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The word ‘langhana’ represents the act of leaping or jumping, stepping across, leaping over, mounting etc. It also represents fasting, hunger or starving system.<ref>Monier-Williams, Monier-Williams Sanskrit- English Dictionary, 1st edition; Oxford University Press, Langhana, Page 895</ref> This is one among the six basic treatment principles in Ayurveda. [Cha.Sa.[[Sutra Sthana]] 22/4] Lightening therapy (langhana) can be achieved even without using any medications. [Cakrapani on Cha.Sa.[[Sutra Sthana]] 22/12-13]
==Etymology and derivation==
Langhana is derived from the root word ‘langha’ by adding ‘lyut’ suffix to it. It means fasting (upavasa) [Sabdakalpadruma]
==Definition==
The procedures which produce lightness or reduction in the body are called ‘langhana’. [Cha.Sa.[[Sutra Sthana]] 22/10]
==Synonyms==
Apatarpana [A.Hr. Sutra Sthana 14/2]<ref name= Hridaya > Vagbhata. Ashtanga Hridayam. Edited by Harishastri Paradkar Vaidya. 1st ed. Varanasi: Krishnadas Academy;2000.</ref>
==Meaning of word ‘langhana’ in different contexts==
*Reducing or lightening therapies as a whole are termed as ‘langhana’. Most commonly ‘langhana’ represents ‘fasting’ which is one among the reducing therapy.
*The term ‘langhana’ also represents the act of jumping. [Cha.Sa.[[Nidana Sthana]] 8/11] [Cha.Sa.[[Vimana Sthana]] 6/18]
==Properties of lightening (langhana) drugs==
The lightening material possess the following properties
*Light (laghu)
*Hot (ushna)
*Sharp / intense (tikshna)
*Clearing (visada)
*Dry (ruksha)
*Subtle (sukshma)
*Rough (khara)
*Unstable / flowing (sara)
*Hard (katina) [Cha.Sa.[[Sutra Sthana]] 22/12-13]
The predominant property is lightness (laghu). [Cakrapani on Cha.Sa.[[Sutra Sthana]] 22/12-13]
==[[Panchamahabhuta]] composition of lightening (langhana) drug==
Drugs with [[agni]], [[vayu]] and [[akasha]] [[mahabhuta]] predominance are usually lightening (langhana) in nature. [A.S Sutra Sthana 24/3]<ref name= Sangraha> Vridha Vagbhata, Ashtanga Sangraha. Edited by Shivaprasad Sharma. 3rd ed. Varanasi: Chaukhamba sanskrit series office;2012.</ref>
==Classification==
Methods to achieve lightening (langhana) can be broadly classified into
*Purifying ([[shodhana]]) procedures
*Pacifying ([[shamana]]) procedures [A.Hr. Sutra Sthana 14/4]<ref name=Hridaya/>
===Purifying ([[shodhana]]) procedures===
This includes the following procedures
#Enema with decoction (niruha [[basti]])
#Therapeutic emesis ([[vamana]])
#Therapeutic purgation (kayavireka)
#Intra nasal drug administration (shirovireka)
#Bloodletting (asravisruti) [A.Hr. Sutra Sthana 14/5]<ref name=Hridaya/>
===Pacifying (shamana) procedures===
This includes the following procedures
#Carminatives ([[pachana]])
#Appetizers ([[dipana]])
#Withstanding hunger (kshut)
#Withstanding thirst (trit)
#Exercises/physical activities ([[vyayama]])
#Exposure to sunlight (atapa)
#Exposure to wind (maruta) [A.Hr. Sutra Sthana 14/6-7]<ref name=Hridaya/>
Charaka considers 10 lightening (langhana) therapies by excluding bloodletting (asravisruti) and appetizers ([[dipana]]) from the above. [Cha.Sa.[[Sutra Sthana]] 22/18]
==Indications==
Lightening therapy (langhana) is indicated in persons who used to consume excess unctuous food, with excess body discharges and for those who had undergone nourishing therapies. [Cha.Sa.[[Sutra Sthana]] 22/24]
Mild lightening therapy (langhana) is indicated for those who desire to undergo nourishing therapy ([[brimhana]]) [A.Hr. Sutra Sthana 14/15]
In the accumulation of undigested/toxic biological waste ([[ama]]), fasting (langhana) and use of digestive recipes are ideal [Su.Sa.Uttara Sthana 40/34]<ref name= Susruta> Sushruta. Sushruta Samhita. Edited by Jadavaji Trikamji Aacharya. 8th ed. Varanasi: Chaukhambha Orientalia;2005.</ref> If [[ama]] gets absorbed along with nutritive fluid ([[rasa dhatu]]) and if it pervades throughout the body then also fasting (langhana) should be advised. [Cha.Sa.[[Chikitsa Sthana]] 15/75]
After purificatory procedures like therapeutic emesis ([[vamana]]) and therapeutic purgation ([[virechana]]) since the digestive power will be less, the person should undergo fasting (langhana).
Persons suffering from fever, stiffness of thighs, herpes, abscess, splenic diseases, diseases of head, throat and eyes, and those who are obese are indicated for lightening therapy (langhana). [A.S.Sutra Sthana 24/10]<ref name=Sangraha/> Skin disorders (kushta) and urinary disorders (prameha) should be treated with lightening therapy (langhana). [Cha.Sa.[[Sutra Sthana]] 22/24]
===Indications of individual lightening therapies (langhana)===
Purifying procedures
*In conditions of excessive increase of [[kapha]], [[pitta]], blood and waste products ([[mala]]).
*Obstruction of [[vata]].
*Those who have good physical strength and bulky stature. [Cha.Sa.[[Sutra Sthana]] 22/19]
*Fever, vomiting, diarrhea, cardiac complaints, constipation, heaviness, belching, nausea etc. [A.Hr. Sutra Sthana 14/12]<ref name=Hridaya/>
Digestive measures ([[pachana]])
*Diseases with moderate strength
*Diseases having [[kapha]] and [[pitta]] predominance
*Vomiting, diarrhea, heart disease, acute intestinal irritation, intestinal sluggishness, fever, constipation, heaviness of body, eructation, nausea and anorexia [Cha.Sa.[[Sutra Sthana]] 22/20-21]
Restraint from food (upavasa) and drink (pipasa)
*Diseases with mild strength [Cha.Sa.[[Sutra Sthana]] 22/22]
Physical exercise ([[vyayama]]), exposure to sunlight (aatapa) and exposure to wind (maruta)
*Mild to moderate intensity diseases for patients with good physical strength [Cha.Sa.[[Sutra Sthana]] 22/23]
==Contraindications==
*[[Vata]] predominant conditions
*Conditions of fear, anger, grief and physical exertion [Cha.Sa.[[Chikitsa Sthana]] 3/139]
*Fever with [[pitta]] predominance [A.S.Chikitsa Sthana 1/13]<ref name=Sangraha/>
*Fever caused by external agents (agantuja jwara) and in fevers of long duration (jeerna jwara) [A.S.Chikitsa Sthana 1/17]<ref name=Sangraha/>
==Features of optimal langhana==
*Proper evacuation of flatus, urine and feces
*Feeling of lightness in the body
*Feeling of clarity in heart, eructation, throat and mouth
*Disappearance of drowsiness and exhaustion
*Appearance of perspiration
*Reappearance of taste, hunger and thirst
*Feeling of wellbeing [Cha.Sa.[[Sutra Sthana]] 22/34-35]
*Unable to tolerate hunger and thirst [Su.Sa. Uttara Sthana 39/105]<ref name=Susruta/>
*Clarity of sense organs [A.Hr. Sutra Sthana 14/17]<ref name=Hridaya/>
==Features of excessive administration of langhana==
*Pain in the joints
*Body ache
*Cough
*Dryness of the mouth
*Complete loss of hunger
*Anorexia
*Thirst
*Weakness of hearing and vision
*Confusion of mind
*Frequent eructation
*Fainting
*Frequent upward movement of vata
*Loss of body weight, digestive power and strength [Cha.Sa.[[Sutra Sthana]] 22/36-37]
*Profound emaciation
*Loss of sleep
*Delirium
*Non elimination of faeces and urine [A.Hr. Sutra Sthana 14/29-30]<ref name=Hridaya/>
*Occurrence of secondary disease like dyspnoea [Su.Sa.Uttara Sthana. 39/106]<ref name=Susruta/>
Fasting (langhana) may also lead to the formation of certain diseases/conditions like:
Emaciation of body [Cha.Sa.[[Sutra Sthana]] 21/11], wasting disorders due to over exertion (sahasaja rajayakshama) [Cha.Sa.[[Chikitsa Sthana]] 8/14], hemorrhoid [Cha.Sa.[[Chikitsa Sthana]] 14/13], excessive thirst (trishna) [Cha.Sa.[[Chikitsa Sthana]] 22/4], diseases of thigh (urustamba) [Cha.Sa.[[Chikitsa Sthana]] 27/9] etc. So lightening therapies (langhana) should be performed to the extent that it does not hamper the vitality or strength of the individual. [Cha.Sa.[[Chikitsa Sthana]] 3/141]
==Benefits of lightening therapy (langhana)==
When the [[dosha]]s become mitigated by fasting, digestive fire (agni) becomes intense and body feels light, then develop health, hunger, thirst, desire for food, digestion, strength and vigour. [A.S.Chikitsa Sthana 1/3]<ref name=Sangraha/>
==Importance in diagnosis==
Craving for fasting (langhana) is seen in conditions were [[vata]] gets occluded by [[kapha]]. [Cha.Sa.[[Chikitsa Sthana]] 28/63]
==Importance in preservation of health and prevention==
For healthy persons lightening therapy (langhana) can be done on winter season (shishira and hemanta) [Cha.Sa.[[Sutra Sthana]] 22/24][A.Hr. Sutra Sthana 14/11]<ref name=Hridaya/> as the body strength will be high during this period. In case of accumulation of toxic biological waste ([[ama]]) and in obese persons, lightening therapy (langhana) should be done daily. [A.Hr. Sutra Sthana 14/10-11] <ref name=Hridaya/>
==Importance in management of disease==
Fasting (langhana) is one among the three depletion therapies. It is indicated if the [[dosha]]s are in less strength. Fasting stimulates digestive fire (agni) and [[vata]], which results in the reduction of [[dosha]] [Cha.Sa.[[Vimana Sthana]] 3/44]
Lightening therapies (langhana) especially fasting is the first-line therapy in many disorders.
It is advocated in the initial stage of
*Fever [Cha.Sa.[[Chikitsa Sthana]] 3/139]
*Bleeding disorders (raktapitta) especially through the upper orifices (eyes, mouth and nose) as it is associated with [[pitta]] along with toxic biological waste (sama pitta) and [[kapha]] [[dosha]] [Cha.Sa.[[Chikitsa Sthana]] 4/30]
*Abdominal tumors (gulma) caused due to [[kapha]] [[dosha]] [Cha.Sa.[[Chikitsa Sthana]] 5/49]
*Swelling associated with toxic biological waste ([[ama]]) [Cha.Sa.[[Chikitsa Sthana]] 12/17]
*Non infectious gastroenteritis (visuchika) [Cha.Sa.[Vimana Sthana]] 2/13]
*Vomiting (cchardi) as it is considered to be originating from the agitations of the [[dosha]]s in the stomach (amashaya) [Cha.Sa.[[Chikitsa Sthana]] 20/20]
All diseases which originate from the stomach (amasaya) can be treated through fasting (langhana). [Cha.Sa.[[Nidana Sthana]] 8/31]
For all disorders of nutritive fluid ([[rasa]])[Cha.Sa.[[Sutra Sthana]] 28/25] and for the conditions specially affecting mouth, the line of treatment is fasting (langhana) [Cha.Sa.[[Chikitsa Sthana]] 12/80]
Fever can be treated with fasting (langhana) alone [Cha.Sa.[[Nidana Sthana]] 8/31] if associated with toxic biological waste accumulation([[ama]]) or during the predominance of [[kapha]] or [[kapha]] and [[pitta]] [[dosha]]. [Cha.Sa.[[Chikitsa Sthana]] 3/284] The [[kapha]] predominant stage of chronic intermittent fever can also be managed through reducing (langhana) therapies. [Cha.Sa.[[Chikitsa Sthana]] 3/295] Fever patients who are unsuitable for oleation and purificatory therapies should be treated by lightening therapies (langhana). [Su.Sa.Uttara Sthana 39/99]<ref name=Susruta/>
Bleeding hemorrhoids with [[kapha]] and [[pitta]] aggravation [Cha.Sa.[[Chikitsa Sthana]] 14/176], Diabetic mellitus (prameha) caused by [[kapha]] [Cha.Sa.[[Chikitsa Sthana]] 6/25], ulcers with [[kapha]] predominance [Cha.Sa.[[Chikitsa Sthana]] 25/16], rhinitis of [[kapha]] origin (kaphaja pinasa) associated with heaviness and anorexia [Cha.Sa.[[Chikitsa Sthana]] 26/149] should be treated through lightening therapies (langhana).
Cardiac disorders [Cha.Sa.[[Chikitsa Sthana]] 26/100] and diseases caused by the suppression of urge of vomiting is to be treated through fasting (langhana). [Cha.Sa.[[Sutra Sthana]] 7/15] Slightly aggravated [[dosha]] should be managed by fasting therapy (langhana) in case of diarrhea. [Cha.Sa.[[Chikitsa Sthana]] 19/19]
In the prodormal stage of all varieties of erysepalas (visarpa), fasting and other lightening therapies (langhana) should be done. [A.S.Chikitsa Sthana 20/2]<ref name=Sangraha/> If erysepalas (visarpa) is caused with [[dosha]] in the state of incomplete transformation ([[ama]]) and is located in thorax and upper body parts (kaphasthana), fasting therapy (langhana) is beneficial. [Cha.Sa.[[Chikitsa Sthana]] 21/44] Fissure in ano if associated with [[ama]] [Cha.Sa.[[Siddhi Sthana]] 6/63], for indigestion caused due to [[ama]] (amajeerna) [Su.Sa.Sutra Sthana. 46/505]<ref name=Susruta/>, bloating in upper abdomen (anaha) as caused by improperly digested food/product of improper digestion ([[ama]]), associated with stiffness in cardiac region, diseases of head and heaviness, retention of belching, common cold should be treated with fasting therapy (langhana) [Cha.Sa.[[Chikitsa Sthana]] 26/26]
The diseases pacified through lightening therapies (langhana) may re-occur as the causative [[dosha]] may not be completely eliminated out from body. [Cha.Sa.[[Sutra Sthana]] 16/20]
==Physiology of fasting==
During the third phase of fasting, glycogen stored in hepatocytes undergo depletion. It also accelerates adipose tissue lipolysis. Thus more fatty acids and glycerol is formed which gets released into blood. At the same time, the other cells may produce ketones. The fatty acids get transported into hepatocytes, get metabolized and produce ketones beta-OHB and acetoacetate. This induces mitochondrial biogenesis.
The ketones thus produced are transported into cells with high metabolic activity such as neurons, muscles etc., become acetyl coenzyme A. It enters the tricarboxylic acid (TCA) cycle where ATP is generated. Thus during fasting, primary energy source of the body shifts from glucose to fatty acids and ketones.<ref name=AntonSD>Anton SD, Moehl K, Donahoo WT, Marosi K, Lee SA, Mainous AG 3rd, Leeuwenburgh C, Mattson MP. Flipping the Metabolic Switch: Understanding and Applying the Health Benefits of Fasting. Obesity (Silver Spring). 2018</ref>
==Current researches==
In a study conducted on 59 patients having poor digestive power, it is reported that the lightening therapies, fasting and digestive medicine, Zingiber officinale (sunti), improves appetite, food intake and enthusiasm. It makes the body feels lighter and also aids in unobstructed expulsion of urine and feaces. The digestive fire acts directly over the [[dosha]] in the absence of food. The body regains its normalcy once the vitiated [[dosha]] undergo digestion (paka).<ref>Rajani A, Vyas MK, Vyas HA. Comparative study of Upavasa and Upavasa with Pachana in the management of Agnisada. Ayu. 2010 Jul;31(3):351-4. doi: 10.4103/0974-8520.77166. PMID: 22131738; PMCID: PMC3221070.</ref>
Fasting therapy results in significant reduction in weight and BMI. In a study conducted on 44 healthy individuals, short term fasting therapy is compared with low calorie diet. Greater reduction in weight and Leptin levels were achieved through fasting than low calorie diet. Increased beta-oxidation is observed during fasting.<ref>Shetty P, Dinesh S, Halappa NG, Rajany T. Comparing the effects of short-term fasting therapy and low-calorie diet on anthropometric and leptin measures among obese or overweight persons: Randomized controlled trial. Ancient Sci Life 2018;37:133-40.</ref>
Average life span is increased by 30% when the rats were maintained on alternate day fasting. Plasma glucose, insulin and leptin levels were low for the rats maintained on fasting. Ketone and adiponectin levels were more. Inflammatory markers were found to be reduced in liver of rats kept on time restricted feeding. The normal decline in muscle mass during ageing is found to be prevented by caloric restriction in mice. Fasting stimulates autophagy in muscles. Cardiovascular stress adaptations were noted in rats kept on alternate day fasting. It also increases brain derived neurotrophic factor which plays a major role in synaptic plasticity and neurogenesis. <ref name=AntonSD/>
Fasting is beneficial in metabolic syndrome by decreasing fasting glucose, fasting insulin and insulin resistance. It also reduce the cardiovascular risk factors like total cholesterol, LDL, triglycerides etc. In diabetic patients improved insulin sensitivity and glucose tolerance was reported immediately after a fast. <ref name=AntonSD/>
==List of theses done==
#Dharmi P Bhuva (2013): Fundamental and applied aspect of karma as karana in Ayurveda w.s.r to langhana karma. Department of basic principles. IPGT&RA Jamnagar
==More information==
[[Langhanabrimhaniya Adhyaya]]
[[Janapadodhvansaniya Vimana]]
[[Jwara Chikitsa]]
==References==
==Etymology and derivation==
Langhana is derived from the root word ‘langha’ by adding ‘lyut’ suffix to it. It means fasting (upavasa) [Sabdakalpadruma]
==Definition==
The procedures which produce lightness or reduction in the body are called ‘langhana’. [Cha.Sa.[[Sutra Sthana]] 22/10]
==Synonyms==
Apatarpana [A.Hr. Sutra Sthana 14/2]<ref name= Hridaya > Vagbhata. Ashtanga Hridayam. Edited by Harishastri Paradkar Vaidya. 1st ed. Varanasi: Krishnadas Academy;2000.</ref>
==Meaning of word ‘langhana’ in different contexts==
*Reducing or lightening therapies as a whole are termed as ‘langhana’. Most commonly ‘langhana’ represents ‘fasting’ which is one among the reducing therapy.
*The term ‘langhana’ also represents the act of jumping. [Cha.Sa.[[Nidana Sthana]] 8/11] [Cha.Sa.[[Vimana Sthana]] 6/18]
==Properties of lightening (langhana) drugs==
The lightening material possess the following properties
*Light (laghu)
*Hot (ushna)
*Sharp / intense (tikshna)
*Clearing (visada)
*Dry (ruksha)
*Subtle (sukshma)
*Rough (khara)
*Unstable / flowing (sara)
*Hard (katina) [Cha.Sa.[[Sutra Sthana]] 22/12-13]
The predominant property is lightness (laghu). [Cakrapani on Cha.Sa.[[Sutra Sthana]] 22/12-13]
==[[Panchamahabhuta]] composition of lightening (langhana) drug==
Drugs with [[agni]], [[vayu]] and [[akasha]] [[mahabhuta]] predominance are usually lightening (langhana) in nature. [A.S Sutra Sthana 24/3]<ref name= Sangraha> Vridha Vagbhata, Ashtanga Sangraha. Edited by Shivaprasad Sharma. 3rd ed. Varanasi: Chaukhamba sanskrit series office;2012.</ref>
==Classification==
Methods to achieve lightening (langhana) can be broadly classified into
*Purifying ([[shodhana]]) procedures
*Pacifying ([[shamana]]) procedures [A.Hr. Sutra Sthana 14/4]<ref name=Hridaya/>
===Purifying ([[shodhana]]) procedures===
This includes the following procedures
#Enema with decoction (niruha [[basti]])
#Therapeutic emesis ([[vamana]])
#Therapeutic purgation (kayavireka)
#Intra nasal drug administration (shirovireka)
#Bloodletting (asravisruti) [A.Hr. Sutra Sthana 14/5]<ref name=Hridaya/>
===Pacifying (shamana) procedures===
This includes the following procedures
#Carminatives ([[pachana]])
#Appetizers ([[dipana]])
#Withstanding hunger (kshut)
#Withstanding thirst (trit)
#Exercises/physical activities ([[vyayama]])
#Exposure to sunlight (atapa)
#Exposure to wind (maruta) [A.Hr. Sutra Sthana 14/6-7]<ref name=Hridaya/>
Charaka considers 10 lightening (langhana) therapies by excluding bloodletting (asravisruti) and appetizers ([[dipana]]) from the above. [Cha.Sa.[[Sutra Sthana]] 22/18]
==Indications==
Lightening therapy (langhana) is indicated in persons who used to consume excess unctuous food, with excess body discharges and for those who had undergone nourishing therapies. [Cha.Sa.[[Sutra Sthana]] 22/24]
Mild lightening therapy (langhana) is indicated for those who desire to undergo nourishing therapy ([[brimhana]]) [A.Hr. Sutra Sthana 14/15]
In the accumulation of undigested/toxic biological waste ([[ama]]), fasting (langhana) and use of digestive recipes are ideal [Su.Sa.Uttara Sthana 40/34]<ref name= Susruta> Sushruta. Sushruta Samhita. Edited by Jadavaji Trikamji Aacharya. 8th ed. Varanasi: Chaukhambha Orientalia;2005.</ref> If [[ama]] gets absorbed along with nutritive fluid ([[rasa dhatu]]) and if it pervades throughout the body then also fasting (langhana) should be advised. [Cha.Sa.[[Chikitsa Sthana]] 15/75]
After purificatory procedures like therapeutic emesis ([[vamana]]) and therapeutic purgation ([[virechana]]) since the digestive power will be less, the person should undergo fasting (langhana).
Persons suffering from fever, stiffness of thighs, herpes, abscess, splenic diseases, diseases of head, throat and eyes, and those who are obese are indicated for lightening therapy (langhana). [A.S.Sutra Sthana 24/10]<ref name=Sangraha/> Skin disorders (kushta) and urinary disorders (prameha) should be treated with lightening therapy (langhana). [Cha.Sa.[[Sutra Sthana]] 22/24]
===Indications of individual lightening therapies (langhana)===
Purifying procedures
*In conditions of excessive increase of [[kapha]], [[pitta]], blood and waste products ([[mala]]).
*Obstruction of [[vata]].
*Those who have good physical strength and bulky stature. [Cha.Sa.[[Sutra Sthana]] 22/19]
*Fever, vomiting, diarrhea, cardiac complaints, constipation, heaviness, belching, nausea etc. [A.Hr. Sutra Sthana 14/12]<ref name=Hridaya/>
Digestive measures ([[pachana]])
*Diseases with moderate strength
*Diseases having [[kapha]] and [[pitta]] predominance
*Vomiting, diarrhea, heart disease, acute intestinal irritation, intestinal sluggishness, fever, constipation, heaviness of body, eructation, nausea and anorexia [Cha.Sa.[[Sutra Sthana]] 22/20-21]
Restraint from food (upavasa) and drink (pipasa)
*Diseases with mild strength [Cha.Sa.[[Sutra Sthana]] 22/22]
Physical exercise ([[vyayama]]), exposure to sunlight (aatapa) and exposure to wind (maruta)
*Mild to moderate intensity diseases for patients with good physical strength [Cha.Sa.[[Sutra Sthana]] 22/23]
==Contraindications==
*[[Vata]] predominant conditions
*Conditions of fear, anger, grief and physical exertion [Cha.Sa.[[Chikitsa Sthana]] 3/139]
*Fever with [[pitta]] predominance [A.S.Chikitsa Sthana 1/13]<ref name=Sangraha/>
*Fever caused by external agents (agantuja jwara) and in fevers of long duration (jeerna jwara) [A.S.Chikitsa Sthana 1/17]<ref name=Sangraha/>
==Features of optimal langhana==
*Proper evacuation of flatus, urine and feces
*Feeling of lightness in the body
*Feeling of clarity in heart, eructation, throat and mouth
*Disappearance of drowsiness and exhaustion
*Appearance of perspiration
*Reappearance of taste, hunger and thirst
*Feeling of wellbeing [Cha.Sa.[[Sutra Sthana]] 22/34-35]
*Unable to tolerate hunger and thirst [Su.Sa. Uttara Sthana 39/105]<ref name=Susruta/>
*Clarity of sense organs [A.Hr. Sutra Sthana 14/17]<ref name=Hridaya/>
==Features of excessive administration of langhana==
*Pain in the joints
*Body ache
*Cough
*Dryness of the mouth
*Complete loss of hunger
*Anorexia
*Thirst
*Weakness of hearing and vision
*Confusion of mind
*Frequent eructation
*Fainting
*Frequent upward movement of vata
*Loss of body weight, digestive power and strength [Cha.Sa.[[Sutra Sthana]] 22/36-37]
*Profound emaciation
*Loss of sleep
*Delirium
*Non elimination of faeces and urine [A.Hr. Sutra Sthana 14/29-30]<ref name=Hridaya/>
*Occurrence of secondary disease like dyspnoea [Su.Sa.Uttara Sthana. 39/106]<ref name=Susruta/>
Fasting (langhana) may also lead to the formation of certain diseases/conditions like:
Emaciation of body [Cha.Sa.[[Sutra Sthana]] 21/11], wasting disorders due to over exertion (sahasaja rajayakshama) [Cha.Sa.[[Chikitsa Sthana]] 8/14], hemorrhoid [Cha.Sa.[[Chikitsa Sthana]] 14/13], excessive thirst (trishna) [Cha.Sa.[[Chikitsa Sthana]] 22/4], diseases of thigh (urustamba) [Cha.Sa.[[Chikitsa Sthana]] 27/9] etc. So lightening therapies (langhana) should be performed to the extent that it does not hamper the vitality or strength of the individual. [Cha.Sa.[[Chikitsa Sthana]] 3/141]
==Benefits of lightening therapy (langhana)==
When the [[dosha]]s become mitigated by fasting, digestive fire (agni) becomes intense and body feels light, then develop health, hunger, thirst, desire for food, digestion, strength and vigour. [A.S.Chikitsa Sthana 1/3]<ref name=Sangraha/>
==Importance in diagnosis==
Craving for fasting (langhana) is seen in conditions were [[vata]] gets occluded by [[kapha]]. [Cha.Sa.[[Chikitsa Sthana]] 28/63]
==Importance in preservation of health and prevention==
For healthy persons lightening therapy (langhana) can be done on winter season (shishira and hemanta) [Cha.Sa.[[Sutra Sthana]] 22/24][A.Hr. Sutra Sthana 14/11]<ref name=Hridaya/> as the body strength will be high during this period. In case of accumulation of toxic biological waste ([[ama]]) and in obese persons, lightening therapy (langhana) should be done daily. [A.Hr. Sutra Sthana 14/10-11] <ref name=Hridaya/>
==Importance in management of disease==
Fasting (langhana) is one among the three depletion therapies. It is indicated if the [[dosha]]s are in less strength. Fasting stimulates digestive fire (agni) and [[vata]], which results in the reduction of [[dosha]] [Cha.Sa.[[Vimana Sthana]] 3/44]
Lightening therapies (langhana) especially fasting is the first-line therapy in many disorders.
It is advocated in the initial stage of
*Fever [Cha.Sa.[[Chikitsa Sthana]] 3/139]
*Bleeding disorders (raktapitta) especially through the upper orifices (eyes, mouth and nose) as it is associated with [[pitta]] along with toxic biological waste (sama pitta) and [[kapha]] [[dosha]] [Cha.Sa.[[Chikitsa Sthana]] 4/30]
*Abdominal tumors (gulma) caused due to [[kapha]] [[dosha]] [Cha.Sa.[[Chikitsa Sthana]] 5/49]
*Swelling associated with toxic biological waste ([[ama]]) [Cha.Sa.[[Chikitsa Sthana]] 12/17]
*Non infectious gastroenteritis (visuchika) [Cha.Sa.[Vimana Sthana]] 2/13]
*Vomiting (cchardi) as it is considered to be originating from the agitations of the [[dosha]]s in the stomach (amashaya) [Cha.Sa.[[Chikitsa Sthana]] 20/20]
All diseases which originate from the stomach (amasaya) can be treated through fasting (langhana). [Cha.Sa.[[Nidana Sthana]] 8/31]
For all disorders of nutritive fluid ([[rasa]])[Cha.Sa.[[Sutra Sthana]] 28/25] and for the conditions specially affecting mouth, the line of treatment is fasting (langhana) [Cha.Sa.[[Chikitsa Sthana]] 12/80]
Fever can be treated with fasting (langhana) alone [Cha.Sa.[[Nidana Sthana]] 8/31] if associated with toxic biological waste accumulation([[ama]]) or during the predominance of [[kapha]] or [[kapha]] and [[pitta]] [[dosha]]. [Cha.Sa.[[Chikitsa Sthana]] 3/284] The [[kapha]] predominant stage of chronic intermittent fever can also be managed through reducing (langhana) therapies. [Cha.Sa.[[Chikitsa Sthana]] 3/295] Fever patients who are unsuitable for oleation and purificatory therapies should be treated by lightening therapies (langhana). [Su.Sa.Uttara Sthana 39/99]<ref name=Susruta/>
Bleeding hemorrhoids with [[kapha]] and [[pitta]] aggravation [Cha.Sa.[[Chikitsa Sthana]] 14/176], Diabetic mellitus (prameha) caused by [[kapha]] [Cha.Sa.[[Chikitsa Sthana]] 6/25], ulcers with [[kapha]] predominance [Cha.Sa.[[Chikitsa Sthana]] 25/16], rhinitis of [[kapha]] origin (kaphaja pinasa) associated with heaviness and anorexia [Cha.Sa.[[Chikitsa Sthana]] 26/149] should be treated through lightening therapies (langhana).
Cardiac disorders [Cha.Sa.[[Chikitsa Sthana]] 26/100] and diseases caused by the suppression of urge of vomiting is to be treated through fasting (langhana). [Cha.Sa.[[Sutra Sthana]] 7/15] Slightly aggravated [[dosha]] should be managed by fasting therapy (langhana) in case of diarrhea. [Cha.Sa.[[Chikitsa Sthana]] 19/19]
In the prodormal stage of all varieties of erysepalas (visarpa), fasting and other lightening therapies (langhana) should be done. [A.S.Chikitsa Sthana 20/2]<ref name=Sangraha/> If erysepalas (visarpa) is caused with [[dosha]] in the state of incomplete transformation ([[ama]]) and is located in thorax and upper body parts (kaphasthana), fasting therapy (langhana) is beneficial. [Cha.Sa.[[Chikitsa Sthana]] 21/44] Fissure in ano if associated with [[ama]] [Cha.Sa.[[Siddhi Sthana]] 6/63], for indigestion caused due to [[ama]] (amajeerna) [Su.Sa.Sutra Sthana. 46/505]<ref name=Susruta/>, bloating in upper abdomen (anaha) as caused by improperly digested food/product of improper digestion ([[ama]]), associated with stiffness in cardiac region, diseases of head and heaviness, retention of belching, common cold should be treated with fasting therapy (langhana) [Cha.Sa.[[Chikitsa Sthana]] 26/26]
The diseases pacified through lightening therapies (langhana) may re-occur as the causative [[dosha]] may not be completely eliminated out from body. [Cha.Sa.[[Sutra Sthana]] 16/20]
==Physiology of fasting==
During the third phase of fasting, glycogen stored in hepatocytes undergo depletion. It also accelerates adipose tissue lipolysis. Thus more fatty acids and glycerol is formed which gets released into blood. At the same time, the other cells may produce ketones. The fatty acids get transported into hepatocytes, get metabolized and produce ketones beta-OHB and acetoacetate. This induces mitochondrial biogenesis.
The ketones thus produced are transported into cells with high metabolic activity such as neurons, muscles etc., become acetyl coenzyme A. It enters the tricarboxylic acid (TCA) cycle where ATP is generated. Thus during fasting, primary energy source of the body shifts from glucose to fatty acids and ketones.<ref name=AntonSD>Anton SD, Moehl K, Donahoo WT, Marosi K, Lee SA, Mainous AG 3rd, Leeuwenburgh C, Mattson MP. Flipping the Metabolic Switch: Understanding and Applying the Health Benefits of Fasting. Obesity (Silver Spring). 2018</ref>
==Current researches==
In a study conducted on 59 patients having poor digestive power, it is reported that the lightening therapies, fasting and digestive medicine, Zingiber officinale (sunti), improves appetite, food intake and enthusiasm. It makes the body feels lighter and also aids in unobstructed expulsion of urine and feaces. The digestive fire acts directly over the [[dosha]] in the absence of food. The body regains its normalcy once the vitiated [[dosha]] undergo digestion (paka).<ref>Rajani A, Vyas MK, Vyas HA. Comparative study of Upavasa and Upavasa with Pachana in the management of Agnisada. Ayu. 2010 Jul;31(3):351-4. doi: 10.4103/0974-8520.77166. PMID: 22131738; PMCID: PMC3221070.</ref>
Fasting therapy results in significant reduction in weight and BMI. In a study conducted on 44 healthy individuals, short term fasting therapy is compared with low calorie diet. Greater reduction in weight and Leptin levels were achieved through fasting than low calorie diet. Increased beta-oxidation is observed during fasting.<ref>Shetty P, Dinesh S, Halappa NG, Rajany T. Comparing the effects of short-term fasting therapy and low-calorie diet on anthropometric and leptin measures among obese or overweight persons: Randomized controlled trial. Ancient Sci Life 2018;37:133-40.</ref>
Average life span is increased by 30% when the rats were maintained on alternate day fasting. Plasma glucose, insulin and leptin levels were low for the rats maintained on fasting. Ketone and adiponectin levels were more. Inflammatory markers were found to be reduced in liver of rats kept on time restricted feeding. The normal decline in muscle mass during ageing is found to be prevented by caloric restriction in mice. Fasting stimulates autophagy in muscles. Cardiovascular stress adaptations were noted in rats kept on alternate day fasting. It also increases brain derived neurotrophic factor which plays a major role in synaptic plasticity and neurogenesis. <ref name=AntonSD/>
Fasting is beneficial in metabolic syndrome by decreasing fasting glucose, fasting insulin and insulin resistance. It also reduce the cardiovascular risk factors like total cholesterol, LDL, triglycerides etc. In diabetic patients improved insulin sensitivity and glucose tolerance was reported immediately after a fast. <ref name=AntonSD/>
==List of theses done==
#Dharmi P Bhuva (2013): Fundamental and applied aspect of karma as karana in Ayurveda w.s.r to langhana karma. Department of basic principles. IPGT&RA Jamnagar
==More information==
[[Langhanabrimhaniya Adhyaya]]
[[Janapadodhvansaniya Vimana]]
[[Jwara Chikitsa]]
==References==