चतुर्दशोऽध्यायः
अथातः स्वेदाध्यायं व्याख्यास्यामः ॥ १ ॥ इति ह स्माह भगनानात्रेयः ॥ २ ॥
We shall now expound the chapter on ‘Fomentation’. Thus, said Lord Atreya. [ 1-2 ] Oleation precedes fomentation. So the chapter on fomentation has followed the one on Oleation.
A simile regarding the effect of fomentation therapy
अतः स्वेदाः प्रवक्ष्यन्ते यैर्यथावत्प्रयोजितैः । स्वेदसाध्याः प्रशाम्यन्ति गदा वातकफात्मकाः ॥ ३ ॥ स्नेहपूर्व प्रयुक्तेन स्वेदेनावजितेऽनिले । सज्जन्ति कथंचन ॥ ४ ॥ पुरीपमूत्ररेतांसि न शुष्काण्यपि हि काष्ठानि स्नेहस्वेदोपपादनैः । नमयन्ति यथान्यायं किं पुनर्जीवतो नरान् ॥ ५ ॥
Now the different types of fomentation will be explained. If properly administered, they can cure such of the vatika and slaismika diseases as are curable by fomentation. If administered after oleation, fomentation brings vata under control and thereby facilitates the elimination of faeces, urine and semen.
Even dry pieces of wood bend by means of oleation and fomentation, duly applied, then how living human beings ( can not be benefitted). [ 3-5 ]
Fomentation is useful for all diseases caused by the the vitiation of vata or kapha, or vata and kapha both. It is not useful when vitiated vata and or kapha are combined with pitta nor is it useful in cases like abdominal diseases (even if caused by vata and / or kapha) which are not curable by fomentation therapy.
Specificity in fomentation
रोगर्तुव्याधितापेक्षो नात्युष्णोऽतिमृदुर्न च । द्रव्यवान् कल्पितो देशे स्वेदः कार्यकरो मतः ॥ ६ ॥
Fomentation-neither too hot nor too mild-combined with proper drugs and applied with due regard to the diseases, the season, the individual patient and bodily organ affected by the disease, is effective indeed. [ 6 ]
Drugs to be used for fomentation should be unctuous or nonunctuous, depending upon the nature of the disease to be treated.
Degree and quality of fomentation
व्याधौ शीते शरीरे च महान् स्वेदो महावले । दुर्बले दुर्बलः स्वेदो मध्यमे मध्यमो हितः ॥ ७ ॥
वातश्लेष्मणि वाते वा कफे वा स्वेद इष्यते । स्निग्धरूक्षस्तथा स्निग्धो रूक्षश्चाप्युपकल्पितः ॥ ८ ॥
If the disease is of serious type, if the season is very cold and if the body of the patient is very strong, strong fomentation is prescribed, If the disease is mild, the season is moderately cold and the body is weak, mild fomentation is prescribed. If all are of moderate nature, then moderate fomentation is prescribed.
In diseases caused by vata, combined with kapha, vata alone or kapha alone, the fomentation to be applied should be prepared by drugs of unctuous and coarse qualities, unctuous quality alone or coarse quality alone respectively. [7-8 ]
आमाशयगते वाते कफे पक्काशयाश्रिते ।
रूक्षपूर्वो हितः स्वेदः स्नेहपूर्वस्तथैव च ॥ ९ ॥
If the vata is accumulated in amasaya (stomach) then the fomentation with drugs having coarse qualities, should precede the prescribed fomentation for vata; one the other hand, if kapha is accumulated in the pakvasuya (colon) fomentation with drugs having unctuous qualities should precede the prescribed fomentation for kapha. [9]
In the preceding verse, fomentation with drugs having unctuous and coarse qualities is prescribed for vatika and slaismika ailments respectively. But if the vata is accumulated in the stomach, in that case, the unctuous fomentation is required to follow the fomentation with drugs having coarse quality. Again, if kapha is accumulated in the colon, the coarse fomentation is to follow the fomentation with drugs having unctuous quality. The reason is quite simple. As stated in the sixth verse above, the fomentation is to be applied with due regard to time, affected bodily organ etc; so, even if stomach is affected by vata, it is necessary that the local dosa, inhabiting the organ, that is kapha, should be alleviated first and this can be done only by the administration of fomentation with drugs having coarse qualities. Similarly, it is necessary to administer fomentation with drugs having unctuous qualities when colon, the abode of vita is affected by kapha. As it has been stated that first of all, the inherent local dosas are to be attended to, with due regard to the treatment of the extraneous dosas.
Contra-Indicated for fomentation
वृषणौ हृदयं दृष्टी स्वेदयेन्मृदु नै वा क्षण मध्यमं शेषमङ्गावयवमिष्टतः ॥ १० ॥ श्री
No fomentation should preferably be administered over testicles, heart and eyes. Even if it is ( very ) necessary to administer, it should be of mild type; over groins it should be moderate; fomentation on other parts of the body could be according to the individual needs. [ 10 ]
Fomentation over testicles, heart and eyes should be administered only when there is no other way to treat the local disease. If they can be treated otherwise, fomentation must not be administered.
सुशुधैर्नक्तकैः पिण्ड्या गोधूमानामथापि वा। पद्मोत्पलपलाशैर्वा स्वेद्यः संवृत्य चक्षुषी ॥ ११ ॥
मुक्तावलीभिः शीताभिः शीतलैर्भाजनैरपि । जलाईर्जलजैर्हस्तैः स्विद्यतो हृदयं स्पृशेत् ॥ १२ ॥
Before applying fomentation, eyes are required to be covered with exceedingly clean cloths, a ball of wheat flour or leaves of kamala ( Nelumbo nucifera Gaertn. ) and utpala (Nymphaea alba Linn. ) or Palas. Similarly heart is to be covered with cool perl necklaces, cool utensils, lotuses wet with water or simply b by the touch of cold hands. [ 11–12 ].
At the time of fomentation, it is necessary to protect delicate organs of the body like eyes, heart and testicles. The instructions contained in the above two verses relate to eyes and heart, being the most delicate parts of the body. Similar protective devices are to be applied to testicles as well.
Signs of Ideal Fomentation
शीतशूलव्यु परमे संजाते मार्दवे स्वेदे
स्तम्भगौरवनिग्रहे । स्वेदनाद्विरतिर्मता ॥ १३ ॥
Fomentation is to be administered until there is complete recovery from cold, colic pain, stiffness and heaviness of the body or until tenderness and sweating appear there. ( Fomentation should be stopped thereafter. ) [ 13 ]
The signs of proper administration of fomentation therapy is the appearance of sweating which indicates that the complications like cold etc. which stand as obstacles to sweating have disappeared. If, on the other hand, there is no sweating inspite of fomentation therapy, it indicates that fomentation has not been properly administered and as such Rudi us! complications like cold etc. are still persisting.
Signs of over fomentation
पित्तप्रकोपो मूर्च्छा च शरीरसदनं तृषा दाहः स्वराङ्गदौर्बल्यमतिस्विन्नस्य लक्षणम् ॥ १४ ॥
उक्तस्तस्याशितीये यो ग्रैष्मिकः सर्वशो विधिः । सोऽतिस्विन्नस्य कर्तव्यो मधुरः स्निग्धशीतलः ॥ १५ ॥
Aggravation of pitta, fainting, prostration, thirst, burning sensation, weakness of the voice and limbs-these symptoms appear when there is over-fomentation. The treatment of patients suffering from complications due to over-fomentation is the same as prescribed in connection with the regimen for summer in the sixth chapter of this section. The regimen to be followed, are of course to be sweet, unctuous and cold. [14-15] Generally speaking, the management of patients suffering from complications due to over fomentation is the same as the one prescribed for summer season. But the regimen to be followed should, as a rule, be sweet, unctuous and cold. So, even though wine in small quantity may be a prescribed regimen for the summer, it is not for such patients because it is neither unctuous nor cold.
कषायमद्यनित्यानां गर्भिण्या रक्तपित्तिनाम् । पित्तिनां सातिसाराणां रूक्षाणां मधुमेहिनाम् ॥ १६ ॥ विदग्ध अष्टब्रधानां विषमद्यविकारिणाम् । श्रान्तानां नष्टसंज्ञानां स्थूलानां पित्तमेहिनाम् ।। १७ ।। तृष्यतां क्षुधितानां च क्रुद्धानां शोचतामपि । कामल्युदरिणां चैव क्षतानामाढ्यरोगिणाम् ॥ १८ ॥ दुर्बलातिविशुष्काणामुपक्षीणौजसां तथा । भिषक् तैमिरिकाणां च न स्वेदमवतारयेत् ॥ १९ ॥
Contra-Indications for fomentation
The physician should not administer fomentation therapy to those who have taken toomuch astringents and alcohols, the pregnant woman, those suffering from raktapitta (a disease characterized by bleeding from different parts of the body ), diarrhoea, paittika type of obstinate urinary disorder specially diabetes mellitus, vidagdha-bhrasta-bradhna (inflammation and prolapse of the rectum), toxic conditions, alcoholism; those having paittika constitution and dry skin; those who are fatigued, unconscious, fatty, thirsty, hungry, in a fit of anger and anxiety, those suffering from jaundice, abdominal diseases, consumption, vatarakta (gout), timira (fainting); those who are weak and dried up and whose ojas has been reduced. [ 16-19 ]
Fomentation therapy should not be administered to individuals who have taken too much astringent substances in general specially wine prepared with astringent drugs. Those who have taken astringent drugs, their body becomes exceedingly rough and stiff. If fomentation is applied over this type of body, it might lead to cracking of the skin (parvabheda).
The disease raktapitta is itself not curable by fomentation. If the patient suffering from raktapitta is afflicted with another disease due to the vitiation of vata and kapha, even then he is not to be given fomentation therapy. This therapy is not to be administered to such patients even as a part of panchakarma therapy. Similarly, this therapy is never to be administered to patients suffering from the diseases enumerated above.
The word “madhumeha” includes all obstinate urinary disorders, specially disorders caused by the vitiation of pitta. In all these cases the body becomes sloth and as such fomentation, which also causes slothness is not prescribed for patients suffering from these diseases. Fomentation is not to be administered to such patients as are taken to alcohol even if they suffer from diseases due to chronic alcoholism of vatika and slaismika type.
All these cases where fomentation is not to be administered are enumerated in the above verses. But then even if an individual is placed in any one of these situations, he may be given fomentation therapy if attacked by another more serious disease like samnyasa (syncope ) which can be cured only by fomentation therapy. As it has been stated, “A smaller anomaly is wellcome if it helps eradicate a greater one.”
Indications for fomentation / Svedya
प्रतिश्याये च कासे च हिक्काश्वासेष्वलाघवे । कर्णमन्याशिरःशूले स्वरभेदे गलग्रहे । २० ।। अर्दितैका सर्वाङ्गपक्षाघाते विनामके | कोष्ठानाहविवन्धेषु मूत्राघाते विजृम्भके ॥ २१ ॥ पार्श्वपृष्ठकटीकुक्षिसंग्रहे गृध्रसीषु च । मूत्रकृच्छ्रे महत्त्वे च मुष्कयोरङ्गमर्दके ॥ २२ ॥ पादजानूरुजङ्घार्तिसंग्रहे श्वयथावपि । खल्लीष्वामेषु शीते च वेपथौ वातकण्टके ॥ २३ ॥ संकोचायामशूलेषु स्तम्भगौरवसुतिषु । सर्वाङ्गेषु विकारेषु स्वेदनं हितमुच्यते ॥ २४ ॥
Fomentation is useful for Pratisyaya ( coryza ), cough, hiccup, dyspnea, heaviness of the body, pain in the ear, neck and head, hoarseness of voice, spasmodic obstruction in the throat, paralysis of the face, one limb, whole body or half of the body, inflexures of the body ( vainamaka ), distension of the abdomen, constipation and suppression of urine, vijrmbhaka (pendiculation), stiffness of sides, back, waiste and abdomen, sciatica, dysuria, enlargement of scrotum, malaise, pain and stiffness of feet, knee, calf, oedema, khalli (neuralgia of upper and lower extremities ), diseases due to impaired digestion and metabolism, in chill and shivering, affliction of the ankle joint by vata ( vata kantaka ), in contraction, extension or colic pain, stiffness, excessive heaviness, numbness and in diseases affecting the whole body. [ 20-24]
13 Types of Svedana – Materials for Svedana
Materials used in pinda sveda
तिलभाषकुलत्थाम्लघृततैलामिषौदनैः पायसैः शरैमासैः पिण्डस्वेदं प्रयोजयेत् ॥ २५ ॥ गोखरोष्ट्रवराहाश्वशकृद्भिः सतुषैर्यवैः । सिकतापांशुपाषाणकरीपायसपूटकैः ॥ २६ ॥ श्लैष्मिकान् स्वेदयेद् पूर्वैर्वातिकान् समुपाचरेत् । द्रव्याण्येतानि शस्यन्ते यथास्वं प्रस्तरेष्वपि ॥ २७ ॥
One should prepare a bolus for fomentation with tila (Sesamum indicum Linn. ), masa ( Phaseolus radiatus Linn. ), kulattha (Doliction biflorus Linn. ), sour preparations, ghee, oil, meat, porridge, payasa ( milk preparations ), and flesh — this is indicated for diseases of vatika origin.
Faeces of cow, ass, camel, pig and horse along with the barley grains with chaff, sand, dust, stone dried cow-dung and iron powder in a bolus form for fomentation in diseases of slaismika origin.
These very drugs may be used for prastara sveda (that is fomentation by a hot stone) depending upon the nature of diseases. [ 25-26]
Materials required for jentaka sveda
भूगृहेषु च जेन्ताकेषूष्णगर्भगृहेषु च । विधूमाङ्गारतप्तेषु स्वभ्यक्तः स्विद्यते सुखम् ॥ २८ ॥
The person should first of all be well massaged and then heated in an underground cellar, jentaka type of room, or warm enclosed central room which is heated with fire brands devoid of smoke. This effects fomentation comfortably. [ 23 ]
Materials used for Nadi sveda
प्राम्यानूपौदकं मांसं पयो बस्तशिरस्तथा । वराहमध्यपित्तासृक् स्नेहवत्तिलतण्डुलाः ॥ २९ ॥ 1 इत्येतानि समुत्काथ्य नाडीस्वेदं प्रयोजयेत् । देशकालविभागशो युक्त्यपेक्षो भिषक्तमः ॥ ३० ॥ वारुणामृतकैरण्ड शिग्रुमूलकसर्षपैः वासावंशकरञ्जार्कपत्रैर इमन्तकस्य शोभाञ्जनकसैरेय मालतीसुरसार्जकैः पत्रैरुत्काथ्य सलिलं नाडीस्वेदं प्रयोजयेत् ॥ ३२ ॥ च ॥ ३१ ॥ । सुरया दधिमस्तुना । सस्नेहैर्नाडीस्वेदं प्रयोजयेत् ॥ ३३ ॥ भूतीकपञ्चमूलाभ्यां मूत्रैरग्लैश्च
The physician conversant with the geological and temporal classification and having the sense of propriety should prepare nadi sveda (a type of fomentation administered by collecting steam through a tube) by boiling the flesh of domesticated, marshy and aquatic animals, milk, head of goat, blood, bile and the flesh of middle part of pig, unctuous substances like castor seeds, seasamum seeds and rice ( for vatika diseases).
For slaismika diseases, nadi sveda should be given by boiling leaves of varuna (Crataeva religiosa Forst.), amrtaka ( Tinspora cordi. folia Miers. ), eranda ( Ricinmus communis Linn. ), sigru ( Moringa bleifera Lam. ), mulaka ( Raphanus sativus Linn. ), sarsapa ( Brassica igra Koch. ), vasa (Adhatoda vasica Neess), vainsa (Bambusa arundi nacea Retz.), karanja (Pongamia Pinnata Merr.), arka (Calotropis gigantea R. Br. ex Ait. ), asmantaka (Bauhinia racemosa Lam.), Sobhanjana ( a variety of sigru ), saireya (Barleria prionitis Linn.), malati (Jasminus grandiflorum ), surasa (Ocimum sanctum Linn.), and arjaka (Ocimum gratissimum Linn. ).
For vataslaismika diseases, nadi sveda should be given boiling bhutika (Trachyspermum ammi Spreague.), panchamula (roots of Aegle marmelos Corr, Oroxylum indicum Vent., Gmelina arborea Linn. Stereospermum suaveolens DC. and Clerodendrum phlomidis Linn. f.) added with wine, whey, urine and acidic preparations. [29-30]
Materials for tub fomentation
एत एव च निर्यूहाः प्रयोज्या जलकोष्टके | स्वेदनार्थ घृतक्षीरतैलकोष्ठांश्च कारयेत् ॥ ३४ ॥
These very decoctions are to be used in a big water-tub for fomentation. These decoctions may also be used for the purpose of the fomentation in ghee-tubs, milk-tubs and oil-tubs. [ 34 ]
Ingredients of upanaha sveda
गोधूमशकलैचूर्णैर्यवानाम्लसंयुतैः सस्नेहकिण्वलवणैरुपनाह: प्रशस्यते ॥ ३५ ॥ गन्धैः सुरायाः किण्वेन जीवन्त्या शतपुष्पया । उमया कुष्ठतैलाभ्यां युक्तया चोपनाहयेत् ॥ ३६ ॥ चर्मभिश्चोपनद्धव्यः सलोमभिरपूतिभिः । उष्णवीर्यैरलाभे तु कौशेयाविकशाटकैः ।। ३७ ।।
Poultice for the purpose of fomentation should be prepared with wheat chips, barley flour, mixed with acidic preparations, unctuous substance, yeast and salt, or with fragrant substance, yeast, jivanti (Leptandenia reticulata W & A), satapuspa (Foeniculum vulgare Mill.), uma ( Linum usitatissimum Linn.), kustha ( Saussurea lappa C. B. Clarke) mixed with oil.
Leather with hair, devoid of bad smell and of usma virya animals (like antelops, etc. whose meat produces heat ) is to be used as bandage. In case of their non-availability, silk or woolen blanket may be used for this purpose. [35-37 ]
By upanaha is meant bandaging of the affected limb of the body with leather, etc. after applying considerable quantity of ointment. Leather bandage may be regarded as an anagnisveda, that is fomentation without involving the direct application of fire.
Svedana – Fomentation
Period for upanaha sveda
रात्रौ यद्धं दिवामुञ्चेन्मुञ्चेद्रात्रौ दिवा कृतम् । विदाहपरिहारार्थ, स्यात् प्रकर्षस्तु शीतले ॥ ३८ ॥
In order that the burning sensation may be prevented, normally, the bandage applied in the night should be removed in the morning and so the one applied during the day, in the evening; the duration of bandage may be prolonged in the winter. [ 38 ]
Thirteen types of fomentation
सङ्करः प्रस्तरो नाडी परिपेकोऽवगाहनम् । जेन्ताकोश्मघनः कर्पूः कुटी भूः कुम्भिकैव च ।। ३९ ।।
कूपो होलाक इत्येते स्वेदयन्ति त्रयोदश । तान् यथावत् प्रवक्ष्यामि सर्वानेवानुपूर्वशः ॥ ४० ॥
The thirteen varieties of fomentation are shankara, prastara, nadi, pariseka, avagahana, jentaka, asmaghana, karsu, kuti, bhu, kumbhika, kupa and holaka. They will be described seriatim. [ 39-40] In this verse, the various procedures to be adopted for fomentation are enumerated. Some of these words like shankara, etc. are accepted traditionally by vaidyas; some of them carry a specific meaning from the derivation of the word itself. For example, nadisveda means the type of fomentation administered through a nadi, that is a tube. On the other hand, there are some whose meanings are without any reference to derivation (pratyaya ), for example, ‘jentaka’.
Definition of shankara sveda
पिण्डैर्यथोक्तरुपस्चेदनं सङ्करस्वेद इति विद्यात् ॥ ४१ ॥ तत्र वस्त्रान्तरितैरव स्त्रान्तरितैर्वा
By sankara sveaa is meant fomentation by means of bolus containing prescribed drugs with or without being wrapped with cloths. [ 41 ]
Definition of prastara sveda
शूकशमीधान्यपुलाकानां वेशवारपायसकृशरोत्कारिकादीनां वा प्रस्तरे कौशेयाविकोत्तरप्रच्छदे पञ्चाङ्गलोरुवूकार्कपत्रप्रच्छदे वा स्वभ्यक्तसर्वगात्रस्य शयानस्योपस्वेदनं प्रस्तरस्वेद इति विद्यात् ॥ ४२ ।।
A bed is to be prepared of the size of the individual with corn, pulse and pulaka (an inferior type of grain) or vesavara ( a preparation of meat without bones together with long-pepper, blackpepper, ginger, sugar-candy and ghee), payasa ( milk preperation), krsara (thick gruel ), utkarika (pudding), etc. covered with silk, woolen or with the leaves of pancangula (Ricinus communis Linn.), urubuka ( a variety of Ricinus communis Linn.), and arka (Calotropis gigantea R. Br. ex Ait. ). The individual, well-massaged all over the body, should be made to lie down over this bed. This process is known as prastara sveda. [ 42 ]
Definition and method of nadi sveda
स्वेदनद्रव्याणां पुनर्मूलफलपत्रशुङ्गादीनां मृगशकुनपशितशिरस्पदादीनामुष्णस्वभावानां वा यथार्हमम्ललवणस्नेहो पसंहितानां मूत्रक्षीरादीनां वा कुम्भ्यां वाष्पमनुद्वमन्त्यामुत्कथितानां नाड्याशरेपीकावंशदलकरआर्कपत्रान्यतमकृतया गजाग्रहस्तसंस्थानया व्यामदीर्घया व्यामार्धदीर्घया वा व्यामचतुर्भागाष्टभागमूलाग्रपरिणाहस्रोतसा सर्वतो वातहरपत्रसंवृतच्छिद्रया द्वित्रिर्वा विनामितया वात सिद्धस्नेहाभ्यक्तगात्रो बाष्पमुपहरेत् ; बाप्पो ह्यनृजुगामी विहतचण्डवेगस्त्वचमविदहन् सुखं स्वेदयतीति नाडीस्वेदः ॥ ४३ ।।
Durgs for fomentation like roots, fruits, leaves, buds, etc. (of trees, plants, etc.) or flesh and head, etc. of animals and birds which bring about heat (in the body) are ( first of all ) mixed up with sour, salt or unctuous substances and urine, milk, etc. depending on the nature of diseases. They are then decocted in a pitcher in such a way the vapour does not leak out. A pipe made of saresika (?) or leaves of vamsa ( Bambusa arundinacea Retz.), karanja (Pongamia pinnata Merr.) or arka (Calotropis gigantea R. Br. ex Ait) with its fore part having the shape of the trunk of an elephant, is then inserted into the pitcher. The pipe is required to be one vyama (91. 44 cm) or half a vyama (45. 72 cm) long with its circumference being one fourth of a vyama ( 22. 86 cm) in its proximal end, and one eighth of vyama (11. 43 cm) in the distal end. All the clefts in the pipe should be wellcovered with the leaves that alleviate vata ( like castor leaves). The pipe should be curved twice or thrice. The individual wellmassaged with unctuous substances that alleviate vata should get this vapour through the curved pipe. Curvatures of the pipe help to lessen the intensity of vapour and so the vapour coming out of this pipe does not cause any burn in the body and thus it foments quite comfortably This is known as nadi sveda. [ 43 ]
The pipe should be of the length of one vyama ( 91.44cm) only when the fomentation is required to be administered in a high dose; otherwise it should be half of a vyama ( 45.72 cm ) only. The force with which the steam comes out is subdued by the length as well as curvatures of the pipe.
Definition and method of pariseka
वातिकोत्तरवातिकानां पुनर्मूलादीनामुत्काथैः सुखोष्णैः कुम्भीर्वर्षणिकाः प्रानाडीर्वा पूरयित्वा यथार्हसिद्धस्नेहभ्यक्तगात्रं वस्त्रावच्छन्नं परिपेचयेदिति परिषेकः ॥ ४४ ॥
Pitchers, varsanika (small pitchers with number of holes at the bottom ) or pipes ( made of bamboo, nala that is Phragmites karka Trin, etc.) are to be filled up with luke warm decoctions of roots, etc. of drugs which can cure vatika diseases or such of the vataslaismika diseases where vata is predominant. Showers are then to be taken by an individual after he has been well-massaged with suitable unctuous substance and has been covered with cloth. This is pariseka type of fomentation. [44]
Definition of avagaha
वातहरोत्काथक्षीरतैलघृतपिशितरसोष्णसलिलकोष्ठकावगाहस्तु यथोक्त एवावगाहः ॥ ४५ ॥
A tub should be filled up with decoction, milk, oil, ghee, meat juice or hot water that alleviate vata and the patient should take bath in it. This is known as avagaha type of fomentation. [45] Administration of fomentation in a tub of above description is of very common use.
Technique of jentaka sveda
अथ जेन्ताकं चिकीर्षुर्भूमिं परीक्षेत-तत्र पूर्वस्यां दिश्युत्तरस्यां वा गुणवति प्रशस्ते भूमिभागे कृष्णमधुरमृत्तिके सुवर्णमृत्तिके वा परीवापपुष्करिण्यादीनां जलाशयानामन्यतमस्य कूले दक्षिणे पश्चिमे वा सूपतीर्थे समसुविभक्तभूमिभागे सप्तायै वाऽरत्तीरुपक्रम्योदकात् प्राङ्मुख मुदखं वाऽभिमुखतीर्थं कूटागारं कारयेत्, उत्सेधविस्तारतः परमरत्नीः षोडश, समन्तात् सुवृत्तं मृत्कर्मसंपन्नमनैकवातायनम्; अस्य कूटागारस्यान्तः समन्ततो भित्तिमरनिविस्तारोत्सेधां पिण्डिकां कारयेदाकप.डात्, मध्ये चास्य कूटागारस्य चतुष्किष्कुमात्रं पुरुषप्रमाणं मृन्मयं कन्दु संस्थानं बहुसूक्ष्मच्छिद्रमङ्गारकोष्ठकस्तम्भं सपिधानं कारयेत् । तं च खादिराणामाश्वकर्णा दीनां वा काष्ठानां पूरयित्वा प्रदीपयेत् ; स यदा जानीयात् साधु दग्धानि काष्ठानि गतधूमान्यवतप्तं च केवलमन्निना तदग्निगृहं स्वेदयोग्येन चोष्मणा युक्तमिति, तत्रैनं पुरुषं वातहराभ्यक्तगात्रं वस्त्रावच्छन्नं प्रवेशयेत्, प्रवेशयंश्चैनमनुशिष्यात्-सौम्य ! प्रविश कल्याणायारोग्याय चेति प्रविश्य चैनां पिण्डिकामधिरुहा पार्श्वापरपावा॑भ्यां यथासुखं शयीथाः, न च त्वया स्वेदमूर्च्छापरीतेनापि सता पिण्डिकैषा विमोक्तव्याऽऽप्राणोच्छासात् अश्यमानो ह्यतः पिण्डिकावकाशाद्वारमनधिगच्छन् स्वेदमूर्छापरीततया सद्यः प्राणाञ्जह्याः, तस्मात् पिण्डिकामेनां न कथंचन मुञ्चेथाः; त्वं यदा जानीयाः– विगताभिष्यन्दमात्मानं सम्यक्प्रस्रुतस्वेदपिच्छ्रं सर्वस्रोतोविमुक्तं लधूभूतमपगत विवन्धस्तम्भसुतिवेदनागौरव मिति, ततस्तां पिण्डिकामनुसरन द्वारं प्रपद्येथाः, निष्क्रम्य च न सहसा चक्षुषोः परिपालनार्थं शीतोदकमुपस्पृशेथाः, अपगतसन्तापक्लमस्तु मुहूर्तात् सुखोष्णेन वारिणा यथान्यायं परिषिक्तोऽछनीयाः; इति जेन्ताकस्वेदः ॥ ४६ ।।
One should examine the land before resorting to the jentaka type of fomentation. One should construct a circular building facing the east or north side having a pond in front. This should be done in the east or in the north side of the village in a good fertile piece of land whose earth be black and sweet or of golden colour. The building is to be erected on the southern or eastern bank of a water reservoir like small or big pond or place contiguous thereto. The level of the land should be uniformly plane and it should be situated at a distance of seven to eight aratnis ( 320cm to 365. 76cm ) from the water reservoir. The height and diameter of the building should be sixteen aratnis (731.52 cm ) each. The building should be uniformly circular, well-plastered with mud and should have many windows. A benchone aratani ( 45. 72 cm ) high and one aratni ( 45.72cm ) wide is then to be prepared all around the wall upto the door. An oven of clay should be prepared in the centre of the room. Its diameter should be four hastas ( 1.8m ) and height should be equal to that of an individual. It should be circular in shape (like a a kandu ? ) and should have many fine holes. The pillar-like oven should have a lid. This should be filled up with the fuel of khadira ( Acacia catechu Willd. ) and asvakarna ( Diperocar pus alatus Roxb. ), etc., and be ignited. When the physician is sure that the fuel has well burnt up, the smoke has completely disappeared and the room is heated by fire alone, and is as such be equipped with heat required for fomentation, he should ask the patient who is well-massaged with (oil prepared of) vatacuring drugs and covered with a cloth, to enter the room. While asking him to do so, the physician should advise, “O noble one! enter the room for the sake of your well-being and cure of diseases. Go over the bench and lie down thereon, changing your sides comfortably. Even if you are fainted owing to (excessive ) heat do not leave the bench so long as you are alive because if you leave this bench, it may not be possible for you to reach the door. This might result in death owing to fainting due to (excessive ) heat. So you should never leave the bench. When you feel that you are free from all obstructions, the sweat along with its sticking portion is completely drained out (of your body ), all channels are light and free from all obstructions there is no stiffness, numbness, pain, heaviness, then you should move towards the door following the bench. In order that your eyes may not get adversely affected, you should not apply cold water immediately after coming out of the room. After the heat and exertion are over, you should take bath with luke warm water after about three-fourth of an hour and then you should take your meals.” This is known as jentaka sveda. [ 46 ] Bath in cold water immediately after jentaka type of fomentation is to be avoided as the heat immediately followed by cold bath is injurious to eyes. Selection of a suitable site, proximity to water reservoir, etc. are important from the point of view of auspiciousness of jentaka. Proximity to water reservoir is also intended to have a soothing effect to the eyes of the individual undergoing fomentation. This will also serve as an antidote to over fomentation and facilitate construction of the building.
Definition of asmaghana sveda
शयानस्य प्रमाणेन घनामचममयीं शिलाम् । तापयित्वा मारुतघ्नैर्दारुभिः संप्रदीपितैः ॥ ४७ ॥ व्यापोज्य सर्वानङ्गारान प्रोक्ष्य चैवोष्णवारिणा । तां शिलामथ कुर्वीत कौषेयाविकसंस्तराम् ॥ ४८ ॥ तस्यां स्वभ्यक्तसर्वाङ्गः स्वपन स्विद्यति ना सुखम् । कौरवाजिनकौषेयप्रावाराद्यैः सुसंवृतः ॥ ४९ ॥ इत्युक्तोऽश्मघनस्वेदः,
A compact slab of stone of the measurement of a man, is to be heated with the fuel of trees having vata curing properties. All fire brands are then to be removed and the stone slab to be sprinkled with hot water. The slab is then to be covered with silk or woollen sheets. The person well-massaged all over the body and well-covered with upper garments, etc. made of cotton, hide and silk should lie down on this slab. By so doing, he will be comfortably fomented. This is known as ‘asmaghana’ fomentation. [ 47-49 ]
Technique of karsu sveda
कर्पूस्वदः प्रवक्ष्यते । खानयेच्छयनस्याधः कर्पू स्थानविभागवित् ।। ५० ।।
दीतैरधूमैरङ्गारेस्तां कर्पू पूरयेत्ततः । तस्यामुपरि शय्यायां स्वपन स्विद्यति ना सुखम् ॥ ११ ॥
Karsu sveda will now be described. The physician conversant with geological classification should get dug a flask-shaped trench below the bed-stead. This trench should be filled up with smoke – less fire-brands. The person lying on bed over this gets comfortably fomented. [ 50-51]
Technique of kuti sveda
अनत्युत्सेधविस्तारां वृत्ताकारामलोचनाम् । घनमिति कुटीं कृत्वा कुष्ठाद्यैः संप्रलेपयेत् ॥ ५२ ॥ कुटीमध्ये भिषक शय्यां स्वास्तीर्णामुपकल्पयेत् । प्रावाराजिनकौशेयकुथकम्बलगोलकैः हसन्तिकाभिरङ्गारपूर्णाभिस्तां च सर्वशः । परिवार्यान्तरारोहेदभ्यक्तः स्विद्यते सुखम् ॥ ५४ ।। ॥ ५३ ॥
any A thick-walled cottage, round in shape, should be constructed. It should neither be too high nor too wide. There should not be window in it. The (inner wall of this ) cottage should be plastered with drugs like kustha (Saussurea lappa C. B. Clarke), etc. In the centre of this cottage. there should be a bed well-covered with sheets prepared of cotton, silk, hide, kutha ( kusa grass ), blanket or golaka ( a variety of woollen cloth ). The bed should be surrounded with furnaces filled up with fire-brands. The person well-massaged should lie over this bed. Thus, he will get comfortably fomented. [ 52-54 ]
Definition of bhu sveda
य एवाश्मघनस्वेदविधिर्भूमौ स एव तु । प्रशस्तायां निवातायां समायामुपदिश्यते ॥ ५५ ॥
‘Bhu’ type of fomentation should be carried out on the same principle as “asmaghana sveda” on the earth. However, an auspicious area, which is free from excessive wind, should be selected for this purpose. [ 55]
Technique of kumbhi sveda
कुम्भी वाताहरक्काथपूर्णा भूमौ निखानयेत् । अर्धभागं त्रिभागं वा शयनं तत्र चोपरि ॥ ५६ ॥ स्थापयेदासनं वाऽपि नातिसान्द्र परिच्छदम् । प्रक्षिपेदयसो गुडान् ॥ ५७ ॥ अथ कुम्भ्यां सुसन्तप्तान् पाषाणान् वोष्मणा तेन तत्स्थः स्विद्यति ना सुखम् । सुसंवृताङ्गः स्वभ्यक्तः स्नैहैरनिलनाशनैः ।। ५८ ।।
A pitcher is to be filled up with the decoction of drugs that alleviate vata and burried in earth upto one half or one-third part of it. A bed or seat covered with a thin sheet should be kept over it and the patient should either lie down or sit over it as the case may be. Thereatfer, hot iron balls or stones should be put into the pitcher. By the heat coming out of the pitcher, the patient who is either sitting or lying on it gets comfortably fomented. Before doing so, he should, however, get his body well-covered after being well-massaged with unctuous substances that alleviate vata. [ 56–58]
The bed or seat over the pitcher should be arranged in such a way that the pitcher may not get broken.
Definition of kupa sveda
कूपं शयनविस्तारं द्विगुणं चापि वेधतः । देशे निवाते शस्ते च कुर्यादन्तः सुमार्जितम् ॥ ५९ ॥ हस्त्यश्वगोखरोष्ट्राणां करीषैर्दग्धपूरिते । स्ववच्छन्नः सुसंस्तीर्णेऽभ्यक्तः स्विद्यति ना सुखम् ।। ६० ।।
A well-like pit of the width of a bed and twice as deep as wide should be dug out in an auspicious place which is not exposed to wind. Inner portion of this should be well-cleaned up. It should be filled out with the dung of elephants, horses, cows, asses or camels and then ignited. A bed should then be placed over this well. The person well-massaged and well-covered, lying on this bed gets comfortably fomented. [ 59-60 ] :
Technique of holaka sveda
धीतीकां तु करीषाणां यथोक्तानां प्रदीपयेत् । शयनान्तः प्रमाणेन शय्यामुपरि तत्र च ॥ ६१ ।।
सुदग्धायां विधूमायां यथोक्तामुपकल्पयेत् । स्ववच्छन्नः स्वपस्तत्राभ्यक्तः स्विद्यति ना सुखम् ।। ६२ ।।
होलाकस्वेद इत्येष सुखः प्रोक्तो महर्षिणा ।
A heap of dung ( of elephants, horses, cows, asses or camels ) of the size of a bed is to be ignited. When it is well burnt and has become smokeless, a bed covered with a thin sheet is to be kept over it. The patient with his body well-covered after a massage should lie over it to get fomentation comfortably. This is known as ‘holaka’ type of fomentation that is good for health. [ 61–62 ]
इति त्रयोदशविधः स्वेदोऽग्निगुणसंश्रयः ॥ ६३ ।।
The above are the thirteen types of fomentation involving the direct application of fire. [ 63 ]
Fomentation without fire
व्यायाम उष्णसदनं गुरुप्रावरणं क्षुधा । बहुपानं भयक्रोधावुपनाहाहवातपाः श्वेदयन्ति दशैतानि ॥ ६४ ॥ नरमन्निगुणाहते ।
The ten devices which in a way serve the purpose of fomentation without involving the direct application of fire, are exercise, residing in a warm chamber, wearing of heavy clothing, hunger, excessive drinking, fear, anger, application of poultice, wrestling and exposure to sun shine. [ 64]
The chamber used for the fomentation of this type is not heated by any external source. But the very construction of the chamber, characterised by thick wall and absence of windows, brings about the desired warmth.
Poultice ( upanaha ) is of two types, viz., sagnika (involving the direct applcation of fire) and niragnika ( that does not involve the direct application of fire ). The former variety of upanaha or poultice is known as sankarasveda-cf. Sutra 14:41-One such formula is described in Sutra 3:13. The latter type which is mentioned here causes fomentation by obstructing the radiation of heat from the body due to the thickness of paste used for poultice. Sun shine is no doubt hot but the heat in this case is not due to fire; hence sun shine is included in this category of fomentation.
Classification of fomentation techniques
इत्युक्तो द्विविधः स्वेदः संयुक्तोऽग्निगुणैर्न च ॥ ६५ ॥
एकाङ्गसर्वाङ्गगतः स्निग्धो रूक्षस्तथैव च । इत्येतन्त्रिविधं द्वन्द्वं स्वेदमुद्दिश्य कीर्तितम् ।। ६६ ।।
The first type of classification of fomentation (as described above) is based on whether it involves the application of fire or not. Another classification is based on its applicability to the one part or the whole of the body. The third classification is whether the fomentation is wet or dry. These are the three pairs based on three types of classifications of fomentation. [ 65-66]
The types of fomentation that can be used only for one organ of the body are sankara, nudi, etc., whereas those which are applicable to the whole body are prastara, jentaka, etc. Unctuous type of fomentations is prescribed for vatika diseases, those of dry type for ‘slaismika’ diseases and those of unctuous-cum-dry type for the vatika-cum-slaismika diseases. Being implied in the former two, the third one of this variety is not separately mentioned in the text. Dichotomy is involved in each of these three pairs.
Pre-fomentation and Post fomentation managements
स्निग्धः स्वेदैरुपक्रम्यः स्विन्नः पथ्याशनो भवेत् । तदहः स्विन्नगात्रस्तु व्यायामं वर्जयेन्नरः ।। ६७ ।।
After the oleation therapy, the patient should be administered fomentation. When duely fomented, he should be kept on wholesome diet. After fomentation, the patient should abstain from exercise on that day. [ 67 ]
Details of the wholesome diet are not specified here. All such diets as are coducive to the alleviation of pitta (which is aggravated during fomentation) are to be taken as wholesome.
तत्र श्लोकाःस्वेदो यथा कार्यकरो हितो येभ्यश्च यद्विधः । यत्र देशे यथा योग्यो देशो रक्ष्यश्च यो यथा ॥ ६८ ॥
स्विन्नातिस्विन्नरूपाणि तथाऽतिस्विन्नभेषजम् । अस्वेद्याः स्वेदयोग्याश्च स्वेदद्रव्याणि कल्पना ।। ६९ ।।
त्रयोदशविधः स्वेदो विना दशविधोऽग्निना । संग्रहेण च षट् स्वेदाः स्वेदाध्याये निदर्शिताः ॥ ७० ॥
Suming up the contents :
स्वेदाधिकारे The procedure for the effective administration of fomentation, patients for whom it is beneficial types of fomentation, the application of various types of fomentation depending on the bodily organ affected, protection of certain tender parts of the body in the course of fomentation, signs and symptoms of proper fomentation and fomentation in excess, cure of complications due to excessive fomentation the persons who are fit for fomentation and those who are not, drugs for fomentation, general principles guiding fomentation, thirteen types of fomentations involving the direct application of fire-the ten types without it, the condensed six-fold classification of fomentation ( in three pairs )-All these are described in this chapter on fomentation. [ 68-70]
यद्वाच्यमुक्तमेतन्महर्षिणा । प्रतिपत्तव्यमुपदेष्टा पुनर्वसुः ॥ ७१ ॥
In this chapter fomentation, whatever aught to be stated have been explained by Lord Punarvasu; hence disciple should faithfully) follow these instructions. [71]
इत्यग्निवेशकृते तन्त्रे चरकप्रतिसंस्कृते श्लोकस्थाने स्वेदाध्यायो नाम चतुर्दशोऽध्यायः ॥ १४ ॥
Thus ends the fourteenth chapter on ‘fomentation of the Sutra section of Agnivesa’s work as redacted by Charaka.
