Ayurpharm Int J Ayur Alli Sci., Vol. 5, No. 3 (2016) Pages 34 – 39 www.ayurpharm.com ISSN: 2278-4772

Review Article

CRITICAL REVIEW ON VISHRAMKALA (GAP DAYS) IN PANCHAKARMA

Rajkala Ramteke*

Assistant Professor, Dept. of Panchakarma, I.P.G.T.&R.A., Gujarat Ayurved University, Jamnagar, Gujarat, India.

Received: 30-01-2016; Revised: 29-03-2016; Accepted: 31-03-2016 ………………………………………………………………………….………….……….……………………..

Abstract

In Panchakarma (five purificatory procedures) particular order should be followed. After Snehapana (internal oleation), (external oleation) and Swedana (fomentation) should be done for specific time duration then only Panchakarma can be administered. After Snehapana or Samyak Snigdha Lakshana (getting proper oleation characters), there is a variation in duration of Abhyanga and Swedana classically and practically. Also there are different opinions among the Acharyas regarding Vishramkala (gap days). So this manuscript is to exemplify the concept of Vishramkala from Brihatrayi and the commentators for (purification) therapy.

Key words: Abhyanga; Gap day; Panchakarma; Snehana; Vishramkala.

………………………………………………………………………………….….……………………………...

*Address for correspondence: Dr. Rajkala S. Ramteke, MD., Ph.D. (Ayu), Assistant Professor, Dept. of Panchakarma, Institute for Post Graduate Teaching & Research in , Gujarat Ayurved University, Jamnagar, Gujarat – 361 008, India Email id: [email protected]

Cite This Article

Rajkala Ramteke. Critical review on Vishramkala (gap days) in Panchakarma. Ayurpharm Int J Ayur Alli Sci. 2016;5(3):34-39.

Ayurpharm - International Journal of Ayurveda and Allied Sciences 34 Ayurpharm Int J Ayur Alli Sci., Vol. 5, No. 3 (2016) Pages 34 – 39 www.ayurpharm.com ISSN: 2278-4772

INTRODUCTION In Panchakarma specific series should be followed. After Snehapana, Abhyanga and According to Ayurveda, health is our natural, Swedana should be done for specific time balanced state. Ayurveda defines the many duration then only Panchakarma can be Panchakarma procedures, both internal and administered. After Snehapana or getting external those are beneficial to a balanced proper oleation characters (Samyak Snigdha state of human being. Ayurveda offers Lakshana - SSL) there is a variation in knowledge to increase awareness of the duration of Abhyanga and Swedana factors that may cause imbalance and ways to theoretically and practically. Among the create balance by regulating the systems of the Acharyas also some difference of opinions are body through Panchakarma. Today there is there. So this manuscript is to exemplify the need of genuine and authentic Panchakarma concept of gap days from Brihatrayi in support which will give better results than modifying of Shodhana purpose. schedule with subjects. Suitable time duration for specific procedure is most important in VAMANA Panchakarma. Appropriate time duration is explained for all Panchakarma that is After getting proper oleation (SSL) characters Asthapana Basti (decoction enema) should be irrespective of Koshtha, patient should be given in early hours of afternoon that is undergo for Abhyanga and Swedana for one Madhyanhe Kinchit Avarte,[1] Vamana day, that is emesis is to be administered one (emesis) should be given in morning hours day after the completion of Snehapana. The that is Purvahne.[2] Virechana (purgation) food prescribed during this interval of one should be given at the end of morning hours day is the same as indicated in the Snehapana. that is Shleshmakale Gate Dnyatva.[3] For Snehapana also, in Mrudu Koshtha it should Charaka be given for 3 days, for Madhyama (Moderate type of intestinal constitution) - 5 days and Chakrapani commented on the same that on for Krura Koshtha (Strong type of intestinal the 1st day of gap day i.e. one day after getting constitution) - 7 days.[4] In cold season SSL, diet should be similar to the diet given (Shishir and Hemant) unctuous enema should during oleation that is Drava (liquid), Ushna be administered in day time whereas in hot (hot) and meat soup along with rice.[6] season (Sharad and Grishma) in night time.[5] In Kalpashthana, Charaka depict that the Vishramkala is the time period between person who has to undergo for emesis purificatory oleation therapy and purificatory procedure, oleation and fomentation should be procedure. It is also called as gap days. It is performed for two or three days. On the different for emesis and purgation therapy. For previous day of emesis, if subject is emesis it is the time period of one day where adequately oleated and fomented then only as for purgation it is of three days but there are Kapha exciting diet should be given. On the some differences of opinion among the next day morning emesis drugs should be Aacharyas and commentators. In practices administered.[7] also many physicians cut off the gap period due to lack of time or to shorten the elongated Chakrapani enlighten the Charaka’s opinion purificatory procedures. It can understand that about Dvaham (two days) and Tryaham (three due to hectic life style nobody is having time days) that after getting SSL patient should for classical Panchakarma. So this manuscript undergo for external oleation and fomentation aimed to put light on different opinions either for two days or three days irrespective regarding gap days and the need of the same. of time taken for the proper oleation. It may be

Ayurpharm - International Journal of Ayurveda and Allied Sciences 35 Ayurpharm Int J Ayur Alli Sci., Vol. 5, No. 3 (2016) Pages 34 – 39 www.ayurpharm.com ISSN: 2278-4772

3, 5 or 7 days which clarifies the gap period is Indu commentary the unchanged. Indu commented that after getting proper The duration of external oleation and oleation symptoms two days interval should fomentation should be decided by the be there before emesis. On 1st day, patient physician using Yukti (intellect and should be administered warm, thin soup interpretation) or after assessing the condition prepared from the meat of animals living in of patient because Charaka has already desert like regions, added with fatty materials instructed as either 2 or 3 days. along with sudation should be given. On the next day, to vitiate Kapha, the food which If the condition of patient or Utkeshanavastha cause increase Kapha such as sesame, black is permitting external oleation and gram, curds, milk, jaggery, fish and meat soup fomentation can be done for 3 days. It can be should be given. On 3rd day emesis should be calculated as first day is last day of internal performed. oleation, 2nd day is gap day and 3rd day is the day on which emesis is to be performed. Ashtanga Sangraha

Sushruta To perform Vamana Karma, person has to consume similar meat soup for one day only. The patient having been oleated and fomented On next day, person has to take food which and when it is observed that are enhances the quantity of Kapha . On loosened or vitiated Doshas goes upwards by third day, emetics should be administered.[10] intake of various soft (slimy) food items it moves out properly. On next day, emetic According to Arundutta drugs should be administered.[8] After getting proper oleation symptoms, on Dalhana commentary the next day, the diet should be liquid, warm, thin soup prepared from the meat of animals Dalhana commented on above cited lines that living in desert like regions, added with fatty in the temperate season, on the previous day materials along with sudation. On 2nd day, of Vamana patient should take diet as soft patient should take diet like black gram, fish with Abhishyandi (slimy) and Gramya, Anupa and sesame and on 3rd day emetic drugs (marshy land) and watery animals flesh, milk should be given. and black gram etc. On the next day in the morning Vamana should be administered. VIRECHANA

Ashtanga Hridaya Virechana (purgation) should be administered 3 days after the completion of the oleation After one more day of oleation therapy and therapy. another day with foods which cause increase of Kapha. Such as Tila (sesame), Masha Charaka (black gram) Dadhi (curd), milk jaggary (molasses) fish and meat soup, the person can Chakrapani says that after getting SSL or after be given Vamana. The Vishramkala or gap completion of internal oleation therapy, days should be two. On third day Vamana can patient should wait for 3 days and on 4th day, be given.[9] Virechana should be administered.[11]

Ayurpharm - International Journal of Ayurveda and Allied Sciences 36 Ayurpharm Int J Ayur Alli Sci., Vol. 5, No. 3 (2016) Pages 34 – 39 www.ayurpharm.com ISSN: 2278-4772

Sushruta massage should be done along with Swedana for two or three days that is on the day when Sushruta stated as, purgation should be given Snehapana is completed, gap day and the day after the 15 days of emesis. Dalhana clarifies on which Vamana is to be administered. that after emesis, 6 days Samsarjana Karma Dalhana mentions that Doshas which are (special diet pattern after Purification) will be lodged in the shakha (extremities) are made to given followed by next 6 days of Snehapana move towards the Kostha by means of as a preliminary preparation of purgation. The Snehana and Swedana, Charaka states that, remaining 3 days are Vishramakala. That fomentation liquefies the morbid matter which means on the 4th day of SSL, purgation should is stuck up in the minute channels of the body be given which is similar to the Charaka’s of the person who has undergone oleation opinion.[12] therapy.[15] Vagbhata mentions that, the waste products are removed from the body by Ashtanga Sangraha oleation and fomentation in the same way, as the dirt of cloth is removed with the help of The patient should be administered warm, thin soap and hot water.[16] Before performing soup prepared from the meat of animals living Vamana Karma it has been clearly mentioned in desert like regions added with fatty that patient should take rest for one day after materials. The patient had been oleated and internal oleation therapy.[17] On that day, the fomented when it is observed that Doshas are patient should be given the diet which has loosened or vitiated after 3 days of such Utklesha (kapha increasing) property. In treatment should be given purgation Sushruta Samhita,[18] it has been stated that the therapy.[13] diet to be taken before the day of Vamana should be Abhisyandi. Dalhana comments that Indu commentary this particular diet should be administered to serve the purpose of Kaphaotklesha.[19] It has After getting proper unctuous symptoms, if been narrated in Charaka Samhita that, this physician is planning for Virechana without type of diet must be taken on the previous performing Vamana previously then also he night of performing of Vamana Karma. It should wait for 3 days or perform Virechana increases the Kapha and Kleda and thus on 4th day. Doshas start to flow towards the Kostha.

Ashtanga Hridaya What happens in the body during this gap days? After administration Sneha properly, the person has to take hot, fatty and liquid meat The aims of gap days may be different soups for a period of three days, then he regarding type of Shodhana. should be undergo Swedana Karma for a period of three days. The next day, he may In Vamana, there are 3 goals which should be take purgative.[14] attain during this period that is

DISCUSSION  To give rest to the body after the tiresome procedure of Snehapana. There must be a gap of one day between the  To prepare patient’s body for further last day of Snehapana and the day of Vamana purification karma, where the patient should be subjected  Maintain or prepare Doshavastha in to massage and Swedana. Chakrapani while the body. elaborating Snehana and Swedana states that  Helps in the further procedure.

Ayurpharm - International Journal of Ayurveda and Allied Sciences 37 Ayurpharm Int J Ayur Alli Sci., Vol. 5, No. 3 (2016) Pages 34 – 39 www.ayurpharm.com ISSN: 2278-4772

In case of Virechana, these goals are The reason behind the gap days is to prepare body for Shodhana. The Doshavastha should  To decrease the Utkleshana of Kapha be maintained or applicable for Shodhana (Vriddhi) this was increased during because the person with excessively Snehapana. aggravated Kapha vomits without any  Maintaining the Doshavastha as Hina difficulty and the person having less Kapha and Pitta Vriddhi aggravated Kapha purgates well. However if  Helps in further procedure by there is less of kapha than the medicine cause preventing complications as Vamana purgation through the downward tract and in happens after giving the Virechana the case of aggravated Kapha the purgative Aushadha.[20] medicine causes emesis through the upward [21] tract. Probable mode of action Snehana and Swedana Karma are performed First of all by the Purvakarma, when internal as Purvakarma to various Shodhana therapies. oleation is done, it goes upto the cellular level The following actions are done by it. where the greasiness of the body parts (Gatra Snigdhata), soft feelings of the body parts  It increases the Apyamsha (liquid) of (Gatra Mardavta), oiliness of the skin (Tvaka the body. Singdhata ) like proper oleation characters are  It acts as solvent. produced. Dosha becomes loosen at cellular  It brings the lodged morbid and level by Snehana. Many substances, which are unexcreted waste products to gastro- deposited at cellular level, they become loosen intestinal tract. by the Snehana. By the act of Abhyanga and Swedana loosen substance becomes mobilized CONCLUSION and it comes in to the blood circulation. Vamana is always done with full stomach so Though Vagbhata commentator has difference the pyloric end of stomach is closed. The site of opinion about gap days before emesis, but of action of Vamana is Amashaya (stomach) Caraka and Sushruta opinion should be which is mentioned as a place of Kapha. By followed. Practically it not gives any the act of Vamana drug, which is having impression to wait for two days. Doshavastha Ushna (hot), Tikshna (strong), Aashukari will be modifying. So it can be concluded as (Immediate acting), Vyavayi, Vikasi Vamana should be administered after one day properties may acts by two ways, first gap and Virechana after 3 gap days for getting produces medically induced mild proper effect. inflammation by its Ushna, Tikshna properties at organ level i.e. stomach and second, REFERENCES stimulates the vomiting centre of brain with its Aashukari, Vyayayi and Vikasi properties. At 1. Vagbhata. Ashtanga Hridaya (Sarvanga stomach level when inflammation occurs, the Sundara commentary of Arunadatta and Ayurveda of Hemadri). Harishastri permeability of blood vessels is increased and Paradkar, editor. 1st ed. Varanasi: the Dosha which are already come into blood Chowkhambha Krishnadas Academy; 1995. steam by the help of Purvakarma, they come Sutra Sthana, 19/36.p. 277. to stomach. This process is compared with the 2. Vagbhata. Ashtanga Hridaya (Sarvanga process of where Dosha comes, in Koshtha Sundara commentary of Arunadatta and Ayurveda Rasayana of Hemadri). Harishastri from the extremities. By the act of vomiting Paradkar, editor. 1st ed. Varanasi: they can thrown out from the body.

Ayurpharm - International Journal of Ayurveda and Allied Sciences 38 Ayurpharm Int J Ayur Alli Sci., Vol. 5, No. 3 (2016) Pages 34 – 39 www.ayurpharm.com ISSN: 2278-4772

Chowkhambha Krishnadas Academy; 1995. Jadavaji Trikamji Acharya, editor. 9th ed. Sutra Sthana, 18/13, p. 263. Varanasi: Chaukhamba Orientalia; 2007. 3. Vagbhata. Ashtanga Hridaya (Sarvanga Chikitsa Sthana, 36/51. p.531. Sundara commentary of Arunadatta and 13. Vriddha Vagbhata. Ashtanga Sangraha Ayurveda Rasayana of Hemadri). Harishastri (Sasilekha commentary of Indu). Sharma SP, Paradkar, editor. 1st ed. Varanasi: editor. 1st ed. Varanasi: Chowkhamba Chowkhambha Krishnadas Academy; 1995. Krishnadas Academy; 2006. Sutra Stahna, Sutra Sthana, 18/13, p.266. 25/44. 4. Charaka. Charaka Samhita (Ayurved Dipika 14. Vagbhata. Ashtanga Hridaya (Sarvanga commentary of Chakrapanidatta). Jadavaji Sundara commentary of Arunadatta and Trikamji Acharya, editor. 1st ed. Varanasi: Ayurveda Rasayana of Hemadri). Harishastri Chaukhamba Krishnadas Academy; 2006. Paradkar, editor. 1st ed. Varanasi: Siddhi Sthana, 1/6. p. 267. Chowkhambha Krishnadas Academy; 1995. 5. Charaka. Charaka Samhita (Ayurved Dipika Chikitsa Sthana, 16/34-35. p. 703. commentary of Chakrapanidatta). Jadavaji 15. Charaka. Charaka Samhita (Ayurved Dipika Trikamji Acharya, editor. 1st ed. Varanasi: commentary of Chakrapanidatta). Jadavaji Chaukhamba Krishnadas Academy; 2006. Trikamji Acharya, editor. 1st ed. Varanasi: Siddhi Sthana, 1/22. p. 681. Chaukhamba Krishnadas Academy; 2006. 6. Charaka. Charaka Samhita (Ayurved Dipika Siddhi Sthana, 1/7. p. 678. commentary of Chakrapanidatta). Jadavaji 16. Vagbhata. Ashtanga Hridaya (Sarvanga Trikamji Acharya, editor. 1st ed. Varanasi: Sundara commentary of Arunadatta and Chaukhamba Krishnadas Academy; 2006. Ayurveda Rasayana of Hemadri). Harishastri Sutra Sthana, 13/80. p.86. Paradkar, editor. 1st ed. Varanasi: 7. Charaka. Charaka Samhita (Ayurved Dipika Chowkhambha Krishnadas Academy; 1995. commentary of Chakrapanidatta). Jadavaji Sutra Sthana, 18/58. p. 270. Trikamji Acharya, editor. 1st ed. Varanasi: 17. Charaka. Charaka Samhita (Ayurved Dipika Chaukhamba Krishnadas Academy; 2006. commentary of Chakrapanidatta). Jadavaji Kalpa Sthana, 1/14. p.654. Trikamji Acharya, editor. 1st ed. Varanasi: 8. Sushruta. Sushruta Samhita Chaukhamba Krishnadas Academy; 2006. (Nibandhasangraha commentatry of Dalhana). Sutra Sthana, 13/81. p. 86. Jadavaji Trikamji Acharya, editor. 9th ed. 18. Sushruta. Sushruta Samhita Varanasi: Chaukhamba Orientalia; 2007. (Nibandhasangraha commentatry of Dalhana). Chikitsa Stahna, 33/7. p.516. Jadavaji Trikamji Acharya, editor. 9th ed. 9. Vriddha Vagbhata. Ashtanga Sangraha Varanasi: Chaukhamba Orientalia; 2007. (Sasilekha commentary of Indu). Sharma SP, Chikitsa Sthana, 33/6. p. 515. editor. 1st ed. Varanasi: Sanskrit Series Office; 19. Sushruta. Sushruta Samhita 2006. Sutra Stahna, 25/56. (Nibandhasangraha commentatry of Dalhana). 10. Vagbhata. Ashtanga Hridaya (Sarvanga Jadavaji Trikamji Acharya, editor. 9th ed. Sundara commentary of Arunadatta and Varanasi: Chaukhamba Orientalia; 2007. Ayurveda Rasayana of Hemadri). Harishastri Chikitsa Sthana, 33/6. p. 516. Paradkar, editor. 1st ed. Varanasi: 20. Charaka. Charaka Samhita (Ayurved Dipika Chowkhambha Krishnadas Academy; 1995; commentary of Chakrapanidatta). Jadavaji Sutra Sthana, 16/36. p.251. Trikamji Acharya, editor. 1st ed. Varanasi: 11. Charaka. Charaka Samhita (Ayurved Dipika Chaukhamba Krishnadas Academy; 2006. commentary of Chakrapanidatta). Jadavaji Siddhi Sthana, 1/9. p. 678. Trikamji Acharya, editor. 1st ed. Varanasi: 21. Charaka. Charaka Samhita (Ayurved Dipika Chaukhamba Krishnadas Academy; 2006. commentary of Chakrapanidatta). Jadavaji Sutra Sthana, 13/80. p.86. Trikamji Acharya, editor. 1st ed. Varanasi: 12. Sushruta. Sushruta Samhita Chaukhamba Krishnadas Academy; 2006. (Nibandhasangraha commentatry of Dalhana). Siddhi Sthana, 1/13. p.679.

Source of Support: Nil Conflict of Interest: None Declared

Ayurpharm - International Journal of Ayurveda and Allied Sciences 39