Acharana – Vipluta Symptoms, Causes, Pathogenesis, Treatment

By Dr Raghuram Y.S. MD (Ay) & Dr Manasa, B.A.M.S

Acharana is one among the 20 gynaecological disorders caused due to non-cleanliness and improper maintenance of genital health by women. While Master Charaka and Sushruta have named it as Acharan, both Vagbhatas have named it as Vipluta.
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Acharana Gynaecological disorder

Etiological factor – Non-cleanliness of vagina subsequently leading to the manifestation of parasites and microbes in vaginal area.

Pathogenesis – The parasites / microbes which develop due to non-cleanliness of vaginal canal, contaminates the vagina and causes acharanam.
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Symptoms –

• Kandu – Severe itching in the vagina
• Ati nara kankshini – Excessive sexual desire in woman due to severe itching in vagina

 Other symptoms given by Sushruta

• Women get severely exited even before coitus, much earlier in comparison to her husband
• Features of kapha vitiation like unctuousness, stickiness and itching in the vaginal canal
• Fertilisation does not occur

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Anandacharana – it is a variant of acharanam and has been termed by Bhavaprakasha treatise. The author tells that the woman excretes raja (orgasm) much before ejaculation of man.

Vipluta Gynaecological Disorder

The name Viplut used by Master Vagbhata itself is completely different from the term Acharana used by Master Charaka. This condition is being discussed in this context because of its similarity with acarana in terms of etiological factors and symptoms.

Due to the non-cleanliness of vagina, the microbes or parasites develop in vagina. These microbes produce severe itching in vaginal canal. Due to severe itching, woman feels excessive sexual desire.
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Sanskrit verse

Modern correlation

Modern correlation and comparative study

Charaka has mentioned acharan under gynaecological disorders caused due to vitiation of vata while classifying the gynaecological disorders. But while defining and explaining the disease he has emphasised the involvement of parasites / microbes in the causation of the disease and unhygienic condition of vaginal area as the primary cause.
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Generally itching is attributed to kapha but acharana is predominantly caused by vata. This seems to be controversial explanation.

Acharana means – a = no, absent + charana = act, mode of life, activity, here charana needs to be taken as cleanliness. Therefore Acharan means no cleanliness, of vaginal area.

The term Viplut used by Vagbhata too seems appropriate. Viplutam means ‘excessively agitated’, ‘excited’ or ‘craving’. Disease is caused due to non-cleanliness of vaginal area. This leads to itching which is causal for the woman to get excessively agitated or exited in terms of intense sexual drive.
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Constitutional Nymphomania (on the basis of Charaka and Vagbhata’s explanation) –
Both Charaka and Vagbhata have mentioned severe itching in vagina as an important symptom in acaran and vipluta respectively. Itching sensation can be felt by many women when they have intense sexual desire, even in the absence of infection.

Ancient authors might have thought about the involvement of krimis (i.e. microbes / parasites) in acharana / viplutam, since no other doshic symptoms other than itching was found in this condition.
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When seen through the modern day lens, we can hardly find any infective disorders of reproductive system of women show presence of intense sexual desire. Thus it cannot be exactly correlated with any modern condition.

Closest modern comparison to acharanam and vipluta is ‘nymphomania’, especially ‘constitutional nymphomania’.

Infertility due to sexual incompatibility (according to Sushruta’s explanation) – Master Sushruta and his followers have mentioned only clinical feature as difference in timings of sexual orgasms between male and female partners. Thus, it can be compared with ‘infertility due to sexual incompatibility’.
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Treatment of acarana / viplut

Uttarabasti – vaginal enema given using oil processed with jivaniya group of herbs

Yoni varti – pessary either prepared with piece of sterile cloth dipped for 21 times in the bile of cow or fish or with kinva (yeast), mixed with honey is useful. This relieves itching, moisture, edema, inflammation and cleanses the channels carrying menstrual blood.

Pichu dharana – administration of tampon soaked with fats medicated with decoction of Boswellia serrata, stem bark of Syzygium cumini, Odina woider (jinghini), and stem bark of Anogeissus latifolia (dhava) along with panchavalkala i.e. five kinds of stem barks known for healing properties.

Dhatakyadi Taila – Oil processed with dhataki etc herbs should be used for administration of tampons and massage.

Oleation followed by sudation should be preferably done. Following this, tampons soaked in medicated oils should be done and vata mitigating dietetic regimen should be advised.

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