Sciresol Sciresol https://www.jcbsonline.ac.in/ Journal of Clinical and Biomedical Sciences 2319-2453 10.58739/jcbs/v15i3.24.154 REVIEW ARTICLE An Ayurveda Prospective on Diagno sis and Management of Penile Disorders: A Comprehensive Review An Ayurveda prospective on diagonsis & management of Penile disorder Chouhan Poona Nath pnchouhan.nah@spu.ac.in 1 Patel Harshal 2 Consultant, Department of Shalya Tantra, Nootan Ayurvedic College and Research Centre, Sankalchand Patel University Visnagar, Gujarat India Consultant, Department of Panchakarma, Nootan Ayurvedic College and Research Centre, Sankalchand Patel University Visnagar , Gujarat India 22 9 2025 15 3 149 3 10 2024 12 12 2024 2025 Abstract

Shooka Dosha refers to a group of disorders arising from the misuse of medications intended for penile enlargement. These disorders are associated with the use of sexual stimulants or penis enlargement products that contain toxic or harmful substances, leading to pathological conditions collectively referred to as Shooka Dosha. Acharya Sushruta identified 18 such diseases, categorizing 14 as Sadhya (curable) and the remaining 4 as Asadhya (incurable). This review examines Shooka Dosha through the lens of modern medicine, correlating its conditions with the treatments available in Ayurveda, on the basis of classical texts. Currently, no clinical trials have been conducted on Shooka Dosha. This study aims to initiate exploration into this largely overlooked aspect of male reproductive health, as preserved in the traditional knowledge of Ayurveda.

Keywords: Ayurveda treatment; Penis length enhancer; Shooka; Shooka Dosha; Sushruta

 Keywords None 1 Introduction

From rise of human beings there is always a concern regarding the length and strength of the penis. In a study it was concluded that in today’s era Hindu civilization it is said to be inappropriate to talk about intercourse whereas in ancient times 1, Hindu mythology has gifted a complete Grantha on reproductive care and health “Vatsayana Samhita 2”. It describes the development of education and awareness regarding sex in ancient times 3. Ayurveda is rich in medical and life living heritage where a major place is assigned to Brahamcharya (rules for sexual activity) and Vajikarna (sexual power enhancement) 4. In westernized world it a taken a wrong aspect regarding necessity of enlarged penile length 5, earlier also males with the larger genital organs were regarded in superior strata than rest 6.

Shooka Dosha is term given to cluster of disorders arising from the improper use of medications intended for penile enlargement. The term Shooka refers to sexual stimulants or penis-enhancing substances containing toxic or harmful compounds, which result in pathological conditions which may occur as an individual disorder or multiple at a time, identified as Shooka Dosha 7, 8. In Madhava Nidana commentary Madhukosha, Shooka is referred to a poisonous insect that is produced from extract or waste products in water. Drugs made from these insects are also referred as Shooka which are applied to increase the length of the penis 9 Acharya Sushruta 10, Acharya Yogratnakar 11, Bhaisajya Ratnavali 12, Madhavkar and Bhavaprkasha 13 had described the 18 diseases with their Lakshana, Sadhyata-Asadhyata and Chikitsa. Among these 18, Acharya Sushruta considered 14 as Sadhya (curable) and rest 4 as Asadhya (incurable).

1.1 <bold id="strong-4846faa1f9d64b7cb199390a71a40446">Aim and Objective</bold>

To study the concept of Shooka Dosha described in Ayurveda texts and its relevance in the modern era.

 2 Material and Methodology

Collection of the data was done using the original text, online resource including journals of Pub Med, Web of Science, and Ayush Research Portal were searched with term “Shooka Dosha”. The gathered literature was subsequently reviewed and thoroughly analysed to ensure a comprehensive understanding of the Shooka Dosha.

 3 Discussion

The use of Shooka (remedies prepared with poisonous drugs for local application, with intention to increase the size or length of the penis) leads to Shookajnya Roga mentioned in Ayurveda text. Acharya Sushruta mentioned 18 Shooka Roga. Symptoms are described individually as indicated in Table 1.

<bold id="strong-8306a80b769f44f7b80f74396af23967">Sadhyata</bold> <bold id="strong-260147ff90e84176817bd48e5cb9e3bd">- </bold> <bold id="strong-6a39f549cafc42b899e97884163bab38">Asadhyata</bold> <bold id="strong-111fa9a4ad1d4e6eb108816ba7a4f713"> of </bold> <bold id="strong-3958fc516237486d91cda31235fc780f">Shooka Dosha</bold>

Acharya Sushruta had mentioned 18 types of Shooka Dosha out of which 14 are Sadhya (curable) and 4 are considered as Ashadya Shooka Dosha (incurable) [Table 2].

<bold id="strong-3f81cecee6ad406f84206f6adafd8aef">Treatment Measure </bold>

An identified curable Shooka has a detailed line of treatment mentioned in Ayurveda. Both the generalized and specialized measures are indicated in text. Generalized concepts are applicable to all entities while specialized are for an individual entity.

 <bold id="strong-1ecfb20ccad6425dbd6e022d78d3a5a5">General measures </bold>

Acharya Sushruta, Vagbhatta, Yogratnakara, Bhaisajya Ratnavali and Bhavaprkasha, adapted similar principles to manage Shooka Dosha. Appropriate use of Kashaya (decoction), Kalka (paste), Churan (powder), Taila (oil), Ghrita (clarified butter), Rasakriya (linctuses), and Shodhana‑Ropana (cleansing and healing). Apart from this intake of Ghrita followed by Virechana (purgation), Raktamokshana (bloodletting), and other treatments measures are similarly adapted for wound management and Visha Chikitsa (treatment measures that are taken for poisonous conditions). Bhav Prakash 14 indicated application of Triphala Kwath (decoction of Amalaki - Emblica officinalis, Vibhitaka- Terminalia bellerica and Haritaki- Terminalia chebula) treated with Gugglu (Commiphora wightii), Irrigation with cold milk. The use of specific oil and paste like Darvi Taila and Medhra Roga Nivaryet Rasanjana Lepa (Sarva Anagroga) indicated by Yogratnakara 15. Intake of Ghee along with Pitta suppressing drugs, diet and procedures like Virechana, bloodletting 16, application of paste, Rasa Aushadh (herbo- mineral drugs) and measures adapted for wound management like Shodhana, Ropana, Patana (Incision of lesion).

 <bold id="strong-9e683e43a82a413a9cd7a65546bc3e7a">Specialized Treatment Protocols of </bold> <bold id="strong-62de13cb9e7a4eb2b526c5d8efa5501c"> <italic id="e-7799774e438e">Sadhya </italic> </bold> <italic id="e-7799774e438e-fb2b2d52-b503-431c-85db-24cb345d64f7"> <bold id="strong-8d48da37867f4b0e96fbef8418ebedb4">Shooka Dosha</bold> </italic>

Sarshapi – Use of Kashaya Dravya (astringent drug or substance) powder on wounds after scrapping the lesion and for wound healing use of Kashaya Dravya paste cooked in oil. 17 Yogratnakara mentioned scraping with Talpatra (Cinnamomum tamala) and application of paste of Trikatu (Shunti- Zingiber officinale, Pippali- Piper longum and Maricha- Piper nigrum), Triphala (Amalaki - Emblica officinalis, Vibhitaka- Terminalia bellerica and Haritaki- Terminalia chebula) and Gomutra (cow urine) 18 .

Ashthila – Repeated use of Jalauka (Medicinal leech) for bloodletting, if not relief is observed, excision is done by sharp instrument 19. Similar line of treatment mentioned by Rasakamdhenu 20. Vangasena 21, Yogratnakara, Bhaisajyaratnavali mentioned the line of treatment like Vagbhatta. Vasavraj 22 Vagbhatta indicated bloodletting, Treatment similar to Kaphaja Granthi (swelling occurred due to predominance of Kapha Dosha) along with irrigation by Tinduk (Diospyros tomentosa Roxb.), Triphala and Lodhra (Symplocos racemosa Roxb.) in the treatment of Ashthila.

Grathitha- Regular Swedana (Sudation therapy) with use of Snigdha (slimy or unctuous) and Koshana (lukewarm) poultice 23. Similar line of treatment adapted by Vangasena, Rasakamdhenu and Bhaisajyaratnavali. Yogratnakara also mentioned similar to Shusruta, additionally indicated application of poultice mentioned in Vrana Chikitsa (management of wound) 24. Vasavraj indicated the same, repeated use of sudation and application of poultice treated with lukewarm oil.

Kumbhika – Suppurated Kumbhika is excised with instrument and after cleaning wound, healing is promoted by Triphala, Lodhra, Tinduka, and Amra (Mangifera indica) 25. Similar concept adapted by Rasakamdhenu while Vangasena, Vasavrajiyama, Yogratnakara, Bhaisajyaratnavali follow the Vagbhatta.

Alaji – Bloodletting by Leech therapy followed by irrigation by decoction of astringent drugs, for wound healing use of same drugs decoction and paste cooked oil 26. Similar concept adapted by Rasakamdhenu while Vangashena, Vasavraj, Yogratnakara and Vaghabhat also follow the same line of treatment.

Mriditta – Irrigation with lukewarm Bala Taila, (Oil of Sida cordifolia), poultice of Ghrita (clarified butter) mixed with Madhura Dravya (sweet tasting drugs) 27. Similar Procedure adapted by Bhaisajya Ratnavali. Vangashena, Yogratnakara, Vasavraj mentioned the same treatment for Twakapaka, and Sparshhani Shooka Dosha.

Sammuddha – Rapid bloodletting by leech, suppurated boil is incised and treated with honey and ghee 28. Similar concept adapted by Rasakamdhenu while Bhaisajyaratnavali, Vangashena, Vasavraj indicated similar management to Pittaja Visarpa (Erysipelas caused by predominance of Pitta Dosha).

Avamantha – On bursting of suppurated lesion, treated with oil cooked with decoction of Dhava (Anogeissus pendula), Ashvakarna (Dipterocarpus turbinatus), Patanga (Caesalpinia sappan Linn.), Shallaki (Boswellia serrata) and Tendu (Diospyros melanoxylon Roxb) 29. Rasakamdhenu describes the same, Vasavraj, Yogratnakara, and Vangashena and, Bhaisajyaratnavali indicated similar to have the same line of treatment like Vagbhatta.

Puskarika – Use of cold therapies/measures, bloodletting by leech, Parisheka (sudation by streaming of pre-warmed liquid) with Ghrita 30. Rasakamdhenu follows the similar concept. Vangashena, Bhaisajya Ratnavali, Vasavraj, Yogratnakara and Vagbhatta indicated the management therapies similar to Pittaja Visarpa.

Sparshhani – Bloodletting, paste application of Madhura Dravya, Parisheka with cold milk, Ikshurasa (sugarcane juice) and Ghrita 31. Rasakamdhenu adapted the same while Vangashena, Yogratnakara, Bhaisajyaratnavali Vasavraj mentioned use of Bala Taila.

Uttama- Excision with Badish Shastra (type of hook used for retraction), dusting of Kashaya Dravya along with honey 32. Vasavraj, Vangashena, Yogratnakara, Bhaisajyaratnavali and Vagbhatta while Rasakamdhenu had not described Uttama Shooka Dosha.

Shatponaka – Scrapping of the lesion, followed by Rasakriya (linctuses/concentrated thick liquid), then use of oil cooked with Prishnaparani Gana (Group of drugs including Urariapicta) 33. Similar line of treatment adapted by Vangasena, Yogratnakara, Vasavrajiyama and Rasakamdhenu.

Twakapaka – Treated like Visarpa (Erysipelas / cellulites) 34. Similar concept adapted by Rasakamdhenu and Ratnavali.

Rakta Arbuda – Treated like Rakta Vidhradhi (abscess caused by Pitta Dosha) 35. Appropriate use of decoction, paste, powder, oils, Rasakriya, Sodhana (procedures or drug application which clears wound), Roapankarma (procedures which promote healing). Use of Ghee, Virechana (purgation therapy), Raktamokshana, Laghubhojna (Light diet) also beneficial. Similar concept adapted by Vangashena, Rasakamdhenu and Yogratnakara.

 <bold id="strong-a913e3df99334f3bb82c803a90d60971"/> <bold id="strong-e94ca4a94bd24ef8975457ee54a702a8"/> <bold id="strong-ed8361a3cd61446f83f611f3eeb7017f"> <italic id="e-0ed932afd126">Lakshana</italic> </bold> <bold id="strong-f0a9ba35fa6a42ea88ccfc6cbbb9f15c"> (Signs and Symptoms) of </bold> <bold id="strong-5c0cf2e815724aac9a3396dee675b2da"> <italic id="e-37cd92430eae">Shooka Dosha</italic> </bold> <bold id="strong-a2bd46e90efd4558b7dafda0cd2b09c2"> <xref id="xref-1f7799d30178453d8d74b6b1dd80e770" rid="R279114433834884" ref-type="bibr">36</xref></bold>

S.N.

Shooka Dosha

Dosha

Lakshana

1.

Sarshapika 37

Kapha-Rakta

White mustard like boils in regional part, a similar entity is known in Modern science Hirsuties coronae glandis, or pearly penile papules which are benign and consider as outcome of anatomical variation. Doesn’t need treatment, treated only for cosmetical concern. 38

2.

Ashthila 39

Vata

With misuse of poisonous medication causing hard and irregular edged boil. It may be correlated with a harden or fibrosis structure due to plaque deposition making a stone or rough feeling (Peyronie’s Disease). 40

3.

Granthita 41

Kapha

Feeling as fully filled with Shooka. It may be similar to an unfamiliar consist with feeling of collected multiple hyper densities making the penis similar to a bullet shape. 42.

4.

Kumbhika 43

Rakta-pitta

Boil’s color appears like seed of Jamuna (Black plum), dark purple in color. Somehow similar to larger angiokeratomas of penis which are usually uncommon vascular tumors, round to oval in shape with a colour variation of red to black. 44.

5.

Alaji 45

Tridosha

Similar to Prameha Pidika mentioned in Sushruta Samhita. It is a swelling red and snowy in appearance surrounded with blisters, it is mostly due to bacterial infection especially in the patients which are having diabetic prevalence. It damages the skin and other structure and mostly spreading rapidly. 46

6.

Mridita 47

Vata

Due to application of medication, initially causing stiffness leading to intention of rubbing the part with hands etc. It may be correlated with stuttering Priapism which leads to unwanted or prolonged irregular erection. 48

7.

Sammudhapidika 49

Vata

Happens due over rubbing and pressing the medication applied part. Penile Mondors’s lump is a similar condition first reported in 1938 characterized by a lump or observable phlebitis. 50

8.

Avamantha 51

Kapha and Rakta

Multiple big boils with burst middle area along with horripilation. Similar condition is reported in herpes of genital regions in which multiple blisters are formed with discharge on bursting. 52.

9.

Pushkarika 53

Pitta and Rakta

A Lotus calamus shaped blister surrounded by multiple small boils. May be co-related to Condyloma acuminatum caused by Human Papiloma Virus giving typical structures similar to lotus or cauliflower. 54

10.

Sparshahani 55

Rakta

Loss of sensation. It a condition may develop due to injury to nerve supply causing numbness in penis. Neurolysis occur mainly due to dorsal branch of Pudendal nerve supplying penis. 56

11.

Uttama 57

Rakta and Pitta

Due to repeated use of medication and indigestion. Mungha (green grams - Vigna radiata) and Masha (black gram - Vigna mungo) in size and shaped, appear like red colored boil. Similarly, Molluscum contagiosum of penis also develops similar papules which spread by sexual, non-sexual or autoinoculation mode. Mostly in adults this appears in immunocompromised or sexually active individuals. 58

12.

Shataponak 59

Vata

Multiple minute opening surrounding genital parts. Condition similar to fistula of urethra with multiple opening, it may arise due to infection to an extreme level in which tract me open into nearby organs like bladder or rectum. 60

13.

Tvakpaak 61

Pitta and Rakta

Suppuration, inflammatory signs with fever and burning. Suppuration in a penis is a very rare condition which may arise due to use of injectable, trauma or any other infective conditions giving above symptoms. Staphylococcus aureus is known to most common causative organism. 62

14.

Shonitarbuda 63

Rakta

Penis covered with red and black blisters, pain in genital region. It may be correlated to tumors arising in surrounding. Benign conditions like cavernous hemangiomas and malignant conditions including SCC, papillary carcinoma, condylomatous tumors and basaloid tumors may fall in this category. 64

15.

Mansaarbuda 65

Mansha

Arise due to Mansha dhatu Dushti (abnormality of muscular tissues). Leiomyosarcoma is a such type of penile sarcoma which arise from either superficial smooth muscle layer or deep smooth muscles of corpus cavernousum. 66

16.

Mansapaaka 67

Tridosha

Muscular tissues got supported and started to fall off and person experiencing all type of pain. It may be correlated with the pathological condition in which severe suppuration of muscular layer of penis occurs.

17.

Vidradhi 68

Tridosha

Various types of pain and discharge. This a very urological conditions which may arise due to trauma, injections or any undefined infections creating Penile abscesses. 69

18.

Tilakalaka 70

Tridosha

Use of black or mottled Shooka as causative factors creating muscle of penis fragile, putrefied and resulting in blackish discoloration, may extend up to necrosis. It may be considered similar to infective moles or eruptive blue nevi on penis which suppurates later on if not treated. 71

<bold id="strong-741ef927bd2b469697fdfb194da58008"><italic id="e-af5e20edf769">Sadhyata</italic> </bold> <bold id="strong-b3b72f97ecfd4a7189e22fc945449e23">- </bold> <bold id="strong-3fa1d8d23bf54995b61be2933d10ed42"> <italic id="e-9de2e713c64c">Asadhyata</italic> </bold> <bold id="strong-40c3d9ae84da42aaafac59a76e512ea6"> of </bold> <bold id="strong-5a488cce20a94dc89983f65570bda2ce"> <italic id="e-f0a8b99c28a7">Shooka Dosha</italic> </bold> <bold id="strong-ed5d62b522d34fd6bacf579136c2a33a"> </bold> <bold id="strong-3603a0841c3240b7ab30f0c0ee789e26"> <xref id="xref-ae448c1e0e354b9c8abcad9e25029182" rid="R279114433834832" ref-type="bibr">72</xref> </bold>

Sadhya Shooka Dosha

Asadhya Shooka Dosha

• Sarshapika

• Ashthila

• Granthita

• Kumbhika

• Alaji

• Mridita

• Sammudhapidika

• Avamantha

• Pushkarika

• Sparshahani

• Uttama

• Shataponak

• Tvakpaak

• Shonitarbuda

• Mansaarbuda

• Mansapaaka

• Vidradhi

• Tilakalaka

4 Conclusion

Shooka Dosha is an important concept but yet no conceptual or clinical work carried out. More research work is needed to understand its importance. Sincere efforts were done by authors to compile the data and made available related to Shooka Dosha from Ayurveda literature. The traced facts were collected systematically and then analyzed. In the first observation, these diseases are mostly seen in society and can be easily correlated with modern existing penile disorders. The searched aetiology, clinical features, and their treatment modalities can be utilized. Clinical trials can be run at the post-graduation dissertation and doctorate work to make it more validate. It is also suggested to make evidence‑based clinical correlations of the Shooka Dosha of Ayurveda with modern science. The research‑based data publications are also solicited to put the subjects on scientific platform. The evaluation of efficacy of mentioned drugs in Shooka Dosha for the antibacterial and wound healing properties needs to explore regarding the treatment of genital disorders.

The exploration of Shooka Dosha through classical Ayurvedic texts reveals a nuanced understanding of disorders associated with inappropriate use of penile enlargement medications. Through a detailed examination of classical Ayurvedic literature, particularly the work of Acharya Sushruta, the research correlates these ancient conditions with analogous symptoms recognized in modern medicine. By categorizing the 18 distinct disorders into curable and incurable forms, as outlined by Sushruta, the study highlights both the pathological consequences of toxic substances used in penile enlargement and the extensive treatment protocols in Ayurveda for each condition. These conditions, as elaborated by Acharya Sushruta, present a unique framework that could complement modern approaches in understanding and addressing penile health disorders.

<p id="p-9cc8c9a88cea">Through comprehensive literature review and correlation with modern medical conditions, this study highlights the potential of Ayurveda in offering both preventive and therapeutic insights into <italic id="e-2415d4a66a89">Shooka</italic> <italic id="emphasis-12">Dosha</italic>. The principles and treatments suggested, including bloodletting, use of herbal formulations, and detoxification techniques, offer a holistic alternative for curable cases and a respectful approach for incurable cases. 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