Changes

<div style='text-align:justify;'>

<div style='text-align:justify;'>

The word ‘swedana’ means act of sweating or perspiring.<ref>Monier-Williams, Monier-Williams Sanskrit- English Dictionary, 1st edition; Oxford University Press, Svedana, Page 1285</ref> The terms like sudation, fomentation, steam are used to denote swedana therapy. It is one among the major six treatment modalities in Ayurveda. [Cha.Sa.[[Sutra Sthana]] 22/4] It is also used as main treatment to subside various disease conditions due to vitiation of [[vata]] and [[kapha]][[dosha]]. This is an important procedure performed before purification therapies ([[panchakarma]]). Different heating modes are used to induce sweating. The swedana therapy essentially includes sweating induced by implementing techniques or following methods for therapeutic purpose. Thus, it excludes pathological sweating either due to disease or sweating due to environmental conditions.

The word ‘swedana’ means act of sweating or perspiring.<ref>Monier-Williams, Monier-Williams Sanskrit- English Dictionary, 1st edition; Oxford University Press, Svedana, Page 1285</ref> The terms like sudation, fomentation, steam are used to denote swedana therapy. It is one among the major six treatment modalities in Ayurveda. [Cha.Sa.[[Sutra Sthana]] 22/4] It is also used as main treatment to subside various disease conditions due to vitiation of [[vata]] and [[kapha]] [[dosha]]. This is an important procedure performed before purification therapies ([[panchakarma]]). Different heating modes are used to induce sweating. The swedana therapy essentially includes sweating induced by implementing techniques or following methods for therapeutic purpose. Thus, it excludes pathological sweating either due to disease or sweating due to environmental conditions.

| |1 ||Bolus fomentation (Sankara) || Fomentation by means of bolus containing prescribed drugs with or without being wrapped with cloth. [Cha.Sa.[[Sutra Sthana]] 14/41] Application of this type of sudation can be done in the following methods also

| |1 ||Bolus fomentation (Sankara) || Fomentation by means of bolus containing prescribed drugs with or without being wrapped with cloth. [Cha.Sa.[[Sutra Sthana]] 14/41] Application of this type of sudation can be done in the following methods also

*Bolus made out of mud or stone or metal is made into red hot. It is then dipped into liquid having sour property. Cover the bolus with woolen or silk cloth. This can be used for sudation

*Bolus made out of mud or stone or metal is made into red hot. It is then dipped into liquid having sour property. Cover the bolus with woolen or silk cloth. This can be used for sudation

Indication: Predominance of [[kapha]][[dosha]] and adipose tissue ([[medadhatu]]), tumors (granthi) and in painful body parts.<ref>Vridha Vagbhata. Sutra Sthana, Cha.26 Swedavidi Adhyaya verse 7. In: Shivaprasad sharma, Editor. Ashtanga Sangraha. 3rd ed. Varanasi: Chaukhamba sanskrit series office;2012</ref>

Indication: Predominance of [[kapha]] [[dosha]] and adipose tissue ([[meda dhatu]]), tumors (granthi) and in painful body parts.<ref>Vridha Vagbhata. Sutra Sthana, Cha.26 Swedavidi Adhyaya verse 7. In: Shivaprasad sharma, Editor. Ashtanga Sangraha. 3rd ed. Varanasi: Chaukhamba sanskrit series office;2012</ref>

*Bolus prepared out of sand, dried cow dung, grains etc, is applied to the affected body parts after dipping in sour liquids. Based on the condition different types of oils or fermented liquid preparations can be used for this.  

*Bolus prepared out of sand, dried cow dung, grains etc, is applied to the affected body parts after dipping in sour liquids. Based on the condition different types of oils or fermented liquid preparations can be used for this.  

|-

|-

| | 2 ||Lying on medicinal mattress (Prastara) ||Mattress is prepared with corn, pulses, steamed boneless meat (vesavara), sweet porridge, boiled mixture of pulses and cereals (krishara) etc. covered with silk cloth, woolen pieces or leaves of Ricinus communis (panchangula), Calotropis gigantean etc. The individual after proper oleation is made to lie over this mattress. [Cha.Sa.[[Sutra Sthana]] 14/42]

| | 2 ||Lying on medicinal mattress (Prastara) ||Mattress is prepared with corn, pulses, steamed boneless meat (vesavara), sweet porridge, boiled mixture of pulses and cereals (krishara) etc. covered with silk cloth, woolen pieces or leaves of Ricinus communis (panchangula), Calotropis gigantean etc. The individual after proper oleation is made to lie over this mattress. [Cha.Sa.[[Sutra Sthana]] 14/42]

|-

|-

| | 3 ||Steam sudation using a tube  (Nadi) ||The drugs is placed in a pot and sufficient amount of water is added and boil it. The pot should be properly sealed so that the vapor should only pass through a hollow tube attached with the pot. The tube should have a length of approximately 45-90 cm and 20cm circumference in proximal end and 10cm at distal end. It should have 2 to 3 curves. [[Vata]][[dosha]] alleviating leaves should be placed at the opening of this tube and the vapor coming out should be directed over the body parts. [Cha.Sa.[[Sutra Sthana]] 14/43]

| | 3 ||Steam sudation using a tube  (Nadi) ||The drugs is placed in a pot and sufficient amount of water is added and boil it. The pot should be properly sealed so that the vapor should only pass through a hollow tube attached with the pot. The tube should have a length of approximately 45-90 cm and 20cm circumference in proximal end and 10cm at distal end. It should have 2 to 3 curves. [[Vata]] [[dosha]] alleviating leaves should be placed at the opening of this tube and the vapor coming out should be directed over the body parts. [Cha.Sa.[[Sutra Sthana]] 14/43]

|-

|-

| | 4 || Shower technique for fomentation or affusion  (Parisheka)||The drugs which mitigates [[vata]] are boiled in water, milk etc. This is filled in pots or vessels and is showered over the body. [Cha.Sa.[[Sutra Sthana]] 14/44]

| | 4 || Shower technique for fomentation or affusion  (Parisheka)||The drugs which mitigates [[vata]] are boiled in water, milk etc. This is filled in pots or vessels and is showered over the body. [Cha.Sa.[[Sutra Sthana]] 14/44]

===Based on the form of heat used ===  

===Based on the form of heat used ===  

*Heat in moist form(snigdha): This is applied in conditions due to vitiation of [[vata]][[dosha]].

*Heat in moist form(snigdha): This is applied in conditions due to vitiation of [[vata]] [[dosha]].

*Heat in dry form(ruksha): This is applied in conditions due to vitiation of [[kapha]][[dosha]].

*Heat in dry form(ruksha): This is applied in conditions due to vitiation of [[kapha]] [[dosha]].

*Mix (snigdha-ruksha): This is applied in conditions due to vitiation of both [[vata]] and [[kapha]][[dosha]].[Cha.Sa.[[Sutra Sthana]] 14/8]

*Mix (snigdha-ruksha): This is applied in conditions due to vitiation of both [[vata]] and [[kapha]] [[dosha]].[Cha.Sa.[[Sutra Sthana]] 14/8]

===Based on intensity of heat ===  

===Based on intensity of heat ===  

==Contraindications:==

==Contraindications:==

*In conditions and body constitutions with predominance of [[pitta]][[dosha]].  

*In conditions and body constitutions with predominance of [[pitta]] [[dosha]].  

*Conditions like bleeding disorders, diarrhea, diabetes mellitus, rectal prolapsed etc.

*Conditions like bleeding disorders, diarrhea, diabetes mellitus, rectal prolapsed etc.

*Those who regularly consumes alcohol and astringents

*Those who regularly consumes alcohol and astringents

==Importance in management of disease==

==Importance in management of disease==

Swedana can liquefy the dormant [[dosha]] adhered in the micro channels of body.[Cha.Sa.[[Siddhi Sthana]] 1/8] It relieves pain [Cha.Sa.[[Sutra Sthana]] 14/12], removes stiffness in joints and improves functioning.  [Su.Sa.Chikitsa Sthana 32/22]<ref name=Susruta/> Generally,swedana pacifies the diseases caused due to [[vata]] and [[kapha]][[dosha]]. [Cha.Sa.[[Sutra Sthana]] 14/3]  

Swedana can liquefy the dormant [[dosha]] adhered in the micro channels of body.[Cha.Sa.[[Siddhi Sthana]] 1/8] It relieves pain [Cha.Sa.[[Sutra Sthana]] 14/12], removes stiffness in joints and improves functioning.  [Su.Sa.Chikitsa Sthana 32/22]<ref name=Susruta/> Generally,swedana pacifies the diseases caused due to [[vata]] and [[kapha]] [[dosha]]. [Cha.Sa.[[Sutra Sthana]] 14/3]  

==Action of different types of sweda on [[dosha]]==  

==Action of different types of sweda on [[dosha]]==  

*Tapa and bashpa sweda : Mitigates [[kapha]]

*Tapa and bashpa sweda : Mitigates [[kapha]]

*Upanaha sweda : Mitigates [[vata]]

*Upanaha sweda : Mitigates [[vata]]

*Drava sweda: Mitigates [[pitta]][[dosha]] associated with [[kapha]]

*Drava sweda: Mitigates [[pitta]] [[dosha]] associated with [[kapha]]

*Niragnisweda: Mitigates [[vata]] associated with [[kapha]] and adipose tissue ([[meda dhatu]])[Su.Sa.Chikitsa Sthana 32/14-15]<ref name=Susruta/>

*Niragnisweda: Mitigates [[vata]] associated with [[kapha]] and adipose tissue ([[meda dhatu]])[Su.Sa.Chikitsa Sthana 32/14-15]<ref name=Susruta/>

The medicines are made into a bolus form and is applied over affected body part directly or after dipping in suitable medium like oil, decoctions, milk etc.

The medicines are made into a bolus form and is applied over affected body part directly or after dipping in suitable medium like oil, decoctions, milk etc.

====Valukasweda:====

====Valuka sweda:====

Clean and fresh sand is used for sudation. The sand is heated and made into a bolus by tying it inside a cloth. This bolus is further heated by placing it over a hot pan and is applied over the body parts. It is dry form of sudation. This is usually indicated in conditions of acute pain associated with swelling where presence of accumulation of metabolic waste (ama) is suspected.

Clean and fresh sand is used for sudation. The sand is heated and made into a bolus by tying it inside a cloth. This bolus is further heated by placing it over a hot pan and is applied over the body parts. It is dry form of sudation. This is usually indicated in conditions of acute pain associated with swelling where presence of accumulation of metabolic waste (ama) is suspected.

    

    

====Churnapindasweda:====

====Churna pinda sweda:====

Medicated powders are used to induce sweating. The bolus can be used in dry form or along with oil as per the condition. It is indicated in conditions of osteoarthritis, stiffness of neck etc.  

Medicated powders are used to induce sweating. The bolus can be used in dry form or along with oil as per the condition. It is indicated in conditions of osteoarthritis, stiffness of neck etc.  

====Jambeerapindasweda:====

====Jambeera pinda sweda:====

The bolus is prepared with citrus fruit, medicated powders and oil. This is indicated in conditions of joint pain, stiffness etc

The bolus is prepared with citrus fruit, medicated powders and oil. This is indicated in conditions of joint pain, stiffness etc

====Patrapindasweda:====

====Patra pinda sweda:====

Leaves of medicinal plants are used for making the bolus. These leaves along with medicated powders and grated coconut is cooked along with sutable medicated oil. The bolus is prepared out of this and applied over the body parts. It is indicated in diseases caused by [[vata]][[dosha]], hemiplegia, paraplegia etc.

Leaves of medicinal plants are used for making the bolus. These leaves along with medicated powders and grated coconut is cooked along with sutable medicated oil. The bolus is prepared out of this and applied over the body parts. It is indicated in diseases caused by [[vata]]  

[[dosha]], hemiplegia, paraplegia etc.

====Shashtikashalipindasweda:====

====Shashtikashali pinda sweda:====

Medicinal pudding is prepared using a special variety of rice grain along with milk and Sida cordifolia (Bala). Bolus is prepared out of this pudding. Before applying it over the body it should be again heated by dipping it in a mixture of hot milk and decoction. This is the most nourishing type of sudation. It is indicated in muscle wasting, degenerative diseases, cerebral palsy etc.

Medicinal pudding is prepared using a special variety of rice grain along with milk and Sida cordifolia (Bala). Bolus is prepared out of this pudding. Before applying it over the body it should be again heated by dipping it in a mixture of hot milk and decoction. This is the most nourishing type of sudation. It is indicated in muscle wasting, degenerative diseases, cerebral palsy etc.

===Sudation using vapour===

===Sudation using vapour===

====Bashpasweda:====

====Bashpa sweda:====

Sudation using a chamber, in which the person either can sit or lie, associated with a steam source outside. Through this whole-body sudation is made possible. Usually this type of sudation is used as pre-operative procedure before purification therapies.

Sudation using a chamber, in which the person either can sit or lie, associated with a steam source outside. Through this whole-body sudation is made possible. Usually this type of sudation is used as pre-operative procedure before purification therapies.

====Nadisweda:====

====Nadi sweda:====

The vapors coming from a steam source is redirected into the affected body parts using a hollow tube. This is indicated in conditions of painful joints like low back ache, knee OA etc.

The vapors coming from a steam source is redirected into the affected body parts using a hollow tube. This is indicated in conditions of painful joints like low back ache, knee OA etc.

====Pouring method====

====Pouring method====

Dhanyamladhara: Warm fermented liquid (dhanyamla), prepared from cereals is poured over the affected body parts to attain sudation.  

Dhanyamladhara: Warm fermented liquid (dhanyamla), prepared from cereals is poured over the affected body parts to attain sudation.  

Instead of dhanyamla, medicated buttermilk, decoctions, medicated milk and medicated oils can also be used as per the condition of the patient.

Instead of dhanyamla, medicated buttermilk, decoctions, medicated milk and medicated oils can also be used as per the condition of the patient.

   

   

====Immersion method====

====Immersion method====

The effected body parts are immersed in warm decoctions or oils

The affected body parts are immersed in warm decoctions or oils

==Mode of action of induced sweating:==

==Mode of action of induced sweating:==

Whole body heating results in cardio vascular stress. There will be increase in cutaneous vascular conductance followed by increase in systemic conductance. But the homeostasis will be maintained by decrease of conductance at non cutaneous bed and by increased cardiac output. It might be due to this increased cardiac output and by the redistribution of blood from central to peripheral circulation, a reduction in central venous pressure occurs during the onset of passive heating. In certain studies, it is noted that passive heating significantly raises the left ventricular ejection fraction.<ref name=PHcentralbloodV/>  In an observational study on sarvangabashpasweda, significant increase in pulse rate and blood pressure was recorded immediately after the completion of the therapy. This raise in blood pressure and pulse rate was transient as it came back to normal after five minutes of therapy.<ref>Sanjeev R, Francesco C.Hemodynamic effects of Sarvanga Swedana (Ayurvedic passive heat therapy): A pilot observational study.Ayu. 2013 Apr;34(2):154-9. doi: 10.4103/0974-8520.119669.</ref>

Whole body heating results in cardio vascular stress. There will be increase in cutaneous vascular conductance followed by increase in systemic conductance. But the homeostasis will be maintained by decrease of conductance at non cutaneous bed and by increased cardiac output. It might be due to this increased cardiac output and by the redistribution of blood from central to peripheral circulation, a reduction in central venous pressure occurs during the onset of passive heating. In certain studies, it is noted that passive heating significantly raises the left ventricular ejection fraction.<ref name=PHcentralbloodV/>  In an observational study on sarvangabashpasweda, significant increase in pulse rate and blood pressure was recorded immediately after the completion of the therapy. This raise in blood pressure and pulse rate was transient as it came back to normal after five minutes of therapy.<ref>Sanjeev R, Francesco C.Hemodynamic effects of Sarvanga Swedana (Ayurvedic passive heat therapy): A pilot observational study.Ayu. 2013 Apr;34(2):154-9. doi: 10.4103/0974-8520.119669.</ref>

==Effect of nadisweda:==

==Effect of nadi sweda:==

   

   

Nadisweda and simultaneous passive stretching have shown beneficial effect in a case of knee joint contractures due to rheumatoid arthritis.<ref>Patel MM, Patel MV, Gupta SN, Patel KB. Effect of Nadisvedana with simultaneous passive stretching on correction of sandhijadya. J Ayurveda Integr Med. 2018;9(1):61‐63. doi:10.1016/j.jaim.2017.07.002</ref> Local hyperthermia improves blood circulation and local blood tissue metabolism. It also helps in reducing the inflammation by reducing various inflammatory mediators.

Nadi sweda and simultaneous passive stretching have shown beneficial effect in a case of knee joint contractures due to rheumatoid arthritis.<ref>Patel MM, Patel MV, Gupta SN, Patel KB. Effect of Nadisvedana with simultaneous passive stretching on correction of sandhijadya. J Ayurveda Integr Med. 2018;9(1):61‐63. doi:10.1016/j.jaim.2017.07.002</ref> Local hyperthermia improves blood circulation and local blood tissue metabolism. It also helps in reducing the inflammation by reducing various inflammatory mediators.

In a study 50 patients of osteoarthritis (sandhigatavata) were treated with Nirgundipatrapindasweda for 21 days and is found to be effective in reducing the symptoms like pain and swelling in joints, stiffness and crepitus. Range of movements of effected joint was improved.<ref>Alpesh J, Charmi SM, Alankruta RD, VD Shukla. Clinical effect of Nirgundi Patra pinda sweda and AshwagandhadiGuggulu Yoga in the management of SandhigataVata (Osteoarthritis).Ayu. 2011 Apr;32(2):207-12. doi: 10.4103/0974-8520.92588.</ref>  

In a study 50 patients of osteoarthritis (sandhigatavata) were treated with Nirgundipatra pinda sweda for 21 days and is found to be effective in reducing the symptoms like pain and swelling in joints, stiffness and crepitus. Range of movements of effected joint was improved.<ref>Alpesh J, Charmi SM, Alankruta RD, VD Shukla. Clinical effect of Nirgundi Patra pinda sweda and AshwagandhadiGuggulu Yoga in the management of SandhigataVata (Osteoarthritis).Ayu. 2011 Apr;32(2):207-12. doi: 10.4103/0974-8520.92588.</ref>  

Shashtikashalipindasweda carried out for 28 days in two courses, each course of 14days with 7 days gap in between, over 8 children shows promising results in improving the motor system functions like muscle power, muscle tone, deep tendon reflexes etc and thereby improving the quality of life of children with cerebral palsy.<ref>Apexa GV, VK Kori, S Rajagopala, Kalpana Sp. Etiopathological study on cerebral palsy and its management by ShashtikaShali Pinda Sweda and SamvardhanaGhrita.Ayu. 2013 Jan;34(1):56-62. doi: 10.4103/0974-8520.115450.</ref>

Shashtikashali pinda sweda carried out for 28 days in two courses, each course of 14days with 7 days gap in between, over 8 children shows promising results in improving the motor system functions like muscle power, muscle tone, deep tendon reflexes etc and thereby improving the quality of life of children with cerebral palsy.<ref>Apexa GV, VK Kori, S Rajagopala, Kalpana Sp. Etiopathological study on cerebral palsy and its management by ShashtikaShali Pinda Sweda and SamvardhanaGhrita.Ayu. 2013 Jan;34(1):56-62. doi: 10.4103/0974-8520.115450.</ref>

   

   

==List of theses done==

==List of theses done==

#Shakuntala Sundi (2008): Comparative study of Nirgundighanavati and Tindukamrita capsule with nirgundipatrapindasweda in the management of Amavata. Department of Kayachikitsa, IPGT&RA  Jamnagar

#Shakuntala Sundi (2008): Comparative study of Nirgundighanavati and Tindukamrita capsule with nirgundipatra pinda sweda in the management of Amavata. Department of Kayachikitsa, IPGT&RA  Jamnagar

#Jayadip Kumar P Shah (2008): Effect of Tiktakshirabasti and patrapindasweda in the management of cervical spondylosis (Asthigatavata). Department of Panchakarma, IPGT&RA  Jamnagar

#Jayadip Kumar P Shah (2008): Effect of Tiktakshira basti and patrapinda sweda in the management of cervical spondylosis (Asthigatavata). Department of Panchakarma, IPGT&RA  Jamnagar

#Apexa G Vyas (2011): A clinical study on SamvardhanaGhrita and Shashtikashalipindasweda in the management of Cerebral palsy. Department of Kaumarabhritya, IPGT&RA  Jamnagar

#Apexa G Vyas (2011): A clinical study on Samvardhana Ghrita and Shashtikashali pinda sweda in the management of Cerebral palsy. Department of Kaumarabhritya, IPGT&RA  Jamnagar

#Rahul Ghuse (2015) : A clinical study on Shashtikashalipindasweda and Yoga basti in the management of cerebral palsy. Department of Kaumarabhritya, IPGT&RA  Jamnagar

#Rahul Ghuse (2015) : A clinical study on Shashtikashali pinda sweda and Yoga basti in the management of cerebral palsy. Department of Kaumarabhritya, IPGT&RA  Jamnagar

#Rani Sangeeta Ishwar Singh (2017): A randomized clinical trial on brihatyadiyapanabasti and patrapindasweda with aadityapakaguggulu in the management of cervical spondylosis w.s.r to asthigatavata.Department of Panchakarma, IPGT&RA  Jamnagar

#Rani Sangeeta Ishwar Singh (2017): A randomized clinical trial on brihatyadi yapanabasti and patrapinda sweda with aadityapakaguggulu in the management of cervical spondylosis w.s.r to asthigatavata.Department of Panchakarma, IPGT&RA  Jamnagar

#Purohit Palak Kishorbhai (2017): A comparative clinical study on Shashtikashalipindasweda and Yoga basti in the management of cerebral palsy. Department of Kaumarabhritya, IPGT&RA  Jamnagar

#Purohit Palak Kishorbhai (2017): A comparative clinical study on Shashtikashali pinda sweda and Yoga basti in the management of cerebral palsy. Department of Kaumarabhritya, IPGT&RA  Jamnagar

==Related chapters==

==Related chapters==