Comparative Clinical Study of Visarpa With Jalokavacharana and Audumbar Lepa: An Ayurvedic Clinical Evaluation

Background: Visarpa is a rapidly spreading inflammatory skin disorder described extensively in the Ayurvedic classics. It is predominantly caused by vitiation of Pitta, Rakta, and associated Dhatus, producing symptoms such as erythema, burning sensation, pain, vesicular eruptions, oedema, and rapid spread of lesions. Based on clinical similarities, Visarpa can be correlated with Herpes Zoster (Shingles). Since Rakta Dushti is the principal pathological factor, Acharya Sushruta has advocated Raktamokshana as the treatment of choice. Jalaukavacharana (Leech Therapy), a form of Raktamokshana, is considered the safest procedure for Pittaja disorders, while Audumbar Lepa possesses Pittahara, Raktaprasadana, Dahashamana, Shothahara and Vranaropana properties. Aim: To compare the clinical efficacy of Jalaukavacharana and Audumbar Lepa in the management of Visarpa (Herpes Zoster). Materials and Methods: A comparative clinical study was conducted on patients diagnosed with Visarpa/Herpes Zoster. Patients were randomly allocated into two groups. Group A received Jalaukavacharana, while Group B received topical application of Audumbar Lepa. Clinical parameters including Vedana (pain), Daha (burning sensation), Raga (erythema), Shotha (swelling), Kandu (itching), Sphota (vesicles), and overall clinical improvement were assessed before treatment, during treatment, and after completion. Statistical analysis was performed using appropriate paired and unpaired statistical tests. Results: Both interventions produced statistically significant improvement in the clinical features of Visarpa. However, Jalaukavacharana demonstrated comparatively superior relief in pain, burning sensation, erythema, oedema, and overall clinical recovery. The rapid action of leech therapy in removing vitiated blood and reducing inflammation contributed to earlier symptom relief compared with Audumbar Lepa. Conclusion: Both Jalaukavacharana and Audumbar Lepa are effective in the management of Visarpa. Jalaukavacharana showed comparatively better therapeutic efficacy and can be considered an effective Panchakarma intervention for Pitta-Rakta predominant Visarpa.