THE CONCEPT OF INDUCED-EXCRETION IN AYURVEDA
Guest Editorial
Hygeia: journal for drugs and medicines
February 2022
OPEN ACCESS
A half yearly scientific, international, open access journal for drugs and medicines
Research article section: Guest Editorial
DOI: 10.15254/H.J.D.Med.13.2022.23
THE CONCEPT OF INDUCED-EXCRETION IN AYURVEDA
Dr. D. Suresh Kumar Ph.D.
Former Head (Product Development), Cymbio Pharma Pvt Ltd, Yeswantapuram, Bangalore 560 022 India.
According to Ayurveda, diseases are caused by the destabilization of three factors v?ta, pitta and kapha, collectively called trida. Treatment of diseases is of two types: elimination therapy (dhana) and curative therapy (amana). Elimination therapy is the adoption and enlargement of the principle of excretion that is given great importance in pharmacokinetics, the branch of clinical pharmacology which comprehensively describes the changes in the quantity of drug or drug metabolite in various body compartments over time. The other three processes considered in pharmacokinetics are absorption, distribution and metabolism.
Measures such as emesis (vamana), purgation (vircana), medicinal enema (vasti), nasal instillation (nasya) and bloodletting (raktamk?a) are the elimination measures for v?ta, pitta and kapha. Sesame oil, clarified butter and honey are the cures for v?ta, pitta and kapha respectively. However, the term pa cakarma (the five actions) is also used in lieu of ??dhana. Elimination therapy is more effective than curative therapy. Nevertheless, it is to be carried out with great care and under direct supervision of the physician. To prevent mishaps, the body of the patient needs to be conditioned first before the main elimination therapy. Internal and topical administration of oleaginous substances (oleation) and sudation (sv?dana) are the preparatory measures (p?rvakarma).
Vamana cures diseases such as food poisoning, internal abscess, cervical glandular swelling, epilepsy, tumor, deafness and nearly 60 other diseases. An equal number of diseases such as hemorrhoids, wounds, cataract, insanity and so on are mitigated by vir?cana. Vasti is the cure for about 100 diseases including andrological and gynecological ailments, cataract, varicose vein and the like.
Clarified butter from milk (gh?ta), bone marrow, visceral fat and oil from sesame seeds (taila) are the excellent oleaginous substances. Oleation is recommended for persons habituated to drinking alcoholic beverages, fornication and exercise; those continuously exposed to mental stress; aged persons; individuals with weak, dry and lean bodies; persons suffering from v?ta diseases, conjunctivitis and cataract and persons with lowered sexual vigor. However, internal consumption of oleaginous substances is contra-indicated in stiffness of thigh muscles, dysentery, indigestion, diseases of throat, poisoning, enlargement of abdomen, vomiting, anorexia, kapha diseases, polydipsia, alcoholism, depressed or exaggerated appetite, obesity and debility. Appropriate oleaginous substance is administered internally to the patient in graded doses so that optimum unctuousness of body is achieved in seven days.
After oleation, the patient is to be subjected to sudation (sv?dana), before undergoing elimination therapy. Suitable mode of sudation using warm medicinal liquids, steam, fire, heated stone slabs and so on is applied. On performance of oleation and sudation, the patient is served food prepared with fish, black gram and sesame seeds. These foods loosen, liquefy the disease-causing agents (d??as) in body and bring them to the alimentary canal. The next day morning, the patient consumes in overabundance gruel mixed with emetic medicine, so as to induce unctuousness. Patient vomits kapha first, followed by bile (pitta) and air (v?ta). On completion of the vomiting reflex, light food is served.
Patient subjected to vamana is made unctuous again by internal and topical administration of taila and or gh?ta. Thereafter purgation is induced by administering appropriate purgative. Medicinal enema (vasti) is suitable in the treatment of v?ta-dominant diseases. It is also the best among all treatment modes. Vasti is performed with decoctions of herbs or oleaginous substances. It is used in the treatment of abdominal tumors, distension of abdomen, v?ta-induced blood disorders, enlargement of spleen, dysentery, pricking pain in stomach, chronic fever, urinary stone and many v?ta diseases.
Nasal instillation of medicines (nasya) is desirable in diseases of throat and head. Medicines administered through nostrils spread to all parts of throat and head, promoting the elimination of d??as lodged therein. One who performs nasya regularly is endowed with well-built and raised neck, shoulders, chest, pleasant countenance and bright skin.
His sense organs will be very well organized and he will never suffer from graying of hair. Leeching and and bloodletting (raktam?k?a) cure around 80 diseases such as black pigmentation on face, hemorrhoids, irregular fever, migraine, vitiligo and so on.
Abdominal (digestive) fire becomes dull after the performance of vamana or vir?cana measures and appetite will be increased. However, heavy food cannot be digested, as the abdominal fire is weak. Therefore, two modes of diets are recommended to improve digestive efficiency. They are p?y?dikrama and tarpa??dikrama. P?y?dikrama starts with fluid decanted from rice gruel. This is followed by gruel with more fluid of and less of grains. After two days the patient is served gruel with more of grains and less of fluid. In this way digestive fire is improved by p?y?dikrama. Sequential consumption of powder of parched rice suspended in water, cooked rice mixed with lentil soup and finally rice with meat soup is known as tarpa??dikrama. This dietary schedule improves digestive efficiency after performance of elimination measures.
Elimination of disease-causing agents (d??as) after applying oleation and sudation measures, cleanses the body excellently. Carrying out elimination measures without oleation and sudation damages health. Properly performed elimination therapy improves intelligence, memory and comprehension. Ayurveda states that diseases are caused by destabilization of d??as. D??as are most probably biochemical substances that accumulate in body as a result of the appearance of the disease. The very fact that pacakarma cures various diseases implies that the ayurvedic concept is sound. Therefore, exponents of modern medicine, pharmacology and pharmacy should investigate the rationale behind this concept. Unravelling of the roles of consumption of large volumes of oleaginous substances in a short span of time, therapeutic warming of the body followed by emesis, purgation and nasal instillation will help us understand how pacakarma cures diseases.
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