Author: Dr. Ajai Kr. Pandey Department of Kayachikitsa, Faculty of Ayurveda Institute of Medical Sciences, Banaras Hindu University Varanasi

1. Concept of Bio-purification (Samshodhana)
Dr. Ajai Kr. Pandey
Department of Kayachikitsa, Faculty of Ayurveda
Institute of Medical Sciences, Banaras Hindu University
Varanasi

2. 2
Object:
Dhatusamya i.e. maintenance of homeostasis of Doshas, Dhatus and Malas.
How it is possible ?
1. Increasing the weakened Doshas.
2. Eliminating the increased Doshas.
3. Pacifying the excited or deranged Doshas.
4. Preserving the normal ones.
Basics of Ayurvedic Therapeutic

3. 3
Therapeutic Approach
1. In Samshamana therapy is palliative cure of various disorders
of body and mind.
2. While Samshodhana therapy is claimed to be a radical
therapy and is supposed to eliminate the vitiated Doshas and
Malas, causing disharmony in the body.
(Ch.Su. 16 : 20).

4.  To normalize deranged Doshas, Dhatus and Malas.
 To maintain healthy life.
 To cure disorders of body and mind.
 To promote vitality and vigor.
 To increase mental competence.
 To advise how to prevent oneself from Seasonal disorders.
Dr. Ajai Pandey, Assistant Professor, IMS, BHU, VNS.
4
Object of Samshodhana Therapy

5. 1. Vamana- therapeutic emesis
2. Virechana- therapeutic purgation
3. Anuvasana vasti- oil based enema
4. Asthapana vasti- decoction based enema
5. Nasya- nasa insufflation
5
Five Fold Bio-Purificatory Measures
(As per Charaka )

6. 6
Relation Between Panchakarma & Doshas
 Vamana - Kapha
 Virechana - Pitta
 Vasti - Vata
 Raktamokshana – Rakta
 Nashyakarma - VPK

7. Nasya Karma
Raktamokshana

8. 1. Purvakarma- preparatory procedure:
Pachana, Snehana and Svedana.
2. Pradhanakarma- bio-purificatory measures: It is consists of five fold
purificatory measures.
3. Pashchatakarma- post therapeutic regimens.
8
Steps of Samshodhana Therapy

9. 1.Deepana-& Pachana- Appetizers & digestants
2. Snehana-
*External massage
*Internal oliation
3.Svedana- Medicated fomentation.
9
Purvakarma- Preparatory Procedures

10. 1. Vamana Karma- -Therapeutic emesis
2. Virechana Karma- -Therapeutic purgation
3. Asthapana Vasti- - Dicoction basd enema
4. Anuvasana Vasti- -Therapeutic oil based enema
5. Sirovirechana- -Therapeutic Errhines
10
Pradhana Karma- Main procedures

11. I) Samsarjanakarma-
II) Shamana chikitsa-
11
Pashchatkarma: Post therapy regimens
- Dietetic regimens
- Rasayana therapy-
- Immuno-promotive regimens.
- Palliative therapy by diet and drugs.

12. 1. The origin and insertion of muscles.
2. Direction of the flow of blood circulation.
3. Direction of lymphatic drainage as well as the degree of adiposity.
4. Vital parts/joints/muscles/heart etc.
5. Nerve supply to the part under the treatment
6. Direction of hair follicles and hairs on the skin.
* The direction of massage should be reversed in clinical conditions associated with venous stasis.
12
Important Considerations at the Time of Abhyanga

13. 13
Effect of Adequate Massage
• To promote blood circulation & lymphatic circulation.
• Pacify the Vata dosha and its related disorder.
• Producing physical and mental relaxation.
• Providing tone to the muscle.

14. 14
Preliminary Procedure During Snehapana
1. Examination of Patient and disease .
2. Fixation of Dose of Sneha Dravyas ( Depends on Status of Koshtha).
3. Assess the status of Jatharagni.
4. Selection of Medicated oil or Ghrita for Snehana Karma.
5. Morning hr should be preferred for internal oleation.
6. Chanting of Mantras is strongly recommended prior to oleation.

15. 15
Commonly used Sneha Dravyas in Different Disorders
1. Panchtikta Ghrita- in skin disorders.
2. Brahmi Ghrita- in Mental disorders.
3. Vasa Ghrita-
4. Shunthi Ghrita-
5. Pippalyadi Ghrita-
6. Amrita taila-
in Bronchitis and Asthma.
in Rheumatic disorders.
in Gulma.
in Vatika disorders.

16. Day
Test dose
Krura koshtha
25 ml
Madhyama koshtha
10 ml
Mridu koshtha
5 ml
1. -50 -75 ml 25 -50 ml 10 -30 ml
2. 75 -100 ml 50 -75 ml 30 -60 ml
3. -100 -150 ml 100 -150 ml 60 -120 ml
4. -150 -200 ml 125 -175 ml -
5. -200 -250 ml 200 -250 ml -
6. -275 -300 ml - -
7. -350 -400 ml - -
Total 1200 -1500 ml 500 -700 ml 100 -210 ml
Practical Schedule Of Snehapana

17.  Increased digestives fire.
 Lack of eating desire of fat.
 Passing loose oily stool.
 Lightness in the body.
 Passage of flatus in due time.
 Smoothness in the body.
 Oleus skin. (C.S.Su. 13/58)
Effect of Adequate Snehapana

18.  30-45 minutes for Abhyanga
 30 to 45 minutes for Svedana karma.
Dr. Ajai Pandey, Assistant Professor, IMS, BHU, VNS.
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Time and Duration

19.  Disappearance of cold.
 Doshas become liquefied.
 Relief of pain & stillness.
 Increased appetites and relief from heaviness .
 Purify the body channels and Smoothness in the body.
 The accumulated Doshas will be mobilize form periphery to the central
parts of the body.
 Adequate sweating and Remission of the disease.
Beneficial effect of Svedana Karma

20. Main Moto of Poorvakarma Procedure
Vridhyah Vishyandnat Pakat
Srotomukha Vishodhanat !
Shakhah Muktah Malah Koshthamayanti
Vayoshcha Nigrahat !!
Charak

21. 1. Snehapana- 3 to 7 days (depends upon the Koshtha) and Svedana for 2- 3 days.
2. Sambhara Dravya-
 Assessing staff.
 Equipments and utensils.
 Suitable drugs for inducing
 Vamana and for managing complications.
Procedure of Vamana Karma

22. 3. Preparation of the patient
 Day before emesis diet that stirs Kapha is to be given e.g. -Fish, Milk, Curd, Rice etc.
 On the day before Vamana karma, apply oil on the head and whole body and perform
massage followed by Svedana.
4. Appropriate suggestion and assurance is given to the patient.
5. B .P. Pulse, P.R.HR. should be examined every half an hour during Vamana karma.

23. 1. Ask the patient to sit comfortably in an open armed chair and keep his
mind calm.
2. Given 250 ml Luke warm milk, before emetic drugs.
3. Madanaphala is considered as best emetic drug and which is commonly
used in clinical practice.
Methods of Vamana Karma

24. 4. Emetic Formulation to induce Vomiting
 Madanaphala Churna - 5-10 gms.
 Madhuyashthi Churna- 3- 5 gms.
 Vacha Churna- 1-2 gms.
 Rock salt 5-10 gms.
 Honey 20-40 ml.
(To make a paste, mix it in a glass of milk and ask the patient to swallow it.)
5. After that Dugdhapana is given up to full stomach.
6. Ask the patient to wait for 10 minutes.

25. Elimination of Malas and Vitiated Doshas in the Vomitus

26. 26
Randia Dumetorum
GLYCYRRHIZA GLABRA
Acorus calamus

27. 7. Clinical Observation during Vamana procedure
 Sweating on forehead, arm & chest.
 Roma Harsha – horripillation.
 Flatulence in the abdomen.
 Excessive salivation.
 Feeling of Nausea.
 Emesis-which is continued up to Pittanta.

28.  If Vamana does not occur spontaneously one should trickle the finger in
the throat to induce Vamana.
 If this also fails Madanphala, madhu yoga should be given up to definite
Vamana.
 If this fails, Ryles tube aspiration and mechanical stomach wash should be
carried out.
 Medicated smoke is given after Vamana therapy.
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Important Suggestions

29. Vamana Hina Shuddhi
Low
Madhyama suddhi
Medium
Pravara Suddhi
Maximum
No. of Bouts 4 6 8
Total quantity 1 Prastha-
325 gm
1½ Prastha-
650 gm
2 Prastha-
1.3 Kg.
Other Factors Kapha
elimination
Kapha elimination Kapha + Pitta
elimination
29
Criteria For Effective Vamana

30.  Malas/Doshas should be eliminated.
 In last bouts eliminations of Pitta is must.
 Mental and sensorial wellbeing.
 Purification of body channels.
 Lightness of the body
 Pacify specific disorder, related to Kapha dosha and Pitta Dosha.
Features Of Adequate Vamana

31. 1. Diarrhea :Patients B P & Pulse have to be monitored.
 No need of active management.
 If it is persists, administer electrol powder/salt and i.v. fluids if necessary.
2. Vomiting of blood:
 Stop procedure.
 Haemostatic drugs may be used if needed.
Contd----
Common Complication of Samshodhana and its Management

32. 3. Excessive vomiting:
• Manage fluid & electrolyte. Anti emetic measures should be used.
4. Neurological Pain:
• Sanjeevani vati, Doshamulaghana vati,Godanti Bhasma .
5. Pain in abdomen:
• Hinguvadi, Shankha, Lahshunadi vati.
6. Burning sensation in abdomen:
• Kamadhudha, Sutashekhara rasa, Shankha Bhasma, Dhatri Lauha etc.
7. Constipation:
• Used mild laxative.

33. 1. Vamana karma: for Kapha Dosha and Kapha related disorders.
2. Virechana karma: for Pitta Dosha and Pitta related disorders.
3. Vasti karma: for Vata Dosha and Vata related disorders.
4. Nasya Karma: for disorders of ENT and Head.
5. Raktamokshana: for Rakta Dosha and Vitiated Rakta related disorders.
Indications of Samshodhana

34. • Chest injury and chest pain.
• Excessive obesity.
• Childhood, Old age & in Pregnancy.
• Excessive coitus.
• Weak and tired person.
• Hemorrhagic disorders,
• Heart diseases.
• Anuria, Severe.
Contra-indications of Samshodhana

35. The combined efforts of these measures are known as Samshodhana
therapy. The basic aim is not only to clean the body but also aims to
eliminate the disease state as well as check the process of disease.
Conclusion