A Literature Review of the Asava and Arista Formulations Mentioned in Kustha Chikitsa W. S. R to the Bruhattrayi

Kustha in Ayurveda refers to a group of chronic skin disorders characterised by tridosha involvement, with predominance of Vata and Kapha and vitiation of rakta, mamsa and lasika. It is considered a Bahu-Dosaja and Chirakari disease, requiring long-term and systemic management through shodhan, shaman and rasayana therapies. Asava and Arista are fermented formulations (Sandhana Kalpana) valued for their quick absorption, enhanced bioavailability and sustained therapeutic action due to its vyavayi & vikasi Guna. In Kustha Chikitsa, they aid in Agnidipana, Amapacana, Raktaprasadana, and Srotosodhana, making them especially useful in chronic and metabolically associated skin disorders. The Brhattrayi—Charaka Samhita, Sushruta Samhita and Ashtang Hridaya—provide foundational insights into the role of Asava and Arista in Kustha Chikitsa. The Sushruta Samhita provides detailed descriptions of Asava and Arista preparations under Mahakustha Chikitsa. Specific formulations, including complex Arista prepared from drugs such as Karanja, Chavya, Chitraka, Devadaru, Sariva, and Triphala, are indicated for Kustha and associated disorders. Palash Bhasmasava and Asava prepared using Tiladi Kshara, Salasaradi and Nyagrodhadi gaṇa are mentioned for Kustha, In contrast, Astang Hridaya does not describe any Asava or Arista formulations in Kustha Chikitsa. The Charaka Samhita mentions Kanakabindvarista, Madhvasava, and Triphalasava for the management of Kustha, with the notable absence of Madhuka pushpa in fermentation. Among the Brhattrayi, the Sushruta Samhita offers the most comprehensive information of Asava and Arista in Kustha Cikitsa, whereas Charaka Samhita provides selective therapeutic references and Vagbhata doesn’t mention anything. This review highlights the classical rationale for using fermented formulations in Kustha and their relevance in chronic dermatological conditions.