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|title=Langhanabrimhaniya Adhyaya

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The signs and symptoms of all these six therapies, if inadequately administered, leave the [[doshas]] unpacified. Rather, they get aggravated.

The signs and symptoms of all these six therapies, if inadequately administered, leave the [[dosha]] unpacified. Rather, they get aggravated.

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

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

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As there are many combinations of ''dosha'', these therapies also have multiple variations. However, the number of these therapies do not exceed than six, just like ''doshas'' are three in number. [43]

As there are many combinations of [[dosha]], these therapies also have multiple variations. However, the number of these therapies do not exceed than six, just like [[dosha]] are three in number. [43]

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== Tattva Vimarsha (Fundamental Principles) ==

== Tattva Vimarsha (Fundamental Principles) ==

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

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

*''Brimhana'' (nourishing) therapy is indicated in emaciated persons and those diseases with degenerative pathology.  

*[[Brimhana]] (nourishing) therapy is indicated in emaciated persons and those diseases with degenerative pathology.  

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

*The group of six treatments (shadupakramas) includes [[langhana]], [[rukshana]], [[swedana]], [[brimhana]], [[snehana]], and [[stambhana]]. The first three of these are reducing in nature, while the latter three are nourishing.

== Vidhi Vimarsha (Applied Inferences) ==

== Vidhi Vimarsha (Applied Inferences) ==

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

Above described six therapies are grouped into "Apatarpana" ([[langhana]], or reducing) and "Santarpana" ([[brimhana]], or nourishing). In "Apatarpana"– lightening, dryness, and sudation therapies, and in "Santarpana"– nourishing, unctuousness, and astringent therapies have been mentioned. (3-8)

The ''Rukshana'' (dryness) therapy produces dryness, roughness, and coarseness. In unctuous therapy, fluidity is due to liquefaction or melting or dissolution of ''dosha, dhatu,'' and ''mala''. The mode of action of sudation therapy is due to warmth or internal heat produced by therapy. The mode of action of astringent therapy is due to inhibition of mobility and flow of ''dosha, dhatu,'' and ''mala''. Here the meaning to be understood is that the materials - ''dosha, dhatu,''and ''mala,'' which are flowing by slow or fast in rate by nature, to be checked or stopped. This condition refers only to the effects of ''atisara'' (diarrhea), ''raktasrava'' (bleeding), ''visha'' (poisoning), ''daha'' (burning), and ''vedana'' (pain). The drugs described here for each therapy are understood to possess such qualities as associated with them. There are, however, exceptional cases. For example, ''pippali'' and ''bhallataka'' have ''ushna guna'' (heat), but their action is ''Brimhana''. ''Priyangu'' is ''sheeta guna'' (cool) but has ''Langhana'' effect.

The [[rukshana]] (dryness) therapy produces dryness, roughness, and coarseness. In unctuous therapy, fluidity is due to liquefaction or melting or dissolution of [[dosha]],[[dhatu]], and [[mala]]. The mode of action of sudation therapy is due to warmth or internal heat produced by therapy. The mode of action of astringent therapy is due to inhibition of mobility and flow of [[dosha]], [[dhatu]],and [[mala]]. Here the meaning to be understood is that the materials - [[dosha]], [[dhatu]],and [[mala]], which are flowing by slow or fast in rate by nature, to be checked or stopped. This condition refers only to the effects of atisara (diarrhea), raktasrava(bleeding), visha(poisoning), daha(burning), and vedana(pain). The drugs described here for each therapy are understood to possess such qualities as associated with them. There are, however, exceptional cases. For example, pippali and bhallataka have "ushna" [[guna]] (heat), but their action is [[brimhana]]. Priyangu is "sheeta" [[guna]](cool) but has [[langhana]] effect.

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'''Table 1: Pharmaco-therapeutic properties of six therapies'''

'''Table 1: Pharmaco-therapeutic properties of six therapies'''

{| class="wikitable"

{| class="wikitable"

! ''S. No.'' !! ''Langhana'' !! ''Brimhana'' !! ''Rukshana '' !! '' Snehana'' !! ''Swedana'' !! ''Stambhana''

! ''S. No.'' !! [[Langhana]] !! [[Brimhana]] !! [[Rukshana]] !! [[Snehana]] !! [[Swedana]] !! [[Stambhana]]

|-

|-

| rowspan="1" style="text-align: center;" | ''1''

| rowspan="1" style="text-align: center;" | 1

| rowspan="1" style="text-align: center;" | ''Laghu''

| rowspan="1" style="text-align: center;" | Laghu

| rowspan="1" style="text-align: center;" | ''Guru''

| rowspan="1" style="text-align: center;" | Guru

| rowspan="1" style="text-align: center;" | ''Laghu''

| rowspan="1" style="text-align: center;" | Laghu

| rowspan="1" style="text-align: center;" | ''Guru''

| rowspan="1" style="text-align: center;" | Guru

| rowspan="1" style="text-align: center;" | ''Guru''

| rowspan="1" style="text-align: center;" | Guru

| rowspan="1" style="text-align: center;" | ''Laghu''

| rowspan="1" style="text-align: center;" | Laghu

|-

|-

| rowspan="1" style="text-align: center;" | ''2''

| rowspan="1" style="text-align: center;" | 2

| rowspan="1" style="text-align: center;" | ''Ushna''

| rowspan="1" style="text-align: center;" | Ushna

| rowspan="1" style="text-align: center;" | ''Shita''

| rowspan="1" style="text-align: center;" | Shita

| rowspan="1" style="text-align: center;" | ''Ushna''

| rowspan="1" style="text-align: center;" | Ushna

| rowspan="1" style="text-align: center;" | ''Shita''

| rowspan="1" style="text-align: center;" | Shita

| rowspan="1" style="text-align: center;" | ''Ushna''

| rowspan="1" style="text-align: center;" | Ushna

| rowspan="1" style="text-align: center;" | ''Shita''

| rowspan="1" style="text-align: center;" | Shita

|-

|-

| rowspan="1" style="text-align: center;" | ''3''

| rowspan="1" style="text-align: center;" | 3

| rowspan="1" style="text-align: center;" | ''Tikshna''

| rowspan="1" style="text-align: center;" | Tikshna

| rowspan="1" style="text-align: center;" | ''Mridu''

| rowspan="1" style="text-align: center;" | Mridu

| rowspan="1" style="text-align: center;" | ''Tikshna''

| rowspan="1" style="text-align: center;" | Tikshna

| rowspan="1" style="text-align: center;" | ''Mridu''

| rowspan="1" style="text-align: center;" | Mridu

| rowspan="1" style="text-align: center;" | ''Tikshna''

| rowspan="1" style="text-align: center;" | Tikshna

| rowspan="1" style="text-align: center;" | ''Mridu''

| rowspan="1" style="text-align: center;" | Mridu

|-

|-

| rowspan="1" style="text-align: center;" | ''4''

| rowspan="1" style="text-align: center;" | 4

| rowspan="1" style="text-align: center;" | ''---''

| rowspan="1" style="text-align: center;" | ---

| rowspan="1" style="text-align: center;" | ''----''

| rowspan="1" style="text-align: center;" | ----

| rowspan="1" style="text-align: center;" | ''-----''

| rowspan="1" style="text-align: center;" | -----

| rowspan="1" style="text-align: center;" | ''Drava''

| rowspan="1" style="text-align: center;" | Drava

| rowspan="1" style="text-align: center;" | ''Drava''

| rowspan="1" style="text-align: center;" | Drava

| rowspan="1" style="text-align: center;" | ''Drava''

| rowspan="1" style="text-align: center;" | Drava

|-

|-

| rowspan="1" style="text-align: center;" | ''5''

| rowspan="1" style="text-align: center;" | 5

| rowspan="1" style="text-align: center;" | ''Vishada''

| rowspan="1" style="text-align: center;" | Vishada

| rowspan="1" style="text-align: center;" | ''Pichchila''

| rowspan="1" style="text-align: center;" | Pichchila

| rowspan="1" style="text-align: center;" | ''Vishada''

| rowspan="1" style="text-align: center;" | Vishada

| rowspan="1" style="text-align: center;" | ''Pichchila''

| rowspan="1" style="text-align: center;" | Pichchila

| rowspan="1" style="text-align: center;" | ''--------''

| rowspan="1" style="text-align: center;" | --------

| rowspan="1" style="text-align: center;" | ''----------''

| rowspan="1" style="text-align: center;" | ----------

|-

|-

| rowspan="1" style="text-align: center;" | ''6''

| rowspan="1" style="text-align: center;" | 6

| rowspan="1" style="text-align: center;" | ''----------''

| rowspan="1" style="text-align: center;" | ----------

| rowspan="1" style="text-align: center;" | ''Bahala''

| rowspan="1" style="text-align: center;" | Bahala

| rowspan="1" style="text-align: center;" | ''----------------''

| rowspan="1" style="text-align: center;" | ----------------

| rowspan="1" style="text-align: center;" | ''------------''

| rowspan="1" style="text-align: center;" | ------------

| rowspan="1" style="text-align: center;" | ''-----------''

| rowspan="1" style="text-align: center;" | -----------

| rowspan="1" style="text-align: center;" | ''----------''

| rowspan="1" style="text-align: center;" | ----------

|-

|-

| rowspan="1" style="text-align: center;" | ''7''

| rowspan="1" style="text-align: center;" | 7

| rowspan="1" style="text-align: center;" | ''Ruksha''

| rowspan="1" style="text-align: center;" | Ruksha

| rowspan="1" style="text-align: center;" | ''Snigdha''

| rowspan="1" style="text-align: center;" | Snigdha

| rowspan="1" style="text-align: center;" | ''Ruksha''

| rowspan="1" style="text-align: center;" | Ruksha

| rowspan="1" style="text-align: center;" | ''Snigdha''

| rowspan="1" style="text-align: center;" | Snigdha

| rowspan="1" style="text-align: center;" | ''Ruksha– Snigdha''

| rowspan="1" style="text-align: center;" | Ruksha– Snigdha

| rowspan="1" style="text-align: center;" | ''Ruksha''

| rowspan="1" style="text-align: center;" | Ruksha

|-

|-

| rowspan="1" style="text-align: center;" | ''8''

| rowspan="1" style="text-align: center;" | 8

| rowspan="1" style="text-align: center;" | ''------------''

| rowspan="1" style="text-align: center;" | ------------

| rowspan="1" style="text-align: center;" | ''Manda''

| rowspan="1" style="text-align: center;" | Manda

| rowspan="1" style="text-align: center;" | ''------------''

| rowspan="1" style="text-align: center;" | ------------

| rowspan="1" style="text-align: center;" | ''Manda''

| rowspan="1" style="text-align: center;" | Manda

| rowspan="1" style="text-align: center;" | ''-------------''

| rowspan="1" style="text-align: center;" | -------------

| rowspan="1" style="text-align: center;" | ''Manda''

| rowspan="1" style="text-align: center;" | Manda

|-

|-

| rowspan="1" style="text-align: center;" | ''9''

| rowspan="1" style="text-align: center;" | 9

| rowspan="1" style="text-align: center;" | ''Sukshma''

| rowspan="1" style="text-align: center;" | Sukshma

| rowspan="1" style="text-align: center;" | ''Sthula''

| rowspan="1" style="text-align: center;" | Sthula

| rowspan="1" style="text-align: center;" | ''------------''

| rowspan="1" style="text-align: center;" | ------------

| rowspan="1" style="text-align: center;" | ''Sthula''

| rowspan="1" style="text-align: center;" | Sthula

| rowspan="1" style="text-align: center;" | ''Sukshma''

| rowspan="1" style="text-align: center;" | Sukshma

| rowspan="1" style="text-align: center;" | ''Sukshma''

| rowspan="1" style="text-align: center;" | Sukshma

|-

|-

| rowspan="1" style="text-align: center;" | ''10''

| rowspan="1" style="text-align: center;" | 10

| rowspan="1" style="text-align: center;" | ''Khara''

| rowspan="1" style="text-align: center;" | Khara

| rowspan="1" style="text-align: center;" | ''Shlakshna''

| rowspan="1" style="text-align: center;" | Shlakshna

| rowspan="1" style="text-align: center;" | ''Khara''

| rowspan="1" style="text-align: center;" | Khara

| rowspan="1" style="text-align: center;" | ''---------''

| rowspan="1" style="text-align: center;" | ---------

| rowspan="1" style="text-align: center;" | ''-------------''

| rowspan="1" style="text-align: center;" | -------------

| rowspan="1" style="text-align: center;" | ''Shlakshna''

| rowspan="1" style="text-align: center;" | Shlakshna

|-

|-

| rowspan="1" style="text-align: center;" | ''11''

| rowspan="1" style="text-align: center;" | 11

| rowspan="1" style="text-align: center;" | ''Sara''

| rowspan="1" style="text-align: center;" | Sara

| rowspan="1" style="text-align: center;" | ''Sthira''

| rowspan="1" style="text-align: center;" | Sthira

| rowspan="1" style="text-align: center;" | ''Sthira''

| rowspan="1" style="text-align: center;" | Sthira

| rowspan="1" style="text-align: center;" | ''Sara''

| rowspan="1" style="text-align: center;" | Sara

| rowspan="1" style="text-align: center;" | ''Sthira- Sara''

| rowspan="1" style="text-align: center;" | Sthira- Sara

| rowspan="1" style="text-align: center;" | ''Sthira''

| rowspan="1" style="text-align: center;" | Sthira

|-

|-

| rowspan="1" style="text-align: center;" | ''12''

| rowspan="1" style="text-align: center;" | 12

| rowspan="1" style="text-align: center;" | ''kathina''

| rowspan="1" style="text-align: center;" | kathina

| rowspan="1" style="text-align: center;" | ''------------''

| rowspan="1" style="text-align: center;" | ------------

| rowspan="1" style="text-align: center;" | ''Kathina''

| rowspan="1" style="text-align: center;" | Kathina

| rowspan="1" style="text-align: center;" | ''-----------''

| rowspan="1" style="text-align: center;" | -----------

| rowspan="1" style="text-align: center;" | ''------------''

| rowspan="1" style="text-align: center;" | ------------

| rowspan="1" style="text-align: center;" | ''------------''

| rowspan="1" style="text-align: center;" | ------------

|-

|-

|}

|}

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

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

There are seven overlapping qualities in the drugs employed in ''Brimhana'' and ''Snehana'' and five overlapping qualities in the drugs employed in ''Brimhana'' and ''Stambhana''.

There are seven overlapping qualities in the drugs employed in [[brimhana]] and [[snehana]] and five overlapping qualities in the drugs employed in [[brimhana]] and [[stambhana]].

Though they are of similar qualities, they should not be concluded to be one and the same. In ''Langhana'' drugs, the qualities of lightness are dominant, while in ''Rukshana'', the drugs employed possess predominantly drying or desiccating qualities. Further, lightness can be induced through non-drug based therapies (''adravyabhuta'') such as fasting. However, dryness can only be brought about by drugs.  

Though they are of similar qualities, they should not be concluded to be one and the same. In [[langhana]] drugs, the qualities of lightness are dominant, while in [[rukshana]], the drugs employed possess predominantly drying or desiccating qualities. Further, lightness can be induced through non-drug based therapies (adravyabhuta) such as fasting. However, dryness can only be brought about by drugs.  

Thus, all these therapies are distinct even when possessing similarities in certain qualities.  

Thus, all these therapies are distinct even when possessing similarities in certain qualities.  

The ''Apatarpana'' type of treatments is related to ''agni'' + ''vayu'' + ''akasha mahabhuta'' dominant qualities in general whereas the ''Santarpana'' type of treatments is related to ''Prithvi'' + ''jala''.

The "Apatarpana" type of treatments is related to [[agni]] + [[vayu]] + [[akasha mahabhuta]] dominant qualities in general whereas the '"Santarpana" type of treatments is related to [[Prithvi]] + [[jala]].

All these (above mentioned) six types of treatments should be used in treating all the diseases. (9-17)

All these (above mentioned) six types of treatments should be used in treating all the diseases. (9-17)

Exposure to the wind can produce lightness in the body, but exposure to cold wind cannot produce lightness. The practical mode of ''maruta sevana'' includes walking or running in open place as exercise. The various types of breathing exercises including ''pranayama'' are included in this category. The drugs which are employed to improve digestion are dominant in ''vayu'' and ''agni mahabhuta''. ''Atapa sevana'' includes sunbath or exposure to ultraviolet rays present in the sunlight of early morning. (18)

Exposure to the wind can produce lightness in the body, but exposure to cold wind cannot produce lightness. The practical mode of "maruta sevana" includes walking or running in open place as exercise. The various types of breathing exercises including "pranayama" are included in this category. The drugs which are employed to improve digestion are dominant in [[vayu]] and [[agni mahabhuta]]. "Atapa sevana" includes sunbath or exposure to ultraviolet rays present in the sunlight of early morning. (18)

''Langhana'' is contraindicated in diseases / disorders caused purely by ''vata''. But when ''vata'' gets associated with excessively provoked ''kapha, pitta, rakta,'' and ''mala, shodhana'' (purificatory) method of lightening therapy should be used. Even though ''asthapana'' ''basti'' (non-unctuous enema) is ''vata shamaka'' (pacifying), it is ''ruksha'' in nature and can aggravate the ''vata''. So ''asthapana basti'' (non-unctuous enema) should be used judiciously wherever indicated.

[[Langhana]] is contraindicated in diseases / disorders caused purely by [[vata]]. But when [[vata]] gets associated with excessively provoked [[kapha]], [[pitta]], [[rakta]],and [[mala]], shodhana (purificatory) method of lightening therapy should be used. Even though asthapana [[basti]] (non-unctuous enema) is [[vata]] shamaka (pacifying), it is ruksha in nature and can aggravate the [[vata]]. So asthapana [[basti]] (non-unctuous enema) should be used judiciously wherever indicated.

   

   

The word ''adau'' (आदौ) is used for disorders caused by a moderate intensity of ''kapha'' and ''pitta'', such as ''chhardi'' (vomiting). In these conditions, after reducing ''dosha'' by digestive medicines (''pachana''), pacification of ''dosha'' (samshamana) shall be done. But sometimes the ''pachana'' method may not be enough to treat the disease, requiring other methods of ''Langhana'' to be explored. In strong people where the diseases manifest with the mild or little intensity of ''doshas'', any treatment course includes ''vyayama'' (exercise) and ''maruta atapa sevana'' (exposure to wind and the sun).  

The word ''adau'' (आदौ) is used for disorders caused by a moderate intensity of [[kapha]] and [[pitta]], such as chhardi (vomiting). In these conditions, after reducing [[dosha]] by digestive medicines ([[pachana]]), pacification of [[dosha]] (samshamana) shall be done. But sometimes the [[pachana]] method may not be enough to treat the disease, requiring other methods of [[langhana]] to be explored. In strong people where the diseases manifest with the mild or little intensity of [[dosha]], any treatment course includes vyayama (exercise) and maruta atapa sevana(exposure to wind and the sun).  

The increase of ''dhatus'' takes place naturally in the winter season (''shishira ritu'') due to ''visarga kala'' (winter solstice). This increase in ''dhatus'' occurs in conjunction with ''kapha''. At this juncture, the rational application of ''Langhana'' does not produce any adverse effect in people afflicted with ''vata'' diseases or possessing ''vata prakriti''.14/10-11]  

The increase of [[dhatu]] takes place naturally in the winter season (shishira ritu) due to visarga kala (winter solstice). This increase in [[dhatu]] occurs in conjunction with [[kapha]]. At this juncture, the rational application of [[langhana]] does not produce any adverse effect in people afflicted with [[vata]] diseases or possessing [[vata]] [[Prakriti]].14/10-11]  

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

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

==== Contemporary researches ====

==== Contemporary researches ====

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

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

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== References ==

== References ==