Role of Agni Karma with Pippali on Kadara- An open labeled clinical trial

INTRODUCTION: Ayurveda has a rich and comprehensive concept of life and health. Callosity is a French word meaning a local thickened or hardened part of the skin. It is a plaque of hyperkeratosis caused by repeated friction or pressure. It is assumed that frictional forces induce hyperkeratosis leading to thickening of stratum corneum of the skin over certain areas prone to mechanical stresses. Kadara, as described by the Samhitas, can be closely related to lesions of the skin caused by hyperkeratosis. Kadara has been enumerated and described in the classical literature under the heading of Kshudra Roga. Agni Karma has been mentioned for the proper management of Kadara. AIMS AND OBJECTIVE: The management of Kadara is aimed at removal of the hyperkeratosis lesion by Agni Karma along with or without Shastra Karma. MATERIAL AND METHODS: Pippali has been mentioned as a Dahana Upakarna in Sushruta Samhita and Ashtanga Samgraha. It was a randomized, prospective, single-blind and clinical trial. Fifteen patients suffering from hyperkeratosis lesions were selected according to the conditions mentioned under inclusion and exclusion criteria and Agni Karma procedure was carried out for them. Assessment of the lesion was done before treatment and after 7 days and 14 days of treatment. RESULTS AND OBSERVATION: Based on the study, it was observed that Pippali can be used to create superficial burns only. The extent of tissue destruction due to burning with Pippali is very minimal. Hence, it was observed to be effective for treating superficial Kadara lesions. It was observed that eventually in 7 days the area of the lesion turned soft with reddish black discoloration. Softening of the lesion and its discoloration might be due to penetration of the volatile oil and active principles of Pippali into the affected area while doing the Agni Karma procedure. It was further observed that the area of lesion eventually dried and peeled off along with the Kadara tissue within about 15 days. CONCLUSION: Hence, Pippali was able to provide satisfactory results in case of superficial hyperkeratosis lesions.