Treatment Protocol in Ayurveda -Part 2 :Lamghana
These treatments are Agni (Heat generating) and produce reducing effect of the body and bring about depletion of Dhathus.
· Increases Agni
· Burn out impure Kapha and Pitta
· Digests Ama
· Purifies Srotas (Channels) connecting Koshta and Dhathus.
Qualities of medicines used for Lamghana treatment.
Hot (Ushana) e.g. Ginger
Dry (Ruksha) e.g. Hareethaki
Sharp (Theekshna) e.g. Long pepper
Light (Laghu) e.g. Trikatu
Mainlylanghanais for Kapha or Kapha - Pitta disorders and brimhanais for Vata or Vata- Pitta disorders.
With Lamghana (Samana and Sodhana) the Kapha-Pitta is balanced or Ama burned out and makes the condition of the disease to Vata Pitta.
When this stage is reached brimahanatreatment is done to balance Vata Pitta
Langhana is divided in to two types
1. Samana (Subsiding measures)
Samana normalizes the increased Doshas without expelling the Ama out of the body instantaneously. Its effect is a state of equal and balanced Doshas. This treatment is advised when Doshas are not very much aggravated.
Indication : 1. The patient is having less amount of dosha vitiation ; or less amount of Ama or ama is in Koshta
2. The patient is week and not enough strength to undergo an elimination therapy even though he has a large amount of dosha vitiation; or excess amont of Ama or the Ama is in deeper tissues
3. The climatically condition (time) is not so good enough to do an elimination therapy.
Pachana (Digesting Ama)
Deepana (Digestive fire increasing type of medicines)
Kshut nirodha (Avoiding food or Fasting)
Trt nirodha (Avoiding drinking fluids so that the ama is burned out)
Vyama (Exercises) eg: Yoga Asana
Atapa seva (Sun bath)
Maruta seva (Wind bath)
Brimhana (Building up therapy like administration of nutritious foods and medicines which is a subsiding measure for Vata and Vata -Pitta)
All the above treatments work in the balance of doshas in a certain amount. It is to be understood that the reduction of Vata is only possible by building up therapies (Brimhana.)
Persons requiring Lamghana treatment (Lamghaneeya)
Lamghana is applied in diseases due to excess Kapaha and Ama where Agni (Digestive fire) is very much reduced.
Diabetes: Kapha Prameha
Poor digestion: Manda agni
Early Fever: Ama Jwara
Skin diseases: Kapha Kushta
Effect of Lamghana treatment
Lamghana therapy increases Agni and digests Ama. This open up the minute pores in the body (Srotas) clogged with Ama and Kapah resulting in digestion of the ama, normal digestion of food and an easy flow of Rasa dhathu to the other dhathus which results in a proper nourishment of the dhathus. Lamghana produces purity of senses, proper expulsion of body wastes, lightness of the body, appetite, hunger, thirst, relief of diseases, mental enthusiasm and alertness.
Line of treatment in Samana Chikitsa
Your Patient complaints of a disease.
Is this disease caused by Ama ?
ie. Predominance of Kapha or Kapha Ama?
For the conclusion
· Consider different dosha aggravated symptoms and conclude dosha predominance.
· Consider the extend of vitiation or derangement happened in the Dhathus and Malas. This will give the idea of proper selection of medicinal plant or combinations.
· Consider the strength of the Patient. This will give you to select a smooth or strong medicine.
· Consider the Season, Place and time in order to adopt the proper treatment.
· Consider the constitution of the patient to find out the prognosis.
· Consider the age of the patient to calculate the dose of medicine.
If your answer is Kapha predominant, the diseases is recent origin, do the following measures.
Langhana therapy of samana chikitsa from Pachana to brimhana.
After a course of kashaya(amapachana)Kapha will be balanced, the ama will be digested and the digestive fire will be improved. The course of kashaya will be usually 7 or 14 or 21 days depends upon the severity. When the Ama complaints are completely reduced medicated ghee should be given. Ghee administration is the final stage of treatment in Samana chikitsa and it is a brimahana treatment. Starting of the treatment can be done in any of the five stages depends upon the digestive fire and ama. This lamgna- Samana Chikitsa can be done at home without going into a center, less expensive.
2. Sodhana (Elimination therapy) (Pancha sodhana)
Shodhana means purification and in Shodhana treatment mobilized Ama are expelled out from the body through the major orifices. Sodhana eliminates Ama & Vitiated Doshas instantaneously from the body and brings about complete cure. But samana chikitsa does it in a gradual manner and there is a chance for the Doshas to aggravate again.
Indication: 1. Patient is having more amount of dosha vitiation and enough strength to undergo an elimination treatment.
2. The climatically condition is good enough to undergo an elimination treatment to purify the person to prevent the diseases.
Therapy: The elimination treatment (shodhana) is the main procedure in sodhana treatment using five techniques by which Doshas are removed from the body or it is also called as pradhana karmaor otherwise called as Pancha sodhana(Five purificatory actions).
All the above treatments work in the reduction of Ama-doshas in a larger amount. It is to be understood that the reduction (shodhana) of Vata is oil enemas (Sneha vasti) which is a building up treatment (Shodhana-Brimhana) and kashaya vasthi is a reduction of Kapha (Shodhana -lamghana).
Line of treatment in Sodhana Chikitsa (Pancha Sodhana)
Your Patient complaints of a disease.
Is the body has a lot of accumulation of deranged doshas ?
By considering the symptoms and chronicity of the disease conclude the dosha predominance and identify whether the samana or sodhana chikitsa should be done.
If the accumilation of deranged Kapha is in the dhatus or any place other than the koshta do Swedana to bring back to the amasaya.
GiveVamana dravyas (emetic drugs) to take out the deranged Kapha from the amasaya.
Peyadikrama- dietery restrictions should be followed after the Vamana in order to improve the digestive fire.
If the accumilation of Pitta is in the dhatus or any place other than the koshta do Snehana and Swedanato bring back to the Pakvasaya.
GiveVirechana dravyas(purgative drugs) to take out the deranged Pitta from the Pakvasaya.
Peyadikrama- dietery restrictions should be followed after the Virechana in order to improve the digestive fire.
If the vitiation is by typical Vata, with the complaints of pain in the sacrum, back and hip do snehavasti (oil enema) after Snehana and Swedana.
If the disease is by the vitiation of Vata, Pitta and Kapha with the complaints of anorexia, heaviness and ama do kashaya vasti (decoction enema).
Peyadikrama- dietery restrictions should be follwed after the sneha vast and kashaya vasti in order to improve the digestive fire.
If the accumilation of doshas are in the head region do Nasyam (errhines) after the external Snehana andSwedana.
If the derangement is there in the Pitta and Rakta dhatu (blood) do Raktamoksha (blood letting)
After Soshana chikitsa, there should be a follow-up with the Samana Chikitsa medicines in order to reduce the residual amount of deranged doshas.
If the doshas are in equilibrium after Sodhana and Samana treatments, Rasayana chikitsa (rejuvinatory measures) should be done to promote the immunity. Rasayana Chikitsa is mostly brimhana Treatment.