Poorva Karma

Dipana-Pachana:-

It refers to oral administration of certain medicines that augments and assists the process of digestion, thus ensuring the optimal state of GIT. Thereby one can expect proper digestion and assimilation of the drugs administered as well as the desired results from the shodhana therapies that follow.

Sluggish functioning of gastrointestinal tract associates many of the diseases. Febrile illness, acid peptic disease, diarrhea, abscess are the few examples. In such cases, digestion is incompatible; as a result there occurs the accumulation of undigested foods. Also this partially digested food gets assimilated to some extent and adds the morbidity of doshas. The resultant of the partial digestion is known as ama and has incriminatory effect on the body. The dosha that associate this ama are called sama dosha. And sama dosha tend to adhere the dhatus and srotas rendering difficulty in its mobilization into the gastrointestinal tract. To carry out the shodhana procedure, optimal functioning of the gastrointestinal tract is essential, as well as morbid dosha has to be brought to the tract of elimination. This is best achieved by the pahchan therapy, as this augments the digestive process and cleans the ama state.

Thus this Dipana-Pachan chikitsa renders the optimal functioning of the gastrointestinal tract, causes the formed state of the morbid dosha, mobilizes it into the gastrointestinal tract, clears the ama and reactivates the body mechanism of healing.

For Dipana- Pachan chikitsa, different herbal of herbomineral combinations may be prescribed for oral administration in different forms like tablet, decoction, powder or infusion etc..

The duration of the Dipana-Pachana chikitsa is continued till the client develops the symptoms of proper Pachana. In an average it takes about 2-7 days for the development of the desired results.

Symptoms of Proper Dipana- Pachana :-

1. Proper passing of flatus
2. Proper evacuation of bladder
3. Proper evacuation of bowel
4. Subjective feeling of lightness in the body
5. Appearance of proper taste in mouth
6. Disappearance of tiredness
7. Disappearance of drowsiness
8. Clarity of mouth
9. Clarity of throat
10. Clear belching devoid of odor and taste.

Ascertaining the desired effect of the pachana chikitsa, as per the predermined course of panchkarma, snehpana, is administered from the nest day onwards. In some clients sluggishness of the gastrointestinal tract may relapse by the discontinuation of the pachana chikitsa. In such situations continuing the oral medication of the pachan chikitsa along with snehpana is advisable.

A simple procedure of applying the oil to the vertex using a cotton pad impregnated with oil, medicated or otherwise is known as shiropichu. Once again here the application of oil does not follow any form of massage. This procedure is said to be more beneficial in dermatological conditions of scalp as well as psychological disorders. As this process does not involve massage, It can be confidently performed in painful conditions or ulcerations of the scalp.

Snehana(Oleation): -

The word snehana refers to imparting greasiness. The therapeutic procedure by which greasiness is imparted to the body using different kinds of fat is called snehana. Certain forms of fats like oil, ghee or animal body fat is administered internally or applied externally to add oiliness to the body. Internal administration means oral, rectal or other roots of administration where the fat is given to inside of the body. External administration refers to the application of fat on to the skin and may be followed by massage.

Snehana is also performed as preparation of the client prior to the administration of shodhana procedures. In such situations, where the sneha is carried out as a part of shodhana procedure it is referred as Purvakarma.

Types of Sneha according to Therapeutic utility:-

1.Shodhana Sneha:- When administered for the therapeutic purposes, the sneha that includes emesis, purgation or nasal discharge is called by the name shodhana sneha. Or else, the shena that is administered prior to the administration of the shodhana procedure is also known by the name of shodhana sneha. Here the sneha is administered as a pre-medication for shodhana procedure. The sneha thus administered does not induce emesis or purgation. Following the sneha procedure, shodhana is carried out by administering emetics or purgatives. Here the shodhana sneha is administered in large does, during early morning in the empty stomach of the client after confirming the proper digestion of the food taken at previous night.

2.Shamana Sneha:- Sneha may be given to alleviate the dosha and is known as shamana sneha. Here the sneha is processed with herbs that can cure diseases is selected for the administration according to the illness in a given client. In general intermediate dose of the sneha is given in empty stomach for the shaman procedure.

3.Brimhana Sneha:- Small amounts of sneha are given probably along with the food for the purpose of nourishment and are known as brimhana sneha.

Routes of administrationof sneha:-

Sneha is administered for the therapeutic purposes in different routes of administration. Accordingly the snehana procedure is named as Abhyantara snehana (internal administration) and Bahaya snehana(used externally).

Abhyantara Snehana:-

The word abhyantara refers to the internal route and the shena refers to administration of the fat substances. Different methods of abhyantar sneha are listed bleow:
a. Snehapana:Oral administration of medicated or plain sneh.
b. Snaihika dhuma:Inhalation of smoke though the nostrils for the snehana effect.
c. Anuvasana Basti:Medicated sneha is administered in the form of enema.
d. Panchakarma following Snehapana.
e. When the snehapana is done as a preparation for any shodhana procedure, naturally snehpana is followed by shodhana procedure like vamana or virechana. In case of vamana karma, following the snehapana client is subjected to abhyanga and svedana for one day and the vamana is carried out the very next day. When the snehana is completed by three day, abhyanga(massage with oils) and swedana(hot fomentation) is carried out on the 4th day and is followed by vaman karma on 5th day. Abhyanga swedana is performed on the 6th day and vamana on 8th day when it takes five days for the snehana procedure.
f. If the snehana is completed in 7 days, abhyanga and swedana is carried out on 8th day and vamana on 9th day.
g. The course is little different from vamana karma in the procedure of virechana karma. Following snehana, abhyanga and swedana is carried out for 3 days and is followed by virechana on the immediate next day.
h. Bahaya Snehana: As the anatomical structure of different parts of the body is different, oil may have to be applied differently accordingly to its structure. Secondly depending upon the degree of snehana effect desired in an individual patient, one may have to adopt different form of oil application in order to get maximum effect.

It is to be done before every primary procedure in panchakarma.

The oil is applied to the skin in different procedures of bahaya sneha, wherein the oil gets absorbed and distributed to the whole body to show systemic or generalized effect. The absorption as well distribution of oils with the herbal ingredients impregnated in its specific duration.

Swedana(Hot Fomentation): -

It induction of sweating for therapeutic purposes is referred by the name svedana in Ayurveda. This may be used either for promotion of health or for curing the illness. By definition the orocedure that alleviates the stiffness of the body, relieves sense of heaviness, and cures feeling of cold is called svedana treatment. And those effects are achieved by increasing the natural process of perspiration. Sweat is a form of body waste.

According to Ayurveda , sweat is produced by the metabolism of Medas dhatu vis-à-vis adipose tissue. And this sweat has considerable role in the maintenance of proper balance of body fluids. The process of sweating also involves elimination of waste and toxins form the body. These natural functions of sweat are utilized for the therapeutic purposes in the swedana process. It is form of treatment, employed to cure specific diseases or to relieve symptoms like pain, stiffness or contracture that may manifest as a symptom in different diseased conditions. That is why swedana is regarded as an upakrama or preliminary procedure. In addition to this, in any patient if eliminatory procedures like therapeutic emesis or therapeutic purgation is planned, swedana is performed as preliminary procedure. And therefore in such situations Swedana is considered as Purvakarma or Preoperative procedure.