This article explains Madava nidana 52nd chapter “Visarpa Nidanam”. Causes, pathology and symptoms of Visarpa are explained in this chapter. Visarpa means herpes.

Visarpa Nidana

Etiological factors of Visarpa
Ingestion of too much of salty, sour, pungent and hot foods and such other factors would lead to abnormal increase of all the three doshas. These vitiated doshas produce seven types of visarpa. Visarpa is called so because of its nature of spreading all over the body. (1)
Read – Visarpa: Causes, Types, Treatment, Medicines

Types of Visarpa

There are seven kinds of visarpa – one from each dosha, one from all three doshas mixed together and three from combination of two doshas. They are –

1. Vataja Visarpa
2. Pittaja Visarpa
3. Kaphaja Visarpa
4. Sannipataja Visarpa
5. Agneya Visarpa – from the combination of vata and pitta
6. Granthi Visarpa – from the combination of kapha and vata
7. Kardama Visarpa – from the combination of pitta and kapha, which is considered dreadful (2-3)
   Read – Difference Between Kushta And Visarpa

Hetu – Sapta Dhatu

7 body components involved in the causation of visarpa
The seven factors involved in the causation of visarpa are –

• Dushyas / tissues (4 in number) – Rakta (blood), Lasīkā (lymph), Tvak (skin) and Mamsa (muscles) are the düsyas (tissues involved) and
• Doshas (3 in number) – all the three doshas are involved in the causation of visarpa

The 4 tissues and 3 doshas put together form the seven important (and mandatory) factors responsible for causation of visarpa. (4)

Symptoms of Doshaja Visarpa

Vataja visarpa – This type of visarpa has identical symptoms as found in vāta jwara (fever). Along with these there will also be the presence of swelling, pulsations, pricking or splitting (cutting) types of pain, tiredness, body aches and horripilation.
Pittaja visarpa – This type of visarpa would progress quickly and has similar symptoms to those of pittaja jwara and the lesions are dark red in colour.
Kaphaja visarpa – This type of visarpa would have itching and unctuousness of the lesions and its symptoms will be similar to those of kaphaja jwara.
Sannipataja Visarpa – In this type of visarpa caused by aggravation of all the three doshas, all the symptoms of individual doshaja visarpa will be seen together. (5-7)
Read – Charaka Chikitsa Sthana: Visarpa Chikitsa 21st Chapter

Agneya Visarpa: Vata Pittaja Visarpa

Visarpa caused by combination of increased väta and pitta will have the following symptoms –

• fever, vomiting, fainting, diarrhea, thirst, giddiness,
• bursting pain in the glands or joints
• poor digestion capacity
• experiencing darkness before the eyes
• loss of taste
• feeling as if the whole body, mainly the affected part of the body has been covered by and is in contact with burning charcoal,
• the skin of the part or parts of the body to which visarpa spreads becomes black or blue just like burning coal which has calmed down and that area quickly gets covered by blebs resembling fire burns, the lesions quickly spread out to other places,
• visarpa gets located in the vital spots or organs (marma) quickly due to the quick spreading nature of the disease,
• (due to this) the vata gets aggravated and produces pain and trouble in the affected parts, and causes loss of consciousness and sleep, hiccough and dyspnoea (difficulty in breathing)
• the patient having reached this condition does not find even slightest of relief with anything and anywhere, he becomes restless sleeps (lays) or sits on the ground repeatedly, while doing so he would faint becoming severely distressed and would enter into a deep sleep (which is equivalent to death) from which he cannot wake up again (dies). This type of visarpa is known as Agni Visarpa. (8-13)

Granthi Visarpa: Vata Kaphaja Visarpa

Visarpa caused by combination of increased vata and kapha will have the following symptoms –
Vata getting obstructed by kapha in turn spreads the kapha immensely in the body. Or in a person in whom the blood has already undergone abnormal increase, vata would vitiate the blood located in the skin, veins, ligaments (and tendons) and muscles. Following these events vata would produce chains of tumours (cystic swellings) which are elongated, small, round, hard or rough. These cysts are red in colour, painful and associated with fever. Other symptoms include dyspnoea (difficulty in breathing), cough, diarrhoea, dryness of the mouth, hiccough, vomiting, giddiness, delusion, discolouration, fainting, pain all over the body and poor digestion. This disease caused by vitiated vata and kapha together is called as Granthi Visarpa. (14-16)
Read – Gulma- Abdominal Tumor- A Unique Disease In Ayurveda

Kardama Visarpa Kapha Pittaja Visarpa

Visarpa caused by combination of increased kapha and pitta will have the following symptoms –

• fever, stiffness of the body parts, stupor, sleep, headache,
• weakness of the body parts, involuntary movements of the body parts, coating of the tongue, loss of taste, giddiness,
• fainting, destruction of digestive fire (loss of digestive functions), splitting pain in the bones, thirst, dullness (heaviness) of the sense organs,
• excretion of faeces mixed with ama (inadequately formed faeces or faeces mixed with undigested portions of foods)
• coating of thick material which leads to obstruction in the channels of the body (orifices, cell pores, tissue spaces, passages of transportation etc)
• this type of visarpa probably invades the stomach or one side of the body and presents with mild pain,
• it is surrounded by small tumours which are of deep yellow, red, pale, unctuous, black, dark black like collyrium and dirty
• they are swollen, heavy, undergoes suppuration deep within (pus is formed inside) and excessively hot,
• since the lesions are filled with fluids, they mostly burst out discharging the pus on touching them
• the muscles become loose, semi-liquid like silt and fall off exposing the network of tendons and veins and emits smell resembling that of a dead body

This type of visarpa is called as Kardama Visarpa. (17-21)
Read – Rakta Pradoshaja Rogas – When Blood Is Vitiated By Doshas

Ksata Visarpa

Another variety of visarpa is caused by ksata (external injury). Vata aggravated due to external injury would provoke blood along with pitta and cause visarpa. In this, vesicles of the size of horse gram appear all over the body and are associated with swelling, fever, pain and burning sensation. The lesions have blackish blue or blood colour. (22-23)

Complications of Visarpa

The complications of visarpa are fever, diarrhea, vomiting, cracking / fissuring of skin and muscles, exhaustion, loss of taste and indigestion are the complications of visarpa. (24)
Read – Indigestion Causes, Symptoms, Treatment

Prognosis of Visarpa

Visarpas produced by anyone dosha – i.e., vata, kapha and pitta are curable.
The tridoshaja and ksataja visarpas do not respond to the treatment.
Visarpa produced by pitta and that in which the body becomes black like anjana (eye salve, collyrium) are incurable.
Visarpa which occurs on the vital spots / organs are difficult to cure. (25)

Thus ends the chapter on Visarpa Nidanam in Madhava Nidana text written by Acharya Madhavakara.