DĪPANA-PĀCANA
अजीर्णे वर्धते ग्लानिर्विबन्धश्चापि जायते|
पीतं संशोधनं चैव विपरीतं प्रवर्तते|| (Cha. Si. 6/14)
If administering Samśodhana Auṣadhas in the conditions of ajīrṇa it will leads to vibandha and glāni. Proper śodhana can’t achieve in the presence of āma.
सर्वदेहप्रविसृतान् सामान् दोषान् न निर्हरेत्|
लीनान् धातुष्वनुत्क्लिष्टान् फलादामाद्रसानिव||
आश्रयस्य हि नाशाय ते स्युर्दुर्निर्हरत्वतः| (A. H. Su. 13/28)
Doṣas should not be eliminated forcefully in conditions like doṣas are mixed with āma, and are circulating all over the body and may be accumulated in the tissues and also not in the state of utkliṣṭa avasthā. Such an attempt is similar to taking the juice from an unripe fruit, which cause harm to the body.
As a pūrvakarma to virecana, pācana, dīpana, and snehapāna is done. The intention of doing pācana and dīpana with specific medicines is for āmapācana and agni dīpana. Dīpana pācana should be done until the patient attains the nirāma lakṣaṇas. Thus, it will help in the proper śodhana without undergoing any vyāpats. Some of the pācana dīpana medicines which can be prescribed are – trikaṭu, pañcakola, citrakādi vaṭī, vaiśvānara cūrṇa, agnituṇḍi vaṭī etc. in the form of cūrṇa, vaṭī, phāṇṭa, kaṣāya etc. But these medicines can be administered only after the proper analysis of koṣṭha and agni.
ĀBHYANTARA SNEHAPĀNA
After the attainment of nirāma lakṣaṇas during pācana dīpana time, the patient will be advised for ābhyantara snehapāna for a maximum of seven days or till the attainment of samyak snigdha lakṣaṇas. The main intention of ābhyantara snehapāna is that the doṣas which are lodged in the śākhā, are moved towards the koṣṭha, in order to make an utkleśana avastha.. The dose of snehapāna will be administered in the increasing pattern according to the agnibala. It has been told in classics that for mṛdu koṣṭha, three days, madhyama koṣṭha five days and for krūra koṣṭha seven days of snehapāna is administered.
स्निग्धात् पात्राद्यथा तोयमयत्नेन प्रणुद्यते|
कफादयः प्रणुद्यन्ते स्निग्धाद्देहात्तथौषधैः|| (Cha. Si. 6/11)
Ācārya Caraka says that by proper snehana and svedana prior to the śodhana helps the vitiated kapha doṣas to easily reaches the koṣṭha, like how water moves easily through the vessel coated with layer of sneha dravya.
Ācārya Cakrapāṇi opined that the snehana guṇa helps to increase “drava guṇa” to transfer the vitiated doṣas.
स्नेहस्वेदावनभ्यस्य यस्तु संशोधनं पिबेत् |
दारु शुष्कमिवानामे देहस्तस्य विशीर्यते || (Su. Chi. 33/46)
Ācārya Suśruta says that, without proper pūrvakarmas like snehana and svedana the samśodhana auṣadhi and the hazardous afflictions produced by the procedure can destroy the body easily like the dried wood.
मलो हि देहादुत्क्लेश्य ह्रियते वाससो यथा||
स्नेहस्वेदैस्तथोत्क्लिष्टः शोध्यते शोधनैर्मलः| (A. H. Su. 18/58)
Ācārya Vāgbhaṭa says that during śodhana the doṣas are removed from the body by snehana and svedana in the same way as dirt in the cloth is removed with the help of soap and hot water.
DIET DURING SNEHAPĀNA
भोज्योऽन्नं मात्रया पास्यन् श्वः पिबन् पीतवानपि|
द्रवोष्णमनभिष्यन्दि नातिस्निग्धमसङ्करम्|| (A. H. Su. 16/25)
Take proper quantity of food which is simple, hot and liquid in nature, containing only little fat and not obstructing the channels.
स्निग्धद्रवोष्णधन्वोत्थरसभुक् स्वेदमाचरेत्|
स्निग्धस्त्र्यहं स्थितः कुर्याद्विरेक ——–|| (A. H. Su. 16/36)
During the three days gap prior to virecana, sarvanga abhyaṅga and svedana should be done. The diet advised during these days should be snigdha, drava, uṣṇa, jaṅgala māṃsa rasa.
After Abhyaṅga and svedana, peyā should be administered on the previous day of virecana.
Before virecana, the diet administered should be drava, laghu, and aśīta āhāra pāna
रसैस्तथा जाङ्गलजैः सयूषैः स्निग्धैः कफावृद्धिकरैर्विरेच्यः| (Cha. Si. 1/9)
The person who is to be given purgation therapy should be given jaṅgalamāṃsa rasa, snigdha yūṣa, and food which do not produce kapha vṛddhi.
स्निग्धस्विन्नो विरेच्यस्तु पेयामात्रोषितः सुखम्| (Cha. Ka. 7/12)
After Abhyaṅga and svedana, peyā should be administered on the previous day of virecana.
सुजरं द्रवभूयिष्ठं, लघ्वशीतं विरेचनम्|| (Cha. Si. 6/12)
Before virecana, the diet administered should be drava, laghu, and aśīta āhāra pāna
अथातुरं श्वो विरेचनं पाययिताऽस्मीति पूर्वाह्णे लघु भोजयेत्, फलाम्लमुष्णोदकं चैनमनुपाययेत् |
(Su. Chi. 33/20)
Whereas Suśruta Ācārya mentions laghu bhojana, amla phala rasa along with uṣṇajala has to be administered as it will alleviates the pitta doṣa and will help in kapha avajayārtha.
अथैनं पुनरेव स्नेहस्वेदाभ्यामुपपाद्यानुपहतमनसमभिसमीक्ष्य सुखोषितं सुप्रजीर्णभक्तं कृतहोमबलिमङ्गलजपप्रायश्चित्तमिष्टे तिथिनक्षत्रकरणमुहूर्ते ब्राह्मणान् स्वस्ति वाचयित्वा त्रिवृत्कल्कमक्षमात्रं यथार्हालोडनप्रतिविनीतं पाययेत् प्रसमीक्ष्य दोषभेषजदेशकालबलशरीराहारसात्म्यसत्त्वप्रकृतिवयसामवस्थान्तराणि विकारांश्च || (Cha. Su. 15/17)
After undergoing sarvāṅga abhyaṅga and bāṣpasweda, the patient should be assessed whether the food taken in the previous night has been digested properly, whether the patient had a sound sleep in the previous night, and should offer prayers, and oblations. The brāhmaṇas should be invited to recite the auspicious svastivācanas, and on an auspicious, tithi nakṣatra, karaṇa and muhūrta. The patient should be administered one akṣa mātrā of trivṛt kalka. The dose is decided, after noticing the rogabala, rogibala, agnibala, koṣṭha, auṣadha vīrya, deśa, kāla, satva, sātmya, prakṛti, vaya and sāmavasthā.
Kalpanā | Hīna for mṛdu koṣṭha | Madhyama for madhyama koṣṭha | Uttama for krūra koṣṭha |
Kvātha | 2 tola | 4 tola | 8 tola |
Kalka, cūrṇa, modaka | 1 tola | 2 tola | 4 tola |
Svarasa | 1 tola | 2 tola | 4 tola |
Uṣṇodaka | 4 tola | 8 tola | 12 tola |
According to Bhāvaprakāśa and Śāraṅgadhara (Sha. Sam. U. 4/16-17)
kalpanā | Heena mātrā | Madhyama mātrā | Uttama mātrā |
Kvātha | ½ pala | 1pala | 2 pala |
Kalka, cūrṇa, modaka | 1 karṣa | 2 karṣa | 1 pala |
According to Su.Chi.33
Mṛdu koṣṭha – 1 tola
Madhyama koṣṭha – 2 tola
Krūra koṣṭha – 3 tola
Some of the anupāna’s administered for virecana – uṣṇodaka, drākṣā rasa, triphalā kaṣāya, guḍa, harītakī kaṣāya, kaṭuki kaṣāya, ikṣu rasa, gomūtra, kṣīra etc.
According to A. H. Su. 18/34
For vāta predominant diseases – virecana with dravyas having the properties of snigdha, uṣṇa and lavaṇa are administered.
For pitta predominant – kaṣāya, madhura dravyas are administered
For kapha predominant – kaṭu dravyas are administered.
अजीर्णे वर्धते ग्लानिर्विबन्धश्चापि जायते|
पीतं संशोधनं चैव विपरीतं प्रवर्तते|| (Ch. Si. 6/14)
If administering Samśodhana Auṣadhas in the conditions of ajīrṇa it will leads to vibandha and glāni. Proper śodhana can’t achieve in the presence of āma.
सर्वदेहप्रविसृतान् सामान् दोषान् न निर्हरेत्|
लीनान् धातुष्वनुत्क्लिष्टान् फलादामाद्रसानिव||
आश्रयस्य हि नाशाय ते स्युर्दुर्निर्हरत्वतः| (AH. Su. 13/28)
Doṣas should not be eliminated forcefully in conditions like doṣas are mixed with āma, and are circulating all over the body and may be accumulated in the tissues and also not in the state of utkliṣṭa avasthā. Such an attempt is similar to taking the juice from an unripe fruit, which cause harm to the body.
स्निग्धात् पात्राद्यथा तोयमयत्नेन प्रणुद्यते|
कफादयः प्रणुद्यन्ते स्निग्धाद्देहात्तथौषधैः|| (Ch.Si. 6/11)
Proper snehana and svedana prior to the śodhana helps the vitiated kapha doṣas to easily reaches the koṣṭha, like how water moves easily through the vessel coated with layer of sneha dravya.
स्नेहस्वेदावनभ्यस्य यस्तु संशोधनं पिबेत् |
दारु शुष्कमिवानामे देहस्तस्य विशीर्यते || (Su.Chi. 33/46)
Without proper pūrvakarmas like snehana and svedana the samśodhana auṣadhi and the hazardous afflictions produced by the procedure can destroy the body easily like the dried wood.
मलो हि देहादुत्क्लेश्य ह्रियते वाससो यथा||
स्नेहस्वेदैस्तथोत्क्लिष्टः शोध्यते शोधनैर्मलः| (AH. Su. 18/58)
During śodhana the doṣas are removed from the body by snehana and svedana in the same way as dirt in the cloth is removed with the help of soap and hot water.
भोज्योऽन्नं मात्रया पास्यन् श्वः पिबन् पीतवानपि|
द्रवोष्णमनभिष्यन्दि नातिस्निग्धमसङ्करम्|| (A.H. Su. 16/25)
Take proper quantity of food which is simple, hot and liquid in nature, containing only little fat and not obstructing the channels.
स्निग्धद्रवोष्णधन्वोत्थरसभुक् स्वेदमाचरेत्।
स्निग्धस्त्र्यहं स्थितः कुर्याद्विरेकं. (AH.Su.16/36)
During the three days gap prior to virecana, sarvanga abhyaṅga and svedana should be done. The diet advised during these days should be snigdha, drava, uṣṇa, jaṅgala māṃsa rasa.
रसैस्तथा जाङ्गलजैः सयूषैः स्निग्धैः कफावृद्धिकरैर्विरेच्यः| (Ch. Si. 1/9)
The person who is to be given purgation therapy should be given jaṅgalamāṃsa rasa, snigdha yūṣa, and food which do not produce kapha vṛddhi.
अथैनं पुनरेव स्नेहस्वेदाभ्यामुपपाद्यानुपहतमनसमभिसमीक्ष्य सुखोषितं सुप्रजीर्णभक्तं कृतहोमबलिमङ्गलजपप्रायश्चित्तमिष्टे तिथिनक्षत्रकरणमुहूर्ते ब्राह्मणान् स्वस्ति वाचयित्वा | (Ch. Su. 15/17)
After undergoing sarvāṅga abhyaṅga and bāṣpasweda, the patient should be assessed whether the food taken in the previous night has been digested properly, whether the patient had a sound sleep in the previous night, and should offer prayers, and oblations. The brāhmaṇas should be invited to recite the auspicious svastivācanas, and on an auspicious, tithi nakṣatra, karaṇa and muhūrta. The patient should be administered one akṣa mātrā of trivṛt kalka. The dose is decided, after noticing the rogabala, rogibala, agnibala, koṣṭha, auṣadha vīrya, deśa, kāla, satva, sātmya, prakṛti, vaya and sāmavasthā.
त्रिवृत्कल्कमक्षमात्रं यथार्हालोडनप्रतिविनीतं पाययेत् प्रसमीक्ष्य दोषभेषजदेशकालबलशरीराहारसात्म्यसत्त्वप्रकृतिवयसामवस्थान्तराणि विकारांश्च || (Ch. Su. 15/17)
Elimination therapy eliminates the doṣas, eradicates diseases and restore normal strength and complexion. If taken properly it brings longevity.