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kshudra rogas

kshudra rogas

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KSHUDRA ROGA CRITICAL UNDERSTANDING

DR. GAURAV DESAI

OBJECTIVES
‡ To shed light on the often neglected topic. ‡ To critically examine the reasons for this classification. ‡ To discuss a few of the commonly seen diseases. ‡ To enlist the treatment principles to be followed.
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REFERENCES
‡ Charaka Samhita
± Su. 18. Trishothiya Adhyaya ± Chi. 12 Shwayathu Chikitsa

‡ No direct reference of the term. ‡ Described the diseases later grouped as kshudra rogas.
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Cont
‡ Sushruta Samhita
± Ni. 15. Kshudra Roganam Nidana. ± Chi. 20. Kshudra Roga Chikitsa. ± Chi. 25. Mishraka Chikitsa.

‡ Grouped the diseases as kshudra rogas.

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Cont
‡ Ashtang Hridaya
± U.T. 31. Kshudra roga Vigyaneeya. ± U.T. 32. Kshudra roga Pratishedhaneeya.

‡ In typical Vagbhata style, arranged logically. ‡ Updated the list, adding and deleting some diseases.
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Cont
‡ Ashtang Sangraha
± U.T 36. Kshudra roga Vigyaneeya. ± U.T. 37. Kshudra roga Pratishedhaneeya.

‡ Similar description as that found in A.H

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KSHUDRA ROGA???
‡ ¤ÉÑSìzÉoSÈ xuÉsmÉÉkÉqÉ¢ÔüUmÉrÉÉïrÉuÉcÉÏ II ‡ ¤ÉÑSìÈ xuÉsmÉåÅkÉqÉå¢ÔüUå CÌiÉ II ‡ Swalpa ‡ Adhama ‡ Krura
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Cont
‡ E£ükÉqÉï rÉÑ£üÉ UÉåaÉÉÈ ¤ÉÑSìUÉåaÉÉÈ II ‡ Diseases with the above qualities are classified as Kshudra Rogas.

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INDU QUOTES
‡ qÉlSuÉåaÉÉqÉWûuÉåaÉÉ urÉÉkÉrÉÉåÅsmÉÂeÉÉåÅÂeÉÈ I ‡ rÉå qÉWûÉliÉÉåÅsmÉMüɶÉæuÉ ¤ÉÑSìUÉåaÉÉxiÉÑ iÉå xqÉëÑiÉÉÈ II ‡ Diseases having: ‡ Manda vega / Maha vega ‡ Alpa ruja / A ruja ‡ Mahan / Alpa
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CLASSIFICATION
‡ INDU, further clarifies that: 

Swalpa : Vyanga, Tila etc.  Adhama : Kunakha, Ruddhaguda,
Sharkararbuda. 

Krura : Agnirohini, Masurika, Vispota, Valmika.
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NUMBERS
‡ Charaka : no specific mention. ‡ Sushruta : 44 ‡ Vagbhata : 36 ‡ Madhavakara : 43

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A LOOK AT A FEW OF THE KSHUDRA ROGAS
*THE COMPARISONS ARE THE PRESENTERS VIEWS AND MAY NOT BE ABSOLUTELY ACCURATE.

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VALMIKA / ACTINOMYCOSIS
‡ Generally affects urdhva ‡ Painful abscesses in jatru. the mouth, lungs, GIT. ‡ Slow growing. ‡ abscesses grow larger often over months. ‡ Vedana, Daha, Kandu, Kleda. ‡ leak large amounts of pus ‡ Tridoshaja.

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TREATMENT
‡ Pratyakhyeya. ‡ Vamana. ‡ Rakta mokshana. ‡ Lepa. ‡ Shastra karma. ‡ Kshara karma. ‡ Appears to fall in the Krura category.
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VISPOTAKA/ B.PHEMPHIGOID
‡ Involves pitta, rakta and vata. ‡ In Twacha ‡ Agni dagdha Spota. ‡ Chronic, autoimmune, sub epidermal, blistering skin disease that rarely involves mucous membranes.

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TREATMENT
‡ For treatment of: Vivruta, Masurika, Vispota, Viddha, Gardhabi, Kaksha, Gandha pitika, Rajika, Jala gardhabha, Irivellika. ‡ Similar to Pittaja Visapra. ‡ Agni rohini : Asadhya. ‡ Start Visarpa Treatment.
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CHIPPA/ ONYCHIA
‡ Pitta and Vata involved. ‡ Paka in nail matrix ‡ With Vedana and Jwara. ‡ Inflammation of the matrix of the nail. ‡ formation of pus.

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TREATMENT
‡ Shodhana. ‡ Reduce the ushma (Pitta?). ‡ Shastra karma. ‡ Kartana of Dushita mamsa. ‡ Rakta mokshana.
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KUNAKHA / SUBUNGAL HAEMATOMA
‡ Due to abhighata. ‡ Krishna varna, ruksha. ‡ Results from a traumatic injury. ‡ It can be extremely painful.

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TREATMENT
‡ Shodhana. ‡ Reduce the ushma (Pitta?). ‡ Shastra karma. ‡ Kartana of Dushita mamsa. ‡ Rakta mokshana.
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PADADARI / CRACKED HEELS
‡ Vata involved. ‡ Atyanta Ruksha. ‡ Saruja. ‡ Caused by dry skin. ‡ They are painful to stand on if deep. ‡ Skin can bleed. ‡ Can become infected.

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TREATMENT
‡ Sira vedha. ‡ Swedana. ‡ Snigdha Lepa

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KADARA / CORN
‡ Due to repeated trauma. ‡ Sa keela, Kathina granthi. ‡ Madhya unnata. ‡ Saruja. ‡ Skin thickens in response to pressure. ‡ Natural body defense. ‡ eventually becomes painful.

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TREATMENT
‡ Shastra karma. ‡ Utkartana. ‡ Followed by Agni karma. ‡ Avoid cause.

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MUKHADUSHIKA / ACNE VULGARIS
‡ Kapha, Vata, Rakta involved. ‡ Shalmali Kantaka. ‡ Affects Young. ‡ Multiple non inflammatory follicular papules ‡ Occurs most commonly during adolescence.

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TREATMENT
‡ Vamana. ‡ Lepa.

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DARUNAKA / DANDRUFF
‡ Kapha, vata involved. ‡ Sakandu, ruksha. ‡ Kesha bhoomi Prapatana. ‡ Shedding of dead skin cells from the scalp. ‡ frequent exposure to extreme heat and cold. ‡ redness and irritation.

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TREATMENT
‡ Snehana. ‡ Swedana. ‡ Murdha sira vedha. ‡ Avapeedana. ‡ Siro basti. ‡ Siro abhyanga.
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PARIVARTIKA / PARAPHIMOSIS
‡ Vyaan vayu. ‡ Improper movements. ‡ Granthi rupa charma. ‡ Foreskin becomes trapped behind the glans penis. ‡ And cannot be reduced.

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TREATMENT
‡ Application of ghrita. ‡ Swedana. ‡ Upanaha. ‡ Abhyanga. ‡ Reduction by gentle Manipulation. ‡ Upanaha.(for 3-5 days). ‡ Vatanashaka basti.
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GUDA BHRAMSHA / RECTAL PROLAPSE
‡ Ruksha, durbala. ‡ Pravahana. ‡ Atisara. ‡ Walls of the rectum protrude through the anus. ‡ Weakening of the ligaments and muscles. ‡ Straining during defecation.

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TREATMENT
‡ Snehana. ‡ Swedana ‡ Reduction by gentle manipulation. ‡ Gophana bandha. ‡ Swedana.
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REASONS FOR NOMENCLATURE???
‡ Localized. ‡ Spot diagnosis. ‡ No involvement of gambhira dhatus. ‡ Treatment mostly localized. ‡ Relatively simple treatment. ‡ Treatment similar to that described else where.
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HOW TO APPROACH KSHUDRA ROGAS???
‡ Do we get confused trying to classify the diseases? ‡ Struggle in deciding the line of treatment? ‡ Blame the science for not describing certain conditions observed clinically? ‡ Comment that Ayurveda is not up to date? OR
Wednesday, July 28, 2010 KSHUDRA ROGAS - CRITICAL REVIEW 34

CHARAKA S OPINION
In Sutra 18. iÉ LuÉÉmÉËUxÉÇZrÉårÉÉ ÍpÉSrÉqÉÉlÉÉ pÉuÉÎliÉ ÌW Iû ÂeÉÉuÉhÉïxÉqÉÑijÉÉlÉxÉÇxjÉÉlÉlÉÉqÉÍp É: II urÉuÉxjÉÉMüÉUhÉiÉåwÉÉÇ rÉjÉÉzjÉÔsÉåwÉÑ xÉÇaÉëWûÈ I iÉjÉÉ mÉë¢ÑüÌiÉxÉÉqÉÉlrÉÇ ÌuÉMüÉUåwÉÔmÉÌSzrÉiÉå II
KSHUDRA ROGAS - CRITICAL REVIEW

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KEY TO KSHUDRA ROGAS
ÌuÉMüÉUlÉÉqÉÉMÑüzÉsÉÉå lÉ ÎeɾûÏrÉÉiÉç MüSÉcÉlÉ I lÉ ÌWû xÉuÉïÌuÉMüÉUhÉÉÇ lÉÉqÉiÉÉåÅÎxiÉkÉëÑuÉÉÎxjÉÌiÉÈ II xÉ LuÉ MÑüÌmÉiÉÉå SÉåwÉÈ xÉqÉÑijÉÉlÉÌuÉzÉåwÉiÉÈ I xjÉÉlÉÉliÉUaÉiɶÉæuÉ eÉlÉrÉirÉÉqÉrÉÉlÉç oÉWÕûlÉç II iÉxqÉÉ̲MüÉUmÉë¢ÑüiÉÏUÍkɸÉlÉÉliÉUÉÍ hÉ cÉ I
KSHUDRA ROGAS - CRITICAL REVIEW

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BHAISHAJYA RATNAVALI
Chapter 60 ¤ÉÑSìUÉåaÉåwÉÑ xÉuÉåïwÉÑ lÉÉlÉÉUÉåaÉÉlÉÑMüÉËUwÉÑ I SÉåwÉÉlÉç SÒwrÉÉlÉuÉxjÉÉÇ cÉ ÌlÉUϤrÉ qÉÌiÉqÉÉlÉç ÍpÉwÉMçü II iÉxrÉ iÉxrÉ cÉ UÉåaÉxrÉmÉjrÉÉmÉjrÉÉÌlÉxÉuÉïzÉÈ I rÉjÉÉSÉåwÉÇ rÉjÉÉSÕwrÉÇ rÉjÉÉuÉxjÉÇ cÉ MüsmÉrÉåiÉç II
KSHUDRA ROGAS - CRITICAL REVIEW

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CONCLUSION
‡ Commonly occurring diseases included under this heading. ‡ Changed with time. ‡ Ready reckoner. ‡ Understand basics. ‡ Modify and formulate new treatment modalities. ‡ Without compromising core philosophy.
Wednesday, July 28, 2010 KSHUDRA ROGAS - CRITICAL REVIEW 38

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