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 Table of Contents  
REVIEW ARTICLE
Year : 2020  |  Volume : 7  |  Issue : 2  |  Page : 41-46

Effect of Vaya (Age) and its association with Panchakarma: A review


1 Department of Panchakarma, National Institute of Ayurveda, Jaipur, Rajasthan, India
2 Department of Swasthavritta, Mahatma JyotibaFule Ayurveda College, Jaipur, Rajasthan, India

Date of Submission14-Jan-2021
Date of Acceptance17-Jan-2021
Date of Web Publication25-Aug-2021

Correspondence Address:
Dr. Jatinder Verma
Department of Panchakarma, National Institute of Ayurveda, Jaipur - 302 002, Rajasthan
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/AYUHOM.AYUHOM_2_21

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  Abstract 


Vaya (age) plays a significant role in Ayurveda in respect to disease, prognosis, and treatment. Three broad classifications of Vaya according to Ayurveda are Balya Avastha (young age), Madhyama Avastha (middle age), and Jirna Avastha (old age). In Ayurveda, both Shodhana (purification) and Shamana (palliative) Chikitsa (treatment) are indicated in various diseases according to Vaya. An Ayurvedic physician should follow the general rules regarding Panchakarma procedures after the assessment of age. The present article elaborates various Panchakarma procedures according to Vaya in respect of Snehana, Swedana, Vamana, Virechana, Basti, Nasya, and Raktmokshana. Along with the doses of drugs, instrumentation used in Panchakarma according to Vaya is also given special consideration in this article. Ayurveda texts have been studied to collect and compile data regarding the dose of drugs and instrumentation used in various Panchakarma procedures mentioned in relation to Vaya. In Ayurveda, Vaya is an important factor to consider particularly in the case of Panchakarma procedures. Special attention should be given while prescribing Panchakarma procedures to children and in old age. Vaya should be considered as an important parameter where Shodhana and Shamana Chikitsa are to be prescribed. There is a need to pay much attention to Vaya where Panchakarma procedures have to be selected, particularly in the case of children and the elderly.

Keywords: Panchakarma, vamana, vaya, virechana


How to cite this article:
Verma J, Mangal G, Garg G. Effect of Vaya (Age) and its association with Panchakarma: A review. AYUHOM 2020;7:41-6

How to cite this URL:
Verma J, Mangal G, Garg G. Effect of Vaya (Age) and its association with Panchakarma: A review. AYUHOM [serial online] 2020 [cited 2021 Sep 20];7:41-6. Available from: http://www.ayuhom.com/text.asp?2020/7/2/41/324632




  Introduction Top


Lack of knowledge or improper planning leads to the failure of treatment. In the field of Panchakarma, treatment should also be prescribed with proper planning and knowledge as the same medicine may react differently in different patients as each of them is specific in respect to Bala, Sharira, Sara, Ahara, Satmya, Satva, Prakriti, Vaya, etc.[1] Any treatment even being wholesome does not hold good if administered at wrong time, in lesser or excessive amount, or given in an un-ethical manner.[2] Before commencement of any of these therapies, determination of the above factors is crucial because therapy or medicine used for it may have to be altered in respect to the patient, Kala, Dosha, Vaya, etc., Vaya (age) plays a significant role in the pathological process of disease. In respect of time, the total life span of a person can be divided into three phases, i.e., Balyavastha (young age), Madhyamavastha (middle age), and Jirnavastha (old age). These phases of life which depend on time are broadly termed as Vaya.[3],[4],[5] Life span of a person is assessed on the basis of his Prakriti, Sara, etc., as well as signs of longevity.[6] A person having a superior type of Prakriti, Sara, etc., and other signs of longevity will have a life of 100 years or more. On the other hand, a person with mediocre levels of Prakriti, Sara, etc., and signs of medium life span will have an average life of 80 years. Persons with lesser age groups have three phases at an early age because of which these phases of life will be reduced rationally in them.[7] All these are considered where Panchakarma procedure is to be prescribed. In this present article, the importance of Vaya (age) in respect to Vamana, Virechana, Basti, Nasya, and Raktamokshana and allied procedures is discussed in this present article along with the dose of drugs and specifications of different Panchakarma instruments mentioned in Ayurveda texts according to the age.


  Methods Top


Various Ayurveda texts have been studied to gather information about Vaya (age)-related factors which should be considered before the commencement of any of the Panchakarma procedures.


  Results Top


Various Acharaya have mentioned Panchakarma procedures at different stages of life, especially in case of children and elderly with caution and with different instructions to be followed strictly in these age groups.

Consideration of Vaya (age) in respect to Panchakarma

A child may be classified into two groups related to Panchakarma; Paratantravriitaya (dependent on mother for nutrition) where the Panchakarma treatment such as Virechana and Marsha Nasya is given to Dhatri (mother) only. Svatantravrittaya (not dependent on mother) child can be given mild forms of purification.[8]

In concern to Snehana, both children and the elderly are subjected to Brimhana.[9],[10] Both children and the elderly are given Sneha after mixing them with food. In case of Shodhana to both, oleation should be done with the preparations which cause immediate Shehana.[11] Snehana Karma is not needed prior to Shodhana in young children as they are always unctuous because they consume only Ghee and milk. In Kshirapa, Vamana can be used instantly in mild form without doing Snehapana. In Kshiraanada, they can be made to vomit just contenting him with breast milk. In Annada, they can be subjected to Vamana after giving Peya added with Ghee.[12] In concern to Swedana, a child can be fomented since birth using different modes of Swedana according to his age.[13] In case of children with weak and moderate strength, Swedana is done only in case of necessity. Eight types of Swedana can be adopted according to the age and need of the children, like Hasta Swedana should be done up to the age of 4 months, while Pata Swedana is advised after the age of 6 years. Swedana should be done in mild form before Shodhana.

According to Charaka, Vamana and Virechana are contraindicated in both children and the elderly as they are weak and are not able to tolerate the medicine given for Shodhana. This may cause death.[14] According to Kashyapa, Vamana can be done in children after attaining the age of 6 years. If Vamana is given before this age, it may cause Kushtha, Hrillasa, Aruchi, Nidra, and Tandra.[15] In certain conditions, Vamana may be given. Vamana should be given to Dhatri as well as her child when Stanya (breast milk) is tainted with Kapha and has caused suffering to the children.[16]

In concern to Virechana, in children, elements are not matured enough and elderly people are in depleting stage.[17] Both children and the elderly have lesser strength and are not good subjects for Virechana. Moreover, Virechana medicines have disagreeable taste and smell. They are Katu (pungent), Tikshna (strong), Ushna (hot), etc., which cause discomfort to the patient in the form of sour eructation, nausea, cardiac discomfort, and pain in the Koshtha. Medicines used for Virechana should be used cautiously. Milder forms of medicines should be used for Virechana such as Trivrat having pink root, Aragvadha, and Eranda in both children and the elderly.[18]

Basti should be preferred over Virechana for the treatment related to children as Virechana drugs cause a lot of discomforts, whereas Basti is free from any such complications. Moreover, Basti increases strength, complexion, pleasure, unctuousness, and tenderness in body. Basti should be used in children, old persons, and to whom Virechana is contraindicated.[19]

According to Kashyapa, Basti can be used lifelong starting from the age when a child has started eating food and started to crawl.[20] Niruha Basti cleans the channels of the body and prevents the aging process and stabilizes youthfulness.[21] Asthapana is the other name of NiruhaBasti due to this property.[22] Basti Karma acts like ambrosia in children and others.[23]

In the elderly, Yapana Basti is especially indicated to promote a healthy life.[24] Children and the elderly should be given Mridu (mild) Basti as Tikshna (strong) Basti can harm strength and life.[25] For both the groups, Niruha and Anuvasana Basti should be prepared with the medicines of Jivaniya Gana. Lavana (salt) should not be added while preparing Niruha Basti in case of children.[26] It is also said that Basti is advised for lifelong, but it should be avoided to use it below the age of 1 year and after 90 years of age unless its use is very essential.[27]

In adult females, Uttara Basti is used for diseases of uterus and urinary bladder. In males, Uttara Basti is used for various urinary problems. In young females, it is used for diseases related to the urinary bladder only because the opening of the uterus remains closed in them.[28] In males, Uttara Basti is used for various urinary problems.

In concern to Nasya, Shirovirechana Nasya should be avoided both in children and the elderly,[29] but Pratimarsha Nasya can be given as it is free from complications.[30] In children who are dependent on mother's milk, Nasya with Katu Taila or Ghrita mixed with Saindhava Lavana should be used to avoid Kaphaja disorders.

Both children and the elderly are not indicated for Siravedha because of immature and depleted body tissues, respectively.[31] Jalauka (leech therapy) can be used for Raktamokshana, as it is a safe and most delicate method of blood-letting.[32]

Description of different doses of drugs and dimensions of various instruments used in Panchakarma is mentioned in Ayurveda to avoid complications, especially in children and the elderly.

Dose of Niruha and Anuvasana Basti [Table 1] is decided on the basis of the age of a person. For 1 year child, dose of Niruha is half Prasrita (one Pala). Dose is increased by one Pala for each successive year up to 12th year of age, with a dose of 12 Pala (6 Prasrita) for the age of 12-year-old child. Thereafter, dose is increased by one Prasrita in each successive year up to the age of 18 years, with a dose of 12 Prasrita (24 Pala) for an18 year old child. This is the maximum dose of Niruha that is to be used till the age of 70 years. After the age of 70 years, the dose should be equal to the dose as mentioned for 16 years of age, i.e. 10 Prasrita.[33] While considering the dose of Anuvasana Basti, it is said to be one-fourth of the quantity of Niruha Basti for that particular age.[34] Size as well as dimensions of Basti-Netra also depends on age [Table 2] and [Table 3]. Caliber of Basti-Netra for age of 6, 12, and 20 years should be such that seed of Mudga (green gram), Satin (pea), and Karkandhu (small variety of jujube) can be passed through them respectively. Insertion of Basti-Netra in the anus should be equal to one-fourth of its total length at any age.[35],[36],[37]
Table 1: Dose of Niruha and Anuvasana Basti

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Table 2: Length of Basti-Netra (according to Charaka Samhita)

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Table 3: Dimensions of Basti-Netra (according to Sushruta Samhita)

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Both in male and female, dose of Uttara Basti is fixed according to age [Table 4]. Maximum dose of Uttara Basti for a 25-year old male is one Prakuncha (one Pala) and is reduced rationally for a person of younger age. For a child of 1 year, it should be 1/25 Prakuncha and so on.[38],[39],[40] In females, maximum dose of Sneha for Uttara Basti is one Prastha and should be reduced rationally for lower age.[39],[41]
Table 4: Dose of oil and Kwatha in Uttara Basti

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  Discussion Top


Balya Avastha (young age) is the phase of life up to first 30 years of age. The first part of this Balya Avastha is called as a stage of Aparipakva Dhatu (immature stage) which lasts till the age of 16 years.[3] By this time, body tissues have not gained maturity and signs of maturity like moustache and beard do not appear. Body is tender and not able to withstand untoward circumstances because complete body strength has not developed yet. Kapha is the dominant Dosha during the stage. The sense organs, Dhatu and Oja, are still in the stage of growth.[42] After completing this first phase of life, stage of Vivardhamana Dhatu (stage of maturation) starts that persists till the age of 30 years. During this stage also, mental faculties have not developed completely. Sushruta mentioned this Balya Avastha only up to the age of 16 years and divided it into three parts.[5] Kshirapa – child up to the aged of 1 year who is dependent only on milk for nutrition is called Kshirapa. Kshiraanada – child in between the age of 1 year to 2 years is called Kshiraanada and can take milk as well as food. Annada – this is the stage after completing the age of 2 years and up to the age of 16 years and the child can take food for his nutrition.

Madhyama Avastha (middle stage) is the period between 16 and 30 years. Pitta is the dominant Dosha at this stage, optimum Bala (strength), Virya (energy), Parakrama (valor), Grahana (understanding), Dharana (retention), Smarana (memory), Vachana (speech), and Vigyana (analytical power) are attained. All the body tissues gain maturity and no body tissue element has started depleting yet and mind is stable.[3] Sushruta defined this stage starting after 16 years up to 70 years and divided this stage into four parts.[5] Vridhi – this period is between the ages of 16 years to 20 years during which growth continues as such. Yauvana – this lasts up to the age of 30 years and this is the period of youthfulness. Sampuranata – by the age of 40 years, all the Dhatu, sense organs, physical strength, and semen have attained their full maturity. Haani – declination of all Dhatu, etc., takes place during this stage and starts after the age of 40 years and continues till the age of 70 years.

Jirna Avastha (old age) is the period between 60 years and 100 years of age.[3] Depletion of Dhatu, sense organs, Paurasha (energy), and other factors starts in this phase. Body increasingly gets afflicted with Vayu and qualities of tissues deteriorate. Sushruta defined this stage starting after the age of 70 years. A person gets Vali (wrinkles), Palita (graying of hair), and Khalitya (baldness) and complications such as Kasa (cough), Swasa (dyspnoea) will occur.[43]

According to Sharangadhara, with each decade of life, Bala, Vridhi, Chavi (beauty), Medha (intellect), Twaka (skin), Drishti (vision), Shukra (semen), Vikrama (velor), Buddhi (intelligence), Karmendriya (physical capacity), Chetna (spirituality), and Jivana (life) are lost in a sequential manner.[44] Precautions must be taken in deciding treatment related to Panchakarma procedures according to age. Strong purification should be avoided in case of children and the elderly as they both have lesser physical strength. In case there is a necessity, procedures should be used in milder form only. Recommended age for different Panchakarma procedures and allied procedures are mentioned in [Table 5]. Hence, Shodhana is not advised for the treatment of Swasa in children as well as elderly.[45] Basti Karma is preferred over Virechana in case of children; similarly, Pratimarsha Nasya is indicated in place of Marsha Nasya.[46] Virechana, Agnikarma, Shastrakarma, and Ksharkarma are the procedures prohibited in children. They should be treated with medicines only which are neither too mild nor too strong.[47]
Table 5: Suitable age for Panchakarma procedures (Ah.Su. 20/30-31, Ss.Pk. 6/54)

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  Conclusion Top


Vaya is an important factor to be considered before adopting Panchakarma or allied procedures. In case of children and the elderly, strong purification should be avoided. Basti, in place of Virechana and Pratimarsha Nasya in place of Marsha Nasya is the best choice for children. Precautions must be taken in deciding treatment related to Panchakarma procedures according to age. Dose of drug and dimensions of instruments used in different types of Panchakarma procedures are other points.

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Conflicts of interest

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