The word ‘pachana’ literally means digestion, cooking, boiling, baking, softening. In medical treatments, it denotes digestion or promoting digestion. It is an important treatment for indigestion. It is intended to remove undigested food/toxins (ama) from the body and is a prerequisite before purificatory therapies. It is prescribed for the pacification of dosha in the treatment of mild diseases. [A.Hr. Sutra Sthana 14/06]
|Section/Chapter/topic||Chikitsa / Pachana|
|Authors||Aneesh E.G., Deole Y.S.|
|Reviewed and Edited by||Basisht G.|
|Affiliations||Charak Samhita Research, Training and Development Centre, I.T.R.A., Jamnagar, India,|
|Publisher||Charak Samhita Research, Training and Development Centre, I.T.R.A., Jamnagar, India|
|Date of first publication:||April 28, 2021|
Etymology and derivation
The word pachana is derived from the root ‘pach’ with ‘nich’ and ‘lyut’ suffix. [Shabdakalpadruma]
The diet or medicine or process which leads to digestion of undigested food/toxic metabolic products (ama) is known as ‘pachana’. This process does not increase or stimulate digestive capacity (agni) at the primary level. [Sha.Purvakhanda 04/01] Thus, pachana occurs at the sites of accumulation of metabolic toxin or undigested food products.
Pachana, paka, vipachana
Additionally, the word ‘pachana’ denotes suppuration. It is a treatment of inflammatory swellings (shopha) and wounds (vrana). Local applications and internal medicines are given to expedite suppuration.
Pachana treatment is administered in two methods:
- Internal administration
- External application
The food items or medicines are given internally.
The pachana medicine is applied externally in the form of poultice [Su.Sa.Chikitsa Sthana 20/52], topical applications etc. E.g.application of alkali (kshara) over inflammatory swelling (vranashopha) for suppuration. [Su.Sa.Sutra Sthana 11/05]
The following table lists some examples for pachana food and medicines.
|Nagakeshara (Mesua ferrea) [Sha.Purvakhanda.04/01]||Curd, buttermilk, vinegar [Su.Sa. Chikitsa Sthana 1/25]|
|Haritaki (Terminalia chebula) [A.Hr Sutra Sthana 6/153]||Citrus fruit (jambeera) [Cha.Sa.Sutra Sthana 27/167],|
|Musta (Cyperus rotundus) [A.S.Sutra sthana 12/38]||Jagala (a variety of wine) [Cha.Sa.Sutra Sthana 27/181],|
|Pippalyadigana [Su.Sa.Sutra Sthana 38/23]||Asafoetida (hingu) [Cha.Sa.Sutra Sthana 27/299],|
|Vachadigana[Su.Sa.Sutra Sthana 38/26]||Oil [Su.Sa.Sutra Sthana 45/112],|
|Haridradigana[Su.Sa.Sutra Sthana 38/27]||Scum of gruel prepared with fried paddy (lajamanda)[Su.Sa.Sutra Sthana 46/340]|
|Mustadigana [Su.Sa.Sutra Sthana 38/54-55]|
Time of administration:The medicines for pachana effect shall be administered before and after food (samudgam). [A.S Sutra Sthana 23/20]
General indications for pachana
- Aggravation of kapha and pittadosha
- Moderate severity of diseases and aggravation of dosha [Cha.Sa.Sutra Sthana 22/20]
- In case of spread of ama all over the body [Cha.Sa.Chikitsa Sthana 15/75]
- In persons with moderate strength
- If ama state prevails during the administration of therapeutic enema (basti)[Cha.Sa.Siddhi Sthana 8/44]
Importance of pachana
The undigested food or metabolic waste products (ama) produce toxic effects on the body. [A.Hr. Sutra Sthana 8/14] It is essential to remove these products and clear body channels for their smooth functioning. However, the purification treatments cannot be performed in the state when the toxins are stuck to the body tissues. . They can lead to untoward effects on body tissues in this stage. It is similar to extracting juice from a raw fruit that destroys the fruit without producing any outcome. The raw state shall be transformed to ripened state to produce juice. Pachana therapy expedites metabolism and transformation of raw state (undigested food or toxic metabolite). The toxins can be either detoxified or freely expelled out from the body after pachana treatment.
Importance of pachana as treatment modality
- Pachana is one of the four techniques to stop bleeding.[Su.Sa.Sutra Sthana 14/39] The powders are applied at the bleeding site to stop it.Example. Nagakeshara (Mesua ferrea), turmeric powders are applied to stop bleeding hemorrhoids.
- It is one of the methods to remove the moving foreign body or undigested toxic product. [Su.Sa.Sutra Sthana 27/04]. The pachana treatment is done to detach it from body tissues and remove it.
- It is one of the eight kinds of treatments advocated for inflammatory swelling (vranasopha).[Su.Sa.Sutra Sthana 37/9]
- It is one among the 60 methods of treatment of wounds. [Su.Sa.Chikitsa Sthana 1/8]
- It is one among ten types of topical applications (alepa). [A.S. Uttara Sthana 30/08]
Importance in management of disease
- Pachana is prescribed as the first line of treatment in moderate conditions of diseases like vomiting, diarrhea, heart disease, acute intestinal irritation, intestinal sluggishness, fever, constipation, heaviness of body, eructation, nausea, anorexia.[Cha.Sa.Sutra Sthana 22/21]
- Hot water is given for pachana purpose in jwara (fever) due to indigestion. [Cha.Sa.Vimana Sthana 3/40]
- The medicated water with pachana properties is prescribed to pacify morbid thirst in jwara. [Cha.Sa.Chikitsa Sthana 3/144]
- The decoctions with pachana property are prescribed after initial phase of jwara. [Cha.Sa.Chikitsa Sthana 3/160]
- Pachana is first line of treatment in kapha dominant intermittent fever(vishamajwara).[Cha.Sa.Chikitsa Sthana 3/295]
- Pachana medicines are used to treat distaste in the mouth and improve appetite [Cha.Sa.Chikitsa Sthana 8/36].
- In the treatment of wasting diseases (rajayakshama), pachana medicines are given to improve digestion in persons with weak digestive capacity. [Cha.Sa.Chikitsa Sthana 11/84]
- For the treatment of swelling associated with toxic waste products (ama), pachana medicines should be administered followed by purification treatment. [Cha.Sa.Chikitsa Sthana 12/17]
- If the glandular erysipelas is not responding to any other treatment, then suppuration of the lump is attained by external applications of pachana medciines . After attaining suppuration, both internal and external purification should be done. [Cha.Sa.Chikitsa Sthana 21/135]
- In diarrhea with predominance of kaphadosha,pachana should be administered in the initial stage. [Cha.Sa.Chikitsa Sthana 19/102]
- In the treatment of hemorrhoids, the recipes for pachana are given. [Cha.Sa.Chikitsa Sthana 14/65]
- In the treatment of kapha dominant alcoholism, pachana is advocated. [Cha.Sa.Chikitsa Sthana 24/167]
- In ulcers with kapha dominance, external and internal administration of pachana medicines is prescribed. [Cha.Sa.Chikitsa Sthana 25/16]
- Pachana is an essential treatment in the initial stage of diseases due to vitiation of vata (vatavyadhi) associated with undigested food or metabolic waste (ama). [A.Hr Chikitsa Sthana 22/50]
- Debilitated patients of vata disorders should be given evacuative enema followed by food mixed with pachana medicines. Therapeutic purgation is contraindicated in these patients. [Cha.Sa.Chikitsa Sthana 28/87]
- If vitiated vatadosha is accumulated in the alimentary tract (kostha) or if it is occluded by excess food, pachan is given first. [Cha.Sa.Chikitsa Sthana 28/90] [Cha.Sa.Chikitsa Sthana 28/196]
- Pachana is treatment for bloating of upper abdomen (anaha) due to undigested food (ama). [Cha.Sa.Chikitsa Sthana 26/26]
Prerequisite before purification treatments
Pachana therapy detaches the undigested dosha from its site. It allows free movement towards the alimentary tract (koshta).[A.Hr. Sutra Sthana 13/18] Thus, it ensures completed purification of vitiated dosha and lessens chances of recurrence of the disease. Therefore, pachana is a prerequisite before purification treatments. [A.Hr Sutra Sthana 13/29]
Management of complications of therapy
- In therapeutic enema, if the enema medicine is obstructed due to presence of food in gut, then pachana should be prescribed. [Cha.Sa.Siddhi Sthana 4/35]
- The complications like a fissure in ano (parikartika), fatigue due to improper purification therapies are treated by pachana medicines. [Cha.Sa.Siddhi Sthana 6/63], [Cha.Sa.Siddhi Sthana 6/93]
There are higher chances of recurrence of disease after pachana treatment as compared to purification treatment.[Cha.Sa.Sutra Sthana 16/20]
Current researches and contemporary views
Food and medicines with pachana effect may work on primary and secondary metabolism at organic and cellular levels. The primary metabolic and biochemical process might be expedited due to pachana.
In experimental studies, the food conversion ratio is used to assess the pachana activity of medicines objectively. It is calculated as the food consumed in gram percentage (gm%) by dividing fecal matter in gm% passed on the same day. Improved metabolism leads to an increase in the nutritional part (sarabhaga) and a subsequent decrease in waste products (kittabhaga). So, pachana can result in higher food conversion ratio. In a study to compare the pachana activity of shyonaka (Oroxylum indicum) and its substituent aralu (Ailanthus excelsa), shyonaka showed more pachana activity.
In another study to compare the efficacy of fasting (upavasa) and fasting with pachana in patients with low digestion capacity, the fasting with pachana group showed better results.
Some researchers used the word digestants to denote medicines with pachana effect. Papain is a proteolytic enzyme obtained from raw papaya is used as digestants. Pachana drugs are chiefly used to manage indigestion. Bitter (tikta) taste is mainly found with the drugs having pachana effect. More research is needed to study the exact mechanism of action of pachana.
List of thesis done
- Jaidev Gehija (2018): Efficacy of Paushtika biscuit with and without deepana pacahana in the management of karshya (Malnutrition) – An open labeled, randomized, comparative clinical trial. Department of KaumaraBhritya, IPGT&RA, Jamnagar
Cha. = Charak, Su. = Sushruta, A. = Ashtanga, S. = Sangraha, Hr. = Hridayam, Sha = Sharangadara, Sa. = Samhita.
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