Charak Samhita – Sutrasthana – Chapter 14 (Swedadhyaya)

Abstract

This chapter discusses the technique known as sudation (Swedana, or therapeutic sweating), which is typically used following oleation therapy. The process of swedana (sudation) involves making someone sweat for therapeutic purposes. It is regarded as a crucial precursor for Panchakarma, a five-procedure purifying therapy in Ayurveda. Swedana is contraindicated in pitta diseases and is used to eliminate elevated vata and kapha dosha. Physical stamina, the seriousness of the dosha, the season, the location, the person’s age, etc. all affect how much and how intensely swedana occurs. For swedana karma, there are precise recommendations and prohibitions, and the recommended signals must be properly adhered to during the procedure. Sagni sweda, or sweating induced with the aid of fire, and niragni sweda, or sweating induced without the use of fire, are two general categories for the various substances that cause perspiration. Some of the highly popular swedana procedures are tub fomentation, poultice fomentation, bolus fomentation, and steam fomentation. There are ten techniques without fire and thirteen different types of fomentations that use direct heat from fire. So in this section, we will discuss the Charaka Samhita Sutrasthana chapter fourteen Swedadhyaya in brief.

Introduction

Soma and agni, which stand for the creators of cold and hot energy, are said to be essential to the universe’s operation according to Ayurveda. Together, uttarayana (The northward sojourn of the sun) and dakshinayana (The southbound sojourn of the sun) are in charge of preserving the planet’s homeostasis. The idea of loka purusha samanya siddhantha (That the individual is a microcosm of the cosmos, the macrocosm) states that this balance is also reflected in the individual. This energy is ingested by the purusha (Particular human being) and constrained as pitta in the body (Sharira). The ushmanattva (Core body temperature) of the body is controlled or, more precisely, is regulated by this pitta. It is in charge of digesting at the gastrointestinal level as well as all cellular metabolic functions. The agni concept is applied in therapy by Swedana. This chapter describes the practical administration of swedana procedures, as well as the indications, contraindications, and difficulties or complications related to their medical treatment.

Significance Of Swedana

The various sudational methods will now be explained. If the sickness has been identified as one of the illnesses that can be treated by making someone sweat, a properly given sudation can treat a variety of disorders with vata and kapha origins. Especially after oleation, administering sudation regulates vata dosha and prevents blockage of faeces, semen, and urine. Why not a person if oleation and sudation might moisten dried-out timber?

Scope Of Swedana

Effective sudation is which neither excessively hot (Uncomfortable) nor excessively mild (Insufficient), given with appropriate medications, applied according to the illness condition, season, and the afflicted individual in particular, at the impacted and the recommended body part. In diseases due to cold and strong persons strong fomentation is prescribed. In weak and medium persons it should be mild and medium respectively. Fomentation is beneficial in vata-kapha or vata or kapha. That should be unctuous-rough, unctuous and rough respectively.

Mode Of Swedana According To Dosha Site

In case of vata located in amashaya (Stomach) and kapha located in pakvashaya (Colon), fomentation should be followed by rough and unctuous measures respectively.

Sensitive Body Areas For Swedana

Testicles, heart, and eyes should not be fomented or, if necessary then should be mildly fomented. In groins medium type of fomentation should be applied. In remaining parts of the body, fomentation should be applied as necessary.

Pre Fomentation Care

Prior to beginning sudation, the eyes should be covered with clean cloth or circular pieces of moistened wheat flour or flowers of lotus, water lily and palasa (Silk cotton).

Care During Fomentation Therapy

The cordial region of the person subjected to fomentation should be touched with cool pearl necklaces, cool utensils, lotus flowers or hand wet with water.

Indications For Discontinue Fomentation

Fomentation should be stopped when cold and pain subsides, stiffness and heaviness are controlled, softness and sweating produced.

Excessive Sudation Symptoms And Its Management

Vitiation of pitta, malaise, fainting, burning sensation, thirst, weakness of organs and voice-these are the symptoms of excess fomentation. In such cases, the regimen prescribed for the summer season in the chapter of Tasyashiteeya etc., particularly sweet, cold and unctuous should be followed.

Contraindications Of Fomentation

Fomentation should not be applied to those who are described below:-

• Habitual users of medicinal extracts and wine
• Pregnant ladies
• Internal haemorrhage
• Pitta predominance person
• Diarrhoea
• Rough persons’
• Diabetes
• Having burns
• Prolapse and inguinal hernia
• Having complications of alcohol and poison
• Fatigue
• Obese
• Unconsciousness
• Pitta predominant diabetes
• Hungry
• Thirsty
• Angery
• Aggressive
• Jaundice
• Abdominal enlargement
• Gout
• Weakness
• Emaciated
• Injury
• Diminished ojas (Immunity)
• Blurred vision

Indications Of Fomentation

Coryza, hiccup, heaviness, dyspnea, cervical pain, cough, pain in ear, headache, hoarseness of voice, paralysis of face, quadriplegia, hemiplegia, monoplegia, prostrated postures, choked throat, constipation, abdominal flatulence, excessive yawning, urinary retention, sciatica, scrotal enlargement, stiffness of dorsum, flanks, abdomen and lumbar, dysuria, stiffness and pain of knee, dorsum of foot, calf and thigh, bodyache, edema, indigestion, severe painful radiculopathy, shivering and chills, contractures, subluxation of ankle, colicky pain, convulsions, heaviness, numbness and stiffness, and general disorders-in these conditions fomentation is beneficial.

Material For Sudation (Swedana Dravya)

Bolus fomentation should be applied with sesame, black gram, horse gram, sour preparations (Vinegar etc.), ghee, meat, oil, cooked rice, preparation of rice and pulse (Krisara), rice cooked with milk, and flesh. This is also administered with feces of ass, cow, pig, horse and camel, husked barley, dust, sand, dried cow dung, iron balls, and stone pieces. The former may be prescribed for those suffering from the disorders of vata while the latter for the kaphaja disorders. These articles are applicable in stone fomentation as well, according to necessity.

Preparation For Suitable Sudation

Oil should be applied to the patient’s body, followed by exposure to heat in a warm, enclosed space that has been heated with smokeless charcoal in order to provide a suitable sudation experience.

Decoctions For Tube Fomentation (Nadi Sweda)

Meat of marshy, aquatic and domestic animals, goat head, milk, trunk, blood and bile of pig, oily sesame seeds-these may be used in pipe fomentation in the form, of decoction by the wise physician who is well conversant with the peculiarities of place and time and acts rationally. Pipe fomentation may also be prepared from decoction of leaves of amritaka (Tinospora cordifolia), shigru (Moringa oleifera), varuna (Crataeva religiosa Forst.), sarshapa (Brassica nigra), eranda (Ricinus communis), vasa (Adhatoda vasica), ashmantaka (Bauhinia racemosa), mulaka (Raphanus sativus), karanja (Pongamia pinnata), vamsha (Bambusa arundinacea), saireya (Barleria prionitis), arka (Calotropis gigantea), malati (Jasminum grandiflorum), arjaka (Ocimum gratissimum), sobhanjana (Variety of shigru), and surasa (Ocimum sanctum). The decoction of bhutika (Trachyspermum ammi) and bigger five roots mixed with curd water, wine, urine, uncting and sour substances is also used in pipe fomentation.

Materials For Tub Fomentation (Avagaha Sweda)

The exact decoctions may be used in the water chamber for fomentation as well. In the same way, the chamber of milk, oil, and ghee may also be prepared for fomentation.

Materials For Poultice Fomentation (Upanaha Sweda)

Poultice fomentation may be prepared with barley flour or wheat powder mixed with unctuous and sour substances, salt and yeast. Poultice may also be prepared from aromatic drugs, Leptandenia reticulata (Jivanti), wine yeast, Foeniculum vulgare (Shatapushpa), Saussurea lappa (Kushta), and Linum usitatissimum (Uma) combined with oil. This type of fomentation may also be managed by bandaging the part with hide, free from hairs and foetid smell, of usna (Hot) potency. In case of their non-availability, woollen, silken, cotton cloth may be used for bandaging. In order to avoid burning sensation, the bandage that was put on at night should be taken off in the morning, and the bandage that was put on throughout the day should be taken off at night. In cold temperatures, the time it takes to apply a bandage may be extended.

Thirteen Varieties Of Sweda

Sankara, prastara, nadi, parisheka, avagahana, jentaka, ashmaghna, karshu, kuti, bhu, kumbhika, kupa, and holaka are the thirteen different types of fomentation. Accordingly, they are further described in the same order.

Bolus Fomentation (Sankara Sweda)

Sankarasweda is the name for the process of bolus-based fomentation that uses prescribed medicines, whether or not they are wrapped in clothing.

Laying On A Therapeutic Mattress (Prastara Sweda)

The fomentation method known as prastar entails a person having oil accurately applied to every inch of his or her body while laying flat on a mattress made of pulses, pulaka (type of grain) and corn, or steamed meat without bone (vesavara), preparation of pulse and rice (krishara), sweet porridge, and a semi solid preparation (utkarika), covered in woollen, silk, or leaves of both arka (Calotropis gigantea) and eranda (Ricinus communis).

Tubular Steam Sudation (Nadi Sweda)

Medications for fomentation-roots, leaves, fruits, buds etc., or flesh, head, feet etc. of birds and animals of hot nature are combined with salt, unctuous, and sour substances according to necessity, or milk, urine, etc., are boiled in a small pitcher which does not emit vapour. This vapour is carried to the patient well massaged with vata alleviating oil for fomentation through a pipe made of karanja (Pongamia pinnata Merr.), arka (Calotropis gigantea), or vamsha (Bambusa arundinacea Retz.), bent at two or three places, and well covered on holes with the leaves of vata alleviating plants. The pipe should be like the forepart of the trunk of an elephant, having vyama (91-44 cm) or ardha vyama (45.72 cm) length, 1/4 vyama (22.86 cm) circumference in proximal, 1 and 1/8 vyama (11.43 cm) in distal end. Vapour travelling through a zigzag course loses its intensity of impulse and as such provides fomentation comfortably without producing burning effects on skin. This is pipe fomentation.

Shower Fomentation Technique (Parisheka Sweda)

Having filled up small pitchers, multi-holed containers and pipe like containers with warm decoction of root etc., of drugs efficacious in Vatika or Vata predominant disorders, the patient well massaged with suitable medicinal uncting preparations and covered with a cloth, should be applied to showers. This is shower fomentation.

Tub Fomentation (Avagaha Sweda)

Fomentation by taking bath in a chamber filled up with vata alleviating decoction, oil, milk, meat juice, hot water or ghee is known as bath fomentation.

Sudation Therapy In A Room (Jentaka Sweda)

Being a construction jentaka, one should examine the land. The land should be in a northern or eastern direction, spacious, auspicious, with black and sweet or golden soil. Here in western or southern bank of a pond, a lake etc., with comfortable stairs and plane level of ground at a distance of seven or eight aratni (320 cm or 365.76 cm) from the water, the temporary room should be constructed which should face towards north or east and be in front of the lake. The height and area of the house should be sixteen aratnis (731.52 cm) and the house should be circular from all sides, well plastered with mud and with many windows. Inside this room a bench-like extension of one aratni (45.72 cm) height and width is provided all along the wall up to the door. In the centre, there should be a pillar having charcoal-chamber, with many small holes, having a lid, in shape like an oven, made of mud and having diameter of four hastas (1.8 cm) and height equal to that of a man. That pillar oven should be filled up with the wood of aswakarna (Dipterocarpus alatus) and khadira (Acacia catechu) etc., and be ignited. When the physician is assured that the wood is well burnt and smokeless and the entire room is heated by that fire and is equipped with fomentable heat, he should admit the patient in, well massaged with vatahara oil and well covered with clothes. While admitting him inside the room, the physician should instruct him like this-O gentle one! Enter the room for well being and health. After entering you should get on the extension and lie down comfortably on both sides in succession. You should not get down from the extension till you expire even if you are sweating too much and fainting. Dropped from this extension and not reaching the door, you will expire due to excessive sweat and fainting. Hence you should never leave this extension. When you feel that you are free from obstruction in passage due to excess fluid, sweat and sliminess are discharged well, lightness has appeared and numbness, stiffness, constipation, heaviness and pain are gone then following the extension you should reach the door and go out. But immediately afterwards, with a view to protecting the eyes, you should not use cold water. When the heat and exhaustion are over, after one muhurta, you should ablution with warm water and then take meals. This is jentaka sweda.

Sudation On A Heated Stone Slab (Ashmaghana Sweda)

A solid stone slab of the man’s size should be heated with vata alleviating wood. Thereafter removing all the charcoal, hot water should be sprinkled over that. Then the slab should be covered with woollen or silken sheet. The patient should sleep on this, after having been well-massaged, well covered gown etc. made to lay on a slab while being fomented. This is ashmaghana sweda.

Trench Fomentation (Karshu Sweda)

The physician, considering the space, should get a trench dug below the cot and fill it up with smokeless burning charcoal. The patient sleeping on the bed above the trench is fomented comfortably.

Fomentation In A Cottage (Kuti Sweda) And Fomentation On Floor (Bhu Sweda)

A cottage room should be constructed with thick walls, not very high and wide, circular, without any window and plastered with kustha (Saussurea lappa) etc. The physician should keep a cot, well equipped with a gown, hide, silken sheet, carpet, blanket and round cap, in the centre and should surround it entirely with furnaces filled up with charcoal. Now the patient, well massaged, should get on the cot and is thus fomented comfortably. In bhu sweda (Ground fomentation), the method prescribed for stone fomentation is followed, the ground should be spacious, free from wind and even.

Pitcher Sudation (Kumbhi Sweda)

A small pitcher, filled up with the decoction of vata alleviating drugs, should be buried in ground up to half or one-third part of it. Over this, a cot or a chair should be kept with not very thick sheet covering. Now, into the pitcher, well heated iron balls or stone should be put. By this the patient, well massaged with vata alleviating uncting substances and well covered is fomented properly sitting or lying there.

Sudation In A Pit (Kupa Sweda)

A well of the cot’s area and twice deep should be made in wind free and auspicious place, after cleaning its interior properly, it should be filled up with the dung of elephant, ass, camel, and cow and ignited, when it is burnt properly, the patient, having been well massaged, should lie down well covered on the well-covered bed. Thus he gets fomented comfortably.

Dung Sudation (Holaka Sweda)

A heap of the dung of the aforesaid animals is ignited below the cot according to its size. When the ground becomes well heated and smokeless, the cot, well-equipped, should be put over it. Now the patient, priorly well-massaged, lies down on the cot, well-covered and thus gets fomented comfortably. Thus holaka sweda, pleasure giving is described by the great sage. Thus fomentation of thirteen types is described where the properties are dependent on application of fire.

Ten Fomentation Methods With No Use Of Fire

Exercises, staying in a warm room, wearing heavy or thick clothing, suppressing hunger, ingesting excessive fluids (Especially alcoholic beverages), anger, fear, wrestling poultice and being exposed to sunshine are among the ten non-fire means of sudation.
Thus the fomentation is said of two types. Apart from this, there are fomentations applied to one part or the whole body, and unctuous or non-unctuous. Thus three duals in relation to fomentation have been mentioned. Fomentation should be applied after unction, fomentated person should take a wholesome diet and after fomentation, he should avoid physical exercise on that day.

Conclusion

In conclusion, this article has covered the following topics: how fomentation is effective, for whom it is beneficial, types of fomentation, application in and protection of different parts, symptoms of under fomentation and over fomentation, treatment of over fomentations, persons suitable and unsuitable for fomentation, drugs for fomentation, management, thirteen types of fomentation, ten types of fomentation without fire, six fold fomentation-these, in brief, have been described in this chapter of fomentation.