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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]].
===Sanskrit text, transliteration and english translation===
===Sanskrit text, Transliteration and English Translation===
१५. उपकल्पनीयोऽध्यायः
१५. उपकल्पनीयोऽध्यायः
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 ====
==== Guidelines for physicians 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||
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||
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||
ēvaṁvādinaṁ bhagavantamātrēyamagnivēśa uvāca- nanu bhagavan! ādāvēva jñānavatā tathāpratividhātavyaṁ yathā prativihitē sidhyēdēvauṣadhamēkāntēna, samyakprayōganimittā hisarvakarmaṇāṁ siddhiriṣṭā, vyāpaccāsamyakprayōganimittā; atha samyagasamyak ca samārabdhaṁkarma siddhyati vyāpadyatē vā'niyamēna, tulyaṁ bhavati jñānamajñānēnēti||4||
ēvaṁvādinaṁ bhagavantamātrēyamagnivēśa uvāca- nanu bhagavan! ādāvēva jñānavatā tathāpratividhātavyaṁ yathā prativihitē sidhyēdēvauṣadhamēkāntēna, samyakprayōganimittā hisarvakarmaṇāṁ siddhiriṣṭā, vyāpaccāsamyakprayōganimittā; atha samyagasamyak ca samārabdhaṁkarma siddhyati vyāpadyatē vā'niyamēna, tulyaṁ bhavati jñānamajñānēnēti||4||
evaMvAdinaM bhagavantamAtreyamagnivesha uvAca- nanu bhagavan! AdAveva j~jAnavatA tathApratividhAtavyaM yathA prativihite sidhyedevauShadhamekAntena, samyakprayoganimittA hisarvakarmaNAM siddhiriShTA, vyApaccAsamyakprayoganimittA; atha samyagasamyak ca samArabdhaMkarma siddhyati vyApadyate vA~aniyamena, tulyaM bhavati j~jAnamaj~jAneneti||4||
evaMvAdinaM bhagavantamAtreyamagnivesha uvAca- nanu bhagavan! AdAveva j~jAnavatA tathApratividhAtavyaM yathA prativihite sidhyedevauShadhamekAntena, samyakprayoganimittA hisarvakarmaNAM siddhiriShTA, vyApaccAsamyakprayoganimittA; atha samyagasamyak ca samArabdhaMkarma siddhyati vyApadyate vA~aniyamena, tulyaM bhavati j~jAnamaj~jAneneti||4||
When Lord Atreya said this, Agnivesha said, “O Lord! A learned physician should prescribe a treatment in such a way that it should surely and invariably be successful. The success of all treatments depends upon proper administration and complications due to improper administration. However, sometimes, the success or failure of treatment doesn’t follow the rules of proper or improper administration, hence knowledge and ignorance becomes equal.” [4]
When Lord Atreya said this, Agnivesha said, “O Lord! A learned physician should prescribe a treatment in such a way that it should surely and invariably be successful. The success of all treatments depends upon proper administration and complications due to improper administration. However, sometimes, the success or failure of treatment doesn’t follow the rules of proper or improper administration, hence knowledge and ignorance becomes equal.” [4]
tamuvAca bhagavAnAtreyaH- shakyaM tathA pratividhAtumasmAbhirasmadvidhairvA~apyagnivesha!yathA prativihite sidhyedevauShadhamekAntena, tacca prayogasauShThavamupadeShTuM yathAvat; nahikashcidasti ya etadevamupadiShTamupadhArayitumutsaheta, upadhArya vA tathA pratipattuM prayoktuMvA; sUkShmANi hidoShabheShajadeshakAlabalasharIrAhArasAtmyasattvaprakRutivayasAmavasthAntarANi,yAnyanucintyamAnAni vimalavipulabuddherapi buddhimAkulIkuryuH kiM punaralpabuddheH;tasmAdubhayametadyathAvadupadekShyAmaH- samyakprayogaM cauShadhAnAM, vyApannAnAM cavyApatsAdhanAni siddhiShUttarakAlam||5||
==== Reply by Atreya ====
तमुवाच भगवानात्रेयः- शक्यं तथा प्रतिविधातुमस्माभिरस्मद्विधैर्वाऽप्यग्निवे श!
यथा प्रतिविहिते सिध्येदेवौषधमेकान्तेन,तच्च प्रयोगसौष्ठवमुपदेष्टुं यथावत्;
नहि कश्चिदस्ति य एतदेवमुपदिष्टमुपधारयितुमुत्सहेत, उपधार्य वा तथा प्रतिपत्तुंप्रयोक्तुं वा;
सूक्ष्माणि हि दोषभेषजदेशकालबलशरीराहारसात्म्यसत्त्वप्रकृतिवयसामवस्थान्तराणि, यान्यनुचिन्त्यमानानिविमलविपुलबुद्धेरपि बुद्धिमाकुलीकुर्युः किं पुनरल्पबुद्धेः;
तस्मादुभयमेतद्यथावदुपदेक्ष्यामः- सम्यक्प्रयोगं चौषधानां,व्यापन्नानां च व्यापत्साधनानि सिद्धिषूत्तरकालम्||५||
tamuvāca bhagavānātrēyaḥ- śakyaṁ tathā pratividhātumasmābhirasmadvidhairvā'pyagnivēśa!
yathāprativihitē sidhyēdēvauṣadhamēkāntēna, tacca prayōgasauṣṭhavamupadēṣṭuṁ yathāvat;
nahi kaścidastiya ētadēvamupadiṣṭamupadhārayitumutsahēta, upadhārya vā tathā pratipattuṁ prayōktuṁ vā;
sūkṣmāṇihi dōṣabhēṣajadēśakālabalaśarīrāhārasātmyasattvaprakr̥tivayasāmavasthāntarāṇi, yānyanucintyamānānivimalavipulabuddhērapi buddhimākulīkuryuḥ kiṁ punaralpabuddhēḥ;tasmādubhayamētadyathāvadupadēkṣyāmaḥ-
samyakprayōgaṁ cauṣadhānāṁ, vyāpannānāṁ cavyāpatsādhanāni siddhiṣūttarakālam||5||
tamuvAca bhagavAnAtreyaH- shakyaM tathA pratividhAtumasmAbhirasmadvidhairvA~apyagnivesha!yathA prativihite sidhyedevauShadhamekAntena, tacca prayogasauShThavamupadeShTuM yathAvat;
nahikashcidasti ya etadevamupadiShTamupadhArayitumutsaheta, upadhArya vA tathA pratipattuM prayoktuMvA;
sUkShmANi hidoShabheShajadeshakAlabalasharIrAhArasAtmyasattvaprakRutivayasAmavasthAntarANi,yAnyanucintyamAnAni vimalavipulabuddherapi buddhimAkulIkuryuH kiM punaralpabuddheH;
tasmAdubhayametadyathAvadupadekShyAmaH- samyakprayogaM cauShadhAnAM, vyApannAnAM cavyApatsAdhanAni siddhiShUttarakAlam||5||
Lord Atreya replied, “Oh Agnivesha!, it is possible for us to treat the patients successfully and also impart instructions for correct administration. But there is none who is able to grasp such instructions or having grasped it, is able to apply it or put it into practice. The variations in conditions of dosha, drugs, place, time, strength, body, diet, suitability, mind pattern, constitution, and age are subtle to understand. While considering these factors, when even a person with great intellect and pure knowledge gets confused, then what will be the condition of a person with less intellect? [5]
Lord Atreya replied, “Oh Agnivesha!, it is possible for us to treat the patients successfully and also impart instructions for correct administration. But there is none who is able to grasp such instructions or having grasped it, is able to apply it or put it into practice. The variations in conditions of dosha, drugs, place, time, strength, body, diet, suitability, mind pattern, constitution, and age are subtle to understand. While considering these factors, when even a person with great intellect and pure knowledge gets confused, then what will be the condition of a person with less intellect? [5]