Romantika: Causes, Symptoms, Types, Prognosis, Treatment, Modern Understanding

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

Romantika is a disease described in the context of Masurika Nidanam chapter of Madhava Nidana. The condition has been described in a two-line verse.

So, we do not find an elaborate explanation of this condition. Master Charaka has explained this condition, again in brief, in a two-line verse, in the context of ‘Shvayathu Chikitsa Adhyaya’.

References –

–        Madhava Nidana, Chapter 54, Shloka 13
–        Charaka Samhita, Sutra Sthana, Chapter 12, Shloka 92

Understanding Romantika

Meaning, definition

The word Romantika is made up of two terms ‘roma’ which means body hair and ‘antika’ which means end or near by to. The disease is also marked by manifestation of small eruptions. These eruptions are found on the skin very near to the roots of the body hair and hence the name.

In the Madhukosha commentary of Madhava Nidana, it has been defined as ‘Romakupa Unnati Sama’ which means ‘the eruptions or bumps appear as if the roots of the body hairs have raised up and elevated over the surface of the skin’. This is the characteristic presentation of romantika.

Context, Relation of Romantika with Masurika

Romantika is a type of Masurika

In Madhava Nidana, the author has explained this condition amidst the context of Masurika. After explaining Masurika, the author brings in the context of Romantika and then continues with the explanation of Masurika. Romantika is sandwiched in between the explanations of Masurika.  So, the disease definitely has a relationship with Masurika.

The commentator further explains the reason for bringing in the context of Romantika amidst the explanation of Masurika. ‘Masurikayah Prakaram Romantikamaha…’. Here, the commentator says that Romantika is a type of Masurika and hence has been mentioned in this context.

Since Romantika is a type of Masurika, the causative factors, symptoms and types and prognosis will be the same as Masurika and so are the treatment principles and medicines.

Romantika is a type of Shvayathu

Master Charaka has explained Romantika in the chapter of ‘Shvayathu’ – a chapter which discusses different types of swellings occurring in the body. This shows that Romantika is a type of swelling. Small eruptions in the form of swellings occur in and around the romakupas i.e. hair follicles or body hair roots.

While Madhava Nidana has interposed Romantika amidst the explanation of Masurika – as a co-context or allied condition, Master Charaka has explained Masurika after Romantika. Here we see that Master Charaka has probably given first importance to Romantika and then brings in the context of Masurika. He has also mentioned that both conditions shall be treated on the same lines and treatment principles and medicines specified in the context of Kushta – skin diseases, shall be considered in treatment of both these conditions. The essence is to tell that Romantika and Masurika shall be treated using the same principles. This indirectly suggests that Romantika and Masurika are similar conditions with slight differences and are interrelated. This also indirectly explains that one condition may give rise to the other.

Master Sushruta has not described Romantika.

Romantika

रोमकूपोन्नतिसमारागिण्यःकफपित्तजाः।कासारोचकसंयुक्तारोमान्त्योज्वरपूर्विकाः।।१३।।

Small, red eruptions occur at the roots of the hairs making slight elevations. They appear like raised / elevated sweat glands or pores. These eruptions are called Romantika and are caused by aggravation of kapha and pitta. This condition is associated with cough, loss of taste and preceded by fever. (Ma.Ni.54/13)

क्षुद्र प्रमाणाः पिडकाः शरीरे सर्वाङ्गगाः सज्वर दाह तृष्णाः|
कण्डूयुताः सारुचिस प्रसेका रोमान्तिकाः पित्तकफात् प्रदिष्टाः ||९२||

Romantika is caused by aggravated Pitta and Kapha. It is characterized by the Kshudra Pramana Pidakas i.e. appearance of small eruptions all over the body. This condition is associated with fever, burning sensation, severe thirst, anorexia and excessive salivation. (Cha.Chi.12/92)

Nidana: Causative factors of Romantika

Specific causative factors have not been mentioned for Romantika. It is said to be caused due to combined aggravation of pitta and kapha. Therefore, anything which aggravates pitta and kapha should be considered as causative factors for romantika. In short, the pitta-kapha aggravating foods, activities and practices should be considered as nidanas.

Other causes

Since it is said that Romantika is a type of Masurika in Madhava Nidana and a type of Shvayathu in Charaka Samhita, the causative factors of Masurika and Shvayathu can also be considered as etiological factors for Romantika.

Related References

Charaka Samhita, Shvayathu Chikitsa Adhyaya

Madhava Nidana – Masurika Nidanam

Purvarupa: Premonitory symptoms

Jwara – fever is mentioned as a premonitory symptom of Romantika. Apart from fever, the other premonitory symptoms of masurika too shall be considered. They are –

–        Kandu – itching
–        Gatra Bhanga – feeling as if the body parts are breaking (breaking pain)
–        Arati – disinterest, loss of interest in doing anything
–        Twachi shothah – swelling of the skin
–        Vaivarnya – discolouration of the skin / body
–        Netra Raga – redness / reddish discolouration of the eyes

Rupa / Lakshana: Symptoms

Below mentioned are the symptoms of Romantika –

–        Romakupa Unnati sama Raginyah – small, red eruptions at and around the roots of body hairs, slightly elevated and appear as raised sweat glands or pores
–        Kasa – cough
–        Jwara – fever
–        Daha – burning sensation
–        Trishna – severe thirst
–        Kandu – severe itching
–        Aruchi / Arochaka – anorexia and
–        Praseka – excessive salivation

Samprapti: Pathogenesis

The samprapti of Romantika should be considered similar to that of Masurika. It is as below explained.

‘Due to the consumption of or exposure to the etiological factors of Masurika, the doshas, mainly kapha and pitta get severely aggravated and get mixed with aggravated rakta i.e. blood. The doshas get lodged around the roots of hairs of the skin and cause elevated eruptions of red colour. This is called Romantika’.

Upadrava: Complications

Complications of romantika too should be considered to be similar to those appearing at the end of masurika i.e. swelling occurring over the elbow, wrists and shoulders / scapular region.

Sadhya-Asadhyata: Prognosis

As in Masurika, in romantika too, the presence of cough, hiccough, diabetes, high grade fever, delirium, tiredness, fainting, thirst, burning sensation, severe cramps and yawning, blood coming from mouth, nose and eyes, sounds from the throat, difficulty in breathing indicates bad prognosis and the patient should not be treated.

Treatment Principles

Specific treatment for Romantika has not been explained. But Master Charaka has given general principles of treatment for Romantika and Masurika. (Cha.Chi.12/93)

वीसर्प शान्त्यै विहिता क्रिया या तां तेषु कुष्ठे च हितां विदध्यात्||९३||

He says that the treatments and medicines explained in the context of treatment of Visarpa – herpes and also those prescribed for the treatment of Kustha – skin diseases including leprosy, are also useful for the treatment of Romantika and Masurika.

In short, Romantika should be treated on the lines of and following the principles of treating –

–        Kushta
–        Visarpa
–        Shotha

Modern Correlation

Masurika is correlated with Measles.

It is a highly contagious disease caused by a virus. It spreads when an infected person breathes, coughs or sneezes. Though it can affect anyone, measles is commonly found to affect the children. Nowadays it is easily preventable by a vaccine. The symptoms will not appear until 10-14 days after exposure. Symptoms of Measles include cough, fever, running nose, inflamed eyes, sore throat and a red, blotchy skin rash. Symptomatic management and preventing dehydration are the main principles of treating measles.

Related Reading – ‘Measles – causes, symptoms, prevention, treatment, Ayurveda Understanding’