Scientific Basis for Ayurvedic Therapies -5

Scientific Basis for

Ayurvedic Therapies 

edited by

Brahmasree Lakshmi Chandra Mishra

The following instructions are given to patients to maintain equilibrium of physiological

factors during and after OT:

1. Avoid day sleeping.

2. Avoid a coarse and constipating diet.

3. Drink warm water.

4. Abstain from sexual activities.

5. Suppress normal urges.

6. Avoid speaking loudly.

7. Avoid anger and anxiety.

8. Avoid exposure to heat and cold.

9. Avoid walking in open air.

10. Avoid exercise and hard work.

OT is done to obtain maximum benefit. Either excess or inadequate oleation may cause

problems. Features of adequate oleation include improved digestion, lightness of the body,

oiliness of the skin, neuraesthenia, lethargy, semisolid stool, and visual fat in the stool.

OT is considered inadequate if the patient passes dry and hard stools and presents with

features like movement of flatus upward (bumping), weak digestive power, burning

sensation in chest, and dryness of skin. Features of excessive oleation are heaviness and

stiffness in the body, drowsiness, anorexia, nausea, dyspepsia, excessive salivation, and

frequent evacuation of mucoid stools.

The possible complications of OT include indigestion, nausea, anorexia, gastrointestinal

tract upsets, drowsiness, stiffness, skin diseases, anemia, edema, and piles. These complications

can be easily treated by frequent use of lukewarm water externally and internally,

with the administration of herbs like Piper longum, Terminalia chebula, Termanalia belarica,

Emblica officinalis and Comiphora mukul, honey, and symptomatic treatment.

4.2.1.3 Sudation and Fomentation Therapy (Svedana Karma)4,5

The therapeutic production and induction of sweat by a variety of methods is termed

sudation therapy (ST). It relieves stiffness, heaviness, and coldness of the body and induces

sweating. It is administered to liquefy the oleated toxic materials (brought about by OT),

which are spread throughout the body, and direct them to the alimentary canal for elimination

by any one of the four cleansing procedures.

ST is administered after OT and it precedes emesis therapy in the sequence of PKT.

Besides being the principal PREP of PKT, ST may also be a specific treatment for a number

of disorders, especially in vata-dominant diseases where it may be a main treatment.

4.2.1.3.1 Types of Sudation Therapy

ST may be applied with the use of direct application of heat (e.g., hot bed, affusion, steam

kettle, sudatorium, etc.) or indirect application of heat (e.g., exercise, wearing heavy

clothes, exposure to sun rays, etc.). It may be used on the basis of properties of drug used,

like unctuous or wet ST and dry ST, which are indicated in vata and kapha-dominant

diseases, respectively. ST may be applied either to one part of the body as a localized ST

or to the whole body as a generalized ST.

ST is indicated in patients of various types of paralysis, musculoskeletal disorders,

coryza, cough, stiffness, and need for undergoing PKT. ST is contraindicated in patients

© 2004 by CRC Press LLC

Panchakarma Therapy in Ayurvedic Medicine 49

with hemorrhages, diarrhea, eruptive skin diseases, alcoholism, pregnancy, and in patients

of pitta-dominant constitution or who are emaciated.

4.2.1.3.2 Procedure of Sudation Therapy

ST must be performed after proper OT. In localized sudation, steam vapors of decoction

of dashamula (or any other drug) are to be used on the affected parts. In generalized ST,

medicated vapors are made to pass all over the oleated patient’s body. ST should be done

for a maximum of 30 to 45 min. Medicated vapors are generated by boiling the herbs in

water.

The process of ST should be stopped when sweat appears over the forehead and there

is relief from pain, stiffness, and heaviness. ST is considered inadequate if the patient does

not produce any sweating and there is no relief from pain or coldness. A burning sensation

of the body, fainting, vertigo, and appearance of blisters may occur if ST is done more

than advised.

During and after ST, the blood pressure, pulse rate, respiratory rate, and temperature

are monitored to make sure they are within normal limits. Direct exposure to cold water

or cold air should be avoided at least for 1 h, and a bath in lukewarm water is indicated

after ST. Generally, emesis should be given on the second day after ST and purgation after

about a 3-day interval.

The standard preparations used for ST (for producing medicated steam) are:

1. Dashamula kwatha (decoction) — Sushruta Samhita Sutra Sthana 39/68–69

2. Rasanasaptaka kwatha (decoction) — CD Amavata– 8

4.2.1.3.2.1 Physical Effects of Sudation Therapy — Various procedures of ST therapeutically

induce sweating, which cleanses microchannels, liquefies toxic materials, and expels

toxic materials along with sweat. It recovers vascular insufficiency of the joints and muscles

and produces relaxation. These factors might be responsible for improving blood circulation

and local metabolic processes, causing relaxation of local structures and producing

relief of local symptoms, functional recovery, and a slowdown of the disease process being

treated. These therapeutic measures are classically antivata and relieve all vata manifestations

and control the disease process. During ST, the body temperature rises to more than

2 to 3∞C, which results in increased sweating.

4.2.1.3.3 Review of Scientific Data on Oleation, Massage, and Sudation Therapies6–11

R.H. Singh and G.N. Chaturvedi at Banaras Hindu University (BHU), Varanasi, studied

the effect of internal oleation clinically7,10 in patients with hyperchlorhydria and peptic

ulcer after internal administration of dadimadya ghrita as a palliative therapy. They

observed significant clinical improvement in these patients, including a decrease in gastric

acid secretions and evidence of healing ulcers confirmed on radiological examinations.

Other researchers also tried internal oleation with different ghrita preparations for peptic

ulcers and reported similar observations.11

Scientific studies conducted on the role of oleation and sudation on a series of patients

of rheumatoid arthritis and other chronic arthropathies by R.H. Singh at BHU, Varanasi,

are reproduced here.8,9 Similar studies have been conducted by this author and his team

on rheumatoid arthritis at the National Institute of Ayurveda, Jaipur, and similar observations

were recorded.6

Another clinical trial tested the role of Pinda Sweda, a type of preparatory procedure, as

a main therapeutic procedure in rheumatoid arthritis, in which application of oil over the

affected part is followed by fomentation with a hot rice paste cloth bundle. At the end of

30 days the researchers observed significant changes in both clinical symptoms, such as

stiffness and pain, as well as in laboratory tests such as erythrocyte sedimentation rate

and urinary hydroxyproline. Improved vascularity at the joints was also observed when

the pre- and postangiograms were compared.

4.2.2 Main Cleansing Procedures (Pradhana Karma)

4.2.2.1 Biopurificatory Therapeutic Emesis — Emesis Therapy (Vamana Karma)12

Emesis therapy (ET) is a process by which the contents of the stomach including kapha

and pitta dosas are expelled out of body through the mouth. It is one of the MCPs that

eliminates toxic materials from upper parts of the body.

Herbs used in PKT as emetics are detailed in Table 4.4.

ET is indicated for patients of asthma, respiratory disorders, sinusitis, rhinitis, anorexia,

dyspepsia, peptic ulcers, and skin diseases and in healthy individuals in different states

where kapha dosa is aggravated within normal limits (e.g., in the spring season for preserving

normal health and preventing diseases). It is contraindicated in patients of hematemesis,

cardiovascular diseases, and cachexia and in children and the elderly.

4.2.2.1.1 Procedure of Emesis Therapy

ET is usually the first main procedure of PKT done after a proper preparation of the body.

After the PREP, OT and ST are done; the out-of-balance kapha is further increased in the

body by giving oily food, fatty food, animal meat, milk, and curd for the next 24 h before

the induction of emesis. On the morning of ET (between 7 and 8 A.M.), a gruel mixed with

ghee in large quantities or 2.5 l of milk or decoction of Glycerrihza glabra or sugarcane juice

is given to the patient. After 10 min, emesis is induced by administering a certain combination

of emetic herbs made into a paste mixed with ghee. Milk or decoction of Glycerrihza

glabra or sugarcane juice is used as a vehicle to push the paste down.

TABLE 4.4

Herbs Used in PKT as Emetics

Medicinal Plant Botanical Name

Madanaphala Randia dumatorum

Madhuka Sapotaceae

Kututumbi Lageneria vulgaris

Nimba Azadirachta indica A.

Bimbi Coccinia grandis (l.) Voight

Visala Citrullus colocynthis Schrad

Trapusa Cucumis sativus Linn.

Kutaja Holarrhena antidysenterica Linn.

Murva Celosia cristata Linn.

Devdali Luffa echinata

Vidanga Embelia ribes Burm

Viduli Salix caprea Linn.

Dahana Toddalia asiatica Linn.

Citra Ipomea remiformi Chois

Kosavati Luffa aegyptica Mill-Hock

Karanja Pongamia pinnata Pierre

© 2004 by CRC Press LLC

Panchakarma Therapy in Ayurvedic Medicine 51

Items commonly used in standard preparation are:

1. Powder seeds of Randia dumatorum (6 to 10 g [4 parts])

2. Powder of Acorus calamus (3 to 5 g [2 parts])

3. Rock salt (3 to 5 g [1 part])

4. Honey (20 ml)

Thoroughly mix the preparations and make them into a paste. Mix in 100 ml of warm

milk or lukewarm water and ask the patient to swallow. If the patient is getting an urge

to vomit, instruct him or her to do so. Start counting the number of bouts of vomiting

and observe its contents.

4.2.2.1.2 Criteria for Proper Emesis Therapy

A bout is the number of times the emetic drug is vomited out after its administration to

the patient. Adequacy of emesis is assessed in terms of the number of bouts, ratio of total

output/input, its contents, and signs and symptoms produced after ET. A proper emesis

will have the sequence of expulsion of saliva, drug, kapha, pitta (yellowish bile), and vata

dosa as the end point. The criteria of assessment for effective ET are described in Table 4.5.

After completing emesis, the patient is asked to inhale smoke from medicated cigars

prepared with specific drugs that expel residual dosas, toxic materials, kapha, and unctuousness

in the throat, mouth, nose, and microchannels. The patient is advised to avoid

speaking loudly, overeating, physical exertion, anger, and anxiety during and after the

therapy to maintain normal physiology of the body and avoid complications.

The persistent urge to vomit, heaviness in the body, itching, and abdominal pain may

occur in the case of an incomplete emesis of gastric contents. Complications such as

hematemesis, frothy vomiting, fainting, cardiac pain, clouding of vision, throat pain, and

weakness may occur in uncontrolled excessive vomiting. The physician should monitor

the subject constantly and stop the whole process at the right time.

4.2.2.1.3 Review of Scientific Data on Emesis Therapy

A clinical trial for assessing the role of ET in 30 patients with bronchial asthma was carried

out by this author and his team on various scientific parameters. After the completion of

the ET, it was observed that there was significant improvement in clinical symptoms,

including marked improvement in breath-holding time, vital capacity, and respiratory

rate. Similarly, statistically significant changes (p >0.05) were observed in ESR, total serum

proteins, serum electrolytes, lipid profile, and radiological changes.

TABLE 4.5

Criterion of Assessment of Purification of the Body by Emesis Therapy

No. Parameters Active Purification

Moderate

Purification Mild Purification

1 No. of bouts 8 6 4

2 Total output and input Output > input Output > input Output < Input

3 Contents vomited Bile and pitta Bile and pitta Bile and pitta

4 Signs and symptoms To be observed for

adequate emesis

To be observed for

adequate emesis

To be observed for

adequate emesis

All the patients reported relief in heaviness in the chest, expectoration, cough, breathlessness,

and a feeling of well-being and lightness in the chest immediately after emesis.

The success rate of ET was approximately 75% in cases of bronchial asthma.

4.2.2.2 Purificatory Purgation — Purgation Therapy (Virecana Karma)

Purgation therapy (PT) is a specific process for elimination of pitta dosa. PT procedure

involves elimination of pitta dominating dosas and toxins of the body through the rectal

route.

PT is indicated mainly in patients suffering with hemorrhage from the upper parts of

the body, poisoning, chronic jaundice, various gastrointestinal tract disturbances, asthma,

skin disorders, epilepsy, insanity, and other pitta disorders. PT is contraindicated in

patients with anorectal injury, prolapse of the rectum, bleeding from lower parts of the

body, diarrhea, emaciating chest diseases, excessive oleation, and after enema. It is also

contraindicated in children, the elderly, and patients who are weak, tired, have fasted,

pregnent women, or persons desirous of coitus and pregnancy.

4.2.2.2.1 Procedures of Purgation Therapy

Internal oleation is done prior to PT. A diet containing fatty materials, liquid, warm/hot

liquid or solid food, and meat soups is given to the patient. General instructions to be

followed in ET are also to be followed in PT.

The dose of the drug to be administered for purgation is decided according to both the

nature of the purgative drug and the patient, as described in Table 4.7. The purgative

recipe is administered at least 2 h after sunrise (between 7 and 8 A.M.). During PT, the

TABLE 4.6

Herbs Used in PKT as Purgatives

Medicinal Plant Botanical Name

Kutaki Picrorrhiza kurrora

Eranda Ricinus communis

Triphala (haritaki, bibhitaka, amalaki) 3 fruits = Terminalia chebula, Termanilia belerica, Embelica officenalis

Gavaksi Citrullus colocynthis schrad

Snuhi Euphorbiorbia nerrifolia Linn.

Trivritta Operculina turpenthum

Nilini Indigofera tinctoria Linn.

Tilvaka Locos racemosa roxb.

Aragvadha Cassia fistula Linn.

Kampillaka Mallotus philippinensis

TABLE 4.7

Dose Schedule for Various Purgativesa

No. Drug of Choice Soft Bowel Medium Bowel Costive Bowel

1 Ricinus communis oil 5–20 ml 20–50 ml 50–100 ml

2 Operculina turpenthum powder 1–3 g 3–6 g 5–10 g

3 Vitis vinifera, cassia fistula,

terminalia chebula decoction

10–20 ml 25–50 ml 50–100 ml

4 Croton tiglium, Euphorbia

neerifolia

60–125 mg 125–250 mg 500–1000 mg

5 Pluntago ovata 3 g 3–6 g 6–12 g

aPurgatives are based on practical experiences.

stomach should preferably be empty, in contrast to emesis where the stomach must be

full. Depending on their mode of action and degree of purgation produced, purgative

drugs may be grouped as mild purgatives (e.g., Operculina turpenthum root), moderate

purgatives (e.g., Cassia fistula), and drastic purgatives (e.g., Euphorbia nerrifolia milk). Var-

4.2.2.2.2 Criteria for Proper Purgation Therapy

The patient should be assessed for proper purgative effect as shown in Table 4.8. A proper

purgation induces a feeling of lightness in the body and abdomen with improved appetite.

The sequence of expulsion in proper PT is urine, stool, pitta, drug, kapha, and vata. If the

patient has dyspepsia, heaviness in the abdomen or body, vomiting, and constipation, this

suggests inadequate purgation. Signs and symptoms of excessive purgation include pain

in the abdomen, blood-mixed serous discharge through the anus, syncope, weakness, and

drowsiness. The physician should constantly monitor the subject and stop the whole

process at the right time.

4.2.2.2.3 Review of Scientific Data on Purgation Therapy14–16

A clinical trial for assessing the role of PT in 30 patients with hepatitis (jaundice) was

carried out by this author and his team on various scientific parameters. After the completion

of the PT, it was observed that there was significant improvement in clinical

symptoms such as anorexia, pruritis, nausea, and abdominal discomforts. There were

significant changes in laboratory tests such as ESR, 24-h stercobilinogen, and D-xylose

excretion.

All the patients reported relief in the feeling of lightness in the body and abdomen and

improved appetite. The success rate of PT was approximately 85% in cases of hepatitis

(jaundice).

After purgation, these patients were put on a short course of posttherapy dietetic regimen

for 2 to 3 days. Within 7 days after purgation, these patients showed notable symptomatic

improvement (p < 0.05). The D-xylose excretion test applied on these patients within a week

of completion of the total procedure showed a statistically significant (p < 0.001) increase in

D-xylose excretion rate, indicating improved absorption power, which determines the rate

of purification of microchannels in these patients.

4.2.2.3 Biopurificatory Therapeutic Enema — Enema Therapy (Vasti Karma)17

Enema therapy (ENT) is a procedure in which medicated oils, decoctions, and decoctions

with pastes of herbs or oils are introduced into the large intestines through the rectum

with the help of an enema apparatus.

TABLE 4.8

Assessing Success of Therapeutic Purgation on the Basis of Clinical Manifestations

No. Parameters Good Purgation Medium Purgation Mild Purgation

1 No. of bouts 15–30 10–15 5–10

2 Quantity of feces in

liters

1.5–2 1–1.5 0.05–1

3 Order of contents Mucin/kapha Mucin Mucin

4 Symptoms Signs and symptoms

as per textual

description

Signs and symptoms

as per textual

description

Signs and symptoms

as per textual

description

ious herbs and drugs used in PKT as purgatives are described in Table 4.6.

4.2.2.3.1 Classification of Enema Therapy

ENT can be classified in different groups on the basis of drugs that are used in an enema,

such as (1) a decoction-based enema in which drugs used for the enema contain decoction

in a larger quantity, or (2) an oil-based enema in which oil is the main ingredient. Usually,

a combination of decoction and oil enema is given; decoction alone is not indicated at any

time. According to therapeutic actions of the drugs, the enema can be an oleation enema

that produces oleation of the body, a roborant enema that improves strength and general

status of health, a purifying enema that removes toxic materials from the body, or a

depleting enema that reduces fat content of the body tissue leading to sound health.

ENT may also be classified according to the number of enemas administered during the

full course of therapy:

1. Karma vasti — Total of 30 enemas, 12 decoction-based and 18 oil-based enemas

administered on alternate days

2. Kala vasti — Total of 16 enemas, 6 decoction-based and 10 oil-based

TABLE 4.9

Herbs Used in PKT to Make Decoctions for Enema

Medicinal Plant Botanical Name

Madanaphala Randia dumatorum

Kutaja Holarrhena antidysenterica Linn.

Kustha Saussurea costus

Devadali Luffa echinata

Vaca Acorus calamus

Dasmula (group of ten drugs: bilva,

agnimantha, syonaka, kasmarya, patala,

saliparni, prsniparni, brhati, kantakari,

goksura)

Aegle marmelose, Premna integrifolia, Oroxylum indicum, Gmelina

arboria, Stereospermum suaveolens, Desmodium gangeticum, Ureria

picta, Solanum indicum, Solanum surrattense, Tribulus terrestris

Devadaru Cedrus deodaru (Roxb)

Rasna Acampe papillosa

Yava Hordeum vulgare

Methi Foeniculum vulgare Mill

Krtavedhanam Luffa acutangula Roxb

Kulattha Dolichos biflorus Linn.

Saindhava lavan Rock salt

Madhu (honey) Honey

TABLE 4.10

Proposed Quantity of Decoction-Based Enema According to Various

Age Groups

No. Age

Maximum Quantity of Decoction-Based

Enema

1 1 year 50 ml

2 10 years 400 ml

3 15 years 900 ml

4 18–70 years 1200 ml

5 Above 70 years 1000 ml

Note: The dose of oil-based enema according to age of the patient is recommend.

Examples are Sneha vasti – 300 ml, Anuvasana vasti – 150 ml, and Matra

vasti – 75 ml.

3. Yoga vasti — Total of 8 enemas, 3 decoction-based and 5 oil-based

ENT is indicated in various gastrointestinal tract disorders, helminthiasis, urogenital

disorders, lithiasis, neuromuscular disorders, articular diseases, venereal diseases, convulsions

and paralytic disorders, and anorectal disorders. ENT is contraindicated in patients

with intestinal obstruction, perforation, ascites, cholera, dysentery, anal inflammation,

anemia, and anasarca.

4.2.2.3.2 Procedure of Enema Therapy

A decoction-based enema is given on an empty stomach between 5 and 7 P.M. after

subjecting the patient to gentle massage and mild fomentation. An oil-based enema is

administered 15 to 30 min after having a light diet in the evening. In both types of ENT,

the quantity of enema is decided according to the schedule as described in Table 4.11.

Duration of elimination of the enema should be a maximum of 48 min. If expulsion

does not occur within the stipulated time, the following complications may occur: tympanitis,

distention of abdomen, painful abdomen, renal colic, reverse peristalsis, and

pressing pain in the chest region; these complications should be managed accordingly.

Proper release of fecal matter and flatus, a feeling of lightness in the abdomen, suggests

proper ENT. It is considered inadequate if the patient has few urges for evacuation,

gripping pain, flatulence, and dyspnea.

After resting, the patient may take a bath with warm water. Lukewarm water, milk,

gruel made of rice, meat soup, or another light diet is given. Excess of physical and mental

exertion is avoided during ENT.

4.2.2.3.3 Uttara Vasti

Uttara vasti is the means by which the drugs of enema are made to pass through the penis

or vagina or through extra genitalia into the urinary bladder or uterus. A dose of uttara

vasti is 20 to 40 ml. The remaining description, indications, contraindications, and mode

of administration of uttara vasti are similar to decoction-based or oil-based enemas.

4.2.2.3.4 Review of Scientific Data on Enema Therapy18,19

A clinical trial for evaluating the efficacy of ENT was conducted on 30 patients with

rheumatoid arthritis with scientific parameters. Patients were subjected to a course of

Vaitarana vasti (a type of decoction-based enema, Chakradatta, Chapter No. 73/32) for 30

days.

TABLE 4.11

Two Types of Topical Errhines (Nasya)

No. Pratimarsha Nasya (Topical) Marsha Nasya (Topical)

1 Never produces complications May produce complications

2 Dose: 2 drops B.D. Dose:

Maximum – 10 drops

Moderate – 8 drops

Minimum – 4 drops

3 Indicated in all seasons and all age groups Needs consideration of seasons and age

4 Least oleus material used Excess oleus material used

5 Slow acting and less potent Quick action and highly potent

Various herbs used in PKT to make decoctions for enemas are described in Table 4.10.

Significant changes such as stiffness, pain, and swelling, as well as laboratory tests like

ESR, were observed in both clinical symptoms. A decrease in the rate of urinary excretion

of hydroxyproline and a trend of restoration of adrenocortical functions, indicating remission

of the disease process with control of connective tissue breakdown, were also noted.

After the course of the therapy, patients showed statistically significant (p < 0.001) increase

in D-xylose excretion rate, indicating significant improvement in GIT absorption capacity,

clearly indicating the cleansing effect of microchannels after the MCP (i.e., ENT). Scientific

study on a current series of patients with rheumatoid arthritis showed relief in symptoms

in 70% of the patients.

4.2.2.4 Errhine Therapy (Nasya Karma)

Errhine therapy (ErT) refers to administration of medicines in various forms through the

nostrils (i.e., instilling medicated oil in the nose or administering paste, powder, or fumes

of errhine drugs in the nostrils). There are two types of ErT: (1) Pratimarsha nasya and (2)

old. ErT is indicated in various diseases of the supraclavicular region such as stiff neck

and jaw, headache, migraine, graying of hair, baldness, facial palsy, aphonia, stammering

or alteration of voice, hoarseness of voice, corrhyza, tonsillitis, sinusitis, rhinitis, and

earache. ErT should be avoided in patients who have acute fevers or acute corrhyza or

have had purgation or oleus enema, had fasted, and had indigestion. There are five

methods of ErT:

1. Inunction (navana)

2. Instillation of nasal drops (avapeedana)

3. Insufflation (dhamapana)

4. Inhalation (dhuma nasya)

5. Topical application (marsha and pratimarsha)

When the oil is being instilled, the head should not be shaken; the patient should not

loose his or her temper, speak, sneeze, or laugh. The unctuous material should not be

swallowed and should be expectorated properly so that no part of it remains inside. The

patient should be instructed to avoid talking, becoming angry, laughing, and swallowing

of errhine drugs during the ErT procedure.

Standard preparations commonly used for ErT are listed in Table 4.12, and herbs used

TABLE 4.12

Standard Preparations Commonly Used for Errhine Therapy

No. Drug Dose (Purification) Reference

1 Anu taila 6 drops in each nostril CSa 5/63–70

2 Rasnadi taila 6 drops in each nostril CCb 26/160

3 Shadbindu taila 6 drops in each nostril BRc 65/83

4 Vyaghhri taila 6 drops in each nostril BR 63/30

5 Pathadi taila 6 drops in each nostril BR 63/29

6 Apamarga taila 6 drops in each nostril BR 65/113

aCS = Charak Sutra.

aCC = Charak Chiikitsa.

cBR = Bhaishajaya Ratnavali.

Marsha nasya (Table 4.11). ErT should be administered to patients who are 7 to 80 years

in PKT for nasal medication (nasya) are described in Table 4.13. The dose of ErT should

be determined according to Table 4.14.

Adequate ErT produces lightness in the body and head and sensorial happiness. ErT is

inadequate if the patient has excessive secretions from the nose, eyes, and mouth and

heaviness in the body. Complications such as headache, confusion, and salivation may

occur in uncontrolled excessive ErT. The physician should constantly monitor the subject

to avoid complications.

After ErT; the patient is given mild sudation over the throat, cheeks, face, and forehead

and a soft massage on the feet, palms, and back of the neck; hot water gargling of the

mouth and medicated smoking (dhumapana) is advised to the patient to clear the mouth

and throat of residual kapha dosa.

4.2.2.4.1 Review of Scientific Data on Errhine Therapy20

Clinical efficacy of ErT was evaluated by the author on 30 patients with chronic sinusitis.

At the end of 21 days, after administration of ErT with Anu Taila, the researchers noted

significant changes such as a growing feeling of well-being, sneezing, nasal secretions,

and headache in both clinical symptoms, as well as in laboratory findings such as ESR

and radiological findings.

There was a statistically significant (p < 0.001) reduction in TLC and ESR. On radiological

examinations there was a marked reduction in the haziness of sinuses along with restoration

of normal mucosa. Nasal passages and sinuses were thoroughly cleansed after a

course of therapy, indicating suppression of the disease process.

TABLE 4.13

Herbs Used in PKT for Nasal Medication (Nasya)

Medicinal Plant Botanical Name

Vidanga Embelia ribes Burm

Apamarga Achyranthes aspera Linn.

Vyosa (3 pungents: sunthi, pippali, marica) Zinziber officenalis, Piper longum, Piper nigrum

Darvi Beriberis aristata

Surala Vateria indica Linn.

Bija of sirisa Albizia lebbek

Brihati Solanum anguivi Lam.

Shigru Moringa oleifera

Madhusarkara Dolichos biflorus Linn.

Saindhava lavana Rock salt

TABLE 4.14

Determination of Dosage in Errhine Therapy

No.

Type of Errhine

Therapy

Mild

Purification

Moderate

Purification

Maximum

Purification

1 Snuffing errhine

therapy

8 drops in each

nostril

16 drops in each

nostril

32 drops in each

nostril

2 Purificatory errhine

therapy

4 drops in each

nostril

6 drops in each nostril 8 drops in each

nostril

3 Blowing errhine

therapy

250 mg 375 mg 500 mg

4 Topical (marsa nasya) 6 drops in each

nostril

8 drops in each nostril 10 drops in each

nostril

5 Topical (pratimarsh

nasya)

2 drops in each

nostril

2 drops in each nostril 2 drops in each

nostril

6 Paste (kalka) 4 drops in each

nostril

6 drops in each nostril 8 drops in each

nostril

7 Smoke (dhumapana) 1–2 min 2–3 min Up to 5 min

© 2004 by CRC Press LLC

58 Scientific Basis for Ayurvedic Therapies

In the author’s clinic, the success rate of ErT in a current series of patients with chronic

sinusitis is about 90%.

4.2.2.5 Bloodletting Therapy (Rakta Mokshana)

Bloodletting therapy (BLT) may be performed with or without the help of metallic instruments.

In the latter type, BLT may be administered by application of leech, cow's horn,

dried bitter gourd, or coupling glass.

BLT is practiced to remove toxic materials in blood in blood-borne diseases; in pittapredominant

diseases; and also in a few vata disorders like erysepalis, boils and carbuncles,

abscesses, blue and black pigmentation on the face, moles, eczema, leucoderma and

vitiligo, scabies, red patches, anorectal inflammation, splenomegaly, jaundice, dyspepsia,

anorexia, stomatitis, halitosis (foul-smelling mouth), gingivitis, and gout. It is contraindicated

in patients with bleeding disorders, general anasarca, cachexia, anemia, piles, and

all conditions where venepuncture is contraindicated.

4.2.2.5.1 Bloodletting Therapy with the Application of Leeches

The patient should be properly screened before leech therapy can be given. Before the

BLT is done with a leech, oleation and sudation should be performed the day before. It

can be done localized or generalized, depending upon the condition, and the part that is

to be leeched should be dried. Then the purified leech is applied to the diseased part. The

leech’s mouth is covered with a smooth, white, moistened cotton swab. When the leech

starts opening its mouth, which is shaped like a horse's hoof, and raising the shoulders,

the leech is sucking the blood. If the leech does not start sucking the blood, a drop of milk

or blood is placed over the affected part and the leech will start sucking the blood. If at

the biting site needling pain and itching occur, then the leech is sucking pure blood. The

leech is then removed from the site by pouring rock salt at its mouth. With the removal

of vitiated blood after leech therapy, the redness and pain subside immediately.

After the leech is detached, the blood from the sucked area should be allowed to flow

for 1 to 3 min and then dressing either with turmeric powder and alum powder or

antiseptic solution is applied. Dressing should be kept in place for 6 to 12 h.

4.2.2.5.2 Bloodletting Therapy by the Venesection

Venesection is the process of cutting open a vein under strict aseptic conditions. It is done

with sharp instruments and is a more severe form of bloodletting than the application of

leeches. When the venesection is done properly, the blood (which is impure) flows automatically.

Adequate venesection is considered if the patient feels lightness in the body, a

decrease in pain, and a remission of symptoms. Signs of inadequate venesection include

swelling, burning sensation, inflammation, pain, itching, and redness at the site of venesection.

4.2.2.5.3 Bloodletting Therapy by Superficial Wounding

Superficial incisions are made over the skin with the help of a scalpel, fine needles, or

instruments under strict aseptic conditions. BLT with this method is commonly used in

localized blood disorders and in certain skin disorders. It must be done after taking aseptic

measures. Antiseptic dressing should be applied over the wound.

BLT improves the collateral circulation of affected parts and cleanses the microcirculatory

channels directly by removing toxic materials and exudating from the affected parts.

Hirudin, the chemical substance present in the saliva of a leech, has a potent anticoagulant

property. It induces bleeding and encourages free flow of blood, removing the virulent

substances present at the site of the lesion and helping to restore healthy blood supply.

Hirudin checks the inflammatory process especially at specific points where bloodletting

is done, which produces rapid symptomatic improvement.

4.3 Beneficial Effects of Panchakarma Therapy21

The beneficial contribution of PKT is that it removes the toxic materials from the body

and provides purification of the body at two levels: (1) the gross level, where various

organs and systems of the body are thoroughly cleansed (e.g., cardiovascular system,

gastrointestinal tract, chest, etc.); and (2) the cellular level, where purification and cleansing

of the body is produced at the level of cells, cell membranes, and molecules. PKT helps

bring the whole body to normalcy; starts rejuvenation and revitalization of all body tissues;

potentates the pharmacological actions of various drugs and medicines administered after

PKT; removes waste products, unwanted materials, various toxins, and stagnant dosas;

and potentiates physiological functions of all the body systems (e.g., gut absorption

improves considerably and metabolism is also corrected). The prognosis of various diseases

that are difficult to treat with simple administration of medicines becomes significantly

improved (good prognosis) after administration of PKT. PKT not only is a

prerequisite for all the therapeutic procedures and medications but also has a full therapeutic

role in promoting preventive, curative, and rehabilitative procedures.

If properly performed, PKT does not produce any serious complications. If any minor

complications are produced, they are easily manageable. Specialized techniques of PKT

are simple to perform and can be carried out at both the outdoor patient and indoor

patient (OPD and IPD) levels. There is no need to carry out all PKT practices at one sitting;

specific techniques of PKT (any of the MCP) can be recommended to the patient after

proper preparation. The toxic materials are eliminated from the body mainly through the

alimentary canal.

4.4 Conclusions

Any type of main cleansing procedure of PKT is believed to affect the cleansing of

microcirculatory channels by eliminating the toxic metabolites from the body. This helps

in the process of curing a disease. Scientific studies indicate that cleansing procedures

appear to help in eradicating chronic diseases more effectively.

It was observed by the author in a case study that when PKT was administered as an

adjuvant therapy along with the allopathic system of medicines, the results were better

than the PKT or allopathic system of medicines given alone.

Acknowledgments

I am thankful to my co-workers, Dr. Uttam Sharma, Dr. Sunil Borkar, Dr. Parshuram Yadav,

Dr. Rajesh Gupta, and my son Amit Sharma, for help in writing this chapter. In addition,

I am extremely thankful to my revered teacher Prof. R.H. Singh, Dean, Faculty of

Ayurveda, Indian System of Medicine, Banaras Hindu University, Varanasi, for extending

help and inspiring me to complete this chapter. I am also thankful to my wife, Dr. (Smt.)

Praveen Sharma, and daughter, Gauri Sharma, for their help.

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Om Tat Sat

                                                        

(Continued...)  

(My humble salutations to H H Maharshi ji,  Brahmasri Sreeman Lakshmi Chandra Mishra ji and other eminent medical scholars and doctors   for the collection)