A Randomized Comparative Clinical trial to evaluate the Shodana effect of Dhoopanakarma with Shreevasadi and Nimbapatradi Dhoopa in Dushtavrana with special reference to Non-healing ulcers

Vrana Chikitsa has been given importance in the classics in which Shashtiupakramas are mentioned by Acharya Sushruta.1 Dhoopanakarma is one among them in which drugs of herbal, herbo-mineral or animal origin is used for Vrana *Dhoopana.*Acharya Sushruta explained Dushta Vrana Lakshanas as Krishna-Rakta-Peeta- Shukla Varna, Putimamsa, Puyasrava, Atyartavedana, Dushtashonitasrava, Daha, Paka, Raga, Kandu, Shopha and *Deerghakaleena2.*Dushtavrana can be correlated to non-healing ulcer in contemporary science by its characteristic features as pain, discharge, itching, burning sensation and foul smell3. Dhoopana is an integral part of Rakshavidhi which ensures the protection of vrana against the microbes and it act as Vranashodaka by reducing Vedana and Srava.4 A non-healing ulcer is a major health problem and it affects nearly 6 million populations worldwide. In India it is reported as 4.5 per 1000 population, the incidence of chronic ulcers is expected to increase as the population age increase5. Non-healing ulcers are treated by antibiotics, but long term usage of these will develop resistance. Hence we adopt Acharya Sushruta’s various Shodana measures like Sharirika Shodana by Vamana, Virechana and Stanika Shodana by Kashaya, Avachurana, and Dhoopana 6 etc.Acharya Chakradattahas mentioned about Shreevasadi Dhoopa under Vranashota Chikitsa for the Vrana Dhoopana which contains drugs like Shreevasa, Guggulu, Agaru, Shala niryasa which possess Krimigna and Vedanahara7 properties.

Acharya Bhavamishra has mentioned about Nimbapatradi Dhoopa under Vranashotadikara for the Vrana Dhoopana which contains drugs like Nimbapatra, Vacha, Hingu, Sarpi, Lavana and Sarshapa8.

Here an attempt is made to evaluate and compare the Shodana effect of Shreevasadi Dhoopa and Nimbapatradi Dhoopa in Dushtavrana with special reference to Non-healing ulcers.