Churna Pinda Sweda

Introduction

Churna Pinda Sweda is a type of fomentation where bolus of medicated powder tied in to a potali is applied over the body by dipping in warm oil for a specific duration of time.

Materials Required

The materials required for performing churna pinda sweda are

• Medicated Churnas like kottamchukkadi, kolakulathadi, jadamayadi, etc.500g( 250g each)
• Cora cloth (18”x18”)
• Thread – 2
• Taila for abhyanga of head and body 60ml and 100ml
• Taila for  heating the potali 100ml
• Potali
• Towel – 1
• Kadai Metal vessel
• Thalam

Duration: 1 hour 10minutes

Purvakarma

Preparation of kizhi

• 2 pieces of cora cloths (18”x18”) are evenly spread on the table.
• 250g of prescribed churna is weighed  and placed at the center of each cora cloth
• The sides of the cora cloth is folded and tied tightly using a thread to make a potali

Pradhana Karma

• The patient is asked to sit comfortably over the dhroni.
• Rasnadi talam is placed over the vertex.
• Then the patient is asked to sit with legs extended
• The body and foot is cleaned with a towel.
• The oil for abhyanga is heated using a water bath
• Temperature of the oil is checked and confirmed with the patient .
• Initially Sarvanga abhyanga is done in all 7 postures starting with Sitting, Supine, Right Lateral, Supine, Left Lateral, Supine and Sitting .
• Oil for dipping the potali is poured into an iron vessel for heating
• Once the oil is adequately heated , the  prepared potalis are dipped into it .
• Once it is heated sufficiently, temperature of the potali is checked by the therapist by placing it  over the dorsum of his hand.
• Temperature is also confirmed with the patient by placing it over his foot.
• The heated potali is applied by patting it as linear strokes over the neck region to the hands, neck to lower back, hip to foot and neck to foot in sitting position.
• The potali is applied quickly in gentle stroking manner to avoid burns.
• The temperature of the potali is maintained throughout the procedure by dipping in hot oil.
• A minimum quantity of oil is ensured for dipping by pouring extra oil into the iron vessel when it gets reduced.
• Then the patient is asked to lie in supine position.
• The heated potali is applied by patting it initially over the abdomen to hands and hip to foot. Then the entire body is covered by patting it simultaneously as linear strokes from hands to foot.
• The potali is to be applied in circular pattern over the joints.
• The patient is then asked to lie in left lateral position with right knee flexed.
• The heated potali is applied by patting it over hand to hip by one therapist, while the other therapist cover back region to foot.
• Then the patient is asked to lie in supine position and same strokes are repeated with heated potalis.
• The patient is then asked to lie in right lateral position with left knee flexed.
• The heated potali is applied by patting it over hand to hip by one therapist, while the other therapist covers from back region to foot.
• Then the patient is again asked to lie in supine position and same strokes are repeated with heated potalis.
• Finally, the patient is made to sit with legs extended and respective strokes mentioned for sitting posture  are repeated.

Paschat Karma

• Thalam is removed.
• Patient is asked to take hot shower after resting for a while. 
• Rasnadi choorna is applied over vertex after bath.

Ruksha Churna Pinda Sweda

Introduction

Ruksha Churna Pinda Sweda is a type of fomentation where heated bolus of medicated powder is tied into a potali and is applied over the body for specific duration of time.

Materials Required

The materials required for performing ruksha churna pinda sweda are

• Churnas like kottamchukkadi, kolakulathadi, jadamayadi, etc.- 1kg
• Cora cloth (18”x18”)
• Small cloth (10”x10”)
• Threads – 4
• Towel
• Iron vessel – 1
• Thalam
• Potali – 4

Duration: 1 hour

Purvakarma

Preparation of kizhi

• 4 pieces of cora cloths (18”x18”) are evenly spread on the table. In the middle of each cloth, a small piece of cora cloth (10”x10”) is kept.
• I kg of prescribed churna is taken and equally divided into 4 parts.
• Each part of churna (ie. 250gms) is placed in each cora cloth to make potali.

Pradhana Karma

• The patient is asked to sit comfortably over the dhroni.
• Rasnadi talam is placed over the vertex.
• Then the patient is asked to sit with legs extended
• The body and foot is cleaned with a towel.
• The procedure  is done in all 7 postures starting with Sitting, Supine, Right Lateral, Supine, Left Lateral, Supine and Sitting .
• The prepared potali of churna is heated by keeping it in a metal vessel  .
• Once it is heated sufficiently, temperature of the potali is checked by the therapist by placing it  over the dorsum of his hand.
• Temperature is also confirmed with the patient by placing it over his foot.
• The heated potali is applied by patting it as linear strokes over the neck region to the hands, neck to lower back, hip to foot and neck to foot in sitting position.
• The potali is applied quickly in gentle stroking manner to avoid burns.
• The temperature of the potali is maintained throughout the procedure by  reheating it in a metal vessel
• Then the patient is asked to lie in supine position.
• The heated potali is applied by patting it initially over the abdomen to hands and hip to foot. Then the entire body is covered by patting it simultaneously as linear strokes from hands to foot.
• The potali is to be applied in circular pattern over the joints.
• The patient is then asked to lie in left lateral position with right knee flexed.
• The heated potali is applied by patting it over hand to hip by one therapist, while the other therapist cover back region to foot.
• Then the patient is asked to lie in supine position and same strokes are repeated with heated potalis.
• The patient is then asked to lie in right lateral position with left knee flexed.
• The heated potali is applied by patting it over hand to hip by one therapist, while the other therapist covers from back region to foot.
• Then the patient is again asked to lie in supine position and same strokes are repeated with heated potalis.
• Finally, the patient is made to sit with legs extended and respective strokes mentioned for sitting posture  are repeated.

Paschat Karma

• Thalam is removed.
• Patient is asked to take hot shower after resting for a while. 
• Rasnadi choorna is applied over vertex after bath.

Jambeera Pinda Swedam

Introduction

Jambeera Pinda Sweda is a type of fomentation where bolus made of lemon and medicated churnas is tied into a potali and applied over the body by dipping in warm oil for a specific duration of time.

Materials Required

The materials required for performing jambeera pinda sweda are

• Prepared Potali of Jambeera Pinda ( 250g each)
• Cora cloth (18”x18”)
• Thread – 2
• Towel -1
• Taila for abhyanga of head and body (60ml and 100ml)
• Taila for heating the potali (100ml)
• Metal vessel – 1
• Thalam

Duration : 1 hour 10 minutes

Pradhana Karma

• The patient is asked to sit comfortably over the dhroni.
• Rasnadi talam is placed over the vertex.
• Then the patient is asked to sit with legs extended
• The body and foot is cleaned with a towel.
• The oil for abhyanga is heated using a water bath
• Temperature of the oil is checked and confirmed with the patient .
• Initially Sarvanga abhyanga is done in all 7 postures starting with Sitting, Supine, Right Lateral, Supine, Left Lateral, Supine and Sitting .
• Oil for dipping the potali is poured into an iron vessel for heating

• Once the oil is adequately heated , the  prepared potalis are dipped into it .
• Once it is heated sufficiently, temperature of the potali is checked by the therapist by placing it  over the dorsum of his hand.
• Temperature is also confirmed with the patient by placing it over his foot.
• The heated potali is applied by patting it as linear strokes over the neck region to the hands, neck to lower back, hip to foot and neck to foot in sitting position.
• The potali is applied quickly in gentle stroking manner to avoid burns.
• The temperature of the potali is maintained throughout the procedure by dipping in hot oil.
• A minimum quantity of oil is ensured for dipping by pouring extra oil into the iron vessel when it gets reduced.
• Then the patient is asked to lie in supine position.
• The heated potali is applied by patting it initially over the abdomen to hands and hip to foot. Then the entire body is covered by patting it simultaneously as linear strokes from hands to foot.
• The potali is to be applied in circular pattern over the joints.
• The patient is then asked to lie in left lateral position with right knee flexed.
• The heated potali is applied by patting it over hand to hip by one therapist, while the other therapist cover back region to foot.
• Then the patient is asked to lie in supine position and same strokes are repeated with heated potalis.
• The patient is then asked to lie in right lateral position with left knee flexed.
• The heated potali is applied by patting it over hand to hip by one therapist, while the other therapist covers from back region to foot.
• Then the patient is again asked to lie in supine position and same strokes are repeated with heated potalis.
• Finally, the patient is made to sit with legs extended and respective strokes mentioned for sitting posture  are repeated.

Paschat Karma

• Thalam is removed.
• Patient is asked to take hot shower after resting for a while. 
• Rasnadi choorna is applied over vertex after bath.

Patra Pinda Sweda

Introduction

Patra Pinda Sweda is a type of fomentation where bolus made of vatahara patras and medicated churnas are  tied into a potali and applied over the body by dipping in warm oil for a specific duration of time.

Materials Required

The materials required for performing patra pinda sweda

• Prepared Potali of Patra Pinda 250g each
• Cora cloth (18”x18”)
• Thread – 2
• Towel – 1
• Taila for abhyanga of head and body  60ml and 100ml
• Taila for heating the potali 100ml
• Metal vessel – 1
• Thalam
• Potali

Duration: 1 hour 10minutes

Pradhana Karma

• The patient is asked to sit comfortably over the dhroni.
• Rasnadi talam is placed over the vertex.
• Then the patient is asked to sit with legs extended
• The body and foot is cleaned with a towel.
• The oil for abhyanga is heated using a water bath
• Temperature of the oil is checked and confirmed with the patient .
• Initially Sarvanga abhyanga is done in all 7 postures starting with Sitting, Supine, Right Lateral, Supine, Left Lateral, Supine and Sitting .
• Oil for dipping the potali is poured into an iron vessel for heating

• Once the oil is adequately heated , the  prepared potalis are dipped into it .
• Once it is heated sufficiently, temperature of the potali is checked by the therapist by placing it  over the dorsum of his hand.
• Temperature is also confirmed with the patient by placing it over his foot.
• The heated potali is applied by patting it as linear strokes over the neck region to the hands, neck to lower back, hip to foot and neck to foot in sitting position.
• The potali is applied quickly in gentle stroking manner to avoid burns.
• The temperature of the potali is maintained throughout the procedure by dipping in hot oil.
• A minimum quantity of oil is ensured for dipping by pouring extra oil into the iron vessel when it gets reduced.
• Then the patient is asked to lie in supine position.
• The heated potali is applied by patting it initially over the abdomen to hands and hip to foot. Then the entire body is covered by patting it simultaneously as linear strokes from hands to foot.
• The potali is to be applied in circular pattern over the joints.
• The patient is then asked to lie in left lateral position with right knee flexed.
• The heated potali is applied by patting it over hand to hip by one therapist, while the other therapist cover back region to foot.
• Then the patient is asked to lie in supine position and same strokes are repeated with heated potalis.
• The patient is then asked to lie in right lateral position with left knee flexed.
• The heated potali is applied by patting it over hand to hip by one therapist, while the other therapist covers from back region to foot.
• Then the patient is again asked to lie in supine position and same strokes are repeated with heated potalis.
• Finally, the patient is made to sit with legs extended and respective strokes mentioned for sitting posture  are repeated.

Paschat Karma

• Thalam is removed.
• Patient is asked to take hot shower after resting for a while. 
• Rasnadi choorna is applied over vertex after bath.

Kashaya Dhara

Introduction

Kashaya Dhara is the process of pouring prepared Kashaya over the body in a continuous and constant stream.

Materials Required

The materials required for performing Kashaya dhara are

• Kashaya –  4 – 5litre
• Dhara table – 1
• Galanthika – 2
• Hot water bath – 1
• Cotton balls
• Vessel – 2

Duration: 50 minutes

Purvakarma

• Patient is asked to sit comfortably over the droni with legs extended.
• Ear plugs are kept on both ears.
• Thalam is applied to the vertex of the patient.

Pradhana Karma

• Kashaya dhara is done in 7 postures: Sitting, Supine, Left Lateral, Supine, Right Lateral, Supine and Sitting.
• Sitting Posture

• The neck region, back and the extremities are covered in this posture.
• Kashaya for dhara is made lukewarm using a hot water bath.
• Temperature of the Kashaya is checked by pouring it over the dorsum of hand.
• Lukewarm Kashaya is taken in galanthika and is poured into either side of the patient’s body in a synchronised manner from a height of 12 angula in downward direction.
• Initially dhara is done from trunk to hand, then from hip to toe and then from nape of neck to hip.
• The poured Kashaya is collected from droni in another vessel.
• The temperature of the Kashaya is maintained throughout the procedure by reheating it in hot water bath.
• The same procedure is repeated for other 6 postures.

• Supine Posture
  • The patient is asked to lie in supine posture.
  • The chest, abdomen, anterior aspects of both hands and legs are covered in this posture.
  • Dhara is done initially from trunk to hand, then from hip to toe and then together from neck to toe.
• Left Lateral Posture
  • The patient is asked to lie on the left side of his body.
  • Right side of the trunk, right arm and lateral aspect of the right leg is covered in this posture. 
  • Therapist on the left side doing dhara initially from neck to hand, then from hip to toe and then together from neck to toe.
  • Another therapist on right side doing dhara initially from whole of the back including spine, then from hip to toe and together from back to toe.
• Supine Posture

• Repeat the procedure

• Right Lateral Posture
  • The patient is asked to lie on the right side of his body.
  • Left side of the trunk, left arm and lateral aspect of the left leg is covered in this posture.
  • Therapist on the right side doing dhara initially from neck to hand, then from hip to toe and then together from neck to toe.
  • Another therapist on left side doing dhara initially from whole of the back including spine, then from hip to toe and then together from back to toe.
• Supine Posture

• Repeat the procedure

• Sitting Posture

• Repeat the procedure

Paschat Karma

• Earplugs and thalam are removed.
• The patient’s body is cleaned with a towel.
• Patient is asked to take hot shower after resting for a while . 
• Rasnadi choorna is applied over vertex after bath.

Pizhichil

Introduction

Pizhichil is the procedure in which warm medicated oil is poured over the patient’s body for a specific period of time.

Materials Required

The materials required for performing pizhichil are

• Taila  – 2.5 – 3 litre
• Towel – 1
• Piece of cloth –  2 metres
• Hot water bath
• Cotton balls
• Droni – 1
• Vessel – 1
• Galanthika – 2

Duration: 1 hour

Purvakarma

• Patient is asked to sit comfortably over the droni with legs extended.
• Ear plugs are kept on both ears.
• Thalam is applied over the vertex of the patient.

Pradhana Karma

• Pizhichil is done in 7 postures: Sitting, Supine, Left Lateral, Supine, Right Lateral, Supine and Sitting.
• Sitting Posture

• The neck region, back and the extremities are covered in this posture.
• Taila for pizhichil is made lukewarm using a hot water bath.
• Temperature of the taila is checked by pouring it over the dorsum of hand.
• Lukewarm  taila is squeezed on either side of the patient’s body from a piece of cloth that is periodically dipped in warm oil in a synchronised manner from a height of 12 angula.
• Height less than 12 angula (x)
• While pouring the taila simultaneous massage is done using the other hand.
• Initially  Pizhichil is done from trunk to hand, hip to toe and finally from nape of neck to hip.
• Then, the taila is collected from droni in a vessel.
• The temperature of the taila is maintained throughout the procedure by reheating it in hot water bath.
• The same procedure is repeated in all the 6 postures.

• Supine Posture

• The patient is asked to lie in supine posture.
• The chest, abdomen, anterior aspects of both hands and legs are covered in this posture.
• Pizhichil is done initially from trunk to hand, hip to toe and finally from neck to toe.

• Left Lateral Posture
  • The patient is asked to lie on the left side of his body.
  • Right side of the trunk, right arm and lateral aspect of the right leg is covered in this posture. 
  • Therapist on the left side will be doing pizhichil initially from neck to hand, hip to toe and finally from neck to toe.
  • Other therapist on right side will be doing pizhichil initially whole of the back including spine, hip to toe and finally from back to toe.

• Supine Posture

• Repeat the procedure.? The procedure is repeated

• Right Lateral Posture
  • The patient is asked to lie on the right side of his body with his left leg flexed.
  • Left side of the trunk, left arm and lateral aspect of the left leg is covered in this posture.
  • Therapist on the right side will be doing pizhichil initially from neck to hand, hip to toe and finally from neck to toe.
  • Other therapist on left side will be doing pizhichil initially in whole of the back including spine, hip to toe and finally from back to toe.
• Supine Posture

• Repeat the procedure

• Sitting Posture

• Repeat the procedure

Paschat Karma:

• Earplugs and thalam are removed.
• The patient’s body is cleaned with a towel.
• Patient is asked to take hot shower after resting for a while .
• Rasnadi choorna is applied over vertex after bath.

                                         Katibasti

Introduction

Katibasti is the procedure in which oil is retained for a specific duration with the help of black gram frame firmly fixed over the lower back.

Materials Required

The materials required for performing Katibasti are

• Medicated Taila 250ml
• Black gram powder 200g
• Water – 100ml
• Bowl – 1
• Water bath – 1
• Spoon – 1
• Katibasti ring (optional)
• Towel – 1

Duration: 30-45minutes

Purvakarma

Preparation of black gram frame

• 200 g of black gram powder is taken in a bowl.
• To this, about 100 ml of water is added.
• This mixture is kneaded well to get a compact dough.
• The dough is then rolled to make a frame wall of approximately 2 inches height.

Pradhana Karma

• The patient is asked to lie in prone position and the low back region is cleaned with a towel.
• The painful area of the patient were the katibasti is to be done is palpated.
• A circular ring of black gram roll is placed around the painful region.
• It is then fixed firmly by sealing it with black gram paste.
• The Taila is made lukewarm using a hot water bath.
• Temperature is checked by pouring it over the dorsum of the hand.
• The lukewarm oil is poured into the inner wall of the ring with a spoon.
• The circular ring should be devoid of any leakage (  and x)
• The patient is instructed not to move or shake his body during the procedure.
• Uniform temperature is maintained throughout the procedure by refilling it with lukewarm oil.
• The duration of the procedure is 30-45 min

Paschat Karma

• The oil is removed using a spoon.
• Then, the frame is removed, and the area is cleaned.
• A gentle abhyanga is given over the low back region.

                                         Janubasti

Introduction

Janubasti is the procedure in which oil is retained for a specific duration with the help of black gram frame firmly fixed over the knee joint.

Materials Required

The materials required for performing Janubasti are

• Medicated Taila 250ml
• Black gram powder 200g
• Water – 100ml
• Bowl – 1
• Water bath – 1
• Spoon – 1
• Janubasti ring(optional)
• Towel – 1

Duration: 30- 45minutes

Purvakarma

Preparation of black gram frame

• 200 g of black gram powder is taken in a bowl.
• To this, about 100 ml of water is added.
• This mixture is kneaded well to get a compact dough.
• The dough is then rolled to make a frame wall of approximately 2 inches height.

Pradhana Karma

• The patient is asked to lie in supine position and the knee joint is cleaned with a towel.
• The painful area of the patient were the janubasti is to be done is palpated.
• A circular ring of black gram roll is placed around the painful region.
• It is then fixed firmly by sealing it with black gram paste.
• The Taila is made lukewarm using a hot water bath.
• Temperature is checked by pouring it over the dorsum of the hand.
• The lukewarm oil is poured into the inner wall of the ring with a spoon.
• The patient is instructed not to move or shake his body during the procedure.
• Uniform temperature is maintained throughout the procedure by refilling it with lukewarm oil.
• The duration of the procedure is 30-45 min.

Paschat karma

• The oil is removed using a spoon.
• Then, the frame is removed, and the area is cleaned.
• A gentle abhyanga is given over the knee.

Karpasa Pinda Sweda

Introduction

Karpasa pinda sweda is the procedure of application heated bolus of cotton seeds over the body to induce perspiration.

Materials Required

The materials required for performing karpasa pinda sweda are:

Karpasabeeja – 250g – 300g

Dhanyamla – 1- 2litre

Vessel  – 1

Cloth for covering the vessel – 1

Towel – 1

Potali

Duration: 1hour 10minutes

Purvakarma

• Patient is asked to sit comfortably over the droni with legs extended.
• Thalam is applied to the vertex of the patient.

Pradhana Karma

• Karpasa pinda sweda is done in 7 postures: Sitting, Supine, Left Lateral, Supine, Right Lateral, Supine and Sitting.
• Sitting Posture

• The neck region, back and the extremities are covered in this posture.
• Dhanyamla is poured into a vessel and made to boil, where the mouth of the vessel is tied up with a cloth.
• The four pottalis are kept over the cloth and by the vapours coming from the boiling Dhanyamla the Pottalis get heated up.
• Once the required temperature is attained, two pottalis are taken.
• Temperature of the potali is checked by the therapist by placing it over the dorsum of his hand.
• Temperature is also confirmed  with the patient by placing it over the foot .
•  
• Two pottalis are taken by the therapists and the temperature of the pottali is checked by touching it on the dorsum of their hands.
• The lukewarm Pottali is gently tapped which is then rubbed on either side of patient’s body in a synchronized manner.
• Initially swedana is done from trunk to hand, hip to toe and finally from nape of neck to hip.
• The pottali is moved in linear fashion on the extremities from above downwards and in the trunk as linear fashion but from below upwards.
• In joints the pottali is moved in circular fashion.
• The temperature of the pottalis are maintained throughout the procedure by replacing it with other pottalis kept in steam on the cloth tied vessel.
• The same procedure is repeated in all the 6 postures.

• Supine Posture
  • The patient is asked to lie in supine posture.
  • The chest, abdomen, anterior aspects of both hands and legs are covered in this posture.
  • Swedana is done initially from trunk to hand, hip to toe and finally from neck to toe.

• Left Lateral Posture
  • The patient is asked to lie on the left side of his body.
  • Right side of the trunk, right arm and lateral aspect of the right leg is covered in this posture. 
  • Therapist on the left side will be doing swedana initially from neck to hand, hip to toe and finally from neck to toe.
  • Other therapist on right side will be doing swedana initially from whole of the back including spine, hip to toe and finally from back to toe.

• Supine Posture
  • Repeat the procedure
• Right Lateral Posture

• • The patient is asked to lie on the right side of his body.
  • Left side of the trunk, left arm and lateral aspect of the left leg is covered in this posture.
  • Therapist on the right side will be doing swedana initially from neck to hand, hip to toe and finally from neck to toe.
  • Other therapist on left side will be doing swedana initially from whole of the back including spine, hip to toe and finally from back to toe.

• Supine Posture

• Repeat the procedure

• Sitting Posture

• Repeat the procedure

Paschat Karma

• Thalam is removed.
• The patient’s body is cleaned with a towel.
• Patient is asked to take hot shower after resting for a while. 
• Rasnadi choorna is applied over vertex after bath.

                                         Greevabasti

Introduction

Greevabasti is the procedure in which oil is retained for a specific duration with the help of black gram frame firmly fixed over the neck region.

Materials Required

The materials required for performing Greevabasti are

• Medicated taila 250ml
• Black gram powder 200g
• Water – 100ml
• Bowl – 1
• Water bath – 1
• Spoon – 1
• Greevabasti ring(optional)
• Towel – 1

Duration: 30- 45minutes

Purvakarma

Preparation of black gram frame

• 200 g of black gram powder is taken in a bowl.
• To this, about 100 ml of water is added.
• This mixture is kneaded well to get a compact dough.
• The dough is then rolled to make a frame wall of approximately 2 inches height.

Pradhana Karma

• The patient is asked to lie in prone position and the neck region is cleaned with a towel.
• The painful area of the patient were the greevabasti is to be done is palpated.
• A circular ring of black gram roll is placed around the painful region.
• It is then fixed firmly by sealing with black gram paste.
• The Taila is made lukewarm using hot water bath.
• Temperature is checked by pouring over the dorsum of the hand.
• The lukewarm oil is poured into the inner wall of the ring with a spoon.
• The patient is instructed not to move or shake his body during the procedure.
• Uniform temperature is maintained throughout the procedure by refilling it with lukewarm oil.
• The duration of the procedure is 30-45 min.

Paschat Karma

• The oil is removed using a spoon.
• Then, the frame is removed, and the area is cleaned.
• A gentle abhyanga is given over the neck region.

Nadi sweda

Introduction

Nadi sweda is the procedure in which perspiration is induced by passing steam over the body parts using Nadi Sweda Yantra.

Materials Required

The materials required for performing nadi sweda are:

• Taila for Abhyanga 50-80ml
• Dasamoola Kashaya churna 20-50g
• Fresh leaves of Eranda, Nirgundi, Arka etc
• Eye pad – 1
• Nadi sweda yantra
• Bowl – 1
• Towel – 1
• Water bath – 1

Duration: 30 minutes

Purvakarma

Preparation of steam

• Sufficient quantity of water is poured in to nadi sweda yantra.
• Dasamoola Kashaya choorna and fresh vatahara leaves are added into it and the lid is closed.
• The electrical heating coil is switched on to generate steam.

Pradhana Karma

• Patient is asked to sit comfortably over the droni with legs extended.
• The tender region is palpated.
• The Taila for Abhyanga is made lukewarm using a hot water bath.
• The temperature of the taila is checked by pouring it over the dorsum of hand.
• The lukewarm taila is then massaged initially from shoulder and finally towards hand in three postures.
• Once steam start to flow from the nozzle, the steam is directed on the shoulder region.
• Considerable distance is maintained between the nozzle and patient.
• The steam is given over neck, shoulder region and towards hand.
• The steam should not be given too far from the body ( ).
• The steam should not be given too near to the body ( ).
• The eyes of the patient are covered using an eye pad if swedana is done in the face region.
• The hot fomentation is continued till the appearance of perspiration.

Paschat Karma                

• The area is cleaned with a towel.
• The patient is asked to take rest.

Nasya Karma

Materials

Gokarna – 1

Dhoomanetra – 1

Haridravarthi – 1

Nadee sweda yantra – 1

Holder – 1

Sputum cup – 1

Saindhava jala – 100ml

Eye pad – 1

Gas stove – 1

Cotton

Droni – 1

Thaila

Duration: 40 minutes

Poorvakarma

1. Before starting snehana and swedana, patient should be asked to get relieved from natural urges like urination, defecation etc. patient should not be athi kshutita, and get cleaned the mouth and face with luke warm water.

2. Snehana of jatrurdhwa organs i.e. organs above neck like neck, ears, face, head and scalp should be well oleated and subjected to swedana. (mridu abhyanga followed by nadi sweda). (While doing nadi sweda eyes should be covered with eye pad)

3. Patients should be given prayogik dhumpana to clear all the strotasas. ( here we do dhumapana with haridra varthi)

4. Patient should be in niwata room (devoid of flowing air) and is given supine position (uttana shirsh) with slightly leg raised condition (unnata pada) and both the upper and lower limbs spread straight (prasarit kara charana).

5. Repeated hastasweda should be administered to jatrurdhwa area.

6. While performing this procedure neck will be partially extended, paricharaka’s (therapist) palm of left hand will stay on forehead of patient, eyes will be covered with pad or clean cloth, tip of nose will be stretched by middle finger and one nasal cavity will be closed by anamika or pradeshini anguli finger.

7. To be administered calculated dose should be divided in three doses.

Pradhana karma

1. After snehana and swedana and earlier mentioned position, prescribed dose of lukewarm (ushnambu prataptam) drug should be administered in three equal divided doses.

2. First of the 3 divided doses of lukewarm medicine should be poured in nasal cavity in one stroke without breaking the stream. Ask the patient to slowly inhale. Same procedure will be done with another nostril.

3. Patient should be advised to avoid sneezing, loose temper, laugh, forceful inhalation (Uchchhindana), excessive talk (vyaahara).

4. After the medicine instilled, ear, forehead, scalp, shoulder, hands and feet should be massaged.

5. The patient should spit kapha to both sides alternatively.

6. Repeated swedana should be given to jatrurdhwa till the expulsion of medicines and kapha through spitting (shthiwana).

7. This should be followed by the third set of a luke warm nasya till the expulsion of medicines.

8. In this way, all the three divided dosage of nasya should be administered one after another with swedana offered in between.

Pashchat karma:

1. After administration of the first nasya dose, samwahana i.e. light massage to ears, forehead, scalp, chicks, neck, shoulders, palms and soles should be given. 

2. If administered medicine arrives in oropharingeal cavity, it should be spitted out by turning towards right or left lateral side. This medicine should not be swallowed as it may cause Agnimandya, and increase in dosha.

3. Repeated fomentation (sweda) should be given to organs above clavicles (jatrurdhwa) organs till the medicine and Kapha will be spitted and sneezed out.

4. After this, likewise 2nd and 3rd dose should be administered.

5. After each dose administration, swedana should be carried out.

6. For virechana and avapida nasya, after medicine administration, according to doshbala sneha nasya should be given.

7. After completion of nasya procedure, Patient should be advised to be in lying down position till 100 matra.

8. If there any vitiated or remaining dosha, Vairechanik or suitable dhumpaan and Gandusha with lukewarm water should be carried out.

9. Patient should be advised to follow the rule mentioned in snehapan i.e. patient should be advised to follow rules like to drink luke warm water, follow Brahmacharya (avoid sex), be Kshapashaya (avoid daysleep and late night sleep), avoid pravaata (direct air), avoid yana (excessive travelling), adhwa (excessive walking), atibhashya (excessive talk), atyasana (sitting on same site for long duration), avoid dhum rajasewana (smoke and dust).

10. Excessive liquid intake should be avoided.

Shashtika Shali Pinda Sweda

Shashtika shali pinda sweda is the procedure of application of heated pottali made of  medicinal rice (Navara) over the body to induce perspiration.

Materials Required

The materials required for performing Shashtika shali pinda sweda are

• Shashtika Shali
• Balamoola
• Water
• Milk Metal vessel  
• Laddle
• Holder
• Cora cloth (18”x18”)
• Thread
• Kizhi
• Vessel
• Taila for Abhyanga 200ml
• Talam
• Towel

Purvakarma

• Patient is asked to sit comfortably over the droni with legs extended.
• Thalam is applied to the vertex of the patient.
• Sarvanga abhyanga is done in 7 postures.

Pradhana Karma

• Shashtika shali pinda sweda  is done in 7 postures: Sitting, Supine, Left Lateral, Supine, Right Lateral, Supine and Sitting.
• Sitting Posture
• The neck region, back and the extremities are covered in this posture.
• The prepared balamoola kashaya is poured in to the metal vessel and boiled along with milk.
• Four potalis are taken and dipped in the mixture of bala moola kashaya and ksheera.
• Once the required temperature is attained, two pottalis are taken.
• Temperature of the potali is checked by the therapist by placing it over the dorsum of his hand.
• Temperature is also confirmed  with the patient by placing it over the foot .
• The warm pottali is now applied on the patient’s body.
• The pottali is rubbed and squeezed gently on the body parts in a synchronised manner.
• Initially kizhi is done from trunk to hand, hip to toe and finally from nape of neck to hip.
• It is rubbed circularly over the joints and linearly over the long bones of the body.
• Once the temperature of the potali is reduced, the other two pottalis boiling in Kashaya and ksheera are used in order to maintain the temperature of the pottali.
• Likewise the procedure is done in all the six postures.
• Supine Posture

• The patient is asked to lie in supine posture.
• The chest, abdomen, anterior aspects of both hands and legs are covered in this posture.
• Kizhi is done initially from trunk to hand, hip to toe and finally from neck to toe.

• Left Lateral Posture
  • The patient is asked to lie on the left side of his body.
  • Right side of the trunk, right arm and lateral aspect of the right leg is covered in this posture. 
  • Therapist on the left side will be doing kizhi initially from neck to hand, hip to toe and finally from neck to toe.
  • Other therapist on right side will be doing kizhi initially whole of the back including spine, hip to toe and finally from back to toe.
• Supine Posture

• Repeat the procedure

• Right Lateral Posture
  • The patient is asked to lie on the right side of his body with his left leg flexed.
  • Left side of the trunk, left arm and lateral aspect of the left leg is covered in this posture.
  • Therapist on the right side will be doing kizhi initially from neck to hand, hip to toe and finally from neck to toe.
  • Other therapist on left side will be doing kizhi initially in whole of the back including spine, hip to toe and finally from back to toe.
• Supine Posture

• Repeat the procedure

• Sitting Posture

• Repeat the procedure

Paschat Karma:

• The  Shashtika is scrapped from the body using coconut leaf .
• Oil  is applied over the body with mild massage.
• Thalam is removed.
• The patient’s body is cleaned with a towel.
• Patient is asked to take hot shower after resting for a while .
• Rasnadi choorna is applied over vertex after bath.

Ksheeradhooma

Introduction 

Ksheeradhooma is a type of Nadi sweda in which steam is generated using ksheerapaka.

Materials Required                    

The materials required for performing ksheeradhooma are

1. Oil for abhyanga – 120ml
2. Water
3. Kashaya choornas like dashamoola kashaya choornam or bala kashaya choorna
4. Milk – 2litres
5. Eye pad – 1
6. Nadi sweda yantra
7. Water Bath  – 1
8. Towel – 1

Duration:30 minutes

Purvakarma                    

Preparation of Ksheerapaka           

• 60 g of dasamoola kashaya choornam is boiled in 2 litre of water and 500ml of milk .
• The kashaya is boiled and reduced to 500 ml .
• Once ksheerapaka is ready, it is filtered and poured in to the nadi sweda yantra to generate steam.

Pradhana Karma                  

• The patient is asked to sit in a knee high chair.
• The Taila for Abhyanga is made lukewarm using a hot water bath and is massaged over face, fore head and neck.
• The eyes of the patient are covered using an eye pad.
• Once steam start to flow from the nozzle, the steam is directed on the patient’s face.
• Considerable distance is maintained between the nozzle and patient.
• The steam is given over face, fore head and neck of the patient.
• The steam should not be given too far from the body ( ).
• The steam should not be given too near to the body ( ).
• The hot fomentation is continued till the appearance of perspiration.

Paschat Karma                

• The eye pad is removed and rasnadi Choorna is applied over vertex.

Shirobasti

Introduction

Shirobasti is the procedure, where medicated oil is retained over the head for a specific time.

Materials Required

The Materials required for performing shirobasti are

1. Medicated Taila  -500 – 750ml
2. Black gram powder 200g
3. Water  – 100ml
4. Rexene/leather sheet or paper cap
5. Cotton balls
6. Spoon  – 1
7. Head band smeared with masha paste -2 in number
8. Towel  – 1
9. Vessel – 1
10. Galanthika – 1
11. Water bath.- 1

Duration: 1 hour

Purvakarma

Preparation of black gram paste:

• 200 gm of black gram powder is taken in a bowl.
• To this, about 100 ml of water is added.
• This mixture is kneaded well to get a compact/tight dough.
• The dough is then rolled to make a frame wall of approximately 1inch height.
• Two head bands are smeared with masha paste on either side.

Pradhana Karma

• The patient with cleanly shaved head is asked to be seated in a knee height chair.
• Ear plug is inserted into both ears.
• The head band smeared with black gram paste is wrapped around the forehead above the ears.
• The Rexene cap is placed over the head band.
• Another head band smeared with black gram paste is firmly tied around the rexin cap
• The inside space between the Rexin cap and head is sealed using the prepared masha ring.
• The Taila for Shirobasti is made lukewarm using a hot water bath.
• The temperature of the medicine is checked by pouring over dorsum of hand.
• Then, the Taila is poured slowly inside the rexin cap using a Galanthika.
• The oil is poured up to a height of 1 angula above the scalp.
• Uniform temperature is maintained throughout the procedure by refilling it with lukewarm oil.
• The oil is retained until samyak lakshanas such as secretion from mouth and nose occur.
• The duration of the procedure depends upon the dosha involved.

Duration of the procedure                   

Paschat Karma

• The oil is removed using a spoon or a cotton piece.
• Then the Masha band, basti cap and masha ring is removed.
• The area is cleaned, and ear plugs are removed.
• The head, ears and shoulders are massaged using lukewarm oil.
• The head is wiped using a towel and  rasnadi choorna is applied over the vertex.

Shirodhara

Introduction

Shirodhara is the procedure in which liquid medicaments like thaila/ksheera/kashaya is poured in a continuous stream of flow on the forehead in oscillating manner.

Materials Required

The materials required for performing Shirodhara are

• Dhara table – 1
• Dhara stand – 1
• Dhara patra – 1
• Liquid Medicaments like Taila/ Ksheera/ Kashaya  – 1.5 – 2 litre
• Cotton balls
• Gauze pads
• Head band – 1
• Eye pad – 1
• Blanket – 1
• Towel – 1
• Hot water bath – 1
• Vessels – 1

Duration: 45 minutes- 1 hour

Purvakarma        

• Patient is asked to sit comfortably over the droni with legs extended.
• Ear plugs are kept on both ears.
• Gauze is tied around the head above the eyebrows of the patient.
• Both the eyes are covered with an eye pad.
• Patient is asked to lie in supine position and covered with a blanket.
• Dhara patra hanged on the dhara stand is fixed 4 angulas above the level of forehead ( ).
• The height of the  dhara patra should not be more than 4 Angula  above the level of forehead ( ).

Pradhana Karma

• The Taila for Shirodhara is made lukewarm using a hot water bath.
• Temperature of the medicine is checked by pouring it over the dorsum of hand.
• Ensure the knob of dharapatra is closed.
• The lukewarm taila is poured into the dhara patra.
• The knob is slowly opened to get a continuous stream of flow.
• The dharapatra is oscillated in a to and fro motion covering the whole forehead.
• Oscillation of the dhara patra should be neither too fast nor too slow ( ).
• Also the stream of flow should not go beyond the temporal region on both sides ( ).
• The head of the patient is simultaneously massaged at frequent intervals.
• Uniform temperature is maintained throughout the procedure by refilling it with lukewarm oil.
• Continue the procedure for 45 mints -1 hour.

Paschat Karma

• The Nozzle is closed and dharapatra is removed
• Earplugs, Gauze and eye pad are removed and the head is wiped with a towel.
• Patient is asked to take hot shower after resting for a while .
• Rasnadi churna is applied over vertex after bath .

                                               Shiropichu

Introduction

Shiropichu is the procedure in which medicated oil is applied to the vertex using a cotton pad for a specific duration.

Materials Required

The Materials required for performing shiropichu are

• Medicated Thaila 50-100ml
• Cotton pad – 1
• Gauze –  1
• Towel -1
• Vessel -1
• Hot water bath – 1
• Galanthika – 1
• Scissors – 1
• Headband – 1
• Plantain leaf – 1

Duration:  15 – 20 minutes

Pradhana Karma

• The patient is asked to sit comfortably in a knee highchair.
• Head of the patient is cleaned using a towel.
• A headband is tied over the head above the eyebrows.
• Taila for shiropichu is made lukewarm using hot water bath.
• The lukewarm oil is then poured into a galanthika.
• Then, a cotton pad with a thickness of approximately 2cm is placed over the scalp.
• The temperature of the oil is checked by pouring it over the dorsum of hand.
• Gently pour the lukewarm oil uniformly over the cotton pad.
• A plantain leaf is placed over the cotton pad.
• The pichu is secured in position by tying it with a headband for specific duration.

Paschat Karma

• Gauze and cotton pad is removed.
• The head is wiped using a towel and rasnadi churna is applied over the vertex.

                                          Takradhara

Introduction

Takradhara is the procedure of pouring medicated takra over the forehead for a specific duration of time.

Materials Required

The materials required for performing Takradhara are

• Musta churnam
• Amalaki churnam
• Milk
• Curd
• Water
• Dhara patra
• Dhara stand
• Dhara table
• Cotton balls
• Gauze piece
• Vessels
• Eye pad
• Towel
• Head band
• Spoon
• Khajam
• Blanket

Purvakarma

Preparation of Amalaki Kashaya

• 250g of Amalaki Churna is boiled in 4L of water and reduced to 1 L.

Preparation of Mustaksheerapaka

• 75 g of Musta Churna is boiled with 600 ml of milk and 2.4L of water.
• It is boiled and reduced to 600ml of musta ksheerapaka .

• Mustha Ksheerapaka  is filtered and  5ml of curd is added to it .
• It is kept overnight for fermentation.
• Next day this is churned well to remove all butter.
• Add amalaka Kashaya to this churned takra and mix it well.

Preparation of patient

• Patient is asked to sit comfortably over the droni with legs extended.
• Ear plugs are kept on both ears.
• Gauze is tied around the head above the eyebrows of the patient.
• Both the eyes are covered with an eye pad.
• Patient is asked to lie in supine position and covered with a blanket.
• Dhara patra hanged on the dhara stand is fixed 4 angulas above the level of forehead.

Pradhana karma

• Ensure the knob of dharapatra is closed.
• The prepared takra is poured into the dharapatra.
• The knob is slowly opened to get a continuous stream of flow.
• The dharapatra is oscillated in a to and fro motion covering the whole forehead.
• The head of the patient is simultaneously massaged at frequent intervals.
• Another therapist has to collect  the takra in a container placed under droni and refill the dharapatra before it gets emptied.
• Continue the procedure for 45 mints -1 hour.

Paschat Karma

• Nozzle is closed and dharapatra is removed.
• Patient is asked to wash the head with Amalaki Kashaya.
• Earplugs, Gauze and eye pad are removed and the head is wiped with a towel.
• Patient is asked to take hot shower after resting for a while .
• Rasnadi Churna  is applied over vertex after bath.

Thalam

Introduction

Thalam is the procedure of applying medicated paste with or without oil over the vertex of the head for a specific duration.

Materials Required

The Materials required for performing Thalam are

• Churnas like rasnadi /amalaki/ kachooradi –  5g
• Liquid medicaments like thaila/ gritha/ ksheera/ navaneeta/ takra/ Swarasa – 5ml
• Plantain leaf – 1
• Vessel – 1
• Cotton
• Spoon – 1
• Scissors – 1

Duration: 5 – 10 minutes

Purvakarma

Preparation of Thalam

• The vessel in which the taila is to be taken is preheated.
• To this hot vessel, the required quantity of taila is poured.
• Lukewarm oil in the vessel is mixed with required quantity of churna to get a thick paste.

Alternative Method of Preparation of Thalam

• Required quantity of Churna is taken in a bowl.
• It is mixed with liquid medicaments like swarasa, takra, ksheera, etc to get a thick paste.

Pradhana Karma

• The patient is asked to sit comfortably on a knee highchair.
• The vertex of the patient is marked by positioning the distance from tip of the nose to vertex.
• The prepared thalam is applied over the vertex with approximately 2cm thickness.
• This paste is then covered using a plantain leaf.
• The thalam is secured in position by tying it with a headband for specific duration.

Paschat Karma

• The thalam is removed from head.
• Head is wiped using a towel and Rasnadi churna is applied over the vertex.

     Thalapothichil

Introduction

Thalapothichil or Shirolepa is a procedure of application of medicated paste on the head for a certain period of time.

Materials Required

The materials required for performing Thalapothichil are

• Plantain leaf – 1
• Medicated Taila – 5- 10ml
• Gokarna – 1
• Spoon – 1
• Scissors – 1
• Headband – 1
• Amalaki churna – 200g
• Butter milk – Q.S
• Towel – 1

Duration: 1.5 hour

Purvakarma

Preparation of Paste

• Take 200g of Amalaki Churna in a bowl.
• To this add sufficient quantity of buttermilk to get a thick paste.

Pradhana Karma

• Patient is asked to sit comfortably in a knee high chair.
• Head is wiped with a towel.
• The neck region is draped using a towel to avoid spillage .
• The prepared Amlaki paste is applied over the scalp covering the entire head
• It is  applied first covering the upper portion , then on either sides, back side , and last on the front.
• Then a plantain leaf is placed over the paste, so that the whole head is covered.
• The vertex of the patient is marked by positioning the distance from tip of nose to vertex using patients hand .
• A small hole is made on the vertex of the head and churna is removed with a spoon.
• Oil is taken in gokarna and instilled in to the hole made over the vertex.
• The minimum duration of the procedure is half yama or 1 1/2 hrs

Paschat Karma

• After specific duration the paste is removed and wiped with a towel.
• Rasnadi choorna is applied over the vertex after bath .

Udwartana

Introduction

Udwartana is the procedure in which churna is  applied on the body and is massaged  in upward direction.

Materilas Required

The materials required for performing udwartana are:

• Choorna 350g
• Heating pan – 1
• Bowl – 1
• Ladle – 1

Duration: 1 hour

Purvakarma

• Patient is asked to sit comfortably over the droni with legs extended.
• Thalam is applied to the vertex of the patient.
• Mask is provided to the patient in order to cover the nose.

Pradhana Karma

• Udwarthana is done in 7 postures: Sitting, Supine, Left Lateral, Supine, Right Lateral, Supine and Sitting.
• Sitting Posture
• The neck region, back and the extremities are covered in this posture.
• Required quantity of churna is taken which is put in to the heating pan and stirred well in low flame to make it lukewarm.
• The luke warm churna is now applied with firm pressure over patients body from downward to upward direction in a synchronised manner.
• Initially it is massaged from trunk to hand, hip to toe and finally from nape of neck to hip.
• Temperature of the churna is maintained throughout the procedure by reheating the collected churna in a hot pan also by adding sufficient amount of fresh churna.
• Likewise the procedure is done in all the six postures.
• Supine Posture

• The patient is asked to lie in supine posture.
• The chest, abdomen, anterior aspects of both hands and legs are covered in this posture.
• Churna is massaged initially from trunk to hand, hip to toe and finally from neck to toe.

• Left Lateral Posture
  • The patient is asked to lie on the left side of his body.
  • Right side of the trunk, right arm and lateral aspect of the right leg is covered in this posture. 
  • Therapist on the left side will be doing massage initially from neck to hand, hip to toe and finally from neck to toe.
  • Other therapist on right side will be doing massage initially whole of the back including spine, hip to toe and finally from back to toe.
• Supine Posture

• Repeat the procedure

• Right Lateral Posture

• The patient is asked to lie on the right side of his body with his left leg flexed.
• Left side of the trunk, left arm and lateral aspect of the left leg is covered in this posture.

• • Therapist on the right side will be doing massage initially from neck to hand, hip to toe and finally from neck to toe.
  • Other therapist on left side will be doing massage initially in whole of the back including spine, hip to toe and finally from back to toe.

• Supine Posture

• Repeat the procedure

• Sitting Posture

• Repeat the procedure

Paschat Karma:

• Thalam is removed.
• Churna is removed from the body.
• Patient is asked to take hot shower after resting for a while .
• Rasnadi choorna is applied over vertex after bath.

Utsadanam

Introduction

Utsadana  means reinforced friction  of body with drugs containing sneha or medicine mixed with oil or other liquids in the form of kalka is called as utsadana.

Materials Required

The materials required for performing utsadanam are:

• Choorna 350g
• Heating pan – 1
• Bowl – 1
• Ladle – 1
• Liquid medicaments like taila, Sneha, etc – QS

Duration: 1 hour

Purvakarma

• Patient is asked to sit comfortably over the droni with legs extended.
• Thalam is applied to the vertex of the patient.

Pradhana Karma

• Utsadana is done in 7 postures: Sitting, Supine, Right Lateral, Supine, Left Lateral, Supine and Sitting.
• Sitting Posture
• The neck region, back and the extremities are covered in this posture.
• Required amount of churna is mixed with taila/sneha to make kalka.
• The kalka for utsadana is made lukewarm using a hot water bath.
• The luke warm kalka is now applied with firm  pressure over patients body from downward to upward direction in a synchronised manner.
• Initially kalka is massaged from from trunk to hand, hip to toe and finally from nape of neck to hip.
• Temperature of the kalka is maintained  throughout the procedure.
• Likewise the procedure is done in all the six postures.
• Supine Posture

• The patient is asked to lie in supine posture.
• The chest, abdomen, anterior aspects of both hands and legs are covered in this posture.
• Kalka is massaged initially from trunk to hand, hip to toe and finally from neck to toe.

• Left Lateral Posture
  • The patient is asked to lie on the left side of his body.
  • Right side of the trunk, right arm and lateral aspect of the right leg is covered in this posture. 
  • Therapist on the left side will be doing massage initially from neck to hand, hip to toe and finally from neck to toe.
  • Other therapist on right side will be doing massage initially whole of the back including spine, hip to toe and finally from back to toe.
• Supine Posture

• Repeat the procedure

• Right Lateral Posture

• The patient is asked to lie on the right side of his body with his left leg flexed.
• Left side of the trunk, left arm and lateral aspect of the left leg is covered in this posture.
• Therapist on the right side will be doing massage initially from neck to hand, hip to toe and finally from neck to toe.
• Other therapist on left side will be doing massage initially in whole of the back including spine, hip to toe and finally from back to toe.
•  

• •  
• Supine Posture

• Repeat the procedure

• Sitting Posture

• Repeat the procedure

Paschat Karma:

• Thalam is removed.
• Patient’s body is cleaned with a towel.
• Patient is asked to take hot shower after resting for a while .
• Rasnadi choorna is applied over vertex after bath.

Valuka sweda

Introduction

Valuka sweda is the procedure of application of heated sand pack over the body to induce perspiration.

Materials Required

The materials required for performing valuka sweda are

• Sand – Q . S
• Iron pan – 1
• Ladle – 1
• Holder – 1
• Cora cloth (18”x18”)
• Thread – 2
• Towel – 1

Duration : 1 hour

    Purvakarma

     Preperation of Valuka Potali

• The Sand to be heated is kept on the iron pan and heated
• Once the sand is heated sufficiently it is transferred in to the cora cloth
• The cora cloth is then tied loosely to make a potali.

     Pradhana Karma

• The patient is asked to sit comfortably on dhroni.
• The knee joint is exposed properly to do the procedure.
• Temperature of the potali is checked by the therapist by placing it over the dorsum of his hand.
• Temperature is also confirmed with the patient by placing it over the foot.
• The potali with heated sand is applied on both knee joints by patting it in circular pattern.
• The temperature of the potali is maintained by reheating it in sand bath.
• The procedure is done up to perspiration appear over the region.
• The procedure can be done likewise on whole body by performing it in all 7 postures

    Paschath Karma

• The area is cleaned using a towel.
• The patient is asked to take rest.

Annalepa

Introduction

Annalepa is the procedure of application of cooked shashtika shali boiled with Balamoola kashaya  and ksheera over the patient’s body to induce perspiration.

Materials Required

The materials required for performing annalepa are

• Shashtika Shali
• Balamoola
• Water
• Milk
• Metal vessel  
• Laddle
• Holder
• Vessel
• Taila for Abhyanga
• Talam
• Towel

Purvakarma

• Patient is asked to sit comfortably over the droni with legs extended.
• Thalam is applied to the vertex of the patient.
• Sarvanga abhyanga is done in 7 postures.

Pradhana Karma

• Annalepa is done in 7 postures: Sitting, Supine, Left Lateral, Supine, Right Lateral, Supine and Sitting.
• Sitting Posture
• The neck region, back and the extremities are covered in this posture.
• The prepared shastika rice is boiled in ksheera to make it sufficiently hot.
• Now, the lukewarm shastika rice is taken and smeared on to patient’s body followed by massaging.

• Initially it is done from trunk to hand, hip to toe and finally from nape of neck to hip.
• Likewise the procedure is done in all the six postures.
• Supine Posture

• The patient is asked to lie in supine posture.
• The chest, abdomen, anterior aspects of both hands and legs are covered in this posture.
• Annalepa is done initially from trunk to hand, hip to toe and finally from neck to toe.

• Left Lateral Posture
  • The patient is asked to lie on the left side of his body.
  • Right side of the trunk, right arm and lateral aspect of the right leg is covered in this posture. 
  • Therapist on the left side will be doing annalepa initially from neck to hand, hip to toe and finally from neck to toe.
  • Other therapist on right side will be doing annalepa initially whole of the back including spine, hip to toe and finally from back to toe.
• Supine Posture

• Repeat the procedure

• Right Lateral Posture
  • The patient is asked to lie on the right side of his body with his left leg flexed.
  • Left side of the trunk, left arm and lateral aspect of the left leg is covered in this posture.
  • Therapist on the right side will be doing annalepa initially from neck to hand, hip to toe and finally from neck to toe.
  • Other therapist on left side will be doing annalepa initially in whole of the back including spine, hip to toe and finally from back to toe.
• Supine Posture

• Repeat the procedure

• Sitting Posture

• Repeat the procedure

Paschat Karma:

• The  Shashtika is scrapped from the body using coconut leaf .
• Oil  is applied over the body with mild massage.
• Thalam is removed.
• The patient’s body is cleaned with a towel.
• Patient is asked to take hot shower after resting for a while .
• Rasnadi choorna is applied over vertex after bath.

Dhoomapana

Introduction 

Dhoomapana is the procedure of inhaling and exhaling medicated smoke for a specific number of times.

Materials Required              

The materials required for performing dhoomapana are

1. Choorna
2. Ghee
3. Lamp
4. Spoon
5. Gauze
6. Dhooma varti
7. Dhooma netra
8. Eye pad
9. Plate

Duration: 10minutes

Purvakarma                    

Preparation of dhoomavarti             

• The required quantity of churna is taken in a bowl.
• To this sufficient amount of ghee is added.
• This is mixed properly to get a thick paste.
• Gauze cloth of required dimension is spread over a plate.
• The prepared thick paste is smeared uniformly over it.
• Then the gauze is evenly rolled with the help of a stick.
• Once the dhoomavarti is rolled, the stick placed in the centre is removed.
• The dhoomavarti is used after drying in sunshade.

Pradhana Karma             

• The patient is asked to sit comfortably on a knee height chair.
• Both eyes are covered using an eye pad.
• The dhoomavarti is ignited using a lamp.
• Once it is properly lit, the flame is put off.
• When adequate smoke is generated, the dhoomavarti is inserted into the dhoomanetra.
• The patient is asked to cautiously inhale the smoke through one nostril after closing the other nostril and exhale through the mouth.
• The same procedure is repeated with the other nostril.
• The smoke is inhaled through the nose in case of diseases of the head, nose and eye. 
• Dhoomapana is also advised through mouth in case of diseases of throat.

Gandusha

Introduction 

Gandusha is the procedure in which liquid medicaments like Taila, Kashaya, Madhu, etc. are held inside the mouth for certain period of time.

Materials Required               

The materials required for performing gandusha are

1. Liquid medicaments like Taila, Kashaya, Dhanyamla, Madhu ambu etc.100ml
2. Spitons
3. Hot water for fomentation
4. Towel
5. Glass

Duration: 10minutes

Purvakarma                      

• The patient is asked to be seated in a knee height chair.
• Then swedana is given to the face and neck using a towel dipped in hot water.

Pradhana Karma              

• The medicine for gandusha is made lukewarm using a hot water bath.
• The temperature of the medicine is checked by pouring it over the dorsum of hand.
• Patient is asked to fill the medicine in the mouth and asked not to swallow.
• It is retained in mouth undisturbed without gargling for a certain period of time.

Paschat Karma               

• Patient is asked to spit out the medicine once the mouth is filled with secretions.

Kavala

Introduction 

Kavala is the procedure in which liquid medicaments like Taila, Kashaya, madhu, etc are filled inside the mouth and gargled for a certain period of time.

Materials Required                  

The materials required for performing kavala are

1. Liquid medicaments like Taila, Kashaya, Dhanyamla, Madhu ambu  100ml
2. Spitons
3. Hot water for fomentation
4. Towel
5. Glass

Duration: 10minutes

Purvakarma                     

• The patient is asked to be seated in a knee height chair.
• Then swedana is given to the face and neck using a towel dipped in hot water.

Pradhana Karma              

• The medicine for kavala is made lukewarm using a hot water bath.
• The temperature of the medicine is checked by pouring it over the dorsum of the hand.
• Patient is asked to fill the medicine in the mouth and asked not to swallow.
• It is swished and gargled for certain period of time.

Paschat Karma                    

Patient is asked to spit out the medicine once the mouth is filled with secretions.

Karnapoorana

Introduction 

Karnapoorana is a procedure in which the medicine is instilled into the ear canal and retained for a specific time.

Materials Required                     

The materials required for performing karnapoorana are

1. Hot water for fomentation  – as per need
2. Thaila for abhyanga 5- 10ml
3. Liquid medicaments like thaila, swarasa or kashaya
4. Cotton balls
5. Gauze pads – 1
6. Gokarna – 1
7. Kidney tray  -1

Duration:10 minutes

Purvakarma                

• The patient is asked to lie in supine position.
• The patient^’s face is turned towards left side exposing the right ear.
• Oil for abhyanga is made lukewarm using a hot water bath.
• The area around the ear is massaged with lukewarm oil.
• Then hot fomentation is given around the ear, using a towel soaked in boiling water.

Pradhana Karma              

• The medicine for karnapoorana is made lukewarm using a hot water bath.
• The temperature of the medicine is checked by pouring it over the dorsum of hand.
• The medicine is poured into the ear using a gokarna till the whole ear canal is filled.
• The duration of the procedure depends upon the rogasthana.

       Duration of the procedure              

Paschat Karma               

• After the specific duration the medicine is drained out of the ear canal into a kidney tray by slowly turning to opposite side.
• Then the ear canal is cleaned with cotton.
• The patient is asked to keep ear plugs throughout the day.

  Akshi Tarpana

Introduction

Akshi Tarpana is the procedure in which medicated ghee is pooled around the eyeballs for a specific duration.

Materials Required                   

The materials required for performing Akshitarpana are

• Prepared Black gram frame – 80-100g
• Medicated ghee – 20-25ml
• Dhooma netra
• Dhooma varti – 1
• Yava pishti pottali – 2 pottalis of 30-40g each
• Malati flowers – 10-15g of flowers for each eye( petals)
• Gauze pad – 1 each eye
• Cotton balls – as per need
• Water- as per need
• Water bath – as per need
• Spoon – 2

Purvakarma                      

Preparation of black gram frame                   

• Take 200 g of black gram powder in a bowl.
• To this about 100 ml of water is added.
• This mixture is kneaded well to form a uniform dough.

Pradhana Karma                 

• The patient is asked to lie in supine position.
• A circular wall is constructed with the prepared dough around the eyes. 
• The height of the frame wall should be 2 inch.
• The framework should be devoid of any leakage. ( and X)
• Medicated ghee should be made lukewarm in hot water bath.
• Temperature of the medicine is checked by pouring it over the dorsum of hand.
• The patient is asked to close the eyes
• The lukewarm medicated ghee is poured into both the eyes through the medial end one after the other using a gokarna.
• The ghee should be filled up to the eye-lashes keeping the eyes closed ( )
• The patient is instructed to slowly open and close both eyes while the ghee is pooled around the eyes.
• The duration of the procedure depends upon the involved dosha and disease 

Duration of the procedure    20-30minutes                

Paschat karma                        

• After the specific duration the ghee is removed by making a small hole at the lateral end of the frame wall.
• Once the ghee is drained out, the frame wall is removed completely.
• Hot fomentation is given around the eyes using yavapishti pinda dipped in warm water.
• Do not apply pressure during fomentation.
• Thereafter, prayogika dhumapana is administered accordingly.
• Later both eyes are bandaged with malathi flowers and kept overnight.

Anjanam

Introduction

Anjana is the procedure of applying medicated collyrium in lower eyelid using fingertip or by Anjana Shalaka

Materials Required                      

The materials required for performing Anjana are

• Medicaments like Elaneer Kuzhambu or Anjana varti
• Galanthika – 1
• Cotton balls
• Gauze pad – 1
• Triphala Kashaya – 100ml for each eye
• Bowls – 2
• Kidney tray – 1
• Towel – 1

Duration: 10- 15 minutes

Pradhana Karma                        

• The patient is asked to sit comfortably in a chair.
• The medicine is taken in a Shalaka or using the little finger by just dipping its tip in the medicine.
• The physician with his left thumb retracts the lower eyelid of the patient.
• The Anjana is applied using the right hand of the physician 
• Anjana is applied inside the lower eyelid of the patient starting from the inner angle of the eye and slowly moving  to its  outer angle ( ).
• Do not apply Anjana with painful manipulation or in the opposite direction ( ).
• Thereafter the patient is asked  to close the eyes and rotate the eyeball slowly ( ).
• Opening and closing of the eyelids should not be done ( ).
• The doshas dissolves and come out in the state of lacrimation.
• Gently open the eyes once lacrimation stops.
• Clear vision is ensured by looking into a vessel filled with water.

Paschat Karma                      

Eye wash or kshalana is the paschath karma of Anjana

• The patient is asked to lie in supine position with eyes open.
• Using a Galanthika filtered triphala Kashaya is poured into the eyes in a circular pattern.
• The Kashaya draining through the outer angle is collected in to a kidney tray.

Aschyotana

Introduction 

Aschyotana is the procedure of instilling medicated eyedrops.

Materials Required               

The materials required for performing Aschyotana are

• Liquid medicaments like Swarasa/Arka/ Gritha/ Ksheera/Kashaya  – 4 – 5ml approx..
• Hot water for fomentation – as per need
• Gauze pad – 2
• Cotton balls –  as per need
• Gokarna – 1
• Water bath as per need
• Towel – 1

Duration: 10minutes

Pradhana Karma              

• Patient is asked to lie in supine position
• The medicine is heated using a water bath.
• The required amount of medicine is droped into a gokarna.
• The eyelid of the patient is lifted using physicians left thumb and fingers.
• Using right hand, the medicine is instilled drop by drop on Kaninaka Sandhi.
• Similarly, the medicine is instilled in left eye.
• Medicine is instilled from a height of 2 Angula ( ).
• Do not pour the medicine from height of more than 2 Angula ( ).
• It is retained for 100 Matrakala.
• The medicine remaining in the eye is wiped out with cotton balls.

Paschat Karma                    

• Hot fomentation is given around the eyes using gauze pad soaked in warm water.
• Do not apply pressure for fomentation. 

Putapaka

Introduction 

Putapaka is one among the netra kriya kalpas, in this Swarasa is pooled around the eyeballs for a specific duration with the help of a  black gram frame firmly fixed around the eyes . During this procedure the patient is asked to blink eyes gently .

Materials Required

Materials required for performing Putapaka are

• Jeevaniya Gana (each drug 12.5g)
• Shatavari (raw) 25g
• Jeevakam (raw) 25g
• Ajamamsam – 250g
• Eranda Leaves- 6-7 leaves
• Mud  – as per need
• Gokarna – 1
• Black gram powder – 100-150g
• Water – as per need
• Yavapishti Sweda – 30g each kizhi
• Dhoomavarti – 1
• Dhoomanetra – 1
• Malathi flowers – 20g each eye
• Cotton Swab – as per the need
• Gauze pad – as per the need
• Bowls – 2
• Kidney tray – 1
• Towel – 1
• Hot waterbath – 1

Duration: 10-15minutes

Purvakarma                      

• Ingredients are cleaned, cut into pieces and properly grinded to make a smooth paste.
• Paste is made into a ball like structure resembling a Bilwaphala.
• This should be wrapped in leaves of Eranda.
• It is tied properly with thread.
• Then this ball is smeared with mud or clay up to 2 inch thickness and dried.
• Once dried ,it is put into fire of burning coal of dried cow dung.
• When it becomes red hot ,it is removed from fire.
• Remove the external coating and leaves around the ball
• The material inside is taken in a clean cloth and squeezed  to obtain the swarasa.

Preparation of black gram frame                   

• Take 200 g of black gram powder in a bowl.
• To this about 100 ml of water is added.
• This mixture is kneaded well to form a uniform dough.

Pradhana Karma                 

• The patient is asked to lie in supine position.
• A circular wall is constructed with the prepared dough around the eyes. 
• The height of the frame wall should be 2 inch.
• The framework should be devoid of any leakage. ( and X)
• Temperature of the svarasa is checked by pouring it over the dorsum of hand.
• The patient is asked to close the eyes
• The lukewarm svarasa is poured into both the eyes through the medial end one after the other using a gokarna.
• The svarasa should be filled up to the eye-lashes keeping the eyes closed ( )
• The patient is instructed to slowly open and close both eyes while the svarasa is pooled around the eyes.

Duration of the procedure                   

Paschat karma                        

• After the specific duration the ghee is removed by making a small hole at the lateral end of the frame wall.
• Once the ghee is drained out, the frame wall is removed completely.
• Hot fomentation is given around the eyes using yavapishti pinda dipped in warm water.
• Do not apply pressure during fomentation.
• Thereafter, prayogika dhumapana is administered accordingly.
• Later both eyes are bandaged with malathi flowers and kept overnight.