WDS 58: Consideration on 'Aabhyantar-visarp' & Twacha & Kalaa by Dr. Pawan Madaan, Dr. Giriraj Sharma, Dr. D.C. Katoch, Dr. Kapil Kapoor, Dr. Shashi Jindal, Dr. Omkar Barage, Dr. Radheshyam Soni & others.

[8/9, 6:09 PM] pawan madan Dr: 

Good Evng everyone...

Whats the practical implications of concept of Abhaantar Visarpa?

Sym as per charak..

...Marma upaghaata

...sammoha

....Sroto avarodha

Please guide...

[8/9, 8:19 PM] Dr Surendra A Soni: 

मर्मोपघातात् सम्मोहादयनानां विघट्टनात् ।

1. तृष्णातियोगा 

Presentation of pittaja dominant features....

2. द्वेगानां विषमाणां प्रवर्तनात् ॥२६॥

Change of pattern of natural urges..... Or changes in pattern of episodes if previously episodic presentation was there. 

3. विद्याद्विसर्पमन्तर्जमाशु

Very acute presentation of disease..

 4.चाग्निबलक्षयात् ।

Acute Loss of strength of Agni and physical as well as mental power.

अतो विपर्ययाद्बाह्यमन्यैर्विद्यात् स्वलक्षणैः ॥२७॥

This is generalised description for all kind of visarp just like *'Antarvega/bahirvega jwar'* .

Shakhasth dosha involves the marma gradually that's why marma dushti is there. Toxemia due to extensive cellulitis is best example to understand the concept of antah/bahir concept. Antar refers here deep in tissue involving the vitals not the internal erruption etc features. Full blown presentation.

यस्य सर्वाणि लिङ्गानि बलवद्यस्य कारणम् ।

यस्य चोपद्रवाः कष्टा मर्मगो यश्च हन्ति सः ॥२८॥

[8/10, 10:29 PM] pawan madan Dr: 

Explained well sir.

I was thinking of getting the meanings of Marma upaghaata, Sammoh and Ayananaam vighatanam ...as these three symptoms are very imp but they are present in many different kinds of disorders/symdromes which dont indicate towards condition like Visarp. 

The example of Cellulitis given by you is worth notable but in shastra in Abhyantar Viaarpa there is no mention of external lesions on skin.

[8/11, 12:03 AM] Dr Surendra A Soni: 

If you still feel that internal visarp presentation is there then no further comment.

If you  have any reference of shastra for abhyantar visarp  please mention.

[8/11, 4:46 AM] Dr Shashi Jindal, Chandigarh: 

Acute peritonitis followed by injury,septic abortion etc. can be examles of internal visarp.

[8/11, 7:30 AM] Dr Bhadresh Nayak, Surat: 

 vd Soni sir

We may consider as a fungal infection in stomach and esophagus

Also h perilous infection

I have one patient having a similar complain 

On endoscopy found a fungus infection also by biopsy results it's confirmed.

[8/11, 7:37 AM] Satish Sharma ji Dr: 

jab shashtrakaro ne abhyanter visharp ka kahi bhi  amollekh nahi kiya hai to alag se abhyanter visharp sangya dene se kya labh 

kusth avam visharp dono hi tridoshaj avam sapt dushya vali vyadhi hote hua bhi ak chirkari aur dusari aasukari savbhav ki hoti hai 

1 vataya tryo dushta tvak rakt mansambu chah 

dushyanti sah kushthana m saptko dravya sagrah 

2raktam lasika twak mansam dushyam doshah trayo malah 

visharpana m samtpatau vigyeh sapt dhatawah

[8/11, 7:54 AM] pawan madan Dr: 

Good Evng everyone...

Whats the practical implications of concept of Abhaantar Visarpa?

Sym as per charak..

...Marma upaghaata

...sammoha

....Sroto avarodha

Satish ji

Ye shastra me abhyantar visatpa ka ullekh charak chi 21 me dekh lijiye.

[8/11, 8:22 AM] Anupma Patra AIMS AYU: 

Madam visarpa due to  external injury may considered as kshataj visarpa. I think abhyantar visarp is a neeja vyadhi. 

[8/11, 8:52 AM] Dr. R S. Soni, Delhi: 

यहां अभ्यन्तर विसर्प के प्रमुख कारण तो अगंतुज प्रतीत होते हैं यथा- मर्मोपघात, अयनानां विघट्टनात !

[8/11, 8:53 AM] Dr Shashi Jindal, Chandigarh: 

not external,  we are talking about internal visarp. even maningitis   can also be an example of internal visarp. I am talking about internal abdominal, joint etc internal injuries.

[8/11, 8:59 AM] Dr Rajender Bishnoi: 

Ye vusarp me kyo aayenge....

Soth me le sakte hai

 Sorry... this is my opinion.

[8/11, 9:26 AM] Dr Shashi Jindal, Chandigarh: 

visarp is ekdeshye soth as per charak.

[8/11, 9:34 AM] Satish Sharma ji Dr: 

yaha vahirmarg abhyanter marg dosho ki teevrta ke àdhàr par dosho ki gati conditions matra hai jo visharp ke kisi bhi bhed me mil sakati hai 

abhyanter vidridhi bhi acharyo ne vatayi hai

2.chhataj visharp ka bhi ullekh kiya gaya hai.

[8/11, 10:30 AM] pawan madan Dr: 

That means

..marmoupaghaat

..sammoha

..ayanaanam vighatan

.are the reasons for abhyantar visarpa and the ati trishana and vishama vega are its symptoms.

Can you please elaborate a little ?

[8/11, 10:40 AM] pawan madan Dr: 

Visarpa spreads to various body parts fast..

Sushrut nidaan 10/3

[8/11, 10:44 AM] pawan madan Dr: 

Ashtaang hridya nidaan 13/45-47 me yahi 3 baahaya visarpa ke laxan bataaye gaye hain

[8/11, 10:45 AM] pawan madan Dr: 

*Is it possible that here the word abhyantar in the case of Abhyantar visarpa.....means deeper layers of the skin?*

*The sthaan of visarpa has been said as ....baahya and abhyantar twacha.*

[8/11, 10:47 AM] Dr Surendra A Soni: 

that'sthat the point I wanted to convey....

[8/11, 10:55 AM] pawan madan Dr: 

The above symptoms of Abhyantar visarp qhich has been mentioned by chaeak....are very much generally.....and they cant be differentiating features...

[8/11, 11:14 AM] Kapil kapoor: 

मर्मोपघातात् सम्मोहादयनानां विघट्टनात्| 

तृष्णातियोगाद्वेगानां विषमाणां प्रवर्तनात्||२६|| 

विद्याद्विसर्पमन्तर्जमाशु चाग्निबलक्षयात्| 

अतो विपर्ययाद्बाह्यमन्यैर्विद्यात् स्वलक्षणैः||२७|| 

आयुर्वेददीपिका व्याख्या ( *चक्रपाणिदत्त कृत* )

 *अन्तराश्रयादि विसर्पलक्षणमाह- मर्मोपघातादित्यादि| मर्मेति हृदयम्| विद्यात् स्वलक्षणैरिति वक्ष्यमाणविसर्पलक्षणैः||२६-२७||* 

What I understand is that ...

 _If vakshyamaana lakshanas of visarpa if in addition to, associated along with_

 marmopghatat.......agnibalkshayat....etc

Then we should consider it as abhyantar visarpa.

External features will be present in both bahya & abhyantar visarpa.

Twag, raktam, mamsa, ambu cannot be put aside in any of visarpa.

[8/11, 11:14 AM] Dr. R S. Soni, Delhi:

 सर

आप उचित कह रहे हैं। मर्मोपघात, सम्मोह, तृषाधिक्य आदि अभ्यन्तर विसर्प के लक्षण ही हैं चरकानुसार भी।

पंचमी विभक्ति होने से हो प्रारम्भ में कारण प्रतीत हो रहे थे किंतु गहन अध्ययन पर स्पष्ट है कि ये लक्षण है जो अभ्यन्तर विषर्प को बाह्य विषर्प से विभेदित करते हैं ।

गलती सुधार के लिये आपका आभार

[8/11, 11:16 AM] Dr. R S. Soni, Delhi: 

ये आशायगत विषर्प के लक्षण भी हो सकते है।

[8/11, 11:18 AM] Dr. R S. Soni, Delhi: 

यदि केवल deeper layer of skin ही अभ्यन्तर माने तो फिर उभयाश्रित का प्रयोजन?

[8/11, 11:36 AM] Dr Ranga prasad Bhat, Chennai: 

Sounds logically acceptable. 

A study on Complications of Herpes (where in marmas like hrdaya and mastishka are involved..- 

http://googleweblight.com/i?u=http://journals.plos.org/plosone/article?id%3D10.1371/journal.pone.0181565&hl=en-IN

[8/11, 11:47 AM] Dr Shashi Jindal, Chandigarh: 

covering layers ie peritoneum, meninges , mucus layers etc. can be, because 6 tvach includes all.

 e.g. fistula may be internal external or ubhayagat.

[8/11, 12:57 PM] pawan madan Dr: 

Thats a possible roght understanding..

Thanks Kapil ji

[8/11, 1:00 PM] pawan madan Dr:

 

सर आप बेहतर जान्ते है।

मेरी तो बस थोडी सी कोशिश है ।

[8/11, 1:14 PM] Dr. R S. Soni, Delhi: 

ये आपका बड़प्पन है।

[8/11, 1:24 PM] Dr Giriraj Sharma: 

विसर्प के कारण अगर मर्म अभिघात हो जाते है अर्थात विसर्प अगर मर्म स्थल ह्रदय आदि को प्रभावित करता है तो उस मर्म अभिघात से सम्मोह , तृष्ना आदि लक्षण भी विसर्प में मिल सकते है ।

 यहां सम्मोह , तृष्ना आदि लक्षण अगर विसर्प रोग में मिलते है तो चिकित्सा विसर्प के साथ मर्म रक्षणार्थ  चिकित्सा भी करनी चाहिए ।।

 तीन प्रकार के रोगों का वर्णन मिलता है ।

शाखागत रोग 

कोष्ठगत रोग 

मर्मगत रोग 

विसर्प के परिपेक्ष्य में 

बाह्य विसर्प  शाखागत श्रेणी ,  आभ्यंतर विसर्प कोष्ठगत एवं असाध्यता को प्राप्त होता हुआ विसर्प मर्मगत विसर्प कहा जा सकता है और इसकी चिकित्सा भी इसी आधार पर करे तो अच्छे परिणाम मिल सकते है ।

[8/11, 1:37 PM] pawan madan Dr: 

जी

यदि इस मे पहले से ही बाहय विसर्पा के भी लक्षण हौ तो,,,

ये सही है ना सर 

[8/11, 1:39 PM] Dr Giriraj Sharma: 

विसर्प का हेतु बाह्य है या आभ्यान्तर ,,,,,

लक्षण आभ्यान्तर है या बाह्य 

ये एक दूसरे के पूरक हो सकते है ।

[8/11, 2:01 PM] Dr Surendra A Soni: 

Exactly

[8/11, 2:06 PM] Dr Surendra A Soni: 

विद्यात्तत्रान्तराश्रयम्॥४५॥ 

मर्मोपतापात्सम्मोहादयनानां विघट्टनात्। 

तृष्णातियोगाद्वेगानां विषमं च प्रवर्तनात्॥४६॥ 

आशु चाग्निबलभ्रंशादतो बाह्यं विपर्ययात्।

A.H. Ni.- 3/46

Arundatta cleared all things.....

सर्वाङ्गसुन्दरा:-

तत्र-तेषु त्रिषु विसर्पेषु मध्ये, अन्तराश्रयं विसर्पं मर्मोपतापादिभिर्विद्यात्। *मर्मणां-हृदयादीनां, उपतापो-दुःखं,*

 तस्मात्। तथा, 

*सम्मोहात्-मूर्च्छोद्भवात्।*

 *अयनानां-कर्णनासादीनां, विघट्टनात्-विशेषेण चलनादतिशयेन परिस्फुरणादित्यर्थः।*

 *तथा, तृष्णाया अतियोगात्। तथा वेगानां-नानारूपाणां वेदनानां, विषमं कृत्वा-विच्छिद्य विच्छिद्य कृत्वा, प्रवर्तनात्।*

*आशुच-शीघ्रमेव, अग्निबलयोर्भ्रंशात्-विनाशात्। अतो [ विपर्ययात्-पूर्वोक्तान्तर्विसर्प ] लक्षणविपर्ययात्,*

 बाह्यं-बाह्याश्रयं, विसर्पं विद्यात्।

Pawan Sir !!

[8/11, 2:14 PM] Dr Surendra A Soni: 

*प्रायेणामाशये गृह्णन्नेकदेशं न चातिरुक्।* 

Arundatta

कफपित्तात् कर्दमाख्यो जायते। 

तत्र ज्वरादयः स्युः। 

स च-विसर्पः, प्रायेण-बाहुल्येन, *आमाशये-नाभिस्तनान्तरमध्ये,* एकदेशं गृह्णन्-आक्रामन्, अनन्तरं *देहं सर्पति*-व्याप्नोति। न चातिरुक् स्यात्। 

[8/11, 2:31 PM] Dr Surendra A Soni: 

Kushtha visarp are completely external dermal presentations.... When menifestated with full signs and symptoms affect the vital then these are at abhyantar as I tried in my first post. 

Gambheer dhatu involvement may also lead to AV.

रक्तं लसीका त्वङ्मांसं दूष्यं दोषास्त्रयो मलाः ।

विसर्पाणां समुत्पत्तौ विज्ञेयाः सप्त धातवः ॥१५॥

Ch. Chi. 21/15

Kushtha and visarp has similar dosha dooshya but the difference is capability of spreading fastly that is specific in visarp.

Manifestation of kushtha has been mentioned on skin clearly.

त्वचः कुर्वन्ति वैवर्ण्यं दुष्टाः कुष्ठमुशन्ति तत्||२||

ASN 14/2

[8/11, 2:33 PM] Dr Shashi Jindal, Chandigarh: 

[8/11, 2:41 PM] Dr Shashi Jindal, Chandigarh: 

kusht is completly external, bur visarp can be only external, only internal and ext int both together .

[8/11, 2:50 PM] Dr Surendra A Soni: 

त्वङ्मांसशोणितगताः कुपितास्तु दोषाः सर्वाङ्गसारिणमिहास्थितमात्मलिङ्गम् । 

कुर्वन्ति *विस्तृतमनुन्नतमाशु शोफं* तं सर्वतो विसरणाच्च विसर्पमाहुः ।।३।।

Shopha is external visible phenomenon....

Internal shopha can't be seen in by normal eyes.

[8/11, 2:53 PM] Dr. D C Katoch sir: 

Again please see the sign-symptom complex and prognostic indication of कर्दम विसर्प ।   cancer does not necessarily and always  equate to ग्रन्थि or अर्बुद।

[8/11, 2:54 PM] Dr Surendra A Soni: 

I ve posted Arun datta teeka in previous post on this shloka.

[8/11, 2:58 PM] Dr Shashi Jindal, Chandigarh: 

Sir I refer charak samhita by Shastri and Chaturvedi,1982 edition, my ug time book.

[8/11, 3:01 PM] Dr Surendra A Soni: 

Yes Sir

Except external presentation all symptomatology is close to gestric ca.

Absence of pratyam laksham drew my attention. Ayurved is so deep.

[8/11, 4:16 PM] Dr Shashi Jindal, Chandigarh: 

right sir granthi/arbud(ch chi 12),granthi visrp(kf vatj) ch chi21, are different . not all granthi arbud or dvandvaj visarp are ca.

Even ca cx can be kardm visarp, but not all kardmvisarp r cancers.

[8/11, 4:23 PM] Dr. D C Katoch sir: 

भेदावस्था of any disease process ( रोग सम्प्राप्ति) could be cancerous, which in Ayurveda is described either  as one of the Updrava lakshan or  Arishta lakshan.

[8/11, 4:54 PM] Dr Surendra A Soni: 

[8/11, 5:51 PM] pawan madan Dr:

 Ji...

Thanks.

[8/11, 5:53 PM] pawan madan Dr: 

Sir

Please elaborate how visarpa is ...only abhyantar....and how we can diagnose this?

[8/11, 7:15 PM] Dr Shashi Jindal, Chandigarh: 

sir according to my interpretation,lakshan of abhyatra visarp will be according to organ and dosh involved.because internal visarp is not visible.

[8/11, 7:54 PM] Dr Shashi Jindal, Chandigarh: 

acc. to charak 6 marm ch sh 7/9

murcha Samohan etc. lakshan seems to relate with these 6.

[8/12, 12:18 AM] Dr Surendra A Soni: 

तासां प्रथमाऽवभासिनी नाम, या सर्वान् वर्णानवभासयति पञ्चविधां च छायां प्रकाशयति, सा व्रीहेरष्टादशभागप्रमाणा, सिध्मपद्मकण्टकाधिष्ठाना; द्वितीया लोहिता नाम, षोडशभागप्रमाणा, तिलकालकन्यच्छव्यङ्गाधिष्ठाना; तृतीया श्वेता नाम, द्वादशभागप्रमाणा, चर्मदलाजगल्लीमषकाधिष्ठाना; चतुर्थी ताम्रा नामाष्टभागप्रमाणा, विविधकिलासकुष्ठाधिष्ठाना; *पञ्चमी वेदिनी नाम पञ्चभागप्रमाणा, कुष्ठविसर्पाधिष्ठाना;*

 षष्ठी रोहिणी नाम व्रीहिप्रमाणा, ग्रन्थ्यपच्यर्बुदश्लीपदगलगण्डाधिष्ठाना; 

सप्तमी मांसधरा नाम व्रीहिद्वयप्रमाणा, भगन्दरविद्रध्यर्शोऽधिष्ठाना ।

Su Sha 4/4

भवन्ति चात्र- 

यथा वनस्पतिर्जातः प्राप्य कालप्रकर्षणम् । 

अन्तर्भूमिं विगाहेत मूलैर्वृष्टिविवर्धितैः ।।२०।। 

एवं कुष्ठं समुत्पन्नं त्वचि कालप्रकर्षतः । 

क्रमेण धातून् व्याप्नोति नरस्याप्रतिकारिणः ।।२१।।

Su Ni 5/20-21

डल्हण

 नि.सं :-इदानीमप्रतिकारिण *उत्तरोत्तरधात्वनुक्रमणे दृष्टान्तं दर्शयन्नाह-*

 भवन्ति चात्रेत्यादि। यथा वनस्पतिर्वृक्षः, कालप्रकर्षणं कालाधिक्यं प्राप्य, मूलैः कृत्वा, अन्तर्भूमिं विगाहेतेति सम्बन्धः। त्वचीति अत्र त्वक्शब्देन रस उक्तः, *रसारब्धत्वात्;*

 तेन रसस्थमित्यर्थः।।२०-२१।।

Above references clear each and every doubts.

[8/12, 12:32 AM] Kapil kapoor: 

अपि च -

वातशोणितीये-

त्वग्मांसाश्रयरमुत्तानम् तत्पूर्वं जायते ततः।

कालान्तरेण गम्भीरं सर्वान् धातूनभिद्रवन् ।।

[8/12, 7:04 AM] Dr Giriraj Sharma: 

जिज्ञासा,,,,,,

आयुर्वेद में वर्णित त्वचा को सिर्फ  Skin तक ही सीमित रखे  या Epithelia.........

कुष्ठ विसर्प गलगंड, ग्रन्थि , अर्बुद आदि रोगों के परिपेक्ष्य में विचारणीय बिंदु है ,,,,

[8/12, 7:18 AM] pawan madan Dr: 

Great input soni sir - thanks

[8/12, 7:47 AM] Dr Shashi Jindal, Chandigarh: 

mesodermal origin and continution of oral anal vaginal and other orifices (all bahye strots)mucosal or epithelia with external skin...

sarp vt spread hone vali acute(pit and rkt) pathologies.

[8/12, 8:29 AM] Dr. R S. Soni, Delhi: 

Pneumonia, hepatitis, encephalitis etc. May be caused by herpes. And these are life threatening problems. These may create 

सम्मोह, 

मर्मोपघात, 

तृषाधिक्य और अन्य अभ्यन्तर विसर्प के लक्षण जो शास्त्रोक्त हैं।

तो क्या फिर विसर्प को सिर्फ त्वकगत व्याधि मानना सही है?

अथवा क्या।त्वचा में internal epithilium को भी शामिल किया जाना चाहिये ?

[8/12, 8:30 AM] Dr. D C Katoch sir: 

Yes, herpes is the best equivalent of Visarpa whether external or internal. Considering the nature of Visarpa as described in samhitas, I am of the view that it is mostly non suppurative ephethelial inflammatory condition, could be external as well as internal.

[8/12, 8:37 AM] Dr Shashi Jindal, Chandigarh: 

visarp can be inflamatory supurative degenrative cancerous as pr different doshas.

[8/12, 8:37 AM] Dr. R S. Soni, Delhi:

 

सर चर्चा का विषय यही था कि शास्त्रों में बताए अभ्यन्तर विसर्प को कैसे समझे?

क्योंकि त्वचा के वर्णन में पंचमी वेदिनी त्वचा को विसर्प का अधिष्ठान माना गया है। अतः ये एक बाह्य त्वकगत व्याधि ही है यह भ्रम उत्पन्न हो रहा है।

[8/12, 8:42 AM] Dr. D C Katoch sir: 

वेदिनी त्वचा आभ्यन्तर भी हो सकती है ।

[8/12, 9:10 AM] Dr Shashi Jindal, Chandigarh: 

this shlok of charak does not specify that tvacha is external or internal ,but it explains about anatomy/physiology . which is simmiliar in case of skin and epithelia.

[8/12, 9:10 AM] Dr Surendra A Soni: 

यह भ्रम नहीं है शास्त्र तो यही कहता है । आप जो तथ्य दे रहे हैं वो आधुनिक विस्तारित प्रत्यक्ष अनुसार है । 

आयुर्वेद स्रोतोदुष्टि के अनुसार वर्णन और चिकित्सा करता है । उक्त वर्णन को हमारे शास्त्र में सम्मिलित किया जा सकता है । मूल शास्त्र विचार गम्भीर धातु गतत्व है जो उक्त आधुनिक वर्णन में प्राप्त नहीं होता है। herpes oesophagitis में भी आपको स्थान स्रोतस् लक्षण ध्यान में रख कर ही आभ्य. चिकित्सा करनी है ।

[8/12, 9:11 AM] Dr Shashi Jindal, Chandigarh: 

even gynae book says vaginal epilithelium can named as vaginal skin.

[8/12, 9:17 AM] Dr Shashi Jindal, Chandigarh: 

Sir I just want to correct myself, Charak gives sutra only(aapt), for prtaksh we have to explain the sutras on the basis of our modren scietific studies.

[8/12, 9:18 AM] Dr Giriraj Sharma: 

अवतत्य शब्द से अगर आवरित अर्थ ग्रहण करे तो सिर्फ skin के परिप्रेक्ष्य में देखा जा सकता है ।

परन्तु अगर यह व्याप्त अर्थ में ग्रहण करे तो बाह्य आभ्यान्तर दोनो स्वीकार्य होंगे ।

गलगण्ड ग्रंथि अर्बुद कुष्ठ विसर्प जैसे रोगो आभ्यान्तर स्वरूप भी मिलते है 

गलगण्ड में  Epithelium of thyroid 

ग्रन्थि में Epithelial tumor, Carcinoma

कुष्ठ विसर्प में Nasal Leprosy जैसे लक्षण , रूप मिलते है ।

[8/12, 9:25 AM] Dr Shashi Jindal, Chandigarh: Thanks sir!

[8/12, 9:33 AM] Dr Surendra A Soni: 

तस्य खल्वेवम्प्रवृत्तस्य शुक्रशोणितस्याभिपच्यमानस्य क्षीरस्येव सन्तानिकाः सप्त त्वचो भवन्ति ।

दूध में जैसे मलाई आती है उसका उदाहरण सुश्रुत ने दिया है अतः त्वचा तो निर्विवाद रूप से बाह्य ही है ।

Epithelium तो कला के समीप है । 

शारीरविद मार्गदर्शन की कृपा करें तो अच्छा ।

[8/12, 9:35 AM] Dr. R S. Soni, Delhi: 

सर आपका कथन अपने स्थान पर प्रमाणित है। कोई संशय नहीं कि चिकित्सा तो स्रोतस और दोषादि के आधार पर ही होती है।

भ्रम शब्द सिर्फ त्वचा की स्थिति को लेकर ही है, जो कटोच सर और आचार्य गिरिराज जी ने भी संदर्भित किया कि केवल बाह्य आवरण ही त्वचा नहीं, अभ्यंतर सतह (इनर एपिथिलिम) भी त्वचा में समाहित की जानी चाहिये। इस बात को मान लेने से कई भ्रम दूर हो रहे हैं।

[8/12, 9:36 AM] Ashwini Kumar Sood Dr: 

Most of the skin diseases involve epithelium , विसर्प and bullous diseases involve subepithelium , sexual diseases too involve epithlium but syphllis in chronic stages involve deep skin like ulcerations ; fungal diseases can also deep skin layers.

[8/12, 9:44 AM] Dr Giriraj Sharma: 

संतानिका शब्द आवरण के लिए प्रयुक्त हुआ है आपकी बात से सहमत हूँ ।

पर बाह्य आवरण ही क्यो ,,,

अन्तः आवरण पर भी विचार करे ,,,,

the outer surface ot the body and the luminal surfaces of cavities within the body are lined by ...

 Tvcha ......

thik about it.

[8/12, 9:46 AM] Dr Shashi Jindal, Chandigarh: 

you r right sir, but kla is not described by charak. form of malai also differs by boilig milk in open vessel and in closed vessel.

[8/12, 9:51 AM] Dr. R S. Soni, Delhi: तार्किक वक्तव्य

[8/12, 9:54 AM] Dr Surendra A Soni: 

भवतश्चात्र- 

यथा हि सारः काष्ठेषु छिद्यमानेषु दृश्यते । 

तथाहि धातुर्मांसेषु छिद्यमानेषु दृश्यते ।।६।। 

स्नायुभिश्च प्रतिच्छन्नान् सन्ततांश्च जरायुणा । 

*श्लेष्मणा वेष्टितांश्चापि कलाभागांस्तु तान् विदुः* ।।७।।

श्लेष्मणा वेष्टितांश्चापि कलाभागांस्तु तान् विदुः पर विचार कीजिए ये कला ही है जिसे हम mucous mambrane कहते हैं ।

इससे स्पष्ट और क्या होगा ।

[8/12, 10:04 AM] Dr Giriraj Sharma: 

कला शब्द से layers के बजाय गुण अर्थ को देखे तो विषय ज्यादा आसान हो जाएगा !

[8/12, 10:04 AM] Dr. R S. Soni, Delhi:

 

कलाः खलु अपि सप्त भवन्ति धातु आशय अन्तर मर्यादाः।(सु.शा.४/५)

इस से ये तो स्पष्ट लगता है कि बाह्य आवरण त्वचा और अभ्यन्तर आवरण कला के लिये प्रयुक्त है।

अब प्रश्न उठता है कि क्या विसर्प कला को आधार बना कर भी फैल सकता है?

क्या कला में अवस्थित विसर्प ही अभ्यन्तर विसर्प है?

[8/12, 10:07 AM] Dr Giriraj Sharma: 

The structural and functional  (various).

[8/12, 10:07 AM] Dr Surendra A Soni:

तासामन्तःस्थितत्वेनाप्रत्यक्षाणामस्तित्वं प्रत्युपमानं प्रमाणं निर्दिशन्नाह- भवत इत्यादि। एतेन कलासाधिष्ठानपृथग्धातूपलम्भकार्येणाव्यक्तमेव कलानामस्तित्वं साधितं भवेत्। तासामुपष्टम्भकं निर्दिशन्नाह- स्नायुभिरित्यादि। कलाभागान् कलाविभागविशेषान्। सन्ततान् सम्यक्प्रकारेण व्याप्तान्। जरायुरुल्बाकारो येन वेष्टिताः प्राणिनो जायन्ते; कलावेष्टकोऽपि तद्वदेव। वृद्धवाग्भटेन कलास्वरूपमभिहितम्। यथा- *“यस्तु धात्वाशयान्तरेषु क्लेदोऽवतिष्ठते स यथास्वमूष्मभिर्विपक्वः स्नायुश्लेष्मजरायुच्छन्नः काष्ठ इव सारो धातुरसशेषोऽल्पत्वात् कलासञ्ज्ञः”* (अ.सं.शा.५) इति।।६-७

विचार कीजिए आचार्य जी ।

[8/12, 10:08 AM] Dr Surendra A Soni: 

कला का व्याधि निरूपण में विचार प्रायशः नहीं किया गया है ।

[8/12, 10:10 AM] Dr Giriraj Sharma: 

धातु और कला का अंतर समझना ही होगा !

[8/12, 10:12 AM] Dr Surendra A Soni: 

Dalahan teeka ke prarambh me nirdisht kiya gaya hai....

Jo upar share ki hai...

[8/12, 10:16 AM] Dr Giriraj Sharma: 

मांस धातु 

A common basic natural  structure

मांस धरा कला 

A distinctive structure and functions in mans dhatu

मांसवह स्रोतः 

A channel of dhatu which constant chemical , electrical,  Transformation and Transfer

मांस मर्म 

A vital part of Dhatu

मांसधरा  त्वचा 

An Epithelial layar of Dhatu.

[8/12, 10:22 AM] Dr Surendra A Soni: 

जरायुछन्न को कैसे ग्रहण करेंगे ?

[8/12, 10:23 AM] Dr Giriraj Sharma: 

आचार्य डलन्ह , चक्रपाणि उस काल के विद्वान थे आज भी उनका सम्मान है ।

पर काल अनुरूप , तकनीकी क्षमता के अनुरूप हमे आर्ष ग्रंथो के सूत्रों को Rewrite, Re edit,  Re-Corelated, Re- understand की जरूर है अगर हमें इस युगानुरूप बनना है तो,,,

बाकी ,,,,

[8/12, 10:24 AM] Dr Surendra A Soni: 

माँसाधरा त्वचा is part of skin not epithelium....

[8/12, 10:24 AM] Dr Giriraj Sharma: 

जरायु श्लेष्मा स्नायु को ,

Ectoderm , Endoderm , Mesoderm समझकर सोचिये ।

आपकी क्षमताओं से मैं वाकिफ हूँ 

एक नही दिशा मिलेगी आयुर्वेद को !

[8/12, 10:29 AM] Dr Giriraj Sharma:

 Skin 

epidermis

dermis

the skin consists of a superficial layer of epidermis , made up to stratified squamous epithelium

and deeper layer the dermis made up of connective tissue मांसधरा कला

[8/12, 10:30 AM] Dr Surendra A Soni: 

Mesoderm में अवयव विकसित होते हैं ।

विचार कीजिए ।

[8/12, 10:30 AM] Kapil kapoor: 

भ्राजक पित्त की स्थिति पुनः आभ्यान्तर मान लेनी पड़ेगी। 

विचारणीय

[8/12, 10:31 AM] Dr Surendra A Soni: Great !

[8/12, 10:31 AM] Dr Giriraj Sharma: 

अवयव का अर्थ 

tissue है आयुर्वेद मतानुसार

[8/12, 10:31 AM] Kapil kapoor: जी 

[8/12, 10:32 AM] Dr Giriraj Sharma: 

आभ्यान्तर अंगों के रंग अलग अलग है जहाँ भी कलर है वहां भ्राजक पित्त है ऐसा माना जा सकता है क्या,,,,,?

[8/12, 10:34 AM] Dr Surendra A Soni: 

वो अभ्यंगादि ग्रहण करेंगे इसमें सं श य है ।

[8/12, 10:35 AM] Dr Giriraj Sharma: 

अवयवा अपरिमेय असंख्य

 भाव      Cell 

अवयव    Tissue

अंग प्रत्यंग कोष्ठआँग  Organ

स्रोतः  System

शरीर Body

[8/12, 10:42 AM] Kapil kapoor: 

Colour of outer exposed parts of body denotes the bhrajak pitta 

[8/12, 10:45 AM] Dr Giriraj Sharma: 

त्वचा को अगर Epithelium माने तो बाह्य आभ्यान्तर रंग भ्राजक पित्त ही कारण होगा ।

सिर्फ स्किन को ही क्यो ?

[8/12, 10:46 AM] Dr Giriraj Sharma: 

Skin also  made up by epithelia....

[8/12, 10:48 AM] Dr Giriraj Sharma: 

heart liver kidney  के रंग के लिए कौन पित्त भेद होगा फिर 

सोचिये,,,

 अन्तः अंगों का रंग किस के कारण है

 कौनसा दोष

[8/12, 10:50 AM] Prof. Ramakant Chulet Sir: 

वात का वर्ण श्याव है, कफ का श्वेत है, पित्त का पीत है, इस श्यावत्व श्वेतत्व एवम् पीतत्व का उत्पादक हेतु नि:संदेह भ्राजक पित्त है ।

अत:जहाँ जहाँ भी श्यावत्व श्वेतत्व एवम् पीतत्व है उस का उत्पादक हेतु भ्राजक पित्त है किन्तु जहाँ जहाँ भी श्यावत्व श्वेतत्व एवम् पीतत्व है वहाँ वहाँ भ्राजक पित्त उपस्थित है ऐसा नहीं है !!

[8/12, 10:50 AM] Dr Giriraj Sharma: 

धातु सार पुरुष की बात करते है तो सब मैं त्वचा की प्रकृति , रंग का उल्लेख मिलता है ।

[8/12, 10:53 AM] Kapil kapoor: 

उनकी उत्पत्ति जिस धातु प्रकार से है उसके अनुरुप वर्ण हैं।

पुनः 

रक्त धातु का वर्ण रंजक‌से है या फिर भ्राजक से ॽ

[8/12, 10:53 AM] Dr. D C Katoch sir: 

Skin derives its lustre and texture from Bhrajak Pitta but it itself in not Bhrajak Pitt. Rightly explained Acharyavar.

[8/12, 10:55 AM] Dr Giriraj Sharma: 

भ्राजक पित्त का मूल स्थान त्वचा है जो दृश्यमान है

परन्तु शरीर के अन्तः अंगो के रंग के लिए भ्राजक पित्त महत्वपूर्ण भूमिका निभाता है जो अन्य दोष धातु मल संसर्ग से अलग अलग रंग बनाता है ।

भ्राजक पित्त सर्व शरीर विधमान है दृश्यमान होने के कारण आचार्य ने ऐसा उल्लेख सूत्र स्वरूप में किया है ।

बाकी आप गुरुजी है आपके वचन आप्त वचन है ।

[8/12, 10:57 AM] Dr. D C Katoch sir: 

Another doubt- Bhrajak Pitta is a cutaneous entity or subcutaneous?

[8/12, 10:59 AM] Dr Giriraj Sharma: 

फिर तो त्वचा वर्ण रस अनुरूप होना चाहिए था 

धातु के साथ दोष व मल भी रंग के प्रति उत्तरदायी है ।

[8/12, 11:13 AM] Kapil kapoor: 

त्वक्, रस धातु interrated, interchangable terms के रूप मेें भी अनेक स्थानों पर प्रयुक्त हुई हैं ।

 आचार्य 

 *रक्त धातु का वर्ण रंजक‌ से है या फिर भ्राजक से*

मार्गदर्शन करें 

[8/12, 11:25 AM] Dr Giriraj Sharma: 

रंजक एक प्रक्रिया है जिसमे रस धातु को रंग युक्त किया जाता है जो उस का स्वाभाविक रंग है वह दोष धातु की प्रक्रिया पर निर्भर है ।

मूत्र औऱ पुरीष का वर्ण भी रंजन प्रक्रिया से ही होता है ।

अगर ऐसा नही होता तो रक्त पुरीष एवं मूत्र समान वर्ण के होते ।

 अतः रक्त का सामान्य वर्ण भ्राजक से है औऱ विशिष्ट वर्ण रंजक से है

[8/12, 11:31 AM] Dr Rajender Bishnoi: 

These are only inflammation....visrup has spreading pathogens.

[8/12, 11:39 AM] Dr Shashi Jindal, Chandigarh: 

Charak has not classified pitt, it classified as 13 types of agani,prdhan agni jatharagni,5bhutagni,7dhatavagni.

[8/12, 11:40 AM] Dr Surendra A Soni: 

Bhrajak-pitta is located at Subcutaneous level !

Giriraj Sir and Barage Sir can say something more authentically.

[8/12, 11:44 AM] Dr Surendra A Soni: 

पहले 'कला-निर्धारण/विनिश्चय' का निवेदन ।

[8/12, 11:46 AM] Dr Giriraj Sharma: 

कला 

तेषां खल्वपि सप्त भवन्ति धात्वाशयान्तर मर्यादा कला  । सु शा 4/5

Natural, Structural & Functional  Variational Lining  of Matter.

धात्वा धातवान्तर मर्यादा कला

Natural, Structural & Functional  Variational Lining  between two different dhatu

आशयाशयानंतर मर्यादा कला

Natural, Structural & Functional  Variational Lining  of between two Aashaya.

धात्वान्तरेषु मर्यादा कला

Natural, Structural & Functional  Variational Lining  within the Dhatu

आशयांतरेषु मर्यादा कला

Natural, Structural & Functional  Variational Lining  within the Aashaya.

तेषां अन्तरेषु मर्यादा सीमाभूता इति अर्थ      डल्हणः

The mean of maryaada between , within the Aashaya and Dhatu.

चरक सूत्र स्थान अध्याय 12 

वातकलाकलिय अध्याय

 कला गुणः , यदुक्तम -  षोडश कला     च सु 10

Quality and  Property of Dosha, Dhatu and Aashaya .

  अकला  गुण विरोध दोष 

तेन वातकलाकलियो अध्याय वात गुण दोषिय इत्यर्थ ।

यदि वा कला सूक्ष्मो भाग  

तस्यापि कला कलाकला , तस्यापि सूक्ष्मो भाग इत्यर्थः ।

Microscopic Structural and  Functional units of Dhatu and Aashaya.

किं गुणो वायु  ,,, 

वायोर्प्रथकविध कर्मोक्तम  चक्रपाणि टीका ।

कला-  Distinctive and Variation of Natural  structural , functional Lining between a , within and together Dhatu and Aashaya.

कलाः खल्वपि सप्त भवन्ति धात्वाष्यन्तरमर्यादा कलाः

 सु शा 4/ 5

Nature of kalaa....

As per Ayurveda Bhav & Panchmhabhut 

As per Developmental and Histological based Mesodermal (Mesenchyme cell)

Matrij Bhav Mridu... 

 1. Mansadhara Kalaa 

 2. Raktadhara 

 3. Medadhara,  

 4. Shleshmaa dharaa -    Shomya 

 5.  Purishdharaa -     Parthiva 

 6. Pitadharaa - Aagneya

  7. Shukrdharaa - Pitrja Bhav    Somya

यथा हि सारः काष्ठेषु छिधमानेषु दृश्यते ।

तथा हि धातुर्मासेषु छिधमानेषु दृश्यते ।।

स्नायुभिश्च प्रतिच्छान्नान संतातश्च जरयुनाम ।।

श्लेष्मानाम वेष्टितामश्चापी  कलाभागनस्तु तान विदुः ।।

सु शा 4/7

As per Gross Anatomy the kalaa 

1.Snaayu Partichhinnaan - Fibres membranes of organ Heart

2. Sansataam Jaraayunaam - seres membranes 

3. Shleshmanaam vishtitaam -  mucus membrane.

As per Histological and Developmental Anatomy 

the kalaa 

1.Snaayu Partichhinnaan - Mesoderm

2. Sansataam Jaraayunaam - Endoderm 

3. Shleshmanaam vishtitaam -  Ectoderm

Nature of kalaa....

As per Ayurveda Bhav & Panchmhabhuts and Mostly as per Formation of kalaa by 

JARAYUJ - Jarayunaam santath 

 SHLESHAMAJ - Shleshmaa Vashtitaanm 

SNAYUJ - Snayubhishch  Pratichhnnaamn 

As per Developmental and Histological based Mesodermal (Mesenchyme cell)

Matrij Bhav Mridu... 

 1. Mansadhara Kalaa Matrija Bhav, Mridu 

 Jarayuja

Mesodermal

Mesenchyme cell

Myocytes , Muscle fibers 

Variations of Arrangement ,  Different position of nucleus. 

 2. Raktadhara 

Matrija Bhav, Mirdu

Jarayuja

    mesoderm

Mesenchyme cell.

Proerythrocyes , Lymphocytes , Thrombocytes

 3. Medadhara,  

Matrija Bhav, Mirdu

SHLESHAMAJ

Intracellular Ground Substances of Connective tissue

 4. Shleshmaa dharaa -   Rasaj Bhav 

 Shomya 

SHLESHAMAJ

 5.  Purishdharaa -     Parthiva 

Rasaj Bhav 

Snaayuj 

 6. Pitadharaa - Aagneya

Matrija Bhav

Snaayuj 

  

  7. Shukrdharaa -

 Pitrja Bhav   Kathin

Somya 

Jarayuja

[8/12, 11:48 AM] Dr Giriraj Sharma: एक छोटा सा प्रयास कला पर

[8/12, 11:51 AM] Dr Surendra A Soni: 

अत्यंत उत्कृष्ट वर्णन ।

गागर में सागर ।

हार्दिक आभार आचार्य ।

चरक की कला का सारगर्भित संग्रह ।

[8/12, 11:51 AM] Omkar Barge Dr Ana: 

आयुर्वेदोक्त त्वचा के स्तर एवम आधुनिक त्वचा के स्तरों का इस तरह तुलनात्मक अध्ययन किया जा सकता हैं,

 *Layers of epidermis:-* 

1)Stratum corneum &

2)Stratum lucidum -     *अवभासिनी*

3) Stratum granulosum -

 *लोहिता*

4) Stratum spinosum & Stratum Basale - *ताम्रा*

 *Layers of Dermis*

5) Papillary layer - *वेदिनी* 

6) Reticular layer - *रोहिणी* 

Subcutaneous tissue - *मांसधरा*

[8/12, 11:52 AM] Dr Giriraj Sharma: 

The definition of kalaa ,,,,

धात्वाशययान्तर मर्यादा कला 

we  understood it by re-write, re-edit and re-interpreted   धात्वा अन्तः मर्यादा कला 

Aacharya Sushrut is not described Asthivah dharaa kalaa independently but Aacharya  used Asthi word in reference of Tritiya MEDODHAR Kalaa

as 

तृतीया मेदो धरा, मेदो हि सर्वभूतानां उदरस्थ अण्व अस्थिषु च,  महत्सु च मज्जा भवति । सु शा 4/12

स्थूलास्थिषु विशेषण मज्जा त्वभ्यंतराश्रित । 

In above mentioned  that Asthi  and majja  are involved in   MEDODHAR Kalaa .

an another reference Aacharya Sushrut said सिराणां तु मृदु पाक , स्नायुनां च ततः खरः 

 मेदश्च स्नायु संभव ,,,,

 these reference the MEDODHAR Kalaa and  MedDhatu are play important role in formations of asthi dhatu .So Aacharya Sushrut not defined the Asthi Dhara kalaa. not only in kalaa but also 

In Reference of srotas Aacharya Sushrut again avoiding Asthivah and Mjjavah srotas .

It principle indicates that the Meda Dhatu , Kalaa and srotas play specific role in formations of Asthi Dhatu ,Kalaa and srotas. 

These Asthi and  Majaa are essential part of MEDODHAR Kalaa dhatu and srotas.

If we re-write, re-edit and re- interpret the defination of Asthi.

As per defination of Asthi Dhatu 

अस्यते इति अस्थि 

The asthi dhatu are not destroyed for long as other dhatu.

re- interpret , re- edit in a other aspect the asthi dhatu is hard remains substance of specially MEDODHAR Kalaa . 

 साराण्यतानि देहिनां ।

 अस्थि सारैस्तथा देहा धीयन्ते देहिनां ध्रुवं ।

तस्माच्चिर विनष्टषु त्वग मांसषु शरीरिणाम  सु शा 5/21

In above mentioned reference the asthi dhatu is the saar bhaag of body . 

In reference of UPDHATU and MALA nakh , kesh , dant understood this process.

As per Histological aspects

A Natural property of bone tissues which located within the bone and continuously froming new tissues of bone Osteocyte.

Mean of कला , सूक्ष्मो इति अर्थ  Osteocyte, a cell that lies within the substance of fully formed bone. It occupies a small chamber called a lacuna, which is contained in the calcified matrix of bone. Osteocytesderive from osteoblasts, or bone-forming cells, and are essentially osteoblasts surrounded by the products they secreted.

An another veiw Kalaa word mean ,"कला शब्द गुणवाची अर्थेने " The quality of the any substance or structural and functional variation of substance.

     As Gross Anatomical Aspect kalaa is a maryaadaa अंतर मर्यादा internal Layer or cover.

Premordial Asthi (Osteocyte) dhātu/bone tissue is transformed and processed into mature (Osteoblast) asthi dhātu/bone tissue through a specialized (Osteoclast) membrane called the periosteum ... which is asthi dhara kalā. in reference of Maryada .

Pathological aspect of Purishdharaa kalaa 

 it is purishdharaa kala becauseThe Purishadharakala of the colon absorbs minerals which have special affinity for bone tissue. Interesting, both colon and bone tissue are special sthana/sites of vata.

Asthi dhatu kalaa not described by aacharya susrut but  Panchmi Purishdhara kalaa . panchm dhatu is asthi dhaatu .....

Acharya Sushrut when described Vish Veg Panchm veg have most sing and symptoms bone releted ....

[8/12, 11:54 AM] Dr Surendra A Soni: 

Thank you Barage Sir !

वेदिनी Papillary layer consists nerve fibre ??

[8/12, 11:58 AM] Omkar Barge Dr Ana: 

Yes sir Papillary layer made up of papillae which contains fibrous tissue, blood vessels ,tactile corpuscles & nerve endings.

[8/12, 12 PM] Dr. Anoop Indoria: Sweta twacha is where?

[8/12, 12:00 PM] Dr Surendra A Soni: It may also be taken as site of bhrajak pitta being a presence of blood circulation...?

[8/12, 12:01 PM] Omkar Barge Dr Ana: 

Also reticular layer have hair follicle, sweat glands, sebaceous glands, & some fibrous tissues..

[8/12, 12:04 PM] Kapil kapoor: Twak 

चर्म्म । इति मेदिनी

त्वक्, [च्] स्त्री, (त्वचति संवृणोति) श. क.

क्षीरस्येव संतानिका-  संतानिका बाह्य , आवरण रुपा, न च आभ्यान्तर क्षीरे।

 *त्वक् च पुनः स्थूल शरीरस्य पंचमहाभूत (human body), अशरीरी पंचमहाभूतान्तर मर्यादा ।*

[8/12, 12:04 PM] Dr Giriraj Sharma: 

*जिज्ञासा*

आयुर्वेदोक्त त्वचा के स्तर एवम धातु स्तरों का इस तरह तुलनात्मक प्रतिनिधित्व एवं रोग  अध्ययन किया जा सकता हैं क्या

 -* 

 *अवभासिनी* रस धातु प्रधान (प्रतिनिधित्व)

 *लोहिता*  रक्त धातु

*शेवता* मेद धातु

*ताम्रा* मज्जा 

 * *वेदिनी* अस्थि धातु

 *रोहिणी*  शुक्र धातु

 *मांसधरा* मांस धातु

[8/12, 12:04 PM] Kapil kapoor: 

त्वक् च पुनः स्थूल शरीरस्य पंचमहाभूत (human body) , अशरीरी पंचमहाभूतान्तर मर्यादा ।

My personal view 

[8/12, 12:04 PM] Dr Surendra A Soni: 

Pappillary and reticular layer are site of bhrajak pitta. 

We can conclude this ?

[8/12, 12:07 PM] Omkar Barge Dr Ana: 

Stratum granulosum will compared with Lohita & Shweta because this layer is formed by white granular  tissue

Typing of shweta is missed 

[8/12, 12:08 PM] Kapil kapoor: 

[8/12, 12:12 PM] Dr Giriraj Sharma: 

[8/12, 12:15 PM] Omkar Barge Dr Ana: 

त्वचा के रंगद्रव्य की उत्पत्ती चौथे स्तर की सेलों में होती हैं।

[8/12, 12:20 PM] Dr Surendra A Soni: 

Lohita ke aage kram bhang ho raha hai Giriraj Sir !

Literally it seems similar but problem is that all 7 layers are not vasculared as we just read. Another important issue that you just mentioned that twacha and ras dhatu are almost similar as per aashraya aashrayi bhav. 

Such hypothesis need more clear evidences to think upon. As pet Ksheer santanika definitely there may be a relationship between twacha and sapta dhatu. We have to think on 2 types of movements of rasdhatu as per hypothesis given by you ...

Ras formation of uttarottar dhatu some are solid and some are liquids...

Ras formation of 7 layers of skin.... How uttar dhatus get reverted back and localize at skin ? 

It is possible as per your hypothesis that ras contains all basic particles that to used in formation of uttarottar dhatu, may be utilized in formation skin. This is indirect relationship may be established.

[8/12, 12:37 PM] Dr Giriraj Sharma: 

अगर त्वचा के परिपेक्ष्य में ग्रन्थि अर्बुद कुष्ठ विसर्प को समझना है तो इस हाइपोथीसिस को अच्छे से दिशा देकर समझना होगा  जो एक टीम वर्क से ही सम्भव है । 

Update on 01/9/2018

[8/17, 8:20 AM] pawan madan Dr: 

Good morning everyone. Following are the symptoms of the KAPHAJA VISARPA as mentioned in Charak. Are these symptoms similar to those present in LUPUS VULGARIS and/or GANGRENE ? Or they are found in what type of clinical manifestation these daays?                                                                                                                                    KAPHAJA VISARPA – 

शीतकः शीतज्वरो गौरवं – bodyaches and feverish with chills or rigors

निद्रा तन्द्राऽरोचको – excessive sleepiness, and loss of appetite

मधुरास्यत्वमास्योपलेपो निष्ठीविका छर्दिरालस्यं – feeling of sweet taste in mout, excessive secretions from the mouth, feeling of nausea and slowness in the body

स्तैमित्य – feeling like wrapped with a wet cloth.

मग्निनाशो – loss of digestive power 

दौर्बल्यं च, - excessive weakness

LOCAL SYMPTOMS - 

यस्मिंश्चावकाशे विसर्पोऽनुसर्पति सोऽवकाशः श्वयथुमान् पाण्डुर्नातिरक्तः – the area of lesion appears yellowish and not much reddish

स्नेहसुप्तिस्तम्भगौरवैरन्वितोऽल्पवेदनः – there is oilyness, numbness, stiffness, heaviness and less pain

कृच्छ्रपाकैश्चिरकारिभिर्बहुलत्वगुपलेपैः स्फोटः श्वेतपाण्डुभिरनुबध्यते, - the eruptions present in KAPHAJA VISARPA are having very slow inflammation, the upper layer of the eruptions appears thick, the lesions appear whitish or yellowish

प्रभिन्नस्तु श्वेतं पिच्छिलं तन्तुमद्धनमनुबद्धं स्निग्धमास्रावं स्रवति, - the secretions in this are whitish yellowish fibrous and more oily appearing

ऊर्ध्वं च गुरुभिः स्थिरैर्जालावततैः स्निग्धैर्बहुलत्वगुपलेपैर्व्रणैरनुबध्यतेऽनुषङ्गी – the lesions then become like chronic wound, appear like a net, their upper layer becomes thich and oily and it heals very slowly

च भवति, श्वेतनखनयनवदनत्वङ्मूत्रवर्चस्त्वं, - the nails, eyes, face, urine and stools appears whitish in such cases

निदानोक्तानि चास्य नोपशेरते विपरीतानि चोपशेरत इति श्लेष्मविसर्पः||३४|| - 

they get subsided by the opposite GUNA YUKTA treatments.

My quesrions is weather such lesion be diagnosed as Kaphaja visarpa...if not....then what type of lesions are Kaphaja visarpa ?

[8/17, 9:01 AM] Dr Bhadresh Nayak, Surat:

 No it's not visharp.

[8/17, 9:04 AM] Dr Bhadresh Nayak, Surat: 

Pitt and rakta dusti

Skin is ashray shtan

Raktava vah strotorodh.

[8/19, 10:15 PM] Dr Surendra A Soni: 

Sir

I have not great experience in handling such cases, so can't say something. 

I think your query missed by honourable gurujan and seniors.

Request all to concentrate on this very well raised issue.

🙏🙏

[8/19, 10:17 PM] pawan madan Dr: 

So nice of you Soni Ji.

Salute to your complete attention.

🙏🏻

[8/19, 10:39 PM] Dr Surendra A Soni: 

Respected Ramakant Sir, Ashwini Sir, Dr Gururaja Sir, Somraj Sir and Dr Rajendra ji,  Dr Ankur !

Please express your valuable inputs on said query.

🙏🙏

[8/19, 10:42 PM] Ankur Sharma Dr Delhi: 

I already posted my views on this query 

🙏🙏

[8/19, 10:43 PM] Dr Surendra A Soni: 

🙏🙏

I think dr pawanji is not satisfied. 

Ok thanks dear !👍👌

[8/19, 10:44 PM] Ankur Sharma Dr Delhi: 

Weeping eczema can be considered as kafaz visarp.

[8/19, 10:47 PM] Dr Surendra A Soni: 

Is generalised features mentioned, are seen practically ? As pawan Sir has quoted ?

[8/28, 7:33 AM] pawan madan Dr: 

Good Mng everybody. I need to understand the meaning of these two things from Charak Visarpa chikitsa.                            in Kardam visarpa --- प्रायश्चामाशये विसर्पत्यलसक एकदेशग्राही च, - this visarpa occurs in the AAMAASHYA ??                                 AND in Granthi Visarpa - कृच्छ्रपाकसाध्यां कफाशये सञ्जनयति - What is Kaphaashya here exactly?                                             The Visarpa is mostly external with some of the systemic symptoms in some varieties. So how to decipher these two terms in terms of anatomy and/or physiology ?

[8/28, 7:49 AM] Vd Saraswati Sharma: 

Prayaha means primarily or usually na sir?  Ekadeshagrahi here means localised ?

[8/28, 7:56 AM] pawan madan Dr: 

yes you are right. Here this Kardam visarpa occurs in aamaashya usually ? What does this mean actually ?

[8/28, 8:01 AM] Dr Sidram Guled: 

Gm...

Nabhi stanantaram jantoramashaya iti srimataha..

Its not just a organ..

Surface landmark covering lower part of chest to nabhi.

[8/28, 8:20 AM] pawan madan Dr:

 I am supposing like this but here chakrapaani says -----  प्रायाश्चामाशये विसर्पतीति कर्दमस्य कफपित्तजन्यत्वात् कफपित्तयोश्च आमाशयस्थितत्वादिति [१] भावः- so with this also we should take the same meaning....?

[8/28, 8:32 AM] Dr Sidram Guled: 

Either abyantara or bahya...dosha involved is kapha pitta so sthana is amashaya...

[8/28, 9:26 AM] pawan madan Dr: 

This is not clear.

If so...then there was no need of texting the word Aamaashya here.

[8/28, 10:01 AM] Dr Giriraj Sharma: 

पुनः

आमाशय Fore Gut , Not only Stomach

विसर्प  के परिपेक्ष्य में त्वचा आवरित करती है बाह्य एवं आभ्यान्तर  Outer and inner lining of Epithelia.....

त्वचा -  The skin is the part of त्वचा ,,,,

त्वचा is epithelial lining of body ,,,,,

🙏🏻🙏🏻🌹🙏🏻🙏🏻🙏🏻

[8/28, 11:23 AM] Anupma Patra AIMS AYU: 

Sir main deficiency in this group is , lots of discussion are going on but without any conclusion.😊

Sir Visarpa is not only external it can involve any parts or organs of the body ,lastly I have given the reference of Sushrut .🙏🙏

[8/28, 5:14 PM] pawan madan Dr: 

That means this type of visarpa also manifest in the internal lining of the foregut ?

[8/28, 5:18 PM] pawan madan Dr: 

Please give the ref again.

🙏🏻

[8/28, 6:38 PM] Dr Giriraj Sharma: 

I think definitely,,,,,,

[8/28, 7:01 PM] Anupma Patra AIMS AYU: 

सर् आप खुद इसी query के माध्यम से दो अभ्यंतर विसर्प के प्रमाण दे रहे हैं।आमाशय एबम श्लेष्माशाय अभ्यंतर ऑर्गन हैं। मैंने सुश्रुत संहिता के एक श्लोक कोटे की थी,फिरसे डें रही हूँ।

🙏🙏

[8/28, 8:26 PM] pawan madan Dr: 

जी धन्यवाद।

पर इस संदर्भ से ये पता नही चलता के विसर्प आभायन्तर अंगो मे फैलता है या नही।

तं सर्वतो विरनातच ,,,,,, से चारो तरफ फैलने वाला बताया गया है।

आचार्यो णे कैसे आमाशय एवं कफाश्य मे फैलता है ,,,, ये जाना होगा

🤔

[8/28, 9:55 PM] Dr Divyesh Desai: 

आमाशय

आम * आशय

आम :- जठराग्नि जन्य आम

उसका आशय means आमाशय( Stomach)

आम:- धातवाग्निमांद्य जन्य आम

7 धातु / उपधातु की विकृति से जो आम बनता है, 

7 धातु का स्थान संपूर्ण शरीर

मतलब आमाशय का मतलब संपूर्ण शरीर ले सकते है? 

आदरणीय अनुपमा मैडम और का्य चिकित्सक गुरुजनों इस पर आप प्रकाश डालकर कृपा करें 

आमशयोत्थ जितने व्याधि है वो पूरे शरीर को असर करते है तो मेरी अल्पमति में आमाशय का proper meaning मालूम नहीं है

आम अन्नानां आशय इति आमाशय अथवा

आम का आशय आमाशय ?

[8/28, 10:00 PM] Dr Divyesh Desai: 

इर्ष्या, द्वेष, लोभ,वासना, भय,क्रोध आदि मनोगत आम है, तो मन को भी आम का आशय बोल सकते है,

जैसा अन्न वैसा मन !

[8/28, 10:06 PM] Dr. D C Katoch sir: 

पक्वाशय से विपरीत कार्य करने वाला महास्रोतस का भाग आमाशय है जहाँ आहार सेवन के बाद पहुँचता है और आहारपाचन की प्रक्रिया शुरू होती है।

[8/28, 10:07 PM] pawan madan Dr: 

Litrally agar lain to ye uchita prateeta hotaa hai.

But as per ayurvediv sharir vigyaan....Katoch sir has explained....

[8/28, 10:15 PM] Dr. D C Katoch sir: 

शास्त्र में सम्भवतः महास्रोतस के अलावा  और कहीं आमाशय होने का वर्णन नहीं है, अगर है तो वह रचनात्मक आमाशय नहीं है, क्रियात्मक आमाशयसंज्ञक हो सकता है ।

[8/28, 10:18 PM] Dr Divyesh Desai:

 धी धृति स्मृति vibhransth

कर्म यत कुरुते अशुभम,

प्रज्ञापराध तं विज्ञात

सर्व दोषाप्रकोपने।

जठर अनल दौर्बलयात,

अविपक्व स्तु यो रसः, 

सः आम्सज्ञको देहे

सर्व दोष प्रकोपण।

प्रज्ञापराध और आम दोनों में सर्वे दोषो का प्रकोप common है,

तो मानस भावो को भी आम बोल  सकते हैं न ?

[8/28, 10:49 PM] shekhar singh MP: 

आमाशय - आम स्थान। यहां आम से अपक्व अन्न लेना होगा, आमदोष नहीं।

जैसे प्राकृत अजीर्ण दोषकारक नही होता उसी प्रकार पाचन व्यापार पूर्ण होने से पहले अन्न आमावस्था में रहता है।

आम की परिभाषा अष्टांग हृदय सूत्र स्थान अध्याय 13 में देख सकते हैं।।

[8/28, 10:53 PM] shekhar singh MP: 

रोगा: सर्वेपि मंदाग्नौ ...

आमदोष का कारण भी मन्दाग्नि है। तो आमदोष को सर्वदोष प्रकोपक कहें या मन्दाग्नि को, एक ही बात है ।

[8/28, 10:57 PM] shekhar singh MP:

 ऊष्मणोऽल्पबलत्वेन धातुमाद्यमपाचितम्। 

दुष्टमामाशयगतं रसमामं प्रचक्षते॥२५॥

[8/28, 10:58 PM] shekhar singh MP: 

आयुर्वेदरसायनम् :-आमलक्षणमाह-ऊष्मण इति। उष्मणोरसाग्नेः। धातुं-न दोषं मलं वा। आद्यं-न रक्तादिकम्। रसं-न रसत्वात्प्रच्युतं रक्तत्वमप्राप्तम्॥२५॥

[8/28, 11:13 PM] Haresh Soni Dr. Parul: 

“आमाशयस्थः कायाग्नेर्दौर्बल्यादविपाचितः| आद्य आहारधातुर्यः स आम इति कीर्तितः||”

“आममन्नरसं केचित्, केचित्तु मलसञ्चयम्| प्रथमां दोषदुष्टिं च केचिदामं प्रचक्षते||”

ईर्ष्याभयक्रोधपरिप्लुतेन लुब्धेन रुग्दैन्यनिपीडितेन | 

प्रद्वेषयुक्तेन च सेव्यमानमन्नं न सम्यक्परिपाकमेति ||८|| 

(सु. सू. अ. ४६) | 

मात्रयाऽप्यभ्यवहृतं पथ्यं चान्नं न जीर्यति | 

चिन्ताशोकभयक्रोधदुःखशय्याप्रजागरैः ||९|| 

(च. वि. अ. २) |

[8/28, 11:22 PM] pawan madan Dr: 

ईर्ष्याभयक्रोधपरिप्लुतेन लुब्धेन रुग्दैन्यनिपीडितेन | 

प्रद्वेषयुक्तेन च सेव्यमानमन्नं न सम्यक्परिपाकमेति ||८|| 

(सु. सू. अ. ४६) | 

मात्रयाऽप्यभ्यवहृतं पथ्यं चान्नं न जीर्यति | 

चिन्ताशोकभयक्रोधदुःखशय्याप्रजागरैः ||९|| 

(च. वि. अ. २) |

In both of these ref there is saying of indigestion of food but not necessarily formatio  of aama...🤔

[8/28, 11:27 PM] Haresh Soni Dr. Parul:

 Yes sir, these are Nidanas of Ajirna. Now in Samprapti of Ajirna Ama is essential factor to rule out. In nutshell these causes of Ajirna are responsible for Agnimandya and which may lead to *_ushmano alpabalattva_* .

[8/28, 11:29 PM] pawan madan Dr: 

True..

But this hetu can be present in almost all diseases...

Rogaa sarve mandagnau...

But in defining Aama we need ro select with some specificity..

🙏🏻

[8/28, 11:33 PM] Haresh Soni Dr. Parul: 

Yes sir, as query was raised that pragyaparadh can be reason of Ama. The manas bhava listed as nidanas of Ajirna can be associated with pragyaparadh and in final result of MANDAGNI amavastha can be a clinical presentation.

[8/28, 11:46 PM] Dr. Venkat Joshi UK: 

मनो कालुष्यं रजो गुणेन....देहे पित्तेन...

सत्वं सद्य चित्त विकाशकं

तनुते धत्ते...प्रबोधं परं

[8/28, 11:47 PM] Dr. Venkat Joshi UK: 

That means if Kapha in body as clear or ap or jala bhuta...satwa gets clarity in pitta.

[8/28, 11:48 PM] Dr. Venkat Joshi UK: 

Kledaka kapha is priority for the pitta function next 

Otherwise pitta get vitiated and thus Agni.

[8/28, 11:53 PM] Raghuram Dr Banguluru: 

Totally agree sir...

Indigestion, ama formation, gastrointestinal disturbances...for all of these there is a mind component contributing.... 

I would put it this way....

Prajgnaparadha ➡ erroneous food selection (viruddha ahara etc) ➡ indigestion ➡ ama ➡ Sama doshas, Sama dushyas, ama Visha ➡ Sroto dushti ➡ Vyadhi utpatti

Irshya, bhaya, krodha etc mind components directly impact the Agni and cause agnimandhya (Agni vikriti) and subsequent formation of ama. Ex, shokatisara.

[8/29, 8:17 AM] Anupma Patra AIMS AYU:

 🙏🙏🙏

सर् त्वक, मांस, रक्त को आधार करके फैलना मतलब ये धातुएं जहां भी हैं वहां विसर्प फैल सकता है। सर्वत विसरण भी येही दर्शाता है। और बीमारि के वर्णन में जो अमाशय ,पक्वाशय, श्लेष्माशय आदि का involve होना बताया गया है वो सीधा सीधा रिफरेन्स है।

और एक शास्त्र को समझने की इनडाइरेक्ट तरीका है जो मैं अक्सर आज़माती हूँ। जिसको प्रतिलोम तरीका कह सकते हैं। मेरे समझसे आयुर्वेद एक सम्पूर्ण शास्त्र है ,अतः कोई भी ऐसे विमारि नहीं है जो आयुर्वेद में वर्णित न हो (कुछ छोटे मोटे प्रारंभिक अवस्था को छोड़कर)।इसीलिए मैं हर बीमारी को शास्त्र के अंदर ढूंढती हूँ। अगर अभ्यंतर विसर्प को consider नहीं करेंगे तो बहुत सारे बोडे बोडे विमारि छूट जाएंगे। जैसे राधेश्याम सोनी सर् सिंघल डिजीज के बारेमें बताये थे।intestinal cancer, fungal infection आदि जो पिछले discussion में आया था।

आप के लास्ट लाइन ही आयुर्वेद को समझने में परेशानी का मुख्य कारण है।😊

आयुर्वेद को कोई विद्वान, कोई ऋषि, कोई देवता सृष्टि नहीं किये हैं ,न जोड़े हैं। वो ज्ञान तो ब्रम्हा सृष्ट सास्वत ज्ञान है जिसको वास् बिभिन्न माध्यम से नीचे लाया गया है। 

मैं तो हिस्ट्री से येही समझी हूँ।

अतः जिसने सारा ब्रम्हांड को सृस्टि किया हो वो अभ्यंतर विद्रधि को कैसे जाने ये सवाल ही नहीं उठ रही है।

🙏🙏🙏

[8/29, 11:28 PM] Dr Surendra A Soni: 

वातपित्तं प्रकुपितमतिमात्रं स्वहेतुभिः ।

परस्परं लब्धबलं दहद्गात्रं विसर्पति ॥३५॥

तदुपतापादातुरः

 *सर्वशरीरमङ्गारैरिवाकीर्यमाणं मन्यते,*

 छर्द्यतीसारमूर्च्छादाहमोहज्वरतमकारोचकास्थिसन्धिभेदतृष्णाविपाकाङ्गभेदादिभिश्चाभिभूयते, यं यं चावकाशं विसर्पोऽनुसर्पति सोऽवकाशः शान्ताङ्गारप्रकाशोऽतिरक्तो वा भवति, 

अग्निदग्धप्रकारैश्च स्फोटैरुपचीयते, 

*स*

👇

 *शीघ्रगत्वादाश्वेव*

👇

 *मर्मानुसारी भवति,*

👇

*मर्मणि चोपतप्ते* *पवनोऽतिबलो*

👇

 *भिनत्त्यङ्गान्यतिमात्रं* *प्रमोहयति सञ्ज्ञां,*(CNS)

 *हिक्काश्वासौ जनयति,*(RS)

 नाशयति निद्रां,

 स नष्टनिद्रः 

*प्रमूढसञ्ज्ञो* *व्यथितचेता*(CNS)

 न क्वचन सुखमुपलभते, अरतिपरीतः स्थानादासनाच्छय्यां क्रान्तुमिच्छति, क्लिष्टभूयिष्ठश्चाशु निद्रां भजति, दुर्बलो दुःखप्रबोधश्च भवति;

Agni visarp

*Description of involvement of Marma because of pathology, not because of extension of superficial visible lesions in marma pradesh, why because of no twacha in internal organs.* 

*Remember 'shadang sharir concept' for reference that you shared.*

Anupama ji !

[8/29, 11:39 PM] Anupma Patra AIMS AYU: 

Sir reference of this shlok please?🙏

[8/29, 11:39 PM] Dr Surendra A Soni: 

Ch chi 21

[8/30, 7:54 AM] Anupma Patra AIMS AYU:

 Good morning sir  and everybody.🙏🙏🙏

Sir I am accepting that all systemic involvement is possible as a complications of these visarp but involvement of kostha is also possible as per shastra.

If we give a look to the general division of diseases(shakha,marmasthi sandhi and kostha), visarpa can occur both kostha and shakha . Kostha is nothing but the elementary canals . So no doubt should  raised regarding the involvement of internal organs.  I am giving another reference of Charak samhita.

Of course there are many reasons for raising doubts in Ayurveda but we have to clear them gradually through this discussion. 

If skin is creating problem we should think more about it. In a previous discussion also perhaps we had reached about the mere conclusion that rohini and maamsadhara may come under internal mucosa(not confirm) I will think about it again.

🙏🙏🙏

[8/30, 7:56 AM] Anupma Patra AIMS AYU: 

The last line is clearly saying about kosthavat chikisa.

[8/30, 8:01 AM] Dr Shashi Jindal, Chandigarh: 

madam concept of internal visarp can be cleared till sharir rachna people donot clear it that we can consider epithelial mucous membranes as internal tvacha.

[8/30, 8:18 AM] Anupma Patra AIMS AYU: 

Yes madam. 

सोच रही हूं त्वक की समाधान की समय भी आ गयी है।😊

Requesting to the interested faculties to  post the  references regarding basics of twak by Charak and Sushrut sanhita.🙏🙏

[8/30, 9:19 AM] pawan madan Dr: 

Agni visarpa presentation is quite clear with your description also.

The other question was regarding other two types in which it has been said to spread to aamaashya and kaphaashya.

Thanks sir.

[8/30, 10:09 AM] Dr Surendra A Soni: 

*As per your opinion, shwitra should also be a internal organ pathology because Rx also administered/used through koshtha....?*

*Naman hain aapko.*

🙏

Reread the illustrated shloka.

Dr Anupama ji !

[8/30, 10:11 AM] pawan madan Dr: 

Ji sir..

I agreed only on the treatment part yet.

Yet I am searching for evidence of the existence of Visarpa internally.

[8/30, 10:32 AM] Anupma Patra AIMS AYU: 

"दोषे कोष्ठ गते भूयात एतत कुर्यात चिकित्सितम"

Kindly explain the meaning of this shlok.

[8/30, 10:40 AM] Dr Surendra A Soni: 

Remember the causes that inspire doshas to go to koshtha leaving the shakha.

If you don't understand sanskrit then decisive statement should be given cautiously.

[8/30, 1:50 PM] Anupma Patra AIMS AYU: 

Sir as per the basic division of diseases  as per text  (shakha,marmasthisandhi and kostha) it is sufficient to draw conclusion that visarpa can occur in kostha also.

There is no role of sanskrit knowledge to understand this division. We all  know, skin may not be  come under kostha.

I think there is no need of prove also for this. Being ayurved people, aaptopadesh is our basic knowledge. We should follow this.

I am not creating any confusion. Even katoch sir also agree with internal involvement.

Pawan sir also trying to collect the reference for internal involvement. Other many members also agree with the involvement of internal structure  in visarp.

🙏🙏🙏

[8/31, 8:57 PM] Dr Surendra A Soni: 

दोषे कोष्ठगते भूय एतत् कुर्याच्चिकित्सितम् ।

This was the point posted by you in favour of aabhyantar visarp, where I had to interfere. 

It has no connection with pathogenesis. 

You are always welcome with hard, harder tough language at the point of discussion.

Regarding other facts I shall post later.

I still didn't reply in context to koshtha.

🙏

🙏🙏

[8/31, 9:50 PM] Dr Surendra A Soni: 

Initial question raised by pawan sir about involvement of marma that I tried to clarify.

I did not deny/ denying the reference of charak quoted by you.

विसर्पश्वयथुगुल्मार्शोविद्रध्यादयः

These are mentioned to occur in shakha as well as koshtha.

Out of mentioned 5, visarp are described minimal in comparison to remaining 4 as per symptomatology, classification, prognosis and management etc. 

Only granthi visarp description contains aabhyantar word in context to granthi with description of dushya ras, rakta and mansa. As per classical reference it is ok but it extends from shakha to koshtha not vise versa. First site of pathogenesis is shakha that extends to koshtha and later on involvement of marma in fully blown/advance condition.

🙏

[8/31, 10:23 PM] Anupma Patra AIMS AYU: 

जी नही सर्, मनमें कोई क्रोध नहीं है, आपके कारण ही तो दिल खोलके कम से कम कुछ बोल पा रही हुँ।😌 

वास् थोड़ा मौन रहने की प्रयास कर रही थी😀😀🙏🙏

[8/31, 10:36 PM] Dr Surendra A Soni: Baba ramdev ji ki tarah aapko bhi aaveg aa gaya lagata hai....

😊😀

[8/31, 10:43 PM] Anupma Patra AIMS AYU: 

Sir we cannot say that it only spread from sakha to kostha but I think vise versa or only involvement of kostha also may be possible . Percentage may be less.Actually these are  serious problem  and hardly such patient  come to us .

[8/31, 11:07 PM] Anupma Patra AIMS AYU: 

Sir as per the available hindi vyakhyaa, here there is mention of treatment for kostha gat visarp so it also  may be considered as  indirect prove for existence of kosthagat visarp.🙏🙏

[8/31, 11:08 PM] Dr Surendra A Soni: 

You are misinterpretating.

Please review...

[8/31, 11:15 PM] pawan madan Dr: 

In this both Vijayrakshit and Vaidya Vachaspati jas interpreted गम्भीर पाक as Antarpaaka.

Need to discuss this also...

🙏

[8/31, 11:15 PM] pawan madan Dr:

 In this both Vijayrakshit and Vaidya Vachaspati jas interpreted गम्भीर पाक as Antarpaaka.

Need to discuss this also...

🙏

[8/31, 11:20 PM] Dr Surendra A Soni: 

Visarp pathology....

First as per shad-kriya kal...

Definitely starting with koshtha except (kshataja visarp...)

Koshthastha symptoms would be there but not as per skin manifestation....

Vyakti avastha- clear shakhastha signs and symptoms.

Now you and pawan ji trying to prove that similar skin lesions are also involves koshtha that is not there, visarpan or spreading will be only on skin. In advance or granthi or with pradhanik hetu like condition it will involve the deeper tissue and this may be taken as koshtha involvement.

Doshas always aggregate from koshtha. No one refuses it the difference is only on skin manifestation.

[8/31, 11:22 PM] Anupma Patra AIMS AYU: 

Sir I think similar description also available in charak samhita.

सर् ऐसा नहीं है 😭में निस्पक्ष मत देती हुँ। काल ही आचार्य वाग्भट्ट के प्रसंसा की थी। कर्ण स्राव के पांच भेद को लेकर।

यद्यपि सुश्रुत में पांच प्रकारके कर्ण स्राव का चिकित्सा वर्णन है पर भेद सिर्फ एक गिना गया है।ऐसे में उनको गलत नहीं बलूंगी।

☺🙏🙏

[8/31, 11:28 PM] pawan madan Dr: 

Sir

I am not trying to prove but trying to explore and find out..

Because in Kardam visarpa ..abhyaantar involvement has been mentioned......and this type of involvement has not been said in any other twak vikaar in wbole of the kushtha chapter.

Yes you are right that internally the lesions may not be like external....and aachaaryas had no means to see this onternally. They mentikned internal involvement only bu observing the symptoms whicb may have bewn originated from the deformity in internal organs in severe cases of visarpa. They didnt actually know what kind of internal deformity this was...but they accepted the internal organs involvement in Visarpa but not in kshudra kushtha or in mahakushtha.

That is it.

🙏🙏😊

[8/31, 11:57 PM] Dr Surendra A Soni: 

Cardinal feature always starts superficially later it spread deeper, this may be conclusion.

Regarding *kardam visarp*, both kapha and pitta are drava dhatu sited at aamashay hence area is mentioned as per my understanding. Possibility of lesions at stomach area can not be denied in form of external sinus opening in peritoneum and stomach in chronic condition. Sushruta has mentioned visarp and nadi chikitsa together.

🙏

[9/1, 12:11 AM] Dr Surendra A Soni: 

Yes

Well said...

If you review other 4 gulm shotha arsh and vidradhi; mentioned in koshtha shakha, visarp has minimum description. That I mentioned in my previous post. 

This is well fit in definition of utran and gambheer.

Thanks Sir for very good discussion.

🙏

[9/1, 12:11 AM] Dr Surendra A Soni: 👍👍

[9/1, 5:11 AM] Dr Shashi Jindal, Chandigarh: 

🙏sir shad vidh krya kaal and internal visarp  how both r linked ?

[9/1, 5:26 AM] Dr Shashi Jindal, Chandigarh: 

shad-vidh krya kal is general doshaj pathophysiology of every disease. Whereas visarp is a disease accompanied by acute inflamatory pathology of integuments.

[9/1, 5:35 AM] Dr Shashi Jindal, Chandigarh: 

Science, Tech, Math › Science

Epithelial Tissue: Function and Cell Types

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 A colored scanning electron micrograph of a section through the wall of the trachea (wind pipe) shows ciliated epithelial cells. Steve Gschmeissner / Science Photo Library / Getty Images

by Regina Bailey

Updated April 15, 2018

The word tissue is derived from a Latin word meaning to "weave." Cells that make up tissues are sometimes "woven" together with extracellular fibers. Likewise, a tissue can sometimes be held together by a sticky substance that coats its cells. There are four main categories of tissues: epithelial, connective, muscle and nervous. Let's take a look at epithelial tissue.

Epithelial Tissue FunctionEpithelial tissue covers the outside of the body and lines organs, vessels (blood and lymph), and cavities. Epithelial cells form the thin layer of cells known as the endothelium, which is continuous with the inner tissue lining of organs such as the brain, lungs, skin, and heart. The free surface of epithelial tissue is usually exposed to fluid or the air, while the bottom surface is attached to a basement membrane.

copied from google.

Epithelial tissue is a sheet of cells that covers a body surface or lines a body cavity. Two forms occur in the human body: Covering and lining epithelium– forms the outer layer of the skin; lines open cavities of the digestive and respiratory systems; covers the walls of organs of the closed ventral body cavity.

[9/1, 7:48 AM] Dr Shashi Jindal, Chandigarh: 

sir visarp is type of shoth, as described in trishothey adhayay of charak.

[9/1, 7:55 AM] Anupma Patra AIMS AYU: 

Sir minimum description of internal involvement are available for  other four diseases also.

It is not a criteria to rule out it's internal involvement visarp.

Uttan and gambhir term in mentioned for vaat rakt . If it was for visarp also then it might have described there. We have no capacity to add single sentence in samhita.

jo  galti acharya Vagbhatt ne kiye the aaj 1500 saal baad ishwar kisike maadhyam se uska khulasa karwa rahe hein. Sacchai kabhi chupti nahin hai. Isiliye behtar hoga  samhita mein jaisa kaha gaya hai usko waise hi samajhne ki kaushish kiya jaaye.

You have welcome every types of talk during discussion so I am telling the truth .

🙏🙏🙏

[9/1, 8:09 AM] Anupma Patra AIMS AYU: 

Madam lots of disease has been described under tri sothiya  adhyay but detail description about the individual also available as a separate disease. So  if we will go through its elaborated form, it will be better to find out specific solution for it. That's why it has been described in sutra sthaan.  🙏🙏

[9/1, 8:14 AM] pawan madan Dr: 

In Kardam visarp the word....Aamashya has been t3xted and in Granthi Visarpa the word....Kaphaashya has been texted.

Chakrapaani doesnt sau anything about this.

I think....as per the context....we should take these as surface landmarks.......with accepting that the Visarpa has systemic symptoms also...

[9/1, 8:19 AM] Dr Giriraj Sharma: 

विसर्प के दुष्य शरीर मे जहां भी अवस्थित है अगर वो दूषित हो रहे है तो विसर्प सर्व शरीरगत हो ही जाना है ,,, मांस , लसिका , रक्त , एवम त्वचा ,,,,  

त्वचा बाह्य आवरण माने पर मांस से तो अन्तःअंग प्रत्यंग

 बने है आयुर्वेद मतानुसार भी 

लसिका त्वग माँसाभ्यांतर होती है ,,,

रक्त सर्वगत है ,,,, 

अतः विसर्प प्रारम्भिक अवस्था मे बाह्य होता हुआ अन्तः दुष्य को भी दूषित करता है ।

चिकित्सक की अपनी समझ है वह इसे बाह्य मॉनकर चिकित्सा करते है या अन्तः,,,,

महत्वपूर्ण है साम्यावस्था,,,

🙏🏻🙏🏻🙏🏻🌹🙏🏻🙏🏻

[9/1, 8:20 AM] pawan madan Dr: 🙏

[9/1, 8:20 AM] Dr Shashi Jindal, Chandigarh: 

👍🙏sir you are right actual confusion is due to 7,  3 v p k, 4 rkt lasika tvacha and mans. Tvach is confising, because as pr text we can not include mucous membrane as tvacha.🙏

[9/1, 8:21 AM] pawan madan Dr:

 We can perhaps take the Kaphaashya here the upper part of the body which is the sthaan of kapha in general....

As we can fing such granthi visarp or painfull reddish glandular swellings in the this part of the body in gemeral..

🤔

[9/1, 8:30 AM] Anupma Patra AIMS AYU: 

Ji madam ,twak hi yahaan confusion paida kar rahi hai. Pehle to humein ispe nischint rahni hai ki abhyantar visarp sambhav hai wo sidhe ho ya baad mein aaya ho. 

Ho sakta hai ye humein twak ke baare mein asli samajh tak le jaaye.🤔

[9/1, 8:33 AM] Anupma Patra AIMS AYU: 

Sir jyada andar jaayenge to bhawantar ke andar ghus jaayenge, jisse nikalna mushkil hoga, pehle superficially samajh lein😀😀

[9/1, 8:39 AM] Dr Shashi Jindal, Chandigarh: 

sir to see these we have to see all endoscopy reports, from simple gastritis to other acute or chronoic APD cases.

[9/1, 8:56 AM] Anupma Patra AIMS AYU: 

Sir 1948 ka Alma ata declaration to fail ho gaya ab 2018 ka WHO ka jo theme hai" Universal health coverage",usko kam se kam saphal karaane mein hum bharpur yog daan dein. Kyun ki bina aayurved kuch bhi sambhav nahin hai.

Hum jyada yogdaan tab de paayenge jab ayurved ki asli taakat ko samjhenge.

Mujhe to humaare selection system, govt  employee ke laayak nahin samjha. Private waale to apne business mein lage huye hein ,isliye aayurved ki is chupe huye taakat ki mein khulasa sabke saamne jarurat padne par karti rahti hun. Taaki hum samaaj ke  need ko poora kar paayein.  Jis ki bharpoor taakat ayurved ke andar hai. Mein ye nahin kah rahi hun ayurved ke upar sirf mera hi viswaas hai par jo viswaas  honi chaahiye usse kam avasya hai. 

Nahin to Mananiya Subhash sir ye nahin kahte ki no science is complete, ya phir Pawan madan sir abhyantar visarp  ko dekhne ki saadhan ko lekar aise vaktavya nahin dete.

Mera kisiko hurt karne ka intention nahin hai par apna laksha saadhan hetu karna pad raha hai.

😌🙏🙏🙏

[9/1, 9:07 AM] Dr Shashi Jindal, Chandigarh: 

sir how aacharyas saw internal visarp; hypothetically they may have had disections of animals,dog cats etc., because so much elaborated symptoms of granthi or kardam visarp can not be only anuman janya.

[9/1, 9:14 AM] Dr Surendra A Soni:

 अत ऊर्ध्वं व्याधेर्दर्शनं वक्ष्यामः- शोफार्बुदग्रन्थिविद्रधि *विसर्प* प्रभृतीनां प्रव्यक्तलक्षणता ज्वरातीसारप्रभृतीनां च । तत्र पञ्चमः क्रियाकालः ।।३४।।

Dr. Shashi ji !

[9/1, 9:15 AM] pawan madan Dr: 

🙏🙏

[9/1, 9:18 AM] Dr Surendra A Soni:

 Shlemasthan too....🙏

Pawan sir !

[9/1, 9:20 AM] Dr Shashi Jindal, Chandigarh: 

👌🙏🙏

[9/1, 10:02 AM] Dr Surendra A Soni:

Dr. Shashi

 Then we shall have to take vaginal candidiasis, UTI, cystitis etc all modern mucosal pathologies as visarp ignoring the sroto/dhatudushti.

Bhadresh ji is revealing the diagnosis as per modern extended pratyaksh. Illustrated case/fungal infection may be taken as vyadhi kshamata karmahani/aagneya guna hani/kheda vriddhi because of saam pitta or shleshma. 

Ayu. Diagnosis might be formed as per clinical presentation. 

Probably this involved the marma so quickly that patient died. 

This is really great contribution of modern science that they introduced us viral, fungal, vascular, lymphatic etc pathology.

[9/1, 10:08 AM] Dr Surendra A Soni: 

Dr Anupama ji 

Please compile all and corelate.

Don't be sentimental....

All pathologies arise from koshtha except Aagantuja. 

Description of classification is based on site of pathology either it is koshthastha, shakhastha or marmatha or in 2 or in all 3 rogamarga. These all are mentioned to plan management strategy accurately.

[9/1, 10:09 AM] pawan madan Dr: 

May be..

I am discussing based on the available text symptoms..

[9/1, 10:12 AM] Dr Shashi Jindal, Chandigarh: 

sir visarp is different from shoth ch sut, shof ch chikitsa, visarp is a full chapter . It is very acute condition. 

******************************************************

Above discussion held on 'Kaysampraday" a Famous WhatsApp-discussion-group  of  well known Vaidyas from all over the India. 

Compiled & edited by

Dr.Surendra A. Soni

M.D.,PhD (KC)

Associate Professor

Dept. of Kaya-chikitsa

Govt. Ayurveda College

Vadodara Gujarat, India.

Email: surendraasoni@gmail.com

Mobile No. +91 9408441150