Charak Samhita

Talk:Langhana

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The word ‘langhana’ represents the act of leaping or jumping, stepping across, leaping over, mounting etc. It also represents fasting, hunger or starving system.[1] This is one among the six basic treatment principles in Ayurveda. [Cha.Sa.Sutra Sthana 22/4] Lightening therapy (langhana) can be achieved even without using any medications. [Cakrapani on Cha.Sa.Sutra Sthana 22/12-13]

Etymology and derivation

Langhana is derived from the root word ‘langha’ by adding ‘lyut’ suffix to it. It means fasting (upavasa) [Sabdakalpadruma]

Definition

The procedures which produce lightness or reduction in the body are called ‘langhana’. [Cha.Sa.Sutra Sthana 22/10]

Synonyms

Apatarpana [A.Hr. Sutra Sthana 14/2][2]

Meaning of word ‘langhana’ in different contexts

  • Reducing or lightening therapies as a whole are termed as ‘langhana’. Most commonly ‘langhana’ represents ‘fasting’ which is one among the reducing therapy.

Properties of lightening (langhana) drugs

The lightening material possess the following properties

  • Light (laghu)
  • Hot (ushna)
  • Sharp / intense (tikshna)
  • Clearing (visada)
  • Dry (ruksha)
  • Subtle (sukshma)
  • Rough (khara)
  • Unstable / flowing (sara)
  • Hard (katina) [Cha.Sa.Sutra Sthana 22/12-13]

The predominant property is lightness (laghu). [Cakrapani on Cha.Sa.Sutra Sthana 22/12-13]

Panchamahabhuta composition of lightening (langhana) drug

Drugs with agni, vayu and akasha mahabhuta predominance are usually lightening (langhana) in nature. [A.S Sutra Sthana 24/3][3]

Classification

Methods to achieve lightening (langhana) can be broadly classified into

  • Purifying (shodhana) procedures
  • Pacifying (shamana) procedures [A.Hr. Sutra Sthana 14/4][2]

Purifying (shodhana) procedures

This includes the following procedures

  1. Enema with decoction (niruha basti)
  2. Therapeutic emesis (vamana)
  3. Therapeutic purgation (kayavireka)
  4. Intra nasal drug administration (shirovireka)
  5. Bloodletting (asravisruti) [A.Hr. Sutra Sthana 14/5][2]

Pacifying (shamana) procedures

This includes the following procedures

  1. Carminatives (pachana)
  2. Appetizers (dipana)
  3. Withstanding hunger (kshut)
  4. Withstanding thirst (trit)
  5. Exercises/physical activities (vyayama)
  6. Exposure to sunlight (atapa)
  7. Exposure to wind (maruta) [A.Hr. Sutra Sthana 14/6-7][2]

Charaka considers 10 lightening (langhana) therapies by excluding bloodletting (asravisruti) and appetizers (dipana) from the above. [Cha.Sa.Sutra Sthana 22/18]

Indications

Lightening therapy (langhana) is indicated in persons who used to consume excess unctuous food, with excess body discharges and for those who had undergone nourishing therapies. [Cha.Sa.Sutra Sthana 22/24]

Mild lightening therapy (langhana) is indicated for those who desire to undergo nourishing therapy (brimhana) [A.Hr. Sutra Sthana 14/15]


In the accumulation of undigested/toxic biological waste (ama), fasting (langhana) and use of digestive recipes are ideal [Su.Sa.Uttara Sthana 40/34][4] If ama gets absorbed along with nutritive fluid (rasa dhatu) and if it pervades throughout the body then also fasting (langhana) should be advised. [Cha.Sa.Chikitsa Sthana 15/75]

After purificatory procedures like therapeutic emesis (vamana) and therapeutic purgation (virechana) since the digestive power will be less, the person should undergo fasting (langhana).

Persons suffering from fever, stiffness of thighs, herpes, abscess, splenic diseases, diseases of head, throat and eyes, and those who are obese are indicated for lightening therapy (langhana). [A.S.Sutra Sthana 24/10][3] Skin disorders (kushta) and urinary disorders (prameha) should be treated with lightening therapy (langhana). [Cha.Sa.Sutra Sthana 22/24]

Indications of individual lightening therapies (langhana)

Purifying procedures:

  • In conditions of excessive increase of kapha, pitta, blood and waste products (mala).
  • Obstruction of vata.
  • Those who have good physical strength and bulky stature. [Cha.Sa.Sutra Sthana 22/19]
  • Fever, vomiting, diarrhea, cardiac complaints, constipation, heaviness, belching, nausea etc. [A.Hr. Sutra Sthana 14/12][2]

Digestive measures (pachana):

  • Diseases with moderate strength
  • Diseases having kapha and pitta predominance
  • Vomiting, diarrhea, heart disease, acute intestinal irritation, intestinal sluggishness, fever, constipation, heaviness of body, eructation, nausea and anorexia [Cha.Sa.Sutra Sthana 22/20-21]

Restraint from food (upavasa) and drink (pipasa):

Physical exercise (vyayama), exposure to sunlight (aatapa) and exposure to wind (maruta):

  • Mild to moderate intensity diseases for patients with good physical strength [Cha.Sa.Sutra Sthana 22/23]

Contraindications

  • Vata predominant conditions
  • Conditions of fear, anger, grief and physical exertion [Cha.Sa.Chikitsa Sthana 3/139]
  • Fever with pitta predominance [A.S.Chikitsa Sthana 1/13][3]
  • Fever caused by external agents (agantuja jwara) and in fevers of long duration (jeerna jwara) [A.S.Chikitsa Sthana 1/17][3]

Features of optimal langhana

  • Proper evacuation of flatus, urine and feces
  • Feeling of lightness in the body
  • Feeling of clarity in heart, eructation, throat and mouth
  • Disappearance of drowsiness and exhaustion
  • Appearance of perspiration
  • Reappearance of taste, hunger and thirst
  • Feeling of wellbeing [Cha.Sa.Sutra Sthana 22/34-35]
  • Unable to tolerate hunger and thirst [Su.Sa. Uttara Sthana 39/105][4]
  • Clarity of sense organs [A.Hr. Sutra Sthana 14/17][2]

Features of excessive administration of langhana

  • Pain in the joints
  • Body ache
  • Cough
  • Dryness of the mouth
  • Complete loss of hunger
  • Anorexia
  • Thirst
  • Weakness of hearing and vision
  • Confusion of mind
  • Frequent eructation
  • Fainting
  • Frequent upward movement of vata
  • Loss of body weight, digestive power and strength [Cha.Sa.Sutra Sthana 22/36-37]
  • Profound emaciation
  • Loss of sleep
  • Delirium
  • Non elimination of faeces and urine [A.Hr. Sutra Sthana 14/29-30][2]
  • Occurrence of secondary disease like dyspnoea [Su.Sa.Uttara Sthana. 39/106][4]

Fasting (langhana) may also lead to the formation of certain diseases/conditions like:

Emaciation of body [Cha.Sa.Sutra Sthana 21/11], wasting disorders due to over exertion (sahasaja rajayakshama) [Cha.Sa.Chikitsa Sthana 8/14], hemorrhoid [Cha.Sa.Chikitsa Sthana 14/13], excessive thirst (trishna) [Cha.Sa.Chikitsa Sthana 22/4], diseases of thigh (urustamba) [Cha.Sa.Chikitsa Sthana 27/9] etc. So lightening therapies (langhana) should be performed to the extent that it does not hamper the vitality or strength of the individual. [Cha.Sa.Chikitsa Sthana 3/141]

Benefits of lightening therapy (langhana)

When the doshas become mitigated by fasting, digestive fire (agni) becomes intense and body feels light, then develop health, hunger, thirst, desire for food, digestion, strength and vigour. [A.S.Chikitsa Sthana 1/3][3]

Importance in diagnosis

Craving for fasting (langhana) is seen in conditions were vata gets occluded by kapha. [Cha.Sa.Chikitsa Sthana 28/63]

Importance in preservation of health and prevention

For healthy persons lightening therapy (langhana) can be done on winter season (shishira and hemanta) [Cha.Sa.Sutra Sthana 22/24][A.Hr. Sutra Sthana 14/11][2] as the body strength will be high during this period. In case of accumulation of toxic biological waste (ama) and in obese persons, lightening therapy (langhana) should be done daily. [A.Hr. Sutra Sthana 14/10-11] [2]

Importance in management of disease

Fasting (langhana) is one among the three depletion therapies. It is indicated if the doshas are in less strength. Fasting stimulates digestive fire (agni) and vata, which results in the reduction of dosha [Cha.Sa.Vimana Sthana 3/44]

Lightening therapies (langhana) especially fasting is the first-line therapy in many disorders.

It is advocated in the initial stage of

  • Fever [Cha.Sa.Chikitsa Sthana 3/139]
  • Bleeding disorders (raktapitta) especially through the upper orifices (eyes, mouth and nose) as it is associated with pitta along with toxic biological waste (sama pitta) and kapha dosha [Cha.Sa.Chikitsa Sthana 4/30]
  • Abdominal tumors (gulma) caused due to kapha dosha [Cha.Sa.Chikitsa Sthana 5/49]
  • Swelling associated with toxic biological waste (ama) [Cha.Sa.Chikitsa Sthana 12/17]
  • Non infectious gastroenteritis (visuchika) [Cha.Sa.[Vimana Sthana]] 2/13]
  • Vomiting (cchardi) as it is considered to be originating from the agitations of the doshas in the stomach (amashaya) [Cha.Sa.Chikitsa Sthana 20/20]

All diseases which originate from the stomach (amasaya) can be treated through fasting (langhana). [Cha.Sa.Nidana Sthana 8/31] For all disorders of nutritive fluid (rasa)[Cha.Sa.Sutra Sthana 28/25] and for the conditions specially affecting mouth, the line of treatment is fasting (langhana) [Cha.Sa.Chikitsa Sthana 12/80]

Fever can be treated with fasting (langhana) alone [Cha.Sa.Nidana Sthana 8/31] if associated with toxic biological waste accumulation(ama) or during the predominance of kapha or kapha and pitta dosha. [Cha.Sa.Chikitsa Sthana 3/284] The kapha predominant stage of chronic intermittent fever can also be managed through reducing (langhana) therapies. [Cha.Sa.Chikitsa Sthana 3/295] Fever patients who are unsuitable for oleation and purificatory therapies should be treated by lightening therapies (langhana). [Su.Sa.Uttara Sthana 39/99][4]

Bleeding hemorrhoids with kapha and pitta aggravation [Cha.Sa.Chikitsa Sthana 14/176], Diabetic mellitus (prameha) caused by kapha [Cha.Sa.Chikitsa Sthana 6/25], ulcers with kapha predominance [Cha.Sa.Chikitsa Sthana 25/16], rhinitis of kapha origin (kaphaja pinasa) associated with heaviness and anorexia [Cha.Sa.Chikitsa Sthana 26/149] should be treated through lightening therapies (langhana).

Cardiac disorders [Cha.Sa.Chikitsa Sthana 26/100] and diseases caused by the suppression of urge of vomiting is to be treated through fasting (langhana). [Cha.Sa.Sutra Sthana 7/15] Slightly aggravated dosha should be managed by fasting therapy (langhana) in case of diarrhea. [Cha.Sa.Chikitsa Sthana 19/19]

In the prodormal stage of all varieties of erysepalas (visarpa), fasting and other lightening therapies (langhana) should be done. [A.S.Chikitsa Sthana 20/2][3] If erysepalas (visarpa) is caused with dosha in the state of incomplete transformation (ama) and is located in thorax and upper body parts (kaphasthana), fasting therapy (langhana) is beneficial. [Cha.Sa.Chikitsa Sthana 21/44] Fissure in ano if associated with ama [Cha.Sa.Siddhi Sthana 6/63], for indigestion caused due to ama (amajeerna) [Su.Sa.Sutra Sthana. 46/505][4], bloating in upper abdomen (anaha) caused by improper digestion, associated with stiffness in cardiac region; diseases of head and heaviness, retention of belching, common cold should be treated with fasting therapy (langhana) [Cha.Sa.Chikitsa Sthana 26/26]

The diseases pacified through lightening therapies (langhana) may re-occur as the causative dosha may not be completely eliminated out from body. [Cha.Sa.Sutra Sthana 16/20]

Physiology of fasting

During the third phase of fasting, glycogen stored in hepatocytes undergo depletion. It also accelerates adipose tissue lipolysis. Thus more fatty acids and glycerol is formed which gets released into blood. At the same time, the other cells may produce ketones. The fatty acids get transported into hepatocytes, get metabolized and produce ketones beta-OHB and acetoacetate. This induces mitochondrial biogenesis.

The ketones thus produced are transported into cells with high metabolic activity such as neurons, muscles etc., become acetyl coenzyme A. It enters the tricarboxylic acid (TCA) cycle where ATP is generated. Thus during fasting, primary energy source of the body shifts from glucose to fatty acids and ketones.[5]

Current researches

In a study conducted on 59 patients having poor digestive power, it is reported that the lightening therapies, fasting and digestive medicine, Zingiber officinale (sunti), improves appetite, food intake and enthusiasm. It makes the body feels lighter and also aids in unobstructed expulsion of urine and feaces. The digestive fire acts directly over the dosha in the absence of food. The body regains its normalcy once the vitiated dosha undergo digestion (paka).[6]

Fasting therapy results in significant reduction in weight and BMI. In a study conducted on 44 healthy individuals, short term fasting therapy is compared with low calorie diet. Greater reduction in weight and Leptin levels were achieved through fasting than low calorie diet. Increased beta-oxidation is observed during fasting.[7]

Average life span is increased by 30% when the rats were maintained on alternate day fasting. Plasma glucose, insulin and leptin levels were low for the rats maintained on fasting. Ketone and adiponectin levels were more. Inflammatory markers were found to be reduced in liver of rats kept on time restricted feeding. The normal decline in muscle mass during ageing is found to be prevented by caloric restriction in mice. Fasting stimulates autophagy in muscles. Cardiovascular stress adaptations were noted in rats kept on alternate day fasting. It also increases brain derived neurotrophic factor, which plays a major role in synaptic plasticity and neurogenesis. [5]

Fasting is beneficial in metabolic syndrome by decreasing fasting glucose, fasting insulin and insulin resistance. It also reduce the cardiovascular risk factors like total cholesterol, LDL, triglycerides etc. In diabetic patients improved insulin sensitivity and glucose tolerance was reported immediately after a fast. [5]

List of theses done

  1. Dharmi P Bhuva (2013): Fundamental and applied aspect of karma as karana in Ayurveda w.s.r to langhana karma. Department of basic principles. IPGT&RA Jamnagar

More information

Langhanabrimhaniya Adhyaya

Janapadodhvansaniya Vimana

Jwara Chikitsa

References

  1. ↑ Monier-Williams, Monier-Williams Sanskrit- English Dictionary, 1st edition; Oxford University Press, Langhana, Page 895
  2. ↑ 2.0 2.1 2.2 2.3 2.4 2.5 2.6 2.7 2.8 Vagbhata. Ashtanga Hridayam. Edited by Harishastri Paradkar Vaidya. 1st ed. Varanasi: Krishnadas Academy;2000.
  3. ↑ 3.0 3.1 3.2 3.3 3.4 3.5 Vridha Vagbhata, Ashtanga Sangraha. Edited by Shivaprasad Sharma. 3rd ed. Varanasi: Chaukhamba sanskrit series office;2012.
  4. ↑ 4.0 4.1 4.2 4.3 4.4 Sushruta. Sushruta Samhita. Edited by Jadavaji Trikamji Aacharya. 8th ed. Varanasi: Chaukhambha Orientalia;2005.
  5. ↑ 5.0 5.1 5.2 Anton SD, Moehl K, Donahoo WT, Marosi K, Lee SA, Mainous AG 3rd, Leeuwenburgh C, Mattson MP. Flipping the Metabolic Switch: Understanding and Applying the Health Benefits of Fasting. Obesity (Silver Spring). 2018
  6. ↑ Rajani A, Vyas MK, Vyas HA. Comparative study of Upavasa and Upavasa with Pachana in the management of Agnisada. Ayu. 2010 Jul;31(3):351-4. doi: 10.4103/0974-8520.77166. PMID: 22131738; PMCID: PMC3221070.
  7. ↑ Shetty P, Dinesh S, Halappa NG, Rajany T. Comparing the effects of short-term fasting therapy and low-calorie diet on anthropometric and leptin measures among obese or overweight persons: Randomized controlled trial. Ancient Sci Life 2018;37:133-40.
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