Article by Dr Raghuram Y.S. MD (Ay)
Visarpa is a condition which has often been compared to erysipelas and herpes due to similarity in presentation. Since erysipelas doesn’t have elevated blisters we can rule it out. But most of the types of visarpa mimic erysipelas. In few types of erysipelas we can find symptoms similar to herpes zoster.
Types of Visarpa
Agneya Visarpa – In this ‘agni dagdhaha iva sphotaha’ i.e. blisters as if burnt by fire (blisters occurring post burning) occur along with associated symptoms which depict high level of inflammation. It is caused by vitiated Vata and Pitta and is associated with fever, vomiting, fainting, diarrhoea, thirst, giddiness, joint pains etc symptoms.
Granthi Visarpa – is caused by dual vitiation of kapha and vayu. This contaminates the skin, ligaments, tendons and muscle tissue and form blisters. The blisters are red and painful. The blisters are elongated or small or rounded or hard or stout in appearance. The blisters are in chains and arranged in the form of beads. This visarpa is associated with fever, pain, cough, dyspnoea, vomiting, giddiness, discolouration, fainting etc symptoms.
Kardama Visarpa – presents as yellow or red coloured blisters which are unctuous, black, dirty, swollen, heavy, suppurated inwards and hot in nature. Since they are filled with fluids they rupture immediately when touched. They emit foul smell. They are caused by dual vitiation of pitta and kapha and associated with fever, headache, feeling as if body is coated, bone pains, excessive sleep, thirst etc symptoms.
Kshataja Visarpa – It is formed due to combined impact of injury and vitiated Vata, rakta and pitta. The blisters resemble that of horse gram in size and shape, has red or blackish brown colour and is associated with fever, pain, burning sensation, diarrhoea, tiredness, vomiting etc symptoms.
These Visarpas closely resembles erysipelas, herpes zoster, blisters due to burns and cutaneous radiation syndrome. This Visarpa is said to be one of the dreadful conditions and difficult to treat. In this perspective we can consider the complicated course of the above said conditions.
Bullous pemphigoid and Epidermolysis bullosa have close resemblance with Kardama Visarpa.
Kshataja visarpa includes blisters occurring due to external causes like Friction and rubbing, chemical exposure, contact dermatitis, exposure to heat, fire and sun, allergic reactions, injuries etc
Treatment principles
Principles of treating Visarpa:
Visarpa vis-à-vis blisters (erysipelas, herpes, dermatitis herpetiformis etc) should be promptly attended by the below said measures –
- Langhana – fasting or lightening measures (to rectify metabolism, to digest ama or immature essence of digestion in circulation which is toxic to all cells)
- Rukshana – to remove excess and unnecessary fluidity in the body
- Virechana – therapeutic purgation for expelling the morbid pitta and reduce the inflammatory process in the body
- Vamana – therapeutic emesis for expelling the vitiated kapha from the body and to reduce excess kleda or unwanted fluidity and blocks in the body
- Lepa – application of medicinal pastes to hasten re recovery process and to heal the lesions (blisters)
- Seka – stream pouring or sprinkling of medicinal fluids over the blisters to heal them
- Raktamokshana – bloodletting to remove the contaminated blood, also heals infections
- Avidahi ahara – non-corrosive foods
Panchatwagadi lepam – application of Shatadhauta Ghrita (ghee washed 100 times in water) with Panchavalkala churna i.e. powders of Nyagrodha (Ficus bengalenesis), Udumbara (Ficus glomerata), Ashwatta (Ficus religiosa), Parisha (Thespesia populanea) and Plaksha (Ficus lacor) highly useful in alleviating burning sensation and Agni Visarpa
Nyagrodhadi Lepam – Paste of roots of Nyagrodha (Ficus bengalenesis), Gunja (Abrus precatorius) and Kadali garbha (pulp of plantain stem mixed in shatadhouta ghrita is highly beneficial in Agni visarpa
Shireeshatwagadi lepam – The paste made by mixing the powder of bark of Shireesha (Albizia lebbeck) in Shatadhouta ghrita is beneficial in Kardama Visarpa
Laghupanchamuladi Kwatha – Decoction of 5 lesser roots i.e. Shalaparni (Desmodium gangeticum), Prishniparni (Uraria picta), Brihati (Solanum indicum), Kantakari (Solanum xanthocarpum) and Gokshura (Tribulus terrestris) and Yava valkala (bark of barley) is used for seka (sprinkling) and pana (intake)
Guduchyadi Kashayam
Patoladi kashayam
Bhunimbadi Kwatha / Kashayam – Decoction of Bhunimba (Andrographis paniculata), Vasa (Adhatoda vasica), Katuki (Picrorrhiza kurroa), Patola patra (leaves of pointed gourd), Amalaki (Emblica officinalis), Haritaki (Terminalia chebula), Bibhitaki (Terminalia bellirica), Chandana (sandal wood), Nimba twak (bark of neem) is a good remedy for visarpa and visphota.
Effective decoctions for Herpes from Sahasrayogam
1. Visarpahara Kashayam
Ref – Sahasrayogam, Kashaya Prakaranam, 49
a. Patoladi Kashayam
| Ingredients | Botanical Name | Method of using | Indications |
| Snake gourd | Trichosanthes dioica | The decoction prepared with these ingredients should be served fresh | 1. Herpes |
| Daruharidra | Berberis aristata | ||
| Neem | Azadirachta indica | ||
| Katukarohini | Picrorhiza kurrooa | ||
| Trayantika | Gentiana kurroo | ||
| Licorice | Glycyrrhiza glabra | ||
| Vasa | Adhatoda vasica | ||
| Musta | Cyperus rotundus |
b. Mustadi Kashayam
| Ingredients | Botanical Name | Method of using | Indications |
| Musta | Cyperus rotundus | The decoction prepared with these ingredients should be served fresh | 1. Herpes of vata origin |
| Neem | Azadirachta indica | ||
| Snake gourd | Trichosanthes dioica | ||
| Devadaru | Cedrus deodara | ||
| Turmeric | Curcuma longa | ||
| Raisins | Vitis vinifera | ||
| Bala | Sida cordifolia | ||
| Ginger | Zingiber officinale |
c. Trayantadi Kashayam
| Ingredients | Botanical Name | Method of using | Indications |
| Trayanti | Gentiana kurroo | The decoction prepared with these ingredients should be served fresh | 1. Herpes of pitta origin |
| Utpala | Nymphaea stellata | ||
| Dhanvayasa | Alhagi camelorum | ||
| Coriander | Coriandrum sativum | ||
| Bhunimba | Andrographis paniculata | ||
| Ushira | Vetiveria zizanioides | ||
| Hrivera | Pavonia odoraa |
d. Shreshtadi Kashayam
| Ingredients | Botanical Name | Method of using | Indications |
| Shreshta | Fruits of – Terminalia chebula Terminalia bellerica Emblica officinalis | The decoction prepared with these ingredients should be served fresh | 1. Herpes of kapha origin |
| Neem | Azadirachta indica | ||
| Snake gourd | Trichosanthes dioica | ||
| Pippali | Piper longum |
2. Kulakadi Kashayam
Ref – Sahasrayogam, Parishishta Prakaranam, 80
| Ingredients | Botanical Name | Method of using | Indications |
| Snake gourd | Trichosanthes dioica | The decoction prepared with these ingredients should be served fresh | 1. Herpes with pain 2. Vomiting 3. Burning sensation 4. Nausea 5. Thirst |
| Vasa | Adhatoda vasica | ||
| Kirata | Swertia chirata | ||
| Neem | Azadirachta indica | ||
| Katuki | Picrorhiza kurrooa | ||
| Bibhitaki | Terminalia bellirica | ||
| Haritaki | Terminalia chebula | ||
| Indian Gooseberry | Emblica officinalis | ||
| Sandalwood | Santalum album | ||
| Guggulu | Commiphora mukul |
3. Nannaryadi Kashayam
Ref – Sahasrayogam, Parishishta Prakaranam, 81
| Ingredients | Botanical Name | Method of using | Indications |
| Krishna Sariva | Hemidesmus indicus | The decoction prepared with these ingredients should be served fresh | 1. Herpes |
| Sandalwood | Santalum album | ||
| Ushira | Vetiveria zizanioides | ||
| Licorice | Glycyrrhiza glabra | ||
| Ambujasya kinjalka / Kamala kesara | Stigma of Nelumbo nucifera | ||
| Manjishta | Rubia cordifolia | ||
| Turmeric | Curcuma longa | ||
| Haritaki | Terminalia chebula |
4. Chunda Tavidvamadi Kashayam
Ref – Sahasrayogam, Parishishta Prakaranam, 82
| Ingredients | Botanical Name | Method of using | Indications |
| Bhunimba | Andrographis paniculata | The decoction prepared with these ingredients should be served fresh with rice gruel | 1. Herpes |
| Punarnava | Boerhavia diffusa | ||
| Ginger | Zingiber officinale | ||
| Duralabha | Fagonia cretica |
5. Trayantyadi Kashayam
Ref – Sahasrayogam, Parishishta Prakaranam, 111
Read more here – Trayantyadi Kashayam – Benefits, Dose, Side Effects And Ingredients
Method to Use – served fresh admixed with ghee
Kusht Visarpa difference
Differentiation of Kushta from Visarpa:
Some Vaidyas are of the opinion that Kushta affects skin whereas Visarpa can be internal, external or both.
Modern correlation
Visarpa can be correlated with Herpes. It is characterized by suppurative epithelial inflammatory condition. It can be both internal or external.
Some Vaidyas correlated it as Inflammatory suppurative degenrative cancerous skin condition.
Kardama Visarpa is correlated with cancer.
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