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{{#seo:
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|title=Panchakarmiya Siddhi
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|titlemode=append
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|keywords=Asthapana-basti, Anuvasana-basti, Panchakarma, Siddhi, Shirovirechana, Vamana, Virechana,indications, contra-indications, therapeutic enema, therapeutic purgation, therapeutic emesis, therapeutic intra-nasal administration, Ayurveda, charak samhita, Indian system of medicine.
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|description=Siddhi Sthana Chapter 2. Successful administration of [[Panchakarma]] therapies
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|image=http://www.carakasamhitaonline.com/resources/assets/ogimgs.jpg
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|image_alt=charak samhita
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|type=article
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}}
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<big>'''[[Siddhi Sthana]] Chapter 2. Successful administration of [[Panchakarma]] therapies'''</big>
 
{{Infobox
 
{{Infobox
 
|title = Panchakarmiya Siddhi
 
|title = Panchakarmiya Siddhi
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|label5 = Other Sections
 
|label5 = Other Sections
 
|data5 = [[Sutra Sthana]], [[Nidana Sthana]], [[Vimana Sthana]],  [[Sharira Sthana]],  [[Indriya Sthana]], [[Chikitsa Sthana]], [[Kalpa Sthana]]
 
|data5 = [[Sutra Sthana]], [[Nidana Sthana]], [[Vimana Sthana]],  [[Sharira Sthana]],  [[Indriya Sthana]], [[Chikitsa Sthana]], [[Kalpa Sthana]]
 
+
|label6 = Translator and commentator
|header3 =  
+
|data6 = Paliwal M.
 
+
|label7 = Reviewer
 +
|data7  = Mangalasseri P., Auti S.
 +
|label8 = Editors
 +
|data8  = Thakar A. B., Mangalasseri P., Deole Y.S., Basisht G.
 +
|label9 = Year of publication
 +
|data9 =  2020
 +
|label10 = Publisher
 +
|data10 =  [[Charak Samhita Research, Training and Skill Development Centre]]
 +
|label11 = DOI
 +
|data11 = [https://doi.org/10.47468/CSNE.2020.e01.s08.003 10.47468/CSNE.2020.e01.s08.003]
 
}}
 
}}
==([[Siddhi Sthana]] Chapter 2, Chapter on the Proper Methods of Application of [[Panchakarma]]==
 
  
=== Abstract ===
+
<big>'''Abstract </big>'''
 +
<div style="text-align:justify;">
 +
[[Charaka Samhita]] [[Siddhi Sthana]] is designed to discuss the proper methods of application of [[Panchakarma]] as well as complications of the same due to improper use and their successful management. In the previous chapter ([[Kalpana Siddhi]]), various aspects of administration of [[Panchakarma]] were discussed. ''Pravritti'' (indications) and ''nivritti'' (contraindications) of [[Panchakarma]] are essential to discuss without which successful administration cannot be assured. In the beginning of the chapter, persons unsuitable for both ''[[shodhana]]'' and ''shamana chikitsa'' are mentioned. At the end of the chapter, it is stated that in spite of having all the instructions, a wise physician should use his own wisdom and reasoning in arriving at the correct judgment as in many cases contraindications turn into indications and vice versa according to the stage of disease and need of the patient.
  
[[Charaka Samhita]] [[Siddhi Sthana]] is designed to discuss the proper methods of application of [[Panchakarma]] as well as complications of the same due to improper use and their successful management. In the previous chapter ([[Kalpana Siddhi]]), various aspects of administration of [[Panchakarma]] were discussed. ''Pravritti'' (indications) and ''nivritti'' (contraindications) of [[Panchakarma]] are essential to discuss without which successful administration cannot be assured. In the beginning of the chapter, persons unsuitable for both ''shodhana'' and ''shamana chikitsa'' are mentioned. At the end of the chapter, Charaka has stated that in spite of having all the instructions, a wise physician should use his own wisdom and reasoning in arriving at the correct judgment as in many cases contraindications turn into indications and vice versa according to the stage of disease and need of the patient.
+
'''Keywords''':  Asthapana-basti, Anuvasana-basti, [[Panchakarma]], Siddhi, Shirovirechana, [[Vamana]], [[Virechana]], indications, contra-indications, therapeutic enema, therapeutic purgation, therapeutic emesis, therapeutic intra-nasal administration.
 +
</div>
  
'''Keywords''': ''Asthapana-basti, Anuvasana-basti, Panchakarma, Siddhi, Shirovirechana, Vamana, Virechana.''
+
== Introduction ==
 +
<div style="text-align:justify;">
 +
''Dhatusamya'' i.e. equilibrium of body tissues needs to be maintained for disease free state. It is achieved by the prevention and promotion of health as well as cure of diseases. The cure of diseases is done by two means i.e. ''shodhana chikitsa'' (bio-purification therapy) and ''shamana-chikitsa'' (alleviation therapy). ''Shodhana-karma'' or ''chikitsa'' is generally considered as a synonym of [[Panchakarma]] and is accepted as the best therapy for cure of diseases without recurrence. If we go into the depth, we find that there are minor differences between ''shodhana-chikitsa'' and [[Panchakarma]]. ''Shodhana-chikitsa'' is of two types on the basis of external and internal purification where as [[Panchakarma]] is only related to internal purification of the body. Another important aspect is that there may be a long list of ''shodhana-karmas'' but [[Panchakarma]] are only five biopurificatory procedures. ''[[Vamana]]'' (therapeutic emesis), ''[[virechana]]'' (therapeutic purgation), ''asthapana-[[basti]]'' (therapeutic enema having more quantity of decoction), ''anuvasana-[[basti]]'' (therapeutic enema with medicated oil, ghee etc. fatty substances) and ''shirovirechana'' (head-evacuation) are considered under the heading of [[Panchakarma]]. These five procedures, eliminate the ''[[dosha]]s'' in more quantity and are more potent in purification of the body. These procedures are intended to bring vitiated [[dosha]] from periphery (shakha) to gut (koshtha) and then expel them outside from nearest external orifice thoroughly. Some scholars include ''[[raktamokshana]]'' (blood-letting) among [[Panchakarma]]. However this opinion is not acceptable as it removes [[dosha]] directly from shakha without any prior effect on vitiated dosha in gut. Hence [[Raktamokshana]] cannot be considered under [[panchakarma]]. 
  
=== Introduction ===
+
[[Panchakarma]] are supposed to produce ''Kaya-kalpa'' i.e. dramatic changes in the body provided properly administered considering ''desha'' (habitat), ''[[kala]]'' (season), ''[[dosha]]'' i.e. ''[[vata]], [[pitta]]'' and ''[[kapha]], [[dushya]]'' (those which get vitiated), ''koshtha'' (nature of bowel), ''agni'' (digestive power), ''bala'' (body strength) and ''[[prakriti]]'' (constitution of the body). Before administration of [[Panchakarma]], indications and contra-indications are essential to be considered to achieve the desired effects. [[Panchakarmiya Siddhi]] is written to discuss the suitable and unsuitable persons or patients for each of the procedure of [[Panchakarma]] which is very much crucial in getting the success. Instructions laid down in this chapter are as per general rule which are followed in most of the cases but exceptions are also found in the text considering the particular stage of disease.
 
+
</div>
''Dhatusamya'' i.e. equilibrium of body tissues needs to be maintained for disease free state. It is achieved by the prevention and promotion of health as well as cure of diseases. The cure of diseases is done by two means i.e. ''shodhana chikitsa'' (bio-purification therapy) and ''shamana-chikitsa'' (alleviation therapy). ''Shodhana-karma'' or ''chikitsa'' is generally considered as a synonym of [[Panchakarma]] and is accepted as the best therapy for cure of diseases without recurrence. If we go into the depth, we find that there are minor differences between ''shodhana-chikitsa'' and [[Panchakarma]]. ''Shodhana-chikitsa'' is of two types on the basis of external and internal purification where as [[Panchakarma]] is only related to internal purification of the body. Another important aspect is that there may be a long list of ''shodhana-karmas'' but [[Panchakarma]] are only five biopurificatory procedures. ''Vamana'' (medicine induced emesis), ''virechana'' (medicine induced purgation), ''asthapana-basti'' (medicated enema having more quantity of decoction), ''anuvasana-basti'' (enema with medicated oil, ghee etc. fatty substances) and ''shirovirechana'' (head-evacuation) are considered under the heading of [[Panchakarma]]. These five procedures, eliminate the ''doshas'' in more quantity and are more potent in purification of the body. Some scholars include ''raktamokshana'' (blood-letting) among [[Panchakarma]] and are supposed to produce ''Kaya-kalpa'' i.e. dramatic changes in the body provided properly administered considering ''desha'' (habitat), ''kala'' (season), ''dosha'' i.e. ''vata, pitta'' and ''kapha, dushya'' (those which get vitiated), ''koshtha'' (nature of bowel), ''agni'' (digestive power), ''bala'' (body strength) and ''prakriti'' (constitution of the body). Before administration of [[Panchakarma]], indications and contra-indications are essential to be considered to achieve the desired effects. [[Panchakarmiya Siddhi]] is written to discuss the suitable and unsuitable persons or patients for each of the procedure of [[Panchakarma]] which is very much crucial in getting the success. Instructions laid down in this chapter are as per general rule which are followed in most of the cases but exceptions are also found in the text considering the particular stage of disease.
+
== Sanskrit text, Transliteration and English Translation ==
 
+
<div class="mw-collapsible mw-collapsed">
===Sanskrit text, Transliteration and English Translation===
 
 
 
==== Prologue ====
 
  
 
अथातः पञ्चकर्मीयां  सिद्धिं व्याख्यास्यामः||१||  
 
अथातः पञ्चकर्मीयां  सिद्धिं व्याख्यास्यामः||१||  
  
 
इति ह स्माह भगवानात्रेयः||२||  
 
इति ह स्माह भगवानात्रेयः||२||  
 +
<div class="mw-collapsible-content">
  
 
athātaḥ Panchkarmiyaṁ  siddhiṁ vyākhyāsyāmaḥ||1||
 
athātaḥ Panchkarmiyaṁ  siddhiṁ vyākhyāsyāmaḥ||1||
Line 40: Line 62:
  
 
iti ha smAha bhagavAnAtreyaH||2||  
 
iti ha smAha bhagavAnAtreyaH||2||  
 +
</div></div>
  
We will now expound the chapter named [[Panchakarmiya Siddhi]] dealing with successful administration of [[Panchakarma]] therapies. As said by Lord Atreya.  [1-2]
+
Now we shall expound the chapter "Panchakarmiya Siddhi" (Successful administration of [[Panchakarma]] therapies). Thus said Lord Atreya.  [1-2]
 +
<div class="mw-collapsible mw-collapsed">
  
येषां यस्मात् पञ्चकर्माण्यग्निवेश न कारयेत्|  
+
येषां यस्मात् पञ्चकर्माण्यग्निवेश न कारयेत्| <br />
येषां च कारयेत्तानि तत् सर्वं सम्प्रवक्ष्यते||३||  
+
येषां च कारयेत्तानि तत् सर्वं सम्प्रवक्ष्यते||३|| <br />
 +
<div class="mw-collapsible-content">
  
yēṣāṁ yasmāt pañcakarmāṇyagnivēśa na kārayēt|  
+
yēṣāṁ yasmāt pañcakarmāṇyagnivēśa na kārayēt| <br />
yēṣāṁ ca kārayēttāni tat sarvaṁ sampravakṣyatē||3||  
+
yēṣāṁ ca kārayēttāni tat sarvaṁ sampravakṣyatē||3|| <br />
 
 
yeShAM yasmAt pa~jcakarmANyAgniveśaa na kArayet|
 
yeShAM ca kArayettAni tat sarvaM sampravakShyate||3||
 
  
 +
yeShAM yasmAt pa~jcakarmANyAgniveśaa na kArayet| <br />
 +
yeShAM ca kArayettAni tat sarvaM sampravakShyate||3||<br />
 +
</div></div>
 +
<div style="text-align:justify;">
 
O! Agnivesha, we will now describe about the patients for whom [[Panchakarma]] therapies are contra-indicated with proper reasoning and the patients for whom [[Panchakarma]] are indicated. [3]
 
O! Agnivesha, we will now describe about the patients for whom [[Panchakarma]] therapies are contra-indicated with proper reasoning and the patients for whom [[Panchakarma]] are indicated. [3]
 +
</div>
 +
=== Persons who are generally ''anupakramya'' (unsuitable for treatment) ===
 +
<div class="mw-collapsible mw-collapsed">
  
==== Persons who are generally ''anupakramya'' (unsuitable for treatment) ====
+
चण्डः साहसिको भीरुः कृतघ्नो व्यग्र एव च|
  
चण्डः साहसिको भीरुः कृतघ्नो व्यग्र एव च|
 
 
सद्राजभिषजां  द्वेष्टा तद्द्विष्टः शोकपीडितः||४||  
 
सद्राजभिषजां  द्वेष्टा तद्द्विष्टः शोकपीडितः||४||  
  
 
यादृच्छिको मुमूर्षुश्च विहीनः करणैश्च यः|  
 
यादृच्छिको मुमूर्षुश्च विहीनः करणैश्च यः|  
 +
 
वैरी वैद्यविदग्धश्च श्रद्धाहीनः सुशङ्कितः||५||  
 
वैरी वैद्यविदग्धश्च श्रद्धाहीनः सुशङ्कितः||५||  
  
 
भिषजामविधेयश्च नोपक्रम्या भिषग्विदा|  
 
भिषजामविधेयश्च नोपक्रम्या भिषग्विदा|  
 +
 
एतानुपचरन् वैद्यो बहून् दोषानवाप्नुयात्||६||  
 
एतानुपचरन् वैद्यो बहून् दोषानवाप्नुयात्||६||  
  
 
एभ्योऽन्ये समुपक्रम्या नराः सर्वैरुपक्रमैः|  
 
एभ्योऽन्ये समुपक्रम्या नराः सर्वैरुपक्रमैः|  
 +
 
अवस्थां प्रविभज्यैषां वर्ज्यं कार्यं च वक्ष्यते||७||
 
अवस्थां प्रविभज्यैषां वर्ज्यं कार्यं च वक्ष्यते||७||
 +
<div class="mw-collapsible-content">
  
 
caṇḍaḥ sāhasiko bhīruḥ kr̥taghnō vyagra ēva ca|  
 
caṇḍaḥ sāhasiko bhīruḥ kr̥taghnō vyagra ēva ca|  
 +
 
sadrājabhiṣajāṁ  dvēṣṭā taddviṣṭaḥ śōkapīḍitaḥ||4||  
 
sadrājabhiṣajāṁ  dvēṣṭā taddviṣṭaḥ śōkapīḍitaḥ||4||  
  
 
yādr̥cchiko mumūrṣuśca vihīnaḥ karaṇaiśca yaḥ|  
 
yādr̥cchiko mumūrṣuśca vihīnaḥ karaṇaiśca yaḥ|  
 +
 
vairī vaidyavidagdhaśca śraddhāhīnaḥ suśaṅkitaḥ||5||  
 
vairī vaidyavidagdhaśca śraddhāhīnaḥ suśaṅkitaḥ||5||  
  
 
bhiṣajāmavidhēyaśca nōpakramyā bhiṣagvidā|  
 
bhiṣajāmavidhēyaśca nōpakramyā bhiṣagvidā|  
 +
 
ētānupacaran vaidyō bahūn dōṣānavāpnuyāt||6||  
 
ētānupacaran vaidyō bahūn dōṣānavāpnuyāt||6||  
  
 
ēbhyō'nyē samupakramyā narāḥ sarvairupakramaiḥ|  
 
ēbhyō'nyē samupakramyā narāḥ sarvairupakramaiḥ|  
 +
 
avasthāṁ pravibhajyaiṣāṁ varjyaṁ kāryaṁ ca vakṣyatē||7||
 
avasthāṁ pravibhajyaiṣāṁ varjyaṁ kāryaṁ ca vakṣyatē||7||
  
 
caNDaH sAhasiko bhIruH kRutaghno vyagra eva ca|  
 
caNDaH sAhasiko bhIruH kRutaghno vyagra eva ca|  
 +
 
sadrAjabhiShajAM  dveShTA taddviShTaH shokapIDitaH||4||  
 
sadrAjabhiShajAM  dveShTA taddviShTaH shokapIDitaH||4||  
  
 
yAdRucchiko mumUrShushca vihInaH karaNaishca yaH|  
 
yAdRucchiko mumUrShushca vihInaH karaNaishca yaH|  
 +
 
vairI vaidyavidagdhashca shraddhAhInaH susha~gkitaH||5||  
 
vairI vaidyavidagdhashca shraddhAhInaH susha~gkitaH||5||  
  
 
bhiShajAmavidheyashca nopakramyA bhiShagvidA|  
 
bhiShajAmavidheyashca nopakramyA bhiShagvidA|  
 +
 
etAnupacaran vaidyo bahUn doShAnavApnuyAt||6||  
 
etAnupacaran vaidyo bahUn doShAnavApnuyAt||6||  
  
 
ebhyo~anye samupakramyA narAH sarvairupakramaiH|  
 
ebhyo~anye samupakramyA narAH sarvairupakramaiH|  
 +
 
avasthAM pravibhajyaiShAM varjyaM kAryaM ca vakShyate||7||  
 
avasthAM pravibhajyaiShAM varjyaM kAryaM ca vakShyate||7||  
 
+
</div></div>
 +
<div style="text-align:justify;">
 
The wise physician should not treat the following types of patients:
 
The wise physician should not treat the following types of patients:
  
Line 107: Line 148:
  
 
Henceforth, we will discuss the indications and contra-indications of each of the procedure of [[Panchakarma]] therapies considering the different situations. [4-7]
 
Henceforth, we will discuss the indications and contra-indications of each of the procedure of [[Panchakarma]] therapies considering the different situations. [4-7]
 
+
</div>
==== Contra-indications of ''vamanakarma'' ====
+
=== Contra-indications of ''vamana karma'' ===
 +
<div class="mw-collapsible mw-collapsed">
  
 
अवम्यास्तावत्-क्षतक्षीणातिस्थूलातिकृशबालवृद्धदुर्बलश्रान्तपिपासितक्षुधितकर्मभाराध्वहतोपवासमैथुनाध्ययनव्यायामचिन्ता-प्रसक्तक्षामगर्भिणीसुकुमारसंवृतकोष्ठदुश्छर्दनोर्ध्वरक्तपित्तप्रसक्तच्छर्दिरूर्ध्ववातास्थापितानुवासितहृद्रोगोदावर्तमूत्राघात-प्लीहगुल्मोदराष्ठीलास्वरोपघाततिमिरशिरशङ्खकर्णाक्षिशूलार्ताः||८||  
 
अवम्यास्तावत्-क्षतक्षीणातिस्थूलातिकृशबालवृद्धदुर्बलश्रान्तपिपासितक्षुधितकर्मभाराध्वहतोपवासमैथुनाध्ययनव्यायामचिन्ता-प्रसक्तक्षामगर्भिणीसुकुमारसंवृतकोष्ठदुश्छर्दनोर्ध्वरक्तपित्तप्रसक्तच्छर्दिरूर्ध्ववातास्थापितानुवासितहृद्रोगोदावर्तमूत्राघात-प्लीहगुल्मोदराष्ठीलास्वरोपघाततिमिरशिरशङ्खकर्णाक्षिशूलार्ताः||८||  
 +
<div class="mw-collapsible-content">
  
 
avamyāstāvat- kṣatakṣīṇātisthūlātikr̥śabālavr̥ddhadurbalaśrāntapipāsitakṣudhitakarmabhārādhvahatōpavāsamaithunādhyayanavyāyāmacintā-prasaktakṣāmagarbhiṇīsukumārasaṁvr̥takōṣṭhaduśchardanōrdhvaraktapittaprasaktacchardirūrdhvavātāsthāpitānuvāsitahr̥drōgōdāvartamūtrāghāta-plīhagulmōdarāṣṭhīlāsvarōpaghātatimiraśiraśaṅkhakarṇākṣiśūlārtāḥ||8||  
 
avamyāstāvat- kṣatakṣīṇātisthūlātikr̥śabālavr̥ddhadurbalaśrāntapipāsitakṣudhitakarmabhārādhvahatōpavāsamaithunādhyayanavyāyāmacintā-prasaktakṣāmagarbhiṇīsukumārasaṁvr̥takōṣṭhaduśchardanōrdhvaraktapittaprasaktacchardirūrdhvavātāsthāpitānuvāsitahr̥drōgōdāvartamūtrāghāta-plīhagulmōdarāṣṭhīlāsvarōpaghātatimiraśiraśaṅkhakarṇākṣiśūlārtāḥ||8||  
  
 
avamyAstAvat- kShatakShINAtisthUlAtikRushabAlavRuddhadurbalashrAntapipAsitakShudhitakarmabhArAdhvahatopavAsamaithunAdhyayanavyAyAmacintA-prasaktakShAmagarbhiNIsukumArasaMvRutakoShThadushchardanordhvaraktapittaprasaktacchardirUrdhvavatasthApitAnuvAsitahRudrogodAvartamUtrAghAta-plIhagulmodarAShThIlAsvaropaghAtatimirashirasha~gkhakarNAkShishUlArtAH||8||  
 
avamyAstAvat- kShatakShINAtisthUlAtikRushabAlavRuddhadurbalashrAntapipAsitakShudhitakarmabhArAdhvahatopavAsamaithunAdhyayanavyAyAmacintA-prasaktakShAmagarbhiNIsukumArasaMvRutakoShThadushchardanordhvaraktapittaprasaktacchardirUrdhvavatasthApitAnuvAsitahRudrogodAvartamUtrAghAta-plIhagulmodarAShThIlAsvaropaghAtatimirashirasha~gkhakarNAkShishUlArtAH||8||  
 +
</div></div>
 +
 +
The persons or patients for whom ''vamana'' is contraindicated are mentioned in the following table:
 +
 +
{| class="wikitable" style="text-align: center;
 +
|-
 +
! scope="col"| Serial No.
 +
! scope="col"| Disease or State in which ''[[vamana]]'' is contraindicated
 +
! scope="col"| Translation in English
 +
|-
 +
| 1
 +
| ''Kshata''
 +
| Chest Injury
 +
|-
 +
| 2
 +
| ''Kshina''
 +
| Emaciated
 +
|-
 +
| 3
 +
| ''Atishula''
 +
| Excessively Obese
 +
|-
 +
| 4
 +
| ''Atikrisha''
 +
| Excessively Lean
 +
|-
 +
| 5
 +
| ''Baala''
 +
| Children (aged under 10 years)
 +
|-
 +
| 6
 +
| ''Vriddha''
 +
| Old/Elderly
 +
|-
 +
| 7
 +
| ''Durbala''
 +
| Weak
 +
|-
 +
| 8
 +
| ''Shraanta''
 +
| Fatigued
 +
|-
 +
| 9
 +
| ''Pipasita''
 +
| Thirsty
 +
|-
 +
| 10
 +
| ''Kshudhita''
 +
| Hungry
 +
|-
 +
| 11
 +
| ''Karmahata''
 +
| Work related fatigue
 +
|-
 +
| 12
 +
| ''Bhaarahata''
 +
| Exhaustion due to carrying heavy-weight
 +
|-
 +
| 13
 +
| ''Adhvahata''
 +
| Exhaustion due to wayfaring/walking on foot
 +
|-
 +
| 14
 +
| ''Upavaasa-prasakta-kshaama''
 +
| Weakness due to excessive fasting
 +
|-
 +
| 15
 +
| ''Maithuna-prasakta-kshaama''
 +
| Exhaustion due to excessive sexual activities
 +
|-
 +
| 16
 +
| ''Adhyayana-prasakta-kshaama''
 +
| Exhaustion due to excessive academic activities
 +
|-
 +
| 17
 +
| ''[[Vyayama]]-prasakta-kshaama''
 +
| Exhaustion due to excessive physical exercise
 +
|-
 +
| 18
 +
| ''Chinta-prasakta-kshaama''
 +
| Exhaustion due to excessive worry/anxiety
 +
|-
 +
| 19
 +
| ''Garbhini''
 +
| Pregnant Woman
 +
|-
 +
| 20
 +
| ''Sukumara''
 +
| One having tender health
 +
|-
 +
| 21
 +
| ''Samvritta Koshtha''
 +
| One having obstructed bowel
 +
|-
 +
| 22
 +
| ''Dushchardana''
 +
| One who does not respond to emesis easily
 +
|-
 +
| 23
 +
| ''Urdhvaraktapitta''
 +
| One suffering from bleeding from the upper tract.
 +
|-
 +
| 24
 +
| ''Prasaktachhardi''
 +
| (One suffering from) Continuous vomiting
 +
|-
 +
| 25
 +
| ''Urdhvavata''
 +
| One suffering from upward movement of vata.
 +
|-
 +
| 26
 +
| ''Asthapita''
 +
| One who has taken medicated enema (having higher amount of decoction)
 +
|-
 +
| 27
 +
| ''Anuvasita''
 +
| One who has taken medicated enema (having higher amount of decoction)
 +
|-
 +
| 28
 +
| ''Hridroga''
 +
| Heart disease
 +
|-
 +
| 29
 +
| ''Udavarta''
 +
| Disorder due to improper functioning of vata
 +
|-
 +
| 30
 +
| ''Mutraghata''
 +
| Anuria/Oliguria
 +
|-
 +
| 31
 +
| ''Pleeha-roga''
 +
| Splenic disorder
 +
|-
 +
| 32
 +
| ''Gulma''
 +
| Abdominal lump
 +
|-
 +
| 33
 +
| ''Udara-roga''
 +
| Obstinate abdominal diseases including ascites
 +
|-
 +
| 34
 +
| ''Ashtheela''
 +
| Enlarged prostrate
 +
|-
 +
| 35
 +
| ''Svaropaghaata''
 +
| Choked voice
 +
|-
 +
| 36
 +
| ''Timira''
 +
| Cataract
 +
|-
 +
| 37
 +
| ''Shirahshoolaarta''
 +
| One suffering from headache
 +
|-
 +
| 38
 +
| ''Shankhashoolaarta''
 +
| One suffering from pain in temporal region
 +
|-
 +
| 39
 +
| ''Karnashoolaarta''
 +
| One suffering from pain in the ears
 +
|-
 +
| 40
 +
| ''Akshishoolaarta''
 +
| One suffering from pain in the eyes
 +
|}
  
The persons or patients for whom vamana is contra-indicated are mentioned in the following table:-
 
Serial
 
Number Disease or state in which vamana is contra-indicated                   English translation of the Disease or state
 
1. Kṣata Chest injury
 
2. Kṣīṇa Emaciated
 
3. Atisthūla Excessively obese
 
4. Atikṛśa Excessively Lean
 
5. Bāla                     Children (below 10 year age)
 
6. Vṛddha Old person
 
7. Durbala                                         Weak
 
8. Śrānta                                     Fatigued
 
9. Pipāsita Thirsty
 
10. Kṣudhita Hungry
 
11. Karmahata Exhausted due to hard labour
 
12. Bhārahata Exhausted due to carrying heavy weight
 
13. Adhvahata Exhausted due to  long wayfaring
 
14. Upavāsa-prasakta-kṣāma Weak by excessive fasting
 
15. Maithuna-prasakta- kṣāma         Weak due to excessive sexual indulgence
 
Serial
 
Number Disease or state in which vamana is contra-indicated                 English translation of the Disease or state
 
16.              Adhyayana-prasakta- kṣāma Weak due to excessive study
 
17. Vyāyāma-prasakta- kṣāma Weak due to excessive exercise
 
18. Cintā-prasakta- kṣāma Weak due to worry
 
19. Garbhiṇi Pregnant woman
 
20. Sukumāra One having tender health
 
21. Saṃvṛtta-koṣṭha One having obstructed bowel
 
22. Duśchardana Person who does not respond to emesis easily
 
23. Urdhvaraktapitta One suffering from bleeding from upward tract
 
24. Prasaktacchardi Constant vomiting
 
25. Urdhvavāta One suffering from upward movement of vata
 
26. Āsthāpita One who has taken medicated enema having more quantity of decoction
 
27. Anuvāsita One who has taken unctuous type of medicated enema
 
28. Hṛdroga Heart-disease
 
Serial
 
Number Disease or state in which vamana is contra-indicated                 English translation of the Disease or state
 
29. Udāvarta Disorder due to improper functioning of vata
 
30. Mūtrāghāta Anuria/Oliguria
 
31. Plīha-roga Splenic disorder
 
32. Gulma Abdominal lump
 
33. Udara-roga Obstinate abdominal diseases including ascites
 
34. Aṣṭhīlā Enlarged prostate
 
35. Svaropaghāta Choked voice
 
36. Timira Cataract
 
37. Śiraḥśūlārta One suffering from headache
 
38. Śaṅkhaśūlārta One suffering from pain in temporal region
 
39. Karṇaśūlārta One suffering from pain in ears
 
40. Akṣiśūlārta One suffering from  pain in eyes
 
 
[8]
 
[8]
  
==== Adverse effects of ''vamana karma'' administered in contra-indicated conditions ====
+
=== Adverse effects of ''vamana karma'' administered in contra-indicated conditions ===
 +
<div class="mw-collapsible mw-collapsed">
  
 
तत्र क्षतस्य भूयः क्षणनाद्रक्तातिप्रवृत्तिः स्यात्, क्षीणातिस्थूलकृशबालवृद्धदुर्बलानामौषधबलासहत्वात् प्राणोपरोधः,श्रान्तपिपासितक्षुधितानां च तद्वत्, कर्मभाराध्वहतोपवासमैथुनाध्ययनव्यायामचिन्ताप्रसक्तक्षामाणां  
 
तत्र क्षतस्य भूयः क्षणनाद्रक्तातिप्रवृत्तिः स्यात्, क्षीणातिस्थूलकृशबालवृद्धदुर्बलानामौषधबलासहत्वात् प्राणोपरोधः,श्रान्तपिपासितक्षुधितानां च तद्वत्, कर्मभाराध्वहतोपवासमैथुनाध्ययनव्यायामचिन्ताप्रसक्तक्षामाणां  
 
रौक्ष्याद्वातरक्तच्छेदक्षतभयं स्यात्, गर्भिण्या गर्भव्यापदामगर्भभ्रंशाच्चदारुणा रोगप्राप्तिः, सुकुमारस्यहृदयापकर्षणादूर्ध्वमधो  वा रुधिरातिप्रवृत्तिः, संवृतकोष्ठदुश्छर्दनयोरतिमात्रप्रवाहणाद्दोषाः समुत्क्लिष्टा अन्तःकोष्ठे जनयन्त्यन्तर्विसर्पं स्तम्भं जाड्यं वैचित्त्यं मरणं वा, ऊर्ध्वगरक्तपित्तिन उदानमुत्क्षिप्य प्राणान् हरेद्रक्तं चातिप्रवर्तयेत्,प्रसक्तच्छर्देस्तद्वत्, ऊर्ध्ववातास्थापितानुवासितानामूर्ध्वं वातातिप्रवृत्तिः, हृद्रोगिणोहृदयोपरोधः, उदावर्तिनो घोरतर उदावर्तःस्याच्छीघ्रतरहन्ता, मूत्राघातादिभिरार्तानां तीव्रतरशूलप्रादुर्भावः, तिमिरार्तानां तिमिरातिवृद्धिः, शिरःशूलादिषु शूलातिवृद्धिः;तस्मादेते न वम्याः|  
 
रौक्ष्याद्वातरक्तच्छेदक्षतभयं स्यात्, गर्भिण्या गर्भव्यापदामगर्भभ्रंशाच्चदारुणा रोगप्राप्तिः, सुकुमारस्यहृदयापकर्षणादूर्ध्वमधो  वा रुधिरातिप्रवृत्तिः, संवृतकोष्ठदुश्छर्दनयोरतिमात्रप्रवाहणाद्दोषाः समुत्क्लिष्टा अन्तःकोष्ठे जनयन्त्यन्तर्विसर्पं स्तम्भं जाड्यं वैचित्त्यं मरणं वा, ऊर्ध्वगरक्तपित्तिन उदानमुत्क्षिप्य प्राणान् हरेद्रक्तं चातिप्रवर्तयेत्,प्रसक्तच्छर्देस्तद्वत्, ऊर्ध्ववातास्थापितानुवासितानामूर्ध्वं वातातिप्रवृत्तिः, हृद्रोगिणोहृदयोपरोधः, उदावर्तिनो घोरतर उदावर्तःस्याच्छीघ्रतरहन्ता, मूत्राघातादिभिरार्तानां तीव्रतरशूलप्रादुर्भावः, तिमिरार्तानां तिमिरातिवृद्धिः, शिरःशूलादिषु शूलातिवृद्धिः;तस्मादेते न वम्याः|  
 
सर्वेष्वपि तु खल्वेतेषु विषगरविरुद्धाजीर्णाभ्यवहारामकृतेष्वप्रतिषिद्धं शीघ्रतरकारित्वादेषामिति  ||९||  
 
सर्वेष्वपि तु खल्वेतेषु विषगरविरुद्धाजीर्णाभ्यवहारामकृतेष्वप्रतिषिद्धं शीघ्रतरकारित्वादेषामिति  ||९||  
 +
<div class="mw-collapsible-content">
  
 
tatra kṣatasya bhūyaḥ kṣaṇanādraktātipravr̥ttiḥ syāt, kṣīṇātisthūlakr̥śabālavr̥ddhadurbalānāmauṣadhabalāsahatvāt prāṇōparōdhaḥ,śrāntapipāsitakṣudhitānāṁ ca tadvat, karmabhārādhvahatōpavāsamaithunādhyayanavyāyāmacintāprasaktakṣāmāṇāṁ  
 
tatra kṣatasya bhūyaḥ kṣaṇanādraktātipravr̥ttiḥ syāt, kṣīṇātisthūlakr̥śabālavr̥ddhadurbalānāmauṣadhabalāsahatvāt prāṇōparōdhaḥ,śrāntapipāsitakṣudhitānāṁ ca tadvat, karmabhārādhvahatōpavāsamaithunādhyayanavyāyāmacintāprasaktakṣāmāṇāṁ  
Line 178: Line 346:
 
raukShyAdvataraktacchedakShatabhayaM syAt, garbhiNyA garbhavyApadAmagarbhabhraMshAccadAruNA rogaprAptiH, sukumArasyahRudayApakarShaNAdUrdhvamadho  vA rudhirAtipravRuttiH, saMvRutakoShThadushchardanayoratimAtrapravAhaNAddoShAH samutkliShTAantaHkoShThe  janayantyantarvisarpaM stambhaM jADyaM vaicittyaM maraNaM vA, Urdhvagaraktapittina udAnamutkShipya prANAn haredraktaMcAtipravartayet, prasaktacchardestadvat, UrdhvavatasthApitAnuvAsitAnAmUrdhvaM vatatipravRuttiH, hRudrogiNohRudayoparodhaH, udAvartino ghorataraudAvartaH syAcchIghratarahantA, mUtrAghAtAdibhirArtAnAM tIvratarashUlaprAdurbhAvaH, timirArtAnAM timirAtivRuddhiH, shiraHshUlAdiShu shUlAtivRuddhiH;tasmAdete na vamyAH|  
 
raukShyAdvataraktacchedakShatabhayaM syAt, garbhiNyA garbhavyApadAmagarbhabhraMshAccadAruNA rogaprAptiH, sukumArasyahRudayApakarShaNAdUrdhvamadho  vA rudhirAtipravRuttiH, saMvRutakoShThadushchardanayoratimAtrapravAhaNAddoShAH samutkliShTAantaHkoShThe  janayantyantarvisarpaM stambhaM jADyaM vaicittyaM maraNaM vA, Urdhvagaraktapittina udAnamutkShipya prANAn haredraktaMcAtipravartayet, prasaktacchardestadvat, UrdhvavatasthApitAnuvAsitAnAmUrdhvaM vatatipravRuttiH, hRudrogiNohRudayoparodhaH, udAvartino ghorataraudAvartaH syAcchIghratarahantA, mUtrAghAtAdibhirArtAnAM tIvratarashUlaprAdurbhAvaH, timirArtAnAM timirAtivRuddhiH, shiraHshUlAdiShu shUlAtivRuddhiH;tasmAdete na vamyAH|  
 
sarveShvapi tu khalveteShu viShagaraviruddhAjIrNAbhyavahArAmakRuteShvapratiShiddhaM shIghratarakAritvAdeShAmiti  ||9||  
 
sarveShvapi tu khalveteShu viShagaraviruddhAjIrNAbhyavahArAmakRuteShvapratiShiddhaM shIghratarakAritvAdeShAmiti  ||9||  
 
+
</div></div>
 +
<div style="text-align:justify;">
 
If a person suffering from ''kshata'' (chest injury) is given ''vamana'' (emetic therapy), then it further aggravates the injury (to the lungs) and causes excessive haemoptysis.  
 
If a person suffering from ''kshata'' (chest injury) is given ''vamana'' (emetic therapy), then it further aggravates the injury (to the lungs) and causes excessive haemoptysis.  
  
If ''vamana'' is given to a person who is ''ksheena'' (emaciated), ''atisthula, atikrisha, bala, vriddha'' and ''durbala'', then this produce danger to their life because such types of patients are incapable to tolerate the effects of drugs which are used for ''vamana''. The similar effect is observed when ''vamana'' is administered to a person who is fatigued, thirsty and hungry.
+
If ''[[vamana]]'' is given to a person who is ''ksheena'' (emaciated), ''atisthula, atikrisha, bala, vriddha'' and ''durbala'', then this produce danger to their life because such types of patients are incapable to tolerate the effects of drugs which are used for ''[[vamana]]''. The similar effect is observed when ''[[vamana]]'' is administered to a person who is fatigued, thirsty and hungry.
  
If ''vamana'' is administered to a person who is broken down by doing hard work, carrying excessive weight and travels long on foot, and who is weakened by long term fasting, sexual indulgence, study, exercise and worry, then because of dryness, the ''vata'' in his body gets aggravated. He may get hemorrhage and injury to his lungs.
+
If ''[[vamana]]'' is administered to a person who is broken down by doing hard work, carrying excessive weight and travels long on foot, and who is weakened by long term fasting, sexual indulgence, study, exercise and worry, then because of dryness, the ''[[vata]]'' in his body gets aggravated. He may get hemorrhage and injury to his lungs.
  
If a pregnant woman is given ''vamana'', then this may produce complications of pregnancy and occurrence of severe diseases because of the abortion of immature fetus.
+
If a pregnant woman is given ''[[vamana]]'', then this may produce complications of pregnancy and occurrence of severe diseases because of the abortion of immature fetus.
  
If the person who is delicate is given ''vamana'', then because of undue pressure on the heart, it may give rise to hemorrhage from the upward or downward tracts.
+
If the person who is delicate is given ''[[vamana]]'', then because of undue pressure on the heart, it may give rise to hemorrhage from the upward or downward tracts.
  
If a person whose ''koshtha'' (bowel) is occluded or who does not respond to ''vamana'' therapy easily, then the administration of this therapy leads to excessive bouts of urge for vomiting leading to the aggravation of ''dosha'' and these ''dosha'' cause internal ''visarpa'' (erysipelas), ''stambha'' (stiffness), ''jadya'' (dullness), ''vaichitya'' (mental perversion) or death.
+
If a person whose ''koshtha'' (bowel) is occluded or who does not respond to ''[[vamana]]'' therapy easily, then the administration of this therapy leads to excessive bouts of urge for vomiting leading to the aggravation of ''[[dosha]]'' and these ''[[dosha]]'' cause internal ''visarpa'' (erysipelas), ''stambha'' (stiffness), ''jadya'' (dullness), ''vaichitya'' (mental perversion) or death.
  
If ''vamana'' is administered to a person suffering from ''urdhvaga-raktapitta'', it may take out vital breath by pushing ''udana'' upwards and may cause excessive bleeding. Similar effects are observed if ''vamana'' is given to a person who is already suffering from constant vomiting.
+
If ''[[vamana]]'' is administered to a person suffering from ''urdhvaga-raktapitta'', it may take out vital breath by pushing ''udana'' upwards and may cause excessive bleeding. Similar effects are observed if ''[[vamana]]'' is given to a person who is already suffering from constant vomiting.
  
If the ''vamana'' is administered to a person suffering from ''urdhvavata'', and who has taken ''asthapana'' or ''anuvasana'' types of medicated enema, then it causes upward movement of the ''vata'' in excess.
+
If the ''[[vamana]]'' is administered to a person suffering from ''urdhvavata'', and who has taken ''asthapana'' or ''anuvasana'' types of medicated enema, then it causes upward movement of the ''[[vata]]'' in excess.
  
If ''vamana'' is given to a person suffering from heart disease, it causes the sudden cessation of cardiac motion i.e. cardiac arrest.
+
If ''[[vamana]]'' is given to a person suffering from heart disease, it causes the sudden cessation of cardiac motion i.e. cardiac arrest.
If ''vamana'' is administered to a person suffering from ''udavarta'', it causes severe ''udavarta'' (disorder due to improper functioning of ''vata'') which results in death of the patient shortly.
+
If ''[[vamana]]'' is administered to a person suffering from ''udavarta'', it causes severe ''udavarta'' (disorder due to improper functioning of ''[[vata]]'') which results in death of the patient shortly.
  
''Vamana'' given to a person suffering from ''mutraghata'' (oliguria/anuria), ''pliha-roga'' (splenic disorder), ''gulma'' (abdominal lump) etc. diseases, causes pain of more severe nature.
+
''[[Vamana]]'' given to a person suffering from ''mutraghata'' (oliguria/anuria), ''pliha-roga'' (splenic disorder), ''gulma'' (abdominal lump) etc. diseases, causes pain of more severe nature.
  
''Vamana'' given to the patients suffering from ''timira'' (cataract), increases the cataract.
+
''[[Vamana]]'' given to the patients suffering from ''timira'' (cataract), increases the cataract.
  
''Vamana'' given to the persons suffering from headache, pain in the ears and eyes etc. leads to aggravation of pain. Therefore, ''vamana'' is contra-indicated for all these types of patients. However, in all these cases ''vamana'' is not contra-indicated in the conditions of poisons, artificial poisons, incompatible food, intake of food during indigestion and ''ama'' (ailment caused by the product of improper digestion and metabolism) because these conditions are of emergent nature.                                                                                                                                           
+
''[[Vamana]]'' given to the persons suffering from headache, pain in the ears and eyes etc. leads to aggravation of pain. Therefore, ''[[vamana]]'' is contra-indicated for all these types of patients. However, in all these cases ''[[vamana]]'' is not contra-indicated in the conditions of poisons, artificial poisons, incompatible food, intake of food during indigestion and ''ama'' (ailment caused by the product of improper digestion and metabolism) because these conditions are of emergent nature.                                                                                                                                           
 
[9]
 
[9]
 +
</div>
 +
=== Indications of ''vamana karma'' ===
 +
<div class="mw-collapsible mw-collapsed">
  
==== Indications of ''vamana karma'' ====
+
शेषास्तु वम्याः; विशेषतस्तु  पीनसकुष्ठनवज्वरराजयक्ष्मकासश्वासगलग्रहगलगण्डश्लीपदमेहमन्दाग्निविरुद्धाजीर्णान्नविसूचिकालसकविषगरपीतदष्टदिग्धविद्धाधःशोणितपित्तप्रसेक (दुर्नाम  )हृल्लासारोचकाविपाकापच्यपस्मारोन्मादातिसारशोफपाण्डुरोगमुखपाकदुष्टस्तन्यादयः श्लेष्मव्याधयो विशेषेणमहारोगाध्यायोक्ताश्च; एतेषु हि वमनं प्रधानतममित्युक्तं केदारसेतुभेदे शाल्याद्यशोषदोषविनाशवत्||१०||
 +
<div class="mw-collapsible-content">
  
शेषास्तु वम्याः; विशेषतस्तु  पीनसकुष्ठनवज्वरराजयक्ष्मकासश्वासगलग्रहगलगण्डश्लीपदमेहमन्दाग्निविरुद्धाजीर्णान्नविसूचिकालसकविषगरपीतदष्टदिग्धविद्धाधःशोणितपित्तप्रसेक (दुर्नाम )हृल्लासारोचकाविपाकापच्यपस्मारोन्मादातिसारशोफपाण्डुरोगमुखपाकदुष्टस्तन्यादयः श्लेष्मव्याधयो विशेषेणमहारोगाध्यायोक्ताश्च; एतेषु हि वमनं प्रधानतममित्युक्तं केदारसेतुभेदे शाल्याद्यशोषदोषविनाशवत्||१०||
+
śēṣāstu vamyāḥ; viśēṣatastu pīnasakuṣṭhanavajvararājayakṣmakāsaśvāsagalagrahagalagaṇḍaślīpadamēhamandāgniviruddhājīrṇānnavisūcikālasakaviṣagarapītadaṣṭadigdhaviddhādhaḥśōṇitapittaprasēka (durnāma )hr̥llāsārōcakāvipākāpacyapasmārōnmādātisāraśōphapāṇḍurōgamukhapākaduṣṭastanyādayaḥślēṣmavyādhayō viśēṣēṇa mahārōgādhyāyōktāśca;
  
śēṣāstu vamyāḥ; viśēṣatastu pīnasakuṣṭhanavajvararājayakṣmakāsaśvāsagalagrahagalagaṇḍaślīpadamēhamandāgniviruddhājīrṇānnavisūcikālasakaviṣagarapītadaṣṭadigdhaviddhādhaḥśōṇitapittaprasēka (durnāma  )hr̥llāsārōcakāvipākāpacyapasmārōnmādātisāraśōphapāṇḍurōgamukhapākaduṣṭastanyādayaḥślēṣmavyādhayō viśēṣēṇa mahārōgādhyāyōktāśca; ētēṣu hi Vamanṁ pradhānatamamityuktaṁkēdārasētubhēdē śālyādyaśōṣadōṣavināśavat||10||  
+
ētēṣu hi Vamanṁ pradhānatamamityuktaṁkēdārasētubhēdē śālyādyaśōṣadōṣavināśavat||10||  
 
 
sheShAstu vamyAH; visheShatastu pInasakuShThanavajvararAjayakShmakAsashvAsagalagrahagalagaNDashlIpadamehamandAgniviruddhAjIrNAnnavisUcikAlasakaviShagarapItadaShTadigdhaviddhAdhaHshoNitapittapraseka (durnAma  )hRullAsArocakAvipAkApacyapasmAronmAdAtisArashophapANDurogamukhapAkaduShTastanyAdayaHshleShmavyAdhayo visheSheNa mahArogAdhyAyoktAshca; eteShu hi VamanM pradhAnatamamityuktaMkedArasetubhede shAlyAdyashoShadoShavinAshavat||10||
+
sheShAstu vamyAH; visheShatastu pInasakuShThanavajvararAjayakShmakAsashvAsagalagrahagalagaNDashlIpadamehamandAgniviruddhAj-
 +
 
 +
IrNAnnavisUcikAlasakaviShagarapItadaShTadigdhaviddhAdhaHshoNitapittapraseka (durnAma  )hRullAsArocakAvipAkApacyapasmAronmAdAtisArashophapANDurogamukhapAkaduShTastanyAdayaHshleShmavyAdhayo visheSheNa mahArogAdhyAyoktAshca;  
 +
 
 +
eteShu hi VamanM pradhAnatamamityuktaMkedArasetubhede shAlyAdyashoShadoShavinAshavat||10||
 +
</div></div>
 
   
 
   
''vamana karma'' is indicated for the diseases other than above mentioned but especially useful in the diseases given in the following table-
+
''vamana karma'' is indicated for the diseases other than above mentioned but especially useful in the diseases given in the following table:
Serial Number Diseases or state in which vamana is indicated English translation of the disease or state
 
1. Pīnasa Coryza
 
2. Kuṣṭha All the skin diseases including leprosy
 
3. Navajvara Acute fever
 
4. Rājayakṣmā Tuberculosis
 
5. Kāsa Cough
 
6. Śvāsa Bronchial Asthma
 
7. Galagraha Spasm in the throat
 
8. Gala-gaṇḍa Goitre
 
9. Ślīpada Elephantiasis
 
10. Meha Obstinate urinary disorders including diabetes mellitus
 
11. Mandāgni Suppression of the power of digestion
 
12. Viruddhānna Ailments caused by the intake of incompatible diet
 
13. Ajīrṇānna Ailment caused by indigestion of food
 
14. Visūcikā Cholera
 
15. Alasaka Intestinal torpor
 
16. Viṣa-pīta Ailments caused by intake of natural poisons
 
17. Gara- pīta Ailments caused by artificially prepared poisons
 
18. Viṣa –daṣṭa Poisonous bites
 
19. Viṣa -digdha-viddha Ailments caused by injury with weapons smeared with poisonous material
 
20. Adhaḥ-soṇitapitta Disease characterized by bleeding from downward tracts
 
21. Praseka Excessive salivation
 
22. Durnāma Piles
 
23. Hṛllāsa Nausea
 
24. Arocaka Anorexia
 
25. Avipāka Indigestion
 
26. Apacī Cervical adenitis
 
27. Apasmāra Epilepsy
 
28. Unmāda Insanity
 
29. Atisāra Diarrhoea
 
30. Śopha Swelling
 
31. Pāṇḍu-roga Anaemia
 
32. Mukhapāka Stomatitis
 
33. Duṣṭa-stanya Vitiated  breast milk
 
34. Śleṣmavyādhayo viśeṣeṇa Mahārogādhyāyoktāḥ Especially useful for all the diseases caused by Kapha doṣa which are mentioned in the Mahārogādhyāya of Caraka-Saṃhitā Sūtrasthāna
 
  
In these above mentioned conditions, action of ''vamana karma'' in causing cure of diseases caused by aggravation of ''kapha'' being similar to water laden paddy field getting spoiled due to clogging of water which can be corrected by the letting out the water out of the field like ''vamana'' does with ''kapha''. [10]
+
{| class="wikitable" style="text-align: center;
 
+
|-
==== Contra-indications of ''virechana karma'' ====
+
! scope="col"| Serial No.
 +
! scope="col"| Disease or State (in which ''vamana'' is contraindicated)
 +
! scope="col"| Translation in English
 +
|-
 +
| 1
 +
| ''Peenasa''
 +
| Coryza
 +
|-
 +
| 2
 +
| ''Kushtha''
 +
| All types of skin diseases, including leprosy
 +
|-
 +
| 3
 +
| ''Navajwara''
 +
| Acute fever
 +
|-
 +
| 4
 +
| ''Rajayakshma''
 +
| Tuberculosis
 +
|-
 +
| 5
 +
| ''Kaasa''
 +
| Cough
 +
|-
 +
| 6
 +
| ''Shvaasa''
 +
| Bronchia Asthma
 +
|-
 +
| 7
 +
| ''Galagraha''
 +
| Spasm in the throat
 +
|-
 +
| 8
 +
| ''Galagandha''
 +
| Goitre
 +
|-
 +
| 9
 +
| ''Shleepada''
 +
| Elephantiasis
 +
|-
 +
| 10
 +
| ''Meha''
 +
| Obstinate urinary disorders, including diabetes mellitus
 +
|-
 +
| 11
 +
| ''Mandaagni''
 +
| Supression of digestion fire
 +
|-
 +
| 12
 +
| ''Viruddhaanna''
 +
| Ailments caused due to intake of incompatible diet
 +
|-
 +
| 13
 +
| ''Ajeernaanna''
 +
| Ailments caused due to indigestion
 +
|-
 +
| 14
 +
| ''Vishuchika''
 +
| Cholera
 +
|-
 +
| 15
 +
| ''Alasaka''
 +
| Intestinal torpor
 +
|-
 +
| 16
 +
| ''Visha-peeta''
 +
| Ailments caused by ingesting natural poisons
 +
|-
 +
| 17
 +
| ''Gara-peeta''
 +
| Ailments caused by ingesting artificial/synthetic poisons
 +
|-
 +
| 18
 +
| ''Visha-dashta''
 +
| Poisonous bites
 +
|-
 +
| 19
 +
| ''Visha-digdha-viddha''
 +
| Ailments caused due to injury with weapons laced with poison
 +
|-
 +
| 20
 +
| ''Adhah - shonitapitta''
 +
| Diseases characterized by bleeding from downward tracts
 +
|-
 +
| 21
 +
| ''Praseka''
 +
| Excessive salivation
 +
|-
 +
| 22
 +
| ''Durnaama''
 +
| Piles
 +
|-
 +
| 23
 +
| ''Hrillasa''
 +
| Nausea
 +
|-
 +
| 24
 +
| ''Arochaka''
 +
| Anorexia
 +
|-
 +
| 25
 +
| ''Avipaaka''
 +
| Indigestion
 +
|-
 +
| 26
 +
| ''Apachi''
 +
| Cervical adenitis
 +
|-
 +
| 27
 +
| ''Apasmara''
 +
| Epilepsy
 +
|-
 +
| 28
 +
| ''Unmada''
 +
| Psychotic disorders
 +
|-
 +
| 29
 +
| ''Atisara''
 +
| Diarrhea
 +
|-
 +
| 30
 +
| ''Shopha''
 +
| Swelling
 +
|-
 +
| 31
 +
| ''Pandu Roga''
 +
| Anemia
 +
|-
 +
| 32
 +
| ''Mukhapaaka''
 +
| Stomatitis
 +
|-
 +
| 33
 +
| ''Dushta-stanya''
 +
| Vitiated breast milk
 +
|-
 +
| 34
 +
| ''Shelshmavyadhayo Visheshena Maharogadhyayoktah''
 +
| All ''[[Kapha dosha]]'' disorders mentioned in the [[Maharoga Adhyaya]] of [[Charaka Samhita]] [[Sutra Sthana]]
 +
|}
 +
<div style="text-align:justify;">
 +
In these above mentioned conditions, action of ''[[vamana]] karma'' in causing cure of diseases caused by aggravation of ''[[kapha]]'' being similar to water laden paddy field getting spoiled due to clogging of water which can be corrected by the letting out the water out of the field like ''[[vamana]]'' does with ''[[kapha]]''. [10]
 +
</div>
 +
=== Contra-indications of ''[[virechana]] karma'' ===
 +
<div class="mw-collapsible mw-collapsed">
  
 
अविरेच्यास्तु सुभगक्षतगुदमुक्तनालाधोभागरक्तपित्तिविलङ्घितदुर्बलेन्द्रियाल्पाग्निनिरूढकामादिव्यग्राजीर्णिनवज्वरि-मदात्ययिताध्मातशल्यार्दिताभिहतातिस्निग्धरूक्षदारुणकोष्ठाः क्षतादयश्च गर्भिण्यन्ताः||११||  
 
अविरेच्यास्तु सुभगक्षतगुदमुक्तनालाधोभागरक्तपित्तिविलङ्घितदुर्बलेन्द्रियाल्पाग्निनिरूढकामादिव्यग्राजीर्णिनवज्वरि-मदात्ययिताध्मातशल्यार्दिताभिहतातिस्निग्धरूक्षदारुणकोष्ठाः क्षतादयश्च गर्भिण्यन्ताः||११||  
 +
<div class="mw-collapsible-content">
  
 
avirēcyāstusubhagakṣatagudamuktanālādhōbhāgaraktapittivilaṅghitadurbalēndriyālpāgninirūḍhakāmādivyagrājīrṇinavajvari-madātyayitādhmātaśalyārditābhihatātisnigdharūkṣadāruṇakōṣṭhāḥ kṣatādayaśca garbhiṇyantāḥ||11||  
 
avirēcyāstusubhagakṣatagudamuktanālādhōbhāgaraktapittivilaṅghitadurbalēndriyālpāgninirūḍhakāmādivyagrājīrṇinavajvari-madātyayitādhmātaśalyārditābhihatātisnigdharūkṣadāruṇakōṣṭhāḥ kṣatādayaśca garbhiṇyantāḥ||11||  
  
 
avirecyAstusubhagakShatagudamuktanAlAdhobhAgaraktapittivila~gghitadurbalendriyAlpAgninirUDhakAmAdivyagrAjIrNinavajvari-madAtyayitAdhmAtashalyArditAbhihatAtisnigdharUkShadAruNakoShThAH kShatAdayashca garbhiNyantAH||11||  
 
avirecyAstusubhagakShatagudamuktanAlAdhobhAgaraktapittivila~gghitadurbalendriyAlpAgninirUDhakAmAdivyagrAjIrNinavajvari-madAtyayitAdhmAtashalyArditAbhihatAtisnigdharUkShadAruNakoShThAH kShatAdayashca garbhiNyantAH||11||  
 +
</div></div>
  
The cases which are considered unfit for ''Virechana Karma'' are mentioned in the following table-
+
The cases which are considered unfit for ''Virechana Karma'' are mentioned in the following table:
  
Serial Number Disease or state in which virechana is contra-indicated English translation of the diseases or state
+
{| class="wikitable" style="text-align: center;
1. Subhaga Those who have  tender health or soft perineum  
+
|-
2. Kṣataguda Wounded anorectum
+
! scope="col"| Serial No.
3. Muktanāla Prolapsed rectum
+
! scope="col"| Disease or State (in which ''[[virechana]]'' is contraindicated)
4. Adhobhāga-raktapittī Bleeding through downward tracts
+
! scope="col"| Translation in English
5. Vilanghita Who are lightened due to excessive fasting
+
|-
6. Durbalendriya Who have weak sensory and motor organs
+
| 1
7. Alpāgni Who have deficient power of digestion
+
| ''Subhaga''
8. Nirūḍha Who have taken nirūha type of enema
+
| A person with tender health or soft perineum
9. Kāmādivyagra Whose mind is agitated by passion etc.
+
|-
10. Ajīrṇa Indigestion
+
| 2
11. Navajvara Acute fever
+
| ''Kshataguda''
12. Madātyayita Suffering from Alcoholism
+
| (A person with) lacerated/bruised anorectum
13. Ādhmāta Abdominal distension or tympanitis
+
|-
14. Śalyārdita Inflicted with foreign bodies
+
| 3
15. Abhihata Injured
+
| ''Muktanaala''
16. Atisnigdha Over-unctuous
+
| (A person with) prolapsed rectum
17. Atirūkṣa Excessively ununctuous
+
|-
18. Dāruṇakoṣṭha Persons who have hard bowel
+
| 4
19. Kṣatādayaḥ garbhiṇyantāḥ Those listed from wounded to pregnant under contra-indications of vamana [11]
+
| ''Adobhaaga-raktapitti''
 +
| Bleeding through downward tracts
 +
|-
 +
| 5
 +
| ''Vilanghita''
 +
| (A person who is)weakened due to excessive fasting
 +
|-
 +
| 6
 +
| ''Durbalendriya''
 +
| (A person with) weak sensory and motor organs
 +
|-
 +
| 7
 +
| ''Alpaagni''
 +
| (A person with) poor digestive fire
 +
|-
 +
| 8
 +
| ''Niruddha''
 +
| (A person who has taken) ''niruha'' type of enema
 +
|-
 +
| 9
 +
| ''Kaamadivyagra''
 +
| (A person whose) mind is agitated by passion/sexual emotions.
 +
|-
 +
| 10
 +
| ''Ajeerna''
 +
| Indigestion
 +
|-
 +
| 11
 +
| ''Navajwara''
 +
| Acute fever
 +
|-
 +
| 12
 +
| ''Madaatyayita''
 +
| Suffering from alchoholism
 +
|-
 +
| 13
 +
| ''Aadhmaata''
 +
| Abdominal distention or tympanitis
 +
|-
 +
| 14
 +
| ''Shalyaardita''
 +
| Inflicted with foreign bodies
 +
|-
 +
| 15
 +
| ''Abhihata''
 +
| Injured
 +
|-
 +
| 16
 +
| ''Atisnigdha''
 +
| Over-unctuous
 +
|-
 +
| 17
 +
| ''Atiruksha''
 +
| Excessively dry/rough
 +
|-
 +
| 18
 +
| ''Daarunakoshtha''
 +
| (A person with) hard bowel
 +
|-
 +
| 19
 +
| ''Kshataadayah Garbhinyantaah''
 +
| Those in the category of conditions ranging from injured to pregnant, under contraindication of ''vamana''
 +
|}
 +
[11]
  
==== Adverse effects of ''virechana karma'' administered in contra-indicated conditions ====
+
=== Adverse effects of ''[[virechana]] karma'' administered in contra-indicated conditions ===
 +
<div class="mw-collapsible mw-collapsed">
  
 
तत्र सुभगस्य सुकुमारोक्तो दोषः स्यात्, क्षतगुदस्य क्षते गुदे प्राणोपरोधकरीं रुजां जनयेत्, मुक्तनालमतिप्रवृत्त्या हन्यात्,अधोभागरक्तपित्तिनं तद्वत्, विलङ्घितदुर्बलेन्द्रियाल्पाग्निनिरूढा औषधवेगं न सहेरन्, कामादिव्यग्रमनसो न प्रवर्तते कृच्छ्रेणवा प्रवर्तमानमयोगदोषान् कुर्यात्, अजीर्णिन आमदोषः स्यात्, नवज्वरिणोऽविपक्वान् दोषान् न निर्हरेद् वातमेव च कोपयेत्,मदात्ययितस्य मद्यक्षीणे देहे वायुः प्राणोपरोधं कुर्यात्, आध्मातस्याधमतो वा पुरीषकोष्ठे  निचितो वायुर्विसर्पन्सहसाऽऽनाहं तीव्रतरं मरणं वा जनयेत्, शल्यार्दिताभिहतयोः क्षते वायुराश्रितो जीवितं हिंस्यात्, अतिस्निग्धस्यातियोगभयंभवेत्, रूक्षस्य वायुरङ्गप्रग्रहं कुर्यात्, दारुणकोष्ठस्य विरेचनोद्धता दोषाहृच्छूलपर्वभेदानाहाङ्गमर्दच्छर्दिमूर्च्छाक्लमाञ्जनयित्वा प्राणान् हन्युः, क्षतादीनां गर्भिण्यन्तानां छर्दनोक्तो दोषः स्यात्;तस्मादेते न विरेच्याः||१२||  
 
तत्र सुभगस्य सुकुमारोक्तो दोषः स्यात्, क्षतगुदस्य क्षते गुदे प्राणोपरोधकरीं रुजां जनयेत्, मुक्तनालमतिप्रवृत्त्या हन्यात्,अधोभागरक्तपित्तिनं तद्वत्, विलङ्घितदुर्बलेन्द्रियाल्पाग्निनिरूढा औषधवेगं न सहेरन्, कामादिव्यग्रमनसो न प्रवर्तते कृच्छ्रेणवा प्रवर्तमानमयोगदोषान् कुर्यात्, अजीर्णिन आमदोषः स्यात्, नवज्वरिणोऽविपक्वान् दोषान् न निर्हरेद् वातमेव च कोपयेत्,मदात्ययितस्य मद्यक्षीणे देहे वायुः प्राणोपरोधं कुर्यात्, आध्मातस्याधमतो वा पुरीषकोष्ठे  निचितो वायुर्विसर्पन्सहसाऽऽनाहं तीव्रतरं मरणं वा जनयेत्, शल्यार्दिताभिहतयोः क्षते वायुराश्रितो जीवितं हिंस्यात्, अतिस्निग्धस्यातियोगभयंभवेत्, रूक्षस्य वायुरङ्गप्रग्रहं कुर्यात्, दारुणकोष्ठस्य विरेचनोद्धता दोषाहृच्छूलपर्वभेदानाहाङ्गमर्दच्छर्दिमूर्च्छाक्लमाञ्जनयित्वा प्राणान् हन्युः, क्षतादीनां गर्भिण्यन्तानां छर्दनोक्तो दोषः स्यात्;तस्मादेते न विरेच्याः||१२||  
 +
<div class="mw-collapsible-content">
  
 
tatra subhagasya sukumārōktō dōṣaḥ syāt, kṣatagudasya kṣatē gudē prāṇōparōdhakarīṁ rujāṁ janayēt,muktanālamatipravr̥ttyā hanyāt, adhōbhāgaraktapittinaṁ tadvat, vilaṅghitadurbalēndriyālpāgninirūḍhāauṣadhavēgaṁ na sahēran, kāmādivyagramanasō na pravartatē kr̥cchrēṇa vā pravartamānamayōgadōṣānkuryāt, ajīrṇina āmadōṣaḥ syāt, navajvariṇō'vipakvān dōṣān na nirharēd vātamēva ca kōpayēt, madātyayitasyamadyakṣīṇē dēhē vāyuḥ prāṇōparōdhaṁ kuryāt, ādhmātasyādhamatō vā purīṣakōṣṭhē  nicitō vāyurvisarpansahasā''nāhaṁ tīvrataraṁ maraṇaṁ vā janayēt, śalyārditābhihatayōḥ kṣatē vāyurāśritō jīvitaṁ hiṁsyāt,atisnigdhasyātiyōgabhayaṁ bhavēt, rūkṣasya vāyuraṅgapragrahaṁ kuryāt, dāruṇakōṣṭhasya virēcanōddhatādōṣā hr̥cchūlaparvabhēdānāhāṅgamardacchardimūrcchāklamāñjanayitvā prāṇān hanyuḥ, kṣatādīnāṁgarbhiṇyantānāṁ chardanōktō dōṣaḥ syāt; tasmādētē na virēcyāḥ||12||  
 
tatra subhagasya sukumārōktō dōṣaḥ syāt, kṣatagudasya kṣatē gudē prāṇōparōdhakarīṁ rujāṁ janayēt,muktanālamatipravr̥ttyā hanyāt, adhōbhāgaraktapittinaṁ tadvat, vilaṅghitadurbalēndriyālpāgninirūḍhāauṣadhavēgaṁ na sahēran, kāmādivyagramanasō na pravartatē kr̥cchrēṇa vā pravartamānamayōgadōṣānkuryāt, ajīrṇina āmadōṣaḥ syāt, navajvariṇō'vipakvān dōṣān na nirharēd vātamēva ca kōpayēt, madātyayitasyamadyakṣīṇē dēhē vāyuḥ prāṇōparōdhaṁ kuryāt, ādhmātasyādhamatō vā purīṣakōṣṭhē  nicitō vāyurvisarpansahasā''nāhaṁ tīvrataraṁ maraṇaṁ vā janayēt, śalyārditābhihatayōḥ kṣatē vāyurāśritō jīvitaṁ hiṁsyāt,atisnigdhasyātiyōgabhayaṁ bhavēt, rūkṣasya vāyuraṅgapragrahaṁ kuryāt, dāruṇakōṣṭhasya virēcanōddhatādōṣā hr̥cchūlaparvabhēdānāhāṅgamardacchardimūrcchāklamāñjanayitvā prāṇān hanyuḥ, kṣatādīnāṁgarbhiṇyantānāṁ chardanōktō dōṣaḥ syāt; tasmādētē na virēcyāḥ||12||  
  
 
tatra subhagasya sukumArokto doShaH syAt, kShatagudasya kShate gude prANoparodhakarIM rujAM janayet,muktanAlamatipravRuttyA hanyAt, adhobhAgaraktapittinaM tadvat, vila~gghitadurbalendriyAlpAgninirUDhAauShadhavegaM na saheran, kAmAdivyagramanaso na pravartate kRucchreNa vA pravartamAnamayogadoShAnkuryAt, ajIrNina AmadoShaH syAt, navajvariNo~avipakvAn doShAn na nirhared vAtameva ca kopayet, madAtyayitasyamadyakShINe dehe vĀyuH prANoparodhaM kuryAt, AdhmAtasyAdhamato vA purIShakoShThe  nicito vĀyurvisarpansahasA~a~anAhaM tIvrataraM maraNaM vA janayet, shalyArditAbhihatayoH kShate vĀyurAshrito jIvitaM hiMsyAt,atisnigdhasyAtiyogabhayaM bhavet, rUkShasya vĀyura~ggapragrahaM kuryAt, dAruNakoShThasya virecanoddhatAdoShA hRucchUlaparvabhedAnAhA~ggamardacchardimUrcchAklamA~jjanayitvA prANAn hanyuH, kShatAdInAMgarbhiNyantAnAM chardanokto doShaH syAt; tasmAdete na virecyAH||12||  
 
tatra subhagasya sukumArokto doShaH syAt, kShatagudasya kShate gude prANoparodhakarIM rujAM janayet,muktanAlamatipravRuttyA hanyAt, adhobhAgaraktapittinaM tadvat, vila~gghitadurbalendriyAlpAgninirUDhAauShadhavegaM na saheran, kAmAdivyagramanaso na pravartate kRucchreNa vA pravartamAnamayogadoShAnkuryAt, ajIrNina AmadoShaH syAt, navajvariNo~avipakvAn doShAn na nirhared vAtameva ca kopayet, madAtyayitasyamadyakShINe dehe vĀyuH prANoparodhaM kuryAt, AdhmAtasyAdhamato vA purIShakoShThe  nicito vĀyurvisarpansahasA~a~anAhaM tIvrataraM maraNaM vA janayet, shalyArditAbhihatayoH kShate vĀyurAshrito jIvitaM hiMsyAt,atisnigdhasyAtiyogabhayaM bhavet, rUkShasya vĀyura~ggapragrahaM kuryAt, dAruNakoShThasya virecanoddhatAdoShA hRucchUlaparvabhedAnAhA~ggamardacchardimUrcchAklamA~jjanayitvA prANAn hanyuH, kShatAdInAMgarbhiNyantAnAM chardanokto doShaH syAt; tasmAdete na virecyAH||12||  
 
+
</div></div>
If ''virechana'' is given to a person who is ''subhaga'' (having tender health or soft perineum), then he or she will suffer from the same disorder as described for ''vamana'' administered to ''sukumara'' (having tender health).
+
<div style="text-align:justify;">
 +
If ''[[virechana]]'' is given to a person who is ''subhaga'' (having tender health or soft perineum), then he or she will suffer from the same disorder as described for ''[[vamana]]'' administered to ''sukumara'' (having tender health).
 
   
 
   
''Virechana'' given to the person suffering from anal injury will cause severe pain in the injured anus which may be even life threatening.
+
''[[Virechana]]'' given to the person suffering from anal injury will cause severe pain in the injured anus which may be even life threatening.
  
''Virechana'' administered to the person suffering from prolapsed rectum may cause excessive diarrhea and prolapse which leads to the death of the patient. Similar adverse effects are observed if ''virechana'' is administered in the person suffering from ''adhobhaga-raktapitta''  (disease characterized by bleeding through the downward tract).
+
''[[Virechana]]'' administered to the person suffering from prolapsed rectum may cause excessive diarrhea and prolapse which leads to the death of the patient. Similar adverse effects are observed if ''[[virechana]]'' is administered in the person suffering from ''adhobhaga-raktapitta''  (disease characterized by bleeding through the downward tract).
  
 
A person, who is specifically lightened due to fasting, has weak senses, low power of digestion or who has undergone ''niruha'' type of enema, cannot tolerate the effects of virechana medicines.  
 
A person, who is specifically lightened due to fasting, has weak senses, low power of digestion or who has undergone ''niruha'' type of enema, cannot tolerate the effects of virechana medicines.  
  
If ''virechana'' is given to the person whose mind is agitated by passion etc., then there will be either no purgation or purgation with difficulty. In such conditions, harmful effects are observed due to improper administration of ''virechana''.
+
If ''[[virechana]]'' is given to the person whose mind is agitated by passion etc., then there will be either no purgation or purgation with difficulty. In such conditions, harmful effects are observed due to improper administration of ''[[virechana]]''.
  
''Virechana'' administered in the persons suffering from ''ajirna'' (indigestion) causes diseases due to ''ama'' (product of improper digestion and metabolism).
+
''[[Virechana]]'' administered in the persons suffering from ''ajirna'' (indigestion) causes diseases due to ''ama'' (product of improper digestion and metabolism).
  
''Virechana'' given to the patients suffering from acute fever does not eliminate the ''dosha'' which are unripened and causes aggravation of ''vata dosha''.
+
''[[Virechana]]'' given to the patients suffering from acute fever does not eliminate the ''[[dosha]]'' which are unripened and causes aggravation of ''[[vata dosha]]''.
  
''Virechana'' administered to a person suffering from alcoholism and whose body is emaciated due to over use of wine leads to aggravation of ''vata dosha'' and causes danger to his life.
+
''[[Virechana]]'' administered to a person suffering from alcoholism and whose body is emaciated due to over use of wine leads to aggravation of ''[[vata dosha]]'' and causes danger to his life.
  
''Virechana'' given in that suffering from tympanitis, ''vata'' accumulated in the chamber of feces may spread further which cause sudden more severe abdominal distension or death.
+
''[[Virechana]]'' given in that suffering from tympanitis, ''[[vata]]'' accumulated in the chamber of feces may spread further which cause sudden more severe abdominal distension or death.
  
''Virechana'' given in a person suffering from foreign body inside the body or injured by weapons, ''vata'' located in the wound may take away the life.
+
''[[Virechana]]'' given in a person suffering from foreign body inside the body or injured by weapons, ''[[vata]]'' located in the wound may take away the life.
  
''Virechana'' administered in the person who is excessively uncted or oleated, exerts the excessive effects and in a "dry" (un-oily) person, ''vata'' may produce stiffness in the body parts. ''Virechana'' given to the person having costive bowel, ''dosha'' excited by purgation may produce cardiac pain, tearing pain in joints, ''anaha'' (hardness of bowels, constipation), body-ache, vomiting, fainting and exhaustion. This may lead to the death of the patient.
+
''[[Virechana]]'' administered in the person who is excessively uncted or oleated, exerts the excessive effects and in a "dry" (un-oily) person, ''[[vata]]'' may produce stiffness in the body parts. ''[[Virechana]]'' given to the person having costive bowel, ''[[dosha]]'' excited by purgation may produce cardiac pain, tearing pain in joints, ''anaha'' (hardness of bowels, constipation), body-ache, vomiting, fainting and exhaustion. This may lead to the death of the patient.
  
''Virechana'' given in those suffering from disease beginning with ''kshata'' (chest wound) and ending with pregnancy, the defects said under ''vamana'' may arise.
+
''[[Virechana]]'' given in those suffering from disease beginning with ''kshata'' (chest wound) and ending with pregnancy, the defects said under ''[[vamana]]'' may arise.
Therefore, above mentioned persons should not be treated with ''virechana karma''.                    [12]
+
Therefore, above mentioned persons should not be treated with ''[[virechana]] karma''.                    [12]
 
+
</div>
==== Indications of ''virechana karma'' ====
+
=== Indications of ''[[virechana]] karma'' ===
 +
<div class="mw-collapsible mw-collapsed">
  
 
शेषास्तु विरेच्याः; विशेषतस्तुकुष्ठज्वरमेहोर्ध्वरक्तपित्तभगन्दरोदरार्शोब्रध्नप्लीहगुल्मार्बुदगलगण्डग्रन्थिविसूचिकालसकमूत्राघातक्रिमिकोष्ठविसर्प-पाण्डुरोगशिरःपार्श्वशूलोदावर्तनेत्रास्यदाहहृद्रोगव्यङ्गनीलिकानेत्रनासिकास्यस्रवणहलीमकश्वासकासकामला-पच्यपस्मारोन्मादवातरक्तयोनिरेतोदोषतैमिर्यारोचकाविपाकच्छर्दिश्वयथूदरविस्फोटकादयः  पित्तव्याधयो विशेषेणमहारोगाध्यायोक्ताश्च; एतेषु हि विरेचनं प्रधानतममित्युक्तमग्न्युपशमेऽग्निगृहवत्||१३||  
 
शेषास्तु विरेच्याः; विशेषतस्तुकुष्ठज्वरमेहोर्ध्वरक्तपित्तभगन्दरोदरार्शोब्रध्नप्लीहगुल्मार्बुदगलगण्डग्रन्थिविसूचिकालसकमूत्राघातक्रिमिकोष्ठविसर्प-पाण्डुरोगशिरःपार्श्वशूलोदावर्तनेत्रास्यदाहहृद्रोगव्यङ्गनीलिकानेत्रनासिकास्यस्रवणहलीमकश्वासकासकामला-पच्यपस्मारोन्मादवातरक्तयोनिरेतोदोषतैमिर्यारोचकाविपाकच्छर्दिश्वयथूदरविस्फोटकादयः  पित्तव्याधयो विशेषेणमहारोगाध्यायोक्ताश्च; एतेषु हि विरेचनं प्रधानतममित्युक्तमग्न्युपशमेऽग्निगृहवत्||१३||  
 +
<div class="mw-collapsible-content">
  
 
śēṣāstu virēcyāḥ; viśēṣatastukuṣṭhajvaramēhōrdhvaraktapittabhagandarōdarārśōbradhnaplīhagulmārbudagalagaṇḍagranthivisūcikālasakamūtrāghātakrimikōṣṭhavisarpa-pāṇḍurōgaśiraḥpārśvaśūlōdāvartanētrāsyadāhahr̥drōgavyaṅganīlikānētranāsikāsyasravaṇahalīmakaśvāsakāsakāmalā-pacyapasmārōnmādavātaraktayōnirētōdōṣataimiryārōcakāvipākacchardiśvayathūdaravisphōṭakādayaḥ  pittavyādhayō viśēṣēṇamahārōgādhyāyōktāśca; ētēṣu hi virēcanaṁ pradhānatamamityuktamagnyupaśamē'gnigr̥havat||13||  
 
śēṣāstu virēcyāḥ; viśēṣatastukuṣṭhajvaramēhōrdhvaraktapittabhagandarōdarārśōbradhnaplīhagulmārbudagalagaṇḍagranthivisūcikālasakamūtrāghātakrimikōṣṭhavisarpa-pāṇḍurōgaśiraḥpārśvaśūlōdāvartanētrāsyadāhahr̥drōgavyaṅganīlikānētranāsikāsyasravaṇahalīmakaśvāsakāsakāmalā-pacyapasmārōnmādavātaraktayōnirētōdōṣataimiryārōcakāvipākacchardiśvayathūdaravisphōṭakādayaḥ  pittavyādhayō viśēṣēṇamahārōgādhyāyōktāśca; ētēṣu hi virēcanaṁ pradhānatamamityuktamagnyupaśamē'gnigr̥havat||13||  
  
 
sheShAstu virecyAH; visheShatastukuShThajvaramehordhvaraktapittabhagandarodarArshobradhnaplIhagulmArbudagalagaNDagranthivisUcikAlasakamUtrAghAtakrimikoShThavisarpa-pANDurogashiraHpArshvashUlodAvartanetrAsyadAhahRudrogavya~gganIlikAnetranAsikAsyasravaNahalImakashvAsakAsakAmalA-pacyapasmAronmAdavAtaraktayoniretodoShataimiryArocakAvipAkacchardishvayathUdaravisphoTakAdayaH  pittavyAdhayo visheSheNamahArogAdhyAyoktAshca; eteShu hi VirecanaM pradhAnatamamityuktamagnyupashame~agnigRuhavat||13||
 
sheShAstu virecyAH; visheShatastukuShThajvaramehordhvaraktapittabhagandarodarArshobradhnaplIhagulmArbudagalagaNDagranthivisUcikAlasakamUtrAghAtakrimikoShThavisarpa-pANDurogashiraHpArshvashUlodAvartanetrAsyadAhahRudrogavya~gganIlikAnetranAsikAsyasravaNahalImakashvAsakAsakAmalA-pacyapasmAronmAdavAtaraktayoniretodoShataimiryArocakAvipAkacchardishvayathUdaravisphoTakAdayaH  pittavyAdhayo visheSheNamahArogAdhyAyoktAshca; eteShu hi VirecanaM pradhAnatamamityuktamagnyupashame~agnigRuhavat||13||
 +
</div></div>
 +
 +
The persons other than above-mentioned are fit for ''[[virechana]] karma''. It is specially advised for the persons mentioned in the table below:
 +
 +
{| class="wikitable" style="text-align: center;
 +
|-
 +
! scope="col"| Serial No.
 +
! scope="col"| Disease or State (in which ''[[virechana]]'' is indicated)
 +
! scope="col"| Translation in English
 +
|-
 +
| 1
 +
| ''Kushtha''
 +
| Obstinate skin diseases, including leprosy
 +
|-
 +
| 2
 +
| ''[[Jwara]]''
 +
| Fever
 +
|-
 +
| 3
 +
| ''Meha''
 +
| Obstinate urinary disorders, including diabetes mellitus
 +
|-
 +
| 4
 +
| ''Urdhva-Raktapitta''
 +
| Bleeding from upward tracts
 +
|-
 +
| 5
 +
| ''Bhagandara''
 +
| Fistula in ano
 +
|-
 +
| 6
 +
| ''Udara roga''
 +
| Obstinate abdominal diseases, including ascites
 +
|-
 +
| 7
 +
| ''Arsha roga''
 +
| Piles
 +
|-
 +
| 8
 +
| ''Bradhna roga''
 +
| Inguinal swelling
 +
|-
 +
| 9
 +
| ''Pleeha roga''
 +
| Splenomegaly
 +
|-
 +
| 10
 +
| ''Gulma roga''
 +
| Abdominal lump
 +
|-
 +
| 11
 +
| ''Arbuda roga''
 +
| Tumor
 +
|-
 +
| 12
 +
| ''Galagandha''
 +
| Goitre
 +
|-
 +
| 13
 +
| ''Granthi roga''
 +
| Lymphadenitis/cystic swellings
 +
|-
 +
| 14
 +
| ''Visuchika roga''
 +
| Cholera
 +
|-
 +
| 15
 +
| ''Alasaka roga''
 +
| Intestinal torpor
 +
|-
 +
| 16
 +
| ''Mutraghata''
 +
| Oliguria/Anuria
 +
|-
 +
| 17
 +
| ''Krimikoshtha''
 +
| Helminthiasis
 +
|-
 +
| 18
 +
| ''Visarpa roga''
 +
| Erysipelas
 +
|-
 +
| 19
 +
| ''Pandu roga''
 +
| Anemia
 +
|-
 +
| 20
 +
| ''Sirah shula''
 +
| Headache
 +
|-
 +
| 21
 +
| ''Parshva shula''
 +
| Pain in lateral sides of chest
 +
|-
 +
| 22
 +
| ''Udavarta roga''
 +
| Upward and oblique movement of wind in abdomen
 +
|-
 +
| 23
 +
| ''Netra daaha''
 +
| Burning sensation in the eyes
 +
|-
 +
| 24
 +
| ''Aasya daaha''
 +
| Burning sensation in the mouth
 +
|-
 +
| 25
 +
| ''Hridroga''
 +
| Heart disease
 +
|-
 +
| 26
 +
| ''Vyanga roga''
 +
| Dark brownish patches over the face
 +
|-
 +
| 27
 +
| ''neelika roga''
 +
| Bluish black moles
 +
|-
 +
| 28
 +
| ''Netra sravana''
 +
| Excessive discharge from the eyes
 +
|-
 +
| 29
 +
| ''Naasika sravana''
 +
| Excessive discharge from the nose
 +
|-
 +
| 30
 +
| ''Aasya sravana''
 +
| Excessive salivation
 +
|-
 +
| 31
 +
| ''Haleemaka''
 +
| A type of jaundice
 +
|-
 +
| 32
 +
| ''Shvasa roga''
 +
| Dyspnea
 +
|-
 +
| 33
 +
| ''Kaasa roga''
 +
| Cough
 +
|-
 +
| 34
 +
| ''Kaamala''
 +
| Jaundice
 +
|-
 +
| 35
 +
| ''Apachi roga''
 +
| Cervical adenitis
 +
|-
 +
| 36
 +
| ''Apasmara roga''
 +
| Epilepsy
 +
|-
 +
| 37
 +
| ''Unmada roga''
 +
| Psychotic disorders
 +
|-
 +
| 38
 +
| ''Vatarakta''
 +
| Gout
 +
|-
 +
| 39
 +
| ''Yoni dosha''
 +
| Defects of female genital tract
 +
|-
 +
| 40
 +
| ''Retodosha''
 +
| Defects of semen
 +
|-
 +
| 41
 +
| ''Timira''
 +
| Cataract
 +
|-
 +
| 42
 +
| ''Arochaka''
 +
| Anorexia
 +
|-
 +
| 43
 +
| ''Avipaka''
 +
| Indigestion
 +
|-
 +
| 44
 +
| ''Chhardi''
 +
| Vomiting
 +
|-
 +
| 45
 +
| ''Shvayathu''
 +
| Edema
 +
|-
 +
| 46
 +
| ''Visphotaka''
 +
| Pustular eruptions
 +
|-
 +
| 47
 +
| ''Pitta vyadhyayo visheshena Maharogadhyayoktah''
 +
| ''Paittika'' type disorders mentioned in [[Maharoga Adhyaya]] of [[Charaka Samhita]] [[Sutra Sthana]]
 +
|}
 +
<div style="text-align:justify;">
 +
For the above-mentioned diseases, ''[[virechana]] karma'' is the foremost therapy. As the extinguisher of fire normalizes a house on fire, similarly ''[[virechana]] karma'' cures the diseases by eliminating aggravated ''[[pitta]]''. [13]
 +
</div>
 +
=== Contra-indications of ''asthapana [[basti]]'' ===
 +
<div class="mw-collapsible mw-collapsed">
  
The persons other than above-mentioned are fit for ''virechana karma''. It is specially advised for the persons mentioned in the table below-
+
अनास्थाप्यास्तुअजीर्ण्यतिस्निग्धपीतस्नेहोत्क्लिष्टदोषाल्पाग्नियानक्लान्तातिदुर्बलक्षुत्तृष्णाश्रमार्तातिकृशभुक्तभक्तपीतोदकवमितविरिक्तकृतनस्तः-
Serial Number Disease or state in which ''virechana'' is indicated English translation of the diseases or state
 
1. Kuṣṭha Obstinate skin diseases including leprosy
 
2. Jvara Fever
 
3. Meha Obstinate urinary disorders including diabetes mellitus
 
4. Urdhva-Raktapitta Bleeding from upward tracts
 
5. Bhagandara Fistula-in-Ano
 
6. Udara-roga Obstinate abdominal diseases including ascites
 
7. Arśa-roga Piles
 
8. Bradhna-roga Inguinal swelling
 
9. Plīha-roga Splenomegaly
 
10. Gulma-roga Abdominal lump
 
11. Arbuda-roga Tumour
 
12. Galagaṇḍa Goitre
 
13. Granthi-roga Lymphadenitis/cystic swellings
 
 
14. Visūcikā-roga Cholera
 
15. Alasaka-roga Intestinal torpor
 
16. Mūtrāghāta Oliguria/Anuria
 
17. Kṛmikoṣṭha Helminthiasis
 
18. Visarpa-roga Erysipelas
 
19. Pāṇḍu-roga Anaemia
 
20. Śiraḥ-śūla Headache
 
21. Pārśva- śūla Pain in lateral sides of chest
 
22. Udāvarta-roga Upward and oblique movement of wind in abdomen
 
23. Netra-dāha Burning sensation in the eyes
 
24. Āsya- dāha Burning sensation in the mouth
 
25. Hṛdroga Heart-disease
 
26. Vyanga-roga Dark brownish patches over the face
 
27. Nīlikā-roga Bluish black moles
 
 
28. Netra-sravaṇa Excessive discharge from the eyes
 
29. Nāsikā- sravaṇa Excessive discharge from the nose
 
30. Āsya- sravaṇa Excessive salivation
 
31. Halīmaka A type of jaundice
 
32. Śvāsa-roga Dyspnoea
 
33. Kāsa-roga Cough
 
34. Kāmalā Jaundice
 
35. Apacī-roga Cervical adenitis
 
36. Apasmāra-roga Epilepsy
 
37. Unmāda-roga Insanity
 
38. Vātarakta Gout
 
39. Yoni-doṣa Defects of female genital tract
 
40. Retodoṣa Defects of semen
 
41. Timira Cataract
 
42. Arocaka Anorexia
 
 
43. Avipāka Indigestion
 
44. Chardi Vomiting
 
45. Śvayathu Oedema
 
47. Visphoṭaka Pustular eruptions
 
48. Pitta-vyādhayo viśeṣeṇa Mahārogādhyāyoktāḥ Paittika type of disorders mentioned in Mahārogādhyāya of Caraka-Saṃhitā
 
  
For the above-mentioned diseases, ''virechana karma'' is the foremost therapy. As the extinguisher of fire normalizes a house on fire, similarly ''virechana karma'' cures the diseases by eliminating aggravated ''pitta''. [13]
+
कर्मकुद्धभीतमत्तमूर्च्छितप्रसक्तच्छर्दिनिष्ठीविकाश्वासकासहिक्काबद्धच्छिद्रोदकोदराध्मानालसकविसूचिकामप्रजातामातिसार-मधुमेहकुष्ठार्ताः||१४||
 +
<div class="mw-collapsible-content">
  
==== Contra-indications of ''asthapana basti'' ====
+
anāsthāpyāstuajīrṇyatisnigdhapītasnēhōtkliṣṭadōṣālpāgniyānaklāntātidurbalakṣuttr̥ṣṇāśramārtātikr̥śabhuktabhaktapītōdakavamitaviriktakr̥tanastaḥ-
  
अनास्थाप्यास्तुअजीर्ण्यतिस्निग्धपीतस्नेहोत्क्लिष्टदोषाल्पाग्नियानक्लान्तातिदुर्बलक्षुत्तृष्णाश्रमार्तातिकृशभुक्तभक्तपीतोदकवमितविरिक्तकृतनस्तःकर्मकुद्धभीतमत्तमूर्च्छितप्रसक्तच्छर्दिनिष्ठीविकाश्वासकासहिक्काबद्धच्छिद्रोदकोदराध्मानालसकविसूचिकामप्रजातामातिसार-मधुमेहकुष्ठार्ताः||१४||  
+
karmakuddhabhītamattamūrcchitaprasaktacchardiniṣṭhīvikāśvāsakāsahikkābaddhacchidrōdakōdarādhmānālasakavisūcikāmaprajātāmātisāra-madhumēhakuṣṭhārtāḥ||14||  
  
anāsthāpyāstuajīrṇyatisnigdhapītasnēhōtkliṣṭadōṣālpāgniyānaklāntātidurbalakṣuttr̥ṣṇāśramārtātikr̥śabhuktabhaktapītōdakavamitaviriktakr̥tanastaḥkarmakuddhabhītamattamūrcchitaprasaktacchardiniṣṭhīvikāśvāsakāsahikkābaddhacchidrōdakōdarādhmānālasakavisūcikāmaprajātāmātisāra-madhumēhakuṣṭhārtāḥ||14||
+
anAsthApyAstuajIrNyatisnigdhapItasnehotkliShTadoShAlpAgniyAnaklAntAtidurbalakShuttRuShNAshramArtAtikRushabhuktabhaktapItodakavamitaviriktakRutanastaH-
  
anAsthApyAstuajIrNyatisnigdhapItasnehotkliShTadoShAlpAgniyAnaklAntAtidurbalakShuttRuShNAshramArtAtikRushabhuktabhaktapItodakavamitaviriktakRutanastaHkarmakuddhabhItamattamUrcchitaprasaktacchardiniShThIvikAshvAsakAsahikkAbaddhacchidrodakodarAdhmAnAlasakavisUcikAmaprajAtAmAtisAra-madhumehakuShThArtAH||14||  
+
karmakuddhabhItamattamUrcchitaprasaktacchardiniShThIvikAshvAsakAsahikkAbaddhacchidrodakodarAdhmAnAlasakavisUcikAmaprajAtAmAtisAra-madhumehakuShThArtAH||14||  
 +
</div></div>
  
Administration of ''asthapana'' or ''niruha basti'' is contra-indicated in the persons mentioned in the table given below-
+
Administration of ''asthapana'' or ''niruha [[basti]]'' is contra-indicated in the persons mentioned in the table given below:
Serial Number Disease or state in which asthāpana- basti is contra-indicated English translation of the disease or state
 
1. Ajīrṇa Indigestion
 
2. Atisnigdha Over-uncted
 
3. Pītasneha Who has just taken uncting substances
 
4. Utkliṣṭa-doṣa Who have excited dosha
 
5. Alpāgni Suppression of the power of digestion
 
6. Yānaklānta Exhausted due to riding
 
7. Atidurbala Excessively weak
 
 
8. Kṣudhārta Excessively hungry
 
9. Tṛṣṇārta Excessively thirsty
 
10. Śramārta Excessively tired
 
11. Atikṛśa Excessively emaciated
 
12. Bhuktabhakta Who has just taken the food
 
13. Pītodaka Who has just taken the water
 
14. Vamita Just undergone emesis
 
15. Virikta Just undergone purgation
 
16. Kṛta-nastaḥ-karma Just taken snuffing
 
17. Kruddha Angry
 
18. Bhīta Under the grip of fear
 
19. Matta Under the influence of narcosis
 
20. Mūrcchita Fainted
 
21. Prasaktacchardi Constant vomiting
 
22. Niṣṭhīvikā Excessive spitting
 
 
23. Śvāsa-roga Dyspnoea
 
24. Kāsa-roga Cough
 
25. Hikkā-roga Hiccup
 
26. Baddhodarādhmāna Tympanitis due to intestinal obstruction
 
27. Chidrodarādhmāna Tympanitis due to intestinal perforation
 
28. Udakodarādhmāna Tympanitis due to Ascites
 
29. Alasaka-roga Intestinal torpor
 
30. Visūcikā-roga Cholera
 
31. Āmaprajātā A woman who delivered premature baby
 
32. Āmātisāra Diarrhoea associated with the symptoms of āma i.e. the product of indigestion
 
33. Madhumeha Diabetes mellitus
 
34. Kuṣṭha-roga Obstinate skin diseases including leprosy
 
  
 +
{| class="wikitable" style="text-align: center;
 +
|-
 +
! scope="col"| Serial No.
 +
! scope="col"| Disease or State (in which ''asthapana [[basti]]'' is contraindicated)
 +
! scope="col"| Translation in English
 +
|-
 +
| 1
 +
| ''Ajeerna''
 +
| Indigestion
 +
|-
 +
| 2
 +
| ''Atisnigdha''
 +
| Over-unctuous
 +
|-
 +
| 3
 +
| ''Peetasneha''
 +
| (A person who has just ingested) smoothening/uncting substances
 +
|-
 +
| 4
 +
| ''Utklishtha [[dosha]]''
 +
| (A person who has) excited ''[[dosha]]''
 +
|-
 +
| 5
 +
| ''Alpaagni''
 +
| Suppression of the power of digestion
 +
|-
 +
| 6
 +
| ''Yaanaklaanta''
 +
| (A person who is) exhausted due to riding
 +
|-
 +
| 7
 +
| ''Atidurbala''
 +
| (A person who is) excessively weak
 +
|-
 +
| 8
 +
| ''Kshudhaarta''
 +
| (A person who is) excessively hungry
 +
|-
 +
| 9
 +
| ''Trishnaarta''
 +
| (A person who is) excessively thirsty
 +
|-
 +
| 10
 +
| ''Shramaarta''
 +
| (A person who is) excessively tired (of doing laborious work)
 +
|-
 +
| 11
 +
| ''Atikrisha''
 +
| (A person who is) excessively emaciated
 +
|-
 +
| 12
 +
| ''Bhuktabhakta''
 +
| (A person who has) just ingested food
 +
|-
 +
| 13
 +
| ''Peetodaka''
 +
| (A person who has) just drunk water
 +
|-
 +
| 14
 +
| ''Vamita''
 +
| (A person who has) just undergone emesis
 +
|-
 +
| 15
 +
| ''Virikta''
 +
| (A person who has) just undergone purgation
 +
|-
 +
| 16
 +
| ''Krita nastah karma''
 +
| (A person who has) just used snuff (powder)
 +
|-
 +
| 17
 +
| ''Kruddha''
 +
| Anger
 +
|-
 +
| 18
 +
| ''Bheeta''
 +
| (A person who is) under the grip of fear
 +
|-
 +
| 19
 +
| ''Matta''
 +
| (A person who is) under the influence of narcosis
 +
|-
 +
| 20
 +
| ''Murchhita''
 +
| (A person who has) fainted
 +
|-
 +
| 21
 +
| ''Prasaktachhardi''
 +
| (A person who is) continuously vomiting
 +
|-
 +
| 22
 +
| ''Nishtheevika''
 +
| (A person who is) excessively spitting
 +
|-
 +
| 23
 +
| ''Shvasa roga''
 +
| Dyspnea
 +
|-
 +
| 24
 +
| ''Kaasa roga''
 +
| Cough
 +
|-
 +
| 25
 +
| ''Hikka roga''
 +
| Hiccup
 +
|-
 +
| 26
 +
| ''Baddhodaraadhmaana''
 +
| Tympanitis due to intestinal obstruction
 +
|-
 +
| 27
 +
| ''Chidrodaraadhmaana''
 +
| Tympanitis due to intestinal perforation
 +
|-
 +
| 28
 +
| ''Udakodaraadhmaana''
 +
| Tympanitis due to ascites
 +
|-
 +
| 29
 +
| ''Alasaka roga''
 +
| Intestinal torpor
 +
|-
 +
| 30
 +
| ''Visuchika roga''
 +
| Cholera
 +
|-
 +
| 31
 +
| ''Amaprajaata''
 +
| A woman who has delivered a premature baby
 +
|-
 +
| 32
 +
| ''Amatisaara''
 +
| Diarrhea associated with the symptoms of ama, i.e., the product of indigestion
 +
|-
 +
| 33
 +
| ''Madhumeha''
 +
| Diabetes mellitus
 +
|-
 +
| 34
 +
| ''Kushtha roga''
 +
| Obstinate skin diseases including leprosy
 +
|}
 +
 
[14]
 
[14]
  
==== Adverse effects of ''asthapana basti'' administered in contra-indicated persons ====
+
=== Adverse effects of ''asthapana [[basti]]'' administered in contra-indicated persons ===
 +
<div class="mw-collapsible mw-collapsed">
  
 
तत्राजीर्ण्यतिस्निग्धपीतस्नेहानां दूष्योदरं मूर्च्छाश्वयथुर्वा स्यात्, उत्क्लिष्टदोषमन्दाग्न्योररोचकस्तीव्रः, यानक्लान्तस्य क्षोभव्यापन्नोबस्तिराशु देहं शोषयेत्, अतिदुर्बलक्षुत्तृष्णाश्रमार्तानां पूर्वोक्तोदोषः स्यात्, अतिकृशस्य कार्श्यं पुनर्जनयेत्,भुक्तभक्तपीतोदकयोरुत्क्लिश्योर्ध्वमधो वा  वायुर्बस्तिमुत्क्षिप्य क्षिप्रं घोरान् विकाराञ्जनयेत्, वमितविरिक्तयोस्तु रूक्षं शरीरं निरूहःक्षतं क्षार इव दहेत्, कृतनस्तःकर्मणो विभ्रंशं भृशसंरुद्धस्रोतसः  कुर्यात्, क्रुद्धभीतयोर्बस्तिरूर्ध्वमुपप्लवेत्, मत्तमूर्च्छितयो र्भृशंविचलितायां सञ्ज्ञायां चित्तोपघाताद् व्यापत् स्यात्, प्रसक्तच्छर्दिर्निष्ठीविकाश्वासकासहिक्कार्तानामूर्ध्वीभूतो वायुरूर्ध्वं बस्तिं नयेत्,बद्धच्छिद्रोदकोदराध्मानार्तानां भृशतरमाध्माप्य बस्तिः प्राणान् हिंस्यात्, अलसकविसूचिकामप्रजातामातिसारिणामामकृतो दोषःस्यात्, मधुमेहकुष्ठिनोर्व्याधेः पुनर्वृद्धिः; तस्मादेते नास्थाप्याः||१५||
 
तत्राजीर्ण्यतिस्निग्धपीतस्नेहानां दूष्योदरं मूर्च्छाश्वयथुर्वा स्यात्, उत्क्लिष्टदोषमन्दाग्न्योररोचकस्तीव्रः, यानक्लान्तस्य क्षोभव्यापन्नोबस्तिराशु देहं शोषयेत्, अतिदुर्बलक्षुत्तृष्णाश्रमार्तानां पूर्वोक्तोदोषः स्यात्, अतिकृशस्य कार्श्यं पुनर्जनयेत्,भुक्तभक्तपीतोदकयोरुत्क्लिश्योर्ध्वमधो वा  वायुर्बस्तिमुत्क्षिप्य क्षिप्रं घोरान् विकाराञ्जनयेत्, वमितविरिक्तयोस्तु रूक्षं शरीरं निरूहःक्षतं क्षार इव दहेत्, कृतनस्तःकर्मणो विभ्रंशं भृशसंरुद्धस्रोतसः  कुर्यात्, क्रुद्धभीतयोर्बस्तिरूर्ध्वमुपप्लवेत्, मत्तमूर्च्छितयो र्भृशंविचलितायां सञ्ज्ञायां चित्तोपघाताद् व्यापत् स्यात्, प्रसक्तच्छर्दिर्निष्ठीविकाश्वासकासहिक्कार्तानामूर्ध्वीभूतो वायुरूर्ध्वं बस्तिं नयेत्,बद्धच्छिद्रोदकोदराध्मानार्तानां भृशतरमाध्माप्य बस्तिः प्राणान् हिंस्यात्, अलसकविसूचिकामप्रजातामातिसारिणामामकृतो दोषःस्यात्, मधुमेहकुष्ठिनोर्व्याधेः पुनर्वृद्धिः; तस्मादेते नास्थाप्याः||१५||
 +
<div class="mw-collapsible-content">
  
 
tatrājīrṇyatisnigdhapītasnēhānāṁ dūṣyōdaraṁ mūrcchāśvayathurvā syāt, utkliṣṭadōṣamandāgnyōrarōcakastīvraḥ, yānaklāntasyakṣōbhavyāpannō bastirāśu dēhaṁ śōṣayēt, atidurbalakṣuttr̥ṣṇāśramārtānāṁ pūrvōktōdōṣaḥ syāt, atikr̥śasya kārśyaṁ punarjanayēt,bhuktabhaktapītōdakayōrutkliśyōrdhvamadhō vā  vāyurbastimutkṣipya kṣipraṁ ghōrān vikārāñjanayēt, vamitaviriktayōstu rūkṣaṁ śarīraṁnirūhaḥ kṣataṁ kṣāra iva dahēt, kr̥tanastaḥkarmaṇō vibhraṁśaṁ bhr̥śasaṁruddhasrōtasaḥ  kuryāt,kruddhabhītayōrbastirūrdhvamupaplavēt, mattamūrcchitayō rbhr̥śaṁ vicalitāyāṁ sañjñāyāṁ cittōpaghātād vyāpat syāt,prasaktacchardirniṣṭhīvikāśvāsakāsahikkārtānāmūrdhvībhūtō vāyurūrdhvaṁ bastiṁ nayēt, baddhacchidrōdakōdarādhmānārtānāṁ bhr̥śataramādhmāpya bastiḥ prāṇān hiṁsyāt, alasakavisūcikāmaprajātāmātisāriṇāmāmakr̥tō dōṣaḥ syāt, madhumēhakuṣṭhinōrvyādhēḥpunarvr̥ddhiḥ; tasmādētē nāsthāpyāḥ||15||
 
tatrājīrṇyatisnigdhapītasnēhānāṁ dūṣyōdaraṁ mūrcchāśvayathurvā syāt, utkliṣṭadōṣamandāgnyōrarōcakastīvraḥ, yānaklāntasyakṣōbhavyāpannō bastirāśu dēhaṁ śōṣayēt, atidurbalakṣuttr̥ṣṇāśramārtānāṁ pūrvōktōdōṣaḥ syāt, atikr̥śasya kārśyaṁ punarjanayēt,bhuktabhaktapītōdakayōrutkliśyōrdhvamadhō vā  vāyurbastimutkṣipya kṣipraṁ ghōrān vikārāñjanayēt, vamitaviriktayōstu rūkṣaṁ śarīraṁnirūhaḥ kṣataṁ kṣāra iva dahēt, kr̥tanastaḥkarmaṇō vibhraṁśaṁ bhr̥śasaṁruddhasrōtasaḥ  kuryāt,kruddhabhītayōrbastirūrdhvamupaplavēt, mattamūrcchitayō rbhr̥śaṁ vicalitāyāṁ sañjñāyāṁ cittōpaghātād vyāpat syāt,prasaktacchardirniṣṭhīvikāśvāsakāsahikkārtānāmūrdhvībhūtō vāyurūrdhvaṁ bastiṁ nayēt, baddhacchidrōdakōdarādhmānārtānāṁ bhr̥śataramādhmāpya bastiḥ prāṇān hiṁsyāt, alasakavisūcikāmaprajātāmātisāriṇāmāmakr̥tō dōṣaḥ syāt, madhumēhakuṣṭhinōrvyādhēḥpunarvr̥ddhiḥ; tasmādētē nāsthāpyāḥ||15||
  
 
tatrAjIrNyatisnigdhapItasnehAnAM dUShyodaraM mUrcchAshvayathurvA syAt, utkliShTadoShamandAgnyorarocakastIvraH, yAnaklAntasyakShobhavyApanno bastirAshu dehaM shoShayet, atidurbalakShuttRuShNAshramArtAnAM pUrvoktodoShaH syAt, atikRushasya kArshyaMpunarjanayet, bhuktabhaktapItodakayorutklishyordhvamadho vA  vĀyurbastimutkShipya kShipraM ghorAn vikArA~jjanayet, vamitaviriktayosturUkShaM sharIraM nirUhaH kShataM kShAra iva dahet, kRutanastaHkarmaNo vibhraMshaM bhRushasaMruddhasrotasaH  kuryAt,kruddhabhItayorbastirUrdhvamupaplavet, mattamUrcchitayo rbhRushaM vicalitAyAM sa~jj~jAyAM cittopaghAtAd vyApat syAt,prasaktacchardirniShThIvikAshvAsakAsahikkArtAnAmUrdhvIbhUto vĀyurUrdhvaM bastiM nayet, baddhacchidrodakodarAdhmAnArtAnAMbhRushataramAdhyApya bastiH prANAn hiMsyAt, alasakavisUcikAmaprajAtAmAtisAriNAmAmakRuto doShaH syAt, madhumehakuShThinorvyAdheHpunarvRuddhiH; tasmAdete nAsthApyAH||15||
 
tatrAjIrNyatisnigdhapItasnehAnAM dUShyodaraM mUrcchAshvayathurvA syAt, utkliShTadoShamandAgnyorarocakastIvraH, yAnaklAntasyakShobhavyApanno bastirAshu dehaM shoShayet, atidurbalakShuttRuShNAshramArtAnAM pUrvoktodoShaH syAt, atikRushasya kArshyaMpunarjanayet, bhuktabhaktapItodakayorutklishyordhvamadho vA  vĀyurbastimutkShipya kShipraM ghorAn vikArA~jjanayet, vamitaviriktayosturUkShaM sharIraM nirUhaH kShataM kShAra iva dahet, kRutanastaHkarmaNo vibhraMshaM bhRushasaMruddhasrotasaH  kuryAt,kruddhabhItayorbastirUrdhvamupaplavet, mattamUrcchitayo rbhRushaM vicalitAyAM sa~jj~jAyAM cittopaghAtAd vyApat syAt,prasaktacchardirniShThIvikAshvAsakAsahikkArtAnAmUrdhvIbhUto vĀyurUrdhvaM bastiM nayet, baddhacchidrodakodarAdhmAnArtAnAMbhRushataramAdhyApya bastiH prANAn hiMsyAt, alasakavisUcikAmaprajAtAmAtisAriNAmAmakRuto doShaH syAt, madhumehakuShThinorvyAdheHpunarvRuddhiH; tasmAdete nAsthApyAH||15||
 
+
</div></div>
Application of ''Asthapana-basti'' (non-unctuous enema) in the persons suffering from indigestion, over-uncted and just taken unctuous substances causes ''dushyodara'' (''udara-roga'' caused by aggravation of all the three ''dosha''), fainting or edema. In the cases having excited ''dosha'' and suppression of digestion power, it causes severe type of anorexia. In a person exhausted due to riding, the ''asthapana''-''basti'' disturbed by agitation dry up the body quickly leading to emaciation. In the persons who are excessively weak and suffering from excessive hunger, thirst and tiredness, ''basti'' causes the same harms as discussed for exhausted due to riding. In excessively emaciated person if ''asthapana-basti'' is applied, it increases the emaciation. In those who have just taken food and water, ''asthapana basti'' causes provocation of ''vata'' which divert the enema upwards or downwards leading to manifestation of severe diseases soon. In that undergone emesis or purgation, the ''niruha'' or ''asthapana-basti'' burns the body as alkali does the wound. In a person who has undergone the snuffing, it causes the untoward effects related to sense organs and further obstruction of the channels of circulation. In the person having anger and fear, the ''basti'' may go upwards and produce agitation. In the condition of narcosis and fainting, the ''basti'' causes further agitation and there may be complications due to mental injury. If ''asthapana basti'' is applied in the conditions of constant vomiting, excessive spitting, dyspnea, cough and hiccup, ''vata'' moving upwards can cause upward movement of ''basti''. In the persons suffering from intestinal obstruction, intestinal perforation and ascites associated with tympanitis, ''asthapana basti'' further increase the distension and may lead to the death of the patient. In the persons suffering from alasaka, visūcikā, premature delivery and amātisāra, it causes the disorders due to ama (product of improper digestion). In Diabetes mellitus and ''kushtha'' (obstinate skin diseases including leprosy), application of ''asthapana basti'' further increases these diseases. Therefore, ''asthapana basti'' should not be given to the above mentioned persons.[15]
+
<div style="text-align:justify;">
 
+
Application of ''Asthapana-[[basti]]'' (non-unctuous enema) in the persons suffering from indigestion, over-uncted and just taken unctuous substances causes ''dushyodara'' (''udara-roga'' caused by aggravation of all the three ''[[dosha]]''), fainting or edema. In the cases having excited ''[[dosha]]'' and suppression of digestion power, it causes severe type of anorexia. In a person exhausted due to riding, the ''asthapana''-''[[basti]]'' disturbed by agitation dry up the body quickly leading to emaciation. In the persons who are excessively weak and suffering from excessive hunger, thirst and tiredness, ''[[basti]]'' causes the same harms as discussed for exhausted due to riding. In excessively emaciated person if ''asthapana-[[basti]]'' is applied, it increases the emaciation. In those who have just taken food and water, ''asthapana [[basti]]'' causes provocation of ''[[vata]]'' which divert the enema upwards or downwards leading to manifestation of severe diseases soon. In that undergone emesis or purgation, the ''niruha'' or ''asthapana-[[basti]]'' burns the body as alkali does the wound. In a person who has undergone the snuffing, it causes the untoward effects related to sense organs and further obstruction of the channels of circulation. In the person having anger and fear, the ''[[basti]]'' may go upwards and produce agitation. In the condition of narcosis and fainting, the ''[[basti]]'' causes further agitation and there may be complications due to mental injury. If ''asthapana [[basti]]'' is applied in the conditions of constant vomiting, excessive spitting, dyspnea, cough and hiccup, ''[[vata]]'' moving upwards can cause upward movement of ''[[basti]]''. In the persons suffering from intestinal obstruction, intestinal perforation and ascites associated with tympanitis, ''asthapana [[basti]]'' further increase the distension and may lead to the death of the patient. In the persons suffering from ''alasaka, visuchika,'' premature delivery and ''amatisara'', it causes the disorders due to ''ama'' (product of improper digestion). In diabetes mellitus and ''kushtha'' (obstinate skin diseases including leprosy), application of ''asthapana [[basti]]'' further increases these diseases. Therefore, ''asthapana [[basti]]'' should not be given to the above mentioned persons.[15]
==== Indications of ''asthapana basti'' ====
+
</div>
 +
=== Indications of ''asthapana [[basti]]'' ===
 +
<div class="mw-collapsible mw-collapsed">
  
 
शेषास्त्वास्थाप्याः; विशेषतस्तुसर्वाङ्गैकाङ्गकुक्षिरोगवातवर्चोमूत्रशुक्रसङ्गबलवर्णमांसरेतःक्षयदोषाध्मानाङ्गसुप्तिक्रिमिकोष्ठोदावर्तशुद्धातिसार-पर्वभेदाभितापप्लीहगुल्मशूलहृद्रोगभगन्दरोन्मादज्वरब्रध्नशिरःकर्णशूलहृदयपार्श्वपृष्ठकटीग्रहवेपनाक्षेपकगौरवातिलाघव-रजःक्षयार्तविषमाग्निस्फिग्जानुजङ्घोरुगुल्फपार्ष्णिप्रपदयोनिबाह्वङ्गुलिस्तनान्तदन्तनखपर्वास्थिशूल-शोषस्तम्भान्त्रकूजपरिकर्तिकाल्पाल्पसशब्दोग्रगन्धोत्थानादयो  वातव्याधयो विशेषेण महारोगाध्यायोक्ताश्च;एतेष्वास्थापनं प्रधानतममित्युक्तं वनस्पतिमूलच्छेदवत्||१६||  
 
शेषास्त्वास्थाप्याः; विशेषतस्तुसर्वाङ्गैकाङ्गकुक्षिरोगवातवर्चोमूत्रशुक्रसङ्गबलवर्णमांसरेतःक्षयदोषाध्मानाङ्गसुप्तिक्रिमिकोष्ठोदावर्तशुद्धातिसार-पर्वभेदाभितापप्लीहगुल्मशूलहृद्रोगभगन्दरोन्मादज्वरब्रध्नशिरःकर्णशूलहृदयपार्श्वपृष्ठकटीग्रहवेपनाक्षेपकगौरवातिलाघव-रजःक्षयार्तविषमाग्निस्फिग्जानुजङ्घोरुगुल्फपार्ष्णिप्रपदयोनिबाह्वङ्गुलिस्तनान्तदन्तनखपर्वास्थिशूल-शोषस्तम्भान्त्रकूजपरिकर्तिकाल्पाल्पसशब्दोग्रगन्धोत्थानादयो  वातव्याधयो विशेषेण महारोगाध्यायोक्ताश्च;एतेष्वास्थापनं प्रधानतममित्युक्तं वनस्पतिमूलच्छेदवत्||१६||  
 +
<div class="mw-collapsible-content">
 
 
 
śēṣāstvāsthāpyāḥ; viśēṣatastusarvāṅgaikāṅgakukṣirōgavātavarcōmūtraśukrasaṅgabalavarṇamāṁsarētaḥkṣayadōṣādhmānāṅgasuptikrimikōṣṭhōdāvartaśuddhātisāra-parvabhēdābhitāpaplīhagulmaśūlahr̥drōgabhagandarōnmādajvarabradhnaśiraḥkarṇaśūlahr̥dayapārśvapr̥ṣṭhakaṭīgrahavēpanākṣēpakagauravātilāghava-rajaḥkṣayārtaviṣamāgnisphigjānujaṅghōrugulphapārṣṇiprapadayōnibāhvaṅgulistanāntadantanakhaparvāsthiśūla-śōṣastambhāntrakūjaparikartikālpālpasaśabdōgragandhōtthānādayō  vātavyādhayō viśēṣēṇa mahārōgādhyāyōktāśca; ētēṣvāsthāpanaṁpradhānatamamityuktaṁ vanaspatimūlacchēdavat||16||
 
śēṣāstvāsthāpyāḥ; viśēṣatastusarvāṅgaikāṅgakukṣirōgavātavarcōmūtraśukrasaṅgabalavarṇamāṁsarētaḥkṣayadōṣādhmānāṅgasuptikrimikōṣṭhōdāvartaśuddhātisāra-parvabhēdābhitāpaplīhagulmaśūlahr̥drōgabhagandarōnmādajvarabradhnaśiraḥkarṇaśūlahr̥dayapārśvapr̥ṣṭhakaṭīgrahavēpanākṣēpakagauravātilāghava-rajaḥkṣayārtaviṣamāgnisphigjānujaṅghōrugulphapārṣṇiprapadayōnibāhvaṅgulistanāntadantanakhaparvāsthiśūla-śōṣastambhāntrakūjaparikartikālpālpasaśabdōgragandhōtthānādayō  vātavyādhayō viśēṣēṇa mahārōgādhyāyōktāśca; ētēṣvāsthāpanaṁpradhānatamamityuktaṁ vanaspatimūlacchēdavat||16||
  
 
sheShAstvAsthApyAH; visheShatastusarvA~ggaikA~ggakukShirogavatavarcomUtrashukrasa~ggabalavarNamAMsaretaHkShayadoShAdhmAnA~ggasuptikrimikoShThodAvartashuddhAtisAra-parvabhedAbhitApaplIhagulmashUlahRudrogabhagandaronmAdajvarabradhnashiraHkarNashUlahRudayapArshvapRuShThakaTIgrahavepanAkShepakagauravAtilAghava-rajaHkShayArtaviShamAgnisphigjAnuja~gghorugulphapArShNiprapadayonibAhva~ggulistanAntadantanakhaparvAsthishUla-shoShastambhAntrakUjaparikartikAlpAlpasashabdogragandhotthAnAdayo  vAtavyAdhayo visheSheNa mahArogAdhyAyoktAshca; eteShvĀsthāpanaMpradhAnatamamityuktaM vanaspatimUlacchedavat||16||  
 
sheShAstvAsthApyAH; visheShatastusarvA~ggaikA~ggakukShirogavatavarcomUtrashukrasa~ggabalavarNamAMsaretaHkShayadoShAdhmAnA~ggasuptikrimikoShThodAvartashuddhAtisAra-parvabhedAbhitApaplIhagulmashUlahRudrogabhagandaronmAdajvarabradhnashiraHkarNashUlahRudayapArshvapRuShThakaTIgrahavepanAkShepakagauravAtilAghava-rajaHkShayArtaviShamAgnisphigjAnuja~gghorugulphapArShNiprapadayonibAhva~ggulistanAntadantanakhaparvAsthishUla-shoShastambhAntrakUjaparikartikAlpAlpasashabdogragandhotthAnAdayo  vAtavyAdhayo visheSheNa mahArogAdhyAyoktAshca; eteShvĀsthāpanaMpradhAnatamamityuktaM vanaspatimUlacchedavat||16||  
 +
</div></div>
  
The persons other than above-mentioned are fit for ''asthapana basti''. It is especially useful for the persons mentioned in the table below-
+
The persons other than above-mentioned are fit for ''asthapana [[basti]]''. It is especially useful for the persons mentioned in the table below:
  
Serial Number Disease or state in which asthāpana-basti is indicated English translation of the disease or state
+
{| class="wikitable" style="text-align: center;
1. Sarvānga-roga Paralysis of the whole body
+
|-
2. Ekānga-roga Paralysis of one of the limb
+
! scope="col"| Serial No.
3. Kukṣi-roga Disorder of abdomen
+
! scope="col"| Disease or State (in which ''asthapana [[basti]]'' is indicated)
4. Vāta-sanga Retention of flatus
+
! scope="col"| Translation in English
5. Varcho- sanga Retention of faeces
+
|-
6. Mūtra- sanga Retention of urine
+
| 1
7. Śukra- sanga Retention of semen
+
| ''Sarvaanga roga''
8. Bala-kṣaya Diminution of strength
+
| Paralysis of the whole body
+
|-
9. Varṇa- kṣaya Loss of complexion
+
| 2
10. Māṃsa- kṣaya Diminution of Muscle-tissue
+
| ''Ekaanga roga''
11. Retaḥ- kṣaya Diminution of semen
+
| Paralysis of one of the limb
12. Doṣādhmāna Tympanitis
+
|-
13. Anga- supti Numbness of body parts
+
| 3
14. Kṛmikoṣhṭha Parasitic infestation of intestine
+
| ''Kukshi roga''
15. Udāvarta Disoirder due to reverse movement of the vata
+
| Disorder of abdomen
16. Śuddhātisāra Diarrhoea without association of ama
+
|-
17. Parvabheda Tearing pain in joints
+
| 4
18. Abhitāpa Feeling of burning sensation
+
| ''[[Vata]] sanga''
19. Plīha-roga Splenic disorder
+
| Retention of flatus
20. Gulma-roga Abdominal lump
+
|-
21. Śūla-roga Colic pain
+
| 5
22. Hṛdroga Heart disease
+
| ''Varcho sanga''
23. Bhagandara Fistula-in-Ano
+
| Retention of feces
+
|-
24. Unmāda-roga Insanity
+
| 6
25. Jvara Fever
+
| ''Mootra sanga''
26. Bradhna-roga Inguinal swelling
+
| Retention of urine
27. Śiraḥśūla Headache
+
|-
28. Karṇaśūla Earache
+
| 7
29. Hṛdaya-graha Stiffness in heart
+
| ''[[Shukra]] sanga''
30. Pārśva-graha Stiffness in sides
+
| Retention of semen
31. Pṛṣṭha-graha Stiffness in back
+
|-
32. Kaṭi-graha Stiffness in waist
+
| 8
33. Vepana-ārta Suffering from tremor  
+
| ''Bala kshaya''
34. Ākṣepaka- ārta Suffering from convulsions
+
| Diminution of strength
35. Gauravārta Suffering from heaviness
+
|-
36. Atilāghavārta Suffering from excessive lightness
+
| 9
37. Rajaḥ-kṣayārta Suffering from amenorrhea
+
| ''Varna kshaya''
38. Viṣamāgni Irregular power of digestion
+
| Diminution of complexion
+
|-
39. Sphik-śūla-śoṣa-stambha Pain, atrophy and stiffness of hip
+
| 10
40. Jānu-śūla-śoṣa-stambha Pain, atrophy and stiffness of knee-joints
+
| ''[[Mamsa]] kshaya''
41. Janghā-śūla-śoṣa-stambha Pain, atrophy and stiffness of the calf region
+
| Diminution of muscle tissue
42. Uru-śūla-śoṣa-stambha Pain, atrophy and stiffness of the thighs
+
|-
43. Gulpha- śūla-śoṣa –stambha Pain, atrophy and stiffness of the ankles
+
| 11
44. Pārṣṇi- śūla-śoṣa –stambha Pain, atrophy and stiffness of heels
+
| ''Retah kshaya''
45. Prapada- śūla-śoṣa –stambha Pain, atrophy and stiffness of feet
+
| Diminution of semen
46. Yoni- śūla-śoṣa –stambha Pain, atrophy and stiffness of the female genital track
+
|-
47. Bāhu- śūla-śoṣa –stambha Pain, atrophy and stiffness of arms
+
| 12
48. Anguli- śūla-śoṣa –stambha Pain, atrophy and stiffness of fingers
+
| ''Doshaadhmaana''
49. Stanānta- śūla-śoṣa –stambha Pain, atrophy and stiffness of the periphery of the breasts
+
| Tympanitis
50. Danta- śūla-śoṣa –stambha Pain, atrophy and stiffness of teeth
+
|-
51. Nakha- śūla-śoṣa –stambha Pain, atrophy and stiffness of nails
+
| 13
+
| ''Anga supti''
52. Parva- śūla-śoṣa –stambha Pain, atrophy and stiffness of joints
+
| Numbness of body parts
53. Asthi- śūla-śoṣa –stambha Pain, atrophy and stiffness of bones
+
|-
54. Āntra-kūjana Intestinal gurgling
+
| 14
55. Parikartikā Cutting pain in anal region
+
| ''Krimikoshtha''
56. Alpālpa-utthāna Voiding stool in small quantity frequently
+
| Parasitic infestation of intestine
57. Saśabda-utthāna Voiding stool with sound
+
|-
58. Ugragandha-utthāna ādayo vyādhayaḥ Voiding of foul smell stool etc. diseases
+
| 15
59. Vāta-vyādhayo viśeṣeṇa Mahārogādhyāyoktāḥ Vatika disorders specially discussed in [[Maharoga Adhyaya]] of [[Charaka Samhita]]
+
| ''Udaavarta''
 
+
| Disorder due to reverse movement of the vata
In the above mentioned diseases, ''asthapana basti'' is the foremost therapy. As a tree gets destroyed by cutting its roots, similarly the above mentioned diseases are eradicated by administration of ''asthapana basti''. [16]
+
|-
 
+
| 16
==== Contra-indications of ''anuvasana basti'' ====
+
| ''Shuddhaatisaara''
 +
| Diarrhea without association of ama
 +
|-
 +
| 17
 +
| ''Parvabheda''
 +
| Tearing pain in joints
 +
|-
 +
| 18
 +
| ''Abhitaapa''
 +
| Feeling of burning sensation
 +
|-
 +
| 19
 +
| ''Pleeha roga''
 +
| Splenic disorder
 +
|-
 +
| 20
 +
| ''Gulma roga''
 +
| Abdominal lump
 +
|-
 +
| 21
 +
| ''Shula roga''
 +
| Colic pain
 +
|-
 +
| 22
 +
| ''Hridroga''
 +
| Heart disease
 +
|-
 +
| 23
 +
| ''Bhagandara''
 +
| Fistula in ano
 +
|-
 +
| 24
 +
| ''Unmada roga''
 +
| Psychotic disorders
 +
|-
 +
| 25
 +
| ''[[Jwara]]''
 +
| Fever
 +
|-
 +
| 26
 +
| ''Bradhna roga''
 +
| Inguinal swelling
 +
|-
 +
| 27
 +
| ''Shirahshula''
 +
| Headache
 +
|-
 +
| 28
 +
| ''Karnashula''
 +
| Earache
 +
|-
 +
| 29
 +
| ''Hridaya graha''
 +
| Stiffness in heart
 +
|-
 +
| 30
 +
| ''Paarshva graha''
 +
| Stiffness in sides
 +
|-
 +
| 31
 +
| ''Prishtha graha''
 +
| Stiffness in back
 +
|-
 +
| 32
 +
| ''Kati graha''
 +
| Stiffness in waist
 +
|-
 +
| 33
 +
| ''Vepana aarta''
 +
| Suffering from tremor
 +
|-
 +
| 34
 +
| ''Aakshepaka aarta''
 +
| Suffering from convulsions
 +
|-
 +
| 35
 +
| ''Gauravaarta''
 +
| Suffering from heaviness
 +
|-
 +
| 36
 +
| ''Atilaaghavaarta''
 +
| Suffering from excessive lightness
 +
|-
 +
| 37
 +
| ''Rajah-kshayaarta''
 +
| Suffering from amenorrhea
 +
|-
 +
| 38
 +
| ''Vishamaagni''
 +
| Irregular power of digestion
 +
|-
 +
| 39
 +
| ''Sphik-shula-shosha-stambha''
 +
| Pain, atrophy and stiffness of hip
 +
|-
 +
| 40
 +
| ''Jaanu-shula-shosha-stambha''
 +
| Pain, atrophy and stiffness of knee-joints
 +
|-
 +
| 41
 +
| ''Janghaa-shula-shosha-stambha''
 +
| Pain, atrophy and stiffness of the calf region
 +
|-
 +
| 42
 +
| ''Uru-shula-shosha-stambha''
 +
| Pain, atrophy and stiffness of the thighs
 +
|-
 +
| 43
 +
| ''Gulpha-shula-shosha-stambha''
 +
| Pain, atrophy and stiffness of the ankles
 +
|-
 +
| 44
 +
| ''Paarshni-shula-shosha-stambha''
 +
| Pain, atrophy and stiffness of the heels
 +
|-
 +
| 45
 +
| ''Prapada-shula-shosha-stambha''
 +
| Pain, atrophy and stiffness of the feet
 +
|-
 +
| 46
 +
| ''Yoni-shula-shosha-stambha''
 +
| Pain, atrophy and stiffness of female genitals
 +
|-
 +
| 47
 +
| ''Baahu-shula-shosha-stambha''
 +
| Pain, atrophy and stiffness of arms
 +
|-
 +
| 48
 +
| ''Anguli-shula-shosha-stambha''
 +
| Pain, atrophy and stiffness of fingers
 +
|-
 +
| 49
 +
| ''Stanaanta-shula-shosha-stambha''
 +
| Pain, atrophy and stiffness of the periphery of the breasts
 +
|-
 +
| 50
 +
| ''Danta-shula-shosha-stambha''
 +
| Pain, atrophy and stiffness of teeth
 +
|-
 +
| 51
 +
| ''Nakha-shula-shosha-stambha''
 +
| Pain, atrophy and stiffness of nails
 +
|-
 +
| 52
 +
| ''Parva-shula-shosha-stambha''
 +
| Pain, atrophy and stiffness of joints
 +
|-
 +
| 53
 +
| ''Asthi-shula-shosha-stambha''
 +
| Pain, atrophy and stiffness of bones
 +
|-
 +
| 54
 +
| ''Aantra koojana''
 +
| Intestinal gurgling
 +
|-
 +
| 55
 +
| ''Parikartika''
 +
| Cutting pain in anal region
 +
|-
 +
| 56
 +
| ''Alpaalpa-utthaana''
 +
| Voiding stool in small quantity frequently
 +
|-
 +
| 57
 +
| ''Sashabda-utthaana''
 +
| Voiding stool with sound
 +
|-
 +
| 58
 +
| ''Ugragandha-utthaana aadayo vyaadhyayah''
 +
| (Diseases that cause) voiding stool with foul smell
 +
|-
 +
| 59
 +
| ''Vata-vyaadhayo visheshena maharogadhyayoktah''
 +
| Vatika disorders specially discussed in [[Maharoga Adhyaya]] of [[Charaka Samhita]] [[Sutra Sthana]]
 +
|}
 +
<div style="text-align:justify;">
 +
In the above mentioned diseases, ''asthapana [[basti]]'' is the foremost therapy. As a tree gets destroyed by cutting its roots, similarly the above mentioned diseases are eradicated by administration of ''asthapana [[basti]]''. [16]
 +
</div>
 +
=== Contra-indications of ''anuvasana [[basti]]'' ===
 +
<div class="mw-collapsible mw-collapsed">
  
 
य एवानास्थाप्यास्त एवाननुवास्याः स्युः;विशेषतस्त्वभुक्तभक्तनवज्वरपाण्डुरोगकामलाप्रमेहार्शःप्रतिश्यायारोचकमन्दाग्निदुर्बलप्लीहकफोदरोरुस्तम्भवर्चोभेद-विषगरपीतपित्तकफाभिष्यन्दगुरुकोष्ठश्लीपदगलगण्डापचिक्रिमिकोष्ठिनः  ||१७||  
 
य एवानास्थाप्यास्त एवाननुवास्याः स्युः;विशेषतस्त्वभुक्तभक्तनवज्वरपाण्डुरोगकामलाप्रमेहार्शःप्रतिश्यायारोचकमन्दाग्निदुर्बलप्लीहकफोदरोरुस्तम्भवर्चोभेद-विषगरपीतपित्तकफाभिष्यन्दगुरुकोष्ठश्लीपदगलगण्डापचिक्रिमिकोष्ठिनः  ||१७||  
 +
<div class="mw-collapsible-content">
  
 
ya ēvānāsthāpyāsta ēvānanuvāsyāḥ syuḥ;viśēṣatastvabhuktabhaktanavajvarapāṇḍurōgakāmalāpramēhārśaḥpratiśyāyārōcakamandāgnidurbalaplīhakaphōdarōrustambhavarcōbhēda-viṣagarapītapittakaphābhiṣyandagurukōṣṭhaślīpadagalagaṇḍāpacikrimikōṣṭhinaḥ  ||17||  
 
ya ēvānāsthāpyāsta ēvānanuvāsyāḥ syuḥ;viśēṣatastvabhuktabhaktanavajvarapāṇḍurōgakāmalāpramēhārśaḥpratiśyāyārōcakamandāgnidurbalaplīhakaphōdarōrustambhavarcōbhēda-viṣagarapītapittakaphābhiṣyandagurukōṣṭhaślīpadagalagaṇḍāpacikrimikōṣṭhinaḥ  ||17||  
  
 
ya evAnAsthApyAsta evAnanuvAsyAH syuH;visheShatastvabhuktabhaktanavajvarapANDurogakAmalApramehArshaHpratishyAyArocakamandAgnidurbalaplIhakaphodarorustambhavarcobheda-viShagarapItapittakaphAbhiShyandagurukoShThashlIpadagalagaNDApacikrimikoShThinaH  ||17|  
 
ya evAnAsthApyAsta evAnanuvAsyAH syuH;visheShatastvabhuktabhaktanavajvarapANDurogakAmalApramehArshaHpratishyAyArocakamandAgnidurbalaplIhakaphodarorustambhavarcobheda-viShagarapItapittakaphAbhiShyandagurukoShThashlIpadagalagaNDApacikrimikoShThinaH  ||17|  
 +
</div></div>
 +
<div style="text-align:justify;">
 +
Those persons who are unfit for ''asthapana [[basti]]'', are considered unfit for ''anuvasana [[basti]]''. Conditions in which ''anuvasana [[basti]]'' is specifically contra-indicated, are listed in the table given below:
 +
</div>
 +
{| class="wikitable" style="text-align: center;
 +
|-
 +
! scope="col"| Serial No.
 +
! scope="col"| Disease or State (in which ''anuvasana [[basti]]'' is contraindicated)
 +
! scope="col"| Translation in English
 +
|-
 +
| 1
 +
| ''Abhuktabhakta''
 +
| A person who has not taken food
 +
|-
 +
| 2
 +
| ''Navajwara''
 +
| Acute fever
 +
|-
 +
| 3
 +
| ''Pandu roga''
 +
| Anemia
 +
|-
 +
| 4
 +
| ''Kaamala''
 +
| Jaundice
 +
|-
 +
| 5
 +
| ''Prameha''
 +
| Obstinate urinary disorders including diabetes
 +
|-
 +
| 6
 +
| ''Arsha roga''
 +
| Piles
 +
|-
 +
| 7
 +
| ''Pratishyaya''
 +
| Coryza
 +
|-
 +
| 8
 +
| ''Arochaka''
 +
| Anorexia
 +
|-
 +
| 9
 +
| ''Mandaagni''
 +
| Supression of the power of digestion
 +
|-
 +
| 10
 +
| ''Durbala''
 +
| Weak
 +
|-
 +
| 11
 +
| ''Pleehodara''
 +
| Splenic disorders
 +
|-
 +
| 12
 +
| ''Kaphodara''
 +
| Obstinate abdominal disease caused by aggravation of [[kapha]]
 +
|-
 +
| 13
 +
| ''Urustambha''
 +
| Stiffness of thigh and calf region
 +
|-
 +
| 14
 +
| ''Varchobheda''
 +
| Diarrhea
 +
|-
 +
| 15
 +
| ''Vishapeeta''
 +
| One who has ingested natural poison
 +
|-
 +
| 16
 +
| ''Garapeeta''
 +
| One who has ingested artificial/synthetic poison
 +
|-
 +
| 17
 +
| ''Pittaabhishyanda''
 +
| Conjuctivitis caused by aggravated ''[[pitta]]''
 +
|-
 +
| 18
 +
| ''Kaphaabhishyanda''
 +
| Conjuctivitis caused by aggravated ''[[kapha]]''
 +
|-
 +
| 19
 +
| ''Gurukoshtha''
 +
| Costive bowel
 +
|-
 +
| 20
 +
| ''Shleepada roga''
 +
| Filaria
 +
|-
 +
| 21
 +
| ''Galagandha''
 +
| Goitre
 +
|-
 +
| 22
 +
| ''Apachi roga''
 +
| Cervical adenitis
 +
|-
 +
| 23
 +
| ''Krimikoshthi''
 +
| (Those suffering from) intestinal parasites
 +
|}
  
Those persons who are unfit for ''asthapana basti'', are considered unfit for ''anuvasana basti''. Conditions in which ''anuvasana basti'' is specifically contra-indicated, are listed in the table given below-
 
 
Serial Number Disease or state in which anuvāsana-basti is contra-indicated English translation of the disease or state
 
1. Abhuktabhakta A person who has not taken food
 
2. Navajvara Acute fever
 
3. Pāṇḍu roga Anaemia
 
 
4. Kāmalā Jaundice
 
5. Prameha Obstinate urinary disorders including diabetes
 
6. Arśa-roga Piles
 
7. Pratiśyāya Coryza
 
8. Arocaka Anorexia
 
9. Mandāgni Suppression of the power of digestion
 
10. Durbala Weak
 
11. Plīhodara Splenic disorders
 
12. Kaphodara Obstinate abdominal disease caused by aggravation of Kapha
 
13. Ūrustambha Stiffness of thigh and calf region
 
14. Varcobheda Diarrhoea
 
15. Viṣapīta One who has ingested the natural poison
 
16. Garapīta One who has ingested artificial poison
 
 
17. Pittābhiṣyanda Conjunctivitis caused by aggravated Pitta
 
18. Kaphābhiṣyanda Conjunctivitis caused by aggravated Kapha
 
19. Gurukoṣṭha Costive bowel
 
20. Ślīpada-roga Filaria
 
21. Galagaṇḍa Goitre
 
22. Apaci-roga Cervical adenitis
 
23. Kṛmikoṣṭhī Those who are suffering from intestinal parasites
 
 
[17]
 
[17]
  
==== Adverse effects of ''anuvasana basti'' in contra-indicated conditions ====
+
=== Adverse effects of ''anuvasana [[basti]]'' in contra-indicated conditions ===
 +
<div class="mw-collapsible mw-collapsed">
  
 
तत्राभुक्तभक्तस्यानावृतमार्गत्वादूर्ध्वमतिवर्तते स्नेहः, नवज्वरपाण्डुरोगकामलाप्रमेहिणां दोषानुत्क्लिश्योदरञ्जनयेत्,अर्शसस्यार्शांस्यभिष्यन्द्याध्मानं कुर्यात्, अरोचकार्तस्यान्नगृद्धिं पुनर्हन्यात्, मन्दाग्निदुर्बलयोर्मन्दतरमग्निं कुर्यात्,प्रतिश्यायप्लीहादिमतां भृशमुत्क्लिष्टदोषाणां भूय एव दोषं वर्धयेत्; तस्मादेते नानुवास्याः||१८||  
 
तत्राभुक्तभक्तस्यानावृतमार्गत्वादूर्ध्वमतिवर्तते स्नेहः, नवज्वरपाण्डुरोगकामलाप्रमेहिणां दोषानुत्क्लिश्योदरञ्जनयेत्,अर्शसस्यार्शांस्यभिष्यन्द्याध्मानं कुर्यात्, अरोचकार्तस्यान्नगृद्धिं पुनर्हन्यात्, मन्दाग्निदुर्बलयोर्मन्दतरमग्निं कुर्यात्,प्रतिश्यायप्लीहादिमतां भृशमुत्क्लिष्टदोषाणां भूय एव दोषं वर्धयेत्; तस्मादेते नानुवास्याः||१८||  
 +
<div class="mw-collapsible-content">
  
 
tatrābhuktabhaktasyānāvr̥tamārgatvādūrdhvamativartatē snēhaḥ, navajvarapāṇḍurōgakāmalāpramēhiṇāṁ dōṣānutkliśyōdarañjanayēt,arśasasyārśāṁsyabhiṣyandyādhmānaṁ kuryāt, arōcakārtasyānnagr̥ddhiṁ punarhanyāt, mandāgnidurbalayōrmandataramagniṁ kuryāt,pratiśyāyaplīhādimatāṁ bhr̥śamutkliṣṭadōṣāṇāṁ bhūya ēva dōṣaṁ vardhayēt; tasmādētē nānuvāsyāḥ||18||  
 
tatrābhuktabhaktasyānāvr̥tamārgatvādūrdhvamativartatē snēhaḥ, navajvarapāṇḍurōgakāmalāpramēhiṇāṁ dōṣānutkliśyōdarañjanayēt,arśasasyārśāṁsyabhiṣyandyādhmānaṁ kuryāt, arōcakārtasyānnagr̥ddhiṁ punarhanyāt, mandāgnidurbalayōrmandataramagniṁ kuryāt,pratiśyāyaplīhādimatāṁ bhr̥śamutkliṣṭadōṣāṇāṁ bhūya ēva dōṣaṁ vardhayēt; tasmādētē nānuvāsyāḥ||18||  
  
 
tatrAbhuktabhaktasyAnAvRutamArgatvAdUrdhvamativartate snehaH, navajvarapANDurogakAmalApramehiNAM doShAnutklishyodara~jjanayet,arshasasyArshAMsyabhiShyandyAdhmAnaM kuryAt, arocakArtasyAnnagRuddhiM punarhanyAt, mandAgnidurbalayormandataramagniM kuryAt,pratishyAyaplIhAdimatAM bhRushamutkliShTadoShANAM bhUya eva doShaM vardhayet; tasmAdete nAnuvAsyAH||18||  
 
tatrAbhuktabhaktasyAnAvRutamArgatvAdUrdhvamativartate snehaH, navajvarapANDurogakAmalApramehiNAM doShAnutklishyodara~jjanayet,arshasasyArshAMsyabhiShyandyAdhmAnaM kuryAt, arocakArtasyAnnagRuddhiM punarhanyAt, mandAgnidurbalayormandataramagniM kuryAt,pratishyAyaplIhAdimatAM bhRushamutkliShTadoShANAM bhUya eva doShaM vardhayet; tasmAdete nAnuvAsyAH||18||  
 
+
</div></div>
If  ''anuvasana basti'' is administered to the person who is empty stomach, it goes upwards due to the absence of any obstruction in the passage. In the acute fever, anaemia, jaundice and ''prameha'', ''anuvasana basti'' causes excitement of ''dosha'' which further leads to ''Udara roga'' (obstinate abdominal disease including ascites). In the person suffering from piles, use of ''anuvasana basti'' may create obstruction in the piles leading to ''adhmana'' (abdominal distension). In the person suffering from anorexia, application of ''anuvasana basti'' further diminishes the desire for food. In case of suppression of power of digestion and weakness, the application of ''anuvasana basti'' makes the digestive power poorer. If ''anuvasana basti'' is administered to the persons suffering from coryza, splenic disorders and such other diseases, it causes the further excitement of ''dosha'' which are already aggravated. Therefore, the above mentioned persons are unfit for the administration of ''anuvasana basti''. [18]
+
<div style="text-align:justify;">
 
+
If  ''anuvasana [[basti]]'' is administered to the person who is empty stomach, it goes upwards due to the absence of any obstruction in the passage. In the acute fever, anaemia, jaundice and ''prameha'', ''anuvasana [[basti]]'' causes excitement of ''[[dosha]]'' which further leads to ''Udara roga'' (obstinate abdominal disease including ascites). In the person suffering from piles, use of ''anuvasana [[basti]]'' may create obstruction in the piles leading to ''adhmana'' (abdominal distension). In the person suffering from anorexia, application of ''anuvasana [[basti]]'' further diminishes the desire for food. In case of suppression of power of digestion and weakness, the application of ''anuvasana [[basti]]'' makes the digestive power poorer. If ''anuvasana [[basti]]'' is administered to the persons suffering from coryza, splenic disorders and such other diseases, it causes the further excitement of ''[[dosha]]'' which are already aggravated. Therefore, the above mentioned persons are unfit for the administration of ''anuvasana [[basti]]''. [18]
==== Indications of ''anuvasana basti'' ====
+
</div>
 +
=== Indications of ''anuvasana [[basti]]'' ===
 +
<div class="mw-collapsible mw-collapsed">
  
 
य एवास्थाप्यास्त एवानुवास्याः; विशेषतस्तु रूक्षतीक्ष्णाग्नयः केवलवातरोगार्ताश्च; एतेषु ह्यनुवासनं प्रधानतममित्युक्तं मूलेद्रुमप्रसेकवत्||१९||  
 
य एवास्थाप्यास्त एवानुवास्याः; विशेषतस्तु रूक्षतीक्ष्णाग्नयः केवलवातरोगार्ताश्च; एतेषु ह्यनुवासनं प्रधानतममित्युक्तं मूलेद्रुमप्रसेकवत्||१९||  
 +
<div class="mw-collapsible-content">
  
 
ya ēvāsthāpyāsta ēvānuvāsyāḥ; viśēṣatastu rūkṣatīkṣṇāgnayaḥ kēvalavātarōgārtāśca; ētēṣu hyanuvāsanaṁ pradhānatamamityuktaṁ mūlēdrumaprasēkavat||19||  
 
ya ēvāsthāpyāsta ēvānuvāsyāḥ; viśēṣatastu rūkṣatīkṣṇāgnayaḥ kēvalavātarōgārtāśca; ētēṣu hyanuvāsanaṁ pradhānatamamityuktaṁ mūlēdrumaprasēkavat||19||  
  
 
ya evAsthApyAsta evAnuvAsyAH; visheShatastu rUkShatIkShNAgnayaH kevalavAtarogArtAshca; eteShu hyAnuvāsanaM pradhAnatamamityuktaMmUle drumaprasekavat||19||
 
ya evAsthApyAsta evAnuvAsyAH; visheShatastu rUkShatIkShNAgnayaH kevalavAtarogArtAshca; eteShu hyAnuvāsanaM pradhAnatamamityuktaMmUle drumaprasekavat||19||
 +
</div></div>
 +
<div style="text-align:justify;">
 +
The persons who are fit for ''asthapana [[basti]]'' are considered fit for ''anuvasana [[basti]]'' also. The conditions where specifically it is indicated, are listed in the table given below:
 +
</div>
 +
{| class="wikitable" style="text-align: center;
 +
|-
 +
! scope="col"| Serial No.
 +
! scope="col"| Disease or State (in which ''anuvasana [[basti]]'' is indicated)
 +
! scope="col"| Translation in English
 +
|-
 +
| 1
 +
| ''Rukshah''
 +
| A person having dryness in the body
 +
|-
 +
| 2
 +
| ''Teekshnagnayah''
 +
| A person having intense power of digestion
 +
|-
 +
| 3
 +
| ''Kevalavata rogaartah''
 +
| A person suffering from diseases caused due to ''[[vata]]'' alone, and not associated with ''ama''.
 +
|}
 +
 +
In such patients, ''anuvasana [[basti]]'' is said to be the most effective and could be likened to watering a plant in its root.[19]
 +
 +
=== Contra-indications of ''shirovirechana'' ===
 +
<div class="mw-collapsible mw-collapsed">
 +
 +
अशिरोविरेचनार्हास्तु अजीर्णिभुक्तभक्तपीतस्नेहमद्यतोयपातुकामाः स्नातशिराः स्नातुकामःक्षुत्तृष्णाश्रमार्तमत्तमूर्च्छितशस्त्रदण्डहतव्यवायव्यायामपानक्लान्तनवज्वरशोकाभितप्तविरिक्तानुवासितगर्भिणीनवप्रतिश्यायार्ताः,अनृतौ दुर्दिने चेति||२०||
 +
<div class="mw-collapsible-content">
  
The persons who are fit for ''asthapana basti'' are considered fit for ''anuvasana basti'' also. The conditions where specifically it is indicated, are listed in the table given below-
+
aśirōvirēcanārhāstu ajīrṇibhuktabhaktapītasnēhamadyatōyapātukāmāḥ snātaśirāḥ snātukāmaḥkṣuttr̥ṣṇāśramārtamattamūrcchitaśastradaṇḍahatavyavāyavyāyāmapāna-
  
Serial Number
+
klāntanavajvaraśōkābhitaptaviriktānuvāsitagarbhiṇīnavapratiśyāyārtāḥ,anr̥tau durdinē cēti||20||
Disease or state in which anuvāsana-basti is indicated English translation of the disease or state
 
1. Rūkṣāḥ The persons having ununctuousness in the body
 
2. Tīkṣṇāgnayaḥ Who have intense power of digestion
 
3. Kevalavāta-rogārtāḥ Who are suffering from diseases caused by Vāta only, not associated with Āma etc.
 
  
In these persons, ''anuvasana basti'' is said to be the most useful like watering the plant in its root.[19]
+
aShirovirechnarhAstu ajIrNibhuktabhaktapItasnehamadyatoyapAtukAmAH snAtashirAH snAtukAmaHkShuttRuShNAshramArtamattamUrcchitashastradaNDahatavyavAyavyAyAmapAna-
  
==== Contra-indications of shirovirechana ====
+
klAntanavajvarashokAbhitaptaviriktAnuvAsitagarbhiNInavapratishyAyArtAH,anRutau durdine ceti||20||
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अशिरोविरेचनार्हास्तु अजीर्णिभुक्तभक्तपीतस्नेहमद्यतोयपातुकामाः स्नातशिराः स्नातुकामःक्षुत्तृष्णाश्रमार्तमत्तमूर्च्छितशस्त्रदण्डहतव्यवायव्यायामपानक्लान्तनवज्वरशोकाभितप्तविरिक्तानुवासितगर्भिणीनवप्रतिश्यायार्ताः,अनृतौ दुर्दिने चेति||२०||
+
The persons unfit for ''shirovirechana'' (head- evacuation therapy) are listed in the table given below:
  
aśirōvirēcanārhāstu ajīrṇibhuktabhaktapītasnēhamadyatōyapātukāmāḥ snātaśirāḥ snātukāmaḥkṣuttr̥ṣṇāśramārtamattamūrcchitaśastradaṇḍahatavyavāyavyāyāmapānaklāntanavajvaraśōkābhitaptaviriktānuvāsitagarbhiṇīnavapratiśyāyārtāḥ,anr̥tau durdinē cēti||20||  
+
{| class="wikitable" style="text-align: center;
 +
|-
 +
! scope="col"| Serial No.
 +
! scope="col"| Disease or State (in which ''shirovirechana'' is contraindicated)
 +
! scope="col"| Translation in English
 +
|-
 +
| 1
 +
| ''Ajeerni''
 +
| A person suffering from indigestion
 +
|-
 +
| 2
 +
| ''Bhuktabhakta''
 +
| A person who has taken food
 +
|-
 +
| 3
 +
| ''Peetasneha''
 +
| A person who has ingested fatty substances.
 +
|-
 +
| 4
 +
| ''Madyapaatukaama''
 +
| A person who is desirous of drinking wine (and other alcoholic beverages)
 +
|-
 +
| 5
 +
| ''Toyapaatukaama''
 +
| A person who is desirous of drinking water
 +
|-
 +
| 6
 +
| ''Snaatashira''
 +
| A person who has taken head bath
 +
|-
 +
| 7
 +
| ''Snaatukaama''
 +
| A person who is desirous of taking bath
 +
|-
 +
| 8
 +
| ''Kshudhaarta''
 +
| A person who is afflicted with hunger, i.e., one who is starving
 +
|-
 +
| 9
 +
| ''Trishnaarta''
 +
| A person who is afflicted with thirst
 +
|-
 +
| 10
 +
| ''Shramaarta''
 +
| A person who is afflicted with exertion
 +
|-
 +
| 11
 +
| ''Matta''
 +
| A person who is afflicted with intoxication
 +
|-
 +
| 12
 +
| ''Murchhita''
 +
| A person who is afflicted with fainting
 +
|-
 +
| 13
 +
| ''Shashtrahata''
 +
| A person who has been injured with a weapon
 +
|-
 +
| 14
 +
| ''Dandahata''
 +
| A person who has been injured with a stick
 +
|-
 +
| 15
 +
| ''Vyavaayaklaanta''
 +
| A person who is exhausted by sexual intercourse
 +
|-
 +
| 16
 +
| ''Vyayaamaklaanta''
 +
| A person who is exhausted by physical exercise
 +
|-
 +
| 17
 +
| ''Paanaklaanta''
 +
| A person who is exhausted by intake of alcohol
 +
|-
 +
| 18
 +
| ''Navajwara''
 +
| Acute fever
 +
|-
 +
| 19
 +
| ''Shokaabhitapta''
 +
| A person who is afflicted with grief
 +
|-
 +
| 20
 +
| ''Virikta''
 +
| A person who has undergone purgation
 +
|-
 +
| 21
 +
| ''Anuvasita''
 +
| A person who has undergone ''Anuvasana [[Basti]]''
 +
|-
 +
| 22
 +
| ''Garbhini''
 +
| A pregnant woman
 +
|-
 +
| 23
 +
| ''Navapratishyaayaarta''
 +
| A person suffering from acute coryza.
 +
|-
 +
| 24
 +
| ''Anritu''
 +
| Unsuitable season
 +
|-
 +
| 25
 +
| ''Durdine''
 +
| Cloudy/Overcast day
 +
|}
  
aShirovirechnarhAstu ajIrNibhuktabhaktapItasnehamadyatoyapAtukAmAH snAtashirAH snAtukAmaHkShuttRuShNAshramArtamattamUrcchitashastradaNDahatavyavAyavyAyAmapAnaklAntanavajvarashokAbhitaptaviriktAnuvAsitagarbhiNInavapratishyAyArtAH,anRutau durdine ceti||20||
 
The persons unfit for Shirovirechna (head- evacuation therapy) are listed in the table given below-
 
Serial Number Disease or state in which shirovirechana is contra-indicated English translation of the disease or state
 
1. Ajīrṇī Persons suffering from indigestion
 
 
2. Bhuktabhakta Who has taken food
 
3. Pītasneha Who has taken fatty substances
 
4. Madyapātukāma Who is desirous of taking wine
 
5. Toyapātukāma Who is desirous of taking water
 
6. Snātaśira Who has taken head bath
 
7. Snātukāma Who is desirous of taking bath
 
8. Kṣudhārta Who is afflicted with hunger
 
9. Tṛṣṇārta Who is afflicted with thirst
 
10. Śramārta Who is afflicted with exertion
 
11. Matta Who is afflicted with intoxication
 
12. Mūrcchita Who is suffering from fainting
 
13. Śastrahata Injured with weapon
 
14. Daṇḍahata Injured with stick
 
15. Vyavāyaklānta Who is exhausted by sexual intercourse
 
16. Vyāyāmaklānta Who is exhausted by physical exercise
 
17. Pānaklānta Who is exhausted by intake of alcohol
 
18. Navajvara Acute fever
 
19. Śokābhitapta Afflicted with grief
 
20. Virikta Who has taken purgation therapy
 
21. Anuvāsita Who has taken Anuvāsana-basti
 
22. Garbhiṇi Pregnant woman
 
23. Navapratiśyāyārta Person suffering from acute coryza
 
24. Anṛtau Unsuitable season
 
25. Durdine Cloudy day
 
 
[20]
 
[20]
  
==== Adverse effects of shirovirechana in contra-indicated conditions ====
+
=== Adverse effects of ''shirovirechana'' in contra-indicated conditions ===
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तत्राजीर्णिभुक्तभक्तयोर्दोष ऊर्ध्ववहानि स्रोतांस्यावृत्य कासश्वासच्छर्दिप्रतिश्यायाञ्जनयेत्, पीतस्नेहमद्यतोयपातुकामानां कृते चपिबतां मुखनासास्रावाक्ष्युपदेहतिमिरशिरोरोगाञ्जनयेत्, स्नातशिरसः कृते च स्नानाच्छिरसः  प्रतिश्यायं, क्षुधार्तस्य वातप्रकोपं,तृष्णार्तस्य पुनस्तृष्णाभिवृद्धिं मुखशोषं च, श्रमार्तमत्तमूर्च्छितानामास्थापनोक्तं दोषं जनयेत्, शस्त्रदण्डहतयोस्तीव्रतरां रुजंजनयेत्, व्यवायव्यायामपानक्लान्तानां शिरःस्कन्धनेत्रोरःपीडनं, नवज्वरशोकाभितप्तयोरूष्मा नेत्रनाडीरनुसृत्य तिमिरं ज्वरवृद्धिंच कुर्यात्, विरिक्तस्य वायुरिन्द्रियोपघातं कुर्यात्, अनुवासितस्य कफः शिरोगुरुत्वकण्डूक्रिमिदोषाञ्जनयेत्, गर्भिण्या गर्भंस्तम्भयेत् स काणः कुणिः पक्षहतः पीठसर्पी वा जायते, नवप्रतिश्यायार्तस्य स्रोतांसि व्यापादयेत्, अनृतौ दुर्दिने च शीतदोषान्पूतिनस्यं शिरोरोगं च जनयेत्; तस्मादेते न शिरोविरेचनार्हाः||२१||  
 
तत्राजीर्णिभुक्तभक्तयोर्दोष ऊर्ध्ववहानि स्रोतांस्यावृत्य कासश्वासच्छर्दिप्रतिश्यायाञ्जनयेत्, पीतस्नेहमद्यतोयपातुकामानां कृते चपिबतां मुखनासास्रावाक्ष्युपदेहतिमिरशिरोरोगाञ्जनयेत्, स्नातशिरसः कृते च स्नानाच्छिरसः  प्रतिश्यायं, क्षुधार्तस्य वातप्रकोपं,तृष्णार्तस्य पुनस्तृष्णाभिवृद्धिं मुखशोषं च, श्रमार्तमत्तमूर्च्छितानामास्थापनोक्तं दोषं जनयेत्, शस्त्रदण्डहतयोस्तीव्रतरां रुजंजनयेत्, व्यवायव्यायामपानक्लान्तानां शिरःस्कन्धनेत्रोरःपीडनं, नवज्वरशोकाभितप्तयोरूष्मा नेत्रनाडीरनुसृत्य तिमिरं ज्वरवृद्धिंच कुर्यात्, विरिक्तस्य वायुरिन्द्रियोपघातं कुर्यात्, अनुवासितस्य कफः शिरोगुरुत्वकण्डूक्रिमिदोषाञ्जनयेत्, गर्भिण्या गर्भंस्तम्भयेत् स काणः कुणिः पक्षहतः पीठसर्पी वा जायते, नवप्रतिश्यायार्तस्य स्रोतांसि व्यापादयेत्, अनृतौ दुर्दिने च शीतदोषान्पूतिनस्यं शिरोरोगं च जनयेत्; तस्मादेते न शिरोविरेचनार्हाः||२१||  
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tatrājīrṇibhuktabhaktayōrdōṣa ūrdhvavahāni srōtāṁsyāvr̥tya kāsaśvāsacchardipratiśyāyāñjanayēt, pītasnēhamadyatōyapātukāmānāṁ kr̥tē capibatāṁ mukhanāsāsrāvākṣyupadēhatimiraśirōrōgāñjanayēt, snātaśirasaḥ kr̥tē ca snānācchirasaḥ  pratiśyāyaṁ, kṣudhārtasya vātaprakōpaṁ,tr̥ṣṇārtasya punastr̥ṣṇābhivr̥ddhiṁ mukhaśōṣaṁ ca, śramārtamattamūrcchitānāmāsthāpanōktaṁ dōṣaṁ janayēt, śastradaṇḍahatayōstīvratarāṁrujaṁ janayēt, vyavāyavyāyāmapānaklāntānāṁ śiraḥskandhanētrōraḥpīḍanaṁ, navajvaraśōkābhitaptayōrūṣmā nētranāḍīranusr̥tya timiraṁjvaravr̥ddhiṁ ca kuryāt, viriktasya vāyurindriyōpaghātaṁ kuryāt, anuvāsitasya kaphaḥ śirōgurutvakaṇḍūkrimidōṣāñjanayēt, garbhiṇyā garbhaṁstambhayēt sa kāṇaḥ kuṇiḥ pakṣahataḥ pīṭhasarpī vā jāyatē, navapratiśyāyārtasya srōtāṁsi vyāpādayēt, anr̥tau durdinē ca śītadōṣān pūtinasyaṁśirōrōgaṁ ca janayēt; tasmādētē na śirōvirēcanārhāḥ||21||  
 
tatrājīrṇibhuktabhaktayōrdōṣa ūrdhvavahāni srōtāṁsyāvr̥tya kāsaśvāsacchardipratiśyāyāñjanayēt, pītasnēhamadyatōyapātukāmānāṁ kr̥tē capibatāṁ mukhanāsāsrāvākṣyupadēhatimiraśirōrōgāñjanayēt, snātaśirasaḥ kr̥tē ca snānācchirasaḥ  pratiśyāyaṁ, kṣudhārtasya vātaprakōpaṁ,tr̥ṣṇārtasya punastr̥ṣṇābhivr̥ddhiṁ mukhaśōṣaṁ ca, śramārtamattamūrcchitānāmāsthāpanōktaṁ dōṣaṁ janayēt, śastradaṇḍahatayōstīvratarāṁrujaṁ janayēt, vyavāyavyāyāmapānaklāntānāṁ śiraḥskandhanētrōraḥpīḍanaṁ, navajvaraśōkābhitaptayōrūṣmā nētranāḍīranusr̥tya timiraṁjvaravr̥ddhiṁ ca kuryāt, viriktasya vāyurindriyōpaghātaṁ kuryāt, anuvāsitasya kaphaḥ śirōgurutvakaṇḍūkrimidōṣāñjanayēt, garbhiṇyā garbhaṁstambhayēt sa kāṇaḥ kuṇiḥ pakṣahataḥ pīṭhasarpī vā jāyatē, navapratiśyāyārtasya srōtāṁsi vyāpādayēt, anr̥tau durdinē ca śītadōṣān pūtinasyaṁśirōrōgaṁ ca janayēt; tasmādētē na śirōvirēcanārhāḥ||21||  
 +
 
tatrAjIrNibhuktabhaktayordoSha UrdhvavahAni srotAMsyAvRutya kAsashvAsacchardipratishyAyA~jjanayet, pItasnehamadyatoyapAtukAmAnAM kRute capibatAM mukhanAsAsrAvAkShyupadehatimirashirorogA~jjanayet, snAtashirasaH kRute ca snAnAcchirasaH  pratishyAyaM, kShudhArtasya vAtaprakopaM,tRuShNArtasya punastRuShNAbhivRuddhiM mukhashoShaM ca, shramArtamattamUrcchitAnAmĀsthāpanaoktaM doShaM janayet,shastradaNDahatayostIvratarAM rujaM janayet, vyavAyavyAyAmapAnaklAntAnAM shiraHskandhanetroraHpIDanaM, navajvarashokAbhitaptayorUShmAnetranADIranusRutya timiraM jvaravRuddhiM ca kuryAt, viriktasya vĀyurindriyopaghAtaM kuryAt, anuvAsitasya kaphaHshirogurutvakaNDUkrimidoShA~jjanayet, garbhiNyA garbhaM stambhayet sa kANaH kuNiH pakShahataH pIThasarpI vA jAyate, navapratishyAyArtasyasrotAMsi vyApAdayet, anRutau durdine ca shItadoShAn pUtinasyaM shirorogaM ca janayet; tasmAdete na ŚirovirecanarhAH||21||  
 
tatrAjIrNibhuktabhaktayordoSha UrdhvavahAni srotAMsyAvRutya kAsashvAsacchardipratishyAyA~jjanayet, pItasnehamadyatoyapAtukAmAnAM kRute capibatAM mukhanAsAsrAvAkShyupadehatimirashirorogA~jjanayet, snAtashirasaH kRute ca snAnAcchirasaH  pratishyAyaM, kShudhArtasya vAtaprakopaM,tRuShNArtasya punastRuShNAbhivRuddhiM mukhashoShaM ca, shramArtamattamUrcchitAnAmĀsthāpanaoktaM doShaM janayet,shastradaNDahatayostIvratarAM rujaM janayet, vyavAyavyAyAmapAnaklAntAnAM shiraHskandhanetroraHpIDanaM, navajvarashokAbhitaptayorUShmAnetranADIranusRutya timiraM jvaravRuddhiM ca kuryAt, viriktasya vĀyurindriyopaghAtaM kuryAt, anuvAsitasya kaphaHshirogurutvakaNDUkrimidoShA~jjanayet, garbhiNyA garbhaM stambhayet sa kANaH kuNiH pakShahataH pIThasarpI vA jAyate, navapratishyAyArtasyasrotAMsi vyApAdayet, anRutau durdine ca shItadoShAn pUtinasyaM shirorogaM ca janayet; tasmAdete na ŚirovirecanarhAH||21||  
Shirovirechana applied in the case of indigestion and full stomach causes the occlusion of the channels moving upwards by vitiated dosha which further leads to manifestation of cough, dyspnoea, vomiting and coryza. In those who have taken fatty substances or desirous of taking wine or water or take after head-evacuation, shirovirechna gives rise  to discharge from mouth and nose, dirt and stickiness in eyes, cataract and head diseases. If the person who has taken head- bath or takes head-bath after the therapy, then it causes the coryza. Application of shirovirechna in a person afflicted with hunger causes aggravation of vāta dossha. If it is administered to the person afflicted with thirst then it further increases the thirst and causes the dryness of mouth. Shirovirechna applied in the cases of fatigue, intoxication and fainting produces the same adverse effects as mentioned under the asthāpana-basti. If this therapy is administered in the persons injured with weapons or stick, it increases the pain. In those exhausted by sexual intercourse, physical exercise and intake of alcohol, it causes pain in head, shoulder, eyes and chest. Shirovirechna applied to those suffering from acute fever and grief causes the heat to spread into the channels of eye, produces the cataract and increases the fever. If this therapy is given to the person who has undergone purgation therapy, then it aggravates vāta dossha which may further leads to the damage of the sense organs. Shirovirechna given to the person who has undergone anuvāsana-basti, causes aggravation of kapha dossha which produces heaviness of head, itching and parasitic infestation. In the case of pregnant woman, this therapy inhibits the growth of the foetus and she gives birth to an offspring who may be blind by one eye, with deformity of upper limbs, hemiplegic and with deformity of lower limbs. Shirovirechna given to the person suffering from acute coryza causes the morbidity of the channels of circulation. If this therapy is given in unsuitable season and on a cloudy day then it causes the diseases due to cold, putrefied rhinitis and head-diseases. Therefore, these persons are not fit for head-evacuation therapy.  [21]
+
</div></div>
 
+
<div style="text-align:justify;">
==== Indications of shirovirechna ====
+
''Shirovirechana'' applied in the case of indigestion and full stomach causes the occlusion of the channels moving upwards by vitiated ''[[dosha]]'' which further leads to manifestation of cough, dyspnea, vomiting and coryza. In those who have taken fatty substances or desirous of taking wine or water or take after head-evacuation, ''shirovirechana'' gives rise  to discharge from mouth and nose, dirt and stickiness in eyes, cataract and head diseases. If the person who has taken head- bath or takes head-bath after the therapy, then it causes the coryza. Application of ''shirovirechana'' in a person afflicted with hunger causes aggravation of ''[[vata dosha]]''. If it is administered to the person afflicted with thirst then it further increases the thirst and causes the dryness of mouth. ''Shirovirechana'' applied in the cases of fatigue, intoxication and fainting produces the same adverse effects as mentioned under the ''asthapana [[basti]]''. If this therapy is administered in the persons injured with weapons or stick, it increases the pain. In those exhausted by sexual intercourse, physical exercise and intake of alcohol, it causes pain in head, shoulder, eyes and chest. ''Shirovirechana'' applied to those suffering from acute fever and grief causes the heat to spread into the channels of eye, produces the cataract and increases the fever. If this therapy is given to the person who has undergone purgation therapy, then it aggravates ''[[vata dosha]]'' which may further leads to the damage of the sense organs. ''Shirovirechana'' given to the person who has undergone ''anuvasana [[basti]]'', causes aggravation of ''[[kapha dosha]]'' which produces heaviness of head, itching and parasitic infestation. In the case of pregnant woman, this therapy inhibits the growth of the fetus and she gives birth to an offspring who may be blind by one eye, with deformity of upper limbs, hemiplegic and with deformity of lower limbs. ''Shirovirechana'' given to the person suffering from acute coryza causes the morbidity of the channels of circulation. If this therapy is given in unsuitable season and on a cloudy day then it causes the diseases due to cold, putrefied rhinitis and head-diseases. Therefore, these persons are not fit for head-evacuation therapy.  [21]
 +
</div>
 +
=== Indications of ''shirovirechana'' ===
 +
<div class="mw-collapsible mw-collapsed">
  
 
शेषास्त्वर्हाः, विशेषतस्तु शिरोदन्तमन्यास्तम्भगलहनुग्रहपीनसगलशुण्डिकाशालूकशुक्रतिमिरवर्त्मरोगव्यङ्गो  
 
शेषास्त्वर्हाः, विशेषतस्तु शिरोदन्तमन्यास्तम्भगलहनुग्रहपीनसगलशुण्डिकाशालूकशुक्रतिमिरवर्त्मरोगव्यङ्गो  
 
पजिह्विकार्धावभेदकग्रीवास्कन्धांसास्यनासिकाकर्णाक्षिमूर्धकपालशिरोरोगार्दितापतन्त्रकापतानकगलगण्ड-दन्तशूलहर्षचालाक्षिराज्यर्बुदस्वरभेदवाग्ग्रहगद्गदक्रथनादय ऊर्ध्वजत्रुगताश्चवातादिविकाराः परिपक्वाश्च; एतेषु शिरोविरेचनंप्रधानतममित्युक्तं, तद्ध्युत्तमाङ्गमनुप्रविश्य मुञ्जादीषिकामिवासक्तां केवलं विकारकरं दोषमपकर्षति||२२||  
 
पजिह्विकार्धावभेदकग्रीवास्कन्धांसास्यनासिकाकर्णाक्षिमूर्धकपालशिरोरोगार्दितापतन्त्रकापतानकगलगण्ड-दन्तशूलहर्षचालाक्षिराज्यर्बुदस्वरभेदवाग्ग्रहगद्गदक्रथनादय ऊर्ध्वजत्रुगताश्चवातादिविकाराः परिपक्वाश्च; एतेषु शिरोविरेचनंप्रधानतममित्युक्तं, तद्ध्युत्तमाङ्गमनुप्रविश्य मुञ्जादीषिकामिवासक्तां केवलं विकारकरं दोषमपकर्षति||२२||  
 +
<div class="mw-collapsible-content">
 +
 
śēṣāstvarhāḥ, viśēṣatastuśirōdantamanyāstambhagalahanugrahapīnasagalaśuṇḍikāśālūkaśukratimiravartmarōgavyaṅgō  
 
śēṣāstvarhāḥ, viśēṣatastuśirōdantamanyāstambhagalahanugrahapīnasagalaśuṇḍikāśālūkaśukratimiravartmarōgavyaṅgō  
 
pajihvikārdhāvabhēdakagrīvāskandhāṁsāsyanāsikākarṇākṣimūrdhakapālaśirōrōgārditāpatantrakāpatānakagalagaṇḍa-dantaśūlaharṣacālākṣirājyarbudasvarabhēdavāggrahagadgadakrathanādaya ūrdhvajatrugatāścavātādivikārāḥparipakvāśca; ētēṣu śirōvirēcanaṁ pradhānatamamityuktaṁ, taddhyuttamāṅgamanupraviśya muñjādīṣikāmivāsaktāṁkēvalaṁ vikārakaraṁ dōṣamapakarṣati||22||
 
pajihvikārdhāvabhēdakagrīvāskandhāṁsāsyanāsikākarṇākṣimūrdhakapālaśirōrōgārditāpatantrakāpatānakagalagaṇḍa-dantaśūlaharṣacālākṣirājyarbudasvarabhēdavāggrahagadgadakrathanādaya ūrdhvajatrugatāścavātādivikārāḥparipakvāśca; ētēṣu śirōvirēcanaṁ pradhānatamamityuktaṁ, taddhyuttamāṅgamanupraviśya muñjādīṣikāmivāsaktāṁkēvalaṁ vikārakaraṁ dōṣamapakarṣati||22||
  
 
sheShAstvarhAH, visheShatastushirodantamanyAstambhagalahanugrahapInasagalashuNDikAshAlUkashukratimiravartmarogavya~ggo  
 
sheShAstvarhAH, visheShatastushirodantamanyAstambhagalahanugrahapInasagalashuNDikAshAlUkashukratimiravartmarogavya~ggo  
pajihvikArdhAvabhedakagrIvAskandhAMsAsyanAsikAkarNAkShimUrdhakapAlashirorogArditApatantrakApatAnakagalagaNDadantashUlaharShacAlAkShirAjyarbudasvarabhedavAggrahagadgadakrathanAdaya UrdhvajatrugatAshcavAtAdivikArAHparipakvAshca; eteShu ŚirovirecanaM pradhAnatamamityuktaM, taddhyuttamA~ggamanupravishyamu~jjAdIShikAmivAsaktAM kevalaM vikArakaraM doShamapakarShati||22||
+
pajihvikArdhAvabhedakagrIvAskandhAMsAsyanAsikAkarNAkShimUrdhakapAlashirorogA-
  
The persons other than above mentioned are fit for shirovirechna (head-evacuation therapy). It is especially useful in the conditions mentioned in the table given below-
+
rditApatantrakApatAnakagalagaNDadantashUlaharShacAlAkShirAjyarbudasvarabhedavAggrahagadgadakrathanAdaya UrdhvajatrugatAshcavAtAdivikArAHparipakvAshca; eteShu ŚirovirecanaM pradhAnatamamityuktaM, taddhyuttamA~ggamanupravishyamu~jjAdIShikAmivAsaktAM kevalaM vikArakaraM doShamapakarShati||22||
Serial Number Disease or state in which shirovirechna is indicated English translation of the disease or state
+
</div></div>
1. Śirostambha Stiffness of head
+
<div style="text-align:justify;">
2. Danta-stambha Stiffness of teeth
+
The persons other than above mentioned are fit for ''shirovirechana'' (head-evacuation therapy). It is especially useful in the conditions mentioned in the table given below:
3. Manyā-stambha Torticollis
+
</div>
4. Galagraha Spasm of the throat
+
{| class="wikitable" style="text-align: center;
5. Hanugraha Lock-jaw
+
|-
6. Pīnasa Chronic coryza
+
! scope="col"| Serial No.
7. Gala-śuṇḍikā Tonsillitis
+
! scope="col"| Disease or State (in which ''shirovirechana'' is indicated)
8. Gala-śāluka Tumour in the throat
+
! scope="col"| Translation in English
+
|-
9. Śukra-roga Disorder of cornea
+
| 1
10. Timira Cataract, Disorder of vision
+
| ''Shirostambha''
11. Vartma-roga Disorders of eye-lids
+
| Stiffness of head
12. Vyaṅga-roga Freckles  
+
|-
13. Upajihvikā Uvulitis
+
| 2
14. Ardhāvabhedaka Hemicrania, migraine
+
| ''Dantastambha''
15. Grīvā-roga Diseases of the neck
+
| Stiffness of teeth
16. Skandha-roga Diseases of the shoulders
+
|-
17. Aṃsa-roga Diseases of the scapula
+
| 3
18. Āsya-roga Diseases of the mouth
+
| ''Manyaastambha''
19. Nāsikā-roga Diseases of the nose
+
| torticollis
20. Karṇa-roga Diseases of the ears
+
|-
21. Akṣi-roga Diseases of the eyes
+
| 4
22. Mūrdha-roga Diseases of the cranium
+
| ''Galagraha''
23. Kapāla-roga Diseases of the forehead
+
| Spasm of the throat
24. Śiroroga Diseases of the head
+
|-
25. Ardita Facial paralysis
+
| 5
26. Apatantraka Convulsions with unconsciousness
+
| ''Hanugraha''
27. Apatānaka Convulsions with consciousness
+
| Lock-jaw
28. Galagaṇḍa Goitre  
+
|-
29. Dantaśūla Toothache
+
| 6
30. Dantaharṣa Tingling sensation of teeth
+
| ''Peenasa''
31. Dantacāla Looseness of teeth
+
| Chronic coryza
32. Akṣirāji Streaks in eye
+
|-
33. Arbuda Tumour
+
| 7
34. Svarabheda Hoarseness of voice
+
| ''Galashundika''
35. Vāggraha Obstructed speech
+
| Tonsillitis
36. Gadgad Spasmodic speech
+
|-
37. Krathana-ādayaḥ Stammering etc.
+
| 8
38. Urdhvajatrugatāśca vātādi vikāraḥ paripakvāśca Diseases of the part above clavicle caused by aggravation of vātādi dosha and which are free from ama-dosha
+
| ''Galashaaluka''
 +
| Tumor in the throat
 +
|-
 +
|9
 +
|''Shukra-roga ''
 +
|Disorder of cornea
 +
|-
 +
|10
 +
|''Timira ''
 +
|Cataract, Disorder of vision
 +
|-
 +
|11
 +
|''Vartma-roga ''
 +
|Disorders of eye-lids
 +
|-
 +
|12
 +
|''Vyanga-roga ''
 +
|Freckles  
 +
|-
 +
|13
 +
|''Upajihvika''
 +
|Uvulitis
 +
|-
 +
|14
 +
|''Ardhavabhedaka''
 +
|Hemicrania, migraine
 +
|-
 +
|15
 +
|''Greeva-roga''
 +
|Diseases of the neck
 +
|-
 +
|16
 +
|''Skandha-roga ''
 +
|Diseases of the shoulders
 +
|-
 +
|17
 +
|''Amsa-roga''
 +
|Diseases of the scapula
 +
|-
 +
|18
 +
|''Asya-roga''
 +
|Diseases of the mouth
 +
|-
 +
|19
 +
|''Nasika-roga''
 +
|Diseases of the nose
 +
|-
 +
|20
 +
|''Karna-roga''
 +
|Diseases of the ears
 +
|-
 +
|21
 +
|''Akshi-roga''
 +
|Diseases of the eyes
 +
|-
 +
|22
 +
|''Murdha-roga''
 +
|Diseases of the cranium
 +
|-
 +
|23
 +
|''Kapala-roga''
 +
|Diseases of the forehead
 +
|-
 +
|24
 +
|''Shiroroga''
 +
|Diseases of the head
 +
|-
 +
|25
 +
|''Ardita ''
 +
|Facial paralysis
 +
|-
 +
|26
 +
|''Apatantraka''
 +
|Convulsions with unconsciousness
 +
|-
 +
|27
 +
|''Apatanaka''
 +
|Convulsions with consciousness
 +
|-
 +
|28
 +
|''Galagandha''
 +
|Goitre  
 +
|-
 +
|29
 +
|''Dantashula''
 +
|Toothache
 +
|-
 +
|30
 +
|''Dantaharsha''
 +
|Tingling sensation of teeth
 +
|-
 +
|31
 +
|''Dantachala''
 +
|Looseness of teeth
 +
|-
 +
|32
 +
|''Akshiraji''
 +
|Streaks in eye
 +
|-
 +
|33
 +
|''Arbuda''
 +
|Tumor
 +
|-
 +
|34
 +
|''Svarabheda''
 +
|Hoarseness of voice
 +
|-
 +
|35
 +
|''Vaggraha''
 +
|Obstructed speech
 +
|-
 +
|36
 +
|''Gadgad''
 +
|Spasmodic speech
 +
|-
 +
|37
 +
|''Krathana-adayah''
 +
|Stammering etc.
 +
|-
 +
|38
 +
|''Urdhvajatrugatashcha vatadi vikarah paripakvashcha''
 +
|Diseases of the part above clavicle caused by aggravation of ''[[vata]]'' etc. [[dosha]]'' and which are free from ''ama dosha''
 +
|}
 +
<div style="text-align:justify;">
 +
In these conditions, head-evacuation is the foremost therapy as it entering into the head eliminates the entire pathogenic impurities like fibrous coating of ''munja'' (a type of grass) from the ''pith'' (''ishika''). [22]
 +
</div>
 +
=== Consideration of appropriate time for ''shirovirechana'' in emergency conditions ===
 +
<div class="mw-collapsible mw-collapsed">
  
In these conditions, head-evacuation is the foremost therapy as it entering into the head eliminates the entire pathogenic impurities like fibrous coating of muñja (a type of grass) from the pith (iṣikā). [22]
+
प्रावृट्शरद्वसन्तेतरेष्वात्ययिकेषु रोगेषु नावनं कुर्यात् कृत्रिमगुणोपधानात्; ग्रीष्मे पूर्वाह्णे, शीते मध्याह्ने, वर्षास्वदुर्दिने चेति||२३||
 +
<div class="mw-collapsible-content">
  
==== Consideration of appropriate time for shirovirechna in emergency conditions ====
+
prāvr̥ṭśaradvasantētarēṣvātyayikēṣu rōgēṣu nāvanaṁ kuryāt kr̥trimaguṇōpadhānāt; grīṣmē pūrvāhṇē, śītēmadhyāhnē, varṣāsvadurdinē cēti||23||
  
प्रावृट्शरद्वसन्तेतरेष्वात्ययिकेषु रोगेषु नावनं कुर्यात् कृत्रिमगुणोपधानात्; ग्रीष्मे पूर्वाह्णे, शीते मध्याह्ने, वर्षास्वदुर्दिने चेति||२३||
 
prāvr̥ṭśaradvasantētarēṣvātyayikēṣu rōgēṣu nāvanaṁ kuryāt kr̥trimaguṇōpadhānāt; grīṣmē pūrvāhṇē, śītēmadhyāhnē, varṣāsvadurdinē cēti||23||
 
 
prAvRuTsharadvasantetareShvAtyayikeShu rogeShu nAvanaM kuryAt kRutrimaguNopadhAnAt; grIShmepUrvAhNe, shIte madhyAhne, varShAsvadurdine ceti||23||  
 
prAvRuTsharadvasantetareShvAtyayikeShu rogeShu nAvanaM kuryAt kRutrimaguNopadhAnAt; grIShmepUrvAhNe, shIte madhyAhne, varShAsvadurdine ceti||23||  
In the case of emergency, shirovirechna (head-evacuation therapy) should be given in the season other than prāvṛṭ (early rain), sharad (autumn) and vasanta (spring) by arranging environment artificially. In summer, it should be applied in the morning, in winter during noon time and in rainy season when sky is free from clouds. [23]
+
</div></div>
 +
<div style="text-align:justify;">
 +
In the case of emergency, ''shirovirechana'' (head-evacuation therapy) should be given in the season other than ''pravriṭ'' (early rain), ''Sharad'' (autumn) and ''Vasanta'' (spring) by arranging environment artificially. In summer, it should be applied in the morning, in winter during noon time and in rainy season when sky is free from clouds. [23]
 +
</div>
 +
=== Summary ===
 +
<div class="mw-collapsible mw-collapsed">
  
==== Summary ====
+
तत्र श्लोकाः-
  
तत्र श्लोकाः-
 
 
इति पञ्चविधं कर्म विस्तरेण निदर्शितम्|  
 
इति पञ्चविधं कर्म विस्तरेण निदर्शितम्|  
 
येभ्यो यन्न हितं यस्मात् कर्म येभ्यश्च यद्धितम्||२४||  
 
येभ्यो यन्न हितं यस्मात् कर्म येभ्यश्च यद्धितम्||२४||  
 +
 
न  चैकान्तेन निर्दिष्टेऽप्यर्थेऽभिनिविशेद्बुधः|  
 
न  चैकान्तेन निर्दिष्टेऽप्यर्थेऽभिनिविशेद्बुधः|  
स्वयमप्यत्र वैद्येन  तर्क्यं बुद्धिमता भवेत्||२५||  
+
स्वयमप्यत्र वैद्येन  तर्क्यं बुद्धिमता भवेत्||२५||
 +
 
उत्पद्येत हि साऽवस्था देशकालबलं प्रति|  
 
उत्पद्येत हि साऽवस्था देशकालबलं प्रति|  
 
यस्यां कार्यमकार्यं स्यात्  कर्म कार्यं च वर्जितम्||२६||  
 
यस्यां कार्यमकार्यं स्यात्  कर्म कार्यं च वर्जितम्||२६||  
 +
 
छर्दिर्हृद्रोगगुल्मानां वमनं स्वे चिकित्सिते|  
 
छर्दिर्हृद्रोगगुल्मानां वमनं स्वे चिकित्सिते|  
 
अवस्थां प्राप्य निर्दिष्टं कुष्ठिनां  बस्तिकर्म च||२७||  
 
अवस्थां प्राप्य निर्दिष्टं कुष्ठिनां  बस्तिकर्म च||२७||  
 +
 
तस्मात् सत्यपि निर्देशे कुर्यादूह्य स्वयं धिया|  
 
तस्मात् सत्यपि निर्देशे कुर्यादूह्य स्वयं धिया|  
 
विना तर्केण या सिद्धिर्यदृच्छासिद्धिरेव सा||२८||  
 
विना तर्केण या सिद्धिर्यदृच्छासिद्धिरेव सा||२८||  
 +
<div class="mw-collapsible-content">
 +
 
tatra ślōkāḥ-  
 
tatra ślōkāḥ-  
 +
 
iti pañcavidhaṁ karma vistarēṇa nidarśitam|  
 
iti pañcavidhaṁ karma vistarēṇa nidarśitam|  
 
yēbhyō yanna hitaṁ yasmāt karma yēbhyaśca yaddhitam||24||  
 
yēbhyō yanna hitaṁ yasmāt karma yēbhyaśca yaddhitam||24||  
 +
 
na caikāntēna nirdiṣṭē'pyarthē'bhiniviśēdbudhaḥ|  
 
na caikāntēna nirdiṣṭē'pyarthē'bhiniviśēdbudhaḥ|  
 
svayamapyatra vaidyēna  tarkyaṁ buddhimatā bhavēt||25||  
 
svayamapyatra vaidyēna  tarkyaṁ buddhimatā bhavēt||25||  
 +
 
utpadyēta hi sā'vasthā dēśakālabalaṁ prati|  
 
utpadyēta hi sā'vasthā dēśakālabalaṁ prati|  
 
yasyāṁ kāryamakāryaṁ syāt  karma kāryaṁ ca varjitam||26||  
 
yasyāṁ kāryamakāryaṁ syāt  karma kāryaṁ ca varjitam||26||  
 +
 
chardirhr̥drōgagulmānāṁ Vamanṁ svē cikitsitē|  
 
chardirhr̥drōgagulmānāṁ Vamanṁ svē cikitsitē|  
 
avasthāṁ prāpya nirdiṣṭaṁ kuṣṭhināṁ  bastikarma ca||27||  
 
avasthāṁ prāpya nirdiṣṭaṁ kuṣṭhināṁ  bastikarma ca||27||  
 +
 
tasmāt satyapi nirdēśē kuryādūhya svayaṁ dhiyā|  
 
tasmāt satyapi nirdēśē kuryādūhya svayaṁ dhiyā|  
 
vinā tarkēṇa yā siddhiryadr̥cchāsiddhirēva sā||28||  
 
vinā tarkēṇa yā siddhiryadr̥cchāsiddhirēva sā||28||  
Line 714: Line 1,849:
 
iti pa~jcavidhaM karma vistareNa nidarshitam|  
 
iti pa~jcavidhaM karma vistareNa nidarshitam|  
 
yebhyo yanna hitaM yasmAt karma yebhyashca yaddhitam||24||  
 
yebhyo yanna hitaM yasmAt karma yebhyashca yaddhitam||24||  
 +
 
na  caikAntena nirdiShTe~apyarthe~abhinivishedbudhaH|  
 
na  caikAntena nirdiShTe~apyarthe~abhinivishedbudhaH|  
 
svayamapyatra vaidyena  tarkyaM buddhimatA bhavet||25||  
 
svayamapyatra vaidyena  tarkyaM buddhimatA bhavet||25||  
 +
 
utpadyeta hi sA~avasthA deshakAlabalaM prati|  
 
utpadyeta hi sA~avasthA deshakAlabalaM prati|  
 
yasyAM kAryamakAryaM syAt  karma kAryaM ca varjitam||26||  
 
yasyAM kAryamakAryaM syAt  karma kAryaM ca varjitam||26||  
 +
 
chardirhRudrogagulmAnAM VamanM sve cikitsite|  
 
chardirhRudrogagulmAnAM VamanM sve cikitsite|  
 
avasthAM prApya nirdiShTaM kuShThinAM  bastikarma ca||27||  
 
avasthAM prApya nirdiShTaM kuShThinAM  bastikarma ca||27||  
 +
 
tasmAt satyapi nirdeshe kuryAdUhya svayaM dhiyA|  
 
tasmAt satyapi nirdeshe kuryAdUhya svayaM dhiyA|  
 
vinA tarkeNa yA siddhiryadRucchAsiddhireva sA||28||  
 
vinA tarkeNa yA siddhiryadRucchAsiddhireva sA||28||  
 +
</div></div>
 +
<div style="text-align:justify;">
 +
Now the summing up verses:-
  
Now the summing up verses:-
+
Thus, the [[Panchakarma]] has been described in detail in following sub-headings-
Thus, the panchkarma has been described in detail in following sub-headings-
+
 
(1) Contra-indications of each of the karma (therapy) along with reasoning;
+
#Contra-indications of each of the ''karma'' (therapy) along with reasoning;
(2) Indications of each of the karma (therapy) of panchkarma.
+
#Indications of each of the ''karma'' (therapy) of [[Panchakarma]].
The wise physician should not blindly follow the general instructions laid down in this chapter in the form of conclusions but he should decide rationally using his own discretion because condition may arise due to the nature of place, time and strength of the patient in which the prescribed therapy may be ineffective and the prohibited therapy may be applicable such as emesis is prescribed in certain stage of vomiting, heart-disease and gulma (abdominal lump) though it is generally contra-indicated. Similarly basti is advised in the treatment of kuṣṭha-roga though it is generally contra-indicated depending upon the particular stage of the disease. Hence, in spite of general instructions available in the text, a physician should rationally think all the aspects using his intellect. The success achieved without proper reasoning is nothing but the success by chance. [24-28]
+
 
 +
The wise physician should not blindly follow the general instructions laid down in this chapter in the form of conclusions but he should decide rationally using his own discretion because condition may arise due to the nature of place, time and strength of the patient in which the prescribed therapy may be ineffective and the prohibited therapy may be applicable such as emesis is prescribed in certain stage of vomiting, heart-disease and ''gulma'' (abdominal lump) though it is generally contra-indicated. Similarly ''[[basti]]'' is advised in the treatment of ''kushtha roga'' though it is generally contra-indicated depending upon the particular stage of the disease. Hence, in spite of general instructions available in the text, a physician should rationally think all the aspects using his intellect. The success achieved without proper reasoning is nothing but the success by chance. [24-28]
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इत्यग्निवेशकृते तन्त्रे चरकप्रतिसंस्कृतेऽप्राप्ते दृढबलसंपूरिते सिद्धिस्थाने पञ्चकर्मीयसिद्धिर्नाम द्वितीयोऽध्यायः॥२॥
 
इत्यग्निवेशकृते तन्त्रे चरकप्रतिसंस्कृतेऽप्राप्ते दृढबलसंपूरिते सिद्धिस्थाने पञ्चकर्मीयसिद्धिर्नाम द्वितीयोऽध्यायः॥२॥
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Ityagniveśakṛte tantre Carakapratisaṃskṛteˈprāpte Dṛḍhabalasampūrite Siddhisthāne Pañcakarmīyasiddhirnāma dvitīyoˈdhyāyaḥ .||2||
 
Ityagniveśakṛte tantre Carakapratisaṃskṛteˈprāpte Dṛḍhabalasampūrite Siddhisthāne Pañcakarmīyasiddhirnāma dvitīyoˈdhyāyaḥ .||2||
  
 
ityAgniveśaakRute tantre carakapratisaMskRute~prApte dRuDhabalasaMpUrite siddhisthAne pa~jcakarmIyasiddhirnAma dvitIyo~dhyAyaH. ||2||
 
ityAgniveśaakRute tantre carakapratisaMskRute~prApte dRuDhabalasaMpUrite siddhisthAne pa~jcakarmIyasiddhirnAma dvitIyo~dhyAyaH. ||2||
Thus, ends the second chapter on successful management of panchkarma in the treatise composed by Agniveśa, redacted by Charaka and because of its non-availability, supplemented by Dṛḍhabala. [2]
+
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 +
Thus, ends the second chapter on successful management of [[Panchakarma]] in the treatise composed by Agnivesha, redacted by Charaka and because of its non-availability, supplemented by Dridhabala. [2]
  
=== Tattva Vimarsha ===
+
== Tattva Vimarsha (Fundamental Principles) ==
 
   
 
   
All the panchakarma procedures like vamana (therapeutic emesis), virechana( therapeutic purgation), asthapana (medicated enema with decoction), anuvasana ( medicated enema with oil), shirovirechana (purification of head and supraclavicular region) shall be performed after through examination of patients about indications and contra-indications.  
+
*All the [[Panchakarma]] procedures like ''[[vamana]]'' (therapeutic emesis), ''[[virechana]]''( therapeutic purgation), ''asthapana'' (medicated enema with decoction), ''anuvasana'' ( medicated enema with oil), ''shirovirechana'' (purification of head and supraclavicular region) shall be performed after through examination of patients about indications and contra-indications.  
If these procedures are performed in the contra-indicated state, it leads to iatrogenic diseases.  
+
*If these procedures are performed in the contra-indicated state, it leads to iatrogenic diseases.  
Vamana (therapeutic emesis) is mainly indicated in kapha dominant diseases.  
+
*''[[Vamana]]'' (therapeutic emesis) is mainly indicated in ''[[kapha]]'' dominant diseases.  
Virechana( therapeutic purgation) is mainly indicated in pitta dominant diseases.
+
*''[[Virechana]]''( therapeutic purgation) is mainly indicated in ''[[pitta]]'' dominant diseases.
Asthapana (medicated enema with decoction) is mainly indicated in vata dominant diseases in wihich purification is the objective of treatment.
+
*''Asthapana'' (medicated enema with decoction) is mainly indicated in ''[[vata]]'' dominant diseases in which purification is the objective of treatment.
Anuvasana (medicated enema with oil) is mainly indicated in vata dominant diseases in which nourishment and sustaining growth of tissues is the objective of treatment.
+
*''Anuvasana'' (medicated enema with oil) is mainly indicated in ''[[vata]]'' dominant diseases in which nourishment and sustaining growth of tissues is the objective of treatment.
Shirovirechana (purification of head and supraclavicular region) is mainly indicated in dosha dominant diseases of all organs present in supraclavicular region including brain.
+
*''Shirovirechana'' (purification of head and supraclavicular region) is mainly indicated in ''[[dosha]]'' dominant diseases of all organs present in supraclavicular region including brain.
 +
 
 +
== Vidhi Vimarsha (Applied Inferences ) ==
 +
 
 +
=== Chapter authority ===
  
=== Vidhi Vimarsha ===
+
It is the pattern of this classic that in the beginning of every chapter, Charaka proposes the topic which is to be discussed and secondly the common sentence for all the chapter (इति ह स्माह भगवानात्रेयः) is used which shows the authenticity of the text. There are number of discourses in medical science and it is not possible for all to discuss them completely and meticulously that’s why Agnivesha declares very honestly in the beginning of all the chapters that whatever has been discussed is as per the preaching of his teacher Lord Punarvasu Atreya. The title ''Bhagavana'' (lord) itself reveals that Punarvasu Atreya was an extraordinary personality who could completely discuss the medical science without any mistake and lacunae<ref>Chakrapani, Charak.  In: Jadavaji Trikamji Aacharya, Editor. Charak Samhita. Varanasi:Chaukhamba Surbharati Prakashan, Varanasi (India), reprint edition-2000, Page No-1-4 </ref>.
  
==== Chapter authority ====
+
=== Success of treatment ===
  
It is the pattern of this classic that in the beginning of every chapter, acārya propose the topic which is to be discussed and secondly the common sentence for all the chapter i.e. ‘इति ह स्माह भगवानात्रेयः’ is used which shows the authenticity of the text. There are number of discourses in medical science and it is not possible for all to discuss them completely and meticulously that’s why Agniveśa declares very honestly in the beginning of all the chapters that whatever has been discussed is as per the preaching of his teacher Lord Punarvasu Ātreya. The title ‘Bhagavān’ (lord) itself reveals that Punarvasu Ātreya was an extraordinary personality who could completely discuss the medical science without any mistake and lacunae. [1]
+
''Chikitsa'' is indicated in curable disease <ref>Chakrapani, Charak.In: Jadavaji Trikamji Aacharya, Editor. Charak Samhita. Varanasi:Chaukhamba Surbharati Prakashan, reprint edition-2000, Page No.-17.</ref> and another important concept of [[Ayurveda]] in this regard is that ''chatushpada upapatti'' (desired qualities of four limbs of treatment) are one of the important cause in the success of treatment<ref>Chakrapani, Charak.In: Jadavaji Trikamji Aacharya, Editor. Charak Samhita. Varanasi:Chaukhamba Surbharati Prakashan, reprint edition-2000,Page No-66.</ref>. In the above mentioned verses the desired qualities of patients are lacking and patient is one of the important components among ''chatushpada''. In such situations chances of complications are also high.< ref name= chakra> Chakrapani, Charak.In: Jadavaji Trikamji Aacharya, Editor. Charak Samhita. Varanasi:Chaukhamba Surbharati Prakashan, reprint edition-2000, Page No.-687</ref>
 
 
==== Success of treatment ====
 
  
Chikitsā is indicated in curable disease [2] and another important concept of Āyurveda in this regard is that chatuṣpāda-upapatti (desired qualities of four limbs of treatment) are one of the important cause in the success of treatment [3]. In the above mentioned verses the desired qualities of patients are lacking and patient is one of the important components among chatuṣpāda. In such situations chances of complications are also high.
+
=== Contraindications of ''[[vamana]]'' ===
  
==== Contraindications of vamana ====
+
The above mentioned contra-indications are as per general rule but in specific conditions exceptions are also found such as generally ''[[vamana]]'' is contra-indicated in ''gulma roga'' but when ''[[kapha]]'' is increased and causing diminution of digestive fire, anorexia, nausea etc. in ''vatika gulma'', ''[[vamana]]'' is indicated exceptionally.<ref>Chakrapani, Charak.In: Jadavaji Trikamji Aacharya, Editor. Charak Samhita.1st ed. Varanasi:Chaukhamba Surbharati Prakashan, reprint edition-2000,Page No.-437 </ref>. Similarly ''[[vamana]]'' is advised in vomiting and heart disease according to condition <ref>Chakrapani, Charak.In: Jadavaji Trikamji Aacharya, Editor. Charak Samhita.1st ed. Varanasi:Chaukhamba Surbharati Prakashan, reprint edition-2000,Page No.- 690</ref> which is the exception of the general instruction. In all the above mentioned states of contra-indications, ''[[vamana]]'' is not contra-indicated in the conditions of poisons, artificial poisons, incompatible food, intake of food during indigestion and ''ama'' (ailment caused by the product of improper digestion and metabolism) because these conditions are of emergent nature. <ref name= chakra />
  
The above mentioned contra-indications are as per general rule but in specific conditions exceptions are also found such as generally vamana is contra-indicated in gulma-roga but when kapha is increased and causing diminution of digestive fire, anorexia, nausea etc. in vātika-gulma, vamana is indicated exceptionally. [5] Similarly vamana is advised in vomiting and heart disease according to condition [6] which is the exception of the general instruction. In all the above mentioned states of contra-indications, vamana is not contra-indicated in the conditions of poisons, artificial poisons, incompatible food, intake of food during indigestion and ama (ailment caused by the product of improper digestion and metabolism) because these conditions are of emergent nature. [7]
+
Vagbhata has added following contra-indications for [[vamana]]:
  
==== Indications of vamana ====
+
krimikoshtha, ashthila, arsha, bhrama, parshwaruk, Vatavyadhi
  
Vamana-karma is mainly indicated in the diseases caused by kapha dossha reason being it is considered the best therapy among all causing elimination of kapha dosha.[8] Ācārya Vāgbhaṭa says that vamana is indicated in the kapha dosha as well as in the combination of dosha where kapha is dominant. In the commentary of the view of Vāgbhaṭa, Aruṇadatta in his Sarvāngasundarā commentary says that here combination of dosha should be understood as kapha-pitta association.[9]    
+
=== Indications of ''[[vamana]]'' ===
 +
 
 +
''[[Vamana]] karma'' is mainly indicated in the diseases caused by ''[[kapha dosha]]'' reason being it is considered the best therapy among all causing elimination of ''[[kapha dosha]]''.<ref>Chakrapani, Charak. In: Jadavaji Trikamji Aacharya, Editor. Charak Samhita.reprint edition. Varanasi: Chaukhamba Surbharati Prakashan;2000.p.4.Page No.-131</ref><ref>Indu. Vagbhata. In:Dr. Shivprasad Sharma,Editor,Ashtanga-Sangraha, 2nd edition, Varanasi: Chaukhamba Sanskrit Series Office, Varanasi (India),2008 Page No.-9</ref><ref>Arunadatta,Hemadri,Vagbhata. In:Bhishagacharya  Harishastri Paradakar Vaidya,9th edition,Varanasi: Chaukhambha Orientalia,2005, Page No.-16</ref>. Vagbhatta says that ''vamana'' is indicated in the ''[[kapha dosha]]'' as well as in the combination of ''[[dosha]]'' where ''[[kapha]]'' is dominant. In the commentary of the view of Vagbhata, Arunadatta in his Sarvangasundara commentary says that here combination of ''[[dosha]]'' should be understood as ''[[kapha]]-[[pitta]]'' association.<ref> Arunadatta,Hemadri,Vagbhata, In:Bhishagacharya  Harishastri Paradakar Vaidya,Editor,9th ed,Varanasi; Chaukhambha Orientalia,2005,Page No.-260</ref>    
 
      
 
      
As per the view of Āchārya Charaka, one predominant in kapha vomits easily. [10] This should be accepted as an ideal condition for vamana-karma. Therefore, either it is the diseased or healthy condition, predominance of kapha should be observed or produced (by the application of snehana and swedana), then one should administer vamana-karma. In the context of jwara-chikitsā, achārya Charaka has given the specific view for the application of vamana which can be accepted in all the cases if kapha dosha is dominant with tendency to come out and situated in amāśaya (stomach). [11]                                                                                                                                                  
+
As per the view of Charaka, one predominant in ''[[kapha]]'' vomits easily.<ref>Chakrapani,Charak,In: Vaidya Yadavji Trikamji Acharya,Editor,repint edition,Varanasi : Chaukhamba Surbharati Prakashan,2000, Page No.-678</ref> This should be accepted as an ideal condition for ''[[vamana]] karma''. Therefore, either it is the diseased or healthy condition, predominance of ''[[kapha]]'' should be observed or produced (by the application of ''[[snehana]]'' and ''[[swedana]]''), then one should administer ''[[vamana]] karma''. In the context of [[Jwara Chikitsa]], Charaka has given the specific view for the application of ''[[vamana]]'' which can be accepted in all the cases if ''[[kapha dosha]]'' is dominant with tendency to come out and situated in ''amashaya'' (stomach). <ref>Chakrapani,Charak,In: Vaidya Yadavji Trikamji Acharya,Editor,reprint edition,Varanasi : Chaukhamba Surbharati Prakashan,2000, Page No.-410</ref>
==== Contraindications of virechana ====
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 +
Vagbhata has added following indications as suitable for [[vamana]]:
 +
 +
Granthi, arbuda, medoroga, vidarika, hridroga, chittavibhrama, visarpa, vidradhi, putinasa, kanthapaka, adhijivhika, galashundika
 +
 
 +
=== Contraindications of ''[[virechana]]'' ===
 +
 
 +
''[[Virechana]]'' is not advised in the conditions when ''[[kapha dosha]]'' is increased because ''manda'' (''alpa'') ''[[kapha]]'' is considered as an ideal condition for proper administration of ''[[virechana]] karma''.<ref> Chakrapani, Charak. In: Vaidya Yadavji Trikamji Acharya,Editors, Charak Samhita, Reprint Ed.,Varanasi; Chaukhamba Surbharati Prakashan,2000, Page No.-678</ref>.[[Panchakarma]] is not administered in the state of indigestion.<ref>Arunadatta, Hemadri,In: Bhishagacharya  Harishastri Paradakar Vaidya,editor, Ashtanga Hridayam, 9th edition,Varanasi:Chaukhambha Orientalia,2005, Page No.-261</ref>
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Chakrapani, the commentator of [[Charaka Samhita]] has interpreted the term ''subhaga kshata guda'' as ''subhaga guda'' (one who has delicate anus) and ''kshata guda'' (one who has anal injury). He has also mentioned ''subhagam'' means ''sukhasamvardhita'' (those who has never faced any hardship) according to the view of other scholars in his commentary. ''[[Virechana]]'' applied in the person having injury to anus or delicate anus causes harm to the patients. In the person who has taken the ''niruha'' type of enema, at least seven days gap is essential to perform ''[[virechana]] karma'' and vice-versa. ''[[Virechana]]'' in pregnant woman is contra-indicated up to seventh month except in emergency. In eighth month if disease is curable by ''[[vamana]]'' or ''[[virechana]]'', then ''mridu [[vamana]]'' (mild emesis) or ''mridu [[virechana]]'' (mild purgative) can be given.<ref>Chakrapani, Charak. In: Vaidya Yadavji Trikamji Acharya,Editors, Charak Samhita, Reprint Ed.,Varanasi; Chaukhamba Surbharati Prakashan,2000, Page No.-344</ref>
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 +
Vagbhata added following conditions in the list of contraindications:
 +
 
 +
Navaprasuta, navapratishyaya, Rajyakshma, Atisara, nityadukkhi, hridrogi, bhayabhita
 +
 
 +
=== Indications of ''[[virechana]]'' ===
 +
 
 +
''[[Virechana]]'' is considered the best therapy to purify ''[[pitta dosha]]'' especially. <ref>Chakrapani, Charak. In: Vaidya Yadavji Trikamji Acharya,Editors, Charak Samhita, Reprint Ed.,Varanasi; Chaukhamba Surbharati Prakashan,2000, Page No.-131</ref><ref>Indu, Vagbhata, In: Dr. Shivprasad Sharma,Editor, Ashtanga Sangraha, 2nd edition,Varanasi: Chaukhamba Sanskrit Series Office,2008,Page No.-9</ref> <ref>Arunadatta,Hemadri,Vagbhata. In: Bhishagacharya  Harishastri Paradakar Vaidya,Editors,Ashtanga Hridaya,reprint ninth edition,Varanasi; Chaukhambha Orientalia,2005, Page No.-16</ref>
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 +
''[[Virechana]]'' eliminates ''[[pitta]]'' or ''[[kapha pitta]]'' situated in ''pittashaya''. <ref name= chakra>Chakrapani, Charak. In: Vaidya Yadavji Trikamji Acharya,Editors, Charak Samhita, Reprint Ed.,Varanasi; Chaukhamba Surbharati Prakashan,2000, Page No.-431</ref>
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 +
''[[Virechana]]'' treatments are of many types such as ''mridu virechana'', ''sukha virechana'' and ''tikshṇa virechana''.<ref name= chakra />
 +
 
 +
All the persons are not treated by the same medicines. So the application depends upon the nature of ''koshtha'', nature of the disease, strength of the person, age, season and many other considerable issues. ''Mridu [[virechana]]'' is not appropriate for the person having ''krurakoshtha'' and ''tikshna [[virechana]]'' is not suitable for ''mridu koshtha''. ''Tikshna [[virechana]]'' is advised in ''mrittika bhakshanajanya pandu roga'' and ''baddhodara'' in [[Charaka Samhita]] but it cannot be given to the patient suffering from the heart disease. ''Mridu [[virechana]]'' is advised in ''kamala roga'' .<ref>Chakrapani, Charak. In: Vaidya Yadavji Trikamji Acharya,Editors, Charak Samhita, Reprint Ed.,Varanasi; Chaukhamba Surbharati Prakashan,2000, Page No.-528</ref> ''[[Virechana]]'' given to the patients suffering from ''paittika'' disorders cannot be given to those suffering from ''pitta shlaishmika'' disorders. Again ''[[virechana]]'' medicines are of two types i.e. ''snigdha virechana'' and ''ruksha virechana''. ''Snigdha [[virechana]]'' is used in the person having dryness in the body and ''ruksha [[virechana]]'' is used in the persons who have unctuousness in the body. For example ''snighdha [[virechana]]'' is advised in ''vatodara''. <ref>Chakrapani, Charak. In: Vaidya Yadavji Trikamji Acharya,Editors, Charak Samhita, Reprint Ed.,Varanasi; Chaukhamba Surbharati Prakashan,2000, Page No.-494</ref>
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 +
''Tikshna [[vamana]]'' and ''[[virechana]]'', and other painful procedures are generally not advised in children and old, if required then ''mridu [[vamana]]'' and ''[[virechana]]'' should be administered .<ref> Dalhana,Gayadasa, Sushruta. Nidana Sthana In: Jadavaji Trikamji Aacharya, Editors. Sushruta Samhita. 7th ed. Varanasi: Chaukhambha Orientalia; 2002. page N-155.</ref>  ''[[Virechana]] karma'' should be administered in ''Sharad ritu'' (autumn season) in healthy individuals because the aggravation of ''[[pitta dosha]]'' takes place in this season naturally. Generally it should not be administered in peak of summer and peak of winter season as it may lead to ''atiyoga'' and ''ayoga'' respectively.<ref>Chakrapani,Charak. In:Vaidya Yadavji Trikamji Acharya,Editor, Charaka Samhita, reprint edition, Varanasi: Chaukhamba Surbharati Prakashan,2000, Page No.-281</ref>
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 +
Vagbhata added following conditions in the list of indications:
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 +
Garavisha, pakwashayaruja, vibandha, Vidradhi, dushtavrana, akshipaka, abhishyanda, kacha, gudadaha, medhradaha, nasadaha, anaha, stanyadosha
 +
 
 +
=== Contraindications of ''asthapana [[basti]]'' ===
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 +
''Asthapana [[basti]]'' is contra-indicated in the stage of ''ajeerna''<ref>Chakrapani, Charak. In:Vaidya Yadavji Trikamji Acharya,Editor, Charak Samhita, reprint edition, Varanasi: Chaukhamba Surbharati Prakashan,2000, Page No.-692</ref> or ''ama''.  ''Asthapana'' and ''anuvasana [[basti]]'' are indicated in the treatment of ''baddhodara''<ref>Chakrapani, Charak. In:Vaidya Yadavji Trikamji Acharya,Editor, Charak Samhita, reprint edition, Varanasi: Chaukhamba Surbharati Prakashan,2000, Page No.-496</ref>, so ''baddhodara'' mentioned in the contra-indications of ''asthapana'' should be read as ''baddhodaradhmana'' means it is contraindicated in ''adhmana'' due to ''baddhodara''<ref>Chakrapani, Charak. In:Vaidya Yadavji Trikamji Acharya,Editor, Charak Samhita, reprint edition, Varanasi: Chaukhamba Surbharati Prakashan,2000, Page No.-689</ref> ''Asthapana [[basti]]'' is contraindicated in ''kushtha roga'' but in a particular stage of the disease, Charaka has exceptionally indicated the ''asthapana'' and ''Anuvasana [[basti]]'' <ref>Chakrapani, Charak. In:Vaidya Yadavji Trikamji Acharya,Editor, Charak Samhita, reprint edition, Varanasi: Chaukhamba Surbharati Prakashan,2000, Page No.-452</ref>.[14]
 +
 
 +
Vagbhata added following conditions in the list of contraindications:
 +
 
 +
Pandu, bhrama, arochaka, unmada, shokagrasta, sthaulya, kanthashosha, kshatakshina, pregnant woman upto 7th month of gestation, gudashotha
 +
 
 +
=== Indications of ''asthapana [[basti]]'' ===
  
Virechana is not advised in the conditions when kapha dosha is increased because manda (alpa) kapha is considered as an ideal condition for proper administration of virechana-karma.[12] Panchkarma is not administered in the state of indigestion.[13]
+
''Asthapana [[basti]]'' is considered the best therapy in ''vatika'' disorders.<ref>Chakrapani, Charak. In: Vaidya Yadavji Trikamji Acharya,Editor, Charaka Samhita,reprint edition, Varanasi; Chaukhamba Surbharati Prakashan,2000, Page No.- 114</ref> <ref>Arunadatta,Hemadri, Vagbhata. In:Bhishagacharya  Harishastri Paradakar Vaidya,editors, Ashtangahridayam, 9th ed, Varanasi; Chaukhambha Orientalia,2005, Page No.-16</ref> It is given in disorders caused by other ''[[dosha]]''. ''[[Basti]]'' can be administered in the vitiation of ''[[vata]], [[pitta]], [[kapha]], samsarga'' (vitiation of two ''[[dosha]]''), ''sannipata'' (vitiation of all the three ''[[dosha]]'') and even in vitiation of ''[[rakta]]'' (blood) also.<ref name=dal>Dalhana,Gayadasa, Sushruta.Nidana Sthana.In: Vaidya Yadavji Trikamji Acharya, Narayan Ram Acharya,Editors, Sushruta Samhita, 7th ed., Varanasi; Chaukhambha Orientalia, 2002, Page No.-525</ref>  Application of first ''asthapana [[basti]]'' removes or purifies ''[[vata]]'', second ''[[basti]]'' removes or purifies ''[[pitta]]'' and third to ''[[kapha dosha]]'' <ref>Chakrapani, Charak. In: Vaidya Yadavji Trikamji Acharya,Editor, Charaka Samhita,reprint edition, Varanasi; Chaukhamba Surbharati Prakashan,2000, Page No.-693</ref>, purification of three ''[[dosha]]'' should be understood of either occlusion or association of ''[[vata]]'' with other ''[[dosha]]''. Different applications of ''asthapana [[basti]]'' show that by processing and combination with different medicines, it exerts many effects such as ''samshodhana'', ''samshamana'', ''samgrahana'', ''[[vajikarana]], [[brimhana]], karshana, vayahsthapana''<ref name=dal />etc. Type of ''[[basti]]'' depends upon the nature of disease such as ''[[basti]]'' given in the condition of ''[[vata]]-[[mala]] sanga'' will be different in comparison to ''[[basti]]'' given in ''shuddhatisara, [[basti]]'' applied in the case of ''bala kshaya, [[mamsa]] kshaya'' and ''retas kshaya'' will be of different composition in comparison to ''[[basti]]'' administered in ''krimikoshhtha''. In ''vatika'' disorders also, only ''asthapana [[basti]]'' is not given for longer duration that’s why ''karma basti, kala basti'' and ''yoga basti'' have been discussed by ancient sages for the rational use of the therapy. In all these types, ''asthapana'' and ''anuvasana [[basti]]'' are administered in a particular sequence for the better efficacy.
Cakrapāṇidatta, the commentator of Caraka-Saṃhitā has interpreted the term “subhaga-kṣata-guda” as “subhaga-guda” (one who has delicate anus) and “kshata-guda” (one who has anal injury). He has also mentioned “subhagam means sukhasaṃvardhita (those who has never faced any hardship)” according to the view of other scholars in his commentary. Virechana applied in the person having injury to anus or delicate anus causes harm to the patients. In the person who has taken the nirūha type of enema, at least seven days gap is essential to perform virechana-karma and vice-versa. Virechana in pregnant woman is contra-indicated up to seventh month except in emergency. In eighth month if disease is curable by vamana or virechana, then mṛdu vamana (mild emesis) or mṛdu virechana (mild purgative) can be given.[14]
 
  
==== Indications of vamana ====
+
Vagbhata added following conditions in the list of indications:
  
Virechana is considered the best therapy to purify pitta doṣa especially. [15] Virecana eliminates pitta or kapha-pitta situated in pittāśaya. [16]  
+
[[Jwara]], ashmari, upadamsha, vatarakta, arsha, stanyakshaya, mudhagarbha, mutakrichhra
Virechana treatments are of many types such as mṛdu-virechana, sukha-virechana and tikṣṇa-virechana. All the persons are not treated by the same medicines. So the application depends upon the nature of koṣṭha, nature of the disease, strength of the person, age, season and many other considerable issues. Mṛdu virechana is not appropriate for the person having krūrakoṣṭha and tikṣṇa virechana is not suitable for mṛdu koṣṭha. Tikṣṇa-virechana is advised in mṛttikā-bhakṣanajanya pānḍu-roga and baddhodara in Charak-Saṃhitā but it cannot be given to the patient suffering from the heart disease. Mṛdu-virechana is advised in kāmalā-roga . [17] Virechana given to the patients suffering from paittika disorders cannot be given to those suffering from pitta-shlaiṣmika disorders. Again virechana medicines are of two types i.e. snigdha-virechana and rukṣa-virechana. Snigdha-virechana is used in the person having dryness in the body and rukṣa-virechana is used in the persons who have unctuousness in the body. For example snighdha-virechana is advised in vātodara. [18] Tikshna vamana and virechana, and other painful procedures are generally not advised in children and old, if required then mṛdu vamana and virechana should be administered .[19]  Virechana-karma should be administered in sharad ṛtu (autumn season) in healthy individuals because the aggravation of pitta-dosha takes place in this season naturally. Generally it should not be administered in peak of summer and peak of winter season as it may lead to atiyoga and ayoga respectively. [20] 
 
                                                 
 
==== Contraindications of asthapana basti ====
 
  
Āsthāpana basti is contra-indicated in the stage of ajīrṇa[21] or ama.  Āsthāpana and anuvāsana basti are indicated in the treatment of baddhodara[22], so baddhodara mentioned in the contra-indications of asthāpana should be read as baddhodarādhmāna means it is contraindicated in adhmāna due to baddhodara[23]. Āsthāpana basti is contraindicated in kuṣṭha-roga but in a particular stage of the disease, achārya has exceptionally indicated the asthāpana and Anuvāsana basti [24]. [14]  
+
=== Contraindications of ''anuvasana [[basti]]'' ===
  
==== Indications of asthapana basti ====
+
''Anuvasana [[basti]]'' is not advised in ''kaphaja'' disorders, ''medo vriddhi'' and ''ama dosha''. Contraindications given in the text are as per general rule. Exceptional instructions are also found in the text considering the need of therapy in particular stage of disease such as in the patient suffering from piles if patient comes with associated symptoms like ''udavarta'', excessive dryness of the body, abnormal movement of ''[[vata]]'' and pain, then ''anuvasana [[basti]]'' is advised.<ref>Chakrapani, Charak. In:Vaidya Yadavji Trikamji Acharya,Editor,Charaka Samhita, ?ed., Varanasi;Chaukhamba Surbharati Prakashan,2000, Page No.-507</ref>
  
Āsthāpana-basti is considered the best therapy in vātika disorders. [25] It is given in disorders caused by other dosha. Basti can be administered in the vitiation of vāta, pitta, kapha, saṃsarga (vitiation of two dosha), sannipāta (vitiation of all the three dosha) and even in vitiation of rakta (blood) also.[26] Application of first asthāpana-basti removes or purifies vāta, second basti removes or purifies pitta and third to kapha dosha [27] , purification of three dosha should be understood of either occlusion or association of vāta with other dosha. Different  applications of asthāpana-basti show that by processing and combination with different medicines, it exerts many effects such as saṃśodhana, saṃśamana, saṃgrahaṇa, vājīkaraṇa, bṛṃhaṇa, karśaṇa, vayaḥsthāpana [28] etc. Type of basti depends upon the nature of disease such as basti given in the condition of vāta-mala sanga will be different in comparison to basti given in shuddhātisāra, basti applied in the case of bala-kṣaya, māṃsa-kṣaya and retas-kṣaya will be of different composition in comparison to basti administered in kṛmikoṣhṭha. In vātika disorders also, only asthāpana-basti is not given for longer duration that’s why karma-basti, kāla-basti and yoga-basti have been discussed by ancient Ācāryas for the rational use of the therapy. In all these types, asthāpana and qnuvāsana basti are administered in a particular sequence for the better efficacy.
+
''Anuvasana'' is contraindicated in the patients suffering from ''krimikoshtha'' also because initially he should not be treated with this type of ''[[basti]]'' as it will increase the disease. In the patient of ''krimikoshtha'', initially ''asthapana [[basti]]'' followed by ''[[vamana]]'' and ''[[virechana]]'' should be applied and when ''koshtha'' is completely purified, ''anuvasana [[basti]]'' with ''vidanga'' oil can be administered.<ref>Chakrapani, Charak. In:Vaidya Yadavji Trikamji Acharya,Editor,Charaka Samhita, ?ed., Varanasi;Chaukhamba Surbharati Prakashan,2000, Page No.-259</ref>
  
==== Contraindications of anuvasana basti ====
+
Vagbhata added following conditions in the list of contraindications:
  
Anuvāsana basti is not advised in kaphaja-disorders, medo-vṛddhi and ama-dosha. Contraindications given in the text are as per general rule. Exceptional instructions are also found in the text considering the need of therapy in particular stage of disease such as in the patient suffering from piles if patient comes with associated symptoms like udāvarta, excessive dryness of the body, abnormal movement of vāta and pain, then anuvāsana basti is advised. [29] Anuvāsana is contraindicated in the patients suffering from kṛmikoṣhṭha also because initially he should not be treated with this type of basti as it will increase the disease.  In the patient of kṛmikoṣhṭha, initially asthāpana basti followed by vamana and virechana should be applied and when koṣṭha is completely purified, anuvāsana basti with viḍanga-oil can be administered. [30]   
+
Prameha, Kushtha, Sthaulya, Pinasa, Krisha
                                                                                                         
 
==== Indications of anuvasana basti ====
 
  
Anuvāsana-basti and asthāpana basti are considered the best therapy in vātika disorders.[ 31] It has been stated that patients suitable for asthāpana basti are suitable for anuvāsana basti  is general instruction, because kṛmikoṣṭhī and patient suffering from heaviness in the body are suitable for asthāpana basti but not for anuvāsana basti. In kṛmikoṣṭhī, first of all asthāpana-basti is administered, then vamana and virechana to purify the koṣṭha. When koṣṭha is purified, then anuvāsana basti is advised as it is discussed in Vimānasthāna. So it should be accepted that instructions given in the text are applicable in most cases, but not in all cases.    [19]
+
=== Indications of ''anuvasana [[basti]]'' ===
  
==== Indications of Shirovirechana ====
+
''Anuvasana [[basti]]'' and ''asthapana [[basti]]'' are considered the best therapy in ''vatika'' disorders.<ref>Chakrapani, Charak. In:Vaidya Yadavji Trikamji Acharya, editor, Charaka Samhita,reprint edition,Varanasi:Chaukhamba Surbharati Prakashan,2000, Page No.-114</ref>
  
Shirovirecana type of nasya is mainly beneficial in kaphaja disorders.[ 32]                              
+
It has been stated that patients suitable for ''asthapana [[basti]]'' are suitable for ''anuvasana [[basti]]'' is general instruction, because ''krimikoshthi'' and patient suffering from heaviness in the body are suitable for ''asthapana [[basti]]'' but not for ''anuvasana [[basti]]''. In ''krimikoshthi'', first of all ''asthapana [[basti]]'' is administered, then ''[[vamana]]'' and ''[[virechana]]'' to purify the ''koshtha''. When ''koshtha'' is purified, then ''anuvasana [[basti]]'' is advised as it is discussed in [[Vimana Sthana]]. So it should be accepted that instructions given in the text are applicable in most cases, but not in all cases.   [19]
Shirovirechna is mainly beneficial in kaphaja disorders where as Ācārya Caraka says that it is beneficial in vātādi-vikāras which are free from ama-dosha. Here vātādi-vikāras means vāta-shlaiṣmika-vikāra of the head region are cured by proper administration of shirovirechana.[33] Pīnasa-roga mentioned in the indications should be accepted as pakva-pratiśyāya (chronic coryza) [34] as shirovirechna is contraindicated in the patients suffering from nava-pratiśyāya (acute coryza).   [22]
 
  
=== References ===
+
=== Indications of ''Shirovirechana'' ===
  
1. Agniveśa, Caraka-Saṃhitā, with the “Āyurveda-Dīpikā” commentary by Cakrapāṇidatta and
+
''Shirovirechana'' type of ''[[nasya]]'' is mainly beneficial in ''kaphaja'' disorders.<ref>Indu, Vagbhata. In: Dr. Shivprasad Sharma, Editor, Ashtanga Sangraha,2nd edition, Varanasi; Chaukhamba Sanskrit Series Office, 2008, Page No.-223</ref>
Edited by Vaidya Yadavji Trikamji Acharya, Chaukhamba Surbharati Prakashan, Varanasi
+
                             
(India), reprint edition-2000, Page No-1-4.
+
''Shirovirechana'' is mainly beneficial in ''kaphaja'' disorders where as Charaka says that it is beneficial in ''vatadi vikaras'' which are free from ''ama dosha''. Here ''vatadi vikaras'' means ''[[vata]] shleshmika vikara'' of the head region are cured by proper administration of ''shirovirechana''.<ref name=ch>Chakrapani, Charak.In:Vaidya Yadavji Trikamji Acharya, Editor, Charaka Samhita,reprint edition, Varanasi; Chaukhamba Surbharati Prakashan,2000, Page No.-690</ref> ''Pinasa roga'' mentioned in the indications should be accepted as ''pakva pratishyaya'' (chronic coryza)<ref name=ch /> as ''shirovirechana'' is contraindicated in the patients suffering from ''nava pratishyaya'' (acute coryza).   [22]
2. Agniveśa, Caraka-Saṃhitā, with the “Āyurveda-Dīpikā” commentary by Cakrapāṇidatta and
 
Edited by Vaidya Yadavji Trikamji Acharya, Chaukhamba Surbharati Prakashan, Varanasi
 
(India), reprint edition-2000, Page No-17.
 
3. Agniveśa, Caraka-Saṃhitā, with the “Āyurveda-Dīpikā” commentary by Cakrapāṇidatta and
 
Edited by Vaidya Yadavji Trikamji Acharya, Chaukhamba Surbharati Prakashan, Varanasi
 
(India), reprint edition-2000, Page No-66.
 
4. Agniveśa, Caraka-Saṃhitā, with the “Āyurveda-Dīpikā” commentary by Cakrapāṇidatta and
 
Edited by Vaidya Yadavji Trikamji Acharya, Chaukhamba Surbharati Prakashan, Varanasi
 
(India), reprint edition-2000, Page No.-687.
 
5. Agniveśa, Caraka-Saṃhitā, with the “Āyurveda-Dīpikā” commentary by Cakrapāṇidatta and
 
Edited by Vaidya Yadavji Trikamji Acharya, Chaukhamba Surbharati Prakashan, Varanasi
 
(India), reprint edition-2000, Page No.-437.
 
6. Agniveśa, Caraka-Saṃhitā, with the “Āyurveda-Dīpikā” commentary by Cakrapāṇidatta and
 
Edited by Vaidya Yadavji Trikamji Acharya, Chaukhamba Surbharati Prakashan, Varanasi
 
(India), reprint edition-2000, Page No.- 690.
 
7.  Agniveśa, Caraka-Saṃhitā, with the “Āyurveda-Dīpikā” commentary by Cakrapāṇidatta and
 
Edited by Vaidya Yadavji Trikamji Acharya, Chaukhamba Surbharati Prakashan, Varanasi
 
(India), reprint edition-2000, Page No.- 687. 
 
8. (I)Agniveśa, Caraka-Saṃhitā, with the “Āyurveda-Dīpikā”  commentary by Cakrapāṇidatta
 
and Edited by Vaidya Yadavji Trikamji Acharya, Chaukhamba Surbharati Prakashan, Varanasi
 
(India), reprint edition-2000, Page No.-131.             
 
(II) Vṛddha Vāgbhaṭa, Aṣṭāṅga-Saṃgraha with “Śaśilekhā” commentary by Indu, Edited by Dr.  
 
Shivprasad Sharma, Chaukhamba Sanskrit Series Office, Varanasi (India), 2nd edition-2008,
 
Page No.-9.                     
 
(III) Vāgbhaṭa, Aṣṭānga-Hṛdaya, with the commentaries “Sarvāngasundarā” of Aruṇadatta
 
and “Āyurveda-Rasāyana”of Hemādri Edited by Bhishagacharya  Harishastri Paradakar
 
Vaidya, Chaukhambha Orientalia, Varanasi (India), reprint ninth edition-2005, Page No.-16.
 
9. Vāgbhaṭa, Aṣṭānga -Hṛdaya, with the commentaries “Sarvāngasundarā” of Aruṇadatta and
 
“Āyurveda-Rasāyana” of Hemādri Edited by Bhishagacharya  Harishastri Paradakar Vaidya,
 
Chaukhambha Orientalia, Varanasi (India), reprint ninth edition-2005, Page No.-260. 
 
10. Agniveśa, Caraka-Saṃhitā, with the “Āyurveda-Dīpikā” commentary by Cakrapāṇidatta and
 
Edited by Vaidya Yadavji Trikamji Acharya, Chaukhamba Surbharati Prakashan, Varanasi
 
(India), reprint edition-2000, Page No.-678. 
 
11. Agniveśa, Caraka-Saṃhitā, with the “Āyurveda-Dīpikā” commentary by Cakrapāṇidatta and
 
Edited by Vaidya Yadavji Trikamji Acharya, Chaukhamba Surbharati Prakashan, Varanasi
 
(India), reprint edition-2000, Page No.-410.
 
12. Agniveśa, Caraka-Saṃhitā, with the “Āyurveda-Dīpikā” commentary by Cakrapāṇidatta and
 
Edited by Vaidya Yadavji Trikamji Acharya, Chaukhamba Surbharati Prakashan, Varanasi
 
(India), reprint edition-2000, Page No.-678.
 
13. Vāgbhaṭa, Aṣṭānga-Hṛdaya, with the commentaries “Sarvāngasundarā” of Aruṇadatta and
 
“Āyurveda-Rasāyana” of Hemādri Edited by Bhishagacharya  Harishastri Paradakar Vaidya,
 
Chaukhambha Orientalia, Varanasi (India), reprint ninth edition-2005, Page No.-261.
 
14. Agniveśa, Caraka-Saṃhitā, with the “Āyurveda-Dīpikā” commentary by Cakrapāṇidatta and
 
Edited by Vaidya Yadavji Trikamji Acharya, Chaukhamba Surbharati Prakashan, Varanasi
 
(India), reprint edition-2000, Page No.-344.
 
15.(I)Agniveśa, Caraka-Saṃhitā, with the “Āyurveda-Dīpikā”  commentary by Cakrapāṇidatta
 
and Edited by Vaidya Yadavji Trikamji Acharya, Chaukhamba Surbharati Prakashan, Varanasi  
 
(India), reprint edition-2000, Page No.-131.   
 
(II)Vṛddha Vāgbhaṭa, Aṣṭānga-Saṃgraha with “Shashilekha”commentary by Indu, Edited by
 
Dr. Shivprasad Sharma, Chaukhamba Sanskrit Series Office, Varanasi (India), 2nd edition-2008,  
 
Page No.-9.
 
(III)Vāgbhaṭa, Aṣṭānga-Hṛdaya, with the commentaries “Sarvāngasundarā” of Aruṇadatta
 
and “Āyurveda-Rasāyana”of Hemādri Edited by Bhishagacharya  Harishastri Paradakar
 
Vaidya, Chaukhambha Orientalia, Varanasi (India), reprint ninth edition-2005, Page No.-16.
 
16.  Agniveśa, Caraka-Saṃhitā, with the “Āyurveda-Dīpikā”commentary by Cakrapāṇidatta
 
and Edited by Vaidya Yadavji Trikamji Acharya, Chaukhamba Surbharati Prakashan, Varanasi
 
(India), reprint edition-2000, Page No.-413.
 
17. Agniveśa, Caraka-Saṃhitā, with the “Āyurveda-Dīpikā”commentary by Cakrapāṇidatta and
 
Edited by Vaidya Yadavji Trikamji Acharya, Chaukhamba Surbharati Prakashan, Varanasi
 
(India), reprint edition-2000, Page No.-528.
 
18. Agniveśa, Caraka-Saṃhitā, with the “Āyurveda-Dīpikā” commentary by Cakrapāṇidatta and
 
Edited by Vaidya Yadavji Trikamji Acharya, Chaukhamba Surbharati Prakashan, Varanasi
 
(India), reprint edition-2000, Page No.- 494. 
 
19. Suśruta, Suśruta-Saṃhitā, with the “Nibandha-Saṃgraha” commentary of Ḍalhaṇa and
 
“Nyāyacandrikā Pañjikā” of Gayadāsa on Nidānsthāna Edited (from beginning to 9th chapter
 
of Cikitsāsthāna) by Vaidya Yadavji Trikamji Acharya and the rest by Narayan Ram Acharya 
 
“Kavyatirth”, Chaukhambha Orientalia, Varanasi (India), seventh edition- 2002, Page No.-155.
 
20. Agniveśa, Caraka-Saṃhitā, with the “Āyurveda-Dīpikā” commentary by Cakrapāṇidatta and
 
Edited by Vaidya Yadavji Trikamji Acharya, Chaukhamba Surbharati Prakashan, Varanasi
 
(India), reprint edition-2000, Page No.-281.
 
21. Agniveśa, Caraka-Saṃhitā, with the “Āyurveda-Dīpikā” commentary by Cakrapāṇidatta and
 
Edited by Vaidya Yadavji Trikamji Acharya, Chaukhamba Surbharati Prakashan, Varanasi
 
(India), reprint edition-2000, Page No.-692.  
 
22. Agniveśa, Caraka-Saṃhitā, with the “Āyurveda-Dīpikā” commentary by Cakrapāṇidatta and
 
Edited by Vaidya Yadavji Trikamji Acharya, Chaukhamba Surbharati Prakashan, Varanasi
 
(India), reprint edition-2000, Page No.-496.
 
23. Agniveśa, Caraka-Saṃhitā, with the “Āyurveda-Dīpikā”commentary by Cakrapāṇidatta and
 
Edited by Vaidya Yadavji Trikamji Acharya, Chaukhamba Surbharati Prakashan, Varanasi
 
(India), reprint edition-2000, Page No.-689.
 
24. Agniveśa, Caraka-Saṃhitā, with the “Āyurveda-Dīpikā”  commentary by Cakrapāṇidatta
 
and Edited by Vaidya Yadavji Trikamji Acharya, Chaukhamba Surbharati Prakashan, Varanasi  
 
(India), reprint edition-2000, Page No.-452.
 
25.(I) Agniveśa, Caraka-Saṃhitā, with the “Āyurveda-Dīpikā” commentary by Cakrapāṇidatta
 
and Edited by Vaidya Yadavji Trikamji Acharya, Chaukhamba Surbharati Prakashan, Varanasi
 
(India), reprint edition-2000, Page No.- 114.                     
 
(II) Vāgbhaṭa, Aṣṭānga-Hṛdaya, with the commentaries “Sarvānׂgasundarā” of Aruṇadatta
 
and “Āyurveda-Rasāyana” of Hemādri Edited by Bhishagacharya  Harishastri Paradakar
 
Vaidya, Chaukhambha Orientalia, Varanasi (India), reprint ninth edition-2005, Page No.-16.
 
26. Suśruta, Suśruta-Saṃhitā, with the “Nibandha-Saṃgraha” commentary of Ḍalhaṇa and
 
“Nyāyacandrikā Pañjikā” of Gayadāsa on Nidānsthāna Edited (from beginning to 9th chapter
 
of Cikitsāsthāna) by Vaidya Yadavji Trikamji Acharya and the rest by Narayan Ram Acharya  
 
“Kavyatirth”, Chaukhambha Orientalia,Varanasi (India), seventh edition- 2002, Page No.-525.
 
27. Agniveśa, Caraka-Saṃhitā, with the “Āyurveda-Dīpikā”commentary by Cakrapāṇidatta
 
and Edited by Vaidya Yadavji Trikamji Acharya, Chaukhamba Surbharati Prakashan, Varanasi
 
(India), reprint edition-2000, Page No.-693.
 
28. Suśruta, Suśruta-Saṃhitā, with the “Nibandha-Saṃgraha” commentary of Ḍalhaṇa and
 
“Nyāyacandrikā Pañjikā” of Gayadāsa on Nidānsthāna Edited (from beginning to 9th chapter
 
of Cikitsāsthāna) by Vaidya Yadavji Trikamji Acharya and the rest by Narayan Ram Acharya 
 
“Kavyatirth”, Chaukhambha Orientalia,Varanasi (India), seventh edition- 2002, Page No.-525.
 
29. Agniveśa, Caraka-Saṃhitā, with the “Āyurveda-Dīpikā”commentary by Cakrapāṇidatta
 
and Edited by Vaidya Yadavji Trikamji Acharya, Chaukhamba Surbharati Prakashan, Varanasi
 
(India), reprint edition-2000, Page No.-507.
 
30. Agniveśa, Caraka-Saṃhitā, with the “Āyurveda-Dīpikā” commentary by Cakrapāṇidatta
 
and Edited by Vaidya Yadavji Trikamji Acharya, Chaukhamba Surbharati Prakashan, Varanasi
 
(India), reprint edition-2000, Page No.-259.
 
31. Agniveśa, Caraka-Saṃhitā, with the “Āyurveda-Dīpikā” commentary by Cakrapāṇidatta
 
and Edited by Vaidya Yadavji Trikamji Acharya, Chaukhamba Surbharati Prakashan, Varanasi
 
(India), reprint edition-2000, Page No.-114.
 
32. Vṛddha Vāgbhaṭa, Aṣṭānׂga-Saṃgraha with “Śaśilekhā” commentary by Indu, Edited by Dr.
 
Shivprasad Sharma, Chaukhamba Sanskrit Series Office, Varanasi (India), 2nd edition-2008,
 
Page No.-223.
 
33. Agniveśa, Caraka-Saṃhitā, with the “Āyurveda-Dīpikā”commentary by Cakrapāṇidatta
 
and Edited by Vaidya Yadavji Trikamji Acharya, Chaukhamba Surbharati Prakashan, Varanasi
 
(India), reprint edition-2000, Page No.-690.
 
34. Agniveśa, Caraka-Saṃhitā, with the “Āyurveda-Dīpikā” commentary by Cakrapāṇidatta
 
and Edited by Vaidya Yadavji Trikamji Acharya, Chaukhamba Surbharati Prakashan, Varanasi
 
(India), reprint edition-2000, Page No.-690.
 
  
=== Glossary ===
+
=== Contra-indications of ''Shirovirechana'' ===
  
1. Siddhisthāna (siddhisthAna; सिद्धिस्थान): - Section dealing with such measures leading to the success in the administration of Panchkarma.
+
Vagbhata added the following conditions in list of contra-indications:  
2. Panchkarma (pa~jcakarma; पञ्चकर्म): - Internal bio-cleansing therapy. 
 
Literally means fivefold therapeutic procedures comprises of vamana-karma, Virechana-karma, anuvāsana-basti, asthāpana-basti and shirovirechna.
 
3. Vamana-karma (vamana-karma, वमन-कर्म): (therapeutic emesis)- vamana is the first procedure of  bio-cleansing therapy and causes vomiting of the vitiated dosha.  Mainly used for diseases manifesting in upper part of body and caused by kapha-dosha
 
4. Virechana-karma (virechana-karma; विरेचन-कर्म): (therapeutic purgation)- virechana literally means catharsis, consists in administration of the purgative drugs which are pleasant and tending to move downward in order to eliminate the vitiated dosha especially pitta through the anus.
 
5.  Anuvāsana-basti (anuvasana-basti; अनुवासन-बस्ति): -A form of medicated unctuous enema which can be given every day and which doesn’t harm the body even if retained inside.
 
6. Āsthāpana-basti (asthapana-basti; आस्थापन-बस्ति) -The medicated enema having more quantity of the decoction prepared out of various drugs and possessing very potent action by which it expels the dosha out of the body and there by gives relief from the diseases, prolongs life and stabilizes the body tissues. Nirūha-basti is another name of asthāpana-basti.
 
7.  Shirovirechna (शिरोविरेचन) -A kind of errhine or head-evacuative therapy which eliminates the morbid factors out of the head region.
 
8.  Avamya (avamya; अवम्य)- Person unsuitable or unfit for vamana-karma.
 
9.  Vamya (vamya; वम्य) – Person suitable or fit for vamana-karma.
 
10.  Avirecya (avirecya; अविरेच्य) –Person unfit for virechana-karma.
 
11. Virecya (virecya; विरेच्य) - Person fit for virechana-karma.
 
12.  Anāsthāpya (अनास्थाप्य) - Person unfit for asthāpana-basti.
 
13. Āsthāpya (आस्थाप्य) - Person fit for asthāpana-basti.
 
14. Ananuvāsya (अननुवास्य)-  Person unfit for anuvāsana-basti.
 
15. Anuvāsya (अनुवास्य) - Person fit for anuvāsana-basti.
 
16. Aśirovirecanārha (अशिरोविरेचनार्ह) - Person unfit for shirovirechna.
 
17. Śirovirecanārha (शिरोविरेचनार्ह) - Person fit for shirovirechna.
 
  
=== Bibliography ===
+
Apatarpita, Pitadrava, Gararta, Kruddha, vegavarodhita, Raktasravita, Sutika, Shwasapidita, Kasapidita
  
1.  Agniveśa, Caraka-Saṃhitā, with the Āyurveda-Dīpikā Commentary by Cakrapāṇidatta
+
=== Current researches ===
and Edited by Vaidya Yadavji Trikamji Acharya, Chaukhamba Surbharati Prakashan, Varanasi
 
(India), reprint edition-2000.
 
2. Agniveśa, Caraka-Saṃhitā, text with English translation Volume-I, Edited and translated by
 
Prof. Priya Vrat Sharma, Chaukhambha Orientalia,Varanasi (India), first edition-1981.
 
3. Agniveśa, Caraka-Saṃhitā, text with English translation Volume- II, Edited and translated by
 
Prof. Priya Vrat Sharma, Chaukhambha Orientalia,Varanasi (India), first edition-1983.
 
4. Sharma R.K. and Dash B., Caraka Saṃhitā with English translation and critical exposition
 
based on Cakrapāṇidatta’s ‘Āyurveda Dīpikā’Commentary, Vol. I to VI, Chaukhambha Bharati
 
Sanskrit Series office, Varanasi (India), edition-2001.
 
5. Agniveśa, Caraka-Saṃhitā- part-1 with introduction by Vaidya Samrat Shri Satyanarayana
 
Shastri and ‘Vidyotinī’ Hindi commentary by Pt. Kashinath Shastri and Dr. Gorakhnath
 
Chaturvedi, Chaukhambha Bharati Academy, Varanasi (India), reprint: year 2009.
 
6. Agniveśa, Caraka-Saṃhitā- part-2 with introduction by Vaidya Samrat Shri Satyanarayana
 
Shastri and ‘Vidyotinī’ Hindi commentary by Pt. Kashinath Shastri and Dr. Gorakhnath
 
Chaturvedi, Chaukhambha Bharati Academy, Varanasi (India), reprint: year 2009.
 
7. Agniveśa, Caraka-Saṃhitā, ‘Āyuṣī’ Hindi commentary of Caraka-Saṃhitā along with
 
Āyurveda-Dīpikā commentary volume- I by Vaidya Harish Chandra Singh Kushwaha,
 
Chaukhambha Orientalia, Varanasi (India), first edition- 2005.
 
8. Agniveśa, Caraka-Saṃhitā, ‘Āyuṣī’ Hindi commentary of Caraka-Saṃhitā along with
 
Āyurveda-Dīpikā commentary Volume-II by Vaidya Harish Chandra Singh Kushwaha,
 
Chaukhambha Orientalia, Varanasi (India), first edition-2009.
 
9.  Suśruta, Suśruta Saṃhitā, with the Nibandha- Saṃgraha commentary of Ḍalhaṇa and
 
Nyāyacandrikā Pañjikā of Shri Gayadāsa on Nidānasthāna Edited (from beginning to 9th chapter
 
of Cikitsāsthāna) by Vaidya Yadavji Trikamji Acharya and the rest by Narayan Ram Acharya 
 
“Kāvyatīrtha”, Chaukhambha Orientalia, Varanasi (India), seventh edition- 2002.
 
10. Suśruta, Suśruta Saṃhitā Volume-1 with English translation of text and Ḍalhaṇa’s
 
Commentary along with critical notes by Priya Vrata Sharma, Chaukhambha Vishvabharati,
 
Varanasi (India), reprint: year-2010.
 
11. Suśruta, Suśruta Saṃhitā Volume-II, English translation by Priya Vrat Sharma,
 
Chaukhambha Vishvabharati, Varanasi (India), Reprint Year: 2005.
 
12. Suśruta, Suśruta Saṃhitā, Illustrated Suśruta Saṃhitā Volume:-I-II with English translation
 
by Prof. K.R. Shrikantha Murthy, Chaukhambha Orientalia, Varanasi (India), first edition-2001.
 
13. Suśruta, Suśruta Saṃhitā, Illustrated Suśruta Saṃhitā Volume:-III-IV with English
 
Translation by Prof. K.R. Shrikantha Murthy, Chaukhambha Orientalia, Varanasi (India), first
 
edition-2002.
 
14. Suśruta, Suśruta Saṃhitā with ‘Suśrutavimarśinī’ Hindi commentary along with special
 
deliberations etc. by Dr. Anant Ram Sharma and foreword by Acharya P.V.Sharma,
 
Volume-I-III, Chaukhambha Surbharati Parakashan, Varanasi (India), first edition-2001.
 
15. Suśruta, Suśruta Saṃhitā, ‘Āyurveda Tattva-Sandīpikā’ Hindi commentary Part-I by Kaviraj
 
Dr. Ambikadatta Shastri, Chaukhambha Sanskrit Sansthan, Varanasi (India), 12th edition-2001.
 
16. Suśruta, Suśruta-Saṃhitā, Āyurveda-Tattva-Sandīpikā Hindi commentary Part-II by Kaviraja
 
Ambikadatta Shastri, Chaukhambha Sanskrit Sansthan, Varanasi (India), fourteenth edition-
 
2001.
 
17.  Vṛddha Vāgbhaṭa, Aṣṭānga-Saṃgraha with Śaśilekhā Commentary by Indu, Edited by Dr.
 
Shivprasad Sharma, Chaukhamba Sanskrit Series Office, Varanasi (India), 2nd edition-2008.
 
18. Vṛddha Vāgbhaṭa, Aṣṭānga-Saṃgraha, Text, English translation, notes and index Volume- I
 
by Prof. K.R. Srikantha Murthy, Chaukhambha Orientalia, Varanasi (India), third edition- 2000.
 
19. Vṛddha Vāgbhaṭa, Aṣṭāna-Saṃgraha, Text, English translation, notes and index Volume-II
 
by Prof. K.R. Srikantha Murthy, Chaukhambha Orientalia, Varanasi (India), fifth edition- 2005.
 
20.  Vāgbhaṭa, Aṣṭānga –Hṛdaya, with the commentaries ‘Sarvāngasundarā of Aruṇadatta and
 
‘Āyurveda-Rasāyana’ of Hemādri Edited by Bhishagacharya  Harishastri Paradakar Vaidya,
 
Chaukhambha Orientalia, Varanasi (India), reprint ninth edition-2005. 
 
21. Vāgbhaṭa, Aṣṭānga –Hṛdaya Vol.-I, with English translation by Prof. K. R. Srikantha
 
Murthy, Krishnadas Academy,Varanasi (India), Edition-first-1997.
 
22. Vāgbhaṭa, Aṣṭānga –Hṛdaya Vol.-II, with English translation by Prof. K. R. Srikantha
 
Murthy, Krishnadas Academy,Varanasi (India),  Reprint Year: 2010.
 
23. Vāgbhaṭa, Aṣṭānga –Hṛdaya, Edited with the ‘Vidyotinī’ Hindi commentary by Kaviraj
 
Atridev Gupta, Chaukhambha Sanskrit Sansthan, Varanasi (India), reprint edition-2005.
 
24. Gaur Prof. Banwarilal, Aṣṭānga Hṛdaya of Vāgbhaṭa (Sūtrasthāna) with ‘Samvartikā’ Hindi
 
Commentary, Chaukhambha Orientalia, Varanasi (India), edition-2007.
 
25. WHO-APW Project, Standardization of non-clinical terminologies of Āyurveda, completed
 
  
and submitted by  National Institute of Āyurveda (Dept. of AYUSH, Govt. of India), Madhav
+
Prameha and Kushtha are considered as contraindications of Asthapana [[Basti]]. Thus the conditions of diabetes and skin diseases comes under this umbrella of contraindication. However, more precisely, if these conditions are associated with aggravated [[vata]], Asthapana [[Basti]] is used with good efficacy. The [[basti]] of gokshura and punarnava has shown good results in microalbuminuria in diabetic patients.<ref>Ramteke RS, Thakar AB, Trivedi AH, Patil PD. Clinical efficacy of Gokshura-Punarnava Basti in the management of microalbuminuria in diabetes mellitus. Ayu. 2012;33(4):537–541. doi:10.4103/0974-8520.110535</ref> Likewise [[basti]] has shown good results in skin condition like psoriatic arthritis.<ref>S. Shruthi, M Kumar Ashvini, Lohith B A, M Uday Shankar, Mishra Gaurav,  AyurvedicManagement of Psoriatic Arthritis: A Case Study, International Journal of Applied Ayurved Research,2017; 2(11):1472-77</ref>
  
Vilas Palace, Joravar-Singh Gate, Amer Road, JAIPUR - 302002 (Rajasthan), INDIA.
+
=== Scope of further research ===
  
26. WHO-APW Project, Standardization of Ayurvedic clinical terminologies, completed and  
+
General indications and contraindications of all [[panchakarma]] are included in this chapter. Further it is needed to elaborate efficacy of these procedures in the specific stages of the disease.
 +
For e.g. Asthapana [[Basti]] is contraindicated in fatigue due to excess travelling (Yanaklanta). However in other reference Yuktaratha [[Basti]] is indicated in certain conditions with similarity of pathogenesis. Though [[basti]] is contraindicated in skin diseases (Kushtha), a formulation for [[basti]] is prescribed in management of Kushtha. This is specific to the conditions associated with specific [[dosha]]. A study is required to elaborate and explain the reasons.
 +
</div>
  
Submitted by Prof. M.S.Baghel et al, IPGTRA, Gujarat Āyurveda University, Jamnagar, Gujarat
+
<big>'''[[Special:ContactMe|Send us your suggestions and feedback on this page.]]'''</big>
  
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Revision as of 22:41, 23 September 2021


Siddhi Sthana Chapter 2. Successful administration of Panchakarma therapies

Panchakarmiya Siddhi
Section/Chapter Siddhi Sthana Chapter 2
Preceding Chapter Kalpana Siddhi
Succeeding Chapter Bastisutriyam Siddhi
Other Sections Sutra Sthana, Nidana Sthana, Vimana Sthana, Sharira Sthana, Indriya Sthana, Chikitsa Sthana, Kalpa Sthana
Translator and commentator Paliwal M.
Reviewer Mangalasseri P., Auti S.
Editors Thakar A. B., Mangalasseri P., Deole Y.S., Basisht G.
Year of publication 2020
Publisher Charak Samhita Research, Training and Skill Development Centre
DOI 10.47468/CSNE.2020.e01.s08.003

Abstract

Charaka Samhita Siddhi Sthana is designed to discuss the proper methods of application of Panchakarma as well as complications of the same due to improper use and their successful management. In the previous chapter (Kalpana Siddhi), various aspects of administration of Panchakarma were discussed. Pravritti (indications) and nivritti (contraindications) of Panchakarma are essential to discuss without which successful administration cannot be assured. In the beginning of the chapter, persons unsuitable for both shodhana and shamana chikitsa are mentioned. At the end of the chapter, it is stated that in spite of having all the instructions, a wise physician should use his own wisdom and reasoning in arriving at the correct judgment as in many cases contraindications turn into indications and vice versa according to the stage of disease and need of the patient.

Keywords: Asthapana-basti, Anuvasana-basti, Panchakarma, Siddhi, Shirovirechana, Vamana, Virechana, indications, contra-indications, therapeutic enema, therapeutic purgation, therapeutic emesis, therapeutic intra-nasal administration.

Introduction

Dhatusamya i.e. equilibrium of body tissues needs to be maintained for disease free state. It is achieved by the prevention and promotion of health as well as cure of diseases. The cure of diseases is done by two means i.e. shodhana chikitsa (bio-purification therapy) and shamana-chikitsa (alleviation therapy). Shodhana-karma or chikitsa is generally considered as a synonym of Panchakarma and is accepted as the best therapy for cure of diseases without recurrence. If we go into the depth, we find that there are minor differences between shodhana-chikitsa and Panchakarma. Shodhana-chikitsa is of two types on the basis of external and internal purification where as Panchakarma is only related to internal purification of the body. Another important aspect is that there may be a long list of shodhana-karmas but Panchakarma are only five biopurificatory procedures. Vamana (therapeutic emesis), virechana (therapeutic purgation), asthapana-basti (therapeutic enema having more quantity of decoction), anuvasana-basti (therapeutic enema with medicated oil, ghee etc. fatty substances) and shirovirechana (head-evacuation) are considered under the heading of Panchakarma. These five procedures, eliminate the doshas in more quantity and are more potent in purification of the body. These procedures are intended to bring vitiated dosha from periphery (shakha) to gut (koshtha) and then expel them outside from nearest external orifice thoroughly. Some scholars include raktamokshana (blood-letting) among Panchakarma. However this opinion is not acceptable as it removes dosha directly from shakha without any prior effect on vitiated dosha in gut. Hence Raktamokshana cannot be considered under panchakarma.

Panchakarma are supposed to produce Kaya-kalpa i.e. dramatic changes in the body provided properly administered considering desha (habitat), kala (season), dosha i.e. vata, pitta and kapha, dushya (those which get vitiated), koshtha (nature of bowel), agni (digestive power), bala (body strength) and prakriti (constitution of the body). Before administration of Panchakarma, indications and contra-indications are essential to be considered to achieve the desired effects. Panchakarmiya Siddhi is written to discuss the suitable and unsuitable persons or patients for each of the procedure of Panchakarma which is very much crucial in getting the success. Instructions laid down in this chapter are as per general rule which are followed in most of the cases but exceptions are also found in the text considering the particular stage of disease.

Sanskrit text, Transliteration and English Translation

अथातः पञ्चकर्मीयां सिद्धिं व्याख्यास्यामः||१||

इति ह स्माह भगवानात्रेयः||२||

athātaḥ Panchkarmiyaṁ siddhiṁ vyākhyāsyāmaḥ||1||

iti ha smāha bhagavānātrēyaḥ||2||

athAtaH pa~jcakarmIyAM siddhiM vyAkhyAsyAmaH||1||

iti ha smAha bhagavAnAtreyaH||2||

Now we shall expound the chapter "Panchakarmiya Siddhi" (Successful administration of Panchakarma therapies). Thus said Lord Atreya. [1-2]

येषां यस्मात् पञ्चकर्माण्यग्निवेश न कारयेत्|
येषां च कारयेत्तानि तत् सर्वं सम्प्रवक्ष्यते||३||

yēṣāṁ yasmāt pañcakarmāṇyagnivēśa na kārayēt|
yēṣāṁ ca kārayēttāni tat sarvaṁ sampravakṣyatē||3||

yeShAM yasmAt pa~jcakarmANyAgniveśaa na kArayet|
yeShAM ca kArayettAni tat sarvaM sampravakShyate||3||

O! Agnivesha, we will now describe about the patients for whom Panchakarma therapies are contra-indicated with proper reasoning and the patients for whom Panchakarma are indicated. [3]

Persons who are generally anupakramya (unsuitable for treatment)

चण्डः साहसिको भीरुः कृतघ्नो व्यग्र एव च|

सद्राजभिषजां द्वेष्टा तद्द्विष्टः शोकपीडितः||४||

यादृच्छिको मुमूर्षुश्च विहीनः करणैश्च यः|

वैरी वैद्यविदग्धश्च श्रद्धाहीनः सुशङ्कितः||५||

भिषजामविधेयश्च नोपक्रम्या भिषग्विदा|

एतानुपचरन् वैद्यो बहून् दोषानवाप्नुयात्||६||

एभ्योऽन्ये समुपक्रम्या नराः सर्वैरुपक्रमैः|

अवस्थां प्रविभज्यैषां वर्ज्यं कार्यं च वक्ष्यते||७||

caṇḍaḥ sāhasiko bhīruḥ kr̥taghnō vyagra ēva ca|

sadrājabhiṣajāṁ dvēṣṭā taddviṣṭaḥ śōkapīḍitaḥ||4||

yādr̥cchiko mumūrṣuśca vihīnaḥ karaṇaiśca yaḥ|

vairī vaidyavidagdhaśca śraddhāhīnaḥ suśaṅkitaḥ||5||

bhiṣajāmavidhēyaśca nōpakramyā bhiṣagvidā|

ētānupacaran vaidyō bahūn dōṣānavāpnuyāt||6||

ēbhyō'nyē samupakramyā narāḥ sarvairupakramaiḥ|

avasthāṁ pravibhajyaiṣāṁ varjyaṁ kāryaṁ ca vakṣyatē||7||

caNDaH sAhasiko bhIruH kRutaghno vyagra eva ca|

sadrAjabhiShajAM dveShTA taddviShTaH shokapIDitaH||4||

yAdRucchiko mumUrShushca vihInaH karaNaishca yaH|

vairI vaidyavidagdhashca shraddhAhInaH susha~gkitaH||5||

bhiShajAmavidheyashca nopakramyA bhiShagvidA|

etAnupacaran vaidyo bahUn doShAnavApnuyAt||6||

ebhyo~anye samupakramyA narAH sarvairupakramaiH|

avasthAM pravibhajyaiShAM varjyaM kAryaM ca vakShyate||7||

The wise physician should not treat the following types of patients:

  1. Who is fierceful or aggressive, adventurous, fearful, ungrateful and fickle minded;
  2. Who hates good persons, kings and physicians and who is intensely disliked by them;
  3. Who is afflicted with grief;
  4. Who does not believe in God (nastika)
  5. Who is in the end stage of disease and is predicted to die soon;
  6. Who is not in position to collect the essential items (karana) for the treatment;
  7. Who is enemy or hostile to the physician;
  8. Who is an impostor and considers himself to be a physician;
  9. Who is unfaithful to the physician;
  10. Who is always suspicious (doubtful); and
  11. Who is not obedient to the physician. The physician, who administers Panchakarma or any medicine to the above mentioned types of patients, faces many difficulties and does not get success. Persons other than those mentioned above are suitable for all types of Panchakarma or treatment procedures.

Henceforth, we will discuss the indications and contra-indications of each of the procedure of Panchakarma therapies considering the different situations. [4-7]

Contra-indications of vamana karma

अवम्यास्तावत्-क्षतक्षीणातिस्थूलातिकृशबालवृद्धदुर्बलश्रान्तपिपासितक्षुधितकर्मभाराध्वहतोपवासमैथुनाध्ययनव्यायामचिन्ता-प्रसक्तक्षामगर्भिणीसुकुमारसंवृतकोष्ठदुश्छर्दनोर्ध्वरक्तपित्तप्रसक्तच्छर्दिरूर्ध्ववातास्थापितानुवासितहृद्रोगोदावर्तमूत्राघात-प्लीहगुल्मोदराष्ठीलास्वरोपघाततिमिरशिरशङ्खकर्णाक्षिशूलार्ताः||८||

avamyāstāvat- kṣatakṣīṇātisthūlātikr̥śabālavr̥ddhadurbalaśrāntapipāsitakṣudhitakarmabhārādhvahatōpavāsamaithunādhyayanavyāyāmacintā-prasaktakṣāmagarbhiṇīsukumārasaṁvr̥takōṣṭhaduśchardanōrdhvaraktapittaprasaktacchardirūrdhvavātāsthāpitānuvāsitahr̥drōgōdāvartamūtrāghāta-plīhagulmōdarāṣṭhīlāsvarōpaghātatimiraśiraśaṅkhakarṇākṣiśūlārtāḥ||8||

avamyAstAvat- kShatakShINAtisthUlAtikRushabAlavRuddhadurbalashrAntapipAsitakShudhitakarmabhArAdhvahatopavAsamaithunAdhyayanavyAyAmacintA-prasaktakShAmagarbhiNIsukumArasaMvRutakoShThadushchardanordhvaraktapittaprasaktacchardirUrdhvavatasthApitAnuvAsitahRudrogodAvartamUtrAghAta-plIhagulmodarAShThIlAsvaropaghAtatimirashirasha~gkhakarNAkShishUlArtAH||8||

The persons or patients for whom vamana is contraindicated are mentioned in the following table:

Serial No. Disease or State in which vamana is contraindicated Translation in English
1 Kshata Chest Injury
2 Kshina Emaciated
3 Atishula Excessively Obese
4 Atikrisha Excessively Lean
5 Baala Children (aged under 10 years)
6 Vriddha Old/Elderly
7 Durbala Weak
8 Shraanta Fatigued
9 Pipasita Thirsty
10 Kshudhita Hungry
11 Karmahata Work related fatigue
12 Bhaarahata Exhaustion due to carrying heavy-weight
13 Adhvahata Exhaustion due to wayfaring/walking on foot
14 Upavaasa-prasakta-kshaama Weakness due to excessive fasting
15 Maithuna-prasakta-kshaama Exhaustion due to excessive sexual activities
16 Adhyayana-prasakta-kshaama Exhaustion due to excessive academic activities
17 Vyayama-prasakta-kshaama Exhaustion due to excessive physical exercise
18 Chinta-prasakta-kshaama Exhaustion due to excessive worry/anxiety
19 Garbhini Pregnant Woman
20 Sukumara One having tender health
21 Samvritta Koshtha One having obstructed bowel
22 Dushchardana One who does not respond to emesis easily
23 Urdhvaraktapitta One suffering from bleeding from the upper tract.
24 Prasaktachhardi (One suffering from) Continuous vomiting
25 Urdhvavata One suffering from upward movement of vata.
26 Asthapita One who has taken medicated enema (having higher amount of decoction)
27 Anuvasita One who has taken medicated enema (having higher amount of decoction)
28 Hridroga Heart disease
29 Udavarta Disorder due to improper functioning of vata
30 Mutraghata Anuria/Oliguria
31 Pleeha-roga Splenic disorder
32 Gulma Abdominal lump
33 Udara-roga Obstinate abdominal diseases including ascites
34 Ashtheela Enlarged prostrate
35 Svaropaghaata Choked voice
36 Timira Cataract
37 Shirahshoolaarta One suffering from headache
38 Shankhashoolaarta One suffering from pain in temporal region
39 Karnashoolaarta One suffering from pain in the ears
40 Akshishoolaarta One suffering from pain in the eyes

[8]

Adverse effects of vamana karma administered in contra-indicated conditions

तत्र क्षतस्य भूयः क्षणनाद्रक्तातिप्रवृत्तिः स्यात्, क्षीणातिस्थूलकृशबालवृद्धदुर्बलानामौषधबलासहत्वात् प्राणोपरोधः,श्रान्तपिपासितक्षुधितानां च तद्वत्, कर्मभाराध्वहतोपवासमैथुनाध्ययनव्यायामचिन्ताप्रसक्तक्षामाणां रौक्ष्याद्वातरक्तच्छेदक्षतभयं स्यात्, गर्भिण्या गर्भव्यापदामगर्भभ्रंशाच्चदारुणा रोगप्राप्तिः, सुकुमारस्यहृदयापकर्षणादूर्ध्वमधो वा रुधिरातिप्रवृत्तिः, संवृतकोष्ठदुश्छर्दनयोरतिमात्रप्रवाहणाद्दोषाः समुत्क्लिष्टा अन्तःकोष्ठे जनयन्त्यन्तर्विसर्पं स्तम्भं जाड्यं वैचित्त्यं मरणं वा, ऊर्ध्वगरक्तपित्तिन उदानमुत्क्षिप्य प्राणान् हरेद्रक्तं चातिप्रवर्तयेत्,प्रसक्तच्छर्देस्तद्वत्, ऊर्ध्ववातास्थापितानुवासितानामूर्ध्वं वातातिप्रवृत्तिः, हृद्रोगिणोहृदयोपरोधः, उदावर्तिनो घोरतर उदावर्तःस्याच्छीघ्रतरहन्ता, मूत्राघातादिभिरार्तानां तीव्रतरशूलप्रादुर्भावः, तिमिरार्तानां तिमिरातिवृद्धिः, शिरःशूलादिषु शूलातिवृद्धिः;तस्मादेते न वम्याः| सर्वेष्वपि तु खल्वेतेषु विषगरविरुद्धाजीर्णाभ्यवहारामकृतेष्वप्रतिषिद्धं शीघ्रतरकारित्वादेषामिति ||९||

tatra kṣatasya bhūyaḥ kṣaṇanādraktātipravr̥ttiḥ syāt, kṣīṇātisthūlakr̥śabālavr̥ddhadurbalānāmauṣadhabalāsahatvāt prāṇōparōdhaḥ,śrāntapipāsitakṣudhitānāṁ ca tadvat, karmabhārādhvahatōpavāsamaithunādhyayanavyāyāmacintāprasaktakṣāmāṇāṁ raukṣyādvātaraktacchēdakṣatabhayaṁ syāt, garbhiṇyā garbhavyāpadāmagarbhabhraṁśāccadāruṇā rōgaprāptiḥ, sukumārasyahr̥dayāpakarṣaṇādūrdhvamadhō vā rudhirātipravr̥ttiḥ, saṁvr̥takōṣṭhaduśchardanayōratimātrapravāhaṇāddōṣāḥ samutkliṣṭā antaḥkōṣṭhē janayantyantarvisarpaṁ stambhaṁ jāḍyaṁ vaicittyaṁ maraṇaṁ vā, ūrdhvagaraktapittina udānamutkṣipya prāṇān harēdraktaṁ cātipravartayēt,prasaktacchardēstadvat, ūrdhvavātāsthāpitānuvāsitānāmūrdhvaṁ vātātipravr̥ttiḥ, hr̥drōgiṇōhr̥dayōparōdhaḥ, udāvartinō ghōratara udāvartaḥsyācchīghratarahantā, mūtrāghātādibhirārtānāṁ tīvrataraśūlaprādurbhāvaḥ, timirārtānāṁ timirātivr̥ddhiḥ, śiraḥśūlādiṣu śūlātivr̥ddhiḥ; tasmādētē navamyāḥ| sarvēṣvapi tu khalvētēṣu viṣagaraviruddhājīrṇābhyavahārāmakr̥tēṣvapratiṣiddhaṁ śīghratarakāritvādēṣāmiti ||9||

tatra kShatasya bhUyaH kShaNanAdraktAtipravRuttiH syAt, kShINAtisthUlakRushabAlavRuddhadurbalAnAmauShadhabalAsahatvAt prANoparodhaH,shrAntapipAsitakShudhitAnAM ca tadvat, karmabhArAdhvahatopavAsamaithunAdhyayanavyAyAmacintAprasaktakShamanAM raukShyAdvataraktacchedakShatabhayaM syAt, garbhiNyA garbhavyApadAmagarbhabhraMshAccadAruNA rogaprAptiH, sukumArasyahRudayApakarShaNAdUrdhvamadho vA rudhirAtipravRuttiH, saMvRutakoShThadushchardanayoratimAtrapravAhaNAddoShAH samutkliShTAantaHkoShThe janayantyantarvisarpaM stambhaM jADyaM vaicittyaM maraNaM vA, Urdhvagaraktapittina udAnamutkShipya prANAn haredraktaMcAtipravartayet, prasaktacchardestadvat, UrdhvavatasthApitAnuvAsitAnAmUrdhvaM vatatipravRuttiH, hRudrogiNohRudayoparodhaH, udAvartino ghorataraudAvartaH syAcchIghratarahantA, mUtrAghAtAdibhirArtAnAM tIvratarashUlaprAdurbhAvaH, timirArtAnAM timirAtivRuddhiH, shiraHshUlAdiShu shUlAtivRuddhiH;tasmAdete na vamyAH| sarveShvapi tu khalveteShu viShagaraviruddhAjIrNAbhyavahArAmakRuteShvapratiShiddhaM shIghratarakAritvAdeShAmiti ||9||

If a person suffering from kshata (chest injury) is given vamana (emetic therapy), then it further aggravates the injury (to the lungs) and causes excessive haemoptysis.

If vamana is given to a person who is ksheena (emaciated), atisthula, atikrisha, bala, vriddha and durbala, then this produce danger to their life because such types of patients are incapable to tolerate the effects of drugs which are used for vamana. The similar effect is observed when vamana is administered to a person who is fatigued, thirsty and hungry.

If vamana is administered to a person who is broken down by doing hard work, carrying excessive weight and travels long on foot, and who is weakened by long term fasting, sexual indulgence, study, exercise and worry, then because of dryness, the vata in his body gets aggravated. He may get hemorrhage and injury to his lungs.

If a pregnant woman is given vamana, then this may produce complications of pregnancy and occurrence of severe diseases because of the abortion of immature fetus.

If the person who is delicate is given vamana, then because of undue pressure on the heart, it may give rise to hemorrhage from the upward or downward tracts.

If a person whose koshtha (bowel) is occluded or who does not respond to vamana therapy easily, then the administration of this therapy leads to excessive bouts of urge for vomiting leading to the aggravation of dosha and these dosha cause internal visarpa (erysipelas), stambha (stiffness), jadya (dullness), vaichitya (mental perversion) or death.

If vamana is administered to a person suffering from urdhvaga-raktapitta, it may take out vital breath by pushing udana upwards and may cause excessive bleeding. Similar effects are observed if vamana is given to a person who is already suffering from constant vomiting.

If the vamana is administered to a person suffering from urdhvavata, and who has taken asthapana or anuvasana types of medicated enema, then it causes upward movement of the vata in excess.

If vamana is given to a person suffering from heart disease, it causes the sudden cessation of cardiac motion i.e. cardiac arrest. If vamana is administered to a person suffering from udavarta, it causes severe udavarta (disorder due to improper functioning of vata) which results in death of the patient shortly.

Vamana given to a person suffering from mutraghata (oliguria/anuria), pliha-roga (splenic disorder), gulma (abdominal lump) etc. diseases, causes pain of more severe nature.

Vamana given to the patients suffering from timira (cataract), increases the cataract.

Vamana given to the persons suffering from headache, pain in the ears and eyes etc. leads to aggravation of pain. Therefore, vamana is contra-indicated for all these types of patients. However, in all these cases vamana is not contra-indicated in the conditions of poisons, artificial poisons, incompatible food, intake of food during indigestion and ama (ailment caused by the product of improper digestion and metabolism) because these conditions are of emergent nature. [9]

Indications of vamana karma

शेषास्तु वम्याः; विशेषतस्तु पीनसकुष्ठनवज्वरराजयक्ष्मकासश्वासगलग्रहगलगण्डश्लीपदमेहमन्दाग्निविरुद्धाजीर्णान्नविसूचिकालसकविषगरपीतदष्टदिग्धविद्धाधःशोणितपित्तप्रसेक (दुर्नाम )हृल्लासारोचकाविपाकापच्यपस्मारोन्मादातिसारशोफपाण्डुरोगमुखपाकदुष्टस्तन्यादयः श्लेष्मव्याधयो विशेषेणमहारोगाध्यायोक्ताश्च; एतेषु हि वमनं प्रधानतममित्युक्तं केदारसेतुभेदे शाल्याद्यशोषदोषविनाशवत्||१०||

śēṣāstu vamyāḥ; viśēṣatastu pīnasakuṣṭhanavajvararājayakṣmakāsaśvāsagalagrahagalagaṇḍaślīpadamēhamandāgniviruddhājīrṇānnavisūcikālasakaviṣagarapītadaṣṭadigdhaviddhādhaḥśōṇitapittaprasēka (durnāma )hr̥llāsārōcakāvipākāpacyapasmārōnmādātisāraśōphapāṇḍurōgamukhapākaduṣṭastanyādayaḥślēṣmavyādhayō viśēṣēṇa mahārōgādhyāyōktāśca;

ētēṣu hi Vamanṁ pradhānatamamityuktaṁkēdārasētubhēdē śālyādyaśōṣadōṣavināśavat||10||

sheShAstu vamyAH; visheShatastu pInasakuShThanavajvararAjayakShmakAsashvAsagalagrahagalagaNDashlIpadamehamandAgniviruddhAj-

IrNAnnavisUcikAlasakaviShagarapItadaShTadigdhaviddhAdhaHshoNitapittapraseka (durnAma )hRullAsArocakAvipAkApacyapasmAronmAdAtisArashophapANDurogamukhapAkaduShTastanyAdayaHshleShmavyAdhayo visheSheNa mahArogAdhyAyoktAshca;

eteShu hi VamanM pradhAnatamamityuktaMkedArasetubhede shAlyAdyashoShadoShavinAshavat||10||

vamana karma is indicated for the diseases other than above mentioned but especially useful in the diseases given in the following table:

Serial No. Disease or State (in which vamana is contraindicated) Translation in English
1 Peenasa Coryza
2 Kushtha All types of skin diseases, including leprosy
3 Navajwara Acute fever
4 Rajayakshma Tuberculosis
5 Kaasa Cough
6 Shvaasa Bronchia Asthma
7 Galagraha Spasm in the throat
8 Galagandha Goitre
9 Shleepada Elephantiasis
10 Meha Obstinate urinary disorders, including diabetes mellitus
11 Mandaagni Supression of digestion fire
12 Viruddhaanna Ailments caused due to intake of incompatible diet
13 Ajeernaanna Ailments caused due to indigestion
14 Vishuchika Cholera
15 Alasaka Intestinal torpor
16 Visha-peeta Ailments caused by ingesting natural poisons
17 Gara-peeta Ailments caused by ingesting artificial/synthetic poisons
18 Visha-dashta Poisonous bites
19 Visha-digdha-viddha Ailments caused due to injury with weapons laced with poison
20 Adhah - shonitapitta Diseases characterized by bleeding from downward tracts
21 Praseka Excessive salivation
22 Durnaama Piles
23 Hrillasa Nausea
24 Arochaka Anorexia
25 Avipaaka Indigestion
26 Apachi Cervical adenitis
27 Apasmara Epilepsy
28 Unmada Psychotic disorders
29 Atisara Diarrhea
30 Shopha Swelling
31 Pandu Roga Anemia
32 Mukhapaaka Stomatitis
33 Dushta-stanya Vitiated breast milk
34 Shelshmavyadhayo Visheshena Maharogadhyayoktah All Kapha dosha disorders mentioned in the Maharoga Adhyaya of Charaka Samhita Sutra Sthana

In these above mentioned conditions, action of vamana karma in causing cure of diseases caused by aggravation of kapha being similar to water laden paddy field getting spoiled due to clogging of water which can be corrected by the letting out the water out of the field like vamana does with kapha. [10]

Contra-indications of virechana karma

अविरेच्यास्तु सुभगक्षतगुदमुक्तनालाधोभागरक्तपित्तिविलङ्घितदुर्बलेन्द्रियाल्पाग्निनिरूढकामादिव्यग्राजीर्णिनवज्वरि-मदात्ययिताध्मातशल्यार्दिताभिहतातिस्निग्धरूक्षदारुणकोष्ठाः क्षतादयश्च गर्भिण्यन्ताः||११||

avirēcyāstusubhagakṣatagudamuktanālādhōbhāgaraktapittivilaṅghitadurbalēndriyālpāgninirūḍhakāmādivyagrājīrṇinavajvari-madātyayitādhmātaśalyārditābhihatātisnigdharūkṣadāruṇakōṣṭhāḥ kṣatādayaśca garbhiṇyantāḥ||11||

avirecyAstusubhagakShatagudamuktanAlAdhobhAgaraktapittivila~gghitadurbalendriyAlpAgninirUDhakAmAdivyagrAjIrNinavajvari-madAtyayitAdhmAtashalyArditAbhihatAtisnigdharUkShadAruNakoShThAH kShatAdayashca garbhiNyantAH||11||

The cases which are considered unfit for Virechana Karma are mentioned in the following table:

Serial No. Disease or State (in which virechana is contraindicated) Translation in English
1 Subhaga A person with tender health or soft perineum
2 Kshataguda (A person with) lacerated/bruised anorectum
3 Muktanaala (A person with) prolapsed rectum
4 Adobhaaga-raktapitti Bleeding through downward tracts
5 Vilanghita (A person who is)weakened due to excessive fasting
6 Durbalendriya (A person with) weak sensory and motor organs
7 Alpaagni (A person with) poor digestive fire
8 Niruddha (A person who has taken) niruha type of enema
9 Kaamadivyagra (A person whose) mind is agitated by passion/sexual emotions.
10 Ajeerna Indigestion
11 Navajwara Acute fever
12 Madaatyayita Suffering from alchoholism
13 Aadhmaata Abdominal distention or tympanitis
14 Shalyaardita Inflicted with foreign bodies
15 Abhihata Injured
16 Atisnigdha Over-unctuous
17 Atiruksha Excessively dry/rough
18 Daarunakoshtha (A person with) hard bowel
19 Kshataadayah Garbhinyantaah Those in the category of conditions ranging from injured to pregnant, under contraindication of vamana

[11]

Adverse effects of virechana karma administered in contra-indicated conditions

तत्र सुभगस्य सुकुमारोक्तो दोषः स्यात्, क्षतगुदस्य क्षते गुदे प्राणोपरोधकरीं रुजां जनयेत्, मुक्तनालमतिप्रवृत्त्या हन्यात्,अधोभागरक्तपित्तिनं तद्वत्, विलङ्घितदुर्बलेन्द्रियाल्पाग्निनिरूढा औषधवेगं न सहेरन्, कामादिव्यग्रमनसो न प्रवर्तते कृच्छ्रेणवा प्रवर्तमानमयोगदोषान् कुर्यात्, अजीर्णिन आमदोषः स्यात्, नवज्वरिणोऽविपक्वान् दोषान् न निर्हरेद् वातमेव च कोपयेत्,मदात्ययितस्य मद्यक्षीणे देहे वायुः प्राणोपरोधं कुर्यात्, आध्मातस्याधमतो वा पुरीषकोष्ठे निचितो वायुर्विसर्पन्सहसाऽऽनाहं तीव्रतरं मरणं वा जनयेत्, शल्यार्दिताभिहतयोः क्षते वायुराश्रितो जीवितं हिंस्यात्, अतिस्निग्धस्यातियोगभयंभवेत्, रूक्षस्य वायुरङ्गप्रग्रहं कुर्यात्, दारुणकोष्ठस्य विरेचनोद्धता दोषाहृच्छूलपर्वभेदानाहाङ्गमर्दच्छर्दिमूर्च्छाक्लमाञ्जनयित्वा प्राणान् हन्युः, क्षतादीनां गर्भिण्यन्तानां छर्दनोक्तो दोषः स्यात्;तस्मादेते न विरेच्याः||१२||

tatra subhagasya sukumārōktō dōṣaḥ syāt, kṣatagudasya kṣatē gudē prāṇōparōdhakarīṁ rujāṁ janayēt,muktanālamatipravr̥ttyā hanyāt, adhōbhāgaraktapittinaṁ tadvat, vilaṅghitadurbalēndriyālpāgninirūḍhāauṣadhavēgaṁ na sahēran, kāmādivyagramanasō na pravartatē kr̥cchrēṇa vā pravartamānamayōgadōṣānkuryāt, ajīrṇina āmadōṣaḥ syāt, navajvariṇō'vipakvān dōṣān na nirharēd vātamēva ca kōpayēt, madātyayitasyamadyakṣīṇē dēhē vāyuḥ prāṇōparōdhaṁ kuryāt, ādhmātasyādhamatō vā purīṣakōṣṭhē nicitō vāyurvisarpansahasānāhaṁ tīvrataraṁ maraṇaṁ vā janayēt, śalyārditābhihatayōḥ kṣatē vāyurāśritō jīvitaṁ hiṁsyāt,atisnigdhasyātiyōgabhayaṁ bhavēt, rūkṣasya vāyuraṅgapragrahaṁ kuryāt, dāruṇakōṣṭhasya virēcanōddhatādōṣā hr̥cchūlaparvabhēdānāhāṅgamardacchardimūrcchāklamāñjanayitvā prāṇān hanyuḥ, kṣatādīnāṁgarbhiṇyantānāṁ chardanōktō dōṣaḥ syāt; tasmādētē na virēcyāḥ||12||

tatra subhagasya sukumArokto doShaH syAt, kShatagudasya kShate gude prANoparodhakarIM rujAM janayet,muktanAlamatipravRuttyA hanyAt, adhobhAgaraktapittinaM tadvat, vila~gghitadurbalendriyAlpAgninirUDhAauShadhavegaM na saheran, kAmAdivyagramanaso na pravartate kRucchreNa vA pravartamAnamayogadoShAnkuryAt, ajIrNina AmadoShaH syAt, navajvariNo~avipakvAn doShAn na nirhared vAtameva ca kopayet, madAtyayitasyamadyakShINe dehe vĀyuH prANoparodhaM kuryAt, AdhmAtasyAdhamato vA purIShakoShThe nicito vĀyurvisarpansahasA~a~anAhaM tIvrataraM maraNaM vA janayet, shalyArditAbhihatayoH kShate vĀyurAshrito jIvitaM hiMsyAt,atisnigdhasyAtiyogabhayaM bhavet, rUkShasya vĀyura~ggapragrahaM kuryAt, dAruNakoShThasya virecanoddhatAdoShA hRucchUlaparvabhedAnAhA~ggamardacchardimUrcchAklamA~jjanayitvA prANAn hanyuH, kShatAdInAMgarbhiNyantAnAM chardanokto doShaH syAt; tasmAdete na virecyAH||12||

If virechana is given to a person who is subhaga (having tender health or soft perineum), then he or she will suffer from the same disorder as described for vamana administered to sukumara (having tender health).

Virechana given to the person suffering from anal injury will cause severe pain in the injured anus which may be even life threatening.

Virechana administered to the person suffering from prolapsed rectum may cause excessive diarrhea and prolapse which leads to the death of the patient. Similar adverse effects are observed if virechana is administered in the person suffering from adhobhaga-raktapitta (disease characterized by bleeding through the downward tract).

A person, who is specifically lightened due to fasting, has weak senses, low power of digestion or who has undergone niruha type of enema, cannot tolerate the effects of virechana medicines.

If virechana is given to the person whose mind is agitated by passion etc., then there will be either no purgation or purgation with difficulty. In such conditions, harmful effects are observed due to improper administration of virechana.

Virechana administered in the persons suffering from ajirna (indigestion) causes diseases due to ama (product of improper digestion and metabolism).

Virechana given to the patients suffering from acute fever does not eliminate the dosha which are unripened and causes aggravation of vata dosha.

Virechana administered to a person suffering from alcoholism and whose body is emaciated due to over use of wine leads to aggravation of vata dosha and causes danger to his life.

Virechana given in that suffering from tympanitis, vata accumulated in the chamber of feces may spread further which cause sudden more severe abdominal distension or death.

Virechana given in a person suffering from foreign body inside the body or injured by weapons, vata located in the wound may take away the life.

Virechana administered in the person who is excessively uncted or oleated, exerts the excessive effects and in a "dry" (un-oily) person, vata may produce stiffness in the body parts. Virechana given to the person having costive bowel, dosha excited by purgation may produce cardiac pain, tearing pain in joints, anaha (hardness of bowels, constipation), body-ache, vomiting, fainting and exhaustion. This may lead to the death of the patient.

Virechana given in those suffering from disease beginning with kshata (chest wound) and ending with pregnancy, the defects said under vamana may arise. Therefore, above mentioned persons should not be treated with virechana karma. [12]

Indications of virechana karma

शेषास्तु विरेच्याः; विशेषतस्तुकुष्ठज्वरमेहोर्ध्वरक्तपित्तभगन्दरोदरार्शोब्रध्नप्लीहगुल्मार्बुदगलगण्डग्रन्थिविसूचिकालसकमूत्राघातक्रिमिकोष्ठविसर्प-पाण्डुरोगशिरःपार्श्वशूलोदावर्तनेत्रास्यदाहहृद्रोगव्यङ्गनीलिकानेत्रनासिकास्यस्रवणहलीमकश्वासकासकामला-पच्यपस्मारोन्मादवातरक्तयोनिरेतोदोषतैमिर्यारोचकाविपाकच्छर्दिश्वयथूदरविस्फोटकादयः पित्तव्याधयो विशेषेणमहारोगाध्यायोक्ताश्च; एतेषु हि विरेचनं प्रधानतममित्युक्तमग्न्युपशमेऽग्निगृहवत्||१३||

śēṣāstu virēcyāḥ; viśēṣatastukuṣṭhajvaramēhōrdhvaraktapittabhagandarōdarārśōbradhnaplīhagulmārbudagalagaṇḍagranthivisūcikālasakamūtrāghātakrimikōṣṭhavisarpa-pāṇḍurōgaśiraḥpārśvaśūlōdāvartanētrāsyadāhahr̥drōgavyaṅganīlikānētranāsikāsyasravaṇahalīmakaśvāsakāsakāmalā-pacyapasmārōnmādavātaraktayōnirētōdōṣataimiryārōcakāvipākacchardiśvayathūdaravisphōṭakādayaḥ pittavyādhayō viśēṣēṇamahārōgādhyāyōktāśca; ētēṣu hi virēcanaṁ pradhānatamamityuktamagnyupaśamē'gnigr̥havat||13||

sheShAstu virecyAH; visheShatastukuShThajvaramehordhvaraktapittabhagandarodarArshobradhnaplIhagulmArbudagalagaNDagranthivisUcikAlasakamUtrAghAtakrimikoShThavisarpa-pANDurogashiraHpArshvashUlodAvartanetrAsyadAhahRudrogavya~gganIlikAnetranAsikAsyasravaNahalImakashvAsakAsakAmalA-pacyapasmAronmAdavAtaraktayoniretodoShataimiryArocakAvipAkacchardishvayathUdaravisphoTakAdayaH pittavyAdhayo visheSheNamahArogAdhyAyoktAshca; eteShu hi VirecanaM pradhAnatamamityuktamagnyupashame~agnigRuhavat||13||

The persons other than above-mentioned are fit for virechana karma. It is specially advised for the persons mentioned in the table below:

Serial No. Disease or State (in which virechana is indicated) Translation in English
1 Kushtha Obstinate skin diseases, including leprosy
2 Jwara Fever
3 Meha Obstinate urinary disorders, including diabetes mellitus
4 Urdhva-Raktapitta Bleeding from upward tracts
5 Bhagandara Fistula in ano
6 Udara roga Obstinate abdominal diseases, including ascites
7 Arsha roga Piles
8 Bradhna roga Inguinal swelling
9 Pleeha roga Splenomegaly
10 Gulma roga Abdominal lump
11 Arbuda roga Tumor
12 Galagandha Goitre
13 Granthi roga Lymphadenitis/cystic swellings
14 Visuchika roga Cholera
15 Alasaka roga Intestinal torpor
16 Mutraghata Oliguria/Anuria
17 Krimikoshtha Helminthiasis
18 Visarpa roga Erysipelas
19 Pandu roga Anemia
20 Sirah shula Headache
21 Parshva shula Pain in lateral sides of chest
22 Udavarta roga Upward and oblique movement of wind in abdomen
23 Netra daaha Burning sensation in the eyes
24 Aasya daaha Burning sensation in the mouth
25 Hridroga Heart disease
26 Vyanga roga Dark brownish patches over the face
27 neelika roga Bluish black moles
28 Netra sravana Excessive discharge from the eyes
29 Naasika sravana Excessive discharge from the nose
30 Aasya sravana Excessive salivation
31 Haleemaka A type of jaundice
32 Shvasa roga Dyspnea
33 Kaasa roga Cough
34 Kaamala Jaundice
35 Apachi roga Cervical adenitis
36 Apasmara roga Epilepsy
37 Unmada roga Psychotic disorders
38 Vatarakta Gout
39 Yoni dosha Defects of female genital tract
40 Retodosha Defects of semen
41 Timira Cataract
42 Arochaka Anorexia
43 Avipaka Indigestion
44 Chhardi Vomiting
45 Shvayathu Edema
46 Visphotaka Pustular eruptions
47 Pitta vyadhyayo visheshena Maharogadhyayoktah Paittika type disorders mentioned in Maharoga Adhyaya of Charaka Samhita Sutra Sthana

For the above-mentioned diseases, virechana karma is the foremost therapy. As the extinguisher of fire normalizes a house on fire, similarly virechana karma cures the diseases by eliminating aggravated pitta. [13]

Contra-indications of asthapana basti

अनास्थाप्यास्तुअजीर्ण्यतिस्निग्धपीतस्नेहोत्क्लिष्टदोषाल्पाग्नियानक्लान्तातिदुर्बलक्षुत्तृष्णाश्रमार्तातिकृशभुक्तभक्तपीतोदकवमितविरिक्तकृतनस्तः-

कर्मकुद्धभीतमत्तमूर्च्छितप्रसक्तच्छर्दिनिष्ठीविकाश्वासकासहिक्काबद्धच्छिद्रोदकोदराध्मानालसकविसूचिकामप्रजातामातिसार-मधुमेहकुष्ठार्ताः||१४||

anāsthāpyāstuajīrṇyatisnigdhapītasnēhōtkliṣṭadōṣālpāgniyānaklāntātidurbalakṣuttr̥ṣṇāśramārtātikr̥śabhuktabhaktapītōdakavamitaviriktakr̥tanastaḥ-

karmakuddhabhītamattamūrcchitaprasaktacchardiniṣṭhīvikāśvāsakāsahikkābaddhacchidrōdakōdarādhmānālasakavisūcikāmaprajātāmātisāra-madhumēhakuṣṭhārtāḥ||14||

anAsthApyAstuajIrNyatisnigdhapItasnehotkliShTadoShAlpAgniyAnaklAntAtidurbalakShuttRuShNAshramArtAtikRushabhuktabhaktapItodakavamitaviriktakRutanastaH-

karmakuddhabhItamattamUrcchitaprasaktacchardiniShThIvikAshvAsakAsahikkAbaddhacchidrodakodarAdhmAnAlasakavisUcikAmaprajAtAmAtisAra-madhumehakuShThArtAH||14||

Administration of asthapana or niruha basti is contra-indicated in the persons mentioned in the table given below:

Serial No. Disease or State (in which asthapana basti is contraindicated) Translation in English
1 Ajeerna Indigestion
2 Atisnigdha Over-unctuous
3 Peetasneha (A person who has just ingested) smoothening/uncting substances
4 Utklishtha dosha (A person who has) excited dosha
5 Alpaagni Suppression of the power of digestion
6 Yaanaklaanta (A person who is) exhausted due to riding
7 Atidurbala (A person who is) excessively weak
8 Kshudhaarta (A person who is) excessively hungry
9 Trishnaarta (A person who is) excessively thirsty
10 Shramaarta (A person who is) excessively tired (of doing laborious work)
11 Atikrisha (A person who is) excessively emaciated
12 Bhuktabhakta (A person who has) just ingested food
13 Peetodaka (A person who has) just drunk water
14 Vamita (A person who has) just undergone emesis
15 Virikta (A person who has) just undergone purgation
16 Krita nastah karma (A person who has) just used snuff (powder)
17 Kruddha Anger
18 Bheeta (A person who is) under the grip of fear
19 Matta (A person who is) under the influence of narcosis
20 Murchhita (A person who has) fainted
21 Prasaktachhardi (A person who is) continuously vomiting
22 Nishtheevika (A person who is) excessively spitting
23 Shvasa roga Dyspnea
24 Kaasa roga Cough
25 Hikka roga Hiccup
26 Baddhodaraadhmaana Tympanitis due to intestinal obstruction
27 Chidrodaraadhmaana Tympanitis due to intestinal perforation
28 Udakodaraadhmaana Tympanitis due to ascites
29 Alasaka roga Intestinal torpor
30 Visuchika roga Cholera
31 Amaprajaata A woman who has delivered a premature baby
32 Amatisaara Diarrhea associated with the symptoms of ama, i.e., the product of indigestion
33 Madhumeha Diabetes mellitus
34 Kushtha roga Obstinate skin diseases including leprosy

[14]

Adverse effects of asthapana basti administered in contra-indicated persons

तत्राजीर्ण्यतिस्निग्धपीतस्नेहानां दूष्योदरं मूर्च्छाश्वयथुर्वा स्यात्, उत्क्लिष्टदोषमन्दाग्न्योररोचकस्तीव्रः, यानक्लान्तस्य क्षोभव्यापन्नोबस्तिराशु देहं शोषयेत्, अतिदुर्बलक्षुत्तृष्णाश्रमार्तानां पूर्वोक्तोदोषः स्यात्, अतिकृशस्य कार्श्यं पुनर्जनयेत्,भुक्तभक्तपीतोदकयोरुत्क्लिश्योर्ध्वमधो वा वायुर्बस्तिमुत्क्षिप्य क्षिप्रं घोरान् विकाराञ्जनयेत्, वमितविरिक्तयोस्तु रूक्षं शरीरं निरूहःक्षतं क्षार इव दहेत्, कृतनस्तःकर्मणो विभ्रंशं भृशसंरुद्धस्रोतसः कुर्यात्, क्रुद्धभीतयोर्बस्तिरूर्ध्वमुपप्लवेत्, मत्तमूर्च्छितयो र्भृशंविचलितायां सञ्ज्ञायां चित्तोपघाताद् व्यापत् स्यात्, प्रसक्तच्छर्दिर्निष्ठीविकाश्वासकासहिक्कार्तानामूर्ध्वीभूतो वायुरूर्ध्वं बस्तिं नयेत्,बद्धच्छिद्रोदकोदराध्मानार्तानां भृशतरमाध्माप्य बस्तिः प्राणान् हिंस्यात्, अलसकविसूचिकामप्रजातामातिसारिणामामकृतो दोषःस्यात्, मधुमेहकुष्ठिनोर्व्याधेः पुनर्वृद्धिः; तस्मादेते नास्थाप्याः||१५||

tatrājīrṇyatisnigdhapītasnēhānāṁ dūṣyōdaraṁ mūrcchāśvayathurvā syāt, utkliṣṭadōṣamandāgnyōrarōcakastīvraḥ, yānaklāntasyakṣōbhavyāpannō bastirāśu dēhaṁ śōṣayēt, atidurbalakṣuttr̥ṣṇāśramārtānāṁ pūrvōktōdōṣaḥ syāt, atikr̥śasya kārśyaṁ punarjanayēt,bhuktabhaktapītōdakayōrutkliśyōrdhvamadhō vā vāyurbastimutkṣipya kṣipraṁ ghōrān vikārāñjanayēt, vamitaviriktayōstu rūkṣaṁ śarīraṁnirūhaḥ kṣataṁ kṣāra iva dahēt, kr̥tanastaḥkarmaṇō vibhraṁśaṁ bhr̥śasaṁruddhasrōtasaḥ kuryāt,kruddhabhītayōrbastirūrdhvamupaplavēt, mattamūrcchitayō rbhr̥śaṁ vicalitāyāṁ sañjñāyāṁ cittōpaghātād vyāpat syāt,prasaktacchardirniṣṭhīvikāśvāsakāsahikkārtānāmūrdhvībhūtō vāyurūrdhvaṁ bastiṁ nayēt, baddhacchidrōdakōdarādhmānārtānāṁ bhr̥śataramādhmāpya bastiḥ prāṇān hiṁsyāt, alasakavisūcikāmaprajātāmātisāriṇāmāmakr̥tō dōṣaḥ syāt, madhumēhakuṣṭhinōrvyādhēḥpunarvr̥ddhiḥ; tasmādētē nāsthāpyāḥ||15||

tatrAjIrNyatisnigdhapItasnehAnAM dUShyodaraM mUrcchAshvayathurvA syAt, utkliShTadoShamandAgnyorarocakastIvraH, yAnaklAntasyakShobhavyApanno bastirAshu dehaM shoShayet, atidurbalakShuttRuShNAshramArtAnAM pUrvoktodoShaH syAt, atikRushasya kArshyaMpunarjanayet, bhuktabhaktapItodakayorutklishyordhvamadho vA vĀyurbastimutkShipya kShipraM ghorAn vikArA~jjanayet, vamitaviriktayosturUkShaM sharIraM nirUhaH kShataM kShAra iva dahet, kRutanastaHkarmaNo vibhraMshaM bhRushasaMruddhasrotasaH kuryAt,kruddhabhItayorbastirUrdhvamupaplavet, mattamUrcchitayo rbhRushaM vicalitAyAM sa~jj~jAyAM cittopaghAtAd vyApat syAt,prasaktacchardirniShThIvikAshvAsakAsahikkArtAnAmUrdhvIbhUto vĀyurUrdhvaM bastiM nayet, baddhacchidrodakodarAdhmAnArtAnAMbhRushataramAdhyApya bastiH prANAn hiMsyAt, alasakavisUcikAmaprajAtAmAtisAriNAmAmakRuto doShaH syAt, madhumehakuShThinorvyAdheHpunarvRuddhiH; tasmAdete nAsthApyAH||15||

Application of Asthapana-basti (non-unctuous enema) in the persons suffering from indigestion, over-uncted and just taken unctuous substances causes dushyodara (udara-roga caused by aggravation of all the three dosha), fainting or edema. In the cases having excited dosha and suppression of digestion power, it causes severe type of anorexia. In a person exhausted due to riding, the asthapana-basti disturbed by agitation dry up the body quickly leading to emaciation. In the persons who are excessively weak and suffering from excessive hunger, thirst and tiredness, basti causes the same harms as discussed for exhausted due to riding. In excessively emaciated person if asthapana-basti is applied, it increases the emaciation. In those who have just taken food and water, asthapana basti causes provocation of vata which divert the enema upwards or downwards leading to manifestation of severe diseases soon. In that undergone emesis or purgation, the niruha or asthapana-basti burns the body as alkali does the wound. In a person who has undergone the snuffing, it causes the untoward effects related to sense organs and further obstruction of the channels of circulation. In the person having anger and fear, the basti may go upwards and produce agitation. In the condition of narcosis and fainting, the basti causes further agitation and there may be complications due to mental injury. If asthapana basti is applied in the conditions of constant vomiting, excessive spitting, dyspnea, cough and hiccup, vata moving upwards can cause upward movement of basti. In the persons suffering from intestinal obstruction, intestinal perforation and ascites associated with tympanitis, asthapana basti further increase the distension and may lead to the death of the patient. In the persons suffering from alasaka, visuchika, premature delivery and amatisara, it causes the disorders due to ama (product of improper digestion). In diabetes mellitus and kushtha (obstinate skin diseases including leprosy), application of asthapana basti further increases these diseases. Therefore, asthapana basti should not be given to the above mentioned persons.[15]

Indications of asthapana basti

शेषास्त्वास्थाप्याः; विशेषतस्तुसर्वाङ्गैकाङ्गकुक्षिरोगवातवर्चोमूत्रशुक्रसङ्गबलवर्णमांसरेतःक्षयदोषाध्मानाङ्गसुप्तिक्रिमिकोष्ठोदावर्तशुद्धातिसार-पर्वभेदाभितापप्लीहगुल्मशूलहृद्रोगभगन्दरोन्मादज्वरब्रध्नशिरःकर्णशूलहृदयपार्श्वपृष्ठकटीग्रहवेपनाक्षेपकगौरवातिलाघव-रजःक्षयार्तविषमाग्निस्फिग्जानुजङ्घोरुगुल्फपार्ष्णिप्रपदयोनिबाह्वङ्गुलिस्तनान्तदन्तनखपर्वास्थिशूल-शोषस्तम्भान्त्रकूजपरिकर्तिकाल्पाल्पसशब्दोग्रगन्धोत्थानादयो वातव्याधयो विशेषेण महारोगाध्यायोक्ताश्च;एतेष्वास्थापनं प्रधानतममित्युक्तं वनस्पतिमूलच्छेदवत्||१६||

śēṣāstvāsthāpyāḥ; viśēṣatastusarvāṅgaikāṅgakukṣirōgavātavarcōmūtraśukrasaṅgabalavarṇamāṁsarētaḥkṣayadōṣādhmānāṅgasuptikrimikōṣṭhōdāvartaśuddhātisāra-parvabhēdābhitāpaplīhagulmaśūlahr̥drōgabhagandarōnmādajvarabradhnaśiraḥkarṇaśūlahr̥dayapārśvapr̥ṣṭhakaṭīgrahavēpanākṣēpakagauravātilāghava-rajaḥkṣayārtaviṣamāgnisphigjānujaṅghōrugulphapārṣṇiprapadayōnibāhvaṅgulistanāntadantanakhaparvāsthiśūla-śōṣastambhāntrakūjaparikartikālpālpasaśabdōgragandhōtthānādayō vātavyādhayō viśēṣēṇa mahārōgādhyāyōktāśca; ētēṣvāsthāpanaṁpradhānatamamityuktaṁ vanaspatimūlacchēdavat||16||

sheShAstvAsthApyAH; visheShatastusarvA~ggaikA~ggakukShirogavatavarcomUtrashukrasa~ggabalavarNamAMsaretaHkShayadoShAdhmAnA~ggasuptikrimikoShThodAvartashuddhAtisAra-parvabhedAbhitApaplIhagulmashUlahRudrogabhagandaronmAdajvarabradhnashiraHkarNashUlahRudayapArshvapRuShThakaTIgrahavepanAkShepakagauravAtilAghava-rajaHkShayArtaviShamAgnisphigjAnuja~gghorugulphapArShNiprapadayonibAhva~ggulistanAntadantanakhaparvAsthishUla-shoShastambhAntrakUjaparikartikAlpAlpasashabdogragandhotthAnAdayo vAtavyAdhayo visheSheNa mahArogAdhyAyoktAshca; eteShvĀsthāpanaMpradhAnatamamityuktaM vanaspatimUlacchedavat||16||

The persons other than above-mentioned are fit for asthapana basti. It is especially useful for the persons mentioned in the table below:

Serial No. Disease or State (in which asthapana basti is indicated) Translation in English
1 Sarvaanga roga Paralysis of the whole body
2 Ekaanga roga Paralysis of one of the limb
3 Kukshi roga Disorder of abdomen
4 Vata sanga Retention of flatus
5 Varcho sanga Retention of feces
6 Mootra sanga Retention of urine
7 Shukra sanga Retention of semen
8 Bala kshaya Diminution of strength
9 Varna kshaya Diminution of complexion
10 Mamsa kshaya Diminution of muscle tissue
11 Retah kshaya Diminution of semen
12 Doshaadhmaana Tympanitis
13 Anga supti Numbness of body parts
14 Krimikoshtha Parasitic infestation of intestine
15 Udaavarta Disorder due to reverse movement of the vata
16 Shuddhaatisaara Diarrhea without association of ama
17 Parvabheda Tearing pain in joints
18 Abhitaapa Feeling of burning sensation
19 Pleeha roga Splenic disorder
20 Gulma roga Abdominal lump
21 Shula roga Colic pain
22 Hridroga Heart disease
23 Bhagandara Fistula in ano
24 Unmada roga Psychotic disorders
25 Jwara Fever
26 Bradhna roga Inguinal swelling
27 Shirahshula Headache
28 Karnashula Earache
29 Hridaya graha Stiffness in heart
30 Paarshva graha Stiffness in sides
31 Prishtha graha Stiffness in back
32 Kati graha Stiffness in waist
33 Vepana aarta Suffering from tremor
34 Aakshepaka aarta Suffering from convulsions
35 Gauravaarta Suffering from heaviness
36 Atilaaghavaarta Suffering from excessive lightness
37 Rajah-kshayaarta Suffering from amenorrhea
38 Vishamaagni Irregular power of digestion
39 Sphik-shula-shosha-stambha Pain, atrophy and stiffness of hip
40 Jaanu-shula-shosha-stambha Pain, atrophy and stiffness of knee-joints
41 Janghaa-shula-shosha-stambha Pain, atrophy and stiffness of the calf region
42 Uru-shula-shosha-stambha Pain, atrophy and stiffness of the thighs
43 Gulpha-shula-shosha-stambha Pain, atrophy and stiffness of the ankles
44 Paarshni-shula-shosha-stambha Pain, atrophy and stiffness of the heels
45 Prapada-shula-shosha-stambha Pain, atrophy and stiffness of the feet
46 Yoni-shula-shosha-stambha Pain, atrophy and stiffness of female genitals
47 Baahu-shula-shosha-stambha Pain, atrophy and stiffness of arms
48 Anguli-shula-shosha-stambha Pain, atrophy and stiffness of fingers
49 Stanaanta-shula-shosha-stambha Pain, atrophy and stiffness of the periphery of the breasts
50 Danta-shula-shosha-stambha Pain, atrophy and stiffness of teeth
51 Nakha-shula-shosha-stambha Pain, atrophy and stiffness of nails
52 Parva-shula-shosha-stambha Pain, atrophy and stiffness of joints
53 Asthi-shula-shosha-stambha Pain, atrophy and stiffness of bones
54 Aantra koojana Intestinal gurgling
55 Parikartika Cutting pain in anal region
56 Alpaalpa-utthaana Voiding stool in small quantity frequently
57 Sashabda-utthaana Voiding stool with sound
58 Ugragandha-utthaana aadayo vyaadhyayah (Diseases that cause) voiding stool with foul smell
59 Vata-vyaadhayo visheshena maharogadhyayoktah Vatika disorders specially discussed in Maharoga Adhyaya of Charaka Samhita Sutra Sthana

In the above mentioned diseases, asthapana basti is the foremost therapy. As a tree gets destroyed by cutting its roots, similarly the above mentioned diseases are eradicated by administration of asthapana basti. [16]

Contra-indications of anuvasana basti

य एवानास्थाप्यास्त एवाननुवास्याः स्युः;विशेषतस्त्वभुक्तभक्तनवज्वरपाण्डुरोगकामलाप्रमेहार्शःप्रतिश्यायारोचकमन्दाग्निदुर्बलप्लीहकफोदरोरुस्तम्भवर्चोभेद-विषगरपीतपित्तकफाभिष्यन्दगुरुकोष्ठश्लीपदगलगण्डापचिक्रिमिकोष्ठिनः ||१७||

ya ēvānāsthāpyāsta ēvānanuvāsyāḥ syuḥ;viśēṣatastvabhuktabhaktanavajvarapāṇḍurōgakāmalāpramēhārśaḥpratiśyāyārōcakamandāgnidurbalaplīhakaphōdarōrustambhavarcōbhēda-viṣagarapītapittakaphābhiṣyandagurukōṣṭhaślīpadagalagaṇḍāpacikrimikōṣṭhinaḥ ||17||

ya evAnAsthApyAsta evAnanuvAsyAH syuH;visheShatastvabhuktabhaktanavajvarapANDurogakAmalApramehArshaHpratishyAyArocakamandAgnidurbalaplIhakaphodarorustambhavarcobheda-viShagarapItapittakaphAbhiShyandagurukoShThashlIpadagalagaNDApacikrimikoShThinaH ||17|

Those persons who are unfit for asthapana basti, are considered unfit for anuvasana basti. Conditions in which anuvasana basti is specifically contra-indicated, are listed in the table given below:

Serial No. Disease or State (in which anuvasana basti is contraindicated) Translation in English
1 Abhuktabhakta A person who has not taken food
2 Navajwara Acute fever
3 Pandu roga Anemia
4 Kaamala Jaundice
5 Prameha Obstinate urinary disorders including diabetes
6 Arsha roga Piles
7 Pratishyaya Coryza
8 Arochaka Anorexia
9 Mandaagni Supression of the power of digestion
10 Durbala Weak
11 Pleehodara Splenic disorders
12 Kaphodara Obstinate abdominal disease caused by aggravation of kapha
13 Urustambha Stiffness of thigh and calf region
14 Varchobheda Diarrhea
15 Vishapeeta One who has ingested natural poison
16 Garapeeta One who has ingested artificial/synthetic poison
17 Pittaabhishyanda Conjuctivitis caused by aggravated pitta
18 Kaphaabhishyanda Conjuctivitis caused by aggravated kapha
19 Gurukoshtha Costive bowel
20 Shleepada roga Filaria
21 Galagandha Goitre
22 Apachi roga Cervical adenitis
23 Krimikoshthi (Those suffering from) intestinal parasites

[17]

Adverse effects of anuvasana basti in contra-indicated conditions

तत्राभुक्तभक्तस्यानावृतमार्गत्वादूर्ध्वमतिवर्तते स्नेहः, नवज्वरपाण्डुरोगकामलाप्रमेहिणां दोषानुत्क्लिश्योदरञ्जनयेत्,अर्शसस्यार्शांस्यभिष्यन्द्याध्मानं कुर्यात्, अरोचकार्तस्यान्नगृद्धिं पुनर्हन्यात्, मन्दाग्निदुर्बलयोर्मन्दतरमग्निं कुर्यात्,प्रतिश्यायप्लीहादिमतां भृशमुत्क्लिष्टदोषाणां भूय एव दोषं वर्धयेत्; तस्मादेते नानुवास्याः||१८||

tatrābhuktabhaktasyānāvr̥tamārgatvādūrdhvamativartatē snēhaḥ, navajvarapāṇḍurōgakāmalāpramēhiṇāṁ dōṣānutkliśyōdarañjanayēt,arśasasyārśāṁsyabhiṣyandyādhmānaṁ kuryāt, arōcakārtasyānnagr̥ddhiṁ punarhanyāt, mandāgnidurbalayōrmandataramagniṁ kuryāt,pratiśyāyaplīhādimatāṁ bhr̥śamutkliṣṭadōṣāṇāṁ bhūya ēva dōṣaṁ vardhayēt; tasmādētē nānuvāsyāḥ||18||

tatrAbhuktabhaktasyAnAvRutamArgatvAdUrdhvamativartate snehaH, navajvarapANDurogakAmalApramehiNAM doShAnutklishyodara~jjanayet,arshasasyArshAMsyabhiShyandyAdhmAnaM kuryAt, arocakArtasyAnnagRuddhiM punarhanyAt, mandAgnidurbalayormandataramagniM kuryAt,pratishyAyaplIhAdimatAM bhRushamutkliShTadoShANAM bhUya eva doShaM vardhayet; tasmAdete nAnuvAsyAH||18||

If anuvasana basti is administered to the person who is empty stomach, it goes upwards due to the absence of any obstruction in the passage. In the acute fever, anaemia, jaundice and prameha, anuvasana basti causes excitement of dosha which further leads to Udara roga (obstinate abdominal disease including ascites). In the person suffering from piles, use of anuvasana basti may create obstruction in the piles leading to adhmana (abdominal distension). In the person suffering from anorexia, application of anuvasana basti further diminishes the desire for food. In case of suppression of power of digestion and weakness, the application of anuvasana basti makes the digestive power poorer. If anuvasana basti is administered to the persons suffering from coryza, splenic disorders and such other diseases, it causes the further excitement of dosha which are already aggravated. Therefore, the above mentioned persons are unfit for the administration of anuvasana basti. [18]

Indications of anuvasana basti

य एवास्थाप्यास्त एवानुवास्याः; विशेषतस्तु रूक्षतीक्ष्णाग्नयः केवलवातरोगार्ताश्च; एतेषु ह्यनुवासनं प्रधानतममित्युक्तं मूलेद्रुमप्रसेकवत्||१९||

ya ēvāsthāpyāsta ēvānuvāsyāḥ; viśēṣatastu rūkṣatīkṣṇāgnayaḥ kēvalavātarōgārtāśca; ētēṣu hyanuvāsanaṁ pradhānatamamityuktaṁ mūlēdrumaprasēkavat||19||

ya evAsthApyAsta evAnuvAsyAH; visheShatastu rUkShatIkShNAgnayaH kevalavAtarogArtAshca; eteShu hyAnuvāsanaM pradhAnatamamityuktaMmUle drumaprasekavat||19||

The persons who are fit for asthapana basti are considered fit for anuvasana basti also. The conditions where specifically it is indicated, are listed in the table given below:

Serial No. Disease or State (in which anuvasana basti is indicated) Translation in English
1 Rukshah A person having dryness in the body
2 Teekshnagnayah A person having intense power of digestion
3 Kevalavata rogaartah A person suffering from diseases caused due to vata alone, and not associated with ama.

In such patients, anuvasana basti is said to be the most effective and could be likened to watering a plant in its root.[19]

Contra-indications of shirovirechana

अशिरोविरेचनार्हास्तु अजीर्णिभुक्तभक्तपीतस्नेहमद्यतोयपातुकामाः स्नातशिराः स्नातुकामःक्षुत्तृष्णाश्रमार्तमत्तमूर्च्छितशस्त्रदण्डहतव्यवायव्यायामपानक्लान्तनवज्वरशोकाभितप्तविरिक्तानुवासितगर्भिणीनवप्रतिश्यायार्ताः,अनृतौ दुर्दिने चेति||२०||

aśirōvirēcanārhāstu ajīrṇibhuktabhaktapītasnēhamadyatōyapātukāmāḥ snātaśirāḥ snātukāmaḥkṣuttr̥ṣṇāśramārtamattamūrcchitaśastradaṇḍahatavyavāyavyāyāmapāna-

klāntanavajvaraśōkābhitaptaviriktānuvāsitagarbhiṇīnavapratiśyāyārtāḥ,anr̥tau durdinē cēti||20||

aShirovirechnarhAstu ajIrNibhuktabhaktapItasnehamadyatoyapAtukAmAH snAtashirAH snAtukAmaHkShuttRuShNAshramArtamattamUrcchitashastradaNDahatavyavAyavyAyAmapAna-

klAntanavajvarashokAbhitaptaviriktAnuvAsitagarbhiNInavapratishyAyArtAH,anRutau durdine ceti||20||

The persons unfit for shirovirechana (head- evacuation therapy) are listed in the table given below:

Serial No. Disease or State (in which shirovirechana is contraindicated) Translation in English
1 Ajeerni A person suffering from indigestion
2 Bhuktabhakta A person who has taken food
3 Peetasneha A person who has ingested fatty substances.
4 Madyapaatukaama A person who is desirous of drinking wine (and other alcoholic beverages)
5 Toyapaatukaama A person who is desirous of drinking water
6 Snaatashira A person who has taken head bath
7 Snaatukaama A person who is desirous of taking bath
8 Kshudhaarta A person who is afflicted with hunger, i.e., one who is starving
9 Trishnaarta A person who is afflicted with thirst
10 Shramaarta A person who is afflicted with exertion
11 Matta A person who is afflicted with intoxication
12 Murchhita A person who is afflicted with fainting
13 Shashtrahata A person who has been injured with a weapon
14 Dandahata A person who has been injured with a stick
15 Vyavaayaklaanta A person who is exhausted by sexual intercourse
16 Vyayaamaklaanta A person who is exhausted by physical exercise
17 Paanaklaanta A person who is exhausted by intake of alcohol
18 Navajwara Acute fever
19 Shokaabhitapta A person who is afflicted with grief
20 Virikta A person who has undergone purgation
21 Anuvasita A person who has undergone Anuvasana Basti
22 Garbhini A pregnant woman
23 Navapratishyaayaarta A person suffering from acute coryza.
24 Anritu Unsuitable season
25 Durdine Cloudy/Overcast day

[20]

Adverse effects of shirovirechana in contra-indicated conditions

तत्राजीर्णिभुक्तभक्तयोर्दोष ऊर्ध्ववहानि स्रोतांस्यावृत्य कासश्वासच्छर्दिप्रतिश्यायाञ्जनयेत्, पीतस्नेहमद्यतोयपातुकामानां कृते चपिबतां मुखनासास्रावाक्ष्युपदेहतिमिरशिरोरोगाञ्जनयेत्, स्नातशिरसः कृते च स्नानाच्छिरसः प्रतिश्यायं, क्षुधार्तस्य वातप्रकोपं,तृष्णार्तस्य पुनस्तृष्णाभिवृद्धिं मुखशोषं च, श्रमार्तमत्तमूर्च्छितानामास्थापनोक्तं दोषं जनयेत्, शस्त्रदण्डहतयोस्तीव्रतरां रुजंजनयेत्, व्यवायव्यायामपानक्लान्तानां शिरःस्कन्धनेत्रोरःपीडनं, नवज्वरशोकाभितप्तयोरूष्मा नेत्रनाडीरनुसृत्य तिमिरं ज्वरवृद्धिंच कुर्यात्, विरिक्तस्य वायुरिन्द्रियोपघातं कुर्यात्, अनुवासितस्य कफः शिरोगुरुत्वकण्डूक्रिमिदोषाञ्जनयेत्, गर्भिण्या गर्भंस्तम्भयेत् स काणः कुणिः पक्षहतः पीठसर्पी वा जायते, नवप्रतिश्यायार्तस्य स्रोतांसि व्यापादयेत्, अनृतौ दुर्दिने च शीतदोषान्पूतिनस्यं शिरोरोगं च जनयेत्; तस्मादेते न शिरोविरेचनार्हाः||२१||

tatrājīrṇibhuktabhaktayōrdōṣa ūrdhvavahāni srōtāṁsyāvr̥tya kāsaśvāsacchardipratiśyāyāñjanayēt, pītasnēhamadyatōyapātukāmānāṁ kr̥tē capibatāṁ mukhanāsāsrāvākṣyupadēhatimiraśirōrōgāñjanayēt, snātaśirasaḥ kr̥tē ca snānācchirasaḥ pratiśyāyaṁ, kṣudhārtasya vātaprakōpaṁ,tr̥ṣṇārtasya punastr̥ṣṇābhivr̥ddhiṁ mukhaśōṣaṁ ca, śramārtamattamūrcchitānāmāsthāpanōktaṁ dōṣaṁ janayēt, śastradaṇḍahatayōstīvratarāṁrujaṁ janayēt, vyavāyavyāyāmapānaklāntānāṁ śiraḥskandhanētrōraḥpīḍanaṁ, navajvaraśōkābhitaptayōrūṣmā nētranāḍīranusr̥tya timiraṁjvaravr̥ddhiṁ ca kuryāt, viriktasya vāyurindriyōpaghātaṁ kuryāt, anuvāsitasya kaphaḥ śirōgurutvakaṇḍūkrimidōṣāñjanayēt, garbhiṇyā garbhaṁstambhayēt sa kāṇaḥ kuṇiḥ pakṣahataḥ pīṭhasarpī vā jāyatē, navapratiśyāyārtasya srōtāṁsi vyāpādayēt, anr̥tau durdinē ca śītadōṣān pūtinasyaṁśirōrōgaṁ ca janayēt; tasmādētē na śirōvirēcanārhāḥ||21||

tatrAjIrNibhuktabhaktayordoSha UrdhvavahAni srotAMsyAvRutya kAsashvAsacchardipratishyAyA~jjanayet, pItasnehamadyatoyapAtukAmAnAM kRute capibatAM mukhanAsAsrAvAkShyupadehatimirashirorogA~jjanayet, snAtashirasaH kRute ca snAnAcchirasaH pratishyAyaM, kShudhArtasya vAtaprakopaM,tRuShNArtasya punastRuShNAbhivRuddhiM mukhashoShaM ca, shramArtamattamUrcchitAnAmĀsthāpanaoktaM doShaM janayet,shastradaNDahatayostIvratarAM rujaM janayet, vyavAyavyAyAmapAnaklAntAnAM shiraHskandhanetroraHpIDanaM, navajvarashokAbhitaptayorUShmAnetranADIranusRutya timiraM jvaravRuddhiM ca kuryAt, viriktasya vĀyurindriyopaghAtaM kuryAt, anuvAsitasya kaphaHshirogurutvakaNDUkrimidoShA~jjanayet, garbhiNyA garbhaM stambhayet sa kANaH kuNiH pakShahataH pIThasarpI vA jAyate, navapratishyAyArtasyasrotAMsi vyApAdayet, anRutau durdine ca shItadoShAn pUtinasyaM shirorogaM ca janayet; tasmAdete na ŚirovirecanarhAH||21||

Shirovirechana applied in the case of indigestion and full stomach causes the occlusion of the channels moving upwards by vitiated dosha which further leads to manifestation of cough, dyspnea, vomiting and coryza. In those who have taken fatty substances or desirous of taking wine or water or take after head-evacuation, shirovirechana gives rise to discharge from mouth and nose, dirt and stickiness in eyes, cataract and head diseases. If the person who has taken head- bath or takes head-bath after the therapy, then it causes the coryza. Application of shirovirechana in a person afflicted with hunger causes aggravation of vata dosha. If it is administered to the person afflicted with thirst then it further increases the thirst and causes the dryness of mouth. Shirovirechana applied in the cases of fatigue, intoxication and fainting produces the same adverse effects as mentioned under the asthapana basti. If this therapy is administered in the persons injured with weapons or stick, it increases the pain. In those exhausted by sexual intercourse, physical exercise and intake of alcohol, it causes pain in head, shoulder, eyes and chest. Shirovirechana applied to those suffering from acute fever and grief causes the heat to spread into the channels of eye, produces the cataract and increases the fever. If this therapy is given to the person who has undergone purgation therapy, then it aggravates vata dosha which may further leads to the damage of the sense organs. Shirovirechana given to the person who has undergone anuvasana basti, causes aggravation of kapha dosha which produces heaviness of head, itching and parasitic infestation. In the case of pregnant woman, this therapy inhibits the growth of the fetus and she gives birth to an offspring who may be blind by one eye, with deformity of upper limbs, hemiplegic and with deformity of lower limbs. Shirovirechana given to the person suffering from acute coryza causes the morbidity of the channels of circulation. If this therapy is given in unsuitable season and on a cloudy day then it causes the diseases due to cold, putrefied rhinitis and head-diseases. Therefore, these persons are not fit for head-evacuation therapy. [21]

Indications of shirovirechana

शेषास्त्वर्हाः, विशेषतस्तु शिरोदन्तमन्यास्तम्भगलहनुग्रहपीनसगलशुण्डिकाशालूकशुक्रतिमिरवर्त्मरोगव्यङ्गो पजिह्विकार्धावभेदकग्रीवास्कन्धांसास्यनासिकाकर्णाक्षिमूर्धकपालशिरोरोगार्दितापतन्त्रकापतानकगलगण्ड-दन्तशूलहर्षचालाक्षिराज्यर्बुदस्वरभेदवाग्ग्रहगद्गदक्रथनादय ऊर्ध्वजत्रुगताश्चवातादिविकाराः परिपक्वाश्च; एतेषु शिरोविरेचनंप्रधानतममित्युक्तं, तद्ध्युत्तमाङ्गमनुप्रविश्य मुञ्जादीषिकामिवासक्तां केवलं विकारकरं दोषमपकर्षति||२२||

śēṣāstvarhāḥ, viśēṣatastuśirōdantamanyāstambhagalahanugrahapīnasagalaśuṇḍikāśālūkaśukratimiravartmarōgavyaṅgō pajihvikārdhāvabhēdakagrīvāskandhāṁsāsyanāsikākarṇākṣimūrdhakapālaśirōrōgārditāpatantrakāpatānakagalagaṇḍa-dantaśūlaharṣacālākṣirājyarbudasvarabhēdavāggrahagadgadakrathanādaya ūrdhvajatrugatāścavātādivikārāḥparipakvāśca; ētēṣu śirōvirēcanaṁ pradhānatamamityuktaṁ, taddhyuttamāṅgamanupraviśya muñjādīṣikāmivāsaktāṁkēvalaṁ vikārakaraṁ dōṣamapakarṣati||22||

sheShAstvarhAH, visheShatastushirodantamanyAstambhagalahanugrahapInasagalashuNDikAshAlUkashukratimiravartmarogavya~ggo pajihvikArdhAvabhedakagrIvAskandhAMsAsyanAsikAkarNAkShimUrdhakapAlashirorogA-

rditApatantrakApatAnakagalagaNDadantashUlaharShacAlAkShirAjyarbudasvarabhedavAggrahagadgadakrathanAdaya UrdhvajatrugatAshcavAtAdivikArAHparipakvAshca; eteShu ŚirovirecanaM pradhAnatamamityuktaM, taddhyuttamA~ggamanupravishyamu~jjAdIShikAmivAsaktAM kevalaM vikArakaraM doShamapakarShati||22||

The persons other than above mentioned are fit for shirovirechana (head-evacuation therapy). It is especially useful in the conditions mentioned in the table given below:

Serial No. Disease or State (in which shirovirechana is indicated) Translation in English
1 Shirostambha Stiffness of head
2 Dantastambha Stiffness of teeth
3 Manyaastambha torticollis
4 Galagraha Spasm of the throat
5 Hanugraha Lock-jaw
6 Peenasa Chronic coryza
7 Galashundika Tonsillitis
8 Galashaaluka Tumor in the throat
9 Shukra-roga Disorder of cornea
10 Timira Cataract, Disorder of vision
11 Vartma-roga Disorders of eye-lids
12 Vyanga-roga Freckles
13 Upajihvika Uvulitis
14 Ardhavabhedaka Hemicrania, migraine
15 Greeva-roga Diseases of the neck
16 Skandha-roga Diseases of the shoulders
17 Amsa-roga Diseases of the scapula
18 Asya-roga Diseases of the mouth
19 Nasika-roga Diseases of the nose
20 Karna-roga Diseases of the ears
21 Akshi-roga Diseases of the eyes
22 Murdha-roga Diseases of the cranium
23 Kapala-roga Diseases of the forehead
24 Shiroroga Diseases of the head
25 Ardita Facial paralysis
26 Apatantraka Convulsions with unconsciousness
27 Apatanaka Convulsions with consciousness
28 Galagandha Goitre
29 Dantashula Toothache
30 Dantaharsha Tingling sensation of teeth
31 Dantachala Looseness of teeth
32 Akshiraji Streaks in eye
33 Arbuda Tumor
34 Svarabheda Hoarseness of voice
35 Vaggraha Obstructed speech
36 Gadgad Spasmodic speech
37 Krathana-adayah Stammering etc.
38 Urdhvajatrugatashcha vatadi vikarah paripakvashcha Diseases of the part above clavicle caused by aggravation of vata etc. dosha and which are free from ama dosha

In these conditions, head-evacuation is the foremost therapy as it entering into the head eliminates the entire pathogenic impurities like fibrous coating of munja (a type of grass) from the pith (ishika). [22]

Consideration of appropriate time for shirovirechana in emergency conditions

प्रावृट्शरद्वसन्तेतरेष्वात्ययिकेषु रोगेषु नावनं कुर्यात् कृत्रिमगुणोपधानात्; ग्रीष्मे पूर्वाह्णे, शीते मध्याह्ने, वर्षास्वदुर्दिने चेति||२३||

prāvr̥ṭśaradvasantētarēṣvātyayikēṣu rōgēṣu nāvanaṁ kuryāt kr̥trimaguṇōpadhānāt; grīṣmē pūrvāhṇē, śītēmadhyāhnē, varṣāsvadurdinē cēti||23||

prAvRuTsharadvasantetareShvAtyayikeShu rogeShu nAvanaM kuryAt kRutrimaguNopadhAnAt; grIShmepUrvAhNe, shIte madhyAhne, varShAsvadurdine ceti||23||

In the case of emergency, shirovirechana (head-evacuation therapy) should be given in the season other than pravriṭ (early rain), Sharad (autumn) and Vasanta (spring) by arranging environment artificially. In summer, it should be applied in the morning, in winter during noon time and in rainy season when sky is free from clouds. [23]

Summary

तत्र श्लोकाः-

इति पञ्चविधं कर्म विस्तरेण निदर्शितम्| येभ्यो यन्न हितं यस्मात् कर्म येभ्यश्च यद्धितम्||२४||

न चैकान्तेन निर्दिष्टेऽप्यर्थेऽभिनिविशेद्बुधः| स्वयमप्यत्र वैद्येन तर्क्यं बुद्धिमता भवेत्||२५||

उत्पद्येत हि साऽवस्था देशकालबलं प्रति| यस्यां कार्यमकार्यं स्यात् कर्म कार्यं च वर्जितम्||२६||

छर्दिर्हृद्रोगगुल्मानां वमनं स्वे चिकित्सिते| अवस्थां प्राप्य निर्दिष्टं कुष्ठिनां बस्तिकर्म च||२७||

तस्मात् सत्यपि निर्देशे कुर्यादूह्य स्वयं धिया| विना तर्केण या सिद्धिर्यदृच्छासिद्धिरेव सा||२८||

tatra ślōkāḥ-

iti pañcavidhaṁ karma vistarēṇa nidarśitam| yēbhyō yanna hitaṁ yasmāt karma yēbhyaśca yaddhitam||24||

na caikāntēna nirdiṣṭē'pyarthē'bhiniviśēdbudhaḥ| svayamapyatra vaidyēna tarkyaṁ buddhimatā bhavēt||25||

utpadyēta hi sā'vasthā dēśakālabalaṁ prati| yasyāṁ kāryamakāryaṁ syāt karma kāryaṁ ca varjitam||26||

chardirhr̥drōgagulmānāṁ Vamanṁ svē cikitsitē| avasthāṁ prāpya nirdiṣṭaṁ kuṣṭhināṁ bastikarma ca||27||

tasmāt satyapi nirdēśē kuryādūhya svayaṁ dhiyā| vinā tarkēṇa yā siddhiryadr̥cchāsiddhirēva sā||28||

tatra shlokAH- iti pa~jcavidhaM karma vistareNa nidarshitam| yebhyo yanna hitaM yasmAt karma yebhyashca yaddhitam||24||

na caikAntena nirdiShTe~apyarthe~abhinivishedbudhaH| svayamapyatra vaidyena tarkyaM buddhimatA bhavet||25||

utpadyeta hi sA~avasthA deshakAlabalaM prati| yasyAM kAryamakAryaM syAt karma kAryaM ca varjitam||26||

chardirhRudrogagulmAnAM VamanM sve cikitsite| avasthAM prApya nirdiShTaM kuShThinAM bastikarma ca||27||

tasmAt satyapi nirdeshe kuryAdUhya svayaM dhiyA| vinA tarkeNa yA siddhiryadRucchAsiddhireva sA||28||

Now the summing up verses:-

Thus, the Panchakarma has been described in detail in following sub-headings-

  1. Contra-indications of each of the karma (therapy) along with reasoning;
  2. Indications of each of the karma (therapy) of Panchakarma.

The wise physician should not blindly follow the general instructions laid down in this chapter in the form of conclusions but he should decide rationally using his own discretion because condition may arise due to the nature of place, time and strength of the patient in which the prescribed therapy may be ineffective and the prohibited therapy may be applicable such as emesis is prescribed in certain stage of vomiting, heart-disease and gulma (abdominal lump) though it is generally contra-indicated. Similarly basti is advised in the treatment of kushtha roga though it is generally contra-indicated depending upon the particular stage of the disease. Hence, in spite of general instructions available in the text, a physician should rationally think all the aspects using his intellect. The success achieved without proper reasoning is nothing but the success by chance. [24-28]

इत्यग्निवेशकृते तन्त्रे चरकप्रतिसंस्कृतेऽप्राप्ते दृढबलसंपूरिते सिद्धिस्थाने पञ्चकर्मीयसिद्धिर्नाम द्वितीयोऽध्यायः॥२॥

Ityagniveśakṛte tantre Carakapratisaṃskṛteˈprāpte Dṛḍhabalasampūrite Siddhisthāne Pañcakarmīyasiddhirnāma dvitīyoˈdhyāyaḥ .||2||

ityAgniveśaakRute tantre carakapratisaMskRute~prApte dRuDhabalasaMpUrite siddhisthAne pa~jcakarmIyasiddhirnAma dvitIyo~dhyAyaH. ||2||

Thus, ends the second chapter on successful management of Panchakarma in the treatise composed by Agnivesha, redacted by Charaka and because of its non-availability, supplemented by Dridhabala. [2]

Tattva Vimarsha (Fundamental Principles)

  • All the Panchakarma procedures like vamana (therapeutic emesis), virechana( therapeutic purgation), asthapana (medicated enema with decoction), anuvasana ( medicated enema with oil), shirovirechana (purification of head and supraclavicular region) shall be performed after through examination of patients about indications and contra-indications.
  • If these procedures are performed in the contra-indicated state, it leads to iatrogenic diseases.
  • Vamana (therapeutic emesis) is mainly indicated in kapha dominant diseases.
  • Virechana( therapeutic purgation) is mainly indicated in pitta dominant diseases.
  • Asthapana (medicated enema with decoction) is mainly indicated in vata dominant diseases in which purification is the objective of treatment.
  • Anuvasana (medicated enema with oil) is mainly indicated in vata dominant diseases in which nourishment and sustaining growth of tissues is the objective of treatment.
  • Shirovirechana (purification of head and supraclavicular region) is mainly indicated in dosha dominant diseases of all organs present in supraclavicular region including brain.

Vidhi Vimarsha (Applied Inferences )

Chapter authority

It is the pattern of this classic that in the beginning of every chapter, Charaka proposes the topic which is to be discussed and secondly the common sentence for all the chapter (इति ह स्माह भगवानात्रेयः) is used which shows the authenticity of the text. There are number of discourses in medical science and it is not possible for all to discuss them completely and meticulously that’s why Agnivesha declares very honestly in the beginning of all the chapters that whatever has been discussed is as per the preaching of his teacher Lord Punarvasu Atreya. The title Bhagavana (lord) itself reveals that Punarvasu Atreya was an extraordinary personality who could completely discuss the medical science without any mistake and lacunae[1].

Success of treatment

Chikitsa is indicated in curable disease [2] and another important concept of Ayurveda in this regard is that chatushpada upapatti (desired qualities of four limbs of treatment) are one of the important cause in the success of treatment[3]. In the above mentioned verses the desired qualities of patients are lacking and patient is one of the important components among chatushpada. In such situations chances of complications are also high.< ref name= chakra> Chakrapani, Charak.In: Jadavaji Trikamji Aacharya, Editor. Charak Samhita. Varanasi:Chaukhamba Surbharati Prakashan, reprint edition-2000, Page No.-687</ref>

Contraindications of vamana

The above mentioned contra-indications are as per general rule but in specific conditions exceptions are also found such as generally vamana is contra-indicated in gulma roga but when kapha is increased and causing diminution of digestive fire, anorexia, nausea etc. in vatika gulma, vamana is indicated exceptionally.[4]. Similarly vamana is advised in vomiting and heart disease according to condition [5] which is the exception of the general instruction. In all the above mentioned states of contra-indications, vamana is not contra-indicated in the conditions of poisons, artificial poisons, incompatible food, intake of food during indigestion and ama (ailment caused by the product of improper digestion and metabolism) because these conditions are of emergent nature. [6]

Vagbhata has added following contra-indications for vamana:

krimikoshtha, ashthila, arsha, bhrama, parshwaruk, Vatavyadhi

Indications of vamana

Vamana karma is mainly indicated in the diseases caused by kapha dosha reason being it is considered the best therapy among all causing elimination of kapha dosha.[7][8][9]. Vagbhatta says that vamana is indicated in the kapha dosha as well as in the combination of dosha where kapha is dominant. In the commentary of the view of Vagbhata, Arunadatta in his Sarvangasundara commentary says that here combination of dosha should be understood as kapha-pitta association.[10]

As per the view of Charaka, one predominant in kapha vomits easily.[11] This should be accepted as an ideal condition for vamana karma. Therefore, either it is the diseased or healthy condition, predominance of kapha should be observed or produced (by the application of snehana and swedana), then one should administer vamana karma. In the context of Jwara Chikitsa, Charaka has given the specific view for the application of vamana which can be accepted in all the cases if kapha dosha is dominant with tendency to come out and situated in amashaya (stomach). [12]

Vagbhata has added following indications as suitable for vamana:

Granthi, arbuda, medoroga, vidarika, hridroga, chittavibhrama, visarpa, vidradhi, putinasa, kanthapaka, adhijivhika, galashundika

Contraindications of virechana

Virechana is not advised in the conditions when kapha dosha is increased because manda (alpa) kapha is considered as an ideal condition for proper administration of virechana karma.[13].Panchakarma is not administered in the state of indigestion.[14] Chakrapani, the commentator of Charaka Samhita has interpreted the term subhaga kshata guda as subhaga guda (one who has delicate anus) and kshata guda (one who has anal injury). He has also mentioned subhagam means sukhasamvardhita (those who has never faced any hardship) according to the view of other scholars in his commentary. Virechana applied in the person having injury to anus or delicate anus causes harm to the patients. In the person who has taken the niruha type of enema, at least seven days gap is essential to perform virechana karma and vice-versa. Virechana in pregnant woman is contra-indicated up to seventh month except in emergency. In eighth month if disease is curable by vamana or virechana, then mridu vamana (mild emesis) or mridu virechana (mild purgative) can be given.[15]

Vagbhata added following conditions in the list of contraindications:

Navaprasuta, navapratishyaya, Rajyakshma, Atisara, nityadukkhi, hridrogi, bhayabhita

Indications of virechana

Virechana is considered the best therapy to purify pitta dosha especially. [16][17] [18]

Virechana eliminates pitta or kapha pitta situated in pittashaya. [6]

Virechana treatments are of many types such as mridu virechana, sukha virechana and tikshṇa virechana.[6]

All the persons are not treated by the same medicines. So the application depends upon the nature of koshtha, nature of the disease, strength of the person, age, season and many other considerable issues. Mridu virechana is not appropriate for the person having krurakoshtha and tikshna virechana is not suitable for mridu koshtha. Tikshna virechana is advised in mrittika bhakshanajanya pandu roga and baddhodara in Charaka Samhita but it cannot be given to the patient suffering from the heart disease. Mridu virechana is advised in kamala roga .[19] Virechana given to the patients suffering from paittika disorders cannot be given to those suffering from pitta shlaishmika disorders. Again virechana medicines are of two types i.e. snigdha virechana and ruksha virechana. Snigdha virechana is used in the person having dryness in the body and ruksha virechana is used in the persons who have unctuousness in the body. For example snighdha virechana is advised in vatodara. [20]

Tikshna vamana and virechana, and other painful procedures are generally not advised in children and old, if required then mridu vamana and virechana should be administered .[21] Virechana karma should be administered in Sharad ritu (autumn season) in healthy individuals because the aggravation of pitta dosha takes place in this season naturally. Generally it should not be administered in peak of summer and peak of winter season as it may lead to atiyoga and ayoga respectively.[22]

Vagbhata added following conditions in the list of indications:

Garavisha, pakwashayaruja, vibandha, Vidradhi, dushtavrana, akshipaka, abhishyanda, kacha, gudadaha, medhradaha, nasadaha, anaha, stanyadosha

Contraindications of asthapana basti

Asthapana basti is contra-indicated in the stage of ajeerna[23] or ama. Asthapana and anuvasana basti are indicated in the treatment of baddhodara[24], so baddhodara mentioned in the contra-indications of asthapana should be read as baddhodaradhmana means it is contraindicated in adhmana due to baddhodara[25] Asthapana basti is contraindicated in kushtha roga but in a particular stage of the disease, Charaka has exceptionally indicated the asthapana and Anuvasana basti [26].[14]

Vagbhata added following conditions in the list of contraindications:

Pandu, bhrama, arochaka, unmada, shokagrasta, sthaulya, kanthashosha, kshatakshina, pregnant woman upto 7th month of gestation, gudashotha

Indications of asthapana basti

Asthapana basti is considered the best therapy in vatika disorders.[27] [28] It is given in disorders caused by other dosha. Basti can be administered in the vitiation of vata, pitta, kapha, samsarga (vitiation of two dosha), sannipata (vitiation of all the three dosha) and even in vitiation of rakta (blood) also.[29] Application of first asthapana basti removes or purifies vata, second basti removes or purifies pitta and third to kapha dosha [30], purification of three dosha should be understood of either occlusion or association of vata with other dosha. Different applications of asthapana basti show that by processing and combination with different medicines, it exerts many effects such as samshodhana, samshamana, samgrahana, vajikarana, brimhana, karshana, vayahsthapana[29]etc. Type of basti depends upon the nature of disease such as basti given in the condition of vata-mala sanga will be different in comparison to basti given in shuddhatisara, basti applied in the case of bala kshaya, mamsa kshaya and retas kshaya will be of different composition in comparison to basti administered in krimikoshhtha. In vatika disorders also, only asthapana basti is not given for longer duration that’s why karma basti, kala basti and yoga basti have been discussed by ancient sages for the rational use of the therapy. In all these types, asthapana and anuvasana basti are administered in a particular sequence for the better efficacy.

Vagbhata added following conditions in the list of indications:

Jwara, ashmari, upadamsha, vatarakta, arsha, stanyakshaya, mudhagarbha, mutakrichhra

Contraindications of anuvasana basti

Anuvasana basti is not advised in kaphaja disorders, medo vriddhi and ama dosha. Contraindications given in the text are as per general rule. Exceptional instructions are also found in the text considering the need of therapy in particular stage of disease such as in the patient suffering from piles if patient comes with associated symptoms like udavarta, excessive dryness of the body, abnormal movement of vata and pain, then anuvasana basti is advised.[31]

Anuvasana is contraindicated in the patients suffering from krimikoshtha also because initially he should not be treated with this type of basti as it will increase the disease. In the patient of krimikoshtha, initially asthapana basti followed by vamana and virechana should be applied and when koshtha is completely purified, anuvasana basti with vidanga oil can be administered.[32]

Vagbhata added following conditions in the list of contraindications:

Prameha, Kushtha, Sthaulya, Pinasa, Krisha

Indications of anuvasana basti

Anuvasana basti and asthapana basti are considered the best therapy in vatika disorders.[33]

It has been stated that patients suitable for asthapana basti are suitable for anuvasana basti is general instruction, because krimikoshthi and patient suffering from heaviness in the body are suitable for asthapana basti but not for anuvasana basti. In krimikoshthi, first of all asthapana basti is administered, then vamana and virechana to purify the koshtha. When koshtha is purified, then anuvasana basti is advised as it is discussed in Vimana Sthana. So it should be accepted that instructions given in the text are applicable in most cases, but not in all cases. [19]

Indications of Shirovirechana

Shirovirechana type of nasya is mainly beneficial in kaphaja disorders.[34]

Shirovirechana is mainly beneficial in kaphaja disorders where as Charaka says that it is beneficial in vatadi vikaras which are free from ama dosha. Here vatadi vikaras means vata shleshmika vikara of the head region are cured by proper administration of shirovirechana.[35] Pinasa roga mentioned in the indications should be accepted as pakva pratishyaya (chronic coryza)[35] as shirovirechana is contraindicated in the patients suffering from nava pratishyaya (acute coryza). [22]

Contra-indications of Shirovirechana

Vagbhata added the following conditions in list of contra-indications:

Apatarpita, Pitadrava, Gararta, Kruddha, vegavarodhita, Raktasravita, Sutika, Shwasapidita, Kasapidita

Current researches

Prameha and Kushtha are considered as contraindications of Asthapana Basti. Thus the conditions of diabetes and skin diseases comes under this umbrella of contraindication. However, more precisely, if these conditions are associated with aggravated vata, Asthapana Basti is used with good efficacy. The basti of gokshura and punarnava has shown good results in microalbuminuria in diabetic patients.[36] Likewise basti has shown good results in skin condition like psoriatic arthritis.[37]

Scope of further research

General indications and contraindications of all panchakarma are included in this chapter. Further it is needed to elaborate efficacy of these procedures in the specific stages of the disease. For e.g. Asthapana Basti is contraindicated in fatigue due to excess travelling (Yanaklanta). However in other reference Yuktaratha Basti is indicated in certain conditions with similarity of pathogenesis. Though basti is contraindicated in skin diseases (Kushtha), a formulation for basti is prescribed in management of Kushtha. This is specific to the conditions associated with specific dosha. A study is required to elaborate and explain the reasons.

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References

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