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=== Introduction ===

== Introduction ==

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In the earlier chapter on eight undesirable body features, the focus of the study was on two of the most undesirable kinds - ''sthula'' (obesity) and ''krisha'' (too thin/skinny/emaciated). The present chapter deals with types of treatments suitable for both conditions as well as other similar pathologies. There are four types of pathologies described in [[Ayurveda]]: ''atipravritti'' (excessive elimination), ''sanga'' (obstruction), ''sira granthi'' (tumor/varicosity), and ''vimarga gamana'' (improperly directed circulation). A disease could be of any of these four pathology types, but its affliction could manifest in different forms depending upon the unique body constitution of the patient and combination of ''doshas, dhatus, mala,'' etc., explained in prior chapters. To tackle such afflictions, [[Ayurveda]] describes six types of therapeutic measures: ''Langhana'' (reduction), ''Brimhana'' (nourishing), ''Rukshana'' (drying), ''Stambhana'' (astringent/styptic), ''Snehana'' (oleation), and ''Swedana'' (sudation). In the case of excessive discharge of anything from the body, ''Stambhana'' (a procedure that slows or stops the discharge) is advised. While in the case of obstructions, ''Langhana, Swedana,'' or ''Rukshana'' are advised. In cases of excessively vitiated ''dosha, Langhana'' (reducing therapy) is indicated to bring the elevated ''dosha'' to a state of equilibrium, whereas in a case of degeneration, ''Brimhana'' (nourishing therapy) and ''Snehana'' (oleation) are prescribed. The ''Snehana'' and ''Swedana'' therapies are described in detail in thirteenth and fourteenth chapters of this section respectively. This chapter describes remaining four therapies , i.e.,''Langhana, Brimhana, Stambhana,'' and ''Rukshana.''

In the earlier chapter on eight undesirable body features, the focus of the study was on two of the most undesirable kinds - ''sthula'' (obesity) and ''krisha'' (too thin/skinny/emaciated). The present chapter deals with types of treatments suitable for both conditions as well as other similar pathologies. There are four types of pathologies described in [[Ayurveda]]: ''atipravritti'' (excessive elimination), ''sanga'' (obstruction), ''sira granthi'' (tumor/varicosity), and ''vimarga gamana'' (improperly directed circulation). A disease could be of any of these four pathology types, but its affliction could manifest in different forms depending upon the unique body constitution of the patient and combination of ''doshas, dhatus, mala,'' etc., explained in prior chapters. To tackle such afflictions, [[Ayurveda]] describes six types of therapeutic measures: ''Langhana'' (reduction), ''Brimhana'' (nourishing), ''Rukshana'' (drying), ''Stambhana'' (astringent/styptic), ''Snehana'' (oleation), and ''Swedana'' (sudation). In the case of excessive discharge of anything from the body, ''Stambhana'' (a procedure that slows or stops the discharge) is advised. While in the case of obstructions, ''Langhana, Swedana,'' or ''Rukshana'' are advised. In cases of excessively vitiated ''dosha, Langhana'' (reducing therapy) is indicated to bring the elevated ''dosha'' to a state of equilibrium, whereas in a case of degeneration, ''Brimhana'' (nourishing therapy) and ''Snehana'' (oleation) are prescribed. The ''Snehana'' and ''Swedana'' therapies are described in detail in thirteenth and fourteenth chapters of this section respectively. This chapter describes remaining four therapies , i.e.,''Langhana, Brimhana, Stambhana,'' and ''Rukshana.''

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===Sanskrit text, Transliteration and English Translation===

==Sanskrit text, Transliteration and English Translation==

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Now we will expound the “Reducing and nourishing therapies” chapter, said Lord Atreya. [1-2]

Now I will explain the chapter on “Reducing and nourishing therapies”. Thus said Lord Atreya. [1-2]

==== Six types of therapies ====

=== Six types of therapies ===

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==== Definitions ====

=== Definitions ===

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==== Pharmaco-therapeutic properties behind these effects ====

=== Pharmaco-therapeutic properties behind these effects ===

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The drug or substance that is used for ''Swedana'' (sudation) therapy possesses hot, acute, flowing (unstable), unctuous, dry, minute (subtle), liquid, stable and heavy qualities. Finally,''Stambhana'' requires the drugs to possess cold, sluggish, soft, smooth, dry, minute (subtle), liquid, stable and light qualities. [12-17]

The drug or substance that is used for ''Swedana'' (sudation) therapy possesses hot, acute, flowing (unstable), unctuous, dry, minute (subtle), liquid, stable and heavy qualities. Finally,''Stambhana'' requires the drugs to possess cold, sluggish, soft, smooth, dry, minute (subtle), liquid, stable and light qualities. [12-17]

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==== Methods of ''langhana'' (reducing/lightening) therapy ====

==== Methods of ''langhana'' (reducing/lightening) therapy ====

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==== ''Brimhana'' (nourishing) therapy ====

=== ''Brimhana'' (nourishing) therapy ===

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==== [[Langhanabrimhaniya Adhyaya#Contemporary researches|''Rukshana'' (drying) therapy]] ====

=== [[Langhanabrimhaniya Adhyaya#Contemporary researches|''Rukshana'' (drying) therapy]] ===

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==== ''Stambhana'' (astringent/styptic) therapy ====

=== ''Stambhana'' (astringent/styptic) therapy ===

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==== Signs of adequate and excess ''langhana'' ====

=== Signs of adequate and excess ''langhana'' ===

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==== Signs of adequate and excess ''brimhana'' (nourishing) therapy ====

=== Signs of adequate and excess ''brimhana'' (nourishing) therapy ===

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Through the proper administration of ''Brimhana'', one gets strength, robustness, and freedom from the diseases of emaciation. On excessive application of ''Brimhana'', one suffers from corpulence (obesity). The symptoms of proper and excessive administration of ''Rukshana'' are the same as those of ''Langhana''. [38-38½]

Through the proper administration of ''Brimhana'', one gets strength, robustness, and freedom from the diseases of emaciation. On excessive application of ''Brimhana'', one suffers from corpulence (obesity). The symptoms of proper and excessive administration of ''Rukshana'' are the same as those of ''Langhana''. [38-38½]

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Signs of adequate and excess ''Stambhana'' (astringent/styptic) therapy:

=== Signs of adequate and excess ''Stambhana'' (astringent/styptic) therapy ===

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Thus, these six most useful therapies, if administrated properly in all diseases which have been described, with due consideration of time and dosage, are sure to accomplish the cure of all curable disorders. [41-42]

Thus, these six most useful therapies, if administrated properly in all diseases which have been described, with due consideration of time and dosage, are sure to accomplish the cure of all curable disorders. [41-42]

==== Summary ====

=== Summary ===

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Thus in the chapter titled “Reducing and nourishing therapies," the six therapies which comprise the entire field of therapeutics have been expounded by the Lord Atreya (teacher) as per the inquiries of the disciples. [44]

Thus in the chapter titled “Reducing and nourishing therapies," the six therapies which comprise the entire field of therapeutics have been expounded by the Lord Atreya (teacher) as per the inquiries of the disciples. [44]

=== ''Tattva Vimarsha'' / Fundamental Principles ===

== Tattva Vimarsha (Fundamental Principles) ==

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*''Langhana'' (reducing) therapy is indicated in obese persons and those diseases with obstructive pathology due to excessively vitiated ''doshas''.

*''Langhana'' (reducing) therapy is indicated in obese persons and those diseases with obstructive pathology due to excessively vitiated ''doshas''.

*The group of six treatments (''shadupakramas'') includes ''Langhana, Rukshana, Swedana, Brimhana, Snehana,'' and ''Stambhana''. The first three of these are reducing in nature, while the latter three are nourishing.  

*The group of six treatments (''shadupakramas'') includes ''Langhana, Rukshana, Swedana, Brimhana, Snehana,'' and ''Stambhana''. The first three of these are reducing in nature, while the latter three are nourishing.  

=== ''Vidhi Vimarsha''  /Applied Inferences ===

== Vidhi Vimarsha (Applied Inferences) ==

Above described six therapies are grouped into ''Apatarpana'' (''Langhana'', or reducing) and ''Santarpana'' (''Brimhana'', or nourishing). In ''Apatarpana'' – lightening, dryness, and sudation therapies, and in ''Santarpana'' – nourishing, unctuousness, and astringent therapies have been mentioned. (3-8)

Above described six therapies are grouped into ''Apatarpana'' (''Langhana'', or reducing) and ''Santarpana'' (''Brimhana'', or nourishing). In ''Apatarpana'' – lightening, dryness, and sudation therapies, and in ''Santarpana'' – nourishing, unctuousness, and astringent therapies have been mentioned. (3-8)

The three categories of ''Langhana'' according to the intensity of disease and ''dosha'' aggravation are described in detail in the third chapter of [[Vimana Sthana]].

The three categories of ''Langhana'' according to the intensity of disease and ''dosha'' aggravation are described in detail in the third chapter of [[Vimana Sthana]].

===== Contemporary researches =====

==== Contemporary researches ====

A case study by Kambale et.al. showed that [[Langhanabrimhaniya Adhyaya#Rukshana (drying) therapy|rukshana upakrama]] therapy in the form of Takra Siddha Yavagu [[Apamarga Tanduliya Adhyaya#Description of various medicated yavagu (gruels)|(Gruel for adverse effects due to improper administration of ghee)]]and Udvartana helped in normalizing lipid profile, reduction of weight; BMI, body circumference and skin fold thickness in case of dyslipidemia.<ref>Patel B, Kamble SB, Vyas HA, Vyas MK, Chinthala R. Hypolipidemic effect of Rukshana Upakrama in the management of dyslipidemia – A case study. AYU [serial online] 2018 [cited 2019 Feb 19];39:72-5. Available from: http://www.ayujournal.org/text.asp?2018/39/2/72/250781</ref>

A case study by Kambale et.al. showed that [[Langhanabrimhaniya Adhyaya#Rukshana (drying) therapy|rukshana upakrama]] therapy in the form of Takra Siddha Yavagu [[Apamarga Tanduliya Adhyaya#Description of various medicated yavagu (gruels)|(Gruel for adverse effects due to improper administration of ghee)]]and Udvartana helped in normalizing lipid profile, reduction of weight; BMI, body circumference and skin fold thickness in case of dyslipidemia.<ref>Patel B, Kamble SB, Vyas HA, Vyas MK, Chinthala R. Hypolipidemic effect of Rukshana Upakrama in the management of dyslipidemia – A case study. AYU [serial online] 2018 [cited 2019 Feb 19];39:72-5. Available from: http://www.ayujournal.org/text.asp?2018/39/2/72/250781</ref>

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== References ==

=== References ===

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