाा syncope/attacks of swooning
पऩऩासा thirst
स्रोतसां प्ररेऩ् feeling of wrapped of स्रोतस
जाड्मभ ् इन्तद्रमाणाभ ् dullness/inactiveness/sluggishness of sense organs
प्रामोऩवेर्नभ ् defecation of stools with आभ
अंगपवऺेऩणभ ् convulsive movements of body
अंगभदा ् generalized bodyache
औत्सुक्तमभ ् anxious curiosity
प्राम् आभार्मे पवसऩातत अरसक् predominantly in आभार्म region
एकदे र्ग्राही affecting specific organ/region/body part
यक्तपऩडकावकीणाावकार््रोदहत area comprised of red nodules
ऩीतपऩडकावकीणाावकार््अततऩीत् area comprised of yellowish nodules
ऩार्णडुपऩडकावकीणाावकार््ऩार्णडुय् area comprised of whitiish nodules
भेचकाबपऩडकावकीणाावकार्् area comprised of भेचक(as like eyes of peacocks
tail or collyrium) nodules
कारपऩडकावकीणाावकार्् area comprised of blackish nodules
भम्ररनावकार्् misty /unclean area
न्स्नग्धावकार्् unctuous area
फहूष्भावकार्् area with excessive heat
गरु
ु heaviness
न्स्तम्रभतवेदना heavy and wet feeling with pain

द्वमथुभान ् oedematous
गम्बीयऩाक् deep seated suppuration
तनयास्राव् without any discharge
र्ीघ्रक्तरेद् getting moist very quickly
न्स्वतनभांसभ ् soft tissue and muscles with sweat
न्क्तरतनभांसभ ् soft tissue and muscles with moisture
न्स्वतनत्वक् skin with sweat

न्क्तरतनत्वक् moist skin
ऩतू तभांस putrifaction of भांस
ऩूतत त्वक् putrid smell
रभेणाल्ऩरुक gradual mild pain
ऩयाभद्श
ृ ो अवदीमाते कदा भ इव breaks down on touch and feel like muddy, slushy
अवऩीडडतो अततयं प्रमच्छतत falls down after suppuration
उऩन्क्तरतनऩूततभांसत्मागी (on pressure) foul smelling n moist soft tissue
(अवऩीडडते)
म्रसयास्नामस
ु ंदर्ी blood vessels and soft tissue/muscles are visible
कूणऩगन्तध् cadaveric smell
संजाहातन् loss of conciousness
स्भतृ तहातन् dementia
स्तम्ब् rigidity/stiffness
इन्तद्रमगौयवभ ् dulling of senses
आभोऩवेर्न् defecation of stools with आभ
गम्बीयऩाक् deep seated suppuration
स्ऩद्श
ृ ् न्क्तरतनोऽवदीमाते| friable to touch as it is sodden
ऩङ्कवच्छीणाभांस् appears like mud due to muscles being decayed
स्ऩद्शस्नामुम्रसयागण्- exposed ligamentstendons and the vascular bundles
र्वगतध् cadaveric smell
ED-10.11 सान्तनऩातजपवसऩा् पवसऩा ( erysipelas/spreading cellulitis) due to all the

three vitiated दोष
ED-10.12 ऺतजपवसऩा्: पवसऩा (erysipelas/spreading cellulitis) due to trauma
श्मावर्ोपभ ् grey colored oedema
रोदहतर्ोपभ ् red colored oedema

ऩाकभ ् inflammation/suppuration
कुरत्थसदृर्् स्पोि् कुरत्थ seed like vescicles
अम्रसतस्पोि् blackish eruptions
रुजा pain
ED-10.13 असाध्म-पवसऩा् irremediable पवसऩा (erysipelas/spreading cellulitis)
भभाागतभ ् that which affects भभा

र्ीणाभांसभ ् withering of भांस
र्ीणास्नामु withering of sinews
र्ीणाम्रसया withering of veins
प्रन्क्तरतन् weeping
र्वगतध् cadaveric smell
ED-10.14 पवसऩा-उऩद्रव् complications of पवसऩा (erysipelas/spreading cellulitis)

अततसाय् diarrhea
वभथु vomiting
त्वक् दयणं breaking and withering of skin
भांस दयणं breaking and withering of muscle-tissue
क्तरभ् exhaustion without exertion
ED-10.15: पवसऩा-अरयद्श् fatal signs of पवसऩा (erysipelas/spreading cellulitis

ICD – O: Kshudra roga
O-1: अन्ग्नयोदहणी(vesicles arising in axilla)
अततदााह् मुक्त स्पोिा् Vesicles with internal burning sensation

कऺाबागेषु स्पोिा् Vesicles in axilla
दीद्ऱऩावकसन्तनब् स्पोिा्(अग्तमाबा) Vesicles resemble blazing of fire
भांस दायण (दारुण) स्पोिा् Vesicles burrowing muscle
O-2: अजगन्ल्रका(greengram like papules in children)
ग्रर्थत पऩदिका hard nodular/papular lesions

नीरुज पऩदिका painless nodule
भुद्ग सन्तनब्पऩदिका nodule of the size of green gram
त्वक सवणा पऩदिका skin coloured nodule
न्स्नग्ध पऩदिका waxy/ unctuous lesion
O-3: अनुर्मी: (deep rooted abscess in foot)
अल्ऩ संयम्ब पऩदिका less inflammed nodules
गम्बीय पऩदिका deep routed lesion
अतत् प्रऩाक् lesion with tendency to suppurate internally
त्वक् सवणा पऩदिका skin coloured nodule

उऩरयन्स्थता् (भस्तकोऩरय) पऩदिका located in scalp/ head
O-4: आतत्रारजी/ आतधारजी(elevated papule)
अल्ऩ ऩूम मुक्त पऩडका Lesion with small amount of pus or with less tendency
to suppurate
अवक्तत्र पऩडका lesion without punctum
उतनत ऩरयभर्णडर पऩडका raised circular lesion
घन पऩडका thick and firm lesion
आभ उदम्
ु फय संकार् पऩडका lesion resembling unripe fig fruit
O-6: अरस्(Interdigital inflammation)

ऩाद अङ्गल्
ु मततया रुजा pain in the interdigital areas of feet
ऩाद अङ्गल्
ु मततया कर्णडु itching in the interdigital areas of feet
ऩादअङ्गुल्मततया sticky moistness of interdigital areas of feet
क्तरेद्न्क्तरतनता/
ऩाद अङ्गुल्माततया दाह् burning sensation of interdigital areas of feet
O-7: अरुं पषका(eruptions on head having multiple openings)
क्तरेद फहुर पऩदिका् /)कऩारे( wet papules on scalp

फहु क्तरेदीतन
कऩारे फहुवक्तत्राणण पऩदिका scalp lesions with multiple openings

म्रसद्धाथातनब पऩदिका lesion resembling the size and shape and colour of
mustard seed
कङ्गतु नब पऩदिका lesion resembling the size and shape of jyotishmati
seeds (celastrus paniculata)
O-8: इतद्रपवद्धा(Lotus pod lesion)
ऩद्मकणणाकवत)् ऩद्मऩुष्कयवत(् / numerous papular lesions conglomerated to give the

appearance of lotus flower thalamus
भध्मे पऩदिका
O-9: उत्कोठ्(multiple pruritic rashes)
कोठ् सानुफतधस्तु उत्कोठ् कोथ that recur again and again
O-10: कोठ्
यागवन्तत भर्णडर् reddish circular rash
फहूतन भर्णडर् multiple circular lesions or rashes

अततकर्णडू भर्णडर् lesions associated with excessive itching
O-11: इरयवेन्ल्रका
ज्वयान्तवत पऩदिका occurrence of lesion associated with fever
उतभाङ्गस्तुजत्रूध्वा/ पऩदिका Papular lesion that occur in supra-clavicular region

वत
ृ पऩदिका circular lesion
उग्ररुजा पऩदिका papular lesion associated with severe pain
O-12: कऺा्(Axillary or inguinal abscess)
फाहुप्रदे र्े स्पोिा् vesicular lesions in upper arm
ऩाद्वेषु स्पोिा् vesicular lesions in and around flanks

कऺासतनेषु कऺे स्पोिा् / vesicular lesions in peri-axillar regions
अंस दे र्े स्पोिा् vesicular lesions in shoulder
कृष्ण स्पोिा् black coloured vesicular lesions
सवेदना स्पोिा् painful vesicles
सूक्ष्भा पऩदिका minute papular/vesicular lesions
राजोऩभा पऩदिका lesions that appear like राजा (parched paddy)
घन पऩदिका lesions that are thick and dense
O-13: कच्छपऩका(Testudinal lesion)
ग्रर्थत् र्ोथ् hard nodular swelling

कच्छऩोतनत)र्ोथ्( tortoise shell like swelling which is elevated in the
middle
ऩञ्चषट्/ 5 or 6 in number
O-14: कदय्(corn / callosity)
कोरवत ् उत्सतन ग्रन्तथ swelling resembling the size and shape of indian
jujube (कोर)
कीरवत ् उत्सतन ग्रन्तथ् swelling that appear like nail
O-15: कुनख्
खय नख rough appearance and texture of nails
अम्रसत नख blackish coloured nails
रूऺ नख dry nails
FA-2: खम्ररत्मभ ्/खरतत (baldness)
O-16: गतधनाभा /गतधभारा: (Solitary large black vesicle)
स्पोि सन्तनब् पऩदिका lesion resembling vesicles
एकं one in number

फाहु दे र्े स्पोि सन्तनब् एक single vesicular lesion in upper arm
पऩदिका
अंस दे र्े स्पोि सन्तनब् एक single vesicular lesion in the shoulder region
पऩदिका
ऩाद्वा दे र्े स्पोि सन्तनब् एक single vesicular lesion in the flanks
पऩदिका
कऺा दे र्े स्पोि सन्तनब् एक single vesicular lesion in the axillary region
पऩदिका
भहती पऩदिका large vesicular swelling
राज सदृर् पऩदिका vesicle/lesions resembling parched paddy
O-17: गदा म्रबका
सयक्त पऩडकार्चतभ ् सयाग् / main lesion surrounded by reddish many small lesions
पऩदिकार्चता
भर्णडराकाय पऩडका rounded eruptions
वत
ृ पऩडका rounded lesions
उत्सतन पऩडका elevated lesions
रुजाकयी पऩडका lesions associated with severe pain
पवऩर
ु पऩडका abundant papular lesions
O-19: चभाकीर् (wart)
त्वचो फदह् कीरोऩभभ ् nail like projection from skin surface

न्स्थयभ ् fixed projection
खयभ ् rough textured projection
त्वचो फदह् अर्ा् pile mass like projection from skin surface
भषेभ्मतत
ू नततया more elevated than भर्
म्रसता whitish projection
अम्रसत blackish projection
O-19.1: वाततक-चभाकीर्
तोद मक्त
ु कीर् projection associated with pricking pain
ऩारुष्म मक्त
ु ् roughness/dryness
O-20: र्चप्मभ ् /अऺता /उऩनख(whitlow)

नख वेष्ट्क भांस दाह् burning sensation in lateral wall of eponychium
नख वेष्ट्क भांस ऩाक् pus formation in the lateral wall of eponychium
चभा नखाततये बर्
ृ दाह् intense burning sensation in the area between nails and skin
underneath the nails
चभा नखाततये बर्

ृ ऩाक् intense burning sensation in the area between nails and skin
underneath the nails
नख भांस रुक pain over and under nails
O-21: जतभ
ु णण् (birthmark-reddish)
नीरुजं भर्णडर् painless circular lesion
उत्सतन भर्णडर् slightly elevated from skin surface

सभं )सक्ष्
ू भ( minute lesion
ईषत यक्तभरोदहतभ
् ् / भर्णडर् reddish or reddish tinged
द्ऴऺण smooth textured lesion
चभाकीरवत ् appear like चभाकीर
सहज present since birth / congenital
O-22: जारगदा ब् (non suppurating cellulitis)

भतद पवसऩाण र्ोप् slow spreading swelling
अऩाक र्ोप् swelling with less tendency to suppurate

तनु र्ोप् little swelling
ताि वणा र्ोप् copper coloured swelling
ज्वयकृत associated with fever
O-23: ततरक् / ततरकारक(sesamum – eruption)
त्वकस्थ् कृष्ण वणाा Black coloured lesion localized on skin surface
ततरभात्राणण sesame sized lesion

नीरुज् painless lesion
त्वक सभ् macular lesion/unelevated from skin
FA-3: दारुणभ ्: (dandruff)

केर्बम्रू भ् प्रऩाट्मते Scalp becomes fissured
दारुण)केर्बम्रू भ्( hard surface (scalp)
कर्णडुय)केर्बम्रू भ्( itching of scalp
रूऺ)केर्बम्रू भ्( dryness of scalp
O-24: तमच्छ्(Birth mark-bluish)
गात्रदे र्े भर्णडरभ ् circular patches on body

भहत ् भर्णडरभ ् large sized patches
अल्ऩ भर्णडरभ ् small sized patches
श्माभ भर्णडरभ ् bluish black coloured patches
अम्रसत भर्णडरभ ् blackish coloured patches
तनरुजं painless patches
O-26: नीम्ररका(black patch)
गात्रे कृष्णा भर्णडर् Black coloured cicular lesion on body

भख
ु े कृष्णा भर्णडर् Black coloured circular lesion on face
नीरुज भर्णडर् painless circular lesion
तनक
ु ं thin lesion over body or face
O-28: प्रसतु द्ऱ्(hypoesthesia)

अल्ऩ कर्णडु mild or no itching
त्वक् ऩार्णडुता pale coloured skin
प्रसुतद्ऱ् numbness
रभेण पवचेतना )त्वक( gradual loss of tactile sensation in skin
अपवक्तरेद् absence of oozing and moistness
O-29: ऩतद्मनीकर्णिक्(Papules-lotus thorn)
कर्णिकैयार्चतभ ् Thorny projections
वत
ृ भर्णड्रभ ् circular elevated lesions
कर्णडूभत ् associated with itching
ऩतद्मनी कर्णिकवत thorny projections that appear like lotus
नीरुज् painless
द्वेत्ऩार्णडु whitish projection
ABB-21: ऩम्ररत्(Premature greying hair)
O-31: ऩाददायी: (Cracked plantar sole)
ऩाद् तर दायण fissuring and cracking of feet
सरुज् associated with pain
O-33: भषक्(Blackgram-spots)
अवेदना भर्णडर् गात्रेषु painless round lesions in the body

भाषवत ् भर्णडर् lesion that appear like भाष (black gram)
कृष्ण भर्णडर् blackish coloured lesion
उत्सतन भर्णडर् elevated from the skin surface
O-34: मवप्रख्मा: (barley seed-macule)
ग्रर्थत पऩडका knotted lesions
भांस संर्श्रत पऩडका lesions located in muscle tissue
मवाकाय् पऩडका barley shaped lesions (thin rimed thick in the

middle)
सुकदठन पऩडका very hard lesions
O-35: मुवानपऩडका (भुखदपू षका)( pimples)
र्ाल्भरी कर्णिकाकाय पऩडका lesion resembling the prickles of silk cotton tree
मूनं वक्तत्रे occurs in the face of young people
सरुज् associated with pain
घन् thick and dense lesion
भेदोगबा् presence of fatty pultaceous material inside the
lesion
O-36: यान्जका: mustard seed-eruptions

यान्जका वणा संस्थान प्रभाण papules resembling the shape size and appearance of
mustard seed
पऩदिका
घन पऩदिका lesions that are thick and dense
सरुज पऩदिका associated with pain
O-37: राञ्छनभ ्(congenital black /white patch)
कृष्णं भर्णडर black coloured patch
म्रसत भर्णडर white coloured patch

सभ भर्णडर unelevated patch
O-38: यकसा
स्रावहीन पऩडका papule without discharge

O-39: रूह्या/ इतद्ररुद्ऱ्(aloepecia)
प्रच्मावतत योभाणण fall of hairs

अतमेषाभ ् असम्बव् absence of hair regrowth in that area
Manual of clinical proforma for examination
of Twak vikara in Ayurveda
A dermatologic history is similar to that in other fields of medicine and includes:
• Chief complaint
• History of present illness (HPI)
• Past medical history (PMH)
• Medications
• Allergies
• Family history
• Health-related behaviours
• Social history
• Review of systems
The examination of skin should include
 Inspection of skin, scalp, hair and nails (as the symptoms manifest in these areas)
 Palpation of skin, scalp, hair and nails
 Inspection and palpation of mucosa of oral cavity, rectum etc
It should have two aspects.
 Local examination of lesion

 Systemic examination of the person to identify whether the condition is caused by dushti
in bahya rogamarga or secondary to systemic illness
Diseases can be generally included in any of the following categories if it complies to the
following
Kushta :
 The manifestation is almost always dermatological

 The onset of the disease may be gradual in most of the cases
 The lesions may run a chronic course
 There will be remissions and relapses
 Direct link can be established between causative factors (ahara/vihara/manasika) with the
exacerbations.
 Only few conditions are designated as asadhya and fatality is low
Visarpa :
 A disease characterised by manifestation of cutaneous and systemic signs simultaneously

 Rapid onset and rapidly spreading lesion
 Fatality is more
 Systemic symptoms should also be considered along with dermatological signs and
symptoms
 Nature of lesion is sopha/granthi/pidaka/sphota
Ksudra roga
 As the name suggests, the etiology and symptoms are minor and doesnot affect the
quality of patients life
 The severity is less
 Often localised and does not spread
I. EXAMINATION OF LESION
1. Externally visible lesions: Present/Absent
The first manifestation of a skin lesion such as kushta and ksudra roga is almost always a skin
lesion which may or may not point towards a specific disease. In visarpa, often the systemic
symptoms precede or succeed the manifestation of skin symptoms.
If a dermatological manifestation is present, then only it will be included in this context.
2. Type of lesion/स्वबाव्
The type of lesion may be included in this context. Majority of the lesions may follow any of
the following pattern
 ग्रन्तथ् / पऩडका / र्ोप् / स्पोि् /भर्णडर / त्वक् स्पुिनभ ् /गर्णड/व्रण/फहर चभा/ केर्बम्रू भ
प्रऩािनं / न्द्वत्र /त्वक् वैवर्णमा / ऩाम्ररत्मं / इतद्ररद्ऱ
ु ं / खय रूऺ नख / नख भांस ऩाक / सतु द्ऱ
खाम्ररत्म (baldness) /others
ग्रन्तथ (nodular eruption that is elevated from skin level)
An example of granthi
ग्रन्तथ(भार)- ग्रन्तथ पवसऩा ( In granthi visarpa, multiple nodular swellings may be visible
over the affected area and the speed of onset and spread may be used as an indicator of
diagnosis as kaphaja visarpa )
कोरवत ग्रन्तथ – कदय (manifestation of nodular swelling the size of jujube fruit in any
area without any systemic implication is diagnostic of kadara )
अणुम्रब: ग्रन्तथ ( ऩाणण/ऩाद)– वल्भीक( in this context, this feature is characteristic of the
disease valmika, where numerous nodular eruptions with minute openings will be observed
and may be considered diagnostic )
Multiple nodular swellings with openings
पऩडका
Papular eruptions with excessive discharge pidakavakeerna

Kilopama pidaka avaktra pidaka
Bahuvaktra pidaka Siddhartha sadrsa pidaka (kapale)
Yavakara mamsastha pidaka salmali kantaka sadrsa pidaka

ककार् पऩडकार्चतं – ऋश्मन्जह्व (karkasa pidakachita here implies manifestation of
numerous rough papular eruption over the affected area )
सयक्त पऩडकार्चतं- पवऩाददक( reddish papular eruptions over the affected area with pain is
Characteristic of vipadika)
याग पऩडका(कर्णडुर)- दद्र ु (reddish papular eruptions associated with excessive itching over
affected area)
पऩडका(द्वेतारुणश्मावा्)- ऩाभा( whitish/slightly reddish/grayish coloured papular eruptions
in the affected area)
पऩडक(फहुस्रावमुक्त) – पवचर्चाका(papular eruptions with excessive discharge )
पऩदकावाकीणा- अन्ग्न पवसऩा- (afflicted area covered with popular
eruptions)
यक्तऩीतऩार्णडुपऩडकावकीणा अवकार्: - कदा भपवसऩा(the afflicted area
covered with numerous eruptions )
उत्सतन पऩडक-गदा म्रबक( pidaka which is much elevated above skin
level )
Salmali kantaka
ककरोऩभ पऩडक – चभाकीर(nail like eruptions on skin )
अवक्तत्र पऩडक- अतत्रारन्ज(eruption without any opening )
फहुवक्तत्र पऩडक – अरुं पषक(eruption with multiple openings)
वत
ृ उग्ररुज पऩडक- इरयवेन्ल्रक(circular eruptions with intense pain )
कदठन पऩडक(मवाकाय) – मवप्राख्मा (hard barley sized eruption )
र्ाल्भम्ररकर्णडकाकाय पऩडक – मुवानऩीडडक(hard eruptions which resemble thorn of salmali
tree)
यान्जका वणा संस्थान प्रभाण पऩदिका-यान्जका(eruptions that appear in colour and size to that
of Brassica Juncea)
स्रावहीन पऩडका- याकस( papular eruptions without discharge)
ऩक्तवोदम्
ु फय सन्तनब पऩडक(पववत
ृ आनन)-पववत
ृ ा(eruption which appear like ripe fig and
with open surface)
Pakwa udumbara pakwodumbara sankasha pidaka with vivruta anana
ऩद्मकणणाकवत पऩडक- पवद्ध-( lesions characterised by multiple eruptions from skin level
with space in between)
Pidaka resembling padmakarnika receptacle of lotus(padmakarnika)
पवदायी कतदवत पऩडक- पवदारयका( broad based lesion which appear like tuber of vidari)
Vidari kanda lesion resembling vidari kanda

सक्ष्
ू भ पऩडक(राजोऩभ) { फाहु/कऺ/अंसदे र्)- कऺ ( numerous small eruptions in the axilla
which resembles parched grain(laaja)
Laaja condition with manifestation of

numerous
eruptions in axilla
स्पोि सन्तनब् पऩदिका(फाहु/अंस/ऩाद्वा/कऺ)- गतधनाभ( blister like eruptions over upper

limb/shoulder/side of thorax/axilla)
भर्णडराकाय पऩडका(सयक्त पऩडकार्चतभ ्)—गदा म्रबक (circular elevated lesion surrounded by
small red eruptions )
Mandala sadrsa vikara surrounded by sarakta pidaka
सूक्ष्भा फहु् पऩदिका(न्स्िक् /ऩाणण/कूऩाय)-ऩाभा( numerous small papular eruption over

buttocks/palms/elbow etc)
Numerous small eruptions over buttocks
घन पऩदिका- कऺ (single dense pidaka in axilla)

Solitary lesion in axilla
ग्रर्थत पऩडका(भांस संर्श्रत)- मवप्रख्मा( papular eruption that is deep seated{ the lesion
might be fixed to muscle tissue and hence rigid and immovable})
मवाकाय पऩडका- मवप्रख्मा (papule resembling the shape and size of barley)
(भस्तकोऩरय) पऩदिका – अनर्
ु ातम – elevated lesion on head
स्पोि ( vesicle/bullous eruption )
र्ीघ्रबेदै: स्पोि – वातज पवसऩा( vesicles/bullae that rupture easily is a symptom of vataja
visarpa)
स्पोि: उऩचीमते र्ोि: - पऩतज पवसऩा( the area afflicted by visarpa will be edematous and
might be studded with numerous vesicular/bullous lesions)
फहुरत्वगुऩरेऩमुक्त स्पोि- कपज पवसऩा ( thick walled vesicles )

अन्ग्नदग्द प्रकाय स्पोि – अन्ग्न पवसऩा (
Agni dagda sphota agni dagdha prakara sphota in body
स्पोि (दरतत च मत ्)) – चभादर ( vesicular/bullous lesion that ruptures with exfoliation of
skin
(द्वेतारुणाबासो) स्पोि- पवस्पोि ( vesicle like eruptions which are white or sanguineous
color )
क्षऺप्र स्पोि – वष
ृ ण कच्छु ( Rapid onset of vesicles in the scrotal region)
गुदे स्पोि – आदहऩूतना( manifestation of vesicles in the perianal region in children)
सूक्ष्भ स्पोि(फाहु/कऺ/अंसदे र्)- कऺ (numerous minute vesicular eruption over upper
limbs/axilla/shoulder )
दीद्ऱऩावकसन्तनब् स्पोिा्(अग्तमाबा) कऺ दे र्-े अन्ग्न योदहणण
Eruptions in the axilla which resembles. Deeptha pavaka
burning embers
र्ोि – edema
उत्सेध(दाह संबेदन ऩयीत) – वातज पवसऩा (area affected by vataja visarpa will be swollen,
often associated with burning sensation and intense pain. )
द्वमथभ
ु ान अवकार् ( श्मावारुणाबास्)- वातज पवसऩा (area affected by vataja visarpa will
have blackish or reddish-orange hue )
कच्चऩोतनत र्ोि- कच्छपऩक(swelling which is elevated and like the back of a turtle)
स्पोिकै: उऩचीमते र्ोि – पऩतज पवसऩा (swelling studded with vesicles/bullae)
ऩार्णडु न अततयक्त र्ोि – कपज पवसऩा (swelling which is pale or not overly red)
भतद पवसऩाण र्ोि(अऩाक) –जारगदा ब (swelling which spreads with delay and doesnot
undergo suppuration )
द्वमथभ
ु ान ् (गम्बीयऩाको)- कदा भ पवसऩा (swelling with deep and intense suppuration
tendency)
उत्सेध(ं ऩुर्णडयीकदरोऩभभ ्) – ऩुर्णडयीक कुद्षं( elevated lesion with edema and resembles lotus
flower in colour)
भर्णडरं
उत्सतन भर्णडरं- भर्णडर कुद्षं( skin lesion which is circular and elevated from skin level )
उद्गत भर्णडरं- दद्र ु ( elevated circular lesion )
अरुण भर्णडरभ ्- वाततक-न्द्वत्र्( hypo pigmented lesion with reddish/reddish orange hue )
ऩद्मऩत्रप्रतीकार्भ ्/कभरऩत्रवत ् भर्णडरं- ऩैपतक-न्द्वत्र्( hypo pigmented skin lesion which is
skin level and resembles the colour of lotus petal)
द्वेत् भर्णडरभ ्- कपजन्द्वत्र्(hypo pigmented pale skin lesion )
यक्तवणा् भर्णडरं – यक्तजन्द्वत्र्(reddish coloured hypo pigmented circular lesion)
तािवणा् भर्णडरं – भांसजन्द्वत्र्( coppery coloured circular lesion)
द्वेतवणा् भर्णडरं – भेदोजन्द्वत्र्( hypo pigmented pale circular lesion )
सम्फद्धभर्णडरभ ् – असाध्मककरास(overlapping circular lesions )
फहु यागवन्तत भर्णडर्(अतत कर्णडु) – कोठ( multiple reddish circular lesions with severe
itching)
चभाकीरवत उत्सतन भर्णडरं(ईषत यक्त) – जतुभणण ( slightly reddish elevated skin lesion
which is similar to charmakeela in its character)
गात्रदे र्े भर्णडरभ ्(अम्रसत/श्माव)- तमच्छ्( hypo/hyper pigmented patches in body )
तनइरुजा कृष्ण भर्णडर(गात्र/भख
ु )- नीम्ररक( painless black patches on body and or face)
भाषवत ् कृष्ण भर्णडर्- भषक(black elevated skin lesion which resembles blackgram in
shape and size)
त्वक् सभा (कृष्ण/म्रसत) भर्णडर – राञ्छनभ ्( unelevated black/white patch in skin )
भुखे श्माव भर्णडरभ ्- र्वमङ्ग्( hyper pigmentation/blackish patches over skin of face)
स्पुिनं/ प्रऩािनं
ऩाणण /ऩाद स्पुिनं – पवऩाददक ( fissuring/flaking and cracking of skin of palms/soles /both)
केर्बुम्रभ प्रऩािनं- दारुणक( cracking and fissuring of scalp )
ऩाद् तर दायण- ऩाददारय( fissuring /cracking of sole )
घद्श
ृ ं यज: ककये त –म्रसध्भं( flaking of scales on rubbing )
चभादरनं
चभादरनं- चभादर ( exfoliation of skin)
गर्णड:
यक्तगर्णडै् (कर्णडूमुतै) र्चतं – अरसकं( covered with reddish bubble like lesions associated
with itching )
फहर/ घन त्वक्
हन्स्तचभावत फहर त्वक् – चभा कुद्षं( thick/keratinized skin which resembles elephant
skin in texture)
ककण खय त्वक् – ककदिब कुद्षं( skin which is rough textured like callus)
फहर त्वक् उऩरेऩमक्त
ु स्पोि – कपज पवसऩा( vesicle/bullae with thick crust)
योभ च्मवनं
योभ प्रच्मावनं – इतद्ररुद्ऱभ ्(falling of hair )

तनरोभ – खाम्ररत्मभ ्( baldness/no hair at all)
भत्स्म र्कर संन्तनब – एक कुद्षं( fish scale like skin lesion )
व्रण
(स्थर
ू भूरं) फहु व्रण – र्तारु(multiple broad based ulcers )
घोय व्रण ( स्पोि: एकीबत
ु ात) गद
ु दे र्े – अदहऩत
ू नक्( blister like lesions which bursts,
then coalesces to form ulcers at guda region)
A. संख्मा (Number of characteristic lesions)
: एक / फहु / अनेक /भार रूऩेण/ अतम
फहुव्रण – र्तारु( multiple ulcers will be seen in sataru)

ग्रन्तथभार – ग्रन्तथ पवसऩा( numerous nodular lesions which resembles garland)
ऩञ्च/षट् – कच्छपऩका( 5 or 6 elevated hard lesions )
एक पऩडक – गतधनाभ( single )
सयक्त पऩडकार्चतभ ्( covered by numerous reddish papular eruptions)- गदा म्रबका
स्पोिकैरुऩचीमते र्ोि – पऩतज पवसऩा( swelling studded with numerous small
eruptions.)
अन्ग्नदग्धप्रकायै द्ळ स्पोिै रुऩचीमते – अन्ग्न पवसऩा( covered by vesicles and bullae which
resembles blisters formed with burn)
यक्तऩीतऩार्णडुपऩडकावकीणा – कदा भ पवसऩा( studded with red/yellow eruptions)
B. स्वबाव(Nature of the lesion ) (any specific feature that may point to a particular disease)
:
ककार् – ऋश्मन्जह्व (karkasha means hard and rough on touch and appearance)
अग्तमाब स्पोि(कऺ)- अन्ग्न योदहणण (vesicle which resembles burning ember)
ग्रर्थत पऩदिका(भुद्ग संतनबा)- अजगन्ल्रक(nodular lesion resembling size and shape of
green gram)
अवक्तत्र घन पऩडका – आतत्रारजी( skin lesion which is dense on palpation and without any
opening)
ऩद्मकणणाकवत ्/(ऩद्मऩुष्कयवत ्) भध्मे पऩदिका – इतद्रपवद्धा ( papular lesion surrounded by
numerous small eruptions)
राजोऩभा पऩदिका(कऺे) – कऺा्( lesions resembling the size and shape of parched grain )
ग्रर्थत् र्ोथ् – कच्छपऩका( swelling which is hard and dense )
कोरवत ् उत्सतन ग्रन्तथ – कदय( swelling which resembles jujube fruit in shape and size)
खय रूऺ नख – कुनख( rough, hard and dense nail)
कीरोऩभभ ् – चभाकीर (( skin lesion which is elevated from skin level and resembling nail
in its appearance)
3. स्थान/र्वमातद्ऱ/Distribution of lesion: सवाभङ्गभ ्/ कपार्मे /म्रसया आर्श्रत/ स्नामआ

ु र्श्रत/
भांसत्वगार्श्रत/ एकदे र्ग्रादह/ ग्रन्तथभारा/ ऊध्वाजत्र/ु न्स्पक्तऩाणणकूऩाय/ ऩाणण- ऩाद / ऩाणण/ ऩाद/
केर्बूम्रभ/ नख /नखाततय/अतगुल्मततय/ फाहु(hands)/सन्क्तथ/ न्स्पक् / कऺ /कऺासतन दे र्ष
े ु
/अंसदे र्/ ऩाद्वा दे र् सन्तध/ गात्र दे र्/भुखभ ्/ अतम
4. स्वरूऩ (Pattern of lesion): This describes the pattern in which the lesion is spread,
single lesion, multiple lesions interconnected, entire area covered with numerous skin
eruptions.
i. पऩडकावकीणाावकार्् (area covered by numerous small eruptions)

ii. ग्रन्तथ भार (a series of nodules arranged like garland)
iii. अतम (others)
5. गतत: (Onset of disease):
i. र्ीघ्र (quick onset)/ द्रत

ु (rapid onset) [onset from seconds to hours)
ii. नैवतत र्ीघ्र नैवातत भतद: (neither too slow nor too fast onset- {weeks} )
iii. भतद (slow onset – months )
iv. अतत भतद ( very slow onset- years)
v. अतम others
Nature of spread Time Dosha Tendency to be
disease
Sheegra gati Rapid spread within Pitta/p-v/pitta Visarpa (if rapid
minutes/ hrs to 1-2 pradhana tridosha manifestation of
days dermatological and
systemic
symptoms)
Druta gati Rapid spread within Pitta / Vata/vata- Either visarpa or
minutes/ hrs to 1-2 pitta/ pitta- kapha pitta pradhana
days kushta / p-v ksudra
kushta
Manda gati Spread will take Kapha/kapha-vata Possibility for
weeks/ months kushta is more
Neither ati manda/ ati Days to weeks Kapha or kapha tama Kushta vikara /
drutha conditions kshudra kushta
Chira gati Months or years.
a. द्रत
ु गतत – it is the character of visarpa, and also in conditions with pitta involvement
(pitta/pittavata) उष्णं च मद्यपऩ न साऺाद्रातजनकं तथाऽपऩ रूऺसम्फतधादष्ु णं वातं कयोतत
द्रत
ु गतत – पऩतज पवसऩा
र्ीघ्रगतत- अन्ग्न पवसऩा
र्ीघ्रक्तरेद्- अन्ग्न पवसऩा
b. भतदसयणं
भतदसयणं – कपज पवसऩा

भतद पवसऩाण र्ोप् -जारगदा ब्
The onset of symptoms can be rapid or chronic. The speed of onset of symptoms and the speed
of spread of the symptoms and also the onset of complications has been explained by acharyas in
the context of various diseases.
It can be observed that drutagati (rapid onset of symptoms, rapid spread and rapid onset of
complications such as suppuration, ulceration, gangrene etc) is mainly seen with conditions
involving
 Pitta dosha /vata- pitta/pitta-rakta
Mandagati can be considered in conditions with kapha predominance
 Kapha/vata-kapha/pitta kapha
However the gati may be affected by other conditions such as patient‟s prakrti, sahaja bala &
samhanana, extend of vitiation of dhatus, vayas, satwa, nature and duration of nidana seva,
and other samprapthi ghatakas
सभुत्थान/onset-
आर्ु सभुथान – वाततक कुद्षं,पऩतज कुद्षं,ऋश्मन्जह्व,ऩुर्णडयीक( pitta kapha)

Rapid onset of skin conditions is seen with pitta/vata/vp/pk(not common)
अनार्ग
ु भ ् – कपज कुद्षं
When the doshas are not vitiated enough to spread rapidly, or when samprapthi ghatakasa are not
strong enough to produce tivra gati, or due to chira swabhava of kapha, the lesion may spread
slowly
c. आर्ु अवदयणभ ् – ऋश्मन्जह्व
d.आर्ु बेदद –ऩुर्णडयीकं
6. पवसऩाण: ( Speed of spread): once the disease manifests, the spread of lesion may be
assessed to analyse the doshic status and extend of spread of disease. when the onset is druta, the
possibility of the skin condition to be visarpa is more.
i. र्ीघ्र (quick onset)/ द्रत

ु (rapid onset) [onset from seconds to hours)
ii. नैवतत र्ीघ्र नैवातत भतद: (neither too slow nor too fast onset- {weeks} )
iii. भतद (slow onset – months ) अतत भतद ( very slow onset- years)
iv. अतम others
7. स्पोिात्व्रणोत्ऩपत (speed of rupture of sphota to form vrana) – In certain conditions, the
disease includes the bhedas stage where there might be rupture of sphota/sotha/pidaka to form
ulcers or so. In this case also, dosha assessment should be done.
i. आर्ु (quick rupture of sphota to form vrana)
ii. भतद (slow rupture of sphota to form vrana)
iii. कृच्र (very difficult to rupture or hardly rupture)
iv. अतम (others)
8. र्चयकारयता (Chronicity of disease) : kushta is by nature chirakari except few, while visarpa is
not. Kshudra roga may not be chronic and severe as the name itself suggests
i. अर्चय न्स्थर्थ(acute)
ii. र्चय न्स्थतत (chronic)
iii. अनष ु ङ्गी(associated over a long period without symptomatic relief in response to
treatment )
iv. ऩुनयावतता ( recurrence)
अनुषङ्गी – दद्र,ु कपज पवसऩा (the term anushangi conveys that the lesions may carry a
chronic course.Chronicity may also imply association with kapha dosha )
व्रणानाभ ् र्चयन्स्थतत – कुद्ष ऩूवरु
ा ऩ (in kushta purvarupa, vrana takes time to heal and also
may remain for a long time because of existent rakta dushti, vitiation of twak (in sukshma
level)
9. दारुणत्व (Severity of disease)

i. भद
ृ ु (mild )
ii. दारुण(severe)
iii. अल्ऩ उऩद्रवमुक्त (associated with less complications/ no systemic symptoms )
iv. फहु उऩद्रव मुक्त(associated with many local and systemic complications)
v. अरयद्श मुक्त (associated with fatal symptoms)
vi. अतम (others)
कदा भ पवसऩा : said as asadhya (which indirectly indicates its severity)

अन्ग्न पवसऩा :
ग्रन्तथ पवसऩा :
काकण कुद्षं :
सन्तनऩात पवसऩा/ कुद्षं(उऩद्रवमुक्त – असाध्म(implies severity)
सावाधातु गत कुद्षं
It should be understood that by nature itself, visarpa is more severe than kushta. Visarpa
caused by samsarga and sannipata is much more severe than that of ekadoshaja. Kushta
caused by sannipata involvement is more severe. When the dosha dushti in kushta
pervades all dhatus it becomes asadhya. Following are the factors that regulate the
severity of disease.
Multiple dhatu involvement
Tridosha involvement
Roga swabhava ( visarpa is more severe)
Multiple rogamarga and doshagati
Impaired bala
Age
The extend and severity of lesions and extend of systemic symptoms can be combined to
assess the prognosis of the disease.
10. फाह्य स्वरूऩ (Morphology of Lesion)
a. रूऩ सादृश्म:(Morphological resemblance )

Morphological resemblance means the resemblance of the lesion to any known
comparable object and is explained as such by acharayas which may help in a direct
diagnosis.
कऩाराबं- वाततक कुद्षं( the appearance of lesion is like earthern vessel, wirth depression in
the middle and everted edges)
कृष्ण कऩाम्ररक वणं- वाततक कुद्षं(lesion resembles that of earthern vessels)
उदम्
ु फयपराबासं – उदम्
ु फय कुद्षं( the appearence of fruit is similar to that of ripe fig)
ऋश्मन्जह्वाकृतत – ऋश्मन्जह्व कुद्षं( the appearance of lesion resembles that of antelope
tongue (pale grayish blue colour with elevated rough papillae)
ऩुर्णडयीक सदृर् - ऩुर्णडयीक कुद्षं(resembles that of lotus(pinkish petals with red tips)
ऩरार् ऩुष्ऩ सदृर्:- ऩुर्णडयीक कुद्षं( lesion resembles that of palasha pushpa (butea
monosperma) which are bright orangish red)
अराफु ऩुष्ऩ - म्रसध्भं ( the lesion in sidhma resembles to that of Lagenaria siceraria(alabu)
ie, whitish coloured.
दौन्ग्धकऩुष्ऩ – म्रसध्भं-(lesion is whiteish in colour like gourd flower)
काकणान्ततक- काकणं- (the lesions in kakana resembles that of seed of abrus precatarius
with black and reddish colours.)
भत्स्म र्कर- एक कुद्षं- in this, skin lesions resembles the scales on fish.
हन्स्तचभा – चभा कुद्षं- (in this thje lesions will be thick hard and appear like keratinized
skin. )
दव
ु ाावत ् – दद्र(ु the spread of lesions will be like durva, ie, spread along adjoining skin)
अतसीकुसुभ – दद्र-ु (appears pale bluish white like the colour of flower of atasi[linum
usitassimum]
दीद्ऱाङ्गायावकीणावत ्- भभागत अन्ग्न पवसऩा (lesion resembles that of red hot embers-orange
red)
र्ातथाङ्गायवत ्- भभागत अन्ग्न पवसऩा(appearance is similar to that of cooled ember after
burning, ie grayish black)
ऩंकवत ् र्ीणाभांस- कदा भ पवसऩा ( the skin appears withered like sludge and the skin gives
way on palpation)
कुरत्थ सदृर्- ऺतज पवसऩा ( appear like dolichos biflorus – elevated from skin surface and
localized to the area of kshata with brownish colour)
दीद्ऱऩावकसन्तनब् स्पोिा्(अग्तमाबा)- अन्ग्न योदहणण ( bullae that appear like that of burning
ember)
भद्ग
ु सन्तनब्- अजगन्ल्रका( lesions with size and shape of green gram )
आभ उदम् ु फय संकार् पऩडका – आतत्रारन्ज (the lesion will be round and elevated like unripe fig
fruit)
म्रसद्धाथातनब पऩदिका- अरुं पषक( lesions that resember mustard seed on scalp)
कङ्गतु नब पऩदिका- अरुं पषक( lesion resembling kangu(seed of celastrus paniculatus in shape and
size on the scalp)
ऩद्मकणणाकवत ्/(ऩद्मऩष्ु कयवत ्) भध्मे पऩदिका- इतद्रपवद्धा(resembles that of the thalamus of lotus with
numerous thorny projections)
कीरवत ् उत्सतन ग्रन्तथ्/ कोरवत ् उत्सतन ग्रन्तथ- कदय्( lesion that is elevated from skn surface
with nail like appearance / jujube)
त्वचो फदह् कीरोऩभभ ्- चभाकीर् – (nail like elongated projection from the surface of skin)
चभाकीरवत ् (ईषत यक्तभ ् /रोदहतभ ् ) – जतभ
ु णण्( slightly reddish projection from skin surface )
ऩतद्मनी कर्णिकवत – ऩतद्मनीकर्णिक्( lesions resembling thorny projections in lotus, on skin)
भाषवत ् भर्णडर्- भषक्( skin lesion which is slightly elevated from skin surface resembling the
colour and appearance of black gram)
मवाकाय् पऩडका- मवप्रख्मा( skin lesion which is similar to barley)
र्ाल्भरी कर्णिकाकाय पऩडका - मव
ु ानपऩडका (भख
ु दपू षका)
यान्जका वणा संस्थान प्रभाण पऩदिका- यान्जका(lesions resembling colour, size and shape of rajika –
mustard )
वल्भीकवत ् अणुम्रब्भख ु ै्ग्रन्तथ्- वल्भीक्( lesion characterised by minute numerous opening on
the skin surface)
पवदायीकतदवत ् वत ृ ् पऩडका - पवदारयका( hard elevated lesion which resembles size and shape of
pueraria tuberosa)
ऩक्तवोदम्
ु फय सन्तनबाभ ् – पववत ृ ा( lesion resembling ripe fig –open surface and reddish tallow in
colour)
Others
b. ऩरयभाण: (Size of individual lesions)
i. सक्ष्
ू भं (minute)
ii. भहावस्तु (occupying large area)
iii. भद्ग
ु सन्तनब (resembling green gram)
iv. स्थर
ू भर
ू (occupying large base)
v. भहत (large sized)
vi. यान्जकवत ् (resembling mustard seeds)
vii. कीरवत ् (resembles nail like projection)
viii. कोरवत ् (resembles size and shape of Indian jujube)
ix. अतम (others)
फहरभ ् – चभा कुद्षं( thick lesion [thickening of skin])
भहावस्तु /भहाश्रमं –एक कुद्षं( involving whole of the body or large part of body,which
means the character of skin itself is altered.)
दीघाप्रतान – दद्र(ु spreading along skin in an elongated manner)
स्थर
ू भर
ू व्रण – र्तारु( large based ulcers over joints)
सूक्ष्भ पऩडक- ऩाभा( minute eruptions)
भद्ग
ु सन्तनब्पऩदिका-अजगन्ल्रका( small sized)
फहूतन भर्णडर्-कोठ् – multiple circular lesions
वत
ृ पऩदिका-इरयवेन्ल्रका(circular lesion)
सक्ष्
ू भा पऩदिका- कऺा्( minute eruptions in kaksha etc)
राजोऩभा पऩदिका-कऺा्( lesions resembling parched paddy)
भहती पऩदिका- गतधनाभा /गतधभारा (single large vesicular lesion)
पवऩर
ु पऩडका- गदा म्रबका( abundant papular lesions )
भषेभ्मतूतनततया-चभाकीर्( lesion more elevated than mashaka)
सक्ष्
ू भ उत्सतन भर्णडर्-जतभ
ु णण्(minute but slightly elevated lesion )
तनु र्ोप्- जारगदा ब्( slight swelling )
ततरभात्राणण- ततरकारक
अल्ऩ भर्णडरभ ्- तमच्छ्(small circular lesion)
सक्ष्
ू भा फहु् पऩदिका-ऩाभा( numerous minute eruptions)
भाषवत ् भर्णडर्- भषक्( lesion the size of black gram)
यान्जका प्रभाण पऩदिका- यान्जका( lesion the size of black mustard)
वत
ृ ् पऩडका(पवदायीकतदवत ्)- पवदारयका( circular large lesion )
c) आकृतत (Shape of lesion):
i. वत
ृ ं (round)
ii. दीघा (long)
दीघाग्रन्तथ् – ग्रन्तथपवसऩा
वत
ृ ग्रन्तथ् - ग्रन्तथपवसऩा
d) औतनत्मभ ् (level of lesion with that of skin) –
i. त्वक् सभं (at the level of skin)

ii. उतनतं (elevated)
iii. तनभग्न (depressed)
iv. पवषभभ ् (irregularly elevated)
v. अतम (others )
दीघा ऩरयभर्णडरं – ऋष्मन्जह्वा

उत्सतन भर्णडरं – दद्र ु
उतनत ऩरयभर्णडर पऩडका- आतत्रारजी

फहूतन भर्णडर्- कोठ्
वत
ृ ् पऩडका(पवदायीकतदवत ्)- पवदारयका( circular lesion)
वत
ृ पऩदिका- इरयवेन्ल्रका
कच्छऩोतनत(र्ोथ्)- कच्छपऩका
उत्सतन ग्रन्तथ- कदय
भर्णडराकाय पऩडका/ वत
ृ पऩडका- गदा म्रबका
उत्सतन पऩडका- गदा म्रबका
कीरोऩभभ ्- चभाकीर
उत्सतन भर्णडर्- जतुभणण्
त्वक सभ्- ततरकारक
भहत ् / अल्ऩ भर्णडरभ ् (श्माभ/ अम्रसत)- तमच्छ्
गात्रे/ भुखे कृष्णा भर्णडर्- नीम्ररका
वत
ृ भर्णड्रभ ्(कर्णिकैयार्चतभ ्)- ऩतद्मनीकर्णिक्
भाषवत ् भर्णडर्(गात्रेषु)- भषक्
e. योग अर्धद्षान आबा/ वणा (colour):

i. द्वेत (white)
ii. द्वेतावबास: (whitish)
iii. ऩार्णडु (pale or hypopigmented)
iv. ऩीत(yellow)
v. ऩीताबास: (yellowish)
vi. अततऩीत(dark yellow)
vii. ईषत यक्त (slightly red)
viii. यक्त (red)
ix. यक्तावबास(reddish)
x. अततयक्त (intense red)
xi. नीर(blue)
xii. नीरबास(bluish)
xiii. हरयतं (green)
xiv. हरयद्र वणा(turmeric yellow)
xv. ताि(copper coloured)
xvi. तािावबस (slight copper coloured)
xvii. श्माव: (bluish black)
xviii. श्माभ: (dark grey)
xix. कृष्ण (black)
xx. अततकृष्ण (deep black)
xxi. भेचकाब- (colour like eye of peacocks feather)
xxii. अरुण (reddish brown)
xxiii. भम्ररन (unclear/ discoloured)
xxiv. कऩाराब: (discoloration similar to that of earthen vessels- brownish red)
xxv. अतम (others)
र्क्त
ु रावबाम्रस- कप कुद्षं
यक्तावबाम्रस – कप कुद्षं, ऩर्ण
ु डयीक कुद्षं
नीराबास: - ऋष्मन्जह्वा
नीरं – पऩतज पवसऩा / अन्ग्न पवसऩा
हरयतं - पऩतज पवसऩा
हारयद्रं - पऩतज पवसऩा
ऩीताबास: - ऋष्मन्जह्वा
ऩीत – कदा भ पवसऩं
अततऩीत – कदा भ पवसऩं
ऩार्णडु – कपज पवसऩं/ कदा भ पवसऩं
तािावबास - ऋष्मन्जह्वा
र्क्त
ु रावबास: - ऩर्ण
ु डयीक कुद्षं
र्क्त
ु रयक्तावबासं – म्रसध्भं
अरुणं – वात कुद्षं/ ऋष्मन्जह्वा / म्रसध्भं / ऩाभा
कृष्णभ ् - वात कुद्षं, कऺा्, ततरकारक, नीम्ररका, भषक्, राञ्छनभ ्, पऩतज पवसऩं,
कऩारवणा/काऩाम्ररका वणं- वात कुद्षं
ताि- पऩत कुद्षं, जारगदा ब्
श्माव: - ऋष्मन्जह्वा / ककदिबं/ ऩाभा / र्तारु: / पवचर्चाक/ र्वमङ्ग्
यक्तं – चभादर / र्तारु: / पऩतज पवसऩा / अन्ग्नपवसऩा / ग्रन्तथ पवसऩा / कदा भ पवसऩा
द्वेतं – ऩाभा, ऩतद्मनीकर्णिक्
अतीवयक्त: - काकणं
अतीव कृष्ण - काकणं
त्वक सवणा – अजगन्ल्रका, अनर्
ु मी, कपज-चभाकीर्,
अम्रसत- कुनख्/अन्ग्नपवसेऩ/ा ऺतज पवसऩा
म्रसता / अम्रसत – चभाकीर्, राञ्छनभ ्
ईषत यक्तभ ्/ रोदहतभ ्- जतभ
ु णण्
श्माभ/ अम्रसत- तमच्छ्
रोदहतं – कदा भ पवसऩा
अतत रोदहतं – पऩतज पवसऩा
भेचकाब - कदा भ पवसऩं
कार - कदा भ पवसऩं

वैवर्णमं – ग्रन्तथपवसऩा
त्वक् वणा – in some lesions, the colour is not changed.

अतत् श्मावं- ऋष्मन्जह्वं
Avabhasa indicates the variations of colour( dominant wavelength of colour irrespective of
intensity) and varna represents the gross colour of the lesion.
f. याग/ Redness - presence of redness would indicate the role of pitta and rakta in the
samprapthi.
g. संताऩभ ्/ फहु ऊष्भा: elevated temperature on the lesion which is ascertained by palpation and
by interrogation.
Santapa is a symptom felt by the patient(might express it as a sensation of burning or

stifling in the area of lesion) and examined by the physician by palpation as elevated
temperature . It is due to pitta involvement.
फहु ऊष्भा said in the context of kardama visarpa indicates elevated temperature within the
lesion which is a sign and symptom and can be explained as a feeling of excess heat
emanating from the lesion
h. पवसतृ त (Symmetry)
i. सभ पवसतृ त (symmetrical)
ii. पवषभ पवसतृ त (asymmetrical)
i. स्ऩर्ोऩरब्धता (Feel on touch)
i. तनु (thin)
ii. रूऺं (dry)
iii. ऩरुषं (coarse)
iv. खयं (rough)
v. कदठनं (hard and thick)
vi. न्स्नग्धं (unctuous)
vii. द्ऴऺण (smooth)
viii. न्स्थयं (static/ immobile)
ix. न्स्नग्ध–अवकार्( lesion and surrounding area is unctuous)
x. रूऺ अवकार् ( lesion and surrounding area is rough)
xi. (अतम (others)
xii. स्ऩद्श
ृ ्न्क्तरतनोऽवदीमाते (friable to touch as it is sodden)
xiii. साधायणभ ् ( no change with that of surrounding skin)
xiv. अवऩीडडतोऽततयं प्रमच्छतत (on palpation with finger, the skin squelches and goes inside)
xv. अतम (others)
Skin is the seat of vata and the manifestation of khara a, parusha etc helps us to understand
the anubandha dosha in this type of condition.
 अततर्रऺण – कुद्ष ऩूवरु
ा ऩ
 अततखय स्ऩर्ा- कुद्ष ऩूवरु
ा ऩ
 रूऺ: - वात कुद्षं, कीदिबं
 ऩरुष - वात कुद्षं, ऋष्मन्जह्वं , म्रसध्भं, कीदिबं
 तनु – वात कुद्षं
 न्स्नग्ध: - कपकुद्ष
 खय: - ऋष्मन्जह्वं , चभा कुद्षं
 फदहस्तनतू न- म्रसध्भं
 अतत: न्स्नग्ध:- म्रसध्भं
 ककणखय स्ऩर्ाभ ् – कीदिबं
 कदठन:- स्थर
ू ारुष्क:
Normal skin is soft, slightly unctuous and supple. Normal appearance of skin occurs
when there is equilibrium of all doshas in the skin.
The appearance of the lesion is to understood both by darshana and sparshana pareeksha.
Snigdha appearance is because of kaphadika dosha and ruksha/khara/parusha are because
of vata predominance. Mridutwam of lesions when compared with surrounding skin is
because of pitta involvement. Identification of associated dosha is necessary to
understand the doshic predominance in twak vikara.
रूऺ sparsha indicates rough and dry appearance of skin on touch and also on visual
inspection. Rookshata is specifically a character of vata dosha
Parusha twak means skin which is rough and coarse to touch. It is also predominantly
vata, but with mild kapha anubandha
Khara should be assessed as due to vata-kapha predominance and ought to be understood
as rough and hard to touch (roughness due to vata and hardened skin due to kapha ),
which is similar to condition of hyperkeratosis.
Katina indicates kapha – vata predominance which is produced as a result of thickening
of skin by kapha and reduced unctuousness leading to dryness and roughness by vata. It
can be likened to the condition of lichenification
Snigdhata to skin is induced by kapha.In conditions of kapha prakopoa there will be
increased unctuousness giving the skin a waxy or shiny appearance.
Kinakhara sparsha in kitibha can also be understood as due to kapha- vata involvement .
Rooksha  parusha  khara katina
Vata v+k v+k2+ v+ k 3+
j. अतमोतम संसक्त (coalescence of lesions): anyonya samsakta is the feature seen in mandala
kushta which is a kaphadika kushta.
k. घषाण ऩयीऺा((Exfoliation of skin on scratching/ rubbing)
l. म्रसयास्नामु दर्ानभ ् (visible veins and tendons)
11. ऩमातत ऩयीऺा (Margins of lesion: the margin represents the outermost rim of the lesion
from where the normal skin starts)
a) दर्ान ऩयीऺा: (On observation):
i. उतनतं(elevated)
ii. तनम्नं(depressed)
iii. सभं(uniform/ regular)
iv. पवषभं (irregular)
v. उद्रतफदह
ृ (protruded outside)
 खयऩमातत: - कऩारकुद्षं
 तन-ू कऩारकुद्षं
 उद्रतफदह-
ृ कऩारकुद्षं
 द्ऴक्ष्णऩमातत- भर्णडरकुद्षं
 न्स्थयऩमातत- भर्णडरकुद्षं
 ऩीतऩमातत- भर्णडरकुद्षं
 तनऩ
ु मातत – ऋष्मन्जह्व
 यक्तऩमातत- ऩर्ण
ु डयीककुद्षं
b) स्ऩर्ान ् ऩयीऺा(On touch):
i. तनु (thin)
ii. रूऺं (dry)
iii. ऩरुषं(rough)
iv. खयं (rough)
v. कदठनं(hard)
vi. न्स्नग्धं(unctuous)
vii. द्ऴऺण(smooth)/
viii. न्स्थयं (immobile)
ix. साधायणभ(normal)
x. अतम (others)
c) वणा ऩयीऺा: / Colour
i. द्वेत (white)
ii. द्वेतावबास: (whitish)
iii. ऩार्णडु (pale or hypopigmented)
iv. ऩीत(yellow)
v. ऩीताबास: (yellowish)
vi. अततऩीत(dark yellow)
vii. ईषत यक्त (slightly red)
viii. यक्त (red)
ix. यक्तावबास(reddish)
x. अततयक्त (intense red)
xi. नीर(blue)
xii. नीरबास(bluish)
xiii. हरयतं (green)
xiv. हरयद्र वणा(turmeric yellow)
xv. ताि(copper coloured)
xvi. तािावबस (slight copper coloured)
xvii. श्माव: (bluish black)
xviii. श्माभ: (dark grey)
xix. कृष्ण (black)
xx. अततकृष्ण (deep black)
xxi. भेचकाब- (colour like eye of peacocks feather)
xxii. अरुण (reddish brown)
xxiii. भम्ररन (unclear/ discoloured)
xxiv. कऩाराब: (discoloration similar to that of earthen vessels- brownish red)
xxv. अतम (others)
Aruna varna, shyava varna, shyama varna and kala/Krishna varna is characteristic of vata
predominant conditions
Rakta- haridra-harita-neela- peeta varna is characteristic of pitta predominant conditions)
mainly
White coloured or creamy white colour is characteristic of kaphaja visarpa
Dual combinations of colour may also be evident in samsargaja conditions.
d) भध्म बाग ऩयीऺा (Middle part of lesion):
i. सभं(regular/uniform)
ii. उतनतं (elevated)
iii. तनम्नं(depressed)
 उत्सतनभध्मा- ऋष्मन्जह्व
12. प्रत्मात्भ रऺण / पवम्रर्द्श रऺण (cardinal signs) : In this context, any symptom that has helped
you in diagnosis ought to be considered and written. For eg:
भम्ररनावकार््(musty /unclean/sloughy appearence) - कदा भपवसऩा्

अतमोतमसंसक्तं- lesions fused with each other - भर्णडरकुद्षं
घद्श
ृ ं यज: पवभञ्
ु चतत (exfoliation of scaly or powdery skin on scratching)- म्रसध्भं
ऩयाभद्श
ृ ोऽवदीमाते (skin breaks down on touch and feel like muddy slush)- कदा भपवसऩा
ऩूततभांसत्मागी - gangrene/necrosis of putrefied tissue- कदा भपवसऩा्
13. ऩरयत् त्वच स्वबाव: (Character of surrounding skin)
i. प्रन्क्तरतन्(association of क्तरेद, excessively moist or sodden appearence)

ii. न्स्नग्ध (unctuous)
iii. द्वमथु (swelling/edema in the surrounding area)
iv. स्तम्ब् (rigid)
v. गौयवभ ् (heaviness )
vi. गरु
ु न्स्थयजाराततह् (appearing as if covered with thick and heavy netted capillary
network)
vii. कोथ: (necrosis or putrefaction)
viii. रृपषत रोभार्चत(horripilation)
ix. रूऺ (dryness)
x. सुतद्ऱ (hypoesthesia)
xi. पऩडकार्चतं (studded with numerous papular eruptions)
xii. तनु त्वक् (thin skin)
xiii. ऩरुष त्वक् (rough skin)
xiv. रोभच्मवनं( loss/ fall of hair)
xv. म्रसयाजार (covered with vascular plexus/capillary network/visible vascularity)
xvi. अततस्वेद (excessive sweating)
xvii. अस्वेद (absence of sweating)
xviii. त्वक् दरनं (peeling of skin)
xix. र्ातताङ्गायप्रकार्: - skin appearing like burnt charcoal
xx. अन्ग्नदग्धप्रकायै द्ळ स्पोिै रुऩचीमते : studded with burn like vesicular lesions
xxi. ऩतू त भांस (putrid flesh)
xxii. ऩूतत त्वक् (putrid skin)
xxiii. त्वच: प्रभाण वैऩमाम (Change in thickness from that of surrounding areas)
xxiv. अतम (others)
 प्रन्क्तरतन – असाध्म पवसऩा
 न्स्नग्ध – कपज पवसऩा
 द्वमथु - कपज पवसऩा
 स्तम्ब: - कपज पवसऩा
 सतु द्ऱयवकार्: - कपज पवसऩा
 गौयवभ ् - कपज पवसऩा
 गुरुन्स्थय जारातत: कपज पवसऩा
 द्वमथुभान ् अवकार्:- वातज पवसऩा
 तनुम्रब: स्पोिकै: उऩचीमते - वातज पवसऩा
 मन्स्भंद्ळावकार्े पवसऩोऽनुसऩातत सोऽवकार्स्तािहरयतहारयद्रनीरकृष्णयक्तानां वणाानाभतमतभं ऩुष्मतत:-
वातज पवसऩा
 स्पोिकैरुऩचीमते अवकार््-(तािहरयतहारयद्रनीरकृष्णयक्तानां)- पऩतज पवसऩा
 उत्सेधैद्ळाततभात्रं – पऩतज पवसऩा
 द्वमथुभान ् अवकार्: - कपज पवसऩा
 फहुरत्वगुऩरेऩै्स्पोि: (द्वेत/ऩार्णडु)- कपज पवसऩा
 गुरुम्रब् न्स्थयै जाारावततै्- कपज पवसऩा
 अन्ग्नदग्धप्रकायै द्ळ स्पोिै रुऩचीमते – अन्ग्न पवसऩा
 र्ातताङ्गायप्रकार्ोऽततयक्तो अवकार््- अन्ग्न पवसऩा
 मन्स्भंद्ळावकार्े पवसऩो पवसऩातत सोऽवकार्ो यक्तऩीतऩार्णडुपऩडकावकीणा इव- कदा भ पवसऩा
 भेचकाब्- कदा भ पवसऩा
 न्स्वतनभांसत्वक् - कदा भ पवसऩा
 न्क्तरतनभांसत्वक् - कदा भ पवसऩा - कदा भ पवसऩा
 ऩूततभांसत्वक् - कदा भ पवसऩा
 कदा भ इवावऩीडडतोऽततयं प्रमच्छतत- कदा भ पवसऩा
 उऩन्क्तरतनऩूततभांसत्मागी- कदा भ पवसऩा
 म्रसयास्नामुसतदर्ी- कदा भ पवसऩा
14. स्राव (Discharge from lesion) :
Srava in kushta is attributed to involvement of pitta. The drava guna of pitta is the guna
responsible for this and in some cases association of kapha is also seen. Usually the
discharge from lesions may be classified as follows.
 Serous- This type of drainage is plasma that‟s thin, clear and watery.
 Sanguineous- fresh blood
 Serosanguineous- thin and watery, colour may vary from pink to dark red.
 Purulent- generally thick and colour may vary from whitish creamy to yellow or
green
Thin and watery discharge (tanu-vishada lasika srava)
Blood discharge (sanguinous discharge/rakta srava )
Ghana puya srava

Shweta picchila srava
Laseekadya (Ghana bhoori laseeka)
a) स्राव प्रकाय (Type of srava):
i. जर स्राव (watery discharge)

ii. रसीक स्राव (serous discharge )
iii. यक्त स्राव (bloody discharge)
iv. ऩूम स्राव (pus discharge)
v. ऩूमयक्त स्राव(pus-blood mixed discharge)
vi. ऩूमयक्त रसीक स्राव (pus-blood-serous mixed discharge)
vii. अतम (others)
Type of srava describes the type of discharge- laseeka srava, puya srava, raktasrava etc.
 फहुफहरऩमू - औदम्
ु फय कुद्षं, ऩर्ण
ु डयीक कुद्षं ( thick purulent discharge is seen in oudumbara
and pundareeka kushta)
 फहुफहरयक्त- औदम्
ु फय कुद्षं, ऩुर्णडयीक कुद्षं(thick bloody discharge is seen in oudumbara and
pundareeka kushta)
 फहुफहररसीका- औदम् ु फय कुद्षं, ऩुर्णडयीक कुद्षं( copious serous discharge is seen in
oudumbara and pundareeka kushta)
 फहुफहरर्ुक्तर स्राव – भर्णडर कुद्षं ( thick white discharge is seen in mandala kushta)
 रसीकाढ्मा- पवचर्चाका ( copious serous oozing is seen in vicharchika, which is a chief
diagnostic feature of it)
 घनबूरयरसीकासक
ृ ् - ऩुर्णडयीक कुद्षं( abundant dense discharge of laseeka and blood)
 तनपु वर्दस्राव: - वातज पवसऩा ( discharge of clear and thin fluid on rupture of sphota in
vataja visarpa)
 न्स्नग्धभास्रावं- द्ऴेष्भपवसऩा्(unctuous discharge in kaphaja visarpa
 तनयास्राव्- कदा भ पवसऩा ( no discharge is seen in kardama visarpa )
Puya srava is character of kapha, pitta or kapha-pitta predominant conditions
Shweta srava is seen with kapha
Rakta srava is seen with deeper dhatu involvement than the level of twak
Clear discharge is seen when there is no involvement of pitta and kapha
b. भात्रा (Quantity): अल्ऩं /फहरं /अतम (others)
 अल्ऩ रम्रसक/यक्त/ऩम
ू – म्रसध्भ ( in sidma kushta, discharge is not much evident and if
present will be in mild quantity)
 फहुस्रुतत - भर्णडर कुद्षं( discharge in large quantity)
 रसीकाढ्मा- पवचर्चाका( thick serous discharge or lesion covered with discharge)
 अल्ऩ स्राव – वातज पवसऩा ( mild quantity )
 फहर यक्त/रसीक/ऩम
ू - औदम्
ु फय कुद्षं, ऩर्ण
ु डयीक कुद्षं (copious discharge of
blood/laseeka/pus or mixture of these is seen in oudumbara and pundareeka kushta)
The quantity of discharge is dependent on the dosha, extend of spread of doshas(
superficial skin lesions may produce clear discharge, deeper may produce sanguinous or
serosanguinous discharge. Dhatu paka at twak and mamsa level may produce puya.
Usually in vatadhika disorders, there will be rookshata and parushata of skin and
scratching produces discharge of clear serous fluid
In conditions were vata is vitiated, if discharge is present , it will be of alpa( less
quantity)
In pittadhika conditions and kaphadika conditions there will be copious discharge. In
pittadhika there will be yellowish colour ( harita-haridra-neela-rakta) and in kaphadika
conditions, there will be whitish coloured dense discharge.
In vata-kapha conditions, the colour of discharge will range from serous (colourless to
pinkish red or white and the quantity of discharge will be more than that of pure vata
condition but less than kapha-pitta condition.
c. वणा (Colour): तािस्राव् /हरयतस्राव्./ हरयद्रस्राव् /नीरस्राव् /कृष्णस्राव् /द्वेतस्राव्/ etc

 अरुणस्राव – वातज पवसऩा ( orange red discharge is seen in vataja visarpa on rupture of
sphota)
 ताि वणास्राव – पऩतज पवसऩा ( coppery coloured discharge in pittaja visarpa )
 हरयत वणास्राव- पऩतज पवसऩा ( greenish tinged discharge seen in rupture of sphota in
pittaja visarpa )
 हारयद्र वणास्राव - पऩतज पवसऩा ( turmeric yellow tinged discharge seen in rupture of
sphota in pittaja visarpa )
 नीर वणास्राव - पऩतज पवसऩा ( bluish coloured discharge seen in rupture of sphota in
pittaja visarpa )
 कृष्ण वणास्राव - पऩतज पवसऩा ( black discharge seen in rupture of sphota in pittaja
visarpa )
 यक्त वणास्राव- पऩतज पवसऩा (sanguinous discharge seen in rupture of sphota in pittaja
visarpa )
 स्पोि् प्रम्रबतनस्तु द्वेत स्राव – कप: पवसऩा (whitish discharge on rupture of sphota is seen
in kaphaja visarpa
Aruna varna srava and colourless discharge is characteristic of vataja conditions

Rakta- haridra-harita-neela- discharge is characteristic of pitta predominant conditions)
White coloured or creamy white coloured discharge is characteristic of kaphaja visarpa
Dual combinations of colour may also be evident in samsargaja conditions.
d. स्वबाव (Character):
घनस्राव् (प्रम्रबतने) /पऩन्च्छरस्राव् (प्रम्रबतने) /तततुभत ्-स्राव्(प्रम्रबतने)/न्स्नग्धस्राव्

(प्रम्रबतने)/अनफ
ु द्धभास्राव् (प्रम्रबतने)
 पऩन्च्छरं- कपज पवसऩा ( the discharge that occurs after rupture of sphota in kaphaja visarpa
is slimy )
 तततुभत ् - कपज पवसऩा(the discharge that presents from kaphaja visarpa will be thready)
 अननफ
ु द्धं- कपज पवसऩा( thick and coagulated)
 न्स्नग्धभास्रावं- द्ऴेष्भपवसऩा्( unctuous or oily discharge will be seen in kaphaja visarpa)
 पऩन्च्छरस्राव- भर्णडर कुद्षं( in mandala kushta, when there is discharge it will be slimy)
 तनुपवर्दस्राव: - वातज पवसऩा ( clear and thin discharge is seen in vataja visarpa)
 घनबूरयरसीकासक्तृ स्राव - ऩुर्णडयीक कुद्षं( thick dense discharge of blood or laseeka is seen in
pundareeka kushta
 फहर ऩम ू /फहु यक्त/फहु रसीक - ऩर्ण
ु डयीक कुद्षं, औदम्
ु फय कुद्षं
The discharge in vatika srava will be tanu( thin) and visada( clear)
In pittaja conditions, the discharge will be hot and abundant(as srava is a manifestation
due to drava swabhava of pitta dosha)
In kaphaja conditions, the discharge will be thick, unctuous, cold, slimy, coagulated
15. र्ोथ (swelling): .
a. प्रकाय (Character of swelling)–: ekadesha swelling means doshas are localised only to that
area. When there is generalised swelling along with skin manifestation, then a deep underlying
pathology such as ubhayashrita visarpa should be considered.
i. एकदे र् (localised over the lesion)

ii. सवांग (present in whole body)
Swelling is a manifestation in the following:
 उत्सेध – भर्णडरकुद्षभ ्, ऩुर्णडयीक कुद्षं,

 द्वमथभ
ु ान ् – वातज पवसऩा , कपज पवसऩा
 उत्सेधद्ळ
ै ाततभात्रं – पऩतज पवसऩा
ु ान ् (गम्बीयऩाक:)- कदा भ पवसऩा
 उत्सेध(दाह संबेदन ऩयीत) – वातज पवसऩा (area affected by vataja visarpa will be swollen,
often associated with burning sensation and intense pain. )
ु ान अवकार् ( श्मावारुणाबास्)- वातज पवसऩा (area affected by vataja visarpa will
have blackish or reddish-orange hue )
 कच्चऩोतनत र्ोि- कच्छपऩक(swelling which is elevated and like the back of a turtle)
 स्पोिकै: उऩचीमते र्ोि – पऩतज पवसऩा (swelling studded with vesicles/bullae)
 ऩार्णडु न अततयक्त र्ोि – कपज पवसऩा (swelling which is pale or not overly red)
 भतद पवसऩाण र्ोि(अऩाक) –जारगदा ब (swelling which spreads with delay and doesnot
undergo suppuration )
ु ान ् (गम्बीयऩाको)- कदा भ पवसऩा (swelling with deep and intense suppuration
tendency)
 उत्सेध(ं ऩर्ण
ु डयीकदरोऩभभ ्) – ऩर्ण
ु डयीक कुद्षं( elevated lesion with edema and resembles lotus
flower in colour)
Swelling is usually not seen in kushta as a major feature
Swelling is usually seen in visarpa over the entire area affected with visarpa due to
the roga swabhava
Swelling is a kapha predominant character and when sopha is present it should be
understood as having either kapha anubandha or ama anubandha
In sopha avastha, its better to opt for langhana or lepana
Sopha that undergoes suppuration is due to pitta involvement and that doesnot
undergo suppuration should be understood as due to kapha swabhava
Sopha that undergoes rapid suppuration is because of pitta/vp involvement
The colour of swelling will be consistent with that of anubandha dosha
Aruna varna will be seen with vata anubandha
Haridra-harita-rakta-nila varna will be seen with pitta anubandha
Krishna varna will be seen with pittaanubandha in case of visarpa and otherwise in
vatadhika conditions
Malina varna or mechakabha varna is seen specifically in kardama visarpa
b. र्ोथवणा: (Colour of swelling) : ऩार्णडु नाततयक्त/यक्त/श्माभ/श्मावर्ोप्/ताि/कृष्ण/ अततकृष्ण

/हरयत/हरयद्रा/ नीर / ऩीत/अरुण/अतम (others)
The doshic implication of sotha varna should be assessed from the varna of corresponding dosha.
12.क्तरेदफाहुल्म(Presence of Kleda / soddened appearance)

म्रभ्माहायपवहाये णपवर्ेषेणपवयोर्धना|साधतु नतदावधातमस्वहयणाद्यैद्ळसेपवतै्|
ऩाप्भम्रब्कभाम्रब्सद्य्प्राक्तनैवेरयताभरा्|म्रसया्प्रऩद्यततय्माग्गास्त्वग्रसीकासग
ृ ाम्रभषभ ्|
दष
ू मतत्द्ऴथीकृत्मतनद्ळयततस्ततोफदह्| त्वच् कुवान्तत वैवर्णमं दद्श
ु ा् कुद्षभुर्न्तत तत ्| प्रऩद्य धातून ्
र्वमाप्मातत् सवान ् संक्तरेद्य चावहे त ्|| A.S.Ni 14/2-4
Kleda means „ardrata‟ which means moistness which imparts a wet appearance to the lesion. In
kushta and visarpa, kleda is produced from drava mala bhava of lasika and rakta generally and
even may include mala bhaga of medas due to its samanya swabhava with lasika which produces
a soddened wet appearance. Kleda is a kapha pitta predominant bhava
दाहोयाग्ऩरयस्रव्ऩाक्| पवस्रो गतध् क्तरेदस्तथाऽङ्गऩतनं च पऩतकृतभ ्||३५| च र्च ७/३५

Kleda in the lesion
a) प्रबाव(character ):
i. अल्ऩ (small amount)

ii. फहु(large amount)
iii. न्क्तरतन भांस (putrid flesh )
iv. न्क्तरतन त्वक् (putrid skin)
v. अतम (others)
b) स्थान (site) -
c) र्चयकारयता (Speed of onset)
i. आर्ु
ii. अनार्ु/र्चय
Kleda is present in the following conditions:
 क्तरेद- ऩुर्णडयीक कुद्षं, उश्मन्जह्वं (अ. स), ऩाभा :( A. S)

 फहुक्तरेद- भर्णडरकुद्षं
 फहुरक्तरेदं- औदम्
 अल्ऩ क्तरेद- ऋष्मन्जह्व
 क्तरेदाढ्मं- र्तारु:( A. S)
 र्ीघ्रक्तरेद्- कदा भ पवसऩा
 न्क्तरतनभांसत्वक् – कदा भपवसऩा्
 अवऩीड्मते उऩन्क्तरतनऩूततभांसत्मागी – कदा भपवसऩा्
 क्तरेद् सन्तधष:ु -भंसग कुद्षं
13. कोथ उऩन्स्थतत (Presence of necrosis/Gangrene/Putrefaction)
a. प्रादब
ु ााव (Onset)
i. Sudden (आर्ु)
ii. Slow (अनार्ु )
iii. others (अतम )
kotha is a feature in the following conditions as per acharyas.
 कोथ: - औदम्
 न्क्तरतनऩूततभांसत्वक् - कदा भ पवसऩा
 ऩयाभद्श
ृ ोऽवदीमाते- कदा भ पवसऩा
 उऩन्क्तरतनऩूततभांसत्मागी- कदा भ पवसऩा
18. कृम्रभ फाहुल्म (Association of krimi) :
Krimi manifestation occurs secondary when visible krimi is present(often happens as infestation
(myiasis)) and in kushta, raktaja krimi(which is invisible) always plays a major role ( kushta,
raktadushti, nakha –loma –asthi-tarunasthi bhakshana). Presence of visible krimi should be
attributed to many factors such as manifestation of kleda, dushti extending to dhatu other than
rakta (mamsa & medas).
 कृम्रभ- औदम्ु फय कुद्षं,ऋष्मन्जह्वं ,ऩुर्णडयीक कुद्षं

 फहुकरभी – भर्णडरं
 जततभ
ु न्तत- kaapala kushta
When presence of krimi is observed treatment should be aimed at removal of
krimi(prakrti vighata) and sodhana ( which is applicable to raktaja krimi which is
sookshma and sudaruna)
The environment for manifestation of krimi is seen with kapha & pitta predominant
dushti, excess kleda, kotha, dushti of rakta, mamsa and medas.
a. संख्मा (Quantity):
i. अल्ऩ ( very few in number)
ii. फहु (countable in number)
iii. अनेक (numerous)
 More quantity of krimi means rapid spread to deeper dhatus and prognosis will worsen
19. अवदयण प्रादब
ु ााव (fissuring) –
a) अवदयण प्रादब
ु ााव गतत (Speed of fissuring )–
 आर्ुअवदयण- औदम्
ु फय कुद्षं( अ. रृ)
 ऩाणणऩाद दायणभ ् – पवऩाददक
 केर्बूम्रभ प्रऩािय्ते – दारुणक
i. भतद (slow)
ii. साभातम ् (moderate)
iii. र्ीघ्र ्( rapid)
20. त्वक् त्वक् ऩािन गतत (Speed of onset)
a) त्वक् ऩािन गतत (Speed of onset)
i. भतद (slow)
21. त्वक् दरन (peeling of skin) –
a) त्वक् दरन गतत (Speed of onset)–

i. भतद (slow)
twak avadaranam(cracking or peeling ) is a feature of pitta and vata dosha

cracking of skin without redness and pain is due to vata (kapha anubandha)
patana -exfoliation of skin (cracking )is also seen with increase of ruksha guna of
vata
dalana of skin is peeling of skin due to increased ushna guna of pitta with secondary
pitta or kapha anubandha
rapid onset of avadarana is because of involvement of pitta and vata
slow splitting/cracking of skin is due to kapha
peeling of skin with redness is always due to pitta-vata involvement.
22. ऩरयत् म्रसया दर्ानभ ् (Presence of siras around the lesion) – present /absent
a) म्रसया वणा (Colour of siras around the lesion)

i. गौय (white)
ii. ताि (copper)
iii. यक्त (red)
iv. अल्ऩयक्त (slight red)
v. कृष्ण (black)
Manifestation of capillary network or engorged veins in and around the lesion should
be assessed
When engorged veins or capillaries are present irt should be understood as a
condition of rakta –pitta prakopa
 गौयम्रसयार्चतं – ओदम्ु फय कुद्षं
 यक्त म्रसयासंततं- ऩुर्णडयीकं
23. ऩरयत् केर्/योभ स्वबाव (Character of hairs on and around the lesion)-
a) स्वबाव (character of lesion)

i. केर् च्मवनं (loss of hair )
ii. केर् वणा र्वमततये क (colour change)
iii. रृपषत योभ (horripilation)
iv. स्ऩर्ा र्वमततये क (altered texture)
v. अल्ऩ योभ: ( less hair)
b) पवकृत केर् र्वमातद्ऱ (Distribution of abnormal hairs)

i. उऩसद्श
ृ त्वचोऩरय:/over the lesion
ii. उऩसद्श
ृ त्वचोसभततत: /around the lesion
iii. सवात:/ over and around the lesion
iv. अतम others
c) केर्/योभ वणा (hair Colour):

i. र्क्त
ु र(white)
ii. ताि (copper coloured)
iii. पववणा(discoloured)
iv. अतम (others )
d) रोभ प्रभाण र्वमततये क ( altered thickness of hair ):

i. तनु
ii. खय
iii. अतम others
 Tamraromaraji – ओदम्ु फय कुद्षं

 Romapinjaram- ओदम्ु फय कुद्षं
 Suklaromaraji- भर्णडर कुद्षं
Colour of hair also depict the nature of dosha dushti. Tamra, pinjara etc depicts
involvement of pitta
White (hypopigmented hair ) may depict the involvement of kapha dosha
Loss of hair is the result of many factors.
Indralupta is the result of interaction of v,p,k and rakta
Excessive hairfall and decreased growth is because of vata predominance( secondary p/k)
Thin hair is seen with vata and pitta
Rough hair is due to vata predominance (kapha kshaya)
 Hrishita- horripilated hair – वातज कुद्षं
 Tanu roma – poorvarupa of kushta
 खय योभ – thick and coarse hair ( vata –kapha)
 Alpa roma – reduced density of hair (vata-pitta)
24) ऩाक (Suppuration) : present/absent
a) प्रादब
ु ााव (Onset):
i. अर्ीघ्रऩाकी (acute onset of suppuration)
ii. र्चयऩाकी (chronic onset of suppuration)
iii. कृच्रऩाकी (rarely suppurates)
b) गाम्बीर्ा (Severity) :
i. अऩाक (no suppuration )
ii. ऩाक् ( suppuration )
iii. गम्बीयऩाक् ( intense suppurative process)
 ऩाक – ओदम्ु फय कुद्षं, ऩुर्णडयीक कुद्षं
 ऩाक फहुरातन – ऋष्मन्जहवं
 कृच्रऩाकी /अर्ीघ्र ऩाक – कपज पवसऩा
 गम्बीयऩाक्- कदा भ पवसऩा
 ऩाकभ ् – ऺतज पवसऩा
 अऩाक – no tendency to suppurate at all ( predominance of kapha – vata)
Tendency to suppurate is due to pitta involvement
Seeghrapaka is character of pitta/pitta-vata with rakta involvement
In kaphadika conditions, there will be no suppuration(कृच्रऩाक)
In vatadhika conditions there will be less suppuration
Chirapaka is because of involvement of k-p
25. र्ीणा धात/ु र्ीणत्वभ (Withering of tissues)- present/absent
a) धातु (tissues affected)

i. त्वक् (skin)
ii. भांस (muscles)
iii. म्रसया (vessels)
iv. अवमव (organ)
v. अङ्गुरी (fingers)
 र्ीणाभांसं- असाध्म पवसऩा
 र्ीणास्नामु्- असाध्म पवसऩा
 र्ीणाम्रसया - असाध्म पवसऩा
 म्रसयास्नामुसतदर्ी - असाध्म पवसऩा
26. गतध ् (Smell from lesion): : present/absent
 र्वगतध् – उऩद्रव
 कुणऩगतध् – कदा भ पवसऩा
27. व्रणोत्ऩपत(manifestation of wounds/ulcers )- present/absent
a. दोष फाहुल्म (Dosha involvement) –

i. वातव्रणोत्ऩपत् (manifestation of vrana with symptoms of vata)
ii. पऩतव्रणोत्ऩपत् (manifestation of vrana with symptoms of pitta)
iii. कपव्रणोत्ऩपत्(manifestation of vrana with symptoms of kapha)
b. अरुह्य व्रण (presence of unhealed wounds) - present/absent
c. व्रण ऩुनयावपृ त (recurrent occurrence of wounds) - present/absent
d. व्रण वस्तु (scars of healed skin conditions) – present/absent
Presence of unhealed skin conditions, easy scarring, recurrent occurrence of skin
conditions all are manifestations seen even in purvarupa of skin conditions which indicate
sthanasamsaraya in twak, rakta, mamsa and laseeka.
28. Examination of nails:
a) नख वणा:
i. अरुण(reddish brown)
ii. ताि (copper colored)
iii. हरयत (green)
iv. नीर (bluish)
v. यक्त (reddish)
vi. कृष्ण (blackish)
vii. हारयद्र(turmeric yellow)
viii. कृष्ण (black)
ix. ऩार्णडु (white)
x. अतम (others)
b) स्ऩर्ा Texture–
i. रूऺ (dry)
ii. अतत न्स्नग्ध (unctuous)
iii. साधायण (normal)
iv. स्पुदित नख (cracked nails)
v. खय (rough)
c) नख भांस –
i. साधायण (normal)
ii. नख भांसाततय ऩाक (suppuration between nails and flesh)
iii. नख भांस रुज: (pain in nails )
d) नख वेद्ष भांस ( eponychium)
i. साधायण (normal)
ii. ऩक्तव (suppurated)
iii. कोथ (necrosis/gangrene)
iv. क्तरेद(association of kleda)
29. प्रधान वेदना (Major symptom/Sensation) -
i. रुज(Pain)
ii. दाह: (burning sensation)
iii. कर्णडु (itching)
iv. सुतद्ऱ (numbness)
v. आमाभ (stretching sensation)
vi. सङ्कोच (contracting sensation)
vii. रोभ हषा (horripilations)
viii. स्ऩतदनं (pulsations )
A. Pain :
a) character of pain /वेदनास्वबाव:
i. तोद (pricking pain)
ii. तनस्तोद (continuos pricking pain)
iii. र्ुकोऩतोऩभ( pain as if pricked by bristles)
iv. रुज(pain)
v. न्स्तम्रभत वेदना (dull pain)
vi. अतम (others )
b) अर्धद्षान / स्थान (site of pain):

c) तीव्रता (Severity) - Grades of pain severity –
i. Grade 0 – no ruja/toda
ii. Grade 1 – alpa/manda ruja
iii. Grade 2 – ruja with moderate intensity
iv. Grade 3 – tivra arti /ruja (intense pain )
v. Grade 4 – tivra ruja with sparshasahatwa
d) वेदना प्रादब
ु ााव सभम (Time of onset of pain) -
i. सततं (continuos)
ii. कप कार( during diurnal and seasonal physiological kapha kala
iii. पऩत कार during diurnal and seasonal physiological pitta kaala
iv. वात कार during diurnal and seasonal physiological vata kaala
e) Speed of onset of pain (वेदना गतत)–
i. आर्ु (rapid onset with or around the manifestation of skin symptoms
ii. अनार्ु ( slow onset )
f) अनुऩर्म: Aggravating factors
g) उऩर्म: Relieving factors
Pain is caused primarily by vata and usually is expressed as ruja, soola, bheda, toda, nistoda
etc . Pain is described as a major symptom in the following conditions:
तोद
तनस्तोद फहुर – वात कुद्षं, कष्मन्जह्वं
तनस्तोद – वातज पवसऩा
अततभात्रं वेदना(ऩक्तव/दग्ध/दद्श/बग्न/ऺत व्रण) – कुद्ष ऩूवरू
ा ऩ
बेद फहुर – कष्मन्जह्वं
तीव्ररुक् /तीव्रवेदनं -काकणभ ्
तीव्रातता/तीव्र वेदनं- पवऩाददका
तीव्र रुज – ग्रन्तथ पवसऩा
अतता – र्तारु:
रुजा – ऩाभा
रुज – ऺतज पवसऩा
रुजाकयभ ्/रुजाऩयीतभ ्- औदम्
ु फयं
र्ुकोऩहत वेदन - कष्मन्जह्वं
अल्ऩवेदन – म्रसध्भं
सवेदन – कष्मन्जह्वं
सरुक् स्पोिभ ् दरतत – चभादर
अल्ऩ वेदन – कपज पवसऩा
 Alpa /manda type of pain (vedana/ruja/arti) is a lakshana of kapha predominance
 Nistoda( continuos type of pricking pain ) and toda( pricking pain is consistent with that
of vata predominance
 Teevra arti/ruja/vedana denotes intense vata vitiation and is seen in conditions with vata
pradhana samsarga and sannipata
 Pain produced by pitta will be associated with daha/paka/dalana
 Grades of pain severity –
 Grade 0 – no ruja/toda
 Grade 1 – alpa/manda ruja
 Grade 2 – ruja with moderate intensity
 Grade 3 – tivra arti /ruja (intense pain )
 Grade 4 – tivra ruja with sparshasahatwa
PAIN
TODA/NISTODA/SULA/RUJ SPARSHASAHA DAHATI IVA MANDA/ABSENT
VATA /VATADHIKA RAKTA + PITTA/RAKTA PITTA/PV KAPHA /kv
B. दाह (Burning Sensation)

a) Character :
i. दाह फाहुल्म(intense burning sensation)
ii. दाह (burning sensation)
iii. ऊष (hot sensation with restlessness)
b) तीव्रता( severity)- Grading of burning sensation
i. Grade 0- No दाह – no burning sensation at all

ii. Grade 1 - अल्ऩ दाह (mild burning sensation is present )
iii. Grade 2 - दाह ( burning sensation is pronounced.)
iv. Grade 3 - अततभात्र दाह ( intense burning sensation)
c) दाह प्रादब
ु ााव कार: (Time of onset of burning sensation) –
d) अनऩ
ु र्म/Aggravating factors
e) उऩर्म/ Relieving factors

f) Site:
Burning Sensation- Burning sensation is produced by disequilibrium in doshic

balance with a predominance of pitta dosha such as sudha pitta prakopa/ pitta- vata
involvement/pittadhika tridosha ; with or without rakta dushti
अततभात्र दाह – पऩतज पवसऩा
दाह – पऩतज कुद्षं, ऩुर्णडयीकं, चभादर, र्तारु, असाध्म कुद्षं, कुद्षोऩद्रव
ऩरयदाह – कुद्ष ऩूवरू
ा ऩ
दाह फहुर- कष्मन्जह्व
दाह ऩयीतं- औदम्
ु फयं
दाहाढ्मं – क्ष्तज पवसऩा
अल्ऩदाह – वाततक कुद्षं, म्रसध्भं
तीव्र दाह - काकणकं
ऊषा: - चभादर
 Grading of burning sensation
 Grade 0- No दाह – no burning sensation at all( can exclude the possibility of pitta
predominance)
 Grade 1 - अल्ऩ दाह (mild burning sensation is present and presence of pitta in
samprapthi should be assessed. Pitta may be present with kapha or alpa prakopa
of pitta in samsarga /sannipatha))
 Grade 2 - दाह ( burning sensation is pronounced. Happens especially when pitta is
prakupita alone or with vata)
 Grade 3 - अततभात्र दाह ( intense burning sensation. Happens when the ushna-
tikshna guna of pitta is augmented by vata or p-v predominant sannipatha )
C. KANDU (ITCHING ):
a) कर्णडु तीव्रता (GRADING of severity of itching )
i. GRADE 0 – NO कर्णडु (no itching)

ii. Grade 1 – अल्ऩ कर्णडु/ईषत ् कर्णडु (mild itching)
iii. Grade 2 – कर्णडु (itching)
iv. Grade 3 – फहु कर्णडु (excessive itching)
b) कर्णडु प्रादब
ु ााव कार (Time of onset of burning sensation)
c) Site:
d) अनुऩर्म/Aggravating factors
e) उऩर्म/ Relieving factors

Itching is a subjective and multidimensional experience. The manifestation of itching and
its nature depends on many factors. The nature of skin ( twak sara has excellent skin),
structural and functional integrity of swedavaha srotas, rasavaha and raktavaha srotas and
koshta, the balance between vata and kapha in the body, response of the body to various
nija and agantu factors etc plays major roles in the manifestation of itching. Kandu seen
in kushta , visarpa are mentioned as
कर्णडु – कुद्ष ऩूवरू
ा ऩ ्, भर्णडर, पऩतज कुद्षं, ऩुर्णडयीकं, चभादरं, ऩाभ, पवचर्चाक
अल्ऩ कर्णडु- वाततक कुद्षं, कष्मन्जह्व, म्रसध्भं
कर्णडूऩयीतं - औदम्
ु फयं
कर्णडूभन्त्ब: गर्णडै:- अरसं
फहु कर्णडू: - कपज कुद्षं
ईषत ् कर्णडू – त्वग्गत कुद्षं
कर्णडूमुत: - कपज पवसऩा
भतदकर्णडु- पवऩाददक
सकर्णडु- दद्र ु
 Slight imbalance in doshas may provoke kandu.
 Increase in twak rukshata, parushyata etc may cause itching ( vatadika)
 Paka, alteration in bhrajaka pitta quality, ati sweda etc may cause itching secondary to
pitta vitiation.
 Vitiated kapha is a major factor that causes itching due to its snigdha (ati) swabhava.
SEVERITY OF ITCHING
 GRADING of severity of itching

 GRADE 0 – NO कर्णडु
 Grade 1 – अल्ऩ कर्णडु/ईषत ् कर्णडु
 Grade 2 – कर्णडु
 Grade 3 – फहु कर्णडु
D. सुद्ऱता/ Numbness
सुतद्ऱ – वातार्धक कुद्षं

स्ऩर्ााऻत्वभ ् – कुद्ष रऺणं
सुद्ऱाङता – कुद्ष ऩूवरू
ा ऩ
त्वक् स्वऩनभ ् - भह कुद्षं
सद्ऱ
ु वत ् सद्ऱ
ु : - वाततक कुद्षं
सुतद्ऱ – कपज पवसऩा
E.हषा /skin paresthesia/ dysesthesia
अंगेषु पऩऩीम्ररका इव संचाय् – वातज पवसऩा

अततभात्र हषा: - वातज पवसऩा
ऩरयहषाा - कुद्ष ऩव
ू रू
ा ऩ
F.Stretching sensation – अततभात्रामाभ् – वातज पवसऩा
G-Contracting sensation - अततभात्रसंकोच् –– वातज पवसऩा
H-Pulsating feeling: अततभात्रस्पुयणभ ् – वातज पवसऩा
In this context, it should be noted that all this sensations are produced by vata predominance and
varying levels of raktadushti, with or without avarana by kapha dosha
1. अनुफतध सवााङ्गीणा रऺण आपवबााव:(Manifestation of systemic symptoms) Y/N
a) सवााङ्गीण रऺण स्वबाव (Character of systemic symptoms )

i. भद
ृ ु (mild symptoms with no severe consequences)
ii. दारुण ( severe systemic manifestations together with cutaneous symptoms)
iii. अतम (others )
b) सवााङ्गीण रऺण उत्बव कार (Time of manifestation of systemic symptoms )

i. त्वक् पवकयोत्ऩपत ऩूव:ा (Just before cutaneous manifestation _
ii. एक कार उत्ऩपत: (Along with cutaneous manifestation)
iii. त्वक् पवकयोत्ऩपतयनततयं (After cutaneous manifestation)
iv. अब्नतमार्श्रत (No time relation)
अनुफतधर्वमार्ध् (should be included when the beginning of disease/symptom coincide with the
skin manifestation.)
When generalised symptoms are present, the diagnosis of visarpa, bahya/abhyantara/ ubhaya
should be considered and the extend of symptoms may give an idea about prognosis.
अनुफतधर्वमार्ध् -
ज्वय्/र्ीतज्वय्/वातज्वयसभर्वमथा/पऩतज्वयसभानरुक् /कपज्वय सभानरुक्
अततसाय्/वभथु /छददा ् /अयोचक्
कास्/दहक्तका /द्वास्
1. General symptoms:
अयोचक्/ अपवऩाक् / अतनद्रे ष् / स्तैम्रभत्मभ ् / क्तरभ् / दौफाल्म / प्रसेक् / पऩऩासा / तष्ृ णा / र्ीतक्/
भधयु ास्मत्वभ ् / स्तैम्रभत्मभ ् / अततदााह/ आस्मोऩरेऩ् / तनद्षीपवका / गौयव्
इन्तद्रमाणां जाड्मं / इन्तद्रमगौयवभ ् / हरयतरूऩदर्ानभ ् / हरयद्ररूऩदर्ानभ ् / चऺुर्ोयकुरत्वभ ् / दवध्ु
म्रर्योगुरुत्वं / म्रर्योरुक् / अन्स्थबेद् / सन्तधबेद् / तनस्तोद् / र्ूरं
अंगावसादं / अंगभदा ्/ अङ्गबेद / अंगबंग / अंगपवऺेऩणं / म्रबनपत अंगातन / अन्स्थपवद्ऴेषणभ ् /
सन्तधपवद्ऴेषणभ ् / र्ोष्/ उद्रे द्शनभ ् /कम्ऩ् / / वेऩनभ ्
तनद्रा / ततद्रा / भोह् / तनद्रानार्् /अस्वप्न / भूच्छाा / संऻाहातन् / स्भतृ तहातन्/ भ्रभ् / प्रराऩ् / तभक् /
आरस्मभ ् / संऻां प्रभोहमतत / प्रभूढसंऻा / र्वमर्थतचेत् / अयतत्/ औत्सुक्तमभ / न्क्तरद्शबूतमद्ष् आर्ु तनद्रां
बजतत / न सुखभुऩरबते / स्थानादासनं आसनात ् र्य्मां राततुम्रभच्छतत
स्रोतसां प्ररेऩ् / आभोऩवेर्नभ/अततभात्रस्वेद /
अन्ग्नसदनभ ् / अन्ग्ननार््
द्वेतनमनवदनभूत्रवचा: / हरयतनेत्रभूत्रत्वक्तवचा:
31. Change in nature of sweating /स्वेद स्वबाव ऩरयवतान-
a. दे र्/ area of manifestation
i. एकदे म्रर्क/local
ii. सावादैदहक/systemic
b. स्वबाव/character –
i. अस्वेद/absence of sweating
ii. अतत स्वेद/excessive sweating
iii. अतम/others
32.दोष पवकल्ऩ रऺण/ Character of individual dosha for dosha vikalpa assessment
a. वात रऺण /vata dosha lakshana
i. श्माव/ bluish black discolouration- present / absent
ii. अरुणवणं / reddish brown discolouration- present / absent
iii. ऩरुषता/ coarse and rough skin- present / absent
iv. यौक्ष्म/ dry and rough skin- - present / absent
v. र्ूर/ painful lesion-- present / absent
vi. र्ोष/ emaciation/ atrophy of skin- present / absent
vii. तोद/ pricking pain in skin- present / absent
viii. वेऩथ/ु tremor of affected area- present / absent
ix. हषा/ paraesthesia- present / absent
x. सङ्कोच:/ contractures- present / absent
xi. स्तम्ब/ stiffness of the area- present / absent
xii. सतु द्ऱ/ numbness - present / absent
xiii. बेद/ sensation like splitting of skin- present / absent
xiv. बङ्ग:/ cracking sensation- present / absent
b. पऩत रऺण /Pitta lakshana

i. दाह/ burning sensation- present / absent
ii. स्वेद/ excessive sweating-- present / absent
iii. क्तरेद/ moistening or soddening of lesion- present / absent
iv. कोथ/ gangrene- present / absent
v. स्राव/ discharge- present / absent
vi. ऩाक/ suppuration- - present / absent
vii. याग:/redness -- present / absent
c. कप रऺण/kapha dosha lakshana

i. द्वैत्म:/paleness or whiteness which is generalised or localized--
present / absent
ii. र्ैत्म:/ excessive coldness- present / absent

iii. कर्णडु:/ itching- present / absent
iv. स्थैम:ा rigidity or fixity of skin or muscles- present / absent
v. गौयव:/ localized or generalized heaviness- present / absent
vi. उत्सेध:/ swelling - present / absent
vii. उऩस्नेह:/ moist appearing skin- present / absent
viii. उऩरेऩ:/ feeling as if anointed with something- present / absent
33. Rakta kshaya lakshana
a. त्वक्तऩारुष्मभ ् /rough and coarse appearance of skin-- present / absent
b. स्पुदितत्वक् /cracking or fissuring of skin-- present / absent
c. म्रानत्वक् /change in luster and brightness of skin/dull skin-- present / absent
d. रूऺत्वक् /rough and dry appearance of skin-- present / absent
e. अम्राम्रबराष:/desire for sour substances -- present / absent
f. र्ीताम्रबराष:/preference for cold things -- present / absent
g. म्रसयार्ैर्थल्म-/lax and unsteady vessel walls- present / absent
34. Rakta vridhi lakshana
a. यक्ताङ्ग्/यक्तत्वक् / hyperemia of organs and skin-- present / absent
b. यक्ताक्षऺता/यक्तनेत्रता/reddish coloured eyes, caruncle etc-- present / absent
c. म्रसयाऩूणत्ा व/ excessive fullness of vessels-- present / absent भ ्-- present /
absent
d. कुद्ष् (skin disease )-- present / absent
e. पवसऩा्/ erysipelas/ skin condition characterized by rapi onset and spread with
cutaneous and systemic manifestations-- present / absent
f. पऩदिका/skin eruptions -- present / absent
g. असग्ृ दय्/ menorrhagia-- present / absent
h. अक्षऺऩाक्/suppuration of eyes-- present / absent
i. भख
ु ऩाक्/oral ulcers-- present / absent
j. दाह.burning sensation in body-- present / absent
k. भेढ्रऩाक्/suppuration in male genitalia-- present / absent
l. गुदऩाक्/suppuration in rectum-- present / absent
m. पवद्रर्ध्/abscess-- present / absent
n. र्वमङ्ग्/melasma-- present / absent
o. अन्ग्ननार््/loss of digestive activity-- present / absent
p. तभ्प्रवेर््/ fainting or appearenec of darkness in front of eyes-- present /
absent
q. उऩकुर््/ gingivitis-- present / absent
r. काभरा/jaundice-- present / absent
35. rakta pareeksha ( examination of bloody discharge as per dosha )
I. Vatika rakta dushti lakshana –
a. अरुणाबं/ reddish brown -- present / absent
b. पवर्दं यक्त्/lacking normal viscosity of blood-- present / absent
c. पेतनरं यक्त्/frothy blood-- present / absent
d. तनु् यक्त्/ without normal texture-- present / absent
e. कृष्णं यक्त्/blackish coloured-- present / absent
f. अस्कन्तद यक्त्/ blood that does not coagulate-- present / absent
g. श्मावं यक्त्/ bluish black blood-- present / absent
h. वेगस्रापव यक्त्/increased flow owing to decreased density-- present / absent
i. अच्छं यक्त्/ clear rakta without actual components of blood-- present / absent
II. ऩैपतकयक्तदपु द्श् lakshana
a. अम्रसतं यक्तभ ्/ blood which is differently coloured than white-- present / absent
b. र्चये ण स्त्मामतत/ coagulates with difficulty-- present / absent
c. नीरं यक्तभ ्/ bluish coloured blood-- present / absent
d. हरयतं यक्तभ ्/ greenish coloured-- present / absent
e. श्मावं यक्तभ ्/ bluish black -- present / absent
f. पवस्रं यक्तभ ्/ fleshy smell-- present / absent
III. द्ऴैन्ष्भकयक्तदपु द्श् lakshana
a. ईषत्ऩार्णडु यक्तभ ्/ slightly pink-- present / absent
b. पऩन्च्छरं यक्तभ ्/ slimy -- present / absent
c. तततुभत ् यक्तभ ्/ thready-- present / absent
d. घनं यक्तभ ्/ thick and dense-- present / absent
e. न्स्नग्धं यक्तभ ्/ extremely unctuos-- present / absent
f. र्ीतरं यक्तभ ्/ extremely cold to touch-- present / absent
g. फहरं यक्तभ ्/ copious quantity-- present / absent
h. र्चयस्रापव यक्तभ ्/ delayed flow-- present / absent
i. स्कन्तद यक्तभ ्/ rapid clotting tendency-- present / absent
j. वसागन्तध यक्तभ ्/smell of marrow-- present / absent
IV. Sannipata dushti
a. दग
ु त
ा धं यक्तभ ्/ putrid smelling blood-- present / absent
b. भम्ररनं यक्तभ ्/ dirty appearing blood-- present / absent
c. आपवरं यक्तभ ्/ turbulent /cloudy blood-- present / absent
All the other symptoms that has been given in this 32-35 serial numbers are to be observed to
collect data regarding the dosha, dhatu dushti to analyse the supporting factors in manifestation
of specific set of symptoms that is specific to each patient.

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Manual of Twak vikara in

Vyakhya: Kushnativapuetikushtam i.e. that which disfigures the body is known as

 Vedana- nature of pain – “काऩारं तोदफहुरं”

1. AHARAJA NIDANA- food related etiological factors

sahaja visesha nidana viharaja

In kushta roga, following nidans could be identified according to samhitas.

 Sannikrishta nidana –sannikrishta nidana is the chief components of roga

नवातन: Newly harvested Kapha Kleda

म्रभत््माहाय: Intake of food Tridosha Rakta

पऩद्शातन ्: Food prepared after Kapha – Raktadushti

गुड: Use of Jaggery and Kapha – Rakta-

उष्णाम्रबतद्ऱस्म अप्सु भज्जनभ ् bathing in cold water Virudha Swedavaha

ICD code -ED-4-kushta

स्ऩर्ााऻत्वभ ् Inability to perceive touch sensation

ED-4.2.1: कऩार्/अरुण-कुद्ष्/वाततककुद्ष्-कुद्ष ( skin affliction) with lesions resembling

रूऺ Dryness of skin lesion and/ surrounding

कृष्णकऩाम्ररकाप्रकार्् -resembling black earthen vessel

ताि् coppery coloured lesion

फहरऩूम् thick pus discharge

न्स्नग्ध् smooth/unctuous /oily appearing skin ldesions

फहुकृम्रभ् excess worms

ED-4.2.6: ऩुर्णडयीक्कुद्ष (skin affliction) with lesions resembling a white lotus

ऩुर्णडयीकसङ्कार््/ऩुर्णडयीकऩत्रप्रकार्् Lesion resembling the petals of a ऩुर्णडयीक (lotus)

अराफुऩुष्ऩसङ्कार्भ ् resembling flowers of a gourd

फहूतन Numerous lesions

अल्ऩबेद् less complications

काकणान्ततकावणा् /काकणान्ततकापरसदृर्् Lesion resembling colour of काकणान्ततका

तीव्रदाह् severe burning sensation

अस्वेदनभ ् anhidrosis/lack of sweating

फहरभ ् large in size

श्मावं bluish black colour

ककणखयस्ऩर्ाभ ् rough on touch

ऩाणणस्पुिनभ ् Cracks/fissuring in the hands

ED-4.3.5: अरसककुद्ष्/अरसकुद्ष्- कुद्ष (skin affliction) with nodular skin lesions

कर्णडू् associated with itching sensation

यक्तभ ् Redness of over lying /surrounding skin.

द्वेत् whitish discoloration of lesion

सूक्ष्भ् Minute papular eruptions

द्वेताबास् whitish hue of lesion

यक्तभ ् reddish ulcerative lesion

फहुव्रण् multiple ulcerative lesion

O-38: यकसा: skin affliction with non- oozing boils

ED-4.4.1-त्वग्गतकुद्ष्--कुद्ष (skin affliction) localized in यसधातु (skin)

स्ऩषाहातन् loss of tactile sensation

ईर्त ् कर्णडू minimal itching

ED-4.4.2: यक्तगतकुद्ष्कुद्ष (skin affliction) localized in यक्तधातु (blood)

त्वक् -स्वाऩ् numbness at the site

ED-4.4.3: भांसगतकुद्ष्-कुद्ष (skin affliction) localized in भांसधातु (muscle)

फाहुल्मभ ् large circular patches

सन्तधषु अर्धकं क्तरेद् discharge, secretion at joint

ED-4.4.4: भेदगतकुद्ष्कुद्ष (skin affliction) localized in भेदोधातु (adipose tissue)

दौगातध्मभ ् bad odour

ED-4.4.5: अन्स्थगतकुद्ष् कुद्ष (skin affliction) localized in अन्स्थधातु (osseus tissue)

ED-4.4.6: भज्जागतकुद्ष्कुद्ष (skin affliction) localized in भज्जाधातु (bone marrow)

नासाबङ्ग् depression of nasal bridge

ED-4.4.7: र्ुरगतकुद्ष्कुद्ष (skin affliction) localized in र्ुरधातु (seminal tissue)

कौर्णमभ ् falling off of the fingers and toes

ED-4.5: असाध्मकुद्ष्irremediable कुद्ष (skin affliction)

ED-4.6: कुद्ष-उऩद्रव्complications of कुद्ष (skin affliction)

ED-4.7: कुद्ष-अरयद्श् fatal signs of कुद्ष (skin affliction)

अऩरयस्रावी not having discharge

भर्णडरभ ् circular patches

ED-5.2: ऩैपतक-न्द्वत्र्/ककरास् न्द्वत्र (leucoderma) due to vitiated पऩत