Changes

The first chapter , [[Kalpana Siddhi]] gives, in brief, the overall content of all the [[Panchakarma]] procedures. It highlights the ''samyak lakshanas'' (the indicators of the optimal activity) of each procedure. It sheds light over the apt spacing between procedures and its relevance. The chapter ends by mentioning the incompetency in treatment due to wrong posology and timing which are worth understanding. The author has laid down the importance of judicious selection of procedures to suitable patients by devoting the second section of [[Siddhi Sthana]]. Explanations for contraindications and indications of ''basti'' have been detailed. Contraindications are narrated first as this pattern reinforces the importance of avoiding wrong procedures to unsuitable patients. The reasons behind the contraindications are also explained in detail which gives further insight to the mode of action of each procedure in different clinical situations. Additional mention about certain specific categories of patients as universal contraindications to all procedures under the terms like ''chanda'' (ferocious), ''sahasika'' (rashful), ''kritaghna'' (ungrateful), ''dweshta'' (hated by others) etc. are incorporated. This reference points to the fact that the physician had discernment upon the society of the period. The last part of the chapter also specifically mentions the concept of withdrawal criteria in clinical practice where ''karya'' (objective) becomes ''akarya'' (paused).

The first chapter , [[Kalpana Siddhi]] gives, in brief, the overall content of all the [[Panchakarma]] procedures. It highlights the ''samyak lakshanas'' (the indicators of the optimal activity) of each procedure. It sheds light over the apt spacing between procedures and its relevance. The chapter ends by mentioning the incompetency in treatment due to wrong posology and timing which are worth understanding. The author has laid down the importance of judicious selection of procedures to suitable patients by devoting the second section of [[Siddhi Sthana]]. Explanations for contraindications and indications of ''basti'' have been detailed. Contraindications are narrated first as this pattern reinforces the importance of avoiding wrong procedures to unsuitable patients. The reasons behind the contraindications are also explained in detail which gives further insight to the mode of action of each procedure in different clinical situations. Additional mention about certain specific categories of patients as universal contraindications to all procedures under the terms like ''chanda'' (ferocious), ''sahasika'' (rashful), ''kritaghna'' (ungrateful), ''dweshta'' (hated by others) etc. are incorporated. This reference points to the fact that the physician had discernment upon the society of the period. The last part of the chapter also specifically mentions the concept of withdrawal criteria in clinical practice where ''karya'' (objective) becomes ''akarya'' (paused).

The subsequent chapters explain procedure of ''basti'' in [[Bastisutriyam Siddhi]], complications of unctuous enema in [[Snehavyapat Siddhi]], instrumental defects in [[Netrabastivyapat Siddhi]] followed by complications of emesis and purgation in [[Vamana Virechana Vyapat Siddhi]]. Here the author has defined the qualities of ''oushadha'' (drug) in general like lesser in quantity providing quick actions, easily assimilated, palatable etc.  These specifications mentioned here provide an edge over conventional definition of drug in contemporary medicine. In the forthcoming chapter the complications associated with procedure of decoction enema is detailed. The methodology of explaining the complications (''vyapat'') highlights the clinical precision with respect to etiology, manifestations and management of complications. In the next chapter named [[Prasrita Yogiyam Siddhi]], the author enlists a number of special ''basti'' formulations with specific actions like virility enhancers, complexion promoters, semenotropics etc. It is interesting to note that different types of diarrhea and their management strategies are also detailed in this chapter. It may be after considering the chance of manifestation of iatrogenic bowel disorders associated with improper administration of shodhana procedure. It can also be identified as an add-on note of omitted information.  

The subsequent chapters explain procedure of ''basti'' in [[Bastisutriyam Siddhi]], complications of unctuous enema in [[Snehavyapat Siddhi]], instrumental defects in [[Netrabastivyapat Siddhi]] followed by complications of emesis and purgation in [[Vamana Virechana Vyapat Siddhi]]. Here the author has defined the qualities of ''oushadha'' (drug) in general like lesser in quantity providing quick actions, easily assimilated, palatable etc.  These specifications mentioned here provide an edge over conventional definition of drug in contemporary medicine. In the forthcoming chapter the complications associated with procedure of decoction enema is detailed. The methodology of explaining the complications (''vyapat'') highlights the clinical precision with respect to etiology, manifestations and management of complications. In the next chapter named [[Prasrita Yogiyam Siddhi]], the author enlists a number of special ''basti'' formulations with specific actions like virility enhancers, complexion promoters, semenotropics etc. It is interesting to note that different types of diarrhea and their management strategies are also detailed in this chapter. It may be after considering the chance of manifestation of iatrogenic bowel disorders associated with improper administration of shodhana procedure. It can also be identified as an add-on note of omitted information.  

The chapter on [[Trimarmiya Siddhi]] highlights the clinicians concern over major vital organs. It is believed that ''marma'' is a topic dealt by surgeons. Contrary to that the three ''marmas'' namely ''basti'' (urinary bladder including kidneys), ''hridayam'' (heart including cardiovascular system)  and ''shiras'' (head including brain) are equally important to a clinician as well. These vital organs also could be afflicted due to endogenous causes like wrong administration of [[Panchakarma]] procedures. Furthermore, the medicated enema is considered as excellent for protection of ''marma''. In this chapter many clinical conditions like convulsive disorders and urinary disorders are highlighted. The procedure of ''uttarabasti'' is also detailed here. Certain major cephalic disorders like ''ardhavabhedaka'' (hemicranias/migraine), ''sooryavrta'' (frontal sinusitis) etc. of ''shalakya'' specialty are also included in this chapter and the details of ''nasya'' as a restorative measure is also conferred. It is highly relevant to note that the formulations of ''basti'' (''basti yoga'') have been mentioned in different contexts. ''Niruha yogas'' (decoction/purification enema formulations) are mentioned in [[Bastisutriyam Siddhi]], ''anuvasana yogas'' in [[Snehabasti Vyapat Siddhi]], quantified ''yogas'' in [[Prasrita Yogiyam Siddhi]], condition specific ''yogas'' in [[Basti Siddhi]] and ''yapana basti'' in [[Phalamatra Siddhi]]. These different, vivid and clinically vibrant formulations indicate the wide practice of ''basti'' methodically in numerous clinical conditions.

The chapter on [[Trimarmiya Siddhi]] highlights the clinicians concern over major vital organs. It is believed that ''marma'' is a topic dealt by surgeons. Contrary to that the three ''marmas'' namely ''basti'' (urinary bladder including kidneys), ''hridayam'' (heart including cardiovascular system)  and ''shiras'' (head including brain) are equally important to a clinician as well. These vital organs also could be afflicted due to endogenous causes like wrong administration of [[Panchakarma]] procedures. Furthermore, the medicated enema is considered as excellent for protection of ''marma''. In this chapter many clinical conditions like convulsive disorders and urinary disorders are highlighted. The procedure of ''uttarabasti'' is also detailed here. Certain major cephalic disorders like ''ardhavabhedaka'' (hemicranias/migraine), ''sooryavrta'' (frontal sinusitis) etc. of ''shalakya'' specialty are also included in this chapter and the details of ''nasya'' as a restorative measure is also conferred. It is highly relevant to note that the formulations of ''basti'' (''basti yoga'') have been mentioned in different contexts. ''Niruha yogas'' (decoction/purification enema formulations) are mentioned in [[Bastisutriyam Siddhi]], ''anuvasana yogas'' in [[Snehavyapat Siddhi]], quantified ''yogas'' in [[Prasrita Yogiyam Siddhi]], condition specific ''yogas'' in [[Basti Siddhi]] and ''yapana basti'' in [[Phalamatra Siddhi]]. These different, vivid and clinically vibrant formulations indicate the wide practice of ''basti'' methodically in numerous clinical conditions.

Tenth chapter of [[Siddhi Sthana]] enlist special enema recipes indicated as per ''dosha'' predominance as well as for specific clinical situations.  The eleventh chapter named [[Phalamatra Siddhi]] is very unique since it has detailed various fruits useful for enema and it has been presented as proceedings of a symposium participated by eminent physicians of that time. It is astonishing that discussions on enema therapy for animals are also detailed here. It also conveys the message that Ayurvedic physicians were capable enough for managing veterinary issues and successfully administered ''basti'' like procedures in animals. In the last chapter of [[Siddhi Sthana]] the author has highlighted certain excellent enema recipes which are superior in efficacy.  It reinforces the wide clinical applications of variety of ''bastis'' and their customer friendly applications. Eight factors are explained as impediments to be avoided during [[Panchakarma]] procedures. A list of ''yapana basti'' with tremendous clinical efficacy which can be administered even to the outpatient population is detailed in the chapter. The [[Siddhi Sthana]] ends with a note by the author about himself and the method of compilation he has done to fulfill the science in terms of ''uccha shilo cchaayam''(collected the subject matter from different sources like picking up the grains). These verses glorify the humility or modesty of the redactor. The list of ''tantrayukti'' described in the last portion explains the richness of literary perfection possessed by the contributor of the text.  

Tenth chapter of [[Siddhi Sthana]] enlist special enema recipes indicated as per ''dosha'' predominance as well as for specific clinical situations.  The eleventh chapter named [[Phalamatra Siddhi]] is very unique since it has detailed various fruits useful for enema and it has been presented as proceedings of a symposium participated by eminent physicians of that time. It is astonishing that discussions on enema therapy for animals are also detailed here. It also conveys the message that Ayurvedic physicians were capable enough for managing veterinary issues and successfully administered ''basti'' like procedures in animals. In the last chapter of [[Siddhi Sthana]] the author has highlighted certain excellent enema recipes which are superior in efficacy.  It reinforces the wide clinical applications of variety of ''bastis'' and their customer friendly applications. Eight factors are explained as impediments to be avoided during [[Panchakarma]] procedures. A list of ''yapana basti'' with tremendous clinical efficacy which can be administered even to the outpatient population is detailed in the chapter. The [[Siddhi Sthana]] ends with a note by the author about himself and the method of compilation he has done to fulfill the science in terms of ''uccha shilo cchaayam''(collected the subject matter from different sources like picking up the grains). These verses glorify the humility or modesty of the redactor. The list of ''tantrayukti'' described in the last portion explains the richness of literary perfection possessed by the contributor of the text.  

From a bird eye view on [[Siddhi Sthana]] it can be stated that this portion of [[Charaka Samhita]] has given much importance to successful clinical practice of [[Panchakarma]] with minute details of pro and adverse effects of the same. Further it can be seen that [[Siddhi Sthana]] is serving as an add-on note to many overlapped facts not mentioned at other places in [[Charaka Samhita]]. [[Siddhi Sthana]], by explaining the procedures in the most scientific way, dealing with every aspect at the level of SOP (Standard operative procedures), drugs to be used, psychological status as well as  physiological and pathological markers in the patient, serves as a part that makes [[Charaka Samhita]] complete.

From a bird eye view on [[Siddhi Sthana]] it can be stated that this portion of [[Charaka Samhita]] has given much importance to successful clinical practice of [[Panchakarma]] with minute details of pro and adverse effects of the same. Further it can be seen that [[Siddhi Sthana]] is serving as an add-on note to many overlapped facts not mentioned at other places in [[Charaka Samhita]]. [[Siddhi Sthana]], by explaining the procedures in the most scientific way, dealing with every aspect at the level of SOP (Standard operative procedures), drugs to be used, psychological status as well as  physiological and pathological markers in the patient, serves as a part that makes [[Charaka Samhita]] complete.