Article by Dr Manasa S, BAMS & Dr Raghuram Y.S. MD (Ay)
It is always a tricky situation to understand if two different disease conditions share the same name.
In this context we shall discuss two such conditions which share the same name. There are two conditions explained in Ayurveda treatises which are named as ‘Vipadika’.
Context 1 – Vipadika has been mentioned among the eighty kinds of ‘Vata Nanatmaja Rogas’. Vata Nanatmaja Rogas are eighty types of special and specific diseases caused by vitiation / aggravation of ‘only vata’. ‘Only vata’ means there is no association of any other dosha in the cause of this condition other than Vata.
Context 2 – The second Vipadika has been mentioned in the context of ‘Kshudra Kushta’. Kushta is a term which encompasses many skin disorders. Kushta is classified as Maha Kushta – major skin diseases and Kshudra Kushta – minor skin diseases. Kshudra Kushtas are eleven in number. Vipadika is one among them. In the verse which describes the symptoms of Vipadika, Master Charaka has mentioned ‘Vaipadika’ instead of Vipadika. This probably is to differentiate between the two types of Vipadika explained in two different contexts. But the same author has mentioned ‘Vipadika’ in the same chapter while explaining the treatment for the same.
Now the question arises – ‘Are these two conditions the same?’
The answer is ‘no’.
Now let us see the differences between these two conditions.
For understanding the differences I will use the word ‘vaipadika’ for the vipadika explained in the context of kshudra kushta in the entire length of this article.
Differences between Vipadika and Vaipadika
1. From the point of view of the context in which these diseases are explained
Vipadika is a Vata Nanatmaja Roga whereas Vaipadika is a Kshudra Kushta.
2. Doshas involved in the pathogenesis
Since Vipadika is a nanatmaja vata roga, no other doshas are involved in its causation except vata.
As a general rule since Vaipadika is a kushta, it is invariably caused by involvement of all the three doshas. But being a kshudra kushta, Vaipadika is caused due to combined aggravation and predominance of vata and kapha. Pitta, though involved, may be dormant in this condition.
3. Description of these conditions
Vipadika has just been mentioned amongst the eighty Nanatmaja Rogas of Vata. We do not find the description of the same just like the other nanatmaja rogas.
On the other hand we can find a brief description of the symptoms of Vaipadika in the context of Kshudra Kushtas.
4. Place of occurrence in the body
Though specific region has not been mentioned in the context of Vipadika as a Vata Nanatmaja Vyadhi, it can be inferred by the term ‘pada’ included in the name of the disease Vaipadika. So, this condition strictly occurs in the pada – foot / feet.
In Vipadika / Vaipadika Kushta it has been clearly specified that the disease afflicts both pani i.e. hands (palmar surface of the hands) and pada i.e. feet (plantar surface of the feet).
This is one gross difference between these two conditions.
5. Nidana – etiological factors
Vipadika is caused by the etiological factors responsible for ‘vata imbalance’.
Vaipadika is caused by etiological factors responsible for causation of ‘kushta’ and also ‘vata-kapha imbalance’.
6. Samprapti – pathogenesis
Vipadika – Vitiated Vata gets localized in the foot of the person and causes cracking of skin therein.
Vaipadika – Vitiated Vata along with Kapha gets localized in the hands and feet, affects the skin, blood, muscles and liquid components therein and causes cracking of skin with pain.
7. Lakshana – symptoms
Symptoms of ‘Vipadika Vata Nanatmaja Vyadhi’ have not been specified. We can infer the symptoms after having a look at the symptoms of Vaipadika Kushta, which is often addressed as Vipadika. Cracking or fissuring of skin especially in the feet is the main symptom of this condition.
Vaipadika presents with –
- pani pada sphutana – cracks and fissures in hands and feet
- teevra vedana – severe pain in the regions of fissures
8. Vedana – pain
It is clear that in both Vipadika and Vaipadika Kushta there occurs cracks and fissures in the skin of the feet. In Vaipadika Kushta it also occurs in the hands.
Teevra Vedana i.e. severe pain has not been mentioned amongst symptoms of Vipadika (Vataroga). In fact no symptoms have been mentioned for vipadika. The name of the disease itself is the main symptom of vipadika. Since it is a vata roga, mild to moderate pain may be associated with vipadika in later stages of the disease as the disease progresses and worsens. But vaipadika is always associated with teevra vedana – severe pain, since it is specified in the context of the disease description.
9. Upashaya
Vipadika will respond to Vata line of treatment but Vaipadika Kushta might not. It will definitely respond to Kushta line of treatment.
10. Chikitsa – treatment
Vipadika is treated on the lines of ‘vata roga chikitsa’. Vaipadika Kushta is treated on the lines of ‘kushta chikitsa’. In less involvement of kapha, vata line of treatment may work out in vaipadika kushta as well.
Just before finishing
Summing up – We need to differentiate the two different Vipadikas mentioned in two different contexts from the point of view of clinical diagnosis and from the perspective of right treatment choices.
Vipadika is a vata vyadhi of nanatmaja type when it presents with purely vata predominant symptoms, caused by only vata vitiation, caused by exposure to vata aggravating factors with cracks and fissures manifesting only in the pada i.e. feet associated with mild to moderate pain and would respond to vata vyadhi chikitsa.
Vaipadika is a kshudra kushta when it presents with vata and kapha symptoms, caused by dual vitiation of both these doshas, caused by exposure to etiological factors of kushta or vata-kapha aggravating factors, with cracks and fissures manifesting in both pani – hands and pada – feet associated with severe pain and would typically respond to kushta chikitsa.
This understanding would help the physician to draw an ideal line of treatment in either condition.
