By Dr. Sajimon George BAMS. AAA. ATMS
Cellulitis is a common skin infection caused by bacteria. Staphylococcus and streptococcus bacteria are the most common causes of celluliti. When there is a break in the skin, these bacteria can cause a skin infection.
Skin in the infected area will become red, hot, irritated, and painful. Its symptoms are similar to Visarpa explained in Ayurvedic classics.
Symptoms of cellulitis include:
• Pain or tenderness in the affected area
• Skin redness or inflammation that gets bigger as the infection spreads
• Skin sore or rash that starts suddenly, and grows quickly in the first 24 hours
• Tight, glossy, “stretched” appearance of the skin
• Warm skin in the the area of redness
Signs of infection:
• Chills or shaking
• General ill feeling
• Muscle aches and pains
• Warm skin
Ayurvedic view of Cellulitis
In Ayurveda, Cellulitis may be compared to Visarpa. It is a skin and subcutaneous tissue disease. This skin disease is of a particular type and it spreads very fast like a snake, hence it is called visarpa. The characteristics of this disease are inflammation of the skin and the tissue along with fever.
Cellulitis Causes and Symptoms
Ayurveda believes that this disease is caused due to the vitiation of all the doshas and pitha dosha being the predominant dosha. Then the blood, skin and muscles also get involved in pathogenesis.
There are numerous symptoms of this disease which are very peculiar. When it is in the starting stage and mild form, the skin becomes hard, thick and red in color and also small vesicles are seen on the skin. These may even form ulcers on the skin. Slowly the redness may spread to the whole body and if the tissue is involved pus may form even under the skin.
The patient may feel drowsy, sick and thirsty, diarrhea and high fever are also seen. Sometimes shivering is also there. The inflammation has to be controlled early and if left untreated it may affect throat, the wind pipe and sometimes the membranes of the brain. This may have fatal results.
According to doshas, this has been divided into various categories:
1. Pitha type – High fever, thirst, nausea and vomiting are seen. The inflamed skin becomes reddish, bluish or blackish in color.
2. Kapha type – Fever , drowsiness, loss of appetite, heaviness and vomiting are symptoms. The inflamed skin has whitish pale color.
3. Vatha type – The inflamed skin becomes very dry with many scratches and is blackish in color. There is severe pain and also burning sensation on the skin.
4. Kardama visarpa (Kapha – Pitha) – The affected skin has red swellings and boils or eruptions which are yellowish in color. It is also very painful.
5. Agni visarpa (Vatha – Pitha) – In this the toxins are in blood, which produce boils on the skin. These boils look very similar to burns. The condition is also coupled with high fever.
6. Granthi visarpa (Kapha – Vatha) – Different types of glandular swelling appear on the skin and is accompanied by severe pain. The patient suffers from cough and fainting. This is a serious condition.
Cellulitis Treatment Principle
Predominance of Pitha dosha and involvement of raktha or blood should always be kept in mind while designing treatment protocol. Snehana or oleation is strictly prohibited by Ayurvedic classics due to inflammatory tendency. According to Sushrutha, when there is suppurative changes, treatment should be similar to wound or Vrana.
Generally in the treatment of cellulites medicines with Tikta (Bitter) taste should be used. Ayurvedic treatment makes the environment of the body inhospitable to the growth of bacteria. In addition to this it builds specific immunity
to the different bacteria that cause cellulites , thus preventing relapses.
Cellulitis Treatment Procedures
Langhana Processes which produces lightness in the body is called as Langhana. Drugs which are Light (laghu), Hot (Ushna), Pungent (Tikshna), Clear (Vishada), Dry (Ruksha) , Subtle (Sukshma), Rough (Khara), Spreading (Sara) and Hard (Katina) can produce Langhana effect in the body. Generally, Langhana may be divided in to two, Langhana by purification procedures (Shodhana) and Langhana by Pacifying formulations or shamana.
Physiological action of Langhana: This Langhana is an act on the body by reducing the body fluid volume and increase the density of body tissue. Prolonged Langhana produces depletion of nutrition to the tissue.
The basic mechanism of Langhana is as follows:
Decrease in nutritional diet and increased metabolic activity of normal cell by different activity like exercise, drugs etc increases Agni and digestion of Ama and stimulation of defense mechanism.
Rookshana: These are procedures and formulations which are dry, light, rough in nature. They cause dryness of the body, absorb excess fluid levels. They are mainly of Spicy or Katu, Bitter or Tiktha, Astringent or Kashaya tastes.
Rakthavaseka: Blood letting can give sudden relief in conditions where rakta is predominating in disease manifestation..This procedure is given utmost importance by Charaka in this disease and considered as the half of the whole treatment of Visarpa.
Vamana: Vomiting. This is done by giving suitable herbs and is useful in reducing excess fluid levels especially in cellulitis.
Virechana or Purgation: Purgation by using suitable formulation is very effective in calming down aggravated Pitha humor and deranged blood or raktha dhatu.
Pradeha: After purification procedures application of medicinal paste or pradeha is externally applied. Pradeha should be applied frequently, the previously applied one should be removed and a new one should be applied. Application should be neither thick nor thin. But only in case of Kaphaja Visarpa , Pradeha should be thick. The Lepa once removed should not be reapplied.
Dhara or Pouring of medicinal liquids: Based on symptoms, dhara or pouring of warm herbal decoction, medicated milk (Ksheera kashaya) over affected joints for 45-50 minutes is useful. This procedure can reduce pain, reddishness and edema within hours.
Dos and Don’ts with Cellulitis
• Rasa (Taste) – It is advisable to take food with Bitter or Tiktha, Sweet or Madhura tastes.
• Cereals such as old wheat and red rice (Not newly harvested) are good. Pulses like green gram is good. Fruits such as grapes, goose berry, and lemon are useful.
• Rasa or Taste – Sour or Amla, Salt or Lavana, Spicy or Katu are contra indicated. Garlic, horse gram, black gram and sesame seeds are contra indicated. Curd is also contra indicated.
• Activities – Exercise, sleep during day time, sexual activities, anger and sorrow are to be avoided.
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