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[[Sutra Sthana]] Chapter 15:
==([[Sutra Sthana]] Chapter 15, Chapter on the Guidelines for Hospital Management and Purification Treatment)==
=== 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.
'''Keywords''': Pre-requisites for [[Panchakarma]] hospital, vamana, virechana, therapeutic emesis, therapeutic purgation.
=== 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]].
१५. उपकल्पनीयोऽध्यायः
===Sanskrit text, transliteration and english translation===
१५. उपकल्पनीयोऽध्यायः
15. upakalpanīyō'dhyāyaḥ
15. upakalpanīyō'dhyāyaḥ
15. upakalpanIyo~adhyAyaH
अथात उपकल्पनीयमध्यायं व्याख्यास्यामः||१||
अथात उपकल्पनीयमध्यायं व्याख्यास्यामः||१||
इति ह स्माह भगवानात्रेयः||२||
इति ह स्माह भगवानात्रेयः||२||
athāta upakalpanīyamadhyāyaṁ vyākhyāsyāmaḥ||1||
athāta upakalpanīyamadhyāyaṁ vyākhyāsyāmaḥ||1||
iti ha smāha bhagavānātrēyaḥ||2||
iti ha smāha bhagavānātrēyaḥ||2||
athAta upakalpanIyamadhyAyaM vyAkhyAsyAmaH||1||
athAta upakalpanIyamadhyAyaM vyAkhyAsyAmaH||1||
iti ha smAha bhagavAnAtreyaH||2||
iti ha smAha bhagavAnAtreyaH||2||
Now let us expound the chapter upakalpaneeyam (guidelines for hospital management), thus said Lord Atreya.[1-2]
Now let us expound the chapter upakalpaneeyam (guidelines for hospital management), thus said Lord Atreya.[1-2]
Guidelines for physician before commencing treatment: इह खलु राजानं राजमात्रमन्यं वा विपुलद्रव्यं वमनं विरेचनं वा पाययितुकामेन भिषजा प्रागेवौषधपानात् सम्भारा उपकल्पनीयाभवन्ति सम्यक्चैव हि गच्छत्यौषधे प्रतिभोगार्थाः, व्यापन्ने चौषधे व्यापदः परिसङ्ख्याय प्रतीकारार्थाः; न हि सन्निकृष्टे कालेप्रादुर्भूतायामापदि सत्यपि क्रयाक्रये सुकरमाशु सम्भरणमौषधानां यथावदिति||३||
==== Guidelines for physician before commencing treatment ====
इह खलु राजानं राजमात्रमन्यं वा विपुलद्रव्यं वमनं विरेचनं वा पाययितुकामेन भिषजा प्रागेवौषधपानात् सम्भारा उपकल्पनीयाभवन्ति सम्यक्चैव हि गच्छत्यौषधे प्रतिभोगार्थाः, व्यापन्ने चौषधे व्यापदः परिसङ्ख्याय प्रतीकारार्थाः; न हि सन्निकृष्टे कालेप्रादुर्भूतायामापदि सत्यपि क्रयाक्रये सुकरमाशु सम्भरणमौषधानां यथावदिति||३||
iha khalu rājānaṁ rājamātramanyaṁ vā vipuladravyaṁ Vamanaṁ virēcanaṁ vā pāyayitukāmēna bhiṣajāprāgēvauṣadhapānāt sambhārā upakalpanīyā bhavanti samyakcaiva hi gacchatyauṣadhē pratibhōgārthāḥ,vyāpannē cauṣadhē vyāpadaḥ parisaṅkhyāya pratīkārārthāḥ; na hi sannikr̥ṣṭē kālē prādurbhūtāyāmāpadisatyapi krayākrayē sukaramāśu sambharaṇamauṣadhānāṁ yathāvaditi||3|| iha khalu rAjAnaM rAjamAtramanyaM vA vipuladravyaM VamanaM virecanaM vA pAyayitukAmena bhiShajAprAgevauShadhapAnAt sambhArA upakalpanIyA bhavanti samyakcaiva hi gacchatyauShadhepratibhogArthAH, vyApanne cauShadhe vyApadaH parisa~gkhyAya pratIkArArthAH; na hi sannikRuShTekAle prAdurbhUtAyAmApadi satyapi krayAkraye sukaramAshu sambharaNamauShadhAnAMyathAvaditi||3||
iha khalu rājānaṁ rājamātramanyaṁ vā vipuladravyaṁ Vamanaṁ virēcanaṁ vā pāyayitukāmēna bhiṣajāprāgēvauṣadhapānāt sambhārā upakalpanīyā bhavanti samyakcaiva hi gacchatyauṣadhē pratibhōgārthāḥ,vyāpannē cauṣadhē vyāpadaḥ parisaṅkhyāya pratīkārārthāḥ; na hi sannikr̥ṣṭē kālē prādurbhūtāyāmāpadisatyapi krayākrayē sukaramāśu sambharaṇamauṣadhānāṁ yathāvaditi||3|| iha khalu rAjAnaM rAjamAtramanyaM vA vipuladravyaM VamanaM virecanaM vA pAyayitukAmena bhiShajAprAgevauShadhapAnAt sambhArA upakalpanIyA bhavanti samyakcaiva hi gacchatyauShadhepratibhogArthAH, vyApanne cauShadhe vyApadaH parisa~gkhyAya pratIkArArthAH; na hi sannikRuShTekAle prAdurbhUtAyAmApadi satyapi krayAkraye sukaramAshu sambharaNamauShadhAnAMyathAvaditi||3||
A physician willing to administer various purification therapies, especially to a king, royalty or a wealthy person, should arrange various necessary drugs and equipments well in advance of the procedures and know correct administration of counter-acting drugs in case of complications. Because, in case of emergency, if complications occur, it is not possible to easily and immediately arrange drugs through sale or import. [3]
A physician willing to administer various purification therapies, especially to a king, royalty or a wealthy person, should arrange various necessary drugs and equipments well in advance of the procedures and know correct administration of counter-acting drugs in case of complications. Because, in case of emergency, if complications occur, it is not possible to easily and immediately arrange drugs through sale or import. [3]
Query by Agnivesha about success of treatment:
Query by Agnivesha about success of treatment:
एवंवादिनं भगवन्तमात्रेयमग्निवेश उवाच- ननु भगवन्! आदावेव ज्ञानवता तथा प्रतिविधातव्यं यथा प्रतिविहितेसिध्येदेवौषधमेकान्तेन, सम्यक्प्रयोगनिमित्ता हि सर्वकर्मणां सिद्धिरिष्टा, व्यापच्चासम्यक्प्रयोगनिमित्ता; अथसम्यगसम्यक् च समारब्धं कर्म सिद्ध्यति व्यापद्यते वाऽनियमेन, तुल्यं भवति ज्ञानमज्ञानेनेति||४||
एवंवादिनं भगवन्तमात्रेयमग्निवेश उवाच- ननु भगवन्! आदावेव ज्ञानवता तथा प्रतिविधातव्यं यथा प्रतिविहितेसिध्येदेवौषधमेकान्तेन, सम्यक्प्रयोगनिमित्ता हि सर्वकर्मणां सिद्धिरिष्टा, व्यापच्चासम्यक्प्रयोगनिमित्ता; अथसम्यगसम्यक् च समारब्धं कर्म सिद्ध्यति व्यापद्यते वाऽनियमेन, तुल्यं भवति ज्ञानमज्ञानेनेति||४||