AYUHOM

REVIEW ARTICLE
Year
: 2022  |  Volume : 9  |  Issue : 1  |  Page : 2--7

Clinical Implementation of Bahihparimarjana Therapy Mentioned in the Aragwadhiya adhyaya of Charakasamhita


Disha Anil Raut1, Arti Choudhary1, Jaikishan Meena2, Asit Kumar Panja3,  
1 Final Year PG Scholar, National Institute of Ayurveda, Jaipur, Rajasthan, India
2 Assistant Professor, Shri Shirdi Sai Baba Ayurved College and Hospital, Jaipur, Rajasthan, India
3 Associate Professor, National Institute of Ayurveda, Jaipur, Rajasthan, India

Correspondence Address:
Disha Anil Raut
National Institute of Ayurveda, Jaipur, Rajasthan
India

Abstract

In Ayurveda, treatment is divided into three categories, Antahparimarjana (Internal), Bahihparimarjana (External), and Shastrapranidhana (Surgical) on the basis of interventions. Acharya charaka categorized Pradeha according to the thickness of application as a Pralepa and Pradeha. In the present review, lepa given in the Aragwadhiya adhyaya is focused and efforts have been made to explore their application on various clinical conditions in other sthana of Charakasamhita. Totally 202 Bahihparimarjana lepa are depicted in entire Charakasamhita. Out of these, a total of 35 lepa are mentioned in the Sutrasthana and 167 lepa are mentioned in the Chikitsathana. Out of which, the majority are mentioned in skin-related, pitta and blood-dominated disorders such as 32 lepa in Aragwadhiya adhyaya and 48, 29, 18, and 13 are in Kushta chikitsa, Visarpa chikitsa, Vrana chikitsa, and Vatashonita chikitsa, respectively. Three categories of bahirparimarjana yoga include 163 Pralepa, twelve Pradeha, and twenty-seven Alepa are differentiated as per the method of application. Contents of the bahihparimarjana lepa mentioned in the Aragwadhiya adhyaya of Sutrasthana, altered in the Chikitsathana on the basis of Nidanapanchaka to have the desired effect on dosha into the different formulations. In Sutrasthana, principles are given in the form of general statements which are elaborated in Chikitsathana. All the lepa mentioned in Aragwadhiya adhyaya can be applied as Pralepa, Pradeha, and Alepa as it is or with modifications according to the condition of the disease in the clinical practice.



How to cite this article:
Raut DA, Choudhary A, Meena J, Panja AK. Clinical Implementation of Bahihparimarjana Therapy Mentioned in the Aragwadhiya adhyaya of Charakasamhita.AYUHOM 2022;9:2-7


How to cite this URL:
Raut DA, Choudhary A, Meena J, Panja AK. Clinical Implementation of Bahihparimarjana Therapy Mentioned in the Aragwadhiya adhyaya of Charakasamhita. AYUHOM [serial online] 2022 [cited 2022 Dec 5 ];9:2-7
Available from: http://www.ayuhom.com/text.asp?2022/9/1/2/356164


Full Text



 Introduction



Ayurveda is not only a medical science it also depicts all possible ways of living. Ancient Ayurveda scholars were endowed with desire for learning, acquisition, retention, critical analysis, and rational conclusion in relation to health science.[1] Ayurveda has divine origin[2] and designed in the form of trisutra (divisions), i.e., hetu (etiology), linga (symptoms), and aushadha (remedy), which were initially revealed by Brahma to the Indra.[3] Trisutra can be applied to both pathological and healthy status. Among this, hetu represents the etiological factors. Linga includes the clinical presentation of the individuals. Aushadha represents the therapeutic measures to maintain dhatusamya. These three divisions are called sutras because they contain chain of ideas in rudimentary forms. The Charakasamhita is designed on the principles of trisutra in eight sthana, namely Sutrasthana, Nidanasthana, Vimanasthana, Sharirasthana, Indriyasthana, Chikitsasthana, Kalpasthana, and Siddhisthana.[4] Sutrasthana is the most important among them as it contains the codified glimpse of the entire compendium. The principles mentioned in Sutrasthana are elaborated in other sthana in clinical perspective as required. Sutrasthana is divided into the “Saptachatushka” (seven quadrates with four chapters each)[5] as per focused subject matter and the last two are called “samgraha adhyaya.”[6] The description of Bhesaja chatuska, i.e., dealing with medicinal substances, in the beginning of signifies its importance in therapeutics and requirement for further implementation.

It includes:

Dirghanjivitiya adhyaya which states the basic principles of Ayurveda on which the whole text is composedApamargatanduliya adhyaya that narrates the principles and medicines for the internal cleansing of the bodyAragwadhiya adhyaya which discusses the principles and medicines required for external cleansing of the bodyShadavirechanashatashritiya that enumerates groups of formulations of both external and internal cleansing on the basis of pharmacological actions.

 Chikitsa (Treatment) in Ayurveda



In Ayurveda, treatment is divided into three categories, namely Antahparimarjana (Internal), Bahihparimarjana (External), and Shastrapranidhana (Surgical)[7] on the basis of interventions. In antahparimarjana chikitsa drugs are given internally for controlling the deranged dosha in the body in the form of ahara and aushadhi. Kostha is the place where all the channels of the body drain. Shakha consists of raktadi dhatu and twacha.[8] Cleansing of kostha is done through the Antahparimarjana (internal purification) therapy. After this therapy, to remove the remaining dosha from the shakha, bahihparimarjana chikitsa done.[9] Shastrapranidhana chikitsa done in the form of chedana, bhedana, vyadhana, darana, lekhana, utpatana, pracchana, sivana, eshana, kshara, and jalouka with the help of surgical instruments.[7]

In the present review, lepa given in the Aragwadhiya adhyaya is focused and efforts have been made to explore their application on various clinical conditions in other sthana (chapter) of Charakasamhita. Lepa is one among the category of Bahihparimarjana chikitsa.

 Bahihparimarjana Therapy



Etymologically, the word bahi signifies “external” while parimarjana signifies “cleansing off.”[10] Bahiparimarjana therapy cleanses the shakha, on the external application of the lepa over the skin.

Bahihparimarjana therapy is an umbrella term within which a group of interventions is clubbed as per the process of application, specific need, and disease condition. These are as follows:

Abhyanga – It involves massage of the body with unctuous substance. It is used to alleviate the three doshas, especially increased Vata dosha[11] and in the diseases such as shirashula and vatavyadhi.[12]Sweda – It is a procedure in which medicated steam is given to the body to relieve pain, stiffness, and heaviness.[13] It is also a preclinical procedure for the panchakarma. It cures increased Vata-Kapha dominant conditions,[14] pratishyaya, hikka, swasa,[15] etc.Parisheka – In this, the medicated decoction is poured over the desired part or all over the body especially in Vataja and Vata-Kaphaja disease conditions[16]Unmardana – Massaging in an upward direction or opposite to the hair root toward the heart is named unmardana. It is mainly done in the diseases such as Shotha[17]Pradeha – Pradeha is a wide term included under lepa concept in the Charakasamhita. It is external application of medicated powder on the skin mixed with base material, especially used in the skin diseases such as kushtha and visarpa.[18]

As per the domain of the current topic, only Pradeha category is explained here in detail.

Acharya charaka categorized pradeha according to the thickness of application[19] as a Pralepa and Pradeha. They are:

Pralepa – A thin paste of medicated powder applied on the skin in the one-third thickness of the thumb.[20]Pradeha – External application of medicated powder in the form of thick paste.[21]Alepa – External application of medicated paste is applied on the skin. Acharya charaka has not mentioned the exact thickness of Alepa.

 Outline of Bahihparimarjana Therapy in Aragwadhiya adhyaya



In Aragwadhiya adhyaya, a total of 32 lepa are documented which are modified and clinically applied according to the conditions of the disease in the Chikitsathana.

These 32 bahihparimarjana treatments are categorized according to the dosage, namely Churnapradeha, lepa, and pradeha [Table 1].{Table 1}

 Results



A total of 35 lepa are mentioned for the Bahihparimarjana in the Sutrasthana. Out of these, six are Pradeha, 28 Pralepa, and one Alepa. In Chikitsathana, 167 lepa are mentioned [Table 2]. Out of these, six are Pradeha, 26 are Alepa, and 135 are Pralepa.{Table 2}

Totally 202 bahihparimarjana are depicted in the entire Charakasamhita. Out of which, majority are mentioned in skin-related, pitta and blood-dominated disorders such as 32 in Aragvadhiya adhaya and 48, 29, 18, and 13 are in Kushta chikitsa, Visarpa chikitsa, Vrana chikitsa, and Vatashonita chikitsa, respectively. Few bahihparimarjana are mentioned in the rest chapters of Charakasamhita as mentioned in the chart below [Table 3].{Table 3}

Out of 202 bahirparimarjana yoga mentioned in Charakasamhita, three categories, namely Pralepa, Pradeha, and Alepa are differentiated as per the method of application [Table 4].{Table 4}

 Discussion



Bahihparimarjana therapy is usually done after proper elimination of the vitiated dosha from the body.

Bahiparimarjana as per the dominance of the dosha

Lepa is described on the basis of doshaghnata activity. In the Sutrasthana, one (1) vatanashaka lepa and one (1) kaphapittanashaka lepa are described which are elaborated in Chikitsathana wherein eleven (11) vatanashaka [Figure 1], thirteen (13) pittanashaka, twenty-six (26) kaphanashaka, two (2) kaphapittanashaka, and eight (8) sannipatanashaka, lepa is clinically used. In Chikitsasthana alteration of the dravya in comparison to Sutrasthana is made on the basis of Nidanapanchaka which reveals the implementation in wider aspects.{Figure 1}

 Bahiparimarjana According to the Site of Application



Twenty-six (26) sthanika, three (3) sarvadehika, and six (6) anukta lepa are mentioned in the Sutrasthana, while in Chikitsathana, ninety-three (93) sthanika lepa, eleven (11) sarvadehika lepa, and sixty-three (63) anukta lepa are mentioned. Increased number of lepa in all the three sites signifying the wider implementation of the yoga mentioned in Sutrasthana in a broader clinical perspective.

 Use of Dravya as Per Sources



In Sutrasthana, eight jangama dravya based formulations, four khanija dravya based, and one hundred and four audabhida based formulations are mentioned, whereas in Chikitsathana, available formulations based on jangama dravya, khanija dravya, and audabhida dravya are seventeen (17), seventeen (17), and one hundred and eighty-seven (187), respectively. These also justify greater and wider uses in Chikitsathana.

 Lepa as Per Kalpana



Lepa can be applied in various dosage forms. In Sutrasthana, six (6) churna, 14 (fourteen) drava, fourteen (14) kalka, one (1) taila, three (3) ghrita, and one (1) yamaka (i.e., made up of ghrita and taila). These have been altered in the chikitsa sthana on the basis of doshaghnata. Eleven (11) churna, nineteen (19) drava, one hundred and fifty-six (156) kalka, nine (9) taila, nineteen (19) ghrita, and three (3) yamaka (i. e. made up of ghrita and taila) are mentioned for bahihparimarjana.

 Addition and Alteration of Dravya in Various Formulations as Per Disease Condition



Contents of the bahihparimarjana lepa mentioned in the Aragwadhiya adhyaya of Sutrasthana, are altered in the different formulations of Chikitsathana on the basis of Nidanapanchaka to have the de sired effect on dosha [Table 3] and [Figure 2].{Figure 2}

In sutrasthana, fourteen lepa of the disease kushtha are mentioned. Ingredients of these formulations have been altered into forty-eight kushthaghna lepa in the Chikitsasthana by adding other kushthaghna dravya having tikta rasa, katu vipaka, and ushna virya as per different conditions. For example in Rasanjanadi lepa dravya such as rasanjana, prapunnada, kapittha, and gomutra are mentioned in sutrasthana. In the Chikitsasthana, the same lepa is altered by adding some dravya such as ela, kushtha, daruharidra, shatapushpa, chitraka, vidanga, abhaya, and rasanjana acting on kushtha. Manashiladi lepa of Sutrasthana[22] is modified by adding vidanga, kutaja, lomasha, edagaja, karanja, bhoaurjagranthi, karavira, palasha for the application in Sidhma kushtha, and shweta kushtha[23] in chikitsasthan. Tutthadi lepa of aragvadhadi adhyaya[24] is altered by adding ingredients such as arka, kataphala, mulakabeeja, rohini, katuka, kutaja, utpala, musta, brihati, karavira, kasisa, edagaja, nimba, patha, duralabha, chitraka, tiktalabu, kampillaka, sarshapa, vacha, daruharidra, and excluded the ingredients maricha, lodhra, and manashila in kushtha[25] in Chikitsathana. Similarly, Argwadhadi lepa of Sutrasthana[26] is modified by adding shirisha twaka, karpasapushpa to aragwadha patra, kakmachi,[27] and excluded the dravya karvira in shwitraroga in Chikitsasthana.

Fourteen lepa for kushtha mentioned in Sutrasthana are altered and framed twenty-nine visarpahara lepa in Chikitsasthana by adding dravya such as chandana, ushira, and yashtimadhu having shita virya.

In sutrasthana, four lepa are mentioned in vatavyadhi,[28] whereas five yogas are clinically used as bahirparimarjana in Chikitsasthana. In chikitsastana, dravya such as Kushtha, shatavha, kola, kulattha, rasna, masha, atasi, yavachurna, and tila having the ushna virya and snigdha guna are added to mitigate the Vata dosha. This alteration is done for getting the adequate oleation of the skin and thus relieves the local pain.

Three lepa of vatarakta[29] mentioned in Sutrasthana are exponentially increased up to thirteen lepa for use in clinical conditions at Chikitsasthana. Dravya such as Madhuka, guduchi, and vidari having madhura-tikta rasa and shita virya is inclusively added which in turn pacifies the Vata dosha and purifies the blood in vatarakta.

Two lepa for daha[30] are mentioned in Sutrasthana which includes padmaka, shaivala, utpala, vetas, prapaundrika, lodhra, kaliyaka, and chandana having shita virya into five lepa in the Chikitsasthana [Figure 3].{Figure 3}

 Conclusion



In Sutrasthana, principles are given in the form of general statements which are elaborated in Chikitsathana. All the lepa mentioned in Aragwadhiya adhyaya can be applied as Pralepa, Pradeha, and Alepa as it is or with modifications according to the condition of the disease in the clinical practice.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

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