Psoriasis–clinical treatment results with Virechana

doi:10.15406/ijcam.2018.11.00385

International Journal of

eISSN: 2381-1803

Complementary & Alternative Medicine

Proceeding Volume 11 Issue 3

Psoriasis–clinical treatment results with Virechana

Manoj Virmani,¹

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Gopesh Virmani²

¹Physical Therapy and Occupational Therapy Department, S
²Professors at College of Ayurveda and Hospital, India

Correspondence: Manoj Virmani, Director & Chief Ayurveda Physician, Vaidya Ayurvedguru Pvt Ltd, Karnal, Haryana, India

Received: April 20, 2018 | Published: May 11, 2018

Citation: Virmani M, Virmani G. Psoriasis–clinical treatment results with Virechana. Int J Complement Alt Med. 2018;11(3):143-144. DOI: 10.15406/ijcam.2018.11.00385

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Proceeding

In ayurveda it is mainly correlated with three conditions of kushtha i.e. Mandal Kustha, Kitibh Kushtha and Eka Kushtha. Psoriasis is chronic inflammatory disease of skin, characterized by well defined erythematous sharply demarcated papules and round plaques covered by silvery micaceous scales variably pyruritic and typical extensor distribution.

Modern medicine rely on cyclosporine A, coal tar, PUVA, Retinoid, Methotraxate, Corticosteroids and Vit D. this conventional treatment shows effective results in management of Psoriasis, but can show serious side effects specially in long use. Thus, chronic and recurring nature of the disease needs proper and adequate treatment or solution. The shodhana therapy (Panchkarma) at regular interval plays very important role along with shaman (balance vitiated dosha with medicinal treatment) followed by Pathya (Do’s and Don’ts of Diet).

Selection of Ghrita and drugs for virechana

Virechana (Drug induced purgation)
Panchtikta ghrita (for internal oleation)
Psoramet oil (for external oleation)
Kushtaghan herbs (for swedan)
Ichhabhedi ras and castor oil
Cow milk.

Inclusion criteria

Patients of both sex, ageing between 18–65years with complaint of raised, inflamed, grayish scales or plaques covering area of body like head, knees, ankle and back, abdomen, buttocks, or entire body surface with itching, burning sensation, dryness, watery or blood stained discharge from lesions, generalized weakness, heaviness, body ache. (Patients were diagnosed psoriasis from 3month to 15years period. Patients treated with conventional medicine, traditional medicines for long period)

Exclusion criteria

A patient who requires emergency treatment for disease like explorative condition, having cardiac, renal patients with unconfirmed diagnosis.

Laboratory parameters

Blood-Hb%
LFT
Vit D
TLC
KFT
DLC
Lipid profile

After complete examination and blood test at Vaidya Ayurved Guru Pvt Ltd, Karnal, Haryana, patients are advised for Deepana & pachana (Improve digestion) for one week or ten days with Ayurvedic medicine or fasting, patients were admitted for virechana.

Virechana

Virechana Therapy is a type of Panchkarma, patient is made to undergo controlled purgation to flush out body toxins like Liver toxins, colon toxins. Virechana is indicated in high pitta condition-like skin disorders, blister, abcess, Liver disorders etc.

Patient is now ready for Virechana panchkarma .The dose Panchtikta ghrita is now decided as per his/her following factor.

Prakruti-Basic constitution (Physical & Mental)
Vikruti-Imbalance of basic constitution
Saar-status, quality, quantity of tissues.
Sahaman-compactness of body
Pramana-Measurments of body parts (Normal/abnormal)
Satva-Mental strength, emotions, tolerance level.
Satmaya-compatibilities, wholesomeness
Ahara Shakti-Metabolism and digestive capacity
Vyayama Shakti-Exercise tolerance
Vaya-Age
Bala-Physical strength and immunity of patient.

Ghrit pana-(Internal oleation)

Early morning patient is given Panchtikta ghrit

DAY 1: 30-40ml
DAY 2: 60-80ml
DAY 3: 90-120ml
DAY 4: 120-160ml

Ghrita is given till proper oleation symptoms appear, it may take 3 to 7days. Next day’s dose is decided as per patients’ digestive power and above mentioned factors.

Abhyang swedan

After internal oleation, patient is given full body massage with Psoramet oil for 40-50minutes, than given medicated steam for 10-15minutes for 2 to 3days.

Main process-virechan

Early morning patient is given Abhyang, Swedan. After bath, patient is given medicine for purgation like ichhabhedi ras 2 to 3tablets with 50 to 70ml of castor oil mixed in 200ml luke warm milk. Now patient is advised to walk for 20minutes. Purgation starts after 30 to 60minutes depending upon patient’s digestion. Minimum vega were 6 and maximum vega 30. After every vega patient is given normal water. This controlled purgation is benificial to flush out body toxins like Liver toxins, colon toxins.

Effect of panchtikta Ghrita for snehana in virechana

The virechana performed by using Panchtikta Ghrita for snehana provide significant relief in scaling 93%, mandala 85%, kandu 92%, daha 84%, Aswednam 100%, Rookshta 100%. 20% patients got complete improvement, 60% marked improvement, 20% moderate improvement. Patients performed virechana for 3 to 6 time in total course of treatment.

Discussion

Irregular food habits, consumption of incompatible food like dairy products with fish or salt, excessive use of yogurt, paneer, black grams, seafood, sour and salty items etc can activate the aetiopathogenesis & produced toxins accumulate in deep tissues of rasa, rakta, mamsa and laseeka. Psoriasis occurs due to vitiation of vata, pitta and kapha. Vitiated vata causes pain, dryness & scaling. Vitialted Pitta leads to burning, redness, inflammation and due to Vitiated Kapha rashes, itching, discharge and thickening of skin happens. Psoriasis is raktaja disease with vitiated doshas as per ayurvedic text.

Virechana (controlled purgation) is used to flush out body toxins like Liver toxins, colon toxins. Virechana has 3 steps like Poorva karma (pre operative), Pradhan karma (operative) and paschat karma (post operative care). Virechana yields better results, if all these 3 steps are followed properly.

Preoperative

Deepana pachana with medicine like Tab liv safe 2BD, Avipatikar churana 1 tsp with warm water for 5 to 7days to increase digestive fire and digestion of Ama( undigested food particles).
Snehana with panchtikta ghrita in increasing dosage, is important for loosening the bond between toxin and dhatu, it acts in reverse order of pathogenesis of psoriasis. Snehana with panchtikta ghrita shows significant results then other snehas.

Operative

After giving 2days external snehan or oleation, patient is given proper virechana medicine 2 to 3tablets of ichhabhedi ras and 50 to 60ml castor oil with 200ml luke warm milk. Patient undergoes 6 to 30vegas (controlled purgation) as per his or her body strength and digestion. This procedure is done under the supervision of expert panchkarma doctor.

Post operative

After successful completion of major process, patient is advised to have bed rest for 2 to 3hours.

Patient feels very light, symptoms of psoriasis subsides.
Digestive power of patient gradually increases.
Patient is given green gram soup.
For 3 to 5days the diet of patient is monitored, in increasing order of nutritional value.
On 5^th day Patient is given his normal home diet.
Medicinal regimen is started.
Patient is advised to have virechana as advised by doctor at regular interval for full cure of psoriasis.

Conclusion

Virechana is better option for curative aspect as well as of preventive aspect for psoriasis. So persons with Rakta diseases, skin diseases, vitiated pitta diseases, Liver toxins, colon toxins and pitta prakruti persons are advised to have virechana regularly. In ayurveda classics, nitya rechana is advised to patients having less chronicity. Patients with chronic psoriasis advised to perform classical virechana for better results. The patients with positive family history of psoriasis must go for virechana to maintain homeostasis of doshas. If psoriasis patient undergo proper shodhana like vamana and virechana then genetic susceptibility may be prevented due to its purification action upto beej (gene) level. Virechana plays an important role in prevention and cure of psoriasis. It needs to be considered that virechana is not only complete treatment for psoriasis but regular diet precaution, nidan parimarjan (removal of cause), regular ayurvedic medicines along with other panchkarma process like vamana, nasya, basti and raktmokshan to be performed as required. Role of satva, mental strength, self confidence and faith on doctor and his treatment is very important in Psoriasis management.