अथातो लङ्घनबृंहणीय मध्यायं व्याख्यास्यामः ॥ १ ॥ इति ह स्माह भगवानात्रेयः ॥ २ ॥
“We shall now expound the chapter on “Reducing and Nourishing Therapies.”
Thus said Lord Atreya.
After describing the object of treatment, i.e. the body, the line of treatment in the form of Reducing and Nourishing therapies is now being explained in all its details in the present chapter.
Questions regarding the six therapies
तप. स्वाध्यायनिरतानात्रेयः घडग्निवेशप्रमुखानुक्तवान् वृंहणं काले लङ्घनं रूक्षणं स्नेनं तथा । स्वेदनं स्तम्भनं चैव जानीते यः स वै भिषक् ॥ ४ ॥ तमुक्तवन्तमात्रेयमग्निवेश भगवल्लङ्घनं वृंहणं वृंहणीयाश्च किंस्विल्लङ्घनीयाध शिष्यसत्तमान् । परिचोदयन् ॥ ३ ॥ उवाच ह ॥ ५॥ कीदृशाः । रूक्षणीयाञ्च रूक्षणम् ॥ ६ ॥ के स्नेहाः स्नेहनीयाश्च स्वेदाः स्वेद्याश्च स्तम्भनं स्तम्भनीयाश्च वक्तुमर्हसि लङ्घनप्रभृतीनां पण्णाषां के मताः । तहुरो ! ॥ ७ ॥ समासतः । कृताकृतातिवृत्तानां लक्षणं वक्तुमर्हसि ॥ ८ ॥
With a view to initiating discussion, Lord Atreya spoke to his six illustrious disciples headed by Agnivesa, who are engaged in penance and studies. One who knows to reduce, to nourish to dry, to oleate, to fomentate and the astringent therapies, is the real physician. After Lord Atreya had concluded his speech, Agnivesa enjoined “O Lord! What are the reducing, nourishing, drying, oleating, fomenting and astringent therapies and for whom these therapies are indicated. You may explain it to us, Sir. You may also kindly tell us about the symptoms of proper application, improper application and excessive application of the six therapies. [ 3 –8 ]
Definition and pharmacology of the six therapies
तदग्निवेशस्य वचो निशम्य स्मृतम् ॥ ९ ॥ यत् किञ्चिल्लाघवकरं देहे तल्लङ्घनं बृहत्त्वं यच्छरीरस्य जनयेत्तञ्च वृंहणम् । रौक्ष्यं खरत्वं वैशद्यं यत् कुर्यात्तद्धि रूक्षणम् ॥ १० ॥ स्नेहनं स्नेहविष्यन्दमार्दव क्लेदकारकम् । स्तम्भगौरवशीतघ्नं स्वेदनं स्वेदकारकम् ॥ ११ ॥ स्तम्भनं स्तम्भयति यद्गतिमन्तं चलं ध्रुवम् । लघृष्णतीक्ष्णविशदं रूक्षं सूक्ष्मं खरं सरम् ॥ १२ ॥ कठिनं चैव यद्दुव्यं प्रायस्तल्लङ्घनं स्मृतम् । गुरु शीतं मृदु स्निग्धं चहलं स्थूलपिच्छिलम् ॥ १३ ॥ प्रायो मन्दं स्थिरं लक्ष्णं द्रव्यं वृंहणमुच्यते । रुक्षं लघु खरं तीक्ष्णमुष्णं स्थिरमपिच्छिलम् ॥ १४ ॥ प्रायशः कठिनं चैव यद्रव्यं तद्धि रूक्षणम् । द्रवं सूक्ष्मं सरं स्निग्धं पिच्छिलं गुरु शीतलम् । प्रायो मन्दं मृदु च यद्रव्यं तत्स्नेहनं मतम् ॥ १५ ॥ उष्णं तीक्ष्णं सरं खिग्धं रूक्षं सूक्ष्मं द्रवं स्थिरम् । द्रव्यं गुरु च यत् प्रायस्तद्धि स्वेदनमुच्यते ॥ १६ ॥ शीतं मन्दं मृदु लक्ष्णं रूक्षं सूक्ष्मं द्रवं स्थिरम् । यद्रव्यं लघु चोद्दिष्टं प्रायस्तत् स्तम्भनं स्मृतम् ॥ १७ ॥
Having thus listened to Agnivesa, Lord Atreya said, “ever is capable to reduce the body is known as ‘langhanareducing therapy, whatever adds to the corpulence of body is ‘brimhana’ or nourishing therapy; whatever causes roughness and non sliminess is ‘yuksana’ or drying whatever causes unctuousness, fluidity, softness and moistness snehana’ or oleating therapy; whatever cures stiffness, coldness ( of the body ) is ‘svedana’ or fomentation the therapy that surely prevents mobility and flow of substances is known as ‘stambhana’ or astringent therapy. गुरुरब्रवीत् ।
What’ or the dryness, therapy; is ‘heaviness and therapy and bodily
The following are characteristic features of the drugs that are mostly employed in the above mentioned therapies :
1. Langhana or Lightening Therapy :
Light, hot, sharp, non-slimy, rough, subtle, dry, fluid and hard.
2. Brimhana or : Nourishing Therapy
Heavy, cold, soft, unctuous, thick, bulky, slimy, sluggish, stable and smooth.
3. Ruksana or Drying Therapy
Rough, light, dry, sharp, hot, stable, non-slimy and hard.
4. Snehana or Oleation Therapy
Liquid, subtle, fluid, unctuous, slimy, heavy, cold, sluggish and soft.
5. Svedana or Fomentation Therapy
Hot, sharp, fluid, unctuous or rough, subtle, liquid, stable and heavy.
6. Stambhana or Astringent Therapy
Cold, sluggish, soft, smooth, rough, subtle, liquid, stable and light.
The characteristic feature of astringent therapy is that it surely prevents the out-flow of substances irrespective of the nature of their mobility-slow or fast. The mobility meant here (verse No. 12) relates to diarrhoea, haemorrhage, pain due to poisoning and burn; it does not relate to vata because the latter gets aggravated by astringent therapy.
The characteristic features of the drugs employed drying therapies are stated to be the same. This should not, however, lead to the conclusion that they are one and the same and there is no difference between the two. In the former only the quality of lightness predominates, whereas in the latter, the quality of dryness predominates. Moreover, while lightness can be brougnt about even by such non-material devices like fast, etc., dryness can be brought about only by meterial drugs. So both these therapies are different. It is true that even the signs and symptoms of proper utilisation or over utilisation of both the therapies, i.e. reducing and drying, are one and the same but in fact, the object of drying therapy is to produce dryness whereas that of the reducing therapy is to produce lightness.
Types of langhana therapy
चतुष्प्रकारा संशुद्धिः पिपासा मारुतातपौ । पाचनान्युपवासश्च व्यायामश्चेति लङ्घनम् ॥ १८ ॥
The four types of elimination therapies (viz. emesis, purgation, niruha type of enema and inhalation), control of thirst, exposure to the wind and sun, intake of substance that stimulates digestior, fast and physical exercise constitute Reducing Therapy. 
All the elimination therapies except the anuvasana type of enema (which helps in nourishment) constitute the Lightening Therapy. Exposure to the wind causes lightness but if it is cold wind, it is not so effective: Drugs that stimulate the digestive power are dominant in vayu and agni mahabhutas in their composition.
Indications for ten types of langhana therapies
प्रभूतश्लेष्मपित्तास्रमलाः बृहच्छरीरा बलिनो लङ्घनीया येषां संसृष्टमारुताः । विशुद्धिभिः ॥ १९ ॥ मध्यबला रोगाः कफपित्तसमुत्थिताः । वम्यतीसारहृद्रोगविसूच्यलसकज्वराः विबन्धगौरवोद्गारहृल्लासारोचकादयः । पाचनैस्तान् भिषक प्राज्ञः प्रायेणादावुपाचरेत् ॥ २१ ॥ एव यथोद्दिष्टा येषामल्पवला गदाः । पिपासानिग्रहस्तेषामुपवासैश्च रोगाञ्जयेन्मध्यबलान् ताञ्जयेत् ॥ २२ ॥ बलम् ॥ २३ ॥ बलिनां किं पुनर्येषां रोगाणामवरं त्वग्दोषिणां प्रमीढानां स्निग्धाभिस्यन्दिबृंहिणाम् । शिशिरे लङ्घनं शस्तमपि वातविकारिणाम् ॥ २४ ॥ व्यायामातपमारुतैः । ।। २० ।।
For the purpose of reducing the body, elimination therapy be administered to such of the persons as are having , strong body and who suffer from diseases due to kapha, pitta, blood and exereta combined with the vitiation.
Diseases like vomiting, diarrhoea, heart diseaes, cholera, intestinal torpor, fever, constipation, heaviness of the body, eructation, nausea and anorexia which are caused by the vitiation of kapha and pitta, and of moderate nature are to be treated in the beginning by drugs that promote digestion.
If the same diseases are of mild nature, they are to be treated by the control of thirst and hunger ( fasting ).
If strong individuals suffer from diseases of moderate nature, such diseases can be cured by physical exercies and exposure to sun and wind. It goes without saying that diseases of mild nature of these individuals can also be cured by the same devices.
Reducing therapy is to be administered during the winter (in hemanta and sisira-November to February, to such of the patients as are suffering from skin diseases and obstinate urinary disorders and to those who possess corpulent body together with unctuousness and fluidity and even to those who suffer from diseases due to the vitiation of vata. [ 19-24]
It is at the initial stage that the digestive drugs are to be administered in the diseases like vomiting. At the latter stage (niramavstha) alleviation therapy is to be administered for their cure.
Signs and symptoms of normal and excessive langhana
वातमूत्रपुरीषाणां हृदयोद्गारकण्ठास्यशुद्धौ विसर्गे गाजलाघवे । तन्द्राक्कमे गते ॥ ३४ ॥
स्वेदे जाते रुचौ चैव क्षुत्पिपासासहोदये । कृतं लङ्घनमादेश्यं नियंथे चान्तरात्मनि ॥ ३५ ॥
पर्वभेदोऽङ्गमर्दश्च कासः शोषो मुखस्य च । क्षुत्प्रणाशोऽरुचिस्तृष्णा दौर्बल्यं श्रोत्रनेत्रयोः ॥ ३६ ।।
मनसः संभ्रमोऽमीक्ष्णमूर्ध्ववातस्तमो हृदि । देहाग्निबलनाशश्च लङ्घनेऽतिकृते भवेत् ।। ३७ ।।
Proper excretion of flatus, urine and feces, lightness of the body, feeling of purity in heart, eructation, throat and mouth, disappearance of drowsiness and exertion, appearance of sweat and taste for food, excessive hunger and thirst and contentment -these are the signs and symptoms of proper administration of “Langhana therapy.”
Cracking of the skin, malaise, cough, dryness of mouth, loss of appetite, anorexia, thirst, weakness of the ears and eyes. (impairment of the power of hearing and sight ), loss of memory, frequent upward movement of vayu, bradycardia, emaciation of body, loss of the power of digestion and strength-these are the signs and symptoms of excessive administration of “Langhana Therapy”. [ 34–37 ] .
Definition and Indications for Nourishing Therapy
अदिग्धविद्धमक्लिष्टं मृगमत्स्यविहङ्गानां वयस्थं सात्म्यचारिणाम् । मांसं बृंहणमुच्यते ॥ २५ ॥ क्षीणाः क्षताः कृशा वृद्धा दुर्बला नित्यमध्वगाः । ये । स्त्रीमद्यनित्या ग्रीष्मे च वृंहणीया नराः स्मृताः ॥ २६ ॥ शोषाशग्रहणी दोषैर्व्याधिभिः कर्शिताश्च तेषां क्रव्यादमांसानां स्नानमुत्सादनं स्वप्नो बृंहणा लघवो रसाः ॥ २७ ॥ मधुराः स्वप्नो मधुराः स्नेहबस्तयः । शर्कराक्षीरसपींषि सर्वेषां विद्धि बृंहणम् ॥ २८ ॥
Fresh meat of young animals, fishes and birds moving their natural surrounding and killed by non-poisonous devices in like arrows, etc. is nourishing.
Persons requiring this therepy are those suffering from wasting, phthisis, emaciation, old age, weakness, exertion from long tours, habitual indulgence in sexual act and wine. Such persons need this therapy all the more during summer.
For patients emaciated due to diseases like consumption, piles, and sprue, soup of meat eating birds and animals ( or better soup of the meat of such of the meat-eating birds and animals as are light by nature ) rendered light for digestion by special devices is specially useful. This helps in bringing about nourishment.
Bath, unction, sleep, enema with sweet and unctuous drugs, sugar, milk and ghee constitute universal nourishing devices. [ 25-28 ]
Signs and symptoms of normal and excessive nourishing therapy
लक्षणं बृंहिते स्थौल्यमति चात्यर्थबृंहिते ॥ ३८ ॥
Over-corpulence is the result of the excessive administration of “Nourishing Therapy”.
The signs and symptoms of proper and excessive administration of Drying therapy are the same as those of the “Reducing Therapy ” [ 38]
कृतातिकृतलिङ्गं यल्लविते तद्धि रूक्षिते ।
Strength, corpulence, disappearance of the defects of emaciation these are the symptoms of proper administration of “Nourishing Tharapy”.
Definition and Indication of drying therapy
कटुतिक्तकषायाणां सेवनं स्त्रीष्वसंयमः । खलिपिण्याकतक्राणां मध्वादीनां च रूक्षणम् ॥ २९ ॥ अभिष्यण्णा महादोषा मर्मस्था व्याधयश्च ये । ऊरुस्तम्भप्रभृतयो रूक्षणीया निदर्शिताः ॥ ३० ॥ स्नेहाः स्नेहयितव्याश्च स्वेदाः स्वेद्याश्च ये नराः । स्नेहाध्याये मयोक्तास्ते स्वेदाख्ये च सविस्तरम् ॥ ३१ ॥
Intake of pungent, bitter and astringent substances, oil of mustard and til, honey, etc. and sexual indulgence constitute cake drying therapy.
Patients suffering from diseases characterized by the obstruction of bodily channels, domination of the aggravated dosha in excess and manifested in vital organs of the body like ‘spasticity urinary disorders of thighs (urustambha ), gout and obstinate should be treated by “Drying Therapy”.
The oleation and fomentation therapies along with the patients fit to be treated by them have been described in the chapter on Oleation and Fomentation in all their details (Sutra 13th and 41th chapters ). [ 29-31]
The signs and symptoms of proper and excessive administration of Drying therapy are the same as those of the “Reducing Therapy ” [ 38]
Definition and Indication of astringent therapy
यावच्छीतीरकरणमौषधम् । द्रवं तन्वसरं स्वादु तिक्तं कषायं च स्तम्भनं सर्वमेव तत् ॥ ३२ ॥
पित्तक्षाराग्निदग्धा ये वम्यतीसारपीडिताः । विषस्वेदातियोगार्ताः स्तम्भनीया निदर्शिताः ॥ ३३ ॥
The drugs constituting Astringent therapy are characterized by liquidity, thinness, consistency, coldness, sweetness, bitterness and astringency. Patients afflicted with pitta, alkalies ( ksara ) and fire, and those suffering from vomiting, diarrhoea, poisoning, excessive administration of Fomentation therapy are fit to be treated by “Astringent Therapy.” [ 32-33 ]
Signs and symptoms of proper and improper astringent therapy
स्तम्भितः स्याले लब्धे यथोक्तैश्चामयैर्जितैः ॥ ३९ ॥ श्यावता स्तब्धगात्रत्वमुद्वेगो हनुसंग्रहः । स्यादतिस्तम्भितलक्षणम् ॥ ४० ॥ हृद्वनिग्रहश्च
By the proper administration of “Astringent Therapy”, the patient gains strength and ailments like affliction with pitta, alkalies and fire are overcome.
The signs and symptoms of the excessive utilisation of “Astringent Therapy” are blackish appearance, stiffness of the body, upward movement of vata, rigidity of jaw, bradycardia and non-excretion of feces. [ 39-40]
Features of effective administration of six types of therapies
लक्षणं चाकृतानां स्यात् षण्णामेषां समासतः । तदौषधानां धातूनामशमो वृद्धिरेव च ॥ ४१ ॥ इति षट् सर्वरोगाणां प्रोक्ताः सम्यगुपक्रमाः । साध्यानां साधने सिद्धा मात्राकालानुरोधिनः ॥ ४२ ॥
Signs and symptoms of non-utilisattion of all the six therapies in brief are the non-alleviation, rather aggravation of diseases for which these therapies have been administered. These are the six therapies which if administered properly with due regard to the doshage and the season can cure all the curable diseases. [ 41-42]
Place of six types of the therapies among the measures of treatment
बहुसंसर्गात् सङ्कीर्यन्ते छुपक्रमाः । दोषाणां षट्त्वं तु नातिवर्तन्ते त्रित्वं वातादयो यथा ॥ ४३ ॥
Thus it is said
Depending upon the permutation and combination of diseases, these therapies are often required to be combined with one another (for example, sometimes Reducing and Fomentation Therapies, sometimes Nourishing and Oleation Therapies are required to be administered jointly ). But inspite of this, the number of these therapies is six only as the number of doshas is three only. [ 43]
इत्यस्मिल्लङ्घनाध्याये व्याख्याताः षडुपक्रमाः । यथाप्रश्नं भगवता चिकित्सा यैः प्रवर्तते ॥ ४४ ॥
To sum up :
Thus, as enquired by the disciples, the six therapies which serve as the basis of treatment have been explained by Lord Atreya in this chapter on “Reducing Therapy”. [ 44 ] इत्यग्निवेशकृते तन्त्रे चरकप्रतिसंस्कृते लोकस्थाने लङ्घनबृंहणीयो नाम द्वाविंशोऽध्यायः ॥ २२ ॥
Thus ends the twenty second chapter on “Reducing and Nourishing Therapies” of the Sutra section of Agnivesa’s work as redacted by Garaka. [ 22 ]