Pañcakarma in Kāyacikitsā

Śodhana in Jvara

वमनैश्च विरेकैश्च बस्तिभिश्च यथाक्रमम् ॥ २८४ ॥

ज्वरानुपचरेद्धीमान् कफपित्तानिलोद्भवान् ।   (C.Chi 284 – 285)

For the cure of jvara caused by the aggravaṭion of vāyu, pitta and kapha, vamana (emesis), virecana (purgation) and basti (enema) therapies should be administered respectively. (284 285)

In verse Nos. 146-147, there is a reference to the administration of Vamana therapy. But that was described for the treatment of jvara caused by the; simultaneous vitiation of two doṣā. In the present context, the vamana therapy is described for the type of jvara caused by the vitiation of only one doṣa. Therefore, this statement should not be construed as a repetition of the earlier statement.

Vamana  and  Virecana in Rakta Pitta

वक्ष्यते बहुदोषाणां कार्य बलवतां च यत् ५४॥

अक्षीणबलमांसस्य यस्य संतपंणोत्थितम् ।

बहुदोषं बलवतो रक्तपित्तं शरीरिणः ॥ ५५ ॥

काले संशोधनार्हस्य तद्धरेन्निरुपद्रवम् ।

विरेचनेनोर्ध्वभागमधोगं वमनेन च॥ ५६ ॥

त्रिवृतामभयां प्राज्ञः फलान्यारग्वधस्य वा । ।

त्रायमाणां गवाक्ष्या वा मूलमामलकानि वा ॥ ५७ ॥

विरेचनं प्रयुञ्जीत प्रभूतमधुशर्करम् ।

रसः प्रशस्यते तेषां रक्तपित्ते विशेषतः ॥ ५८ ।।

वमनं मदनोन्मिश्रो मन्यः सक्षौद्रशर्करः ।

सशर्करं वा सलिलमिक्षूणां रस एव वा ॥ ५९ ॥

वत्सकस्य फलं मुस्तं मदनं मधुकं मधु ।

अधोवहे रक्तपित्ते वमनं परमुच्यते ।। ६० ।।

ऊर्ध्वगे शुद्धकोष्ठस्य तर्पणादिः क्रमो हितः ।

अधोगते यवाग्वादिर्न चेत्स्यान्मारुतो बली ॥ ६१ ।। C.Chi.4/54-61

We shall now describe the therapies that should be administered to persons having exceedingly aggravated doṣā and physical strength.

Virecana should be given to a patient suffering from ūrdhvāṅga rakta pitta, and vamana  should be given to a patient suffering from adhogata rakta pitta, in the following circumstances

1. If the strength and muscle tissue of the patient are not reduced by nature;
2. If the disease is caused because of santarpaṇa (over nourishment);
3. If there is excess of aggravated doṣā;
4. If the patient is physically strong because of the sonal effects;
5. If the time is conducive to the administration of elimination therapy i.e. if the reason is neither hot nor very cold;
6. If the patient is suitable for the administration of these therapies
7. If the patient is free from complications or if the recipe to be administered is not associated with any complications

For the purpose of virecana, a wise physician should administer along with liberal quantity of honey and sugar, the following recipes:

1. Trivṛt and abhayā;
2. Fruits of āragvadha;
3. Trāyamāṇa
4. Gavākṣī
5. Mülaka and āmalakī

In rakta pitta, the juice of these drugs is especially useful. In adhoga rakta pitta, vamana is an excellent therapy and it should be administered by the following recipes:

1. Mantha is prepared with madana and added with honey and sugar along with additional sugar and water. 2. Mantha prepared of madana and added with honeyand sugar and added with sugarcane juice. 3. The fruits of vatsaka, musta, madan, madhuka and madhu

In the ürdhvanga type of rakta pitta, when the bowels are cleaned by the administration of purgation, tarpaṇa etc., should be gradually given to the patient. In adhoga type of rakta pitta, when the alimentary tract is cleaned by emesis, yavāgū etc., should be given to the patient, if vāyu is not aggravated in excess, [54-61]

Elimination is best among the therapies for the treatment of diseases. Therefore, these therapies are described in the beginning for the treatment of the patients, In rakta pitta, elimination therapies are not given to remove doṣā through the same tract through which the disease is manifested. Doṣā should be eliminated through the opposite tract-vide Nidāna 2 : 19.

For purgation therapy, the juice of purgative drugs are especially useful in rakta pitta. In other diseases, paste etc., of these drugs are also indicated.

In adhoga rakta pitta, after the administration of elimination therapy, yavāgū etc., should be given to the patient if vāyu is not aggravated in excess. If however,vāyu is aggravated in excess, then following the principle laid down for the treatment of jvara, meat mixed with rice should be given to the patient

Basti in Gulma

बस्तिकर्म परं विद्याद्गुल्मघ्नं तद्धि मारुतम् ।

स्वे स्थाने प्रथमं जित्वा सद्यो गुल्ममपोहति ॥ १०० ।।

तस्मादभीक्ष्णशो गुल्मा निरूहैः सानुवासनैः ।

प्रयुज्यमानं: शाम्यन्ति वातपित्तकफात्मकाः ॥ १०१ ॥

गुल्मघ्ना विविधा दिष्टाः सिद्धाः सिद्धिषु बस्तयः । C.Chi.5/100-102

Medicated enema is the best therapy for curing gulma. In the beginning, it overcomes vāyu in its own site, and thus, immediately overcomes gulma. Therefore, nirüha and anuvāsana types of medicated enema should be administered frequently for the cure of vātika, paittika and kaphaja types of gulma. Different effective recipes of medicated enema for successful treatment of this disease are described in Siddhi section of this work [100-102]

Śodhana in Kuṣṭha

वातोत्तरेषु सर्पिर्वमनं श्लेष्योत्तरेषु कुष्टेषु।

पित्तोत्तरेषु मोक्षो रक्तस्य विरेचनं चाग्रे ॥ ३९ ॥

वमनविरेचनयोगाः कल्पोक्ताः कुष्ठिनां प्रोयक्तव्याः।

प्रच्छनमल्पे कुष्ठे महति च शस्तं सिराव्यधनम् ॥ ४० ॥

बहुदोषः संशोध्यः कुष्ठी बहुशोऽनुरक्षता प्राणान्।

दोघे ह्यतिमात्रहृते वायुर्हन्यादवलमाशु ॥ ४१ ॥

स्नेहस्य पानमिष्टं शुद्धे कोष्ठे प्रवाहिते रक्ते।

वायुर्हि शुद्धकोष्ठं कुष्ठिनमवलं विशति शीघ्रम् ॥ ४२ ॥. Ch.Chi.7/39-42

The patient suffering from kuṣṭha dominated by vāyu should first be administered ghee internally. The patient suffering from kuṣṭha dominated by kapha should first be administered emetic therapy. The patient suffering from kuṣṭha dominated by pitta should first be administered blood-letting and purgation therapies. For emetic and purgation therapies to a patient suffering from kuṣṭha, the recipes described in the kalpa  section should be employed. Blood-letting should be performed in the less acute stage of kuṣṭha by pracchāna (rubbing with a coarse device) and in the more acute stage of kuṣṭha, by venesection.

The patient of kuṣṭha with more vitiated doṣā should be given śodhana several times. The physician, while administering these elimination therapies frequently should be vigilant about their life. Excessive elimination of doṣas (morbid factors) might weaken the patient and the aggravated vāyu might endanger his life instantaneously.

After the elimination of doṣās from the gastro-intestinal tract (by emetic and purgation therapies) and from blood (by blood-letting therapy), the patient should be given sneha (oil, ghee etc.,) to drink. Because vāyu gets aggravated and the patient becomes weak soon after the elimination therapies (which condition will be remedied by the administration of the oleation therapy].

After the administration of the above-mentioned therapies, the patient suffering from kuṣṭha should be given treatment as described hereafter. These therapies are to be repeated again and again. The physician should not administer therapies to eliminate a large quantity of morbid doṣā at a time. If that is done, then it might weaken the patient and endanger his life. This applies to vitiation of one or more of the doṣā.

Oleation therapy should be given only after the morbid doṣā are eliminated from the body. Without that, administration of oleation therapy might aggravate the disease. [39-42]

Śodhana in Rājayakṣma

दोषाधिकानांवमनंशस्यतेसविरेचनम्।

स्नेहस्वेदोपपन्नानांसस्नेहंयन्त्रकर्शनम्॥८७॥

शोषीमुञ्चतिगात्राणिपुरीषस्स्रंसनादपि।

अबलापेक्षिणीमात्रांकिंपुनर्योविरिच्यते॥८८॥Ch.Chi.8/87-88

The patient suffering from rajayakṣmā] having excessively vitiated doṣās should be given oleation and fomentation therapies, and thereafter, vamana (emetic therapy) and virecana (purgation therapy) should be administered. The recipe for these therapies should contain sneha (ghee, oil etc.), and these recipes should not have a depleting (karşana) effect. The patient of rājayakṣma will die if there are loose bowels. Therefore, the dose of theserecipes should be such, which a weak person can stand, and he should never be given a strong purgative. [87-88] The patient of rājayakṣma should be given exceedingly mild emetic and purgation therapies which should not cause the depletion of body tissues.

Śodhana in Udara

वातोदरं बलमतः पूर्व स्नेहरुपाचरेत् ।

दोषातिमात्रोपचयात् स्त्रोतोमार्गनिरोधनात् ।

स्त्रिग्धाय स्वेदिताङ्गाय दद्यात् स्नेहविरेचनम् ॥ ५९ ॥

हते दोषे परिम्लानं वेष्टयेद्वाससोदरम्।

तथाऽस्यानवकाशत्वाद्वायुर्नाघ्मापयेत् पुनः ।। ६० ।।

संभवत्युदरं तस्मान्नित्यमेव विरेचयेत् ॥ ६१ ॥

शुद्धं संसृज्य च क्षीरं बलार्थं पाययेत्तु तम्।

प्रागुत्क्लेशान्निवर्त्यं च बले लब्धे क्रमात् पयः ॥ ६२ ॥

यूपै रसैर्वा मन्दाम्ललवणैरेधितानलम् ।

सोदावर्त पुनः स्त्रिग्धं स्विन्नमास्थापयेन्नरम् ॥ ६३ ॥

स्फुरणाक्षेपसन्ध्यस्थिपार्श्वपृष्ठत्रिकार्तिषु दीप्ताग्निं बद्धविड्वातं रूक्षमप्यनुवासयेत् ॥ ६४ ॥

तीक्ष्णाधोभागयुक्तोऽस्य निरूहो दाशमूलिकः ।

वातघ्नाम्लशृतैरण्डतिलतैलानुवासनम् अविरेच्यं तु यं विद्याद् दुर्बलं स्थविरं शिशुम् ।’तु ॥६५॥

सुकुमारं प्रकृत्याऽल्पदोषं वाऽथोल्बणानलम् ॥ ६६ ॥

तं भिषक् शमनैः सर्पिर्यूषमांसरसौदनैः ।

बस्त्यभ्यङ्गानुवासैश्च क्षीरैश्चोपाचरेद्बुधः ॥ ६७ ॥Ch.Chi. 13/59-67

If the patient is suffering from udara roga (obstinate type of abdominal diseases) caused by the aggravaṭion of vāyu, andif he is strong, then in the beginning, he should be given unctuous therapy. After the administration of oleation and fomentation therapies, he should be given purgatives prepared of unctuous drugs. After the doṣā (fecal material) are removed, the abdomen of the patient becomes flaccid. Then the abdomen should be tightly wrapped with the help of a cloth, so that the vāyu (wind), in view of the empty space in the abdomen, may not cause distension again.

Udara roga is caused because of excessive accumulation of doṣā (fecal matter, etc.) in the gastro-intestinal tract, and also because of the obstruction to the (opening of the) channels of circulation. Therefore, the patient suffering from udara roga (obstinate abdominal diseases) should be given purgation therapy every day.

After the body is cleansed, the patient should be given saṃsarjana krama (administration of lighter to heavier diet gradually).Thereafter, he should be made to drink milk for the promotion of his strength. If milk is given continuously for a long time, then the patient is likely to get nausea. Therefore, after he has regained strength and prior to the occurence of nausea, milk should be withdrawn.

The patient should then be given vegetable soup or meat soup added with small quantities of sour drugs and salt to promote his appetite. If he gets flatulence, then again oleation and fomentation therapies should be administered. This should be followed by āsthāpana (a type of medical enema prepared by decoctions, etc.).

If the patient suffers from itching sensation, cramps, pain in joints, bones, sides of the chest, back and lumber region; if he has strong power of digestion; and if there is retention of stool and flatus, then even without oleation therapy, the patient should be given anuvāsana type of enema (a type of medicated enema prepared by oil, etc.).

For the purpose of nirüha and āsthāpana types of enema, the decoction of daśamula and such other drugs having tīkṣṇa (sharp) attributes should be used.

For the purpose of vāyu type of enema, castor oil or til oil boiled with sour drugs which help in the alleviation of vāyu should be used.

If the patient is not suitable for purgation therapy; if he is weak, old, too young or of tender nature; if there is slight aggravaṭion of doṣā, and if vāyu is aggravated much in excess, then the wise physician should treat him with alleviation therapies. Such a patient should be given medicated ghee, vegetable soup and meat soup along with rice, and he should be given therapies, like basti (āsthāpana type of enema), massage therapy, anuvāsana type of enema and milk [boiled with vāyu-alleviating drugs]. [59-67]

Pañcakarma in Kaumārabhṛtya

Paediatric Pañcakarma has been prime and leading modality of treatment and classics clearly mentions about its indications and contraindications. one can understand that importance of Pañcakarma procedures as well as consider these procedures in paediatric patients. Pañcakarma remove the toxic elements from the body, strengthens immune system and increase acceptability of body to various therapeutic regimen. All the five Karmas are systematically explained in classics with special interest of the child. It is most important when doing pañcakarma procedure in paediatric patient measures should be taken in the prevention of complications.

Pañcakarma in Rasāyana & Vājīkaraṇa

Pañcakarma has got a great importance as pūrvakarma for Rasāyana, Vājīkaraṇa especially,

ना अविशुद्ध शरीरस्य युक्तो रासायनो विधिः ।

न भाति वाससि क्लिष्टे रंगयोग इवाहिः ।। (Su. Chi.27/4)

Ācāryas have highlighted that; Śodhana of Śarīra is an essential pre-requisite for the administration of Rasāyana therapy. Because, if Srotases are not clean then Rasāyana effect will not be achieved to the maximum extent-just as an unclean cloth does not take up the colour. Hence, if Śodhana is administered before Rasāyana, it will help in cleaning all the Srotases of the body and thus this helps in getting maximum benefits from the Rasāyana.

“बुद्धिप्रसादं बलम् इन्द्रियाणं धातु स्थिरत्वं ज्वलनस्य दीप्तिम्।

चिरात् च पाकं वयसः करोति संशोधनं सम्यग् उपास्य मानम्।।”

(AH.Su. 18/60)

Śodhana helps in the proper attainment of Rasāyana effect by Srotośodhana (cleansing the channels) and provides Buddhi & Indriya prasāda (clarity of intellect and sense organs),dhātusthiratva (stability of body tissues), Agnidīpana (increase in digestive power). This leads to Cirāt vayasa pākaḥ, which is the delayed process of ageing.

Pañcakarma in Śalya Tantra

Sirāvyadha Vidhi(सिराव्ययविध्यध्यायः)

Bloodletting through venesection

विसर्पविद्रधिप्लीहगुल्याग्निसदनज्वरान् ।

मुखनेत्रशिरोरोगमदतृड्लवणास्यताः।। ३।।

कुष्ठवातास्त्रपित्तास्त्रंकट्वम्लोहिरणभ्रमान् ।

शीतोष्णस्निग्यरूक्षाद्यैरुपक्रान्ताश्च ये गदाः ।।४।।

सम्यक्साध्या न सिध्यन्ति ते च रक्तप्रकोपजाः ।। AH.Su.27/2-4

The vitiated blood causes suppuration with inflammation, abscesses. splenomegaly, intestinal growths, loss of appetite, fever, diseases of the oral cavity and eyes, diseases of the head, stupor, thirst, salty taste of the mouth, skin diseases, arthritis with the involvement of skin, haemorrhages, acidic regurgitation and vertigo. The other diseases, which are not properly cured by adapting general line of treatment like using cold and hot, viscous and dry substances or therapies are also considered to have originated due to the vitiation of blood.

Venesection (सिराव्यघं)

तेषु स्रावयितुं रक्तमुद्रिक्तं व्यथयेत्सिराम् ।।५।। AH.Su.27/5

In all such diseases, to let out venesection is indicated.

Persons unfit for venesection (सिराव्यधानहर्हाः)

न तूनषोडशातीतसप्तत्यब्दस्रुतासृजाम्।

अस्निग्धास्वेदितात्यर्थस्वेदितानिलरोगिणाम्।।६।।

गर्भिणीसूतिकाजीर्णपित्तास्त्रश्वासकासिनाम् ।

अतीसारोदरच्छर्दिपाण्डुसर्वाङ्गशोफिनाम् ।।७।।

स्नेहपीते प्रयुक्तेषु तथा पञ्चसु कर्मसु ।

नायन्त्रितां सिरां विध्येन्त्र तिर्यङ्नाप्यनुत्थिताम् ।।८।।

नातिशीतोष्णवाता श्रेष्वन्यत्रात्ययिकाद्गदात् । AH.Su.27/6-8

Bloodletting is not indicated in persons below the age of 16 years and above 70 yrs.

Those who recently underwent the same treatment, those who didn’t consume fat/oil or fomented or excessively fomented, those suffering from the diseases of Vāta doṣā, pregnant and recently delivered women, those suffering from indigestion, haemorrhages, dyspnoea, cough, diarrhoea, visceral organ diseases, vomiting, anaemia, and generalized edema are also to stay away. It is also not advised in those who just consumed fat/oil and underwent purification through the five procedures. A vein should not be severed without bandaging the upper area.

Horizontal section and improperly exposed vein are to be avoided. I there is no emergency, this procedure is not to be performed in a cold or hot climate, when the wind is blowing and while raining.

SIRĀVYADHA : CLINICAL SIGNIFICANCE IN ŚALYA TANTRA

1.Penile diseases(शुक्ररोगे)

शुक्रमेदामये मे…

In the diseases of semen production and penis, a vein from the penis may be used for venesection.

2.Gala Ganda (Goitre) (गलगण्डे)

ऊरुगां गलगण्डयोः ।।१४।।

In case of Galagaṇḍa or goitre, a vein from the thigh may be severed.

3.Grdhrasi (Lumbago sciatic syndrome) (गृध्रसीवाते)

गृध्रस्यां जानुनोऽधस्तादूर्ध्वं वा चतुरङ्गुले

In case of Grdhrasī vāta, the vein present 4 Aṅgula above or below the knee joint may be severed.

4.Apacī (Non ulcerative lymphadenitis) (अपच्या)

इन्द्रबस्तेरथोऽपच्यां द्व्यङ्गुले…..

In case of apacī, a vein, 2 aṅgula below the indrabasti (calf muscle in the lower limb and cubital muscle in the upper limb)

5.Sakthi Roga (Painful hamstring) (सक्थिरोगे)

चतुरङ्ग ।।१५।।

ऊर्ध्वं गुल्फस्य सक्थ्यत तथा क्रोष्टुकशीर्षके ।

When, a person is suffering from sakthiroga (pain or cramps in the hamstrings) a vein 4 aṅgula above the ankle joint may be severed. The same vein is puncted in kroṣṭuka śīrṣa (bursitis of the knee joint) also.

PAÑCAKARMA IN VIṢA CIKITSĀ

1) Vamana (Induction of Emesis):-

In cold season, in the presence of secretion of cold saliva, when the predominant increase is in kapha, and when the patient is of śleṣma constitution, induction of emesis is to be done by the administration of emetics. (SS 5/39)

Emesis is to be induced in latent poisoning (dūṣiviṣa) after sudation. (AH U 35/38)

In the first and second phases (vega) of inanimate poisoning, emesis is indicated. (AH U 35/17, 18)

Emesis is to be induced in the treatment of concocted poisoning (gara), as the initial measure. (AH U 35/44)

After performing Hṛdayāvaraṇa, emetics are to be administered. (AH U 36/55)

In the second, fourth, fifth and sixth phases of cobra (Darvīkara) poisoning, emetics are indicated. (AH U 75, 76)

In the third phase of viper (maṇḍalī) poisoning, emesis is to be induced. (AH U 36/79)

In the second, fourth and fifth phases of krait (Rājila) poisoning, emetics are indicated. (AH U 36/71)

In worm or insect bites (Keetaviṣa), external applications are to be done after – purification therapies such as emesis and purgation. (AH U 37/26)

In ślaiṣmika spider poisoning, if the magnitude of derangement of doṣa is great, genetics are to be given. (AH U 37/75)

In rat poisoning (Mūṣika), emetics are to be given. Inanimate poisoning where śleṣmadoṣa that is subjected to major derangement, Emesis is indicated. (AH U 35/66)

2) Virecana (Purgation):-

When the patient suffers from burning sensation and pain of the gut (Koṣṭha), flatulence and block or difficulty in passing urine, purgatives are indicated. (SS 5/40)

In the second phase of inanimate poisoning, purgation is to be done. In the first stage of latent poisoning (Dūṣiviṣa) the purification measure includes purgation. (AH U 35/38)

Inanimate poisoning where pitta is the doṣa that is subjected to major derangement, purgation is indicated. (AH U 35/67)

In major insect poisoning, purgatives are to be given. (AH U 24, 26)

In rat poisoning, purgation is to be done. (AH U 38/23)

In rabies, purgation is to be done with medicines that are mixed with the milky latex of Arka (Calotropis gigantia). (AH U 38/36)

3) Nasya (Nasal medication): –

Nasal medications are given in the form of liquids and fine powders. Pradhamana (blowing) nasal medication is usually given when the patient is unconscious. Drugs having pungent properties are commonly given for the purpose.

In the third phase of cobra bite, nasya is indicated. (AH U 36/754)

In the seventh phase of cobra bite, strong nasya is indicated. (AH U 36/77)

In the sixth phase of krait bite, strong ‘Pradhamana’ nasya is indicated.

4)Raktamokṣaṇa(Bloodletting):-

Bloodletting in the last and most potent treatment when the poison has spread to the entire body. Among the purification therapies, it occupies a significant role. When the poison has spread, bloodletting is to be done because when poisoned or toxic blood is removed, the toxicity manifestations fail to sustain and vanishes altogether. (AH U 36/47)

Sirāvedha at the site of bite or bloodletting by cutting the veins at the extremities and forehead is effective in removing the toxic blood from the system. Due to this reason, bloodletting is the top most treatment in toxicity manifestations of poisons. (SS 5/25, 26)

In conditions where the veins become invisible due to the presence of oedema, śṛṅga (horns of animals) or leeches may be applied over the site of bite to remove the contaminated blood. Horns of animals have been prepared and kept ready for the purpose. The sharp tip of the horn is applied to the suction pump and the wider end is applied to the site of bite. At times, the venom is removed by sucking at the sharp end where a nipple like suction appendage made of metal is affixed.

Bloodletting is contraindicated during pregnancy, in children and in-old age. (SS 5/30)

Pañcakarma in Netra Roga cikitsā

Vamana

Kukūṇaka

Child should be made to vomit by administering (paste of) fruit of kharamañjari (apămārga) added with either honey and saindhava: of pippali, lavana (saindhava) and honey, if the child is vomiting on its own accord, then vamana need not be induced again (by using vamanopaga dravyas).

तं वामयेतु मथुसैन्यवर्ंप्रयुक्तै: पीत्तं पय: खलु फलैः खरमरीणाम् ।

स्यापिप्पलीलवणमाथिकर्सयुती नैनं वमन्तमयि वामयितुतु यतेत ।।(Su.U.19/11)

For kṣīrānnāda, vamana should be induced using vacă, and for children above that stage (annāda) vamana should be produced administering madanaphala.

दत्त्वा वचामशनदुग्यभुजे प्रयोज्यमूर्ध्वं ततः फलायुतं वपन वियिते ॥(Su.U.19/12)

Kaphotkliṣṭa vartma

In kaphotkliṣṭa vartma, vamana and other kaphāhāra therapies should be done.

वमनाञ्जननस्यादि सर्वं च कफजिद्धितम्॥(A.H.U.9/23. page 83)

Virecana

Pakṣmakopa

Four methods , each  one  separately  are  best  suited  for  curing  inflammation  of  the  region  of  the  eyelashes;  these  are  to  be  done  followed  by virecana,  ascyotana,  dhūma,  nasya,  lepa,  snehana  rasakriya  and  añjana.

चत्वार एते विधयो विहन्तुं पक्ष्मोपरोधं पृथगेव शस्ताः।

विरेचनाश्च्योतनधूमनस्यलेपाङ्जनस्नेहरसक्रियाश्च ।। (Su.U.16/9) 67

Raktaja, Adhimantha, Abhiṣyanda, Sirotpāta, Sirāharṣa

Adhimantha,  abhiṣyanda,  sirotpāta  and  sirāharṣa  produced  by  rakta. Patients  should  be  given  oleation  therapy  using  either  kumbha  sarpi (ghee  of  hundred  years)  or  meat  soup  (added  with  ghee)  in  more  quantity;  after  that siramokṣaṇa should  be  done.  They  should  be  purified  with  virecana  and  then śiro virecana is also  to  be  done  using  ghee  boiled  with  śiro virecanopaga dravyas  or  using  majjā  or vasā (instead  of  ghṛta)  boiled  with  those  drugs.

Kāca

In  kāca  produced  by  vāta, eraṇḍa taila  added  to  boiled  milk  is  ideal  for  producing virecana;  in  that  produced  by  rakta  and  pitta, Triphala  ghṛta  is  specially  suitable  for  śodhana (virecana).In  that  produced  by  kapha,  trivṛt  is  ideal  and  in  that  produced  by  tridoṣas  together, taila  boiled  with  trivṛt is  said  to  be  ideal  for  producing  virecana.

पयोविमिश्रं पवनोद्भवे हितं वदन्ति पञ्चाङ्गुलतैलमेव तु ।

त्रैफलमेव शोधनं विशेषतः शोणितपित्तरोगयोः ।।

त्रिवृद्विरेकः कफजे प्रशस्यते त्रिदोषजे तैलमुशन्ति तत्कृतम् ।।(Su.U.17/29. )

Pittotkliṣṭa and Rakthotkliṣṭa Vartma roga

After making the patient oleated with ghee that has been obtained through compounding the herbs of madhura gaṇa, followed by virecana with trivṛt in the case of the pittotkliṣṭa and raktotkliṣṭa. Then, after the bleeding stops, the scrapping of the lid should be done.

पित्तास्रोत्क्लिष्टयोः स्वादुस्कन्धसिद्धेन सर्पिषा ॥१६॥

सिराविमोक्षः स्निग्धस्य त्रिवृच्छ्रेष्ठं विरेचनम्।

लिखिते उतरक्ते च वर्त्मनि क्षालनं हितम्॥१७॥

यष्टीकषायः, सेकस्तु क्षीरं चन्दनसाधितम्। (A.H.U.9/16-17)

Vātaja timira

Medicated ghee processed with the decoction of daśamüla, four parts of milk and paste of śresthā should be consumed in the case of vātaja timira. But in order to produce virecana, kaṣāya of triphalā and pañcamula along with milk and eraṇḍa taila should be applied.

वातजे तिमिरे तत्र दशमूलाम्भसा घृतम् ।

चतुर्गुणे श्रेष्ठाकल्कपक्वं पिबेत्ततः ॥ 

कषायं क्षीरसंयुतम् ।एरण्डतैल संयुक्तं योजयेच्च विरेचनम् ॥  (Su.U.13/49,50)

Nasya

Vātaja Abhiṣyanda & Adhimantha

Persons affected  by vātaja abhiṣyanda and adhimantha caused  by  vāta  should  be  given  oleation  using purāṇaghrtha, followed by  swedana  according  to  appropriate  procedure;  then  sirāmokṣaṇa, basti  and  sneha virecana is administrated. Eyes should be given tarpaṇa,  putapākaḥ,  dhūma  and  ascyotana  therapies; nasya,  pariseka,  and  śirobasti  therapies  should  also  be  administered. Nasya to be made  use  of  taila boiled  with  sthirā,  kṣīrā  (milk) and  madhura  (drugs  of  sweet  group)  is  desirable.

Pittaja Abhiṣyanda &  Adhimantha

In abhiṣyanda and  adhimantha  produced  by  pitta,  bloodletting  and  purgative  therapy  to the  body,  pariseka,  lepa  and  añjana  to  the  eyes  and  nasya  are  the  methods  of  treatment  to  be  adopted. Four kinds of nasya  is  done with gundradi ghṛta.

Kaphaja Abhiṣyanda &  Adhimantha

Abhiṣyanda and adhimañtha produced by kapha which are severe should be treated with therapies such as venepuncture, sudation, avapīḍa nasya, Añjana, dhūma, parişeka, lepa, kavala graha, āścyotana and puṭapāka, which are dry (devoid of fats); apatarpaṇa (purgation) after every third day and then use of Tiktaka ghṛta in the morning daily are best suited.

स्यन्दाधिमन्यी कफजी प्रवृद्धौ जयेत् सिराणामथ मोक्षणेन ।।

स्वैदावपीडाङ्जनधूमसेकप्रलेपयोगैः कवलग्रहैश।।३।।(Su.U.11/3)

Praklinna Vartma

After eliminating  the  aggravated  doṣā  through snehana and  other   therapies  and  obtaining  satisfaction,  the  physician  should  treat  praklinna  vartma  by  use  of  pariseka,  añjana,  nasya  and  dhūma.

Timira

Oil  cooked  with  juice  of  fresh  cowdung  is  beneficial  in  timira  caused  by  kapha  when  used  as  nāvana (nasal  drops);  in  that  produced  by  pitta,  ghee  of  either  goat  or  sheep  either  alone  or  cooked  with  drugs  of  madhura rasa  is  beneficial (as  nasya );  in  those  produced  by  the  vāta  and  rakta, taila  boiled  with  drugs  of  sthirādi (vidārī  gandhādi  gaṇa) and  madhura  gaṇa  (kakolyadi  gaṇa)  or  Anu  taila  is  best  for  nasya.

गवां शकृत्काथविपक्वमुत्तमं हितं तु तैलं तिमिरेषु नावनम् ।।३२।।

हितं घृतं केवल एव पैत्तिके हजाविकं यन्मधुरैर्विपाचितम् ।।

तैलं स्थिरादौ मधुरे च यद्गणे तथाऽणुतैलं पवनासृगुत्थयोः ।।(Su.U.17/32,33)

Kaphaja Kāca Cikitsa

Uśīra, rodhra, triphala  and  priyangu  should  be  cooked (along  with  tila  taila)  and  used  as  nasya  for  mitigating  the  disease (kāca) produced  by  kapha.

उशीरलोध्रत्रिफलाप्रियङ्गभिः पचेत्तु नस्यं कफरोगशान्तये ।।(Su.U.17/41)

Raktamokṣaṇa

स्वदाधिमन्यौ कफजौ प्रवृद्धौ जयेत् सिराणामथ मोक्षणेन ।। (Su.U.11/3)

In abhiṣyanda, sira mokṣaṇa is one among the treatment principles adopted.

पुराणसर्पिषास्निग्धौस्यन्दाधीमन्थपीडितौ।

स्वेदयित्वायथान्यायंसिरामोक्षेणयोजयेत्।।३।। (Su.U.9/3)

 In vātaja abhiṣyanda, sira mokṣaṇa is indicated.

रसैरुदारैरथवा सिरामोक्षेण योजयेत् ॥४॥ (Su.U.12/4)

In raktaja abhiṣyanda, siramokṣaṇa should be done after giving snehana with kumbha sarpi or māṃsa rasa.

सशोफश्चाप्यशोफश्च द्वौ पाको यौ प्रकीर्तितौ ।।

स्नेहस्वेदोपपन्नस्य तत्र विद्ध्वा सिरां भिषक् ।।३८।।  (Su.U.12/38)

In both saśopha and aśophaakṣipākaḥ, sirāvyadhana should be done after snehana and swedana.

Pañcakarma in Nasa roga cikitsā

Vamana

In Pratiśyāya:

नवं प्रतिश्यायमपास्य सर्व मुपाचरेत् सर्पिष एव पानैः ।।

स्वेदैविचित्रैर्वमनैश्च युक्तः कालोपपनैरवपीडनैश्च ।।१८।।

Except the nascent pratiśyāya, vamana is advised along with ghṛtapāna, swedana and avapīḍana nasya especially in kaphaja pratiśyāya, where vamana is done with ghee or yava prepared with tila and Māṣa.

कफजे सर्पिषा स्निग्धं तिलमाषविपक्कया ।

यवाग्वावामयेद्वान्तःकफघ्नंक्रममाचरेत्।।   (सु .उ 24/30)

Pīnasa:

Patient of pīnasa who is of suitable age (middle age) should be made to vomit by administrating Vamana Dravyas.

बहुद्रवैर्वातकफोपसृष्टं प्रच्छर्दयेत् पीनसिनं वयःस्थम् ।।(सु.उ24/24)

Virecana

In pittaja and raktaja pratiśyāya, purgation may be induced by drugs of sweet taste.

पित्तरक्तोत्थयोः …. विरेको मधुरैरपि ।(सु.उ24/38)

Nasya

In nāsāgata rakta pitta,three days  of avapīḍana  nasya  done along  with  any  one  from  these  six types of remedies.

1. Svarasa is collected from Paste of root of trapusa and honey
2. Svarasa collected from paste of yaṣṭīmadhu.
3. Svarasa collected from paste of candana,  madhuka and lodhra
4. Svarasa collected from paste  of  karañja  seeds  and water
5. Paste of iṅgudi phala majjā and honey. Root and flowers of mātuluṅgā macerated and consumed alongwith rice wash and putting drops of sugar water into the nose stops bleeding from the nose. Drākṣā svarasa along with milk and  ghee is  beneficial  for nasal drops.

मलानि पुष्पाणि च मातुलुङ्ग्याः पिष्ट्वा पिबेत्तण्डुलधावनेन।                                  

घ्राणप्रवृत्ते जलमाशु नासिकया पयो वा।।         

द्राक्षारसं क्षीरघृतं पिबेद्वा सशर्करं चेक्षुरसं हिमं वा ।।३७।। (सु.उ 45/36,37)

In pūtinasya,

हिङ्ग व्योषं वत्सकाख्यं शिवाटी लाक्षा बीजं सौरभं कट्फलं च ।।                                                       उग्रा कुष्ठं तीक्ष्णगन्या विडङ्गं श्रेष्ठं नित्यं चावपीडे करञ्जम् ।।४।(सु.उ 23/4)                              

Hiṅgu, vyoṣa, vatsaka, Sivaṭi (sveta punarnava), laksā, seed of surabhi, kaṭphala, ugra, kuṣṭha, tīkṣṇagandha, (Sobhañjanaka) and vidanga- these are best for use of avapīḍa nasya daily.

In vātaja pratiśyāya,

Nasya with taila prescribed in ardita cikitsā.

वातिके तु प्रतिश्याये पिबेत् सर्पियथाक्रमम् ।।

पञ्चभिलवणैः सिद्धं प्रथमेन गणेन च ।।

नस्यादिषु विधिं कृत्स्नमवेक्षेतार्दितेरितम् ।(सु.उ24/19)

In Kaphaja pratiśyāya,

Medicated oil prepared with  the balā, ati  balā,  bṛhatī,  kaṇṭakārī,  vidanga, trikaṇṭaka,  root  of sweta,  sadābhadrā  (kāśmarī),  and  varṣābhū  is  used  for Nasyakarma.

In sannipāta pratiśyāya,

1.For pratiśyāya produced by all the dosãs, taila prepared by boiling with rasañjana, ativiṣa, mustā and bhadradāru should be used as nasal drops.

रसाञ्जने सातिविषे मुस्तायां भद्रदारुणि ।।

तैलं विपक्वं नस्यार्थे विदध्याच्चान बुद्धिमान् ।।         (सु.उ 24/35)

2 . Milk is boiled with half it’s quantity of water and boiled with jāṅgala māṃsa, aquatic flowers and vātāhāra dravya till only milk remains. This should be churned, butter attained and made into ghee; this is added with paste of sarvagandha, sita, ananta  sāriva, madhuka  and  candanaand  ten  parts of  milk and  cooked  to  form  medicated  ghee called dasaksirā ghṛta which is  used  as  nasal drops to mitigate  the  increased  nasal  catarrh.

क्षीरमर्धजले क्वाथ्यं जाङ्गलैगपक्षिभिः ।         

पुष्पैर्विमिश्रं जलजैर्वातघ्नैरौषधैरपि ।।                  

हिमे क्षीरावशिष्टेऽस्मिन् घृतमुत्पाद्य यत्नतः ।

सर्वगन्धसितानन्तामधुकं चन्दनं तथा ।।            

आवाप्य विपचेद्भूयो दशक्षीरं तु तद्धृतम् ।          

नस्ये प्रयुक्तमुद्रिक्तान् प्रतिश्यायाम् व्यपोहति ।।       

यथास्वं दोषशमनैस्तैलं कुर्याच्च यत्नतः । (सु.उ.24/41)

Nāsā śoṣa:

Innāsāśoṣa, kṣīra sarpi and anutaila are important for use as nasal drops.

नासाशोषे क्षीरसर्पिः प्रधानं सिद्धं तैलं चाणुकल्पेन नस्यम् ।। (सु.उ 24/21)

Raktamokṣaṇa

एतैर्द्रव्यैः सार्पं मूत्रयुक्तं तैलं धीमान्नस्यहेतोः पचेत ।।

नासापाके पित्तहृत्संविधानं कार्यं सर्वं बाह्यमाभ्यन्तरं च ।।५ ।

हृत्वा रक्त क्षीरवृक्षत्वचश्च साज्याः सेका योजनीयाश्च लेपा: ।। (Su.U.23/5) 123

 In nasapākaḥ, pittāhāra therapies should be administered and bloodletting is done.

Pañcakarma in Karṇa roga cikitsā

Vamana

Karṇakandu

Therapies such as nādīsveda, vamana, dhūmapana, sirovirecana and all other kaphāhāra treatments should be done for the cure of karṇakandu.

नाडीस्वेदोऽथ वमनं धूमो मूर्धविरेचनम् ।

विधिश्च कफहृत्सर्वः कर्णकण्डूमपोहति |।(Su.U.21)

Kaphaja Karṇaśūla

In kaphaja Karṇaśūla, patient should undergo for Vamana after attaining snigdhata by taking pippali ghṛta. Dhūmapana, Nāvananasya, Gandusa and Sweda with the drugs which mitigate kapha should be done. (Cikitsā manjari)

Virecana

In Pittaja Karṇaśūla, Sarkara sidha ghṛta is used for intake and doṣā is eliminated with Virecana process. (Cikitsā manjari)

Nasya

Vātaja karṇaśūla

The patient should consume ghee on empty stomach at night and drink milk after it. Satapākaḥ balā taila is best to be used as Nasya.

निरन्नो निशि तत्सर्पिः पीत्वोपरि पिबेत् पयः ।।

मूर्धबस्तिषु नस्ये च मस्तिष्के परिषेचने ।

शतपाकं बलातैलं प्रशस्तं चापि भोजने ।।

Karṇa srava,

Śiro Virecana should be done considering the doṣās by using the kwatha of rajavrksadi gaṇa or surasadi gaṇa.

शिरोविरेचनं चैव धूपनं पूरणं तथा ।

प्रमार्जनं धावनं च वीक्ष्य वीक्ष्यावचारयेत् ।

राजवृक्षादितोयेन सुरसादिगणेन वा ।।    (Su.U 21/39-41)

Karṇanada, Badirya and Karṇaśūla:

In Karṇanada, Badirya and Karṇaśūla, swarasa of leaves of Eraṇḍa, Sigru, Varuna and Kadali mula are cooked with 4 times of oil and 8 times of milk and add paste of Yastimadhu , Kṣīra kakoli. This oil is used for Nāvana nasya, Abhyanga and Karṇa Pūraṇa (cikitsā manjari).

Pañcakarma in Siro Roga cikitsā

Nasya

 Vāta śiroroga

After administration of snehana, oil boiled with the soup of crab should be used as nasal drops.

स्निग्धस्य तैलं नस्यं स्यात् कुलीररससाधितम् ।।(Su.U.26/7)

Drugs of varunadi gaṇa should be cut into pieces, put into one part of milk added with half part of water and boiled till milk only remains; then it is churned and the essence (butter) obtained, this is boiled again along with drugs of sweet tastes, this ghee is ideal for use as nasal drops.

वरुणादौ गणे क्षुण्णे क्षीरमर्धोदकं पचेत् ।। 

क्षीरशेषं च तन्मथ्यं शीतं सारमुपाहरेत् ।  

ततो मधुरकैः सिद्धं नस्ये तत् पूजितं हविः ।। (Su.U.26/7,8)

In pittaja and raktaja śiroroga,

क्षीरसर्पिर्हितं नस्यं वसा वा जाङ्गला शुभा ।।  (Su.U.26/16)

Basti

Vātaja śiroroga

Trivṛt taila and   taila can be used as snehapāna, abhyanga, nasya, anuvāsana basti and seka.

पानाभ्यञ्जननस्येषु बस्तिकर्मणि सेचने ।

विदध्यात्रैवृतं धीमान् बलातैलमथापि वा ।। (Su.U.26/10)

Pittaja and Raktaja śiroroga, 

Milk boiled with utpaladi gaṇa is best for basti

उत्पलादिविपक्केन क्षीरेणास्थापनं हितम् ।। (Su.U.26)

Raktamokṣaṇa

अनन्तवाते कर्तव्यः सूर्यावर्तहरो विधिः ।

सिराव्यधश्च कर्तव्योऽनन्तवातप्रशान्तये ।। (Su.U.26/36, 37)

For anantavāta, sūryāvarta treatment is done together with sirāvyadha.

Pañcakarma includes Vamana, Virechana, Niruha & Anuvasana Basti. Sodhana comes under Panchakarma. Pañcakarma is not merely a Sodhana therapy as it is understood, but also has a wider range of therapeutics such as Brimhana, Snehana, Lekhana, Stambhana, Rasayana, Vrishya etc. According to Maharshi Caraka, there are four types of Sodhana there as evidenced in the context of Dashavidha Langhana II Ca.Su.22/18. According to Caraka among five Karma only four (except Anuvasana. because of its Brimhana Karma) does Sodhana. Anuvasana is considered as Karma because it performs the expulsion of stool and Pakāvasayagata Väta. But according to Väagbhata Pañcakarma & Pañca Sodhana are the same.

यदीरयेद्वहिदीषान् पञ्चधा शोधनं च तत् । निरूहो वमनं कायशिरोरेकोऽस्त्रविस्स्रुतिः ॥A.H.Su.14/5

The process of the forceful expulsion of the Dosha is known as Sodhana. It is of five types i.e. Niruha , Vamana, Virecana, Nasya, and Raktamokshana.

Shodhana therapy plays an important role in Ayurveda. The importance of Shodhana is justified by the fact that it eradicates diseases completely (स मूलदोष हरत्वं) and such diseases once cured do not reoccur unless there is a strong etiopathogenesis. Shodhana acts as preventive as well as curative.

Purvakarma plays a vital role for the success of Shodhana therapy. Snehana and swedana make the vitiated doshas into Upasthita Doshavastha which is necessary for shodhana.

तानि उपस्थित दोषाणां स्नेह स्वेदो उपपादनः । पक्षकर्माणि कुर्वीत मात्राकाली विधारयन्।। (Cha.Su.2/15)

After attaining Upasthita dosha avastha by Snehana & Swedana, Panchakarma should be done by considering proper Matra & Kala.

Chakrapani says that, Upasthita Dosha means:

• The doshas which have left the periphery (Shaakha) and are moving towards Koshta..
• The doshas which have lost leenatvam deep seated (adherence),
• Pradhaanaavasta- Have attained the qualities to be expelled.

Panchakarma & Shodhana

Panchakarma is not only meant for shodhana, but is also a measure for Langhana, Brumhana, Lekhana & Shamana. It is a Vyapaka chikitsa (pervades many areas) and is a great measure to attain all types of phala shruthis (benefits).

यद् इवेंद् बहिर् दोषान् पञ्चधा शोधनं च तत् ।

निरुहो वमनं कायशिरोरेको अस्त्रविस्रुतिः।। (As. Hru. Su. 14/5)

शोधनं यत् कुपितान दोषान् निःसार्य बहिः रोगोपशमनं करोति ।

(As. San. Su. 1/37 Indu teeka)

Procedure for evacuation of Prakupita Doshas (aggravated doshas) from the body for the purpose of Roga upashamana (pacifying disease) is known as Shodhana. Vagbhata named 5 types of Shodhana popularly known as Pancha Shodhanas viz., Vamana, Niruha, Kaya vireka, Shiro vireka, Asra visruthi.

 Purvakarma are Deepana, Pachana, Snehana (oleation) and Swedana (sudation).Presence and absence of Ama shall determine the use of Pachana Dravyas, whereas the strength of Agni is assessed by Deepana Dravyas. Snehana (oleation) is administration of any one of Chatur Sneha, and is the major preparatory procedure carried out before Shodhana (purificatory procedure ).

Importance and Method of Pācana in Snehana

पाचनमिति आमदोषपचनम् (Cakra on Ca.Ci.3/160)

Pācana means digestion of āmadoṣa.

अथ खलु लघुकोष्ठायातुराय

दोषपाचनाविति आमसंसृष्टानां दोषाणां पाचनी

                                                             (Dalhana on Su. Su.38/26-28)

पचेत् आमं न वह्नि कुर्यात् यत् तद्धि पाचनम् ।

नागकेशरवत् विद्यात् चित्रो दीपनपाचनः॥ (Śā.Pū. 4/2)

Pācana drugs does the digestion of āma but not increases the agni.

पक्वामदोषवपुषस्तदनन्तर हि स्नेहो हितः। (Hemadri)

The order of kriyākrama explained bytīsaṭa in cikitsākalikā was quoted by hemādri along with medicines for pācana  (प्राक्पाचनं स्नेहविधिस्तत्श्च स्वेदो हित: स्याद्वमनं विरेक: निरूहणान्वासनवस्तिकर्म नस्यं क्रमश्चेति भिषग्वराणां). Tīsaṭahad specified that snehana should begin only after the pācana of āma is attained. Kvātha of rāsna, paṭolaand picumanda is mentioned for the pācana of vātadoṣa associated withāma; kvātha ofśuṇṭhī, and triphala are ideal for Pittadoṣa associated with ama and kvātha of surabhi, vāsā and kaṭphala can be used for the pācanaof kapha doṣaassociated with āma.

पाचनं किञ्चिन्न दीपनं यथा पटोलं। (Cakra on Ca.Ci.28/83-88

In the disease state, when śodhanapurva snehana is to be administered, one should consider the sāmāvastha of the disease, and if present āmapācanais essential.

Pācana karma is for the digestion of āma and detachment of morbiddoṣa from the dūṣya and srotas. If snehana is done in āmayuktadoṣa then it leads to destruction of saṃjñā (consciousness) and even death. Also in sarvāngāshrita āma, the śodhanashould not be given without the pācana otherwise serious complications or destruction of the body occurs.

Āma is harmful to the body so it is to be expelled out from the body. For its elimination, it is to be brought to koṣṭha from sākhā. For e.g. when eraṇḍa taila having sāndra, picchila, guṇa becomes drava by heating. Likewise, by pāka or pācana, āma is liquified and srotorodha gets corrected.

In nutshell, the importance of pācana drugs is to bring the sāmadoṣa to nirāma.

अजीर्णे वर्धते ग्लानिर्विबन्धश्चापि जायते। पीतं संशोधनं चैव विपरीतं प्रवर्तते ॥(Ca.Si. 6/14)

If samśodhana medicine is taken in the condition of ajīrṇa, it will lead to vibandha and glāni. On the contrary, it will produce samyak śodhana in the absence of āma.

सर्वदेहप्रविसृतान् सामान् दोषान् न निहरेत् ।

लीनान् धातुष्वनुत्क्लिष्टान् फलादामाद्रसानिव ॥

आश्रयस्य हि नाशाय ते स्युर्दुर्निहरत्वतः। (A.H.S.13/28-29)

The sāmadoṣa spread all over the body should not be eliminated because, if one tries to remove sāmadoṣa, which is deep and strongly bind to dhātu by samśodhana, it will destroy the body, just like the extracting juice from unripe fruit (it does not yield juice and fruit is also destroyed).

Method of use: The pãcana drugs are selected as per the palatability of the patient and according to thedoṣa. these drugs are administered 3-5 days with suitable anupāna till the appearance of āma pācana symptoms such as lightness of abdomen, increased digestion capacity, vātānulomana, timely evacuation of stool, removal of tongue coating etc.

Drugs used for Pācana

Pācana Auṣadhi currenty used in Practice:

Vāta Vikāra                                                                         

• Sañjīvanī vaṭi (250mg-500mg TID before food)
• Citrakādi vaṭi (250mg-500mg TID before food)
• Agnituṇḍi vaṭi (250mg-500mg TID before food)
• śaṅkhavaṭi (250mg-500mg TID before food)
• Hingvāshtaka cūrṇa (3gm TID)
• Śuṇṭhī curna (3gm TID)
• Vaiśvānara curna

Pitta Vikāra

• Sudarśana ghana vaṭi
• Patola kaṭurohiṇyādi kaṣāya/tablet
• Patolādi kaṣāya/tab . bhūnimbadi kaṣāyam
• Dhānya-Nāgara Kvātha

Kapha Vikāra

• Ārogyavardhini vaṭi
• Sañjīvanī Vaṭi (250mg-500mg TID before food)
• Mahāsankha Vaṭi
• Āmapācana Vaṭi
• Dhānyapañcaka Kvātha
• Trikațu Cūrna (2-3gm TID)
• Pañcakola Cürna

Duration: Till samyak āma pācana

Samyak Āmapácana Lakṣaṇa:

• Disappearance of sāmānya sāma lakṣaṇa
• Disappearance of specific sāma lakṣaṇa features of samyak jaraṇa (Optimal digestion))
• Signs of nirāmatā in jihva, purīṣa, nādi, mūtra

Utility of Pācana Karma and Dravya

1. It increases the digestive capacity of sneha, so that the agni of the patient becomes sthira (stable), strong and able to digest the large doses of sneha given on subsequent days of snehapāna.
2. It is beneficial in diseases like agnimāndya, ajīrṇa, grahaṇī, āmavāta etc.
3. Along with yūṣa and māṃsarasa during saṃsarjana krama
4. In the treatment of nava (āma) jvara
5. Inaatisāra for preparation of peya etc. pathya kalpanā
6. In atisāra as a medicine

Samyak lakṣaṇa of Pācana is Niraāmatva

Mode of Action

• Stimulation of vagus nerve which secretes gastric juice in cephalic phase. • Stimulates duodenum which leads to secretion of digestive enzymes & hormones.
• Stimulates liver to secrete bile
• Stimulates pancreas to secrete pancreatic juice