Charak Samhita

Brimhana

The word ‘brimhana’ means building, nourishing or strengthening.[1] It is one among the six important treatment principles.[Cha.Sa.Sutra Sthana 22/4] The brimhana therapies are indicated in degenerative conditions or to nourish and replenish the depleted body components. The medicines or procedures increase bulk of body components by quantity or quality [Cha.Sa.Sutra Sthana 22/10]. Thus, this therapy makes body strong and firm.

Contributors
Section/Chapter/topic Chikitsa / Brimhana
Authors Aneesh E.G.1, Chaudhary Sujata 2, Deole Yogesh S. 1
Reviewed and Edited by Basisht G.1
Affiliations 1Charak Samhita Research, Training and Development Centre, I.T.R.A., Jamnagar, India, 2Assistant professor, Shri Santpal Singh Ayurved Medical College and Hospital, Mirzapur, Shahjahanpur, Uttar Pradesh, India
Correspondence email: carakasamhita@gmail.com
Date of first publication: April 24, 2021
DOI Awaited

Etymology, definition and synonyms

The term ‘Brimhana’ in Sanskrit is used as a noun and a verb. As a verb, it indicates ‘therapy’. While as a noun, it points out food articles/ medicines/ physical activities capable of performing the action of brimhana.

Definition:‘Brimhana’ is the procedure to nourish tissues and improve their quality to make body compact. [Dalhana on Su.Sa.Sutra Sthana 45/113][2]

Synonyms: Santarpana [A.Hr. Sutra Sthana 14/2][3]

Properties

The nourishing (brimhana) substance possess properties like heavy (guru) leading to fullness, cold potency (sheeta), softness (mrudu), unctuousness (snigdha), thickness (bahala), gross (sthoola), sliminess (picchila), slowness (manda), stability (sthira) and smoothness (shlakshna). [Cha.Sa. Sutra Sthana 22/13]

The substances having these properties are high energy density, satiety index, heavy to digest, slow and long acting.[Cha.Sa.Sutra Sthana 22/13-14]

Panchamahabhuta constitution

The brimhana substance has Prithvi and jala mahabhuta predominance.[A.Hr. Sutra Sthana 14/02][3]

Dosha specific action

Pacify Vata and pitta [A.Hr. Sutra Sthana 14/7][3] and increase Kaphadosha

Indications

  • Persons with vata predominant constitution. [A.Hr. Sutra Sthana 14/8-9][3]
  • Weak or emaciated persons, traumatized or injured persons [Cha.Sa.Sutra Sthana 22/26]
  • Pregnant women, post-partum period [A.Hr. Sutra Sthana 14/8-9][3]
  • Aged persons (above 60 years)
  • Individuals who walk for long distances, those who indulge in excessive sexual intercourse, and those who take alcohol daily.
  • In summer season (grishma), when the body strength is naturally low [Cha.Sa.Sutra Sthana 22/26]
  • In winter season, when the digestive capacity is stronger [A.S. Sutra Sthana 4/9][4]
  • To regain strength after purification therapies [Cha.Sa.Sutra Sthana16/22]

Contraindications

Methods

The nourishing therapies are done in the following methods:

  1. Diet
  2. Daily habits
  3. Psychological factors
  4. Therapeutic measures

Diet

Meat: The best nourishing diet is meat. [A.S.Sutra Sthana 13/2][4] Meat of adult (mature) animals, fish, and birds which are found roaming in their suitable natural surroundings, which are healthy, is considered to be ideal for nourishing therapy. [Cha.Sa.Sutra Sthana 22/25] Especially meat of goat, sheep [Cha.Sa.Sutra Sthana 27/62] and hog [Cha.Sa.Sutra Sthana 27/78] provides nourishment. River fish is more stoutening than that of marine. [Su.Sa.Sutra Sthana 46/121] The eggs of swan, rooster and peacock [Cha.Sa.Sutra Sthana 27/85] are also nourishing in nature.

Milk: Milk [Cha.Sa.Sutra Sthana 27/224] provides nourishment to body due to its unctuous and cold nature. [Cha.Sa.Sutra Sthana 1/107] Cow milk possess maximum qualities for nourishing therapy.[Cha.Sa.Sutra Sthana 27/217] The fat in goat milk is similar to cow milk fat. Lipid fractions of whole milk and cream, containing 97 to 99% free lipid (97% of which was in the form of triglycerides) and 1 to 3% bound lipid (containing neutral lipid, glycolipid, and phospholipid) are same in both types.[5] However, goat's milk has no clear nutritional advantage over cow's milk.[6] Goat’s milk is easier to digest [Cha.Sa.Sutra Sthana 27/222] than cow’s milk. It can be preferred over cow’s milk to nourish those having low appetite, weak digestive capacity or any disease [fever/ tuberculosis/ diarrhea/ bleeding disorders [Ch.Sa.Sutra Sthana 27/222]. A research conducted on undernourished children also showed that goat’s milk can be considered as a substitute for cow’s milk.[7]

Camel milk is also a good source of nutrition; however, it is not suitable for weight gain therapy. Camel milk lipids contain lower saturated fatty acids, higher unsaturated fatty acids and low sugar and cholesterol value as compared to cow milk.[8] Camel milk can lead to dryness (rukshata) in the body.[Cha.Sa Sutra Sthana 27/220] It is used for nourishment in disorders like ascites, where restriction of liquid intake is advised. [Cha.Sa.Chikitsa Sthana 13/183]

Other recipes: Ghee, relishing soups prepared with cereals [Cha.Sa.Sutra Sthana16/22], rice, blackgram, sugarcane, wheat and jaggery preparations[Chakrapani on Cha.Sa.Sutra Sthana 21/29-34], curd[Cha.Sa.Sutra Sthana 27/225], butter [Su.Sa.Sutra Sthana 45/92][2] and oil [Su.Sa.Sutra Sthana 45/113][2] are nourishing in nature.

Fruits: Dates, common figs, Indian hog plum, coconut, ripe peach[Cha.Sa.Sutra Sthana 27/127-129, 133], mango [Su.Sa.Sutra Sthana 46/153],wild lemon (madulunga)etc.[A.S.Sutra Sthana 7/176][4] have nourishing property.

Food items having sweet [Cha.Sa.Sutra Sthana 26/43] or sour taste [A.S.Sutra Sthana 18/6][4] generally possess nourishing property.

Daily regimen

Oil massage, bath [Cha.Sa.Sutra Sthana16/22][Chakrapani on Cha.Sa.Sutra Sthana 22/18], sleep and less physical activities [Chakrapani on Cha.Sa.Sutra Sthana 21/29-34] makes the body stout.

Sleep (swapna/ nidra): It is one of the three pillars of life. It produces coolness and sluggishness in the body and provides strength. It smoothens and softens body tissues after their repair. [Cha.Sa.Sutra Sthana.21/36] During deep sleep, most of the body's systems are in an anabolic state. Thus, sleep helps to restore all the body systems including immune, nervous, skeletal, and muscular systems. Quality and amount of sleep is crucial in any nourishing regimen.

Bath (snana): Bathe is an important activity that has direct impact on body and mind. It soothes mind and relaxes the body. Thus, it provides sluggishness and strength to the body. [Ch.Sa.Sutra Sthana 5/94]

Mental factors that promote nourishment

Cheerfulness/happiness, contentment and avoiding mental worries has nourishing effect. [Chakrapani on Cha.Sa.Sutra Sthana 21/29-34][A.Hr. Sutra Sthana 14/9][3] Worries always increase energy expenditure. A recent study revealed a link between anxiety and hyper-metabolism. The researchers found that increased activation of anxiogenic circuits can reduce body weight via the promotion of adaptive thermogenesis and basal metabolism.[9] Mental distress leads to poor nutrition and reduces weight. Hence, distress and worries shall be avoided during nourishment therapy. Blissful living with appropriate nourishment and desirable physical activities always helps in nourishment of the body.

Therapeutic measures

Medicines:

The group of 10 herbs that possess nourishing property [Cha.Sa.Sutra Sthana 4/8(2)] are as follows:

  • Euphorbia prostrate (kshirini)
  • Brasica juncea (rajakshavaka)
  • Withania somnifera (ashwagandha)
  • Fritillaria cirrhosa (kakoli)
  • Lilium polyphyllum (kshirakakoli)
  • Sida rhombifolia (vatyayani/shwetabala)
  • Sida cordifolia (bhadraudani/pitabala)
  • Bhardwaji/vanakarpasi
  • Pueraria tuberose (payasya/vidarikanda)
  • Abutilon indicum (rishyagandha)

Holostemma annulare (jeevanti) [A.S.Sutra Sthana 7/120][4], skin and pulp of Semecarpus anacardium (bhallataka) [A.S.Sutra Sthana 7/177][4] etc. also possess nourishing property.

The time of administration: With food (sabhakta annakala) [A.S.Sutra Sthana 11/54][4]

Nourishing procedures:

  • Low dose unctuous enema (matrabasti) [Cha.Sa.Siddhi Sthana 4/54]
  • Oil massage (abhyanga)
  • Fomentation with bolus of medicated rice (shashtika shali pinda sweda)
  • Nourishing unction therapy (brimhana snehapana)
  • Nourishing intranasal drug administration (brimhana nasya)
  • Nourishing enema (brimhana basti)
  • Nourishing smoke inhalation (dhumapana)
  • Rejuvenating therapy (rasayana)
  • Aphrodisiac therapy (vajikarana)

Assessment

The assessment of effect of nourishing therapy is done on the basis of observation of clinical features. The weight of individual, body fat percentage, skin fold thickness, abdominal girth, waist circumference, hip circumference can be used as objective parameters for assessment.

Features of optimal nourishing (brimhana) therapy

  • The person attains good strength and robustness
  • Recovery from emaciation and related problems [Cha.Sa.Sutra Sthana 22/38]
  • Clarity of senses and improved perceptions
  • Proper elimination of waste products
  • Feeling of lightness of body and improvement in taste [A.S.Sutra Sthana 24/15][4]

Features of excessive nourishing (brimhana) therapy

  • Obesity[Cha.Sa.Sutra Sthana 22/38]
  • Person may suffer from fever, scrofula, diabetes, abdominal enlargement, cough, accumulation of toxic metabolic waste (ama) and skin diseases (kushtha). [A.Hr. Sutra Sthana 14/20][3]

Importance

Brimhana in preservation of health and prevention

Proper nourishment is essential for preservation of health. The therapeutic measures like elimination of dosha at proper time, regular use of rejuvenating and aphrodisiac formulations nourishes the body. [Cha.Sa.Sutra Sthana21/33] Thus it improves health and prevents diseases. Nourishing therapy maintains quality of tissues and decreases the risk of disease complications. It builds up the immunity and defensive systems of body. Thus, helps to prevent occurrence and recurrence of diseases.

Importance in the management of diseases

Nourishing (brimhana) is the treatment of choice for all vata dominant disorders. [Cha.Sa.Chikitsa Sthana 28/106] Nourishing therapy (brimhana) itself acts as pacifying therapy (shamana) also. [A.Hr. Sutra Sthana 14/7][3] The diseases caused by the depletion of body constituents should be treated through nourishing therapy (brimhana) [Indu on A.S.Sutra Sthana 19/13][4]

For the management of leanness, nourishing therapy is advised. [Cha.Sa.Sutra Sthana21/29-34] Meat soup of carnivorous animals and birds are nourishing in nature especially to persons who became lean as a result of diseases like assimilation disorders (grahani), piles (arsa) etc. [Cha.Sa.Sutra Sthana 22/27]

Nourishing therapies are indicated in the following conditions:

  • If body becomes weak by chronic stage of jwara, to preserve strength of the person. [Cha.Sa.Chikitsa Sthana 3/292]
  • In abdominal tumors caused by vata [Cha.Sa.Chikitsa Sthana 5/183]
  • For lean diabetic patients [Cha.Sa.Chikitsa Sthana 6/15] and chronic stage of diabetes.
  • In respiratory disorders (shwasa) and hiccups (hikka) [Cha.Sa.Chikitsa Sthana 17/150]
  • In the initial stages of cough due to depletion of body tissues (kshayaja kasa) [Cha.Sa.Chikitsa Sthana 18/150]
  • In poisoning leading to vata aggravation [Cha.Sa.Chikitsa Sthana 23/170]
  • It is a process to remove foreign body from the fleshy body parts [A.S.Sutra Sthana 37/32][4] and for treating fractures [Su.Sa.Chikitsa Sthana 3/5][2] also.
  • During loss of hunger due to fasting, gruel mixed with ghee given in between meals (annavapeditam) makes the body nourish. [Cha.Sa.Chikitsa Sthana 15/209]

Current researches

In a study, 72 healthy students were divided into two groups. One group was provided with a nourishing compound having Pueraria tuberose (vidarikanda), Triticum aestivum (wheat), Hordeum vulgare (Barley), sugar and ghee as the ingredients; and the other group with placebo. The group administered with nourishing compound showed significant improvement in anthropometric parameters like body weight, chest, mid-arm and mid-thigh circumference. Significant improvement in muscular strength and endurance; and cardio-respiratory functions were also noted by administration of nourishing compound.[10]

Pueraria tuberose possess growth hormone inducing, nootropic, anxiolytic, adaptogenic, immunomodulatory and antioxidant properties. The similar properties of nourishing (brimhana) drugs might be the cause for its bulk promoting, strength-enhancing and stress tolerating abilities.[5]It can improve sports performance.

A case of Erb’s palsy treated with nourishing therapies like oil massage (abhyanga) and rice paste application (annalepa) associated with physiotherapy showed promising results. The power of the affected upper limb improved from zero to near normal. The disparity in length and mid-arm circumference of affected and normal upper limbs was also reduced after the treatment.[11]

In another study conducted on 34 patients having low BMI, supplementation of nutritional compound with Phoenix dactylifera (dates) and cow ghee as ingredients, showed highly significant improvement in weight, BMI and fat percentage. Skin fold thickness of biceps, triceps and abdomen was also increased. Dates are having high nutritional value as it contains abundant macro and micronutrients.[12]

A study showed that the neonatal weight gain in the infants with the oil massage was 21 g daily on average, whereas the increase in infant massage without oil was 7 g. This difference was statistically significant (P < 0.001).[13] Another study conducted to test the role of Ashwagandha oil massage in the management of emaciation (Karshya) in adults also gave significant results.[14] When oil is applied all over the skin and massage is done, it pacifies vatadosha and nourishes body tissues underneath the skin (mainly muscle mass and fat tissue). [Su.Sa. Chikitsa Sthana 24/30][2] Oils processed with nourishing (brimhana) herbs may fulfill the purpose well.

List of theses done

  1. Nirali Doshi (2011). A clinical study on brumhan effect of prinan modaka and godhumadi modaka in the management of karshya in children. Department of Kaumarabrithya. IPGT&RA Jamnagar
  2. Shweta Patil (2013): A comparative study on the effect of vamana and virechana karma followed by brumhana snehapana (kantakari ghrita) in the management of tamaka shvasa w.s.r to Bronchial asthma. Department of Panchakarma, IPGT&RA Jamnagar
  3. Dobariya Nitinkumar Parsotambhai (2016): A study of Santarpaniya adhyaya of Charaka samhita in the context to principal of management for santarpan nimittaja vyadhi. Department of Basic Principles. IPGT&RA Jamnagar

More information

Langhanabrimhaniya Adhyaya

Ashtauninditiya Adhyaya

Abbreviations

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

List of References

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

References

  1. ↑ Brimhana [Internet] [Updated 2020 Oct 21; cited 2020 Nov 11]. Available from https://www.wisdomlib.org/definition/brimhana
  2. ↑ 2.0 2.1 2.2 2.3 2.4 Sushruta. Sushruta Samhita. Edited by Jadavaji Trikamji Aacharya. 8th ed. Varanasi: Chaukhambha Orientalia;2005.
  3. ↑ 3.0 3.1 3.2 3.3 3.4 3.5 3.6 3.7 3.8 Vagbhata. Ashtanga Hridayam. Edited by Harishastri Paradkar Vaidya. 1st ed. Varanasi: Krishnadas Academy;2000.
  4. ↑ 4.0 4.1 4.2 4.3 4.4 4.5 4.6 4.7 4.8 4.9 Vridha Vagbhata, Ashtanga Sangraha. Edited by Shivaprasad Sharma. 3rd ed. Varanasi: Chaukhamba sanskrit series office;2012.
  5. ↑ 5.0 5.1 Clark S, Mora García MB. A 100-Year Review: Advances in goat milk research. J Dairy Sci. 2017 Dec;100(12):10026-10044. doi: 10.3168/jds.2017-13287. PMID: 29153153.
  6. ↑ Turck D. Cow's milk and goat's milk. World Rev Nutr Diet. 2013;108:56-62. doi: 10.1159/000351485. Epub 2013 Sep 6. PMID: 24029787.
  7. ↑ Razafindrakoto O, Ravelomanana N, Rasolofo A, Rakotoarimanana RD, Gourgue P, Coquin P, Briend A, Desjeux JF. Goat's milk as a substitute for cow's milk in undernourished children: a randomized double-blind clinical trial. Pediatrics. 1994 Jul;94(1):65-9. PMID: 8008540.
  8. ↑ Maqsood S, Al-Dowaila A, Mudgil P, Kamal H, Jobe B, Hassan HM. Comparative characterization of protein and lipid fractions from camel and cow milk, their functionality, antioxidant and antihypertensive properties upon simulated gastro-intestinal digestion. Food Chem. 2019 May 1;279:328-338. doi: 10.1016/j.foodchem.2018.12.011. Epub 2018 Dec 13. PMID: 30611498.
  9. ↑ Xie X, Yang H, An JJ, Houtz J, Tan JW, Xu H, Liao GY, Xu ZX, Xu B. Activation of Anxiogenic Circuits Instigates Resistance to Diet-Induced Obesity via Increased Energy Expenditure. Cell Metab. 2019 Apr 2;29(4):917-931.e4. doi: 10.1016/j.cmet.2018.12.018. Epub 2019 Jan 17. PMID: 30661931; PMCID: PMC6507421.
  10. ↑ Ingle NM, Ojha NK, Kumar A. Clinical study to evaluate the Brinhaniya effect of Vidarikandadi Yog to enhance the sport performance in children. J Ayurveda Integr Med 2013;4:171-5.
  11. ↑ Srilakshmi D, Chaganti S. A holistic approach to the management of Erb's palsy. J Ayurveda Integr Med 2013;4:237-40.
  12. ↑ Dhoke SP, Dwivedi R, Vyas M. A placebo-controlled clinical evaluation of Kharjurapaka in Mamsakshaya. Ayu 2015;36:404-9.
  13. ↑ Jabraeile, M., Rasooly, A. S., Farshi, M. R., & Malakouti, J. (2016). Effect of olive oil massage on weight gain in preterm infants: A randomized controlled clinical trial. Nigerian medical journal: journal of the Nigeria Medical Association, 57(3), 160–163. https://doi.org/10.4103/0300-1652.184060.
  14. ↑ Asutkar, S., et al (2017). Role of Ashwagandha tail abhyanga in the management of Karshya. International Ayurvedic Medical Journal, 5(2), 375-381. Available from: http://www.iamj.in/posts/images/upload/375_381.pdf.
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