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Abstract-

Abstract-

The fifteenth chapter, Upakalpaniya adhyaya continues the discussion on detoxication procedures (samshodhana karmas) from the preceding sections, but also focuses on the pre-requisites for construction of a well-equipped hospital facility suitable for administration of panchakarma therapies. Pre-procedure, main procedure and post-procedure guidelines have been described in detail in this chapter, along with descriptions of dosages of drugs for vamana and virechana therapies as well as signs and symptoms of inadequate, proper and excess purification. Dosha afflictions, complications, dietetic regimen during the therapy and after the therapy (samsarjana karma) have also been clearly elaborated.  

The fifteenth chapter, Upakalpaniya adhyaya continues the discussion on detoxication procedures (samshodhana karmas) from the preceding sections, but also focuses on the pre-requisites for construction of a well-equipped hospital facility suitable for administration of [[Panchakarma]] therapies. Pre-procedure, main procedure and post-procedure guidelines have been described in detail in this chapter, along with descriptions of dosages of drugs for vamana and virechana therapies as well as signs and symptoms of inadequate, proper and excess purification. Dosha afflictions, complications, dietetic regimen during the therapy and after the therapy (samsarjana karma) have also been clearly elaborated.  

Keywords: Pre-requisites for panchakarma hospital, vamana, virechana, therapeutic emesis, therapeutic purgation.

Keywords: Pre-requisites for [[Panchakarma]] hospital, vamana, virechana, therapeutic emesis, therapeutic purgation.

Introduction:

Introduction:

Upakalpaniya adhyaya is a part of the Kalpana chatushka tetrad and follows the chapters on pre-purification (snehana (oleation) and swedana (sudation)) procedures. The sequence of chapters suggests that after completing the pre-purification procedures, the vitiated doshas come into koshtha [gut] and should be expelled out by suitable procedures like therapeutic emesis or therapeutic purgation. Guidelines for managing the purification therapies as well as for setting up a good panchakarma hospital with all infrastructure and equipment required for patient care have been described in this chapter. The rationale for providing guidelines for setting up a hospital is that, should complications arise, prompt medical care could be provided to the patient. Special emphasis has been given to the need for planning of relevant equipment and medicines required for panchakarma and any medical care it may necessitate. It is incredible to think that 3000 years back when there were hardly any in-door hospital facilities available in other parts of the world, there were thinkers and practitioners who could conceive of such a hospital management system as described in this text.  

Upakalpaniya adhyaya is a part of the Kalpana chatushka tetrad and follows the chapters on pre-purification (snehana (oleation) and swedana (sudation)) procedures. The sequence of chapters suggests that after completing the pre-purification procedures, the vitiated doshas come into koshtha [gut] and should be expelled out by suitable procedures like therapeutic emesis or therapeutic purgation. Guidelines for managing the purification therapies as well as for setting up a good [[Panchakarma]] hospital with all infrastructure and equipment required for patient care have been described in this chapter. The rationale for providing guidelines for setting up a hospital is that, should complications arise, prompt medical care could be provided to the patient. Special emphasis has been given to the need for planning of relevant equipment and medicines required for [[Panchakarma]] and any medical care it may necessitate. It is incredible to think that 3000 years back when there were hardly any in-door hospital facilities available in other parts of the world, there were thinkers and practitioners who could conceive of such a hospital management system as described in this text.  

It is important to assess the dosha, potency of drugs, location, time, strength, body constitution, diet, mental status, and the age of a patient before initiating any purification procedure. The preparation of the patient, clinical observations during purification therapy and post-procedure management (with appropriate dietary regimen) are three important steps for successful completion of any purification therapy. Therapies, if administered properly, can cure diseases or reduce their recurrence, but if not done well, can cause complications and therefore require a sound understanding of the guidelines (or protocols) for panchakarma.  

It is important to assess the dosha, potency of drugs, location, time, strength, body constitution, diet, mental status, and the age of a patient before initiating any purification procedure. The preparation of the patient, clinical observations during purification therapy and post-procedure management (with appropriate dietary regimen) are three important steps for successful completion of any purification therapy. Therapies, if administered properly, can cure diseases or reduce their recurrence, but if not done well, can cause complications and therefore require a sound understanding of the guidelines (or protocols) for [[Panchakarma]].  

The chapter:

The chapter:

१५. उपकल्पनीयोऽध्यायः

१५. उपकल्पनीयोऽध्यायः

ityagniveshakRute tantre carakapratisaMskRute shlokasthAne upakalpanIyo nAmapa~jcadasho~adhyAyaH||15||  

ityagniveshakRute tantre carakapratisaMskRute shlokasthAne upakalpanIyo nAmapa~jcadasho~adhyAyaH||15||  

Thus ends the fifteenth chapter on “Prerequisites for therapeutic (panchakarma) treatment” of Sutra sthana , of Agnivesa’s work as redacted by Caraka.

Thus ends the fifteenth chapter on “Prerequisites for therapeutic ([[Panchakarma]]) treatment” of Sutra sthana , of Agnivesa’s work as redacted by Caraka.

Tattva vimarsha:

Tattva vimarsha:

• It is necessary to manage the panchakarma hospital properly, equipping it with good quality medicines and skilled staff for assuring successful administration of purification therapies.

• It is necessary to manage the [[Panchakarma]] hospital properly, equipping it with good quality medicines and skilled staff for assuring successful administration of purification therapies.

• All possibilities of complications and their management should be considered before initiating any treatment.  

• All possibilities of complications and their management should be considered before initiating any treatment.  

• Clinical observation of patients at each stage during purification theapy is necessary to assess movement of dosha.  

• Clinical observation of patients at each stage during purification theapy is necessary to assess movement of dosha.  

Snehapana- Unctuous agents or fats that make dosha slimy, moist, slippery and work as solvents:

Snehapana- Unctuous agents or fats that make dosha slimy, moist, slippery and work as solvents:

• Use of fats as a solvent

• Use of fats as a solvent

There are two types of solvent in biochemistry - polar and non-polar. Among polar solvents, water is the best while among non-polar solvents, ketones (intermediate metabolic products of fats) are the best solvents. These solvents, during their course of internal administration, may react with cellular and metabolic debris and convert them into a soluble form that could be easily excreted out through urine, faeces or sweat by means of panchakarma procedures.

There are two types of solvent in biochemistry - polar and non-polar. Among polar solvents, water is the best while among non-polar solvents, ketones (intermediate metabolic products of fats) are the best solvents. These solvents, during their course of internal administration, may react with cellular and metabolic debris and convert them into a soluble form that could be easily excreted out through urine, faeces or sweat by means of [[Panchakarma]] procedures.

• Use of fats as a high energy substance-

• Use of fats as a high energy substance-

Oils and fats yield 9 KCal energy in contrast to 4.5 Kcal from carbohydrates and proteins, which could be expended as a substitute or replacement source of energy during purification procedure.

Oils and fats yield 9 KCal energy in contrast to 4.5 Kcal from carbohydrates and proteins, which could be expended as a substitute or replacement source of energy during purification procedure.