18. VAMANA VIRECHANA VIDHI ADHYAYA / वमन –विरेचन विधि – EMESIS AND PURGATION THERAPIES
कफे विध्यात् वमनं संयोगे वा कफोलबणे
तद्वद् विरेचनं पित्ते
a) Vamana –
· Emesis should be administered for increase of Kapha
a. either alone
b. or in combination with other Doshas where Kapha is predominant
b) Virechana –
· purgation should be administered to treat increase of Pitta
a. alone or
b. in combination with other Doshas where Pitta is predominant.
PERSONS SUITABLE FOR VAMANA PROCEDURE – VAMANA ARHA
विशेषेण तु वामयेत्
नवज्वरातिसाराधः पित्तासृक्राजयक्ष्मिणः
कुष्ठमेहापचिग्रन्थिश्लीपद उन्मादकासिनः
श्वासह्रुल्लासवीसर्पस्तन्यदोषोर्ध्वरोगिणः
Emesis should be administered to persons suffering from
1. Navajwara – fever of recent origin
2. Atisara – diarrhoea, dysentery
3. Adha:pitta – Pitta imbalance in lower part of abdomen
4. Pittasruk – Bleeding disorder due to Pitta imbalance
5. Rajayakshma – Chronic Respiratory disorder
6. Kushta – skin diseases
7. Meha – diabetes, urinary tract disorders
8. Apachi,
9. Granthi – Goitre, tumour, fibroid
10. Shleepada – Elephantiasis, Filariasis
11. Unmada – Schizophrenia
12. Kasa – cough, cold
13. Shwasa – Chronic Respiratory tract disease, Asthma
14. Hrullasa – nausea
15. Visarpa – herpes
16. Stanyadosha – vitiated breast milk
17. Urdhvaroga – diseases affected neck and above region
PERSONS NOT SUITABLE FOR VAMANA PANCHAKARMA –VAMANA ANARHA – AVAMYA
अवाम्या गर्भिणी रूक्षः क्षुधितो नित्यदुःखितः
बालवृद्धकृशस्थूलहृद्रोगिक्षतदुर्बलाः
प्रसक्तवमथुप्लीहातिमिरक्रिमिकोष्ठिनःउर्ध्वप्रवृत्तवाय्वस्रदत्तबस्तिहतस्वराः
मूत्राघात्युदरी गुल्मी दुर्वमो अत्यग्निरर्शसः
उदावर्तभ्रमाष्ठीलापार्श्वरुग्वातरोगिणः
ऋते विषगराजीर्णविरुद्धाभ्यवहारतः
1. Garbhini – The pregnant woman,
2. rooskha – persons who are dry –not undergone oleation therapy,
3. Kshudhita – hungry,
4. Nitya Dukhita – constantly grief-stricken,
5. children,
6. old persons,
7. Krusha – the emaciated,
8. Sthula – the obese,
9. Hrudrogi – patient of heart disease,
10. Kshata – the wounded,
11. Durbala – weak, debilitated,
12. who are having bouts of vomiting,
13. Pleeha – enlargement of spleen,
14. Timira – blindness,
15. Krimikoshta – intestinal parasites,
16. upward movement of vata and Asra- blood,
17. Soon after administration of Vamana,
18. who have loss of speech, dysuria,
19. Udara – ascites, interstinal obstruction,
20. tumor of the abdomen,
21. who faced difficulties during Vamana therapy,
22. who have strong digestive activity,
23. Arsha – haemorrhoids
24. Urdhva Vata – upward movement of air – reverse peristalisis,
25. Giddiness / Dizziness
26. enlargement of the prostate,
27. Parshva vata – pain in the flanks and diseases caused by vata;
28. Person suffering from poisoning,
29. indigestion
30. and who have consumed incompatible foods.
प्रसक्तवमथोः पूर्वे प्रायेणामज्वरो अपि च
धूमान्तैः कर्मभिर्वर्ज्याः, सर्वैरेव त्वजीर्णिनः
1. Those persons enumerated earlier to praskta vamathu and persons who are suffering from recent fevers,
· Are generally to be rejected for therapies ending with dhuma
2. And those suffering from indigestion
· From all therapies
VIRECHYAH – PERSONS SUITABLE FOR PURGATION THERAPY:-
Diseases requiring purgation therapy are-
विरेकसाध्या गुल्मार्शोविस्फोटव्यङ्गकामलाः
जीर्णज्वरोदरगरच्छर्द्दिप्लीहहलीमकाः
विद्रधिस्तिमिरं काचः स्यन्दः पक्वाशयव्यथाः
योनिशुक्राश्रयरोगाः कोष्ठगाः कृमयो व्रणाः
वातास्रमूर्ध्वगं रक्तं मूत्राघातः शकृन्ग्रहः
वाम्याश्च कुष्ठमेहाद्याः
1. Gulma – Tumors of the abdomen,
2. Arsha – Piles,
3. Visphota- blisters,
4. Vyanga – discolored patch on face,
5. Kamala – Jaundice, Liver disease
6. Jeernajwara - Chronic fever,
7. Udara – ascites, interstinal obstruction
8. Poisoning, Chronic poisoning
9. Chardi – Vomiting
10. Pleeha – Disease of the spleen, Splenomegaly,
11. Haleemaka – advanced jaundice,
12. Vidradhi – Abscess
13. Timira – blindness,
14. Kacha, Syanda – Cataract
15. pain in the large intestine,
16. Diseases of male and femal urogenital system
17. wounds/ Ulcers,
18. Vatasra – Gout,
19. Urdhwarakta – bleeding disorders of upper parts of the body (such as nasal bleeding)
20. Diseases of blood vitiation,
21. Mutraghata – Dysuria
22. Shakrut graham – constipation
23. Those persons who are Suitable for emesis therapy- enumerated in earlier verses commencing with “ those suffering from Kustha” are curable- to be treated with purgation therapy.
Those diseases are -
a. Kushta – skin diseases
b. Meha – diabetes, urinary tract disorders
c. Apachi,
d. Granthi – Goitre, tumour, fibroid
e. Shleepada – Elephantiasis, Filariasis
f. Unmada – Schizophrenia
g. Kasa – cough, cold
h. Shwasa – Chronic Respiratory tract disease, Asthma
i. Hrullasa – nausea
j. Visarpa – herpes
k. Stanyadosha – vitiated breast milk
l. Urdhvaroga – diseases affected neck and above region
CONTRA INDICATION FOR VIRECHANA – AVIRECHYA – VIRECHANA ANARHA-
न तु रेच्या नवज्वरी
अल्पाग्न्यधोगपित्तास्रक्षतपाय्वतिसारिणः
सशल्यास्थापितक्रूरकोष्ठादिस्निग्धशोषिणः
1. Navajwara – fever of recent origin
2. Alpa Agni – poor digestive activity,
3.Adhoga Raktapitta – bleeding disease of lower part of the body (such as bleeding per rectum
wounds, Ulcers of the rectum
4.Atisara – diarrhoea, dysentery
5.Sashalya – foreign bodies;
6. Who have been administered decoction enema,
7.Krurakoshta – Persons who naturally have hard bowel movement,
8. Atisnigdha – who have undergone excess of Oleation treatment
9. Shosha – emaciated
VAMANA VIDHI- PROCEDURE OF EMESIS THERAPY:-
अथ साधारणे काले स्निग्ध स्विन्नं यथाविधि
श्वोवम्यमुत्क्लिष्टकफं मत्स्यमाषतिलादिभिः
निशां सुप्तं सुजीर्णान्नं पूर्वाह्ने कृतमङ्गलम्
निरन्नमीषत्स्निग्धं वा पेयया पीतसर्पिषम्
वृद्धबालाबलक्लीबभीरून् रोगानुरोधतः
आकण्ठं पायितान्मद्यं क्षीरमिक्षुरसं रसम्
यथाविकारविहितां मधुसैन्धवसंयुताम्
कोष्ठं विभज्य भेषज्यमात्रां मन्त्राभिमन्त्रिताम्
ब्रह्मदक्षाश्विरुद्रेन्द्रभूचन्द्रार्कानिलानलाः
ऋषयः सौषधिग्राम भूतसङ्घाश्च पान्तु वः
रसायनमिवर्षीणामामराणामिवामृतम्
सुधेवोत्तमनागानां भैषज्यमिदमस्तु ते
ॐ नमो भगवते भैषज्यगुरवे वैडूर्यप्रभराजाय
तथागतायार्हते सम्यक्सम्बुद्धाय तद्यथा
ॐ भैषज्ये भैषज्ये महाभैषज्ये समुद्गते स्वाहा
प्राङ्गमुखं पाययेत्
Next,
1. during temperate seasons,
2. after administering oleation and sweating therapy properly,
3. on the day previous to the day of emesis,
· The patient is made sure that he has slept well the previous night.
· Patient is made sure that his previous food is well digested
4. In the morning of the previous day to Vamana,
· at first, Auspicious rituals are carried out.
· Next, Kapha Dosha is excited in the patient by administering peya (drink) / thin gruel prepared from
a. fish,
b. Masha (black gram) ,
c. Tila (Sesame) etc.
d. added with little quantity of fats, in morning.
5. On the day of Vamana, again,
· it is made sure that the patient’s previous food has got digested and he had slept well.
· is either maintained on empty stomach or a little quantity of ghee is given.
· The Aged, children, the debilitated, VIPs and cowards, should be made to drink
a. wine,
b. milk,
c. sugarcane juice
d. or meat juice added with honey and Saindhava salt,
appropriate to the disease, to their maximum capacity.
· Afterwards, determining the nature the nature of his bowels (Intestines – Koshta), the emetic drug is administered sanctifying it with the following hymn-
“let Brahma, Daksa, Ashvinis, Rudra, Indra, the Earth, Moon, Sun, Air, Fire, Sages, comity of herbs, and of living beings protect you; let this medicine be to you like Rasayana for the Sages, Nector for gods and Sudha for the good serpents; Om, Salutations to the medicine.” Uttering these hymns, he should drink the medicine, facing east.
Note: The medicine given for Vamana depends on the disease. It usually contains Madanaphala (Randia spinosa), Licorice etc. Various combinations of Vamana drugs are discussed in a later chapter.
VAMANA VIDHI – PROCEDURE OF VAMANA –
पीतो मुहूर्तमनुपालयेत्
तन्मनाः जातहृल्लासप्रसेकश्च्छर्द्दयेत्ततः
अङ्गुलिभ्यां अनायस्तो नालेन मृदुना अथवा
गालताल्वरुजन् वेगान् अप्रवृत्तान् प्रवर्तयन्
प्रवर्तयन् प्रवृत्तांश्च जानुतुल्यासने स्थितः
उभे पार्श्वे ललाटं च वमतश्चास्य धारयेत्
प्रपीडयेत्तथा नाभिं पुष्टं च प्रतिलोमतः
a. After consuming the medicine, he should await for one Muhurta – 48 minutes for the commencement of vomiting, with keen intent.
b. With the appearance of oppression in the chest and salivation he should try to vomit
c. If the bouts are not coming up easily, he should tickle his throat either with his fingers or a soft tube without injuring the throat,
d. Sitting on a seat of the height of one knee, the bouts of vomiting should be held supported by another person.
e. His umbilical region and back should be massaged in upward direction.
कफे तीक्ष्नोष्णकटुकैः पित्ते स्वादुहिमैरिति
वमेत् स्निग्धाम्ललवणैः संसृष्टे मरुता कफे
1. In case of increase of Kapha,
· vomiting should be induced with drugs having properties
a. like penetrating,
b. hot and
c. Pungent (Teekshna, Ushna, Katu);
2. In case of Pitta with drugs of
a. sweet
b. and cold properties and
3. In case of association of Vata with Kapha, with drugs of
a. Unctuous,
b. sour and
c. salt properties. (Snigdha Amla Lavana)
पित्तस्य दर्शनं यात्रच्छेदो वा श्लेष्मणो भवेत्
Vomiting should be allowed till the appearance- coming out of Pitta or complete expelling of Kapha.
हीनवेगः कणाधात्री सिद्धार्थः लवणोदकैः
वमेत्पुनः पुनः
If bouts are insufficient, they should be induced again and again
by drinking water boiled with
a. Kana,
b. Dhatri,
c. Siddhartha
d. and salt.
(long pepper, Amla, White mustard and black salt)
vishama yoga / abnormal bouts
तत्र वेगानामप्रवर्तनम्
प्रवृत्तिः सविबन्धा वा केवलस्यौषधस्य वा
अयोगस्तेन निष्ठीवकण्डूकोठज्वरादयः
Less bouts – Ayoga –
1. Non – commencement of bouts,
2. bouts coming on with hindrance
3. or elimination of the medicine only-
are the features of Ayoga- inadequate bouts;
from it arise,
a) excess of expectoration,
b) itching,
c) appearance of skin rashes,
d) fever etc.
PROPER BOUTS – SAMYAK YOGA –
निर्विबन्धं प्रवर्तन्ते कफपित्तानिलाः क्रमात्
मनः प्रसादः स्वास्थ्यं चावस्थानं च स्वयं भवेत्
वैपरीत्यमयोगानां न चातिमहती व्यथा
सम्यक् योगे
1. Kapha, Pitta and vata coming out in successive order, without any hindrance,
2. calmness of the mind and
3. cessation of vomit bouts on its own,
4. absence of features of inadequate bouts and
5. feeling of not too much of discomfort
are the features of samyag yoga- proper bout.
IN ATIYOGA-
अतियोगे तु फेनचन्द्ररक्तवत्
वमितं क्षामता दाहः कण्ठशोषस्तमो भ्रमः
घोरा वायु आमया मृत्यु जीवशोणित निर्गमनात्
excess bouts
1. the vomited materials will be frothy,
2. with glistering particles and blood;
3. The patient will experience weakness,
4. burning sensation,
5. dryness of the throat,
6. giddiness,
7. powerful disease of vata origin
8. and even death due to discharge of life supporting blood.
CARE AFTER VOMITING THERAPY - VAMANOTTARA UPACHARA-
सम्यग्योगेन वमितं क्षणात् आश्वास्य पाययेत्
धूमत्रयस्यान्यतमं स्नेहाचारमथादिशेत्
After the patient had proper bouts of vomiting,
a. he should be comforted with encouraging words,
b. made to inhale any one kinds of smoke (Dhuma)- mild, medium, or strong,
c. and then allowed to follow the regimen of after-care of oleation therapy.
ततः सायः प्रभाते वा क्षुध्वान् स्नातः सुखाम्बुना
भुञ्जानो रक्तशाल्यन्नं भजेत्पेयादिकं क्रमम्
Then,
1. either in the evening or next morning,
2. after feeling hungry,
3. after bath with warm water,
4. he can eat mass prepared with red rice
5. or if he not feeling hungry he should adhere to the following regimen of Peya (Thin gruel) etc.
This regimen is called as Samsarjana Karma.
SAMSARJANA – PEYADI AHARA KARMA- REGIMEN OF LIQUID DIET –
पेयां विलेपीमकृतं कृतं च यूषं रसं त्रीनुभयं तथैकम्
क्रमेण सेवेत नरो अन्नकालान् प्रधानमध्यावरशुद्धिशुद्धः
Persons who have had the maximum, medium and minimum purificatory therapies, should consume
1. Peya- thin Gruel,
2. Vilepi- thick Gruel,
3. Akruta Yusa- soup not processed with fat, salt, sours etc.
4. Krutayusa- Soup processed with fat, salt and Sours and
5. Rasa- meat juice- in Successive order, for three, two and one Annakala- time of meal respectively.
Note:
Eating periods = Anna Kala.
Each day has two anna kala. – morning and evening.
· If the maximum vomiting bouts were observed (Ati Yoga),
a. Then, the patient should take Peya, Vilepi, Akruta Yusha, Kruta Yusha and Mamsarasa – three eating periods (Annakala) each. The patient will not have any food except these.
· Likewise, for the medium vomiting bouts,
b. the number of eating periods Is two each and
· for lesser bouts (Heena Yoga),
c. the number of eating periods (Anna kala) is one each.
BENEFITS OF SAMSARJANA KARMA –
यथा अणुरग्निः तृणगोमयाद्यैः सन्धुक्ष्यमाणो भवति क्रमेण
महान् स्थिरः सर्वपचस्तथैव शुद्धस्य पेयादिभिरन्तरग्निः
Just as a spark of fire after being fed by grass, powder of dry cow dung etc, gets augmented gradually and becomes great, steady, and capable of burning everything,
similarly, the internal digestion fire, by the Samsarjana regimen, in the patient who has undergone Vamana karma, gains strength.
VEGA SAMKHYA- MANA- NUMBER OF BOUTS AND QUANTITY:-
जघन्यमध्यप्रवरे तु वेगाश्चत्वार इष्टा वमने षडष्टौ
दशैव ते द्वित्रिगुणा विरेके प्रस्थस्तथा स्यादद्विचतुर्गुणश्च
For Vamana,
1. Heenayoga – Minimum bouts – 4 bouts
2. Madhyama vega – Moderate – 6 bouts
3. Atiyoga – Maximum bouts – 8 bouts
For Virechana –
1. Heenayoga – 10 bouts of purgation or half prastha of purgated material (384 grams)
2. Madhyamayoga – 20 bouts – 1 prastha of material (768 grams)
3. Atiyoga – 30 bouts. – 2 prastha (1,536 grams).
पित्तावसानं वमनं विरेकादर्द्धं, कफान्तं च विरेकमाहुः
द्वित्रान् साविट्कानपनीय वेगान् मेयं विरेके, वमने तु पीतम्
a. Vomiting therapy is allowed till the expulsions of pitta or half of purgations
b. Purgation therapy is allowed till Kapha comes out;
c. Measurement to be done after rejecting 2 – 3 bouts, containing faeces
d. in case of Vamana and after rejecting the medicine- emetic Drug in case of Vamana.
VIRECHANA VIDHI- PURGATION THERAPY PROCEDURE -
अथैनं वामितं भूयः स्नेहस्वेदोपपादितम्
श्लेष्मकाले गते ज्ञात्वा कोष्ठं संयग्विरेचयेत्
After Vamana therapy,
1. patient is given Samsarjana regimen.
2. After that, he is again given Snehana and Swedana treatment.
3. After that, in the morning, after Kapha time has lapsed (after around 9 – 10 am,) Virechana drug should be given.
4. The kind and quantity of purgation medicine should be determining the nature of his Kostha (alimentary tract, bowels).
बहुपित्तो मृदुः कोष्ठः क्षीराणपि विरिच्यते
प्रभूत मारुतः क्रूरः कृच्छ्रात् श्यामादिकैरापि
a) A person with Mrudukoshta (soft intestines),
· even milk will induce purgation.
b) For a person with Krurakoshta, (hard bowels, intestines),
· even Trivrit (a purgative herb) might cause purgation with great difficulty.
कषायमधुरैः पित्ते विरेकः, कटुकैः कफे
स्निग्धोष्णलवणैर्वायौ
A.For Pitta disease,
· Kashaya – astringent and Madhura – sweet drugs should be used for purgation.
B. For Kapha disease,
· Katu (pungent) herbs should be given for purgation.
C.For Vata, drugs with
· Snigdha – unctuous, oily, Ushna (hot) and Lavana (salt) taste b given to induce purgation.
अप्रवृत्तौ तु पाययेत्
उष्णाम्बु, स्वेदयेदस्य पाणितापेन चोदरम्
If bouts of purgation do not commence,
· he should drink hot water
· and his abdomen should be fomented with warmed with palms of the hand.
उत्थाने अल्पे दिने तस्मिन्भुक्त्वा अन्येध्युः पुनः पिबेत्
अदृढस्नेहकोष्ठस्तु पिबेदूर्ध्वं दशाहतः
भूयो अप्युपस्कृततनुः स्नेहस्वेदैर्विरेचनम्
यौगिकं सम्यगालोच्य स्मरन्पूर्वमतिक्रमम्
If, on the day of consuming the purgative drug, the patient responds poorly,
· he should be allowed to take his food on that day
· and the purgative drugs administered again on the next day;
Persons who have unstable and unlubricated alimentary tract,
· should consume the purgative drugs after ten days – during which Snehana and sweating therapies
· should be done because the body which has been well prepared with Snehana and sweating therapies, will be able to have purgation properly;
· then the purgative drug should be administered after considering all aspects and remembering the procedures described earlier .
VISHAMA YOGAH – ABNORMAL BOUTS:-
हृतकुक्षि अशुद्धिरुचिरुत्क्लेशः श्लेष्मपित्तयोः
कण्डूविदाहः पिटिकाः पीनसो वातविड्ग्रहः
अयोगलक्षणम्
योगो वैपरीत्ये यथोदितान्
विट्पित्तकफवातेषु निःसृतेषु क्रमात्स्रवेत्
निःश्लेष्मपित्तमुदकं श्वेतं कृष्णं सलोहितम्
मांस धावनतुल्यं वा मेदः खन्दाभमेव वा
गुदनिःसरणं तृष्णाभ्रमो नेत्रप्रवेशनम्
भवन्ति अतिविरिक्तस्य तथा अतिवमनामयाः
Ayoga – lesser quantity of purgation –
1. Discomfort in the region of the heart and abdomen,
2. Aruchi – anorexia,
3. Too much of Kapha and Pitta increase in the intestines (because they are not properly thrown out of the body) or expulsion of Doshas coming out through the mouth,
4. Kandu – itching,
5. Vidaha – burning sensation,
6. Pitika – eruption on the skin,
7. Peenasa – rhinitis,
8. Vata Vidgraha – blocking of flatus and constipation
are the features of Ayoga- inadequate bout of purgation therapy;
opposite of these are the features of proper bouts;
In case of Atiyoga – excess bouts
After the elimination of faeces, Pitta, Kapha and vata in Succeeding order,
1. there will be elimination of watery material which does not contain Kapha or Pitta,
2. which is white, black or slightly red in color,
3. resembling the water in which meat has been washed or resembling a piece of fat;
4. prolapse of the rectum,
5. thirst,
6. giddiness
7. Sunken eyes
8. and diseases caused by excess of vomiting- will appear.
VIRECANOTTARA UPACARA / CARE AFTER PURGATION
सम्यग्विरिक्तमेनं च वमनोक्तेन योजयेत्
धूमवर्ज्येन विधिना ततो वमितवानिव
क्रमेणान्नानि भुञ्जानो भजेत् प्रकृतिभोजनम्
The person who has undergone proper purgation therapy,
·should administered all other therapies, except inhalation of smoke, which are described under emesis therapy;
·afterwards he should stick to the regimen of diet, in the same way as of emesis therapy
·and then resume his normal food.
मन्दवह्निमसंशुद्धमक्षामं दोशदुर्बलम्
अदृष्टजीर्णलिङ्गं च लङ्घयेत्पीतभेषजम्
स्नेहस्वेदौषदोत्क्लेशसङ्गैरिति च बाध्यते
·
On the day of consuming the purgation,
a. If the patient has weak digestion strength (Mandagni),
b. coated feeling in the gut,
c. and if the digestion symptoms of previous food are not seen,
then he should be made to fast.
By this fasting he will not be harmed by the discomfort caused by the obstruction of Doshas, aggravated by oleation, Sweating therapies.
संशोधनास्रविस्रावस्नेहयोजनलङ्घनैः
यात्यग्निर्मन्दतां तस्माद् क्रमं पेयादिमाचरेत्
The digestive activity becomes weak
1. by purification therapies,
2. blood letting,
3. oleation
4. and fasting;
hence the regimen of Peya- thin Gruel etc. should be followed.
स्रुतास्यपित्तश्लेष्माणं मद्यपं वातपैत्तिकम्
पेयां न् पाययेत्तेषां तर्पणादिक्रमो हितः
Peya should not be given
a) when only little quantities of Pitta and Kapha are expelled out,
b) to the person is Addicted to wine,
c) and in whom Vata and Pitta are Predominant;
for them regimen of Tarpana etc. – nourishing therapy are suitable.
अपक्वं वमनं दोषान् पच्यमानं विरेचनम्
निर्हरेत्वमनस्यातः पाकं न प्रतिपालयेत्
· Vamana (Emesis) brings out Doshas which are not cooked (processed by heat)
· Whereas Virechana (purgation) brings out the Doshas which have undergone Paka (cooking- process by heat);
· hence in case of emesis – the physician need not await Doshapaka (cooking of the Doshas).
दुर्बलो बहुदोषश्च दोषपाकेन यः स्वयम्
विरिच्यते भेदनीयैर्भोज्यैस्तुमुपपादयेत्
Person
· who is weak,
· who has great amount of increased Doshas
develops purgation on his own – without consuming purgative Drug;
he should be treated with foods which are purgative.
दुर्बलः शोधितः पूर्वमल्पदोषाः कृशो नरः
अपरिज्ञातकोष्ठश्च पिबेन्मृद्वल्पमषौधम्
वरं तदसकृत्पीतमन्यथा संशयावहम्
हरेद्बहूंश्चलान् दोषानल्पानल्पान् पुनः पुनः
दुर्बलस्य मृदुद्रवैरल्पान् संशयमेत्तुतान्
Persons
a) who are weak,
b) who have undergone purification therapy previously,
c) who have little amount of imbalanced Doshas,
d) who are emaciated and
e) whose nature of the alimentary tract is not known
· should be given mild purgative drug in a small dose;
· It is better given in small doses often;
· Large dose given once creates doubt of death;
The drug in small and repeated doses will eliminate the circulating Doshas little by little;
in a weak person, little quantity of Doshas should only be mitigated by mild drugs,
they need not be expelled out by purification therapies .
क्लेशयन्ति चिरं ते हि हन्युर्वैनमनिर्ह्रताः
Doshas which are more in quantity trouble the person greatly and even kill him, if not expelled out- by purification therapies.
मन्दाग्निं क्रूरकोष्ठं च साक्षारलवणैर्घृतैः
संधुक्षिताग्निं विजितकफवातं च शोधयेत्
Person who have weak digestion strength, Krura koshta – hard bowels (hard natured alimentary tract),
a. should be administered ghee processed with Kshara and Lavana (Alkalis and salts),
b. to Augment his digestive capacity and Vanquish Kapha and Vata;
c. afterwards he should be given purification therapies.
रूक्षबहूनिलक्रूरकोष्ठव्यायामशीलिनाम्
दीप्ताग्नीनां च भेषज्यमविरेचैव जीर्यति
येभ्यो बस्तिं पुरा दद्यात्ततः स्निग्धं विरेचनम्
शकृन्निर्हृर्त्य वा किञ्चितीक्ष्णाभिः फलवर्तिभिः
प्रवृत्तं हि मलं स्निग्धो विरेको निर्हरेत्सुखम्
In persons
a. who are Rooksha (dry),
b. who have great increase of Vata,
c. who have hard natured Alimentary tract (Krura koshta),
d. who do exercise regularly
e. and who have strong digestion strength,
the purgative drug gets digested without producing purgation;
विषाभिघातपिटिकाकुष्ठशोफविसर्पिणः
कामलापाण्डुमेहार्तन्नातिस्निग्धान् विशोधयेत्
सर्वान् स्नेहविरेकैश्च, रूक्षैस्तु स्नेहभावितान्
Persons
a) who are suffering from poison ,
b) Abhighata (Trauma),
c) Pitika(skin eruption),
d) Kushta – skin diseases,
e) Shopha (inflammation),
f) Visarpa- herpes,
g) Kamala (Jaundice),
h) Anaemia and
i) Diabetes,
should be given the purgative therapy without too much of Snehana (oleation. Mild oleation itself is sufficient for them.
कर्मणां वमनादीनां पुनरप्यन्तरेअन्तरे
स्नेहस्वेदौप्रयुञ्जीत, स्नेहमन्ते बलाय च
Note:
Virechana is of two types.
1. Snigdha Virechana and
2. Rooksha Virechana.
1. Snigdha Virechana-
· done by fatty purgative, such as a castor oil.
vOr the fatty material is mixed with herbs. Such as Castor oil mixed with Haritaki.
2. Rooksha Virechana –
· where in dry purgative herb alone is given. For example,Trivrit Lehyam.
मलो हि देहादुत्क्लेष्य ह्रियते वाससो तथा
स्नेहस्वेदैत्तथोत्क्लिष्टः शोष्यते शोधनैर्मलः
Doshas getting loosened from the body by oleation and Sweating therapies are expelled out by purification therapies just like the dirt from the cloth – by washing.
स्नेहस्वेदावनभ्यस्य कुर्यात् संशोधनं तु यः
दारु शुष्कं इवानामे शरीरं तस्य दीर्यते
The body of the person who resorts to purification therapies without undergoing oleation and Sweating habitually, gets broken just like a log of dry wood while being bent.
SHODHANA PHALA- BENEFITS OF PURIFICATION THERAPIES:-
बुद्धिप्रसादं बलमिन्द्रियाणां धातुस्थिरत्वं ज्वलनस्य दीप्तिं
चिराच्च पाकं वयसः करोति संशोधनं सम्यगुपास्यमानम्
1. Clarity of the mind,
2. strength of the sense organs,
3.stability of the tissues,
4.keenness of digestive power and
5.slow ageing occur from purification therapies, properly undertaken.
कफे विध्यात् वमनं संयोगे वा कफोलबणे
तद्वद् विरेचनं पित्ते
a) Vamana –
· Emesis should be administered for increase of Kapha
a. either alone
b. or in combination with other Doshas where Kapha is predominant
b) Virechana –
· purgation should be administered to treat increase of Pitta
a. alone or
b. in combination with other Doshas where Pitta is predominant.
PERSONS SUITABLE FOR VAMANA PROCEDURE – VAMANA ARHA
विशेषेण तु वामयेत्
नवज्वरातिसाराधः पित्तासृक्राजयक्ष्मिणः
कुष्ठमेहापचिग्रन्थिश्लीपद उन्मादकासिनः
श्वासह्रुल्लासवीसर्पस्तन्यदोषोर्ध्वरोगिणः
Emesis should be administered to persons suffering from
1. Navajwara – fever of recent origin
2. Atisara – diarrhoea, dysentery
3. Adha:pitta – Pitta imbalance in lower part of abdomen
4. Pittasruk – Bleeding disorder due to Pitta imbalance
5. Rajayakshma – Chronic Respiratory disorder
6. Kushta – skin diseases
7. Meha – diabetes, urinary tract disorders
8. Apachi,
9. Granthi – Goitre, tumour, fibroid
10. Shleepada – Elephantiasis, Filariasis
11. Unmada – Schizophrenia
12. Kasa – cough, cold
13. Shwasa – Chronic Respiratory tract disease, Asthma
14. Hrullasa – nausea
15. Visarpa – herpes
16. Stanyadosha – vitiated breast milk
17. Urdhvaroga – diseases affected neck and above region
PERSONS NOT SUITABLE FOR VAMANA PANCHAKARMA –VAMANA ANARHA – AVAMYA
अवाम्या गर्भिणी रूक्षः क्षुधितो नित्यदुःखितः
बालवृद्धकृशस्थूलहृद्रोगिक्षतदुर्बलाः
प्रसक्तवमथुप्लीहातिमिरक्रिमिकोष्ठिनःउर्ध्वप्रवृत्तवाय्वस्रदत्तबस्तिहतस्वराः
मूत्राघात्युदरी गुल्मी दुर्वमो अत्यग्निरर्शसः
उदावर्तभ्रमाष्ठीलापार्श्वरुग्वातरोगिणः
ऋते विषगराजीर्णविरुद्धाभ्यवहारतः
1. Garbhini – The pregnant woman,
2. rooskha – persons who are dry –not undergone oleation therapy,
3. Kshudhita – hungry,
4. Nitya Dukhita – constantly grief-stricken,
5. children,
6. old persons,
7. Krusha – the emaciated,
8. Sthula – the obese,
9. Hrudrogi – patient of heart disease,
10. Kshata – the wounded,
11. Durbala – weak, debilitated,
12. who are having bouts of vomiting,
13. Pleeha – enlargement of spleen,
14. Timira – blindness,
15. Krimikoshta – intestinal parasites,
16. upward movement of vata and Asra- blood,
17. Soon after administration of Vamana,
18. who have loss of speech, dysuria,
19. Udara – ascites, interstinal obstruction,
20. tumor of the abdomen,
21. who faced difficulties during Vamana therapy,
22. who have strong digestive activity,
23. Arsha – haemorrhoids
24. Urdhva Vata – upward movement of air – reverse peristalisis,
25. Giddiness / Dizziness
26. enlargement of the prostate,
27. Parshva vata – pain in the flanks and diseases caused by vata;
28. Person suffering from poisoning,
29. indigestion
30. and who have consumed incompatible foods.
प्रसक्तवमथोः पूर्वे प्रायेणामज्वरो अपि च
धूमान्तैः कर्मभिर्वर्ज्याः, सर्वैरेव त्वजीर्णिनः
1. Those persons enumerated earlier to praskta vamathu and persons who are suffering from recent fevers,
· Are generally to be rejected for therapies ending with dhuma
2. And those suffering from indigestion
· From all therapies
VIRECHYAH – PERSONS SUITABLE FOR PURGATION THERAPY:-
Diseases requiring purgation therapy are-
विरेकसाध्या गुल्मार्शोविस्फोटव्यङ्गकामलाः
जीर्णज्वरोदरगरच्छर्द्दिप्लीहहलीमकाः
विद्रधिस्तिमिरं काचः स्यन्दः पक्वाशयव्यथाः
योनिशुक्राश्रयरोगाः कोष्ठगाः कृमयो व्रणाः
वातास्रमूर्ध्वगं रक्तं मूत्राघातः शकृन्ग्रहः
वाम्याश्च कुष्ठमेहाद्याः
1. Gulma – Tumors of the abdomen,
2. Arsha – Piles,
3. Visphota- blisters,
4. Vyanga – discolored patch on face,
5. Kamala – Jaundice, Liver disease
6. Jeernajwara - Chronic fever,
7. Udara – ascites, interstinal obstruction
8. Poisoning, Chronic poisoning
9. Chardi – Vomiting
10. Pleeha – Disease of the spleen, Splenomegaly,
11. Haleemaka – advanced jaundice,
12. Vidradhi – Abscess
13. Timira – blindness,
14. Kacha, Syanda – Cataract
15. pain in the large intestine,
16. Diseases of male and femal urogenital system
17. wounds/ Ulcers,
18. Vatasra – Gout,
19. Urdhwarakta – bleeding disorders of upper parts of the body (such as nasal bleeding)
20. Diseases of blood vitiation,
21. Mutraghata – Dysuria
22. Shakrut graham – constipation
23. Those persons who are Suitable for emesis therapy- enumerated in earlier verses commencing with “ those suffering from Kustha” are curable- to be treated with purgation therapy.
Those diseases are -
a. Kushta – skin diseases
b. Meha – diabetes, urinary tract disorders
c. Apachi,
d. Granthi – Goitre, tumour, fibroid
e. Shleepada – Elephantiasis, Filariasis
f. Unmada – Schizophrenia
g. Kasa – cough, cold
h. Shwasa – Chronic Respiratory tract disease, Asthma
i. Hrullasa – nausea
j. Visarpa – herpes
k. Stanyadosha – vitiated breast milk
l. Urdhvaroga – diseases affected neck and above region
CONTRA INDICATION FOR VIRECHANA – AVIRECHYA – VIRECHANA ANARHA-
न तु रेच्या नवज्वरी
अल्पाग्न्यधोगपित्तास्रक्षतपाय्वतिसारिणः
सशल्यास्थापितक्रूरकोष्ठादिस्निग्धशोषिणः
1. Navajwara – fever of recent origin
2. Alpa Agni – poor digestive activity,
3.Adhoga Raktapitta – bleeding disease of lower part of the body (such as bleeding per rectum
wounds, Ulcers of the rectum
4.Atisara – diarrhoea, dysentery
5.Sashalya – foreign bodies;
6. Who have been administered decoction enema,
7.Krurakoshta – Persons who naturally have hard bowel movement,
8. Atisnigdha – who have undergone excess of Oleation treatment
9. Shosha – emaciated
VAMANA VIDHI- PROCEDURE OF EMESIS THERAPY:-
अथ साधारणे काले स्निग्ध स्विन्नं यथाविधि
श्वोवम्यमुत्क्लिष्टकफं मत्स्यमाषतिलादिभिः
निशां सुप्तं सुजीर्णान्नं पूर्वाह्ने कृतमङ्गलम्
निरन्नमीषत्स्निग्धं वा पेयया पीतसर्पिषम्
वृद्धबालाबलक्लीबभीरून् रोगानुरोधतः
आकण्ठं पायितान्मद्यं क्षीरमिक्षुरसं रसम्
यथाविकारविहितां मधुसैन्धवसंयुताम्
कोष्ठं विभज्य भेषज्यमात्रां मन्त्राभिमन्त्रिताम्
ब्रह्मदक्षाश्विरुद्रेन्द्रभूचन्द्रार्कानिलानलाः
ऋषयः सौषधिग्राम भूतसङ्घाश्च पान्तु वः
रसायनमिवर्षीणामामराणामिवामृतम्
सुधेवोत्तमनागानां भैषज्यमिदमस्तु ते
ॐ नमो भगवते भैषज्यगुरवे वैडूर्यप्रभराजाय
तथागतायार्हते सम्यक्सम्बुद्धाय तद्यथा
ॐ भैषज्ये भैषज्ये महाभैषज्ये समुद्गते स्वाहा
प्राङ्गमुखं पाययेत्
Next,
1. during temperate seasons,
2. after administering oleation and sweating therapy properly,
3. on the day previous to the day of emesis,
· The patient is made sure that he has slept well the previous night.
· Patient is made sure that his previous food is well digested
4. In the morning of the previous day to Vamana,
· at first, Auspicious rituals are carried out.
· Next, Kapha Dosha is excited in the patient by administering peya (drink) / thin gruel prepared from
a. fish,
b. Masha (black gram) ,
c. Tila (Sesame) etc.
d. added with little quantity of fats, in morning.
5. On the day of Vamana, again,
· it is made sure that the patient’s previous food has got digested and he had slept well.
· is either maintained on empty stomach or a little quantity of ghee is given.
· The Aged, children, the debilitated, VIPs and cowards, should be made to drink
a. wine,
b. milk,
c. sugarcane juice
d. or meat juice added with honey and Saindhava salt,
appropriate to the disease, to their maximum capacity.
· Afterwards, determining the nature the nature of his bowels (Intestines – Koshta), the emetic drug is administered sanctifying it with the following hymn-
“let Brahma, Daksa, Ashvinis, Rudra, Indra, the Earth, Moon, Sun, Air, Fire, Sages, comity of herbs, and of living beings protect you; let this medicine be to you like Rasayana for the Sages, Nector for gods and Sudha for the good serpents; Om, Salutations to the medicine.” Uttering these hymns, he should drink the medicine, facing east.
Note: The medicine given for Vamana depends on the disease. It usually contains Madanaphala (Randia spinosa), Licorice etc. Various combinations of Vamana drugs are discussed in a later chapter.
VAMANA VIDHI – PROCEDURE OF VAMANA –
पीतो मुहूर्तमनुपालयेत्
तन्मनाः जातहृल्लासप्रसेकश्च्छर्द्दयेत्ततः
अङ्गुलिभ्यां अनायस्तो नालेन मृदुना अथवा
गालताल्वरुजन् वेगान् अप्रवृत्तान् प्रवर्तयन्
प्रवर्तयन् प्रवृत्तांश्च जानुतुल्यासने स्थितः
उभे पार्श्वे ललाटं च वमतश्चास्य धारयेत्
प्रपीडयेत्तथा नाभिं पुष्टं च प्रतिलोमतः
a. After consuming the medicine, he should await for one Muhurta – 48 minutes for the commencement of vomiting, with keen intent.
b. With the appearance of oppression in the chest and salivation he should try to vomit
c. If the bouts are not coming up easily, he should tickle his throat either with his fingers or a soft tube without injuring the throat,
d. Sitting on a seat of the height of one knee, the bouts of vomiting should be held supported by another person.
e. His umbilical region and back should be massaged in upward direction.
कफे तीक्ष्नोष्णकटुकैः पित्ते स्वादुहिमैरिति
वमेत् स्निग्धाम्ललवणैः संसृष्टे मरुता कफे
1. In case of increase of Kapha,
· vomiting should be induced with drugs having properties
a. like penetrating,
b. hot and
c. Pungent (Teekshna, Ushna, Katu);
2. In case of Pitta with drugs of
a. sweet
b. and cold properties and
3. In case of association of Vata with Kapha, with drugs of
a. Unctuous,
b. sour and
c. salt properties. (Snigdha Amla Lavana)
पित्तस्य दर्शनं यात्रच्छेदो वा श्लेष्मणो भवेत्
Vomiting should be allowed till the appearance- coming out of Pitta or complete expelling of Kapha.
हीनवेगः कणाधात्री सिद्धार्थः लवणोदकैः
वमेत्पुनः पुनः
If bouts are insufficient, they should be induced again and again
by drinking water boiled with
a. Kana,
b. Dhatri,
c. Siddhartha
d. and salt.
(long pepper, Amla, White mustard and black salt)
vishama yoga / abnormal bouts
तत्र वेगानामप्रवर्तनम्
प्रवृत्तिः सविबन्धा वा केवलस्यौषधस्य वा
अयोगस्तेन निष्ठीवकण्डूकोठज्वरादयः
Less bouts – Ayoga –
1. Non – commencement of bouts,
2. bouts coming on with hindrance
3. or elimination of the medicine only-
are the features of Ayoga- inadequate bouts;
from it arise,
a) excess of expectoration,
b) itching,
c) appearance of skin rashes,
d) fever etc.
PROPER BOUTS – SAMYAK YOGA –
निर्विबन्धं प्रवर्तन्ते कफपित्तानिलाः क्रमात्
मनः प्रसादः स्वास्थ्यं चावस्थानं च स्वयं भवेत्
वैपरीत्यमयोगानां न चातिमहती व्यथा
सम्यक् योगे
1. Kapha, Pitta and vata coming out in successive order, without any hindrance,
2. calmness of the mind and
3. cessation of vomit bouts on its own,
4. absence of features of inadequate bouts and
5. feeling of not too much of discomfort
are the features of samyag yoga- proper bout.
IN ATIYOGA-
अतियोगे तु फेनचन्द्ररक्तवत्
वमितं क्षामता दाहः कण्ठशोषस्तमो भ्रमः
घोरा वायु आमया मृत्यु जीवशोणित निर्गमनात्
excess bouts
1. the vomited materials will be frothy,
2. with glistering particles and blood;
3. The patient will experience weakness,
4. burning sensation,
5. dryness of the throat,
6. giddiness,
7. powerful disease of vata origin
8. and even death due to discharge of life supporting blood.
CARE AFTER VOMITING THERAPY - VAMANOTTARA UPACHARA-
सम्यग्योगेन वमितं क्षणात् आश्वास्य पाययेत्
धूमत्रयस्यान्यतमं स्नेहाचारमथादिशेत्
After the patient had proper bouts of vomiting,
a. he should be comforted with encouraging words,
b. made to inhale any one kinds of smoke (Dhuma)- mild, medium, or strong,
c. and then allowed to follow the regimen of after-care of oleation therapy.
ततः सायः प्रभाते वा क्षुध्वान् स्नातः सुखाम्बुना
भुञ्जानो रक्तशाल्यन्नं भजेत्पेयादिकं क्रमम्
Then,
1. either in the evening or next morning,
2. after feeling hungry,
3. after bath with warm water,
4. he can eat mass prepared with red rice
5. or if he not feeling hungry he should adhere to the following regimen of Peya (Thin gruel) etc.
This regimen is called as Samsarjana Karma.
SAMSARJANA – PEYADI AHARA KARMA- REGIMEN OF LIQUID DIET –
पेयां विलेपीमकृतं कृतं च यूषं रसं त्रीनुभयं तथैकम्
क्रमेण सेवेत नरो अन्नकालान् प्रधानमध्यावरशुद्धिशुद्धः
Persons who have had the maximum, medium and minimum purificatory therapies, should consume
1. Peya- thin Gruel,
2. Vilepi- thick Gruel,
3. Akruta Yusa- soup not processed with fat, salt, sours etc.
4. Krutayusa- Soup processed with fat, salt and Sours and
5. Rasa- meat juice- in Successive order, for three, two and one Annakala- time of meal respectively.
Note:
Eating periods = Anna Kala.
Each day has two anna kala. – morning and evening.
· If the maximum vomiting bouts were observed (Ati Yoga),
a. Then, the patient should take Peya, Vilepi, Akruta Yusha, Kruta Yusha and Mamsarasa – three eating periods (Annakala) each. The patient will not have any food except these.
· Likewise, for the medium vomiting bouts,
b. the number of eating periods Is two each and
· for lesser bouts (Heena Yoga),
c. the number of eating periods (Anna kala) is one each.
BENEFITS OF SAMSARJANA KARMA –
यथा अणुरग्निः तृणगोमयाद्यैः सन्धुक्ष्यमाणो भवति क्रमेण
महान् स्थिरः सर्वपचस्तथैव शुद्धस्य पेयादिभिरन्तरग्निः
Just as a spark of fire after being fed by grass, powder of dry cow dung etc, gets augmented gradually and becomes great, steady, and capable of burning everything,
similarly, the internal digestion fire, by the Samsarjana regimen, in the patient who has undergone Vamana karma, gains strength.
VEGA SAMKHYA- MANA- NUMBER OF BOUTS AND QUANTITY:-
जघन्यमध्यप्रवरे तु वेगाश्चत्वार इष्टा वमने षडष्टौ
दशैव ते द्वित्रिगुणा विरेके प्रस्थस्तथा स्यादद्विचतुर्गुणश्च
For Vamana,
1. Heenayoga – Minimum bouts – 4 bouts
2. Madhyama vega – Moderate – 6 bouts
3. Atiyoga – Maximum bouts – 8 bouts
For Virechana –
1. Heenayoga – 10 bouts of purgation or half prastha of purgated material (384 grams)
2. Madhyamayoga – 20 bouts – 1 prastha of material (768 grams)
3. Atiyoga – 30 bouts. – 2 prastha (1,536 grams).
पित्तावसानं वमनं विरेकादर्द्धं, कफान्तं च विरेकमाहुः
द्वित्रान् साविट्कानपनीय वेगान् मेयं विरेके, वमने तु पीतम्
a. Vomiting therapy is allowed till the expulsions of pitta or half of purgations
b. Purgation therapy is allowed till Kapha comes out;
c. Measurement to be done after rejecting 2 – 3 bouts, containing faeces
d. in case of Vamana and after rejecting the medicine- emetic Drug in case of Vamana.
VIRECHANA VIDHI- PURGATION THERAPY PROCEDURE -
अथैनं वामितं भूयः स्नेहस्वेदोपपादितम्
श्लेष्मकाले गते ज्ञात्वा कोष्ठं संयग्विरेचयेत्
After Vamana therapy,
1. patient is given Samsarjana regimen.
2. After that, he is again given Snehana and Swedana treatment.
3. After that, in the morning, after Kapha time has lapsed (after around 9 – 10 am,) Virechana drug should be given.
4. The kind and quantity of purgation medicine should be determining the nature of his Kostha (alimentary tract, bowels).
बहुपित्तो मृदुः कोष्ठः क्षीराणपि विरिच्यते
प्रभूत मारुतः क्रूरः कृच्छ्रात् श्यामादिकैरापि
a) A person with Mrudukoshta (soft intestines),
· even milk will induce purgation.
b) For a person with Krurakoshta, (hard bowels, intestines),
· even Trivrit (a purgative herb) might cause purgation with great difficulty.
कषायमधुरैः पित्ते विरेकः, कटुकैः कफे
स्निग्धोष्णलवणैर्वायौ
A.For Pitta disease,
· Kashaya – astringent and Madhura – sweet drugs should be used for purgation.
B. For Kapha disease,
· Katu (pungent) herbs should be given for purgation.
C.For Vata, drugs with
· Snigdha – unctuous, oily, Ushna (hot) and Lavana (salt) taste b given to induce purgation.
अप्रवृत्तौ तु पाययेत्
उष्णाम्बु, स्वेदयेदस्य पाणितापेन चोदरम्
If bouts of purgation do not commence,
· he should drink hot water
· and his abdomen should be fomented with warmed with palms of the hand.
उत्थाने अल्पे दिने तस्मिन्भुक्त्वा अन्येध्युः पुनः पिबेत्
अदृढस्नेहकोष्ठस्तु पिबेदूर्ध्वं दशाहतः
भूयो अप्युपस्कृततनुः स्नेहस्वेदैर्विरेचनम्
यौगिकं सम्यगालोच्य स्मरन्पूर्वमतिक्रमम्
If, on the day of consuming the purgative drug, the patient responds poorly,
· he should be allowed to take his food on that day
· and the purgative drugs administered again on the next day;
Persons who have unstable and unlubricated alimentary tract,
· should consume the purgative drugs after ten days – during which Snehana and sweating therapies
· should be done because the body which has been well prepared with Snehana and sweating therapies, will be able to have purgation properly;
· then the purgative drug should be administered after considering all aspects and remembering the procedures described earlier .
VISHAMA YOGAH – ABNORMAL BOUTS:-
हृतकुक्षि अशुद्धिरुचिरुत्क्लेशः श्लेष्मपित्तयोः
कण्डूविदाहः पिटिकाः पीनसो वातविड्ग्रहः
अयोगलक्षणम्
योगो वैपरीत्ये यथोदितान्
विट्पित्तकफवातेषु निःसृतेषु क्रमात्स्रवेत्
निःश्लेष्मपित्तमुदकं श्वेतं कृष्णं सलोहितम्
मांस धावनतुल्यं वा मेदः खन्दाभमेव वा
गुदनिःसरणं तृष्णाभ्रमो नेत्रप्रवेशनम्
भवन्ति अतिविरिक्तस्य तथा अतिवमनामयाः
Ayoga – lesser quantity of purgation –
1. Discomfort in the region of the heart and abdomen,
2. Aruchi – anorexia,
3. Too much of Kapha and Pitta increase in the intestines (because they are not properly thrown out of the body) or expulsion of Doshas coming out through the mouth,
4. Kandu – itching,
5. Vidaha – burning sensation,
6. Pitika – eruption on the skin,
7. Peenasa – rhinitis,
8. Vata Vidgraha – blocking of flatus and constipation
are the features of Ayoga- inadequate bout of purgation therapy;
opposite of these are the features of proper bouts;
In case of Atiyoga – excess bouts
After the elimination of faeces, Pitta, Kapha and vata in Succeeding order,
1. there will be elimination of watery material which does not contain Kapha or Pitta,
2. which is white, black or slightly red in color,
3. resembling the water in which meat has been washed or resembling a piece of fat;
4. prolapse of the rectum,
5. thirst,
6. giddiness
7. Sunken eyes
8. and diseases caused by excess of vomiting- will appear.
VIRECANOTTARA UPACARA / CARE AFTER PURGATION
सम्यग्विरिक्तमेनं च वमनोक्तेन योजयेत्
धूमवर्ज्येन विधिना ततो वमितवानिव
क्रमेणान्नानि भुञ्जानो भजेत् प्रकृतिभोजनम्
The person who has undergone proper purgation therapy,
·should administered all other therapies, except inhalation of smoke, which are described under emesis therapy;
·afterwards he should stick to the regimen of diet, in the same way as of emesis therapy
·and then resume his normal food.
मन्दवह्निमसंशुद्धमक्षामं दोशदुर्बलम्
अदृष्टजीर्णलिङ्गं च लङ्घयेत्पीतभेषजम्
स्नेहस्वेदौषदोत्क्लेशसङ्गैरिति च बाध्यते
·
On the day of consuming the purgation,
a. If the patient has weak digestion strength (Mandagni),
b. coated feeling in the gut,
c. and if the digestion symptoms of previous food are not seen,
then he should be made to fast.
By this fasting he will not be harmed by the discomfort caused by the obstruction of Doshas, aggravated by oleation, Sweating therapies.
संशोधनास्रविस्रावस्नेहयोजनलङ्घनैः
यात्यग्निर्मन्दतां तस्माद् क्रमं पेयादिमाचरेत्
The digestive activity becomes weak
1. by purification therapies,
2. blood letting,
3. oleation
4. and fasting;
hence the regimen of Peya- thin Gruel etc. should be followed.
स्रुतास्यपित्तश्लेष्माणं मद्यपं वातपैत्तिकम्
पेयां न् पाययेत्तेषां तर्पणादिक्रमो हितः
Peya should not be given
a) when only little quantities of Pitta and Kapha are expelled out,
b) to the person is Addicted to wine,
c) and in whom Vata and Pitta are Predominant;
for them regimen of Tarpana etc. – nourishing therapy are suitable.
अपक्वं वमनं दोषान् पच्यमानं विरेचनम्
निर्हरेत्वमनस्यातः पाकं न प्रतिपालयेत्
· Vamana (Emesis) brings out Doshas which are not cooked (processed by heat)
· Whereas Virechana (purgation) brings out the Doshas which have undergone Paka (cooking- process by heat);
· hence in case of emesis – the physician need not await Doshapaka (cooking of the Doshas).
दुर्बलो बहुदोषश्च दोषपाकेन यः स्वयम्
विरिच्यते भेदनीयैर्भोज्यैस्तुमुपपादयेत्
Person
· who is weak,
· who has great amount of increased Doshas
develops purgation on his own – without consuming purgative Drug;
he should be treated with foods which are purgative.
दुर्बलः शोधितः पूर्वमल्पदोषाः कृशो नरः
अपरिज्ञातकोष्ठश्च पिबेन्मृद्वल्पमषौधम्
वरं तदसकृत्पीतमन्यथा संशयावहम्
हरेद्बहूंश्चलान् दोषानल्पानल्पान् पुनः पुनः
दुर्बलस्य मृदुद्रवैरल्पान् संशयमेत्तुतान्
Persons
a) who are weak,
b) who have undergone purification therapy previously,
c) who have little amount of imbalanced Doshas,
d) who are emaciated and
e) whose nature of the alimentary tract is not known
· should be given mild purgative drug in a small dose;
· It is better given in small doses often;
· Large dose given once creates doubt of death;
The drug in small and repeated doses will eliminate the circulating Doshas little by little;
in a weak person, little quantity of Doshas should only be mitigated by mild drugs,
they need not be expelled out by purification therapies .
क्लेशयन्ति चिरं ते हि हन्युर्वैनमनिर्ह्रताः
Doshas which are more in quantity trouble the person greatly and even kill him, if not expelled out- by purification therapies.
मन्दाग्निं क्रूरकोष्ठं च साक्षारलवणैर्घृतैः
संधुक्षिताग्निं विजितकफवातं च शोधयेत्
Person who have weak digestion strength, Krura koshta – hard bowels (hard natured alimentary tract),
a. should be administered ghee processed with Kshara and Lavana (Alkalis and salts),
b. to Augment his digestive capacity and Vanquish Kapha and Vata;
c. afterwards he should be given purification therapies.
रूक्षबहूनिलक्रूरकोष्ठव्यायामशीलिनाम्
दीप्ताग्नीनां च भेषज्यमविरेचैव जीर्यति
येभ्यो बस्तिं पुरा दद्यात्ततः स्निग्धं विरेचनम्
शकृन्निर्हृर्त्य वा किञ्चितीक्ष्णाभिः फलवर्तिभिः
प्रवृत्तं हि मलं स्निग्धो विरेको निर्हरेत्सुखम्
In persons
a. who are Rooksha (dry),
b. who have great increase of Vata,
c. who have hard natured Alimentary tract (Krura koshta),
d. who do exercise regularly
e. and who have strong digestion strength,
the purgative drug gets digested without producing purgation;
- for them, an enema should be given first and
- then purgative drug which is Snigdha – (unctuous, oily) should be given ;
- or the faeces should be removed first by using a strong rectal suppository made from fruits; the Doshas thus initiated in their movement, the purgative drug expels them easily.
विषाभिघातपिटिकाकुष्ठशोफविसर्पिणः
कामलापाण्डुमेहार्तन्नातिस्निग्धान् विशोधयेत्
सर्वान् स्नेहविरेकैश्च, रूक्षैस्तु स्नेहभावितान्
Persons
a) who are suffering from poison ,
b) Abhighata (Trauma),
c) Pitika(skin eruption),
d) Kushta – skin diseases,
e) Shopha (inflammation),
f) Visarpa- herpes,
g) Kamala (Jaundice),
h) Anaemia and
i) Diabetes,
should be given the purgative therapy without too much of Snehana (oleation. Mild oleation itself is sufficient for them.
- All of them should be given fatty purgatives;
- those who have had oleation earlier should be given dry- non- fatty purgatives
कर्मणां वमनादीनां पुनरप्यन्तरेअन्तरे
स्नेहस्वेदौप्रयुञ्जीत, स्नेहमन्ते बलाय च
Note:
Virechana is of two types.
1. Snigdha Virechana and
2. Rooksha Virechana.
1. Snigdha Virechana-
· done by fatty purgative, such as a castor oil.
vOr the fatty material is mixed with herbs. Such as Castor oil mixed with Haritaki.
2. Rooksha Virechana –
· where in dry purgative herb alone is given. For example,Trivrit Lehyam.
मलो हि देहादुत्क्लेष्य ह्रियते वाससो तथा
स्नेहस्वेदैत्तथोत्क्लिष्टः शोष्यते शोधनैर्मलः
Doshas getting loosened from the body by oleation and Sweating therapies are expelled out by purification therapies just like the dirt from the cloth – by washing.
स्नेहस्वेदावनभ्यस्य कुर्यात् संशोधनं तु यः
दारु शुष्कं इवानामे शरीरं तस्य दीर्यते
The body of the person who resorts to purification therapies without undergoing oleation and Sweating habitually, gets broken just like a log of dry wood while being bent.
SHODHANA PHALA- BENEFITS OF PURIFICATION THERAPIES:-
बुद्धिप्रसादं बलमिन्द्रियाणां धातुस्थिरत्वं ज्वलनस्य दीप्तिं
चिराच्च पाकं वयसः करोति संशोधनं सम्यगुपास्यमानम्
1. Clarity of the mind,
2. strength of the sense organs,
3.stability of the tissues,
4.keenness of digestive power and
5.slow ageing occur from purification therapies, properly undertaken.
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