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Ashtanga samgrahaSVEDA VIDHI ADHYAYA SWEDANA - Sudation therapy - A.S.S Chapter 26

SVEDA VIDHI ADHYAYA SWEDANA – Sudation therapy – A.S.S Chapter 26

अथातः स्वेदविधिं नामाध्यायं व्याख्यास्यामः । इति ह स्माहुरात्रेयादयो महर्षयः ॥१॥

We will now expound the chapter called Sveda vidhi (sudation therapy) – procedure to cause perspiraton; thus said atreya and other great sages. (1)

Sveda bheda – Types of Sudation

चतुर्विधोऽग्निस्वेदो भवति तापोपनाहद्रवोष्मभेदेन ।

तत्र तापस्वेद; पाणिकांस्यफालवालुकावस्त्रघटिकादिभिः साक्षादग्निना च प्रयोक्तव्यः ॥२॥

Producing sweating using fire – Saagnisweda is of four kinds viz., Tapa (fomentation), Upanaha (poultices), Drava (use of warm liquids) and Usma (fomentation);

Tapa Sweda

heating by the palm of the hand, flat piece of bronze, flat surface of a weapon, sand, cloth or potsherds over fire and applying it warmly on the part of the body or exposing the part to the fire directly is Tapa. ( 2 )

Upanaha – poultice

उपनाहस्वेदस्तु सर्वगन्धधान्यसर्षपकिण्ववचादेवदारुरास्त्रैरण्डमुलमधुकशताह्वासुराकि ट्टादिवातहरद्रव्य चूर्णैर्यवगोधूमशलैरानूपासृक्पित्तशिरः पादाऽमिषवेशवारैश्च । तथा श्लेष्मसंसृष्टे वायै सुरसादिभिः । पित्तसंसृष्टे च पद्मकादिभिः । पृथक् सहितैर्वा । क्षीरशुक्तधान्याम्ललवणमस्तुप्रगाढैः सुस्निग्धैः सुखोष्णैः साल्वलाभिधानैस्तैर्बहुशः प्रदिह्योष्णवीर्यापूतिमृदुरोमचर्मभिस्तदभावेघनवातहरपत्राविक कौशेयैरुपनद्धमङ्गमहस्थितं विदाहपरिहारार्थं निशिमुञ्चेत् । दिवा निशि बद्धम् । दोषकालबलवशेन वा ॥ ३ ॥

Upanaha (hot poultice) is prepard from all (any of) the fragrant herbs, grains, sarsapa, kinva (precipitate of fermented liquor), vaca, devadaru, rasna, roots of eranda, madhuka, satahwa, precipitate of sura and such other which mitigate vata are powdered and mixed with course powder of yava (barley) godhuma (wheat), blood, bile, meat taken out from the head or legs of animals of marshy regions, or vesavara (chopped meat well steamed) are all made into (a thick paste);

if vata has undergone an increase associated with kapha, the drugs of surasadi gana may be used,

if it is associated with pitta drugs of padmakadi gana (may be added); the paste may be used either alone or mixed with milk, sukta (sour – buttermilk), dhanyamla (fermented grain wash) salt and mastu (whey) but with liberal quantity of fatty materials (oil, ghee etc.).

The paste should be made warm and spread thickly on the part of the body, comfortably warm and covered with soft leather devoid of hairs or in its absence with thick and broad leaves of plants which mitigate vata or cloth made of wool or silk and tied firmly. That tied in the day should be removed at night and that tied at night removed in the day, to relieve the discomfort; or it may be removed at suitable times depending on the condition of the doshas and the season. This is known as Salvala upanaha. (3)

Dravasweda – sudation by liquids

द्रवस्वेदस्तु द्विविधः। परिषेकोऽवगाहश्च । तत्र शिग्रुवरणाम्रातकमूलकसर्षपसुरसार्जकवासावंशाश्मन्त काशोकशिरीषार्ककरञ्चैरण्डमालतीपत्रभङ्गपूतीकदशमूलादिवातहरैर्द्रव्यैर्मस्तुसलिलसुराक्षीरशुक्तादि भिःक्वथितैः पूर्वोक्तैश्चयथादोषं पृथक् सहितैर्वाकुम्भीर्वर्षलिकाः प्रणालीर्वा पूरयित्वा वातहरसिद्धस्नेहा भ्यक्तमनभ्यक्तं वोपविष्टं किलिचे वा शयानमेकाङ्गे सर्वाङ्गे वा वस्त्रावच्छन्ने परिषेचयेत् । तैरेवाद्भिः पूर्णे महति कटाहे कुण्डे द्रोण्यांवाऽवगाहयेत् ॥४॥

Dravasweda (use of liquids to produce sweating) is of two kinds; Pariseka and Avagaha.

Drugs such as sigru, varana, amrataka, mulaka, sarsapa, surasa, arjaka, vasa, vamsa, asmantaka, asoka, sirisa, arka, karanja, eranda, malatipatra, bhanga (bits of malati leaves), putika, dasamulas and such others which mitigate vata are boiled in liquids such as mastu (whey), water, sura (wine) milk, sukta (sour buttermilk) etc. and used either alone or mixed with other drugs, as described previously, appropriate to the (other associated) doshas.

Pariseka Sweda

This liquid is filled into pot or vessels having spout with sieve in front (so as to make for a shower) or into long tubes, and poured over the part of the body, which has been anointed with oil which mitigates vata or even without such anointment, but wrapped with cloth; the patient either sitting or lying on a couch (made of grass or weeds), pouring being done on any part or whole of the body. This is pariseka.

Avagaha Sweda

A bath tub or pit, large enough to accommodate the body of the person in filled with the warm water described above and the person is made either to sit or lie inside the water. This is Avagaha. (4)

Ushmasweda – suddation by steam

ऊष्मस्वेदः पुनरष्ठधा भिद्यते । पिण्ड: संस्तरो नाडी घनाश्म कुम्भी कूपः कुटी जेन्ताकश्च । तत्र मृत्कपालपाषाणलोष्टलोहपिण्डानग्निवर्णान् सन्दंशेन ग्रहीत्वाम्भस्यम्ले वा निमज्जयेत् । तैरार्द्राविक वस्त्रेण वेष्टितैः श्लेष्ममेदोभूयिष्ठं सरुजमङ्गं ग्रन्थिमद्वा स्वेदयेत् । पांसुसिकतागवादिपुरीषधान्यबुसपुला कपललैर्वाऽम्लोत्क्वथितैः पूर्ववद्वेष्टितैः । गवादिशकृतार्देण पिण्डीकृतेनोपनाहद्रव्योत्कारिकाकृसरमां सपिण्डैर्वा वातरोगेष्विति पिण्डस्वेदः । स एव सङ्कराख्यः॥५॥

Ushma sweda (use of steam to cause sweating) is of eight kinds viz., pinda, samstara, nadi, ghanasma, kumbhi, kupa, kuti and jentaka.

Potsherds, stone or iron ball are heated redhot in fire, taken out by tongs and immersed into a vessel containing water or a sour liquid. The fumes that emerge are made to spread over the part of the body which is covered with a moist woolen cloth. The parts of the body which have predominance of kapha and fat, which are painful, or which have tumours in them may be steamed in this manner.

Pindasweda

Mud, sand, dung of cow or other animals, husk of grains, bran, half-cooked rice or meat are boiled in a sour liquid and tied in bundles; or dung of animal like cow, which is still moist is made into balls along with drugs useful for upanaha, are made in the form of a cake or thick paste of meat is made into bundles, (all these bundles are kept inside a boiling sour liquid and applied warm over a part or the whole body) and used to cause sweating in diseases of Vata origin. This method, the pinda sweda, is also known as Sankara sweda. (5)

Samstara sweda

यथार्हस्वेदद्रव्याणि पिहितमुखायामुखायां सम्यगुपस्वेद्य निवाताशरणशयनस्थे किलिचे प्रस्तीर्याविककौशेयवातहरपत्रान्यतमोत्तरप्रच्छदे रौरवाजिनप्रवारादिभिः स्ववच्छन्नं स्वेदयेदिति संस्तरस्वेदः ॥६॥

The drugs useful for upanaha are cut into small pieces and exposed to steam by spreading over a cloth which is tied to the mouth of a pot containing a boiling liquid or spread over a mouthless pot which is kept inside a oven which expels steam on the drugs directly. When they become soft and hot by steam, they are spread evenly on a wooden cot kept in a room devoid of breeze and covered with thick cloth of wool or silk or leaves of plants which mitigate vata. The patient is covered with the skin of deer or a woollen blanket and made to lie down on the cot till he gets perspiration. This method is known as Samstara sweda. (6)

Nadisweda

पूर्ववदेवोपस्वेद्योखामुखेऽन्यामुखायां वा नाडीमूलच्छिद्रप्रमाणपार्श्वच्छिद्रामुपसन्धायावलिप्य च पार्श्वच्छिद्र स्थया नाड्या शरेषिकावंशदलकिलिञ्जकरञ्जपत्रान्यतमकृ तया गजाग्रहस्तसंस्थानया व्यामदीर्घयाध्यर्द्ध व्यामंदीर्घया वा स्वायामचतुर्भागाष्टभागपरिणाहमूलाग्रस्त्रोतसा सर्वतोवातहरपत्रसंवृतछिद्रया द्विस्त्रिर्वा विनर्मितया सुखोपविष्टस्य स्वभ्यक्तप्रावृतेङ्गेबाष्पमुपहरेत् । बाष्पो ह्युनृजुगामी विहतचण्डवे गस्त्वचमवि दहन् सुखं स्वेदयतीति नाडीस्वेदः ॥७॥

The drugs mentioned earlier are cut into pieces, put into a pot, water added and pot placed over fire for boiling. Another smaller pot is kept inverted over the first and the mouths of the two sealed tight. A hole is made on the side of the upper pot to which a hollow pipe is adjusted such that the steam will come out through it. The pipe can be of the sara reed, hollow arrow, bambooshoot, stem of a green plant, leaves of karanja or any such thing, made in the shape of an elephant trunk, one or one and half vyama (length of two stretched arms is one vyama), in length, one-fourth or one-eighth of a vyama in circumferences, having an opening at both ends.

Both the openings should be covered with leaves of plants which mitigate vata, the leaves pierced with two or three holes to allow the steam (in little quantities, slowly). The part of the body should be anointed with oil and the steam allowed over it, with the patient comfortably sitting. The steam touching the skin in irregular/curvy routes, devoid of the intensity of heat and not burning the skin produces sweating easily and comfortably. This method is known as Nadisweda. (7)

Ghanasma sweda

पुरुषायाममात्रमधिकं वा घनंसमं च शिलातलं भूप्रदेशं वा वातहरदारुदीप्तेनाग्निना सर्वतस्तापयित्वाग्नि मपोह्योष्णोदकाम्लादिभिरभ्युक्ष्य यथोक्तप्रच्छदे संस्तरात्स्वेदयेदिति घनाश्मस्वेदः ॥८॥

A stone slab which is of the length a man or even slightly more, thick and even; or a mound of earth of these features, should be made hot by keeping firewood of trees which mitigate vata, from all the sides, top and bottom and setting fire to it. After the stone slab has become quite hot, the burning coal and wood are removed from it and the slab is sprinkled with water, sour liquids etc. The patient is then asked to lie down on the slab (with his body covered with deer skin or woollen blanket). This method is known as Ghanasma sweda. (8)

Kumbhisweda

पूर्ववत् स्वेदद्रव्याणि कुम्भ्यामुक्ताथ्याश्लिष्योपविष्टस्तद्वदूष्माणं गृह्णीयात् । भूमौ वा तां निखाय तदूर्ध्वमासनं शयनं वा नातिघनप्रच्छदं परितः प्रलम्बमानकुथाकम्बलगोणिकं निधाय तत्रस्थस्योष्माणं गृह्णतः कुम्भ्यामग्निवर्णानयोगुडानुपलांश्च शनैर्निमज्जयेदिति कुम्भीस्वेदः ॥९॥

The drugs mentioned earlier, are cut into pieces, put into a pot, water added, allowed to boil and emit steam. The patient is made to sit very near the pot, and the steam allowed over the affected part, covering himself with a blanket. Another method is to keep some pots buried and the patient made to lie on them; blanket or other thick cloth covered over the person in such a way that the edges of the cloth touch the ground in all the sides. If the decoction becomes cold and does not give out sufficient steam, iron balls or stones made red hot should be slowly immersed into it to produce steam. These methods are known as Kumbhi sweda. ( 9 )

Kupasweda

शयनस्याधोविस्तारद्विगुणखाते कूपे वातहरदारुकरीषन्यतरपूर्णदग्धे विगतधूमे स्वास्तीर्णशयनस्थं स्वेदयेदिति कूपस्वेदः ॥१०॥

A pit is made in the ground equivalent to double the width of the cot, filled with coal-dust of trees which mitigate vata or with powder of dried cowdung and then set fire. When the smoke has cleared away, leaving the hot ashes behind, a cot is placed over the pit and patient made to lie on it and made to perspire. This method is known as Kupa sweda. (10)

Kutisweda

कुर्टी नात्युच्चविस्तारां वृत्तामच्छिद्रामुपनाहकल्कघनप्रदिग्दकुड्यां सर्वतोविधूमप्रदीप्त – खदिराङ्गारपूर्ण हसन्तिकासमूहपरिवृतां विधाय तन्मध्ये च शय्यां तत्रस्थं स्वेदयेदिति कुटीस्वेदः ॥११॥

An apartment is constructed which is not very high, not very wide, circular in shape, its walls having thick plastering, but not having crevices or cracks anywhere; and with open smokeless hearths set throughout the interior. The hearths are filled with burning coal of khadira wood. The patient is made to lie on the cot placed at the centre of the room and allowed to sweat. This method is called Kutisweda. (11)

Jentakasweda

अथ जेन्ताकं चिकीर्षुभूमिं परीक्षेत । पूर्वस्यामुत्तरस्यां वा दिशि गुणवति प्रशस्तभूमिभागे कृष्णमृत्तिके वा सुवर्णवर्णमृत्तिके परिघापुष्करिण्यादीनां जलाशयानामन्यतमस्य कूले । दक्षिणे पश्चिमे वा सुतीर्थे समसुविभक्तभूमिभागे । सप्ताष्टौ वाऽरत्नीरपक्रम्योदकात् प्राङ्मुखमुदङ्मुखं वाभिमुखतीर्थं कूटागारं कारयेत् । उत्सेधविस्तारतः परमरत्नयः षोडश । समन्तात्सुवृत्तं मृत्कर्मसंपन्नमनेकवातायनम् । अस्य च कूटागारस्यान्तः समन्ततो भित्तिमरनिविस्तारोच्छ्रायां पिण्डिकां कारयेदाकवाटात् । मध्ये चास्य कूटागारस्य किष्कुमुक्तं द्विपुरुषप्रमाणं मृन्मयं कन्दुसंस्थानंबहुसूक्ष्मच्छिद्रमङ्गारकोष्ठकस्तम्भं सापिधानं कारयेत् । तं च खादिराणामश्वकर्णानां वा काष्ठाना पूरयित्वा दीपयेत् । स यदा जानीयात्साधुदग्धानिकाष्ठानि विगतधूमान्यवतप्तं सर्वमग्निना तदग्निगृहं स्वेदयोग्येन चोष्मणा युक्तमिति । तत्रैनं वातहराभ्यङ्गाभ्यक्तगात्रं वस्त्रावच्छन्नं प्रवेशयेत् । अनुशिष्यात्सौम्य प्रविश कल्याणायारोग्याय च । प्रविश्य चैनां पिण्डिकामारुह्य पार्श्वापरपार्श्वाभ्यां यथासुखं शयीथाः । न च त्वरयास्वेदमूर्छापरीतेनापिपिण्डिकैषा विमोक्तव्याप्राणोच्छ्वासात् । भ्रश्यमानोह्यतः पिण्डिकावकाशाद् द्वारमनधिगच्छन् स्वेदमूर्च्छा परीततया सद्यः प्राणान् जह्यात् । तस्मात् · पिण्डिकामेनां न कथञ्चन मुञ्चेथाः । त्वं यदा जानीयात् विगताभिष्यन्दमात्मानं सम्यक् प्रस्त्रुतस्वेदपिच्छं सर्वस्त्रोतोविमुक्तं लघुभूतमपगतविबन्धस्तम्भसुप्तिवेदनागौरवमिति । ततः पिण्डिकानुसारेण द्वारं प्रपद्येथाः । निष्क्रम्य च चक्षुषोः परिपालनार्थमतिस्विन्नोऽपि न सहसा शीतोदकमनुप्रविशेथाः । सम्यक् स्विन्नस्त्वपगतसन्तापक्लमो मुहूर्तात् सुखोष्णेन वारिणा यथान्यायं परिषिक्तोऽश्नीयादिति जेन्ताकस्वेदः ॥ १२ ॥

Contemplating to administer Jentaka method of sudation therapy, the physician should first select a place and construct a kutagara (concealed house). The site should be either in the east or north, pleasant and beautiful, having black or golden yellow soil, surrounded by lakes and ponds. The house should be constructed about seven or eight aratni (arms length) away from the bank of the ponds, on the either south or west; it should be having the entrance either to east or north and facing the water of the pond. It should not be more than sixteen arathni (arms length) both in length and breadth; with fine plastering inside, having many windows; a circular bench is constructed all around inside, adjacent to the wall from door to door. In the the centre of the room hollow pillar, of the length of double the height of man, is to be constructed from mud, round in shape, with very small holes having shutters. This hollow pillar is filled with wood of ether khadira or aswakarna and set fire. When burning coal gets formed and all the smoke has gone away and the room becomes hot inside it shold be considered as suitable. The patient should be anointed with an oil processed with drugs which mitigate vata, and brought into the hot chamber and instructed as follows : “You, the good man, enter the chamber for obtaining prosperity and health. Lie on these benches comfortably, exposing all the protions of your body to the heat and slowly move forwards. Even though you become full of sweat and even quickly, you should not leave the bench and try to reach for the door, you will run the risk of losing your life for you will not be able to find the door, because of your fatigue and fainting. So never get out of the bench, till your feel that fluids inside your body are moving freely, the obstrucion to the flow of sweat has been removed, all the orifices of the body are open and have become light, cleared of any obstructions, and stiffness, loss of sensation, pain and heaviness have disappeard”. With these instructions he should be left alone inside the room, and the physician come out, closing behind him all the windows and doors. After some time, after the patient is brought out, he should not be spalshed with cold water immediately for protecting his eyes even though he is full of sweat. He should be allowed to take rest, get rid of the fatigue and given a bath in warm water. Next he should be given food suitable to him. This medhod is known as Jentaka Sweda. (12)

तेषां विशेषतास्तापोष्मस्वेदौ कफे प्रयोजयेत् । उपनाहमनिले। किञ्चित् पित्तसंसृष्टेऽन्यतरस्मिन् द्रवमिति ॥ १३ ॥

Out of these methods, Tapa and Usma sweda should be resorted to especially for kapha (mitigate increased kapha) and upanaha for vata. Other methods are to be used during mild association of pitta also. (13)

Anagneya sweda

अनानेयं पुनर्मेदाः कफावृते वायौ निवातसदनगुरुप्रावरणबहुमद्यपानव्यायामक्षुदातपनियुद्धाध्वभारभरणामर्षभयैः । उपनाहं च पित्तान्वये पूर्वोक्तेनैव विधिनाग्निरहितमिति । भवति चात्र ॥१४॥

Anagneya Sweda (making the person to perspire wihout the use of fire) is suitable for (disorders of) vata obstructed by medas (fat) and Kapha; it is brought about by, remaining inside an airtight room, covered with a thick cloth, a heavy dose of alcoholic drink, exercise, keeping hungry, exposing to sunlight, boxing, walking long distances, lifting heavy weights, anger and fear.

In conditions of increase of vata associated with pitta, the upanaha method or any one of the above methods devoid of the use of fire is suitable. (14)

Swedana vidhi – procedure of sudation therapy

निवातेऽन्तर्बहिः स्त्रिग्धोजीर्णान्नः स्वेदमाचरेत् । व्याधिव्याधितदेशर्त्तुवशान्मध्यवरावरम् ॥ १५ ॥

Sudation therapy should be done in a room devoid of heavy breeze,the patient having been lubricated both internally and externally and after the digestion of food. It should be either mild, moderate or heavy depending upon the disease, the diseased, the land (habitat) and season. (15)

कफार्तो रूक्षणं रूक्षो रूक्षस्त्रिग्धं कफानिले। आमाशयगते वायौ कफे पक्वाशयाश्रिते ॥१६॥ रूक्षपूर्वं तथा स्नेहपूर्व स्थानानुरोधतः ।

Persons suffering from diseases caused by kapha should be prescribed dry sudation, and those suffering from kapha and vata should be given dry and moist combined together ( after lubrication).

If vata is localised in the amasaya (stomach) and kapha in the pakwasaya ( colon), dry sudation and moist (lubricatted) sudation respectively should be done in accordance with site of the doshas. (16-17a)

अल्पं वङ्क्षणयोः स्वल्पं दृड्मुष्कहृदये न वा ॥१७॥ पोत्पलादिभिः सक्तुपिण्ड्या वाच्छाद्य चक्षुषी । शीतैर्मुक्तावलीपद्मकुमुदोत्पलभाजनैः ॥१८॥ मुहः करैश्च तोयार्यैः स्विद्यतो हृदयं स्पृशेत् ।

Sudation should be done very less at the groins; mild or not at all to the eyes, scrotum and the heart. If sudation (fomentation) is very necessary for the eyes, they should be covered with petals of lotus or lily or with a wet ball of flour; if it is necessary for the heart, the area should be touched repeatedly during fomentation with vessels containing coolant substances, pearls, lotus and lily or even by hand moistened with water. (17-18)

शीतशूलक्षये स्विन्नो जाते ऽङ्गानां चमार्दवे | स्याच्छनैर्मृदितः स्नातस्ततः स्नेहविधिं भजेत् ॥१९॥

After sudation therapy when the feeling of cold and pain have disappeared and the body parts become soft, the person should be given a mild massage and bath. He should then follow the regimen prescribed for oleation therapy. (19)

पित्तास्त्रकोपतृणमूर्च्छास्वराङ्गसदनभ्रमाः । सन्धिपीडाज्वरश्यावरक्तमण्डलदर्शनम् स्वेदातियोगाच्छर्दिश्च तत्र स्तम्भनमौषधम् । विषक्षाराग्न्यतीसारछर्दिमेहातुरेषु च ॥ २१ ॥ ॥ २० ॥

Abnormal increase (aggravation) of pitta and blood, thirst, fainting, weakness of the voice and body, giddiness, pain in the joints, fever, appearance of black or red patches on the skin and vomiting will result from an excess of sudation therapy. For these diseases stambhana (stopping of sweating, absorbing water) is the ideal method of treatment. Such a therapy is also to be given to those suffering from diseases caused by poison, and alkalies; and from diarrhoea, vomiting and diabetes. (20-21 )

स्वेदनं गुरु तीक्ष्णोष्णं प्रायः स्तम्भनमन्यथा । द्रवस्थिरसरस्निग्धरूक्षसूक्ष्मं च भेषजम् ॥२२॥ स्वेदनं स्तम्भनं श्लक्ष्णरूक्षसूक्ष्मसरद्रवम् । प्रायस्तिक्तं कषायं च मधुरं च समासतः ॥२३॥

Swedana (perspiration) is brought about generally by qualities such as heavyness, penetrating and hot, whereas stambhana ( stopping, withholding) is brought about by the opposite qualities. Drugs which are liquid, static, moving, unctous, dry and thin, cause sudation (warming up) of the body; those which are smooth, dry, thin, moving, liquid, bitter, astringent and sweet tastes generally cause sthambhana (withholding, obstructing, stopping any discharge from the body). (22-23)

स्तम्भितः स्यात् बले लब्धे यथोक्तामयसङ्क्षयात् । स्तम्भत्वक्स्नायुसङ्कोचकम्पहृद्वाग्घनुग्रहैः ॥२४॥ पादौष्ठत्वक्करै: श्यावैरतिस्तम्भितमादिशेत् ।

Disappearance of the disease and gaining of strength are the results of stambhana therapy; if this therapy becomes excessive it causes stiffness, contraction of skin, of tendons, tremors, catching pain in the heart, loss of voice, lock-jaw, black discolouration of the feet, lips, skin and hands. (24-25.a)

Svedana anarha-persons unfit for sudation

न स्वेदयेदतिस्थूलरूक्षदुर्बलमूर्च्छितान् तिमिरोदरवीसर्पकुष्ठशोषाढ्यरोगिणः।

भ्रष्टदग्धगुदग्लानिक्रोधशोकभयार्दितान् गर्भिणीं पुष्पितां सूतां मृदु वात्ययिके गदे । ।

स्तम्भनीयक्षतक्षीणक्षाममद्यविकारिणः ॥ २५॥ पीतदुग्धदधिस्त्रेहमधून् कृतविरेचनान् ॥२६॥ ।

क्षुत्तृष्णाकामलापाण्डुमेहिनः पित्तपीडितान्॥२७॥

Swedana (sudation) therapy should not be administered to persons who are very obese, dry, weak unconsious; those who are to be given stambhana therapy(Raktatisara? etc.); those emaciated by wounds, very thin, suffering from diseases of alcoholic excess, blindness, enlargement of abdomen(Udara roga?), visarpa (herpes), leprosy ( and other skin diseases), tuberculosis, gout; who have just drunk milk, curds, lubricating materials (oils, ghee etc.) and honey who have undergone purgation therpay(During samsarjanakrama), who have prolapse of the rectum or the rectum having been treated with application of alkalies, who are having severe exhaustion, anger, grief, fear, hunger, thirst, jaundice, anaemia, diabetes(Diabetic Neruropathy: Loss of Touch, Pain & Temperature), and diseases of pitta origin; the pregnant woman, the lady in menstruation (Panchakarma is contraindicated during menstruation) and parturition. If sudation is very much needed for these persons as an emergency, it should be given very mildly. (25-28.a)

Swedana yogya (persons fit for sudation) :

श्वासकासप्रतिश्यायहिध्माध्मानविबन्धिषु । स्वरभेदानिल व्याधिपक्षाघातापतानके ॥ २८ ॥

अङ्गमर्दकटीपार्श्वपृष्ठकुक्षिहनुग्रहे । महत्त्वे मुष्कयोः खल्यामायांमे वातकण्टके ॥२९॥

मूत्रकृच्छ्रार्बुदग्रन्थिशुक्राघाताढ्यमारुते । वेपथुश्वयथुस्वापस्तम्भजृम्भाङ्गगौरवे ॥३०॥

कर्णमन्याशिरः कोष्ठजङ्घापादोरुरुक्षु च । स्वेदं यथायथं कुर्यात्तदौषधविभागतः ॥३१॥

Sudation therapy, appropriately administered is indicated in diseases such as dyspnoea, cough, nasal catarrh, hicup, flatulence, constipation, hoarseness of voice, diseases of vata origin, hemiplegia, tetanus, bodyache, severe catching pain of the waist, flanks, back, lower abdomen and lower jaw; enlargement of the scrotum, contractures of the hands and feet, different kinds of tetanus, sprains, difficulty of micturition, malignant tumors (cancer), benign tumors, obstruction of semen, stiffness of the legs, tremors, dropsy, loss of cutaneous sensation, stiffness of the body, excessive yawning, feeling of heaviness of the body; pain in the ears, neck, head, alimentary tract, calves feet and thighs. The therapy should be followed by suitable foods appropriate to the doshas and diseases. (28-31 )

स्विन्नोऽन्नं पथ्यमश्नीयाद्दोषरोगानुरोधतः । तदहः स्विन्नसर्वांङ्गो व्यायामं सुतरां त्येजत् ॥३२॥

On the day of sudation therapy, the person should eat suitable food in accordance with the doshas and the diseases and avoid exercises absolutely. (32)

Swedana phala – nbenefits of sudation

अग्नेप्तिं मार्दवं त्वक्प्रसादं भक्तश्रद्धां स्रोतसां निर्मलत्वम् ।

कुर्यात् स्वेदो जाड्यतन्द्रापहारं स्तब्धान् सन्धींश्चेष्ठयत्याशु चास्य ॥३३॥

Sudation therapy increases the digestive capacity, causes softness, brilliance of the skin, desire for food and cleanliness of the orifices, removes laziness and stupor, and makes the stiffened joints to have movements quickly. (33)

स्नेहक्लिन्नाः कोष्ठगा धातुगा वा स्तोतोलीना ये च शाखास्थिसंस्थाः ।

दोषाः स्वेदैस्ते द्रवीकृत्य कोष्ठं नीताः सम्यक् शुद्धिभिर्निर्ह्रियन्ते ॥३४॥

The doshas which have been lubricated and localised in the alimentary tract, in the various tissues and channels, in the extremities and bones, get liquified by sudation therapy and are brought into the alimentary tract, to be eliminated (out of the body) by appropriate purificatory therapies. ( 34 )

॥ इति षड्विंशोऽध्यायः ॥

Thus ends the twenty-sixth chapter.

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