KUSHTA – A ROGA NIDANA & VIKRITI VIJNANA PERSPECTIVE

KUSHTA – A ROGA NIDANA & VIKRITI VIJNANA PERSPECTIVE

Kushta refers to a group of chronic skin disorders characterized by discoloration, scaling, roughness, and deformity of the skin due to the vitiation of all three Doshas and Dushyas.

सर्वं त्वक्गतमेवाहुः कुष्ठं दोषसमुद्भवम्।
त्रिदोषदुष्टिभावेन तद्भवत्यल्पमत्यपि॥
— Charaka Samhita, Chikitsa Sthana 7/8

Meaning: All skin diseases are grouped under Kushta, which arises due to vitiation of Doshas, predominantly Tridosha involvement.

HETU (ETIOLOGY) OF KUSHTA

स्निग्धोष्णशीतरूक्षाम्ललवणक्षारसेविनाम्।
विदाहिनां विरुद्धानां पिच्छिलानां च भोजनम्॥
प्रदुष्य त्वग्गतं रक्तं त्वगादीन् दुष्यतीवहि॥
— Charaka Samhita, Chikitsa Sthana 7/4-5

Key Causative Factors:

• Viruddhahara (incompatible food combinations)

• Atisevana of Lavana, Amla, Kshara (excess salt, sour, alkaline substances)

• Suppression of natural urges

• Excess sexual indulgence

• Contact with contaminated water and environment

• Bee stings or poison exposure

• Hereditary factors (Bīja-dosha)

Modern Correlation (Etiology):

• Genetic predisposition (e.g., psoriasis, eczema)

• Autoimmune mechanisms

• Allergen exposure

• Stress and poor hygiene

• Chronic infections

SAMPRAPTI (PATHOGENESIS) OF KUSHTA
Vitiated Doshas along with Rakta, Mamsa, Lasika, and Tvak as Dushyas lead to the obstruction of Swedavaha Srotas and vitiation of skin tissues, causing various types of Kushta.

सर्वं त्वग्गतमेवाहुः कुṣ्ठं दोषसमुद्भवम्।
दोषाश्च त्वङ्मसं रक्तं स्रावं च मलमेव च॥
— Charaka Samhita, Chikitsa Sthana 7/8

Involved Doshas:

• Tridosha with predominance of Pitta and Kapha

• Dushyas: Tvak, Rakta, Mamsa, Lasika

Srotas Involved:

• Rasavaha

• Raktavaha

• Swedavaha

Modern Correlation (Pathogenesis):

• Immune-mediated inflammatory responses

• T-cell mediated skin cell proliferation (e.g., in psoriasis)

• Cytokine storm and inflammation

BHEDA OF MAHA KUSHTA & KSHUDRA KUSHTA

Charaka Samhita, Chikitsa Sthana 7/11–13

Maha Kushta (Major Kushta) – 7 Types:

1. Kapala

2. Audumbara

3. Mandala

4. Rishya Jihva

5. Pundarika

6. Sidhma

7. Kakanaka

Kshudra Kushta (Minor Kushta) – 11 Types:

1. Eka Kushta

2. Kitibha

3. Charmadala

4. Alasaka

5. Vipadika

6. Dadru

7. Pama

8. Visarpa

9. Charmakhya

10. Vicharchika

11. Indralupta

PURVAROOPA (PRODROMAL SYMPTOMS) OF KUSHTA

त्वङ्मांसरक्तलसितं कुष्ठस्योद्धातपूर्वकम्।
कण्डूस्पर्शासहत्वं च त्वचः श्यावत्वमेव च॥
— Madhava Nidana 51/3

Key Symptoms:

• Kandu (itching)

• Rukshata (dryness)

• Sparshasahatva (tenderness to touch)

• Shyavata (blackish discoloration)

• Toda (pricking pain)

• Twak vaivarnya (discoloration of skin)

VISHISHTA LAKSHANA OF MAHA KUSHTA

लक्षणं तत्र कुṣ्ठानां सर्वेषामप्युदाहृतम्।
विशेषं तु महाकुष्ठं दारुणं पिडकाव्रतम्॥
— Charaka Samhita, Chikitsa Sthana 7/11-12

Features:

• Severe presentation

• Deeper involvement of tissues

• Chronic, difficult to treat

• Disfigurement and disability

• More Dushyas involved

VISHISHTA LAKSHANA OF KSHUDRA KUSHTA

• Comparatively milder

• Superficial involvement

• Less number of Doshas involved

• Better prognosis

• Less disfigurement

DOSHA ANUSARA KUSHTA LAKSHANA

Vataja Kushta:

• Dryness, black discoloration, fissures

• Cracking, pain, roughness

Pittaja Kushta:

• Redness, burning sensation, suppuration

• Foul-smelling discharge, inflammation

Kaphaja Kushta:

• Thickening, heaviness, itching

• Cold, slimy, white patches

Sannipataja (Tridoshaja):

• Mixed symptoms, most severe

• Difficult to manage

SADHYA-ASADHYATA OF MAHA KUSHTA & KSHUDRA KUSHTA

Charaka Samhita, Chikitsa Sthana 7/36-38

Sadhya Kushta (Curable):

• Involves single dosha

• Present in early stages

• In patients with strong immunity

• Kshudra Kushta is generally sadhya

Asadhya Kushta (Incurable):

• Tridosha involvement

• Chronicity, complications

• Involvement of vital tissues (Marma)

• Maha Kushta is usually krichchra sadhya or asadhya

DIFFERENCE BETWEEN MAHA KUSHTA & KSHUDRA KUSHTA

MODERN CORRELATION (WITH EXAMPLES):

• Psoriasis: Eka Kushta

• Eczema: Vicharchika

• Tinea (Fungal infection): Dadru

• Vitiligo: Switra (not in Kushta but shares classification logic)

• Leprosy (Hansen’s disease): Maha Kushta types (e.g., Kakanaka)

Modern Pathological Concepts:

• Autoimmune basis (e.g., Psoriasis)

• Chronic inflammatory conditions

• Fungal and bacterial infections

• Hypersensitivity reactions

• Genetic mutations (e.g., HLA linkage)