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|title=Apamarga Tanduliya Adhyaya

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|keywords=Apamarga tandula, dehusked seeds, shirovirechana,nasal errhines, vamana,therapeutic emesis, virechana,therapeutic purgation, yavagu kalpana (medicated gruel), purification therapies, Ayurveda, Indian system of medicine, charak samhita.

|description=The second chapter within Bheshaja Chatushka (tetrad constituting four chapters on medicinal treatment) deals with list of herbs used in Panchakarma (bio-purification processes)

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|image_alt=carak samhita

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<big>'''Sutra Sthana Chapter 2. Dehusked Seeds of Apamarga and other medicines'''</big>

{{Infobox

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|data7 = Sawant B.

|label8 = Editors

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|data8 = Sawant B., Deole Y.S., Basisht G.

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|data8 = Sawant B., [[Yogesh Deole|Deole Y.S.]], [[Gopal Basisht|Basisht G.]]

|label9 = Year of publication

|data9 = 2020

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|~~label11~~ = Publisher

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|label10 = Publisher

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|~~data11~~ = [[Charak Samhita Research, Training and Skill Development Centre]]

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|data10 = [[Charak Samhita Research, Training and Skill Development Centre]]

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|~~label10~~ = DOI

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|label11 = DOI

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|~~data10~~ = [https://doi.org/10.47468/CSNE.2020.e01.s01.004 10.47468/CSNE.2020.e01.s01.004]

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|data11 = [https://doi.org/10.47468/CSNE.2020.e01.s01.004 10.47468/CSNE.2020.e01.s01.004]

}}

<big>'''Abstract'''</big>

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<p style='text-align:justify;'>The second chapter within Bheshaja Chatushka (tetrad constituting four chapters on medicinal treatment) deals with list of herbs used in [[Panchakarma]] (bio-purification processes). The liberty to execute this treatment based upon dose and time of administration is given through logical reasoning (Yukti pramana). Specific diet preparations like gruels (Yavagu) are enlisted with their benefits and indications to be used in preservation of health and treatment of diseases. The chapter denotes importance of body purification and diet in healthcare system.</p>

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<div style="text-align:justify;">The second chapter within Bheshaja Chatushka (tetrad constituting four chapters on medicinal treatment) deals with list of herbs used in Panchakarma (bio-purification processes). The liberty to execute this treatment based upon dose and time of administration is given through logical reasoning (Yukti pramana). Specific diet preparations like gruels (Yavagu) are enlisted with their benefits and indications to be used in preservation of health and treatment of diseases. The chapter denotes importance of body purification and diet in healthcare system.</div>

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'''Keywords''': ''Apamarga tandula'', dehusked seeds, ''shirovirechana'',nasal errhines, ''[[vamana]]'',therapeutic emesis, ''[[virechana]]'',therapeutic purgation, ''yavagu kalpana'' (medicated gruel), purification therapies.

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'''Keywords''': ''Apamarga tandula'', dehusked seeds, ''shirovirechana'',nasal errhines, ''vamana'',therapeutic emesis, ''virechana'',therapeutic purgation, ''yavagu kalpana'' (medicated gruel), purification therapies.

==Introduction==

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<div style="text-align:justify;">The aim of [[Ayurveda]] is to maintain the health of a healthy individual and cure diseases of an unhealthy one. Purificatory procedures (such as [[Panchakarma]], or five purificatory procedures) play a pivotal role to protect and promote the health of the individual. In the previous chapter of [[Deerghanjiviteeya Adhyaya]], plants with therapeutic qualities (in their roots and fruits particularly) have been described for use in purification therapies. The present chapter is written with a view to enumerate the remaining drugs that are useful for various bio-purificatory procedures, along with an explanation of their properties and the objectives of those procedures. It has been named as ''Apamarga tanduliya'' to stress that the dehusked seeds of ''Apamarga'' (Achyranthes aspera), rather than husked ones, are to be prescribed for therapeutic purposes. In addition to the bio-purification procedures, this chapter also explains the need for post-purification dietary regimen ([[samsarjana krama]]) to be followed in order to re-kindle ''agni'' (digestive powers). It includes importance of gruels to eradicate specific diseases and re-kindle ''jatharagni'' (digestive powers) and provides detailed descriptions and procedures for ''yavagukalpana'' (preparation of ''yavagu'', or a special form of gruel). Among this '' yavagu'', some are ''ahara pradhana'' (or diet-centric), while others are ''aushadha pradhana'' (medication-centric). The chapter also emphasizes the importance of dosage (''matra''), timing and frequency (''kala''), and rational judgement (''yukti'') required for effective administration of the purificatory procedures. The chapter begins with an explanation of medicines for ''shirovirechana'' (catharsis of cephalic region) and then explains purificatory procedures for ''vamana'' (therapeutic emesis), ''virechana'' (therapeutic purgation), ''anuvasana'' (oil enemata), and ''~~niruhabasti~~'' (decoction enemata). The reason for such a beginning is the importance or superiority of head among all body parts. [Cha.Sa.[[Sutra Sthana]] 17/2]

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<div style="text-align:justify;">The aim of [[Ayurveda]] is to maintain the health of a healthy individual and cure diseases of an unhealthy one. Purificatory procedures (such as [[Panchakarma]], or five purificatory procedures) play a pivotal role to protect and promote the health of the individual. In the previous chapter of [[Deerghanjiviteeya Adhyaya]], plants with therapeutic qualities (in their roots and fruits particularly) have been described for use in purification therapies. The present chapter is written with a view to enumerate the remaining drugs that are useful for various bio-purificatory procedures, along with an explanation of their properties and the objectives of those procedures. It has been named as ''Apamarga tanduliya'' to stress that the dehusked seeds of ''Apamarga'' (Achyranthes aspera), rather than husked ones, are to be prescribed for therapeutic purposes. In addition to the bio-purification procedures, this chapter also explains the need for post-purification dietary regimen ([[samsarjana krama]]) to be followed in order to re-kindle ''agni'' (digestive powers). It includes importance of gruels to eradicate specific diseases and re-kindle ''jatharagni'' (digestive powers) and provides detailed descriptions and procedures for ''yavagukalpana'' (preparation of ''yavagu'', or a special form of gruel). Among this '' yavagu'', some are ''ahara pradhana'' (or diet-centric), while others are ''aushadha pradhana'' (medication-centric). The chapter also emphasizes the importance of dosage (''matra''), timing and frequency (''kala''), and rational judgement (''yukti'') required for effective administration of the purificatory procedures. The chapter begins with an explanation of medicines for ''shirovirechana'' (catharsis of cephalic region) and then explains purificatory procedures for ''[[vamana]]'' (therapeutic emesis), ''[[virechana]]'' (therapeutic purgation), ''anuvasana [[basti]]'' (oil enemata), and ''niruha [[basti]]'' (decoction enemata). The reason for such a beginning is the importance or superiority of head among all body parts. [Cha.Sa.[[Sutra Sthana]] 17/2]

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It further lists down ''Panchakarma dravya'' (drugs useful for purificatory procedures), description of ''yavagu'' (food preparation) and characteristics of an ideal physician eligible to administer these procedures and preparations.

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It further lists down ''[[Panchakarma]] dravya'' (drugs useful for purificatory procedures), description of ''yavagu'' (food preparation) and characteristics of an ideal physician eligible to administer these procedures and preparations.

</div>

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</div></div>

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''Madana'' (Catunaregam spinosa (Thunb.) Tirvengadum), ''Madhuka'' (Glycyrrhiza glabra Linn.), ''Nimba'' (Azadirachta indica A. Juss.), ''Jimuta''(Luffa echinata Roxb.), ''Kritavedhana'' (Luffa acutangula Roxb.), ''Pippali''(Piper longum Linn.), ''Kutaja'' (Holarrhena pubescens (Buch.-Ham.) Wallich ex Don), ''Ikshvaku'' (Lagenaria siceraria (Mol.) Standley), ''Ela'' (Elettaria cardamomum Maton), ''Dhamargava'' (Luffa aegyptiaca Mill.), are the drugs to be used by the physician in the conditions caused by vitiation of ''kapha'' and ''pitta'' in upper gastrointestinal tract for emesis without causing strain to the body. [7-8]</div>

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''Madana'' (Catunaregam spinosa (Thunb.) Tirvengadum), ''Madhuka'' (Glycyrrhiza glabra Linn.), ''Nimba'' (Azadirachta indica A. Juss.), ''Jimuta''(Luffa echinata Roxb.), ''Kritavedhana'' (Luffa acutangula Roxb.), ''Pippali''(Piper longum Linn.), ''Kutaja'' (Holarrhena pubescens (Buch.-Ham.) Wallich ex Don), ''Ikshvaku'' (Lagenaria siceraria (Mol.) Standley), ''Ela'' (Elettaria cardamomum Maton), ''Dhamargava'' (Luffa aegyptiaca Mill.), are the drugs to be used by the physician in the conditions caused by vitiation of ''[[kapha]]'' and ''[[pitta]]'' in upper gastrointestinal tract for emesis without causing strain to the body. [7-8]</div>

{| border=1 style="border-collapse: collapse;"

|-style="text-align: center;"

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''Trivrit'' (Operculina turpethum (Linn.) Silva Manso), ''Triphala'' (Three myrobalans), ''Danti'' (Baliospermum montanum (Wild.) Muell-Arg.), ''Nilini'' (Indigofera tinctoria Linn.), ''Saptala'' (Acacia concinna DC.), ''Vacha'' (Acorus calamus Linn.), ''Kampillaka''(Mallotus philippensis (Lam.) Muell.- Arg.), ''Gavakshi'' (Citrullus colocynthis (Linn.) Schrader), ''Kshirini'' (Mimusops hexandra Roxb.), ''Udakeerya''(Pongamia pinnata (Linn.) Pierre), ''Pilu'' (Salvadora persica Linn.), ''Aragwadha'' (Cassia fistula Linn.), ''Draksha'' (Vitis vinifera Linn.), ''Dravanti'' (Croton tinglium Linn.), ''Nichula'' (Barringtonia acutangula (Linn.) Gaertn.) are the drugs used for purgation when vitiating factors are located in ''Pakwashaya'' (colon).[9-10]

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‎ </div>

{| border=1 style="border-collapse: collapse;"

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''Patala'' (Stereospermum colais (Buch.-Ham.ex Dillw), ''Agnimantha'' (Premna corymbosa Rottl.), ''Bilwa'' (Aegle marmelos (Linn.) Corr.), ''Shyonaka'' (Oroxylumindicum (Linn.)Benth. ex Kurz) ''Kashmarya'' (Gmelina arborea Roxb.), ''Shalaparni''(Desmodium gangeticum (Linn.) DC.), ''Prishnaparni'' (Uraria picta Desv.), ''Nidigdhika'' (Solanum xanthocarpum Schrad. & Wendl.), ''Bala'' (Sida cordifolia Linn.), ''Shwadamshtra'' (Tribulus terrestris Linn.), ''Brahati'' (Solanum indicum auct.non Linn.), ''Eranda'' (Ricinus communis Linn.), ''Punarnava'' (Boerrhavia diffusa Linn.), ''Yava'' (Hordeum vulgare Linn.), ''Kulattha'' (Dolichos lablab Linn.), ''Kola'' (Ziziphus mauritiana Lam.), ''Guduchi'' (Tinospora cordifolia), ''Madana'' (Catunaregam spinose (Thunb.) Tirvengadum), ''Palasha'' (Butea monosperma (Lam.) Taub.), ''Kuttrana'' (Cymbopogon citratus (DC) Stapf), ''Sneha'' (fat), and ''Lavana'' (salt) are the drugs to be selected for ''Asthapana''( a variety of enema with decoction) in the event of ''udavarta'' (conditions caused by the inhibition of natural urges) and ''vibandha'' (constipation).

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These drugs are to be used for ''anuvasana'' (another variety of enema with oil /unctuous substances) for the pacification of vitiated ''vata''. Thus the bio-purificatory therapies are mentioned here in brief. [11-14]

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These drugs are to be used for ''anuvasana'' (another variety of enema with oil /unctuous substances) for the pacification of vitiated ''[[vata]]''. Thus the bio-purificatory therapies are mentioned here in brief. [11-14]

</div>

{| border=1 style="border-collapse: collapse;"

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pa~jcakarmANi kurvIta mAtrAkAlau vicArayan||15||<br />

</div></div>

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In the event of vitiated 'dosha'' (vitiated factors) brought to ''koshtha'' (gut) by oleation and sudation therapies, a physician should administer five bio-purificatory therapies by duly considering the ''matra'' (dose) and ''kala'' (time). [15]

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In the event of vitiated '[[dosha]]'' (vitiated factors) brought to ''koshtha'' (gut) by oleation and sudation therapies, a physician should administer five bio-purificatory therapies by duly considering the ''matra'' (dose) and ''[[kala]]'' (time). [15]

===[[Talk:Apamarga Tanduliya Adhyaya#Yukti Praman(Rational therapeutics)|Yukti (rational therapeutics)]]===

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tiShThatyupari yuktij~jo dravyaj~jAnavatAM sadA||16||<br />

</div></div>

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Therapeutic aptness or rational therapy depends on the ''matra'' (dose) and ''kala''(time). Success of the treatment depends on ''yukti'' (rational therapeutics). But prior to the application of ''yukti'' (rational therapeutics) the physician should always possess complete knowledge about drugs. [16]

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Therapeutic aptness or rational therapy depends on the ''matra'' (dose) and ''[[kala]]''(time). Success of the treatment depends on ''yukti'' (rational therapeutics). But prior to the application of ''yukti'' (rational therapeutics) the physician should always possess complete knowledge about drugs. [16]

=== Description of various medicated ''yavagu'' (gruels) ===

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pAcanI grAhiNI, peyA savAte pA~jcamUlikI||19||<br />

</div></div>

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Gruel prepared with Dadhittha (Limonia acidissima Groff), Bilwa [Aegle marmelos (L.) Corrêa], Changeri (Oxalis corniculata L.), Takra (buttermilk), Dadima (Punica granatum L.) are ''pachana'' (digestive) and ''grahi'' (styptic and promoting absorption of liquid).

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Gruel prepared with Dadhittha (Limonia acidissima Groff), Bilwa [Aegle marmelos (L.) Corrêa], Changeri (Oxalis corniculata L.), Takra (buttermilk), Dadima (Punica granatum L.) are ''[[pachana]]'' (digestive) and ''grahi'' (styptic and promoting absorption of liquid).

Whereas thin gruel prepared with ''Panchamoola'' (roots of five herbs- Sthiradi Panchamoola) are beneficial in disorders of [[vata]] (dominant diarrhea).[19]

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==== Gruel used in diarrhoea with dominance of ''pitta'' and ''kapha''====

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==== Gruel used in diarrhoea with dominance of ''[[pitta]]'' and ''[[kapha]]''====

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Whereas in the case of diarrhea associated with ''Ama'', gruel prepared with Ativisha (Aconitum heterophyllum Wall. ex Royle), Amla dadima (Sour pomegranate)/Punica granatum L.) and Nagara (Zingiber officinale Roscoe) is beneficial.

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In the case of mutrakrichchra(dysuria) one should use the gruel prepared with Shwadamshtra (Tribulus terrestris L.), Kantakari (Solanum virginianum L.), and Phanita (a preparation of sugarcane).[22]

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In the case of mutrakrichchra (dysuria) one should use the gruel prepared with Shwadamshtra (Tribulus terrestris L.), Kantakari (Solanum virginianum L.), and Phanita (a preparation of sugarcane).[22]

==== Gruel for ''krimi'' (worm infestation)====

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pipAsAghnI, viShaghnI ca somarAjIvipAcitA||24|| <br />

</div></div>

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Gruel prepared using ''Mridvika'' (Vitis vinifera Linn.), ''Sariva'' (Hemidesmus indicus R. Br.), ''Laja'' (popped sorghum), ''Pippali'' (Piper longum) , ''madhu'' (honey), ''Nagara'' (Zingiber officinale Rosc.) relieves thirst.

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Gruel prepared using ''Mridvika'' (Vitis vinifera Linn.), ''Sariva'' (Hemidesmus indicus R. Br.), ''Laja'' (popped sorghum), ''Pippali'' (Piper longum), ''madhu'' (honey), ''Nagara'' (Zingiber officinale Rosc.) relieves thirst.

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When it is ~~further~~ cooked with ''Somaraji'' (Psoralea corylifolia Linn.) it acts as anti-toxic particularly in skin diseases. [24]

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When it is cooked with ''Somaraji'' (Psoralea corylifolia Linn.) it acts as anti-toxic particularly in skin diseases. [24]

==== Gruels for nourishment/weight gain and weight loss ====

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kushAmalakaniryUhe shyAmAkAnAM virUkShaNI||26||<br />

</div></div>

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For the ''snehana'' (unctuousness) one should use the gruel prepared using ''tila'' (Sesamum indicum Linn.) and ''lavana'' (salt).

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For the ''[[snehana]]'' (unctuousness) one should use the gruel prepared using ''tila'' (Sesamum indicum Linn.) and ''lavana'' (salt).

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Whereas for ''rukshana'' (dryness/un-oiliness) one can prepare the gruel using ''kusha'' (Desmostachya bipinnata Staff.), ''Amalaki'' (Emblica officinalis Gaertn.) and ''Shyamaka'' (Punicum italicum Linn.)[26]

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Whereas for ''[[rukshana]]'' (dryness/un-oiliness) one can prepare the gruel using ''kusha'' (Desmostachya bipinnata Staff.), ''Amalaki'' (Emblica officinalis Gaertn.) and ''Shyamaka'' (Punicum italicum Linn.)[26]

==== Gruels for respiratory diseases and colic pain ====

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yamake madirAsiddhA pakvAshayarujApahA||27|| <br />

</div></div>

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Gruel prepared with ''Dashamoola'' (ten root drugs) is beneficial in ''hikka'' (hiccough), ''shwasa'' (dyspnea), ''kasa'' (cough) and is considered as ''~~kaphahara~~'' (reduces kapha).

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Gruel prepared with ''Dashamoola'' (ten root drugs) is beneficial in ''hikka'' (hiccough), ''shwasa'' (dyspnea), ''kasa'' (cough) and is considered as ''[[kapha]] hara'' (reduces [[kapha]]).

The one prepared using ghee, oil and ''madira'' (alcoholic beverage) alleviates pain in the colon [27]

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tailavyApadi shastA syAttakrapiNyAkasAdhitA||30|| <br />

</div></div>

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Gruel prepared with buttermilk eradicates untoward effects caused by ''ghritavyapada'' (improper administration of ghee).

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Gruel prepared with buttermilk eradicates untoward effects caused by ''ghritavyapada'' (improper administration of ghee).

Intake of gruel with buttermilk and ''pinyaka'' (oil cake) alleviates untoward effects caused by the improper administration of oil.[30]

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kaNThyA yavAnAM yamake pippalyAmalakaiH shRutA||31||<br />

</div></div>

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Gruel prepared using cow meat and sour ''Dadima'' (Punica granatum) is beneficial in ''~~vishamajwara~~'' (type of fever with irregular pattern).

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Gruel prepared using cow meat and sour ''Dadima'' (Punica granatum) is beneficial in ''vishama [[jwara]]'' (type of fever with irregular pattern).

Gruel prepared with ''Yava'' (Hordeum vulgare),ghee, oil, ''Pippali'' (Piper longum Linn.) and ''Amalaki''(Phyllanthus emblica Linn.) is useful for throat.[31]

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One prepared with ''Upodika'' (Basella rubra Linn.) and curd cures mada (intoxication).

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Gruel prepared with ''Apamarga'' (Achyranthes aspera Linn.), milk and extract of ~~inguinal~~ flesh is beneficial in polyphagia. [33]

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Gruel prepared with ''Apamarga'' (Achyranthes aspera Linn.), milk and extract of iguana flesh is beneficial in polyphagia. [33]

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bhiShagauShadhasaMyogaishcikitsAM kartumarhati||36|| <br />

</div></div>

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A physician endowed with good memory([[smriti]]), knowledge of cause and effect of disease (hetu-yuktijna), self restraint (jitatma), and presence of mind (pratipattiman), is entitled to practice [[Ayurveda]] through the combination of various drugs. [36]

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A physician endowed with good memory ([[smriti]]), knowledge of cause and effect of disease (hetu-yuktijna), self restraint (jitatma), and presence of mind (pratipattiman), is entitled to practice [[Ayurveda]] through the combination of various drugs. [36]

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== Tattva Vimarsha(Fundamental Principles) ==

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* Body purification is an important method for disease management. ''~~Shirovirachana~~'' (catharsis of the cephalic region) is indicated for disease in head region. ''Vamana'' (therapeutic emesis) is indicated for vitiated ''kapha'' disorders. ''Virechana'' (therapeutic purgation) is indicated for vitiated ''pitta'' disorders. ''Aasthapana'' (enema with decoction) and ''Anuvasana'' (enema with oil/unctuous substances) are indicated in vitiation of disorders of ''vata''.

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* Body purification is an important method for disease management. ''Shirovirechana'' (catharsis of the cephalic region) is indicated for disease in head region. ''[[Vamana]]'' (therapeutic emesis) is indicated for vitiated ''[[kapha]]'' disorders. ''[[Virechana]]'' (therapeutic purgation) is indicated for vitiated ''[[pitta]]'' disorders. ''Aasthapana'' (enema with decoction) and ''Anuvasana'' (enema with oil/unctuous substances) are indicated in vitiation of disorders of ''[[vata]]''.

* Specific ''yavagu'' (gruel) processed with various herbs are indicated for treatment of specific curable diseases as well as re-kindling ''jatharagni'' (digestive powers).

* Physicians require good memory, knowledge of etiology of diseases, self-restraint, and good presence of mind to be able to formulate Ayurvedic preparations and administer them to the patients.

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== Vidhi Vimarsha (Applied Inferences)==

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In the previous chapter ([[Deerghanjiviteeya Adhyaya]] (Quest for longevity), plants and their different useful parts have been explained. There are however some other plants like ''Pippali'' (Piper longum Linn.), ''Maricha'' (Piper nigrum Linn.) which are also useful for panchakarma (five purificatory procedures), but not described in that chapter. Hence in this chapter remaining drugs which are useful for various bio-purificatory therapies and the objectives of applications are enumerated. The drugs mentioned in each group can be used either individually or in a combination of as many as are available. [Su.Sa.Sutra Sthana 36/33]

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In the previous chapter ([[Deerghanjiviteeya Adhyaya]] (Quest for longevity), plants and their different useful parts have been explained. There are however some other plants like ''Pippali'' (Piper longum Linn.), ''Maricha'' (Piper nigrum Linn.) which are also useful for [[panchakarma]] (five purificatory procedures), but not described in that chapter. Hence in this chapter remaining drugs which are useful for various bio-purificatory therapies and the objectives of applications are enumerated. The drugs mentioned in each group can be used either individually or in a combination of as many as are available. [Su.Sa.Sutra Sthana 36/33]

==== Herbs used for Shirovirechana (catharsis of cephalic region) ====

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==== Herbs used in vamana (therapeutic emesis) ====

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These refer to the plants used for emesis for a disease that originates from the site of ''kapha''; the upper portion of ''amashaya'' (stomach). ''Pitta'' vitiation may not require emesis, but when this aggravated ''pitta'' reaches the site of ''kapha'', then it is to be eliminated through emesis. Different sites or parts of the body are associated with different ''dosha''. So when a vitiated ''dosha'' leaves its own “site” and occupies the site of another ''dosha'', then it is to be treated on the lines of treatment for the latter. [Cha.Sa.[[Chikitsa Sthana]] 3/142] Among all plants enumerated for emesis ''Madnaphala'' (Catunaregam spinosa ) is considered important owing to its lesser side effects[Cha.Sa.[[Kalpa Sthana]]1/13] and its strong effect. [Cha.Sa.[[Sutra Sthana]] 25/40]

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These refer to the plants used for emesis for a disease that originates from the site of ''[[kapha]]''; the upper portion of ''amashaya'' (stomach). ''[[Pitta]]'' vitiation may not require emesis, but when this aggravated ''[[pitta]]'' reaches the site of ''[[kapha]]'', then it is to be eliminated through emesis. Different sites or parts of the body are associated with different ''[[dosha]]''. So when a vitiated ''[[dosha]]'' leaves its own “site” and occupies the site of another ''[[dosha]]'', then it is to be treated on the lines of treatment for the latter. [Cha.Sa.[[Chikitsa Sthana]] 3/142] Among all plants enumerated for emesis ''Madnaphala'' (Catunaregam spinosa ) is considered important owing to its lesser side effects[Cha.Sa.[[Kalpa Sthana]]1/13] and its strong effect. [Cha.Sa.[[Sutra Sthana]] 25/40]

Therefore, it is widely used in clinical practice. Apart from ''Madanaphala'', five other drugs, and in total 355 formulations are described; One of these formulations is ''Kritavedhana'' (Luffa acutangula) ''kalpa'' (formulations). It is specially indicated to be effective for treating cases of ''kushtha'' (skin diseases), ''garavisha'' (slow poison) etc for therapeutic emesis.<ref> Available from www.ncbi.nlm.nih.gov › NCBI › Literature › PubMed Central (PMC)jpsionline.com/admin/php/uploads/110_pdf.pdf </ref> [verse 7-8]

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==== Herbs for ''virechana'' [therapeutic purgation] ====

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==== Herbs for ''[[virechana]]'' [therapeutic purgation] ====

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Evacuation of the fecal matter and other accumulated ''dosha''(vitiated factors) in the lower gastrointestinal tract through the anal route is known as ''virechana karma''.[Cha.Sa.[[Kalpa Sthana]]1/4) Among the three ''dosha'' the morbid accumulation of ''pitta dosha'' is best eliminated by this procedure. Abnormal accumulation of ''kapha dosha'' in the lower gastro-intestinal tract or ''pitta sthana'' (place) is also treated by the ''virechana karma''. This also includes treatment of vitiated ''dosha'' of the stomach, small intestine, liver and gall bladder, as well as a method of bringing them to the gastro-intestinal tract for their eventual expulsion from the body through rectum. This process not only eradicates the diseases of ''pitta'' and blood, but also it helps in rejuvenating all the tissues and organs in the abdomen, improving skin complexion, imparting longevity and increasing immunity.[Cha.Sa.[[Sutra Sthana]]15/23]; [Su.Sa.[[Chikitsa Sthana]] 33/18] [Cha.Sa.[[Sutra Sthana]] 15/23; [Su.Sa.[[Chikitsa Sthana]] 33/18)

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Evacuation of the fecal matter and other accumulated ''[[dosha]]''(vitiated factors) in the lower gastrointestinal tract through the anal route is known as ''[[virechana]] karma''.[Cha.Sa.[[Kalpa Sthana]]1/4) Among the three ''[[dosha]]'' the morbid accumulation of ''[[pitta dosha]]'' is best eliminated by this procedure. Abnormal accumulation of ''[[kapha dosha]]'' in the lower gastro-intestinal tract or ''[[pitta]] sthana'' (place) is also treated by the ''[[virechana]] karma''. This also includes treatment of vitiated ''[[dosha]]'' of the stomach, small intestine, liver and gall bladder, as well as a method of bringing them to the gastro-intestinal tract for their eventual expulsion from the body through rectum. This process not only eradicates the diseases of ''[[pitta]]'' and blood, but also it helps in rejuvenating all the tissues and organs in the abdomen, improving skin complexion, imparting longevity and increasing immunity.[Cha.Sa.[[Sutra Sthana]]15/23]; [Su.Sa.Chikitsa Sthana 33/18] [Cha.Sa.[[Sutra Sthana]] 15/23]; [Su.Sa.Chikitsa Sthana 33/18]

The selection of medicines for purgation depends upon, softness or hardness of bowel movements and constitution of the patient. Among the plants for purgation, ''Trivrit'' (Operculina turpethum) is considered the best because it causes comfortable evacuation. [Cha.Sa.[[Sutra Sthana]] 25/40]<ref> www.ijpbs.net/issue-4/Ph-53.pdf </ref>

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==== Herbs used in enema ====

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Administration of liquid medicine through the rectal, urethral or vaginal route is collectively known by the term ''basti'' (enema) (Sha. Ut. 5/1). In general ''basti'' (enema) refers to the administration of medicine through any of the above said routes, but more particularly it refers to the therapeutic enema using the decoction through the rectal route. Administration of medicine done through the urethral or vaginal route is specifically known by the name ''uttara basti''. Moreover the procedure is also practiced to administer the medicine into a sinus wound, where it is referred by the name ''vrana basti''(wound enema).

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Administration of liquid medicine through the rectal, urethral or vaginal route is collectively known by the term ''[[basti]]'' (enema) (Sha. Ut. 5/1). In general ''[[basti]]'' (enema) refers to the administration of medicine through any of the above said routes, but more particularly it refers to the therapeutic enema using the decoction through the rectal route. Administration of medicine done through the urethral or vaginal route is specifically known by the name ''uttara [[basti]]''. Moreover the procedure is also practiced to administer the medicine into a sinus wound, where it is referred by the name ''vrana [[basti]]''(wound enema).

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''Basti''(enema) is a prime procedure among purificatory procedures. It is described as the best line of treatment to cure the imbalances of ''vata''. Simultaneously it is also true that this procedure is equally effective in rectifying the abnormal accumulation of ''pitta'' as well as ''kapha dosha''.

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''[[Basti]]''(enema) is a prime procedure among purificatory procedures. It is described as the best line of treatment to cure the imbalances of ''[[vata]]''. Simultaneously it is also true that this procedure is equally effective in rectifying the abnormal accumulation of ''[[pitta]]'' as well as ''[[kapha dosha]]''.

Depending upon the composition of medicines used in the administration of enema, it is said to be of two types: ''asthapana'' or ''niruha'' (with decoction) and ''anuvasana''(with oil).

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The decoction of herbs used for ''niruha'' or ''asthapana'' helps in keeping the body healthy as well as prolongs the life span. The enema administered using such herbs is referred as ''asthapana basti''. [Su.Sa.Chikitsa Sthana 35/17-18]

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The decoction of herbs used for ''niruha'' or ''asthapana'' helps in keeping the body healthy as well as prolongs the life span. The enema administered using such herbs is referred as ''asthapana [[basti]]''. [Su.Sa.Chikitsa Sthana 35/17-18]

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Likewise, the enema administered predominantly containing ''sneha'' (oil) is known as ''anuvasana basti''. Among these two types of enema, ''niruha'' (decoction enema) is considered superior to ''anuvasana'' (oil enema) because it is more effective in the elimination of vitiated factors. Details about these drugs have been mentioned in [[Vimana Sthana]]. [Cha.Sa.[[Vimana Sthana]] 8/138-144]

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Likewise, the enema administered predominantly containing ''sneha'' (oil) is known as ''anuvasana [[basti]]''. Among these two types of enema, ''niruha'' (decoction enema) is considered superior to ''anuvasana'' (oil enema) because it is more effective in the elimination of vitiated factors. Details about these drugs have been mentioned in [[Vimana Sthana]]. [Cha.Sa.[[Vimana Sthana]] 8/138-144]

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The pharmacodynamics of systemic effect of ''basti'' (enema) may be understood through the absorption mechanism, concept of systems biology, neural stimulation mechanism, and excretory mechanism. As it is a homogenous emulsion mixture of honey, ''saindhava'' (salt), ''sneha dravya'' (oil/unctuous material), ''kalka'' (paste of drugs), and decoction of crude drugs which is given through rectum. Through rectal route large quantity of drugs can be delivered for systemic circulation. The concept of systems biology is that a change at cellular level can bring changes in tissues, organs and consequently in the whole body. As per recent advancements in medicine, the intestine not only is a highly vascular organ, but is also a highly innervated organ that forms an "enteric nervous system" (ENS). ENS may work synergistically with the central nervous system of body. The cleansing action of ''basti'' (enema) is related to the facilitation of excretion of morbid substances responsible for the disease process into the colon, from where it is evacuated.<ref> www.ijpba.info/ijpba/index.php/ijpba/article/viewFile/758/519 </ref> [verse 11-14]

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The pharmacodynamics of systemic effect of ''[[basti]]'' (enema) may be understood through the absorption mechanism, concept of systems biology, neural stimulation mechanism, and excretory mechanism. As it is a homogenous emulsion mixture of honey, ''saindhava'' (salt), ''sneha dravya'' (oil/unctuous material), ''kalka'' (paste of drugs), and decoction of crude drugs which is given through rectum. Through rectal route large quantity of drugs can be delivered for systemic circulation. The concept of systems biology is that a change at cellular level can bring changes in tissues, organs and consequently in the whole body. As per recent advancements in medicine, the intestine not only is a highly vascular organ, but is also a highly innervated organ that forms an "enteric nervous system" (ENS). ENS may work synergistically with the central nervous system of body. The cleansing action of ''[[basti]]'' (enema) is related to the facilitation of excretion of morbid substances responsible for the disease process into the colon, from where it is evacuated.<ref> www.ijpba.info/ijpba/index.php/ijpba/article/viewFile/758/519 </ref> [verse 11-14]

==== [[Panchakarma]] therapy ====

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The Sanskrit term [[Panchakarma]] denotes five therapeutic procedures. ''Pancha''(five), and ''karma'' (work) refer to the therapy that brings about homeostasis. ''Vamana'' (emesis), ''virechana'' (purgation), ''asthapana basti'' (enema), ''anuvasana basti'' (purgation) and ''nasya'' (nasal therapy) are the five procedures comprising [[Panchakarma]]. Sushruta enumerates ''vamana'' (emesis), ''virechana'' (purgation), ''basti'' (enema), ''nasya'' (nasal therapy) and ''raktamokshana'' (blood-letting) under five purificatory procedure.

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The Sanskrit term [[Panchakarma]] denotes five therapeutic procedures. ''Pancha''(five), and ''karma'' (work) refer to the therapy that brings about homeostasis. ''[[Vamana]]'' (emesis), ''[[virechana]]'' (purgation), ''asthapana [[basti]]'' (enema), ''anuvasana [[basti]]'' (purgation) and ''[[nasya]]'' (nasal therapy) are the five procedures comprising [[Panchakarma]]. Sushruta enumerates ''[[vamana]]'' (emesis), ''[[virechana]]'' (purgation), ''[[basti]]'' (enema), ''[[nasya]]'' (nasal therapy) and ''[[raktamokshana]]'' (blood-letting) under five purificatory procedure.

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Besides these five purificatory procedures, there are several other therapies like ''ashchotana'', a method of administering medicine in to the eye that are capable of bringing about evacuation of the morbid vitiated factors from the body. However, only five major procedures are referred as [[Panchakarma]] procedures. Ability of evacuation, superiority of efficacy, and enormity of the procedure, target ''dosha'' (vitiated factor) eradication and various other actions are characteristics of [[Panchakarma]]. Though specific procedures like ''anjana'' and ''ashchotana'' (application of medicine to eye) are capable of evacuating morbid vitiated factors, their efficacy is minimum and restricted to one organ. That is why these procedures are not enlisted in the class of [[Panchakarma]] treatment.

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Besides these five purificatory procedures, there are several other therapies like ''ashchotana'', a method of administering medicine in to the eye that are capable of bringing about evacuation of the morbid vitiated factors from the body. However, only five major procedures are referred as [[Panchakarma]] procedures. Ability of evacuation, superiority of efficacy, and enormity of the procedure, target ''[[dosha]]'' (vitiated factor) eradication and various other actions are characteristics of [[Panchakarma]]. Though specific procedures like ''anjana'' and ''ashchotana'' (application of medicine to eye) are capable of evacuating morbid vitiated factors, their efficacy is minimum and restricted to one organ. That is why these procedures are not enlisted in the class of [[Panchakarma]] treatment.

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Elimination of vitiated factors from the body is the main aim of [[Panchakarma]]. Pre-therapeutic procedures, ''snehana'' (oleation) and ''swedana'' (sudation) are done to shift ''dosha'' from peripheral tissues to gut for removal by [[Panchakarma]].

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Elimination of vitiated factors from the body is the main aim of [[Panchakarma]]. Pre-therapeutic procedures, ''[[snehana]]'' (oleation) and ''[[swedana]]'' (sudation) are done to shift ''[[dosha]]'' from peripheral tissues to gut for removal by [[Panchakarma]].

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There are certain situations in which ''snehana'' (oleation) and ''swedana'' (sudation) ''karma'' may not be necessary before administering bio-purificatory measures. In suitable cases and at appropriate times, a physician is required to eliminate, vitiated factors from gastro-intestinal tract, dominated by ''kapha'', responsible for causing fever by using emetic therapy. In this case emesis is administered even without oleation and sudation therapy.

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There are certain situations in which ''[[snehana]]'' (oleation) and ''[[swedana]]'' (sudation) ''karma'' may not be necessary before administering bio-purificatory measures. In suitable cases and at appropriate times, a physician is required to eliminate, vitiated factors from gastro-intestinal tract, dominated by ''[[kapha]]'', responsible for causing fever by using emetic therapy. In this case emesis is administered even without oleation and sudation therapy.

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Administration of fatty substances either through the internal route or external route is referred to as ''snehana chikitsa'' (oleation). Before evacuation, oleation helps in the mobilization of vitiated factors from the site of morbidity to the site of elimination.

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Administration of fatty substances either through the internal route or external route is referred to as ''[[snehana]] chikitsa'' (oleation). Before evacuation, oleation helps in the mobilization of vitiated factors from the site of morbidity to the site of elimination.

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The procedure of inducing perspiration by different methods of applying heat to the body is known as ''swedana'' (sudation). This procedure helps in the mobilization of vitiated factors into the gastro-intestinal tract from where they are eliminated out of the body.

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The procedure of inducing perspiration by different methods of applying heat to the body is known as ''[[swedana]]'' (sudation). This procedure helps in the mobilization of vitiated factors into the gastro-intestinal tract from where they are eliminated out of the body.

These two preliminary procedures are termed as ''purvakarma'' and help in easy and effective administration of the five eliminatory procedures of [[Panchakarma]]. These preliminary procedures do not eliminate vitiated factors out of the body, whereas [[Panchakarma]] (five eliminatory) therapies have direct role in expelling out vitiated factors. Hence these two preliminary procedures cannot be enumerated under [[Panchakarma]]. [15]

==== Medicated gruels ====

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''Shodhana'' (purificatory) procedures are likely to cause debility in recipients by decreasing the functions of ''agni''. There are specific dietetic regimen prescribed such as ''samsarjana karma'' that could restore normal functions of ''agni''.

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''[[Shodhana]]'' (purificatory) procedures are likely to cause debility in recipients by decreasing the functions of ''agni''. There are specific dietetic regimen prescribed such as ''samsarjana karma'' that could restore normal functions of ''agni''.

Just as a small particle of fire kindled with the help of grass, cow dung etc. starts fire, similarly appetite is enhanced and stabilized with the help of medicated gruel. [Cha.Sa.[[Siddhi Sthana]] 1/12-13] [17]

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The detailed methods of preparation of gruel, quantity of water, proportion of medicaments etc. are to be referred from ''Sudashastra'' (text book on cookery). [17]

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A proper diet is considered more effective than a hundred medicines and no medication will help a patient who does not observe a strict regimen of diet. In modern science, food articles are primarily classified by their chemical composition such as carbohydrates, proteins, fats, vitamins, minerals etc. But in [[Ayurveda]], such classification is based on the biological action of the food articles and their ''rasa'' (taste). For example, while modern science may treat all varieties of rice as one group on the basis of their carbohydrate content, [[Ayurveda]] considers that freshly harvested rice, heavy for digestion and aggravates ''kapha'', while old rice stored over six months is considered to be light and easier to digest for an average person. According to modern science, ''yavagu'' (gruel) considered sources of carbohydrates, but according to [[Ayurveda]], these gruel not only have nutritive value but also help in curing diseases. Thus, ''yavagu kalpana'' (gruel preparation process), a recommended post purificatory formulation for helping in kindling digestive fire, also tones the intestine besides giving the nutrition. [18-33]

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A proper diet is considered more effective than a hundred medicines and no medication will help a patient who does not observe a strict regimen of diet. In modern science, food articles are primarily classified by their chemical composition such as carbohydrates, proteins, fats, vitamins, minerals etc. But in [[Ayurveda]], such classification is based on the biological action of the food articles and their ''rasa'' (taste). For example, while modern science may treat all varieties of rice as one group on the basis of their carbohydrate content, [[Ayurveda]] considers that freshly harvested rice, heavy for digestion and aggravates ''[[kapha]]'', while old rice stored over six months is considered to be light and easier to digest for an average person. According to modern science, ''yavagu'' (gruel) considered sources of carbohydrates, but according to [[Ayurveda]], these gruel not only have nutritive value but also help in curing diseases. Thus, ''yavagu kalpana'' (gruel preparation process), a recommended post purificatory formulation for helping in kindling digestive fire, also tones the intestine besides giving the nutrition. [18-33]

General use and applicability of drugs in relation to bio-purificatory therapies have been described in the first chapter. But in this chapter detailed explanation of these five bio-purificatory therapies along with their particular drug index have been provided. [35]

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#Singh R.H. The classical Ayurvediya Panchakarma Therapy; Recent advances in Panchakarma Therapy; Chaukamabha Sanskrit Series Office; First edition, 1992.

#Sushruta Samhita of Sushruta, Text with Sanskrit Commentary ‘Nibandhasamgraha’ of Dalhana, Edited by Jadavaji Trikamaji Acharaya, Published by Nirnaya Sagar Press, Mumbai, Third edition in 1938. Reprinted by Chaukamaba Surabharati Prakashan, Varanasi 2003.

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