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DETAILS & TYPES-

Masurika (small pox) is highly contagious viral disease with febrile episode accompanied by skin eruption.

According to madavkar-five types

1. vataj masurika

2. pittaj masurika

3. kaphaj masurika

4. raktaj masurika

5. sannipataj masurika

other types (three types)-

1. vrihat masurika(small pox)

2. laghu masurika(chicken pox)

3. romantika(measles) 

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PURVA RUPA- 

1. Jwar

2. Kandu(itching)

3. Angamardana(malaise)

4. Arati(restlessness)

5. Vertigo

6. Twakshotha(inflammed skin)

7. Twak vevarnya(discoloration)

8. Red eyes 

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SAMPRAPTI

Samprapti (Pathogenesis)-

It spreads by droplet infection or by contamination with materials from skin lesions. After penetration virus localises in adjacent lymph node and then liver and spleen. After the lapse of incubation period viraemia occurs and it spreads to skin and mucous membrane. This period coincides with prodomal period.

Then antibody will form and the virus after disappearing from blood continues to multiply in skin, lungs and brain. The initial cutaneous lesion is epidermal necrosis with capillary dilation (macule).

In the same lesions epidermis will proliferate (papule) and then vacuolate in to septate vesicles and ultimately will be invaded by polymrophs to be transformed in pustules.  

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SYMPTOMS- 

1. Fever with chills,rigors and headache

2. Lumbago and backache

3. Pralapa(delirium)

4. Nidranasa

5. Malavrodh(constipation)

6. After 3rd day fever comes down

7. Hard rashes on skin

8. Dry & coated tongue

9. featuresProdomal Phase Eruptive Stage

‘Onset is sudden, starts with Initial eruption is macular, they high fever, restlessness, headerupt first on forehead and wrists, ache, severe backache, cough, then arms and trunk then legs. vomiting and prostration. In Eruptions are more dense in exmost cases fever subsides on tremities and specially on extenthird day with the appearence sor surface. With in a few hoursof rash. macules turn in to papules and after 2-3 days papule turn 1 t0 vesicles.

The vesicles are firm and multiocular. After two more days vesicles become pustules. These are itchy. In this stage again fever and other constitutional manifestations recur.

In another 9-10 days time pustules dry up with formation of scales which sepalate after a few days leaving behind pitted scars.  

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PRICIPAL OF CHIKITSA 

Ayurvedic Treatment-

a.sansodhana cikitsa-

1. langana

2. vamana

3. virechana

b.sansamana cikitsa

1. Yastimadhu (powder of liquorice root) 1-2 grams. Thrice a day.

2. Water boiled with Nimba (neem) leaves, Kisamarda, ushira, sandalwood should be used for bathing.

3. Compound of Shonti (ginger dry), black peeper, and long peeper power with honey twice a day.

4. Bhunimbidi Kada 30 ml with equal quantity of water thrice a day is very effective.  

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SMALL POX

Etiology

Smallpox results from infection by variola virus (genus Orthopoxvirus, family Poxviridae). At least two strains of virus exist: the more virulent strain causes variola major and the less virulent strain causes variola minor.

The Orthopoxvirus genus also includes the vaccinia, monkeypox, cowpox, camelpox and ectromelia viruses; these agents resemble each other in electron micrographs and in many culture systems. They are also serologically cross–reactive. Monkeypox, which usually found in Africa, closely resembles smallpox; in monkeypox infections, the mortality rate is lower and the cervical and inguinal lymph nodes are highly enlarged.

Transmission

The smallpox virus must be continuously transmitted from human to human to survive; humans do not become long–term carriers and animal reservoirs do not exist. Virus is spread by direct contact or inhalation of aerosols; infectious virus is present in oronasal secretions and in scabs from the skin. (The virus in scabs may be tightly bound and spread by this method may be less efficient.) Close contact is usually required for efficient virus transmission; therefore, smallpox mainly spreads to household members and others in close contact. Variola viruses can also be transmitted by individuals who maintain the virus in the throat without clinical signs. The potential for long–distance aerosol spread is controversial but has been demonstrated under certain conditions such as in hospitals. Transmission on fomites such as contaminated clothing or bedclothes is possible for short periods of time; however, variola does not remain viable for more than 2 days outside a human host. It is sensitive to heat and humidity; most natural epidemics occurred in the winter and spring.

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Incubation Period

The incubation period is 7 to 19 days; 12 to 14 days is average.

Clinical Signs

Smallpox has an acute onset; the initial clinical signs may include fever, malaise, rigors, vomiting, headache, backache and occasionally delirium. Some people develop an erythematous rash during this prodromal phase. The characteristic skin lesions usually appear 2 to 3 days later; the first signs are macules, which develop into papules and eventually pustular vesicles. These lesions are most common on the face and extremities and develop in synchronous “crops.” Approximately 8 to 14 days after the first symptoms appeared, the pustules develop scabs and heal, leaving depressed, depigmented scars. Severe scarring may occur.

Two forms of smallpox may be seen. Variola minor is characterized by milder clinical signs, smaller skin lesions and a low mortality rate; variola major is characterized by more severe disease and scarring and a higher mortality rate.

Approximately 5 to 10% of individuals develop flat–type or hemorrhagic variants of variola major. The hemorrhagic form is more common in pregnant women. Patients with this form have more severe initial symptoms, which are followed by generalized erythema and hemorrhages in the skin and mucosa. The initial symptoms are similar in the malignant or ‘flat’ form; in this form, confluent, flat nonpustular lesions develop and the epidermis often peels in survivors. The hemorrhagic and malignant forms are usually fatal.

Diagnostic Tests

Smallpox is usually diagnosed by finding the characteristic viruses in skin scrapings examined by electron microscopy. Aggregations of virus particles called Guarnieri bodies are found under the light microscope. Gispen’s modified silver stain can demonstrate Guarnieri bodies in vesicular scrapings; this test is rapid but relatively insensitive.

Treatment and Vaccination

No effective treatment other than supportive therapy is known; cidofovir and other antiviral agents are under investigation.

An effective human vaccine is available and appears to be protective for at least 3 years. Vaccination after exposure can prevent disease or reduce clinical signs and the risk of death; vaccination is most effective if it is given within a few days after exposure. Vaccinia Immune Globulin (VIG) may also be helpful in post–exposure prophylaxis. Vaccines are contraindicated in immunosuppressed persons, those infected with HIV, persons with eczema, and people with three or more cardiac risk factors. Rare vaccine complications may include generalized vaccinia, progressive vaccinia, and postvaccinial encephalitis (which has a 25% fatality rate).

PATHYA-

- Purana Sali, Mudga, Masoor, Parval, Karela, Sahijan, Choulai, Gaduchi, Jeevanti, Makoya, Manukka, Anar, Laghu Ahar, Yavagu, Peya, Vilepi, Yava, Lajamanda, Daliya

APATHYA-

- Guru, vidahi, vistambhi, dushita jala sevana, ankurita anna, tilkuta, sweet, chole, lassi, chana dal

- Vegadharana, vyayama, divasvapna, sanana, adhyasana

NISHEDHJA-

- Nava jvar me divasvapna, snana, abhyanga, maithuna, krodha, dhimi hava   

RASODHI/BHASMA/PISTI-(120-250MG WITH MADHU/USHNODAKA)

- Ashvakanchuki rasa

- Sarvathobhadra rasa-(rasasindura,abhrak,svarna,rajat,manashila,vanshlochana)

- Tribhuvan kirti rasa-(hingula,vatsanabh,trikatu,tankan)

- Hinguleshver rasa-(vatsanabh,pippali,hungula)

- Swarnbasant malti rasa-(swarna,muktapisti,hingula,maricha)

- Kasturi bhairav rasa-(javitri,jayphala,marich,pippali,kasturi)

- Mritunjaya rasa-(vatsanabh,hingula,gandhak,tankan,pippali,marich)

- Jwar keshri rasa-(parad,gandhak,triphala,trikatu,vatsanabh,jayphaala)

- Jwar sanhar rasa-(rasasindura,trikatu,kuth,mustak,tankan,katuki)

- Godanti bhasma-(godanti)

- Shringa bhasma-(mrigshringa)

- Jaharmora pisti-(jaharmohra)

- Laxmivilas rasa-(swarn,rajat,abhrak,tamra,nagabhasma)

- Praval pisti

- Kaphaketu rasa-(vatsanabh,tankan,sankh,pippali)

VATI-(250-500MG WITH USHNA JALA)

- Indrakala vati-(shilajatu,loha,svarna)

- Kanchnar gugglu-(kanchnar,gugglu)

- Sanjeevani vati-(vidang,nagar,pippali,abhaya,vibhitaki,vacha,guduchi,bhallataka,visha)

- Shoubhagya vati-(rasasindura,dvikshar,trilavan,loha,trikatu,triphala)

- Sansamani vati-(guduchi)

- Vishatindukadi vati-(kuchala,mustak,parpat,triphala)

- Jayavati-(suddha visha,trikatu,motha,haridra,nimbapatra,bidanga)

- Amrita satva-(guduchi)

- Karanjadi vati-(karanj beej,parpat,atish,guduchi,patol,kutki)

CURNA-(3-6GM WITH MADHU/USHNODAKA)

- Nimba curna-(nimba)

- Patolpatra curna

- Ushnadi curna-(marich,pippalimula,kutha,motha,mulethi)

- Badira majja curna-(suska badira majja)

KAVATH/ASAV/ARISHTA-(20-40ML WITH SAMABHAG WATER)

- Kanchnar kvatha-(kanchnar tvak)

- Khadirastak kvatha-(khadira,triphala,nimba)

- Shishir tvak kvatha

- Guduchyadi kvatha-(guduchi,mulethi,munakka,anar,guda)

- Jatyadi kvatha-(chameli patra,manjistha,daruharidra,amla,mulethi)

- Eladharista-(choti ela,vasa,danti,haridra dvya)

GHRITA(20-30ML WITH USHNODAKA)

- Panchtikta ghrita-(patol,saptaparna,nimba,vasa,guduchi)

- Patoladhya ghrita

- Amritadhya ghrita-(guduchi,mulethi,draksha)

- Shatpalak ghrita-(pippali,pippali mula, chavya,chitrak,sunthi,saindhav)

- Chandanadi ghrita-(svetachandan,vasa,karanj)

AVLEHA-(20-30 GM WITH DUGDHA)

- Drakshavaleha-(draksha,madhur varga aushadhiya)

- Chyavanprash-(amla,trikatu,jeevaniyagana)