Changes

In practice, usually in all these conditions virechana  is done with ruuksha prayoga like cuurna, kashaya etc. Avipathi chuurna (A.H.Ka), Vidangatandulaadi chuurna (A.H.Ka), Trvrt kashaaya, Maanibhadra chuurna (chuurna form of Maanibhadra gudam- A.H.Ci), Patolaadi shodhana kashayam (sahasrayoga) are used.

In practice, usually in all these conditions virechana  is done with ruuksha prayoga like cuurna, kashaya etc. Avipathi chuurna (A.H.Ka), Vidangatandulaadi chuurna (A.H.Ka), Trvrt kashaaya, Maanibhadra chuurna (chuurna form of Maanibhadra gudam- A.H.Ci), Patolaadi shodhana kashayam (sahasrayoga) are used.

9th Verse:

==== 9th Verse ====

 

Following the principle, ‘vrdhisamane sarvesham vipareetai viparyata’ (A.H.Su.1/14) if an excessively oleated person is administered a drug which is unctuous in nature, it will not work, rather when medicine of opposite guna like ruksha is used for shodhana, the appropriate action will happen. Cakrapaani says sneha virechana  means snigdha virechana, that is virechana  with snigdha (unctuous) dravya. If sneha virechana  is given to an atisnigdha shareera, because of sneha prakarsha (excess sneha) the vitiated doshaas already in a the morbid state cannot be removed. These vitiated doshas that has already moved from their site will clog the srotas. Hence to remove this vitiated dosha ununctuous/ ruuksha kind of shodhana need to be performed.

Following the principle, ‘vrdhisamane sarvesham vipareetai viparyata’ (A.H.Su.1/14) if an excessively oleated person is administered a drug which is unctuous in nature, it will not work, rather when medicine of opposite guna like ruksha is used for shodhana, the appropriate action will happen. Cakrapaani says sneha virechana  means snigdha virechana, that is virechana  with snigdha (unctuous) dravya. If sneha virechana  is given to an atisnigdha shareera, because of sneha prakarsha (excess sneha) the vitiated doshaas already in a the morbid state cannot be removed. These vitiated doshas that has already moved from their site will clog the srotas. Hence to remove this vitiated dosha ununctuous/ ruuksha kind of shodhana need to be performed.

10th Verse:

==== 10th Verse ====

 

Samyak is the word used to indicate appropriate/ optimum action in many contexts. Any kriyakrama is performed for its appropriate outcome as desired by the physician. The shloka here reveals the four important limbs of it, which are equally important. The first being the proper preparation of the patient in the form of sneha sweda, the second being the physiological status of the patient with respect to aahraa, only then can the agni do its duty. So the medicine has to be given after the ahaara is digested. The third being the importance of maatra which is previously well explained in Charaka vimaanasthaana trividhakuksheeyam adhyaayam. There Acharya lays importance to the appropriate maatra of aahaara. Here Acharya, gives importance to the appropriate maatra of oushadha. Only the desired dosage is acted upon by agni to create the optimum response in the body. Fourthly, the relevance of focused mind is explained. Cakrapaani says the patient must concentrate only on the action of shodhana, the presence of negative emotions like lust, anger, jealousy will only have negative effect on the outcome.  

Samyak is the word used to indicate appropriate/ optimum action in many contexts. Any kriyakrama is performed for its appropriate outcome as desired by the physician. The shloka here reveals the four important limbs of it, which are equally important. The first being the proper preparation of the patient in the form of sneha sweda, the second being the physiological status of the patient with respect to aahraa, only then can the agni do its duty. So the medicine has to be given after the ahaara is digested. The third being the importance of maatra which is previously well explained in Charaka vimaanasthaana trividhakuksheeyam adhyaayam. There Acharya lays importance to the appropriate maatra of aahaara. Here Acharya, gives importance to the appropriate maatra of oushadha. Only the desired dosage is acted upon by agni to create the optimum response in the body. Fourthly, the relevance of focused mind is explained. Cakrapaani says the patient must concentrate only on the action of shodhana, the presence of negative emotions like lust, anger, jealousy will only have negative effect on the outcome.  

Verses 11,12,13:

==== Verses 11,12,13 ====

 

We can see the use of similes at various contexts in Ayurvedic classics. It not only gives the reader a clear idea behind the concept, but it also reveal observational talent of Ayurvedic seers to relate external world (macrocosm) with the internal world (microcosm), principles acting inside the body are similar to that act outside and vice versa. The simile of pot smeared with oil to oleated body and water that can be taken out linked to shodhana therapy explain the action to its fullest. Similarly, the malaas removed from the body by shodhana similar to the dirt adhered to the cloth by rinsing in water also explains the mechanism of action in the most understandable way.

We can see the use of similes at various contexts in Ayurvedic classics. It not only gives the reader a clear idea behind the concept, but it also reveal observational talent of Ayurvedic seers to relate external world (macrocosm) with the internal world (microcosm), principles acting inside the body are similar to that act outside and vice versa. The simile of pot smeared with oil to oleated body and water that can be taken out linked to shodhana therapy explain the action to its fullest. Similarly, the malaas removed from the body by shodhana similar to the dirt adhered to the cloth by rinsing in water also explains the mechanism of action in the most understandable way.

14th verse:

==== 14th verse ====

 

The importance of understanding the physiological state of the human body during the shodhana therapy is revealed here. We can see the lakshana indicating srotorodha and aama-avastha like glaani and vibandha on administering medicine to patient in ajeerna avastha. Here this ajeerna will definitely lead to aama, which will again aggravate the condition.

The importance of understanding the physiological state of the human body during the shodhana therapy is revealed here. We can see the lakshana indicating srotorodha and aama-avastha like glaani and vibandha on administering medicine to patient in ajeerna avastha. Here this ajeerna will definitely lead to aama, which will again aggravate the condition.

For the practical assessment of the jeerna-aahaara in the patient to be administered with the shodhana therapy, the following signs and symptoms can be assessed like the elimination of the faeces and urine unobstructed, when the mind is clear, belching are pure, hunger is well manifest, flatus moving downward, digestive activity is clean, sense organs are clear, body is light as mentioned in A.H.Suu. Maatrasheetiyam Adhyayam (A.H.Su.8/55) can be taken into account.

For the practical assessment of the jeerna-aahaara in the patient to be administered with the shodhana therapy, the following signs and symptoms can be assessed like the elimination of the faeces and urine unobstructed, when the mind is clear, belching are pure, hunger is well manifest, flatus moving downward, digestive activity is clean, sense organs are clear, body is light as mentioned in A.H.Suu. Maatrasheetiyam Adhyayam (A.H.Su.8/55) can be taken into account.

Verse 15,16 :

==== Verse 15,16 ====

 

The lakshana of maatravad oushadham touches all aspects of an ideal drug. We can see the pharmacoleptic, pharmacologicaland pharmacokinetic aspects being mentioned here for selecting the right drug in the appropriate dosage.

The lakshana of maatravad oushadham touches all aspects of an ideal drug. We can see the pharmacoleptic, pharmacologicaland pharmacokinetic aspects being mentioned here for selecting the right drug in the appropriate dosage.

Each formulation has its own guna with respect to its contents. Even though the drug has its guna, the outcome of the kriyakrama in the patient will also depend on the physiological and the environmental factors too. However, an ideal drug and its ideal dosage in a particular clinical condition, in a particular patient can only be assessed only after the continuous practice and experience of the physician. The same medicine may have different outcome in different patients. Hence, an ideal drug even though is important, more important is fixing the dosage appropriately considering all other factors.

Each formulation has its own guna with respect to its contents. Even though the drug has its guna, the outcome of the kriyakrama in the patient will also depend on the physiological and the environmental factors too. However, an ideal drug and its ideal dosage in a particular clinical condition, in a particular patient can only be assessed only after the continuous practice and experience of the physician. The same medicine may have different outcome in different patients. Hence, an ideal drug even though is important, more important is fixing the dosage appropriately considering all other factors.

17th verse:

==== 17th verse ====

 

The shloka explains the context of ekagra manah, as mentioned earlier. It reinforces the idea that negative emotions of mind like kaamaadi would hinder the effective outcome of shodhana for which the mind must be free and fully concentrating only on shodhana therapy.

The shloka explains the context of ekagra manah, as mentioned earlier. It reinforces the idea that negative emotions of mind like kaamaadi would hinder the effective outcome of shodhana for which the mind must be free and fully concentrating only on shodhana therapy.

18th verse:

==== 18th verse ====

 

After warning about ajeerna ahaara, the present context explain the guna of ahaara. For vamana, all kind of kapha-aggravating ahaara that is easily digestible and liquid in nature is advised on the previous day which is to facilitate the intending karma. The increased kapha state as specified in the kalpana sidhi as well as the decreased kapha state are important for vamana and virechana  respectievely. Kapha is the dosha that basically decides the action (C.S.Si.1/9)

After warning about ajeerna ahaara, the present context explain the guna of ahaara. For vamana, all kind of kapha-aggravating ahaara that is easily digestible and liquid in nature is advised on the previous day which is to facilitate the intending karma. The increased kapha state as specified in the kalpana sidhi as well as the decreased kapha state are important for vamana and virechana  respectievely. Kapha is the dosha that basically decides the action (C.S.Si.1/9)

For virechana, the ahaara on the previous day is mentioned to be laghu and asheeta, that is, easily digestible and hot. Hence, the action of vamana happens with utklishta kapha and for virechana  with alpa kapha. In similar context, Susruta Samhita Cikitsa sthaana, he speaks of pitta-utklehsa before virechana, with amla dravya like beeja-puurka rasa. This will also ultimately result in alpa-kaphatvam.

For virechana, the ahaara on the previous day is mentioned to be laghu and asheeta, that is, easily digestible and hot. Hence, the action of vamana happens with utklishta kapha and for virechana  with alpa kapha. In similar context, Susruta Samhita Cikitsa sthaana, he speaks of pitta-utklehsa before virechana, with amla dravya like beeja-puurka rasa. This will also ultimately result in alpa-kaphatvam.

In practice, we give porridge made of maasha (black gram) with sugar, yoghurt, boiled fish with no spices, preparation of masha like iddli (south Indian dish), rice and milk porridge, milk peda, jilebi (north indian sweet) as kaphakara aahaara before vamana. On previous day of virechana  like hot rasam (A south Indian dish mainly of tamarind juice, lime juice etc. with meal.)

In practice, we give porridge made of maasha (black gram) with sugar, yoghurt, boiled fish with no spices, preparation of masha like iddli (south Indian dish), rice and milk porridge, milk peda, jilebi (north indian sweet) as kaphakara aahaara before vamana. On previous day of virechana  like hot rasam (A south Indian dish mainly of tamarind juice, lime juice etc. with meal.)

Verse 19-20:

==== Verse 19-20 ====

 

The sloka explains specific objective signs to assess optimum activity of the shodhana karma. Like in vamana, the output of kapha is succeeded by bile and in virechana, first faeces must come out followed by pitta and then kapha. However, after both the procedure, if done properly, will make the patient feel light, fatigued and emaciated which indicates the expulsion or mitigation of kapha and pitta and increase of vata as expected after any shodhana therapy.

The sloka explains specific objective signs to assess optimum activity of the shodhana karma. Like in vamana, the output of kapha is succeeded by bile and in virechana, first faeces must come out followed by pitta and then kapha. However, after both the procedure, if done properly, will make the patient feel light, fatigued and emaciated which indicates the expulsion or mitigation of kapha and pitta and increase of vata as expected after any shodhana therapy.

Verse 21:

==== Verse 21 ====

 

Even though aacharya gives us practical tips to understand the presence of residual drug and emesis to be done to remove the residue, in our limited experience, we have not come across such practice. The practice of vamana as a correction therapy other than main procedure is seldom done.

Even though aacharya gives us practical tips to understand the presence of residual drug and emesis to be done to remove the residue, in our limited experience, we have not come across such practice. The practice of vamana as a correction therapy other than main procedure is seldom done.

Verse 22,23:

==== Verse 22,23 ====

 

The after-measure of vamana is specifically told here. It probably highlights the seriousness of the procedure, which is the only one done in the pratiloma direction among the pancakarma. Hence, the removal of residual dosha becomes even more pertinent.

The after-measure of vamana is specifically told here. It probably highlights the seriousness of the procedure, which is the only one done in the pratiloma direction among the pancakarma. Hence, the removal of residual dosha becomes even more pertinent.

Verse 24,25:

==== Verse 24,25 ====

 

As explained already in the first chapter of Siddhi sthana, the mentioning of peyaadikrama here again, is only to reinforce its importance in the practice of shodhana karma. However, Cakrapaani, in his commentary reminds the fact that, after vasti, peyadi is not mentioned because the status of agni after vasti is not hampered as much as in virechana  and vamana. Cakrapani intelligently compare the context wherein it is mentioned that shodhanakriya improves / kindles agni. He says it is as mentioned in Sidhi 1/17,22. He says the agni is kindled when compared to the earlier status of agni before shodhana.

As explained already in the first chapter of Siddhi sthana, the mentioning of peyaadikrama here again, is only to reinforce its importance in the practice of shodhana karma. However, Cakrapaani, in his commentary reminds the fact that, after vasti, peyadi is not mentioned because the status of agni after vasti is not hampered as much as in virechana  and vamana. Cakrapani intelligently compare the context wherein it is mentioned that shodhanakriya improves / kindles agni. He says it is as mentioned in Sidhi 1/17,22. He says the agni is kindled when compared to the earlier status of agni before shodhana.