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Swedana (Fomentation) Karma | Ayurvedic Steam Bath Therapy | Panchakarma Treatment in Ayurveda

Abstract

Ayurveda is a science of life which provides not only curative but also preventive principles for healthy and long life. Panchakarma therapy is gaining popularity in the public because of its quick and permanent relief in many hazardous diseases. Efforts should be made to implement this therapy not only for diseased persons but also for healthy individuals to maintain their health as a preventive measure. Ayurvedic texts describe five major karmas or therapeutic procedures namely Vamana (Emesis), Virechana (Purgation), Basti (Enema), Nasya (Medication through nose) and Raktamokshan (Bloodletting). Snehana (Oleation) and swedana (Fomentation) therapy are described under poorva karma (pre-operative managements) advocated for all purificatory procedures. But these treatments are described as pradhana karma (Main upkarmas) for vata and kaphaja vyadhies (Diseases). Hence these are independent therapies and said to be main treatment procedures for so many diseases.

Swedana, Fomentation, Karma, Ayurvedic, Steam Bath, Therapy, Panchakarma, Treatment, Ayurveda

Introduction

स्तम्भगौरवशीतघ्नं स्वेदनंस्वेदकारकम। (C.Su.22/11)

It is defined as the process by which perspiration of the body will be produced. It removes stiffness, heaviness and coldness of the body. After the snehana (Oleation) therapy fomentation must be adopted to regulate the movement of blood circulation, extra and intra-cellular fluids of the body without any obstruction. It enhances the nutrition to the cells and evacuates the waste materials from the tissues.

Fomentation is said to be effective if applied with consideration of disease, season and the diseased, is not too hot or too mild, combined with proper drugs and arranged in the proper place. 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 and kapha dosha.

Properties Of Swedana Drugs

उष्णं तीक्षणं सरं स्निग्धं रुक्षं सूक्ष्मं द्रवं स्थिरम।
द्रव्यं गुरु च यत प्रायस्तध्दि स्वेदनमुच्यते।।
(C.Su.22/16)

  • Hot
  • Sharp
  • Unstable
  • Swedana (Fomentation) Karma | Ayurvedic Steam Bath Therapy | Panchakarma Treatment in Ayurveda

    Abstract

    Ayurveda is a science of life which provides not only curative but also preventive principles for healthy and long life. Panchakarma therapy is gaining popularity in the public because of its quick and permanent relief in many hazardous diseases. Efforts should be made to implement this therapy not only for diseased persons but also for healthy individuals to maintain their health as a preventive measure. Ayurvedic texts describe five major karmas or therapeutic procedures namely Vamana (Emesis), Virechana (Purgation), Basti (Enema), Nasya (Medication through nose) and Raktamokshan (Bloodletting). Snehana (Oleation) and Swedana (Fomentation) therapy are described under poorva karma (pre-operative managements) advocated for all purificatory procedures. But these treatments are described as pradhana karma (Main upkarmas) for vata and kaphaja vyadhies (Diseases). Hence these are independent therapies and said to be main treatment procedures for so many diseases.

    Swedana, Fomentation, Karma, Ayurvedic, Steam Bath, Therapy, Panchakarma, Treatment, Ayurveda

    Introduction

    स्तम्भगौरवशीतघ्नं स्वेदनंस्वेदकारकम। (C.Su.22/11)

    It is defined as the process by which perspiration of the body will be produced. It removes stiffness, heaviness and coldness of the body. After the snehana (Oleation) therapy fomentation must be adopted to regulate the movement of blood circulation, extra and intra-cellular fluids of the body without any obstruction. It enhances the nutrition to the cells and evacuates the waste materials from the tissues.

    Fomentation is said to be effective if applied with consideration of disease, season and the diseased, is not too hot or too mild, combined with proper drugs and arranged in the proper place. 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 and kapha dosha.

    Properties Of Swedana Drugs

    उष्णं तीक्षणं सरं स्निग्धं रुक्षं सूक्ष्मं द्रवं स्थिरम।
    द्रव्यं गुरु च यत प्रायस्तध्दि स्वेदनमुच्यते।।
    (C.Su.22/16)

    • Hot
    • Sharp
    • Unstable
    • Unctuous
    • Rough
    • Minute
    • Liquid
    • Stable drugs are mostly sweating in effect

    Indications

    • Coryza
    • Cough
    • Hiccup
    • Dyspnea
    • Non-lightness
    • Pain in ear
    • Back Neck and head
    • Hoarseness of voice
    • Choked throat
    • Paralysis of face, one limb, whole or half body
    • Bending of body
    • Hardness of bowels and constipation
    • Suppression of urine
    • Excessive yawning
    • Stiffness in sides, back, waist and abdomen
    • Sciatica
    • Dysuria
    • Enlargement of scrotum
    • Body-ache
    • Pain and stiffness in feet, knees, thighs and shanks
    • Swelling
    • Contracture
    • Conditions of ama (Toxins), cold, shivering
    • Heaviness and numbness in organs and general disorders

    Contraindications

    • Habitual users of medicinal extracts and wine
    • Pregnant ladies
    • Those afflicted with internal hemorrhage
    • Pitta dosha and diarrhea
    • Rough persons
    • Diabetics
    • Burns
    • Prolapse and inguinal hernia
    • Having complications of poison and alcohol
    • Fatigue
    • Unconscious
    • Thirsty
    • Hungry
    • Angry
    • Aggrieved
    • Jaundice
    • Abdominal enlargement
    • Injury and gout
    • Weak people emaciated
    • Suffering from blurred vision

    Prevention

    During fomentation, 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). Similarly, 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.

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

    Classification Of Swedana

    1. Snigdha and ruksha (Dry and wet)
    2. Ekanga (For one organ) and sarvanga (Whole body)
    3. Agnikrita (Which requires heat) and anagnikrita (Which do not require heat)

    Dry fomentation should be administered to kaphaja disorders and wet fomentation is very useful in vataja disorders.

    Ekanga Sweda

    Fomentation is done to one part of the body, for example nadi swedana, sankara swedana, valuka sweda (Sand fomentation).

    Sarvanga Sweda

    Fomentation is done to all parts of the body, for example kuti, prasthara, bashpa swedana etc.

    Acharya Sushruta classified swedana into four varieties.

    1. Tapa sweda
    2. Upanaha sweda
    3. Ushma sweda
    4. Drava sweda

    Agnikrita Sweda

    संकर: प्रस्तरो नाड़ीपरिषेकोअवगाहनम।
    जेनताको अश्मघन: कर्षू: कुटी भू: कुम्भीकेवच।।
    कुपोहोलाक इत्येते स्वेदयन्ती त्रयोदश।।
    (C.Su.14/39-40)

    There are 13 varieties of agnikrita swedanas (fomentation with the help of heat) have been mentioned in Ayurveda:-

    1. Sankara
    2. Prasthara
    3. Nadi
    4. Parisheka
    5. Jentaka
    6. Ashmaghana
    7. Karshu
    8. Kuti
    9. Bhoo
    10. Kumbhika
    11. Koopa
    12. Holaka
    13. Avagaha

    Anagnikrita Sweda

    व्यायाममुष्णसदनं गुरुप्रावरणम क्षुधा।
    बहुपानं भयक्रोधावुपनाहाहवाआतपा:।
    स्वेदयन्ति दशैतानि नरं अग्निगुणादृते।।
    (C.Su.14/64-65)

    There are 10 varieties of anagnikrita swedanas (fomentation without the help of heat) have been mentioned in Ayurveda:-

    1. Vyayama (Exercise):- The work which produces tiredness (Ayasa) in the body is called exercise (Vyayam). Exercise is a kind of langhana (Reducing) chikitsa. A person should do exercise till the sweda (Sweat) appears on forehead, armpit, nose, joints of legs and hands.
    2. Ushna sadana (Residing in a warm room) :- Residing in a warm room without heating by any external source and lying or sitting till the sweating appears.
    3. Gurupravarana (Wearing of heavy clothing):- This is the method in which the body is covered by thick blankets, clothes etc till the sweat appears.
    4. Kshudha (hunger) :- It is referred to as fasting (Langhan) treatment. Fasting is done till the perspiration starts.
    5. Bahupanam (Excessive alcohol):- Consumption of excessive alcohol leads to sweating because alcohol (Madya) is ushna (Hot), tikshana (Sharp), vyavahi (Diffuse), vikashi (Spreading nature), sukshma (Minute), ruksha (Dry), laghu (Light) and amla (Sour) properties.
    6. Bhaya (Fear):- Fear leads to sweating.
    7. Upanaha (application of poultice):- poultice may also be prepared from aromatic drugs, wine yeast, jivanti (Leptadenia reticulata) and shatapushpa (Anethum graveolens) and also be managed by bandaging the part with hide, free from hairs and foetid smell of usna virya (Having heating effect).
    8. Krodha (Angry):- Emotions like anger lead to induce perspiration.
    9. Aahava (Wrestling):- It is a type of vyayam (Exercise) which induces sweating.
    10. Aatap (Exposure to sun rays):- Exposure to the sun leads to sweating.

    There are 13 types of Agnikrita Sweda out of which the following are the mostly performed and effective procedures:-

    Nadi Swedana

    It is a process by which the person is made to perspire by using a tube and medicated steam will be passed on the whole body or affected part of the body. It relieves pain immediately without oral drugs.

    Indications

    This therapy is indicated in the following diseases.

    • Sandhi vata (Osteoarthritis)
    • Pakshaghata (Paralysis)
    • Bal pakshaghata (Poliomyelitis)
    • All nervous disorders
    • Swasa (Asthma)
    • Kasa (Cough)
    • Ardita (Facial paralysis)
    • Adhmana (Flatulence)
    • Manyashoola (Neck pain)
    • Katishoola (Backache)
    • Gridhrasi (Sciatica)

    Contraindications

    • Atisara (Diarrhea)
    • Kamala (Jaundice)
    • Raktapitta (Bleeding disorder)
    • Twacha vikriti (Skin disorders)
    • Visha peedita (Poisoning cases)
    • Jwara (Fever)
    • Madhu meha (Diabetes mellitus)

    Materials

    1. 6 litres of pressure cooker
    2. 2 metres rubber tube
    3. Gas stove

    Note:- If anybody wants to electrify this instrument 1500 voltage coils can be installed inside the cooker. It will be very useful for the physicians to handle the nadi swedana treatment.

    Medicines

    1. Dashamoola
    2. Rasna (Pluchea lanceolata)
    3. Nirgundi patra (Vitex negundo)
    4. Eranda patra (Ricinus communis)
    5. Bala-moola (Sida cordifolia)
    6. Vasa-patra (Adhatoda vasica)
    7. Arka patra (Calotropis procera)
    8. Shigru-patra (Moringa oleifera)
    9. Guduchi patra (Tinospora cordifolia)

    Procedure

    100 grams of mixture of all above herbs or available herbs should be taken for Nadi sweda.

    Poorva Karma (Pre-operative Procedure):-

    The patient who is fit for nadi swedana should be applied oil to the whole body or the part affected and he should be asked to sit on the stool (Sometimes in kapha pradhana diseases or amajanya vyadhis there is no need to apply oil). Meanwhile the cooker is filled with 2/3 water and add above-mentioned drugs 25-50 gm and keep it on the stove or switch on if it is an electrical Nadi swedan yantra. After 10-15 minutes steam will start coming out from the tube.

    Pradhana Karma (Operative Procedure):-

    When steam is coming out from the tube the tolerable steam should be made to pass over the affected parts for 10-15 minutes. While giving Nadi swedana, patients should be asked to do some exercises (Light flexion and extension) of the affected part for better results. If a patient is not able to sit on the stool the Nadi swedana can be given in a lying posture.

    Paschat Karma (Post-operative Procedure):-

    After completion of Nadi swedana that part will be cleaned with a towel and the patient is required to take complete rest for half an hour in a closed room. He should not be exposed directly to air. After one hour he can take a hot water bath.

    Uses

    • It acts as an analgesic and relieves pain immediately.
    • It reduces the swelling.
    • It softens the ligaments.
    • It improves the movements of the joints by reducing rigidity of the muscles.
    • It enhances blood circulation and improves the nutrition to that part and also drains the waste material.
    • It is very useful therapy for muscular sprains and relieves pain immediately.

    Avagaha Swedana

    The process by which the patient is made to bath in medicated decoction, oil or ghee in a tub is known as avagaha swedan.

    Materials

    1. Tub (full or spinal bath tub)
    2. Dasha mool kwath or bala mool kwath or eranda mool kwath, or nirgundi kwath (Sufficient quantity to fill the tub)

    Procedure

    Poorva Karma (Pre-operative Procedure):-

    Patients should be given a whole body massage with medicated oil before avagaha swedana.

    Pradhana Karma (Operative Procedure):-

    Patient is asked to sit in the tub containing warm medicated kwath and then he can lie down in it throughout the period the temperature of the liquid should be maintained. It should be continued for 45 minutes to one hour.

    Paschat Karma (Post-operative Procedure):-

    Patients should be given a bath with fresh warm water. Then he should be asked to take complete rest.

    Uses

    • It is very useful for a whole body ache
    • Useful in muscular pain
    • It relieves pains in the vertebral column
    • It is useful in ankylosing spondylosis, avascular necrosis of the neck of femur
    • It induces sleep

    Bashpa Swedana

    Bashpa swedana is one of the varieties of sarvanga (Whole body), snigdha (Oily) and agnikruta swedana. It is a procedure by which the perspiration is produced from the body with the help of bashpa swedana yantra.

    Indications

    This therapy is indicated in the following diseases.

    • Sandhi vata (Osteo-arthritis)
    • Pakshaghata (Paralysis)
    • All types of nervous disorders
    • Swasa (Asthma)
    • Ardita (Facial paralysis)
    • Adhmana (Flatulence)
    • Katishool (Back ache)
    • Gridhrasi (Sciatica)
    • Sthoulya (Obesity)
    • Body ache
    • Muscular atrophy
    • Hypertension

    Contraindications

    • Atisara (Diarrhea)
    • Kamala (Jaundice)
    • Raktapitta (Bleeding disorder)
    • Twacha vikriti (Skin disorders)
    • Visha peedita (Poison)
    • Jwara (Fever)
    • Madhu meha (Diabetes mellitus)
    • Garbhini (Pregnant women)
    • Kushta (Leprosy)
    • All types of pitta predominant diseases
    • Bhrama (Giddiness)
    • Hridrogas (Cardiac diseases)
    • Renal failures

    Materials

    1. Bashpa swedana yantra or electrically operated multipurpose panchakarma instrument
    2. Medicated oils for external application
    3. Bed sheet
    4. Woollen blanket

    Procedure

    Poorva Karma (Pre-operative Procedure):-

    Before giving the bashpa swedana treatment every patient must undergo abhyanga (External application of oil). Patients should be asked to pass urine and stools before massage and also asked to remove all the clothes except underwear. It should be proper if he gets snehana in seven postures that is:-

    1. Seated with both legs extended
    2. Lying in supine position
    3. Lying on left side of the body
    4. Lying in prone position
    5. Lying on right side of the body
    6. Lying on supine position
    7. Seated with both legs extended

    After completion of snehana in above postures, now he is ready for swedana treatment.

    Pradhana Karma (Operative Procedure):-

    When proper steam is coming out from bashpa swedana yantra, cover it with one bed sheet on the table and ask the patient to lie down on the table in a convenient position and cover him with a blanket. After getting required heat, advised to change the postures so that he should get perspiration from the whole body. This should be continued up to 20 to 30 minutes or until the desired results are obtained or up to samyak sweda (Proper sudation symptoms) lakshanas are seen. If he gets any sort of giddiness or weakness ask the patient to get up from the table and should be kept on proper management.

    Paschat Karma (Post-operative Procedure):-

    After completion of bashpa swedana, clean the patient's body with a towel and advice to take complete rest for half an hour. He should not be exposed directly to air immediately after bashpa swedana. After one hour he can take a hot water bath.

    Uses

    • Swedana therapy will liquify the doshas due to its ushna (Hot) and tikshna (Sharp) properties.
    • The perspiration is the result of the excreta of rasa (Plasma), rakta (Blood cells), majja (Bone marrow) dhatus. It removes the waste products which are stagnated in the cells and tissues.
    • It acts as a best analgesic and relieves body ache.
    • It softens the ligaments of the body.
    • It enhances circulation so that it improves the nutrition to the whole body and also it drains the waste products from the body.
    • It reduces the swelling of the body.
    • It removes the rigidity and spasticity of the muscles and improves the movements of the joints.
    • It reduces body weight.
    • It is very useful for obese patients.
    • It cleans the channels of the body and brings better circulation.
    • It makes the body strong and sturdy.

    Pinda Swedana (Sankara Swedana / Bolus Fomentation)

    Shastika shali pinda sweda is an important fomentation for the patients who are getting emaciation in their muscles and also very useful for those, who are suffering from the deformities in their joints, it checks the emaciation and gives strength to the muscles and ligaments. It is a process by which the whole body or part of the body is made perspiration by the external application of medicated bolus. Acharya Charaka and Vagabhata have mentioned the Pinda Sweda in their texts but they have not described the procedure on how to perform on the patients. This treatment is said to be one of the varieties of sankara sweda. Fomentation by means of bolus containing prescribed drugs with or without being wrapped with clothes is known as sankara sweda. In Kerala, it has been practiced by Ayurved physicians from time immemorial and still existing in the name of “NAVARA-KI-ZI”.

    Indications

    • Pakshaghata (Paralysis)
    • Ekanga vata (Monoplegia)
    • Avabahuka (Frozen shoulder)
    • Pangu (Paraplegia)
    • Bala Pakshaghata (Poliomyelitis)
    • Karshya (Emaciation)
    • Kshaya (Tuberculosis)
    • Shoola (Muscular pain)
    • Sandhivata (Osteoarthritis)

    Contents Of Pinda Sweda

    • Bala moola churna (Sida cordifolia) - 50 gms
    • Dashamoola churna - 50 gms
    • Rice - 250 gms
    • Milk - 500 ml
    • Two cloth pieces - 18”x18”

    Some physicians include Mamsa Rohini churna apart from bala moola and dashamoola churna.

    Method Of Preparation

    • Decoction:- Take 50 gms each of balamoola and dashamoola churna and add 4 litres of water and boil it in a vessel and reduce it upto 1 litre decoction.
    • Rice:- From above decoction take 1/2 litre in a separate vessel and add 1/2 litre milk, 250 gms of rice and cook like a paste.
    • Bolus:- Keep the cooked paste in two clean cloth pieces, measuring 18”x18” and prepare into bolus (pinda). The remaining half decoction should be used for dipping the bolus while performing the fomentation.
    • Tala kalk:- Take 50 grams of Amalaki churna mix with water or buttermilk kept overnight and prepare the paste.

    Procedure

    Poorva Karma (Pre-operative Procedure):-

    Remove the patient's clothes after wearing langot (a cloth wear in between the legs) and take him on a wooden table and apply bala tail or mahanarayana tail to the head first. Then apply the same oil to the whole body and massage for 15 minutes in all postures. After massage, apply amalaki (Emblica officinalis) paste over the head and tie with a piece of cloth.

    Pradhana Karma (Operative Procedure):-

    One member from either side should hold the pinda in their right hands after making it suitably warmed by dipping in decoction. The temperature of the pinda has to be tested by keeping the left hand on it, to confirm whether the heat is suitable for the patient or not. After confirmation of the temperature, give a gentle massage with bolus on the body and the bolus will be changed as soon as its temperature becomes less. Every time we must test the temperature of the bolus before massage. In this way the massage should be done slowly for a period of 30 to 45 minutes in following seven postures:-

    1. Sitting with his legs extended
    2. Lying on his back
    3. Lying on his left side
    4. Lying on his right side
    5. Lying on his front side
    6. Lying on his back side
    7. Sitting by extending his legs

    Paschat Karma (Post-operative Procedure):-

    After completion of pinda sweda, the contents of the bolus should be mixed with the remaining decoction and made it lukewarm and apply this paste to the affected part of the body. After 10-15 minutes the paste should be removed and be advised to take a hot water bath and complete rest.

    Duration

    According to the condition and requirement of the patient it should be continued for 7 days, 14 days, 21 days or 28 days.

    Uses

    • It improves the blood supply
    • Removes the stiffness of the joints
    • Clean all the channels of the body and bring better circulation.
    • It increases the body weight by correcting the emaciation of the muscles.
    • It cures all types of nervous disorders. The treatment makes the body strong and sturdy.

    Patra Pinda Swedana

    Indications

    • Sandhivata (Osteoarthritis)
    • Amavata (Rheumatoid arthritis)

    Drugs

    • Arka patra (Calotropis gigantea)
    • Eranda patra (Ricinus communis)
    • Nirgundi patra (Vitex negundo)
    • Dhatura patra (Datura stramonium)

    Preparation

    Make all leaves upto small pieces and prepare pulp and heat in a vessel then prepare bolus in a cloth piece.

    Procedure

    Take a little oil in a vessel, slightly heat it and rotate the bolus in oil then administer swedana to the patient. After half an hour of rest the area should be cleaned with hot water.

    Conclusion

    In this article we read about fomentation, its uses, indications, contraindications, pre-operative, operative and post-operative procedures etc. Testicles, heart and eyes should not be fomented or, if necessary, should be mildly fomented. Fomentation is very effective in vata dosha and kapha dosha. It clears the channels of the body and removes the toxins from the body. It improves the complexion of the skin and clears out the pores of the skin and prevents acne, pimples, etc.

  • Unctuous
  • Rough
  • Minute
  • Liquid
  • Stable drugs are mostly sweating in effect

Indications

  • Coryza
  • Cough
  • Hiccup
  • Dyspnea
  • Non-lightness
  • Pain in ear
  • Back Neck and head
  • Hoarseness of voice
  • Choked throat
  • Paralysis of face, one limb, whole or half body
  • Bending of body
  • Hardness of bowels and constipation
  • Suppression of urine
  • Excessive yawning
  • Stiffness in sides, back, waist and abdomen
  • Sciatica
  • Dysuria
  • Enlargement of scrotum
  • Body-ache
  • Pain and stiffness in feet, knees, thighs and shanks
  • Swelling
  • Contracture
  • Conditions of ama (Toxins), cold, shivering
  • Heaviness and numbness in organs and general disorders

Contraindications

  • Habitual users of medicinal extracts and wine
  • Pregnant ladies
  • Those afflicted with internal hemorrhage
  • Pitta dosha and diarrhea
  • Rough persons
  • Diabetics
  • Burns
  • Prolapse and inguinal hernia
  • Having complications of poison and alcohol
  • Fatigue
  • Unconscious
  • Thirsty
  • Hungry
  • Angry
  • Aggrieved
  • Jaundice
  • Abdominal enlargement
  • Injury and gout
  • Weak people emaciated
  • Suffering from blurred vision

Prevention

During fomentation, 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). Similarly, 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.

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

Classification Of Swedana

  1. Snigdha and ruksha (Dry and wet)
  2. Ekanga (For one organ) and sarvanga (Whole body)
  3. Agnikrita (Which requires heat) and anagnikrita (Which do not require heat)

Dry fomentation should be administered to kaphaja disorders and wet fomentation is very useful in vataja disorders.

Ekanga Sweda

Fomentation is done to one part of the body, for example nadi swedana, sankara swedana, valuka sweda (Sand fomentation).

Sarvanga Sweda

Fomentation is done to all parts of the body, for example kuti, prasthara, bashpa swedana etc.

Acharya Sushruta classified swedana into four varieties.

  1. Tapa sweda
  2. Upanaha sweda
  3. Ushma sweda
  4. Drava sweda

Agnikrita Sweda

संकर: प्रस्तरो नाड़ीपरिषेकोअवगाहनम।
जेनताको अश्मघन: कर्षू: कुटी भू: कुम्भीकेवच।।
कुपोहोलाक इत्येते स्वेदयन्ती त्रयोदश।।
(C.Su.14/39-40)

There are 13 varieties of agnikrita swedanas (fomentation with the help of heat) have been mentioned in Ayurveda:-

  1. Sankara
  2. Prasthara
  3. Nadi
  4. Parisheka
  5. Jentaka
  6. Ashmaghana
  7. Karshu
  8. Kuti
  9. Bhoo
  10. Kumbhika
  11. Koopa
  12. Holaka
  13. Avagaha

Anagnikrita Sweda

व्यायाममुष्णसदनं गुरुप्रावरणम क्षुधा।
बहुपानं भयक्रोधावुपनाहाहवाआतपा:।
स्वेदयन्ति दशैतानि नरं अग्निगुणादृते।।
(C.Su.14/64-65)

There are 10 varieties of anagnikrita swedanas (fomentation without the help of heat) have been mentioned in Ayurveda:-

  1. Vyayama (Exercise):- The work which produces tiredness (Ayasa) in the body is called exercise (Vyayam). Exercise is a kind of langhana (Reducing) chikitsa. A person should do exercise till the sweda (Sweat) appears on forehead, armpit, nose, joints of legs and hands.
  2. Ushna sadana (Residing in a warm room) :- Residing in a warm room without heating by any external source and lying or sitting till the sweating appears.
  3. Gurupravarana (Wearing of heavy clothing):- This is the method in which the body is covered by thick blankets, clothes etc till the sweat appears.
  4. Kshudha (hunger) :- It is referred to as fasting (Langhan) treatment. Fasting is done till the perspiration starts.
  5. Bahupanam (Excessive alcohol):- Consumption of excessive alcohol leads to sweating because alcohol (Madya) is ushna (Hot), tikshana (Sharp), vyavahi (Diffuse), vikashi (Spreading nature), sukshma (Minute), ruksha (Dry), laghu (Light) and amla (Sour) properties.
  6. Bhaya (Fear):- Fear leads to sweating.
  7. Upanaha (application of poultice):- poultice may also be prepared from aromatic drugs, wine yeast, jivanti (Leptadenia reticulata) and shatapushpa (Anethum graveolens) and also be managed by bandaging the part with hide, free from hairs and foetid smell of usna virya (Having heating effect).
  8. Krodha (Angry):- Emotions like anger lead to induce perspiration.
  9. Aahava (Wrestling):- It is a type of vyayam (Exercise) which induces sweating.
  10. Aatap (Exposure to sun rays):- Exposure to the sun leads to sweating.

There are 13 types of Agnikrita Sweda out of which the following are the mostly performed and effective procedures:-

Nadi Swedana

It is a process by which the person is made to perspire by using a tube and medicated steam will be passed on the whole body or affected part of the body. It relieves pain immediately without oral drugs.

Indications

This therapy is indicated in the following diseases.

  • Sandhi vata (Osteoarthritis)
  • Pakshaghata (Paralysis)
  • Bal pakshaghata (Poliomyelitis)
  • All nervous disorders
  • Swasa (Asthma)
  • Kasa (Cough)
  • Ardita (Facial paralysis)
  • Adhmana (Flatulence)
  • Manyashoola (Neck pain)
  • Katishoola (Backache)
  • Gridhrasi (Sciatica)

Contraindications

  • Atisara (Diarrhea)
  • Kamala (Jaundice)
  • Raktapitta (Bleeding disorder)
  • Twacha vikriti (Skin disorders)
  • Visha peedita (Poisoning cases)
  • Jwara (Fever)
  • Madhu meha (Diabetes mellitus)

Materials

  1. 6 litres of pressure cooker
  2. 2 metres rubber tube
  3. Gas stove

Note:- If anybody wants to electrify this instrument 1500 voltage coils can be installed inside the cooker. It will be very useful for the physicians to handle the nadi swedana treatment.

Medicines

  1. Dashamoola
  2. Rasna (Pluchea lanceolata)
  3. Nirgundi patra (Vitex negundo)
  4. Eranda patra (Ricinus communis)
  5. Bala-moola (Sida cordifolia)
  6. Vasa-patra (Adhatoda vasica)
  7. Arka patra (Calotropis procera)
  8. Shigru-patra (Moringa oleifera)
  9. Guduchi patra (Tinospora cordifolia)

Procedure

100 grams of mixture of all above herbs or available herbs should be taken for Nadi sweda.

Poorva Karma (Pre-operative Procedure):-

The patient who is fit for nadi swedana should be applied oil to the whole body or the part affected and he should be asked to sit on the stool (Sometimes in kapha pradhana diseases or amajanya vyadhis there is no need to apply oil). Meanwhile the cooker is filled with 2/3 water and add above-mentioned drugs 25-50 gm and keep it on the stove or switch on if it is an electrical Nadi swedan yantra. After 10-15 minutes steam will start coming out from the tube.

Pradhana Karma (Operative Procedure):-

When steam is coming out from the tube the tolerable steam should be made to pass over the affected parts for 10-15 minutes. While giving Nadi swedana, patients should be asked to do some exercises (Light flexion and extension) of the affected part for better results. If a patient is not able to sit on the stool the Nadi swedana can be given in a lying posture.

Paschat Karma (Post-operative Procedure):-

After completion of Nadi swedana that part will be cleaned with a towel and the patient is required to take complete rest for half an hour in a closed room. He should not be exposed directly to air. After one hour he can take a hot water bath.

Uses

  • It acts as an analgesic and relieves pain immediately.
  • It reduces the swelling.
  • It softens the ligaments.
  • It improves the movements of the joints by reducing rigidity of the muscles.
  • It enhances blood circulation and improves the nutrition to that part and also drains the waste material.
  • It is very useful therapy for muscular sprains and relieves pain immediately.

Avagaha Swedana

The process by which the patient is made to bath in medicated decoction, oil or ghee in a tub is known as avagaha swedan.

Materials

  1. Tub (full or spinal bath tub)
  2. Dasha mool kwath or bala mool kwath or eranda mool kwath, or nirgundi kwath (Sufficient quantity to fill the tub)

Procedure

Poorva Karma (Pre-operative Procedure):-

Patients should be given a whole body massage with medicated oil before avagaha swedana.

Pradhana Karma (Operative Procedure):-

Patient is asked to sit in the tub containing warm medicated kwath and then he can lie down in it throughout the period the temperature of the liquid should be maintained. It should be continued for 45 minutes to one hour.

Paschat Karma (Post-operative Procedure):-

Patients should be given a bath with fresh warm water. Then he should be asked to take complete rest.

Uses

  • It is very useful for a whole body ache
  • Useful in muscular pain
  • It relieves pains in the vertebral column
  • It is useful in ankylosing spondylosis, avascular necrosis of the neck of femur
  • It induces sleep

Bashpa Swedana

Bashpa swedana is one of the varieties of sarvanga (Whole body), snigdha (Oily) and agnikruta swedana. It is a procedure by which the perspiration is produced from the body with the help of bashpa swedana yantra.

Indications

This therapy is indicated in the following diseases.

  • Sandhi vata (Osteo-arthritis)
  • Pakshaghata (Paralysis)
  • All types of nervous disorders
  • Swasa (Asthma)
  • Ardita (Facial paralysis)
  • Adhmana (Flatulence)
  • Katishool (Back ache)
  • Gridhrasi (Sciatica)
  • Sthoulya (Obesity)
  • Body ache
  • Muscular atrophy
  • Hypertension

Contraindications

  • Atisara (Diarrhea)
  • Kamala (Jaundice)
  • Raktapitta (Bleeding disorder)
  • Twacha vikriti (Skin disorders)
  • Visha peedita (Poison)
  • Jwara (Fever)
  • Madhu meha (Diabetes mellitus)
  • Garbhini (Pregnant women)
  • Kushta (Leprosy)
  • All types of pitta predominant diseases
  • Bhrama (Giddiness)
  • Hridrogas (Cardiac diseases)
  • Renal failures

Materials

  1. Bashpa swedana yantra or electrically operated multipurpose panchakarma instrument
  2. Medicated oils for external application
  3. Bed sheet
  4. Woollen blanket

Procedure

Poorva Karma (Pre-operative Procedure):-

Before giving the bashpa swedana treatment every patient must undergo abhyanga (External application of oil). Patients should be asked to pass urine and stools before massage and also asked to remove all the clothes except underwear. It should be proper if he gets snehana in seven postures that is:-

  1. Seated with both legs extended
  2. Lying in supine position
  3. Lying on left side of the body
  4. Lying in prone position
  5. Lying on right side of the body
  6. Lying on supine position
  7. Seated with both legs extended

After completion of snehana in above postures, now he is ready for swedana treatment.

Pradhana Karma (Operative Procedure):-

When proper steam is coming out from bashpa swedana yantra, cover it with one bed sheet on the table and ask the patient to lie down on the table in a convenient position and cover him with a blanket. After getting required heat, advised to change the postures so that he should get perspiration from the whole body. This should be continued up to 20 to 30 minutes or until the desired results are obtained or up to samyak sweda (Proper sudation symptoms) lakshanas are seen. If he gets any sort of giddiness or weakness ask the patient to get up from the table and should be kept on proper management.

Paschat Karma (Post-operative Procedure):-

After completion of bashpa swedana, clean the patient’s body with a towel and advice to take complete rest for half an hour. He should not be exposed directly to air immediately after bashpa swedana. After one hour he can take a hot water bath.

Uses

  • Swedana therapy will liquify the doshas due to its ushna (Hot) and tikshna (Sharp) properties.
  • The perspiration is the result of the excreta of rasa (Plasma), rakta (Blood cells), majja (Bone marrow) dhatus. It removes the waste products which are stagnated in the cells and tissues.
  • It acts as a best analgesic and relieves body ache.
  • It softens the ligaments of the body.
  • It enhances circulation so that it improves the nutrition to the whole body and also it drains the waste products from the body.
  • It reduces the swelling of the body.
  • It removes the rigidity and spasticity of the muscles and improves the movements of the joints.
  • It reduces body weight.
  • It is very useful for obese patients.
  • It cleans the channels of the body and brings better circulation.
  • It makes the body strong and sturdy.

Pinda Swedana (Sankara Swedana / Bolus Fomentation)

Shastika shali pinda sweda is an important fomentation for the patients who are getting emaciation in their muscles and also very useful for those, who are suffering from the deformities in their joints, it checks the emaciation and gives strength to the muscles and ligaments. It is a process by which the whole body or part of the body is made perspiration by the external application of medicated bolus. Acharya Charaka and Vagabhata have mentioned the Pinda Sweda in their texts but they have not described the procedure on how to perform on the patients. This treatment is said to be one of the varieties of sankara sweda. Fomentation by means of bolus containing prescribed drugs with or without being wrapped with clothes is known as sankara sweda. In Kerala, it has been practiced by Ayurved physicians from time immemorial and still existing in the name of “NAVARA-KI-ZI”.

Indications

  • Pakshaghata (Paralysis)
  • Ekanga vata (Monoplegia)
  • Avabahuka (Frozen shoulder)
  • Pangu (Paraplegia)
  • Bala Pakshaghata (Poliomyelitis)
  • Karshya (Emaciation)
  • Kshaya (Tuberculosis)
  • Shoola (Muscular pain)
  • Sandhivata (Osteoarthritis)

Contents Of Pinda Sweda

  • Bala moola churna (Sida cordifolia) - 50 gms
  • Dashamoola churna - 50 gms
  • Rice - 250 gms
  • Milk - 500 ml
  • Two cloth pieces - 18”x18”

Some physicians include Mamsa Rohini churna apart from bala moola and dashamoola churna.

Method Of Preparation

  • Decoction:- Take 50 gms each of balamoola and dashamoola churna and add 4 litres of water and boil it in a vessel and reduce it upto 1 litre decoction.
  • Rice:- From above decoction take 1/2 litre in a separate vessel and add 1/2 litre milk, 250 gms of rice and cook like a paste.
  • Bolus:- Keep the cooked paste in two clean cloth pieces, measuring 18”x18” and prepare into bolus (pinda). The remaining half decoction should be used for dipping the bolus while performing the fomentation.
  • Tala kalk:- Take 50 grams of Amalaki churna mix with water or buttermilk kept overnight and prepare the paste.

Procedure

Poorva Karma (Pre-operative Procedure):-

Remove the patient’s clothes after wearing langot (a cloth wear in between the legs) and take him on a wooden table and apply bala tail or mahanarayana tail to the head first. Then apply the same oil to the whole body and massage for 15 minutes in all postures. After massage, apply amalaki (Emblica officinalis) paste over the head and tie with a piece of cloth.

Pradhana Karma (Operative Procedure):-

One member from either side should hold the pinda in their right hands after making it suitably warmed by dipping in decoction. The temperature of the pinda has to be tested by keeping the left hand on it, to confirm whether the heat is suitable for the patient or not. After confirmation of the temperature, give a gentle massage with bolus on the body and the bolus will be changed as soon as its temperature becomes less. Every time we must test the temperature of the bolus before massage. In this way the massage should be done slowly for a period of 30 to 45 minutes in following seven postures:-

  1. Sitting with his legs extended
  2. Lying on his back
  3. Lying on his left side
  4. Lying on his right side
  5. Lying on his front side
  6. Lying on his back side
  7. Sitting by extending his legs

Paschat Karma (Post-operative Procedure):-

After completion of pinda sweda, the contents of the bolus should be mixed with the remaining decoction and made it lukewarm and apply this paste to the affected part of the body. After 10-15 minutes the paste should be removed and be advised to take a hot water bath and complete rest.

Duration

According to the condition and requirement of the patient it should be continued for 7 days, 14 days, 21 days or 28 days.

Uses

  • It improves the blood supply
  • Removes the stiffness of the joints
  • Clean all the channels of the body and bring better circulation.
  • It increases the body weight by correcting the emaciation of the muscles.
  • It cures all types of nervous disorders. The treatment makes the body strong and sturdy.

Patra Pinda Swedana

Indications

  • Sandhivata (Osteoarthritis)
  • Amavata (Rheumatoid arthritis)

Drugs

  • Arka patra (Calotropis gigantea)
  • Eranda patra (Ricinus communis)
  • Nirgundi patra (Vitex negundo)
  • Dhatura patra (Datura stramonium)

Preparation

Make all leaves upto small pieces and prepare pulp and heat in a vessel then prepare bolus in a cloth piece.

Procedure

Take a little oil in a vessel, slightly heat it and rotate the bolus in oil then administer swedana to the patient. After half an hour of rest the area should be cleaned with hot water.

Conclusion

In this article we read about fomentation, its uses, indications, contraindications, pre-operative, operative and post-operative procedures etc. Testicles, heart and eyes should not be fomented or, if necessary, should be mildly fomented. Fomentation is very effective in vata dosha and kapha dosha. It clears the channels of the body and removes the toxins from the body. It improves the complexion of the skin and clears out the pores of the skin and prevents acne, pimples, etc.

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Author Bio:

Best Ayurvedic Doctor - Dr. Meenakshi Chauhan

Dr. Meenakshi Chauhan

MD (ALT. MEDICINE)

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Reviewed By:

Best Ayurvedic Doctor in Mohali - Dr. Vikram Chauhan

Dr. Vikram Chauhan

MD (AYURVEDA)

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