Reviewed by medical experts • For informational purposes only
Introductory Summary
Scabies correlates with the Ayurvedic conditions Pama and Kacchu classified under Kshudra Kustha. It is explicitly recognized as an Aupasargika Roga meaning a contagious disease that spreads through direct physical contact or sharing personal items. The condition arises from the vitiation of Kapha and Pitta doshas which contaminate the skin and blood. Symptoms include intense itching known as Kandu and the formation of pustules called Pidaka often accompanied by discharge. Pama typically appears on the hands while Kacchu presents as larger hard lesions on the buttocks. Management prioritizes topical therapies using antimicrobial herbs like Neem and Sulphur or Gandhaka formulations such as Marichyadi Taila to eliminate the infestation and soothe the skin.
Scabies
Scabies is a contagious skin infestation by the mite Sarcoptes scabiei that causes intense itching and pimple-like skin rash. In Ayurveda, this condition correlates with specific types of (skin diseases), predominantly and . These are classified as (minor skin diseases) but are significant due to their symptoms of intense (), pustules (), and discharge (). explicitly recognizes this as a () that spreads through physical contact.
Pama: A skin condition characterized by numerous small pustules (Pidaka) that are white, reddish, or dark, accompanied by intense itching (Kandu) and burning sensation (Daha).
Kacchu: A condition similar to Pama but characterized by larger, harder pustules, often appearing on the buttocks and loins, accompanied by severe itching.
2. Etymology & Conceptual Meaning
Pama: The term generally refers to a condition of "scab" or "eczema" characterized by suppuration and itching.
Kacchu: The name suggests a resemblance to the rough skin of a tortoise or relates to the painful itching sensation.
Conceptual Interpretation:Ayurveda views these conditions as a disturbance of the Kapha and Pitta doshas. Kapha causes the itching and swelling, while Pitta causes the redness, burning, and pus formation. These vitiated doshas affect the Twak (skin), Rakta (blood), Mamsa (flesh), and Lasika (lymph).
3. Causes (Nidana)
The causes are multifactorial, involving diet, lifestyle, and direct contact with infection.
Contagion (Aupasargika Roga):Madhava Nidana and Sushruta Samhita explicitly list skin diseases (Kustha) as contagious. They spread through Gatrasamsparsha (physical contact), Nishvasat (breath/close proximity), Sahashayyasana (sharing beds and seats), and Vastramalyanu-lepana (sharing clothes, garlands, and unguents).
Dietary Causes:
Viruddha Ahara: Incompatible foods (e.g., milk with fish).
Excessive intake of liquid (Drava), unctuous (Snigdha), and heavy (Guru) foods.
Consumption of new grains (Navanna), curd, sour (Amla), and salty (Lavana) foods.
Lifestyle Causes:
Vegadharana: Suppression of natural urges (like vomiting).
Mithya Vihara: Improper lifestyle habits such as day sleep (Divaswapna) and sudden temperature changes (cold water after heat).
4. Journey of the Disease (Pathogenesis/Samprapti)
Samprapti Ghataka (Components):
Dosha:Pitta and Kapha are the primary aggravators in Pama and Kacchu. Vata may be involved if there is dryness.
Dushya (Tissues):Twak (Skin), Rakta (Blood), Mamsa (Muscle), and Lasika (Lymph/Plasma).
Srotas (Channels):Raktavaha (blood-carrying) and Rasavaha channels.
While Pama and Kacchu are themselves specific subtypes of skin disease, Madhava Nidana classifies them under:
Kshudra Kustha: Minor skin diseases (group of 11), which includes Pama and Kacchu.
Dosha Dominance:
Pitta-dominant Pama: Marked by redness, burning, and suppuration.
Kapha-dominant Pama: Marked by severe itching and thick discharge.
Dry Pama (Vata): Rough, dry lesions with itching (less common in classical Pama descriptions).
7. Diagnosis
Ayurvedic Diagnosis (Roga Pariksha):
Darshana (Observation): Inspecting the size, color, and nature of the pustules (e.g., white, reddish, or blackish).
Prashna (Questioning): Inquiring about itching intensity (usually worse at night due to Kapha/warmth) and history of contact with others sharing the same symptoms (contagion).
Sparshana (Touch): Checking for discharge (Srava) or roughness.
Differential Diagnosis:
Differentiated from Vicharchika (Eczema), which usually has darker pigmentation and lichenification, whereas Pama presents with distinct pustules.
8. Disease Management
Management focuses on destroying the "germs" (Krimighna), purifying the blood (Raktashodhana), and relieving itching (Kandughna).
Medicines (External & Internal)
Gandhaka (Sulphur): Pure Sulphur is considered the supreme remedy for skin diseases. Ayurveda Prakasha states that Gandhaka cures Kandu (itching), Visarpa, and Kustha. It dries up the discharge and kills pathogens.
Marichyadi Taila: A specific oil containing black pepper (Maricha), toxins (Visha), and other herbs, indicated for Pama, Kustha, and Kacchu.
Sinduradya Taila: An oil formulation containing vermilion (Sindura) used for curing Pama and Kacchu.
Jiraka-adi Taila: An oil processed with Cumin (Jiraka) and Sindura, specifically mentioned to destroy Pama.
Khadira:Acacia catechu is a primary blood purifier used in decoctions.
Aragvadha: Used in pastes (Lepa) to cure skin diseases and cleanse wounds.
Panchakarma (Therapies)
Vamana(Emesis): Since Pama involves Kapha and Pitta, therapeutic vomiting is indicated to expel Doshas from the upper body.
Virechana(Purgation): The primary treatment for Pitta and Rakta disorders. It helps clear the blood of toxins.
Raktamokshana (Bloodletting): In severe cases with burning and redness, letting out impure blood is recommended.
Diet (Ahara)
Pathya (Beneficial): Light foods, bitter vegetables (like Patola/pointed gourd, Nimba/Neem), and old grains.
Apathya (Avoid): Sour foods, curd, milk, jaggery, sesame, black gram, and incompatible foods (Viruddha Ahara).
9. Prognosis
Sadhya (Curable):Pama and Kacchu are generally considered curable (Sadhya) as they are Kshudra Kustha, provided the patient follows hygiene and diet restrictions.
Krichrasadhya (Difficult): If the condition becomes chronic, spreads extensively, or if the patient continues the intake of incompatible foods.
10. Modern Correlations
Scabies: The symptoms of Pama (itchy pustules, vesicles) and Kacchu (buttock lesions) correlate directly with the clinical presentation of Scabies.
Contagion: The Ayurvedic classification of Kustha as an Aupasargika (contagious) disease perfectly aligns with the transmission mode of Scabies mites.
A: Yes. Ayurveda lists skin diseases like Pama under Aupasargika Rogas (contagious diseases). It states that the disease spreads through contact (Gatrasamsparsha), sharing beds, clothes, and ornaments.
Q: What is the best Ayurvedic remedy for Scabies itching?
A: Gandhaka (Purified Sulphur) is highly praised in texts like Ayurveda Prakasha for curing Kandu (itching) and Pama. It is often used in oils or internal preparations. Neem (Nimba) is also a powerful remedy.
Q: Can diet help cure Scabies?
A: While external treatment is primary, diet helps prevent aggravation. Ayurveda recommends avoiding "heating" and "fermented" foods like sour curd, pickles, and excessive salt, as well as incompatible foods like milk with fish, which worsen skin inflammation.
Q: What is "Kacchu" in Ayurveda?
A: Kacchu is a type of skin disease very similar to Pama (Scabies) but characterized by harder, larger pustules, typically located on the buttocks and loins, accompanied by severe burning and itching.
