Rukshana

The word ‘rukshana’ means drying or absorbing the moisture. It is a therapy to reduce excess body fluids, fat or corpulence., Rukshana is one of the six treatment modalities in Ayurveda. [Cha.Sa.Sutra Sthana 22/04] It is a type of langhana (reducing) therapy. Rukshana therapy is indicated in diseases due to over nutrition, excess kaphadosha, excess body fluids. The diseases like obesity, edema, obstinate urinary disorders including diabetes, ascites are treated with rukshana therapy. This therapy is widely used in the case of metabolic syndrome.

Contributors

Section/Chapter/topic	Chikitsa / Rukshana
Authors	Aneesh E.G., Deole Yogesh S.
Reviewed and Edited by	Basisht G.
Affiliations	Charak Samhita Research, Training and Development Centre, I.T.R.A., Jamnagar, India,
Correspondence email:	carakasamhita@gmail.com
Date of first publication:	April 28, 2021
DOI	Awaited

Etymology and derivation

The word ‘rukshana’ is derived from ‘ruksha’ meaning dry or absence of oiliness. [Amarakosha]

Definition

The food, medicine or therapy that cause dryness, roughness and coarseness in the body are known as ‘rukshana’. [Cha.Sa.Sutra Sthana 22/10]

Synonyms

Apremam, Acchikkana [Amarakosha]

Classification

It can be classified into three categories based on the form of administration.

1. Diet
2. Medicines/treatments
3. Regimens

Diet

Various food items are used in the rukshana therapy. Use of oil-cakes of mustard and sesame, buttermilk, honey [Cha.Sa.Sutra Sthana 22/29] khala (prepared from curd), uddalaka (prepared from rice), yava (Hordeum vulgare Linn.), shyamaka (Echinochioa frumentacea Linn.), kodrava (Paspalum scrobiculatum L.) etc. [A.Hr Sutra Sthana 16/34] helps in rukshana. Overuse of substances having pungent, bitter and astringent tastes also results in rukshana. [Cha.Sa.Sutra Sthana 22/29]

Medicines/treatments

The rukshana therapy is applied in two ways like internal administration and external application

Internal administration: Arishta (self-fermented decoctions), pippali (Piper longum), pathya (Terminalia chebula), guggulu (Commiphora mukul), triphala (Phyllanthus emblica, Terminalia chebula, Terminalia bellirica), honey [A.Hr Sutra Sthana 16/34], and lekhana basti (therapeutic enema with scrapping action). [Su.Sa.Sutra Sthana 15/32] acts as rukshana.

External application: Powder massage (udwartana), pouring sour fermented cereals liquid over the body (dhanyamladhara), pouring medicated buttermilk over the body (takradhara), fomentation with sand (valuka sweda), external application of dry powders imparts rukshana.

Regimen

Excessive indulgence in sexual activities [Cha.Sa.Sutra Sthana 22/29], exercise [Su.Sa.Sutra Sthana 15/32], and awake for late nights lead to rukshana in the body.

Properties

The food or medicine or therapy having properties like dryness, lightness, roughness, sharply acting/intense activity, hot potency, stability, non-slimy nature and hardness can cause rukshana. [Cha.Sa.Sutra Sthana 22/14]

Indications

Rukshana is indicated as a main treatment in the following conditions [Cha.Sa.Sutra Sthana 22/30]

• Obstruction of body channels due to excess discharge (abhishyanda)
• Diseases with greater morbidity
• Diseases of vital organs
• Stiffness of thighs and hips (urustambha).

Rukshana is done as a preparatory measure prior to oleation in the following conditions [A.Hr Sutra Sthana 16/37]

• Stout built or obese persons having excess meda dhatu or kaphadosha
• The person with an irregular digestive pattern
• Those who are accustomed to consumption of oils

Rukshana is indicated as a measure to treat the complications caused by oleation. [A.Hr Sutra Sthana 16/33-34]

Assessment

The effect of rukshana therapy is assessed based on following clinical features:

Clinical features of optimum rukshana

• Proper evacuation of flatus, urine and feces
• A feeling of lightness in the body
• A feeling of clarity in heart, eructation, throat and mouth
• The disappearance of drowsiness and exhaustion/ feeling energetic and enthusiastic
• The appearance of proper perspiration
• Feeling of good taste, hunger and thirst
• Feeling of wellbeing [Cha.Sa.Sutra Sthana 22/34-35]

Clinical features of excessive rukshana

Excess administration of rukshana can lead to untoward effects as below:

• Joint pains
• Body aches
• Dry cough
• Dryness in the mouth
• Complete loss of hunger/anorexia
• Excess thirst
• Weakness of sense of hearing and vision
• Mental confusion
• Frequent eructation
• Fainting
• Frequent upward movement of vatadosha
• Excess weight loss
• Weak digestive capacity
• Loss of strength [Cha.Sa.Sutra Sthana 22/36-37]

The ruskhana therapy shall be stopped after observing above clinical features. Nourishment and oleation therapy are advised to treat the complications.

Importance in preservation of health and prevention

Rukshana diet and lifestyle regimen are essential to maintain the equilibrium by reducing excess kaphadosha and meda dhatu. Rukshana therapy is indicated as a part of the seasonal regimen in spring (vasanta) season.The person is advised to follow exercise and powder massage to prevent the diseases due to naturally aggravated kaphadosha.[Cha.Sa.Sutra Sthana 06/24] The complications due to internal administration of fats and oils can be prevented by rukshana therapy. [A.Hr Sutra Sthana 16/37]

Importance in management of disease

• Rukshana is the prime treatment for all diseases due to excess of kapha and meda dhatu.
• If the site of origin of a disease is site of kapha, then rukshana is the primary treatment. For example, if a disease originates in thorax (ura), a site of kaphadosha, then rukshana is the first treatment.
• Rukshana therapies treat the diseases caused due to excessive oleation.
• In vitiligo (shwitra) treatment, rukshana therapy is advised after purificatory therapies [Cha.Sa.Chikitsa Sthana 7/172]
• If the edema is caused due to unctuousness, then rukshana is the treatment. [Cha.Sa.Chikitsa Sthana 12/17]
• Cough with expectoration of sputum (productive cough) due to vata or kaphadosha is treated with rukshana therapies. [Cha.Sa.Chikitsa Sthana 18/132]

Current researches

A study showed efficacy of rukshana treatment in transverse myelitis. Rukshana therapy with valuka sweda (sudation with sand bolus) and other internal medicines showed remarkable recovery within 10 days in the patient with predominance of kaphadosha.

The hypo-lipidemic action of powder massage (udwartana) and gruel prepared out of buttermilk (takra siddha yavagu) is observed. Udwartana mutilates and liquefied kaphadosha and meda dhatu (fat). The property of dryness in buttermilk (takra) and shyamaka decrease excess unctuousness (sneha) in the body. Significant reduction in serum cholesterol levels and weight of the patient were observed in the study.

Powder massage (udwartana) followed by enema causing dryness (ruksha basti) effectively reduces the blood sugar levels and clinical features of type ll diabetes mellitus. The sliminess/moistness (kleda), kaphadosha and meda dhatu vitiated in body are corrected by rukshana therapy.

List of thesis done

1. Anand Buchake (2002). An assessment of the activities of rooksha guna w.s.r to sthaulya. Department of Dravyaguna. IPGT&RA Jamnagar

More information

Langhanabrimhaniya Adhyaya

Abbreviations

Cha. = Charak, Su. = Sushruta, A. = Ashtanga, S. = Sangraha, Hr. = Hridayam, Sa. = Samhita.

List of references

The list of references for rukshana in Charak Samhita can be seen here

References