‘ Human body is non linear and follows the

holistic rules of universe’’
–Dr. B.M Hegde
The modern equation of disease:
Damage done by Harmful agent + Body’s reaction =
Disease
Our science follows a distinctive discretion of the
disease, centered for the purpose of treatment:
Vikara prakr̥ti : adṣṭhānāntarāṇi: hetuviśeṣa =
upakramam.
“Ayurveda never visualizes cohorts but it views through individual phenotypes.”
‘In clinical medicine don’t be satisfied by
seeing the flower (the obvious), try to see
the insect sitting over it (the minute); but
missing the obvious and seeing the
minute is unpardonable.’
Dr Kashinath padhiary
Concept of disease in routine ayurvedic clinical
practice ……….
नरिसंहभथश्यम .१-१
kaḥ punarasau roga iti. avasthāviśiṣṭo
doṣaḥ.
narasiṁhabhāṣyam. 1-1
Message from Caraka
यथ�थकथथ�्थ ्ुि�ः िसि�्ुा�ौ ितिशषतथ ।
ितशषत्ुपुर ्ुि�िो ्ञ्िथनवतथं सोथ ॥
ारक संिहतथ सू�स्थनयम २-१६
Line of treatment………………
न य

*मवधारणिमदमे व 9धानिमदं ने ित
िचिक~ायां िह 9धानमव¹ान

िवधानम


R.V.Su.१-९३
Cikitsā
Apakarṣaṇa Prakr̥ti vighāta nidāna tyāga
Ābhyantara bāhya ābhyantara
Bāhya abhyaṅga
sveda
pradeha
pariṣekādi
Prakr̥tivighātaḥ duṣṭasya doṣādeḥ dehasthasya śamanaṃ
sāmyakaram’
Vikprakr̥ti :
General components analysed (Like doṣāvastha) :
• Āma, līna, utkliṣṭha etc.
Specific disease pattern, like (roge doṣāvasthā)
•Raktotleda ( rakta pitta , visarpa)
•Bahu, abaddha medo-māṃsa –śarīraja kleda
•Rakta mārga nihanana (vātarakta)
•Dhātu śaithilya (pāṇḍu, kuṣtha )
•Saṃhata doṣa (śotha)
And the basic knowledge of
•sāmānya vyādhi
•nānātmaja vyādhi
vikāra
prakr̥ti
sāmāny
doṣādyavsth
vyādhi
viśiṣha
doṣāvastha
duṣyāvasthā
Sāmānyaja or nānātmaja vyādhi
svabhāva
Śodhana
And
Bāhya kriyā kramāḥ
Kuṣtha – śopha- visarpa
Śotha Visarpa kuṣtha
Tridoṣa tridoṣa tridoṣa
Tvak tvaṅ tvaṅ
Māṃsa lasīkā lasīkā
Asr̥k asr̥k asr̥k
āmiṣa āmiṣa
  
Bahiḥ sirāḥ bahiḥ sirāḥ tiryaggāḥ sirāḥ
  
Saṃhataṃ sophaṃ utkliṣtḥa svabhāva dūṣayanti ślathī kr̥tya
  
Śodhana Nirhr̥te asre śodhana
- less Viśuddhe antaḥ
Doṣe tvaṅ-māmsa Saṃśraye

bahiḥ kriya
Vāta vyādhi

Kevalaṃ āvaraṇajaṃ vāta śoṇita
  
Dhātu sārataḥ kṣaya pratibandhakatvāt margāvaraṇa and rakta duṣṭi
   
Sneha svedau śodhana medaḥ-kapha sāme
Āvaraṇa
  
Saṃśuddhasya āḍhya vātokta sveda,
Utthite agniḥ vidhi
laṅghana-
 
pācana
Sneha svedau vāta śoṇitakīṃ 
Kriyāṃ
kevala
vāta
cikitsā
Kevala vāta- dhātu sārakṣaya
Sneha Sveda
 
Saṃśuṣka dhātūn vakraṃ
Puṣṇāti stabdhaṃ
Balaṃ savedanaṃ
Agni balaṃ 
Puṣṭiṃ yatheṣṭhaṃānamayituṃ
śakyate
Prāṇāścābhivardhayati
+·r-r -r ·r ·r¸·rr·r· =·r«=r·r-r+-rºrr-r! |
·rºr·r|·r|·r-r·rr·rr ·rº·r·r |·r·r·rº·r-r!!
SSV
Role of the different modes of bāhya sneha / sveda
To meet the different nuances of doṣas / expression of same disease
“Ayurveda never visualizes cohorts but it views through individual phenotypes.”
वात�ेष्मोववंषृवां्व ावांगवेांसषवते
vāte kaphe dvayoḥ
snigdhaḥ rūkṣaḥ sādhārāṇa
The variant forms of sveda and the clinical states where they have to be
administered are well expounded in Br̥hadyogataraṅgiṇī.
·rrnr·rr¨rr-·rºr·rr¨r·rr·rºr¸ ±r+|c:rrr-r!
=r±±r|«º=÷r·r·rr-rr ·r =-rr=´r«·rº»r·r·r!!
===·r¨-r »r·rr¸=r=´r«¨r«-r +r|ºr+·!!
´rr¨r-r·´rr=·r=r=+r·r-r=·r-r«:rr´·r·rr·!
¨r«-r ´r|=·r|-r· +´rr·r · =´r«-rº·r |-r·r·r »r·r·r!
»·r·rr-r·rºrr·rr¨rr =-rr·rºr |·r|+|·=r·r ·!
»=·rºr=·r=·r¨-r+¨·r+rº·r+rº·r ·rr«-r !!
«r·r ±·r =+ººr §rºr =-rr¨r«-r|¨rº·r·r!
•In conditions like bāhyāyāma, antarāyāma,
pārśvaśūla, kaṭigraha, khallī, daṇḍāpatānaka,
sneha sveda is the first line of management.
• In conditions like ūrustambha rūkṣa sveda
has to be implemented primarily.
• In vāmana, aṅgasaṅkoca, bhaṅga,bheda,
graham and vyathā sveda is indicated.
• In aṅgaraukṣya, stambha, kampa, kārśya,
toda, daurbalya, sphuraṇa, bhraṃśa –
snehamardana is recommended.
Bāhya kriyākramāḥ
Mūrdha sekādi vidayaḥ saṃhitāsvapi sūcitāḥ.
Keralīyādr̥taṃcaiṣāṃ sādhu vakṣye kriyākramaṃ.
Abhyaṅga seka picavo vastiścaiva caturvidhaṃ.
Dvitīyaṃsecanaṃtatra pradhānamr̥ṣibhiḥ smr̥tam.’ SSV
The bāhya kriyākramās are basically grouped into four categories viz.
abhyaṅga; seka ; Picu Vasti
And the variant procedres; of which seka is given higher importance.
śirodhāra
21
Seka
Procedure:
Śirasseka
Kāya seka
Dravya
Kaṣāya
Kṣīra
Dhānyāmla
Sneha
Takra
Śirasseka
1. fever with burning –
sensation & dizziness milk Y 2/57
2. nocturnal fever ,, Y -2
3. Arocaka ,, C.M
4. Somaroga ,, C.M
5. Svarasāda Śīrodhārā and vasti Y 11/1
6. jvara (antarvraṇa) takradhāra Y 2/76
7. ardita śirodhāra and kāyaseka
With balātaila Y 40
8. Prameha Takradhāra Y 26
9. asr̥gdhara milk Y 26
10. ardhāvabhedaka śirodhāra AKD
Experiments on śirodhārā elucidate some of its actions over the
physiological and psycho-somatic strata of the body.
•Śirodhārā induced bradycardia, and the expired gas analysis showed a
decreased tidal volume and CO
2
excretion.
• A power frequency analysis of R-R variability in ECG during
shirodhara, in order to assess the balance of the autonomic nervous
system, indicated that the cardiac sympathetic activity was suppressed
during and after śirodhāra.
•The EEG results monitored during the process of śirodhārā indicated
restful alertness in which the frontal lobe, limbic systemand medulla
oblongata were activated. These metabolic, ECG, and EEG findings
support the reported experiences of relaxed and low metabolic states
during śirodhārā.
•The differences in heart rate, CO
2
excretion, sympathetic tone, and EEG
were quite similar to the findings reported in the study of meditation, and
they indicate a change in the function of the frontal lobe, limbic system,
brain stem, and autonomic nervous system.
• The assessment of POMS (Profile of Mood States) score after a
course of śirodhārā revealed anxiolytic effects. The result indicated
a significant decrease of tension and anxiety, and a tendency towards
a decrease in exhaustion. It also showed some kinds of ASC (Altered
States of Consciousness). The highest ASC scores were obtained in
the domains of trance, passiveness, timeless sensation, wordless
sensation, and concentration.
•A study showed that śirovasti and śirodhāra, in progressive
degenerative cerebellar ataxia showed subjective improvement in
walking and there was a statistically significant improvement in the
overall and anteroposterior balance indices of dynamic stability.
- Sriranjini SJ, etal Improvement of balance in progressive
degenerative cerebellar ataxias after Ayurvedic therapy: A
preliminary report. Neurol India 2009;57:166-71; Department of
Neurology, National Institute of Mental Health and Neurosciences,
Bangalore
26
Kāya seka
In Dhārākalpa we find a very brief mentioning of the
procedure, kāyaseka. The first detailed description
regarding the procedure of kāyaseka is found in the
Hr̥dayapriya of Parameśvaraśivadvija (Vaikkaittu
Pāccumuttatu):
•vata
•vatottara roga
•rukshitanga
Duration - yamardha
Sneha seka Benefits
•Drudhatha of Dhathus
•Vrushatha, Deha, Agni, Varna, Ojas
•Sthairyam
•Indriyapatavam
•Jaraso mandyam, Chira jeevitham
Indications of kāyaseka
•Āyāma
•Śoṣa vāta
•Pakṣāghāta
• apabāhuka
•Ākṣepaka
•Apatanra
•jihvāstambha
• hanugraha
•gr̥dhrasī
•viśvācī
•rakta vāta
•kampa
•stambha
•Prasupti
•Sramsa vyāsa vyathā
•sarvāṅga ekāṅga vāta – gulma mehādikeṣu api
KPC.
Kāyaseka
1. burning sensation and thirst
in prameha sarvāṅga takradhāra
2. ākṣepa , āyāma,
and apatānaka Snehadhārā and
ṣāṣṭika piṇḍa sveda Y 40
3. Aśīti vāta vikāras taila ghr̥ta CM
4. apatānaka traivritsneha Suśruta
5. bāhyāyāma, paṅguvāta rasataila AKD
Picu
daṇḍāpatānaka vātāśani taila AKD
manyāstambha vātāśanī taila
dhānvantara taila
Nasal discharge / block
Without oil – sigru / thulasi swarasa with
breast milk
With Eranda thaila with thrikatu etc
Śirovasti
Ardita trimiśraka taila
balādhātryādi taila Y 40
Oil is warmed to
comfortable
temparature
Oil poured into the
vasthiputaka through a
strip of cloth &
coconut leaflet which
touches the scalp
Filled up to a height of
2-3cm above the hair
root.
Sirovasthi
 Time - between 3 to 6 pm
 Pre operative procedure:
 Shave the head
completely.
 Make sure to empty bowel
and bladder
 Keep cotton /cloth in both
ears
• to prevent the entry of
oil in to the ear.
 Do generalised
abhyanga.
Siro Vasthi
Sirovasthy - indications
 Arditha
 Thrimisraka thaila / baladhathryadi
 Darunaka
 Darunaka thailam/ durdhoorapathradi
 Sirograha
 sirovasthi with dasamoola, mathulunga etc. >>> oil
 Insomnia, Indriyasada, dryness of eyes etc
Piṇḍasveda
C.S.Su.14/25-26
• Tila
• Māṣa
• Kulattha
• Odana
• Āmiṣa
• Ghr̥ta
• Taila
The indications of ṣāṣṭikasveda
सव� षुंके वलािनल�वकारे षववत्त बर्ंगनेरगवेासं.ं
तैरे वंचं्ावसै्त रागनेरसवसव सैगता्ानाानाम्वं �्ण्ाबागवेाा्ं
A.S.Ci.23
• sarvanga ekanga sosha
• ghoreshu anila vyadhishu
• Ayama- akshepa
• Sankoca
• stambha
• pakshavadhadishu
1. It is clear from Aṣṭāṅgasaṅgrahakāra, vātavyādhi cikitsa that the diseased
condition of vāta which is not associated with any other doṣā-s (i.e., kevalānila
avasthā), is ideal for administration of piṇḍa sveda.
2. The first reference regarding this procedure is detected in the rājayakṣma cikitsā-
adhikāra of Carakasaṃhitā; wherein svedana with a preparation of grains boiled in
milk is mentioned in condition of śūla( caused by vāta doṣa) in the regions of the
head (śiraḥ), flanks (pārśva) and shoulder blade (aṃsa).
A.H. Ci. 4/14
3. The reference from śvāsa also clarifies that the svedana using milk etc., is ideal in
conditions where the benefits of svedana are looked for but the patient is not suitable
for the svedana.
4. Ṣāṣṭikapiṇḍa sveda is advocated in vātika kāsa associated with emaciation
5 In śvāsa ṣāṣṭikapiṇḍasveda and sneha dhārā with ghee and oil is beneficial
6. ṣāṣṭika piṇḍasveda and snehadhārā are also employed similarly in the m anagement
of hiccup (hidhmā)
7. In hemiplegia (pakṣāghāta), sudation with the bolus of sesame seeds or ṣāṣṭika rice
is recommended, or godhūmapiṇḍasveda processed in the milk decoction of balā and
the flesh soup of wild cock is also recommended
8. ṣāṣṭika piṇḍasveda is also advocated in the management of chardi, udāvarta,
halīmaka, vātaśleṣmajāśmarī.
9. In the management of diseases of vāta (vātavyādhi) ṣāṣṭikapiṇḍasveda plays an
essential role, it is prescribed in the treatment of ardita, apabāhuka, ākṣepa, āyāma,
sarvāṅgavāta, jaṅghāgraha, ūrugraha, trikagraha, pr̥ṣṭhagraha and kaṭigraha,
sakthisvāpa, jihvāstaṃbha, saktiśoṣa and śūla.
10. In khalāyakhañja, godhūma piṇdasveda processed in milk and saireyaka
decoction is indicated
11. ṣāṣṭika piṇḍa sveda is indicated in khañja vāta.
12. Sveda with tilakalka is advocated in vātaja śūla
13. In ardhāvabhedaka and sūryāvarta sudation with tila triturated in milk and jīvanīya
group of drugs is beneficial;
14. I n vātaja mūtrakr̥cchra, snigdha sveda, lepa, seka and avagāha are indicated.
Ūṣma sveda
The other treatment processes which are in vogue at Kerala are:
patra poṭṭala sveda,
jaṃbīra poṭṭala sveda,
dhānya poṭṭala sveda and
cūrṇa poṭṭala sveda.
ऊ+ा तू ~ािरकालो9 कपालोपलपां स

िभः।
प4भ\ेन धाFे न करीष िसकता त

षै ः॥
अने कोपाय स~8ै ः 9यो7ो दे शकालतः।
A.H.Su. 17/6
Some of the materials used for ūṣma sveda are:
utkārikā - It is a ball-like cake prepared by boiling
grains or pulses and seeds like atasī, kusuṃbha etc.
loṣṭa - earthen lump
kapāla - brick fragments
upala - stone
pāṃsu - sand
patrabhaṅga - chopped leaves
dhānya - grains and pulses
karīṣa - dung of cow and other animals
sikatā - gravels
tuṣa - husk.
Patrapoṭṭala sveda
The process of sudation using a bolus of chopped leaves is called patrapoṭṭala sveda.
This procedure is extension of the verse ‘patrabhaṅgena’ in ūṣmā sveda. Śridāsapaṇḍita
explain that patrabhaṅga refers to a cluster of chopped leaves and sprouts.
प4भ\ेन छद समू हे न।
Aruṇadatta.
तथा प4भ\ेन प4ाणां भ\ः समू हः, प4भ\ः िनकृ ¬िकसलय समू हः। Śridāsapaṇḍita
A direct reference regarding patra poṭṭala sveda is available in the traditional text of
Kerala, Ārogya kalpadruma, under the context of vātavyādhi cikitsā.
िशR

िच¾ाक िनग
ु 7डीवरणै र7डप§वै ः अFै वा त~मै िH7ै ~ै लि~7ै Hके रकै ः।
कापा सिपि7डकाः कृ ~ा तािभ~8ािभरे ववा सUे हपा4े स~8े िनि¬8ािभमु çमु çः॥
A.K.D. 17/36,37
The leaves of the following plants are usually used for this purpose, either entirely or
selectively as necessary:
eraṇḍa - Ricinus communis Linn.
arka - Calotropis gigantica R.Br
Dhattūra - Datura metel.Linn.
nirguṇḍī - Vitex nigundo Linn.
śigru - Moringa oleifera Lam.
varaṇa - Crataeva religiosa Forst.
vāsa - Adhatoda vasica Nees.
karañja -Pongamia pinnata(Linn)
vr̥kṣāmla - Tamarindus indica Linn.
Method of preparation
The fresh leaves are cut into small pieces and fried in a pan with grated coconut
and a suitable medicated oil till it assumes a brownish colour. In certain cases,
powdered drugs may also be added. This mixture is divided into two or four equal
parts, added into the pieces of cloth and tied in the form of a bolus with a tuft of
cloth above it to hold.
Some of the clinical conditions where patrapoṭṭala sveda is indicated are:
• patrapoṭṭala sveda with castor leaves and coconut gratings is beneficial
in painful state of āntravr̥ddhi
• sveda with the leaves of tamarind and coconut gratings is indicated in
udāvarta
• the same poṭṭala is also beneficial in pakṣāghāta and sarvāṅga vāta
• the sudation with the leaves of castor is indicated in kaṭīgraha
• in pārśvaśūla, poṭṭala sveda with arkapatra is applied after anointing
either with dhānvantara taila, kṣīrabalā taila or vātāśanī taila.
Vālukāsveda
The sveda from vāluka is also a variety of ūṣma sveda.
In the early texts the vālukāsveda is indicated for sannipātajvara; and in the
later texts it is extended to other conditions like āmavāta. Vālukāsveda is one
of the primary treatment processcess in tridoṣaja jvara and in vātakapha jvara
The purpose of its indication is mainly to eradicate the kapha, by which the
pitta and vāta can be pacified easily. By the depletion of kapha the channels
get clarified resulting in lightness of the body.
It is in Bhāvaprakāśa and later texts that the vālukā sveda is indicated in the
treatment of āmavāta.
1. Udvartana with tvak, patra, rāsnā, aguru, śigru, kuṣṭha, vacā and śatāhvā triturated
in dhānyāmla cures khallī and visūcikā.
2. Udvartana with the paste of siddharthaka, rajanī, prapunnāṭa , tila mixed in oil is recommended
in śītapitta.
3. Elādi gaṇa is also used for udvartana.
4. Udvartana with picumana and other drugs is indicated in ūrustambha.
5. Nimbādi and mustādi udvartana formulations are also mentioned. Udvartana with the leaves of
āragvadhā, kākamācī triturated in buttermilk is mentioned in kūṣṭha.
6. In sidhma, udvartana with the friut of dhātrī, sarjarasa, pākya (yavakṣāra), triturated in sauvīra
is beneficial.
7. Rūkṣā udvartana is advocated in prameha.
8. In kṣaya, udvartana with the paste of aśvagandha, apāmārga, nākulāī, gaurasarṣapa, tilā and
bilva is indicated.
9. Udvartana with burnt turmeric removes the bad odour of the body
10. Udvartana with tila and other drugs cures the bad odour caused by vitiated medas.
7. In sidhma, udvartana with the friut of dhātrī, sarjarasa, pākya (yavakṣāra), triturated in
sauvīra is beneficial.
8. Rūkṣā udvartana is advocated in prameha.
9. In kṣaya, udvartana with the paste of aśvagandha, apāmārga, nākulāī, gaurasarṣapa, tilā
and bilva is indicated.
10. Udvartana with burnt turmeric removes the bad odour of the body
11. Udvartana with tila and other drugs cures the bad odour caused by vitiated medas.
Na amulaṃ likhyate kiñcit na anapekṣita muchyate
Śubhaṃ

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