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Table of Contents
CASE REPORTS
Year : 2022  |  Volume : 10  |  Issue : 2  |  Page : 146-149

Effect of Vamana Karma (therapeutic emesis) in Mukhadushika (acne vulgaris)—A case study


Department of Panchakarma, All India Institute of Ayurveda, New Delhi, India

Date of Submission09-Mar-2022
Date of Acceptance27-May-2022
Date of Web Publication28-Jun-2022

Correspondence Address:
Harshali A Shende
Department of Panchakarma, All India Institute of Ayurveda, New Delhi
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jism.jism_27_22

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  Abstract 

Acne vulgaris is a chronic skin disease that comes about mostly in adolescent. It is identified by both inflammatory (papules, pustules, and nodules) and noninflammatory (comedones, open and closed) lesions. In the Ayurvedic classics, Mukhadushika is mentioned under Kshudra Rogas, which is declared that it transpires in young age, and its signs and symptoms are similar to those of acne vulgaris. In the Ayurvedic classics, Mukhadushika is mentioned under Kshudra Rogas, which is stated that it occurs in young age and its manifestations are similar to those of acne vulgaris. In Ayurveda, it is mentioned that Mukhadushika occurs due to the vitiation of Vata, Kapha, and Rakta having the Shalmali thorn like thick or hard painful eruptions, which are impregnated with Meda. Vamana karma is indicated for the treatment of Mukhadushika. This is a single case study on the effective management of Mukhadushika. Treatments included are Deepana, Pachana with Chitrakadi Vati and Musta Choorna, Shodhananga Snehapana with Tiktak Ghrita and Vamana Karma (therapeutic emesis) with Madanphala Yoga. After the completion of Vamana Karma (therapeutic emesis), a significant relief in signs and symptoms of Mukhadushika was observed. On the account of result acquired, it can be deduced that Vamana Karma (therapeutic emesis) with Madanphala Yoga can be used as an effective treatment for Mukhadushika and improve the quality of life in the patients of Mukhadushika.

Keywords: Acne vulgaris, Mukhadushika, Vamana Karma


How to cite this article:
Shende HA, Bhatted SK. Effect of Vamana Karma (therapeutic emesis) in Mukhadushika (acne vulgaris)—A case study. J Indian Sys Medicine 2022;10:146-9

How to cite this URL:
Shende HA, Bhatted SK. Effect of Vamana Karma (therapeutic emesis) in Mukhadushika (acne vulgaris)—A case study. J Indian Sys Medicine [serial online] 2022 [cited 2022 Aug 13];10:146-9. Available from: https://www.joinsysmed.com/text.asp?2022/10/2/146/348474




  Introduction Top


Acne vulgaris is a disorder practice exclusively in juvenile and adolescent, although perhaps 10%–20% of adults may continue to affair the same form of diseases.[1] In Ayurveda, it is mentioned that Mukhadushika occurs due to the vitiation of Vata, Kapha, and Rakta having the Shalmali thorn like thick or hard painful eruptions, which are impregnated with Meda.[2] In Ayurveda, Vamana Karma (therapeutic emesis) is indicated for the treatment of Mukhadushika.[3] Everyone wants to have beautiful, clean, and attractive face. Even a fleck on the countenance especially of younger ones bothers them. “Mukhadushika” is one of the clinical conditions that disturbs physical and psychological states of youngsters. The prevalence rate of acne vulgaris is 80%–90% in adolescence. These skin lesions occur when there is a change in the skin cell units known as pilosebaceous units that contain sebaceous glands, a substance called sebum and a hair follicle. When dead skin builds up and clogs these units, a breakout or lesions are likely to occur. In Ayurveda, mainly two types of Chikitsa (treatments) have been used to treat Mukhadushika, i.e., Shodhana (the purification of body) and Shamana (conservative treatment by oral and topical medicines). In this case study, Mukhadushika (acne vulgaris) was successfully treated with Shodhana Chikitsa, particularly Vamana Karma (therapeutic emesis), followed by Shaman Chikitsa (oral medications). Vamana Karma is an elite course of action in the governance of Kaphaja disorders where Kapha is chief Dosha.[4]

Objective

The aim of this work was to study the effect of Ayurveda medicine in the case of Mukhadushika (acne vulgaris).


  Materials and Methods Top


A 24-year-old female forbearing visited the Panchakarma out-patient department at All India Institute of Ayurveda, New Delhi, with following complaints:

  • Pidika (papules) on face including Medogarbhata (filling material)


  • Todavata Peeda (pricking pain)


  • Daha (burning sensation)


  • Srava (discharge).


  • History of Past Illness

    There was no significant history.

    History of Present Illness

    The patient was asymptomatic 3 years back; since then she has been enduring from multiple papules, pustules with pain, prickling, and discharge. Simultaneously, she was also suffering from constipation and mental stress. She took allopathic medicines such as steroids for long time but did not found any significant result.

    Asthavidha Pariksha

  • Nadi: Vata-Pitta


  • Mutra: Prakrita


  • Mala: Sakathina Malapravrutti


  • Jivha: Saam


  • Shabda: Spashta


  • Sparsha: Ruksha


  • Drika: Prakrita


  • Akriti: Madhyama


  • Dashavidha Pariksha

  • Prakriti: Vata-Pitta


  • Vikruti: Pitta-Rakta


  • Saar: Raktasaar


  • Samhanana: Madhyama


  • Pramana: Madhyam


  • Satmya: Katu rasa satmya


  • Satva: Madhyama


  • Ahaarshakti: Madhyama


  • Vyayamshakti: Madhyama


  • Vaya: Yuva


  • Treatment Plan

    There were two phases of treatment.

    First phase (Samshodhana Chikitsa)

    The first phase included one of the Samshodhana Karmas (biopurification treatment), i.e., Vamana Karma (therapeutic emesis). Vamana is done by the classical methods as per Ayurveda.[5],[6]

    Madanphala Pippali was taken in Antaranakhamusthi Pramana by the patient’s own hand. It was then added in Yashtimadhu Kwatha and kept overnight (the previous night of Vamana Karma). In the morning time, it was stirred properly and filtered; then it was given to the patient in lukewarm state mixing with Madhu and Saindhava.[7]

    Second phase (Samshamana Chikitsa)

    After Shodhana, the second phase of treatment includes oral medication and Nidana Parivarjana (the avoidance of causative factor).

    The probable mode of action of Shamana Dravya is described in [Table 1].
    Table 1: Probable mode of action of Shamana Dravya

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    Assessment of the Patient

    In [Table 2] and [Table 3], the severity grade is calculated using the formula: Local score = factor multiply by grade (0–4). In this case report, the severity of disease = 25.
    Table 2: The Global Acne Grading System[8]

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    Table 3: Gradation of acne severity

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    Ayurvedic Assessment Scale[9]

    The scores of the Ayurvedic Assessment Scale are given in [Table 4], and the treatment timeline adopted is described in [Table 5].
    Table 4: Ayurvedic Assessment Scale[9]

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    Table 5: Treatment timeline

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      Observation and Result Top


    Pictures [Figure 1] before treatment (BT) that is before Vamana karma (therapeutic emesis) and after treatment (AT) that is after completion of Samsarjana Karma (diet regimen) is provided in the last of the article.
    Figure 1: Before treatment and after treatment (after Samsarjana Krama)

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      Discussion Top


    Mukhadushika (acne vulgaris) is the major face-paint-related diseases of younger age group, mainly 15–24 years, which leads to every inch of neurodevelopmental-behavioral damage and ambiguity concerning their persona as well as mien. In the present case study, after Vamana (therapeutic emesis), the patient got 80% benefit from signs and symptoms of Mukhadushika (acne vulgaris). Vamana is the main treatment in Mukhadushika (acne vulgaris) as stated by Acharya Sushruta, Acharya Vagbhata. As predominance Doshas of Mukhadushika are Kapha and Rakta, Vamana (therapeutic emesis) helps in eliminating Kapha Dosha associated with Pitta from the body to moderate extent and in turn corrects the Rakta also. Hence the reduction in the size of acne and discharge from pustules was observed after Vamana Karma.

    Further, the oral administration of Laghumalini Vasanta, Mahamanjisthadi Kwatha, Shankha Bhasma, and Amritarishta due to its Agnideepana, Rasa Rakta Prasadana, and Strotoshodhana effects showed further improvement in signs and symptoms with the reduction in number, size, and discharge from pustules, improvement in discoloration, and delay the relapse.


      Conclusion Top


    Mukhadushika is Kapha-Vata Pradhan Rakta Dushtijanya Vyadhi, which has similar attributes to acne vulgaris. Vamana (therapeutic emesis) as Shodhana Chikitsa (biopurification treatment) followed by oral use of medicines such as Laghumalini Vasant, Mahamanjisthadi Kwatha, Shankha Bhasma, and Amritarishta given together provided a significant relief in signs and symptoms of Mukhadushika. No adverse effect was noted during the follow-up period. So the conclusion is that Ayurveda can treat Mukhadushika without any side effects.

    Limitation of the Study

    In this Ayurvedic management, a satisfactory relief was found in signs and symptoms of Mukhadushika. As it was only a single case study, it may be adopted for other cases of Mukhadushika with a greater sample size and for further research in the management of Mukhadushika (acne vulgaris).

    Declaration of patient consent

    The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given her consent for her images and other clinical information to be reported in the journal.

    Financial support and sponsorship

    Nil.

    Conflicts of interest

    There are no conflicts of interest.



     
      References Top

    1.
    Fauci AS, Braunwald E, Kasper DL Alteration in the skin acne vulgaris. In: Harrisons Principle of Internal Medicine. 15th ed. Vol. 1. p. 314.  Back to cited text no. 1
        
    2.
    Yadavji Trikamji Sushrut Samhita of Sushruta, Dalhanacharya Tika Nidanasthana Kshudraroga Nidana 13/39. Varanasi: Chaukhambha Surbharati Publication; 2022. p. 323.  Back to cited text no. 2
        
    3.
    Yadavji Trikamji Sushrut Samhita of Sushruta, Dalhanacharya Tika Chikitsasthana Kshudraroga Chikitsa, 20/37. Varanasi: Chaukhambha Surbharati Publication; 2022. p. 480.  Back to cited text no. 3
        
    4.
    Yadavaji Trikamaji, Charak Samhita Charak Dridhabala Chakrapani Tika Sutra Sthan Yajjahpuruseeya Adhyaya 25/40. Varanasi: Chaukhambha Surbharati Prakashan; 2021. p. 131.  Back to cited text no. 4
        
    5.
    Yadavaji Trikamaji, Charak Samhita Charak Dridhabala Chakrapani Tika Kalpasthana Madanakalpam 2/14. Varanasi: Chaukhambha Surbharati Prakashan; 2021. p. 654.  Back to cited text no. 5
        
    6.
    Yadavji Trikamji Sushrut Samhita of Sushruta, Dalhanacharya Tika Sutrasthana Vamanadravyavikalpa Adhyaya, 43/2-3. Varanasi: Chaukhamba Sanskrit Sansthan; 2022. p. 187-8.  Back to cited text no. 6
        
    7.
    Sharma PV Dravyaguna Vigyana 11. Varanasi: Chaukhamba Bharati Academy; 1998. p. 376.  Back to cited text no. 7
        
    8.
    Doshi A, Zaheer A, Stiller MJ A comparison of current acne grading systems and proposal of a novel system. Int J Dermatol 1997;36:416-8.  Back to cited text no. 8
        
    9.
    Nesari RS The study of Shalmali with special reference to its efficacy of Mukhadushika. Int J Ayurvedic Med 2001;6:874-95.  Back to cited text no. 9
        


        Figures

      [Figure 1]
     
     
        Tables

      [Table 1], [Table 2], [Table 3], [Table 4], [Table 5]



     

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      In this article
    Abstract
    Introduction
    Materials and Me...
    Observation and ...
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