Swedadhyaya

Swedadhyaya

Section/Chapter	Sutra Sthana Chapter 14
Tetrad/Sub-section	Kalpana Chatushka
Preceding Chapter	Snehadhyaya
Succeeding Chapter	Upakalpaniya
Other Sections	Nidana Sthana, Vimana Sthana, Sharira Sthana, Indriya Sthana, Chikitsa Sthana, Kalpa Sthana, Siddhi Sthana

(Sutra Sthana Chapter 14, Chapter on Sudation Therapies)

Abstract

Swedana (sudation) is a process in which the individual is subjected to therapeutic sweating. It is considered an essential prerequisite to Panchakarma (purification therapy involving five procedures) in Ayurveda and is secondary to snehana (oleation) in importance. When done without snehana, it is called ruksha sweda (dry fomentation). Swedana is intended to remove excessive vata and kapha dosha and is contraindicated in pitta disorders. The extent and severity of swedana depends upon various factors such as physical strength, amount of dosha, season, site, age etc. There are specific indications and contraindications for swedana karma and the optimal signs should be strictly followed for the procedure. There are many agents to induce sweating which can be broadly divided into sagni sweda (sweating induced with the help of fire) and niragni sweda (induced without using fire). Bolus fomentation, steam fomentation, tub fomentation and poultice fomentation are some of the very common types of swedana procedures. There are thirteen varieties of fomentations (prevalent in the olden days) that involve direct usage of heat derived from fire, and ten methods without fire. Swedana is an effective therapeutic method in Ayurveda and is the focus of study in this chapter.

Keywords: Avagaha sweda, fomentation, jentaka sweda, nadisweda, niragnisweda, ushmasweda, pottalisweda, ruksha sweda, sagnisweda, sankarasweda, samyakswinna lakshana, snigdha sweda, sudation swedana, swedatiyoga, swedayoga trayodasha sweda, upanaha sweda, fomentation, heat, sudation therapy.

Introduction

As per Ayurveda, the functioning of universe depends upon agni and soma which symbolize sources of hot and cold energy. Uttarayana (northward sojourn of sun) and dakshinayana (southward sojourn of sun) are together responsible for maintaining homeostasis on this planet. This homeostasis is also mirrored in the individual through the concept of loka purusha samanya siddhantha (that the individual is a microcosm of the universe, the macrocosm). The purusha (individual human being) imbibes this energy and confines it in the sharira (body) as pitta. This pitta controls, or rather regulates, the ushmanattva (core body temperature) of the body (Charaka Samhita Sutra Sthana 12/11). It is responsible for all the metabolic processes at the cellular level and digestion at the level of the gut. Pitta is the contributor of ushna guna (warmth) to the body. The stimulator (preraka) of pitta is vata (the accelator-sameerano agnehe (Charaka Samhita Sutra Sthana 12). Vata, in association with pitta and kapha, maintains the normal core body temperature by controlling the heat regulating system and balancing the sheeta and ushna guna.

Swedana uses the agni principle in therapy. Practical applications of swedana procedures, along with indications, contraindications and complications associated with their management have been described in this chapter. It is recommended after proper snehana and is enlisted as one among six important therapies along with langhana (fasting or reducing therapy), brimhana (nourishing therapy), snehana (oleation), stambhana (styptic therapy) and rukshana (drying therapy).Swedana has to be adopted based on the symptoms and conditions considering the samanya visesha sidhantha (theory of similarity and dissimilarity). Swedana procedures are indicated in vata, kapha and vata-kapha dosha dominant disorders, but are contraindicated in pittaja disorders. There are three types of twin procedures (with opposing actions to each other) used for various conditions:

1. Thirteen types of procedures of sagni sweda (induced with help of fire) and ten types of niragni/anagniswedana (induced without help of fire) described for various sudation procedures.
2. Ekangtah-sarvangtah (localized-generalized). An ekangtah, or localized swedana, is administered by means of sankara sweda (bolus fomentation) and naadisweda (using a tube for fomentation) etc. and sarvantah or generalized swedana is administered by means of prastar (lying down on medicated hot mattress) and jentaaka, (sudation in a heated room) etc.

Snigdha (unctuous) procedures for vata dominant disorders and ruksha (dry) procedures for kapha dominant disorders are advised. In vata-kapha dominant disorders, snigdha-ruksha procedures are recommended.

Sanskrit text, Transliteration and English Translation

अथातः स्वेदाध्यायं व्याख्यास्यामः||१||

इति ह स्माह भगवानात्रेयः||२||

athātaḥ svēdādhyāyaṁ vyākhyāsyāmaḥ||1||

iti ha smāha bhagavānātrēyaḥ||2||

athAtaH svedAdhyAyaM vyAkhyAsyAmaH||1||

iti ha smAha bhagavAnAtreyaH||2||

Let us now elaborate the chapter on sudation, thus said the master Atreya. [1-2]

Importance of swedana

अतः स्वेदाः प्रवक्ष्यन्ते यैर्यथावत्प्रयोजितैः| स्वेदसाध्याः प्रशाम्यन्ति गदा वातकफात्मकाः||३||

स्नेहपूर्वं प्रयुक्तेन स्वेदेनावजितेऽनिले| पुरीषमूत्ररेतांसि न सज्जन्ति कथञ्चन||४||

शुष्काण्यपि हि काष्ठानि स्नेहस्वेदोपपादनैः| नमयन्ति यथान्यायं किं पुनर्जीवतो नरान्||५||

ataḥ svēdāḥ pravakṣyantē yairyathāvatprayōjitaiḥ| svēdasādhyāḥ praśāmyanti gadā vātakaphātmakāḥ||3||

snēhapūrvaṁ prayuktēna svēdēnāvajitē'nilē| purīṣamūtrarētāṁsi na sajjanti kathañcana||4||

śuṣkāṇyapi hi kāṣṭhāni snēhasvēdōpapādanaiḥ| namayanti yathānyāyaṁ kiṁ punarjīvatō narān||5||

ataH svedAH pravakShyante yairyathAvatprayojitaiH| svedasAdhyAH prashAmyanti gadA vAtakaphAtmakAH||3||

snehapUrvaM prayuktena svedenAvajite~anile| purIShamUtraretAMsi na sajjanti katha~jcana||4||

shuShkANyapi hi kAShThAni snehasvedopapAdanaiH| namayanti yathAnyAyaM kiM punarjIvato narAn||5||

Now the various techniques of sudation will be explained. A well administered sudation cures various disorders of vata and kapha origin, provided they have been identified among a set of diseases that are curable by inducing sweat. Administering sudation, especially after oleation, controls vata and prevents clogging of feces, urine as well as semen. If oleation and sudation could soften dried out timber, then why not a human being? [3-5]

Scope of Swedana

रोगर्तुव्याधितापेक्षो नात्युष्णोऽतिमृदुर्न च| द्रव्यवान् कल्पितो देशे स्वेदः कार्यकरो मतः||६||

rōgartuvyādhitāpēkṣō nātyuṣṇō'timr̥durna ca| dravyavān kalpitō dēśē svēdaḥ kāryakarō mataḥ||6||

rogartuvyAdhitApekSho nAtyuShNo~atimRudurna ca| dravyavAn kalpito deshe svedaH kAryakaro mataH||6||

Sudation that is neither too hot (and unbearable) nor too mild (and insufficient), administered with suitable drugs and applied as per the disease condition, season and the diseased person in specific, at the affected and the indicated body part, is indeed effective. [6]

व्याधौ शीते शरीरे च महान् स्वेदो महाबले| दुर्बले दुर्बलः स्वेदो मध्यमे मध्यमो हितः||७||

वातश्लेष्मणि वाते वा कफे वा स्वेद इष्यते| स्निग्धरूक्षस्तथा स्निग्धो रूक्षश्चाप्युपकल्पितः||८||

vyādhau śītē śarīrē ca mahān svēdō mahābalē| durbalē durbalaḥ svēdō madhyamē madhyamō hitaḥ||7||

vātaślēṣmaṇi vātē vā kaphē vā svēda iṣyatē| snigdharūkṣastathā snigdhō rūkṣaścāpyupakalpitaḥ||8||

vyAdhau shIte sharIre ca mahAn svedo mahAbale| durbale durbalaH svedo madhyame madhyamo hitaH||7||

vAtashleShmaNi vAte vA kaphe vA sveda iShyate| snigdharUkShastathA snigdho rUkShashcApyupakalpitaH||8||

Strong fomentation is indicated in a physically strong patient with severe illness in an extreme cold climate. In a weak person, mild fomentation and in a moderately strong patient, moderate fomentation is preferred. In vatakapha, vata or kapha-dominant, sudation technique is to be applied with the help of unctuous and dry agents, only unctuous agents or only dry agents respectively. [7-8]

Mode of swedana as per site of dosha

आमाशयगते वाते कफे पक्वाशयाश्रिते| रूक्षपूर्वो हितः स्वेदः स्नेहपूर्वस्तथैव च||९||

āmāśayagatē vātē kaphē pakvāśayāśritē| rūkṣapūrvō hitaḥ svēdaḥ snēhapūrvastathaiva ca||9||

AmAshayagate vAte kaphe pakvAshayAshrite| rUkShapUrvo hitaH svedaH snehapUrvastathaiva ca||9||

When vata is located at the site of ama (amashaya or stomach), sudation is administered with dry agents and when kapha is located in the site of pakva (pakwashaya,or colon) , sudation is initiated with unctuous agents. [9]

Sensitive areas for swedana

वृषणौ हृदयं दृष्टी स्वेदयेन्मृदु नैव वा| मध्यमं वङ्क्षणौ शेषमङ्गावयवमिष्टतः||१०||

vr̥ṣaṇau hr̥dayaṁ dr̥ṣṭī svēdayēnmr̥du naiva vā| madhyamaṁ vaṅkṣaṇau śēṣamaṅgāvayavamiṣṭataḥ||10||

vRuShaNau hRudayaM dRuShTI svedayenmRudu naiva vA| madhyamaM va~gkShaNau sheShama~ggAvayavamiShTataH||10||

In the sensitive areas of testicles, precordium and eyes, sudation is not done or done very gently. Moderate sudation may be applied in the area of groins. In other parts of the body, sudation is done as desired. [10]

Pre-sudation care

सुशुद्धैर्नक्तकैः पिण्ड्या गोधूमानामथापि वा| पद्मोत्पलपलाशैर्वा स्वेद्यः संवृत्य चक्षुषी||११||

Suśuddhairnaktakaiḥ piṇḍyā gōdhūmānāmathāpi vā| padmōtpalapalāśairvā svēdyaḥ saṁvr̥tya cakṣuṣī||11||

sushuddhairnaktakaiH piNDyA godhUmAnAmathApi vA| padmotpalapalAshairvA svedyaH saMvRutya cakShuShI||11||

Before starting sudation, eyes should be closed and covered with very clean cloth or bolus of wet wheat powder or petals of lotus (Nelumbo nucifera) or white lotus (Nymphaea alba). [11]

Care during sudation therapy

मुक्तावलीभिः शीताभिः शीतलैर्भाजनैरपि| जलार्द्रैर्जलजैर्हस्तैः स्विद्यतो हृदयं स्पृशेत्||१२||

muktāvalībhiḥ śītābhiḥ śītalairbhājanairapi| jalārdrairjalajairhastaiḥ svidyatō hr̥dayaṁ spr̥śēt||12||

muktAvalIbhiH shItAbhiH shItalairbhAjanairapi| jalArdrairjalajairhastaiH svidyato hRudayaM spRushet||12||

While sudation is being administered, the precordial region should be frequently touched with a string of cool pearls or cold vessels or wet lotuses or even with wet hands. [12]

Indications for stopping sudation

शीतशूलव्युपरमे स्तम्भगौरवनिग्रहे| सञ्जाते मार्दवे स्वेदे स्वेदनाद्विरतिर्मता||१३||

śītaśūlavyuparamē stambhagauravanigrahē| sañjātē mārdavē svēdē svēdanādviratirmatā||13||

shItashUlavyuparame stambhagauravanigrahe| sa~jjAte mArdave svede svedanAdviratirmatA||13||

It is indicated that sudation procedure should be stopped when the patient is relieved from feeling cold, pain, stiffness, heaviness and feels softness in the body. [13]

Signs of over-sudation and its treatment

पित्तप्रकोपो मूर्च्छा च शरीरसदनं तृषा| दाहः स्वराङ्गदौर्बल्यमतिस्विन्नस्य लक्षणम्||१४||

उक्तस्तस्याशितीये यो ग्रैष्मिकः सर्वशो विधिः| सोऽतिस्विन्नस्य कर्तव्यो मधुरः स्निग्धशीतलः||१५||

pittaprakōpō mūrcchā ca śarīrasadanaṁ tr̥ṣā| dāhaḥ svarāṅgadaurbalyamatisvinnasya lakṣaṇam||14||

uktastasyāśitīyē yō graiṣmikaḥ sarvaśō vidhiḥ| sō'tisvinnasya kartavyō madhuraḥ snigdhaśītalaḥ||15||

pittaprakopo mUrcchA ca sharIrasadanaM tRuShA| dAhaH svarA~ggadaurbalyamatisvinnasya lakShaNam||14||

uktastasyAshitIye yo graiShmikaH sarvasho vidhiH| so~atisvinnasya kartavyo madhuraH snigdhashItalaH||15||

kaShAyamadyanityAnAM garbhiNyA raktapittinAm|

The symptoms of oversudation include aggravation of pitta, fainting, generalized fatigue, thirst, burning sensation, low or weak voice, and weakness of limbs. In oversudation the entire regimen explained for summer season in Tasyashiteeya chapter, and consuming food articles that are sweet, unctuous and cool is to be followed. [14-15]

Contra-indications of swedana

कषायमद्यनित्यानां गर्भिण्या रक्तपित्तिनाम्| पित्तिनां सातिसाराणां रूक्षाणां मधुमेहिनाम्||१६||

विदग्धभ्रष्टब्रध्नानां विषमद्यविकारिणाम्| श्रान्तानां नष्टसञ्ज्ञानां स्थूलानां पित्तमेहिनाम्||१७||

तृष्यतां क्षुधितानां च क्रुद्धानां शोचतामपि| कामल्युदरिणां चैव क्षतानामाढ्यरोगिणाम्||१८||

दुर्बलातिविशुष्काणामुपक्षीणौजसां तथा| भिषक् तैमिरिकाणां च न स्वेदमवतारयेत्||१९||

kaṣāyamadyanityānāṁ garbhiṇyā raktapittinām| pittināṁ sātisārāṇāṁ rūkṣāṇāṁ madhumēhinām||16||

vidagdhabhraṣṭabradhnānāṁ viṣamadyavikāriṇām| śrāntānāṁ naṣṭasañjñānāṁ sthūlānāṁ pittamēhinām||17||

tr̥ṣyatāṁ kṣudhitānāṁ ca kruddhānāṁ śōcatāmapi| kāmalyudariṇāṁ caiva kṣatānāmāḍhyarōgiṇām||18||

durbalātiviśuṣkāṇāmupakṣīṇaujasāṁ tathā| bhiṣak taimirikāṇāṁ ca na svēdamavatārayēt||19||

pittinAM sAtisArANAM rUkShANAM madhumehinAm||16||

vidagdhabhraShTabradhnAnAM viShamadyavikAriNAm| shrAntAnAM naShTasa~jj~jAnAM sthUlAnAM pittamehinAm||17||

tRuShyatAM kShudhitAnAM ca kruddhAnAM shocatAmapi| kAmalyudariNAM caiva kShatAnAmADhyarogiNAm||18||

durbalAtivishuShkANAmupakShINaujasAM tathA| bhiShak taimirikANAM ca na svedamavatArayet||19||

The physician should be aware that sudation is contraindicated in those who regularly consume astringents and alcohol, in pregnant women, persons with bleeding disorders, individuals with pitta predominance, those who are suffering from diarrhoea and sicca, patients with diabetes mellitus, inflamed colon, prolapsed rectum, in toxic conditions, fatigued, unconscious, obese, pitta-predominant diabetics, individuals having thirst, hunger, anger, depression, jaundice, ascitis, injured, rheumatoid diseases, weakness, extremely emaciated, highly immune compromised and those who often suffer from blackouts. [16-19]

Indications of swedana

प्रतिश्याये च कासे च हिक्काश्वासेष्वलाघवे| कर्णमन्याशिरःशूले स्वरभेदे गलग्रहे||२०||

अर्दितैकाङ्गसर्वाङ्गपक्षाघाते विनामके| कोष्ठानाहविबन्धेषु मूत्राघाते विजृम्भके||२१||

पार्श्वपृष्ठकटीकुक्षिसङ्ग्रहे गृध्रसीषु च| मूत्रकृच्छ्रे महत्त्वे च मुष्कयोरङ्गमर्दके||२२||

पादजानूरुजङ्घार्तिसङ्ग्रहे श्वयथावपि| खल्लीष्वामेषु शीते च वेपथौ वातकण्टके||२३||

सङ्कोचायामशूलेषु स्तम्भगौरवसुप्तिषु | सर्वाङ्गेषु विकारेषु स्वेदनं हितमुच्यते||२४||

pratiśyāyē ca kāsē ca hikkāśvāsēṣvalāghavē| karṇamanyāśiraḥśūlē svarabhēdē galagrahē||20||

arditaikāṅgasarvāṅgapakṣāghātē vināmakē| kōṣṭhānāhavibandhēṣu mūtrāghātē vijr̥mbhakē||21||

pārśvapr̥ṣṭhakaṭīkukṣisaṅgrahē gr̥dhrasīṣu ca| mūtrakr̥cchrē mahattvē ca muṣkayōraṅgamardakē||22||

pādajānūrujaṅghārtisaṅgrahē śvayathāvapi| khallīṣvāmēṣu śītē ca vēpathau vātakaṇṭakē||23||

saṅkōcāyāmaśūlēṣu stambhagauravasuptiṣu | sarvāṅgēṣu vikārēṣu svēdanaṁ hitamucyatē||24||

pratishyAye ca kAse ca hikkAshvAseShvalAghave| karNamanyAshiraHshUle svarabhede galagrahe||20||

arditaikA~ggasarvA~ggapakShAghAte vinAmake| koShThAnAhavibandheShu mUtrAghAte vijRumbhake||21||

pArshvapRuShThakaTIkukShisa~ggrahe gRudhrasIShu ca| mUtrakRucchre mahattve ca muShkayora~ggamardake||22||

pAdajAnUruja~gghArtisa~ggrahe shvayathAvapi| khallIShvAmeShu shIte ca vepathau vAtakaNTake||23||

sa~gkocAyAmashUleShu stambhagauravasuptiShu | sarvA~ggeShu vikAreShu svedanaM hitamucyate||24||

It is said that swedana is useful in rhinitis, cough, hiccups, breathing difficulties, heaviness of body, earache, headache, cervical pain, hoarseness of voice, choking sensation of throat, facial palsy, monoplegia, quadriplegia, hemiplegia, prostrated postures, abdominal flatulence, constipation, urinary retention, excessive yawning, stiffness of flanks, dorsum, lumbar and abdomen, sciatica, dysuria, scrotal enlargement, body ache, pain and stiffness of dorsum of foot, knee, thigh and calf, edema, severely painful radiculopathy, indigestion, chills and shivering, subluxation of ankle, contractures, convulsions, colicky pains, stiffness, heaviness and numbness, and such disorders anywhere in the body. [20-24]

Swedana dravya (material for sudation)

तिलमाषकुलत्थाम्लघृततैलामिषौदनैः| पायसैः कृशरैर्मांसैः पिण्डस्वेदं प्रयोजयेत्||२५||

गोखरोष्ट्रवराहाश्वशकृद्भिः सतुषैर्यवैः| सिकतापांशुपाषाणकरीषायसपूटकैः||२६||

श्लैष्मिकान् स्वेदयेत् पूर्वैर्वातिकान् समुपाचरेत्| द्रव्याण्येतानि शस्यन्ते यथास्वं प्रस्तरेष्वपि||२७||

tilamāṣakulatthāmlaghr̥tatailāmiṣaudanaiḥ| pāyasaiḥ kr̥śarairmāṁsaiḥ piṇḍasvēdaṁ prayōjayēt||25||

gōkharōṣṭravarāhāśvaśakr̥dbhiḥ satuṣairyavaiḥ| sikatāpāṁśupāṣāṇakarīṣāyasapūṭakaiḥ||26||

ślaiṣmikān svēdayēt pūrvairvātikān samupācarēt| dravyāṇyētāni śasyantē yathāsvaṁ prastarēṣvapi||27||

tilamAShakulatthAmlaghRutatailAmiShaudanaiH| pAyasaiH kRusharairmAMsaiH piNDasvedaM prayojayet||25||

gokharoShTravarAhAshvashakRudbhiH satuShairyavaiH| sikatApAMshupAShANakarIShAyasapUTakaiH||26||

shlaiShmikAn svedayet pUrvairvAtikAn samupAcaret| dravyANyetAni shasyante yathAsvaM prastareShvapi||27||

Fomentation bolus prepared with tila (Sesamum indicum Linn.), masha (Phaseolus radiates Linn.), kulatha (Dolichos biflorus Linn.), sour preparations, ghee, oil, meat, boiled rice (odana), sweet porridge (payasa), boiled mixture of cereals and legumes (krishara) and flesh, feces of cow, ass, camel, pig and horse along with barley grains with chaff, sand, dust, stone, dried cow dung and iron powder is effective for fomentation in the cases of kapha and vata related diseases. These articles may also be used for fomentation using a hot stone (prastara sweda). [25- 27]

Preparation for comfortable sudation

भूगृहेषु च जेन्ताकेषूष्णगर्भगृहेषु च| विधूमाङ्गारतप्तेषु स्वभ्यक्तः स्विद्यते सुखम्||२८||

bhūgr̥hēṣu ca jēntākēṣūṣṇagarbhagr̥hēṣu ca| vidhūmāṅgārataptēṣu svabhyaktaḥ svidyatē sukham||28||

bhUgRuheShu ca jentAkeShUShNagarbhagRuheShu ca| vidhUmA~ggAratapteShu svabhyaktaH svidyate sukham||28||

To get a comfortable sudation experience, the patient should have oil applied to his body and then exposed to some heat in an underground cellar (jentaka) type room, or a warm enclosed room that is heated with firebrands and is devoid of smoke. [28]

Decoctions for nadi sweda (tubular fomentation)

ग्राम्यानूपौदकं मांसं पयो बस्तशिरस्तथा| वराहमध्यपित्तासृक् स्नेहवत्तिलतण्डुलाः||२९||

इत्येतानि समुत्क्वाथ्य नाडीस्वेदं प्रयोजयेत्| देशकालविभागज्ञो युक्त्यपेक्षो भिषक्तमः||३०||

वारुणामृतकैरण्डशिग्रुमूलकसर्षपैः| वासावंशकरञ्जार्कपत्रैरश्मन्तकस्य च||३१||

शोभाञ्जनकसैरेयमालतीसुरसार्जकैः | पत्रैरुत्क्वाथ्य सलिलं नाडीस्वेदं प्रयोजयेत्||३२||

भूतीकपञ्चमूलाभ्यां सुरया दधिमस्तुना| मूत्रैरम्लैश्च सस्नेहैर्नाडीस्वेदं प्रयोजयेत्||३३||

grāmyānūpaudakaṁ māṁsaṁ payō bastaśirastathā| varāhamadhyapittāsr̥k snēhavattilataṇḍulāḥ||29||

ityētāni samutkvāthya nāḍīsvēdaṁ prayōjayēt| dēśakālavibhāgajñō yuktyapēkṣō bhiṣaktamaḥ||30||

vāruṇāmr̥takairaṇḍaśigrumūlakasarṣapaiḥ| vāsāvaṁśakarañjārkapatrairaśmantakasya ca||31||

śōbhāñjanakasairēyamālatīsurasārjakaiḥ | patrairutkvāthya salilaṁ nāḍīsvēdaṁ prayōjayēt||32||

bhūtīkapañcamūlābhyāṁ surayā dadhimastunā| mūtrairamlaiśca sasnēhairnāḍīsvēdaṁ prayōjayēt||33||

grAmyAnUpaudakaM mAMsaM payo bastashirastathA| varAhamadhyapittAsRuk snehavattilataNDulAH||29||

ityetAni samutkvAthya nADIsvedaM prayojayet| deshakAlavibhAgaj~jo yuktyapekSho bhiShaktamaH||30||

vAruNAmRutakairaNDashigrumUlakasarShapaiH| vAsAvaMshakara~jjArkapatrairashmantakasya ca||31||

shobhA~jjanakasaireyamAlatIsurasArjakaiH | patrairutkvAthya salilaM nADIsvedaM prayojayet||32||

bhUtIkapa~jcamUlAbhyAM surayA dadhimastunA| mUtrairamlaishca sasnehairnADIsvedaM prayojayet||33||

Proper decoctions may be prepared out of flesh of domesticated, marshy or aquatic animals, milk, head of goat, blood, bile and flesh of pig, unctuous substances like sesame seeds and cereals, and tubular fomentation may be applied appropriately by an expert physician, considering variations in geography and season. Tubular fomentation can also be done with decoctions of leaves of varuna (Crataeva religiosa Forst.), amritaka (Tinospora cordifolia), eranda (Ricinus communis), shigru (Moringa oleifera), mulaka (Raphanus sativus), sarshapa (Brassica nigra), vasa (Adathoda vasica), vamsha (Bambusa arundinacea), karanja (Pongamia pinnata), arka (Calotropis gigantea), ashmantaka (Bauhinia racemosa), sobhanjana (variety of shigru), saireya (Barleria prionitis), malati (Jasminum grandiflorum), surasa (Ocimum sanctum), and arjaka (Ocimum gratissimum). [29-33]

Material for avagaha sweda (tub fomentation)

एत एव च निर्यूहाः प्रयोज्या जलकोष्ठके| स्वेदनार्थं घृतक्षीरतैलकोष्ठांश्च कारयेत्||३४||

ēta ēva ca niryūhāḥ prayōjyā jalakōṣṭhakē| svēdanārthaṁ ghr̥takṣīratailakōṣṭhāṁśca kārayēt||34||

eta eva ca niryUhAH prayojyA jalakoShThake| svedanArthaM ghRutakShIratailakoShThAMshca kArayet||34||

These same decoctions can be used in a water tub for fomentation. In a similar manner, ghee, milk, and sesame oil may also be used in tub fomentation. [34]

Material for upanaha sweda (poultice foementation)

गोधूमशकलैश्चूर्णैर्यवानामम्लसंयुतैः| सस्नेहकिण्वलवणैरुपनाहः प्रशस्यते||३५||

गन्धैः सुरायाः किण्वेन जीवन्त्या शतपुष्पया| उमया कुष्ठतैलाभ्यां युक्तया चोपनाहयेत्||३६||

चर्मभिश्चोपनद्धव्यः सलोमभिरपूतिभिः| उष्णवीर्यैरलाभे तु कौशेयाविकशाटकैः||३७||

gōdhūmaśakalaiścūrṇairyavānāmamlasaṁyutaiḥ| sasnēhakiṇvalavaṇairupanāhaḥ praśasyatē||35||

gandhaiḥ surāyāḥ kiṇvēna jīvantyā śatapuṣpayā| umayā kuṣṭhatailābhyāṁ yuktayā cōpanāhayēt||36||

carmabhiścōpanaddhavyaḥ salōmabhirapūtibhiḥ| uṣṇavīryairalābhē tu kauśēyāvikaśāṭakaiḥ||37||

godhUmashakalaishcUrNairyavAnAmamlasaMyutaiH| sasnehakiNvalavaNairupanAhaH prashasyate||35||

gandhaiH surAyAH kiNvena jIvantyA shatapuShpayA| umayA kuShThatailAbhyAM yuktayA copanAhayet||36||

carmabhishcopanaddhavyaH salomabhirapUtibhiH| uShNavIryairalAbhe tu kausheyAvikashATakaiH||37||

Poultice for fomentation can be prepared with wheat powder and/or barley flour mixed with sour preparations, oily substances, yeast, and salt. Poultice can also be logically prepared with aromatic drugs, jivanti (Leptandenia reticulata), shatapushpa (Foeniculum vulgare), uma (Linum usitatissimum), and kushta (Saussurea lappa) mixed with oil.

Non-putrefied hairy leather of hot potency animals should be used as a bandage when using poultice. In case of non availability, silk or woolen blanket can also be used. [35-37]

रात्रौ बद्धं दिवा मुञ्चेन्मुञ्चेद्रात्रौ दिवा कृतम्| विदाहपरिहारार्थं, स्यात् प्रकर्षस्तु शीतले||३८||

rātrau baddhaṁ divā muñcēnmuñcēdrātrau divā kr̥tam| vidāhaparihārārthaṁ, syāt prakarṣastu śītalē||38||

rAtrau baddhaM divA mu~jcenmu~jcedrAtrau divA kRutam| vidAhaparihArArthaM, syAt prakarShastu shItale||38||

To prevent burning sensations, the bandage applied at night should be removed in the morning and the one applied during the day.