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{{#seo:
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|title=Langhanabrimhaniya Adhyaya
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|titlemode=append
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|keywords=Ayurvedic therapeutics, Santarpana(nourishing), Apatarpana(reducing), Langhana (fasting/reducing), Brimhana(nourishing), Snehana(oleation), Swedana(sudation), Stambhana(astringent/styptic), Rukshana(drying),Ayurveda, Indian system of medicine, charak samhita.
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|description=Sutra Sthana Chapter 22. Reduction and nourishing therapies
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|image=http://www.carakasamhitaonline.com/mediawiki-1.32.1/resources/assets/ogimgs.jpg
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|image_alt=carak samhita
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|type=article
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}}
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<big>'''Sutra Sthana Chapter 22. Reduction and nourishing therapies'''</big>
 
{{Infobox
 
{{Infobox
 
|title =  Langhanabrimhaniya Adhyaya
 
|title =  Langhanabrimhaniya Adhyaya
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|label5 = Other Sections
 
|label5 = Other Sections
 
|data5 = [[Nidana Sthana]], [[Vimana Sthana]],  [[Sharira Sthana]],  [[Indriya Sthana]], [[Chikitsa Sthana]], [[Kalpa Sthana]], [[Siddhi Sthana]]
 
|data5 = [[Nidana Sthana]], [[Vimana Sthana]],  [[Sharira Sthana]],  [[Indriya Sthana]], [[Chikitsa Sthana]], [[Kalpa Sthana]], [[Siddhi Sthana]]
 +
|label6 = Translator and commentator
 +
|data6 = Murthy K.N., Deole Y. S.
 +
|label7 = Reviewer
 +
|data7  = Byadgi P.S.
 +
|label8 = Editors
 +
|data8  = Dwivedi R.B., Deole Y.S., Basisht G.
 +
|label9 = Year of publication
 +
|data9 =  2020
 +
|label10 = Publisher
 +
|data10 =  [[Charak Samhita Research, Training and Skill Development Centre]]
 +
|label11 = DOI
 +
|data11 = [https://doi.org/10.47468/CSNE.2020.e01.s01.024 10.47468/CSNE.2020.e01.s01.024]
 +
}}
   −
}}
+
<big>'''Abstract'''</big>
==[[Sutra Sthana]] Chapter 22, Chapter on reduction and nourishing therapies ==
+
 
+
<div style="text-align:justify;">In continuation with the earlier chapter, the main course of treatments for the morbidly obese and the extremely thin/skinny/emaciated persons are described in this chapter. Ayurvedic therapeutics are categorized broadly under two categories like reducing (Apatarpana) or nourishing (Santarpana); It is further classified into six types: Langhana (Fasting, reducing), Brimhana (nourishing), Rukshana (drying), Stambhana (astringent/styptic), Snehana (oleation), and Swedana (sudation). Besides providing insights into these therapeutic measures, this chapter also describes specific advantages of these therapeutic procedures, pharmacological actions of properties and their indications in detail. The features of optimally administered techniques while understanding the consequences of their over and under-application are also included. </div>
=== Abstract ===
  −
<div style="text-align:justify;">
  −
The courses of treatment for the ''sthula'' (obese) and the ''krisha'' (too thin/skinny/emaciated), and of various other diseases form the basis of Ayurvedic therapeutics and is the theme of the present chapter. Ayurvedic therapeutics are reducing (''Apatarpana'') or nourishing (''Santarpana''), and are of six types: ''Langhana'' (reduction), ''Brimhana'' (nourishing), ''Rukshana'' (drying), ''Stambhana'' (astringent/styptic), ''Snehana'' (oleation), and ''Swedana'' (sudation). Besides providing insights into these therapeutic measures, this chapter also describes specific qualities of these therapeutic procedures and their indications in detail. Finally, the reader would also expect to learn about features of optimally administered techniques while understanding the consequences of their over and under-application.  
      
'''Keywords''': Ayurvedic therapeutics, ''Santarpana''(nourishing), ''Apatarpana''(reducing), ''Langhana'' (fasting/reducing), ''Brimhana''(nourishing), ''Snehana''(oleation), ''Swedana''(sudation), ''Stambhana''(astringent/styptic), ''Rukshana''(drying).
 
'''Keywords''': Ayurvedic therapeutics, ''Santarpana''(nourishing), ''Apatarpana''(reducing), ''Langhana'' (fasting/reducing), ''Brimhana''(nourishing), ''Snehana''(oleation), ''Swedana''(sudation), ''Stambhana''(astringent/styptic), ''Rukshana''(drying).
 
</div>
 
</div>
=== Introduction ===
+
 
 +
 
 +
 
 +
== Introduction ==
 
<div style="text-align:justify;">
 
<div style="text-align:justify;">
In the earlier chapter on eight undesirable bodily features, the focus of the study was on two of the most undesirable kinds - ''sthula'' (obesity) and ''krisha'' (too thin/skinny/emaciated). The present chapter deals with types of treatments suitable for both body types as well as other similar pathologies. There are four types of pathologies described in Ayurveda: ''atipravritti'' (excessive elimination), ''sanga'' (obstruction), ''sira granthi'' (tumor/varicosity), and ''vimarga gamana'' (improperly directed circulation). A disease could be of any of these four pathology types, but its affliction could manifest in different forms depending upon the unique body constitution of the patient and combination of ''doshas, dhatus, mala,'' etc., explained in prior chapters. To tackle such afflictions, Ayurveda describes six types of therapeutic measures: ''Langhana'' (reduction), ''Brimhana'' (nourishing), ''Rukshana'' (drying), ''Stambhana'' (astringent/styptic), ''Snehana'' (oleation), and ''Swedana'' (sudation). In the case of excessive discharge of anything from the body, ''Stambhana'' (a procedure that slows or stops the discharge) is advised. While in the case of obstructions, ''Langhana, Swedana,'' or ''Rukshana'' are advised. In cases of excessively vitiated ''dosha, Langhana'' (reducing therapy) is indicated to bring the elevated ''dosha'' to a state of equilibrium, whereas in a case of degeneration, ''Brimhana'' (nourishing therapy) and ''Snehana'' (oleation) are prescribed. The ''Snehana'' and ''Swedana'' therapies are described in detail in thirteenth and fourteenth chapters of this section respectively. This chapter describes remaining four therapies , i.e.,''Langhana, Brimhana, Stambhana,'' and ''Rukshana.''
+
In the earlier chapter on eight undesirable body features, the focus of the study was on two of the most undesirable kinds - ''sthula'' (obesity) and ''krisha'' (too thin/skinny/emaciated). The present chapter deals with types of treatments suitable for both conditions as well as other similar pathologies. There are four types of pathologies described in [[Ayurveda]]: ''atipravritti'' (excessive elimination), ''sanga'' (obstruction), ''sira granthi'' (tumor/varicosity), and ''vimarga gamana'' (improperly directed circulation). A disease could be of any of these four pathology types, but its affliction could manifest in different forms depending upon the unique body constitution of the patient and combination of ''doshas, dhatus, mala,'' etc., explained in prior chapters. To tackle such afflictions, [[Ayurveda]] describes six types of therapeutic measures: ''Langhana'' (reduction), ''Brimhana'' (nourishing), ''Rukshana'' (drying), ''Stambhana'' (astringent/styptic), ''Snehana'' (oleation), and ''Swedana'' (sudation). In the case of excessive discharge of anything from the body, ''Stambhana'' (a procedure that slows or stops the discharge) is advised. While in the case of obstructions, ''Langhana, Swedana,'' or ''Rukshana'' are advised. In cases of excessively vitiated ''dosha, Langhana'' (reducing therapy) is indicated to bring the elevated ''dosha'' to a state of equilibrium, whereas in a case of degeneration, ''Brimhana'' (nourishing therapy) and ''Snehana'' (oleation) are prescribed. The ''Snehana'' and ''Swedana'' therapies are described in detail in thirteenth and fourteenth chapters of this section respectively. This chapter describes remaining four therapies , i.e.,''Langhana, Brimhana, Stambhana,'' and ''Rukshana.''
 
</div>
 
</div>
===Sanskrit text, Transliteration and English Translation===
+
==Sanskrit text, Transliteration and English Translation==
 +
<div class="mw-collapsible mw-collapsed">
    
अथातो लङ्घनबृंहणीयमध्यायं व्याख्यास्यामः  ||१||
 
अथातो लङ्घनबृंहणीयमध्यायं व्याख्यास्यामः  ||१||
 
   
 
   
 
इति ह स्माह भगवानात्रेयः||२||  
 
इति ह स्माह भगवानात्रेयः||२||  
 +
<div class="mw-collapsible-content">
    
athātō laṅghanabr̥ṁhaṇīyamadhyāyaṁ vyākhyāsyāmaḥ  ||1||  
 
athātō laṅghanabr̥ṁhaṇīyamadhyāyaṁ vyākhyāsyāmaḥ  ||1||  
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iti ha smAha bhagavAnAtreyaH||2||  
 
iti ha smAha bhagavAnAtreyaH||2||  
 +
</div></div>
   −
Now we will expound the “Reducing and nourishing therapies” chapter, said Lord Atreya. [1-2]
+
Now we shall expound the chapter “Langhanabrimhaniya" (Reducing and nourishing therapies). Thus said Lord Atreya. [1-2]
   −
==== Six types of therapies ====
+
=== Six types of therapies ===
 +
<div class="mw-collapsible mw-collapsed">
    
तपःस्वाध्यायनिरतानात्रेयः शिष्यसत्तमान्|  
 
तपःस्वाध्यायनिरतानात्रेयः शिष्यसत्तमान्|  
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कृताकृतातिवृत्तानां  लक्षणं वक्तुमर्हसि||८||  
 
कृताकृतातिवृत्तानां  लक्षणं वक्तुमर्हसि||८||  
 +
<div class="mw-collapsible-content">
    
tapaḥsvādhyāyaniratānātrēyaḥ śiṣyasattamān|  
 
tapaḥsvādhyāyaniratānātrēyaḥ śiṣyasattamān|  
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kRutAkRutAtivRuttAnAM  lakShaNaM vaktumarhasi||8||  
 
kRutAkRutAtivRuttAnAM  lakShaNaM vaktumarhasi||8||  
 +
</div></div>
 +
 
<div style="text-align:justify;">
 
<div style="text-align:justify;">
To initiate a discussion, Lord Atreya addressed to his six disciples, who are dedicated to a life of penance and learning and who are led by Agnivesha, “He indeed is the true physician who knows the timely use of therapies to produce strength, dryness, unctuous, sweating and astringent effects.” Once Lord Atreya had spoken, Agnivesha asked the following questions, “O Thou, our worshipful preceptor, Sir, what are the therapies that are ''Langhana'' (reducing), ''Brimhana'' (nourishing), ''Rukshana'' (dryness-causing), ''Snehana'' (oleation) and, ''Swedana'' (sudation), and ''Stambhana'' (astringent/styptic)? Who are fit for this, O beloved teacher? You may kindly tell us all about them, and you may also tell briefly about the symptoms of proper application, improper application, and over-application of these six therapies.” [3-8]
+
To initiate a discussion, Lord Atreya addressed to his six disciples, who are dedicated to a life of penance and learning and who are led by Agnivesha, “He indeed is the true physician who knows the timely use of therapies to produce lightness, strength, dryness, unctuous, sweating and astringent effects.” Once Lord Atreya had spoken, Agnivesha asked the following questions, “O Thou, our worshipful preceptor, Sir, what are the therapies that are ''Langhana'' (reducing), ''Brimhana'' (nourishing), ''Rukshana'' (dryness-causing), ''Snehana'' (oleation) and, ''Swedana'' (sudation), and ''Stambhana'' (astringent/styptic)? Who are fit for this, O beloved teacher? You may kindly tell us all about them, and you may also tell briefly about the symptoms of proper application, improper application, and over-application of these six therapies.” [3-8]
 
</div>
 
</div>
   −
==== Definitions ====
+
=== Definitions ===
 +
<div class="mw-collapsible mw-collapsed">
    
तदग्निवेशस्य वचो निशम्य गुरुरब्रवीत्|  
 
तदग्निवेशस्य वचो निशम्य गुरुरब्रवीत्|  
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स्तम्भनं स्तम्भयति यद्गतिमन्तं चलं ध्रुवम्|  
 
स्तम्भनं स्तम्भयति यद्गतिमन्तं चलं ध्रुवम्|  
 +
<div class="mw-collapsible-content">
    
tadagnivēśasya vacō niśamya gururabravīt|  
 
tadagnivēśasya vacō niśamya gururabravīt|  
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stambhanaM stambhayati yadgatimantaM calaM dhruvam|  
 
stambhanaM stambhayati yadgatimantaM calaM dhruvam|  
 +
</div></div>
 +
 
<div style="text-align:justify;">
 
<div style="text-align:justify;">
 
Hearing these words of Agnivesha, the mentor (Atreya) explained the therapies thus.  
 
Hearing these words of Agnivesha, the mentor (Atreya) explained the therapies thus.  
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</div>
 
</div>
   −
==== Pharmaco-therapeutic properties behind these effects ====
+
=== Pharmaco-therapeutic properties behind these effects ===
 +
<div class="mw-collapsible mw-collapsed">
    
लघूष्णतीक्ष्णविशदं रूक्षं सूक्ष्मं खरं सरम्||१२||  
 
लघूष्णतीक्ष्णविशदं रूक्षं सूक्ष्मं खरं सरम्||१२||  
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यद्द्रव्यं लघु चोद्दिष्टं प्रायस्तत् स्तम्भनं स्मृतम्||१७||  
 
यद्द्रव्यं लघु चोद्दिष्टं प्रायस्तत् स्तम्भनं स्मृतम्||१७||  
 +
<div class="mw-collapsible-content">
    
laghūṣṇatīkṣṇaviśadaṁ rūkṣaṁ sūkṣmaṁ kharaṁ saram||12||  
 
laghūṣṇatīkṣṇaviśadaṁ rūkṣaṁ sūkṣmaṁ kharaṁ saram||12||  
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yaddravyaM laghu coddiShTaM prAyastat stambhanaM smRutam||17||  
 
yaddravyaM laghu coddiShTaM prAyastat stambhanaM smRutam||17||  
 +
</div></div>
    
<div style="text-align:justify;">
 
<div style="text-align:justify;">
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*The drug or substance that possesses dry, light, rough, sharply acting, hot, stable, non-slimy and primarily hard qualities is used for ''Rukshana'' (drying) therapy.   
 
*The drug or substance that possesses dry, light, rough, sharply acting, hot, stable, non-slimy and primarily hard qualities is used for ''Rukshana'' (drying) therapy.   
 
*''Snehana'' (oleation) therapy requires the drug or substance that possess liquid, minute (subtle), flowing (unstable), unctuous, slimy, heavy, cold, sluggish and soft qualities.   
 
*''Snehana'' (oleation) therapy requires the drug or substance that possess liquid, minute (subtle), flowing (unstable), unctuous, slimy, heavy, cold, sluggish and soft qualities.   
 
+
*The drug or substance that is used for ''Swedana'' (sudation) therapy possesses hot, acute, flowing (unstable), unctuous, dry, minute (subtle), liquid, stable and heavy qualities.  
The drug or substance that is used for ''Swedana'' (sudation) therapy possesses hot, acute, flowing (unstable), unctuous, dry, minute (subtle), liquid, stable and heavy qualities. Finally,''Stambhana'' requires the drugs to possess cold, sluggish, soft, smooth, dry, minute (subtle), liquid, stable and light qualities. [12-17]
+
*Finally,''Stambhana'' requires the drugs to possess cold, sluggish, soft, smooth, dry, minute (subtle), liquid, stable and light qualities. [12-17]
 
</div>
 
</div>
    +
===Langhana (reducing or lightening) therapy ===
 
==== Methods of ''langhana'' (reducing/lightening) therapy ====
 
==== Methods of ''langhana'' (reducing/lightening) therapy ====
 +
<div class="mw-collapsible mw-collapsed">
    
चतुष्प्रकारा संशुद्धिः पिपासा मारुतातपौ|  
 
चतुष्प्रकारा संशुद्धिः पिपासा मारुतातपौ|  
    
पाचनान्युपवासश्च व्यायामश्चेति लङ्घनम्||१८||  
 
पाचनान्युपवासश्च व्यायामश्चेति लङ्घनम्||१८||  
 +
<div class="mw-collapsible-content">
    
catuṣprakārā saṁśuddhiḥ pipāsā mārutātapau|  
 
catuṣprakārā saṁśuddhiḥ pipāsā mārutātapau|  
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pAcanAnyupavAsashca vyAyAmashceti la~gghanam||18||  
 
pAcanAnyupavAsashca vyAyAmashceti la~gghanam||18||  
 +
</div></div>
    
<div style="text-align:justify;">
 
<div style="text-align:justify;">
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==== Indications of ''langhana'' ====
 
==== Indications of ''langhana'' ====
 +
<div class="mw-collapsible mw-collapsed">
    
प्रभूतश्लेष्मपित्तास्रमलाः संसृष्टमारुताः|  
 
प्रभूतश्लेष्मपित्तास्रमलाः संसृष्टमारुताः|  
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त्वग्दोषिणां प्रमीढानां  स्निग्धाभिष्यन्दिबृंहिणाम्|  
 
त्वग्दोषिणां प्रमीढानां  स्निग्धाभिष्यन्दिबृंहिणाम्|  
 
शिशिरे लङ्घनं शस्तमपि वातविकारिणाम्||२४||  
 
शिशिरे लङ्घनं शस्तमपि वातविकारिणाम्||२४||  
 +
<div class="mw-collapsible-content">
    
prabhūtaślēṣmapittāsramalāḥ saṁsr̥ṣṭamārutāḥ|  
 
prabhūtaślēṣmapittāsramalāḥ saṁsr̥ṣṭamārutāḥ|  
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tvagdoShiNAM pramIDhAnAM  snigdhAbhiShyandibRuMhiNAm|  
 
tvagdoShiNAM pramIDhAnAM  snigdhAbhiShyandibRuMhiNAm|  
 
shishire la~gghanaM shastamapi vAtavikAriNAm||24||
 
shishire la~gghanaM shastamapi vAtavikAriNAm||24||
 +
</div></div>
 +
 
<div style="text-align:justify;">
 
<div style="text-align:justify;">
 
Those who are suffering from excessive vitiation of ''kapha, pitta,'' blood and waste products, are afflicted with obstructed ''vata'' and who have bulky and strong bodies should be treated using ''shodhana'' (purificatory) procedures of ''Langhana''.  
 
Those who are suffering from excessive vitiation of ''kapha, pitta,'' blood and waste products, are afflicted with obstructed ''vata'' and who have bulky and strong bodies should be treated using ''shodhana'' (purificatory) procedures of ''Langhana''.  
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</div>
 
</div>
   −
==== ''Brimhana'' (nourishing) therapy ====
+
=== ''Brimhana'' (nourishing) therapy ===
 +
<div class="mw-collapsible mw-collapsed">
    
अदिग्धविद्धमक्लिष्टं वयस्थं सात्म्यचारिणाम्|  
 
अदिग्धविद्धमक्लिष्टं वयस्थं सात्म्यचारिणाम्|  
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शर्कराक्षीरसर्पींषि सर्वेषां विद्धि बृंहणम्||२८||  
 
शर्कराक्षीरसर्पींषि सर्वेषां विद्धि बृंहणम्||२८||  
 +
<div class="mw-collapsible-content">
    
adigdhaviddhamakliṣṭaṁ vayasthaṁ sātmyacāriṇām|  
 
adigdhaviddhamakliṣṭaṁ vayasthaṁ sātmyacāriṇām|  
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sharkarAkShIrasarpIMShi sarveShAM viddhi bRuMhaNam||28||  
 
sharkarAkShIrasarpIMShi sarveShAM viddhi bRuMhaNam||28||  
 +
</div></div>
    
<div style="text-align:justify;">
 
<div style="text-align:justify;">
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</div>
 
</div>
   −
==== ''Rukshana'' (drying) therapy ====
+
=== [[Langhanabrimhaniya Adhyaya#Contemporary researches|''Rukshana'' (drying) therapy]] ===
 +
<div class="mw-collapsible mw-collapsed">
    
कटुतिक्तकषायाणां सेवनं स्त्रीष्वसंयमः|  
 
कटुतिक्तकषायाणां सेवनं स्त्रीष्वसंयमः|  
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स्नेहाध्याये मयोक्तास्ते स्वेदाख्ये च सविस्तरम्||३१||
 
स्नेहाध्याये मयोक्तास्ते स्वेदाख्ये च सविस्तरम्||३१||
 +
<div class="mw-collapsible-content">
    
kaṭutiktakaṣāyāṇāṁ sēvanaṁ strīṣvasaṁyamaḥ|  
 
kaṭutiktakaṣāyāṇāṁ sēvanaṁ strīṣvasaṁyamaḥ|  
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snehAdhyAye mayoktAste svedAkhye ca savistaram||31||  
 
snehAdhyAye mayoktAste svedAkhye ca savistaram||31||  
 +
</div></div>
    
<div style="text-align:justify;">
 
<div style="text-align:justify;">
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</div>
 
</div>
   −
==== ''Stambhana'' (astringent/styptic) therapy ====
+
=== ''Stambhana'' (astringent/styptic) therapy ===
 +
<div class="mw-collapsible mw-collapsed">
    
द्रवं तन्वसरं यावच्छीतीकरणमौषधम्|  
 
द्रवं तन्वसरं यावच्छीतीकरणमौषधम्|  
 +
 
स्वादु तिक्तं कषायं च स्तम्भनं सर्वमेव तत्||३२||  
 
स्वादु तिक्तं कषायं च स्तम्भनं सर्वमेव तत्||३२||  
    
पित्तक्षाराग्निदग्धा ये वम्यतीसारपीडिताः|  
 
पित्तक्षाराग्निदग्धा ये वम्यतीसारपीडिताः|  
 +
 
विषस्वेदातियोगार्ताः स्तम्भनीया  निदर्शिताः||३३||  
 
विषस्वेदातियोगार्ताः स्तम्भनीया  निदर्शिताः||३३||  
 +
<div class="mw-collapsible-content">
    
dravaṁ tanvasaraṁ yāvacchītīkaraṇamauṣadham|  
 
dravaṁ tanvasaraṁ yāvacchītīkaraṇamauṣadham|  
 +
 
svādu tiktaṁ kaṣāyaṁ ca stambhanaṁ sarvamēva tat||32||  
 
svādu tiktaṁ kaṣāyaṁ ca stambhanaṁ sarvamēva tat||32||  
    
pittakṣārāgnidagdhā yē vamyatīsārapīḍitāḥ|  
 
pittakṣārāgnidagdhā yē vamyatīsārapīḍitāḥ|  
 +
 
viṣasvēdātiyōgārtāḥ stambhanīyā  nidarśitāḥ||33||  
 
viṣasvēdātiyōgārtāḥ stambhanīyā  nidarśitāḥ||33||  
    
dravaM tanvasaraM yAvacchItIkaraNamauShadham|  
 
dravaM tanvasaraM yAvacchItIkaraNamauShadham|  
 +
 
svAdu tiktaM kaShAyaM ca stambhanaM sarvameva tat||32||  
 
svAdu tiktaM kaShAyaM ca stambhanaM sarvameva tat||32||  
    
pittakShArAgnidagdhA ye vamyatIsArapIDitAH|  
 
pittakShArAgnidagdhA ye vamyatIsArapIDitAH|  
 +
 
viShasvedAtiyogArtAH stambhanIyA nidarshitAH||33||  
 
viShasvedAtiyogArtAH stambhanIyA nidarshitAH||33||  
 +
</div></div>
 +
 
<div style="text-align:justify;">
 
<div style="text-align:justify;">
 
All the drugs that are characterized by liquid, thin, stable, cold properties and possessing sweet, bitter and astringent tastes are used for ''Stambhana'' (astringent/styptic) therapy. ''Stambhana'' is indicated in patients afflicted with ''pitta'', burned with ''kshara'' (alkali) and fire, those who are afflicted with vomiting, diarrhea, and those who are suffering from complications of excess sudation and poisoning. [32-33]
 
All the drugs that are characterized by liquid, thin, stable, cold properties and possessing sweet, bitter and astringent tastes are used for ''Stambhana'' (astringent/styptic) therapy. ''Stambhana'' is indicated in patients afflicted with ''pitta'', burned with ''kshara'' (alkali) and fire, those who are afflicted with vomiting, diarrhea, and those who are suffering from complications of excess sudation and poisoning. [32-33]
 
</div>
 
</div>
==== Signs of adequate and excess ''Langhana'' ====
+
 
 +
=== Signs of adequate and excess ''langhana'' ===
 +
<div class="mw-collapsible mw-collapsed">
    
वातमूत्रपुरीषाणां विसर्गे गात्रलाघवे|  
 
वातमूत्रपुरीषाणां विसर्गे गात्रलाघवे|  
 +
 
हृदयोद्गारकण्ठास्यशुद्धौ तन्द्राक्लमे गते||३४||  
 
हृदयोद्गारकण्ठास्यशुद्धौ तन्द्राक्लमे गते||३४||  
    
स्वेदे जाते रुचौ चैव क्षुत्पिपासासहोदये|  
 
स्वेदे जाते रुचौ चैव क्षुत्पिपासासहोदये|  
 +
 
कृतं लङ्घनमादेश्यं निर्व्यथे चान्तरात्मनि||३५||  
 
कृतं लङ्घनमादेश्यं निर्व्यथे चान्तरात्मनि||३५||  
    
पर्वभेदोऽङ्गमर्दश्च कासः शोषो मुखस्य च|  
 
पर्वभेदोऽङ्गमर्दश्च कासः शोषो मुखस्य च|  
 +
 
क्षुत्प्रणाशोऽरुचिस्तृष्णा दौर्बल्यं श्रोत्रनेत्रयोः||३६||  
 
क्षुत्प्रणाशोऽरुचिस्तृष्णा दौर्बल्यं श्रोत्रनेत्रयोः||३६||  
    
मनसः सम्भ्रमोऽभीक्ष्णमूर्ध्ववातस्तमो हृदि|  
 
मनसः सम्भ्रमोऽभीक्ष्णमूर्ध्ववातस्तमो हृदि|  
 +
 
देहाग्निबलनाशश्च लङ्घनेऽतिकृते भवेत्||३७||  
 
देहाग्निबलनाशश्च लङ्घनेऽतिकृते भवेत्||३७||  
 +
<div class="mw-collapsible-content">
    
vātamūtrapurīṣāṇāṁ visargē gātralāghavē|  
 
vātamūtrapurīṣāṇāṁ visargē gātralāghavē|  
 +
 
hr̥dayōdgārakaṇṭhāsyaśuddhau tandrāklamē gatē||34||  
 
hr̥dayōdgārakaṇṭhāsyaśuddhau tandrāklamē gatē||34||  
    
svēdē jātē rucau caiva kṣutpipāsāsahōdayē|  
 
svēdē jātē rucau caiva kṣutpipāsāsahōdayē|  
 +
 
kr̥taṁ laṅghanamādēśyaṁ nirvyathē cāntarātmani||35||  
 
kr̥taṁ laṅghanamādēśyaṁ nirvyathē cāntarātmani||35||  
    
parvabhēdō'ṅgamardaśca kāsaḥ śōṣō mukhasya ca|  
 
parvabhēdō'ṅgamardaśca kāsaḥ śōṣō mukhasya ca|  
 +
 
kṣutpraṇāśō'rucistr̥ṣṇā daurbalyaṁ śrōtranētrayōḥ||36||  
 
kṣutpraṇāśō'rucistr̥ṣṇā daurbalyaṁ śrōtranētrayōḥ||36||  
    
manasaḥ sambhramō'bhīkṣṇamūrdhvavātastamō hr̥di|  
 
manasaḥ sambhramō'bhīkṣṇamūrdhvavātastamō hr̥di|  
 +
 
dēhāgnibalanāśaśca laṅghanē'tikr̥tē bhavēt||37||  
 
dēhāgnibalanāśaśca laṅghanē'tikr̥tē bhavēt||37||  
    
vAtamUtrapurIShANAM visarge gAtralAghave|  
 
vAtamUtrapurIShANAM visarge gAtralAghave|  
 +
 
hRudayodgArakaNThAsyashuddhau tandrAklame gate||34||  
 
hRudayodgArakaNThAsyashuddhau tandrAklame gate||34||  
    
svede jAte rucau caiva kShutpipAsAsahodaye|  
 
svede jAte rucau caiva kShutpipAsAsahodaye|  
 +
 
kRutaM la~gghanamAdeshyaM nirvyathe cAntarAtmani||35||  
 
kRutaM la~gghanamAdeshyaM nirvyathe cAntarAtmani||35||  
    
parvabhedo~a~ggamardashca kAsaH shoSho mukhasya ca|  
 
parvabhedo~a~ggamardashca kAsaH shoSho mukhasya ca|  
 +
 
kShutpraNAsho~arucistRuShNA daurbalyaM shrotranetrayoH||36||  
 
kShutpraNAsho~arucistRuShNA daurbalyaM shrotranetrayoH||36||  
    
manasaH sambhramo~abhIkShNamUrdhvavAtastamo hRudi|  
 
manasaH sambhramo~abhIkShNamUrdhvavAtastamo hRudi|  
 +
 
dehAgnibalanAshashca la~gghane~atikRute bhavet||37||  
 
dehAgnibalanAshashca la~gghane~atikRute bhavet||37||  
 +
</div></div>
 +
 
<div style="text-align:justify;">
 
<div style="text-align:justify;">
The signs of proper administration of ''Langhana'' include thorough elimination of flatus, urine, and feces, feeling of lightness in body, cleansing in heart, eructation, throat and mouth, the disappearance of drowsiness and exhaustion, the appearance of perspiration and reappearance of taste, hunger and thirst along with a feeling of well-being.
+
The signs of proper administration of ''langhana'' include thorough elimination of flatus, urine, and feces, feeling of lightness in body, cleansing in heart, eructation, throat and mouth, the disappearance of drowsiness and exhaustion, the appearance of perspiration and reappearance of taste, hunger and thirst along with a feeling of well-being.
   −
The signs of excessive administration of ''Langhana'' include pain in the joints, body aches, 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, feeling of darkness in the heart (''tamo hridi''), loss of body weight, loss of digestive power and strength. [34-37]
+
The signs of excessive administration of ''Langhana'' include pain in the joints, body aches, 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'', feeling of darkness in the heart (''tamo hridi''), loss of body weight, loss of digestive power and strength. [34-37]
 
</div>
 
</div>
==== Signs of adequate and excess ''Brimhana'' (nourishing) therapy ====
+
 
 +
=== Signs of adequate and excess ''brimhana'' (nourishing) therapy ===
 +
<div class="mw-collapsible mw-collapsed">
    
बलं पुष्ट्युपलम्भश्च कार्श्यदोषविवर्जनम्|  
 
बलं पुष्ट्युपलम्भश्च कार्श्यदोषविवर्जनम्|  
 +
 
लक्षणं बृंहिते स्थौल्यमति चात्यर्थबृंहिते||३८||  
 
लक्षणं बृंहिते स्थौल्यमति चात्यर्थबृंहिते||३८||  
    
कृतातिकृतलिङ्गं यल्लङ्घिते तद्धि रूक्षिते |३९|
 
कृतातिकृतलिङ्गं यल्लङ्घिते तद्धि रूक्षिते |३९|
 +
<div class="mw-collapsible-content">
    
balaṁ puṣṭyupalambhaśca kārśyadōṣavivarjanam|  
 
balaṁ puṣṭyupalambhaśca kārśyadōṣavivarjanam|  
 +
 
lakṣaṇaṁ br̥ṁhitē sthaulyamati cātyarthabr̥ṁhitē||38||  
 
lakṣaṇaṁ br̥ṁhitē sthaulyamati cātyarthabr̥ṁhitē||38||  
   Line 517: Line 601:     
balaM puShTyupalambhashca kArshyadoShavivarjanam|  
 
balaM puShTyupalambhashca kArshyadoShavivarjanam|  
 +
 
lakShaNaM bRuMhite sthaulyamati cAtyarthabRuMhite||38||  
 
lakShaNaM bRuMhite sthaulyamati cAtyarthabRuMhite||38||  
    
kRutAtikRutali~ggaM yalla~gghite taddhi rUkShite  |39|  
 
kRutAtikRutali~ggaM yalla~gghite taddhi rUkShite  |39|  
 +
</div></div>
 +
 
<div style="text-align:justify;">
 
<div style="text-align:justify;">
 
Through the proper administration of ''Brimhana'', one gets strength, robustness, and freedom from the diseases of emaciation. On excessive application of ''Brimhana'', one suffers from corpulence (obesity). The symptoms of proper and excessive administration of ''Rukshana'' are the same as those of ''Langhana''. [38-38½]
 
Through the proper administration of ''Brimhana'', one gets strength, robustness, and freedom from the diseases of emaciation. On excessive application of ''Brimhana'', one suffers from corpulence (obesity). The symptoms of proper and excessive administration of ''Rukshana'' are the same as those of ''Langhana''. [38-38½]
 
</div>
 
</div>
Signs of adequate and excess ''Stambhana'' (astringent/styptic) therapy:
+
=== Signs of adequate and excess ''Stambhana'' (astringent/styptic) therapy ===
 +
<div class="mw-collapsible mw-collapsed">
    
स्तम्भितः स्याद्बले लब्धे यथोक्तैश्चामयैर्जितैः||३९||  
 
स्तम्भितः स्याद्बले लब्धे यथोक्तैश्चामयैर्जितैः||३९||  
    
श्यावता स्तब्धगात्रत्वमुद्वेगो हनुसङ्ग्रहः|  
 
श्यावता स्तब्धगात्रत्वमुद्वेगो हनुसङ्ग्रहः|  
 +
 
हृद्वर्चोनिग्रहश्च स्यादतिस्तम्भितलक्षणम्||४०||  
 
हृद्वर्चोनिग्रहश्च स्यादतिस्तम्भितलक्षणम्||४०||  
 +
<div class="mw-collapsible-content">
    
stambhitaḥ syādbalē labdhē yathōktaiścāmayairjitaiḥ||39||  
 
stambhitaḥ syādbalē labdhē yathōktaiścāmayairjitaiḥ||39||  
    
śyāvatā stabdhagātratvamudvēgō hanusaṅgrahaḥ|  
 
śyāvatā stabdhagātratvamudvēgō hanusaṅgrahaḥ|  
 +
 
hr̥dvarcōnigrahaśca syādatistambhitalakṣaṇam||40||  
 
hr̥dvarcōnigrahaśca syādatistambhitalakṣaṇam||40||  
   Line 538: Line 629:     
shyAvatA stabdhagAtratvamudvego hanusa~ggrahaH|  
 
shyAvatA stabdhagAtratvamudvego hanusa~ggrahaH|  
 +
 
hRudvarconigrahashca syAdatistambhitalakShaNam||40||  
 
hRudvarconigrahashca syAdatistambhitalakShaNam||40||  
 +
</div></div>
 +
 
<div style="text-align:justify;">
 
<div style="text-align:justify;">
 
Properly administered ''stambhana'' helps the patient to regain his strength and get rid of afflicted diseases as told earlier.  
 
Properly administered ''stambhana'' helps the patient to regain his strength and get rid of afflicted diseases as told earlier.  
 
Excessive administration of ''stambhana'' causes blackish discoloration, stiffness in body parts, uneasiness, the stiffness of jaw, feeling of constriction in cardiac region, and constipation. [39-40]
 
Excessive administration of ''stambhana'' causes blackish discoloration, stiffness in body parts, uneasiness, the stiffness of jaw, feeling of constriction in cardiac region, and constipation. [39-40]
 
</div>
 
</div>
 +
<div class="mw-collapsible mw-collapsed">
 +
 
लक्षणं चाकृतानां स्यात् षण्णामेषां समासतः|  
 
लक्षणं चाकृतानां स्यात् षण्णामेषां समासतः|  
 +
 
तदौषधानां धातूनामशमो  वृद्धिरेव च||४१||  
 
तदौषधानां धातूनामशमो  वृद्धिरेव च||४१||  
    
इति षट् सर्वरोगाणां प्रोक्ताः सम्यगुपक्रमाः|  
 
इति षट् सर्वरोगाणां प्रोक्ताः सम्यगुपक्रमाः|  
 +
 
साध्यानां साधने सिद्धा मात्राकालानुरोधिनः||४२||  
 
साध्यानां साधने सिद्धा मात्राकालानुरोधिनः||४२||  
 +
<div class="mw-collapsible-content">
    
lakṣaṇaṁ cākr̥tānāṁ syāt ṣaṇṇāmēṣāṁ samāsataḥ|  
 
lakṣaṇaṁ cākr̥tānāṁ syāt ṣaṇṇāmēṣāṁ samāsataḥ|  
 +
 
tadauṣadhānāṁ dhātūnāmaśamō  vr̥ddhirēva ca||41||  
 
tadauṣadhānāṁ dhātūnāmaśamō  vr̥ddhirēva ca||41||  
    
iti ṣaṭ sarvarōgāṇāṁ prōktāḥ samyagupakramāḥ|  
 
iti ṣaṭ sarvarōgāṇāṁ prōktāḥ samyagupakramāḥ|  
 +
 
sādhyānāṁ sādhanē siddhā mātrākālānurōdhinaḥ||42||  
 
sādhyānāṁ sādhanē siddhā mātrākālānurōdhinaḥ||42||  
    
lakShaNaM cAkRutAnAM syAt ShaNNAmeShAM samAsataH|  
 
lakShaNaM cAkRutAnAM syAt ShaNNAmeShAM samAsataH|  
 +
 
tadauShadhAnAM dhAtUnAmashamo  vRuddhireva ca||41||  
 
tadauShadhAnAM dhAtUnAmashamo  vRuddhireva ca||41||  
    
iti ShaT sarvarogANAM proktAH samyagupakramAH|  
 
iti ShaT sarvarogANAM proktAH samyagupakramAH|  
 +
 
sAdhyAnAM sAdhane siddhA mAtrAkAlAnurodhinaH||42||  
 
sAdhyAnAM sAdhane siddhA mAtrAkAlAnurodhinaH||42||  
 +
</div></div>
    
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 ''doshas'' 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]
   −
==== Summary ====
+
=== Summary ===
 +
<div class="mw-collapsible mw-collapsed">
    
भवति चात्र-  
 
भवति चात्र-  
 +
 
दोषाणां बहुसंसर्गात् सङ्कीर्यन्ते ह्युपक्रमाः|  
 
दोषाणां बहुसंसर्गात् सङ्कीर्यन्ते ह्युपक्रमाः|  
 +
 
षट्त्वं तु नातिवर्तन्ते त्रित्वं वातादयो यथा||४३||  
 
षट्त्वं तु नातिवर्तन्ते त्रित्वं वातादयो यथा||४३||  
 +
<div class="mw-collapsible-content">
    
bhavati cātra-  
 
bhavati cātra-  
 +
 
dōṣāṇāṁ bahusaṁsargāt saṅkīryantē hyupakramāḥ|  
 
dōṣāṇāṁ bahusaṁsargāt saṅkīryantē hyupakramāḥ|  
 +
 
ṣaṭtvaṁ tu nātivartantē tritvaṁ vātādayō yathā||43||  
 
ṣaṭtvaṁ tu nātivartantē tritvaṁ vātādayō yathā||43||  
    
bhavati cAtra-  
 
bhavati cAtra-  
 +
 
doShANAM bahusaMsargAt sa~gkIryante hyupakramAH|  
 
doShANAM bahusaMsargAt sa~gkIryante hyupakramAH|  
 +
 
ShaTtvaM tu nAtivartante tritvaM vAtAdayo yathA||43||  
 
ShaTtvaM tu nAtivartante tritvaM vAtAdayo yathA||43||  
 +
</div></div>
    
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 ''doshas'' are three in number. [43]
 +
<div class="mw-collapsible mw-collapsed">
    
तत्र श्लोकाः-  
 
तत्र श्लोकाः-  
 +
 
इत्यस्मिँलङ्घनाध्याये व्याख्याताः षडुपक्रमाः|  
 
इत्यस्मिँलङ्घनाध्याये व्याख्याताः षडुपक्रमाः|  
 +
 
यथाप्रश्नं भगवता चिकित्सा यैः प्रवर्तते||४४||  
 
यथाप्रश्नं भगवता चिकित्सा यैः प्रवर्तते||४४||  
 +
<div class="mw-collapsible-content">
    
tatra ślōkāḥ-  
 
tatra ślōkāḥ-  
 +
 
ityasmimँlaṅghanādhyāyē vyākhyātāḥ ṣaḍupakramāḥ|  
 
ityasmimँlaṅghanādhyāyē vyākhyātāḥ ṣaḍupakramāḥ|  
 +
 
yathāpraśnaṁ bhagavatā cikitsā yaiḥ pravartatē||44||
 
yathāpraśnaṁ bhagavatā cikitsā yaiḥ pravartatē||44||
    
tatra shlokAH-  
 
tatra shlokAH-  
 +
 
ityasmi@mla~gghanAdhyAye vyAkhyAtAH ShaDupakramAH|  
 
ityasmi@mla~gghanAdhyAye vyAkhyAtAH ShaDupakramAH|  
 +
 
yathAprashnaM bhagavatA cikitsA yaiH pravartate||44||  
 
yathAprashnaM bhagavatA cikitsA yaiH pravartate||44||  
 +
</div></div>
    
Now the (re-capitulatory) verse –
 
Now the (re-capitulatory) verse –
Line 597: Line 719:  
Thus in the chapter titled “Reducing and nourishing therapies," the six therapies which comprise the entire field of therapeutics have been expounded by the Lord Atreya (teacher) as per the inquiries of the disciples. [44]
 
Thus in the chapter titled “Reducing and nourishing therapies," the six therapies which comprise the entire field of therapeutics have been expounded by the Lord Atreya (teacher) as per the inquiries of the disciples. [44]
   −
=== ''Tattva Vimarsha'' ===
+
== Tattva Vimarsha (Fundamental Principles) ==
 
<div style="text-align:justify;">
 
<div style="text-align:justify;">
 
*''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 ''doshas''.
Line 603: Line 725:  
*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'' ===
+
== 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)
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| 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;" | ''Pichchala''
+
| 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;" | ''Pichchala''
+
| 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;" | ''----------''
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| 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;" | ''Slakshna''
+
| 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;" | ''Slakshna''
+
| rowspan="1" style="text-align: center;" | ''Shlakshna''
 
|-
 
|-
 
| rowspan="1" style="text-align: center;" | ''11''
 
| rowspan="1" style="text-align: center;" | ''11''
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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 ====
 +
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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   −
=== Glossary ===
+
== References ==
 
  −
Sanskrit term in English meaning
  −
Diacritical Phonetic Sanskrit
  −
laṅghanaṁ la~gghanaM लंघनम् Lightening, bulk reducing measures, fasting catabolisers; 
  −
br̥ṁhaṇaṁ bRuMhaNaM बृंहणं Roborant; bulk enhancer; bulk promoting;  anabolizers
  −
rūkṣaṇaṁ rUkShaNaM रूक्षणं Dryness; Therapeutic measure inducing dryness
  −
snēhanaṁ snehanaM स्नेहनं unctuousness; Therapeutic oleation measure
  −
stambhanaṁ stambhanaM स्तम्भनं Astringent effect; Astringent action, Styptic therapy
  −
swēdanaṁ svedanaM स्वेदनं Sudation therapy;
  −
Upakrama Upakrama उपक्रम Therapeutic measures
  −
{| class="wikitable"
  −
! colspan="3"| Sanskrit term in
  −
! rowspan="2" |''English meaning''
  −
|-
  −
! Diacritical !! Phonetic !! Sanskrit
  −
|-
  −
|laṅghanaṁ || la~gghanaM || लंघनम् || Lightening, bulk reducing measures, fasting catabolisers; 
  −
|-
  −
|br̥ṁhaṇaṁ  || bRuMhaNaM || बृंहणं || Roborant; bulk enhancer; bulk promoting;  anabolizers
  −
|-
  −
| rūkṣaṇaṁ || rUkShaNaM || रूक्षणं || Dryness; Therapeutic measure inducing dryness
  −
|-
  −
| snēhanaṁ || snehanaM || स्नेहनं || unctuousness; Therapeutic oleation measure
  −
|-
  −
| stambhanaṁ || stambhanaM || स्तम्भनं || Astringent effect; Astringent action, Styptic therapy
  −
|-
  −
| swēdanaṁ || svedanaM || स्वेदनं|| Sudation therapy;
  −
|-
  −
| Upakrama || Upakrama || उपक्रम || Therapeutic measures
  −
|-
  −
|}
   
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