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Panchakarma
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Introduction
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Vaman karma
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Virechan karma
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Anuvasan vasti
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Nirooh vasti
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Nasya karma
Panchakarma: Procedures in Panchakarma
As the name suggest, panchkarma means panch karma i.e.
five methods or five operation in ayurvedic medicinal
system. These are:
Vaman karma (emetic)
Virechan karma (purgative)
Anuvasan vasti (soothing enema)
Nirooh vasti (cleansing enema)
Nasya karma (nasal purge)
Ayurveda believes that any substance entering in our
body has an effect on our body. Thus to clensify the
wrong effects in the body by that external substance,
panchkarma methods were devised. Panchkarma procedures
purify, pacify and remove the cause on any disease. For
curing any disease one must purify the effective body
system by eliminating the aberrant material from the
body. Secondly one must soothe the already effected
part. And thirdly one must remove the hetu (cause) of
the disease. Panchkarma procedures are so designed that
they satisfy the above mentioned three requirements of a
physician in eradicating a disease. Shad upkarmas (six
methods of treatment).Ayurveda has mentioned six
upkarmas i.e. six methods of treatment under which all
the treatments are performed. These are
Brimhana karma (promoting growth)
Lahghan karma (effecting reduction)
Snehan karma (lubrication)
Rookshan (drying)
Swedan (sweating)
Stambhana (promoting contraction)
According to Charak, the great ancient physician, says
the best physician is that who has mastery over in
performing methods of Brimhana karma (promoting growth),
Lahghan karma (effecting reduction), Snehan karma
(lubrication), Rookshan (drying), Swedan (sweating),
Stambhana (promoting contraction). All methods of
medical treatment in ayurvedic system of medicine may be
classified under one or the other of the following
categories mentioned below
Brimhana karma (promoting growth) promoting growth
or encouraging plumpiness in body.
Lahghan karma (effecting reduction) effecting
leanness, it is opposite of brimhana karma
Snehan karma (lubrication) lubrication or increasing
fat or watery content in the body Rookshan (drying)
promoting dryness, the opposite of the above i.e.
removal of the fat or moisture
Swedan (sweating) promoting sweat or diaphoresis,
etc, i.e., encourages the dilatation (vikaaranaam) of
all channels and opening in the body
Stambhana (promoting contraction) promoting
contraction (sankochanam) or the vessels of supply such
as arterioles, blood, lymph vessels etc, i.e. the
opposite of swedanam.
In a general view all the above method mentions methods
can be classified into the first two methods i.e.
brimhana and lahghan. As ultimate all the six promotes
growth or auses reduction in body. Langahan karma,
swedan karma and rookshan karma all comes into one
category. And brimhana, Snehan and stambhana come in one
category. On account to the multifarious complex
combinations of the three doshas, the medical treatment
also may become complicated. However combined, number
does not exceed six, just as the number of doshas
however combined cannot be transcended their three fold
character.
These methods of treatment should be performed in a very
delicate and balanced manner, so that any excess or
deficiency of the six methods or their combinations may
be avoided.
The patient is the best judge to know weather the method
of treatment is performed correctly or not. The progress
in the relief of the sufferings of the patient confirms
the utility of the treatment. The patient feels happier
if the equilibrium prevails and he feels unhappy the
moment equilibrium is disturbed. For instance, if a
particular portion of the body is dirty and non oily and
if a little lubricant is applied to this, the opposite
treatment of drying is given, the patient is sure to
feel more discomfort. As in other system of medicine
ayurveda also gives treatment generally consist of
supplying the opposite of supplementing the lost element
in the body by the effect of the diseased condition. It
may be mentioned here that all the above methods
oftreatment and operations included in the six
categories of the treatment called the shad upkarmas,
includes the panchkarma, which constitute mainly, the
Langahan part of the six methods. All these process of
treatments are included in antaparimarjana (internal
cleaning) and bahirparimarjana (external cleaning)
Introduction of panchkarma
As mentioned earlier, term panchkarma literally means
five procedures. These are efined in two ways:-Charak
includes the following five operations or procedures in
panchkarma
Nasya karma: it is popularly known as shiroveraechan.
Nasya is the administration of medicine either in
theliquid or in the powder forms into the nostrils. Its
main function is to purify the nasal passage and
relieves the congestion in the cranial region. In fact,
the administration of nasya karma is considered as a
purgative to the head as the term shiroveraechan
literally implies.
Vaman karma: according to ayurveda, definitions say that
it is the procedure in which aggravated doshas ofthe
body are expelled out of the body by oral canal. Vaman
or administration of emetics is one of the procedures by
which Shodhana (cleansing) of the body is being done.
The aim and the objective of performing Vaman karma are
different from and more comprehensive than those of
administration emetics. It is widely used in eradicating
disorders caused by kapha dosha.
Virechan karma: its the procedure by which aggravated
or imbalanced doshas are expelled out of the body
through anal region. Virechan means purgative. This is
chiefly in disorders caused due to pitta dosha. It helps
in cleansing the body from doshas thus helping in
providing stability and homeostasis in the body. Nirooh
vasti karma: nirooh vasti is commonly known as astthapan
vasti. It includes the administration of certain
decoctions of specific herbs as enemata for the chief
purpose of cleaning the intestine. It is widely used in
intestinal colic due to irregular eristalsis (udaavartham)
and in constipation (vibhandh).
Anuvasan vasti karma: this is also called Snehan vasti.
It helps in brimhana trengthening) of the body hence
provides power to the body organs. This is
administration of enemata, which is prepared whole
solely in oils there fore helps in toning up of organs.
Besides cleansing purpose it also helps in relieving
disorders caused by vata dosha.
Karma in normal terminology means special operations or
procedure. The word karma means special act whose main
purpose is to expel out the vitiated doshas thus helping
in cleaning the body. As understood by name panch karma
is five in numbers in which four are Shodhana karma i.e.
helps in cleaning the body. These are Vaman, virechan,
nasya, and nirooh vasti. There main purpose is to purify
body or eliminating the aggravated doshas (vata, pitta
and kapha) out of the body or subduing them, there fore
they are classified into Langahan karma. The one left is
anuvasan vasti which is considers as growth promoter and
toner thus helps in lubricating and toning muscles and
organs often body. Therefore it is characterized into
samana karma, a soothing treatment: although its main
purpose is also to eliminate or check a premier dosha
i.e. vata hence included in brimhana chikitsa
(treatment). Rakta mokshana as a panchkarma
Maharishi Charak has mentioned the above mentioned five
karmas but Maharishi Sushurut has considered rakta
mokshana karma in panchkarma therapy and has included
anuvasan vasti and nirooh vasti under vasti karma. Rakta
mokshana commonly signifies to venesection or blood
letting, to treat disorders caused by aggravated doshas.
Maharishi Vagabhatta has accepted and supported this
view as mentioned in ashtang hridayam. One thing is
worth mentioning here that Maharishi sushurut has
considered four doshas instead of three i.e. vata, pitta,
kapha and rakta.
Stambhana karma: Stambhana karma is the method of
treatment by which contraction of the part of the body
of the constriction of the arteries or other vessels in
that part of the body or in the whole body takes place.
This is the opposite of swedan karma, whose purpose is
to dilate the pores and to lubricate (Snehan), to
liquidate (vishyand), to soften (maardava), or to
moisten (kleda) the part. Swedanam encourages
perspiration. It checks sthambhan (contraction or
solidification), heaviness (gauravam) and cold (sheet).
The purpose of stambhana on the other hand is to check
movement (sthambhayati yat gatimantham, chalam) by
contracting or congealing the opening of the channels.
Things used for causing stambhana. The things used for
casing contraction are generally promoting slowness in
movement, sheet (cold), mand (slow), soft (mridu),
slakshan (glaszy), rookksh (non oily), sooksham (subtle
or quickly permeating), dravya (liquid), sthir (steady)
and laghu (light). Soft and cold potters earth, ice,
styptic, haemostatic, constipation, anti diuretics (like
opium), and anti diaphoretics (like atropine), vaso
constrictors (like adrenaline) may all be included under
stambhana substances.Substances which are sweet, bitter
and astringent are stmabhak in action.
Person fit for stambhana karma - Those people who have
aggravated pitta and presently the same picture as of
pitta dominance like buring eyes, having persistent
diarrhoea and vomiting. People who are affected by
poison, people who sweat excessively or people suffering
from similar kind of diseases are considered fit for
stambhana karma.
Symptoms for proper stambhana treatment Following are
the symptoms by which pplication of stambhana karma is
recognized: -
The relief by the patient of all the distressing
symptoms which he has been previously suffering
The acquisitation of strength which is easily felt by
the patient who had a proper stambhana treatment
Symptoms of excessive stambhana treatment Following
are the symptoms presented when a person is over treated
by stambhana karma. black or grey discoloration of the
treated part due to excessive venous congestion,
necrosis or gangrene
Stupefaction, loss of sensation or heaviness of the
part treated. hurried respiration or excitement tendency
of lock jaw
A feeling of heaviness in heart region.
Constipation.
Method of administrating panchkarma procedures
Panchkarma procedures are considered to as operations,
which are to be performed in a sequence designed by
ancient rishis and physicians. A pattern as followed by
modern surgeons has been taken from ayurvedic medicinal
system. It includes three steps. These are:
Purva karma or the pre-operative procedure
Pradhan karma or the main procedure
Paschat karma or the post-operative care
It is very essential that panchkarma procedures are to
be followed in proper sequence and an expert guidance is
extremely essential as even little bit of carelessness
and ignorance in performing the procedures can lead to
extreme effects on body. One should also be ery cautions
in following the pre-operative and post-operative
procedures for very good results.
A. Purvakarmas or the pre-operative procedures Purva
karma means procedures of the karmas which are to be
performed before starting with the main procedure. It
can be included in the prior preparation of the main
procedures which includes preparing patient mentally and
physically for the main procedure. It includes three
procedures. These are.
Pachan karma
Snehan karma
Swedan karma
B. Pradhan karma or the main procedure It includes the
main treatment to be given to the patient. It is most
essential step in curing the patients from the disease.
It includes all the panchkarma procedures. These are:
Vaman karma
Virechan karma
Vasti karma
Shiroveraechan karma
Rakta mokshana
C. Paschat karma or the post-operative care Post
operative care is one in which certain precautions are
to be taken to get the full benefit of the main
procedure. It also includes management and maintenance
after recovery period by lifestyle management and diet
management or by giving some herbal supplements. These
includes following procedures.
sansarjan karma
rasayan adi prayogam
shaman chikitsa
Vaman Karma
It is expulsion of aggravated doshas from the mouth
region or the oral canal is called Vaman karma. It
should not be compared with vomiting. Vomiting is the
forceful expulsion of content of stomach. Where as Vaman
karma is performed after sequence of procedures under
the supervision of panchkarma expert and is done
according to the patients requirements from treating him
from the disease.
Definition. - Vaman or administration of emetics is one
of the series of panchkarma procedures. This is a
Shodhana karma (cleansing procedure) or purifying
operation with regards to kapha dosha. The aim and
administration of Vaman karma are different from and
more comprehensive than those of administration of
emetics in modern sciencesDifference between
administration of emetics and Vaman karma
Benefits of Vaman karma
Properties of herbs that are used in Vaman karma
Unfit for Vaman karma
Uses of Vaman in dieses mentioned by various rishis.
Avamya roga (contra indication of Vaman karma)
Necessity of performing purva karma before performing
Vaman Procedure
Selection of emetic
Herbs used for Vaman karma.
Herbs mentioned by various rishis for Vaman purpose
Various kalpnaye (various recipes) for preparation of
vamaka dravya.
Purva karmas of Vaman karma
Administration of the vamaka dravya
How does an emetic work
Panchakarma: Difference between administration of
emetics and Vaman Karma
Vaman karma is not done merely with the object of
relieving stomach with its contents, especially
poisonous contents and to clear out passage of children
as stated above. Vaman karma in ayurvedic system of
medicine is performed when there is presentation of
kapha doshas, which has symptoms such as heaviness in
body etc. The doshas predominantly affects amashya
(compared to stomach), then the Vaman karma is advised
after performing the purva karma i.e., Snehan and swedan
in a proper procedure mentioned according to ayurvedic
text. These injunctions will be set below and if carried
out, no untoward symptoms such as depression and
gastrointestinal irritation should result. More over, in
ayurveda, the herbs used such as madanphala, pipilli,
nimb, and kutaja seed, etc. are of vegetable origin and
are not minerals such as tartar emetic etc, are
therefore not poisonous and depressant and therefore are
not involved in degrading and deteriorating bodies
mechanism. Their selection again depends upon the
condition of doshas presented by the patient.
Benefits of Vaman Karma
Vaman karma is effective in Shodhana of amashya i.e.
cleaning stomach
Vaman karma is highly recommended on countering the
kapha dosha which is in aggravated state
Vaman karma is very effective and acts as a life saver
in situations like ajirn (indigestion), vish peet
(consumption of poisonous substance), visuchika
(cholera) and virudh aahar (food poisoning).
Vaman not only cleanses the doshas present in stomach
but also helps in purification of the whole body as the
purvakarmas i.e. Snehan and swedan helps in bringing
kleda (aggravated kapha) to the amashya (stomach) which
is been removed from the body by practicing Vaman karma
Herbs used for Vaman karma.
The herbs mentioned below are used in performing Vaman
karma in general use.
Madan phala
Yastimadhu
bitter gourd
neem
kaakanaasa
indravaruni
bitter cucumber
kutaja
morrvamool
devadaali
vidanga
jalavetasa
chitraka
mooshikaparnee
kosavatee
karanja
pipilli
saindhav lavan
vacha
ela
mustard
kritavedhana
kaanchanaara
ashwagandha
bandhujeeva
satapushpa
Unfit for Vaman Karma
Vaman is not permissible in patients who are
sufferingfrom aneurism, hernia, prolepses of uterus or
rectum, peritonitis or tendency of hemorrhages, because
of straining induced by vomiting, which should make us a
cautious in giving it to those who have disease
ofvessels or high tension in them, for the straining may
lead to hemorrhage
Uses of Vaman in diseases mentioned by various rishis.
Serial no. Disease Maharishi charak Maharishi
sushurut Maharishi Vagabhatta
1 Peenus (sinusitis and influenza) + + +
2 Kushth (skin disease) + - +
3 Nav jwar (acute fever) + + +
4 Rajyakshma (tuberculosis) + + +
5 Kaas (cough) + + +
6 Shwas (asthma) + + +
7 Malgrah (constipation) + - -
8 Shlipada (elephantiasis) + + +
9 Galgand (goiter) + + +
10 Prahmeh (urine related diseases) + - +
11 Mandagni (loss of appetite) + + +
12 Virudh aahar (food poisoning) + + +
13 Ajirn (indigestion) + - +
14 Visuchika (cholera) + - +
15 Alsak () + + +
16 Vish peet () + + +
17 Dasht, digdhviddh + - +
18 Adhog rakt pitta (bleeding per rectum) + - +
19 Mutraprasek () + + +
20 Arsh (hemorrhoids) + - -
21 Hallaas + + +
22 Aruchi (tastelessness) + + +
23 Avipaak + - +
24 Apchi + - +
25 Granthi - - +
26 Apasmar (epilepsy) + + +
27 Unnmad (hysteria) + + +
28 Atisaar (diarrhoea) + + +
29 Shauf (oedema) + - -
30 Pandu (anemia) + - -
31 Mukh paak (stomastis) + + -
32 Stanay dushti () + + +
33 Arburd (tumor) - - +
34 Vidarika (skin disease) - + +
35 Medo roga (obesity) - + +
36 Hridya roga (heart disease) - + -
37 Chitt vibrham (depression) - + -
38 Visarp (ery) - + +
39 Vidradhi (abscess) - + -
40 Pootinash - + -
41 Kanth paak (pharyngitis) - + -
42 Karn srav(otoria) - + -
43 Adhijivika (uvilitis) - + -
44 Gal shundika (adenoids) - + -
45 kapha roga + + +
Avamya roga
Serial no.
Disease Maharishi charak Maharishi
sushurut Maharishi Vagabhatta
1 Shat shirn (weakened due disease) + + +
2 Atisthool (obese) + - +
3 Atikrish (weak + + +
4 Baal (child) + + +
5 Vridh (old) + + +
6 Durbal (weak) + + +
7 Shrant + + +
8 Pipasit (thirsty) + + +
9 Shudhit (hungry) + + +
10 Karmhatt + - -
11 Nhar hatt + - -
12 Adharv hatt + - -
13 Upvasit (fasting) + - -
14 Maityhun prast + - -
15 Adhyan prast + - -
16 Vyayam prast + - -
17 Chinta prast (tensed) + - -
18 Ksham + - -
19 Garbhini (pregnant) + + +
20 Sukumar (new born) + - -
21 Sanvritam koshth + + -
22 Krimi koshth - + +
23 Dushchardan + + +
24 Udharv rakt pitta (epistasis) + + +
25 Prasakt chardi + + +
26 Asthapitt + + +
27 Udhrava vata + + +
28 Anuvasit+ + + +
29 Hridya roga (heart disease) + - +
30 Udavaata + +
Selection of emetic
There have been some principles laid down for selection
of vamaka dravya (emetic). It is judged according to the
prakruti (nature and body constitution of the
individual) and the status of all the three doshas of
the body. When a person has the predominance of kapha
dosha then the herb which is to be selected must be of
katu rasa and dominant. It should also be tikshan in
guna and ushan in virya (hot potency).When the patient
is of pitta dominance then madhur rasa dominant herbs
should be preferred in treating the pitta dosha. Sheet
virya (cold potent) herb is to be administered in the
cases of pitta dominance that will help in subduing the
pitta aggravation in the body, especially in amashya (stomach).If
there is vata predominance with the association of
aggravated kapha then the herbs that are madhur (sweet),
amal (sour) and lavan (salty). Herbs which are ushan in
virya i.e. hot in potency are to be used to counter the
vata dosha.
According to sharanghdhar samhita in kapha dominant
disease pipilli (piper longum), madan phala and saindhav
lavan are to administered by hot waterIf pitta dosha is
of dominance then the cool decoction of patol patra,
vasa and neem are to be taken. In vata dominance
diseases associated with kapha dosha present in urah
pradesh (chest region) or amashya (stomach), madan phala
is to be given with cows milk. In indigestion, saindhav
lavan is to be taken with hot water to produce Vaman.
Various Recipes for Preparation of Vamaka Dravya
churan (powder)
kalk
kashaya (decoction)
sneh
varti
avleh
kshir
dahi (curd)
dadhisaar
ghrit (ghee)
takr
mastu
yvagu
krishra
yuush (soup)
utkarika
shaskuli
apuup
shadav
kambalik
faint
modak (ladoo like sweet)
manth
navneet
matrayen
madira (alcohol)
suramand
aasut
palal
mansras
dhreyeyog
ikshuras (juice of sugarcane)
salil
Administration of the Vamaka Dravya
If the patient is a delicate one or weak or very much
afraid of the emetic or a boy or an old man, he should
be give yavagu (conjee) or milk or butter milk or curds
to the fullest and then the emetic dose is to be given
to vomit it out along with the dosha. After taking the
dose of the emetic, the patient has to rest for a
muhurat. To have his body fomented with heated hands all
the while. If sweat appears, it should be known that
dosha is being melting and liquefying, if horripilation
occurs, it should be known that the dosha has begun to
move from its location, if the distension of the abdomen
appears, it should be known that the dosha has come to
kukshi (koshtha). When nausea (hrillaasa) and the
watering of the mouth (aasyasravanam) occur, it should
be known that the dosha is coming out. The patient
should sit on a cushioned chair about eighteen inches in
height, so as to enable him to stoop forward and vomit
easily and to rest in the interval. He should be held by
the attendants. These parts should be also massaged by
them. If the patient does not feel sufficiently
nauseous, he should tickle his face with finger or with
his fingers or with the stem of errand nalaa (stem of
castor plant), or with the stalk of the water lily
flower, so that he may easily vomit out the contents.The
patient is thus induced to vomit when he gets the
nauseous sensation; he should not be made to vomit when
he gets the nauseous sensation, he should not be made to
vomit sufficient nausea. In this way, he may vomit four
to six times or eight times according to his strength.
Four vomits are considered to be due to an inferior
action of medicine. Six vomits are considered to be due
to medium action of the medicine and eight vomits are
due to drastic action of the medicine. There are four
ways of knowing that the dose of the emetics has
produced its results in a satisfactory manner. The four
ways of such knowledge are named by the
commentators.laingikee: the patient should experience a
feeling of relief as he vomits out the dosha, and he
feels lightness of heart region, sides, heads, senses
and upper koshta and a feeling of relief their in . This
sort of feeling demotes the laingikee way of knowing
that the emetic has acted in the desirable manner.
Maanikee: the total volume of the vomited matter is
measured and one prastha (2 seers= about 48 fluid ozs.)
of the matter is considered as madhayama (medium) suddhi
(purification) and four prastha are considered as uttam
(best) suddhi (purification). This consideration of
suddhi is according to manna or measurement and hence it
is called maanikee
Vaigikee: the number of vegaas or urges to vomit is
another consideration. It is noted already that four
vegaas or urges or vomits are considered as madhayama
suddhi and eight vegaas are considered uttam suddhi (pradhaana
suddhi). As the consideration of suddhi rests on the
number of vegaas of the patient, it is called vaigikee.
Aantikee: the patient who has taken an emetic should
first vomit the medicine and gradually kapha in the
succeeding vomits and pitta in the last vomit. Thus
pitta is the last to be vomited and hence it is said
pittaanam isstam vamanam i.e. pitta should be the last
to be vomited. The appearance of pitta (bile) in the
concluding vomit is desired and this kind of suddhi is
called aantikee (pertaining to conclusion). Or Vayu is
also, however, said to be the last or concluding dosha.
But the discharge of the Vayu is only inferred by the
empty urges (to vomit) in the end and it is not attended
with any matter. If there is matter, however little, it
should be pitta. Hence pitta is practically the last
dosha to appear concretely. This consideration of suddhi
is called aantikee. The commentators (Chakarpani and
Dalhan etc) say that there may be fallacies in
concluding that the doshas have been expelled by any one
or two of these consideration and hence all these points
should be considered in deciding weather the patient had
a thorough suddhi or not.
Panchakarma: Herbs Used in Vaman Karma
Ushan (heat): due to this ushan gunn (hot property)
vamaka dravya (emetic herbs) makes doshas vishyand i.e.
it melts the doshas and then makes it to reach amashya
(stomach) and mahastrota (gastro intestinal tract)thus
doshas enters in kushth, which are easier to eliminate
from the body.
Tikshan (sharpness): it is an agneye (fire) in dominance
thus helps in melting the doshas which get stick to the
body parts due to this property it easily penetrate
Suksham (fineness): due to Aakash mahabhoot, vyavyahi
and tejas gunna it gets the property of penetrating
power which helps it to penetrating into the small
strotas (channels)
Vyavyahi: it is property in which the herb enters body
and digested in the whole body. It has dominance of
Aakash and Vayu mahabhoot.
Vikashi; herb that gets spreads in whole body and then
decreases oja ands creates shathiliye in dhatus and
sandhis. It has been predominantly Vayu mahabhoot rich.
Udhrapravati: in literal meaning it means the tendency
to move upwards. These vamaka herbs help in upward
movements the doshas thus helping in emesis.
Procedure
In the morning, the panchkarma is to be performed;
proper dose of the vamaka dravya (emetic) is to be
administered to the patient. The decoction of madanphala
is advocated as the best. Honey, decoction of Yastimadhu,
saindhav lavan (rock salt) and some quantity of phaanita
(syrup of jaggery) are added to the medicine prepared.
Not only madan phala but the herbs mentioned in the kalp
sthana (chapter based on the vamaka dravya and virechak
dravya) i.e. jeemutak, ishwaaku, dhaamaargrava, vatsaka,
kritavedhana, etc are advocated in charak samhita.
According to Maharishi Charak there are 355 recipes of
vamaka dravya preparation. According to him these herbs
can be administered in the form of powders, confections,
lehyams (jam form), inhalations, etc. however he
consider madan phalka the best out of all the emetics
mentioned. The various recipes mentioned in kalp sthana
of Charak samhita are composed according to different
constitutions, temperatures, diseases, tastes, habits
etc.
Purva karmas of Vaman karma
Following points have to be kept in mind before the
Vaman karma is to be administered
Atmanirikshan (self analysis) First of all the physician
performing panchkarma procedure has to have that
confident that, he is capable in performing the
procedure efficiently and with ease. He should be having
expertise in handling all the complications or
situations that might arise during the procedure.
Atur pariksha (patients condition)
It is very important to examine the patient thoroughly
and then the procedure should be preceded. Check the
strength of the patient, his physical fitness,
environmental conditions, his condition of doshas. His
diet, things that would be suitable to him while
performing the procedure and most importantly his age.
Vaman samagri (things required in performing Vaman
karma)
It is necessary to have the proper availability of
substances needed in performing the Vaman karma like a
well shielded room in which patient do not gets exposed
to the out side environment. Room should be cozy and
should able to capacitate small family. It should be
well supplied with water. it should have a proper
kitchen, washroom and bathroom. The utensils which are
to be used or are used in performing Vaman karma are to
be well equipped in that place.
Paricharak (assistance)
A trained assistant must be present who will help in
performing the procedure and also to nurse the patient.
He should help patient in performing his day to day
activity like bathing etc. He should be expert in
helping the physician in carrying out the procedure and
should follow instruction given by the doctor carefully.
And most importantly should be very enthusiastic in
performing his duties. He should also have feeling of
kindness towards the patients.
Aushadh (herb that is vamaka in nature)
The herb which has been decided after the proper
examination of the patient should be in adequate amount
and its availability should always be there. In case of
any emergency antidotes should be available. Certain
drugs and herbs should be available to counter any kind
of situations and complications
Rogi ka utklesh (preparing patient for the operation)
After performing the Snehan and swedan of the body
patient should be advice a diet which is rich in food of
kapha origin especially a night before the procedure has
top be performed. For example milk, curd, till and meat
of fish and animals who live in water etc. It helps in
increasing the kapha content in the body therefore which
is essential for expulsion of kapha dosha the next day
when the procedure has to be performed the next day.
Snehan swedan (lubrication and sweating)
According to the category of the disease patient should
be lubricated with the oils internally and externally.
When the symptom of proper swedan appears then the
swedan should be stopped. After the appearance of these
symptoms swedan should be performed. Swedan should be of
stream which is helpful in whole body sweating.
Vamankalika achar (phsycological therapy)
Patient should be given proper sympathy and should be
taken in confidence, that the physian is expert in
performing the Vaman procedure and has all the
qualification and confidence in treating the patient and
curing him off, of his ailments. Patient should also be
informed about the steps involved in the procedure and
all the steps to be followed while performing the
procedure. Patient should be given full guaranteed that
he will not face any trouble and he would definitely
will get well from the suffering he is suffering from.
Accompanied of the patient should also be given
assurance that the procedure is for benefit of the
patient and it would help him getting free from his
troubles. They should also be informed that procedure is
safe and has very little chances of that the procedure
has complications.
Necessity of performing Purva Karma before performing
Vaman
Purva karma is very essential before performing the
Vaman karma. Other wise many complications can arise.
Snehan (lubrication) and swedan (sweating) are very
important procedures are very critical before the Vaman
karma is initiated. Snehan (lubrication) checks the Vayu,
softens the tissues (deham) and separates the debris (mala)
from the healthy tissue. Sweating, if it is conducted
after proper lubrication, liquefies the debris which is
entangled in the tiny channels. In order to enhance the
effect of Snehan and swedan, kapha or moisture should be
increased by the previous administration of milk or
other kapha increasing foods.
In a chronic disease, such as prameha (urine disorder),
kushth (skin disease), apasmaara (epilepsy), etc which
is caused principally by kapha dosha or by any other
dosha located in amashya (stomach) along with kapha, the
preliminary process of Snehan karma and swedan karma has
to be sufficiently executed before Vaman karma is
administered, carefully regulating the diet and other
habits all the while. Such processes were described by
charaka and sushurut in the following manner. The
patient is to undergo snehakarma along with proper diet.
Usually three to six days relapse in such a course.
Swedan karma suited to constitution and the dosha
vitiation of the patient in the next administered. If
the patient is in the habit of taking snigdh foods, he
may have swedan karma administers on the next day
following Snehan karma. He has to take abhishyandi or
kapha producing food such as anoop maasam or milk or
black gram etc, on the night of the next day. This act
of eating such food increases kapha and this increased
kapha makes the old stationary kapha somewhat mobile. If
the static dosha is thus made mobile; it may easily be
removed by administration of proper emetic.
How does an Emetic Work
According Maharishi Charak the emetic substance which is
empowered with be ushan, tikshan, suksham, vyavyahi and
vikashi qualities, reaches the hridya by its own
penetrating power (swa veeryena) and from there, it gets
into the dhamanees (channels) and entering the big and
minute strotas (sthoola anu srotrebhyah) throughout the
body (kevelam sareeragatam), liquefies the doshas lodge
there, by its agneye (biochemical) quantities and breaks
(vicchindati) the dosha by its tikshan qualities. The
dosha thus liberated, enters the circulation broken and
when the patients body had been sufficiently lubricated
by the previous Snehan, the dosha cannot stick up
anywhere, just as honey cannot stick up in a vessel,
which is anointed with oil and therefore the dosha
naturally comes to the koshth. From the alimentary canal
the dosha is finally vomited out by the action of udan
Vayu. The emetic which starts its action in the
alimentary canal enters the circulation and brings the
dosha along with it, into the alimentary canal for
elimination from there.
Excessive use of the emetics
If the dose of the emetic is excessive, there would be
atiyoga, i.e. excessive action of the emetic which is
not desirable. Such a dose produces excessive evacuation
of pitta, unconsciousness and pain in the heart region
and throat. Moreover thirst, coma, , vitiation of Vayu,
sleepiness, excessive weakness also may be caused.
Streaks of blood, foam etc, and may be seen in the
vomited matter. There may be tympanitis, hemorrhages etc
as a result of an excessive dose of an emetic herb.
Ayoga- insufficient dose of emetics
There, in the Ayoga or improper evacuation of the dosha
the emetic , the symptoms caused by such an improper
dose are dribbling of saliva, sensation as if there is
no purification in the heart region and itching, skin
eruption (kotha and sphotaka) and heaviness of the body.
Dhumapanam after emetics
The patients who has had a desirable evacuation (samyoga)
of the dosha by the emetic (Vaman karma) should have a
Dhumapanam (medicated smoking). There are three kinds of
medicated smokes, Snehan, virechan, and samana. The
proper one should be selected. If there is still some
little dosha, a little virechan or samana Dhumapanam
should be given: if there is excessive evacuation and
consequently a little increase of vata is suspected, a
Snehan Dhumapanam is given.
Diet to administered after Vaman karma
The patient should not take food immediately; he should
at least fast until afternoon. When according to his
jatharagni, he should be allowed to take a light meal
with kulutha yoosha or mugadha yoosha or aadhaka yoosha
or jaangalamaamsarasa, having taken a refreshing hot
water bath.
Maharishi charak says that the patient should fast for
that day or may take a thin manda and yavagu of old red
saali rice on that day in the evening if he is so
allowed by the physician after judging his digestive
capacity. He should repeat the same at the time of the
two meals on the next day also; on the third day, he
should take the vilepi or thick kanjee of the same rice
preferably without salt or with very little salt (if it
is so desired by the (patient). The same is too repeated
on the third day evening and fourth day forenoon (only
two meals are to allowed). On the evening of the fourth
day, he may take same old rice well boiled with the
mudga yoosha. The same is to be repeated on the fifth
day both forenoon and evening. On the sixth day, in the
morning, he may take the same food with
jaangalamaamsarasa added to it (according top satmyam of
the body) the same food is to be repeated in the evening
and on the seventh day both in the morning and evening.
On the eight day onwards, the patient may gradually
indulge in his usual food but with good care. The
principal to be noted here is that the consideration of
jatharagni (digestive fire)is most important. The
Shodhana karma (Vaman) makes the jatharagni weak by its
nature and any food hastily given after such Shodhana
Kama only weakens the jatharagni further which means
further vitiation of the tridoshas eventfully. Hence, if
his jatharagni is alright the patient may be allowed to
take light meals: otherwise manda, peya etc should be
given prior to the administration of the usual food for
some days till his jatharagni becomes proper. In this
connection, Maharishi Charak has mentioned that just as
the fire in the outside world is kindled by the bits of
dry straw, hay, dry cow dung cakes, small dry twigs,
etc. and gradually develops into a large fire, when it
will be able to consume powerful by graded and planned
diet, hence it should be kindled by peya etc, and made
firm before normal indulgence in ordinary foods. It is
very important to mention here that during the whole
course of treatment of Vaman karma, a person should
follow all the rules and regulation of brahmacharya (non
indulgence in sexual affair) as mentioned by Maharishi
sushurut.
Things to be avoided
In chronic diseases where systematic Vaman karma is done
after sneak and swedan, the patient, in addition to the
regulation of diet mentioned already, should rest in the
room free from draughts and should not indulge in
overwork, fasting, excessive walking, walking in night,
sexual intercourse, sleep, heavy and in compatible food
etc.
Vaman in rasayan treatment
Person who desires to take rasayan treatment (though
they do not suffer from any disease) should first
undergo panchkarma, Vaman being the first karma in the
sequence of five methods of treatment. Patient should
carefully and patiently undergo all the procedures for
the duration each and every process requites.
Panchakarma: Introduction to Virechan Karma
Virechan Karma (Administration of Purgative)
Virechan means administration of purgative for the
purpose of eradicating dosha from the body. It is mainly
done to eradicate the aggravated pitta dosha in the
body. It is the karma thats should be performed only
after doing Snehan and swedan. Virechan karma is to be
performed on the sunny day, wind should not be blowing
and day should be auspicious. Various forms of herbal
preparations like churn (powders), swaras (juices) are
to be administered to perform virechan karma. The kind
of herb and the method of its preparation are to be
considered according to the disease and the condition of
dosha. As an example trivith is very beneficial in the
diseases which have pitta and kapha dominance. If there
is Vayu, herb containing or mixture with the herbs which
have snigdh, ushan qualities and lavan rasa are to be
used as medicated castor oil etc.
Definition - Virechan or administration of purgatives is
one of the series of panchkarma procedures. This is a
Shodhana karma (cleansing procedure) or purifying
operation with regards to pitta dosha. The aim and
administration of virechan karma are different from and
more comprehensive than those of administration of
purgatives in modern sciences.
Benefits of virechan
Properties of herbs that are used in virechan karma
Virechan is indicated in following diseases.
Action of virechan dravya (purgative) dravya
(substance)
Importance of performing purva karma before performing
Vaman
Mode of administration
Different types of bowels (koshth)
Purva karmas of Virechan karma
Pradhan karma (main procedure)
Complication of improper virechan karma
Panchakarma: Types of Bowels, Mild Bowel, Severe
Bowel, Medium Bowel
There are three of koshth or the bowel
Mridu koshth (mild bowel)
Karoor koshth (severe bowel)
Madhya koshth (medium bowel)
If a person has a Mridu koshth he ahs to administered by
mild laxative like warm milk, which has the potency to
evacuate bowel. Karoor koshth or the habitual
constipated bowel is administered by using drastic
purgatives. This type of koshth is to handles by first
administrating it with the Snehan (lubrication) at least
for six days and then the swedan karma (sweating) is to
done. Madhayama or the medium koshth can be administered
by any purgative of normal potency. Karoor koshth is the
result of vata. Mridu koshth is the result of pitta and
madhayama koshth is due to homeostasis of the all the
doshas. After the purgative has been administered person
should not obstruct the urge of evacuation of the bowel.
Panchakarma: Purva Karmas of Virechan Karma
In this process, we prepare our selves to perform the
major process i.e. the virechan karma. Following are the
points which are to be taken care of before the
procedure has to start.
(a) Samagri or the collection
Before performing virechan one must do Snehan, swedan
and Vaman karma. It is very important to perform these
karmas before the virechan karma otherwise complications
may arise.
(b) Rogi pariksha or the investigation of the patient
It should be first adjudged that does patient require
virechan karma. If he requires this karma then he should
be care fully investigated and his health should be
judged on the criteria of desh (place), kaal (time and
season), bal (strength), sharir (body), prakruti
(nature). Depending on all these conditions it should be
decided, that to what degree of and what type of
virechan is to be given.
(c) Preparation of the Rogi
If the patient has also to be administered with Vaman
karma prior to the virechan karma, then after performing
Vaman karma, Snehan and swedan is to be performed again.
After performing Vaman karma sansarjan karma is to be
performed in sequence and on the ninth, tenth, eleventh
day and twelth day snehpaan (internal lubrication of
body) is to be done.
After performing this one should take rest and then the
procedure of virechan is to be performed.
The person who has to be given virechan must be given
fatty stuff like ghee butter etc mixed with meat; rice
etc prior 2 to 3 days before virechan karma and then he
should be given purgatives.
Virechan should be performed empty stomach only.
Person who is to treated should be given psychological
encouragement that he will be fine after the procedure
is over.
(d) Preparing medicine
A person who is week, lean and sensitive should be given
Mridu virechak (mild purgative)
If a person has the Mridu koshth (mild bowel) he can be
given sugarcane juice, milk, ghee, triphala and warm
water for performing virechan karma.
If a person has Karoor koshth, he has vata dominance in
his grehni (first part of intestine).
It should be determined earlier the condition of koshth
(bowel) of the person.
Panchakarma: Introduction to Pradhan Karma (Main
Procedure)
After careful examination patient should be administered
with the purgatives when he is empty stomach. According
to Maharishi Sharanghdhar following are the doses that
are to be administered in the following doses. Type of
purgative Maximum dose Medium dose Least dose
Kashaya (decoction)2 pal (100 ml)1 pal (50 ml)½ pal (12
ml)
kalk50 gram25gram12 gram
Churan (powder)50 gram25 gram12 gram
Modak (laddu like sweet)50 gram25 gram12 gram
Some of the doses of commonly used purgatives Serial
number purgative Doses in Karoor koshth 2waDoses in
madhayama koshth Doses in Mridu koshth
1Ichabhedi rasa500 mg250 mg125 mg
2erand tail120 gram60 gram30 gram
3Isabgol15 gram8 gram4gram
4Trivritt churan15 gram8 gram4 gram
5Panchaskar churan15 gram8 gram4 gram
6Amaltas kwath120 ml60ml30 ml
After the purgative has been given he should be kept
under careful observation.
It should be check that patient due do bad taste of the
purgative should not vomit out the medicine. To prevent
all this he should be kept in well fragmented place with
calm ness all around.
He should also gargle his mouth with the warm water.
Wash his face with cold water to make him feel fresh.
He should be kept in a place which is undisturbed by
people.
He should be made to drink warm water in small small
amount.
He should evacuate on bed in bed pan in lying down
condition.
In the process of virechan first of all mal (faeces),
then pitta (bile juices) and at last kapha (mucous)
comes out. After it patient feels weakness and lightness
in the body. If the medicines has digested and there is
no out flow of faeces then the patient is given food
that day and virechan karma is administered next day. If
still virechan is in effected then after ten days again
Snehan and swedan are done and with the strong
purgatives.
Amount of evacuation in virechan karma. One should not
count the first 2 to 3 Vegas (times) of the faeces and
then it should be counted that how many times the
patient has evacuated. The degrees up to which the
virechan is done is classified into three categories
i.e. pravar (most), Madhya (medium) and avar (least).
Serial number Degree of shuddhi Vegas (time) Maan
(quantity) Dosha which comes out the last 1Pravar304
prasthKapha2Madhya203 prasthKapha 3Avar102 prasthkapha.
It is advised that after every evacuation the bed pan
should be changed so as the analysis of the last passed
stool could be done.
Panchakarma: Importance of performing Purva Karma
before performing Vaman
Importance of performing purva karma before performing
Vaman Purva karma is very essential before performing
the virechan karma. Other wise many complications can
arise.
Snehan (lubrication) and swedan (sweating) are very
important procedures are very critical before the
virechan karma is initiated.
Snehan (lubrication) checks the Vayu, softens the
tissues (deham) and separates the debris (mala) from the
healthy tissue.
Sweating, if it is conducted after proper lubrication,
liquefies the debris which is entangled in the tiny
channels. In order to enhance the effect of Snehan and
swedan, pitta or heat should be increased by the
previous administration of In a chronic disease, such as
prameha (urine disorder), kushth (skin disease),
apasmaara (epilepsy), etc which is caused principally by
kapha dosha and pitta or by any other dosha located in
amashya (stomach) along with kapha, the preliminary
process of Snehan karma and swedan karma has to be
sufficiently executed before Virechan karma is
administered, carefully regulating the diet and other
habits all the while. Such processes were described by
charaka and sushurut in the following manner
The patient is to undergo Snehan karma along with proper
diet. Usually three to six days relapse in such a
course. Swedan karma suited to constitution and the
dosha vitiation of the patient in the next administered.
If the patient is in the habit of taking hot potency
foods, he may have swedan karma administers on the next
day following Snehan karma. He has to take pitta
producing food on the night of the next day. This act of
eating such food increases pitta and this increased
pitta makes the old stationary pitta somewhat mobile. If
the static dosha is thus made mobile; it may easily be
removed by administration of proper emetic.
Panchakarma: Mode of Administration of Panchakarma
If there is presence of kapha in the amashya (stomach)
then one should. First go for Vaman karma and then after
again going Snehan and swedan karma he should go for
virechan of removing predominance of pitta. Most
important of all the things is to properly handle the
diet. If there is any kapha, the vairechanika dravya or
the purgative is to be administered properly only serves
to bring the kapha to the grehni (first part of the
intestine) and creating imbalance in jatharagni
(digestive fire).hence it must be noted that virechan
should not be given without overcoming kapha by
following the suitable diet regimen and doing lahghan
karma. It is advised that the person should take laghu
aahar (light food), ushanodak (warm water) and juice
liker that of orange Etc. on seeing in the next morning
weather the previous meals had been digested. If yes
then one should perform virechan karma.
Panchakarma: Diseases where Virechan is Indicated and
Contraindicated
Virechan is indicated in following diseases.
Serial no. Disease charak sushurut Vagabhatta
1 Jwar + + +
2 Kushth + + +
3 Prameha + + +
4 Udharvagata rakta pitta + + +
5 Bhagandar + + +
6 Arsh + + +
7 Pliha dosha + + +
8 Gulm + + +
9 Arburd + + -
10 Galgand + + +
11 Granthi + + +
12 Visuchika + + -
13 Alsak + + -
14 Mutra ghaat + + +
15 Krimi koshth + + +
16 Visarpa + + +
17 Pandu + + -
18 Shirr shool + + +
19 Parshav shool + - -
20 Netra dah + + -
21 Hridya roga + + -
22 Aruchi + + -
23 Netra sraav + - -
24 Halimak + - +
25 Shwas + - +
26 Kaas + - +
27 Kamala + - +
28 Apchi + - +
29 Apasmaara + + -
30 Unnmad + - -
31 Vatarakt + + +
32 Yoni dosha + + +
33 Rakta dosha + - +
34 Timir + + +
35 Chardi + + +
36 Visphot + + +
37 Vibhandh - + -
38 Vidradhi - + +
39 Shavthu + + +
40 Dagdh - + -
41 Akshi paak - + -
42 Abhishayad - + -
43 Guda dah - + -
44 medh dah-+- - + -
45 Nasika dah - + -
46 Anah - + +
47 Shlipada - - +
48 Stabnnya dosha - - +
Virechan contraindicated in following diseases.
Serial no. Disease charak sushurut Vagabhatta
1 Shat guda + - +
2 Adhog rakta pitta + + +
3 Durbal + - -
4 AlpglanI + + +
5 Ajirn + + +
6 Nav jwar + - +
7 Ati snigdh + + +
8 Ati ruksh + + +
9 Ati sthool + + +
10 Ati krish + + +
11 Balak + + +
12 Vridh + + +
13 Shrant + + -
14 Pipasit + + -
15 Upvasit + + -
16 Methun Prasakt + - -
17 Garbhini + + +
18 Rajyakshma - - +
19 Atisaar - - +
20 Shudhit - - +
21 Hridya Rogi - - +
22 Bhyabhiitgt - - +
23 Subhag (child) + - -
Panchakarma: Benefits of Virechan
Virechan karma is the wonderful remedy in disorders
caused by pitta dosha
It helps in reducing jwar (fever).
Helps in normalizing blood pressure
Helps in relieving constipation
It helps in normalizing the menstrual problems
It is very helpful in gouty arthritis (vatarakt)
It is help ful in conditions like jalodar (ascitis)
It remove oedema from the body
It makes our genital organs strong.
By performing virechan karma our sense organs also
gains strength
It provides overall strength to the body.
Panchakarma: Properties of Herbs Used in Virechan
Karma
Properties of herbs that are used in Virechan Karma
Ushan (hot): due to this ushan gunn (hot property)
virechak dravya (purgative herbs) makes doshas vishyand
i.e. it melts the doshas and then makes it to reach
amashya (stomach) and mahastrota (gastro intestinal
tract) thus doshas enters in koshth (body trunk), which
are easier to eliminate from the body.
Tikshan (sharpness) ): it is an agneye (fire) in
dominance thus helps in melting the doshas which get
stick to the body parts due to this property it easily
penetrate Vyavyahi: it is property in which the herb
enters body and digested in the whole body. It has
dominance of Aakash and Vayu mahabhoot. Vikashi: it
helps in separating the doshas which are stuck to the
dhatus (tissues) so as to make the movement in the body
trunk so as to get it removed by the action of
purgatives. Suksham (fineness): due to Aakash mahabhoot,
vyavyahi and tejas gunna it gets the property of
penetrating power which helps it to penetrating into the
small strotas (channels)
Adhomargharan: due to this property the downward
movement is obtained and the dosha re carried in the
downward direction and hence acts as purgative.
Panchakarma: Action of Virechan Dravya
Action of Virechan Dravya (purgative) Dravya (substance)
Action of virechan dravya (purgative) dravya (substance)
It generally acts in four ways.Some or the purgative
herbs stimulates the mucous membrane of our
gastrointestinal tract which makes it to secrete more
secretions. E.g. indravaruni.
Some of the herbs increase the peristaltic movements in
the gastro intestinal tract especially in the
intestines. It also increases the bile secretions which
are involved in producing the purgation.] Some herbs get
absorbed in the blood and perform there function. E.g.
sanai leaves.
Panchakarma: Complication of Improper Virechan Karma
Complication of improper virechan karma. If the
procedure of virechan is not properly carried out then
following complications occur.
Heaviness in body
Piercing pain in chest region
Burning sensation
Itching over the body
Retention of stools
Vertigo
Unconsciousness
anal prolepses
pain in the body
Diet
If the patient has no appetite or hunger for food, do
not force him to take any thing and let him fast instead
of giving him peya. If the patient feels weak and
thirsty then he may be given with the warm kanji.
Paschat karma
After completion of Virechan karma one should administer
Sansarjan karma: It is the sequence of easily digestible
food.
Tarpan Aushadh: these are the medicines that
provide strength to the patient weekend after the
vairechanika procedure
Sayam Niyam: it means disciplined life.
Anuvasan Vasthi
Anuvasan vasti is also known as Snehan vasti. It
consists of oil ghee or vasa (animal fats) and
medications. Anuvasan vasti is to be given after proper
purva karma i.e. Snehan and swedan. Anuvasan vasti can
be administered even as a purva roopa but it is
generally given after as the sequence is maintained.
After virechan karma is performed generally a gap of
seven days is maintained so as to reignite the
jatharagni or the digestive fire anuvasan vasti is
administered. Even after performing anuvasan and nirooh
vasti anuvasan vasti is being given Anuvasan vasti is
indicated in people who have voracious appetite (ati
Agni), in person who are very ruksh or in those
afflicted by pure vata i.e. unmixed with pitta or kapha.
Both anuvasan and nirooh vasti are to be administered in
various diseases mentioned below. They are both
mentioned by Maharishi charak and Maharishi sushurut
Sarvang roga Eking rogaKukshi roga
Vata sangMutra sangMala sang
Shukra sangBal kshayMans kshay
Dosha kshayShukra kshayAdhyamaan
angsuptiKrimi koshthAtisaar
Hridya rogaBhagandarShool
jwarShirh shoolUnnmad
Hridya shoolParshav shoolPrisht shool
Kati shoolaakshepAng gaurav
RajyakshmaJanu shooljangha rhool
Uru shoolGulm shoolYoni shool
Anguli shoolStan shoolDant shool
Nakha shoolShoshStambh
PericardiaTimirPratishyay
AdhimandArditPakshghat
AshmariUpdanshVatarakt
ArshStanya kshyaManya grah
Hanu grahSharkra shoolmutrakritch
Certain disease in which anuvasan should not be
administered are
Nav
jwarPanduKamala
PramehaArshPratishyay
ArochakMandagniDurbalta
PlihodarKaphodarUrustambh
Vish pitShlipadaGalgand
ApchiKrimi koshthKushth
Sthaulyapeenus
Anuvasan vasti is generally given by the method as
follows
The maximum dosage is six pals (300ml) and minimum is
four pals (200 ml) {1 pal = 50 ml}. The ghee or the oil
used for the purpose may be mixed with the saindhav
lavan (rock salt) and sataahwa powder each to be
powdered and mixed in 6,4 and 2 masha (64 masha =1 pal)
respectively for the above doses. Ghee or medicated oil
with the following herbs may also be administered. These
are.
Dashmoola
Roots of errand (castor tree)
Punarnava
Yav (barley)
Khulthi dal (horse gram)
Badara fruit
Guduchi
Madan phala
Palash
Saindhav lavan (rock salt)
The medicated oils or the pure oil mixed with the rock
salt is to be rectally, injected lowly and it is to be
retained in the intestines by the patient for sometimes.
The patient may sleep after this procedure. Do not let
him expel out the medicine which has been inserted. To
an estimate, medicine should be retained in for nine
hours. If it gets absorbed in the intestines and there
is no urge, let another day pass. On the day of
administration of anuvasan vasti let the patient take
abhayang (massage). After giving him the rectal
injection, then patients legs are to be massaged for
some times. The potion in of the bed which bears the
legs of the patient should be raise for some time and
the position of the bed is again brought to normal. This
is to be done for three times. This process is adapted
so as to make sure that all the medicines is absorbed
and lubricate the intestines. If after 4 hours, it does
not come out of the feces then nirooh vasti is to be
given. On the other hand if the oil comes out with the
faeces with out producing any symptoms like heaviness in
abdomen, loss of apatite, heavy sensation in body etc,
it should be considered that the anuvasan vasti has got
to its place to produce desired result. Patient after
this allowed taking his meals which are light and easily
digestible. If heaviness, dullness occurs then he should
not eat any thing at night. Instead he should be given
decoction of sunthi (dried ginger) and dhania
(coriander) the next morning. Anuvasan vasti is to be
repeated on the third day after the previous vasti. But
if the person is healthy and is habitual of taking these
vasti then he can be administered with the anuvasan
vasti everyday. In such a condition the dose should be
lessened. If the sneh vasti is taken daily it is called
matra vasti. 3 to 4 anuvasan vasti are enough to make a
parsons body lubricated. He should also be given nirooh
vasti so as to along with anuvasan vasti so as to
counter the vata and its allied doshas. If the anuvasan
vasti soon comes out then another vasti is to be given
soon.
Uttar vasti
It is a part of vasti karma in which vasti is
administered in the vaginal cavity or in the urethra.
The nozzle of the kale urethra is to be about 12 anguli.
Now a days rubber catheter is being used. The nozzle of
the vasti is of flexible material and the bag attached
to it should be compressible. The nozzle is to be
sterilized and the smeared with the ghee. The person who
has to be administered with the Uttar vasti should
previously be given with the nirooh and anuvasan vasti
alternately. Now the person is to be seated on a stool
or should lay on his back the nozzle of the tube should
then be inserted. Only about seven anguli of the tube is
to be passed inside the urethra and then the tube is
gent ally withdrawn. The fluid may be allowed to remain
for a while but retention for too longer time is not
advisable. Small pills made out of araghwadh leaves with
Nirgundi juice, rock salt and cows urine is made of the
size that of mustard seed and then it is introduced in
the urethra in order to avoid the sneh coming out that
has been introduced. The sneh that has to be given to
the person has to be about 30 grams in a youth of age 25
years and 50 grams above the age of 25 years. Maharishi
sushurut has advised that the u suppository Uttar vasti
is to be carried out in the morning time and up to four
Uttar vasti can be administered in a day, in this manner
Uttar vasti can be given consecutively for three days.
In case of any allergic reaction, a decoction prepared
from Yastimadhu and honey and sugar and be used as Uttar
vasti. Uttar vasti is being advised in disease like
mutrakritch (Dysurea), ashmari (Calculi), spermatorrhoea,
pain in the bladder or in the groin region, disease of
the bladder etc. For women the Uttar vasti may be given
in vagina or urethra in a thin tube of about 2 anguli.
It should be introduced in the urethra. In virgins it
should be only of one finger length. It should be
injected when the women are in supine position with her
knees raised. The Uttar vasti is to be administered in
the ritu kaalam (12 days commencement of the
menstruation) only. Uttar vasti is recommended in
disease like of cervix, uterus, and vagina etc. as well
as the diseases of the bladder.
Panchakarma: Introduction to Nirooh Vasti
It is also known as astthapan vasti. As the anuvasan
vasti imparts snigdh vasti, nirooh imparts Shodhana
vasti i.e. it performs the function of clearance and
purification. Hence it should always be kept in mind
that before the administration of anuvasan vasti one
should never ever administer nirooh vasti. It is given
along with the anuvasan vasti to counter the vata
disorder.
In persistent vata disorder nirooh is to be administered
only after 3 to 4 anuvasan vasti. Following are the
diseases that are to be administered with the nirooh
vasti. As entioned by both Maharishi charak and
Maharishi sushurut.
Sarvang rogaEking rogaKukshi roga
Vata sangMutra sangMala sang
Shukra sangBal kshayMans kshay
Dosha kshayShukra kshayAdhyamaan
angsuptiKrimi koshthAtisaar
Hridya rogaBhagandarShool
jwarShirh shoolUnnmad
Hridya shoolParshav shoolPrisht shool
Kati shoolaakshepAng gaurav
RajyakshmaJanu shooljangha rhool
Uru shoolGulm shoolYoni shool
Anguli shoolStan shoolDant shool
Nakha shoolShoshStambh
PericardiaTimirPratishyay
AdhimandArditPakshghat
AshmariUpdanshVatarakt
ArshStanya kshyaManya grah
Hanu grahSharkra shoolmutrakritch
It has to be kept in mind the nirooh vasti should never
to be given after meals; it should only be administered
before meals. In the beginning the rock salt is mixed
after grinding the salt with honey. (150 grams of honey
mixed with 40 grams of rock salt). To this availed
mixture Snehan (oil, ghee and animal fats) are being
added and then it is homogenously mixed. Now the kalk of
the herbs that are to be administered are being added in
the form of decoction. The mixture is put in a vapor
bath and used when it is comfortably warm. If the
patient fells that he is having natural urge then he
should be allowed to evacuate his bowel. If the nirooh
vasti does not come out even after 48 hours of the
administration then a tikshan (stronger) vasti is being
given like that of go mutra (cows urine) so as to expel
it out of the body. A phala varti (suppository) may also
be helpful in such a condition.
In the discharge after the vasti karma the fecal matter
should appear first, then the pitta or the bile as we
say in modern sciences and then the kapha i.e. the
mucus. If the person feels relieved, light and strength
then it is considered as the vasti has been doing right
function in the body for which it has been administered.
On an average 3 to 4 nirooh vasti are necessary to a
person to get a relief. After it the person should be
administered with the vasti he should be given hot water
bath and then he should be given light meals Nirooh
vasti is still classified into three categories These
are:
Utklesh vasti
Dosha hara vasti
Saman vasti
Nasya
Karma
It is also
known as shiroveraechan. A very important part of the
panch karma therapy. Nasya karma is a procedure
mentioned in ayurvedic texts regarding the diseases
related to head, eyes, nose etc. i.e. in urdhv jatru
gata roga. Nasya karma means administration medicine
through the nostrils. Nostril is considered as the
pathway to the brain.
Importance of nasya karma
The importance of administration of treatment through
nostril has been practiced in India since ages. Nasal
douching with the clean and pure water early morning is
considered good for improving eyesight, prevents
premature graying of hairs and hair fall. Purpose of
performing nasya karma is to through out the vitiated
dosha in the head region. Nasya karma is particularly
advised in disease of head such as inflammation of nasal
sinuses, diseases of eyes such as pains, inflammation,
reddishness and weakness, diseases of ears and diseases
of the upper throat. It has been regularly being
prescribed in insanity.
Diseases in which nasya karma is used
Shirh stambhManya stambh
HanugrahPeenus
Dant stanbh shoolGal shalook
Netra rogaTimir
Vartam rogaUpjhivika
Ardh vibehdakGriva roga
Skandh rogaAns shool
Mukh rogaKarn shool
Nasa shoolAkshi shool
Shirh shoolArdit
AptantrakGalgand
Dant shoolDant harsh
ArburdSwar bheda
Following are the diseases in which nasya karma is not
to be given
AjirnPitt sneh
Shudha yuktShrammit
MoorchaShastra dand hatt
VyayamkalantNav jwar
Shok santaptGarbhini
BaalVridh
VegavrodhitSwasgrast
Rakta sravitSutika
Kaas grasitGar peerit
krudh
The main function of the nose is to warm the air when it
passes through the labyrinth of the intricate passage
into the nose and also to filter the air of certain
impurities contained in the atmosphere. If the air comes
in contact with the epithelium of the lungs, without
undergoing the process of drying and filtration, it is
sure that it may cause an injury. To make the nose
capable for inhaling nasya is also advised.
Timings of performing nasya karma
Usually nasya karma is to be performed in early morning
for kapha related disorders. In pitta related disorders
nasya is to be performed in the noon or mid day time.
Evening is the time for treating vata related disorders.
Nasya is also advised in night time for certain disease
s like excessive salivating, talking in sleep, grinding
of teeth, greaning in sleep, difficulty in opening the
eye lids, offensive breathe, karna naada (tinnitus
aurium), hemiplegia, disease of head, swas roga
(asthma), cough and excessive sleepiness.
It is to be kept in mind that before performing nasya
karma, Snehan and swedan is to be done to the head
region. Usually paanitaap sweda (application of heat
with the heated palms) is to be done all over the head
Procedure of nasya karma Before stating the main
procedure one should always apply the oil on the head
and then it is massaged and then it is warmed with the
palms. The patient is then laid down on a hard bench on
his back and is bent bit backwards. Now the tumbler
containing the medicine is put into hot water so as to
warm the medicine. Now close one nostril and the
medicine is put into other nostril and vice versa. The
excess medicine that reaches his mouth is to be spitted
out. A good massage to his feet, shoulders and head is
to done. After the first administration of nasya, the
head, cheeks, neck etc are again done with swedan. After
this procedure is over the patient is advised Dhumapanam
(medicated smoking). Patient should be kept in a clean
environment where he is to be protected fro direct
exposure to air, dirt and dust. Emotional stress should
also be avoided. If the nasya is performed in a proper
way the patient feels lightness on his head and has good
sleep with out any discomfort.
Important points to be noted for nasya karma
Nasya karma may be at the most consecutively performed
for seven days.
Nasya karma can be performed in both morning and
evening in diseases like hiccups, tonsillitis etc.
After the completion of nasya karma one should take
nutritious diet.
After completion of virechan nasya (avapeed or
pradhamana) some oil drops are to be put into the
nostril.
After the nasya is complete, the patient should lie
down on the bed for at least half an hour.
Paschat karma of nasya karma
Following are the things that are to be performed after
nasya karma.
Dhumapanam
Kaval and Gandusha
Life style
Dhumapanam
Dhumapanam is the inhalation of medicated smoke. It is
employed in certain diseases i.e. kapha and vata
disorders pertaining to head and neck. The patient is
made to smoke through pipe, or through inhalation of
dhum (fumes) or by specially prepared cigars. It is also
of three types
Snigdh
Madyam
Tikshan.
Procedure
The dhum is to be taken when the person is sitting erect
with his mind attentive on the act. Usually dhum is
sucked is taken through one nostril and the process is
repeated in vice versa. If the dosha is situated in the
head region or in the nose and if it moved from its seat
(utklishta). In such a case person should smoke through
nose. In contrast, if the dosha is firmly attached in
the head or nose and is not moving, then he may take the
smoke through the mouth. If the dosha is situated in the
throat then, he should first take the smoke through the
nostril and next through the mouth. In all the cases,
this inhalation of smoke should be left off through the
mouth and never through the nose. The smoke is to be
drawn in and then left off and this process is repeated
three times on an occasion.
Herbs used for Dhumapanam
Shallaki, laksha, prithveeka, lotus, lily, nyagrodha
bark, udumbara, aswatha, plaksha, lodhar, sugar,
muklethi, suwarnatwak, padmakam, manjishtha and all the
fragrants substavces excepts kushta and tagra. These are
saman dravya (herbs), if after these still some doshas
are left then administration of tikshan dhum is done.
Disease in which Dhumapanam is indicated
Disease or symptoms like cough, asthma, peenus, loss of
voice, offensive breath, anemia, premature graying of
hairs, ottorrhoea, discharge from eyes, excessive
salivation, itching and pain in the eyes, ears and
mouth, stiffness in these parts, sleepiness and
sluggishness and hiccough. These symptoms or disease are
prevented in a person who uses proper humapanam. Dhum
may be applied to the ulcers and at that procedure it is
called vranadhupnah (fumigation of the wound.)
Kaval and Gandusha
Gandusha means holding a mouthful of tailam or any
decoction for a while after filling the mouth wit it.
Kaval means filling the mouth partially and gargling
with it.
Gandusha is of for types
Snigdh Gandusha : it is done with oils. These are
medicated with sweet, sour and saltish substances. It is
useful in pitta disorders. Saman Gandusha : it is done
by decoction prepared with the bitter, astringent and
sweet substance. It is useful in kapha
disorders.Shodhana Gandusha: it is done with the
decoction etc. prepared with astringent and sweet
substance. It is useful in vata disorder. Ropana
Gandusha: it is done with the decoction which is
prepared with astringent and bitter substances. It is
useful in ulceration of mouth.
Dravya (herbs) used in Gandusha For performing Gandusha
oils, ghee, milk, water mixed with honey, liquors, meat
juice, cows urine, and dhaanyaamlam etc, mixed or
unmixed with other herbs may be used. These herbs have
rasa or the taste, as indicated the disease we are
treating. Sweet gingerly oil or meat juice may be
employed for Gandusha daily by all the people, even they
are not suffering from any disease also.
In mukh paak (stomatitis) or the ulceration of the mouth
or in inflammation of any part of the mouth accompanied
with burning sensation or in injuries caused in the
mouth, Gandusha with honey, ghee and milk are very
effective. If there is kapha in mouth, Gandusha with
ksharodaka is very useful.
Life style
One should avoid cold water, curd; heavy food stuff and
fatty food items. One should bathe with warm water. One
should reside in cozy and warm environment. Atmosphere
should clean without any dirt, dust and any kind of
pollution. Any kind of emotional stress should be
avoided. Traveling shold also be avoided.
Types of nasya karma
Virechan
Brimhana
Samana
Brimhana
It is a kind of nasya which make our body organs strong.
It is also called nutrient nasya. It is useful in
relieving from pain which is predominantly caused by
vata vitiation. Certain disease like Surya avartha (a
kind of head ache), swar bhang (loss of voice), parching
of nose and throat, loss of speech, opening of the
eyelids with difficulty and apabhaahuka (paralysis of
arm), brimhana nasya may also be performed with the meat
juice of jaangula animal or birds, flesh, blood of the
animals etc, extract or exudations of certain herbs.
It is still of two types: These are:
Marsa it means large dose of Snehan. Thirty two drops
constitute the maximum dose and sixteen drops is the
minimum dose. These doses may not be administered at one
go but may be given in two or three times. It is useful
in disease caused by vata vitiation.
Pratimarsa this type of nasya is given in the healthy
person. In this only one drop per nostril is being
administered. It is basically maintaing the normal
health of the individual. The dose should be dropped any
number of time in a day without any restrictions. This
nasya is advised in any time of the day and even in the
night. This nasya is generally recommended in people
having hemoptysis, in emaciated people, in children, in
old men and in people who desires comforts. It is not
advisable in dusht peenus (severe cold), after use of
alcohol, when ears are filled with pusetc.
Samana
In this types of nays karma, a patient is administered
by providing him the medication by milk and water.
Samana nasya are performed in people who are of soft
physical built like children, women and old aged people.
Timings of performing nasya karma. Usually nasya karma
is to be performed in early morning for kapha related
disorders. In pitta related disorders nasya is to be
performed in the noon or mid day time. Evening is the
time for treating vata related disorders.
Nasya is also advised in night time for certain disease
s like excessive salivating, talking in sleep, grinding
of teeth, greaning in sleep, difficulty in opening the
eye lids, offensive breathe, karna naada (tinnitus
aurium), hemiplegia, disease of head, swas roga
(asthma), cough and excessive sleepiness. It is to be
kept in mind that before performing nasya karma, Snehan
and swedan is to be done to the head region. Usually
paanitaap sweda (application of heat with the heated
palms) is to be done all over the head Procedure of
nasya karma Before stating the main procedure one should
always apply the oil on the head and then it is massaged
and then it is warmed with the palms. The patient is
then laid down on a hard bench on his back and is bent
bit backwards. Now the tumbler containing the medicine
is put into hot water so as to warm the medicine. Now
close one nostril and the medicine is put into other
nostril and vice versa. The excess medicine that reaches
his mouth is to be spitted out. A good massage to his
feet, shoulders and head is to done. After the first
administration of nasya, the head, cheeks, neck etc are
again done with swedan. After this procedure is over the
patient is advised Dhumapanam (medicated smoking).
Patient should be kept in a clean environment where he
is to be protected fro direct exposure to air, dirt and
dust. Emotional stress should also be avoided. If the
nasya is performed in a proper way the patient feels
lightness on his head and has good sleep with out any
discomfort.
Important points to be noted for nasya karma Nasya karma
may be at the most consecutively performedfor seven
days. Nasya karma can be performed in both morning and
evening in diseases like hiccups, tonsillitis etc. After
the completion of nasya karma one should take nutritious
diet. After completion of virechan nasya (avapeed or
pradhamana) some oil drops are to be put into the
nostril. After the nasya is complete, the patient should
liedown on the bed for at least half an hour.
Paschat karma of nasya karma
Following are the things that are to be performed
after nasya karma.
Dhumapanam
Kaval and Gandusha
Life style
Dhumapanam
Dhumapanam is the inhalation of medicated smoke. It is
employed in certain diseases i.e. kapha and vata
disorders pertaining to head and neck. The patient is
made to smoke through pipe, or through inhalation of
dhum (fumes) or by specially prepared cigars. It is also
of three types
Snigdh
Madyam
Tikshan.
Procedure
The dhum is to be taken when the person is sitting erect
with his mind attentive on the act. Usually dhum is
sucked is taken through one nostril and the process is
repeated in vice versa. If the dosha is situated in the
head region or in the nose and if it moved from its seat
(utklishta). In such a case person should smoke through
nose. In contrast, if the dosha is firmly attached in
the head or nose and is not moving, then he may take the
smoke through the mouth. If the dosha is situated in the
throat then, he should first take the smoke through the
nostril and next through the mouth. In all the cases,
this inhalation of smoke should be left off through the
mouth and never through the nose. The smoke is to be
drawn in and then left off and this process is repeated
three times on an occasion. Herbs used for Dhumapanam
Shallaki, laksha, prithveeka, lotus, lily, nyagrodha
bark, udumbara, aswatha, plaksha, lodhar, sugar,
muklethi, suwarnatwak, padmakam, manjishtha and all the
fragrants substavces excepts kushta and tagra. These are
saman dravya (herbs), if after these still some doshas
are left then administration of tikshan dhum is done.
Disease in which Dhumapanam is indicated Disease or
symptoms like cough, asthma, peenus, loss of voice,
offensive breath, anemia, premature graying of hairs,
ottorrhoea, discharge from eyes, excessive salivation,
itching and pain in the eyes, ears and mouth, stiffness
in these parts, sleepiness and sluggishness and
hiccough. These symptoms or disease are prevented in a
person who uses proper Dhumapanam. Dhum may be applied
to the ulcers and at that procedure it is called
vranadhupnah (fumigation of the wound.) Kaval and
Gandusha Gandusha means holding a mouthful of tailam or
any decoction for a while after filling the mouth wit
it. Kaval means filling the mouth partially and gargling
with it. Gandusha is of for types
Snigdh Gandusha : it is done with oils. These are
medicated with sweet, sour and saltish substances. It is
useful in pitta disorders.
Saman Gandusha : it is done by decoction prepared with
the bitter, astringent and sweet substance. It is useful
in kapha disorders.
Shodhana Gandusha: it is done with the decoction etc.
prepared with astringent and sweet substance. It is
useful in vata disorder.
Ropana Gandusha: it is done with the decoction which
is prepared with astringent and bitter substances. It is
useful in ulceration of mouth.
Dravya (herbs) used in Gandusha For performing Gandusha
oils, ghee, milk, water mixed
with honey, liquors, meat juice, cows urine, and
dhaanyaamlam etc, mixed or unmixed with other herbs may
be used. These herbs have rasa or the taste, as
indicated the disease we are treating. Sweet gingerly
oil or meat juice may be employed for Gandusha daily by
all the people, even they are not suffering from any
disease also. In mukh paak (stomatitis) or the
ulceration of the mouth or in inflammation of any part
of the mouth accompanied with burning sensation or in
injuries caused in the mouth, Gandusha with honey, ghee
and milk are very effective. If there is kapha in mouth,
Gandusha with ksharodaka is very useful.
Life style
One should avoid cold water, curd; heavy food stuff and
fatty food items. One should bathe with warm water. One
should reside in cozy and warm environment. Atmosphere
should clean without any dirt, dust and any kind of
pollution. Any kind of emotional stress should be
avoided. Traveling shold also be avoided.
Virechan nasya
Virechan nasya or seerssha virechan is useful in shirh
shool (head ache), abhishyandi (conjunctivitis), kanth
roga (disease of throat), mukh shoof (swelling of the
face), Krimi (worms), granthi (enlargement of the
glands), kushth (leprosy), apasmaara (epilepsy), peenus
(nasal disease in which smell sensation is lost).
Following are the herbs used in giving virechan nasya.
Garlic juice mixed with mustard oil or medicated sprits
with also a addition of marich (black pepper).
Apamarg seeds, pipilli (piper longum), marich (black
pepper), vidang, siguru seeds, mustard oils, tamburu
(tobacco), ajeern (indigestion), ajagandha, peelu, ela
(cardamoms), herenuka, prithweeka, tulsi (holy
basil),kutheraa, phanijjaka, saindhav lavan (rock salt),
souvarchal lavan, haridra (turmeric), daru haridra,
jyotish mati, and sunthi. These herbs are used in
performing nasya of vairechanika type. Virechan is thus
of two types
Avapeed
Pradhamana
Avapeed nasya
Usually fresh juice or juice extracted after throbbing
the herb with a little water, if the herbs are dry, oils
and sprits medicated with the above termed as avapeed
nasya. It is a form of virechan nasya in which the fresh
juices or the extracted rasa from there kalk are being
used. On an average about four, six or eight drops of
the herbs are recommended. This type of nasya is very
helpful in kanth roga (disease of throat), jwar (fever),
Nidra Nash (insomnia), manas roga (mental disorder),
Krimi (worms) etc.
Pradhamana nasya
If the dry drugs are powdered and blown in the nostril,
it is called as pradhamana nasya. The pradhamana is more
irritating as it is more tikshan (stronger). This kind
of nays is administered when the dosha are very intense
as it has the capability to absorb doshas. The herbs
that are usually used are saindhav lavan (rock salt),
marich (black pepper), pipilli, sunthi, garlic, guggulu
etc. All these herbs are mixed in equal quantity and is
powdered well along with the gall stone of a fish and
kept dry. The powder is then used to perform nasya
karma.
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