Case-presentation: Ayurvedic management of 'Masurika' (Chickenpox)- A Case Series

 

Ayurvedic Management of Masurika(Chickenpox)-A Case Series

 

Case no. 1

A Male Patient of age 30 years, developed chickenpox around 28-29 april, 2026 which was associated with persistent high-grade fever for 10–12 days. The fever was continuous, with temperatures ranging between 100–102°F, rising up to 104°F during the night. Multiple vesicular skin eruptions appeared over the body during this period. This 'Jwar-pattern' called is 'Santat-jwar' by 'Punarvasu-atreya Maharshi in Charak-samhita, Jwar-chapter. 

During the acute illness, the patient experienced a marked loss of appetite, generalized weakness, and progressive weight loss of approximately 5–6 kg during the period of  1–1.5 months, that remained nearly 35 kg. Although the fever and skin eruptions resolved, the patient continued to have poor appetite, sticky (Aam-yukta) stools, weakness, and incomplete recovery of body weight, for which he sought Ayurvedic consultation.

 

History of Present Illness

The patient was apparently healthy until 2.5 years ago, when he developed recurrent episodes of blood- and mucus-mixed stools associated with abdominal discomfort. Colonoscopic evaluation was performed, and he was diagnosed with Amoebic Colitis. Before this course of the illness, he also experienced anal fissure with burning sensation on-off due to constipation and uneven lifestyle routine. The patient subsequently underwent treatment at P. G. Department of Kayachikitsa, Government Akhandanand Ayurved College & Hospital, Ahmedabad, following which his symptoms gradually resolved. His bowel habits returned to normal, his appetite improved, and he remained symptom-free for a considerable period.

 

Past History

Diagnosed with Amoebic Colitis 2.5 years ago.

Treated successfully at P.G. Department of Kayachikitsa, Government Akhandanand Ayurved College & Hospital, Ahmedabad, with complete symptomatic improvement.

 

Personal History

Appetite: Reduced (improved after treatment but not completely normal)

Diet: Vegitarian

Bowel: 1–2 motions/day; stools sticky (Aam-yukta)

Sleep: Disturbed due to late-night working habit 

Addiction: No any

Weight History

Weight during illness: ~35 kg

Weight regained after treatment: 5–6 kg

Present weight: 39–40 kg

 

 

Before/On starting

 

 

After/On starting Ayurved Treatment

 

 

 

  

 

 

 

Case No. 2

An unmarried male, the younger brother of the case no.1, was apparently healthy until he came into close household contact with his elder brother, who was suffering from chickenpox. During his brother's illness, he remained in close proximity while caring for him, including frequently monitoring his body temperature and doing his care. A few days after this exposure, he developed fever, generalized weakness, and subsequently multiple vesicular eruptions over the body, following which he was clinically diagnosed with chickenpox.

Treatment

The patient took symptomatic allopathic drugs as self-medication for 1 day by which his fever reduced but other complains kept increasing itching, burning, spreading of skin lesions. After that he received Ayurvedic treatment telephonically, following which his fever subsided, vesicular eruptions healed completely, and generalized weakness gradually improved, resulting in complete clinical recovery.

Before/On starting

 

 

  

 

After Ayurved Treatment

 

 

 

 

 

 

Nidana (Etiological Factors)

कट्वम्ललवणक्षारविरुद्धाध्यशनाशनैः ।
दुष्टनिष्पावशाकाद्यैः प्रदुष्टपवनोदकैः ॥१॥
क्रूरग्रहेक्षणाच्चापि देशे दोषाः समुद्धताः ।
जनयन्ति शरीरेऽस्मिन् दुष्टरक्तेन सङ्गताः ॥२॥

(Madhava Nidana 54/1–2)

Purvarupa of Masurika 

तासां पूर्वं ज्वरः कण्डूर्गात्रभङ्गोऽरतिर्भ्रमः ।
त्वचि शोथः सवैवर्ण्यो नेत्ररागश्च जायते ॥

(Madhava Nidana 54/3–4)

Ayurvedic Purvarupa	Modern Correlation (Prodromal phase of Chickenpox/Varicella)
ज्वर (Jwara):	Low- to high-grade fever occurring 1–2 days before rash due to cytokine release (IL-1, IL-6, TNF-α).
कण्डू (Kandu):	Early cutaneous irritation before or during the appearance of vesicles.
गात्रभङ्ग (Gatrabhanga):	Myalgia and malaise due to systemic viral infection.
अरति (Arati):	General malaise, fatigue, reduced activity.
भ्रम (Bhrama):	Weakness and dizziness associated with fever and dehydration.
त्वचि शोथ (Twachi Shotha):	Early inflammatory changes in the skin before vesicle formation.
सवैवर्ण्य (Savaivarnya):	Erythematous macules preceding vesicles.
नेत्रराग (Netraraga):	Conjunctival congestion occasionally seen during the prodromal phase.

 Lakshana of Masurika

दाहज्वररुजावन्तस्ताम्राः स्फोटाः सपीतकाः ।
गात्रेषु वदने चान्तर्विज्ञेयास्ता मसूरिकाः ॥३८॥ (Sushrut Nidan-13/38)

Classical Lakṣaṇa (Ayurveda)	Modern Correlation (Chickenpox/Varicella)

दाह (Daha)

Burning sensation due to inflammation of vesicular skin lesions.

ज्वर (Jwara)

Moderate to high-grade fever caused by viremia and inflammatory cytokine release (IL-1, IL-6, TNF-α).

रुजा (Ruja)

Painful skin lesions with generalized myalgia and malaise during acute viral infection.

ताम्राः स्फोटाः (Tamra Sphoṭa)

Erythematous macules and papules progressing to clear vesicles on an erythematous base ("dew drop on a rose petal").

सपीतकाः (Sa-pitakaḥ)

Vesicles become cloudy or yellowish due to inflammatory exudate before crusting.

गात्रेषु (Gatreṣu)

Generalized vesicular eruption involving the trunk, extremities and scalp (centripetal distribution).

वदने (Vadane)

Facial involvement with vesicular lesions is commonly seen.

Samprapti(Pathogenesisi)

Nidan Sevana

 

याः सर्वगात्रेषु मसूरमात्रा मसूरिकाः पित्तकफात् प्रदिष्टाः।

(Pitta and Kapha become aggravated because of Nidana)

 

Jatharagni Mandya

(Aggravated Doshas impair Jatharagni)

 

Ama Nirmiti

(Improper digestion results in Ama formation)

 

Ama associates with Pitta and Kapha

(The circulating Ama further vitiates Pitta and Kapha)

 

Rasa Dhatu Dushti

(The first affected Dhatu is Rasa, resulting in improper nourishment and circulation.)

 

Rasa Dhatvagnimandya

(Defective metabolism of Rasa leads to poor formation of subsequent Dhatus.)

 

Rakta Dushti

पित्तं शोणितसंसृष्टं यदा दूषयति त्वचम्।(Sushruta Commentary)

(Pitta combines with Rakta and vitiates it.)

 

Pitta-Rakta Sammurchana

(Pitta and Rakta together become excessively Ushna, Drava and Tikshna.)

 

Rasavaha & Raktavaha Srotodushti

Predominantly Sanga, Prasara,Vimargagamana

 

Dosha Prasara through Rasayani

The vitiated Doshas spread throughout the body via circulation.

 

Sthanasamshraya in Twak, Rakta and Lasika

The Doshas localize in Twak, Rakta, and Lasika, which become the principal Adhisthana.

 

Twak Dushti

तदा करोति पिडकाः सर्वगात्रेषु देहिनाम्।

⬇

Pidaka Utpatti : मसूरमुद्गमाषाणां तुल्या (Masura-shaped vesicles develop)

Samprapti Ghataka

Dosha:	Pitta-Kapha Pradhana
Dushya:	Rakta, Rasa, Twak, Lasika, Mamsa
Agni:	Jatharagni Manda
Ama:	Saama
Srotas:	Rasavaha, Raktavaha, Swedavaha
Srotodushti:	Sanga, Vimargagamana
Udbhava Sthana:	Amashaya
Sanchara:	Rasayani
Vyaktisthana:	Twak (whole body)
Adhisthana:	Shareer-manas
Roga Marga:	Bahya
Roga Swabhava	Ashukari, Upasargaja/Aupasargika

     Sadhyasadhyata:       Sadhya 

 

 

Kriyakala

 

Sanchaya

Pitta-Kapha accumulation due to Nidana

 

Prakopa

Pitta-Kapha aggravated

 

Prasara

Spread through Rasa & Rakta

 

Sthanasamshraya

Twak, Rakta, Lasika

 

Vyakti

Masurika (fever + vesicles)

 

Bheda

Karshya, Daurbalya, secondary infection, post-viral complications (that was prevented with proper management as patient was very sincere  & obedient)

  

Comparative Pathogenesis/Samprapti

 

Ayurvedic Samprapti (Masurika)	Modern Pathophysiology (Chickenpox/Varicella)
Nidana Sevana (Katu, Amla, Lavana, Kshara, Viruddhahara, Dushta Anna, Dushta Jala, Dushta Vayu, Upasargaja Hetu)	Exposure to Varicella-Zoster Virus (VZV) through respiratory droplets or direct contact with vesicular fluid.
⬇	⬇
Pitta-Kapha Prakopa (याः सर्वगात्रेषु मसूरमात्रा मसूरिकाः पित्तकफात् प्रदिष्टाः)	Initial viral replication in the nasopharyngeal mucosa with activation of innate immune responses.
⬇	⬇
Jatharagni Mandya	Early systemic viral infection causing cytokine-mediated metabolic disturbance and anorexia.
⬇	⬇
Ama Nirmiti	Release of inflammatory mediators (IL-1, IL-6, TNF-α, IFN-γ) causing systemic inflammatory response.
⬇	⬇
Rasa Dhatu Dushti	Primary viremia with viral dissemination through blood and lymphatics.
⬇	⬇
Rasa Dhatvagni Mandya	Viral multiplication in the reticuloendothelial system (lymph nodes, liver and spleen).
⬇	⬇
Rakta Dushti (पित्तं शोणितसंसृष्टं यदा दूषयति त्वचम्)	Secondary viremia leading to widespread dissemination of VZV.
⬇	⬇
Pitta-Rakta Sammurchana	Systemic inflammatory response with vascular involvement.
⬇	⬇
Rasavaha & Raktavaha Srotodushti (Sanga, Prasara, Vimargagamana)	Hematogenous spread of the virus to skin and mucous membranes.
⬇	⬇
Twak, Rakta & Lasika Sthanasamshraya	Viral invasion of epidermal keratinocytes and dermal capillary endothelium.
⬇	⬇
Twak Dushti	Ballooning degeneration of epidermal cells and intercellular edema.
⬇	⬇
Masura-akriti Pidaka Utpatti (मसूराकृतिसंस्थानाः पिडकाः)	Formation of characteristic erythematous macules, papules and clear vesicles ("dew-drop on a rose petal").
⬇	⬇
Jwara, Daha, Ruja, Kandu, Tamra-Peeta Sphota	Fever, malaise, pruritus, vesicular rash and cutaneous inflammation.
⬇	⬇
Jwara → Agnimandya → Aruchi → Alpashana (Case-1)	Prolonged fever leading to anorexia and reduced caloric intake.
⬇	⬇
Rasa Kshaya → Mamsa Kshaya → Karshya → Bala Kshaya	Hypermetabolic state, protein catabolism, muscle wasting, weight loss and generalized weakness.
⬇	⬇
Residual Agnimandya & Ama (Aam-yukta Mala)	Post-viral weakness with transient gastrointestinal dysfunction and delayed nutritional recovery.

 

Treatment

1)Panchanimba Churna - 1 TSF-5gram with Mahamanjishthadi kwath BD

2)Mahamanjisthadi Kwatha 40ml Twice a day

3)Sanshamani Vati 4/4/4/4

4)Mahasudarshan Ghan Vati 2/2/2/2

5)Sarvatobhadra Vati 1/0/1

Pathya

It is key in 'Jwar-chikitsa'. Patient was advised to take complete indoor rest in cool environment with maintaining external hygiene. 

Draksha Siddha Jala, Mudga Yusha, Manda-Peya,Tikta Veg Soup(Bottle gourd (Lauki), Ridge gourd (Turai), Ash gourd (Kushmanda), Coriander (Hara Dhaniya)

Initially both patients were given 'Mand' & Draksha/munakka Sharbat (it was soaked in water for 4 hours & crushed / squeezed to obtained raw juice) whenever they felt mild appetite & thirst. later on after Mudga-yusha started as appetite increased.

 

Discussion

These 2 cases highlights the successful management of Masurika (Chickenpox) with a Samprapti-based Ayurvedic approach. The treatment protocol comprising Panchanimba Churna, Mahamanjishthadi Kwatha, Sanshamani Vati, Mahasudarshan Ghan Vati, and Sarvatobhadra Vati was planned to address the underlying Pitta-Kapha-Rakta pathology described in the Ayurvedic classics.

Panchanimba Churna, owing to its Tikta-Kashaya Rasa, Sheeta Virya, Pitta-Kapha Shamaka, Rakta Prasadana, Kandughna, and Kushthaghna properties, helped in reducing cutaneous inflammation and promoting healing of the vesicular eruptions.

Mahamanjishthadi Kwatha was selected for its Rakta Shodhana, Rakta Prasadana, and Pitta Shamaka actions, while its Virechana effect facilitated the elimination of vitiated Pitta, reduced cutaneous inflammation, and promoted faster resolution of skin lesions.

Sanshamani Vati (Guduchi Ghana) acted as a Jwaraghna, Rasayana, Tridosha Shamaka, and Deepana-Pachana formulation, thereby alleviating fever, restoring Agni, enhancing immune response, and preventing post-viral debility.

Mahasudarshan Ghan Vati, with its potent Jwaraghna, Deepana, Pachana, Amapachana, and Pitta-Kapha Shamana properties, effectively controlled fever and aided in the digestion of Ama generated during the acute phase of the disease.

Sarvatobhadra Vati was added to case no. 1 only after 7 days when this immune compromised patient had severe burning, vertigo, insomnia and excessive weakness as  it is containing Rajat & Swarn-makshik bhasma along with other ingredients, provided Jwaraghna, Dahaprashamana, and Pitta Shamaka effects, contributing to overall relief and recovery from the systemic manifestations of Masurika.

Following treatment, the patient showed gradual subsidence of fever, complete healing of the vesicular eruptions without secondary infection or other complications, improvement in appetite and general well-being, and complete clinical recovery.

This case demonstrates that an Ayurvedic treatment based on the classical understanding of Masurika and its Samprapti is effective in the management of uncomplicated chickenpox. 

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

Presented by

Dr. Shubham Tripathi
B.A.M.S.
MD IInd Yr. Scholar
P. G. Dept. of Kayachikitsa
Govt. Akhandanand Ayu. College,
Bhadra, Ahmedabad, Gujarat, India
Mob.- +91-6260097626

Guided by

Prof. Surendra A. Soni

M.D., Ph.D (Kayachikitsa)

H.O.D.

P.G. Dept. of Kayachikitsa

Govt. Akhandanand Ayurved College,

Bhadra, Ahmedabad, Gujarat, India.

email: kayachikitsagau@gmail.com