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ityagniveshakRute tantre carakapratisaMskRute shlokasthAne upakalpanIyo nAmapa~jcadasho~adhyAyaH||15||  
 
ityagniveshakRute tantre carakapratisaMskRute shlokasthAne upakalpanIyo nAmapa~jcadasho~adhyAyaH||15||  
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Thus ends the fifteenth chapter on “Prerequisites for therapeutic ([[Panchakarma]]) treatment” of Sutra sthana , of Agnivesa’s work as redacted by Caraka.
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Thus ends the fifteenth chapter on “Prerequisites for therapeutic ([[Panchakarma]]) treatment” of [[Sutra Sthana]] , of Agnivesha’s work as redacted by Charaka.
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Tattva vimarsha:
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=== ''Tattva Vimarsha'' ===
It is necessary to manage the [[Panchakarma]] hospital properly, equipping it with good quality medicines and skilled staff for assuring successful administration of purification therapies.
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All possibilities of complications and their management should be considered before initiating any treatment.  
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*It is necessary to manage the [[Panchakarma]] hospital properly, equipping it with good quality medicines and skilled staff for assuring successful administration of purification therapies.
Clinical observation of patients at each stage during purification theapy is necessary to assess movement of dosha.  
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*All possibilities of complications and their management should be considered before initiating any treatment.  
The dose of emetics should be decided according to individual needs considering all key variables such as dosha, potency of medicine, place of residence, time of administration, strength of patient, constitution, dietary pattern, suitability and age. A suitable post-therapeutic rehabilitative dietary regimen should be designed (taking into consideration the needs and predisposition of the patient) and administered, after therapeutic emesis and purgation, in order to restore the normal levels of agni and strength of the patient.  
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*Clinical observation of patients at each stage during purification theapy is necessary to assess movement of ''dosha''.  
Sometimes all enlisted pre-requisites cannot be made available, especially when treating poorer or less resourceful patients. In such cases, the procedures can be followed with the available and suitable medicines.  
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*The dose of emetics should be decided according to individual needs considering all key variables such as ''dosha,'' potency of medicine, place of residence, time of administration, strength of patient, constitution, dietary pattern, suitability and age. A suitable post-therapeutic rehabilitative dietary regimen should be designed (taking into consideration the needs and predisposition of the patient) and administered, after therapeutic emesis and purgation, in order to restore the normal levels of ''agni'' and strength of the patient.  
Properly administered purification is beneficial for removal of morbid toxins, alleviation of disease while improving strength, complexion and longevity of a person.  
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*Sometimes all enlisted pre-requisites cannot be made available, especially when treating poorer or less resourceful patients. In such cases, the procedures can be followed with the available and suitable medicines.  
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*Properly administered purification is beneficial for removal of morbid toxins, alleviation of disease while improving strength, complexion and longevity of a person.  
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Vidhi Vimarsha:
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=== ''Vidhi Vimarsha'' ===
 
   
 
   
a. Construction of a hospital-
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==== Construction of a hospital ====
A well equipped facility with the following recommended criteria is needed for various ayurvedic purification treatments:
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a. Location- An architect should design the building on a site not situated in a hilly terrain nor located near a bigger building but located on a clean, sunny, flat surface near a water reservoir.  
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A well equipped facility with the following recommended criteria is needed for various ayurvedic purification treatments:
b. Facilities- The building should have all the necessary facilities for indoor patients, with good source for light, water, ventilation, kitchen, and sanitation (toilet, bath, etc).  
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#'''Location'''- An architect should design the building on a site not situated in a hilly terrain nor located near a bigger building but located on a clean, sunny, flat surface near a water reservoir.  
c. Staff requirements- For smooth running of the hospital, adequate staff support should be made available.  The attendants should possess necessary nursing skills, good conduct, hygiene, character, devotion, and compassion and be conversant in the administration of therapies.
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#'''Facilities'''- The building should have all the necessary facilities for indoor patients, with good source for light, water, ventilation, kitchen, and sanitation (toilet, bath, etc).  
d. Recreational measures- The fact that various forms of recreation such as  music, poetry, and drama were suggested, made available or arranged within hospices or healthcare facilities shows how elaborate and extensive the field of healthcare management was within Ayurveda. Today, hospices or healthcare services providers arrange for televisions and music system in the rooms of patients.  
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#'''Staff requirements'''- For smooth running of the hospital, adequate staff support should be made available.  The attendants should possess necessary nursing skills, good conduct, hygiene, character, devotion, and compassion and be conversant in the administration of therapies.
 +
#'''Recreational measures'''- The fact that various forms of recreation such as  music, poetry, and drama were suggested, made available or arranged within hospices or healthcare facilities shows how elaborate and extensive the field of healthcare management was within Ayurveda. Today, hospices or healthcare services providers arrange for televisions and music system in the rooms of patients.  
 
e. Drugs, equipments and other resources: Kitchen appliances and utensils of varied sizes should be available within the kitchen. Arrangements should be made for the availability of bedding with appropriate furnishings (bedsheet and pillow), towel, clean cloths, cotton, wool and various other equipments for smooth induction of oleation, massage, sudation, emesis, purgation, medicated enema, and nasya to the patients. There should also be grinding stones with pestle, knife, smoking pipes, weighing scale, enema tubes and measuring vessels. Food articles like ghee, oil, muscle fat, honey, salt, gruel, various types of wine and dhanyamla should be available in the hospital. Various drugs like shali (rice), mudga (pulses), tila, kullattha, parushaka, and triphala should be made available, along with drugs to treat complications arising duringprocedures. This is akin to having a pharmacy within the premises of a hospital.
 
e. Drugs, equipments and other resources: Kitchen appliances and utensils of varied sizes should be available within the kitchen. Arrangements should be made for the availability of bedding with appropriate furnishings (bedsheet and pillow), towel, clean cloths, cotton, wool and various other equipments for smooth induction of oleation, massage, sudation, emesis, purgation, medicated enema, and nasya to the patients. There should also be grinding stones with pestle, knife, smoking pipes, weighing scale, enema tubes and measuring vessels. Food articles like ghee, oil, muscle fat, honey, salt, gruel, various types of wine and dhanyamla should be available in the hospital. Various drugs like shali (rice), mudga (pulses), tila, kullattha, parushaka, and triphala should be made available, along with drugs to treat complications arising duringprocedures. This is akin to having a pharmacy within the premises of a hospital.
 
b. General plan of treatment-
 
b. General plan of treatment-