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Swedadhyaya (view source)

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<big>'''Abstract'''</big>

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<div style="text-align:justify;">This chapter deals with sudation (Swedana, therapeutic sweating) therapy, essentially followed after oleation therapy. Swedana (sudation) is a process in which the individual is subjected to therapeutic sweating. It is considered an essential prerequisite to Panchakarma (purification therapy involving five procedures) in [[Ayurveda]]. Swedana is intended to remove excessive vata and kapha dosha and is contraindicated in pitta disorders. The extent and intensity of swedana depends upon various factors such as physical strength, severity of dosha, season, site, age etc. There are specific indications and contraindications for swedana karma and the optimal signs should be strictly followed for the procedure. There are many agents to induce sweating which can be broadly divided into sagni sweda (sweating induced with the help of fire) and niragni sweda (induced without using fire). Bolus fomentation, steam fomentation, tub fomentation and poultice fomentation are some of the very common types of swedana procedures. There are thirteen varieties of fomentations (prevalent in the olden days) that involve direct usage of heat derived from fire, and ten methods without fire. Swedana is an effective therapeutic method in [[Ayurveda]] and is the focus of study in this chapter. </div>

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<div style="text-align:justify;">This chapter deals with sudation ([[Swedana]], therapeutic sweating) therapy, essentially followed after oleation therapy. [[Swedana]] (sudation) is a process in which the individual is subjected to therapeutic sweating. It is considered an essential prerequisite to [[Panchakarma]] (purification therapy involving five procedures) in [[Ayurveda]]. [[Swedana]] is intended to remove excessive [[vata]] and [[kapha dosha]] and is contraindicated in [[pitta]] disorders. The extent and intensity of [[swedana]] depends upon various factors such as physical strength, severity of [[dosha]], season, site, age etc. There are specific indications and contraindications for [[swedana]] karma and the optimal signs should be strictly followed for the procedure. There are many agents to induce sweating which can be broadly divided into sagni sweda (sweating induced with the help of fire) and niragni sweda (induced without using fire). Bolus fomentation, steam fomentation, tub fomentation and poultice fomentation are some of the very common types of [[swedana]] procedures. There are thirteen varieties of fomentations (prevalent in the olden days) that involve direct usage of heat derived from fire, and ten methods without fire. [[Swedana]] is an effective therapeutic method in [[Ayurveda]] and is the focus of study in this chapter. </div>

'''Keywords''': ''Avagaha sweda,'' fomentation, ''jentaka sweda, nadi sweda, niragni sweda, ushma sweda, pottali sweda, ruksha sweda, sagni sweda, sankara sweda, samyak swinna lakshana, snigdha sweda, sudation swedana, swedatiyoga, swedayoga, trayodasha sweda, upanaha sweda,'' fomentation, heat, sudation therapy, hydrosis.

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== Introduction ==

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As per [[Ayurveda]], the functioning of the universe depends upon ''agni'' and ''soma'' which symbolize sources of hot and cold energy. ''Uttarayana'' (northward sojourn of sun) and ''dakshinayana'' (southward sojourn of sun) are together responsible for maintaining homeostasis on this planet. This homeostasis is also mirrored in the individual through the concept of ''loka purusha samanya siddhantha'' (that the individual is a microcosm of the universe, the macrocosm). The ''purusha'' (individual human being) imbibes this energy and confines it in the ''sharira'' (body) as ''pitta''. This ''pitta'' controls, or rather regulates, the ''ushmanattva'' (core body temperature) of the body. [Cha.Sa.[[Sutra Sthana]] 12/11] It is responsible for all the metabolic processes at the cellular level and digestion at the level of the gut. ''Pitta'' is the contributor of ''ushna guna'' (warmth) to the body. The stimulator (''preraka'') of ''pitta'' is ''vata'' (the accelator-''sameerano agnehe''. [Cha.Sa.[[Sutra Sthana]] 12] ''Vata'', in association with ''pitta'' and ''kapha'', maintains the normal core body temperature by controlling the heat regulating system and balancing the ''sheeta'' and ''ushna guna''.

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As per [[Ayurveda]], the functioning of the universe depends upon ''agni'' and ''soma'' which symbolize sources of hot and cold energy. ''Uttarayana'' (northward sojourn of sun) and ''dakshinayana'' (southward sojourn of sun) are together responsible for maintaining homeostasis on this planet. This homeostasis is also mirrored in the individual through the concept of ''loka purusha samanya siddhantha'' (that the individual is a microcosm of the universe, the macrocosm). The ''[[purusha]]'' (individual human being) imbibes this energy and confines it in the ''sharira'' (body) as ''[[pitta]]''. This ''[[pitta]]'' controls, or rather regulates, the ''ushmanattva'' (core body temperature) of the body. [Cha.Sa.[[Sutra Sthana]] 12/11] It is responsible for all the metabolic processes at the cellular level and digestion at the level of the gut. ''[[Pitta]]'' is the contributor of ''ushna [[guna]]'' (warmth) to the body. The stimulator (''preraka'') of ''[[pitta]]'' is ''[[vata]]'' (the accelator-''sameerano agnehe''. [Cha.Sa.[[Sutra Sthana]] 12] ''[[Vata]]'', in association with ''[[pitta]]'' and ''[[kapha]]'', maintains the normal core body temperature by controlling the heat regulating system and balancing the ''sheeta'' and ''ushna [[guna]]''.

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''Swedana'' uses the ''agni'' principle in therapy. Practical applications of ''swedana'' procedures, along with indications, contraindications and complications associated with their management have been described in this chapter. It is recommended after proper ''snehana'' and is enlisted as one among six important therapies along with ''langhana'' (fasting or reducing therapy), ''brimhana'' (nourishing therapy), ''snehana'' (oleation), ''stambhana'' (styptic therapy) and ''rukshana'' (drying therapy).''Swedana'' has to be adopted based on the symptoms and conditions considering the ''samanya visesha sidhantha'' (theory of similarity and dissimilarity). ''Swedana'' procedures are indicated in ''vata, kapha'' and ''vata-kapha dosha'' dominant disorders, but are contraindicated in ''pittaja'' disorders. There are three types of twin procedures (with opposing actions to each other) used for various conditions:

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''[[Swedana]]'' uses the ''agni'' principle in therapy. Practical applications of ''[[swedana]]'' procedures, along with indications, contraindications and complications associated with their management have been described in this chapter. It is recommended after proper ''[[snehana]]'' and is enlisted as one among six important therapies along with ''[[langhana]]'' (fasting or reducing therapy), ''[[brimhana]]'' (nourishing therapy), ''[[snehana]]'' (oleation), ''[[stambhana]]'' (styptic therapy) and ''[[rukshana]]'' (drying therapy).''[[Swedana]]'' has to be adopted based on the symptoms and conditions considering the ''samanya visesha sidhantha'' (theory of similarity and dissimilarity). ''[[Swedana]]'' procedures are indicated in ''[[vata]], [[kapha]]'' and ''[[vata]]-[[kapha]] [[dosha]]'' dominant disorders, but are contraindicated in ''pittaja'' disorders. There are three types of twin procedures (with opposing actions to each other) used for various conditions:

#Thirteen types of procedures of ''sagni sweda'' (induced with help of fire) and ten types of ''niragni/anagniswedana'' (induced without help of fire) described for various sudation procedures.

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#''Ekangtah-sarvangtah'' (localized-generalized). An ''ekangtah'', or localized ''swedana,'' is administered by means of ''sankara sweda'' (bolus fomentation) and ''naadisweda'' (using a tube for fomentation) etc. and ''sarvantah'' or generalized ''swedana'' is administered by means of ''prastar'' (lying down on medicated hot mattress) and ''jentaaka'', (sudation in a heated room) etc.

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#''Ekangtah-sarvangtah'' (localized-generalized). An ''ekangtah'', or localized ''[[swedana]],'' is administered by means of ''sankara sweda'' (bolus fomentation) and ''naadisweda'' (using a tube for fomentation) etc. and ''sarvantah'' or generalized ''[[swedana]]'' is administered by means of ''prastar'' (lying down on medicated hot mattress) and ''jentaaka'', (sudation in a heated room) etc.

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''Snigdha'' (unctuous) procedures for ''vata'' dominant disorders and ''ruksha'' (dry) procedures for ''kapha'' dominant disorders are advised. In ''vata-kapha'' dominant disorders, ''snigdha-ruksha'' procedures are recommended.

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''Snigdha'' (unctuous) procedures for ''[[vata]]'' dominant disorders and ''ruksha'' (dry) procedures for ''[[kapha]]'' dominant disorders are advised. In ''[[vata]]-[[kapha]]'' dominant disorders, ''snigdha-ruksha'' procedures are recommended.

</div>

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Now we shall expound the chapter "Sweda"(sudation). Thus said Lord Atreya. [1-2]

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=== Importance of ''swedana'' ===

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=== Importance of ''[[swedana]]'' ===

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Now the various techniques of sudation will be explained. A well administered sudation cures various disorders of ''vata'' and ''kapha'' origin, provided they have been identified among a set of diseases that are curable by inducing sweat. Administering sudation, especially after oleation, controls ''vata'' and prevents clogging of feces, urine as well as semen. If oleation and sudation could soften dried out timber, then why not a human being? [3-5]

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Now the various techniques of sudation will be explained. A well administered sudation cures various disorders of ''[[vata]]'' and ''[[kapha]]'' origin, provided they have been identified among a set of diseases that are curable by inducing sweat. Administering sudation, especially after oleation, controls ''[[vata]]'' and prevents clogging of feces, urine as well as semen. If oleation and sudation could soften dried out timber, then why not a human being? [3-5]

</div>

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=== ''Scope of Swedana'' ===

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=== ''Scope of [[Swedana]]'' ===

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Strong fomentation is indicated in a physically strong patient with severe illness in an extreme cold climate. In a weak person, mild fomentation and in a moderately strong patient, moderate fomentation is preferred. In ''vatakapha, vata'' or ''kapha''-dominant, sudation technique is to be applied with the help of unctuous and dry agents, only unctuous agents or only dry agents respectively. [7-8]

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Strong fomentation is indicated in a physically strong patient with severe illness in an extreme cold climate. In a weak person, mild fomentation and in a moderately strong patient, moderate fomentation is preferred. In ''vatakapha, [[vata]]'' or ''[[kapha]]''-dominant, sudation technique is to be applied with the help of unctuous and dry agents, only unctuous agents or only dry agents respectively. [7-8]

</div>

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=== Mode of ''swedana'' as per site of ''dosha'' ===

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=== Mode of ''[[swedana]]'' as per site of ''[[dosha]]'' ===

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When ''vata'' is located at the site of ''ama'' (''amashaya'' or stomach), sudation is administered with dry agents and when ''kapha'' is located in the site of ''pakva'' (''pakwashaya'',or colon) , sudation is initiated with unctuous agents. [9]

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When ''[[vata]]'' is located at the site of ''ama'' (''amashaya'' or stomach), sudation is administered with dry agents and when ''[[kapha]]'' is located in the site of ''pakva'' (''pakwashaya'',or colon) , sudation is initiated with unctuous agents. [9]

</div>

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=== Sensitive body parts for ''swedana'' ===

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=== Sensitive body parts for ''[[swedana]]'' ===

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The symptoms of oversudation include aggravation of ''pitta'', fainting, generalized fatigue, thirst, burning sensation, low or weak voice, and weakness of limbs. In oversudation the entire regimen explained for summer season in [[Tasyashiteeya]] chapter, and consuming food articles that are sweet, unctuous and cool is to be followed. [14-15]

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The symptoms of oversudation include aggravation of ''[[pitta]]'', fainting, generalized fatigue, thirst, burning sensation, low or weak voice, and weakness of limbs. In oversudation the entire regimen explained for summer season in [[Tasyashiteeya]] chapter, and consuming food articles that are sweet, unctuous and cool is to be followed. [14-15]

</div>

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=== Contra-indications of ''swedana'' ===

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=== Contra-indications of ''[[swedana]]'' ===

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The physician should be aware that sudation is contraindicated in those who regularly consume astringents and alcohol, in pregnant women, persons with bleeding disorders, individuals with ''pitta'' predominance, those who are suffering from diarrhoea and sicca, patients with diabetes mellitus, inflamed colon, prolapsed rectum, in toxic conditions, fatigued, unconscious, obese, ''pitta''-predominant diabetics, individuals having thirst, hunger, anger, depression, jaundice, ascitis, injured, rheumatoid diseases, weakness, extremely emaciated, highly immune compromised and those who often suffer from blackouts. [16-19]

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The physician should be aware that sudation is contraindicated in those who regularly consume astringents and alcohol, in pregnant women, persons with bleeding disorders, individuals with ''[[pitta]]'' predominance, those who are suffering from diarrhoea and sicca, patients with diabetes mellitus, inflamed colon, prolapsed rectum, in toxic conditions, fatigued, unconscious, obese, ''[[pitta]]''-predominant diabetics, individuals having thirst, hunger, anger, depression, jaundice, ascitis, injured, rheumatoid diseases, weakness, extremely emaciated, highly immune compromised and those who often suffer from blackouts. [16-19]

</div>

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=== Indications of ''swedana'' ===

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=== Indications of ''[[swedana]]'' ===

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It is said that ''swedana'' is useful in rhinitis, cough, hiccups, breathing difficulties, heaviness of body, earache, headache, cervical pain, hoarseness of voice, choking sensation of throat, facial palsy, monoplegia, quadriplegia, hemiplegia, prostrated postures, abdominal flatulence, constipation, urinary retention, excessive yawning, stiffness of flanks, dorsum, lumbar and abdomen, sciatica, dysuria, scrotal enlargement, body ache, pain and stiffness of dorsum of foot, knee, thigh and calf, edema, severely painful radiculopathy, indigestion, chills and shivering, subluxation of ankle, contractures, convulsions, colicky pains, stiffness, heaviness and numbness, and such disorders anywhere in the body. [20-24]

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It is said that ''[[swedana]]'' is useful in rhinitis, cough, hiccups, breathing difficulties, heaviness of body, earache, headache, cervical pain, hoarseness of voice, choking sensation of throat, facial palsy, monoplegia, quadriplegia, hemiplegia, prostrated postures, abdominal flatulence, constipation, urinary retention, excessive yawning, stiffness of flanks, dorsum, lumbar and abdomen, sciatica, dysuria, scrotal enlargement, body ache, pain and stiffness of dorsum of foot, knee, thigh and calf, edema, severely painful radiculopathy, indigestion, chills and shivering, subluxation of ankle, contractures, convulsions, colicky pains, stiffness, heaviness and numbness, and such disorders anywhere in the body. [20-24]

</div>

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=== ''Swedana dravya'' (material for sudation) ===

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=== ''[[Swedana]] dravya'' (material for sudation) ===

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Fomentation bolus prepared with ''tila'' (Sesamum indicum Linn.), ''masha'' (Phaseolus radiates Linn.), ''kulatha'' (Dolichos biflorus Linn.), sour preparations, ''ghee'', oil, meat, boiled rice (''odana''), sweet porridge (''payasa)'', boiled mixture of cereals and legumes (''krishara'') and flesh, feces of cow, ass, camel, pig and horse along with barley grains with chaff, sand, dust, stone, dried cow dung and iron powder is effective for fomentation in the cases of ''kapha'' and ''vata'' related diseases. These articles may also be used for fomentation using a hot stone (''prastara sweda''). [25- 27]

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Fomentation bolus prepared with ''tila'' (Sesamum indicum Linn.), ''masha'' (Phaseolus radiates Linn.), ''kulatha'' (Dolichos biflorus Linn.), sour preparations, ''ghee'', oil, meat, boiled rice (''odana''), sweet porridge (''payasa)'', boiled mixture of cereals and legumes (''krishara'') and flesh, feces of cow, ass, camel, pig and horse along with barley grains with chaff, sand, dust, stone, dried cow dung and iron powder is effective for fomentation in the cases of ''[[kapha]]'' and ''[[vata]]'' related diseases. These articles may also be used for fomentation using a hot stone (''prastara sweda''). [25- 27]

</div>

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</div></div>

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Drugs for fomentation like plant-based articles (roots, fruits, leaves, buds etc.) or animal-based articles (flesh and heads of animals and birds) are mixed up with sour, salt or unctuous substances and urine, milk, etc. and decocted in a pitcher in such a way that the vapor does not leak out. Then, a pipe made up of leaves of ''vamsha'' (Bambusa arundinacea Retz.), ''karanja'' (Pongamia pinnata Merr.) or ''arka'' (Calotropis gigantea) with its fore part having the shape of the trunk of an elephant is inserted into the pitcher. The pipe required should be of one ''vyama'' (91.44cm) or half a ''vyama'' (45.72 cm) length, with its circumference being one-fourth of a ''vyama'' (22.86 cm) in its proximal end, one-eighth of a ''vyama'' in the distal end, and curved twice or thrice. All the clefts in the pipe should be well covered with leaves that alleviate ''vata''. The well-massaged patient should then get this steam through the curved pipe. Curvatures of the pipe help in lessening the intensity of steam and thus help in providing a comfortable fomentation experience. This fomentation technique is called ''nadi sweda''. [43]

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Drugs for fomentation like plant-based articles (roots, fruits, leaves, buds etc.) or animal-based articles (flesh and heads of animals and birds) are mixed up with sour, salt or unctuous substances and urine, milk, etc. and decocted in a pitcher in such a way that the vapor does not leak out. Then, a pipe made up of leaves of ''vamsha'' (Bambusa arundinacea Retz.), ''karanja'' (Pongamia pinnata Merr.) or ''arka'' (Calotropis gigantea) with its fore part having the shape of the trunk of an elephant is inserted into the pitcher. The pipe required should be of one ''vyama'' (91.44cm) or half a ''vyama'' (45.72 cm) length, with its circumference being one-fourth of a ''vyama'' (22.86 cm) in its proximal end, one-eighth of a ''vyama'' in the distal end, and curved twice or thrice. All the clefts in the pipe should be well covered with leaves that alleviate ''[[vata]]''. The well-massaged patient should then get this steam through the curved pipe. Curvatures of the pipe help in lessening the intensity of steam and thus help in providing a comfortable fomentation experience. This fomentation technique is called ''nadi sweda''. [43]

==== ''Parisheka sweda'' (shower technique for fomentation) ====

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</div></div>

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A fomentation technique that involves taking shower, using pitchers or vessels with holes at the bottom (''varshanika'') or pipes, filled with lukewarm decoctions of roots of drugs that alleviate isolated ''vata'' or ''vata''-predominant disorders, after suitable application of oil over body parts covered with cloth, is termed as ''parisheka''. [44]

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A fomentation technique that involves taking shower, using pitchers or vessels with holes at the bottom (''varshanika'') or pipes, filled with lukewarm decoctions of roots of drugs that alleviate isolated ''[[vata]]'' or ''[[vata]]''-predominant disorders, after suitable application of oil over body parts covered with cloth, is termed as ''parisheka''. [44]

==== ''Avagaha sweda'' (tub fomentation) ====

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</div></div>

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Fomentation by immersion in a tub filled up with ''vata'' alleviating decoctions, milk, oil, ghee, meat juices or hot water is termed as ''avagaha''. [45]

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Fomentation by immersion in a tub filled up with ''[[vata]]'' alleviating decoctions, milk, oil, ghee, meat juices or hot water is termed as ''avagaha''. [45]

==== ''Jentaka sweda'' (sudation therapy in room) ====

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</div></div>

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Examine the land thoroughly before resorting to the ''jentaka'' type of fomentation. Construct a circular building facing east or north, with a pond in front and ensuring that the site is in the eastern or northern side of the village. The building should be situated at a distance of 7- 8 ''aratnis'' (320-365 cm) from the pond. The land should be fertile, plain, and black or golden in colour. The height and diameter of the building should be 16 ''aratni'' each. (731 cm) and should be circular (as mentioned earlier), well plastered with mud and with many windows. A bench having 1 ''aratni'' (approximately 45 cm) width and height should be prepared all around the wall up to the door. An oven of clay, with a lid and with many holes, of four ''hasta'' diameter, and of height equal to that of the individual should be prepared in the center of the room. This oven should be filled up with fuel of ''khadira'' (acacia catechu) and ''aswakarna'' (dipterocarpus alatus) and ignited. As the wooden fuel is properly burned and the room is wellheated with fire alone (i.e., devoid of any smoke), it should be understood as fit for sudation with heat. Then you request the patient,who is well massaged with oil prepared with vata alleviating drugs and covered with a cloth, to enter the room by saying “Oh gentleman! Enter the room for the sake of your auspicious health. Go to the bench and lie down thereon, alternately changing sides comfortably, you should not leave the bench even if you feel fainting by severe sweating until you feel suffocated, otherwise on leaving you may not be able to reach the door and it may be fatal, do not leave the bench. As you feel yourself free from all clogging, with sticky sweat drained and all channels open, light and devoid of obstructions, stiffness, numbness, pain, and heaviness, you should then leave the bench and exit through the door. After coming out of that room, do not immediately apply cold water for the sake of your eyes. After one ''muhurta'', as the heat and exertion subsides, you should bathe in lukewarm water and then eat a meal”. This is ''jentaka sweda''. [46]

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Examine the land thoroughly before resorting to the ''jentaka'' type of fomentation. Construct a circular building facing east or north, with a pond in front and ensuring that the site is in the eastern or northern side of the village. The building should be situated at a distance of 7- 8 ''aratnis'' (320-365 cm) from the pond. The land should be fertile, plain, and black or golden in colour. The height and diameter of the building should be 16 ''aratni'' each. (731 cm) and should be circular (as mentioned earlier), well plastered with mud and with many windows. A bench having 1 ''aratni'' (approximately 45 cm) width and height should be prepared all around the wall up to the door. An oven of clay, with a lid and with many holes, of four ''hasta'' diameter, and of height equal to that of the individual should be prepared in the center of the room. This oven should be filled up with fuel of ''khadira'' (acacia catechu) and ''aswakarna'' (dipterocarpus alatus) and ignited. As the wooden fuel is properly burned and the room is wellheated with fire alone (i.e., devoid of any smoke), it should be understood as fit for sudation with heat. Then you request the patient,who is well massaged with oil prepared with [[vata]] alleviating drugs and covered with a cloth, to enter the room by saying “Oh gentleman! Enter the room for the sake of your auspicious health. Go to the bench and lie down thereon, alternately changing sides comfortably, you should not leave the bench even if you feel fainting by severe sweating until you feel suffocated, otherwise on leaving you may not be able to reach the door and it may be fatal, do not leave the bench. As you feel yourself free from all clogging, with sticky sweat drained and all channels open, light and devoid of obstructions, stiffness, numbness, pain, and heaviness, you should then leave the bench and exit through the door. After coming out of that room, do not immediately apply cold water for the sake of your eyes. After one ''muhurta'', as the heat and exertion subsides, you should bathe in lukewarm water and then eat a meal”. This is ''jentaka sweda''. [46]

==== ''Ashmaghana sweda'' (sudation on heated slab of stone) ====

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</div></div>

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A compact slab of stone, of the length of an average human body, is heated with ''vata'' alleviating wooden fuel. Then all the firebrands are removed and the slab sprinkled with hot water and covered with silk or woolen sheets. The person, well massaged with oil all over his body and covered with garments is made to lie down on the slab for sudation. This fomentation technique is called ''ashmaghna sweda''. [47-49]

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A compact slab of stone, of the length of an average human body, is heated with ''[[vata]]'' alleviating wooden fuel. Then all the firebrands are removed and the slab sprinkled with hot water and covered with silk or woolen sheets. The person, well massaged with oil all over his body and covered with garments is made to lie down on the slab for sudation. This fomentation technique is called ''ashmaghna sweda''. [47-49]

==== ''Karshu sweda'' (sudation by using heat in a trench under bed) ====

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</div></div>

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A pitcher, filled up with decoction of vata alleviating drugs should be buried in earth upto one-fourth or one-fourth of it and a bed covered with a thin sheet kept over it. The patient, well massaged with oil alleviating ''vata'' and covered with a cloth, should either lie down or sit on the bed. Thereafter hot iron balls or stones should be put into the pitcher. The heat coming out of the pitcher helps in fomentation and this is termed as ''kumbhisweda''. [56-58]

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A pitcher, filled up with decoction of [[vata]] alleviating drugs should be buried in earth upto one-fourth or one-fourth of it and a bed covered with a thin sheet kept over it. The patient, well massaged with oil alleviating ''[[vata]]'' and covered with a cloth, should either lie down or sit on the bed. Thereafter hot iron balls or stones should be put into the pitcher. The heat coming out of the pitcher helps in fomentation and this is termed as ''kumbhisweda''. [56-58]

==== ''Kupa sweda'' (sudation in a pit) ====

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