Preprint / Version 1

Ayurvedic Management of Venous ulcer (Dushta Vrana)- A Case Report


  • Shanti K Assistant Professor, Dept of Shalakya Tantra, Amrita School of Ayurveda
  • Sarathchandran R Chief physician, BS Ayurveda Vaidyashala, Haripad, Kerala



Ayurveda, Venous Ulcer, Dushtavrana, Trendelenberg Test, Case Report


Background- Vrana (ulcer), in Ayurveda is defined as a structural deformity in the skin and deeper structures (gaatra avachurnana), associated with ruja (pain), srava (discharge) etc and caused either by the vitiation of the Dosas (humuors of the body) or by trauma.

Vrana is basically of 2 types- Dushta vrana and Shudha vrana. Shudha Vrana (acute ulcer) is easily treatable, whereas Dushta vrana is a chronic ulcer, mostly unresponsive to any treatment. Acharya Sushrutha has described sixty methods for treating such vranas (ulcers).

An ulcer, according to contemporary science is considered chronic; if it takes more than 2 weeks to heal. Their chronic wound management strategies include compression therapy and antimicrobial therapy (if infected). However, in unresponsive cases, surgery is done. In this case, symptoms like Deerghakalaanubandhi (chronic), Teevra ruja (painful), Teevra puti srava (smelly discharge) etc were suggestive of Pitta pradhana Sarakta Tridoshaja Dushta vrana on the left leg.


Case & intervention- A 38-year-old non-diabetic, non-hypertensive female sought Ayurvedic treatment after a wound on her left leg did not respond to the conventional medicines even after 7 months of treatment. The ulcer was painful and foul-smelling, to the extent of disturbing her sleep and restricting her daily activities. Her Ayurvedic treatment comprised of Patoladi kashaya, Kaishora guggulu, Guduchyadi kashaya, Manjishtadi kashaya and Avipathi churna, orally and Vrana prakshalana (wound cleaning) and Vrana lepa (application of medicinal paste) externally.


Outcome- The ulcer which did not heal for 7 months even after conventional treatment, at the end of 60 days of Ayurvedic intervention, healed completely.


Conclusion- Ayurvedic treatment was effective in healing the Dushta vrana completely in this case. This proves the competence of Ayurveda in the management of chronic ulcers. However, a detailed study of the same with larger sample sizes will help to formulate a treatment protocol for such cases.

Take away message- A Dushta vrana of such chronic nature can also be easily managed through a well-planned and systematic Ayurvedic intervention.


Acharya Yadavji Trikamji, Acharya Narayan Ram, editors. Susrutasamhita of Sushruta. Varanasi: Chaukhambha Sanskrit Sansthan; 2008.Chikitsasthana, chapter 1, ver 6, p- 396, Sutrasthana, chapter 22, ver 7, p- 108.

Jones KR, Fennie K, Lenihan A. Evidence-based management of chronic wounds. Advances in skin & wound care. 2007.

Ayurvedic Formulary of India, Part 1,2nd ed:The controller of publications civil lines, Delhi; 2003.p 127,136,157, 340,309,173,326,161.

Indradeva Tripathy, D.S.Tripathy,editors, Ygaratnakara with Vaidyaprabha Hindi commentary, Chaukhambha Sanskrit Sansthan;2011. Rasayana adhikara, p-892.

Ayurvedic Management of Venous Ulcer