Global J Res. Med. Plants & Indigen. Med. | Volume 2, Issue 1 | January 2013 | 30–39
ISSN 2277-4289 | www.gjrmi.com | International, Peer reviewed, Open access, Monthly Online Journal
Research article
A CLINICAL STUDY TO COMPARE VIRECHANA AND
JALAUKAVACHARANA PROCEDURES IN THE MANAGEMENT OF
VICHARCHIKA
Dass Ranjip Kumar¹, Nayak Annada Prasad²*
¹
Assistant Professor, Dept. of Panchakarma, M.S.M. Institute of Ayurveda, B.P.S. Mahila Vishwa vidyalaya,
Khanpur Kalan, Sonipat, Haryana, India
² Assistant Professor, Dept. of Kayachikitsa, M.S.M. Institute of Ayurveda, B.P.S. Mahila Vishwa vidyalaya,
Khanpur Kalan, Sonipat, Haryana, India
*Corresponding Author: E-Mail: [email protected]
Received: 10/12/2012; Revised: 27/12/2012; Accepted: 03/01/2013
ABSTRACT
Now-a-days, Vicharchika (one among 11 types of mild skin diseases as per Ayurveda) has
become one of the prime skin diseases at general O.P.D. level due to offensive diet habits, fast life
style, industrial and occupational hazard, repeated use of chemical additives etc. Ayurveda has a lot
to offer in this regard since times immemorial. Virechana (Purgation) is the chiefly advocated,
purificatory measure in this disease and so it was taken in the present study for treatment purpose.
Considering Rakta dushti (vitiation of blood) in all types of skin diseases, Jalaukavacharana
(bloodletting by Leech) provides excellent results by its ideal method to expel out the vitiated blood
safely, quickly and effectively. In this study total 28 patients were randomly distributed into two
groups, as Group – A, where the patients were given Virechana (purgation) by classical method
followed by Gandhaka Rasayana (an Ayurveda medicine prepared from purified Sulphur) for 1
month and Group– B, where the patients were given four sittings of Jalaukavacharana for 1 month
followed by Gandhaka Rasayana for 1 month. It was concluded that although Virechana (purgation)
has provided significant relief in the symptoms of Vicharchika yet, Jalaukavacharana (bloodletting
by Leech) has provided relatively better relief in most of the symptoms.
KEY WORDS: Virechana (purgation), Jalaukavacharana Karma (bloodletting by Leech),
Vicharchika (one among 11 types of mild skin diseases as per Ayurveda), Shamana drug (Palliation
drugs)
Cite this article:
Dass Ranjip K, Nayak A P (2013), A CLINICAL STUDY TO COMPARE VIRECHANA AND
JALAUKAVACHARANA PROCEDURES IN THE MANAGEMENT OF VICHARCHIKA,
Global J Res. Med. Plants & Indigen. Med., Volume 2(1): 30–39
Global Journal of Research on Medicinal Plants & Indigenous Medicine || GJRMI ||
Global J Res. Med. Plants & Indigen. Med. | Volume 2, Issue 1 | January 2013 | 30–39
INTRODUCTION
The skin is a highly complex organ which
plays vital role in the body‟s general
functioning. Skin is described as an ornament
of the body in classics. The study of Indian
medical classics reveals that all skin diseases
were described under the broad heading of
“Kushtha” (Skin diseases). According to
Vagbhattaa(who wrote astanga hridaya),
Kushtha (skin disease) (Vagbhatta, 4th AD) is
a disease which involves breakage in the charm
of skin.
Sushruta (who wrote Susruta sahmita) has
described Vicharchika (one among 11 types of
mild skin diseases as per Ayurveda) as one of
the Kshudra Kustha (11 mild skin diseases)
(Susruta, 2000 BC). The Vicharchika simulate
with Eczema. It is one of the blazing problems
in the society as accurate medicament is not
available to treat the disease and to control its
reappearance. The Shodhana (Purification)
therapy and Shamana (palliative medicines)
treatment forms the core of this reputed
discipline of medicine. Because of preventive,
promoting, prophylactic and rejuvenating
properties as well as providing a radical cure;
Panchakarma (five purification procedures) is
a very unique therapeutic procedure, serving as
a Shodhana (purification) therapy. Virechana
(Purgation) procedure has been selected for the
present study, is chiefly advocated for
purification measure in Vicharchika (one
among 11 types of mild skin diseases as per
Ayurveda) (Charaka, 200 BC). Though the
pathology of kustha (Skin diseases) establishes
raktadusti
(vitiation
of
blood),
Jalaukavacharana (bloodletting by Leech) is
being advocated here to expel out the vitiated
blood safely.
With this point of view, a study was
undertaken to evaluate the effects of virechana
(purgation)
and
Jalaukavacharana
(bloodletting by Leech) in the management of
Vicharchika.
MATERIAL AND METHODS
A. Selection of Patients
Total 28 patients fulfilling the criteria for
diagnosis (mentioned below) of the disease
were registered for the present study
irrespective of the age, sex, religion, etc.
Among these, 8 patients left full course of the
treatment before the completion of the therapy.
All patients were selected from the O.P.D. and
I.P.D. of the Department of Panchakarma (five
purification procedures). Institutional ethics
committee has approved the trial on 24.05.11
with letter no. Inst. Ayu. /11/2447.
B. Criteria for Diagnosis
The patients were diagnosed on the basis of
classical signs and symptoms (Kandu (itching),
Pidaka (Eruption)), Shyavata (darkness of
skin), Srava (secretion) etc.) of Vicharchika
(one among 11 types of mild skin diseases as
per Ayurveda) described in Ayurvedic classics.
Inclusion criteria:
Age less than 15 years and more than 70
years. Patients fulfilling the symptomatology of
Vicharchika (one among 11 types of mild skin
diseases as per Ayurveda), like Kandu
(itching),
Pidaka
(Eruption),
Shyavata
(darkness of skin), Srava (secretion) etc.
Exclusion criteria:
Patients suffering from Diabetes Mellitus,
Hypertension with hyperlipidemia, age less
than 15 years and more than 70 years and
patients having any other systemic disorders.
Scoring criteria:
Table -1, Kandu (Itching)
Score
1
2
Grade
Often mild type of itching (1–2 times in a day
Moderate itching along with mild itching episode (1–2 times in a day)
3
Moderate itching along with moderate itching episode (3–4 times in a
day)
Severe itching episode (more than 5 times a day even)
4
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0
1
2
3
Table -2, Daha (Burning sensation)
No burning sensation even after rubbing
Mild type of burning sensation, sometime and not disturbing
normal activity
After rubbing mild type of burning sensation
Severe burning sensation disturbing normal activity
0
1
2
3
Table -3, Shrava (secretion)
No discharge
Moisture on the skin lesion
Weeping from the skin lesion
Weeping from the skin lesion followed by crusting
0
1
2
3
Table -4, Rukshata (Dryness/Roughness)
No dryness (Snigdha)
Dryness with rough skin (Ruksha)
Dryness with scaling (Khara)
Dryness with cracking (Parushang)
0
1
2
3
Table -5, Pidika (Eruption)
No eruption in the lesion
Scanty eruption in few lesion
Scanty eruption in at least half of the lesion
All the lesions full of eruption
0
1
2
3
Table -6, Vaivarnya (De-pigmentation)
Nearly normal skin color
Brownish red discoloration
Blackish red discoloration
Blackish discoloration
Table -7, Raji (Thickening Of Skin)
No thickening of the skin
Thickening of the skin but no criss-cross marking
Thickening of skin with criss-cross marking
Severe lichenification
0
1
2
3
Grouping Pattern:
The patients were randomly distributed in to 2 groups.
Table -8, Distribution of 28 patients of Vicharchika (one among 11 types of mild skin diseases
as per Ayurveda) in both groups
Patients
Total
No. of Patients
Group A
Group B
Completed
10
10
20
LAMA
05
03
08
Total
15
13
28
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Group-A (Virechana (purgation) + Shamana
(Palliative) drugs):
Method of Virechana (purgation) (Dwivedi
Acharya Mukundilal, 2008):
Virechana (Purgation) was carried out as
per classical indications.
Purva Karma (preparatory procedure):
Abhyantara Snehapana (Internal oleation)
was carried out by Shuddha Ghrita (pure
ghee)in increasing dose starting from 30 ml
then in multiplication for a maximum of 7
days as per the conditions of Agni
(digestive capacity) and Koshtha (bowel
habit) of patient till the occurrence of
Samyak Snigdha Lakshana (symptoms of
proper oleation).
Sarvang Abhyanga (whole body massage)
and Mrudu Vaspa Sweda (mild fomentation
by steam) were performed after getting the
Samyak Siddha Snehapana lakshanas
(symptoms of proper oleation) for 3 days in
morning and evening
the dose of 5 gm/day in Capsule form into three
divided doses for the duration of 30 days with
water as Anupana (adjuvant during intake of
medicine).
Group-B (Jalaukavacharana (bloodletting by
Leech) + Shamana (palliative) drug ):
Jalaukavacharana (bloodletting by Leech):
In this group one sitting of Jalaukavacharana
(bloodletting by Leech) was carried out on
every week for four weeks. Number of
Jalaukas (leeches) used per sitting were
decided depending upon the condition of
affected lesion.
Shamana (Palliative) drugs: After completion
of four sittings of Jalaukavacharana
(bloodletting by Leech) the patients were given
powder of Gandhaka Rasayana as a Shamana
Yoga (palliative formulation) in the dose of 5
gm/day in Capsule form into three divided
doses for the duration of 30 days with water as
Anupana (adjuvant during intake of medicine).
Criteria for Overall Effect of Therapy
Pradhana Karma (main procedure)
(Kasture H. S., (2004): After proper
Snehana-Swedana
(Oleation
and
fomentation),
patients
were
given
Virechaka Yoga (purgation drugs) on empty
stomach.
Virechana Yoga (medicines for purgation)
(Charaka, 200 BC) was prepared by
Triphala + Trivrita + Danti along with
Eranda Taila and Icchabhedi Rasa (if
needed).
Pashchat Karma (post purification
procedure): Samsarjana Krama (special
dietary regimens after purgation) was given
as per type of purification and in sequence
mentioned by classics.
Shamana (Palliative) drug: After completion of
Virechana (purgation) process and Samsarjana
Krama (special dietary regimens after
purgation), the patients were given powder of
Gandhaka Rasayana (Shastri Laxmipati, 2004)
as a Shamana Yoga (Palliative formulation) in
The total effect of the therapy was assessed
considering the following criteria.
Cured: 100% relief in the sign and
symptoms with plain skin surface and
significant changes in color of the affected
skin lesion towards normal were considered
as cured.
Complete remission: More than 75% relief
in the signs and symptoms were recorded as
complete
remission
with
marked
improvement
in
pigmentation
and
thickening of the skin.
Marked Improvement: 51–75% relief in
sign and symptoms were considered
showing marked improved with moderate
improvement
in
pigmentation
and
thickening of the skin.
Improvement:
Patients
showing
improvement in between 26–50% in sign
and symptoms with slight improvement of
pigmentation and thickening of the skin
was taken as improvement.
Unchanged: Below 25% relief in sign and
symptoms was considered as unchanged.
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Statistical Analysis:
The information gathered on the basis of
classical symptomatology was subjected to
statistical analysis in term of mean (X),
standard deviation (SD) and standard error
(SE). Paired „t‟ test was carried out at P <
0.10, P < 0.05, P < 0.01, P < 0.001
significance level. The obtained results
were interpreted as –
Insignificant
- P > 0.05
Significant
- P < 0.05
Highly significant - P < 0.01, P < 0.001.
DRUGS CONTRIVE:
Snehapana (internal oleation): by Suddha
Ghrita (pure ghee) 30ml/day increasing
dose
Abhyanga (oil massage): by Bala taila q.s.
for twice 3 days
Swedana (fomentation): by Baspa Sweda
(steam bath) for 20 mins for twice 3 days
Virechana Yoga (formulation for purgation)
contains:- Triphala Kwatha (decoction of three
herbal fruit): 100 ml
- Trivrita Churna (powder of Operculina
turpethum): 50 gm
- Danti Churna (powder Baliospermum
Montanum): 25 gm
- Eranda Taila (castor oil): 50 ml
- Ichchabhedi Rasa (an Ayurvedic
medicine): 2 Tab. (S.O.S.)
Samsarjan karma (special dietary regimens
after purgation): by Peya, Vilepee (recipe
made from rice) etc as per texts.
For Virechana (purgation), drug was
attributed in accordance with Charaka (the
author of
Charaka Samhita) in which
combination of Triphala, Trivrit, Danti,
Eranda Taila was given after considered
necessary Snehapana (internal oleation) by
Suddha Ghrita (pure ghee). Here Combination
of medicine taken for Virechana (purgation),
act like: Triphala (fruit of Terminalia chebula,
Terminalia bellirica, and Emblica officinalis) is
mild laxative in action, Trivritta (Operculina
turpethum) has property to liquefy the Mala
(fecal matter) of Annarasa (chyle), Danti
(Baliospermum Montanum) acts as strong
Virechaka (purgative) which cleans Annavaha
Srotas (alimentary canal) by removing sticking
Mala also and Eranda Taila (castor oil)
provides soothing effect to intestinal mucosal
membranes to ease Virechana (purgation).
Jalaukavacharana (bloodletting by Leech)
(Charaka, 200 BC) is the safest and scientific
method amongst Raktamokshana (bloodletting)
procedures.
Merely Panchakarma (five purification
procedures) is not the complete treatment, but
it is just a preparatory procedure for application
of medicaments; hence Gandhaka Rasayana
(Shastri Laxmipati, 2004) (an Ayurveda
medicine prepared from purified Sulphur) in
the dose of 5 gm/day for 30 days for both
groups is chosen as a Shamana (palliative) drug
after the completion of Shodhana (purification)
procedure.
RESULTS
Observations
Observations of Group-A: Samyaka
Snehana (proper oleation) was found on 7th day
in 70.00% of patients. Total amount of
Abhyantara Snehana (Internal oleation) was
about 840 ml in 70.00% of cases. 40.00% of
the patients showed Madhyama Shuddhi
(medium purification).
Observations of Group-B: Maximum 40%
patients were used nearly 16–20 Jalauka
(leech) during full course of treatment, whereas
30% patients were used 21–25 number of
jalauka (leech), 10% patients were used 25–30
Jalauka (leech) and 20% patients were used
11–15 jalauka (leech). . Maximum 55% of
Jalauka (leech) have been sucked for 1–2 h.
The effect of both therapies in various
symptoms of the diseases can be highlighted as
follows -
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Sr.
No.
Table no.-9, The Effect of Therapies on Individual Signs and Symptoms
Symptoms
% of Relief
Group-A
48.15 (>0.05)
57.15 (<0.05)
36.85 (<0.001)
61.89 (<0.01)
25.64 (<0.01)
61.11 (<0.01)
33.33 (>0.05)
24.98 (<0.05)
Kandu (Itching)
Daha (Burning sensation)
Pidika (eruption)
Srava (Secretions)
Vaivarnya (De-pigmentation)
Shotha (Inflammation)
Rukshta (Dryness)
Raji (Thickening Of Skin)
1
2
3
4
5
6
7
8
Group-B
69.70 (<0.001)
76.31 (<0.001)
58.35 (<0.05)
75.00 (<0.01)
38.24 (<0.001)
87.50 (<0.001)
55.17 (<0.01)
66.67 (<0.01)
Graph No.-1, The Effect of Therapies on Individual Signs and Symptoms
Table No.-10 : Overall effect on symptoms of Virechana Karma (Purgation) + Shamana
Chikitsa (Palliative treatment) in Group-A
Sr.
No.
1
2
3
4
5
6
7
8
Symptoms
BT
AT
X
%
SD
SE
T
P
Kandu(n=10)
Daha(n=10)
Pidika(n=6)
Srava(n=8)
Vaivarnya(n=10)
Sotha(n=10)
Rukshta(n=10)
Raji(n=9)
2.700
2.000
2.111
2.333
3.900
1.800
2.625
2.222
1.400
0.857
1.333
0.889
2.900
0.700
2.250
1.667
1.300
1.143
0.778
1.444
1.000
1.100
0.875
0.555
48.15↓
57.15↓
36.85↓
61.89↓
25.64↓
61.11↓
33.33↓
24.98↓
0.823
0.900
0.441
1.014
0.816
0.748
1.356
0.527
0.260
0.340
0.147
0.338
0.258
0.233
0.479
0.176
1.300
3.360
5.292
4.274
3.873
4.714
1.823
3.162
>0.05
<0.05
<0.001
<0.01
<0.01
<0.01
>0.05
<0.05
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Table No.-11 Overall effect on symptoms of Jalaukavacharana Karma (Leech therapy) +
Shamana Chikitsa (Palliative treatment) in Group-B
Sr.
No.
1
2
3
4
5
6
7
8
Symptoms
BT
AT
Kandu(n=10)
Daha(n=10)
Pidika(n=6)
Srava(n=8)
Vaivarnya(n=10)
Sotha(n=10)
Rukshta(n=10)
Raji(n=9)
3.300
2.330
2.000
1.500
3.400
1.600
2.900
2.667
1.000
0.552
0.833
0.375
2.100
0.200
1.300
0.889.
_
X
2.300
1.778
1.167
1.125
1.300
1.400
1.600
1.778
It can be observed from the above
mentioned table that although Virechana
(Purgation) has provided significant relief in
the symptoms of Vicharchika (one among 11
types of mild skin diseases as per Ayurveda),
yet, Jalaukavacharana (bloodletting by Leech)
has provided relatively better relief in most of
the symptoms.
%
SD
SE
t
P
69.70↓
76.31↓
58.35↓
75.00↓
38.24↓
87.50↓
55.17↓
66.67↓
0.789
0.440
0.753
0.835
0.675
0.699
1.350
1.202
0.249
0.146
0.307
0.295
0.213
0.221
0.427
0.401
8.820
12.090
3.796
3.813
6.091
6.331
3.748
4.438
<0.001
<0.001
<0.05
<0.01
<0.001
<0.001
<0.01
<0.01
result in Group-B, Unchanged was noted in
30% patients of only in Group-A as shown on
table no.13 and Graph no.2.
The effect of all the therapies viz.
Jalaukavacharana (Leech therapy) on the
cardinal signs and symptoms of the disease was
remarkable; however, Virechana (purgation)
provided comparatively better relief.
Overall effect of therapy
This showed that Jalaukavacharana Karma
(Leech therapy) is more effective in curing the
disease in comparison to Virechana
(purgation).
Complete remission was found in 30 %
patient of Group-B, Marked improvement was
noted in 40% patients of Group-A and only
10% patients of Group-B, Moderate
improvement was observed in 30% patient in
Group-A where 60% shows improved effective
Sr. No.
1
Table No.-13- Overall Effect of therapy in both groups
Result
Group-A
%
Group-B
Complete remission
0
00
3
%
30
2
Marked improvement
4
40
1
10
3
Improvement
3
30
6
60
4
Unchanged
3
30
0
00
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Graph No.-2, Total Effect of therapy in both groups
Total Effect of Therapy in Both Groups
70
60
60
50
Complete Remission
40
40
30 30
30
Marked Improvement
30
Improvement
20
10
10
0
0
Unchanged
0
Group-A
DISCUSSION
Commonest age of occurrence of
Vicharchika has been reported between 41–50
years. Cool atmosphere is much susceptible for
eczematous patients. Vicharchika (one among
11 types of mild skin diseases as per Ayurveda)
is Kaphapradhana Vyadhi. (Kapha dominant
disease) (Charaka, 200 BC). So humid, cold,
watery contacts may increases the symptoms of
Vicharchika (one among 11 types of mild skin
diseases as per Ayurveda). Excessive intake of
Lavana (salty diet), Katu (pungent diet) and
Madhura rasa (sweetening diet) are common
causative factors for Vicharchika (one among
11 types of mild skin diseases as per
Ayurveda). Viharaja Nidana (unlawful habit)
like allergic factors and industrial pollutants
can be considered as main causative factors
behind the increasing incidence of Vicharchika.
Same as Kushtha (skin disease), Vicharchika
(one among 11 types of mild skin diseases as
per Ayurveda) is also Tridhoshik (three basic
constituent of body as vata, pitta and kapha) in
which Kapha (one among three basic
constituent) and Vata (one among three basic
constituent) are dominant involved.
Disturbed sleep is interesting symptoms of
Vicharchika (one among 11 types of mild skin
diseases as per Ayurveda), which leads Vata
prakopa (vitiation of vata) and may further
deteriorate the diseased condition. Hence, it
becomes a vicious cycle. Leech saliva, contains
Hirudin, which has property of anti coagulants.
So it may be helpful in other skin diseases,
Group-B
obstructive blood disorders like Thrombosis,
Hemangioma, and Gangrene etc.
Probable Mode of Action of Virechana
karma (Purgation):
Snehapana (oleation) by virtue of its
Doshotkleshana (vitiation of dosha) effects
separates toxins accumulated in the patient‟s
body by Nidanas (causes) like Viruddha ahara
(food ingestion either in inappropriate way or
quantity etc. and the separated Utklilshta
Doshas (vitiated humours) are eliminated by
Virechana (purgation). Virechana (purgation)
might have removed the toxins from the
cellular level, improving Jatharagni (Digestive
fire) and Dhatvagni (hormones and enzymes),
so that metabolism is normalized.
Probable
mode
of
action
of
Jalaukavacharana (bloodletting by Leech):
Vicharchika (one among 11 types of mild
skin diseases as per Ayurveda), is a type of
Kushtha (Skin diseases) having Tridosha
prakopa (vitiation of all the three doshas),
pradhana Raktadushti (vitiation of blood
dominantly)
and
Chirakari
(chronic)
manifestation. Sushruta (the author of Susruta
Samhita) has given great emphasis to
Jalaukavacharana (bloodletting by Leech) in
the treatment of Raktapradoshaja Vyadhi
(Blood
originated
disease),
Tridosha
Prakopajanya (vitiated all three body humours)
and
Chirakari
(chronic)
diseases.
Jalaukavacharana (bloodletting by Leech) is
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better for the superficial blood (Avagadha
grathita Rakta). Vitiated Rakta (blood) may be
washed-out by application of Leeches after
slight scraping on the lesion of Kushtha (skin
disease). Thus; it is well proved that Jalauka
(leeches) gives better effect in Raktaja Roga
(Blood originated disease), or Kushtha (skin
disease) on the basis of classical references.
Jalauka (leech) sucks the impure blood only
with ideal example of Swan by Vagbhatta (the
author of Astanga Hridaya). Leeches when
applied to the skin, sucks the blood at
superficial level might be from capillaries or
extra-cellular so it may be more impure than
other body channels, Jalauka (leech) (Vridha
Vagbhatta, 4th AD) can easily suck impure
blood due to superficial distribution of veins.
Leech application has counter irritant effect
on the lesion, which creates new cellular
division after removing dead cell layer, and
result in reduction of local Swelling and
Lichenification. Leech sucks blood from
restricted area. When leech applied in only
pathogenic area, then it can be said that leech
expelled blood from where the pathological
state is more. So ultimately blood of that area
comparatively more vitiated than other area.
Hence, it can be said that leeches give best
effect in Vicharchika (one among 11 types of
mild skin diseases as per Ayurveda) by
expelling the morbid, vitiated Doshas (three
basic constituent of body) and Dhatus (7 types
of body tissues). The effect of therapy is not
only by expelling the vitiated blood but also by
leech that emits some enzymes in the wound.
CONCLUSION
It can be observed from the table number10 and 11 that although Virechana has
provided significant relief in the symptoms of
Vicharchika
yet,
Jalaukavacharana
(bloodletting by leech) has provided relatively
better relief in most of the symptoms. Most of
the patients had reported in the chronic stage of
Vicharchika. Negligence in early stage of
eczema is common phenomenon observed in
patients. Most of the affected sites for
Vicharchika are lower feet, axilla and neck like
skin folds regions. Relapsing nature of
Vicharchika is most common, which suggest
that, long term intensive therapy is necessary
for eradication of the disease. Virechana
(purgation) provides comparative better result
in symptoms of Shushka Vicharchika (dry
eczema) like, Shotha (oedema), Shyavata
(secretion), Pidika (eruption), Raji (Thickening
of Skin) etc. Jalaukavacharana (bloodletting
by leech) is a choice of therapy for Sravi
Vicharchika (wet eczema) symptoms like,
Kandu (itching), Srava (secretion), Daha
(burning) etc. Markedly improved was obtained
in 40% of group-A, 10% of group-B. Improved
was found in 30% in group-A, 60% in group-B.
Only 30% of patients of group –A remain
unchanged. The effect of all the therapies viz.
Jalaukavacharana on the cardinal signs and
symptoms of the disease was remarkable;
however the Virechana therapy was provided
comparatively better relief.
ACKNOWLEDEMENT
We acknowledge gratitude to Prof. Vijay
Kaushik, Dean and superintendent of M.S.M.
Institute of Ayurveda & Hospital, Khanpur
Kalan for his extensive support in providing all
resources in the OPD & IPD of the hospital.
We express our gratitude to Dr. K.V.Singh,
H.O.D, M.S.M. Institute of Ayurveda &
Hospital, Khanpur Kalan for his inspiring spirit
and parental affection besides his subject
knowledge and direction that helped in
accomplishing this work. We owe our thanks to
our friends, hospital staffs, laboratory staffs,
library staffs of M.S.M. Institute of Ayurveda
and patients for their sincere support in this
clinical trial.
Global Journal of Research on Medicinal Plants & Indigenous Medicine || GJRMI ||
Global J Res. Med. Plants & Indigen. Med. | Volume 2, Issue 1 | January 2013 | 30–39
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Conflict of Interest: None Declared
Global Journal of Research on Medicinal Plants & Indigenous Medicine || GJRMI ||