POST GRADUATE CERTIFICATE COURSES

Admission to Post Graduate Certificate courses in Ayurveda, KLE University, Shri.B.M.Kankanawadi Ayurveda Mahavidyalaya

Post Graduate Certificate Course in Panchakarma, Manipal University

FROM PLATELETS TO PAPAYA LEAVES

By Nayel Noorani.........
I killed it within seconds of seeing it, but by then it was too late. My ankle was itching. Still, who pays any attention, right? I scratched my ankle and drove off.

Two weeks later, I noticed a few black marks on my arms, which I figured were bruises. I was running late to get to a wedding, so I paid no attention. When I got back, my back was covered in bruises and when I woke up the next morning, I had a large bruise on the inner side of my lower lip. I rushed to my family practitioner, who said: “It’s nothing to worry about. Probably a viral. It’ll go away in a day or two.”

On somebody’s instinct, I got a blood test done, but before the results could come back, I had spiked a fever and was feeling extremely nauseous. My parents took me to the nearest hospital, where the emergency room doctor ordered an immediate platelet count. It was 3,000 (the minimum for a healthy person is 150,000).

Within half an hour, I was placed in the ICU, with strict orders not to brush my teeth or shave and to think twice before so much as going to the bathroom. The next three days I was averaging temperatures of 104 degrees. I couldn’t eat. I still don’t understand how my family and friends could look at me then – my lips were constantly oozing blood. Then the fevers stopped and all hell broke loose.

In all this while, my brother and uncles were constantly hunting down volunteers to donate platelets, which were given to me twice a day for the first eight of the 10 days I was hospitalised. After the first three days, my platelet count crossed 10,000 and my blood resumed some semblance of its normal ability to clot outside my veins.

The blood oozing from my gums and lips became semi-solid. My lips turned to black stone. Two days later, the blood starting clotting in my bladder and doing pretty much what a kidney stone does – blocking the piping, 12 times. All the while, the only medicine they could give me was paracetamol to help with the fever.

As if all this wasn’t bad enough, the doctors couldn’t decide whether I had dengue, Congo fever or Idiopathic Thrombocytopenic Purpura (ITP). Checking for ITP meant drilling a hole in the breastbone to draw a sample of bone marrow, which couldn’t be done. Why? Because my blood wasn’t clotting enough for me to be able to cope with the wound and so, if they did, I was a goner.

Everything seemed bleak, when a family friend suggested to my mother to give me the juice of a few papaya leaves twice a day. Within two days of that, my platelet count jumped past 450,000. From needing platelets, I could now donate! The doctors put me under observation for 24 hours and then the ordeal was over, or so I thought. It was a month before my muscles, particularly those in my back, realised that I was no longer bed-ridden and that they had to start doing their jobs.

To date, I shudder to think what my family went through, even just to look at me. What’s worse, not only did they have to take care of me, but they also go through the effort of finding donors so that I could get the platelet infusions I needed twice a day. I’ve learnt my lesson —take that mosquito seriously next time. And use mosquito repellent.

The writer contracted dengue in August 2009. He is a former medical student and rotary representative.

Published in The Express Tribune, September 18^th, 2011.

For further details u can go to the following link

http://tribune.com.pk/story/254685/true-story-from-platelets-to-papaya-leaves-my-brush-with-dengue/

PICHU

Definition

               “pichu sthoola kavalika” (su.ut)

                A thick swab or a cotton pad is called as Pichu

Introduction

                Pichu Dharana (placing of soaked linen) is a process in which a piece of cloth, gauze or linen is soaked in the medicated ghee or oil and placed in the desired position over the body or in the body parts according to the site of the treatment

¨  At the time of Swedana karma PICHU is placed on the Brahmarandhra

¨  By the employment of this procedure one can achieve all the beneficial effects of (MURDHA TAILA)

¨  The procedure is said to be more beneficial in dermatological conditions of the scalp as well as psychological disorders

¨  As this process does not involve massage ,it can be confidently performed in painful conditions or ulceritis of the scalp also

Differentiation between PICHU and PLUTHA

Pichu –Swab or thick cotton pad (kavalika) soaked in the medicated ghee or oil and placed in the desired position over the body for a prescribed time

Plutha- Medicated gauze piece (vikesika) or packed swab which is soaked in medicated ghee or oil and placed on the affected place and removed immediately in the process of cleaning (prakshalana) eg- vrana/yoni prakshalana

TYPES OF PICHU

¨  Shiro pichu - placed on the Brahmarandhra (anterior fontanalle)

¨  Yoni pichu – placed at vulvae or at the external os in vaginal canal

¨  Guda pichu – placed at anus or at anal canal

¨  Karna pichu – inserted in the external ear

¨  Nasa pichu – inserted in the region of nostrils

¨  Nabhi pichu – placed over the naval the umbulicus

SHIRO PICHU

¨  This is a type of Moordha Thaila , where in cotton pad/gauze soaked with oil is placed on the head by tying for a prescribed time.

“Abhyanga seka pichavo vastischeti chaturvidam moordatailam bahugunam thadvidyat utharotharam”

Indications of Moorda taila

   “pichuhu keshashata sputana dupane netra stambecha”

It is indicated in alopecia, sputana breaking/splitting of hairs/skin of scalp

Materials required:

1. Suitable Sneha 50-100ml(just above body temperature)
2. Cotton-Q.S
3. Hot water bath-Q.S
4. Gauze (60cm)-1
5. Vessel(200ml)-1
6. Rasnadi churna-5gm
7. Soft towel-1
8. Attendent-1
9. Armed chair-1

Pre operative procedure:

          Remove hair completely from the head for better therapeutic efficacy. It may be done without removing the hairs too

Prescription of the oil:

In healthy patients oil may be prescribed according to the prakriti of the patient as listed below:

¨  Vata prakriti: Himasagara tailam

¨  Pitta prakriti: Chandanadi taila , Chandana Bala Lakshadi taila , Ksheera Bala taila

¨  Kapha prakriti: Triphaladi taila

¨  Sama prakriti: Asanavilvadi taila

Where prakriti of the person is by the combination of doshas, mixture of the above oil  can be used according to yukti of vaidya

                In equal amounts may be effectively used in accordance with the doshas involved in the formation of prakriti. Further , if the patient has any complaints related to head, scalp or hair specific oil may be used for the abhyanga as detailed bellow:

¨  Dandruff : Dhaturapatradi  taila

¨  Cranial nerve disorders : Narayana taila, Dhanvantara taila, Masha taila etc.

¨  Premature graying of hairs: Neelibringadi taila , Bhringaraja taila etc.

If these specific oil is not available , simple murchita taila may be used to get the benefits of abhyanga. To get the maximum benefits it is better to use specific oils, prescribed for different conditions

PROCEDURE

¨  Patient should sit comfortably .Massage the head with Luke warm oil(around 40^oC).Place the cotton over the scalp uniformly with a thickness of 2cm.Gauze piece is tied around the head above the eyebrows ,to hold the cotton in place and to prevent oozing of oil into the face. Pour the Luke warm oil(around 40^oC) over the bregma region so that sufficient quantity reaches the scalp

Post operative procedure:

              After the prescribed time, gauze and cotton should be removed. Wipe the head,  and Rasnadi choorna should be applied. Bathing can be done after 1 hour.

Duration:

              30minutes-1 hour, for required number of days

Complications and management:

             Peenasa-stop the procedure and treat accordingly

YONIPICHU

¨  A tampoon soaked in the medicated oil placed at the vulva or at the external os in vaginal canal

¨  It is mainly indicated in treatment of vataja yoni rogas

“Vatartanam cha yoninam sekabhyanga pichu kria”

Such as-

¨  Vamini,upapluta,vipluta etc..

Medicines used :

·         Udumbaradi-Taila

·         Udumbaradi-Dugdha

·         Dhatakiyadi-Taila etc..

GUDAPICHU

¨  A tampoon soaked in the medicated oil placed at anus or anal canal

Indicated in the treatment of –

·         Hemorrhoids

·         Fissure in ano

·         Rectal prolapse etc..

Medicines used-

• Mushika taila-rectal prolapse
• Jathyadi ghritam/oil-fissure in ano

KARNAPICHU

¨  A tampoon soaked in the medicated oil inserted in the external ear

¨  Pichu in karna sandana-Otoplasty

  “abhyajya madusarpibhyam pichu plothavaguntitham”

                                Skin below the border of the hair at the back of the ears is everted by scraping rolled over the joint to the pinna and placed on it ,the site is then anointed with honey and ghee and covered with a swab tied with a thread neither too loose nor tight

Karna pichu is also indicated in the treatment of-

• Karna shoola
• Bhadiryam etc

NASAPICHU

¨  A tampoon soaked in the medicated oil inserted in the nostrils

¨  Nasika sandhana-Rhinoplasty

“sithyed ganda tatha soochya sevinya pichuyukthaya”

¨  After the new flap taken from the cheek and sutured on the nose the place is anointed with raw oils

¨  Nasa srava-pichu is done with druvankara patra swarasa

¨  Pichu in Oshtakopa chikitsa-

     “mahasnehena vatoshte sindhenaktha pichurhita

       devadoopa maduschishta guggulu amaradarubhi”

                               

                                In osthakopa caused by vata, cotton swab soaked in mahasneha cooked with devadhupa,maduschishta.gugglu and amaradaru should be placed on lips

The key conditions which the treatment addresses are:

¨  Facial palsy

¨  Headache

¨  Insomnia

¨  Poor memory

¨  Dermatitis of the scalp

¨  Dandruff

¨  Neurological disorder

¨  Paralysis

¨  Skin disorders such as eczema

¨  Premature graying of hairs

¨  Local inflamation

¨  Stiffness of the eyes

¨  Epistasis,ear ache,tinnitus,lock jaw

¨  Some pathological conditions of vagina

¨  Cervical erosions

¨  Vulvo-vaginitis

¨  Leucorrhea and types of inerftility

¨  Rectal prolapse and fissure in ano

MODE OF ACTION

It can be basically divided into two types

 Local and Systemic mode of action

¨  Local action of pichu depends on :

¨  Place of application of pichu and medicine used

¨  Local action of pichu is based on cellular absorption of medicine,acts as snehana lekahana etc eg: vrana ropana ,baghna, nasa arsas etc

¨  Systemically  cellular absorption and circulation and effects on CNS

¨  Eg :shiro pichu in paithika type of disease and insomnia

  

Contibuted by

Dr.Gautham .M

09538369420

KATIVASTI

          Kativasti is one of the variety of bahya sneha  and comes under the type of bahir parimarjana chikitsa . Normally we can administer this treatment for 3 to 7 days and changes can be made according to the condition of rogi , roga , dosha , kala etc. . The oil should be decided according to the conditionof the patient and roga . It’s a modification of moordha taila chikitsa (siro abhyanga , dhara , pichu , vasti ) . In this treatment both snehana and swedana will take place simultaneously . The biggest benefit of this treatment is that it will give an immediate result because of the action at the site of lesion.

Definition

            Oushdha yuktha taila poured over the kati pradesa is made to stay in a particular temperature in a circular shape of instrument prepaid out of masha (masha pishti).

Nirukthi

            The word vasti is derived from the root word vas+chit . Here in this context we can take vas aaschadane ethi vasti means to cover or wrap

Reference

            The procedure is not mentioned in any of the classical texts but the reference regarding the sirovasti is mentioned in chikitsa manjari (a therapeutic book which is written in malayalam  ) according to the site the name of the treatment changes like siro vasti , kati vasti , greeva vasti , jaanu vasty etc.

Indication

1 , kati soola - according to the gada nigraha and bhava                                                                                                             prakasa it is the condition their vitiated vata alone (kevala) or with other doshas causing pain and stiffness in kati pradesha

2 , gridhrasi

3 , thrika graha – pakvasayasritha vata kopa lakshana

4 , lumbar spondylosis  , spondylolythesis , disc prolapses , ankylosing  spondilitis , rheumatoid arthritis , sacroileitis , lumbar sacral strain .

Site and size

                        With the help of lumbo sacral x-ray, lesion must located for the kati vasti

For prushta vasti generally between c7 to t12 vertebrae and kati vasti t12 to s1 vertebrae

Time           

            Genarally 1000 matrakala (55mts)

         in vataja rogas 10000 matrakala

         in pittaja rogas 80000 matrakala

         in kaphaja rogas 60000 matrakala                                                                                        

                                                         (ref-chikitsa manjari)

 Temperature of the oil

          35° to 45° minimum temperature . Heat of the oil should be felt by physician or therapist  before pouring.

Contraindication

·         Localised skin lesion

·         Fracture in vertebrae

·        Open wounds

Precautions

                      Observe the heat of the oil before pouring , patient have to take complete bed rest , vatatapa is contraindicated , restricted for lifting weight , restrict forward and backward bending .

Oils(taila)

           Commonly tila taila , vishagarbha taila , bala taila , mahamasha taila , dhanwanthara taila , karpasasthyadi taila , dhathoora taila , nirgundi taila are using .

Tila taila

          It is vatahara , thridoha hara , thhekshna , vyavai , and it will not cause kapha aggravation

             twak dosha krith –

                  twak dosha hara - if externally apply

                        twak dosha kara – if internally administering                                                                    (ref – ashtanga hrudaya sutra sthana )

Masha choorna

           It is snigdha , bala sleshma mala pitta kara , guru ushna , anilahara , madhura rasa , sukla vardhaka and sukla vireka krit                                                                                      
 (ref – ashtanga hrudaya sutra sthana )

Requirements

·         masha choorna – 500 gm

·         medicated oil – 300 ml [ 150 ml at a time pouring in kati

region ]

·         facility to heat the oil

·         towel

Procedure

                       Preparation of masha pishti

Poorva karma

                        Preparation of the client – after evacuation of mala , mootra  etc.

                        Before staring the procedure swasthi vachana 

Pradhana karma

                         Patient have to lie down in prone position with low back region exposed the area should be cleaned with the help of a cotton piece after that masha pishti have to fix on that region. The luke warm taila pouring on that region with the help of a cotton swab , when the poured oil becomes cool have to replace it   . Normally 30 – 50 mts of time duration we can keep for this procedure and according to the condition we can administer the gentle massage over that area with the help of fingers .

Paschath karma

                       Remove the oil with the help of a cotton swab , removing the frame , slight massage over the area , swedana [nadi sweda for 5 mts ]

Observation

              Observe the symptoms indicate of proper effect of swedana , if deficient or excessive to be treated accordingly after the procedure the patient have to take rest for 15 mts in supine  position , hot water bath with the help of green gram powder . Patient have to take rest in a flat cot made up of wood without using any type of thick matters.

Probable mode of action

             The seat of vata is – pakvasaya , kati , sakthy , sparsanendriya

Kati pradesa – vertebral coloumn joints with hip bone on either sides , the lumbar , sacral and sacro iliacal joints

Sakthy – both lower limbs – uru

Vitiation of vata in any one of this location leads to shows symptoms like sthambha and ruja

                                   Kati vasti action its local site ,  because of the guna of sneha (yasya kledanae sakthi sa) it creates unctuousness . Their after it undergo paka with the help of bhrajaka pitta (lies in skin) further it will assimilated under the influence of bhoothagni paka and it will pacify the dosha .

Effect of kati vasti in kati soola

                            In case of vata a dosha which causes kati soola supposed to get pacify from its moola , out of the sthanas of vata pakvasaya is given more importance because vata developed from their . Apart from this it is enumerated that vata is placed in asthi dhathu to pacify vata , here the taila will reach in asthi not only by absorption but also through its local action . On the basis of dallana clarification we can tell that the sneha will reach in asthi dhathu with in 800 matrakala (245 seconds) . Thus in practice to use the kati vasti in vata vyadhi especially in kati graha.

Prepared by

Dr.Vishnu Raj. S 

08904747803

v4vishnuraj@gmail.com

LEPA

External/Topical Applications in Ayurveda

                 The goal of medicine is to prevent disease, restore health and reduce suffering. Understanding and appropriately treating pain is an important component of this goal. In allopathic science analgesics are given in the form of topical applications, is said to provide the therapeutic benefits by reaching the local tissue and with minimal side effects. Apart from treating pain they are also useful in treating various skin lesions, ulcers etc…

In Ayurveda the topical applications are known as Lepas and this comes under the broad heading of Bahiparimarjana Chikitsa. Skin is the largest protective barrier in the body which prevents invasion of microorganism, foreign substances in the body. The main area of Bahiparimarjana Chikitsa is Twak and the treatments like Abhyanga, Swedana, Pradeha, Parisheka, Unmardana etc...  according to disease are known as Bahiparimarjana Chikitsa

Lepas are Just like the ‘Pastes or Plasters intended with the Ointments’ of Western Pharmacopoeias, ‘Kalimbu, Mezhugu and Vannai’ of Siddha Pharmacopoeia’, and ‘Merham and jimad of Unani system of medicine’.

Definition

“द्रव्यमार्द्रं शिलापिष्टं शुष्कं वा सद्रवं तनु

    देहे प्रलेपनार्थं तत् लेप: इत्युचते बुधै:” (द्र.गु.वि-यादव्जि)

Either Ardra dravyas or Sushka dravyas with water, are ground well and is made into a paste and are used for external application are called Lepas.

Synonyms

                “आलेपस्य च नामानि लिप्तो लेपश्च लेपनम्” (शा.स.उ-११/१)

      The synonyms of Lepa are Lipta, Lepana, Alepa etc..

       In the context of Vrana lepana Bandana Vidhi Susruta tells

                “अलेप आद्योपक्रम: एष सर्वशोफानां सामान्य: प्रधानतमश्च:” (सु. सू-१८/३)

        First treatment to be done in sopha is lepana and it is the most important one also...

Types of Lepa

1) Acc. To Sarngadhara Samhita – 3 types (शा.स.उ-११/१)

They are

Ø  दोषघ्न लेप -1/4 angula thick

Ø  विषघ्न लेप -1/3 angula thick

Ø  वर्ण्य लेप -1/2 angula thick

2) Acc. to सुश्रुत – 3 types (प्रलेप /प्रदेह/ अलेप)

a)  Pralepa: - “तत्र प्रलेप: शीतस्तनुरविशोषी विशोषी वा ” (सु. सू-१८/६)

These are applied as cold(शीत), thin(तनु) and which dries either very quickly or not (विशोषि/अविशोषि).Acharya Sarngadhara explains Pralepa as विशोषि .

b) Pradeha:-

Acharya Susruta explains this as अविशोषि  and this should be applied as Ushna ( in Vata Kapha conditions) or Seeta ( in Pitta conditions). This can be applied either Bahala or Abahu. It does Sodhana and Ropana and can be used in Vata Kapha Pradhana Sopha.

Pradeha is also known as कल्क (since used in kshata) & निरुध लेप 

               “Yastu kshateshu upayujyate sa booya kalka iti samjna labate” (A.S.u-30/7)

It removes the srava causes mridutva, does Mamsapakarshana, Vranashudhi

Acharya Sarngadhara explains this as Ardra, Ghana and Ushna

c) Alepa :-

                 “मध्यमोऽत्त्रालेप: तत्र रक्तपित्त प्रसादकृत् अलेप” (सु. सू-१८/६)

                The action , thickness ,etc.. will be moderate and is useful in रक्तपित्तधिक शोफ, अविदग्ध शोफ,  and this is Dahakandu rujapaha , Tridoshasamana ..  This can be used in Shodhana of diseases in Marma and Guhya Desha.  Alepa is considered to be त्वक् प्रसादनमेवाग्र्यम्

3) Acc. To Ashtanga Samgraha – 10 types

                They are Snaihika, Nirvapana, Prasadana, Sthambana, Vilayana, Pachana, Peedana, Sodhana, Ropana, Savarneekara

Pramana of Lepa

                “तस्य प्रमाणं महिषार्द्र चर्म्मोत्सेधमुपदिशन्ति ” (सु. सू-१८/११)

The thickness of Lepa should be of Ardra Mahisha Charma

                              Do’s & Don’ts while applying Lepa

1) Do Lepa in the pratiloma direction (सु.सू-१८/४)

      “तत्र प्रतिलोममालिम्बेत् - प्रतिलोमे हि सम्यक् औषधमवतिष्ट्ते

      अनु प्रविश्यति च रोमकूपान् स्वेदवहिबिश्च सिरमुखै:वीर्यम् प्रप्नोति”

By doing Lepa in the Pratiloma direction it helps the Oushadha to remain there properly and allows it to enter the romakoopas and thereby veerya entering svedavahi srotas

      “प्रतिलोममालिम्बेत् इति लोमाबिमुखमालिम्बेत्” (डल्हण)

2) Never allow Lepa to get dry (सु.सू-१८/५)

       “न च शुष्यमाणमुपेक्षेत अन्यत्र पीटयितव्यात् शुष्कोह्यपार्थको रुक् करन्ज”

Only allowed to dry for vrana Peedana otherwise it will have less effect & causes pain

3) Don’t do Lepa at night

 “न चालेपं रात्रौ प्रयुन्जीत,मा भूच्छैत्य विहितोष्णस्तदनिर्गमात् विकार प्रवर्तिरिति” (सु.सू-१८/१२)

          If applied at night due to the Seeta svabhava of rathri kala the ooshma gets rodha and it will lead to Rogavridhi

    Lepa can  be applied in night, in conditions like Apakwa Sopha, Gambheera Sopha, Rakta Sleshma Samudbava

4) Don’t apply Lepas which are old

   “न च पर्यूषितं लेपं कदाचित् अवचरयेत्” (सु.सू-१८/१४)

5) Never apply Lepa on & on without removing the earlier one

“उपरि उपरि लेपं न कदाचित् प्रदपयेत्  ऊष्माणं वेदनां दाहं घनत्वात् जनयेत् सहि”(सु.सू-१८/१५)

                 If applied so causes rise in temp., vedana, daha & ghanatva

6) If a Lepa once becomes Sushka –Don’t use again as it becomes Nirveerya

7) A Lepa once applied becomes Sushka it should be removed only after making it Ardra

 “तमार्द्रयित्वापनयेत् तत् अन्ते अभ्यंगमचरेत्”  (अ.ह्र.सू-२२/१५)

                 Once removed apply a little oil & do a slight massage

                     Prayojana of Lepa-Benefits of Lepa

“यथा अम्बुभि: सिच्यमान: शान्तिमग्निर्नियश्चति

 दोषाग्निरेवं सहसा प्रलेपाध्यै: प्रयोजितै:” (अ.सं.उ-३०/५)

Just like Agni getting shantha after putting water, Dosha also gets pacified after lepana….

“यथा प्रज्ज्वलिते वेश्मन्यम्भसा परिषेचनं

क्षिप्रं प्रशमयत्यग्निमेवालेपनं रुज:

प्रह्लादने शोधने च शोफस्य हरने तथा

उत्सादने रोपणे च लेप: स्यत्तु तदर्थक्रित्” (सु.चि.१/१५-१६)

Lepa cures pain & causes happiness and is also useful in Shodhana, sophahara, does utsadana and ropana of vrana…

MUKHALEPA

Acharya Vaghbata explains about Mukhalepa Mukham in Malayalam means face and Lepa, lepana means application of a paste. The herbal pack contains different herbs made into a paste. Now a days this has been used more in the cosmetic aspects across the globe and different kinds of Lepas for face are available. Vaghbata explains to use warm (उष्ण) Mukhalepa in Vata Kapha diseases and in Pitta conditions and all other conditions as अत्यन्त शीतल

He explains 3 kinds of Mukhalepa as namely  1) Doshahara 2) Vishahara 3) Varnakrit

Indications of Mukhalepa

Vaghbata says to use Mukhalepa in conditions like अकालपलित (Premature greying of hair) , व्यन्ग (Blackish pigmentation of the skin) , वली (Wrinkles of facial skin) , तिमिर (Progressive cataract) नीलिक (Bluish discolouration)  and यौवन पिडका (Acne vulgaris)

Contra Indications of Mukhalepa

It is contraindicated in पीनस (Chronic Rhinitis), अजीर्ण (Indigestion), दत्त नस्य (Immediately following Nasya Karma), हनुग्रह (Lockjaw) , अरोचक (Tastelessness ), जागरित (Keeping awake at Night)

After Mukhalepa-Avoid

After Mukhalepa one must avoid the following things like दिवास्वप्न  (Sleeping in day time), अतिबाष्य  (Excessive talk), अग्नि &आतप (Exposure to fire and Sunlight), शोक & शोक (Grief & Anger)

                                    Arunadatta further explains

“अह:स्वप्नादि सेवनात् कण्डु त्वक्शोष पीनस द्रुष्ट्युपघातादिभयं स्यात्” (अरुण दत्त)

DRUGS FOR MUKHALEPA IN VARIOUS SEASONS

v  Hemanta -Kolamajja, Vrishamoola, Sabara, Gourasarshapa

v  Sisira - Simhimoola, Krishnatila, Darvitvak, Nistusha Yava

v  Vasanta- Darbhamoola, Chandana, Useera, Sireesha, Misi, Tandula

v  Grishma- Kumuda, Utpala, Kalhara, Doorva, Madhuka, Chandana

v  Varsha - Kaliyaka,  Tila, Useera, Mamsi, Tagara, Patimukha

v  Sarat - Taleesapatra, Gundra, Pundrahva, Yashtimadhu, Kasa, Nata, Aguru

Some Lepa Yogas acc. To Ashtanga Hridaya

In Arshas  Chikitsa Acharya explains to use the Lepa with drugs mentioned in Pippalyadi Anuvasana thailam(Pippali, Madana, Vilwa, Satahwa, Madhuka, Vacha, Kushta, Shunti, Pushkaramoola ,Chitraka, Devadaru). He Also explains the use of Snuk Ksheera along with Nisa and Peelumoola, Vilwa and Hingu as Lepa

In Kushta Chikitsa also many Lepa Yogas are told. The famous Jeevanthyadi Yamaka is told here.The use of Guggulu Marichadi Choornam with Chakrikathailam is explained in this context.

Also Snuhyadi Lepa is explained in  Visarpa .For the preparation of Snuhyadi Lepa, thick stems of Snuhi Should be taken. After removing the thorns, its pulp should be taken out with knife and the hollow space thus obtained should be filled with coarse powder of seeds of yellow Sarshapa and pulp of Snuhi. It should be then kept in an oven at fixed temperature(80⁰C) for about 4 to 5 days, till it become dry powder. Thereafter  it should be  taken from oven, made in the form of powder and then filtered through sieve. To this powder, Sarshapa oil was added in the ratio of 1:4 and filled in cleaned bottles with tight lid. Before using it should be mixed well.

In Svitra Avalguja beejadi choorna (Avalgujabeeja-4pala, Harithala-1/4^th)- Gavam moothrena pishtam as Lepa. Another prayoga of Avalgujabeeja in Gajamootra is also told. Another teekshna Lepa of  Bhallataka ,Dweepi, Sudha, Arkamoola, GunjaPhala, Tryooshana, Sankhachoorna, Tutha, Kushta, Panchalavana, Ksharadvayam, Langalika in Snuk,  Arka Dugda should be applied with Salaka only.

In VataVyadhi also Lepas with Grihadhoomadi Choorna is mentioned.  Other commonly used Lepas include Jadamayadi Choorna, Eladi Choorna, Kottamchukkadi Choorna, Rasnadi Choorna, Kumkumadi Lepa, Kachooradi Choornam etc…

Acc. To Charaka Samhita

                Charaka exclusively describes 32 choorna pradehas in the 3^rd chapter of Sutrasthana- Aragwadeeyam. The Chapter Starts with a pradeha containing Aragwadha in Gopitta to be used in various Kushtas and hence the name. Kolakulathadi Choorna is told in this Chapter.

                Some of the Yogas include

v  Kushtahara:- Manasila +Harithala +Maricha + Arkapaya

v  VataRaktahara:-GodhoomaChoorna+Ajapaya+Ajaghritam

v  Vishahara:-Sireesham,Sindhuvara

v  Jatararthi:-Yavachoorna+Yavakshara+Takra

v  Shirorukhara:- Natholpalam+Chandana+Kushta+Ghrita

v  Sareeradourgandhyahara:- Patra+Ambu+Lodhra+Abhaya+Chandana

Lepas in Visha Chikitsa

                Lepa is one among the Chaturvimshadi Vishopakrama acc. To Charaka. The Yogas include Dashanga Lepa, Nagaradi Lepa, Hingwadi Gulika etc…

POSSIBLE MODE OF ACTION OF LEPA

                                In the Chapter Dhamani Vyakarana Adhyaya Susruta explains dhamanis which are Oordhwagata ,Adhogata and Tiryakgata. Here he explains 4 Tiryakgami Siras. Out of these 4,each divides gradually hundred and thousand times and thus become innumerable: by these the body  is covered like network, bound and pervaded their openings are attached to hair follicles which carry sweat and replenish rasa inside and outside (“Swedamabhivahanti  Rasam chabhitarpayanthi Antharbahischa…..”) ; through them only the veerya of abhyanga, snana and lepa enter the body after being transformed in skin; the same also carry the sensation of touch pleasant or otherwise.

                                The physico chemical properties of a drug in a topical dosage form affects that drug’s trans-dermal delivery and topical bioavailability. The molecules of the formulation after penetrating through the stratum corneum and hence, into viable epidermis and dermis produces its characteristic pharmacological response through receptors even before the blood and lymph circulations remove it ,in which case it may set in a cascade of systemic effects .Though the horny layer is very impermeable to most chemicals, contributing the rate limiting step in transdermal absorption because of its high diffusional resistance, providing a small fractional area of 0.1 % only as permeable appendageal shunt route. Besides this route the drug molecules may penetrate through the hair follicles and sebaceous glands or through sweat ducts also.

CONCLUSIONS

                Ayurveda has addressed transdermal use of medicines in versatile conditions from neurological affections to rheumatological conditions and also for skin ailments in various modes and methods since time immemorial. Lepa done externally through skin is only one example. Though the Lepas described in our texts are effective, they are less used and less known. Knowledge of different varieties of Lepas available in different forms may help future research scholars and physicians to use it in an appropriate way

Prepared by

Dr.Sanjay.M
09448467075
drsanjayjayaraj@gmail.com