Article by Dr Raghuram Y.S. MD (Ay)
Eruptive skin disorders, bullous eruptions such as blisters are explained as Visphota in Ayurvedic text books. Visphota is generally caused by vitiated Pitta and rakta (blood), but it will present itself in various forms and may have vitiated vata and kapha also involved in the picture.
Vishpota – eruptive disorders, bullous eruptions
अग्नि दग्ध निभाः स्फोटाः स ज्वरा रक्त पित्तजाः।
क्वचित् सर्वत्र वा देहे विस्फोट इति ते स्मृताः॥(मा.नि.५३/३)|
Agni dagdha nibhaaha sphotaaha sa jwaraa rakta pittajaaha
Kwachit sarvatra vaa dehe visphota iti te smrutaaha (Ref – Madhava Nidana 53/3)
The blisters or eruptions looking like the burnt areas, associated with fever and are caused by vitiated rakta (blood) and pitta are called Visphota. They may appear scattered in one part of the body or the whole body.
Types Of Visphota: Vata type of Visphota – will present as black coloured blisters, associated with jwara (fever), shiroruk (headache), trishna (thirst), parvabheda (pain in small joints of fingers and toes) etc symptoms
Pittaja Visphota – will present with peeta-lohita varna sphota (yellowish and red coloured blisters or eruptions). This indicates infected and blood blisters. Associated symptoms will be jwara (fever), daha (burning sensation), ruja (pain), srava (discharges) paka (suppuration) and trishna (thirst). All type of inflammatory blisters and eruptive fevers presenting with blisters can be included under Pittaja Visphota.
Kaphaja Visphota – will present with blisters which are hard (kathina), having pandu varna (pale colour), associated with kandu (itching), alpa vedana (less pain) and chira paka (delayed suppuration). It is said that blisters develop on wet surfaces. The surface of the skin of kapha type of people and in kapha disorders will be wet (also in pitta type) and will predispose to formation of blisters. All blisters with itching and less pain can be included under kapha type of visphota.
Vata-pitta type of visphota – will be associated with severe pain, all blisters with pain and inflammation (redness, burning sensation, heat etc) fall under this type of visphota
Vata-kapha type of visphota – will be associated with itching, feeling of dampness and heaviness. Blisters having severe itching and less pain can be considered under this category.
Pitta-kapha type of visphota – will be associated with itching sensation, burning sensation, vomiting and fever. Blisters with inflammation and collection of fluids in the blisters like bulla can be considered in this category.
Sannipataja type of visphota formed due to vitiation of all the doshas – present with blisters which are pitted at the centre and elevated at the periphery, hard and indurated in nature, with a tendency of suppurating late. They are associated with burning sensation, redness, vomiting, fainting, fever, pain, delirium, tremors and drowsiness. All complicated blisters which are chronic and stubborn in nature and cause systemic complications can be included under this category.
Raktaja type of visphota – are red in colour and caused due to vitiation of rakta or blood due to excessive consumption of pitta aggravating foods. These cannot be treated successfully in spite of many attempts.
Seeing Visphota and its types various diseases of modern times which present with blisters can be included under Visphota. They are as mentioned below:
- Herpes simplex virus infections
- Shingles or herpes zoster
- Bullous pemphigoid
- Dermatitis herpetiformis
- Chronic bullous dermatosis
Principles of treatment of Visphota include:
Langhana – fasting (to correct metabolism, to digest ama or immature essence of digestion which is in circulation, which is toxic to all the cells and make way for medicines to act to perfection)
Vamana – therapeutic emesis (to throw away the toxins and excess pitta and kapha, this reduces inflammation and accumulation of fluids in the body and blisters, hastens quick recovery)
Virechana – therapeutic purgation (works in the same way as vamana but is more pitta specific, useful in inflammatory blisters)
Amritadi Kwatha – decoction of Guduchi (Tinospora cordifolia), Vasa (Adhatoda vasica), Patola patra (leaves of pointed gourd), Musta (Cyperus rotundus), Saptaparna (Alstonia scholaris), Khadira (Acacia catechu), Vetra (Calamus tenuis), Nimba patra (leaves of neem plant), Haridra (turmeric) and Daruharidra (Berberis aristata) is a remedy for Visphota, Kushta and Visarpa (Amrutavrishapatoladi Kashayam, SNA Oushadashala)
Patoladi Kwatham / Kashayam – Decoction of Patola patra (leaves of pointed gourd), Guduchi (Tinospora cordifolia), Bhunimba (Andrographis paniculata), Vasa (Adhatoda vasica), nimba twak (bark of neem tree), parpataka (Fumaria indica), khadira (Acacia catechu) and Musta (Cyperus rotundus)
Nimbadi Kwatha / Kashayam – Decoction of Nimba (neem bark) and Khadira (Acacia catechu) mixed with honey
Guduchyadi Kwatha – decoction of Guduchi (Tinospora cordifolia) and Indrayava (seeds of Holarrhena antidysenterica) mixed with honey
Chandanadi Lepam – Application of paste of Chandana (red sandal wood), Nagakeshara (Mesua ferrea), Shireesha (Albizzia lebbeck) and Jati patra (jasmine leaves) made in Tanduliyaka vari (juice of Amarantus spinosus) will relieve burning sensation associated with blisters
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