Kushtha (chronic skin diseases)

The commentary counts kitibha, dadru and kachchhu among the many kinds of kushtha.

Through the primary and secondary roles of the doshas, kushtha is said to be of eighteen kinds.

Seven great kushthas (mahakushtha) are named: aruna from vata; kapala, rishyajihva, audumbara and kakanaka from pitta; dadru and pundarika from kapha. Because they penetrate the tissues they are mostly incurable, and so are called great.

Minor kushtha (kshudra kushtha) is said to have thousands of varieties through kapha and blood; arush kushtha and sidhma are kapha-predominant among them.

Mahakushtha is said to arise from vata, parisarpa and others from pitta, and all the remaining kinds from the three doshas.

Kushtha is said to arise in general from vitiated vata, pitta and kapha (all three doshas), with signs shaped by the primary and secondary roles of the doshas.

Eating mercury processed with other metal groups containing rasa is said to give rise to kushtha and many other groups of disease.

Milk taken with meat, fish, jaggery, black gram or modaka sweets is said to bring on kushtha.

Milk taken with meat, fish, jaggery or sweets made of black gram is said to cause kushtha.

Excessive sweating or none at all, horripilation, loss of touch sensation, blackening of the blood, great heaviness of the body, itching, roughness and tremor are named as the prodromal signs.

In vata kushtha there are loss of skin sensation, drying, hoarseness, disturbed sleep and similar disorders.

In pitta kushtha there are sores on the eyebrows, ears and nose, red eyes, and rotting and ulceration of the toes.

Discharge, itching, heaviness of the body, coldness and swelling are the signs of kapha kushtha.

Kushtha seated in the skin shows a colour unlike that of the skin and dryness.

Excessive sweating, numbness of the limbs, deformity and swelling are the signs of kushtha seated in the blood; in strong kushtha reaching the flesh, severe discharging blisters arise.

Kushtha that has reached the fat, vessels and sinews causes lameness of the hand, sores, spreading, damage to the body, difficulty in walking, lassitude and foul ulcers, among other disorders.

Dreadful kushtha that has reached the marrow and bone brings severe eye disease, the breeding of worms, splitting, sores in the nose and loss of voice, and the signs of each earlier tissue stage are found in the later ones.

Through wrong conduct, such as reviling gods, teachers and scriptures, or through unwholesome diet, vitiated vata takes up aggravated kapha and pitta and, at the place where it throws and lodges them, produces a very painful kushtha according to the dominant doshas.

Kushtha in the fat is said to be very troublesome and only to be kept in check with many kinds of medicine; kushtha in bone, marrow and semen does not heal even with panchakarma and is to be abandoned as incurable.

Kushtha patients are to be thoroughly purified upward and downward and bled freely; if any dosha remains, the kushtha returns, so treatment must be pursued diligently.

Triphala with iron calx, pyrite, long pepper, vidanga and bhringaraja, taken with milk, is said to be a nectar that removes kushtha.

Stone flower cooked with khadira heartwood and then with triphala is said to remove even the most dreadful kushtha.

Rock water drunk with shilajatu, stone flower paste and the bark of nimba and kunimba is said to destroy every kind of kushtha.

The kushtha patient should not take milk, curd, sugar, jaggery and other sugarcane products, field beans, black gram, sesame, oil, horse gram, flour preparations, heavy (dense) foods, fruits (sour fruits in the verse), meat, salt or nourishing food and drink.

Kilasa, kushtha produced by the three doshas, non-discharging pale kushtha seated in the skin and congenital kushtha are all said to be incurable.

Kushtha seated in the skin, blood and flesh is said to be curable with the prescribed medicines, kushtha in the fat manageable (yapya), and the rest incurable and to be left alone.

Pundarika that looks like a white lotus, kakanaka with pitta coloured like the bandhuka flower, gold or the bimba fruit, and kushtha present from birth are to be abandoned as incurable.

A child born of parents with kushtha through vitiated menstrual blood and semen who is badly affected is to be considered incurable.

Severe eye disease, loss of voice and pus flowing from the sores are named as the fatal signs (rishta) in kushtha.