Changes

==Introduction==

==Introduction==

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

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

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

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

</div>

</div>

== Vidhi Vimarsha (Applied Inferences)==

== Vidhi Vimarsha (Applied Inferences)==

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

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

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

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

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

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

The drug ''Apamarga'' (Achyranthes aspera Linn.) is considered to be the potential drug to eliminate vitiating factors from head. [Ca.Su.25/40] ''Surasa'' (Ocimum sanctum Linn.), ''Shweta Surasa'' (Ocimum sanctum Linn.), ''Phanijjaka'' (Origanum majorana), ''Kutheraka'' (Ocimum canum) are the drugs of ''Surasadi gana''. [Su.Su.38], and are said to be ''krimighna'' (antimicrobial) and ''kaphaghna'' (which alleviate phlegm). Chakrapanidatta terms ''Ajagandha'' as ''Ajamoda'' (Apium graveolens Linn.). The reference of ''krimi''(microbe) in the context of those invading the head and not the body. <ref> Available from www.iamj.in/posts/images/upload/298_303.pdfnopr.niscair.res.in/bitstream/123456789/.../IJTK%208(3)%20372-378.pdftheglobaljournals.com/gra/file.php?val=September_2014...42.pdf </ref> [verse 1-6]

The drug ''Apamarga'' (Achyranthes aspera Linn.) is considered to be the potential drug to eliminate vitiating factors from head. [Cha.Sa.[[Sutra Sthana]] 25/40] ''Surasa'' (Ocimum sanctum Linn.), ''Shweta Surasa'' (Ocimum sanctum Linn.), ''Phanijjaka'' (Origanum majorana), ''Kutheraka'' (Ocimum canum) are the drugs of ''Surasadi gana''. [Su.Sa.Sutra Sthana 38], and are said to be ''krimighna'' (antimicrobial) and ''kaphaghna'' (which alleviate phlegm). Chakrapanidatta terms ''Ajagandha'' as ''Ajamoda'' (Apium graveolens Linn.). The reference of ''krimi''(microbe) in the context of those invading the head and not the body. <ref> Available from www.iamj.in/posts/images/upload/298_303.pdfnopr.niscair.res.in/bitstream/123456789/.../IJTK%208(3)%20372-378.pdftheglobaljournals.com/gra/file.php?val=September_2014...42.pdf </ref> [verse 1-6]

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

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

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

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

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

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

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

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

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

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

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

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

Operculina turpethum has anthraquinone glycoside also known as emodin. Unabsorbed in the small intestine, they are passed to the colon where bacteria liberates the active form, which either acts locally or is absorbed into circulation and gets excreted in bile to act on small intestine. The active principle is believed to work on myenteric plexus to increase peristalsis and decrease segmentation.

Operculina turpethum has anthraquinone glycoside also known as emodin. Unabsorbed in the small intestine, they are passed to the colon where bacteria liberates the active form, which either acts locally or is absorbed into circulation and gets excreted in bile to act on small intestine. The active principle is believed to work on myenteric plexus to increase peristalsis and decrease segmentation.

Cassia fistula’s laxative action comes from a group of well documented compounds called anthraquinones that are found in all cassia and senna plants in varying degrees.

Cassia fistula’s laxative action comes from a group of well documented compounds called anthraquinones that are found in all cassia and senna plants in varying degrees.

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

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

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

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

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

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

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

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

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

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

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

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

In total, 28 gruels are explained which are to be used after the administration of [[Panchakarma]] to help re-kindle the digestive fire, simultaneously providing nutrition to the body. Gruels are made of two types of ingredients- cereals and herbs. Rice, barley and other cereals are major food staples, whereas herbs having medicinal properties are second type of ingredients known as ''veerya pradhana'' (potency).  These herbs are typically classified by their potency - ''mridu''(mild), ''madhyama'' (medium) and ''teekshna'' (strong). ''Amalaki'' (Emblica officinalis), ''Bilwa'' (Aegle marmelose), ''Shunthi'' (Zingiber officinalis) are respective examples for these three potencies.

In total, 28 gruels are explained which are to be used after the administration of [[Panchakarma]] to help re-kindle the digestive fire, simultaneously providing nutrition to the body. Gruels are made of two types of ingredients- cereals and herbs. Rice, barley and other cereals are major food staples, whereas herbs having medicinal properties are second type of ingredients known as ''veerya pradhana'' (potency).  These herbs are typically classified by their potency - ''mridu''(mild), ''madhyama'' (medium) and ''teekshna'' (strong). ''Amalaki'' (Emblica officinalis), ''Bilwa'' (Aegle marmelose), ''Shunthi'' (Zingiber officinalis) are respective examples for these three potencies.