The disease of Leucoderma/Vitiligo/Switra was reported in ancient literature. Several references are found in the Vedas, regarded as one of the oldest written documents since the dawn of civilization. The word Switra has its root in the Sanskrit word Sveta, which means white patch. So Switra is a disease where white patches appear on the body. The disease has got a special importance as it causes ugliness of the body. Probably keeping this in mind Ayurveda described the disease along with Kustha.
In the Atharva literature Switra appears for the first time in the commentary of Darila on Kau Sutra 26.22. References to Kilasa is found in Atharva Veda in two hymns (A.V. 1.23 and 1.24). In Rig-Veda (V.53.1) also the reference to Kilasa is found in different places as well as it is available in Vajaseneji Samhita, Kathaka Samhita; Taittiriya Brahmana and Tandya Mahabrahmana3. the disease is described in Panini Vyakarana also.
Reference to Switra is found in Samhita Kala also. Manu abhors marriage to the son or daughter of a Switra Kushtha patient.
The important classical texts of Ayurveda such as Charaka Samhita, Sushruta Samhita, Astanga Hriday etc. clearly mention the treatment of Switra along with its classification and prognosis. Most of them use Switra and Kilasa as Synonyms. Medieval authors like Madhava, Bhavamishra, Sarangadhara and Chakradatta also enumerated certain additional information regarding Switra.
References to this diseases are available in Agni Purana, Guruda Purana and Mahabharata also.
Switra is known by different names like.
- Kilasam (diseases where normal colour of skin is destroyed) Atharva Veda.
- Palitam (meant particularly for whiteness of the scalp hair) Atharva.
- Kilasi (meaning spotted dear) Max Muller’s commentary on Rig Veda
- Alasa (Atreya Bhraman).
- Darun, Charuna, Switra – (Charaka Samhita).
- Darun Varun (Bhaluki Samhita)
- Padur Kustha.
- Pada Sphota, TwakPuspi, Kilasa, Sidhmali. These four terms have been used as synonym of Switra in Amarakosha.
Besides these some other terms are used colloquially. They are as follows:-
- Saphed Kustha (Northern India)
- Chitala or Chitkabra (Himachal and Punjab)
- Switra Kustha and Dhala Chhau (Orissa)
- Saphed Dag Phulbazi (Hindi speaking area)
- Dhaval Kustha, Kahiphula (Assam)
- Sweti (Bengal).
- Safed Kodh (Gujarat)
It is said that, by the touch of Jesus Christ, the vitiligo of a Palestinian was cured. It is mentioned in Persian history, that vitiligo was known in the period of Aushooryans in 2200 B.C.
The occurance of this disease in Arab country and the efforts at its treatment are mentioned in Arabic literature. Koran the religious book of Islam written during 6Century A.D. described this disease as Bars and remarked that it can be cured by the grace of the Almighty.
Behl, (1962) says that disease is an acquired idiopathic depigmentary condition found mostly in tropical countries like India, Egypt, Japan. In India vitiligo has assumed epidemic proportions in several parts of India
The diseases Switra has been equated with leucoderma and vitiligo. The two terms leucoderma and vitiligo are used synonymously by most physicians, but a little bit difference exists between this two terminology. The world leucoderma is composed of two words leuco and derma. Leuco means whiteness and derma means skin. Therefore leucoderma is whiteness of the skin. But this whiteness of skin is due to burn or found after healing of wounds. The white patch may remain throughout life whereas vitiligo denotes the primary lesion of the disease. Vitiligo is a skin disease characterized by milky white patches with hypopigmented border due to failure of melanin formation. References to vitiligo are available in other traditions also.
Any part of the body, any age group and any sex can be affected, but the sites of predilection as the face, dorsa of the feet and hand, wrist and leg. As per age relation the disease is generally seen in the first decade of life and after menopause.
This is a non-infectious disorder of skin, where white lesion (Patches) are formed. Vitiligo is caused by stoppage of melanin (colour pigment) formation by melanin producing cells, melanocytes; as a result depigmented macules are formed. These macules may vary in size and shape and can be located in any part of the body even on mucus membrane of lip and genitals. The common areas affected are face, hand, feet, axilla, groins and trunk. The areas which are subjected to friction and trauma are usually involved; and any damage to skin leaves to white depigmented scar. Frequently this disease is progressive and usually associated with autoimmune disorders like Diabetes mellitus, myasthenia gravies etc. Exact cause of Vitiligo remains vague in modern medical science. The treatment of Vitiligo is not completely satisfactory in spite of advanced modern technology and medicine
Atharva Veda has stated four causative factors in case of Kilasa. They are as follows:
- Contact – (Yat-tvachi).
- One’s own previous sins – (Asthijasya).
- Inheritance from parents – (Tanujasya)
- Witchcraft or infection – (Dushya Krtyasya bhrahmans)
According to Ayurveda, Leucoderma is caused due to the aggravation of Pitta Dosha. Pitta is an Ayurvedic humor which symbolizes heat or fire, and is manifested in the skin. Aggravated Pitta leads to accumulation of ama (toxins) in deep layers of the skin, leading to the condition of Leucoderma.
Pitta is of five types; one of them is Bhrajak Pitta that gives coloration to skin. In the case of Leucoderma, Bhrajak Pitta is in an imbalanced state, and therefore, the skin starts losing its color and white patches appear. Along with Pitta Dosha, deeper body tissues like Rasa Dhatu (nutrient plasma), Rakta (blood), Mansa (muscles), Lasika (lymph) are also involved in the disease.
As per Ayurvedic texts Vitiligo is a disease which had its presence since decades and cause of Vitiligo is inefficient or disturbed immune system of the body. Ayurveda stresses on food habits, lifestyle and hygiene as to the point reason behind immunity disorder and Vitiligo. Odd food combinations like taking milk and non-vegetarian food items together or taking cooked vegetable preparations like brinjal and milk together, there are several examples of “Virud Ahar Sevan” mentioned in Ayurvedic text books. Such intake of food gives rise to toxins inside and that formed toxin in fact disturbs the metabolic system causing a state of autoimmunity in which body defence system gets paralysed and starts destruction of its own native cells causing colour loss over skin. Colour less areas of skin converts into white spots which are termed Vitiligo.
Excessive stress or worry, chronic gastric problems or improper liver functions, excessive consumption of opposite food items (e.g. milk and fish together), worms/parasites in the digestive system, burns and injuries and heredity may be responsible for causing leucoderma.
Leucoderma is the gradual loss of skin pigment, called melanin, from layers of the skin. White patches occur all over the body including face, scalp and genitals.
White patches (de-pigmentation) on skin
Premature graying of scalp hair, eyelashes
There is a common myth about the vitilago that it can not be cured but contrary to this; remarkable repigmentation can be achieved in every patient and its spread can be arrested; provided that patient follows dietary restrictions and take appropriate treatment for prescribed period. A proper assessment of known causative factor of vitilago; such as plastic slippers, shoes, gloves, bindi, and other rubber or plastic materials ;pressure or trauma is mandatory and if there is any such factors, patients should discard them.
The principle line of treatment explained in such condition is virechana. Sramsana in particular is indicated for the treatment of Switra. As Switra affects the skin hence lepa is more rational.
Treatment consists of pacifying imbalanced body energies, cleansing the blood and administrating herbs that restore skin color. Poor digestion is the root cause of this disease, as it causes the build-up of toxins in the tissues. An essential part of treatment, therefore, is restoring digestion. The patient should also follow the correct diet and lifestyle adjustments to assure good early results as well as prevent recurrence of the disorder.
After initiation of repigmentation; treatment must be continued till the desired complete regimentation of all the lesions are achieved. But some stubborn lesions especially of mucosal surface of palms and finger tips; sometimes responds very poorly or incomplete.
Deit & Life Style
Increase consumption of vegetables that are bitter in taste, like drumsticks and bitter gourd.
Stay away from difficult to digest foods, sour taste, excessive salt, curd, fish, jaggery and sesame seeds.
Avoid consumption of opposite foods, such as fish and milk together.
Have sound and adequate sleep daily.
Do not over-expose yourself to excessive cold or heat conditions.
Important – Leucoderma is nothing but the localized loss of pigmentation on the skin. The white patches which is known as leucoderma is many times harmless to the patient and cause no physical trouble but it creates big problem in social life as many misinterpret as leprosy and keep distance from such patient.
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