Ayurveda emphasizes the individualized treatment which is based on assessment of dasa-vidha pariksya bhavas (ten factors of examination).These have been deacribed in Caraka Samhita in relation to pancakarma therapy. In this book, an efforts has been made to incorporate all the required examinations (like dosa, bhasaja, desa, kala, satmya etc.) needed prior to various pancakarma treatment under these dasa- vidha pariksya bhava. Purpose of the writing is to throw light on the basic principles of Ayurveda in more practical and comprehensive manner through examples of pancakarma which will certainly beneficiate the physician during treatment.
The principles of Ayurveda are valid when practiced properly. The quantitative results of principles are well versed in the compendium. Any theoretical concept is adopted in medical sciences once it has proven its therapeutic applicability. The resultant of an epic theory is differentiated classically in context in to the study of pancakarma, but is specifically illustrated in relation to (dasa-vidha pariksya bhava) or ten points of examination for its clinical application. Pancakarma is now accepted as a practice resulting in palatable curative and preventive effects and is accepted by society maintain a healthy life.
Many clinical books have been written on pancakarma from the perspective of being a reference in practice, but the in-depth insight on pancakarma with respect to its basic principles has never been classified in any published works. The book entitled “Pancakarma Siddhi” authored by Dr. Nitin Jindal is one of its. Kinds. The basic principles have been justified with proper analysis, and at the same time presented with practical applicability. It is my sincere hope that this literary work will be helpful to researchers, students, scholars and scientists interested in the field of Ayurveda, looking to achieve the fruitful potential of the branch of pancakarma, presented herewith from a fresh perspective.
Purification of body by way of elimination of vitiated dosas helps to alleviate the disease in same manner as uprooting a tree which nullifies its chance of re-growth. That is why sodhana cikitsa (purification therapy)is considered a better than samana cikitsa (palliative treatment). In the present time, pancakarma is the most demanded modality of Ayurveda that can be used for treatment of acute as well as chronic diseases. Although it is widely used all over India and some other parts of the world, yet it has not gained its desired status of mainstream treatment. Probably this is because of the fact that these therapies are done either casually or many misnomer therapies are practised in the name of pancakarma which some people use to make money out of it by promoting it as a treatment modality for incurable diseases also. Cakrapani has clearly mentioned that pancakarma therapies are effective only in curable diseases. So, such selfish acts are just defaming this noble science in a serious manner.
Body is considered as part of cosmos having vata, pitta and kapha as representative of wind, sun and moon respectively. To treat a curable disease, treatment should be employed after proper assessment of dosa, bhesaja, desa, Kala, bala, sarira, ahara, satmya, sattva, prakrti and vaya. As each body is different in respect to these said factors, individualized treatment is always better in comparison to generalized treatment. But is commonly observed observed that almost everywhere pancakarma is in a generalized manner with fixed protocols and combination of medicines. This type of approach, though provides satisfaction of doing something in the name of pancakarma, always hampers the best possible outcome of treatment. The classics are abound with lots of combinations of medicines that should be used precisely in specific disease condition. To use them accordingly, the examination of the above said factors is necessary. Though exact assessment of the permutation and combination of all these factors is not possible even to a brilliant, yet it is also not ethical for a good physician to bind himself with fixed protocols. So, to achieve success, physician should plan treatment after assessing these factors as much as possible rather treating a disease in a generalized manner.
This book is based on assessment of dasa-vidha pariksya bhava (ten factors of examination) which make foundation of success of any venture. These have been described in Caraka Samhita in relation to pancakarma therapy itself. Here an effort has been made to incorporate all the required examinations needed prior pancakarma treatment (like dosa, bhaisaja, desa, kala etc.) under these dasa-vidha pariksya bhava. Purpose of this writing is to throw light on the subject in more practical and comprehensive manner that may beneficiate the physician during pancakarma treatment.
Some of the concepts mentioned in this book may be found repeated on various places. This is due to the fact that these factors work individually as well as in combination to each other. For the sake of better understanding of the subject, it became imperative to put them at relevant places so that their importance can be emphasized. Though raktamoksana is a part of sodhana cikitsa, it has not been included under title pancakarma in any of the ayurvedic classics. As these days it is also practised as part of pancakarma therapy, parallel topics related to raktamoksana has been included in this book to make it helpful for readers. At the end of the book, an annexure has been added having some useful informations which were not possible to include in the main text. References from Jalpakalpataru commentary of Caraka Samhita has been mentioned as the verse no. As depicted in Cakrapani’s commentary edited by Y.T. Acharya as primary one and then the same from Gangadhara commentary edited by Kaviraja N.C. Sengupta and U. Sengupta within the bracket. Hope this effort of the author will encourage the students as well as ayurvedic physicians to become more responsible in their approach towards pancakarma treatment.
Efforts are always made to achieve success but nobody can be sure about the result. This holds well with treatment of disease also, where no certainty exists regarding its effectiveness in a particular condition. Failure of treatment is alwaya related with lack of knowledge or improper planning. In the field of medicine, even a minute error may harm patient’s health in a significant manner. Although introspection helps to find out the faults occurred treatment but it is of no use when treatment has already failed. Thus, before starting any treatment; proper examination is advised to get acquainted is advised to get acquainted with the actual status of patient and his disease. To get the all-round knowledge of disease and patient, physician should examine them through pratyaksa (perceptual), anumana (inferential) and aptopadesa (instructions) pramana.
Maintaining the state of health and attainment of equipoise state of dosas in a diseased condition is the aim of Ayurveda. There is nothing in this world that condition is the aim of Ayurveda. There is nothing in this world that can not be used as medicine when prescribed with proper planning. But, even same medicine may react differently in different patients as each of them is specific in bala, sarira, ahara, satmya, sattva, prakrti, vaya etc. For example, madhu (honey) is itself tonic but becomes fatal when used with equal quantity of ghrta; useful in kapha prakrti but harmful in persons having vata prakrti; good for children and young but harmful to old persons; wholesome in winter but not in summer; wholesome to persons inhabiting the anupa desa but not to jangala desa; small quantity of it works for health but excess in harmful; ama condition presented due to it causes serious consequences because of its antagonist treatment; on consuming it with kakamaci and ripe fruit of nikuca, it causes loss of strength, complexion, energy and luster or even death; and it work in a specific manner when combined with other material.
An ideal treatment is one which alleviates the present disease and does not produce any new disease. Any treatment even being wholesome does not hold good if employed at wrong time, in lesser or excessive amount or given in an un-prescribed manner. So, after examining the disease with panca-vidha nidana, medicines should be prescribed after due consideration of dosa, bhesaja, desa, Kala, bala, sara, ahara, satmya, sattva, prakrti and vaya.
Pancakarma includes five therapies viz., vamana, virecana, niruha basti, anuvasana basti and nasya karma, each of which is preceded and followed by some other therapies know as purva-karma (snehana-svedana) and pascata-karma (samsarjana karma, samana cikitsa, rasayana, vajikarana etc.). Before commencement of any of these therapies, determination of the above said factors is crucial because therapy or medicine used for it may have to be altered in respect to patient, Kala, dosa etc. For example, according to season, tiksna, madhyama or mrdu basti should be used in cold, moderate and hot season respectively; mrdu, Madhya or tiksna basti is used in patients having mild, moderate or strong body strength; depending on dosas, tiksna, madhya or mrdu basti is used in kapha-vata, kapha-pitta or pitta-rakta condition. Besides that consideration of kostha and disease is also essential before usinf basti.
The number of these factors are somewhat different at different places but cakrapani has clarified that dosa, ausadha, desa, Kala, satmya, agni, sattva, oka, vaya and bala are the ten factors which should be examined before any treatment. Factors like ahara, sarira, prakrti, sara and vikara mentioned on other places can be included under these ten parameters itself. As term desa stands both for bhumi desa (habitat) as well as atura desa (patient), examination of sarira, sara and prakrti are incorporated in desa itself. Ahara is considered under satmya. Inclusion of vikara as one of the examining factor has been given separately when considering these factors for virecana. But this can be incorporated under examination of dosa as well.
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