“A comparative clinical study of ‘Siddharthaka yoga’ ‘Parisheka’ and ‘Abhyantara prayoga’ in the management of ‘Kitibha kushta’ with the special reference to ‘Psoriasis’”. By Ashok M.G. Dissertation submitted to the Rajiv Gandhi University of Health Sciences, Karnataka, Bangalore In partial fulfilment of the degree of Ayurveda Vachaspati M.D. In Kayachikitsa Under the Guidance of Dr. Raghavendra V. Shettar M.D. (Ayu) Department of Kayachikitsa Post Graduate Studies & Research Centre D.G. MELMALAGI AYURVEDIC MEDICAL COLLEGE, GADAG 2005-2008
A comparative clinical study of ‘Siddharthaka yoga’ ‘Parisheka’ and ‘Abhyantara prayoga’ in the management of ‘Kitibha kushta’ with the special reference to Psoriasis, By Ashok M.G., Department of Kayachikitsa, Post graduate studies and research center D.G. MELMALAGI AYURVEDIC MEDICAL COLLEGE, Gadag - 582 103
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“A comparative clinical study of ‘Siddharthaka yoga’ ‘Parisheka’ and
‘Abhyantara prayoga’ in the management of ‘Kitibha kushta’ with the
special reference to ‘Psoriasis’”.
By
Ashok M.G. Dissertation submitted to the
Rajiv Gandhi University of Health Sciences, Karnataka, Bangalore
In partial fulfilment of the degree of
Ayurveda Vachaspati M.D. In
Kayachikitsa Under the Guidance of
Dr. Raghavendra V. Shettar M.D. (Ayu)
Department of Kayachikitsa Post Graduate Studies & Research Centre
D.G. MELMALAGI AYURVEDIC MEDICAL COLLEGE, GADAG 2005-2008
Ayurmitra
TAyComprehended
D.G.M.AYURVEDIC MEDICAL COLLEGE
POST GRADUATE STUDIES AND RESEARCH CENTRE GADAG - 582 103
Certificate
This is to certify that the dissertation entitled “A comparative clinical study of
‘siddharthaka yoga’ ‘parisheka’ and ‘abhyantara prayoga’ in the management of
‘kitibha kushta’ with the special reference to ‘psoriasis’” is a bona fide research work
done by “Ashok M.G.” in partial fulfilment of the requirement for the post graduation
degree of “Ayurveda Vachaspati M.D. (Kayachikitsa)” Under Rajiv Gandhi University
of Health Sciences, Bangalore, Karnataka.
Dr. Raghavendra V. Shettar
M.D. (Ayu) Guide
Asst. prof. in P.G, Dept. of kayachikitsa DGMAMC. PGS. & RC., Gadag.
Date:
Place: Gadag
J.S.V.V. SAMSTHE’S
D.G.M.AYURVEDIC MEDICAL COLLEGE POST GRADUATE STUDIES AND RESEARCH CENTRE
GADAG, 582 103
Endorsement by the H.O.D, Principal/ head of the institution
This is to certify that the dissertation entitled “A comparative clinical study of
‘siddharthaka yoga’ ‘parisheka’ and ‘abhyantara prayoga’ in the management of
‘kitibha kushta’ with the special reference to ‘psoriasis’” is a bona fide research work
done by “Ashok M.G” under the guidance of Dr. R.V Shettar, M.D. (Ayu) Asst.
professor in P.G, Dept. of kayachikitsa, DGMAMC, PGS&RC, Gadag, in partial
fulfilment of the requirement for the post graduation degree of “Ayurveda Vachaspati
M.D. (Kayachikitsa)” Under Rajiv Gandhi University of Health Sciences, Bangalore,
Karnataka.
.
(Dr. G. B. Patil) Principal,
DGM Ayurvedic Medical College, Gadag
Date: Place:
Prof. and HOD
P.G. Dept of Kayachikitsa DGM Ayurvedic Medical College,
Gadag Date: Place:
Declaration by the candidate
I here by declare that this dissertation / thesis entitled “A
comparative clinical study of ‘siddharthaka yoga’ ‘parisheka’ and
‘abhyantara prayoga’ in the management of ‘kitibha kushta’ with the
special reference to ‘psoriasis’” is a bona fide and genuine research work
carried out by me under the guidance of Dr. R.V. Shettar, M.D. (Ayu),
Asst. professor in post graduate department of Kayachikitsa, DGMAMC,
PGS&RC, Gadag.
Date:
Place:
(Ashok M.G)
Copy right
Declaration by the candidate
I here by declare that the Rajiv Gandhi University of Health
Sciences, Karnataka shall have the rights to preserve, use and disseminate
this dissertation/ thesis in print or electronic format for the academic /
I wish to express my deepest gratitude first to my guide Dr. Raghavendra V.
Shettar, M.D. (Ayu), Asst. Prof. for his timely advises and encouragement during this
research work and for his inspirational clinical knowledge.
I express my gratefulness to my professor Dr. V. Varadacharyulu, M.D.(Ayu),
who was former H.O.D. of the department and my former guide
I express my gratitude to Prof. Dr. K. Shiva Rama Prasad, M.D. (Ay), M.A. (Jyo)
Ph.D. (Jy), for his timely advises and encouragement during the coarse of this research
work..
I express my thankfulness to my beloved principal Dr. G. B. Patil, for his
encouragement and support by providing all necessary facilities for this research work.
I extend thankfulness to my inspirational teacher Dr. M.B. Gururarja M.D. (Ayu),
who was prime reason for my academic career since my under graduation, also I thank
Dr. B.S. Shreedhar, M.D. (Ayu), prof and HOD, Dept of Panchakarma, GAMC,
Bangalore for all his supports.
I extend deepest gratitude to Dr. Jitendra Shetty, Managing Director, Prakruti
Remidies Pvt. Ltd, Karwar who has extended his support for the study whole heartedly
by providing the required trial drug free of cost. His support is appreciated at the
highest level.
I give my respect at this moment to my father Sri M.G. Chandrashekharappa,
my mother Smt G Sarvamangala for their blessings which gave me enough strngth. I
thank my elder brother Sri. Basavanagowda C.G. and Smt. Asha Basavana gowda
for thier continuous encouragement. I thank my brother Mr. Nagaraja M.G. for his
affection. I thank my brother in law Sri. Siddanagowda G.K. and his family for their
concern.
I extend my sincere thanks to Dr.B.M Mulkipatil. Dr. Kuber Sankh, Dr.
Yasmeen P., Dr. Nidagundi, and Dr. M. D. Samudri who supported me by providing
the patients, I am thankful to Dr. M.C.Patil, Dr.Danappagoudar and Dr. Jagadeesh Mitti
who provided facilities for the trial drug preparation in the college pharmacy with their
valuable suggestions.
I express my sincere thanks to Sri. Nandakumar for his help in statistical
analysis of results. I take the privilege to thank Sri. Mundinamani, Librarian. I also
extend my thanks to assistant librarians Mr. Shyavi and Mr. Keroor who provided me
all the necessary books and time for my literary work.
I am very much thankful to Sri Tippanagowdar, and Sri. Kallanagouda, for their
help during the study. I extend my thaks to Sri Kulakarni and Mr. Manju for their
timely help.
I feel immense pleasure thank my seniors Dr. Kishore Kumar Hullatti, Dr.
Venkatakrushna, Dr. Venkaraddi, Dr. Kalmath, Dr. Satish Rao, Dr. G.G. Patil and others.
I give deepest acknowledgement to my friend Dr. Basavanth Kumar M.V.Sc. who
is kind to me since my school days. I extend my thankfulness to Dr. Abhishek N.Y. for
being so nice to me.
I thank my fellow colleagues Dr. Shivaleela Kalyani, Dr. Kamalakshi,
Dr. Sulochana, Dr. Shekhar, Dr. Ashwini, Dr. Jayashree, Dr. Madhushree, Dr. Siba, my
junior collegues Dr. Nataraj Dr. Adarsh, Dr.Joshi, Dr. Shailej, Dr. Uday, Dr. Veena
Jigalur, Dr. Sanjeev, Dr. Neeraj, Dr. Ishwar, Dr. Praveen, Dr. Vijayalaksmi, Dr. Kanti,
Dr. Bodke, Dr. Totar, Dr.Shabareesh, Dr. Rajesh and Dr. Sanath for their support.
I thank my juniors Dr. Neeraj Gupta, Dr. Vinay B.G., and internees
Mr.Basavanyappa, Mr. Rajashekhar, Mr. Vasantha Kumar, Mr. Satish Jalikal, Mr. Satish
Angadi, Mr. Sharanu, Mr. Veeresh, Mr. Siddalinga Swamy, Mr.Asif, Miss. Sunitha M,
Miss. Vidya Chandu for their support. I thank specially Mr.Santosh and Mr.Mahantesh
for their help during the trial.
Lastly I pay my deepest respect for those patients who took part in the study and I
share my success with them.
Dr. Ashok M.G.
Abbreviations used:
C.S – Charaka Samhita
S.S – Sushruta Samhita,
A.S – Ashtanga Samgraha
A.H – Ashtanga Hrudaya
B.S – Bhela Samhita
M.N – Madhava Nidana
B.P – Bhavaprakasha
Y.R – Yogaratnakara
V.S – vangasena
Abstract:
Charaka Samhita, leading from the front, states the management of kushta
disease with two distinctive types of treatment anthahaparimarjana chikitsa and
bahirparimarjana chikitsa. The disease kitibha though not life threatening makes the
life of the sufferer miserable. The ugly appearance in this disease makes the patient
psychologically stressed more than anybody. With the fear of getting dejected from
family and society adds up to misery. Itching is the other most disturbing symptom in
this disease which is more dangerous than pain as patient continues to scratch the
body even if it is causing pain. Similarity in the signs and symptoms of psoriasis and
lakshana of kitibha kushta after a primary literary review made us more convenient to
set up the criteria and to have PASI as objective criteria.
Ayurvaeda also believes for any skin diseases topical administration of the
drug is essential. One such yoga advised to use for both internally and externally is
Siddharthaka yoga, though not advised as shamanoushadha but is advised for vamana
and virechana. Here it was taken for granted that if this yoga is administered in lesser
dose it won’t cause any adverse effects. Also the prabhava of some of the ingredients
of the yoga encouraged to try this as none of the ingredients if advised were having
any systemic toxicity. So a study was planned to evaluate its comparative efficacy in
kitibha kushta under the title “A comparative clinical study of ‘siddharthaka yoga
‘parisheka and abhyantara prayoga in the management of ‘kitibha kushta’ with the
special reference to ‘psoriasis’”.
Objectives of the study:
To evaluate the efficacy of siddharthaka yoga parisheka in kitibha kushta.
To evaluate the efficacy of siddharthaka yoga abhyantara prayoga in kitibha kushta.
To evaluate the comparative efficacy of siddharthaka yoga parisheka and abhyantara
prayoga.
Materials and Methods:
A total of 30 patients were selected from O.P.D and I.P.D. of D.G.M.A.M.C &
H after fulfilling the inclusion and exclusion criteria randomly. They were divided in
to two groups Group A and Group B. 15 patients of Group A underwent parisheka for
10 days continuously. Group B patents were advised with the abhyantara prayoga of
Siddharthaka Yoga in the form of capsules in 3 divided doses per day.
Assessment of results was done by considering the base line data of subjective
and objective parameters to pre and post medication and was compared for
assessment of the results. All the results were be analysed statistically for “P” value
using Student “t” test.
Results:
The overall results of the study were as follows;
Group A: All (15(100%)) got best response in this group.
Group B: Best response – 4 (26.66%), Moderate response – 8 (53.33%),
Mild response – 2 (13.33%) and No response – (1 6.66%). Ware the results in this
group.
Statistically all the parameters in both groups have shown highly significant.
All the parameters in Group A have shown highly significance than the Group B.
Comparative efficacy: The efficacy Siddharthaka yoga bahya prayoga is more
significant than the abhyantara prayoga.
Contents Contents Page number
1. Introduction 1
2. Objectives 4
3. Literary review 5
4. Materials and methods 60
5. Observations and results 71
6. Discussion 102
7. Conclusion 124
8. Summary 126
9. Bibliography 128
List of tables. Table no. and content Page No.
Table 01, showing the layers of twacha according to Acharya Charaka 13
Table 02, showing the Layers of twacha according to Acharya Sushruta 14
Table 03, showing correlation between twacha and skin layers 14
Table 04, showing the nidanas of disease kushta mentioned in various books. 16-18
Table 05 showing the possible reason by which individual nidana causes kushta 19
Table 06, showing the Poorvaroopa of kushta 24
Table 07 showing the roopa of Kitibha Kushta 26
Table 08 showing Maha Kushta bheda according to different authors 31
Table 09 showing Kshudra Kushta bheda according to different authors 32
Table 10 showing the analysis of the individual drug of siddharthaka yoga 55
Table 11 showing the analysis of the individual drug of siddharthaka yoga 56
Table 12 showing the distribution of patients age group 72
Table 13 showing the distribution of patients according to sex 72
Table 14 showing distribution of patients by Religion 73
Table 15 showing distribution of patients by Economical status 74
Table 16 Showing distribution of patients by Occupation 75
Table 17. Showing distribution of patients by Nature of work 75
Table 18. Showing distribution of patients by Matra of ahara 76
Table 19. Showing distribution of patients by Kala of ahara 77
Table 20. Showing distribution of patients by Rasa 77
Table 21. Showing distribution of patients by Guna of ahara 78
Table 22. Showing distribution of patients Type of diet 79
Table 23. Showing distribution of patients by Vyasana 79
Table 24. Showing distribution of patients by Hygiene 80
Table 25. Showing distribution of patients by Manaska sthiti 80
Table 26. Showing distribution of patients by observed nidana in no & % 81
Table 27. Showing distribution of patients by observed poorvaroopa in the
study in Group A patients
82
Table 28. Showing distribution of patients by lakshanas observed. 82
Table 29. Showing distribution of patients by anubandha vedana observed. 82
Table 30. Showing distribution of patients by site of onset 83
Table 31. Showing distribution of patients by mode of onset of the disease 83
Table 32. Showing distribution of patients by aggravation time 84
Table 33. Showing distribution of patients by aggravation season 84
Table 34. Showing distribution of patients by Kula vruttanta 85
Table 35. Showing distribution of patients by Chikitsa vruttanta 85
Table 36. Showing distribution of patients by confirmatory signs 86
Table 37. Showing demographic data in patients of in Group A 87
Table 38. Showing demographic data in patients of in Group B 87
Table 39 Showing Lakshanas of kitibha kushta in Group A 88
Table 40 Showing Lakshanas of kitibha kushta in Group B 88
Table 41 Showing Confirmatory signs in psoriasis Group A 89
Table 42 Showing Confirmatory signs in psoriasis Group A 89
Table 43 Showing Anubandha vedana of kitibha kushta in Group A 90
Table 44 Showing Anubandha vedana of kitibha kushta in Group B. 90
Table 45 Showing the observed features of the nature of kitibha kushta in Group A 91
Table 46 Showing the observed features of the nature of kitibha kushta in Group B 92
Table 47 Showing the observed vaiktika vruttanta in Group A 93
Table 48 showing the observed vaiktika vruttanta in Group B 93
Table 49 showing the rogi pareekshain Group A 94
Table No. 50 showing the rogi pareekshain Group B 94
Table 51 showing the Nidana observed in Group A 95
Table 52 showing the Nidana observed in Group B 96
Table No. 53 showing poorvaroopas observed in Group A 97
Table 54 showing poorvaroopas observed in Group B 97
Table 55 Showing assessment of grading of subjective and objective parameter values of Group – A
98
Table 56 Showing assessment of grading of subjective and objective parameter values of Group – B
99
Table 57 Showing t Statistical analysis of parameter values of Group – A 100 Table 58 Showing t Statistical analysis of parameter values of Group – B 100 Table 59 Showing Statistical analysis of parameters values of inter Group (Group – A and Group – B)
101
Table 60 Showing the overall statement of results of Group A 119 Table 61 Showing the overall statement of results of Group B 120
List of Figure Figure Page no
Figure no 01 shows the samprapti flow chart in general. 29
figure no 2 showing the anatomy of normal skin 42
Figure no 03 showing dermal vasculature of normal skin and psoriatic skin 44
Figure no 04 showing ingredients f siddhrthaka yoga. 52
Figure no 05 showing materials used in the study 59
Figure no 06 showing step wise dhara procedure 67
Figure 07 showing distribution of patients by age 72
Figure 08 showing distribution of patients by sex 73
Figure 09 showing distribution of patients by religion 74
Figure 10 showing distribution of patients by Economical status 74
Figure 11 showing distribution of patients by occupation 75
Figure 12 showing distribution of patients by nature of work 76
Figure 13 showing distribution of patients by matra of ahara 76
Figure 14 showing distribution of patients by kala of ahara 77
Figure 15 showing distribution of patients by rasa 78
Figure 16 showing distribution of patients by gune of ahara 78
Figure 17 showing distribution of patients by type of diet 79
Figure 18 showing distribution of patients by vyasana 79
Figure 19 showing distribution of patients by hygine 80
Figure 20 showing distribution of patients by manasika sthiti 80
Figure 21 showing distribution of patients by site of onset 83
Figure 22 showing distribution of patients by mode of onset 83
Figure 23 showing distribution of patients by aggravation time 84
Figure 24 showing distribution of patients by aggravation season 85
Figure 25showing distribution of patients by kula vruttana 85
Figure 26 Showing distributions of patients by chikitsa vruttanta 86
Figure 27 showing distribution of patients by confirmatory signs 86
Figure 28 Showing the overall statement of results 118
Introduction
Evaluation of Efficacy of Siddharthaka Yoga in Kitibha Kusta
1
Introduction
Acharya Agnivesha, the all time intelligent scholar of Ayurveda, the science
of life notes down the preaching of Adhyupadeshta Punarvasu Atreya in the form of
doctrine to become popular later as Charaka Samhita after the addition from the
experience of Acharya Drudhabala and redactation of Acharya Charaka. This is the
only doctrine honored & referred over centuries. The redactor Acharya Charaka
viewed the river of medicine, raising from an obscure past, ever flowing, ever
growing and racing to the flood waters of today. He had urged us to learn from
greatest sages as well as shepherds; both are the teachers in their own way 1.
Entire Charaka samhita deals the subject keeping in mind the concept of
chikitsa. This attitude is seen from the chapter number one. He discusses the types of
chikitsa as of Antahparimarjana and Bahirparimarjana types. After dealing the entire
chapter about panchakarmaroopa anathparimarjana chikitsa, he dedicates
Aragwadeeya adhyaya 2 for bahirparimarjana chikitsa especially for the disease
Kushta. This shows the importance of treating kushta, a deergha roga 3 after its
thorough understanding. He further says performing bahirparimarjana chikitsa yields
sadhya siddhi 4.
For the first time in the entire history of medicine the disease Kitibha Kushta
is cited from Charaka Samhita 5 where choorna pradeha is advocated over the tailakta
gatra.
It is evident after going through different classical texts of Ayurveda that
Kushta, a noted mahagada 6 requires multiple route of administration of drugs. Two
such different modalities are antahparimarjana and bahirparimarjana chikitsa. One
such yoga mentioned for the use in both route is Siddharthaka snanokta aushadha
siddha kashaya.
Introduction
Evaluation of Efficacy of Siddharthaka Yoga in Kitibha Kusta
2
Kitibha kushta simulating to the disease Psoriasis in the contemporary system
of medicine results in the fear of getting dejected from the society because of the
appearance of the body. Kandu, Shyava kina and khara sparsha and scratching the
body in the public by the patient creates an enormous psychological stress over the
diseased and kandu is more miserable than the pain because patients don’t stop
scratching the body even though it causes pain so it is postulated clinically that the
itching is stronger symptom in any patient. Hence the management of kandu, shyava
kina and khara sparsha is the need of the hour in kitibha sufferer. The utility of drugs
of modern science like methotrexate, which is still of ‘gold standard’ has increased
risk of bone-marrow toxicity and hepatotoxicity. This gives an edge of advantage to
Ayurveda over the modern system of medicine to help the sufferer with its non toxic
medicament, also suffer is compelled to seek prescription from an Ayurvedic
physician.
The ingredients of Siddharthaka snana yoga was estimated to suit the demands
as the drugs of the compound are blessed with kushtaghna and kandughna property.
Most of these drugs are included in kushtaghna and kandughna gana which are set as
an example for the physician to proceed their thoughts basing on these 7. This yoga
was taken for the study to draw a comparative efficacy of the drug under the title “A
comparative clinical study of ‘siddharthaka yoga ‘parisheka and abhyantara
prayoga in the management of ‘kitibha kushta’ with the special reference to
‘psoriasis’”.
The study included a total of 30 subjects divided randomly in to two groups as
A and B. 15 patients of group A received the bahirparimarjana chikitsa in the form of
parisheka. As stressed by the all time great physician of Ayurveda Acharya Charaka
to administer external therapy for better efficacy over Tailakta gatra 8, taila was
Introduction
Evaluation of Efficacy of Siddharthaka Yoga in Kitibha Kusta
3
preapared using the same ingredients. Though snana is told in the Samhita, for
hospital supervision the procedure was modified to parisheka. The other set of 15
patients received antahparimarjana chikitsa in the form of capsules. The subjects were
selected from OPD and IPD of D.G.M.A.M.C. and hospital, Gadag.
The entire study was done to evaluate the efficacy of Siddharthaka yoga by
duly considering the clinical signs and symptoms as subjective parameter and PASI
scoring as objective parameter. The subjective and objective of base line data to pre
and post medication was compared for the assessment of the results. All the results
were analysed statistically for ‘p’ value by using un-paired test to analyse the mean
effect of two groups, and paired‘t’ test was used to compare the effect of drug by
assuming that the drug is not responsible for the changes in the observation before and
after the treatment.
Objectives
Evaluation of Efficacy of Siddharthaka Yoga in Kitibha Kusta
4
Objectives
The objectives of the study were;
1. To study kushta disease with special reference to kitibha kushta simulating
to psoriasis in detail.
2. To study the properties and mode of action of ingredients of ‘siddharthaka
yoga’ in kitibha kushta.
3. To study the therapeutic procedure parisheka and its role in the
management of kitibha kushta
4. To evaluate the efficacy of siddharthaka yoga parisheka in kitibha kushta.
5. To evaluate the efficacy of siddharthaka yoga abhyantara prayoga in
kitibha kushta.
6. To evaluate the comparative efficacy of siddharthaka yoga parisheka and
abhyantara prayoga.
Literary review
Evaluation of Efficacy of Siddharthaka Yoga in Kitibha Kusta
5
Literary review
Historical review:
Ayurvedic literature:
The science of life, Ayurveda was developed on the base of Vedas
only hence the Indian system of medicine is also devine. This auxiliary of Atharva
veda is said to be the perfect since the time of its inception. It is important to study the
subject of Ayurveda i.e. from primitive state and the recession at a particular stage – it
must be viewed as a part of our cultural history and cultural history must be studied in
relation to the social history against the background of historical evolution of India.
The reason behind development and decline will then come to our notice.
The nidana panchaka except lakshanas of kitibha kushta are not told in any of
the texts of Ayurveda. Hence the samanya nidana, poorvaroopa, upashaya and
samprapti of Kushta are considered in the entire study.
Charaka Samhita
Agnivesha samhita is now known as Charaka samhita, after the handy
contribution from Acharya Charaka, the greatest redactor in the world history of
literature. This was compiled in the second century B.C. The disease kushta is dealt
with the great importance as is evident from the fact that the treatment of kushta is
dealt in the very third chapter of the samhita where the external therapeutics are
explained for the disease.
The disease kushta is dealt in two broad headings as Maha kushta and kshdra
kushta and are told as seven and eleven types respectively. Kitibha is dealt under the
second variety of lesser important type of kushta in chikitsa sthana.
Literary review
Evaluation of Efficacy of Siddharthaka Yoga in Kitibha Kusta
6
The other parts of the book where the disease kushta is explained are as
follows;
a) Chardhi nigrahana is told to manifest the disease kushta 9
b) Kushta is told as bahya marga roga 10.
c) It is advised with madhyama matra of sneha 11.
d) Is told as nija shotha karana 12.
e) Classification of kushta is told as 713.
f) Langhana is adviced for twak dosha 14.
g) Kushta is told as santarpanottha vyadhi 15.
h) This disease is told as raktadushtijanya roga 16.
i) Kushta is told as shreshta deergha roga 17.
j) Atilavana rasa sevana leads to kushata 18.
k) Tikta rasa is told as kushtahara 19.
l) Is told as resultant of viruddhaharajanya roga 20.
m) Is counted as raktapradoshajanya vikara 21.
n) Pancha nidana of kushta is detailed with explanations of
mahakushta 22.
o) Adhishtana of kushta is told as chaturtha tamra nama twak 23.
p) Kushta arishta lakshanas are told in indriya sthana 24.
q) References of kithibha kushta lakshanas are available in chikitsa
sthana 25.
r) The dosha pradhanyata of kitibha kushta is told as vata kapha 26.
Sushruta samhita
This doctrine of Ayurvada counted under bruhatrayee was written by Acharya
Sushruta basing on the preaching of Divodasa. This is the book which has dealt both
Literary review
Evaluation of Efficacy of Siddharthaka Yoga in Kitibha Kusta
7
the types of kushta in the nidana sthana counting kitibha kushta in ksudra kushta.
Some of the references available regarding kushta are;
a) Pratisarana kshara is told for Kushta 27.
b) Kushta is told as papajanya roga28.
c) Is counted under Aupasargika roga along with jwara, shosha and
netrabhishyanda 29.
d) Saptadhatugata kushta lakshanas are told in this book 30.
e) Kushta is told as hereditary (streepumsa shukrashonitajanya) i.e.
adibala pravrutta vyadhi 31.
f) Sadhyasadhyata of the kushta is told based on the basis of dhatu
involvement 32.
g) Kushta is told as mahagada33.
h) Kushta adhishtana is told as 5th layer i.e. vedini, the thickness of
which is 1/5th of a vreehi danya 34.
i) Varjya and pathya is dealt in detail in this samhita 35.
j) The predominant dosha involved in kitibha kushta is told as pitta.
Bhela samhita:
The work of Acharya Bhela, the student of Punarvasu Atreya Bhela samhita is
lost and the presently available book is not a complete one.
a) The disease kushta is dealt in nidana sthana as well as chikitsa
sthana.
b) Like Charaka Samhita he discusses kitibha kushta in chikitsa sthana
only.
c) Hareeta shakas, Madhya and pippali are told as nidanas for kushta
apart from those told in Charaka Samhita 36.
Literary review
Evaluation of Efficacy of Siddharthaka Yoga in Kitibha Kusta
8
d) Mootra and pureesha vegadharana are told as nidana for kushta
(Bhe.Chi.6/4).
e) Vartate cha samutpannam is the extra lakshana told in this book for
kitibha kushta i.e. relapsing nature 37.
Hareeta Samhita:
Achrya Hareeta is quoted to be the other disciple of Punarvasu Atreya and a
colleague of Acharya Agnivesha.
He had also counted 18 number of kushta but he had not used the word
Kitibha, he might have used kina kushta for it 38.
Kushta is said to be papodbhava according to the author.
Kashyapa Samhita:
This book is as old as Charaka Samhita and Sushruta Samhita perhaps even
more so is obtained in mutilated form, missing preface, conclusion and some other
portions. Like Atreya in Charaka Samhita and Divodasa in Sushruta Samhita, the
original preceptor of this Samhita is Acharya Kashyapa. Young Jeevaka had
condensed the teachings of Kashyapa to be known later as Kashyapa Samhita or
Vruddha Jeevakeeya Tantra.
Kushta is dealt in kushta chikitsadhyaya of chikitsa sthana. The extra
information availed from this is pipasa as a purvaroopa of kushta.
Prashanti cha punaha utpadhyate is extra lakshana told for kitibha kushta 39.
Ashtanga Samgraha: Acharya Vagbhatta’s compilation work on the basis of
Charaka Samhita and Sushruta Samhita had dominated the readers in the recent time
as it avails the information of two different schools of thoughts in one single book.
This book gives the definition of Kushta. He mentions bahya kushta
samprapti. Both maha and kshudra kushtas are dealt in nidana sthana only. Medogata
Literary review
Evaluation of Efficacy of Siddharthaka Yoga in Kitibha Kusta
9
kushta and there after are told told as yapya and asadhya respectively. Pittaja,
dwandwaja and asra mamsagata kushta are told as krucchrasadhya. The vata kaphaja
kushta notably are told as sukhasadhya 40. The chikitsa aspect of the disease is dealt in
chikitsa sthana.
Ashtanga Hrudaya:
The other book almost consisted versions of Ashtanga samgraha out of the pen
of Laghu Vagbhatta is very famous in the southern part of the country for its poetic
way of writing.
Acharya Laghu Vagbhatta conveys krimi as nidana of kushta 41. He explains
the sequential progressive involvement of loma to tarunasthi if kushta is untreated 42.
He had followed the version of Acharya Sushruta in the context of Chikitsa sutra
explanation.
Madhva Nidana:
The worth book referred for the pathophysiology of the diseases in Ayurveda,
is the work of Acharya Madhavakara. He with little contribution of his own had
compiled mostly the versions of bruhattrayees. He had followed Charaka Samhita and
Ashtanga Samgraha for the explanation of nidana and lakshanas, while he followed
Acharya Sushruta in explaining saptadhatugata kushta.
Sharngadhara Samhita:
Damodara soota Sharngadhra’s work is the choice of book to be referred for
the pharmacology and therapeutics in Ayurveda. While dealing the classifications of
vyadhis he says kushta is of 18 types, including the kitibha kushta 43. He contributes
with new formulations for kushta disease by calling those set as kushtaghna 44.
Literary review
Evaluation of Efficacy of Siddharthaka Yoga in Kitibha Kusta
10
Basavarajeeyam:
The author who hails from south India is very special because he gives a list of
herbo-mineral formulations for every disease. He had added kandu as a lakshana of
kitibha to the version of Acharya Charaka. He is the first author to indicate
formulations for individual types kushta. He advocates Vajrapani rasa for kitibha
kushta 45.
Vaidhya Jeevanam:
The poet cum Ayurveda Acharya is special because of his contributions of
effective yogas and poetic explanation of their efficacy. One eg of such yoga is found
in 4th Vilasa 18th shloka 46.
Bhavaprakasha:
Bhavamishra son of Latakana Mishra had written a book concentrating more
of the herbs explaining their properties. He also had written Chikitsa of various
vyadhis prevalent in madhyama kala. He followed Acharya Charaka in explaining
kushta, in addition he told arishta lakshanas47, includes nisha in the pathya sevana 48
and he advises kaishora guggulu for kushta 49.
Sahasra yoga:
The book written by an anonymous author belonging to Kerala state is an
important asset. The entire book comprises only the formulations for various diseases
in different forms. In each prakarana there are kushtaghna yogas. The therapeutic
index of this book is undoubtedly a part and parcel of the prescription in the
practitioners of this part of the country.
Nirukti
Evaluation of Efficacy of Siddharthaka Yoga in Kitibha Kushta
11
Nirukti and paribhasha of kushta:
The word kushta is originated from kush – katana (kuda pratyaya) 47 means; to
deform the twacha (kusha nishkarsha), to change the colour of twacha
(kushnatyangam), to discontinue the integrity of twacha (kutsitam tishtati). Also the
etymology of the word kushta is from the root ‘kush’ meaning; that which comes
from inner part, after adding hani to kush it becomes kushta 48. The meaning can be
concluded as the condition in which there is hani to the twacha especially to its
appearance as the factors like rakta, laseeka, ambu and tridoshas from inner part of the
body reach the outer most part of the body being skin which exactly matches with the
samprapti of kushta.
Ashtangakaras were first to define kushta as “twacha kurvanti vaivarnya
dushtaha kushtamushanti tat ||” 49, meaning the condition in which there is
discolouration and dushti of twacha. The discontinuity of the twacha is resulted in this
disease.
Further the same author says; once the condition is allowed to lapse by time, it
makes the entire body to look ugly. It spreads to all the dhatus, resulting in the
increase of the kleda in the body because of which sankotha of twacha occurs leading
to utpatti of sookshma krimi inturn. These krimis later invade loma, twak, snayu,
dhamani and tarunasthi in an order 50.
Nirukti
Evaluation of Efficacy of Siddharthaka Yoga in Kitibha Kushta
12
Nirukti and paribhasha of kitibha kushta:
The word meaning of kitibha is kesha keeta 51. Shri Kavirama Umeschandra
says it as kesha koti 52. Kitibha in English is a louse (a parasitic insect, pediculus
humanus, infecting the human hairs and skin and transmitting various diseases) and a
kind of exanthema 53. Condensing all these, the definition of kitibha can be
summerised as ‘a diseased condition in which the twacha gets discoloured like kesha
keeta (blackish brown), or a condition in which the skin gets afflicted with kesha
keeta.’ The same meaning is also told by Shri Tarakanath as, kitiriva bhati
krushnatwat i.e. a condition where the skin gets krushna varna like kiti, the kesha
keeta 54. As for as the present understanding of the disease kitibha kushta is known,
the first explanation of similarity in the colour of the kesha keeta holds good where as
we don’t find any krimi affecting the twacha as per the second opinion.
Twacha shareera
Evaluation of Efficacy of Siddharthaka Yoga in Kitibha Kushta
13
Twacha Shareera.
Twak is the simulating term used for skin in the modern anatomy. It
invaginates and covers the entire structures of human body. Covering the entire body,
has a surface area of 1.5 2 sq. m., weighs about 4-5 kg making almost 7% of the total
body weight. Thus it is told as sthira and bahala by Ayurveda 55.
The twak is upadhatu of mamsa produced in the intrauterine life 56. Twacha is
the moola of mamsavaha srotas 57. The 7 layers of twak are formed when shukra and
shonita are subjected for the paka by doshas and the layers are formed just like the
formation of santanika after boiling the ksheera 58. But Ashtanga samgrahakara says
that the 6 layers of twacha are formed out of processing of asruk 59. Twak is the place
for tactile sensation 60 and is made up of vayu mahabhuta predominantly 61, 62 this is
also the site of bhrajaka pitta, the factor responsible for the digestion of the external
application of medicaments 63, 64, the seven and six laters according to Acharya
Charaka and Acharya Sushruta are shown in table no. 01 and 02 indicating their
features.
Table 01 showing the layers of twacha according to Acharya Charaka 65
Sl.no. Layer Features
01 Udakadhara Bahya twacha, protects the jaleeyamsha
02 Asrugdhara Holds the rakta
03 Truteeya Adhishthana of sidma, and kilasa kushta.
04 Chaturtha Adhishthana of dadru kushta.
05 Panchamee Adhishthana of alaji and vidradhi.
06 Shashtee If incised it causes severe pain and leads to tamah pravesha.
Causes sthula moola arumshikas over sandhis which are
asadhya to treat.
Twacha shareera
Evaluation of Efficacy of Siddharthaka Yoga in Kitibha Kushta
14
Table 02 showing the Layers of twacha according to Acharya Sushruta 66
Sl.no. Layer Measurement Features 01 Avabhasini 1/18th vreehi Varna and chaya prakashaka, sidma and
Evaluation of Efficacy of Siddharthaka Yoga in Kitibha Kushta
56
Table 11 showing the analysis of the individual drug of siddharthaka yoga Sl.no Name of the
drug
Botanical name Family Rasa Guna Karma Veerya Vipaka Pryojyanga
06 Karanja Pongamia
pinnata
Leguminosae Katu, tikta,
kasaya.
Laghu,
teekshna
Pittala, kaphavata shamaka,
kushtaghna,kandughna,krimi,shotha and
arshahara.
Ushna Katu Twak, patra,
beeja.
07 Aragwada Cassia fistula Leguminosae Tikta,
madhura
Guru,
sheeta,
Tridoshahara. Jwara, gulma, udara, vrana and
pramehahara
Patra-shoshana
of kapha, medas.
08 Kalinga yava Holerrhena
antidysentrica
Apocynaceae Tikta,
katu,
Grahi ,
rooksha,
anushna
Trisoshahara, kushtaghna, jwara, visarpa
hara.
Sheeta Katu Twak, beeja.
09 Daruharidra Berberis aristata
Berberidaceae Tikta,
kashaya
Laghu,
rooksha,
ushna.
Kaphapittahara, kandu, twagdosha, meha,
vrana hara.
Ushna Katu Moola, kanda,
phala.
10 Saptaparna Alstonia
scholaris
Apocynacea Tikta,
kashaya.
Laghu,
snigdha.
Kapha pitta shamaka, kushtaghna,vrana,
krimihara,raktaja rogas.
Usna Katu Twak and patra
Parisheka
Evaluation of Efficacy of Siddharthaka Yoga in Kitibha Kushta
57
Parisheka:
The word parisheka denotes snana 225. Acharya Sushruta uses the word repeatedly
to indicate snana by dugdha, kashaya etc. in swabhava vyadhi pratishedeeyadhaya where
rasayana is dealt in detail. Parisheka is also the term used as an equivalent word for
parisechana in the context of Shashtivranopakrama 226. This is also told as one among the
thirteen type of sweda according to Acharya Charaka 227. The procedure is detailed in the
same chapter as; the swedana dravyas like moola etc. are used for kashaya preparation
and this kashaya is then taken in a kumbha or varshanika or pranadi. This procedure is
said to yield the result when it is done after the gatra abhyanga with yathartha siddha
sneha. Acharya Chakrapani, ‘charaka chaturanana’ says that this procedure of sweda is
very much beneficial in vatakapha diseases, varshanika as alpa ghata, a small pot,
varshanika as sahasra dhara and pranadi as venunalanadyadhya 228. Acharya Vagbhatta
includes this parisheka in drava sweda along with avagaha sweda. Acharya Indu a noted
commentator of Ashtanga Samgraha says this procedure is done with the kwatha over
sarvanga or ekanga according to the need, he says pranalika as urdhwatavishta bhanda
which is a instrument used for the purpose of parisheka which is generally known as dhar
patra now a days 229. However both the authors have advised to do the parisheka after
making acchadana of gatra by vastra. The reason and the advantage are not spoken by
any author. Parisheka word is used equivalent to dhara in many of the contexts 230. The
inclusion of parisheka in the vranopakrama is used to substantiate the utility of parisheka
in kitibha kushta as kina is vrana sthana accoding to Acharya Charaka. A similarity is
given in Sushruta to convey the mode of action and utility of parisheka as; parisheka
subsides the dosha and agni responsible for paka very similarly like how ambu sinchana
Parisheka
Evaluation of Efficacy of Siddharthaka Yoga in Kitibha Kushta
58
results in agni shanti 231. This statement made by the Acharya signifies the importance of
parisheka, a local treatment to avoid dosha accumulation, vrana paka and to accelerate
vrana ropana.
Materials
Evaluation of Efficacy of Siddharthaka Yoga in Kitibha Kushta
60
Materials and methods
Materials used for the study:
The materials used for the study were
1. Siddharthaka snanokta dravya siddha kashaya – for parisheka.
2. Siddharthaka snanokta dravya siddha taila – for application before parisheka.
3. Siddharthaka yoga capsules – for abhyantara prayoga.
Siddharthaka snanokta dravya siddha kashaya –
The 10 ingredients of the siddharthaka yoga; root nodules of musta, fruits of
madanaphala with seeds, fruits of amalaki (nirbeeja), vibheetaki (nirbeeja), hareetaki
(nirbeeja), karanja patra, aragwada patra, kalingayava (seeds of kutaja), daruharidra
kanda and saptaparna patra were supplied by Prakruti Remedies private limited,
Karwar, Karnataka in the raw form. The drugs were checked with the criteria
mentioned in the classical Ayurvedic texts and modern botanical parameters with
experts before using them in the study.
An approximate of 4 liters of kashaya was prepared for the parisheka daily, for
which 1 kg of yava kuta choorna was used. For this100 gram of yavakuta choorna of
each ingredient was weighed and packed for the preparation of kashaya for one day
for the convenience.
The kashaya was prepared according to Sharngadhara Samhita reference 232. A
total of 16 liters of water was taken and 1 kg of siddharthaka yoga yavakuta choorna
was added and boiled to get 4 liters of kashaya. This was then filtered and made ready
to be used for parisheka. The kashaya was prepared in the panchakarma theatre of the
hospital daily. For dhara karma, dhara patra of 4 liter capacity was used.
Materials
Evaluation of Efficacy of Siddharthaka Yoga in Kitibha Kushta
61
Siddharthaka snanokta dravya siddha taila:
A total of 15 liter of taila was prepared in the department of Rasashastra and
Bhaishajya kalpana, D.G.M.A.M.C. and H. Gadag. The taila was prepared according
to Sharngdhara Samhita 233. For this a total of 17 liters taila was taken, 68 liters of
kashaya prepared out of Siddharthaka yoga, 4.25 kg of Siddharthaka yoga kalka was
used. For the preparation of kashaya for tailapaka 17 kg of Siddharthaka yoga
yavakuta choorna, 272 liters of water was used to get 68 liters of kashaya. In a span of
two days the taila paka was completed and got approximately 15 liters of
Siddharthaka taila. This was then packed in 750 ml bottle to be used for individual
patients separately to avoid soiling.
Siddharthaka yoga capsules:
Basically the usage of Siddharthaka yoga is in the form of kashaya for
vamanartha and virechanartha. But for the present study it was modified in to capsule
form for easy dispensing and acceptability and accurate dose maintenance. A total of
2 kg (each ingredient weighing 200 g.) of vastragalita choorna was taken and
approximately 3 liters of Siddharthaka yoga kashaya was used for each bhavana (750
g. of yavakuta choorna for one bhavana), (total of 5250g. of choorna for seven
bhavanas)). It was completed in a span of seven days. The choorna was again made
vastra galita and 500 mg capsules were filled using capsule filling machine in college
pharmacy. 90 Capsules were packed in a plastic cover and were dispensed to the
patients. Patients were advised to take 2 capsules thrice daily with plane water
preferably boiled and cooled. Patients were dispensed with the other 90 capsules on
the second consultation i.e. 15 days after the first consultation.
Methods
Evaluation of Efficacy of Siddharthaka Yoga in Kitibha Kushta
62
Methods:
Type of study:
The study was a comparative clinical study of siddharthaka yoga Bahya and
abhyantara prayoga in kitibha kushta with special reference to psoriasis.
Source of data:
The minimum numbers of patients included for the study were 30. Patients of
either sex were selected from the O.P.D. and I.P.D. of D.G.M.A.M.C. and Hospital after
screening. The inclusion and exclusion criteria were duly considered before including the
patient for the study.
Selection of patients:
After fulfilling the criteria set in the form of inclusion and exclusion criteria, 30
patients were randomly distributed in to two groups.
Group – A: 15 patients were advised with Bahya prayoga of Siddharthaka by subjecting
them for parisheka.
Group – B: 15 patients were included for abhyantara prayoga of Siddharthaka yoga in
the form of capsules.
Inclusion criteria:
Patients were seen for signs and symptoms of kitibha kushta those told by
different Acharyas. Signs like Shyavavarna Kina, Krishnavarna Kina, Parusha
Kina, Ghana, Khara sparsha, Snigdha sparsha of kina and symptom Ugra kandu
were appreciated in all patients before their inclusion.
The age limitation for the study was kept to a minimum of 15 years and maximum
of 60 years.
Methods
Evaluation of Efficacy of Siddharthaka Yoga in Kitibha Kushta
63
Patients belonging to both the gender were included in the study.
Patients suitable for the procedure parisheka were included. For Group A patients,
parisheka procedure was explained and the consent was taken and those who
refused to undergo were convinced for the participation in the Group B of the
research work.
Exclusion criteria:
Chronic cases of more than 5 years were refused to be the part of trial.
Patients with the secondary systemic involvement like psoriatic arthritis etc were
excluded.
Patients with secondary systemic diseases like diabetes and hypertension were
excluded from the study.
Patients with psoriatic lesions over genitalia were excluded from the Group A as
parisheka with hot kashaya is contraindicated.
Pregnant women and lactating mothers were not considered for the study.
Diagnostic criteria:
The above mentioned clinical signs and symptoms of kitibha kushta were used as
diagnostic tools. Also the signs and symptoms of psoriasis were seen for. Patchy
circumscribed skin lesions with erythematous, well defined, dry, silvery scaly papules
and plaques were appreciated before their inclusion in the study. Patients were also seen
for ‘Candle grease sign’ and ‘Auspitz sign’.
Posology:
The posology for either bahya prayoga or abhyantara prayoga is not mentioned in
the context by Acharya Charaka. Hence the amount of kashaya sufficient to use for the
Methods
Evaluation of Efficacy of Siddharthaka Yoga in Kitibha Kushta
64
parisheka was known by conducting pilot study and 4 liter of kashya was found as
sufficient to perform parisheka of whole body. But the dose for abhyantara prayoga was
purely postulated by duly considering the safety factors.
For parisheka: four liters of kashaya was used for most of the patients and if the
lesions were confined to local part then sufficient quantity (less) of kashaya was taken.
For abhyantara prayoga: two 500 mg. capsules thrice daily were advised with
plain water or boiled and cooled water.
Study duration:
Parisheka: Parisheka was done for ten days continuously. The actual follow up of
the study was 30 days.
Abhyantara prayoga: Capsules were administered for 30 days continuously with
a follow up of 30 days.
Assessment of results:
Assessments of results were done on the basis of readings of subjective and
objective parameters before and after the treatment. The outcome of the observations
were analysed statistically for ‘p’ value using unpaired Student‘t’ test.
Subjective parameters:
Shyava krushna varna, Parushata, Ghanatwa, Kharasparsha and Kandu were set as
subjective parameters. The grading was given as follows;
Sl. no.
Subjective parameter
Score0 Score 1 Score 2 Score 3 Score 4
01 Shyava krushna varna No Mild Moderate Severe Extensive02 Parushata No Mild Moderate Severe Extensive03 Ghanatwa No Mild Moderate Severe Extensive04 Kharasparsha No Mild Moderate Severe Extensive05 Kandu No Mild Moderate Severe ExtensiveThe readings before and after the treatment were compared to assess the result.
Methods
Evaluation of Efficacy of Siddharthaka Yoga in Kitibha Kushta
65
Objective parameter:
PASI 234
Sl.No Head Upper extremities
Trunk Lower extremities
a Redness + b Thickness + c Scaling + Sum of rows of 1, 2
and 3
d Area score e Score of
row 4x row 5 x the area multiplier
row 4 x row 5 x 0.1
row 4 x row 5 x 0.2
row 4 x row 5 x 0.3
row 4 x row 5 x 0.4
f Sum row 6 for each column for PASI score
Steps in generating PASI score:
(a) Divide body into four areas: head, arms, trunk to groin, and legs to top of buttocks.
(b) Generate an average score for the erythema, thickness, and scale for each of the 4
areas (0 = clear; 1–4 = increasing severity).
(c) Sum scores of erythema, thickness, and scale for each area.
(d) Generate a percentage for skin covered with psoriasis for each area and convert that to
Evaluation of Efficacy of Siddharthaka Yoga in Kitibha Kushta
73
Group A: Among 15 numbers of patients 12 (80%) were males and 03 (20%) were
females.
Group B: Among 15 numbers of patients 09 (60%) were males and 06 (40%) were
females.
Overall: distribution of sex was; male – 21 (70%) and females were 09 (30%) in 30 patients. Figure 08 showing distribution of patients by sex
Table 14 showing distribution of patients by Religion Religion
Group A no. and %
Group B no. and %
Group A and B no. and %
Hindu 13 (86.6%) 12 (80%) 25 (83.3%) Muslim 02 (13.3%) 02 (13.3%) 04 (13.3%) Christian 00 (00%) 01 (6.6%) 01 (3.3%) Others 00 (00%) 00 (00%) 00 (00%) Group A: out of fifteen patients 13 (86.6%) were Hindus, 02 (13.3%) were Muslims
and none were Christians and others
Group B: out of fifteen patients 12 (80%) ere Hindus, 02 (13.3%) were Muslims, 01
(6.6%) was Christian, and none were from other caste.
Overall: Hindus were 5 (83.3%), 04 (13.3%) were Muslims, 01 (3.3%) was Christian
and none were from other category among thirty total number of patients.
12
3
9
6
21
9
0
5
10
15
20
25
Group A Group B Total
MaleFemale
Observation
Evaluation of Efficacy of Siddharthaka Yoga in Kitibha Kushta
74
Figure 09 showing distribution of patients by religion
Table 15 showing distribution of patients by Economical status Economical status Group A no. and
% Group B no. and %
Group A and B no. and %
Poor 03 (20%) 00 (00%) 03 (10%) Middle class 10 (66.6%) 15 (100%) 25 (83.3%) Rich 02 (13.3%) 00 (00%) 02 (6.6%) Group A: out of fifteen patients 03 (20%) were belonging to poor status, 10 (66.6%)
were of middle class and 02 (13.3%) were rich.
Group B: out of fifteen patients none were belonging to poor status, all 15 (100%)
were of middle class and none were from rich status
Overall: out of thirty patients 03 (10%) were poor, 25 (83.3%) were of middle class
and 02 (6.6%) were rich
Figure 10 showing distribution of patients by Economical status
13
20 0
12
21 0
25
41
00
5
10
15
20
25
Group A Group B Total
Hindu Muslim Christian Others
3
10
20
15
0
3
25
2
0
5
10
15
20
25
Group A Group B Total
Poor Middle class Rich
Observation
Evaluation of Efficacy of Siddharthaka Yoga in Kitibha Kushta
75
Table 16 Showing distribution of patients by Occupation Occupation
Group A no. and %
Group B no. and %
Group A and B no. and %
Student 1 (6.6%) 02 (13.3%) 03 (10%) Labor 7 (46.6%) 06 (40%) 13 (43.3%) Executive 1 (6.6%) 00 (00%) 01 (3.3v) Sedentary 5 (33.3%) 01 (6.6%) 06 (20%) Group A: out of fifteen patients 1 (6.6%) was student, 7 (46.6%) were labors, 1
(6.6%) was executive and 5 (33.3%) were sedentary by occupation
Group B: out of fifteen patients 02 (13.3%) were students, 06 (40%) were labors,
none were executives and 01 (6.6%) was of sedentary by occupation.
Overall: out of thirty patients 03 (10%) were students, 13 (43.3%) were labors, 01
(3.3%) was executive and 06 (20%) were belonging to sedentary category.
Figure 11 showing distribution of patients by occupation
Table No. 17. Showing distribution of patients by Nature of work Nature of work
Group A no. and %
Group B no. and %
Overall
Stressful 7 (46.6%) 06 (40%) 13 (43.3%) Near heat 3 (20%) 01 (6.6%) 04 (13.3%) Traveling 4 (26.6%) 00 (00%) 04 (13.3%) Group A: out of fifteen patients 7 (46.6%) were working stressfully, 3 (20%) were
working near heat and 4 (26.6%) were having traveling nature of work.
Group B: out of fifteen patients 06 (40%) were working stressfully, 01 (6.6%) were
working near heat and, none were from traveling category.
Overall: out of thirty patients 13 (43.3%) were working stressfully, 04 (13.3%) were
working near heat and 4 (26.6%) were having traveling nature of work.
1
7
1
5
2
6
01
3
13
1
6
0
2
4
6
8
10
12
14
Gro up A Gro up B T o tal
Student Labor Executive Sedentary
Observation
Evaluation of Efficacy of Siddharthaka Yoga in Kitibha Kushta
76
Figure 12 showing distribution of patients by nature of work
Vaiyaktika vruttanta of the patients:
Table No. 18. Showing distribution of patients by Matra of ahara Bahu Madhyama Alpa Group A 08 (53.3%) 06 (40%) 01 (6.6%) Group B 04 (26.6%) 09 (60%) 02 (13.3%) Overall 12 (40%) 15 (50%) 03 (10%) Group A: 08 (53.3%) patients were taking bahu matra ahara, 06 (40%) were taking
madhyama matra and 01 (6.6%) was taking alpa matra ahara.
Group B: 04 (26.6%) patients were taking bahu matra ahara, 09 (60%) were taking
madhyama matra ahara and 02 (13.3%) were taking alpa matra ahara.
Overall: out of thirty patients 12 (40%) were taking bahu matra ahara, 15 (50%) were
taking madhyama matra ahara and 03 (10%) were taking alpa ahara.
Figure 13 showing distribution of patients by matra of ahara
7
34
6
10
13
4 4
0
2
4
6
8
10
12
14
Group A Group B Total
Stressful Near heatTraveling
8
6
1
4
9
2
12
15
3
0
2
4
6
8
10
12
14
16
Group A Group B Total
BahuMadhyamaAlpa
Observation
Evaluation of Efficacy of Siddharthaka Yoga in Kitibha Kushta
77
Table No. 19. Showing distribution of patients by Kala of ahara Regular Irregular Group A 11 (73.3%) 04 (26.6%) Group B 14 (93.3%) 01 (6.6%) Overall 25 (83.3%) 05 (16.6%) Group A: out of fifteen patents 11 (73.3%) were taking food at regular time, 04
(26.6%) were taking irregularly and 01 (6.6%) was taking food twice daily and 14
(93.3%) were taking thrice daily.
Group B: out of fifteen patents 14 (93.3%) were taking food regularly, 01 (6.6%) was
taking irregularly and 02 (13.3%) were taking it twice a day and 13 (86.6%) were
taking food thrice a day.
Overall: out of thirty patents 25 (83.3%) were taking it regularly, 05 (16.6%) were
not taking regularly and 03 (10%) were taking for two times a day and 27 (90%) were
having thrice a day.
Figure 14 showing distribution of patients by kala of ahara
Table No. 20. Showing distribution of patients by Rasa Madhura Amla Lavana Katu Tikta Kashaya Group A 09 (60%) 10 (6.6%) 01 (6.6%) 10(66.6%) 00 (00v) 00 (00%) Group B 09 (60%) 02(13.3%) 03(13.3%) 10(66.6%) 00 (00%) 00 (00%) Overall 18 (60%) 12 (40%) 04 (10%) 20(66.6%) 00 (00%) 00 (00%) Group A: out of fifteen patents 09 (60) were liking madhura rasa, 10 (6.6) were
liking amla rasa, 01 (6.6%) was liking lavana and 10 (66.6%) were liking katu rasa.
None liked tikta.and kashaya rasa.
Group B: out of fifteen patents patents 09 (60%) were liking madhura rasa, 02
(13.3%) were liking amla rasa, 03 (20%) liked lavana and 10 (66.6%) were like katu
rasa. None liked tikta and Kashaya rasa
11
4
14
1
25
5
0
5
10
15
20
25
Group A Group B Total
RegularIrregula
Observation
Evaluation of Efficacy of Siddharthaka Yoga in Kitibha Kushta
78
Overall: out of thirty patents18 (60%) were fond of madhura, 12 (40%) were fond of
amla, 04 (13.33%) liked lavana and 20 (66.6%) were fond of katu rasa and none liked
katu and kashaya rasa.
+
Table No. 21. Showing distribution of patients by Guna of ahara Laghu Guru Rooksha Snigdha Group A 01 (6.6%) 08 (53.3%) 12 (80%) 03 (20%) Group B 09 (60%) 06 (40%) 09 (60%) 04 (26.6%) Overall 10 (33.3%) 14 (46.6%) 21 (70%) 07 (23.3%) Group A: out of fifteen patents 01 (6.6%) use to take laghu ahara, 08 (53.3%) use to
take guru ahara, 12 (80%) used rooksha and 03 (20%) were using snigdha ahara.
Group B: out of fifteen patents 09 (60%)were taking laghu ahara, 06 (40%) were
taking guru ahara, 09 (60%) were taking rooksha and 04 (26.6%) were taking snigdha
ahara.
Overall: out of thirty patents10 (33.3%) were taking laghu, 14 (46.6%) were taking
guru, 21 (70%) taking rooksha ahara and 07 (23.3%) were taking snigdha.
Figure 16 showing distribution of patients by gune of ahara
910
1
10
0 0
9
23
10
0 0
18
12
4
20
0 00
2
4
6
8
10
12
14
16
18
20
Group A Group B Total
MadhuraAmlaLavanaKatuTiktakashya
1
8
12
3
9
6
9
4
10
14
21
7
0
5
10
15
20
25
Group A Group B Total
LaghuGuruRookshaSnigdha
Observation
Evaluation of Efficacy of Siddharthaka Yoga in Kitibha Kushta
79
Table No. 22. Showing distribution of patients Type of diet Vegetarian Mixed Group A 05 (33.3%) 10 (66.6%) Group B 07 (46.6%) 08 (53.3%) Overall 12 (40%) 18 (60%) Group A: out of fifteen 05 (33.3%) were vegetarians and 10 (66.6%) were mixed diet
Group B: out of fifteen 07 (46.6%) were vegetarians and 08 (53.3%) were mixed diet
Overall: out of thirty patents 12 (40%) were vegetarians and 18 (60%) were of mixed diet Figure 17 showing distribution of patients by type of diet
Table No. 23. Showing distribution of patients by Vyasana Alcohol Tobacco
chewing Smoking Tea/coffee
Group A 05 (33.3%) 01 (6.6%) 03 (20%) 01 (6.6%) Group B 05 (33.3%) 04 (26.6%) 02 (13.3%) 03 (20%) Overall 10 (33.3%) 05 (16.6%) 05 (16.6%) 04 (13.3%) Group A: out of fifteen patents 05 (33.3%) were alcoholics, 01 (6.6%) was tobacco
chewer, 03 (20%) were smokers and 01 (6.6%) was taking excess tea/ coffee.
Group B: out of fifteen patents 05 (33.3%) were alcoholics, 04 (26.6%) were tobacco
chewers, 02 (13.3%) were smokers and 03 (20%) were taking excess tea/ coffee.
Overall: out of thirty patents 10 (33.3%) were alcoholics, 05 (16.6%) were tobacco
chewers, 05 (16.6%) were smokers and 04 (13.3%) were taking excess tea/ coffee.
Figure 18 showing distribution of patients by vyasana
5
1
3
1
54
23
10
5 54
0
1
2
3
4
5
6
7
8
9
10
Group A Group B Total
AlcoholTobacco chewingSmokingTea/Coffee
5
107 8
12
18
0
2
4
6
8
10
12
14
16
18
Group A Group B Total
VegetarianMixed
Observation
Evaluation of Efficacy of Siddharthaka Yoga in Kitibha Kushta
80
Table No. 24. Showing distribution of patients by Hygiene Good Fair Poor Group A 07 (46.6%) 07 (46.6%) 01 (6.6%) Group B 07 (46.6%) 08 (53.3%) 00 (00%) Overall 14 (46.6%) 15 (50%) 01 (3.3%) Group A: out of fifteen patents 07 (46.6%) were maintaining good hygiene, 07
(46.6%) were of fair and 01 (6.6%) was poorly hygienic.
Group B: out of fifteen patents 07 (46.6%) were maintaining good hygiene, 08
(53.3%) were of fair and none poorly hygienic.
Overall: out of thirty patents 14 (46.6%) were maintaining good hygiene, 15 (50%)
were of fair and 01 (3.3%) was poorly hygienic.
Figure 19 showing distribution of patients by hygine
Table No. 25. Showing distribution of patients by Manaska sthiti Chinta Shoka Bhaya Group A 12 (80%) 12 (80%) 12 (80%) Group B 12 (80%) 12 (80%) 12 (80%) Group A and B 24 (80%) 24 (80%) 24 (80%) Group A: out of fifteen patents 12 (80%) were suffering from chinta, shoka bhaya.
Group B: out of fifteen patents 12 (80%) were suffering from chinta, shoka bhaya.
Overall: out of thirty patents 24 (80%) were suffering from chinta, shoka and bhaya.
Figure 20 showing distribution of patients by manasika sthiti
7 7
1
78
0
14 15
10
2
4
6
8
10
12
14
16
Group A Group B Total
GoodFairPoor
12 12 12 12 12 12
24 24 24
0
5
10
15
2 0
2 5
Group A Group B Total
ChintaShokaBhaya
Observation
Evaluation of Efficacy of Siddharthaka Yoga in Kitibha Kushta
81
Table No. 26. Showing distribution of patients by observed nidana in no & % Nidana Group
A Group B
Overall Nidana Group A
Group B
Overall
Milk with fish
08 (53.3%)
07 (46.6%)
15 (50%)
Excess snigdha
03 (20%)
01 (6.6%)
04 (13.3%)
Milk with mamsa
08 (53.3%)
07 (46.6%)
15 (50%)
Raw moolaka alone or with dugdha
14 (93.3%)
13 (86.6%)
27 (90%)
Milk with acidic foods
01 (6.6%)
01 (6.6%)
02 (6.6%)
Ati ashana
05 (33.3%)
01 (6.6%)
06 (20%)
Excess madhura rasa
05 (33.3%)
08 (53.3%)
13 (43.3%)
Ati jala sevana after gharma
01 (6.6%)
00 (00%)
01 (3.3%)
Excess amla rasa
09 (60%)
02 (13.3%)
11 (36.6%)
Masha 06 (40%)
05 (33.3%)
11 (36.6%)
Excess lavana rasa
01 (6.6%)
03 (20%)
04 (13.3%)
shrama, bhaya
00 (00%)
00 (00%)
00 (00%)
Dadhi other milk products
15 (100%)
13 (86.6%)
28 (93.3%)
Guda 14 (93.3%)
14 (93.3%)
28 (93.3%)
Navanna 00 (00%)
00 (00%)
00 (00%)
Pishta vikara
04 (26.6%)
10 (66.6%)
14 (46.6%)
Matsya, 10 (66.6%)
08 (53.3%)
18 (60%)
Vyayama after bhojana
03 (20%)
03 (20%)
06 (20%)
Mamsa 10 (66.6%)
08 (53.3%)
18 (60%)
Diwa swapna
09 (60%)
05 (33.3%)
14 (46.6%)
Observation
Evaluation of Efficacy of Siddharthaka Yoga in Kitibha Kushta
82
Table No. 27. Showing distribution of patients by observed poorvaroopa in the study in Group A patients Sl. No Poorva roopa Group A Group B Over all 01 Twak parushata 14 (93.3%) 09 (60%) 23 (76.6%)02 Akasmad romaharsha 00 (00%) 00 (00%) 00 (00%) 03 Swedabahulya 01 (6.6%) 01 (6.6%) 02 (6.6%) 04 Asweda 04 (26.6%) 03 (20%) 07 (23.3%)05 Anga pradesha swapa 00 (00%) 00 (00%) 00 (00%) 06 Vaivarnya 15 (100%) 15 (100%) 30 (100%) 07 Kandu 15 (100%) 15 (100%) 30 (100%) 08 Suptata 00 (00%) 00 (00%) 00 (00%) 09 Nistoda 00 (00%) 00 (00%) 00 (00%) 10 Ati shlakshnata 00 (00%) 00 (00%) 00 (00%) 11 Gourava 08 (53.3%) 06 (40%) 14 (46.6%)12 Mala pradeha over kaya 00 (00%) 01 (6.6%) 01 (3.3%) 13 Kshata visarpa (spreads on injury), 04 (26.6%) 03 (20%) 07 (23.3%)14 Paridaha 00 (00%) 00 (00%) 00 (00%) Table No. 28. Showing distribution of patients by lakshanas observed. Sl. no Lakshana Observed in
number of patients and % in Group A
Observed in number of patients and % in Group B
Observed in number of patients and % in Group A and B
Evaluation of Efficacy of Siddharthaka Yoga in Kitibha Kushta
83
Table No. 30. Showing distribution of patients by site of onset Site of onset Scalp Knee Elbow Ear lobe Group A 04 (26.66%) 07 (46.6%) 02 (13.3%) 02 (13.3%) Group B 07 (46.6%) 04 (26.6%) 02 (13.3%) 02 (13.3%) Overall 12 (40%) 11 (36.6%) 04 (13.3%) 04 (13.3%) Group A: out of fifteen patents 04 (26.66%) got origin from scalp, 07 (46.6%) from
knee, 02 (13.3%) from elbow and 02 (13.3%) from ear lobe.
Group B: out of fifteen patents 07 (46.6%) got the first lesion on scalp, 04 (26.6%) in
knee, 02 (13.3%) in elbow and 02 (13.3%) in ear lobe.
Overall: out of thirty patents12 (40%) observed lesion first in scalp, 11 (36.6%) in
knee, 04 (13.3%) in elbow and 04 (13.3%) patients observed first in ear lobe
Figure 21 showing distribution of patients by site of onset
Table No. 31. Showing distribution of patients by mode of onset of the disease Mode of onset
Sudden Gradual After injuryGroup A 03 (20%) 11 (73.3%) 01 (6.6%) Group B 01 (6.6%) 14 (93.3%) 00 (00%) Overall 04 (13.3%) 25 (83.3%) 01 (3.3%) Group A: out of fifteen patents 03 (20%) got sudden onset while 11 (73.3%) got
gradual onset and 01 (6.6%) got onset of lesion after injury.
Group B: out of fifteen patents 01 (6.6%) got lesions suddenly, 14 (93.3%) got it
gradually and none got after injury in this group.
Overall: out of thirty patents 04 (13.3%) got it suddenly, 25 (83.3%) got gradual
onset and 01 (3.3%) got it after injury.
Figure 22 showing distribution of patients by mode of onset
4
7
2 2
7
4
2 2
1211
4 4
0
2
4
6
8
10
12
Group A Group B Total
Scalp
Knee
Elbow
Ear lobe
3
11
1 1
14
0
4
25
10
5
10
15
2 0
2 5
Group A Group B Total
Sudden
Gradual
After injury
Observation
Evaluation of Efficacy of Siddharthaka Yoga in Kitibha Kushta
84
Table No. 32. Showing distribution of patients by aggravation time Aggravation
Day Night Group A 03 (20%) 12 (80%) Group B 00 (00%) 15 (100%) Overall 03 (10%) 27 (90%) Group A: out of fifteen patents, in 03 (20%) aggravation was during day, in 12 (80%)
during night, in 04 (26.6%) it was in summer, none observed aggravation in rainy
season and in 11 (73.3%) aggravation was in winter.
Group B: out of fifteen patents, none got aggravation in day time, 15 (100%) got in
night, 01 (6.6%) in summer season, 01 (6.6%) in rainy season and 12 (80%) got
aggravation in winter season.
Overall: out of thirty patents, 03 (10%) got aggravation in day time, 27 (90%) got in
night, 05 (16.6%) in summer season01 (3.3%) in rainy season and 23 (76.6%) got
aggravation in winter season.
Figure 23 showing distribution of patients by aggravation time
Table No. 33. Showing distribution of patients by aggravation season
Aggravation Summer Rainy Winter
Group A 04 (26.6%) 00 (00%) 11 (73.3%) Group B 01 (6.6%) 01 (6.6%) 12 (80%) Overall 05 (16.6%) 01 (3.3%) 23 (76.6%) Group A: out of fifteen patents, in 03 (20%) aggravation was during day, in 12 (80%)
during night, in 04 (26.6%) it was in summer, none observed aggravation in rainy
season and in 11 (73.3%) aggravation was in winter.
Group B: out of fifteen patents, 01 (6.6%) in summer season, 01 (6.6%) in rainy
season and 12 (80%) got aggravation in winter season.
3
12
0
15
3
27
0
5
10
15
20
25
30
Group A Group B Total
Day
Night
Observation
Evaluation of Efficacy of Siddharthaka Yoga in Kitibha Kushta
85
Overall: out of thirty patents, 05 (16.6%) in summer season01 (3.3%) in rainy season
and 23 (76.6%) got aggravation in winter season.
Figure 24 showing distribution of patients by aggravation season Table No. 34. Showing distribution of patients by Kula vruttanta
Maternal Parental Group A 00 (00%) 00 (00%) Group B 01 (6.6%) 01 (6.6%) Overall 01 (3.3%) 01 (3.3%) Group A: out of fifteen patents none had family history.
Group B: out of fifteen patents 01 (6.6%) maternal reported family history and 01
(6.6%) reported with parental history.
Overall: out of thirty patents01 (3.3 %) maternal reported family history and 01
(3.3%) reported with parental history.
Figure 25showing distribution of patients by kula vruttana
Table No. 35. Showing distribution of patients by Chikitsa vruttanta
Chikitsa vruttanta Ay Al O
Group A 03 (20%) 15 (100%) 00 (00%) Group B 03 (20%) 15 (100%) 00 (00%) Overall 06 (20%) 30 (100%) 00 (00%) Group A: out of fifteen patents all have taken the allopath treatment 15 (100%), 03
(20%) Ayurveda treatment and none of them had got treatment from other medicine.
0 0
1 1 1 1
0
1
2
3
Group A Group B Total
Maternal
Parental
4
0
11
1 1
12
5
1
23
0
5
10
15
20
25
Group A Group B Total
Summer
Rainy
Winter
Observation
Evaluation of Efficacy of Siddharthaka Yoga in Kitibha Kushta
86
Group B: out of fifteen patents 03 (20%) had treatment history of Ayurveda, all had
allopath treatment history positive and none reported with other medicine history.
Overall: out of thirty patents all have taken the allopath treatment 30 (100%), 06
(20%) Ayurveda treatment and none of them had got treatment from other medicine
Figure 26 Showing distributions of patients by chikitsa vruttanta
Table No. 36. Showing distribution of patients by confirmatory signs
Confirmatory sign Auspitz sign Candle grease sign Koeber’s sign. Group A 15 (100%) 15 (100%) 04 (26.6%) Group B 15 (100%) 15 (100%) 07 (46.6%) Overall 30 (100%) 30 (100%) 11 (36.6%) Group A: out of fifteen patents all were reported with Auspitz sign and Candle grease
sign 15 (100%) each and 04 (26.6%) patients reported with positive Koeber’s sign.
Group B: out of fifteen patents all were reported with Auspitz sign and Candle grease
sign 15 (100%) each and 07 (46.6%) patients reported with positive Koeber’s sign.
Overall: out of thirty patents all were reported with Auspitz sign and Candle grease
sign 30 (100%) each and 11 (36.6%) patients reported with positive Koeber’s sign.
Figure 27 showing distribution of patients by confirmatory signs
3
15
0
3
15
0
6
3 0
00
5
10
15
2 0
2 5
3 0
Gr oup A Gr oup B Tot a l
Ay ur v e da
Al l opa t h
Ot he r
15 15
4
15 15
7
30 30
11
0
5
10
15
20
25
30
Group A Group B Total
Auspitz signCandle grease signKoeber's sign
Statistical observation
Evaluation of Efficacy of Siddharthaka Yoga in Kitibha Kushta
87
Table No. 37. Showing demographic data in patients of in Group A Group OPD
TOTAL 9 6 12 2 1 0 0 15 0 2 6 0 1 6 1 0 Abbreviations used: Sex: M – male, F – female, Religion: H- Hindu, M – Muslim, C – Christian, O – others, Economical status: P – poor, M – middle class, R – rich, Occupation: St – student, L – labor, E – executive, S – sedentary, Nature of work: S – stressful, N – near heat, T – traveling
Statistical observation
Evaluation of Efficacy of Siddharthaka Yoga in Kitibha Kushta
88
Table No. 39 Showing lakshanas of kitibha kushta in Group A Group OPD
No. Shyava
kina Krishnavarna
kina Parushata
of kina Ghana Khara
sparsha Snigdha sparsha
Ugra kandu
A 3634 + + + + + - + A 235 + + + + + - + A 538 + + + + + - + A 309 + + + + + - + A 613 + + + - + - + A 1427 + + + + + - + A 1715 + + + + + - + A 502 + + + + + - + A 3073 + + + + + - + A 3089 + + + + + - + A 3069 + + + + + - + A 3220 + + + + + - + A 3413 + + + + + - + A 4023 + + + + + - + A 4370 + + + + + - +
Total 15 15 15 14 15 0 15 Table No. 40 Showing lakshanas of kitibha kushta in Group B Group OPD
No. Shyava
kina Krishnavarna
kina Parushata
of kina Ghana Khara
sparsha Snigdha sparsha
Ugra kandu
B 1846 + + + + + - + B 1968 + + + + + - + B 2851 + + + + - - + B 2758 + + + + + - + B 3216 + + + + + - + B 3217 + + + + - - + B 3556 + + + - + - + B 3591 + + + + + - + B 3849 + - + + + - + B 4006 + + + - + - + B 4039 + + + + + - + B 4279 + + + + + - + B 4284 + + + + + - + B 4228 + + + + + - + B 4426 + + + + + - +
Total 15 14 15 13 13 0 15
Statistical observation
Evaluation of Efficacy of Siddharthaka Yoga in Kitibha Kushta
89
Table No. 41 Showing Confirmatory signs of psoriasis in Group A Group OPD no. Confirmatory sign
Auspitz sign Candle greace sign Koeber’s sign. A 3634 + + - A 235 + + - A 538 + + + A 309 + + + A 613 + + - A 1427 + + - A 1715 + + + A 502 + + - A 3073 + + - A 3089 + + - A 3069 + + - A 3220 + + - A 3413 + + - A 4023 + + - A 4370 + + +
TOTAL 15 15 04 Table No. 42 Showing Confirmatory signs of psoriasis in Group A Group OPD no. Confirmatory sign
Auspitz sign Candle greace sign Koeber’s sign. B 1846 + + - B 1968 + + + B 2851 + + - B 2758 + + + B 3216 + + + B 3217 + + - B 3556 + + + B 3591 + + - B 3849 + + - B 4006 + + + B 4039 + + - B 4279 + + - B 4284 + + - B 4228 + + + B 4426 + + +
TOTAL 15 15 07
Statistical observation
Evaluation of Efficacy of Siddharthaka Yoga in Kitibha Kushta
90
Table No. 43 Showing Anubandha vedana of kitibha kushta in Group A. Group OPD
No. Daha Raga Srava Vedana Shaitya Kleda Anga
gourava A 3634 + - - + - - + A 235 + - - - - - - A 538 + - - - - - - A 309 - - - + + - + A 613 - + - - - - - A 1427 + - - - - - + A 1715 - - - - - - - A 502 + - - - - - - A 3073 + - - - - - - A 3089 - + - - - - - A 3069 - - - - + - + A 3220 - + - - - - - A 3413 + - - - - - - A 4023 - - - - - - - A 4370 - - - - - - +
Table No. 44 Showing Anubandha vedana of kitibha kushta in Group B. Group OPD
No. Daha Raga Srava Vedana Shaitya Kleda Anga
gourava B 1846 - - - - + - + B 1968 - - - - - - - B 2851 - - - - + - + B 2758 - - - - - - + B 3216 - - - - + - + B 3217 - - - - - - + B 3556 - - - - - - + B 3591 + - - - - - + B 3849 + - - - - - - B 4006 + - - - - - - B 4039 - - - - - - + B 4279 - - - - - - + B 4284 - - - - + - + B 4228 + - - - - - + B 4426 - - - - - - +
Statistical observation
Evaluation of Efficacy of Siddharthaka Yoga in Kitibha Kushta 91
Table No. 45 Showing the observed features of the nature of kitibha kushta in Group A Group OPD No. Site of onset Mode of onset Aggrevation
Kula vruttanta Chikitsa vruttanta
S K E EL S G AI D N S R W M P AY AL O A 3634 + - - - - + - - + + - - - - - + - A 235 + - - - - + - + - - - + - - - + - A 538 - + - - + - - - + - - + - - - + - A 309 + - - - + - - - + - - + - - - + - A 613 - + - - - + - + - + - - - - - + - A 1427 - + - - + - - - + - - + - - - + - A 1715 - - + - - + - - + + - - - - - + - A 502 + - - - - + - - + + - - - - - + - A 3073 - + - - - + - - + - - + - - - + - A 3089 - - - + - + - - + - - + - - - + - A 3069 - + - - - + - - + - - + - - - + - A 3220 + - - - - + - - + - - + - - - + - A 3413 - + - - - + - + - - - + - - + + - A 4023 - + - - - - + - + - - + - - + + - A 4370 - - + + - + - - + - - + - - + + -
Total 05 07 02 02 03 11 01 03 12 04 00 11 00 00 03 15 00 Abbreviations used Site of onset: S – Scalp, K – Knee, E – Elbow, El – Ear lobe. Mode of onset: S – Sudden, G – Gradual, AI –After injury. Aggravation: D – Day, N – Night, S – summer, R – rainy, W – winter. Kula Vruttanta: M – Maternal, P – parental, Chikitsa vruttanta: Ay – Ayurveada, Al – Allopath, O – Others.
Statistical observation
Evaluation of Efficacy of Siddharthaka Yoga in Kitibha Kushta 92
Table No. 46 Showing the observed features of the nature of kitibha kushta in Group B Group OPD No. Site of onset Mode of onset Aggravation
Kula vruttanta Chikitsa vruttanta
S K E EL S G AI D N S R W M P AY AL O B 1846 + - - - - + - - + - - + - - + + - B 1968 + - - - - + - - + - - + - - - + - B 2851 - + - - - + - - + - - + - - - + - B 2758 + - - - - + - - + - - + - - - + - B 3216 - - - + - + - - + - - + - - - + - B 3217 - + - - - + - - + - - + - - + + - B 3556 + - - - + - - - + - - - - - - + - B 3591 - + - - - + - - + + - - - - - + - B 3849 - - + - - + - - + - - + - - - + - B 4006 - - - + - + - - + - + + - + - + - B 4039 + - - - - + - - + - - + + - - + - B 4279 - - + - - + - - + - - - - - - + - B 4284 - + - - - + - - + - - + - - - + - B 4228 + - - - - + - - + - - + - - + + - B 4426 + - - - - + - - + - - + - - - + -
Total 07 04 02 02 01 14 00 00 15 01 01 12 01 01 03 15 00 Abbreviations used Site of onset: S – Scalp, K – Knee, E – Elbow, El – Ear lobe. Mode of onset: S – Sudden, G – Gradual, AI – After injury. Aggravation: D – Day, N – Night, S – summer, R – rainy, W – Winter. Kula Vruttanta: M – Maternal, P – parental. Chikitsa vruttanta: Ay – Ayurveada, Al – Allopath, O – others.
Statistical observation
Evaluation of Efficacy of Siddharthaka Yoga in Kitibha Kushta
93
Table No. 47 Showing the observed vaiktika vruttanta in Group A Group OPD
No. Ahara Vihara
Matra Kala Rasa Guna Type Vyasana Hygine Manas A 3634 A R MA LR M T/C G CS A 235 B R MKA GR M A G - A 538 M I KAL GR M - F CB A 309 B I MA GS M A,S P CB A 613 B I MK GR M A,T F C A 1427 M R MK R M - F C A 1715 B R KA R V - F - A 502 B I MK R V - G - A 3073 B R KA GS M S F C A 3089 M R KA R V - G C A 3069 B R KA GR M S F C A 3220 M R M R V - G CB A 3413 B R K R M A F C A 4023 M R MA GR M A G C A 4370 M R MA GS V - G CB
Table No. 48 Showing the observed vaiktika vruttanta in Group B Group OPD
No. Ahara Vihara
Matra Kala Rasa Guna Type Vyasana Hygine Manas B 1846 B R M GS M A G C B 1968 B R MK GS M S G C B 2851 M R MA G V T G CSB B 2758 M R MK LR V T G CS B 3216 B R MA GS M A F CB 3217 B R K LR V A F C B 3556 M R M GS M - F B B 3591 M I K LR M T F C B 3849 M R MK LR M A F C B 4006 A R KL LR V - G CSB B 4039 M R KL LR M T F CS B 4279 M R K LR V T/C F C B 4284 M R KL LR V T/C F C B 4228 M R MK G M A,S G C B 4426 A R M LR V T/C F C
Evaluation of Efficacy of Siddharthaka Yoga in Kitibha Kushta
94
Table No. 49 showing the rogi pareekshain Group A G opd
no Prakruti Sara Samhanana Satmya Satva Ahaa
shakti Vyama shakti
Vaya
A 3634 VP MS M R M M M M A 235 VK MS S S P P P M A 538 VK MeS S V A M M M A 309 VK A S V A P P M A 613 V A S V M P M M A 1427 VP T S V A M A M A 1715 VP MeS M V P P P M A 502 VP MS S V P P P M A 3073 VK R M V M P M M A 3089 VK A S V M M M M A 3069 VK M M V P P M M A 3220 VP MjS S V M M M M A 3413 PK S S V M P P B A 4023 VK M S V P M M M A 4370 VP S S V M M M B Table No. 50 showing the rogi pareekshain Group B opd no
Prakruti Sara Samhanana Satmya Satva Ahara shakti
Vyama shakti
Vaya
B 1846 MS S V P P P M B 1968 A S V P P M M B 2851 R M V A M M M B 2758 Mes M V A M M M B 3216 A M V M P M M B 3217 R M V A P M M B 3556 A M V A M M M B 3591 A M R P M P M B 3849 MS M V M M M M B 4006 T A V A A A M B 4039 MS M V M M M M B 4279 A S V M M A V B 4284 MS M V M M M M B 4228 A M V M M M M B 4426 MeS S V A A A M
Abbreviations used: Prakruti: V – vataja, VP – vatapittaja, VK – vatakaphaja, PK – pittakaphaja. Sara: T – twak sara, R – raktasara, MS – mamsasara, MeS – medasara, A – asthisara, MjS – majjasara, S shukrasara Samhanana: S – susamhata, M – madhyama, A – asamhata. Satmya: S – sarvarasa, R – rooksha, V – vyamishra. Stawa: P – prvara, M – madhyama, A – avara. Ahaa shakti: P – prvara, M – madhyama, A – avara. Vyamashakti: P – prvara, M – madhyama, A – alpa. Vaya: B – bala, M – madhyama, V – vruddha.
Statistical observation
Evaluation of Efficacy of Siddharthaka Yoga in Kitibha Kushta
95
Table No. 51 showing the Nidana observed in Group A
Abbreviations used. 01-Milk with fish, 02-Milk with mamsa, 03-Milk with acidic foods, 04-Excess madhura rasa, 05-Excess amla rasa, 06-Excess lavana rasa, 07-Dadhi other milk products, 08-Navanna, 09-Matsya, 10-Mamsa, 11-Excess snigdha, 12-Raw moolaka alone or with dugdha, 13-Adhyashana, 14-Ati jala sevana after gharma, shrama, bhaya, 15-Masha 16-Tila, 17-Guda, 18-Pishtavikara, 19-Vyayama after bhojana, 20-Diwaswapna
R.G Valia, IADVL Text book and atlas of dermatology, Vol. I, Chapter 5, second edition, Bhalani publishing house, Bombay, 1994, Page no. 142-147. 191 A.C.Ritchei, Boyd’s text book of pathology, 9th ed., vol 2, chapter 62, K.M. Varghes Company, PB no.7119Bombay 400031, 1990, page no. 1985-1986 192. Behcet PE, Psoriasis, a brief historical review. Arch Dermatol Syphilol 1936; 33:327–334. 193. Farber EM, McClintock RP Jr. A current review of psoriasis Calif med 1968; 108: 440 – 457 194Baker H. psoriasis: a review. Dermatologica 1975; 150:16-25 195. Lane CG, Crawford GM. Psoriasis a statistical study of two hundred and thirty one cases. Arch Dermatol Syphilol 1937, 35: 1051-1061. 196. Ambady BM, Gopinath T, Nair BKH. Psoriasis. Indian J Dermatol Venereol 1961; 23: 27 – 34. 197. Bedi TR. Psoriasis in children. Indian J Dermatol Venereol 1979; 45: 410 - 413 198. Lal S. clinicalpattern in psoriasis in Punjab. Indian J Dermatol Venereol 1966; 35:5 – 12 199. Sharma T, Sepha GC. Psoriasis – a clinical study. Indian J Dermatol Venereol 1964; 30: 191 – 197 200. Kaur I, Kumar B, Sharma VK, et al. epidemiology of psoriasis in a clinic from North Indian. Indian J Dermatol VenereolLeprol 1986; 52:208 - 212. 201. Farber EM, Nall ML, Watson W. natural history of psoriasis in 61 twin pairs. Arch dermatol 1974; 109:207 – 211
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202. Alan Menter MD et al., Fast Fact Psoriasis, second edition, Chapter 1, Health press Oxford 2004, page no.8. 203. Eugine Braunwald, Stephen L. Hauser, Anthony S. Fauc et.al.Vol-1, chapter 56, McGraw- medical publishing division, 15th edition, 2001, page no. 312. 204. Alan Menter MD et al., Fast Fact Psoriasis, second edition, Chapter 1, Health press Oxford 2004, Page no.9. 205. Nicholas A Boon, Nicki R. Colledge et.al, Davidson’s Principle & Practice of Medicine, chapter 13, Cristopher Haslett & Others, 20th Edition, Harcourts Publishers, 2006, Edinburgh, UK, Page n. 1288. 206. Nicholas A Boon, Nicki R. Colledge et.al, Davidson’s Principle & Practice of Medicine, chapter 13, Cristopher Haslett & Others, 20th Edition, Harcourts Publishers, 2006, Edinburgh, UK, Page n. 1289. 207. Fast Fact Psoriasis, second ed,Alan Menter MD et al. Chapter 1, Health press Oxford 2004, Page no.9. 208. A.C.Ritchei, Boyd’s text book of pathology, 9th ed., vol 2, chapter 62, K.M. Varghes Company, PB no.7119Bombay 400031, 1990, page no. 1985-1986 209. Alan Menter MD et al. Fast Fact Psoriasis, , Chapter 1,. Health press Oxford, second edition, 2004, page no.9. 210. 203. Eugine Braunwald, Stephen L. Hauser, Anthony S. Fauc et.al.Vol-1, chapter 56, McGraw- medical publishing division, 15th edition, 2001, page no. 312. 211. R.G Valia, IADVL Text book and atlas of dermatology, Vol. II, Chapter 27, second edition, Bhalani publishing house, Bombay, 1994, Page no. 714. 212. Alan Menter MD et al., Fast Fact Psoriasis, second edition, Chapter 1, Health press Oxford 2004, Page no.14. 213 R.G Valia, IADVL Text book and atlas of dermatology, Vol. II, Chapter 27, second edition, Bhalani publishing house, Bombay, 1994, Page no. 714. 214. R.G Valia, IADVL Text book and atlas of dermatology, Vol. II, Chapter 27, second edition, Bhalani publishing house, Bombay, 1994, Page no. 714. 215. Alan Menter MD et al., Fast Fact Psoriasis, second edition Chapter 3, Health press Oxford 2004, Page no.25-30. 216. Alan Menter MD et al. Fast Fact Psoriasis, second edition. Chapte4, Health press Oxford 2004. Page no.31-69,
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235. Joel G. Hardman & Lee E. LimbridGoodman & Gilman’s The pharmacological basis of therapeutics, Chapter 1, page 8, 10th edition, McGraw-Hill, Medical Publishing Division, New Delhi.) 236Joel G. Hardman & Lee E. LimbridGoodman & Gilman’s The pharmacological basis of therapeutics, Chapter 1, page 8, 10th edition, McGraw-Hill, Medical Publishing Division, New Delhi. 237. Anthony S. and Fanci, Joseph B. Martin, etc., Harrison’s principles of medicine, Vol-l, part-2, chapter 55, 14th edition, Mc Graw Hill health publishers divisions, New Delhi, page no. 300 238. Acharya Agnivesha, Charaka Samhita, Acharya Chakrapani, Sutra sthana, chapter 7, shloka no. 36-37, edited by Vaidya Jadavaji Trikamji Acharya, Chawkhambha Sanskrit Sansthan P.B no. 1139, K.37/16, Gopal Mandir lane, Varanasi (UP), reprint, 2004, Page no. 51-52. 239. Joel G. Hardman & Lee E. LimbridGoodman & Gilman’s The pharmacological basis of therapeutics, Chapter 1, page 8, 10th edition, McGraw-Hill, Medical Publishing Division, New Delhi. 240. Joel G. Hardman & Lee E. LimbridGoodman & Gilman’s The pharmacological basis of therapeutics, Chapter 65, page 1804, 10th edition, McGraw-Hill, Medical Publishing Division, New Delhi. 241. Joel G. Hardman & Lee E. LimbridGoodman & Gilman’s The pharmacological basis of therapeutics, Chapter 65, page 1804, 10th edition, McGraw-Hill, Medical Publishing Division, New Delhi.
Summary
Evaluation of Efficacy of Siddharthaka Yoga in Kitibha Kushta
126
Summary:
The present study entitled “A comparative clinical study of ‘siddharthaka yoga
‘parisheka and abhyantara prayoga in the management of ‘kitibha kushta’ with the special
reference to ‘psoriasis’ was taken for the trial in search of the route of administration of
the for the effective treatment of kitibha kushta vis-à-vis psoriasis. The drug was same for
both antahaparimarjana and bahirparimarjana chikitsa so that the result will not influence
by the change of medicines.
The objectives of this trial was to evaluate the efficacy of siddharthaka yoga parisheka in
kitibha kushta, to evaluate the efficacy of siddharthaka yoga abhyantara prayoga in
kitibha kushta, to evaluate the comparative efficacy of siddharthaka yoga parisheka and
abhyantara prayoga in kitibha kushta. For the convenience of the study snana was
modified to parisheka and kashaya to capsules. The patients were selected from O.P.D
and I.P.D. of D.G.M.A.M.C & H. they were examined for their inclusion and exclusion
in the study. Totally 30 number of patients were divided in to two groups. 15 patients of
Group A underwent Parisheka for 10 days and 15 patients of Group B received 3 grams
of capsules in 3 divided doses for 30 days. Follow up was 1 month for both the groups.
The readings of subjective and objective parameters before and after the treatment
were noted and were calculated for statistical significance using paired and un-paired
Student-t test.
Observations made in the trial revealed the highest significance (36.6%) in the 46-
60 age group, male dominated the attendance (70%), Hindu religion were more (83.3%),
middle class patients were more (83.3%).
Summary
Evaluation of Efficacy of Siddharthaka Yoga in Kitibha Kushta
127
The result was best response in all (100%) patients of Group A than those of
Group B (26.6%). Maximum patients of Group B patients got moderate response
(53.33%).
In the present study the bahya prayoga in the form of parisheka has shown highly
significant results than the abhyantara prayoga of Siddharthaka yoga.
Annexure
Evaluation of Efficacy of Siddharthaka Yoga in Kitibha Kushta
1
SRI DANAPPA GURUSIDDAPPA MELMALAGI AYURVEDIC MEDICAL COLLEGE, POST GRADUATE & RESEARCH CENTRE, GADAG.
SPECIAL CASE SHEET OF KITHIBHA KUSHTA (PSORIASIS), AS TAKEN FOR THE DISSERTATION WORK UNDER THE TITLE - “A COMPARITIVE
CLINICAL STUDY OF ‘SIDDHARTHAKA YOGA’ PARISHEKA AND ABHYANTARA PRAYOGA IN THE MANAGEMENT OF ‘KITIBHA KUSHTA’
WITH SPECIAL REFERENCE TO ‘PSORIASIS’”.
Guide: Dr. Varadacharyulu M.D. (Ayu) Prof. & Head, P.G. Dept Of Kaya chikitsa. D.G.M.A.M.C. Gadag.
Co - Guide: Dr. Raghavendra V. Shettar M.D. (Ayu) Asst. Prof. P.G. Dept Of Kaya chikitsa. D.G.M.A.M.C. Gadag.
Scholar: Ashok M.G. Name of the patient Sl. No. Father’s name/ Husband’s name OPD No. Age (in years) IPD No. Sex: Male Female Bed No. Religion Hindu Christian Muslim Others Economical Status Poor Middle cl. Rich Occupation Birth place Marital Status Case referred by Residential address: …………………………………….. …………………………………….. …………………………………….. ……………………………………..
Evaluation of Efficacy of Siddharthaka Yoga in Kitibha Kushta
5
Vikruti pareeksha: Hetu: Aharaja: Milk with fish Milk with flesh Milk with acidic foods Excess madhura rasa Excess amla rasa Excess lavana rasa Dadhi Ikshu vikara Navanna Matsya Mamsa Excess snigdha Raw moolaka or with milk Adhyashana Pishtavikara Ati jala sevana after gharma shrama,
bhaya
Masha Tila Viruddha if any other Guda Viharaja Chardi vega dharana Cold bath / swimming soon
after sunbath
Vyayama/vyavaya/santapa after bhojana or during ajeerna
Diwaswapna
Panchakarma apachara Sneha aticharana Papa karma Vipra guru gharshata Purvaroopa Twak parushata Akasmadromaharsha Kandu Swedabahulya Asweda Anga pradesha swapa Parushyata Vaivarnya Nistoda Atishlakshnata Gourava Mala pradeha over kaya Kshata visarpa (spreads on injury) Paridaha Upashaya Samprapti ghatakas Vata Shyava Aruna Ruksha Khara Vedana Pitta Daha Raga Srava Kapha Kleda Ghana Snigdh
a Kandu Shaitya Gaurava
Annexure
Evaluation of Efficacy of Siddharthaka Yoga in Kitibha Kushta