Non Healing Ulcer
Definition of an Ulcer:
An ulcer is a breach in the continuity of surface epithelium- skin or mucous membrane, due to molecular death of tissue. According to Ayurveda, Ulcer is considered as ‘Nija Vrana’ and Non Healing Ulcer is termed as ‘Dushta Vrana’. ‘Vrana’ is defined as the condition where the tissues undergo destruction (Vichurnan). ‘Vrana’ is a condition, which even after complete healing leaves a scar (Vrana vastu) over the area, which stays as long as the person is alive.
What is Non Healing Ulcer?
- The Non Healing Ulcer shows no tendency towards healing.
- The floor of the ulcer covered with pale (yellowish) granulation tissue.
- Sometimes the floor of the ulcer is covered with wash-leather slough, which is typically seen in syphilitic ulcer.
- Discharge is scanty or absent.
- The base of the ulcer considerably indurate and so is the edge and surrounding skin.
Non Healing Ulcer includes:
- Tubercular ulcer
- Diabetic ulcer
- Chronic fissure in ano
- Rodent ulcer
- Varicose ulcer
- Tropic ulcer (Neurogenic ulcer)
- Tropical ulcer
- Chronic bed sores
- Marjolin’s ulcer
- Meleney’s ulcer
- Gummatous ulcer
- Hard chancre
- Soft sores
- Malignant ulcer
- Chronic ulcer of mouth
- Callous ulcer
- Non healing wound
Features of Non Healing Ulcer/ Infected Wound (According to Ayurveda):
- Very constricted (Ati samvrita)
- Very broad (Ati vivrita)
- Very hard (Ati kathina)
- Very soft (Ati mrudu)
- Very raised (Ati utsanna)
- Very depressed (Ati avasanna)
- Very cold (Ati sita)
- Very hot (Ati ushna)
- Black/ Yellow/ White/ Red coloured (Krishan/ Pita/ Sukla/ Rakta)
- Fearful features (Bhairava)
- Filled with necrotic tissues
- Foul smelling pus
- With discharge collected in pockets below or above the opening
- Unfavourable sight (Amanogna darshana)
- Dislikeable smell (Amanogna gandha)
- Severely painful (Atyartha vedana)
- Associated complications like severe inflammation, burning sensation, redness, itching, swelling, boils etc.
- Discharge of severely vitiated blood
- Associated with body from long time
- Based on prominence of Doshas – (Six varieties) i.e. Vataja, Pittaja, Kaphaja, Raktaja, Sannipataja and Agantuja
Features of Completely Healed Ulcer/ Wound:
Completely Healed Ulcer/ Wound are considered as ‘Samyaka rudh vrana’ in Ayurveda.
According to Sushruta (School of Ayurvedic surgery), the features of completely healed ulcer are-
(Reference: Sushruta Samhita Sutra sthana Chapter 23/ Verse 30)
- Margins of the ulcer are completely healed (Rudh vartma)
- No swelling or inflammation surrounding the ulcer (Ashuna)
- No hardness /No scar tissues remaining (Agranthi)
- No pain remaining (Arujam)
- Colour of the site should be like that of the surrounding skin (Twak savarnam)
- The site should be flat /Neither raised nor depressed (Samtalam)
Ayurvedic treatment for Non Healing Ulcer/ Ayurvedic treatment for Infected wound:
(Reference: Sushruta Samhita Chikitsa sthana Chapter 2/ Verse 86-88)
1) Purification of body by Ayurvedic Panchkarma Therapy (Specifically by ‘Vamana’ (medicated emesis) and ‘Virechana’ (purgation) procedures)
2) Diet which can slim the body (One should follow the diet plan belongs to ‘Ayurvedic lifestyle’ given on homepage of this website)
3) Ayurvedic ‘Siravyadha chikitsa’ (Bloodletting)
4) The ulcer should be washed with the use of decoctions e.g. Panchvalkal kwath, Aargwadhadi kwath, Surasadi ghan kwath, Triphala kwath
5) For proper dressing of the ulcer, one should use medicated oils (For external use only) e.g. Jatyadi taila( Jatyadi oil), Panchguna taila (Panchguna oil), Nimba taila (Nimba oil), Karanja taila (Karanaja oil), Arka taila (Arka oil), Apamarga kshar taila (Apamarga kshar oil)
Famous Ayurvedic formulations for Treatment of Non Healing Ulcers:
Aaragwadhaarishtam (Nagarjuna kerala Pharmacy), Ayaskruthi (Aryavaidhyasala Pharmacy), Nimbaadyarishtam (Nagarjuna kerala), Vidangaarishtam (Sandu Brothers Pharma), Khadirarishta
Avipattikar Churna, Trivrutadi Churna, Panchnimba Churna, Harde Churna, Triphala Churna
Tab. Panchtikta grita guggulu, Tab. Kaishor guggulu, Tab. Triphala guggulu
Aampaachak kwath, Triphala kwath, Pathyadi kwath, Faltrikaadi kwath, Aargwadhaadi kwath, Asanaadi kwath
Haridra khand avleha, Thrivruthu lehyam (Nagarjuna kerala pharma), Amrut bhallatak avleha
Kashaayam (Decoction syrups):
Aaragwadham Kashaayam, Gulgulu Thikthakam kashaayam, Guloochyaadi kashaayam, Mahaathikthakam kashaayam
Ghrutham (Medicated clarified butter):
Gulgulu Thikthaka ghrutham (Nagarjuna kerala Pharma), Mahaathikthaka ghrutham
Best Healing Drug for Non Healing Ulcer (For External Application):
(Reference: Su. Chi. 1/65-69)
‘Nimbadi Kalka’ (Medicated herbal paste of Neem patra – Leaves of ‘Azadirechta indica’ and other ingredients:
Leaves of Neem Tree
Medicated herbal paste should be made by ‘Til’ (Grinded Sesame seeds), Madhu (Honey), Cow Ghee (Clarified butter made by cow milk) and Neem patra (leaves of Neem Tree- ‘Azadirechta indica’) in equal quantity. Take all the above ingredients in equal proportion and mix them well and make it a paste form. This herbal paste is known as ‘Nimbadi Kalka’. This paste should be applied on the wound or ulcer which shows no tendency towards healing. This will give excellent result in non healing ulcer or infected wound.